Biomedical subjects

S Kohno

Publications and source records attributed to S Kohno.

At least 505 records · Page 28Linked to original sources

PubMed1995

A clinical study of mortality due to asthma.

BACKGROUND: Despite identification of the pathophysiologic mechanisms of asthma and improvement in therapy, asthma mortality has not decreased in recent years. OBJECTIVE: The pathophysiology and asthma-related death preventive measures were investigated with a physician-based questionnaire survey. METHODS: Questionnaires were sent to physicians primarily involved in treating asthma in Nagasaki Prefecture, Japan. The clinical characteristics of 32 patients who died of asthma (fatal cases) from 1984 to 1992 were compared with those of 17 patients with severe asthma who survived as a result of treatment by mechanical ventilation (nearly fatal cases). RESULTS: The number of deaths due to asthma increased in the last 2 years. Fatal cases and nearly fatal cases included patients with severe asthma as well as patients with mild asthma. Analysis of the clinical histories of patients judged to have died suddenly revealed the presence of persistent wheezing in these patients for a few days prior to the fatal episode. Airway obstruction was more marked and bronchial hyperresponsiveness was greater in fatal cases compared with those of a group of 70 patients without a history of nearly fatal acute asthma. CONCLUSIONS: The following measures may help prevent asthma deaths. Both patients and physicians should realize that even mild episodes can lead to severe, even fatal acute asthma. The severity of asthma should be evaluated not only by symptoms and peak expiratory flow rates but also bronchial hyperresponsiveness. Treatment should include reduction of bronchial hyperresponsiveness using oral or inhaled corticosteroids.

Adult↗

PubMed1995

[Pericardial effusion following surgery using cardiopulmonary bypass].

Of 156 patients who underwent cardiac or aortic surgery using cardiopulmonary bypass, postoperative pericardial effusion was detected in 89 patients (57%). They were divided into four groups according to the size of pericardial effusion: No effusion (group N, n = 66), small effusion (group S, n = 42), moderate effusion (group M, n = 22) and large effusion (group L, n = 25). In group L, 68% of patients had symptoms and 44% had complications such as subxiphoid drainage and constrictive pericarditis. Fewer patients with perioperative pleurotomy were found in group L than group N (p < 0.05). Postoperative anticoagulation did not affect the size of pericardial effusion. Postoperative amount of drainage were larger in groups, S, M, L than group N (p < 0.05, p < 0.05, p < 0.005). The CRP reelevation rate of each group was equal but the maximum CRP value was higher in group L than group N (p > 0.05). These results suggest that some relationship exists among postoperative drainage, inflammatory response and postoperative pericardial effusion. Since large pericardial effusion is often symptomatic and accompanied by various complications, earlier detection of pericardial effusion and appropriate treatment seems to be essential.

Adult↗

PubMed1995

[A case of surgical treatment of acute aortic dissection without an intimal tear].

We experienced a case of acute aortic dissection without an intimal tear. A 55-year-old woman with SLE presented with acute chest pain. TEE study showed dissection of the ascending aorta, and accompanied by pericardial effusion. An emergency operation was performed four hours after onset. Intraoperatively, thrombus was encountered in the false lumen of the ascending aorta and the proximal arch. However, intimal tear was not found. She underwent graft replacement of the ascending aorta and the total aortic arch, and had an uneventful postoperative course. Histological examination of a segment of ascending aorta showed no evidence of mucinous degeneration and pathological rupture of the elastic fiber.

Acute Disease↗

PubMed1995

[A rapid susceptibility test of Mycobacterium tuberculosis using hybridization protection assay].

The conventional drug susceptibility tests of Mycobacterium tuberculosis are time-consuming and usually require 2 to 4 weeks to obtain final results. In this study, we attempted to develop a novel method for rapid detection of drug-resistant M. tuberculosis using hybridization protection assay (HPA). Clinically isolated strains of M. tuberculosis including seven isoniazid (INH) susceptible strains and six resistant strains were used. The organisms grown on Ogawa egg medium were inoculated into Middlebrook 7H9 broth and cultured at 37 degrees C for one week. Then, the inoculum of each strain was prepared as a tenfold dilution of bacterial suspension at McFarland No. 0.5. The inocula were mixed with INH solutions to yield final concentrations of 0.1 and 1.0 micrograms/ml, and the resulting bacterial suspensions with or without test drug were cultured on the swaying plate at 37 degrees C for up to 5 days. At intervals, 50 microliters of each sample was withdrawn and subjected to the protocol of the HPA using acridinium-ester (AE) labeled DNA probe, and then the relative light unit (RLU) was read in a luminometer. In the case of the susceptible strains, a significant difference in the mode of increase in RLU ratio (% of RLU on day x/RLU on day 0) was observed between the INH-treated and drug-free control sets within three days of cultivation, while no such differences were seen in the case of the resistant strains.(ABSTRACT TRUNCATED AT 250 WORDS)

Acridines↗

PubMed1995

[Evaluation of 5-FU, leucovorin, etoposide, and cisplatin (FLEP) chemotherapy by hepatic artery injection in the treatment of multiple liver metastases from gastric cancer].

