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Biomedical subjects

Y Ichikawa

Publications and source records attributed to Y Ichikawa.

At least 397 records · Page 22Linked to original sources
PubMed1993

[In vitro and clinical studies of MRSA infections in compromised hosts].

From January to December 1991, 47 clinical cases in when methicillin-resistant Staphylococcus aureus (MRSA) strains were isolate were investigated at our internal medicine ward. The MRSA infection rate was 57.4% (27/47). The mortality due to MRSA bacteremia was 75.0% (9/12) and that due to MRSA pneumonia was 57.1% (4/7). We think that MRSA infections must be treated by multiple antibiotics. At out institution, most of the patients were given a combination therapy of imipenem + fosfomycin or imipenemt + mynocycline. Although in vitro the MICs of imipenem did not show excellent activity against MRSA strains, in vivo these combination therapy including imipenem showed excellent activity against MRSA infections. We think that this result was due to the additive effect of the two drug combination. We determined the MICs of single antibiotics against MRSA strains. Most of the MRSA strains were sensitive to minocycline and arbekacin. All MRSA strains were sensitive to vancomycin we think that vancomycin is a highly useful drug to combat MRSA infection.

Adult↗
PubMed1993

HLA-DPB1 allele associates with early-onset myasthenia gravis in Japan.

We investigated the HLA-DPB1 allele in 43 unrelated Japanese patients with myasthenia gravis (MG) using digestion of polymerase chain reaction (PCR)-amplified DNA with allele-specific restriction endonucleases (PCR-RFLP method). We found a higher frequency of the DPB1*0201 allele in female patients whose ages at onset were less than 30 years (83.3%) than in controls (35.6%). The study also included serologic typing of HLA-A, -B, -C, and -DR antigens in 72 patients with MG, and confirmed previous results demonstrating a strong association of HLA-DR53 with early onset of MG in females. These results indicate that both the DPB1*0201 allele and DR53 play key roles in the disease process of MG in early-onset females, and that the genetic background of Japanese females with early-onset MG is different from that of other patients with MG.

Adolescent↗
PubMed1993

Pulmonary infiltrates recovered by FK506 in a patient with Behçet's disease.

Behçet's disease (BD) affects the lung as well as the intestine, central nervous system, kidney, and other organs. Pulmonary vasculitis is one of the most severe complications in BD because it can cause fatal bleeding. Corticosteroids and other immunosuppressive drugs have been used to treat pulmonary vasculitis, but the efficacy of these agents has not yet been established. We administered FK506, a novel immunosuppressive agent, as a treatment for BD. A 21-year-old woman presented definitive symptoms of BD, ie, repeated oral and genital ulcers, folliculitis, and panuveitis. The patient showed localized pulmonary infiltrates on her chest x-ray film that were histologically proved to be venulitis consistent with BD. These pulmonary infiltrates evanesced after the oral administration of FK506 for 8 weeks; in addition, the skin lesions and uveitis improved. This clinical observation indicates that FK506 is an effective agent in the treatment of pulmonary vasculitis associated with BD.

Adult↗
PubMed1993

Acquisition of CD13 and CD33 expression at relapse on acute myeloid leukemia cells with an unusual phenotype: MPO+CD13-CD33-.

A case of acute myeloid leukemia (AML) with an unusual phenotype which was negative for a panel of myeloid antigens determined by flow cytometry, but was strongly positive for myeloperoxidase has recently been reported. We herein describe a case of AML with this unusual phenotype at diagnosis; relapse occurred with the acquisition of CD13 and CD33 expressions. Morphological features of the blasts at relapse seemed to be more compatible with myeloblasts than those at diagnosis. These phenotypic and morphological changes are suggestive of asynchronous differentiation, clonal evolution or clonal change of leukemic cells.

Antigens, CD↗
PubMed1993

Clinical studies of oral quinolone once daily in the treatment of lower respiratory tract infections.

