Search PubMed⌕ Search

Biomedical subjects

T Hajiro

Publications and source records attributed to T Hajiro.

29 records · Page 2Linked to original sources
PubMed1998

[Effect of treatment on health-related quality of life in patients with asthma].

The aim of the study was to assess the effect of treatment on health-related quality of life (HRQoL) in patients with asthma. We used the Japanese version of the Living With Asthma Questionnaire (LWAQ) as an asthma-specific HRQoL measure. Thirty-four new patients were enrolled and treated according to Guidelines on the Management of Asthma by the British Thoracic Society. The LWAQ and spirometry were evaluated on the initial visit, and three and six months after treatment. The LWAQ score, forced expiratory volume in one second (FEV1), and forced vital capacity (FVC) were significantly improved three months after treatment. The Japanese version of the LWAQ was reliable. For the first three months, there were no correlations between changes in FEV1 or FVC and LWAQ scores (Rs = 0.11-0.25). Pulmonary functions could not predict HRQoL well. Therefore, HRQoL should be measured directly to assess HRQoL in asthmatics.

Administration, Inhalation↗
PubMed1996

Influence of high dose inhaled steroids on hypothalamo-pituitary-adrenal axis function in Japanese patients with asthma: a comparison over the course of time.

Although the influence of high dose inhaled steroids on hypothalamo-pituitary-adrenal (HPA) function in patients with asthma has been extensively studied worldwide, there has been limited information on Japanese asthmatics, especially in terms of a prospective analysis of HPA function in the course of time. We analyzed the changes in HPA function using 2 serial short tetracosactrin tests (STT) separated by an interval of one year in 11 Japanese asthmatics who were treated with high dose inhaled steroids alone [beclomethasone dipropionate (BDP); mean dose 982 micrograms/day] during the period between 2 STTs. Mean values of plasma cortisol before administration of ACTH, maximum cortisol and the rise in cortisol in response to ACTH in the 2 STTs were 7.8, 20.5 and 12.7 micrograms/dl for the 1st test, and 8.9, 23.6 and 14.7 micrograms/dl for the 2nd test, respectively. Overall, there was no significant change in the course of time in each of these 3 values. Although the results of the 1st STT proved to be abnormal in 3 patients who had been receiving systemic steroids before their 1st STT, they improved uniformly in their 2nd STT. In the remaining 8 patients, who had never received systemic steroids, 4 patients showed improvements while the other 4 showed deterioration in HPA function in their serial STTs over the course of time. The dose of BDP was 800 micrograms/day in the former 4 patients, while it was 1,200 micrograms/day in the latter 4. Furthermore, only one patient, in whom BDP had been increased from 800 micrograms/day to 1,200 micrograms/day between the 2 tests, developed an abnormal response in the 2nd STT. On the other hand, one patient whose BDP dose was increased from 800 micrograms/day to 1,600 micrograms/day showed an improvement in HPA function in the 2nd test. These results indicate that the threshold dose of BDP which may cause HPA suppression in Japanese asthmatics lies between 800-1,200 micrograms/day, although there is a large inter-individual variation in terms of such doses.

Administration, Inhalation↗
PubMed1996

[Computed tomographic findings in septic pulmonary emboli secondary to renal abscess].

A 73-year-old woman with diabetes mellitus and hypothyroidism had been well until 4 days before she presented with fever, productive coughing, and general malaise. Dyspnea gradually worsened, and she was admitted to Kobe City General Hospital. She appeared toxic and was in moderate respiratory distress on admission. There were scattered rales in both lung fields. The abdomen was soft with no tenderness. A chest roentgenogram showed peripheral infiltrates in both lung fields. Arterial blood gas analysis showed a Po2 of 48.6 Torr and Pco2 of 27.2 Torr. A blood culture on admission showed Escherichia coli. Computerized tomography of the chest showed multiple nodules of various sizes in the peripheral lung fields. Some nodules had necrotic centers and feeding vessels. Wedge-shaped lesions abutting the pleura were also seen. These findings strongly suggested septic pulmonary emboli. An abscess in the left kidney, which was considered to be the source of the septic pulmonary emboli, was found with Ga scintigraphy, ultrasonography, and computerized tomography of the abdomen. Treatment with antibacterial drugs was effective against the lung lesions but not the renal abscess. A left nephrectomy was done. In the proper clinical setting, characteristic CT features of septic emboli can contribute to early diagnosis of this disease.

