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Biomedical subjects

S Kohno

Publications and source records attributed to S Kohno.

At least 361 records · Page 20Linked to original sources
PubMed1998

Detection of Mycobacterium tuberculosis in preserved tuberculous lymph nodes by polymerase chain reaction.

We evaluated the usefulness of three types of polymerase chain reaction (PCR) targeting 16S rRNA, protein antigen b and IS6110 in detecting Mycobacterium tuberculosis in preserved tuberculous lymph nodes. The detection limit of all PCR methods was 100 colony forming unit (CFU) of M. tuberculosis in tissue. The test samples included eight paraffin-embedded tuberculous lymph nodes containing microscopical epithelioid cell granuloma with caseous necrosis and Langhans giant cells. Although acid-fast stained organisms in lymph node tissue were not detected in any sample, all three types of PCR tests were positive in four of eight lymph nodes. Our results suggest that PCR is not only a rapid and sensitive diagnostic method for tuberculous lymphadenitis, but also clinically significant in retrospective study for detecting M. tuberculosis even in some preserved lymph node tissues without evidence of acid-fast stained organisms.

Antigens, Bacterial↗
PubMed1998

Liddle's syndrome in an elderly woman.

A 78-year-old woman with hypertension was hospitalized with acute bronchitis. However, she was also found to have hypernatremia, hypokalemia, and metabolic alkalosis. Detailed examination showed a low plasma renin activity and plasma aldosterone concentration. A provisional diagnosis of Liddle's syndrome was established and the patient was successfully treated with triamterene. Although Liddle's syndrome is generally considered an inherited hypertensive disease found in young people, a review of the literature indicated that muscle weakness is an important clinical finding in elderly patients with this disease. Liddle's syndrome should be considered in the differential diagnosis of hypertension even in elderly individuals.

Aged↗
PubMed1998

Pulmonary Nocardia otitidiscaviarum infection in a patient with chronic respiratory infection.

We report a case of pulmonary Nocardia (N.) otitidiscaviarum infection in a 76-year-old man with chronic respiratory infection. The patient responded poorly to intravenous imipenem and oral minocycline, but later improved after treatment with trimethoprim-sulfamethoxazole. Pulmonary infection with N. otitidiscaviarum should be considered in the differential diagnosis of chronic respiratory infections. Further studies are needed to evaluate the correlation between species and drug susceptibility.

Aged↗
PubMed1998

Codon 972 polymorphism of the insulin receptor substrate-1 gene in impaired glucose tolerance and late-onset NIDDM.

OBJECTIVE: To assess the relevance of a Gly-->Arg substitution in codon 972 of the insulin receptor substrate-1 gene in impaired glucose tolerance (IGT) and NIDDM. RESEARCH DESIGN AND METHODS: The genotype of 1,106 Japanese subjects consisting of 310 subjects with NIDDM, 305 subjects with IGT, and 491 normal control subjects was analyzed by an allele-specific assay using polymerase chain reaction and restriction fragment length polymorphism. RESULTS: The frequency of the variant allele was not different between subjects with NIDDM (0.021) and normal control subjects (0.020). However, subjects with IGT showed a significantly higher prevalence of the variant allele (0.041, P = 0.027). We found two homozygous individuals for the variant; both had IGT with mild insulin resistance. The allelic frequency tended to be lower in normal control subjects aged > 50 years than in younger control subjects. Conversely, in the subjects with IGT or NIDDM, the Gly972Arg substitution was more frequently found in subjects aged > 50 years. Furthermore, NIDDM patients with the variant allele had older ages of diagnosis than patients without the variant. CONCLUSIONS: The codon 972 variant may be associated with IGT and a subset of late-onset NIDDM in the elderly Japanese population.

Adult↗
PubMed1998

A patient with Paget's disease of bone treated with etidronate disodium.

A 69-year-old Japanese woman was referred to our hospital because of abnormal skull X-ray findings. Serum total alkaline phosphatase, bone-specific alkaline phosphatase 3, osteocalcin and propeptide carboxyterminal of type I procollagen (PICP) levels were markedly elevated. Urinary excretion of hydroxyproline was also increased, suggesting that both bone formation and resorption were accelerated. Radiography of the skull showed "cotton wool" appearance. T1-enhanced MRI revealed that the skull-cap and diploe were swelled up. In 99mTc-MDP bone scintigraphy, all areas of the skull and a part of the right hemipelvis showed high uptake of the radioisotope. Based on the findings we made diagnosis of Paget's disease of bone which is a rare bone disorder in Japanese. Three-month oral administration of etidronate disodium resulted in normalization of serum PICP levels and urinary hydroxyproline excretion, whereas alkaline phosphatase levels were only partially lowered. Levels of the markers of bone turnover remained normal during a follow-up period of 3 months after the discontinuation of the treatment.

Aged↗
PubMed1998

[Severe mycosis-factors with fungus and host].

