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Biomedical subjects

T Aikawa

Publications and source records attributed to T Aikawa.

At least 91 records · Page 5Linked to original sources
PubMed1991

Prognosis of idiopathic pulmonary fibrosis in patients with mucous hypersecretion.

In order to determine the prognosis of patients with chronic idiopathic pulmonary fibrosis (IPF), we evaluated clinical, laboratory, and bronchoalveolar lavage (BAL) data at the onset of IPF in 25 patients who survived beyond 1 yr (nine women and 16 men, 59 +/- 3 yr of age, mean +/- SE). When the patients were divided into two groups according to whether they had or did not have mucous hypersecretion, 11 patients with hypersecretion (Group A) had a poorer survival rate (6 yr) than did 14 patients without hypersecretion (Group B) (10 yr) (p less than 0.01). Further, there was a significant negative correlation between sputum volume and the duration of survival in 25 patients (r = -0.55, p less than 0.01). Before glucocorticoid treatment, we also found significantly larger numbers of neutrophils (17%) and eosinophils (5%) in differential cell counts of bronchoalveolar lavage fluid (BALF) in Group A than in Group B (neutrophils, 1%; eosinophils, 0.6%) (p less than 0.05 each). Chest radiographic findings and other laboratory data including pulmonary function tests did not correlate with the survival rate. These findings suggest that mucous hypersecretion as well as neutrophils and eosinophils in BALF are among the determinants of prognosis in patients with chronic IPF.

Aged↗
PubMed1991

Treatment of status asthmaticus with intravenous magnesium sulfate.

The bronchodilating effect of magnesium sulfate (MgSO4) was studied in two patients with status asthmaticus, who were intubated and mechanically ventilated by a respirator. Airway resistance was continuously monitored by the respiration-controlled interruption technique. After administration of 0.5 mmol/min MgSO4 intravenously, airway resistance decreased from 17 to 9, and from 13 to 8 mmHg/L/s in the two patients, respectively, and piping rales diminished or disappeared. We conclude that while corticosteroid therapy requires several hours to demonstrate significant effects in status asthmaticus, MgSO4 is of great benefit in the rapid improvement of airflow obstruction.

Adolescent↗
PubMed1991

[A controlled study with medroxyprogesterone acetate (MPA) alone or in combination with cyclophosphamide (CPA) in the treatment of advanced or recurrent breast cancer unresponsive to other therapies. Osaka Study Group for the Treatment of Breast Cancer].

Forty-eight patients with advanced or recurrent breast cancer unresponsive to other therapies were treated orally with medroxyprogesterone acetate (MPA) 1,200 mg/day alone (Group A: 28 patients) or in combination with cyclophosphamide (CPA) 100 mg/day (Group B: 20 patients). Either complete response (CR) or partial response (PR) was obtained in eight (28.6%) patients of Group A and PR in five (25.0%) of Group B. The median duration of the response was 5.3 months in Group A and 4.4 months in Group B. Despite the expected better result of the combined chemo-endocrine therapy for Group B, there were no statistical difference in usefulness between the two regimens. No severe adverse reactions were observed in this study. We conclude that MPA alone is useful for treatment of patients with advanced or recurrent breast cancer unresponsive to other therapies.

Adult↗
PubMed1991

Chemical oxidant potentiates electrically and acetylcholine-induced contraction in rat trachea: possible involvement of cholinesterase inhibition.

