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Biomedical subjects

T Tashiro

Publications and source records attributed to T Tashiro.

At least 145 records · Page 8Linked to original sources

In vitro susceptibility of Trichosporon beigelii to antifungal agents.

The minimum inhibitory concentrations (MICs) and minimum fungicidal concentrations (MFCs) of amphotericin B, flucytosine, miconazole, fluconazole and itraconazole against 21 isolates of Trichosporon beigelii in RPMI-1640 medium were determined using National Committee for Clinical Laboratory Standards (NCCLS) methodology in microdilution method. Most isolates were sensitive to miconazole (MIC90 0.78 microgram/ml), fluconazole (MIC90 6.25 micrograms/ml), and itraconazole (MIC90 0.19 microgram/ml), with the former being the most active agent tested (MFC90 3.12 mu/ml). Although amphotericin B inhibited most strains (MIC range, 0.78-3.12 micrograms/ml), poor fungicidal activity was observed (MFC range, 1.56-12.5 micrograms/ml) showing a pattern of relative resistance in vitro. Flucytosine showed generally poor activity against most isolates tested. These in vitro findings confirm the resistance of T.beigelii to amphotericin B and suggest that azoles may be an alternative to the former for the treatment of disseminated trichosporonosis. However, in vivo studies would better validate these in vitro findings.

Amphotericin B↗

Incidence of methicillin-resistant Staphylococcus aureus (MRSA) isolation in a skilled nursing home: a third report on the risk factors for the occurrence of MRSA infection in the elderly.

A case control study was carried out in order to evaluate the various factors which may influence the occurrence of methicillin-resistant Staphylococcus aureus (MRSA) infections in a skilled nursing home. From April 1991 to March 1994, bacterial cultures were performed in 55 out of 102 residents in a nursing home based on various clinical aspects. We divided 102 residents into following three groups; (1) the MRSA group (n = 10), residents whose materials for bacterial culture were positive for MRSA, (2) the non-MRSA group (n = 45), residents whose specimens were negative for MRSA but positive for other bacteria, (3) the control group (n = 47), residents who did not have to undergo a bacterial culture because they were free from moderate and severe infectious diseases. Compared with the control group, the activities of daily living score and the serum albumin level were significantly lower in the MRSA group and the non-MRSA group at the beginning of the study. In contrast, the number of antibiotics used prior to the bacterial culture and the proportion of hospitalization within 6 months prior to the bacterial culture were significantly larger in the MRSA group than in either the non-MRSA group, or the control group. These results thus suggest that a low activities of daily living score, the use of many kinds of antibiotics and a recent previous hospitalization may be risk factors of MRSA infection in a nursing home environment.

Aged↗

[Usefulness of open lung biopsy for corrective surgery on incomplete atrioventricular septal defect associated with severe pulmonary hypertension and right to left shunting].

In congenital heart defects, it is sometimes difficult to decide the operative indication in patients, who has severe pulmonary hypertension (PH) and right to left shunting, from clinical symptoms and cardiac catheterization. We here report a case of incomplete atrioventricular septal defect. The patient is 9 months old with the Down's syndrome. The cardiac catheterization showed severe PH and right to left shunting. Preoperative mean pulmonary artery pressure was 75 mmHg, pulmonary systemic pressure to systemic pressure ratio (PP/PS) was 1.17, pulmonary systemic flow to systemic flow ratio (QP/QS) was 0.79, pulmonary systemic resistance to systemic resistance ratio (RP/RS) was 1.54 and pulmonary vascular resistance (PVR) was 9.6 woodunits.m2. These data suggested that the irreversible pulmonary vascular disease was present. However the PVR decreased from 9.6 to 3.6 woodunits.m2 after inspiration of 100% oxygen. We therefore performed open lung biopsy for further evaluation of the pulmonary vascular bed. The pathological findings obtained at lung biopsy indicated that there was no irreversible pulmonary vascular disease. This case was diagnosed suitable for a corrective surgery. Total repair was performed and the subsequent clinical course was satisfactory. We thus suggest that the open lung biopsy is useful to decide the surgical indication when it is difficult to determine an operative indication from hemodynamic measurement alone.

Biopsy↗

[Anesthetic management of a patient with renal cell carcinoma extending into the right atrium].

A 60-year-old man with renal cell carcinoma extending through inferior vena cava into the right atrium was scheduled for the removal of the right kidney under general anesthesia and the cardiopulmonary bypass technique. In order to obtain a clear operative field and to minimize the risk for pulmonary embolism of necrotizing tumor, total circulatory arrest under profound hypothermia (20 degrees C) was performed. Anesthesia was maintained with high doses of fentanyl (62 micrograms.kg-1), midazolam and supplemented with enflurane. We attempted to prevent circulatory collapse due to acute pulmonary embolism by tumor fragments during operation. The body temperature of the patient was decreased down to 20 degrees C for protecting central nervous system with the minimal damage. No complications occurred during anesthesia and the post-operative period. For the safe anesthetic management of the patient such as our case, adequate monitoring of circulation and protection of central nervous system are essential.

