Biomedical subjects
Publications and source records attributed to S Asai.
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A 15-year-old man with food-dependent exercise-induced anaphylaxis is reported. The patient had begun to run 4 hours after he had lunch on fried shrimps. When running about 2000 m, he suffered from general cutaneous erythema with itching, urticaria, angioedema of face and dyspnea. He had experienced the similar episodes associated with postprandial exercise before. Skin test and IgE-RAST were positive for shrimp. Exercise challenge test after having 20 g boiled shrimp was conducted, and the elevation of plasma histamine level was recognised. 25 cases with food-dependent exercised-induced anaphylaxis have reported in Japan. 13 of 25 cases were related with wheat, and 10 cases were related with shrimp. 14 of 25 cases had experienced the similar episodes. Exercise as part of planned health program has virtually mushroom world-wide. Therefore, the fact that anaphylaxis can be a complication of such exercise must be recognised if appropriate prevention and treatment are to be administered.
YM-09151-2, a novel benzamide derivative, significantly increased the concentrations of dopamine (DA) metabolites, both 3,4-dihydroxyphenylacetic acid and 3-methoxy-4-hydroxyphenylacetic acid (homovanillic acid). The maximum increase in such metabolites was about 4-fold the concentration in control animals, and was observed at 2 hr after oral administration. 3-Methoxy-4-hydroxyphenylethylene glycol, a metabolite of noradrenaline, was slightly increased in its concentration exhibiting a transient effect, but 5-hydroxyindoleacetic acid was not. YM-09151-2 antagonized the decreasing effects of apomorphine, a nonselective DA agonist, and LY-171555, a selective D2 DA receptor agonist, on the concentrations of DA metabolites in the brain. In contrast, SCH-23390, a selective D1 DA receptor antagonist, did not antagonize the effects of DA agonist. These results strongly suggest that YM-09151-2 is a selective antagonist of D2 DA receptor and a candidate as a new antipsychotic agent for clinical use.
Recently cases of tsutsugamushi disease have been reported in various areas in Japan. We met a case infected in a rural area, Sennan of Osaka prefecture. The patient suffered from high fever, left axillary lymphadenitis. At his left elbow an eschar was detected, so tsutsugamushi disease was suspected, despite no rash nor CRP elevation. By indirect immunofluorescence (IF) method, the diagnosis was confirmed. At an early stage (the fifth day after onset) he was followed by probable DIC, remitted successfully by administration of minocycline. For 20 years tsutsugamushi disease has not been reported in Osaka prefecture. This case is the second one and the first child case in Wakayama prefecture. Epidemiologic assessments may need to be investigated in Osaka and Wakayama Prefecture.
Human oral spirochetes are prominent inhabitants of subgingival plaque in patients with periodontal disease. By immunoelectron microscopy using protein A-gold complexes and either polyclonal mouse antiserum against the 53-kDa antigen or 53-kDa-antigen-specific monoclonal antibody, a major polypeptide antigen, with a molecular weight of 53,000 (molecular size, 53 kilodaltons [kDa]), of a human oral spirochete, Treponema denticola ATCC 33520, was found to localize on the surface of the outer envelope.
A 66 year-old male was admitted on October 31, 1987 because his chest X-ray film revealed a well-defined round shadow in the right inferior mediastinum. Chest CT showed a large homogenous mass in the right anterior mediastinum. The mass was identified as a cyst on echogram. Surgical removal of the cyst was done with right thoracotomy. The cyst was 15 cm in size and contained about 500 ml of grayish white fluid. Pathological examination showed a thymic cyst and no malignancy. Biochemical analysis of the cystic fluid revealed increased CEA value of 223.2 ng/dl in spite of normal CEA level in serum. CEA was demonstrated in the epithelium of the surface and Hassall's corpuscles by PAP stain. It is conceivable that this elevated CEA observed in the cystic fluid might be correlated with CEA-like antigens such as NCA, NFA and BGP.