To determine the roles of oxidants in airway responsiveness, we studied the effects of the chemical oxidant N-chlorosuccinimide (NCS) on the contractile responses to electrical field stimulation (EFS) and acetylcholine (ACh) in isolated rat tracheal smooth muscle segments. Effects of NCS on the contractile response to EFS (5 Hz, 20 sec of duration, 50 V) reached the maximum with a 60-min incubation time. NCS potentiated the contractile response to EFS, with a maximum effect at 3 x 10(-7) M and to ACh, with a maximum effect at 3 x 10(-6) M. Thus, at a concentration of 3 x 10(-6) M, NCS significantly decreased log ED50 concentration of ACh from a control value of -5.56 +/- 0.05 to -6.24 +/- 0.06. Physostigmine (10(-7) M), at a concentration that did not alter resting tension, mimicked NCS-induced effects on contractile responses to ACh and EFS with the greater degree of shift in the respective dose-response curves. However, NCS failed to alter dose-response curves to carbachol. Removal of the epithelium shifted the dose-response curves to ACh to lower concentrations, but NCS showed similar effects on dose-response curves to ACh with and without the epithelium. Active staining showed that both acetylcholinesterase (EC 3.1.1.7) and butyrylcholinesterase (EC 3.1.1.8) activities were found in the smooth muscle of the rat trachea. NCS inhibited both enzyme activities from rat tracheal homogenates in a concentration-dependent fashion. These results suggest that NCS potentiates cholinergically induced contraction by decreasing cholinesterase activity and that the oxidation of cholinesterase may cause hyperresponsiveness of airway smooth muscle by inhibition of the enzyme activity.

Acetylcholine↗
PubMed1990

Temporal bone pathology in intracochlear schwannoma with profound hearing loss.

Intracochlear schwannoma was found in the temporal bone of a 85-year-old man in whom audiometric study, 26 days before death, had shown total deafness in the left ear. The tumor occupied the entire lumen of the cochlea in the basal turn involved Rosenthal's canal, but it occupied only the scala tympani in the second turn. Intralabyrinthine schwannomas are difficult to diagnose by clinical examination. They were discovered accidentally during destructive labyrinthectomy for presumed Ménière's disease or discovered incidentally by postmortem temporal bone pathology. Although intralabyrinthine schwannomas are a rare occurrence and cannot usually be diagnosed without surgery or postmortem histopathology, it is important to suspect the possibility of their existence in differential diagnosis of atypical Ménière's disease or unilateral idiopathic progressive deafness. Long-term follow-up is obviously necessary to exclude the tumor.

Aged↗
PubMed1990

Temporal bone findings in two cases of head injury.

Temporal bone findings in two cases of head injury are reported. In one patient, longitudinal fractures occurred in both temporal bones, and extended to the middle ear bilaterally. Bleeding was seen in the tympanic cavity, mastoid air cells, internal auditory meatus and facial nerve canal. Bleeding was observed in the scala tympani, cochlear aqueduct and endolymphatic sac, but there were no fractures. In the other patient, bleeding was seen in the internal auditory meatus and facial nerve canal. In the right ear, endolymphatic hydrops was observed in all turns of the cochlea.

Adult↗
PubMed1990

Inhibitory actions of prostaglandin E1 on non-adrenergic non-cholinergic contraction in guinea-pig bronchi.

We have investigated the effect of prostaglandin E1 (PGE1) on non-adrenergic, non-cholinergic (NANC) contraction in guinea-pig bronchial strips. PGE1 (10 nM to 10 microM) did not alter baseline tension but reduced NANC contractions induced by electrical field stimulation (EFS) in a concentration-dependent fashion (-log EC50 was 6.60 +/- 0.10 M and maximum inhibition was 88.7 +/- 2.9%). PGE1 (greater than 0.3 microM) also reduced the contraction induced by substance P (1 microM). Removal of epithelium did not alter the effects of PGE1 on NANC contraction. These results suggest that PGE1 exerts both pre- and post-junctional inhibitory actions on NANC contraction.

Alprostadil↗
PubMed1990

Ozone increases susceptibility to antigen inhalation in allergic dogs.

