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Biomedical subjects

R Soejima

Publications and source records attributed to R Soejima.

At least 109 records · Page 6Linked to original sources
PubMed1990

[Foreign body-induced bronchial actinomycosis with severe stenosis that must be distinguished from lung cancer].

A 59-year-old woman who accidentally swallowed a foreign body (fish bone) 9 months ago was admitted to our hospital because of cough, hemosputum and sleep wheezing for two months. Chest roentgenograms and chest CT scanning revealed severe stenosis of the right lower lobe bronchus and truncus intermedius, suggesting lung cancer. Bronchoscopic examination revealed an intrabronchial foreign body. The biopsy specimen from granulation tissue revealed bronchial actinomycosis. The foreign body was removed bronchoscopically after an extensive chemotherapy with penicillin G (for actinomycosis) and prednisolone (for granulation tissue of the bronchus). This was considered to be a rare case of bronchial actinomycosis without a pulmonary lesion produced by a foreign body.

Actinomycosis↗
PubMed1990

[A case of massive hemoptysis occurring after lung injury due to a torn segment of pleural calcification].

A 64-year-old man was referred to our hospital because of little improvement of hemoptysis lasting three days after drug therapy. A chest roentgenogram and fiberoptic bronchoscopic examination performed on the second hospital day when the patient experienced a massive hemoptysis of about 2,000 ml revealed arterial bleeding from the left upper lobe. Even after extensive embolizations of the left upper bronchial, the first, second, third and 4th intercostal arteries, the patient's hemoptysis did not improve. On the 73rd hospital day the patient underwent left upper lobectomy. Macroscopic and microscopic examinations in the resected specimen revealed lung injury due to a torn segment of pleural calcification after tuberculous pleuritis, resulting in the massive hemoptysis. Although physicians encounter many patients complaining of hemoptysis and/or hemosputum, this case is considered to be very rare.

Calcinosis↗
PubMed1990

[A case of hemoptysis due to administration of an anti-thrombotic drug].

A 63-year-old woman was referred to our division because of massive hemoptysis (200 ml) after administration of ticlopidine, an anti-thrombotic drug, for prevention of recurrent brain infarction. Ticlopidine treatment was stopped on the first hospital day, thereafter the patient's hemoptysis immediately disappeared. A chest roentgenogram and broncho-fiberscopic examination did not reveal any organic lesion associated with hemoptysis. Laboratory data revealed prolonged bleeding time and decreased platelet aggregation, suggesting that the patient had had a hemorrhagic diathesis associated with the administration of ticlopidine. Although many anti-thrombotic drugs have been recently employed in a variety of clinical cases, the patient's hemoptysis was considered to be due to side effects.

Cerebral Infarction↗
PubMed1990

[A case of polycythemia vera associated with idiopathic interstitial pneumonia successfully treated by alkylating agents].

A 62-year-old female was referred to our division because of general fatigue, low grade fever and exertional dyspnea for 2 months. Laboratory data and chest roentgenograms on admission revealed polycythemia vera associated with idiopathic interstitial pneumonia. Alkylating therapy with carboquone and cyclophosphamide resulted in the improvement of abnormalities on chest X-ray films which had previously shown decreased lung fields and abnormal interstitial shadows, as well as hematological abnormalities. Six months later, the results of the patient's pulmonary function tests and arterial blood gas analysis became within normal limits. Little information about polycythemia vera associated with idiopathic interstitial pneumonia is available. This case indicated that alkylating therapy with no steroidal combination is effective for idiopathic interstitial pneumonia.

Alkylating Agents↗
PubMed1990

[A study of the coexistence of pulmonary tuberculosis and bronchogenic carcinoma: results of a questionnaire in Chugoku and Shikoku areas].