The efficacy and safety of oral ofloxacin, 400 mg once daily, for the treatment of patients with lower respiratory tract infections were studied. The most common species recovered from the sputum specimens of these patients were Haemophilus influenzae, followed by Streptococcus pneumoniae (S. pneumoniae), Staphylococcus aureus (S. aureus), Gram positive cocci unidentified, Pseudomonas aeruginosa (P. aeruginosa), Morexella catarrhalis, Streptococcus epidermidis, and another Haemophilus species in this order. All these bacteria were susceptible to ofloxacin except for one strain of methicillin resistant S. aureus. A satisfactory clinical outcome was achieved in 34 of 40 patients (85%). It is concluded that ofloxacin, 400 mg once daily, is useful for patients with respiratory tract infections.

Administration, Oral↗
PubMed1993

Low-dose/long-term erythromycin for treatment of bronchiolitis obliterans organizing pneumonia (BOOP).

Bronchiolitis obliterans organizing pneumonia (BOOP) is a pathologic entity characterized by intraluminal fibrosis of distal air spaces. Corticosteroids have been widely used for the treatment of this condition, and most patients showed a dramatic response to it. However, long-term treatment with corticosteroids, which often increases the risk of several undesirable side-effects, is usually required because a relapse tends to occur soon after termination of treatment. We administered erythromycin (EM) at low-dose (600 mg daily) for 3-4 months to 6 patients with BOOP, and obtained a good clinical, radiological, and physiological improvement. This suggests that EM can be successfully used, instead of corticosteroids, in the treatment of BOOP.

Adolescent↗
PubMed1993

Thrombomodulin levels in the plasma and joint fluid from patients with rheumatoid arthritis.

The hemostatic mechanism is thought to contribute to the inflammatory process of rheumatoid arthritis (RA). Thrombomodulin (TM), an inhibitor of blood coagulation, is synthesized by various cells which are recognized in the inflammatory lesions of RA. To elucidate a possible relation of TM with the process of RA, therefore, we measured soluble forms of TM in the plasma and joint fluid (JF) from RA patients by a recently developed sandwich enzyme immunoassay using monoclonal antibodies. TM levels in the plasma and JF were not significantly elevated in RA patients, although TM levels in plasma were positively correlated with those in JF. The plasma TM levels were related to renal functions (serum creatinine levels), but the levels showed no connection with systemic inflammatory indices of RA such as erythrocyte sedimentation rates, serum C-reactive protein levels and Lansbury's activity index. In the JF, TM levels were not correlated with the numbers of neutrophils or monocytes/macrophages associated with articular inflammations. Our results indicate that TM levels in the plasma and JF do not reflect systemic and articular inflammations of RA, and suggest that TM molecules in JF are mainly recruited from circulating TM.

Adult↗
PubMed1993

Comparison of antinuclear antibody and other immunohematological profiles among primary Sjögren's syndrome, secondary Sjögren's syndrome associated with rheumatoid arthritis or systemic lupus erythematosus, and corresponding systemic disease.

Sjögren's syndrome (SS) is currently classified into two groups (primary and secondary), because of differences in the disease in the two groups. We determined antinuclear antibody and other immunohematological parameters by using newer, more sensitive serologic methods on patients with primary SS, or secondary SS associated with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE), and patients with just the systemic disease free of SS. This study defined both distinctive and common features between primary SS and each systemic disease: High titers of fluorescent antinuclear antibodies (FANAs), anti-SS-A/SS-B antibodies, and rheumatoid factors (RFs), as well as leukocytopenia were considered the main features of primary SS. Elevated levels of RFs and C-reactive protein were prominent in RA patients. In contrast, high titers of FANAs and anti-single stranded or anti-double stranded DNA antibodies, positive anti-ribonucleoprotein or Sm antibodies, leukocytopenia, and hypocomplementemia were characteristic for SLE. Furthermore, patients with secondary SS plus RA or SLE were found to have mixed features of SS and the associated systemic disease. The results strongly suggest that patients with secondary SS have two separate diseases, SS and the associated systemic disease.

Adult↗
PubMed1993

Surgical experience on patients with serum lupus anticoagulants. A report of two cases.

Lupus anticoagulants (LA) are antiphospholipid IgG, IgM, or IgA auto antibodies. When LAs are present, a prolongation of activated partial thromboplastin time is usually found and arteriovenous thrombosis is likely to occur during or after surgery. We report here two LA-positive cases (a 29-year-old male taking chlorpromazine for schizophrenia, and a 44-year-old female diagnosed as systemic lupus erythematosus) who underwent surgical procedures without complications.