To determine whether O3 exposure increased airway responsiveness to antigen inhalation, we studied airway responsiveness to acetylcholine (ACh) and Ascaris suum antigen (AA) before and after O3 in dogs both sensitive and insensitive to AA. Airway responsiveness was assessed by determining the provocative concentration of ACh and AA aerosols that increased respiratory resistance (Rrs) to twice the base-line value. O3 (3 parts per million) increased airway responsiveness to ACh in dogs both sensitive and insensitive to AA, and it significantly decreased the ACh provocation concentration from 0.541 +/- 0.095 to 0.102 +/- 0.047 (SE) mg/ml (P less than 0.01; n = 10). AA aerosols, even at the highest concentration in combination with O3, did not increase Rrs in dogs insensitive to AA. However, O3 increased airway responsiveness to AA in AA-sensitive dogs and significantly decreased log AA provocation concentration from 2.34 +/- 0.22 to 0.50 +/- 0.17 (SE) log protein nitrogen units/ml (P less than 0.01; n = 7). O3-induced hyperresponsiveness to ACh returned to the base-line level within 2 wk, but hyperresponsiveness to AA continued for greater than 2 wk. The plasma histamine concentration after AA challenge was significantly higher after than before O3 (P less than 0.01). Intravenous infusion of OKY-046 (100 micrograms.kg-1.min-1), an inhibitor of thromboxane synthesis, inhibited the O3-induced increase in responsiveness to ACh, but it had no effects on the O3-induced increase in responsiveness to AA and the increase in the plasma histamine concentration. These results suggest that O3 increases susceptibility to the antigen in sensitized dogs via a different mechanism from that of O3-induced muscarinic hyperresponsiveness.

Acetylcholine↗
PubMed1990

Nonadrenergic inhibitory nerves attenuate neurally mediated contraction in cat bronchi.

Effects of nonadrenergic and noncholinergic (NANC) inhibitory nerves on cholinergic neurotransmission were examined in isolated bronchial segments from cats in the presence of propranolol (10(-6) M) and indomethacin (10(-6) M) by use of electrical field stimulation (EFS) techniques. EFS caused contraction alone in tissues at the baseline tension and biphasic responses (contraction and relaxation) in tissues precontracted with 5-hydroxytryptamine. Contraction was abolished by atropine (10(-6) M), and relaxation was abolished by tetrodotoxin (10(-6) M). At the baseline tension, EFS at frequencies greater than 10 Hz inhibited the subsequent (4 min later) contraction induced by EFS at 1-5 Hz. EFS-induced inhibition was stimulus frequency dependent and reached maximum at 20 Hz. However, EFS at 20 Hz did not inhibit the subsequent contractile response to acetylcholine (10(-7) to 10(-3) M). Exogenously applied vasoactive intestinal peptide mimicked EFS-induced inhibitory effects, but substance P and calcitonin gene-related peptide did not. The inhibitory effect of EFS at 20 Hz was not altered by pyrilamine, cimetidine, naloxone, methysergide, phentolamine, BW755C, AF-DX 116, or removal of epithelium. These results imply that the NANC transmitter acts via presynaptic cholinergic receptors.

Animals↗
PubMed1990

Allergic sensitization in elderly patients with chronic obstructive pulmonary disease.

To study whether allergic sensitization occurs in elderly patients with chronic pulmonary obstructive disease (COPD), we examined serum IgE and skin test reactivity to allergens in three age-matched groups of normal subjects, and in patients with COPD and bronchial asthma (BA). Serum IgE was significantly higher in patients with COPD and BA than in normal subjects (p less than 0.05), and patients with COPD showed serum IgE levels as high as those of patients with BA. However, the skin test scores were significantly higher in patients with BA than in normal subjects and patients with COPD (p less than 0.05). Neither serum IgE nor skin test score significantly correlated with FEV1%, PaO2, PaCO2 or Brinkman's Index in any group (p greater than 0.20). These results suggest that allergic sensitization occurs in elderly patients with COPD and that symptoms associated with COPD may be partly due to allergic inflammation.

Asthma↗
PubMed1990

Eosinophil supernatant causes hyperresponsiveness of airway smooth muscle in guinea pig trachea.