The deep-seated mycosis occurred in immunocompromized patients. Normally, the deep-seated mycosis became sever infection because of the defects of host defense or the adverse effects of antifungal agents. The major factors of the reason on the severity of the deep-seated mycosis depends on the pathogenesity and the drug resistance for antifungal agents in infected fungi. The clinical factors related with hosts defenses are important to the other reason on the severity. We investigated that the multiple drug resistant (MDR) mechanism may be one of the major roles plays in the azole resistant Candida albicans strains isolated form the patients with oropharyngeal candidiasis infected HIV. We analyzed which clinical factors are related with the prognosis of the patients with pulmonary cryptococcosis and aspergilloma. The titer of cryptococcal capsular antigen was earlier improve in the patient without underline disease than in the patients with underline diseases diagnosed pulmonary cryptococcosis. CRP was higher in the death cases in the patients with pulmonary aspergilloma, compared with alive cases.

AIDS-Related Opportunistic Infections↗
PubMed1998

Cryptosporidiosis in Indonesia: a hospital-based study and a community-based survey.

Hospital-based and community-based studies were conducted to understand the prevalence and mode of transmission of Cryptosporidium parvum infection in Surabaya, Indonesia. In both studies people with and without diarrhea were examined for oocysts. A community-based survey included questionnaires to a community and stool examination of cats. Questionnaires covered demographic information, health status, and hygienic indicators. In the hospital, C. parvum oocysts were found in 26 (2.8%) of 917 patients with diarrhea and 15 (1.4%) of 1,043 control patients. The most susceptible age was less than two years old. The prevalence was higher during the rainy season. A community-based study again showed that C. parvum oocysts were frequently detected in diarrhea samples (8.2%), exclusively during rainy season. Thirteen (2.4%) of 532 cats passed C. parvum oocysts. A multiple logistic regression model indicated that contact with cats, rain, flood, and crowded living conditions are significant risk factors for Cryptosporidium infection.

Adolescent↗
PubMed1998

[Drug delivery system for infectious diseases].

Various types of antimicrobial agents have been evolved to inhibit growth of or to kill different microorganisms. In recent years, encapsulation of antimicrobial agents in lipid formulations has been a popular practice in research work related to drug delivery system, although most of the studies are based primary on animal models. The recent developments of lipid formulations of anti-infectious drug (antibiotics, antifungals, and antiviral agents) with longer half-life opens new therapeutic avenues in treating infections. The passive targeting of liposomes to the sites of infection is of great value with respect to clinical application. Liposome entrapment can exchange their pharmacokinetics and, hence reduce their toxicity.

Anti-Bacterial Agents↗
PubMed1998

Leucocyte kinesis in blood, bronchoalveoli and nasal cavities during late asthmatic responses in guinea-pigs.

Recently, we reported a reproducible model of asthma in guinea-pigs in vivo, which developed a late asthmatic response (LAR) as well as an early response. In this study, time-related changes in the occurrence of the LAR and leucocyte kinesis were assessed. Furthermore, the state of the activation of eosinophils that migrated into the lower airways was characterized in vitro. Guinea-pigs were alternately sensitized/challenged by inhalation with aerosolized ovalbumin adsorbed on aluminium hydroxide and ovalbumin alone, once every 2 weeks. At defined times before and after the fifth challenge, airway resistance was measured, blood was drawn and bronchoalveolar lavage (BAL) and nasal cavity lavage (NCL) were performed. Superoxide anion (.O2-) production of eosinophils was measured with cytochrome c. Occurrence of LAR and considerable increases in circulating eosinophils coincided with each other 5-7 h after the challenge. After 7 h, eosinophil infiltrations into bronchoalveolar spaces were observed. The capacity of eosinophils from the sensitized animals to produce .O2- was higher than those from the non-sensitized ones, when eosinophils were stimulated by platelet-activating factor. Although an increased number of eosinophils in the NCL fluid was observed, it was much less than that in the BAL fluid. Thus, it has been concluded that eosinophilia in the blood and the lung may participate in the occurrence of the late asthmatic response, which is thought to be preferentially evoked in the lower airways in guinea-pigs in vivo.

Animals↗
PubMed1998

[A case of pulmonary sarcoidosis with multiple cavitation and pneumothorax].

We describe a rare case of pulmonary sarcoidosis with multiple cavitation and pneumothorax. A 32-year-old woman was admitted to our hospital with a dry cough and an interstitial shadow with dense infiltrates in both upper lungs and cavitation in the right upper lung on chest roentgenogram and CT. Laboratory tests revealed an elevated level of serum lysozyme. BAL fluid demonstrated a high proportion of lymphocytes with an increased CD4/CD8 ratio, compatible with sarcoidosis. Transbronchial lung and skin biopsies showed evidence of noncaseating epithelioid-cell granuloma, and a diagnosis of sarcoidosis was made. Although pneumothorax appeared in the left lung on chest roentgenogram during clinical observation conservative treatment without corticosteroids or any other therapy for a follow-up period of 3 years resulted in improvement of her clinical condition and abnormal X-ray findings.

Adult↗
PubMed1998

[Role of peptide-leukotrienes in bronchial asthma].

