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Biomedical subjects

S Kohno

Publications and source records attributed to S Kohno.

At least 613 records · Page 34Linked to original sources
PubMed1992

An outbreak of Legionnaires' pneumonia in a nursing home.

An outbreak of Legionnaires' pneumonia occurred at a nursing home in December 1990. A 79-year-old female and a 73-year-old male clerk who were staying at the nursing home developed pneumonia with only a 5-day interval. Legionella pneumophila serogroup I was isolated from transtracheal aspirate of the former and sputum of the latter. After treatment with a combination of erythromycin and rifampicin both patients improved. Serological surveillance of inpatients and staff of the nursing home was performed in February 1991. Seven out of 51 samples (14.0%) showed a titer higher than 1:128 of anti-Legionella pneumophila serogroup I antibody determined by indirect immunofluorescence; two of these seven complained of respiratory symptoms. Molecular epidemiology analyzed by restriction endonuclease digestion of isolated L. pneumophila showed an identical pattern which suggested a common origin.

Aged↗
PubMed1992

Superinfection of chronic necrotizing pulmonary aspergillosis by Mycobacterium tuberculosis.

A 63-year-old woman with chronic necrotizing pulmonary aspergillosis complicated by active pulmonary tuberculosis is reported. A small infiltrative shadow appeared, but no definite diagnosis was made. Six years later the shadow was found to have increased in size; chest CT revealed a fungus ball, while a transbronchial lung biopsy revealed aspergillus hyphae. The intrabronchial inoculation of amphotericin B proved ineffective, and a lobectomy was performed. Histopathologic findings showed necrotic granulomas containing aspergillus and some acid-fast bacilli. While the superinfection of healed tuberculous lesions by Mycobacteria or Aspergillus species is well documented, their coexistence is rare.

Aspergillosis↗
PubMed1992

Fatal pneumonia caused by Corynebacterium group JK after treatment of Staphylococcus aureus pneumonia.

A 76-year-old man who was admitted to the hospital because of chronic renal insufficiency and chronic hepatitis died of Corynebacterium group JK pneumonia, after showing a slight improvement by treatment of Staphylococcus aureus with sulbactam/cefoperazone and minocycline. Transtracheal aspiration (TTA) just before his death revealed numerous gram-positive bacilli phagocytized by many neutrophils and more than 10(8) colony forming units (CFU)/ml of Corynebacterium group JK. A drug susceptibility test showed Corynebacterium group JK was resistant to many antibiotics, with the exception of vancomycin and amikacin.

Aged↗
PubMed1992

Effect of SA-103 on experimental allergic models in vivo and in vitro--comparison with disodium cromoglycate.

The anti-allergic action of N-[4-(4-methoxyphenyl)-2-thiazolyl]-1H-tetrazol-5-carboxamide (SA-103) was investigated and compared with that of disodium cromoglycate (DSCG). 1) Oral administration of SA-103 (0.1-10 mg/kg, p.o.) showed dose-dependent inhibition of 48 hr homologous passive cutaneous anaphylaxis (PCA) in rats. The inhibition rate (50%) of the compound at 1 mg/kg was comparable to that of DSCG at 1 mg/kg (i.v.). 2) Both of the drugs concentration-dependently inhibited the release of in vitro anaphylactic histamine from rat peritoneal exudate cells, but SA-103 was 1,000 times as potent as DSCG. 3) High doses (50 and 100 mg/kg, p.o.) of SA-103 tended to suppress 7-day homologous PCA in guinea pigs by only 20-30%. DSCG (100 mg/kg, i.v.) did not influence the reaction. 4) Neither anaphylactic histamine nor leukotriene release from guinea pig lung fragments was markedly influenced by SA-103 (10(-8)-10(-5) g/ml) or DSCG (10(-5)-10(-3) g/ml). 5) The histamine and serotonin induced contractions of the isolated guinea pig ileum were minimally enhanced or suppressed by very high concentrations (10(-4) g/ml) of SA-103 and DSCG. In addition to the above results, prolonged treatment with either compound before antigen challenge decreased the inhibitory response to anaphylactic histamine release from rat peritoneal cells. It is suggested, therefore, that the main mechanism(s) of the anti-allergic action of SA-103 is similar to that of DSCG, and SA-103 may be expected to be effective against allergic diseases.