Abscess↗
PubMed1996

[Pharmacologic therapy for patients with stable chronic obstructive pulmonary disease--emphasis on inhaled agents].

One dose of an anticholinergic agents has about the same bronchodilatory effect as one of a beta 2-agonist. Anticholinergic agents may be used first in patients with stable chronic obstructive pulmonary disease, because of the possible adverse effects of beta 2-agonists. One puff of a metered-dose inhaler will not cause a maximal bronchodilatory effect. Both anticholinergic and beta-adrenergic drugs cause dose-dependent bronchodilation when given as aerosols from metered-dose inhalers, and a combination of the two can provide better results. If the response to a single agent is unsatisfactory, use of higher doses is advised and the use of a combination of anticholinergic agents and beta-agonists is recommended. With regard to inhaled corticosteroids, a high dose of inhaled beclomethasone dipropionate (1,500 micrograms per day) can be a effective as oral corticosteroids. Step-by-step pharmacologic therapy with the drugs mentioned above should be used in outpatient management of patients with chronic obstructive pulmonary disease.

Administration, Inhalation↗
PubMed1995

[Ultrasonically guided needle biopsy of small mediastinal and peripheral pulmonary nodules].

From 1983 to 1993, we performed ultrasonically guided percutaneous needle biopsies on 320 thoracic tumors. Of these, 77 tumors were smaller than 3 cm in diameter and were peripherally located adjacent to the chest wall (n = 71) or in the posterior mediastinum (n = 6). We evaluated the efficacy and safety of UGNB for diagnosing these small lesions. The mean tumor size was 2.0 +/- 0.7 cm. Nine nodules were less than 1.0 cm in diameter, 38 were between 1.1 and 2.0 cm, and 30 were between 2.1 and 3.0 cm. Biopsies were done with a 17-gauge Trucut needle; a 21-gauge needle was used to aspirate specimens for cytological study. A definitive diagnosis was made in 31 (77%) of 40 malignant lesions and in 19 (51%) of 37 benign lesions. Complications included pneumothorax (n = 5) and hemoptysis (n = 3), but no special medications were needed. Thus, real-time sonographic guidance is a safe, easy, and reliable biopsy method for small pulmonary and mediastinal nodules adjacent to the chest wall.

Adult↗
PubMed1994

[Can patients with chronic asthma discontinue inhaled corticosteroid?].

As an initial investigation to determine whether or not inhaled corticosteroids can be discontinued, we evaluated the results of discontinuation in patients who had been well controlled with inhaled corticosteroids for more than one year prior to this study. The average dose of BDP which the patients had been inhaling at the start of this study was 365 micrograms/day. To determine the effect of discontinuing inhaled corticosteroids, we compared the patients' peak expiratory flow rates and the frequency of beta-agonist use between the 4-week observation period and follow-up periods of varying duration. Only three out of twenty patients enrolled were able to maintain their discontinuation of BDP, while the remaining seventeen patients restarted after a mean period of 30.8 days. Mean peak flow values began to fall during the first week after discontinuation, and decreased morning peak flow values became significant in the 2nd, 3rd and 4th weeks. The mean peak flow value during the observation period was 85.2% of each patient's personal best, but had dropped to 68.8% of this level just before restarting inhaled corticosteroid. The frequency of beta-agonist use during the study period (2.99 +/- 3.39 times a day) was significantly higher than during the observation period (1.94 +/- 2.95 times a day). This finding strongly suggests that the patients' asthmatic conditions had become unstable during the study period. These results suggest that any decision to discontinue the use of inhaled corticosteroid, even in well controlled patients with chronic asthma, should be taken with great care.

Administration, Inhalation↗