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Biomedical subjects

S Nishima

Publications and source records attributed to S Nishima.

At least 37 records · Page 2Linked to original sources
PubMed1998

Effects of epinastine hydrochloride on cholinergic neuro-effector transmission in canine tracheal smooth muscle.

We determined the effects of epinastine hydrochloride, an anti-asthmatic drug, on cholinergic neuro-effector transmission in canine trachea. Isometric tension of tracheal strips was measured in the presence of indomethacin and propranolol. Epinastine (10(-6) M) significantly suppressed the contraction evoked by electrical field stimulation, but had no effect on the acetylcholine-evoked contraction. An L-type Ca2+ channel blocker, nicardipine, did not suppress the electrical field stimulation-induced smooth muscle contraction and did not alter the inhibitory effect of epinastine. An N-type Ca2+ channel blocker, omega-conotoxin, suppressed the electrical field stimulation-induced contraction in a dose-dependent manner, and in a subthreshold/intermediate concentration abolished the inhibitory effect of epinastine. These findings indicate that epinastine exerts prejunctional inhibitory effects on airway smooth muscle of dogs, presumably by inhibiting acetylcholine release from vagal nerve terminals, and suggest that this effect is mediated by N-type Ca2+ channels.

Animals↗
PubMed1998

Effect of nitric oxide synthase inhibitor on allergen- and hyperventilation-induced bronchoconstriction in guinea-pigs.

To elucidate the role of endogenous nitric oxide (NO) in allergen- (AIB) and hyperventilation-induced bronchoconstriction (HIB), the effects of an NO synthase inhibitor, NG-nitro-L-arginine methyl ester (L-NAME), on AIB and HIB were studied in guinea-pigs. In the AIB group, 21 anaesthetized guinea-pigs, actively sensitized with 1% ovalbumin, were challenged with aerosolized 0.1% ovalbumin solution under mechanical ventilation. In the HIB group, 14 guinea-pigs were challenged with hyperventilation (tidal volume of 12 mL x kg(-1) at 150 breaths x min(-1) with 21% O2 and 5% CO2 dry gas) for 5 min. In both groups, lung resistance (RL) was measured using a pressure-volume-sensitive body plethysmograph, with or without L-NAME pretreatment (8 mg x kg(-1) i.v. followed by 2 mg x kg(-1) x min(-1) i.v.). The NO precursor, L-arginine was injected at a rate of 15 mg x kg(-1) x min(-1) after L-NAME injection (10 mg x kg(-1)) in the AIB group. The results were as follows. In the AIB group, the maximal RL change was significantly potentiated by pretreatment with L-NAME. This potentiating effect of L-NAME was reversed by L-arginine. In the HIB group, the pretreatment with L-NAME had no effect on increases in RL. These findings suggest that endogenous nitric oxide may play an important role in the modulation of allergen-, but not hyperventilation-induced bronchoconstriction in guinea-pigs.

Airway Resistance↗
PubMed1998

[Cough variant asthma among patients with chronic persistent cough and its clinical outcome].

Thirty-nine patients with chronic persistent cough continuing more than eight weeks were examined regarding to their airway responsiveness to methacholine challenge using the Astograph (TCK-6100H, Chest Corp. Japan). Of these, twenty-three individuals (59%) had airway hyperresponsiveness, leading to diagnose as having cough variant asthma (CVA). Patients with CVA had a higher percentage of eosinophils in peripheral blood and a lower forced expiratory volume in one second than those in non-CVA group. Furthermore, four patients (17%) developed the classic signs and symptoms of asthma, whereas 7 cases (30%) resolved their cough without further treatment and 12 cases (52%) continued to have CVA. These data suggested that a significant proportion of patients with chronic persistent cough had CVA and some of them may develop to classic wheezing asthma.

Asthma↗
PubMed1998

[Sarcoidosis presenting as a diffuse micronodular shadow on a chest radiograph].

A 36-year-old man was admitted to our hospital with chest-radiographic findings of diffuse ground-glass shadows in both lungs. A chest CT scan revealed disseminated micronodules with mediastinal lymphadenopathy. Histological examination of a transbronchial lung-biopsy specimen showed non-caseous epithelioid cell granulomata. Marked lymphocytosis and an abnormally high CD 4/CD 8 ratio was found in bronchoalveolar lavage fluid. These findings suggested a diagnosis of sarcoidosis despite the atypical radiographic findings.

