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Biomedical subjects

S Suetsugu

Publications and source records attributed to S Suetsugu.

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

Identification of the major allergens in wheat flour responsible for baker's asthma.

Baker's asthma, a typical occupational allergic disease, is a serious problem in the food industries. In this study, purification and identification of major allergens recognized by IgEs in sera of allergic patients were performed. Major immunoreactive proteins were purified from the albumin fraction by gel filtration on a Toyopearl HW-50 column followed by reverse-phase HPLC. The N-terminal amino acid sequences and molecular masses measured by MS indicated that the major immunoreactive proteins are members of the alpha-amylase inhibitor family, 0.19 and 0.28. Significant leukotriene release by each purified protein was observed in cell-associated stimulation tests, suggesting in vivo activity of these antigens. Carbohydrate analyses of major allergens indicated that they are monoglycosylated but not N-glycosylated in spite of the presence of a potential N-glycosylation site. Recombinant 0.19 expressed in Escherichia coli showed the same reactivity with IgE as native wheat 0.19 in Western blotting and ELISA using methyl vinyl ether maleic anhydride co-polymer as an immobilizing reagent, suggesting that the allergenic epitopes are located in the peptide portions.

Allergens↗
PubMed1998

[Trends of asthma death among adults in Japan 1992-1994. Analysis of 313 cases reported questionnaires sent to hospitals with more than 100 beds].

The Japan Asthma Death Investigation Committee sent questionnaires to hospitals with more than 100 beds, and studied the clinical characteristics of 313 reported cases who died of asthma between 1992 and 1994. Forty percent of them were at the age between 60 and 79. Deaths of young adults in the twenties tended to increase. One third of the deaths was due to asphyxia. More than half of the patients were classified infectious or mixed type of asthma and 43.9% were graded as severe asthma. The main causes of the fatal asthma attacks were respiratory infections, fatigue and stress. Insufficient education, low compliance, delay in treatment with corticosteroids and other drugs, delay in emergency treatment, past histories of life-threatening attacks and hospitalization due to severe attacks were suggested to be risk factors of adult asthma death. Pulmonary emphysema showed relatively high frequency as a complication.

Adult↗
PubMed1997

[Actual status of the management of tuberculosis patients in a university hospital without isolation wards for infectious diseases].

We retrospectively evaluated clinical findings and the actual status of management of 69 tuberculosis patients admitted to the Fujita Health University Hospital, a hospital without isolation wards for infectious diseases, between 1991 and 1994. The largest age group was 60s (27.5%) followed by 70s (24.6%), 80s (15.9%) and 50s (13.0%). Eight patients (11.6%) were in the 20s. Forty-nine patients were smear-positive and 22 patients were smear-negative and culture-positive. Fourteen patients (20.3%) had a past history of pulmonary tuberculosis. Twelve patients (17.4%) also had diabetes mellitus, ten patients (14.5%) had cancer, ten patients (14.5%) gastric ulcer and five patients (7.2%) renal failure. Positive skin reaction to PPD was not found in eleven patients (15.9%) and seven of these patients were quite elderly (over 70 years old). Twenty-five cases (36.2%) were classified as type II (cavitary) and 29 cases (42.0%) as type III (non-cavitary) according to the GAKKAI classification of findings on chest X-ray films for pulmonary tuberculosis. Twenty-four patients (34.8%) were not diagnosed as tuberculosis on admission by physicians in charge. Physicians in charge tended not to suspect smear-negative patients of tuberculosis. Most of the patients with cavities on their chest X-ray films were strongly suspected of tuberculosis on admission, but in some of them, tuberculosis was not considered at all. Smear-positive patients with strongly suspected tuberculosis were diagnosed with the disease within three hospital days, while it took about three weeks in patients who were not considered as tuberculosis on admission to be diagnosed as tuberculosis. In the case of smear-negative patients, it took about one month and two months respectively to diagnose the case as tuberculosis. About half (51.1%) of the smear-positive patients were admitted and treated in single-bed rooms while 44.7% were attended in multiple-bed rooms for 11 days before they were transfered to single-bed rooms. When acid-fast bacilli were detected, 57.4% of the smear-positive patients were transfered to hospitals with isolation wards for infectious diseases, while the remaining smear-positive patients were treated in single-bed rooms at the university hospital. About one-third (31.7%) of the smear-negative patients had already left the hospital when specimens were found to be culture positive for tubercle bacilli. In conclusion, it is utmost important for physicians to suspect tuberculosis for the early diagnosis of the disease.