We performed FLEP chemotherapy (consisting of 5-FU, leucovorin, etoposide, and cisplatin) by hepatic artery injections for three patients with multiple liver metastases from gastric cancer, and two of three resulted in partial response (PR). We presented two PR cases. Case 1 is a 57-year-old male with multiple liver metastases from gastric cancer. Distal partial gastrectomy with regional lymphadenectomies were carried out, and an injection port was implanted in the hepatic artery. We performed FLEP chemotherapy from 16 days after the operation. Liver metastases subsided and resulted in PR after 3 months by CT scan. He is now healthy and working for 15 months after the operation. Case 2 was a 49-year-old female with multiple liver metastases from gastric cancer. Total gastrectomy with regional lymphadenectomies was carried out. We performed FLEP chemotherapy by hepatic artery injections from 21 days after the operation. The response of chemotherapy resulted in PR by CT scan, and she is now healthy and has been working for 11 months after the operation. Thus, this form of chemotherapy may be useful for patients with multiple liver metastases from gastric cancer.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1995

[Effect of mao-bushi-saishin-to (MBST), a formula of Chinese medicines, on 48 hr homologous passive cutaneous anaphylaxis in rats].

We studied the effect of oral administration of the extracts from MBST and its component chinese plants, and 1-ephedrine on 48 hr homologous passive cutaneous anaphylaxis (PCA), and histamine- or serotonin-induced skin reaction in rats. Administration (100-1,000 mg/kg) of MBST 1 hr before antigen challenge dose-dependently inhibited PCA. Skin reaction induced by histamine was also inhibited by this formula at 1,000 mg/kg 1 hr prior to the provocation in some degree. The inhibitory component of MBST of PCA was found to be Mao. Further examinations revealed that 1-ephedrine, which is contained in Mao in a large amount, did not substantially inhibit histamine- or serotonin-induced skin reaction. These results indicate that MBST has a significantly inhibitory activity on PCA, to which 1-ephedrine from Mao in the formula almost totally contributes, through the inhibition of chemical mediator release. Since MBST showed some inhibition of histamine-induced skin reaction, on which 1-ephedrine did not affect, it is suggested that some ingredient of MBST responsible for inhibition of PCA may be involved in addition to 1-ephedrine.

Animals↗

PubMed1995

[Effects of mao-bushi-saishin-to (MBST) on experimental allergic models in rats].

Effects of oral administration of MBST on 48 hr homologous passive cutaneous anaphylaxis (PCA) and allergic rhinitis in rats were examined. Administration of MBST (1,000 mg/kg/day) for 5 consecutive days with the final dosing at 1 day before antigen challenge did not effect on PCA. However, the reaction was significantly inhibited when the drug (1,000 mg/kg) was singly given 1 hr before antigen challenge. The drug (1,000 mg/kg, 1 hr prior to antigen challenge) tended to reduce the dye leakage into nasal cavities by antigen, while it did not affect on the anaphylactic histamine release into the cavities. The component of the chinese plants in the formula inhibiting the dye leakage was found to be Mao. However, l-ephedrine and d-pseudoephedrine, which are contained in Mao in a large amount, did not contribute to the inhibiting effect on dye leakage. These results suggest that MBST may be therapeutically effective for atopic disease including rhinitis, through the mechanism other than the inhibition of histamine release.

Animals↗

PubMed1994

Endothelin-1, one of the most potent histamine releasers in mouse peritoneal mast cells.