Adult↗
PubMed1998

[Long-term effects of bicycle-ergometry training on exercise endurance and dyspnea in patients with chronic pulmonary emphysema].

Exercise reconditioning has long been considered an essential component of the pulmonary rehabilitation regime. To investigate the long-term effects of exercise training on exercise endurance and dyspnea in patients with chronic pulmonary emphysema (CPE), we developed a supervised exercise program using bicycle ergometers. Nineteen patients (mean age: 67) with moderate to severe airflow limitation (average FEV1/FVC, 39.8%) were enrolled in a predominantly outpatient rehabilitation program. After their lactate thresholds were measured by an incremental symptom-limited maximum test, patients engaged in exercise training 15 to 30 minutes per day in an arbitrary frequency and at a work rate at or below their lactate threshold (average: 20.1 w). No significant improvements were observed in resting pulmonary function, blood gas, nutrition, or systemic muscle volume. After long-term exercise training (average period: 33 months; average frequency: 6.5 times per month, individually), the patients demonstrated significantly improved exercise endurance and relief of their dyspnea during exercise. These findings provide a physiologic rationale for long-term exercise training by patients with CPE.

Aged↗
PubMed1997

Twenty-three-year follow-up study of rubella antibodies after immunization in a closed population, and serological response to revaccination.

Twenty-six institutionalized children immunized with a Japanese rubella vaccine, Matsuba strain, have been observed for 23 years and the persistence of vaccine-induced rubella immunity documented. All vaccinees were shown to have seroconverted to rubella virus in a haemagglutination inhibition (HI) test, and the geometric mean titre (GMT) of rubella HI antibody rose to 2 5-8 months after vaccination (Ueda et al., Acta Paediatrica Japonica, Overseas Edition 1978, 20, 8-14). The GMT then declined gradually to 2 23 years after inoculation, except in four cases (15.4%) which had reverted to negative. However, three of the four maintained a rubella HI antibody titre of 1:4. Twelve of the 26 vaccinees were revaccinated 24 years after primary vaccination, and all ten cases having initial titres of < or = 1:16 demonstrated secondary responses. Rubella immunity induced by vaccination had persisted, so routine booster immunization did not seem necessary. However, a second immunization programme should be considered to achieve high antibody-positive rates and to protect against primary vaccine failure.

Adolescent↗
PubMed1997

[The combination of amoxicillin-clavulanic acid and ofloxacin in the treatment of multidrug-resistant Mycobacterium tuberculosis].

A 67-year-old [correction of 53] man with multidrug resistant tuberculosis (MDR-TB) had been persistently positive for acid-fast bacilli (AFB) both on sputum smear and also on culture with the Ogawa egg medium for 30 years since 1951. The case had been treated previously with isoniazid, rifampin, streptomycin, ethambutol, kanamycin, ethionamide, paraaminosalicylate and cycloserine; however, M. tuberculosis strains isolated from this patient acquired a high resistance to all of these agents. Then, a new regimen of chemotherapy, INH combined with ofloxacin (OFLX) and amoxicillin-clavulanic acid (AMPC/ CVA), was applied to the case. He was successfully treated with this regimen, and a marked decrease in the amount of AFB on smear as well as on culture was observed during the course of chemotherapy. No adverse effects were seen meanwhile. These data suggest that it is worth while to try a regimen containing AMPC/CVA and OFLX in the treatment of MDR-TB.

Aged↗
PubMed1997

[Relationship between PEF and SpO2 on acute asthma attack in children].