Peptide-leukotrienes (p-LTs) (LTC4, LTD4 and LTE4) are major metabolites of the arachidonate 5-lipoxygenase pathway. Although a number of papers have reported that p-LTs induce potent bronchial smooth muscle constriction as well as airway mucus secretion, vascular permeability and proliferation of airway smooth muscle cells, it had not been recognized that they are pivotal chemical mediators in asthmatic diseases until recently. Yet, several potent and selective antagonists against p-LTs and inhibitors of p-LT formation revealed that p-LTs play significant roles in not only allergic but non-allergic asthma including exercise- and aspirin-induced asthma. In addition, it has been reported that p-LTs participate in rhinitis, especially nasal blockage. In this article, recent development of drugs relating to p-LTs and their therapeutic effects for asthma are mainly reviewed.

Asthma↗
PubMed1998

[Hyponatremia in Duchenne muscular dystrophy on mechanical ventilation].

To evaluate the pathomechanism of hyponatremia occasionally seen in Duchenne muscular dystrophy (DMD) on intermittent positive pressure ventilation (IPPV), we performed a comparative study on 26 DMD patients, 7 IPPV in trachetomized intermittent positive pressure ventilation (TIPPV), 6 nasal intermittent positive pressure ventilation (NIPPV), 6 cuirass respirator (CR), and 7 spontaneous breathings (SB). We followed fluctuation of serum sodium levels for several years. Since the serum sodium level was gradually reduced with years on mechanical ventilation, we speculated positive relationship between hyponatremia and antidiuretic hormone (ADH) secretion. Serum sodium levels of 135.6 +/- 2.8 mEq/L in average on IPPV (TIPPV + NIPPV) patients was significantly lower than the levels of 137.8 mEq/L +/- 0.98 on CR patients and 138.8 +/- 0.69 mEq/L on SB patients. Plasma ADH levels in IPPV patients were not reduced when plasma osmolarity was less than 280 mOSm/L. Previous reports showed that ADH was inappropriately secreted only during IPPV with positive end expiratory pressure (PEEP). Ours is the first report of inappropriate secretion of ADH during IPPV without PEEP. It becomes clear that inappropriate ADH secretion is one of the causes of hyponatremia in DMD, though the exact mechanism is not clear. We should bear in mind the change of serum electrolyte level in ventilated DMD patients, especially patients on antidepressant known to release of ADH.

Adult↗
PubMed1998

[Cytokines produced by cells in bronchoalveolar lavage fluid from a patient with primary pulmonary cryptococcosis].

Cytokines in the culture supernatant of concanavalin A-stimulated macrophages/lymphocytes isolated from bronchoalveolar lavage (BAL) fluid in a 29-year-old patient with primary pulmonary cryptococcosis were evaluated to study the immune reaction against Cryptococcus neoformans in the lung. Before fungicidal therapy, levels of interferon-gamma and interleukin-10 were markedly elevated, and declined after therapy. There were no changes in interleukin-2 or interleukin-4 throughout the clinical course. This result suggests that IFN-gamma and IL-10 may be involved in the immune reaction against pulmonary cryptococcosis.

Adult↗
PubMed1998

[Real time sonographic imaging of fasciculation].

We studied the clinical value of real time sonographic imaging of fasciculation in patients with neuromuscular diseases, which presented for 4 with amyotrophic lateral sclerosis (ALS), 2 with Kennedy-Alter-Sung syndrome, 1 with Kugelberg-Welander disease, and 1 with n-hexane neuropathy. The ultrasound image of fasciculation showed characteristic of each disease in several features. Analysis of sonographic image revealed that duration, size of fasciculation, and interval of fasciculation in Kennedy-Alter-Sung syndrome and Kugelberg-Welander disease, which is chronic progressive neuromuscular disorders, were longer than that in ALS, n-hexane neuropathy which are acute progressive disorders. We believe the fasciculation image may have significant implications with clinical course. Real time sonography offers a quantitative and qualitative means of investigating fasciculation and is effective to identify pathological information.

Amyotrophic Lateral Sclerosis↗
PubMed1998

[Twelve cases of systemic lupus erythematosus in boys].

We compared clinical findings in 12 cases of systemic lupus erythematosus (SLE) in boys with those in 49 cases in girls. The age at which SLE developed in boys was consistent with that of infantile SLE and there was no age specificity. Momy cases in boys were diagnosed earlier as compared with cases in girls. Symptoms of infantile SLE, such as fever, arthalgia, butterfly rash, and urinary abnormalities, did not differ between boys and girls. However, a higher percentage of boys (58.3%) had central nervous system complications at onset than did girls (30.6%). Platelet counts tended to be higher in boys than in girls, a finding that suggests SLE tends to be more severe in boys than in girls. The incidence in the appiarance of LE cells, anti-Sm antibodies and immune complexes was higher in boys than in girls. Type IV or V renal pathologic changes (World Health Organization Histologic Classification) were present in 70% of boys. Our findings suggest that SLE in boys is more severe than that in girls and is more likely to be associated with central nervous system complications and severe renal complications.

Adolescent↗