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Biomedical subjects

Y Ichikawa

Publications and source records attributed to Y Ichikawa.

At least 541 records · Page 30Linked to original sources
PubMed1990

[A case of Mycoplasma pneumoniae infection followed by Staphylococcus aureus bacteremia].

A 19-year-old young man was admitted to our hospital complaining of fever and general fatigue. There were infiltrative shadows and pleural effusions in the both lung fields. Mycoplasma pneumoniae infection was diagnosed because of the elevation of mycoplasma antibody titers in the serum and pleural fluid. There was no recovery in clinical symptoms in spite of the administration of the EM (1200 mg) and CLDM (1200 mg) combination chemotherapy. Three week after admission, a cavity-like shadow appeared in the lt. middle lung field on the chest X-ray film, suprative arthritis and penicillin resistant S. aureus by blood culture test were found. Mycoplasma pneumoniae infection followed by S. aureus bacteremia was diagnosed. After the administration of antibiotics (CTT, FMOX) the clinical symptoms and laboratory findings improved 2 month after admission. Clinical and basic studies about the dual infection between M. pneumoniae and several bacteria were discussed.

Adult↗
PubMed1990

Neutrophilia in bronchoalveolar lavage fluid of diffuse panbronchiolitis.

The clinical and pathologic features of diffuse panbronchiolitis (DPB) have been well reported to date, although its pathogenesis remains unknown. In the present study, we performed bronchoalveolar lavage (BAL) on three patients with biopsy specimen-proven DPB and eight patients with highly probable DPB (six women and five men; one smoker and ten nonsmokers), nine patients with chronic bronchitis (all men, five smokers and four nonsmokers), and nine normal control subjects (six women and three men, all nonsmokers) to clarify the cell populations in the lower respiratory tract. Neutrophils comprised 55.3 +/- 24.4 percent of recovered cells by BAL in DPB patients but only 6.6 +/- 6.4 percent in chronic bronchitis patients, and 1.8 +/- 1.5 percent in normal control subjects (p less than 0.001, all comparisons). The DPB patients also exhibited a decreased percentage of alveolar macrophages (34.9 +/- 23.5 percent) compared with chronic bronchitis patients and normal control subjects (p less than 0.001, all comparisons). The percentage of lymphocytes of the recovered lavage cells in DPB patients did not differ from that in chronic bronchitis patients and normal control subjects. These results indicate that neutrophils play an important role in the pathogenesis of DPB. They also suggest that neutrophilia of BAL-recovered fluid is a common finding in diseases associated with bronchiolar inflammation despite some clinical and pathophysiologic differences.

Adult↗
PubMed1990

Lymphocyte subsets of the peripheral blood in myasthenia gravis determined by two-color flow cytometry.

Lymphocyte subsets of the peripheral blood in 43 patients with myasthenia gravis (MG) were determined by two-color flow cytometry using a number of monoclonal antibodies. In the MG patients without thymectomy (Tx) and prednisolone (PSL) treatment, lymphocyte counts, B-cells, CD4+ cells and their subsets were normal, but numbers of T-cells, CD8+ cells and CD8+ CD 11-subsets were significantly decreased. Furthermore, proportions of activated cells in T-cells, CD 16+ Leu7- and CD16+ Leu7+ NK subsets were significantly high in the patients. The changes in T-cells, CD8+ cells and activated T-cells were less marked in the MG patients than Sjögren's syndrome (SS) used as a disease control. Contrary to MG patients, lymphocyte counts, CD4+ cells and their subsets were decreased, and the proportions of B-cells were high in SS patients. These results suggest altered immunologic conditions, immunologically active and deficient conditions, in both diseases, although the alterations were more prominent in SS than MG. PSL treatments and Tx significantly altered the lymphocyte profiles: PSL decreased lymphocytes, B-cells, T-cells, CD4+ cells and their subsets, while the proportions of CD8+ cells were increased. The changes were compatible with the known immunosuppressive effects of PSL. After Tx, lymphocytes and B-cells decreased, but the proportions of T-cells, CD8+ cells and their subsets, and NK cells subsets returned toward normal. CD4+ CD8+ cells were not increased in MG patients, and the cells did not decrease after Tx. Some of these observations might be relevant to clinical effects of Tx, although the mechanism responsible for these changes is still unknown.

Adolescent↗
PubMed1990

Extracellular production of human tumor necrosis factor-alpha by Escherichia coli using a chemically-synthesized gene.

A DNA fragment of approximately 490 base pairs encoding human TNF was chemically synthesized and expressed within Escherichia coli cells. Furthermore, extracellular production of human TNF and several N-terminal deletion mutants of TNF was attempted using the excretion vector pEAP8. The TNF mutant with two N-terminal amino acids deleted (N delta 2-TNF) was efficiently excreted into the culture medium by E. coli carrying the plasmid pEXTNF3. In this clone, the signal peptide was correctly processed during the excretion. The E. coli-excreted N delta 2-TNF had higher antitumor activity than wild-type TNF or N delta 2-TNF produced intracellularly by E. coli.