We evaluated the relationship between PEF and SpO2 on 126 acute asthma attacks of 52 asthmatic children (25 males, 27 females, age 6-17 yrs-old) whose PEF and SpO2 being measured either before or after inhalation of beta-agonist at out-patient clinic. In the whole age group over 6 yrs-old, values of %PEF were proportional to individual SpO2 (n = 76, R = 0.472, p < 0.001). However, the relationship between %PEF and SpO2 in the present study was different from that of the guideline proposed by WHO (Global Initiative for asthma, GINA), showing that the value of SpO2 corresponding to %PEF was higher in the present study than in GINA. Regarding the difference in age group, significant relationship between %PEF and SpO2 was observed in both lower (6-9 yrs-old) and middle age group (10-12 yrs-old) but not in older age group (over 12 yrs-old). Also, there was a significant relationship between %PEF and SpO2 in cases whose pulmonary function during stable condition showed no-obstructive change (FEV1.0% > 80%), but not in cases with obstructive change. On the other hand, averaged values of %PEF, SpO2, heart rate (HR), respiratory rate (RR) before inhalation of beta-agonist at out-patient clinic in cases with or without admission were 32.3% vs 50.0%, 93.0%, vs 95.0%, 115 bpm vs 100 bpm, and 27/min vs 25/min respectively, those difference being statistically significant. Although measurement of SpO2 is thought to be a useful index for assessing severity of childhood asthma exacerbation, clinician should recognize that value of SpO2 could be greater than 91% even though % predicted PEF is less than 60%. Especially in older age group, obstructive change during stable condition may disturb the relation of SpO2 to %PEF. In such cases, not only SpO2 but also PEF, which is objective index of airway obstruction, should be taken into account for assessing severity of exacerbation.

Acute Disease↗
PubMed1996

Role of tachykinins in bronchoconstriction induced by intravenous administration of bradykinin in guinea-pigs.

To elucidate the role of tachykinins in bronchoconstriction induced by intravenous administration of bradykinin (Bk), we studied the effects of FK224, a neurokinin-1 (NK1) and neurokinin-2 (NK2) receptor antagonist, on the bronchoconstriction induced by intravenous (i.v.) administration of Bk (5-100 micrograms.kg-1) in guinea-pigs. Total pulmonary resistance -(RL) was measured using a pressure-volume sensitive body plethysmograph in anaesthetized artificially ventilated guinea-pigs pretreated with atropine (1 mg.kg-1) and propranolol (1 mg.kg-1). In the control group, i.v. administration of Bk produced a dose-dependent increase in RL. In animals pretreated with FK224, bronchoconstriction induced by higher doses of Bk (10, 50 and 100 micrograms.kg-1) was significantly reduced, whilst the bronchoconstriction caused by lower doses of Bk (5 and 7.5 micrograms.kg-1) was not. Pretreatment with a combination of FK224 and indomethacin markedly inhibited the bronchoconstriction induced by each dose of Bk compared with the groups pretreated with FK224 alone. Although pretreatment with indomethacin alone significantly reduced RL at a high dose of Bk (50 micrograms.kg-1), the reduction was significantly lower than that produced by a combination of FK224 and indomethacin. These results suggest that intravenous administration of a high dose of bradykinin causes bronchoconstriction both by cyclo-oxygenase products and by release of tachykinins.

Animals↗
PubMed1996

Change in osmolarity of disodium cromoglycate solution and protection against exercise-induced bronchospasm in children with asthma.

It has been suggested that osmolarity and/or nebulizer output may affect the protective effects of disodium cromoglycate (DSCG) in asthma. The aim of this study was to evaluate the influence of osmolarity of the DSCG solution on exercise-induced bronchospasm (EIB) in children with bronchial asthma. A jet nebulizer was used for DSCG inhalation in Study 1 and an ultrasonic nebulizer in Study 2. Thirteen asthmatic children (7 males and 6 females, aged 6-14 yrs) were enrolled in Study 1, and nine asthmatic children (5 males and 4 females, aged 9-13 yrs) in Study 2. After pretreatment with saline (control), hypotonic DSCG or isotonic DSCG, children underwent exercise challenge with a cycle ergometer. The percentage fall in forced expiratory volume in one second (FEV1) was measured at 5 and 15 min postexercise. The data were compared by analysis of variance (ANOVA). Both in Study 1 and Study 2, there were no significant differences in minute ventilation volume or maximum heart rate during exercise between the different treatment groups. Both hypotonic and isotonic DSCG significantly reduced the maximum percentage fall in FEV1. There were no significant differences in protective effects between hypotonic and isotonic DSCG in either study. We conclude that the efficacy of hypotonic and isotonic disodium cromoglycate solutions is similar for protection against exercise-induced bronchospasm. Hypotonic disodium cromoglycate seems to be clinically effective for prevention of exercise-induced bronchospasm and treatment of asthmatic children.