Adult↗
PubMed1993

Improved methods for genotype determination at the ALDH2 locus using PCR by introducing the MBOII recognition site or conducting secondary PCR.

Two convenient methods for determining the ALDH2 genotype using PCR were devised. The first method for distinguishing ALDH2(1) and ALDH2(2) alleles was conducted by introducing a single base change into an oligonucleotide primer for PCR, which produced the MboII recognition site for ALDH2(1) but not for ALDH2(2). The second method was conducted with a secondary PCR using allele-specific primers. Both methods have enabled us to easily determine the genotype of the ALDH2 locus without using isotopes. By applying these methods, the genotype of 112 Japanese individuals was determined. The frequency of ALDH2(1) was estimated to be 0.75 and that of ALDH2(2) was to be 0.25.

Alcohol Dehydrogenase↗
PubMed1993

Identification of a microsomal retinoic acid synthase as a microsomal cytochrome P-450-linked monooxygenase system.

1. To characterize an enzyme which metabolizes retinal in liver microsomes, several properties of the enzymatic reaction from retinal to retinoic acid were investigated using rabbit liver microsomes. 2. The maximum pH of the reaction in the liver microsomes was 7.6. 3. The Km and Vmax values for all-trans, 9-cis and 13-cis-retinals were determined. 4. The reaction proceeded in the presence of NADPH and molecular oxygen. 5. The incorporation of one atom of molecular oxygen into retinal was confirmed by using oxygen-18, showing that the reaction comprised monooxygenation, not dehydrogenation. 6. The monooxygenase activity was inhibited by carbon monoxide, phenylisocyanide and anti-NADPH-cytochrome P-450 reductase IgG, but not by anti-cytochrome b5 IgG. 7. The enzymatic activity inhibited by carbon monoxide was photoreversibly restored by light of a wavelength of around 450 nm. 8. The retinal-induced spectra of liver microsomes with three isomeric retinals were type I spectra. 9. The microsomal monooxygenase activity induced by phenobarbital or ethanol were more effective than that by 3-methylcholanthrene, clotrimazole or beta-naphthoflavone. 10. These results showed that the monooxygenase reaction from retinal to retinoic acid in liver microsomes is catalyzed by a cytochrome P-450-linked monooxygenase system.

Animals↗
PubMed1993

[Renal and cerebral infarctions in a patient with systemic lupus erythematosus without antiphospholipid antibodies].

Renal artery infarction is a very rare complication in patients with systemic lupus erythematosus (SLE), even in patients with antiphospholipid syndrome which often causes thromboembolism: Renal infarctions have only been reported in 4 SLE patients with antiphospholipid antibodies (aPL). Here we report a case of SLE without aPL who accompanied by renal and cerebral infarctions. A 42-year old Japanese woman with 8 year history of SLE manifested by arthralgia, central nervous system symptoms, positive-antinuclear and anti-DNA antibodies was admitted to our hospital for the treatment of progressive lupus nephritis. Physical examinations revealed hypertension (130-160/80-110 mmHg) without pitting pretibial edema. Laboratory evaluations showed proteinuria (3.7 g/day), normal serum creatinine level (0.9 mg/dl), low serum albumin level (2.3 g/dl) and high cholesterol level (317 mg/dl). Old cerebral infarctions were recognized by magnetic resonance imaging. However, hematological and immunological studies revealed that this case has neither a prolonged activated partial thromboplastin time, lupus anticoagulant nor anticardiolipin antibodies. Prednisolone was increased from 30 mg/every other day to 30 mg/day, and oral azathioprine, 50 mg/day, was started for the treatment of lupus nephritis. On the 11th day, she suddenly complained severe abdominal pain, which gradually localized on the right side. Computed tomography of the kidney suggested right renal infarctions, and arteriography of right renal artery confirmed both an obstruction of the ventral branch and a narrowing of the dorsal branch of right renal artery. No intra-cardiac thrombus was demonstrated by echocardiography. Following to the treatment with fibrinolytic agent and anticoagulant, her symptoms have improved.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[The worsening of tissue damage due to the transient release during the ischemia of rat small intestine--the relation with reactive oxygen species and lipid peroxidation].