Adult↗
PubMed1996

[Trends in asthma-related death among adults in Japan, 1986-1991--analysis of responses to questionnaires sent to hospitals with at least 200 beds].

The death rate among patients with asthma in Japan has been reported by Japan's Ministry of Health and Welfare to approximately 5/100,000 population. Over the past 15 years, this rate has remained relatively constant, but it is higher than that in western countries. To clarify recent trends in adult asthma mortality, the Japan Asthma Death Investigation Committee studied the clinical characteristics of 649 patients who died of asthma between 1986 and 1991. The annual number of deaths decreased slightly: from 145 in 1986 to 89 in 1991. There was a large difference between sexes: the male:female ratio was 3:2. Most patients ranged in age from 50 to 70 years old. It is noteworthy that in one third of the patients death was caused by asphyxic-type asthma, while status asthmaticus was the cause in only 23.7%. The number of patients with mild or moderate asthma was slightly increased, although patients with severe asthma accounted for at least 70% of all deaths. The main causes of fatal asthma attacks were airway infections, fatigue, and stress. Other responses on the questionnaires indicated the following areas of concern: deficiencies in patient education, delays in treatment with corticosteroids and other antiasthma drugs, and delays in provision of emergency treatment.

Adolescent↗
PubMed1996

[Sarcomatous malignant mesothelioma diagnosed after death].

A 77-year-old man with diabetes mellitus who was being treated as an outpatient had abnormal shadow in the right lower lobe on a chest roentgenogram in June 1993. In July 1994, a productive cough developed, and subsequent dyspnea obliged him to enter our hospital. Retention of pleural fluid led us to suspect tuberculosis pleurisy and to perform a pleural biopsy and a thoracentesis to remove pleural fluid but no final diagnosis was reached. About 14 months later he died of dyspnea with a rapidly growing tumor. An autopsy disclosed a giant tumor that occupied the right pleural cavity, excluding the lung. The tumor was well-defined between the lung and had infiltrated into the mediastinum. The histopathological diagnosis was primary malignant mesothelioma, sarcomatous type, of the visceral pleura.

Aged↗
PubMed1996

[A patient with lung metastasis of medulloblastoma].

A 15-year-old boy had metastasis to the spinal cord and then to the lung after an operation to remove a primary medulloblastoma. A medulloblastoma developed at the age of 10 years. The tumor was completely resected and the brain and spinal cord were irradiated. At the age of 13 years, metastasis to the sacral spinal cord developed and was treated with radiotherapy and intramedullary injection of methotrexate. At the age of 15 years, metastasis to the lung developed and was treated with chemotherapy (CBDCA, VP-16) followed by radiotherapy. Three months after the end of that therapy, the disease recurred but another course of radiotherapy and chemotherapy (VCR) was successful. Chemotherapy and radiotherapy were effective against metastatic lesions of medulloblastoma. With improvement in the survival rate among patients with medulloblastoma, we can expect incidence of extraneural metastases to increase. In addition to recurrence of the primary lesion and intramedullary dissemination, these metastatic lesions also require attention.

Adolescent↗
PubMed1995

[Effect of supplementation with eicosapentaenoic acid ethyl ester, MND-21, on generation of leukotrienes by calcium ionophore-activated leukocytes in bronchial asthma].

