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Biomedical subjects

S Umeki

Publications and source records attributed to S Umeki.

At least 91 records · Page 5Linked to original sources

Anticancer chemotherapy accelerates scalp hair loss with no androgenic involvement.

The involvement of plasma testosterone in patients associated with scalp hair loss accelerated by anticancer drugs including aclarubicin and cisplatin was investigated. Scalp hair loss observed was minor in 12 and severe in 2 out of 31 patients. In patients without significant hair loss, the combination of aclarubicin and cisplatin produced a significant decrease in the plasma testosterone concentration in male patients and a significant increase in female patients 3 days after the anticancer chemotherapy. Six days after the chemotherapy, however, these concentrations returned to pretreatment values. Similar changes were observed in patients with minor or severe scalp hair loss induced by these drugs. These results suggest that aclarubicin and/or cisplatin may accelerate scalp hair loss with no androgenic involvement.

Aclarubicin↗

Study on background factors associated with impaired glucose tolerance and/or diabetes mellitus.

In a cross-sectional health screening 636 persons with negative urine glucose, a 75-g-oral glucose tolerance test was performed. We report the clinical features of the subjects with impaired glucose tolerance or diabetes mellitus. In 96 subjects with impaired glucose tolerance, the frequencies of alcohol dependency, fatty liver, and of increased levels of serum uric acid, cholesterol, triglycerides, total serum protein and gamma-glutamyl transpeptidase were significantly higher than in normal subjects. In 37 subjects with diabetes mellitus, the frequencies of fatty liver, hypertension and of increased erythrocyte sedimentation rate, triglycerides and gamma-glutamyl transpeptidase were significantly higher than in normal subjects. In addition, significant increases in serum gamma-glutamyl transpeptidase, triglycerides, serum total cholesterol and body mass index, and a significant decrease in high density lipoprotein cholesterol were also observed in subjects with impaired glucose tolerance and diabetes mellitus. These results suggest that alcohol dependency, fatty liver, obesity and hyperlipidemia are important concomitants of impaired glucose tolerance.

Adult↗

[Primary macroglobulinemia with severe neutropenia, leading to a rapid development of septic shock].

A 88-year-old man was admitted because of the left chest pain due to herpes zoster for 1 week. Blood analyses and immunoelectrophoresis revealed anemia, severe neutropenia, rouleaux formation and IgM, lambda-type monoclonal gammopathy. The HE staining and peroxidase-anti-peroxidase staining of biopsy specimens of the cervical lymph node swelling appeared from the fifth hospital day, revealed an increase in atypical lymphocytes bearing IgM, lambda-type immunoglobulin. Then a diagnosis of primary macroglobulinemia was made. Although the patient's clinical findings transiently improved after chemotherapy with prednisolone and vindesine, he died of a septic shock which appeared after klebsiella pneumonia and sepsis. We reported an unusual case of primary macroglobulinemia with severe neutropenia, leading to a rapid development of septic shock after the chemotherapy.

Aged↗

[Investigation of two cases of a clinically unknown large cell carcinoma of the lung involved with severe stenosis of the bilateral main bronchi].

Reported are two rare cases of a clinically unknown large cell carcinoma of the lung, associated with severe stenosis of the bilateral main bronchi. Case 1: A 61-year-old man was admitted to our hospital because of chief complaints that included a cough, hemosputum, and dyspnea. Based on the bronchoscopic findings that revealed severe stenosis of the bilateral main bronchi and a specimen that was biopsied from tracheal spur, a diagnosis of large cell carcinoma of the lung was made. Although anticancer chemotherapy and irradiation therapy produced a slight improvement in the patient's symptoms, at the 10th hospital week the patient died of suffocation. Case 2: A 77-year woman was admitted to hospital with chief complaints that included a cough and hemosputum. A bronchoscopy revealed severe stenosis of the bilateral main bronchi. After the 4th hospital day the patient complained of increasing dyspnea. At the 9th hospital day the patient died of suffocation. An autopsy results revealed a large cell carcinoma (giant type) of the lung.

Aged↗

[M. kansasii lung infection occurring in a compromised host with idiopathic pulmonary fibrosis].

A 61-year-old man was admitted to our hospital because of persisting cough, sputum and shortness of breath for four months. Brushing specimens and BALF bronchoscopically obtained revealed acid-fast bacilli and TBLB showed pathological findings consistent with interstitial pneumonia. Based on these results, clinical symptoms, chest roentgenograms on admission and identification of M. kansasii, a diagnosis of M. kansasii lung infection occurred in idiopathic pulmonary fibrosis was made. The patient's symptoms consistent with M. kansasii lung infection and his sputum became negative 6 weeks after antituberculosis chemotherapy with INH, SM and RFP. Because of an increasing dyspnea due to pulmonary fibrosis, however, the patient received oxygen therapy. This case suggested an increasing tendency of compromised hosts associated with M. kansasii lung infection.

