Biomedical subjects

Y Fukuchi

Publications and source records attributed to Y Fukuchi.

At least 181 records · Page 10Linked to original sources

PubMed1994

[Improvement of post-operative activities of daily living in an aged patient with vanishing lung].

A 71-year-old male was admitted to our hospital due to progressive dyspnea. The right lung of this patient was replaced by multiple bulous lesions including giant bullae. He had severe deterioration of lung function and gas exchange. He did not complete the pre-operative examinations for thoracic surgery, but improvement in ventilatory function was expected after bullectomy. After multiple bullectomy, this case showed marked improvements in lung function and gas exchange, subsequently his dyspnea improved, as did his activities of daily living. These lung functional improvement may have resulted not only from the mechanical advantage of diaphragmatic motion due to removal of space-occupying lesion of the lung, but also from the reduction of tough fibrous adhesion between the lung and the parietal pleura which had impaired smooth lung movement. Thorough evaluation of operative indications in necessary before surgery in aged patients with lung diseases.

Activities of Daily Living↗

PubMed1994

[Clinical usefulness of the combined empirical therapy with flomoxef and fosfomycin for intractable respiratory tract infections. With a background of increasing MRSA incidence].

We conducted a multicenter trial to determine the clinical usefulness of the combined therapy with flomoxef (FMOX) and fosfomycin (FOM) (FF therapy) as an empirical therapy in the treatment of intractable respiratory tract infections, because FF therapy has clinically been proved to be very useful for the treatment of severe infections including MRSA infections. The overall efficacy rate of FF therapy was 69.2%. The efficacy rate for "pneumonia/lung abscess," which occupy the largest portions of respiratory tract infections, was 70.0%, showing a statistically significant difference from the efficacy rate for FMOX alone (56.7%) found in a previous study (P = 0.09 by chi-squared test). Although MRSA was eradicated in only 3 cases (37.5%) including superinfection cases, of 8 patients, from whom MRSA had been isolated as causative organisms, none of our patients were superinfected with MRSA. Thus it has been concluded that FF therapy is clinically very useful when used as an empirical therapy in the treatment of respiratory tract infections.

Aged↗

PubMed1993

Subjective symptoms and neurobehavioral performances of ex-mercury miners at an average of 18 years after the cessation of chronic exposure to mercury vapor. Mercury Workers Study Group.

In order to determine if there are any residual effects of long-term exposure to mercury vapor, neurobehavioral tests were given to ex-mercury miners about 18 years after the cessation of mercury exposure. Seventy-six male ex-mercury miners who had been exposed to relatively high concentrations of mercury vapor (over 1.0 mg/m3) and with a past history of mercury intoxication were compared to age (+/- 3 years)-, sex-, and years of education-matched controls. Although the extent of the workers' symptoms caused by mercury poisoning, termed erethismus merculialis, markedly decreased after the cessation of exposure, the prevalence of neurological symptoms (such as hand tremors, headaches, and slurred speech) and symptoms of senility (such as low-back pain, loss of sexual desire) in the ex-miners was significantly higher than those in the controls. Matched-pair analysis showed that performances of motor coordination, Simple reaction time, and Short-term memory in the ex-miners were significantly deteriorated compared to those of controls. There are slight but persistent effects on neurobehavioral function, especially on motor coordination function, among mercury miners more than 10 years after the cessation of exposure.

Aged↗

PubMed1993

The effects of aging on the function of alveolar macrophages in mice.

In order to determine whether the function of alveolar macrophages (AM) is modulated by aging, we measured the TNF-alpha production, phagocytic function, and surface antigen expression of AM from young and old mice. When AM were primed by IFN-gamma (500 units/ml) and triggered by LPS (100 micrograms/ml), TNF-alpha production by AM was significantly smaller in old mice as compared with young mice (young mice: 161.7 +/- 28.2 units/ml; old mice: 89.3 +/- 13.6 units/ml, P < 0.05). The percentage of AM which phagocytosed latex particles (more than one particle) in old mice was significantly lower than in young mice (young: 78.1 +/- 2.5%; old: 62.8 +/- 3.4%, P < 0.05). Ia antigen expression of the AM was significantly higher and asialo-GM1 antigen expression was significantly lower in old mice than in young mice (Ia: young, 0.030 +/- 0.005; old, 0.092 +/- 0.024, P < 0.05; asialo-GM1: young, 0.-9 +/- 0.01; old, 0.75 +/- 0.07, P < 0.01). These results suggest that alveolar macrophage function is at least decreased in part with aging in mice.