Anesthesia, General↗

[Tizanidine for preanesthetic medication].

The effect of tizanidine given as a premedication on perioperative hemodynamics (mean blood pressure, heart rate), sedation, hypnosis and midazolam requirements for induction were assessed in 68 patients scheduled for elective surgery under general anesthesia. Patients were assigned to three groups. Group 1 was premedicated 90 min prior to induction with tizanidine 4 mg po (n = 28); group 2 was premedicated with tizanidine 2 mg po (n = 12); group 3 received no premedication (n = 28). In group 1, increase of mean blood pressure on anesthesia induction was attenuated significantly and sedative and hypnotic effects were stronger significantly compared with other groups. We also found that the amounts of midazolam necessary for loss of consciousness were significantly less in patients who had received tizanidine 4 mg. In conclusion, tizanidine is a useful drug as preanesthetic medication for general anesthesia.

Adjuvants, Anesthesia↗

[Differential diagnosis of tuberculous pleurisy by the measurement of cytokine concentration in pleural effusion].

Pleural fluids obtained from 26 patients with tuberculous pleurisy (T-group), 11 with parapneumonic pleurisy (B-group) and 21 with malignant pleurisy (M-group) were tested for their biologic parameters and cytokine concentrations. 1) The average age of T-group was over 10 years lower than that of M-group with a statistically significant difference. 2) The average CRP value of B-group and the positivity on PPD skin test of T-group were higher than those of the other groups, respectively. 3) Yellowish pleural fluids were mainly observed in T- and B-group, while bloody pleural fluids were mostly seen in M-group with a statistically significant difference. The average total protein amount and adenosine deaminase value in pleural fluid significantly increased in T-group. The percentage of polymorphonuclear leukocytes showed a significant increase in B-group, while lymphocytes significantly increased in T-group with a statistically significant difference. 4) Although no significant difference in concentrations of IL-1 beta, IL-2, IFN-gamma and TNF-alpha in serum was noticed among the three groups, the average concentrations of IFN-gamma and TNF-alpha in pleural fluid in T-group were significantly higher than those in the other groups. 5) TNF-alpha-mRNA of mononuclear cells in pleural fluid was strongly expressed in 3 out of 11 patients of T-group, while no expression was observed in 6 patients of M-group. In conclusion, the measurement of concentrations of two kinds of cytokines in pleural fluid, IFN-gamma and TNF-alpha, may be clinically useful for the differential diagnosis of tuberculous pleurisy from parapneumonic pleurisy and malignant pleurisy.

Adult↗

Preparation of tau from the peripheral nerve: presence of insoluble low molecular weight tau with high phosphorylation.

Purely axonal tau protein of the peripheral nervous system (PNS) obtained from adult rat ventral roots was composed of both high (HMW) and low molecular weight (LMW) isoforms. While the PNS-specific HMW isoform (110 kDa) was soluble, 60-70% of the LMW isoforms with apparent molecular weights of 67 kDa, 62 kDa and 58 kDa was insoluble. When analyzed by two-dimensional electrophoresis, these axonal LMW isoforms corresponded to the most acidic species among the large number of isoforms found in brain microtubule-associated tau. Immunoreactivities towards phosphorylation-dependent antibody tau-1 and the two anti-phosphopeptide antibodies (PP1 and PP2) indicate that PNS axonal tau is highly phosphorylated at Ser190, Ser193, and Ser387, which are the sites shown to be phosphorylated in fetal brain tau and tau comprising the paired helical filaments of Alzheimer's disease.

Animals↗

Expression of osteopontin in a macrophage cell line and in transgenic mice with pulmonary fibrosis resulting from the lung expression of a tumor necrosis factor-alpha transgene.

The expression level of osteopontin (OPN) mRNA was found to be increased in a macrophage cell line in the presence of recombinant tumor necrosis factor-alpha (TNF-alpha). OPN mRNA level was also explored in the lungs of transgenic mice which were expressing TNF-alpha in type II pneumocytes, a condition leading to pulmonary alveolitis and progressive fibrosis. OPN mRNA was significantly increased in the lungs of these transgenic mice. In situ hybridization showed that it was localized mostly in alveolar macrophages. Since OPN can be induced in macrophages by TNF-alpha stimulation and since on the other hand osteopontin appears to decrease the level of nitric oxide synthase, and thus the production of nitric oxide, osteopontin might also indirectly have an antifibrotic effect. The role played by osteopontin in fibrotic lesions resulting from the release of TNF-alpha deserves further study, since it may be involved in the balance of opposite effects eventually leading to local tissue damage ending in fibrosis.