Adolescent↗
PubMed1996

[Diffuse tracheobronchial amyloidosis with airflow limitation and repeated pneumonias].

A 67-year-old man was first admitted to our hospital complaining of a productive cough, and repeated episodes of pneumonia in different sites. Physical examination revealed expiratory wheezing and airflow limitation wlas documented with lung function tests. A chest X-ray film showed patchy pneumonic infiltrates. Chest computed tomography revealed a marked thickening of the tracheal and bronchial wall with linear calcification. Fiberoptic bronchoscopy revealed a diffuse infiltrative process in the tracheobronchial tree, which uniformly reduced the bronchial lumen. Bronchial biopsy specimens showed amyloid deposits with focal calcification, which was confirmed by Congo red and Dylon staining. Extensive examinations including rectal biopsy were negatie for systemic amyloidosis. We suggest that diffuse tracheobronchial amyloidosis should be included in the differential diagnosis of repeated pulmonary infections with airflow obstruction.

Aged↗
PubMed1996

[Three cases of tuberculous mediastinal lymphadenitis].

Mediastinal lymph node involvement is uncommon in intrathoracic tuberculosis. We report three cases of this disease, each of which had a different clinical course. Chest CT scans showed preferential involvement of right paratracheal nodes, central areas of relatively low density with peripheral rim enhancement after injection of contrast medium. Specimens obtained by mediastinoscopy and fiberoptic bronchoscopy revealed acid-fast bacilli in all cases. In view of its relative frequency, tuberculous mediastinal lymphadenitis in adults must be distinguished from other causes of mediastinal masses.

Adult↗
PubMed1995

[Air pollution (NO2, suspended particulate material) and the number of acute hospitalization of patients with asthmatic attack].

There were many reports about the relationship between the air pollution and the incidence of asthma. In Japan some of the concentrations of air pollutants, for example, SO2, CO, have been reduced in these ten-twenty years. However the concentrations of suspended particulate material (SPM) and NO2 have not been reduced, and the incidence of bronchial asthma have been increasing gradually. The relationship between the concentrations of NO2, SPM and the number of patients admitted to our hospital because of asthmatic attack was studied. The concentration of each air pollutant was measured at the air quality monitoring stations in Minami-ku and Jonan-ku Fukuoka, Japan. Between Jan, 1988 and Dec. 1991, 3661 patients with asthmatic attacks were admitted to our hospital. The relationship between the monthly averaged one-hour mean value for a day, and monthly max. of one-hour mean. value for a day, and one-day max. value for a month of NO2 and SPM and the numbers of asthmatic attack patients admitted was evaluated. There was a statistically significant relationship between concentrations of NO2 and SPM levels and the numbers of asthmatic patients admitted aged 6 or less. However, there was no such a relationship when the patients were aged between 7 and 20. These results suggested that the airways of asthmatic patients in the age of 6 or less might be more sensitive to NO2 and SPM than that of those patients in the age of 7 to 20.

Adolescent↗
PubMed1993

Immunization of institutionalized asthmatic children and patients with psychomotor retardation using live attenuated cold-adapted reassortment influenza A H1N1, H3N2 and B vaccines.

Live attenuated cold-adapted reassortant (CR) influenza virus vaccines were evaluated in institutionalized asthmatic children and severe psychomotor-retarded (SPR) patients. Almost all the vaccinees were seropositive to the vaccine strains before immunization. Trivalent CR vaccine (containing A H1N1 (CR-125), A H3N2 (CR-149) and B (CRB-117)), bivalent CR vaccine (CR-125 and CR-149) and monovalent CRB-117 were inoculated to 19 asthmatic children and 36 and 16 SPR patients, respectively. Overall 49, 22, and 11% of vaccinees were infected by A H1N1, A H3N2 or B vaccine viruses, respectively, as indicated by significant haemagglutination-inhibition (HI) antibody titre rises 4 weeks after inoculation. No severe adverse reactions associated with CR vaccination were observed in the handicapped patients. A nosocomial outbreak of influenza A H1N1 occurred in the ward with asthmatic children, but none of the 19 CR-trivalent vaccinees became infected. However, five of 20 non-vaccinees in the same ward, and ten of 30 vaccinees in another ward that received inactivated split vaccine became infected. The CR vaccines demonstrated significant protective effects against natural exposure to the A H1N1 virus, and were well tolerated and safe when given to patients with bronchial asthma and severe psychomotor retardation.