To study the role of eosinophils in airway hyperresponsiveness, we studied the effect of supernatant obtained from activated eosinophils on the responses of isolated guinea pig tracheal smooth muscle segments to histamine. Eosinophils obtained from guinea pig peritoneal fluid were purified and activated with Ca2+ ionophore A23187 using a two-stage reaction. Supernatant obtained from different eosinophil cell numbers (3 x 10(5) to 10(7) cells) did not alter resting tension but potentiated the contractile response to histamine in a cell number-dependent fashion. Thus, at a cell number of 10(7), the supernatant decreased the mean (+/- SE) log histamine concentration producing 50% of maximum contraction significantly from a control value of -5.62 +/- 0.10 to -5.99 +/- 0.07 M (p less than 0.05). The potentiating effect of the supernatant (10(7) cells) was not altered by either removal of tracheal epithelium or by pretreatment with indomethacin when cells were activated. However, pretreatment with AA 861 completely inhibited the supernatant (10(7) cells)-induced potentiating effect associated with inhibition of leukotriene C4, D4, and E4 release in the supernatant. The concentrations of exogenous authentic leukotrienes chosen to match concentrations in the supernatant mimicked the supernatant-induced potentiating response to histamine. These results suggest that leukotrienes released from eosinophils cause hyperresponsiveness of airway smooth muscle in vitro.

Animals↗
PubMed1990

Immuno-electron microscopic study of keratin distribution in the cochlea using monoclonal antibody.

Keratin distribution in the cochlea has been studied immuno-electron microscopically by both pre-embedding and postembedding methods. Keratin immunoreactivity in the guinea pig cochlea was clearly demonstrated in Hensen's cells, the reticular lamina surrounding both outer and inner hair cells, outer and inner pillar cells, Claudius' cells, inner and external sulcus cells, interdental cells of the spiral limbus, Reissner's membrane, border cells, inner phalangeal cells, Deiters' cells, and spiral prominence cells. Keratin expression at the ultrastructural level showed a nonfilamentous keratin system in the cytoplasm of cochlear supporting cells.

Animals↗
PubMed1990

The effect of long term ethanol intake on the parotid gland in rats.

To elucidate the effects of long term ethanol intake on the parotid gland, light and electron microscopic observations of the parotid glands from male Wistar rats that had been given 20% ethanol ad lib instead of water were carried out. The findings were compared with the changes in the pancreas previously reported (Kakizaki et al. 1987). The results were as follows: (1) Severe lesions involving lobular units of the parotid gland were found in three rats exposed to ethanol. (2) From the early stages of ethanol ingestion, the lateral interdigitations of acinar cells widened irregularly. In the striated ducts, basal enfoldings became also irregular and short, while the mitochondria (which were a slender rod shape and arranged parallel to the basal enfoldings in control rats) became swollen, developed a dark matrix, a decrease in the cristae, and showed random arrangement. (3) Later, both tortous proliferation of the intercalated ducts and destruction as well as irregular lamination of the basal lamina of the striated ducts were observed frequently. (4) The animals developing severe morphological changes in the pancreas following ethanol ingestion were different from the animals developing severe changes in the parotid gland.

Animals↗
PubMed1990

Permanent brain damage possibly caused by theophylline in two elderly patients with airway obstruction.

Two aged patients with bronchial asthma and chronic obstructive pulmonary disease who suffered convulsions that resulted in permanent brain damage during treatment with the recommended therapeutic dose of theophylline are presented here. A dose or concentration of theophylline lower than the recommended one should be considered in the treatment of some aged patients with pulmonary obstructive disease.

Aged↗
PubMed1990

Prolonged hypoxemia after 10 min walking exercise in aged patients with chronic obstructive pulmonary disease.