Animals↗

Two stages in neurite formation distinguished by differences in tubulin metabolism.

Changes in tubulin solubility during neurite formation were studied biochemically using rat dorsal root ganglion neurons in culture. When fractionated with Ca(2+)-containing buffer at low temperature, a considerable proportion of total cellular tubulin was recovered in the insoluble fraction. We designated this cold/Ca(2+)-insoluble tubulin (InsT) and distinguished it from cold/Ca(2+)-soluble tubulin (SoIT). From the relative amount of InsT, neurite formation was found to proceed through two distinct stages. The first 6 days after plating (stage 1) in which the proportion of InsT increased dramatically (from 5 to 60%) coincided with neurite outgrowth. In the following period (stage 2), a constant level of InsT was maintained, whereas neurite maturation took place. Pulse-labeling experiments further revealed that the two stages differed significantly in terms of tubulin metabolism. High rates of synthesis as well as conversion from SoIT to InsT were observed in stage 1, whereas stage 2 was characterized by a decrease in both of these rates and an increase in the rate of degradation. The results show for the first time the coordinated changes in tubulin metabolism that underlie the process of neurite formation.

Animals↗

[Microbiological and clinical study of fungemia between 1981 and 1992].

Fungi were isolated from 113 (14.2%) of 789 patients with positive blood cultures at Oita Medical University Hospital between 1981 and 1992. The rates of fungemia increased in recent years, 13.9% (1981-1985), 12.1% (1986-1988) and 16.9% (1989-1992). The isolated fungi were Candida parapsilosis (25.7%), C. albicans (24.8%), C. tropicalis (14.2%), Trichosporon beigelii (10.6%), C. glabrata (8.0%) and so on. The major fungi were T. beigelii and C. glabrata in patients with hematologic malignancies, whereas they were C. albicans and C. parapsilosis in patients with non-hematologic diseases and C. glabrata increased in both groups. Prophylactic or emiric administration of antifungal agents probably influenced the difference of the causative organisms in the two groups.

Adolescent↗

[Detection and quantitation of cytomegalovirus DNA in plasma from patients with cytomegalovirus pneumonia].

Detection and semiquantitation of cytomegalovirus (CMV) DNA in plasma from 17 immunocompromised patients with CMV pneumonia diagnosed histopathologically, 15 CMV seropositive patients without CMV pneumonia and 24 CMV-seropositive healthy volunteers were evaluated, using the polymerase chain reaction (PCR). CMV DNA was detected in plasma from all of 17 patients with CMV pneumonia, from 1 of 15 patients without CMV disease, but from none of healthy volunteers. One patient without CMV disease exhibited positive CMV DNA by PCR 2 days before death. Plasma CMV DNA was negative at the time of admission in all patients, however, it became positive 1-28 days (mean, 14 days) before the onset of CMV pneumonia in 16 patients. The amount of viral DNA in plasma were 10(3) - 10(5) copies/ml (mean, 10 (4.0) copies/ml) when first detected by PCR. At the onset of CMV pneumonia, they were 10(4)-10(6)(mean, 10(5.3) copies/ml), and increased with disease progression and decreased with disease improvement because of treatment with antiviral agents. We succeeded in detection of CMV DNA in plasma before the development of CMV pneumonia, and showed the amount of viral DNA reflected the extent of active CMV pneumonia. Thus, PCR amplification of CMV DNA in plasma is a useful tool for early diagnosis and monitoring of immunocompromised patients.

Adult↗

Early diagnosis and monitoring of human cytomegalovirus pneumonia in patients with adult T-cell leukemia by DNA amplification in serum.

A nested polymerase chain reaction (PCR) was used to detect human cytomegalovirus (HCMV) DNA in serum of patients with adult T-cell leukemia (ATL). Serum samples were collected consecutively from 11 patients with HCMV pneumonia diagnosed histopathologically and 7 HCMV-seropositive patients without HCMV disease. Serum samples obtained from 24 HCMV-seropositive healthy volunteers were used as controls. The HCMV DNA was detected in serum a mean of 14 days before the onset of HCMV pneumonia, which suggests that DNAemia exists prior to the development of HCMV pneumonia. The amount of viral DNA in serum increased with disease progression and decreased with disease improvement. Thus, the detection of HCMV DNA in serum by nested PCR is useful for monitoring and the early diagnosis of HCMV pneumonia in patients with ATL. In addition, quantitation of HCMV DNA may be useful for monitoring HCMV infection, because it appears to correlate with the activity of the disease.

Adult↗

Trichosporon beigelii pneumonia in patients with hematologic malignancies.