Animals↗
PubMed1992

[The culture of mouse bone marrow-derived mast cells (BMMC) and the anaphylactic release of chemical mediators].

Bone marrow cells from BALB/c, C3H/He and WBB6F1+/+ mice were cultured for 5 wks in the presence of the culture supernatant from prokoweed mitogen-stimulated spleen cells to assess and compare the degree of growth, proliferation and chemical mediator release of the mast cells (BMMC) derived from them. BMMC, which were positive to alcian blue staining, were found in the suspension cells on the culture of the bone marrow cells of either species of mice after 2 wk culture. The percentages of BMMC in the suspension cells were increased with time of culture, reaching more than 90% after 5 wks. No differences in the growth and proliferation rate among BMMC from these three species were observed. However, in regard to the amount of anaphylactic leukotriene (LT) and histamine release. BMMC from BALB/c mice were superior to those from other species. From the above results, subsequent experiments were executed with BMMC from BALB/c mice. There was no obvious difference in the releasability of anaphylactic mediators among BMMC obtained at any stages of the passage during 4-12 wk culture. On the other hand, although BMMC cultured for 4 and 5 wks well responded to Ca ionophore A23187 for these mediator release, those for 6 to 12 wks obviously deteriorated with prolongation of the culture. The time course of the anaphylactic release of immunoreactive (i-) LTB4, i-LTC4 and histamine from BMMC revealed that almost maximum release was reached at 10, 20 and 5 min, respectively, after antigen challenge. Several drugs including antiallergics and beta-stimulants had no effect on their release. From these results, it is suggested that present BMMC may be inadequate cells for evaluation of antiallergic drugs that can inhibit the anaphylactic mediator release, but may be useful for the research of the mechanism of the release because the cells likely release the mediators without occurrence of complicated subordinate reactions.

Animals↗
PubMed1992

[Tumor associated carbohydrate antigens in bronchoalveolar lavage fluid in patients with diffuse panbronchiolitis].

It is known that tumor associated carbohydrate antigens are significantly increased in the serum of patients with diffuse panbronchiolitis (DPB). We investigated carbohydrate antigens (SLX, CA19-9) in bronchoalveolar lavage fluid (BALF) obtained from 24 patients with DPB. The concentrations of SLX and CA19-9 were significantly higher in BALF from patients with DPB than those from healthy subjects (7 cases) and patients with pulmonary sarcoidosis (16 cases). No significant correlation was observed between either SLX or CA19-9 concentrations in the serum and BALF, and no significant correlation was observed between the concentrations of these carbohydrate antigens in BALF and clinical findings. Immunohistochemical study of SLX and CA19-9 in open lung biopsy specimens obtained from patients with DPB showed expression of SLX and CA19-9 on the bronchiolar surface epithelial cells and mucinous exudates in air spances. These results indicate that carbohydrate antigens are presumably increased in the pulmonary lesions of patients with DPB, and this increase causes high levels of these antigens in the serum. Furthermore, we investigated the change of concentrations of SLX and CA19-9 in BALF obtained from patients with DPB after erythromycin (EM) treatment. The concentrations of these two antigens were decreased after EM treatment.

Adolescent↗
PubMed1992

[DNA probe and polymerase chain reaction for detection and identification of mycobacteria].

The DNA probe and polymerase chain reaction (PCR) technique for detection and identification of mycobacteria were compared with the conventional smear and culture method. The results of identification by DNA probe agreed well with those of the biochemical method. Moreover, six percent of Mycobacterium avium complex (MAC) were revealed to be mycobacteria other than MAC by DNA probe. The nested PCR for detection of gene coding protein antigen b of Mycobacterium tuberculosis complex showed excellent specificity and sensitivity. Then we applied this technique to rapid detection of M. tuberculosis in 222 clinical samples. The agreement between nested PCR and the biochemical method was excellent, and 17 cases were diagnosed by only nested PCR in spite of negative results by smear and culture. These cases were unlikely to have yielded false positive results since their clinical features were compatible to tuberculosis. From these data, it was considered that the DNA probe and PCR technique were extremely useful strategies and would contribute to rapid diagnosis of mycobacterial infectious diseases.