Humans↗

[Clinical investigation of pulmonary dirofilariasis with unusual abnormalities on chest roentgenograms].

The authors recently encountered three cases of pulmonary dirofilariasis with unusual abnormalities on chest roentgenograms. In case 1, with right upper and lower lobe masses and right pleural effusion, the right lower lobe mass and pleural effusion spontaneously disappeared one month after admission. In case 2, chest roentgenograms and chest CT scanning revealed a small mass with cavity formation. In case 3, with a right lower lobe mass and pleural effusion, steroid therapy resulted in disappearance of the mass and a remarkable reduction of pleural effusion. Human pulmonary dirofilariasis is a rare disease. In Japan, only 32, including our cases, have been reported in the literature of pulmonary dirofilariasis with unusual abnormalities on chest roentgenograms. The literature was reviewed.

Aged↗

[A case of chronic bronchitis with Pasteurella multocida possibly resulting from infection from a bird].

A 60-year-old woman was admitted to our division for further evaluation of fever and purulent sputa. In sputum cultures performed when the patient had complained of an increase in symptoms on three occasions during the previous 6 months, Pasteurella multicoida was usually detected. Based on the fact that the bacteria had been detected from the patient's sputa after feeding a macaw, but was not detected after treatment of the bird with OFLX, a diagnosis of respiratory tract infection by P. multocida was made. Clinical symptoms and laboratory data of the patient were markedly improved after treatment with cefaclor (750 mg/d). The bacteria in this case were sensitive toward many antibiotics. This case was considered to be the first case of bird-mediated Pasteurella infection.

Animals↗

[Two cases of primary racemose hemangioma of the bronchial artery].

Two cases of primary racemose hemangioma of the bronchial artery are reported. The first case was admitted because of massive hemoptysis after transbronchial biopsy in another hospital. Bronchoscopic examination revealed a polypoid tumor of the left B4 bronchus, which was resected and diagnosed as racemose hemangioma. The second case was admitted because of massive hemoptysis. Bronchoscopic examination revealed polypoid tumor in the left B3b bronchus, which was resected and diagnosed as racemose hemangioma.

Aged↗

[A case of Mycobacterium scrofulaceum lung infection occurring in old lung tuberculosis lesion].

A 68-year-old man was admitted because of a persistent productive cough of 6 weeks' duration and detection of acid-fast bacilli from sputum. Based on chest roentgenograms and isolation of Mycobacterium scrofulaceum from sputum, on admission, a diagnosis of Mycobacterium scrofulaceum lung infection was made. Although the organisms were resistant to 0.1 microgram/ml of INH, 2.5 micrograms/ml of EB and 10 micrograms/ml of RFP, sputum converted to negative by the use of INH (0.4 g/day), EB (0.5 g/day) and RFP (0.3 g/day) for 2 months. The incidence rate of nontuberculous lung mycobacteriosis seems to be increasing recently. This is partially considered to be due to an increase of various strains of nontuberculous mycobacteria in the environment. A striking advance of clinical medicine and changes in the constitution of human society and environment surrounding us produce an increase in the number of compromised hosts. The lung disease due to Mycobacterium scrofulaceum, a kind of opportunistic pathogen, is considered to be increasing in a wide variety of compromised hosts in the future.

Aged↗

[Investigation of severe tuberculous pneumonia associated with irreversible exacerbation after intensive antitubercular chemotherapy--with regard to the etiology of initial reversible roentgenographic progression].

We reported 3 cases of severe tuberculous pneumonia associated with irreversible exacerbation and sequential death appeared after each intensive antitubercular chemotherapy containing INH, RFP, EB and SM. Acute tuberculous pneumonia probably represents an exudative hypersensitivity reaction to tuberculoprotein, rather than actual inflammation caused by the Mycobacterium tuberculosis organism. Mechanisms of the reversible roentgenographic progression are considered to be also similar to those of acute tuberculous pneumonia regarding the involvement of an exudative hypersensitivity reaction to tuberculoprotein. Our cases indicate that the involvement of reversible roentgenographic progression in patients with severe tuberculous pneumonia may result in the development of acute respiratory failure or adult respiratory distress syndrome (ARDS), resulting from the acceleration of exudative hypersensitivity reactions by the intensive antitubercular chemotherapy. In the present report, relationships between tuberculous pneumonia, reversible roentgenographic progression and the appearance of acute respiratory failure (or ARDS) were discussed. Furthermore, the use of steroids is discussed.

Acute Disease↗

[A case of tuberculous pleurisy associated with myoclonus and Quincke's edema due to isoniazid and isoniazid sodium methanesulfonate].