The effects of dietary supplementation with highly purified eicosapentaenoic acid ethyl ester (EPA-E) (MND-21) on asthma symptoms, fatty acids in serum, and generation of leukotriene (LT) C4, LTC5, LTB4 and LTB5 by leukocytes stimulated with calcium ionophore A23187 were studied in 10 patients with bronchial asthma. The patients received nine capsules of MND-21 (2.7 g EPA-E) each day for 12 weeks. Leukocytes obtained from 39 patients with asthma who did not receive EPA-E were used as the control. Fatty acid composition was evaluated by gas chromatography and LT generation was measured by reverse-phase high performance liquid chromatography. EPA-E increased EPA content more than threefold, without changing the quantities of arachidonic acid in serum lipids. Leukocytes obtained from patients given EPA-E for 4 weeks generated less LTC4 (53.5 +/- 23.3 ng/10(7) cells) and LTB4 (24.9 +/- 12.4 ng/10(7) cells) than did those from control patients (142.4 +/- 91.6 ng/10(7) cells and 58.3 +/- 34.8 ng/10(7) cells, respectively). Although significant levels of LTC5 and LTB5 were present after 4 weeks of EPA-E (6.5 +/- 1.9 ng/10(7) cells and 4.6 +/- 2.7 ng/10(7) cells, respectively), generation of total LTC (LTC4 + LTC5) and total LTB (LTB4 + LTB5) were substantially suppressed. Symptoms had improved after two months of EPA-E, but the effect was temporary. We conclude that in patients with asthma, treatment with EPA-E may attenuate leukocyte function without distinctly changing the severity of asthma.

Aged↗
PubMed1995

[Treatment of obstructive sleep apnea syndrome with a mandibular positioning device and other nonsurgical modalities].

The therapeutic approach to a patient with obstructive sleep apnea syndrome (OSAS) must be individualized because of the heterogeneity in the pathogenesis of the disorder. Although nasal continuous positive airway pressure (CPAP) is effective no matter what the pathogenesis, risk factors for this disorder should be identified in each patient. Nasal CPAP will be discussed by others. Weight loss is one of the best nonsurgical treatments of OSAS and it should be strongly recommended to obese patients with the disorder, even though only a few achieve satisfactory weight reduction. Sleeping in the lateral position or upright may be effective in some patients with OSAS. Acetazolamide, medroxyprogesterone, or protriptyline may also have a role in some patients, although the efficacy must be weighed against the considerable side effects. The cross-sectional area of the oropharynx measured by computed tomography in patients with OSAS was significantly lower than that in control subjects. Lateral cephalograms revealed a retarded mandible in many patients. A dental device designed to advance the mandible 2 to 7 mm and to eliminate the airway obstruction at the base of tongue was used in 20 consecutive patients (17 men and 3 women, average age 53.8 years) to treat the obstructive sleep apnea. The body mass index of the patients was 27.6 +/- 4.2 kg/m2 (mean +/- SD). The device moved the mandible forward (p = 0.038) and increased the airway space in the lower part of the oropharynx (p = 0.031) as assessed with lateral cephalograms. After nightly use of the device for 24 to 211 days, overnight polysomnography was performed for two nights: without the device for the first night and with it for the second night. The apnea index was reduced from an average of 30.7 to 18.5 events/hour (60.4% of the pretreatment value, p = 0.004). The number of desaturations (more than 5% decrease from the base line SaO2) decreased and the lowest level of SaO2 increased: from 26.5 to 14.4 events/hour (p = 0.009) and from 63.6 to 70.1% (p = 0.005), respectively. Not every patient improved sufficiently. Eleven of 20 patients were classified as good responders, because of a reduction in apnea index of at least 50% of the pretreatment value, and the remaining nine patients were classified as poor responders. Use of the device reduced the severity ratings of snoring and excessive daytime sleepiness not only in the good responders but also in the poor responders. No serious complications were observed. The mandibular positioning device is an effective treatment for some patients with OSAS. The effectiveness of the device should be predicted from polysomnographic and cephalometric data, and from CT measurements of the upper airway and other characteristics of the patients.