Base Sequence↗
PubMed1992

[A 14-year-old with pulmonary hamartomatous lymphangiomyomatosis associated with bilateral pneumothoraces].

A 14-year-old girl was admitted because of cough, chest pain and hemosputum. Chest roentgenogram on admission showed a pneumothorax and a cavitary lesion with niveau formation in the right lung and cystic lesions in the bilateral lung fields. After bed rest and intravenous administration of antibiotics for two weeks, the right lung inflated well and the niveau formation disappeared, and the patient was discharged. One week later, she was readmitted with sudden-onset severe dyspnea, caused by bilateral pneumothoraces. Emergency tube thoracostomy and wedge resection of the bullous lesion was performed. Macroscopically, multiple small cystic changes were seen on the surface of the right lung. Histological examination revealed nodular proliferations of smooth muscle cells in the interstitium and vessel walls in the lung, which contained slit-like lymphatic channels. The diagnosis of pulmonary lymphangiomyomatosis was made. In this case, we could not measure receptors for estrogen and progesterone. Recently, hormonal therapy and oophorectomy have been reported as being useful. Tamoxifen (Norvadex) was therefore initiated, and the patient has remained well with slight dyspnea on exertion. There has been no recurrence of pneumothorax. Lymphangiomyomatosis is a rare disease of unknown etiology which occurs exclusively in women, mostly in those of reproductive age. We report a 14-year-old female patient with lymphangiomyomatosis associated with repeated pneumothorax, who had been under treatment for epilepsy. We believe this case to be of importance because of the long discussed relation between pulmonary lymphangiomyomatosis and tuberous sclerosis.

Adolescent↗
PubMed1992

[A clinical study of tuberculous pleurisy].

Forty-eight cases of tuberculous pleurisy were examined and the following results were obtained. (1) Most of the patients were male, and there was no significant age and underlying diseases. (2) Fever and chest pain were observed mainly in younger patients, and sputum and dyspnea in older patients. (3) All of the cases examined had exudative pleural effusion, and increased ADA activity was frequently observed. (4) Mycobacterium tuberculosis was detected in the sputum of 65%, and also in the pleural effusion of 28% of the patients. The pathological diagnosis of tuberculosis was made by pleural biopsy in 83% of the patients, suggesting that pleural biopsy is very useful in the diagnosis of tuberculosis pleurisy. (5) The prognosis of the patients with tuberculosis pleurisy was good. Steroid therapy was generally ineffective.

Adolescent↗
PubMed1992

[Laboratory and clinical studies on levofloxacin].

A newly developed broad-spectrum fluoroquinolone, levofloxacin (LVFX, DR-3355), was evaluated in vitro and in vivo in comparison with ciprofloxacin (CPFX), ofloxacin (OFLX) and norfloxacin (NFLX). The results were as follows. 1. Antimicrobial activity Minimal inhibitory concentrations (MICs) against 480 clinical isolates including 16 different species were determined using the microbroth dilution method. LVFX showed excellent antimicrobial activities against Gram-positive and -negative bacteria. The MIC values of LVFX for Gram-positive bacteria were superior to those of the other quinolones tested. The MIC values of LVFX for Gram-negative bacteria were comparable to those of CPFX and superior to those of OFLX and NFLX. 2. LVFX concentrations in serum and sputum LVFX was orally administered in a single dose of 200 mg to 2 patients with chronic lower respiratory tract infections, and its concentrations in serum and sputum were measured at intervals using bioassay. The peak concentrations of LVFX in serum were 1.52 and 1.24 micrograms/ml, and 84-95% of serum level were detected in sputum. From these data, it appeared that LVFX penetrate well into the lung. 3. Clinical efficacy and adverse reactions Fifteen patients with respiratory tract infections were treated with LVFX, and the overall efficacy rate was 78.6% (excellent in 3 cases, good in 8, fair in 3, poor in 0). As adverse reactions, anorexia was observed in 2 cases, diarrhea in 1 case and tremor of finger in 1 case. Although an elevation of total bilirubin in serum was observed in a case as an abnormal laboratory finding, it was mild, transient and improved rapidly after the completion of LVFX treatment.