A study to obtain information on the relation between tuberculosis and carcinoma of the lung was carried out in 24 hospitals in Chugoku and Shikoku areas during the period from January 1979 to December 1988 using a questionnaire. As a result of this survey, 142 cases of coexisting active pulmonary tuberculosis and bronchogenic carcinoma were reported during the period. The incidence of coexisting cases was 2.32% of patients with pulmonary tuberculosis and 2.22% of patients with bronchogenic carcinoma. The foci of tuberculosis and carcinoma were found more often in the same lobe than in different lobes. The proportions of histological types of bronchogenic carcinoma were as follows: squamous cell carcinoma 43.9%, adenocarcinoma 36.0%, small cell carcinoma 16.5% and large cell carcinoma 3.6%. These findings were not significantly different from those in the general population. No significant difference in the proportions of histological types was found by coexisting lobe. some cases indicated that coexisting tuberculosis gave a favorable influence to the prognosis of lung cancer.

Carcinoma, Bronchogenic↗
PubMed1990

[Involvement of infections in asthmatic attack: with special reference to changes in leukocytes and eosinophils].

Changes in leukocytes and eosinophils in 60 patients with non-infectious attack (NIA patients) were compared with those in 50 patients with infection-related attack (IRA patients). In 30 (50%) of the 60 NIA patients, eosinophilia without leukocytosis was observed on admission, and in 23 (76%) of these 30 patients eosinophilia disappeared within 2 weeks of admission. In 36 (72%) of the 50 IRA patients, leukocytosis without eosinophilia was observed on admission, and the periods from the onset of infection to admission were inversely correlated with leukocyte counts. In 22 eosinophilia patients among the 50 IRA patients, the periods from the onset of infection to admission were correlated with eosinophil counts for up to 40 days, and in 13 (76%) of 17 eosinophilia patients not receiving a long-term steroid therapy during admission, eosinophilia continued for more than 2 weeks even after anti-asthmatic and anti-infectious therapies. There was no significant difference in serum IgE levels between the two groups on admission. These results suggest that evaluations of leukocytes/eosinophils on admission and clinical courses are very useful in the management of asthmatic patients with or without bacterial infections.

Adult↗
PubMed1990

[Harlequin syndrome (unilateral flushing and sweating attack) due to a spinal invasion of the left apical lung cancer].

A 54-year-old man was admitted to our hospital because of a persistent pain of the left cervix and scapular region of three-month duration and an abnormal shadow in the chest roentgenograms. Neurological examinations, chest roentgenograms, chest CT scanning, vertebral tomograms and myelogram revealed Pancoast's syndrome concomitant with Horner's syndrome. Four months later, the patient complained of a sudden onset of unilateral flushing and sweating appearing on the right face, cervix and upper chest. Eye drop tests with cocaine, epinephrine and tyramine indicated the lesion of ciliospinal centers between the 8th cervical and 2nd thoracic spines. The unilateral flushing and sweating attack appearing on the intact side without Horner's syndrome seemed to be an excessive response by an intact sympathetic pathway, the other side failing to respond because of a sympathetic deficit.

Flushing↗
PubMed1990

[The present situation and the future prospect of pulmonary function test].

We described 6 points of the present situation and the future prospect of pulmonary function tests. The pulmonary function test using different equipment on the same subject gave different results. The results of the pulmonary function test were affected by the subject's efforts. There were no standard prediction equations. Normal subjects and patients with respiratory disease reached the limit of exercise tolerance when the ratio of tidal volume during exercise to vital capacity (VT/VC ratio) approached 50%. Respiratory rehabilitation was evaluated by pulmonary function tests. The development of equipment allowing measurement by subject's quiet breathing is awaited.

Exercise Test↗
PubMed1989

Urinastatin (Kunitz-type proteinase inhibitor) reducing cisplatin nephrotoxicity.