Ischemia and reperfusion experiments were carried out using rat small intestine. Intestinal segment and supplying vessels was occluded and released after following procedure: In group I, 60 minute occlusion. In group II, 30 minute occlusion-10 minute release-20 minute occlusion. In group III, superoxide dismutase (SOD) and catalase (CAT) were given during the period of intermittent release in the same time schedule as in group II. Tissue damage was evaluated histopathologically and lipid peroxide (LPO) of involved segment and chemiluminescence (CL) of draining venous blood was investigated. It was concluded as follows: 1. In these experiments, the tissue damage and the increment of LPO and CL were severer in group II than in group I. Then, the reactive oxygen species (ROS) derived from neutrophils was thought to play an important role in the tissue damage. 2. At the end of intermittent release, LPO and CL increased in group II, and these increments were suppressed by SOD and CAT treatment in group III. 3. After last release, the tissue damage in group II was diminished in group III. The severe tissue damage after intermittent occlusion is thought to be caused by reperfusion injury during the intermittent release.

Animals↗
PubMed1993

[Refractory acute myelogenous leukemia successfully treated with a continuous infusion chemotherapy of low dose aclarubicin and cytosine arabinoside: a case report].

A 44-year-old female with refractory acute myelogeneous leukemia had experienced an early relapse after a third complete remission (CR) with combination chemotherapy (BHAC-AMP) using daily one-shot infusion of 20 mg aclarubicin (ACR). Further treatments including intermediate dose of cytosine arabinoside (Ara-C) were not effective. After treatment with a continuous administration of low dose ACR (9 mg/day) and Ara-C (21 mg/day) for 14 days she entered a fourth CR. The mechanism of this treatment relates to both cell-killing and differentiation effects on leukemic cells.

Aclarubicin↗
PubMed1993

[A successful surgical repair of ventricular septal perforation, whose perforated position could be marked by Swan-Ganz catheter before the operation].

The patient was a 72-year-old woman who was admitted with AMI. On the next day, a systolic murmur of Levine II/VI became audible on the left sternal border of the 5th intercostal space and VSP was diagnosed by the echocardiogram. The hemodynamics was comparatively stable, and so we scheduled the elective operation in the expectation of the healing of the infarction tissue. At the cardiac catheterization just before the operation, L-R shunt ratio was 64.9% and main PA was 41/18 (26) mmHg. Before the operation we marked the VSP position by Swan-Ganz catheter through the left ventricle and VSP closure and 2 CABG was performed. We concluded that this method was useful for the diagnosis and therapy of VSP.

Aged↗
PubMed1993

[Occurrence of bronchiolitis obliterans organizing pneumonia (BOOP) in a flare-up stage of systemic lupus erythematosus (SLE)].

A 33-year old housewife who developed BOOP in a flare-up stage of SLE was reported. She had been treated for Hashimoto's thyroidtis since the age of 18. When the patient was 21 years old, she noticed polyarthritis and subcutaneous nodules. She had a high titer of rheumatoid factor and a diagnosis of rheumatoid arthritis was made. At the age of 23, ulnar drift was noted despite the lack of subjective and objective signs of active articular inflammation. At the age of 25, she developed dry eyes and dry mouth, and at the age of 27, photosensitivity was experienced. At the age of 28, she was first admitted to our department and diagnosis of Sjögren's syndrome and SLE was made. Since then, she had been treated by corticosteroid and remained in a stable condition. In January 1991, she developed facial erythema, dry cough and edema of the lower extremities. Laboratory findings included profuse proteinuria, hypoalbuminemia, hyperlipidemia, elevated anti-DNA titer, depressed serum complements. Chest X-ray films showed a presence of patchy non-segmental infiltrates in both lung fields. TBLB specimen showed the characteristic findings of BOOP described by Epler at al. She had marked ulnar deviation at the MCP joints bilaterally and X-ray findings were consistent with Jaccoud's arthropathy. The pulmonary lesions and nephrotic syndrome responded to the combined therapy of prednisolone and immunosupressants. An occurrence of BOOP associated with flare of SLE indicates that immunological mechanisms might be involved for development of BOOP. Indeed, review of the literature shows that substantial numbers of patients with BOOP had clinical and serological overlapping findings with autoimmune diseases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