Adult↗
PubMed1992

[Arterial redistribution to prevent hepatic arterial occlusion and gastric ulcer using hepatic arterial infusion chemotherapy with percutaneous catheterization].

Clinical usefulness of arterial redistribution using steel coils to prevent hepatic arterial occlusion and gastric ulcer was compared with the conventional method. Fifty-two patients with liver malignancies were inserted with steel coils into the common hepatic artery after percutaneous hepatic catheterization (CHA-coil) to prevent hepatic arterial occlusion. The tip of the indwelling catheter was fixed to the vascular wall, and the contact area between the catheter and blood into the liver became smaller. Fifty-nine other patients were inserted with steel coils into the right gastric artery (RGA-coil) to prevent gastric ulcer. The CHA-coil succeeded in 84% of the patients, and hepatic arterial occlusion occurred in only 4% of these patients. The RGA-coil succeeded in 88%, and gastric ulcer occurred in 2%. The rates of hepatic arterial occlusion (4%) and gastric ulcer (2%) were much decreased in comparison with 25% and 16%, respectively, in the previous cases undergoing percutaneous hepatic catheterization without such arterial redistribution. In conclusion, these procedures are highly effective to prevent complications of hepatic arterial infusion employing percutaneous hepatic catheterization and to allow continuation of arterial infusion chemotherapy for longer periods.

Catheterization↗
PubMed1992

[Clinical and pathological investigation of opportunistic pulmonary mycoses in autopsy cases].

Clinical and pathological investigations were performed in 58 cases of opportunistic pulmonary mycoses diagnosed at autopsy during the 10 years between 1979 and 1988 at Sasebo General City Hospital. The following findings were obtained. 1) The incidence of opportunistic pulmonary mycoses during the 10 years was 7.7%, with a significant increase in the incidence of fungal infections during the last 5 years of the study. The incidence of pulmonary mycoses was higher in patients with blood dyscrasia than in those with solid tumor or benign disease (p less than 0.001). 2) Administration of steroid hormone and anticancer drugs were suspected to be causative factors in the development of pulmonary aspergillosis and cryptococcosis, but not in candidiasis. 3) Characteristic radiographic patterns and clinical symptoms were absent in cases of pulmonary candidiasis due to the small size of the lesions and the high incidence of other complicating pulmonary infections and edema. 4) The most common initial roentgenographic pattern in opportunistic pulmonary aspergillosis was localized infiltrate, subsequently progressing to either multifocal infiltrates or cavitation. 5) The initial symptom in opportunistic pulmonary aspergillosis was usually high fever, and the radiographic abnormalities appeared later. The median duration between onset and death in 19 patients with pulmonary aspergillosis was 23.1 days. 6) Pulmonary aspergillosis should be suspected in the compromised host with high fever refractory to antibiotics and pulmonary infiltrates. Empiric antifungal therapy should be initiated at an early stage for the best chance for survival.

Aged↗
PubMed1992

[A case report of left ventricular myxoma].

We reported a case of successful surgical extirpation of a left ventricular myxoma arising from the anterior wall of the left ventricle. A 17-year-old asymptomatic boy had been followed due to premature ventricular contractions. Two-dimensional echocardiography revealed a small mass in the left ventricle. He underwent transaortic extirpation of the mass under extracorporeal circulation in November, 1989. The gelatinous mass of 11 by 9 by 5 mm and weighing 0.4 g was a myxoma pathohistologically. His postoperative course has been uneventful. Left ventricular myxomas are very rare. In the literature, 26 cases in English and 6 in Japanese have been reported. Recurrence was reported in one case, thus careful follow-up is necessary.

Adolescent↗
PubMed1992

[Epidemiology of HTLV-I carriers in Hirado Island and virological and immunological investigation of HTLV-I associated pulmonary disease].