Aging↗

PubMed1993

Age changes in visceral content of glutathione in the senescence accelerated mouse (SAM).

Free radical formation is known to play a role in the aging processes. However, it is still disputable whether the scavengers of free radicals including glutathione (GSH) decrease during aging. The senescence accelerated mice (SAM) are known to show age-related disorders. Some of these syndromes were thought to be closely associated with oxidative damages. Using the two strains of SAM, SAM-R/1 and SAM-P/2, we examined age-related changes in GSH content in the tissues and its oxidation. In the eye, GSH levels were significantly decreased at the age of 16 months in SAM-P/2 and female SAM-R/1. The ratio of oxidized glutathione to total GSH increased, indicating GSH may play an important role in the eyes. But there were no remarkable age-related changes in GSH contents of other tissues such as liver, kidney and lung in both SAM-R/1 and SAM-P/2. These data suggest that the GSH level of the tissues in general can not be a proper indicator for senescence.

Aging↗

PubMed1993

Effects of inhaled anticholinergic drug on dyspnea and gas exchange during exercise in patients with chronic obstructive pulmonary disease.

To elucidate the effect of oxitropium bromide (OTB), an anticholinergic drug, on dyspnea and gas exchange during exercise in patients with chronic obstructive pulmonary disease (COPD), we performed the cycle exercise test on 19 patients with COPD (mean age, 72.0 +/- 1.9 years; mean FEV1, 1.28 +/- 0.07 L) before and after inhalation of OTB, 300 micrograms, or placebo, 300 micrograms, in randomized fashion. Spirometry was performed immediately before and 30 min after inhalation of either OTB or placebo. Dyspnea during exercise was evaluated using the Borg scale (BS) and the slope of the regression between BS and oxygen uptake (VO2) during exercise (Borg scale slope: BSS). Arterial oxygen saturation (SaO2) was continuously monitored by pulse oximeter during and after exercise. We also measured the recovery time, which was defined as the time to recover decreases in SaO2 after exercise. After OTB, spirometric indices were improved (delta FEV1 16.8 +/- 0.9 percent) and maximal VO2 during exercise increased significantly (from 986 +/- 46 ml/min to 1,156 +/- 55 ml/min, p < 0.01), but not after placebo. The maximal scores of BS and the BSS were significantly decreased after OTB, but not after placebo. Although the SaO2 at rest and during exercise did not differ with or without either OTB or placebo, the recovery time after OTB (77.3 +/- 6.8 s) was significantly shorter than that before administration (98.4 +/- 14.6 s) (p < 0.01). We conclude that the inhaled OTB produces small but significant improvement both in dyspnea during exercise and in exercise performance in stable COPD and may contribute to improve the quality of life in some patients with COPD. However, gas exchange during exercise of COPD patients is little affected by OTB.

Administration, Inhalation↗

PubMed1993

[An aspiration pneumonia in acute airway damage model induced by HCl and/or LPS].

The purpose of this study is to evaluate chemical and pathological changes of the lung and to elucidate the role of TNF alpha and elastase in acute lung injury induced by HCl or lipopolysaccharide (LPS). Anesthetized rats were injected with pH 1.4 0.7 ml/kg body weight of HCl and 0.5 mg/kg body weight (BW) of LPS (E. coli) into the lung. Acute tracheal injury model (Mendelson Syndrome) were made. Control animals received only saline. Animals were sacrificed 1, 6, or 12 hours after the HCl or LPS or HCl and LPS injection, bronchoalveolar-lavage (BAL) was performed in the same way in control and experimental groups. The other animals which were treated as well were excised by histology. There was neither increase in TNF alpha-production nor increase in neutrophils resulting from HCl injection only. Elastase-like activity was not detected in animals treated only with HCl. However, 1 hour after LPS injection, the production of TNF alpha (37.0 +/- 8.0 Units/ml) was significantly greater than that of the control group (12.1 +/- 4.2 Units/ml) in BALF. Six hours after HCl and LPS injection, the concentration of elastase-like activity (0.023 +/- 0.002 nM) was significantly greater than that of the LPS group (0.011 +/- 0.001 nM). Only patches of intraalveolar hemorrhage and elevation of fibrin was observed in the HCl injected rats at 1 hour after injection. Six hours after LPS injection, the alveolar spaces were filled with large amounts of neutrophils. These findings suggest that TNF alpha and elastase play a significant role in HCl and LPS-induced acute lung injury.