Whether endothelin-1 or -3 is capable of inducing histamine release from the peritoneal mast cells of BALB/c mice was investigated in vitro and compared to the release induced by compound 48/80. In contrast to the mouse bone marrow-derived mast cells, which originated from the same strain and have been reported upon previously, the (both crude and purified) peritoneal mast cells potently secreted histamine in response to either endothelin-1 or endothelin-3 in a concentration-dependent fashion. Even at a concentration as low as 10 nM, endothelin-1 induced a histamine release of more than 50% from the peritoneal mast cells. Cyclo(D-Asp-Pro-D-Val-Leu-D-Trp) (BQ-123), an endothelin ETA receptor antagonist, markedly suppressed not only the histamine released induced by endothelin-1 but also that due to endothelin-3 at a similarly low concentration range. Treatment with islet-activating protein (IAP) for 3 h, an inactivator of guanosine triphosphate (GTP) (Gi)-protein, markedly reduced the histamine release induced by endothelin-1. Neomycin at 0.1 and 1 mM or ethylenediaminetetraacetic acid (EDTA) at 0.1 mM in the absence of Ca2+, neither of which affected the histamine release induced by endothelin-1, substantially reduced histamine release caused by compound 48/80. On the other hand, treatment with O-O'-bis(2-aminophenyl)ethyleneglycol-N,N,N',N'-tetraacetic acid, tetraacetoxymethyl ester (BAPTA-AM), an intracellular calcium chelating agent, completely inhibited the release induced by both endothelin-1 and compound 48/80. These results indicate that endothelin-1 is one of the most potent histamine releasers in mouse peritoneal mast cells discovered so far.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗

PubMed1994

Complete obstruction of the inferior vena cava due to chronic relapsing pancreatitis: a case report.

A woman aged 62 with long history of chronic relapsing pancreatitis presented with swelling and ulcer in the lower limbs and occasional gastrointestinal bleeding. The radiological imaging showed complete obstruction of Inferior Vena Cava (IVC) at the level of the pancreas and well developed collateral vessels. Portal vein and splenic vein were also obstructed and superior mesenteric venous blood drained into the liver via coronary vein. She was originally found to have pancreas head tumor, which was not resectable. A palliative operation was performed, but histological examination of pancreatic specimen suggested only chronic inflammation and no evidence of malignancy. She was diagnosed as tumor-forming type chronic pancreatitis. Although SPV or SMV-PV obstruction has been recognized as a complication of chronic pancreatitis, IVC obstruction can occur by the same mechanism. This is the only case but one ever reported. Not only splenoportography but IVC-graphy will contribute to more precise understanding of patient's condition with chronic pancreatitis.

Chronic Disease↗

PubMed1994

Endothelin-1 induces release of histamine and leukotriene C4 from mouse bone marrow-derived mast cells.

Whether specific binding sites for endothelin-1 and endothelin-3 exist in mouse bone marrow-derived mast cells (BMMC) and if these endothelins are capable of stimulating chemical mediator release from the cells was investigated. A single component of binding sites for endothelin-1 was found in the cells, but no binding sites for endothelin-3 were observed. Endothelin-1 at 1-100 nM concentration dependently induced release of histamine and immunoreactive leukotriene C4 from BMMC, while endothelin-3 at up to 100 nM did not stimulate the release of either mediator. Time course experiments revealed that the release of histamine and immunoreactive leukotriene C4 induced by endothelin-1 occurred rapidly, reaching near maximal levels within 20 s and 2 min, respectively, after the stimulation, while histamine release induced by antigen, at the concentration which induced an extent of release similar to that induced by 100 nM endothelin-1, required comparatively prolonged incubation (approximately 10 min for submaximal levels). Cyclo(D-Asp-Pro-D-Val-Leu-D-Trp) (BQ-123), a selective antagonist of endothelin ETA receptors, not only dissociated [125I]endothelin-1 specifically bound to BMMC but also inhibited the release of both mediators from endothelin-1-induced cells. These results suggested strongly that BMMC have endothelin ETA receptors on their cell membrane, stimulation of which leads to chemical mediator release, probably via a mechanism different from that involved in the antigen-induced release.

Animals↗

PubMed1994

Detection of Candida enolase antibody in patients with candidiasis.

The serodiagnostic value of candida enolase antibody was evaluated in 27 patients with systemic candidiasis. The glycolytic enzyme enolase was prepared from Candida albicans IFM 40009 and used as the antigen for immunoblot assays. IgG class antibody was found in the sera of 17 of 27 patients (62.9%) obtained during the early course of the infection. Serial sampling of sera increased the number of patients with positive Candida enolase antibody, which was detected in 25 of 27 patients (92.5%). None of the patients with localized candidiasis showed a positive IgG titer more than 1:100. The specificity of Candida enolase IgG antibody was 95%. This antibody was observed in various candida species: Candida albicans (6/7, 85.7%); C. parapsilosis (7/9, 77.9%); C. tropicalis (5/5, 100%); C. guilliermondii (4/4, 100%); and C. glabrata (1/3, 33.3%).

Adult↗

PubMed1994

The Eiken Latex test for detection of a cryptococcal antigen in cryptococcosis. Comparison with a monoclonal antibody-based latex agglutination test, Pastorex Cryptococcus.