Adult T-cell leukemia (ATL) is endemic in Kyushu. Our study at Hirado island in Nagasaki prefecture revealed a higher incidence (35.9%) of HTLV-I carriers in villages with fishing than in those without (16.5%). HTLV-I carriers showed a higher incidence of abnormal findings on chest roentgenogram (21.7%) than non-carriers (16.5%), but most were lesions of old pulmonary tuberculosis and pleural thickening. Virological and immunological investigations were performed for 10 HTLV-I carriers, 3 patients with HTLV-I associated myelopathy (HAM), and 3 patients with ATL to determine the presence of HTLV-I associated pulmonary disease. In HAM patients, there were high titers of anti HTLV-I antibody, positive IgA reaction to HTLV-I, and an increase in interleukin-2 receptor (IL-2)-positive T-cells in the peripheral blood; and lymphocytosis and an increase in IL-2-positive T-cells in the bronchoalveolar lavage fluid (BALF). Virological examination showed the presence of pX gene and tax1/rex1 mRNA in the peripheral blood and BALF. Similar immunological and virological findings in 2 of 10 carriers suggested the presence of HTLV-I associated pulmonary disease.

Aged↗
PubMed1991

[Clinical evaluation of serological antigen detection tests for candidemia].

The new serological tests for candidemia were evaluated. In nine cases of candidemia, fungal index (Endotoxin D-Endospecy) was 146.8 +/- 116.8 pg/ml and D-arabinitol/creatinine 1.10 +/- 1.04 mumol/mg. Fungal index was significantly (p less than 0.01) higher in candidemia than suspected infections. All candidemia were positive for Cand-Tec latex agglutination, but twelve of the sixteen cases of suspected infections were also positive. Mannan latex agglutination was very specific for candidemia. Four cases of candidemia was positive for Mannan latex agglutination and only one case was positive in suspected infections. Fungal index and D-arabinitol/creatinine was decreased after treatment of antifungal agents. In poor clinical efficacy case, these titer remained high even after treatment. These data suggested the usefulness of these serological tests for candidemia.

Adolescent↗
PubMed1991

[Early diagnosis of Mycoplasma pneumoniae pneumonia by antigen detection using immunobinding assay].

The possibility of rapid diagnosis of Mycoplasma pneumoniae infection by immunobinding assay is described. Immunobinding assay which was developed by Kotani and McGarrity is a simple and rapid method for identification of mycoplasmas. Small amounts of antigen were spotted onto the nitrocellulose membrane. It was treated with a specific rabbit antisera against M. pneumoniae. The antigen-antibody complex was visualised with the avidin-biotin horseradish peroxidase method. Cross reaction was seen between M. pneumoniae and M. genitalium. Throat swabs from hamsters infected with M. pneumoniae were positive on 7th and 14th day after infection. Although the cross reaction was seen between M. pneumoniae and M. genitalium, this method could be useful for rapid diagnosis of M. pneumoniae infection.

Animals↗
PubMed1991

[Bacteriological studies on pharyngeal and tracheal colonization in patients of operations and patients in ICU].

Bacterial colonization of the pharynx before and one week after operation, and contamination of the trachea during intubation in 7 patients who underwent operations were investigated. And bacterial colonization of pharynx, tracheas, and mechanical-ventilators in 7 ICU patients was investigated. Flora of palms of 10 ICU personnel was also examined: 1) Oral bacteria began to be found in the trachea several hours after intubation. 2) In oropharyngeal flora, one week after operation, Neisseria and anaerobes which belong to normal flora decreased because of antibiotics, but no new resistant bacteria appeared. 3) Although isolates from pharynx of preoperative patients were normal flora, those of ICU patients were Staphylococcus epidermidis, Enterococcus spp., gram-negative rods such as Pseudomonas aeruginosa, and yeast liked organisms etc, which were resistant to antibiotics. 4) From the trachea of intubated patients in ICU, oral bacteria were isolated. 5) Pseudomonas pickettii was isolated from the expiratory side of ventilator circuits in one patient, but it was not isolated from the patient. 6) From hands of ICU personnel, gram-positive bacteria such as coagulase negative staphylococci, Coryne bacterium spp. and Bacillus spp. were isolated. 7) One patient in ICU, who developed pneumonia due to resistant Bacteroides fragilis following oropharyngeal colonization, was reported. These studies suggested the importance of environmental control, careful selection of antibiotics, and attention to change of flora.

Aged↗