A case of tuberculous pleurisy associated with myoclonus and Quincke's edema due to isoniazid (INH) and isoniazid sodium methanesulfonate (IHMS) was reported. A 75-year-old man was admitted to our division because of chest discomfort and the left chest pain of one month's duration. A conventional chest roentgenogram revealed pleural effusion in the left thoracic cavity. The pleural specimen obtained from the left parietal pleura revealed caseating granuloma. Myoclonus suddenly appeared two months after the administration of antituberculous drugs for tuberculous pleurisy. Therefore, INH was discontinued. Three days later the patient's myoclonus disappeared and nine days later IHMS was newly administered. The patient abruptly developed myoclonus and Quincke's edema. IHMS was discontinued and 30 mg of prednisolone was simultaneously given. Two days later myoclonus disappeared and two days more later Quincke's edema was improved. The lymphocyte stimulation test using IHMS was positive. At that time, levels of serum vitamin B6 were within normal levels. These results suggest that myoclonus may result from epileptogenic action caused by INH or IHMS, and Quincke's edema may result from hypersensitive reaction associated with IHMS.

Aged↗

[Prognostic factors in cases of diffuse malignant pleural mesothelioma].

Among 56 cases of diffuse malignant pleural mesothelioma (including three cases from our institute and 53 reported in Japan from 1978 to 1987), we investigated several prognostic factors, such as age, sex, exposure to asbestos, smoking history, symptom duration, tuberculin skin test, localization of the lesion, pleural effusion, histologic type, metastasis, treatment and some laboratory data, concerning periods from the appearance of symptoms to death. In our series, exposure to asbestos, smoking history, localization of the lesion, pleural effusion and histologic type have no influence on the median survival from symptoms. However, the median survival from symptoms was significantly shorter in males, subjects more than 49 years of age, those having symptoms less than 6 months, those with a negative tuberculin skin test, or those with metastasis of the tumor compared with females, subjects less than 50 years of age, those having symptoms more than 6 months, those with a positive tuberculin skin test, or those without metastasis of the tumor, respectively. In subjects receiving surgery, anticancer chemotherapy, or no treatment, the fifty percent survival period was about 16, 9, or 6 months, respectively. There were, however, no significant relationships between the median survival from symptoms and the Brinkmann smoking index, or the median survival from symptoms and period of asbestos exposure.

Adult↗

Therapeutic effect of fleroxacin against experimental pneumonia in mice.

Fleroxacin is a newly developed quinolone derivative with marked antimicrobial activity. In this study, we have compared the therapeutic effects of fleroxacin with those of ofloxacin, norfloxacin, ciprofloxacin, pipemidic acid and cefaclor against pneumonia in mice caused by Klebsiella pneumoniae. Fleroxacin showed a high therapeutic effect against the experimental pneumonia with an ED50 of 3.4 mg/kg/day, after three times a day oral administration. It was about twice as effective as ofloxacin and ciprofloxacin and more than 15 times more active than norfloxacin. Once or twice a day administration of fleroxacin also showed outstanding therapeutic effects.

Animals↗

Supplemental fosfomycin and/or steroids that reduce cisplatin-induced nephrotoxicity.

The protective effects of fosfomycin and steroids on the nephrotoxicity induced by cisplatin in lung cancer patients were studied by measuring N-acetyl-beta-D-glucosaminidase (NAG) activity in 24-hour urine, creatinine clearance, serum creatinine and blood urea nitrogen as factors of nephrotoxicity. In control patients treated with anticancer drugs containing cisplatin but no supplemental fosfomycin or steroids, the 24-hour urine NAG level increased two-fold (15.5 +/- 7.5, p less than 0.01) over the pretreatment level (8.0 +/- 5.2) 3 days after anticancer therapy. Supplemental fosfomycin or steroids inhibited an increase in urinary NAG level 3 days after the anticancer therapy. There were, however, no significant changes in creatinine clearance, serum creatinine and blood urea nitrogen levels before and after anticancer and/or supplemental therapies. These results suggest the possibility that supplemental treatment with fosfomycin, like that with steroids, reduces cisplatin-induced nephrotoxicity, especially proximal tubular damage.

Acetylglucosaminidase↗

Elastase/antielastase systems in pulmonary diseases.

Levels of serum elastase 1 in a variety of respiratory diseases were studied. In patients with pulmonary emphysema, pulmonary fibrosis, bronchial asthma, or pulmonary infections, including pneumonia and pulmonary tuberculosis, serum elastase 1 levels were greater than those of an age-matched control group. In lung cancer patients, however, the serum elastase 1 level was within normal limits. Although alpha 1-antitrypsin levels were significantly higher in patients with pulmonary infections and lung cancer than in the normal group, they were within normal limits in patients with pulmonary emphysema, pulmonary fibrosis, and bronchial asthma. Alpha 2-macroglobulin levels were slightly increased in patients with pulmonary emphysema and pneumonia. These results suggest that the increases in serum elastase 1 levels in these respiratory diseases may be mainly caused by an imbalance of elastase/antielastase system in the lung tissue and the bloodstream.

Aged↗