The authors investigated the reductive effects of a Kunitz-type proteinase inhibitor, urinastatin, on the nephrotoxicity seen in lung cancer patients treated with cisplatin by measuring N-acetyl-beta-D-glucosaminidase (NAG) activity and beta 2-microglobulin (BMG) content in 24 hour urine, creatinine clearance, blood urea nitrogen (BUN), serum creatinine, uric acid, and BMG as factors of nephrotoxicity. In control patients treated with anticancer drugs containing cisplatin but no supplemental urinastatin, the 24 hour urine NAG and BMG levels increased more than three-fold over the pretreatment levels, 3 days after anticancer therapy, respectively. Creatinine clearance significantly decreased and levels of BUN, serum uric acid, and BMG in control patients significantly increased over the corresponding pretreatment levels, 3 days after anticancer therapy. However, supplemental urinastatin reduced abnormalities in levels of all these factors 3 days after therapy. These results suggest that supplemental urinastatin protects from cisplatin-induced nephrotoxicity, especially proximal tubular damage.

Acetylglucosaminidase↗
PubMed1989

[Detection of inducible beta-lactamase in sputum--clinical studies on Pseudomonas respiratory infection].

To investigate the clinical incidence of inducible beta-lactamase, we measured the beta-lactamase activity in the sputum of 5 patients with chronic respiratory tract infection due to P. aeruginosa, by using the spectrophotometric method. During the piperacillin (PIPC) therapy given twice a day with a single dose of 2-3 g, sputum samples were collected every 2 hours for 3 days, and on the second day, two grams of Cefmetazole (CMZ) was added to PIPC therapy. The antibiotics concentration of each collected sputum samples were also measured by HPLC. In one out of 5 patients, no beta-lactamase activity in sputum was detected throughout the 3 days. However in three out of 5 patients, after the addition of CMZ to PIPC, the beta-lactamase activity significantly increased 2-3 times (max: 0.03 units/ml) that on PIPC alone, and gradually decreased on the 3rd day when PIPC was given alone. Then the peak concentration of PIPC with the addition of CMZ decreased to 38-73%, compared with that of PIPC alone. These findings were supported by the fact that CMZ showed a high in vitro inducer activity against the isolates from the sputum. In the remaining one patient, high beta-lactamase activity (mean: 0.16 units/ml) and no antibiotics concentration was detected to be constant throughout the 3 days, and it was confirmed for the reason that one of the isolates constitutively produced large amounts of beta-lactamase. These results suggest that inducible and constitutive beta-lactamase would clinically cause undesirable effects in the treatment by some beta-lactams and have a possibility of indirect pathogenesis.

Cefmetazole↗
PubMed1989

[Double-blind comparative study of roxithromycin (RU 28965) and midecamycin acetate (MOM) in the treatment of pneumonia].

The clinical efficacy and safety of Roxithromycin (RU) were compared with those of Midecamycin acetate (MOM) in patients with pneumonia in a double blind study. RU and MOM were administered orally for 14 days with daily doses of 300 mg (150 mg b.i.d.) and 600 mg (200 mg t.i.d.), respectively. The following results were obtained. 1. RU and MOM were administered to a total of 204 patients (RU: 101, MOM: 103). The clinical efficacy was judged in 150 patients (RU: 70, MOM: 80), with 54 of the patients excluded from the total by the committee. 2. The clinical efficacy rates were 81.4% for RU and 70.0% for MOM on the basis of the committee's judgement. There was no significant difference between the two groups. In the evaluation of the clinical efficacy by the doctors in charge, the efficacy rates were 81.4% for RU and 67.5% for MOM, which constitutes a significant difference between the two groups (p less than 0.05). 3. No significant difference was found between the two drugs in bacteriological efficacy. 4. No significant differences were observed in either the incidence of side effects between RU (4.3%) and MOM (4.0%) or in abnormal changes in the laboratory findings. 5. Regarding the clinical usefulness judged by the committee, RU showed a significantly higher rate than MOM (79.2% vs. 67.9%). There was no significant difference in the judgement by the doctors in charge. From the above results, it was concluded that a daily dosage of 300 mg of RU was equal in usefulness to 600 mg daily of MOM in the treatment of mild to moderate pneumonia.

Adolescent↗
PubMed1989

Young's syndrome accompanied by medullary sponge kidney.