Acute Disease↗

PubMed1993

[Successful weaning from mechanical ventilation in an aged subject with severe apneas due to brain damage].

A 73-year-old male was admitted to Tokyo University Hospital due to cardiac arrest secondary to ventricular arrhythmias. Although the patient survived after cardiopulmonary resuscitation, he needed mechanical ventilation. When we tried to wean the patient from mechanical ventilation, we found that he suffered from frequent sleep apneas of over 40 times/hour. To evaluate the severity and frequency of the apneas, we performed polysomnographic study on the patient under assist ventilation. The polysomnographic study revealed that frequency of apneas was very high but the magnitude of desaturation was not so severe during the night. Since we confirmed the lowest SaO2 in this patients was over 90% during day and night, we tried to wean from the patient from the ventilator again and succeeded. The clinical application and usefulness of nocturnal ventilatory monitoring for patients with mechanical ventilation was discussed.

Aged↗

PubMed1993

[The importance of the host nutritional and immune status on the prognosis of urinary tract infection in the elderly].

This study was performed to evaluate the role of the nutritional and immune status on the prognosis of urinary tract infections (UTI) in the elderly. 192 patients among the 790 inpatients were diagnosed as UTI. Age-related increase in the prevalence of UTI was accompanied with poor prognosis in the patients with hypoalbuminemia (< 2.6 g/dl) and lymphocytopenia (< 700/mm3). To study the immunologic basis for susceptibility to UTI in the aged further, we compared the T-cell functions between outpatients without serious disease and inpatients with chronic UTI. The absolute numbers of lymphocyte, OKT3 (pan T-cell marker), OKT4 (Helper/Inducer marker) and Interleukin (IL)-2 as well as serum albumin concentration were decreased in the patients with UTI. A prospective study was done to confirm that these nutritional and immunological changes become risk factors in the prognosis of UTI with long-term and low-dose chemotherapy. In the patients continued with bacteriuria (Non-responders, n = 6), serum albumin concentration and IL-2 production were significantly lower than the patients who became free from bacteriuria (Responders, n = 7). These results suggest that poor nutrition-related immune dysfunction contributes to the vulnerability of elderly patients to UTI and becomes risks for he prognosis of UTI.

Adult↗

PubMed1993

[Two elderly cases with acute exacerbation of interstitial pneumonia].

We studied two cases of the elderly with acute exacerbation of interstitial pneumonia to elucidate a prognostic role of super oxide generation in peripheral whole blood. The first case was a 70-year-old man, who presented with acute exacerbation of interstitial pneumonia and was hospitalized. Following steroid-pulse therapy, CRP, ESR, blood-gas and his physical condition improved, resulting in successful discharge. In this case, super oxide generation standardized by the number of neutrophils (K) decreased to less than 1.0 in association with the improvement of physical condition. The second case was a 92-year-old woman in whom acute exacerbation of interstitial pneumonia was diagnosed. While the pulse therapy, CRP, LDH and blood-gas temporarily improved, K was continuously greater than 1.0 and the physical condition worsened, resulting in her death. These cases suggest that the measurement of super oxide generation in peripheral whole blood may play a useful role in assessing the prognosis of the elderly with acute exacerbation of interstitial pneumonia.

Acute Disease↗

PubMed1993

[Successful surgical repair of emphysematous giant bullae of the elderly with severely depressed pulmonary function].

A 71-year-old male was admitted to an emergency hospital owing to severe dyspnea of sudden onset. Bilateral tension pneumothorax with two giant bullae occupying more than the third of the right lung was disclosed on the chest X-ray. Bilateral chest drainages and cardiopulmonary resuscitation were performed. He could be freed from ventilatory support several days after tracheostomy and was referred to our hospital. The pulmonary function was severely depressed: VC (%) 1.20 l (40%) and FEV1.0 (%) 0.55 l (46%). In spite of oxygen inhalation he could not keep sitting due to dyspnea (Hugh-Jones grade V). Right multiple bullectomy was performed successfully and his postoperative course was uneventful. He was discharged eight weeks later. Seven months after surgery his pulmonary function was remarkably improved: VC (%) 2.05 l (64%) and FEV1.0 (%) 0.94 l (46%). He became to walk almost equally with a healthy man one year later (Hugh-Jones grade II).