Although the behavior and factors of exercise tolerance have been studied during exercise in patients with chronic obstructive pulmonary disease (COPD), little attention has been paid to the after-effects of such activity. Arterial oxygen saturation (SaO2) was monitored during and after a 10 min walking exercise in aged patients with COPD. Neither baseline SaO2 nor mean SaO2 during exercise correlated to the 10 min walking distance. However, the recovery time of SaO2 to the baseline value shows significant correlation to the 10 min walking distance. Careful attention should be paid to prolonged hypoxemia after exercise in severe cases of COPD.

Aged↗
PubMed1990

Improvement of biliary enzyme levels and itching as a result of long-term administration of ursodeoxycholic acid in primary biliary cirrhosis.

Ursodeoxycholic acid (UDCA) was administered to 10 patients diagnosed as having primary biliary cirrhosis (PBC) after liver biopsy. Eight patients were anicteric, and two were icteric cases. One patient was in stage I, seven were in stage II, one in stage I-III, and one in stage III-IV of Scheuer's classification. Six hundred milligrams of UDCA were administered orally after meals three times daily to all of the patients for more than 1 yr. The period of UDCA administration ranged from 6 to 41 months. The major findings are as follows: 1) in six out of seven patients with pruritus, itching disappeared 1 month after administration of UDCA; 2) both serum alkaline phosphatase and gamma-glutamyltranspeptidase levels began decreasing significantly the first month after the onset of UDCA treatment, and continued decreasing throughout the treatment; 3) GOT and GPT levels also decreased significantly during the administration of UDCA, compared with before-treatment levels; 4) in one icteric patient with portal hypertension, although serum biliary enzyme levels improved after treatment, serum bilirubin level got worse, and the patient died of esophageal variceal hemorrhage. In another icteric case, biliary and bilirubin levels improved slightly after treatment; 5) antimitochondrial antibody titer decreased in four cases, but IgM levels and other immunological parameters were not changed; 6) serum UDCA increased significantly during UDCA treatment; in particular, glyco-UDCA occupied up to 40% of the total bile acid and CDC decreased to 25%; 7) portal inflammation activity decreased in all five patients who had undergone follow-up liver biopsy, more than 1 yr after UDCA administration--bridging fibrosis decreased in three cases; and 8) no side effects were observed in any of the cases. Although large-scale, randomized, controlled, double-blind tests are necessary, it is speculated that the long-term administration of UDCA is a safe and effective treatment for the improvement of biliary enzyme levels and pruritus in anicteric PBC.

Adult↗
PubMed1990

[Causes of death in patients with rheumatoid arthritis--analysis of 117 cases for 13 years].

One hundred seventeen deaths of RA patients (30 males and 87 females) at National Sagamihara Hospital for 13 years (1975-1988) were analysed. The average duration of disease were 10.5 years in male patients and 17.7 years in female. The average life span of the patients with RA, revealing 65.8 years in male and 63.7 years in female, were much shorter than of general population. The causes of all deaths were investigated by ourselves and/or autopsy. The autopsy was performed in 56.6%. The most common causes of death in RA patients were infectious diseases (20.5%), respiratory diseases (16%, mainly interstitial pneumonia and chronic obstructive lung diseases), and gastrointestinal diseases (14.7% chiefly perforation or bleeding of peptic ulcer). The distribution of causes of death in RA patients was quite different from in general population. The gastrointestinal disease decreased from 20% in the early half (1975-1981) to 12.6% in the latter half (1982-1987). It seems likely that H2-receptor antagonist played a major role for preventing the death by perforation or bleeding of ulcer, because the drug has been used since 1982 in Japan. Renal insufficiency including amyloidosis increased markedly in the latter half (14.9%) compared with in the early half (6.7%). Frequency of infectious diseases, respiratory diseases, and basilar impression remain unchanged in all course. Although our study are case-analysis in only one institute and further study will be necessary, the accumulation of the data investigated by rheumatologist will be helpful to grasp correct cause of death in patients with RA.

Adult↗