Adolescent↗
PubMed1993

Trivalent cold recombinant influenza live vaccine in institutionalized children with bronchial asthma and patients with psychomotor retardation.

Twenty asthmatic children and 48 patients with severe psychomotor retardation were inoculated intranasally with trivalent cold-adapted recombinant (CR) influenza vaccine containing CR-125 (H1N1), CR-159 (H3N2) and CRB-117 (B). The vaccinees were mostly seropositive. Severe adverse reactions or asthmatic attacks were not observed, but 7 (15%) of 48 vaccinees with severe psychomotor retardation developed mild to moderate fever. Significant antibody responses in hemagglutination-inhibition tests were demonstrated in 33 (49%) vaccinees to CR-125, 20 (29%) to CR-159 and 8 (12%) to CRB-117. Two nosocomial outbreaks of influenza were observed in the subsequent winter. During an outbreak with H3N2 in one ward of severe psychomotor retardation patients, 2 (11%) of 18 vaccinees became infected compared with 10 (48%) of 21 placebo controls in the same ward (P < 0.05). In the other outbreak, with influenza B virus, 2 (14%) of 14 vaccinees and 13 (52%) of 25 controls in the ward for asthmatic children were infected (P < 0.05). The results indicate that trivalent CR vaccine is safe and effective against nosocomial outbreaks of influenza.

Adolescent↗
PubMed1993

[Characteristics of bronchial asthma in the elderly].

To characterize asthma in the elderly, we compared asthma in patients aged over 70 without chronic obstructive pulmonary disease with that in patients in their twenties. In the elderly, 65.5% of the patients had developed asthma after they were fifty years old. The mean duration from onset of asthma was 21.4 years. Of cases in the elderly, 42.1% were severe, and 93.0% were chronic type. IgE was significantly lower in the elderly than in those in their twenties. Among the patients in their twenties, the severe cases had early onset and long duration. In the elderly, however, there were no correlations between severity and age at onset or duration. Severe cases in their twenties had more obstructive ventilatory dysfunction in the stable state than the mild cases. In the elderly, however, the mild cases had the same level of obstructive ventilatory dysfunction as the severe cases. The elderly patients who had more than twenty years duration had lower V50 and V25 than those who had a less than twenty-year history. Small airway obstruction was observed in long-standing cases. As asthma in the elderly causes obstructive ventilatory dysfunction in the stable state, elderly patients might easily develop respiratory failure, even during mild attacks.

Adult↗
PubMed1993

[A study on the prevalence of bronchial asthma in school children in western districts of Japan--comparison between the studies in 1982 and in 1992 with the same methods and same districts. The Study Group of the Prevalence of Bronchial Asthma, the West Japan Study Group of Bronchial Asthma].

UNLABELLED: The prevalence of bronchial asthma in school children was examined both in 1982 (55,388 children) and in 1992 (45,674 children) in 11 western districts of Japan. Both studies were conducted with the same Japanese version of a modified ATS-DLD children's questionnaire in the same districts. RESULTS: 1) The study in 1992 established a prevalence rate of 5.6% in males and 3.5% in females with an overall average of 4.6%, which was 1.4 times higher than that of 10 years ago. The higher prevalence was observed in every grade of school children and in all districts. 2) The study in 1992 showed no differences based on the grades of the school children were in. The prevalence rate in males was 1.6 times higher than that in females with fewer regional differences than in the 1982 study. 3) Higher prevalence rates were found in those who had histories of respiratory diseases during their infancy, family histories of allergic disease or who lived in urban areas. The prevalence rate was 13.3% in children living in urban areas with family histories of bronchial asthma. 4) The prevalence rate of wheezing was 5.2%, which was 1.3 times higher than that of 10 years ago. The rate had increased in every district, but it decreased as the children moved into higher grades.

Age Factors↗