Aged↗

PubMed1992

Low ligand binding activities of two distinct types of Fc gamma receptor on guinea-pig peripheral blood polymorphonuclear leukocytes are differentially improved by proteolysis or platelet activating factor.

The expression and ligand binding activity of Fc receptors for IgG (Fc gamma R) on guinea-pig peripheral blood polymorphonuclear leukocytes (blood PMN) have been compared with those on casein-elicited peritoneal PMN (exudate PMN). Both the PMN were found to express two distinct types of Fc gamma R, one specific for IgG1 and IgG2 (Fc gamma 1/gamma 2 R) and the other for IgG2 alone (Fc gamma 2 R), when evaluated by their reactivity to monoclonal antibodies (mAb) directed against each type of Fc gamma R. The surface density of Fc gamma 1/gamma 2 R was not significantly different between the two cell types, whereas exudate PMN expressed five times as many Fc gamma 2 R as blood PMN. Moreover, IgG immune complex (IC) binding activities of both the Fc gamma R on blood PMN were markedly low as compared with those on exudate PMN. In addition, blood PMN could not significantly generate superoxide anion (O2-) when exposed to IC. However, these lower activities were improved by protease treatment of the cells or by incubation with platelet activating factor (PAF). Fc gamma 2 R on blood PMN was found to be sensitive to pronase, whereas Fc gamma 1/gamma 2 R was resistant. Pronase-treated blood PMN showed a marked IC binding activity, though they lacked Fc gamma 2 R. This activity was completely blocked by anti-Fc gamma 1/gamma 2 R mAb, indicating that the proteolysis augments the ligand binding capacity of Fc gamma 1/gamma 2 R. In contrast, PAF was found to specifically modulate Fc gamma 2 R. The Fc gamma 2 R expression was significantly increased within 5 min incubation with PAF, whereas that of Fc gamma 1/gamma 2 R was not affected. The cells also exhibited enhanced IgG2-IC binding and subsequent O2- generating activities. These results indicate that both the Fc gamma R on blood PMN are functionally immature and are converted to exhibit intrinsic activities by proteases and PAF; such changes may occur in vivo during exudation and at inflammatory sites.

Animals↗

PubMed1992

Inhibition of mouse alveolar macrophage production of tumor necrosis factor alpha by acute in vivo and in vitro exposure to tobacco smoke.

We investigated the effects of tobacco smoke exposure on the production of tumor necrosis factor alpha (TNF alpha) by alveolar macrophages (AM) in mice (C57BL/6). The results obtained are as follows: (1) In vivo tobacco smoke exposure caused a significant decrease in the production of TNF alpha by AM with the stimulation of lipopolysaccharide (LPS; control group: 19.32 +/- 5.52 U/ml, smoked group: 4.28 +/- 0.98 U/ml; p less than 0.05). (2) In vitro exposure of AM to tobacco smoke extracts (water-soluble extracts) also caused a decrease in the production of TNF alpha up to 93% of control with stimulation of LPS (p less than 0.05) without any decrease in cellular viability. We concluded that the production of TNF alpha by AM was impaired by smoking via direct action of the factors present in tobacco smoke.

Animals↗

PubMed1992

Quantitative assessment of dyspnea during exercise before and after bullectomy for giant bulla.

Incremental exercise testing using a cycle ergometer was performed in eight patients with giant bulla before and after bullectomy to assess dyspnea. There was a significant positive linear relationship between dyspnea expressed in the Borg scale (BS) and oxygen consumption (VO2) during exercise in all subjects. From these correlations, we introduced the following three new parameters for quantitative assessment of dyspnea: the Borg scale slope (BSS); the threshold load of dyspnea (TLD); and the breakpoint load of dyspnea (BLD), representing the slope of the regression line, onset of dyspnea on the regression line, and the maximum oxygen consumption before the subjects interrupted exercise, respectively. After surgery, the BSS showed marked decrease, and the TLD and BLD showed significant increase. Therefore, the reduction in the dyspnea with peak exercise after surgery was thought to be, at least in part, based on the delay of dyspnea onset, the decrease in dyspnea sensitivity, and the improvement in exercise capacity. The improvement in dyspnea during exercise in patients with giant bulla after surgery was extensively evaluated by newly introduced parameters based on BS-VO2 regression line.

Blister↗

PubMed1992

Gerontological education in Japan--geriatric education and training.