A 33-year-old man was admitted to our division for further evaluation of repeated fever and purulent sputa of more than 10 years duration. Based on clinical symptoms, chest roentgenograms, bronchograms, seminal examination, testicular biopsy specimen and electron micrograph of cilia from the left main bronchial mucosa, the diagnosis of Young's syndrome was made. A drip infusion myelogram, which was performed because of a persistent hematuria, revealed bilateral medullary sponge kidney, suggesting the involvement of this hereditary disorder in Young's syndrome.

Adult↗
PubMed1989

Anticancer chemotherapy accelerates scalp hair loss with no androgenic involvement.

The involvement of plasma testosterone in patients associated with scalp hair loss accelerated by anticancer drugs including aclarubicin and cisplatin was investigated. Scalp hair loss observed was minor in 12 and severe in 2 out of 31 patients. In patients without significant hair loss, the combination of aclarubicin and cisplatin produced a significant decrease in the plasma testosterone concentration in male patients and a significant increase in female patients 3 days after the anticancer chemotherapy. Six days after the chemotherapy, however, these concentrations returned to pretreatment values. Similar changes were observed in patients with minor or severe scalp hair loss induced by these drugs. These results suggest that aclarubicin and/or cisplatin may accelerate scalp hair loss with no androgenic involvement.

Aclarubicin↗
PubMed1989

[A clinical evaluation of fluconazole in the treatment of deep mycosis].

Fluconazole is a novel triazole antifungal agent developed by Pfizer Inc. and available in both oral and intravenous forms. It is characterized by a long serum half-life of 25 to 30 hours and good absorbability into tissues. In the present study, fluconazole was given to 12 patients with deep mycosis orally, intravenously or by local infusion. The patients included 4 cases of candidemia, 1 case each of candidemia and candiduria, candiduria, esophageal candidiasis, Candida hepatic abscess, pulmonary cryptococcosis and septicemia due to unspecified yeasts and 2 cases of pulmonary aspergillosis. Clinical efficacies of fluconazole against these infections were excellent in 2 cases, good in 8 and fair in 2. None of the patients reported any side effects. From the results of the study, fluconazole appears to be a useful and safe drug for the treatment of deep seated mycosis.

Administration, Oral↗
PubMed1989

[Investigation of two cases of a clinically unknown large cell carcinoma of the lung involved with severe stenosis of the bilateral main bronchi].

Reported are two rare cases of a clinically unknown large cell carcinoma of the lung, associated with severe stenosis of the bilateral main bronchi. Case 1: A 61-year-old man was admitted to our hospital because of chief complaints that included a cough, hemosputum, and dyspnea. Based on the bronchoscopic findings that revealed severe stenosis of the bilateral main bronchi and a specimen that was biopsied from tracheal spur, a diagnosis of large cell carcinoma of the lung was made. Although anticancer chemotherapy and irradiation therapy produced a slight improvement in the patient's symptoms, at the 10th hospital week the patient died of suffocation. Case 2: A 77-year woman was admitted to hospital with chief complaints that included a cough and hemosputum. A bronchoscopy revealed severe stenosis of the bilateral main bronchi. After the 4th hospital day the patient complained of increasing dyspnea. At the 9th hospital day the patient died of suffocation. An autopsy results revealed a large cell carcinoma (giant type) of the lung.

Aged↗
PubMed1989

[M. kansasii lung infection occurring in a compromised host with idiopathic pulmonary fibrosis].

A 61-year-old man was admitted to our hospital because of persisting cough, sputum and shortness of breath for four months. Brushing specimens and BALF bronchoscopically obtained revealed acid-fast bacilli and TBLB showed pathological findings consistent with interstitial pneumonia. Based on these results, clinical symptoms, chest roentgenograms on admission and identification of M. kansasii, a diagnosis of M. kansasii lung infection occurred in idiopathic pulmonary fibrosis was made. The patient's symptoms consistent with M. kansasii lung infection and his sputum became negative 6 weeks after antituberculosis chemotherapy with INH, SM and RFP. Because of an increasing dyspnea due to pulmonary fibrosis, however, the patient received oxygen therapy. This case suggested an increasing tendency of compromised hosts associated with M. kansasii lung infection.

Humans↗