Adult↗
PubMed1995

[Aspirin-induced asthma as an important type of bronchial asthma].

Aspirin-induced asthma (AIA) should be recognized as an important types of bronchial asthma for the following reasons. 1) The pathogenesis of AIA is specific. Inhibition of cyclooxygenase a (key enzyme for the production of prostanoids from arachidonic acid) by non-steroidal antiinflammatory drugs (NSAID) is an important trigger of asthma attacks. 2) The frequency of AIA is not low. It is estimated to be 9.8% in adults with chronic asthma. 3) Some clinical features of AIA are characteristic. Naso-sinus complications, such as rhinitis, chronic sinusitis, nasal polyposis, and anosmia, are commonly found in patients with AIA. 4) Glucocorticoids with succinate ester, which are commonly used to treat asthma attacks, induce asthma symptoms or provoke severe asthma attacks in 70% to 80% of patients with AIA. 5) Some patients with AIA are hypersensitive to some agents in addition to NSAID, e.g., tartrazine (15.1%), sodium benzoate (14.3%), and parabens (12.0%). 6) Patients with latent AIA are in danger of having fatal or near-fatal asthma attacks if they take NSAID. We should educate patients to eliminate the risk posed by NSAID and other agents that may induce asthma attacks, and should enlighten doctors and pharmacists, who are not specialists in allergy or respiratory disease, about AIA. 7) Asthma in these patients will be less severe if their condition is correctly diagnosed and they receive appropriate medical treatment.

Adult↗
PubMed1995

[Long-term mechanical ventilation in Japan, with special reference to home mechanical ventilation].

Some patients in respiratory care units are difficult to wean from mechanical ventilation, and may be candidates for home mechanical ventilation (HMV). HMV may improve these patients' quality of life and decrease medical expenses. Since 1987, six nationwide questionnaire surveys were done to study the status of long-term mechanical ventilation (defined as mechanical ventilation for at least 90 days) and HMV in Japan. In 1994, an additional questionnaire regarding opinions about HMV was sent to physicians, patients undergoing HMV, their families, and people in companies that deal with home ventilators. From 1987 to 1994, the number of patients who had been mechanically ventilated for at least 90 days increased from 368 to 956. According to the 1994 survey, 565 of those patients were not candidates for HMV, 235 of them were candidates for HMV but could not be shifted (reasons are given below), and 156 were shifted to HMV. The reasons that some patients who were considered to be candidates for HMV could not be shifted included a lack of caregivers at home (58.1%), the cost of a ventilator (44.5%), lack of proper health insurance (39.8%), problems with ventilator maintenance and delays in obtaining repairs (37.7%), and inadequacies in the system for providing medical care in the home (33.1%). Despite the problems entailed in shifting to HMV, many patients undergoing HMV (77.8%) and members of their families (83.3%) expressed a desire to continue this therapy. Many physicians (94.0%) said they believed that HMV improves the quality of life of patients with chronic respiratory failure. Some companies intend to begin renting ventilators for HMV. The use and development of HMV in Japan would be promoted if the national health insurance covered the costs of this therapy.

Chronic Disease↗
PubMed1994

[A case of idiopathic pulmonary hemosiderosis of adult onset].

A 69-year-old woman suddenly suffered massive hemoptysis and was admitted to the hospital. The test of anti-glomerular basement membrane antibodies was negative. Chest radiograph showed diffuse infiltrative shadows similar to those of lung edema in the both lung fields. The patient's condition worsened gradually during the next 3 weeks, with repeated massive hemoptysis. Steroid pulse therapy had limited effects on the progressive respiratory failure, and the patient died. Autopsy showed alveolar hemorrhage and macrophages containing haemosiderin. Immunofluoresence microscopy showed no deposits of immunoglobulin in the kidney. Idiopathic pulmonary hemosiderosis of adult onset with acute respiratory failure is rare in Japan.