A latex agglutination test for cryptococcal antigen, the Eiken Latex test (Eiken, Tokyo, Japan), was compared with a monoclonal antibody-based agglutination assay, Pastorex Cryptococcus (Diagnostics Pasteur, Marneur-la-Coquette, France). In a murine model of disseminated cryptococcosis, the kinetics of the antigen titers by the Eiken Latex were similar to those by the Pastorex Cryptococcus, but sensitivity was much higher. In HIV-negative patients with pulmonary cryptococcosis, a cryptococcal antigen was detected in 6 of 10 patients by the Eiken Latex test and in only 3 of those patients by the Pastorex Cryptococcus. The results indicate that the Eiken Latex is more sensitive for the detection of the cryptococcal antigen, even in non-disseminated cryptococcosis. The sensitivity and specificity of the Eiken Latex were examined using 195 sera from 25 patients with pulmonary cryptococcosis and 170 patients with non-cryptococcosis. The cutoff value of > or = 1:8 showed a sensitivity of 76% (19/25) and a specificity of 98.9% (168/170).

Agglutination Tests↗

PubMed1994

In vitro and in vivo antifungal activities of liposomal amphotericin B, and amphotericin B lipid complex.

The in vitro and in vivo antifungal activities of liposomal amphotericin B (L-AMPH) and amphotericin B lipid complex (ABLC), which is composed of amphotericin B and the phospholipids dimyristoyl phosphatidylcholine and dimyristoyl phosphatidylglycerol, were compared with those of conventional amphotericin B (Fungizone, AMPH). The acute intravenous toxicity was markedly lower in BALB/c mice; 50% lethal doses (LD50s) were 2.75 mg/kg in AMPH, 32.9 mg/kg in L-AMPH and > 75 mg/kg in ABLC. In vitro antifungal activities against Candida albicans, C. parapsilosis, C. tropicalis, C. glabrata, and C. krusei were evaluated by the agar plate dilution method. The activities were unchanged against C. albicans, but MICs increased more than four fold in 18 of the 20 strains other than C. albicans in L-AMPH and in 9 of the 20 in ABLC. L-AMPH and ABLC were as efficacious as AMPH in the treatment of mice infected with C. albicans, and at a dose of 0.5 and 1.0 mg/kg of body weight, ABLC was more efficacious on survival A ten-times larger dose (10 mg/kg) of L-AMPH and ABLC was administered to mice with 100% survival, suggesting improved tolerability as compared to amphotericin B.

Amphotericin B↗

PubMed1994

Pseudomembranous enterocolitis and hemorrhagic necrotizing enterocolitis in Hirschsprung's disease.

From 1977 to 1991, we encountered 67 patients with Hirschsprung's disease and 14 of them developed enterocolitis, with 3 cases being fatal. Enterocolitis occurred preoperatively in 12 infants, as well as after ileostomy in one and after a pull-through procedure in another. Seven infants had severe enterocolitis, including three with pseudomembranous enterocolitis and four with hemorrhagic necrotizing enterocolitis. Enterocolitis in Hirschsprung's disease mainly occurs due to intestinal obstruction and ischemia; however, in some cases, Clostridium difficile overgrowth and its toxin also appears to be related to severe pseudomembranous enterocolitis. In severe enterocolitis, antibiotics and enterostomy often prove to be ineffective, and thus an early resection of the affected bowel appears to be necessary. Moreover, when the aganglionic segment extends to the small bowel, severe enterocolitis tends to occur in the aganglionic intestine even after performing an enterostomy, and a resection of the aganglionic bowel is therefore recommended to allow for adequate lavage of the segment distal to the enterostomy site.

Enterocolitis, Pseudomembranous↗

PubMed1994

Usefulness of echocardiographic measurement of bilateral pulmonary artery dimensions in congenital diaphragmatic hernia.

In nine patients with left-sided congenital diaphragmatic hernia (CDH) developing within 24 hours of birth, the authors measured the dimensions of the bilateral main pulmonary arteries by echocardiography, and investigated whether the left:right main pulmonary artery dimension ratio (PAD ratio) was a useful index for predicting pulmonary hypoplasia and persistent fetal circulation (PFC). Echocardiography was performed shortly after admission, the PAD ratio was calculated, and the clinical course of each patient was determined. When the PAD ratio was approximately 1.0, patients did not suffer from PFC and had little evidence of pulmonary hypoplasia. When the PAD ratio was low, the patients suffered from PFC and had pulmonary hypoplasia on the side of the hernia. Thus, the PAD ratio measured by echocardiography appears to be a useful index for predicting pulmonary hypoplasia and the risk of PFC in patients with CDH.