There are 13 academic geriatric departments among 80 medical schools in Japan as of November 1991. The first independent department was established in 1962 at Tokyo University. The undergraduate education program includes lectures in geriatrics (20 hours/year in 11/12 medical schools), bedside teaching at geriatric ward (6/12 medical schools, 66 hours on average per year). The theme of lectures are diverse and incorporate all the three major fields in gerontology: biology of aging, clinical geriatrics and socio-economical aspects of aging society. The postgraduate geriatric education is carried out mainly at university setting and most of the medical schools (83%) accept graduate students who are trained at independent geriatric ward (92%) as well as at outpatient clinics. In 1989, Japan Geriatrics Society started a new certification system by which 687 MDs have been temporarily certified in geriatrics. The first examination will be given by the society in 1992 and the eligibility to sit in the examination requires three years geriatrics fellowship after certification in medicine or general surgery. The curriculum proposed by the society shares many items of training in common with those found in north American and in Europe. Some points of suggestions and recommendations were presented for future improvement in the education of gerontology in Japan.

Certification↗

PubMed1992

Age-related changes in GSH content of eyes in mice--a comparison of senescence-accelerated mouse (SAM) and C57BL/J mice.

1. Age-related changes in glutathione (GSH) content of eye lenses were investigated in senescence-accelerated mouse (SAM) and C57BL/J mice. 2. The decrease of GSH content with aging is markedly observed in SAM strains. 3. The oxidized glutathione (GSSG) content of eyes increased significantly with aging in SAM. 4. Ophthalmic changes, including cataract, increased with age in SAM alone. 5. The decrease of GSH content and the increase of GSH oxidation may be involved in the pathogenesis of cataract in SAM.

Aging↗

PubMed1992

[Problems in ulcer surgery after the introduction of H2-receptor antagonists].

Recently, antisecretory drugs such as H2-receptor antagonists (H2-RA) or proton pump inhibitor have been used for peptic ulcer patients widely in Japan. However, there are possibilities that long term administration of H2-RA might cause changes in intragastric environment. The present study was designed to clarify the changes of surgical treatment in Japan Surgical Society training hospitals, before and after introduction of H2-RA. Serum gastrin and antral G-cell number was measured after administration of H2-RA (1 mg/kg 14 days continuous infusion) in rat. Also, acid secretion and gastrin response stimulated by adrenalin (40 ng/kg.min) were measured in duodenal ulcer patients. 1) In the view of surgical treatment, elective operation highly decreased after the introduction of H2-receptor antagonists, and showed the increase of the rate of emergency operation up to 70%. 2) Hypergastrinemia and antral G cell hyperplasia were observed after administration of H2-RA in rats. 3) Acid secretion stimulated by adrenalin which is considered as antral G cell dependent, showed a higher response in H2-RA treated cases than in those untreated. 4) Antrectomy was carried out in 43.4% of the patients treated with H2-RA versus 18.9% to the patients untreated.

Animals↗

PubMed1992

[Pharmacokinetics and clinical efficacy of ciprofloxacin in aged patients with chronic respiratory diseases].

Pharmacokinetics and clinical efficacy of ciprofloxacin (CPFX) were investigated in aged patients with chronic respiratory diseases. Serum and sputum concentrations of CPFX were determined upon oral administration of 200 mg CPFX in 6 aged patients with chronic respiratory diseases (mean age = 78.8 +/- 3.2 years, 2 cases diagnosed chronic obstructive pulmonary disease with pneumonia, 3 cases were diagnosed bronchiectasis with acute exacerbation, and 1 case diagnosed chronic lung abscess). Maximal serum concentrations in these patients were 0.88-1.29 micrograms/ml (mean = 1.08 micrograms/ml). Thus, maximal serum concentrations of CPFX after oral administration in these aged patients were slightly lower than those in young subjects. However, peak sputum levels of CPFX following oral administration of 200 mg CPFX ranged from 0.53 to 1.47 micrograms/ml at 1-4 hours. These sputum concentrations of the 6 patients were sufficiently high for the inhibition of most infecting organisms in vitro. Clinical responses to CPFX in these 6 patients were good in 5, fair in 1, with an efficacy rate of 100%. Upon administration of CPFX, these 6 patients did not show any adverse reactions. These results suggest that oral administration of CPFX may keep effective levels in serum and sputum over 3 hours in aged patients with chronic respiratory diseases, and good clinical responses should be obtained without side effects in such patients.

Aged↗