Age of Onset↗
PubMed1994

[Inhibitory effects of exogenous eicosapentaenoic acid on generation of leukotriene C4 and leukotriene B4 by human leukocytes stimulated with calcium ionophore].

Effects of exogenous eicosapentaenoic acid (EPA) and arachiodonic acid (AA) on generation of leukotriences C4, C5, B4 and B5 were assessed in human leukocytes stimulated with calcium ionophore A23187. Human leukocytes were obtained from healthy volunteers using the dextran sedimentation of peripheral blood and stimulated with 1 microgram/ml calcium ionophore A23187 in the absence or presence of EPA (1-30 micrograms/ml) and/or AA (1-30 micrograms/ml). Leukotriences from leukocytes samples were separated and quantitated by reverse phase high performance liquid chromatography. Mean generation of LTC4 in the absence of fatty acid was 78.2 +/- 25.4 ng/10(7) cells (Mean +/- SD, n = 6). In the presence of EPA, the generation of LTC4 increased a little but significant (p < 0.05) to 85.3 +/- 24.2 ng/10(7) cells at low dose (1 microgram/ml) of EPA, and then decreased to 39.7 +/- 23.4 ng/10(7) cells at high dose (30 micrograms/ml) of EPA (p < 0.05). LTB4 generation was 213.2 +/- 38.0 ng/10(7) cells without fatty acids, and decreased to 174.0 +/- 48.0 ng/10(7) cells at 30 micrograms/ml EPA (p < 0.05). LTC5 and LTB5 production were detectable at 1 microgram/ml EPA and reached to maximum at 10 micrograms/ml EPA with 21.9 +/- 15.6 ng/10(7) cells and 21.8 +/- 7.1 ng/10(7) cells, respectively. Total LTC (LTC4 + LTC5) generation with high dose of EPA (57.2 +/- 28.0 ng/10(7) cells) decreased significantly compared with that in the absence of fatty acids (78.2 +/- 25.4 ng/10(7) cells). At 10 micrograms/ml of AA, both LTC4 and LTB4 generation significantly increased to 114.2 +/- 5.3% and 129.0 +/- 9.5% of control, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Prevalence of risk factors for sleep apnea in Japan: a preliminary report.

A final goal of the present study is to estimate the prevalence of sleep apnea in the general population of Japan. As the first step, the detailed questionnaires were sent out to the presumably healthy subjects who underwent regular medical checkups at four hospitals in different cities of Japan. The questionnaires included queries about difficulties in initiating and maintaining sleep, habitual snoring, parasomniac symptoms, excess daytime sleepiness, any present illness, consumptions of cigarettes and alcohol and so on. A total of 3,243 replies were obtained so far (2,029 male and 1,214 female; mean age = 50 years). The results were consistent among the four hospitals, and the prevalences of risk factors were as follows: habitual snoring was reported by 12.8-16.0%, excess daytime sleepiness by 8.1-9.4% and frequent awakenings by 7.3-12.6%, respectively. The prevalence of systemic hypertension ranged from 5.3% to 12.9%. Polysomnographic studies are being performed on the possible cases of sleep apnea who were sorted out by the questionnaires.

Adult↗
PubMed1993

[Sleep-disordered breathing in Japan: an overview].