Echocardiography↗

PubMed1994

Inhibitory effect of ONO-1078 on specific binding of peptide leukotrienes to human lung crude membrane.

We investigated the effects of ONO-1078, a newly synthesized peptide leukotriene (p-LT antagonist, on the specific binding of radiolabelled [3H]-LTC4, [3H]-LTD4 and [3H]-LTE4 to a human lung crude membrane fraction (HLMF). The binding assay was performed under conditions in which [3H]-LTC4 and [3H]-LTD4 were not metabolized by HLMF; that is, the metabolism of LTC4 to LTD4 or LTE4 was almost completely prevented by pretreating HLMF with 5 mM acivicin at 37 degrees C for 180 min, and metabolism of LTD4 to LTE4 was inhibited by including 5 mM L-cysteine and 5 mM glycine in the assay. [3H]-LTD4 specific binding was potently and concentration-dependently dissociated by ONO-1078. Its potency was 180-fold stronger than that of FPL 55712, a standardized p-LT antagonist, whereas high concentrations of ONO-1078 similar to those of FPL 55712 were required to inhibit [3H]-LTC4 specific binding. The rank order of the inhibitory potencies of p-LT agonists and antagonists for [3H]-LTD4 specific binding was LTD4 > ONO-1078 > LTE4 > LTC4 > FPI 55712. On the other hand, not only high concentrations of ONO-1078 and FPL 55712 but also more than a 100-fold excess of unlabelled LTE4 was required to inhibit [3H]-LTE4 specific binding, indicating that the binding sites do not appear to be receptors of LTE4. From these results, it is suggested that ONO-1078 is a highly potent LTD4 antagonist which is expected to be very effective on bronchial asthma.

Cell Membrane↗

PubMed1994

Increase in T-cells bearing CD25 in bronchoalveolar lavage fluid from HAM/TSP patients and HTLV-I carriers.

To determine the immunologic characteristics of T-cells in local pulmonary lesions of human T-cell lymphotropic virus type I (HTLV-I) carriers, we investigated lymphocyte surface markers in peripheral blood and bronchoalveolar lavage fluid (BALF) of 38 HTLV-I carriers, 8 HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP) patients, 44 HTLV-I seronegative patients with pulmonary diseases and 7 healthy volunteers using two-color flow cytometric analysis. In peripheral blood, activated T-cells, CD4+HLA-DR+, CD8+HLA-DR+ and CD3+CD25+, and CD4+CD29+ cells increased significantly in carriers and HAM/TSP patients compared with healthy volunteers and seronegative patients. In BALF, T-cells, especially CD25+ cells, increased significantly in carriers and HAM/TSP patients, compared with healthy volunteers and seronegative patients. These findings indicated that T-cells in the lungs, as well as in peripheral blood, are activated in carriers and HAM/TSP patients. Interestingly, there was dissociation between expression of CD3+CD25+ cells in BALF and peripheral blood from these patients. These results suggest that T-cells activated probably by HTLV-I accumulate in the lungs in some carriers and HAM/TSP patients, and HTLV-I may be involved in the immunologic dysfunction in the lungs of these patients. However, we did not find any correlation between the degree of clinical features and the elevation of CD3+CD25+ cells in BALF, or its characteristic features on chest roentgenograms.

Aged↗

PubMed1994

Influence of molecular sizes of Cryptococcus neoformans capsular polysaccharide on phagocytosis.

The role of capsular polysaccharides (CPS) of Cryptococcus neoformans in phagocytosis by murine alveolar macrophages was investigated in four strains of C. neoformans serotype A, YC-11, YC-5, YC-27 and YC-13. Phagocytosis rates increased markedly after adding 10% mouse serum, compared to fetal calf serum. The reverse relation between capsular thickness of C. neoformans and phagocytosis by alveolar macrophages was observed except in YC-27, which had thin capsules and high virulence. The phagocytosis rate in mice serum was 17.3% in YC-11 (capsule thickness 2.8-3.5 microns), 39.8% in YC-5 (capsule size 0.8-1.5 microns), 20.3% in YC-27 (capsule size 0.6-1.1 microns), and 62.8% in YC-13 (capsule not detected microscopically). The CPS of YC-11, YC-5, and YC-27 analyzed by gel-filtration using CL-2B showed high molecular fractions near the void volume. However, the CPS of YC-13 showed only low molecular fractions. The widely eluted CPS of YC-11 was separated into 3 fractions and each fraction was added in the phagocytosis assay of YC-13. Phagocytosis was markedly suppressed particularly by the addition of a higher molecular fraction. These results suggest that phagocytosis of C. neoformans by alveolar macrophages is influenced by the molecular sizes of the CPS.

Animals↗