The effect, duration and complications of subarachnoid anesthesia with hyperbaric bupivacaine solution, adjusted at a gravity of 1.044 and 1.033 by adding glucose, were compared with those of isobaric 0.5% bupivacaine anesthesia. Thirty patients undergoing surgical operations on lower abdomen or lower extremities were divided into three groups and given 2.0 to 4.0 ml of bupivacaine at L3-4 according to the body height. The upper margin of analgesic zone at 15min and 60min after the subarachnoid injection of bupivacaine was higher in the hyperbaric groups, but it receded thereafter and significant differences were found at 120min compared with the isobaric group. Hypotension occurred less frequently in the hyperbaric groups. The short duration of analgesia in the hyperbaric groups may be attributable to the lower concentrations of bupivacaine, 0.40 and 0.45%, but the low frequency of hypotension might be due to the younger mean ages of these two groups. No notable complications were found in any group. Bupivacaine solution of 0.5% with a higher gravity is desired in the market.
A 70-year-old woman was admitted complaining of gait disturbance and difficulty in urination. Neurological examination showed myelopathy and both serum and CSF anti ATLA antibodies were positive. A diagnosis of HTLV-associated myelopathy (HAM) was made and steroid therapy was initiated. Chest X-ray film on admission showed no abnormality, but three months later, diffuse fine nodular and reticular shadows appeared in both lung fields. The patients had no respiratory symptom. The results of pulmonary function tests were normal, aside from a mild obstructive defect as indicated by reduced V25. Arterial blood gas was also normal. Bronchoalveolar lavage studies showed increased total cell counts and an increased proportion of T-cells. The histological findings of the transbronchial lung biopsy specimen were bronchiolitis and alveolitis. Subsequently, within the next eight months the abnormal shadows on chest X-ray cleared gradually on maintenance dosage of prednisolone, 10 mg/day. Possible relationships between HAM and the pulmonary lesions were discussed.
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Occupational asthma caused by isonicotinic acid hydrazide (INH) inhalation occurred in a 26-year-old female hospital pharmacist after symptoms of allergic rhinitis. Intradermal, inhalation, and Prausnitz-Küstner tests were performed with INH dissolved in saline, INH dissolved in the subject's serum and incubated at 25 degrees C for 4 hours, and an INH conjugate with human serum albumin. An INH conjugate with bovine serum albumin was also used in the prick tests alone. All preparations caused rapid positive skin reaction in the patient. Prausnitz-Küstner tests on the subject's mother were also rapidly positive. Furthermore, positive results were obtained not only in the inhalation tests with the three antigens but also in the environmental provocation tests. These results strongly suggested that the asthmatic symptoms of the subject were not caused by physical irritation from INH or other drugs and might be mediated by an IgE antibody specific to INH, a suggestion subsequently confirmed by in vitro enzyme-linked allergosorbent test for the antibody previously reported. This is the first precise description of INH-induced bronchial asthma, and the four kinds of INH preparations used in these tests might be very useful as tools of clinical diagnosis in INH allergy.
Detection by in vitro serologic techniques of circulating antibody directed against isonicotinic acid hydrazide (INH, known as isoniazid) in humans has not been reported. In the past few months, however, sera from a patient with a recent history of isoniazid hypersensitivity of the immediate type have been studied, and reaginic antibodies (IgE) specific to INH were detected by means of an enzyme-linked allergosorbent test. Preliminary enzyme-linked allergosorbent tests also demonstrated that INH-specific IgE occurred in the serum of two of 150 patients with tuberculosis who had been treated with INH.
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A 34 year old man suffering from oral and genital ulceration with uveitis (the complete type of Behçet's syndrome) developed fluctuating radiological opacities in the right lung and showed recurrent hemoptysis. Pulmonary angiography showed multiple aneurysms and obstruction of the pulmonary arteries. After he was treated with prednisolone, the symptoms and pulmonary manifestation improved temporarily. However, he died suddenly from a massive hemoptysis. An autopsy revealed the aneurysmal rupture of right basilar branch of pulmonary artery into the right B6 bronchus. Histopathological findings in the lung showed multiple organized thrombi, inflammatory infiltration and vascular wall destruction of pulmonary arteries of various sizes. Only 47 previously reported cases of Behçet's syndrome which showed pulmonary involvements were revealed by a search of the published literature.
The morphological changes which occur in Raji cells during EBV induced fusion are described. Of particular interest is the formation of local contacts between cells, at these points the plasmalemmae of the two cells become disorganized and cytoplasmic bridges are formed.