Trichosporon beigelii is a causative agent of hypersensitivity pneumonia in immunocompetent individuals and of invasive pneumonia in immunocompromised patients. The actual incidence and clinical manifestations of T beigelii pneumonia are obscure because the diagnosis is sometimes difficult. We studied eight patients with T beigelii pneumonia diagnosed by immunohistochemical investigation of lung tissue sections and/or isolation of the organism from the lung, sputum, or blood. All patients had underlying hematologic malignancies for which they had received cytotoxic chemotherapy, resulting in profound neutropenia. The clinical manifestations were persistent fever unresponsive to broad-spectrum antibiotic therapy, cough, bloody sputum, and rapidly progressive dyspnea. The chest radiographs showed diffuse alveolar infiltrates in four patients, diffuse interstitial infiltrates in one, patchy reticulonodular infiltrates in one, and focal alveolar infiltrates in two. Histopathologic examination demonstrated numerous centrally necrotic foci with minimal cellular inflammatory reaction, intra-alveolar hemorrhage, and edema. Trichosporon beigelii consisting of both yeast and hyphal forms was located predominantly in the alveolar vessels. In neutropenic patients with hematologic malignancies, this fungus appears to enter the lung not only through the airways but also via the hematogenous route. In vitro susceptibility testing indicated borderline susceptibility to amphotericin B and showed that some azoles were active against T beigelii at safely achievable serum concentrations.

Aged↗

Non-secretory alpha chain disease involving stomach, small intestine and colon.

A case of alpha chain disease, involving stomach, small and large intestine, and caecum with poor prognosis is reported. Endoscopic examination revealed gastric erosion, edematous mucosa with enlarged villi of duodenum and jejunum, multiple hyperplastic lymph follicles of terminal ileum and thickening mucosa of caecum. Light microscopy revealed a conspicuous infiltration of plasma cells and lymphocytes in gastric, duodenal, jejunal and caecal lamina propria. Immunohistochemistry demonstrated alpha heavy chain protein devoid of light chain in these plasma cells. The patient developed paralytic ileus and died of septic shock on the 179th hospital day.

Colon↗

[The effects of systemic bupivacaine on baroreflex sensitivity in dogs].

To evaluate the effects of systemic bupivacaine on the baroreflex control of heart rate, we investigated the baroreflex sensitivity assessed with a pressor and a depressor test using phenylephrine and nitroglycerin in pentobarbital anesthetized dogs (n = 12). Intravenous injection of bupivacaine (mean plasma concentration of 2.4 +/- 0.9 micrograms.ml-1) caused a significant suppression of the baroreflex sensitivity, defined by the slopes of regression line (in msec of RR interval change per mmHg increase or decrease in systolic blood pressure). The sensitivity obtained with the pressor and the depressor tests decreased from 6.0 +/- 2.3 to 3.5 +/- 1.7, from 2.4 +/- 1.3 to 1.3 +/- 0.8 msec.mmHg-1, respectively (P < 0.01). Suppression of the baroreflex sensitivity during epidural anesthesia with bupivacaine could be due not only to cardiac sympathectomy but also to a direct effect of bupivacaine on the reflex arch including the receptors, the afferent nerve pathways, the CNS, the efferent pathway, and the effector organs. Therefore, the hemodynamic responses to reduction of blood pressure are likely to be inhibited by epidural bupivacaine.

Anesthesia, Epidural↗

[Combination therapy of doxifluridine, pirarubicin and cisplatin for human gastric cancers implanted in nude mice].

In the preclinical study of a new combination therapy for gastric cancer, dFTP, consisting of doxifluridine (5'-DFUR), pirarubicin (THP) and cisplatin (DDP) as a modification of conventional FAP regimen (5-fluorouracil+Adriamycin+DDP), we compared antitumor and toxic effects of two sequential treatment schedules, single injection of DDP before or after 4 daily administrations of 5'-DFUR, on 5 strains of human gastric cancer bearing nude mice. Results indicated that both schedules of the dFTP regimen had potent antitumor effects. There was no significant difference between them. On the other hand, in terms of the host toxicity as observed by body weight loss, the post-DDP schedule was significantly less toxic than pre-DDP. These results suggest that dFTP regimen (post-DDP schedule) may be useful for clinical treatment of gastric cancers.

Adenocarcinoma↗

Central giant cell granuloma of the temporal bone.

We present two cases of central giant cell granuloma in the temporal bone. CT showed an enhancing tumor causing a smoothly margined temporal squamosa and floor of the middle fossa. External carotid angiograms showed tumor stain mainly supplied by the temporal branches of the internal maxillary artery. In one case, MR images showed a hypointense mass on both T1- and T2-weighted images that was thought to reflect the pathologic character of this lesion.

Adult↗