Questionnaires were answered by 3,243 presumably healthy subjects who underwent regular medical checkups in four cities. The prevalences of risk factors for sleep-disordered breathing (SDB) were as follows; habitual snoring was reported by 13-16%, excessive daytime sleepiness by 8-9%, insomnia by 7-13% and systemic hypertension by 5-13%. Polysomnographic studies performed on some possible SDB cases who were selected by the presence of risk factors estimated that the average prevalence of SDB in the present population would be in the range of 1.14-1.94%. Secondly, questionnaires were sent to the main hospitals and institutes involved in the management of patients with SDB, asking about diagnostic criteria, number of SDB patients, management, effectiveness of treatment, etc. The total number of patients registered at those hospitals was 2,751 in 1991. Of the 132 patients who were followed for more than six months, the efficacies of body weight loss, medications, nasal CPAP and UPPP were compared. Based on the analyses of the 279 patients examined some tentative vriteria for diagnosis and for treatment are proposed.

Female↗
PubMed1993

Effects of caffeine on diaphragmatic contractility and fatigue.

The effects of caffeine on diaphragmatic contractility and fatigue was investigated in 21 dogs. Diaphragmatic contractility was assessed by measuring transdiaphragmatic pressure (Pdi) during supermaximal stimulation of the phrenic nerves at different frequencies, and Pdi was measured with a pair of balloons. In protocol 1, the effect of caffeine on contractility of non-fatigued diaphragm was studied in 7 dogs. Caffeine infusion increased Pdi significantly at all frequencies of stimulation. In protocol 2, diaphragmatic fatigue was induced by electrophrenic stimulation (30 Hz, duty cycle 1.0, 30 minutes). The recovery profile after fatigue run was observed in 5 dogs. In another group of 9 dogs, caffeine was infused during stable fatigue period and Pdi increased significantly at all frequencies of stimulation after caffeine infusion. The increase in Pdi was not due to changes in cardiac output or lung mechanics (Cdyn and Rtot), neither of which changed significantly after caffeine infusion. We conclude that caffeine improves muscle contractility both in non-fatigued and fatigued diaphragm in dogs.

Animals↗
PubMed1993

Vertebral bone metastasis of small cell carcinoma of lung in a diabetic patient, initially diagnosed as pyogenic vertebral osteomyelitis.

A 40-year-old man with a 3-year history of uncontrolled NIDDM, 2-pack/month cigarette smoking habit and alcohol abuse, was admitted to our university hospital. He presented with severe back pain, persistent cough and fever. A left lung infiltrate was noted on chest X-ray film. Staphylococcus aureus was isolated from arterial blood. Thoracic bone destruction with pleural mass lesion confirmed by computed tomography (CT) and magnetic resonance image (MRI). These findings mislead our diagnosis to pyogenic osteomyelitis associated with NIDDM. An absence of marked clinical and roentgenological improvement after antibiotic therapy and strict glycemic control with insulin was noted. This suggested to us the need for needle biopsy of the osteolytic and mass lesions confirmed by imaging techniques. This resulted in making the diagnosis of metastasis of small cell carcinoma from the left lung. The correlation between NIDDM and pulmonary small cell carcinoma possibly induced by genetic abnormality remains to be resolved. By making the most of imaging techniques and needle biopsy, the possibility of pulmonary small cell carcinoma complicating NIDDM can be appropriately evaluated.

Adult↗
PubMed1992

[Prophylactic effect of ulinastatin on cisplatin-induced renal disorders in lung cancer patients].

In order to determine whether ulinastatin (US) can prevent renal dysfunction due to cisplatin (CDDP) or not, we comparatively studied serum BUN, serum creatinine (Cr), creatinine clearance (Ccr), urine gamma-glutamyl transpeptidase (gamma-GTP) excretion, urine N-acetyl-beta-D-glucosaminidase (NAG) excretion, fractional excretion of Na (FENa) and urine beta 2-microglobulin excretion between one group of 10 patients receiving single treatment with CDDP and another group of 10 patients receiving combination treatment with CDDP+US, in 20 subjects with primary lung cancer. In the US combination treatment group, urine gamma-GTP excretion, urine NAG excretion, and FENa elevation were significantly inhibited. Urine beta 2-microglobulin excretion was inhibited. In summary, US was considered to have a preventive effect against renal toxicity due to CDDP.

Aged↗