Amino Acid Sequence↗
PubMed1990

Superoxide scavenging activity of leukocytes in rheumatoid arthritis and Behçet's diseases.

Superoxide radical anion (O2-) has been suggested to mediate tissue damage associated with chronic inflammatory disorders such as rheumatoid arthritis (RA) and Behçet's disease (BD). Despite that protection from O2- is provided by superoxide dismutase (SOD), there are controversial results about SOD-like activity of polymorhonuclear cells (PMN) in RA and there are no reports about it in BD. In addition, colchicine, a potent inhibitor of phagocytosis, has been used for the treatment of BD, no report about its effect on SOD-like activity of PMN is available. The present study investigates the superoxide scavenging activity (SSA) of PMN and mononuclear cells (MNC) in both RA and BD, and it examines the effects of colchicine on SSA of PMN in BD using the electron paramagnetic resonance/spin trapping method. The SSA of PMN, but not MNC, was significantly lower in patients with either RA or BD, as compared with that in healthy controls. The SSA of PMN in both RA and BD showed a strong negative correlation with that in healthy controls. The SSA of PMN in both RA and BD showed a strong negative correlation with erythrocyte sedimentation rates and C-reactive protein levels. Colchicine treatment increased the SSA of PMN toward normal level in BD patients, and prevented the decrease of SSA in PMN obtained from healthy adults after the stimulation with opsonized zymosan in vitro. Our results suggest that the decrease of SSA in PMN is not disease specific and it is probably the results of the increased amount of O2- generated by these cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Possible involvement of platelet-activating factor in the induction of liver cell injury.

In order to examine whether the platelet-activating factor (PAF) plays a role in the induction of liver cell injury, the effects of a PAF antagonist were studied in an experimental model of mice with acute liver cell injury induced by intravenous injection of heat-killed Propionibacterium acnes (P. acnes) and lipopolysaccharide. As a result, an intravenous injection of the PAF antagonist was shown to improve the histological changes in the liver, reducing the degree of focal tissue necrosis. In addition, liver adherent cells isolated from normal mice and from those pretreated with P. acnes were shown to produce PAF by stimulation with calcium ionophore A 23187. These results suggested that PAF produced by liver adherent cells may be involved in the induction of liver cell injury.

Animals↗
PubMed1990

Expression of MHC class II antigens and other T cell activation antigens on T cells and salivary duct epithelial cells in the salivary gland of cases of Sjögren's syndrome.

We studied infiltrating T cells and salivary duct epithelial cells in the sublingual glands of 10 patients with primary Sjögren's syndrome (SS) using monoclonal antibodies (MoAb) to T cell subsets (OKT-series), natural killer cells (Leu7) and activation antigens of T cells such as OKT10, OKT9, interleukin 2 receptor (anti-Tac antibody) and major histocompatibility complex (MHC) class II antigens (anti-DR and anti-DQ antigens). DR antigens were identified on salivary duct epithelial cells, suggesting that the cells might function as antigen-presenting cells (APC). Among the salivary duct epithelial cells, OKT8+ cells, which are known to be suppressor/cytotoxic cells, were found in 9 out of 10 patients. Three types of mononuclear cell infiltrations were also evaluated separately: (1) periductal foci, (2) periacinal foci and (3) lymph follicles. We found that the majority of the infiltrating cells in the central portion of the periductal foci were activated T cells (OKT3+, OKT4+, OKIa-1+, DR+ and DQ+), but OKT9, OKT10 and Tac antigens were rarely found in this portion. However, most of the infiltrating cells in the peripheral portion of the periductal foci were OKT10+, and some of them were also positive for OKT9 antigen (transferrin receptor). The results indicated that the T cells in the peripheral portion of the periductal foci are at an early or intermediate phase of activation, whereas the T cells around the salivary ducts are at a later phase. Infiltrating cells in the periacinal foci resembled the cells on the peripheral portion of the periductal foci. Cells within lymph follicles were mainly B cells although scattered OKT4+ or OKT8+ cells were also present.

Antigen-Presenting Cells↗
PubMed1990

[Regulation of coagulo-fibrinolytic activity and lupus anticoagulants in systemic lupus erythematosus].

We determined the following coagulo-fibrinolytic activities in 24 patients with systemic lupus erythematosus (SLE) and 20 healthy adults: prothrombin time (PT), activated partial thromboplastin time (A-PTT), factor VIII: coagulant activity), von Willebrand factor antigen (vWF: Ag), antithrombin-III (AT-III), plasminogen (PLG), alpha 2 plasmin inhibitor (alpha 2 PI), alpha 2-plasmin inhibitor-plasmin complex (PIC), protein C (PC: activity and antigen concentration), and protein S (PS: total PS and free PS). PLG, AT-III, PC antigen concentration and total PS were significantly decreased in ten female controls as compared with ten male controls. Therefore, we used the ten healthy females as controls and excluded two male SLE patients in the analysis of the correlations of coagulo-fibrinolytic activities with lupus anticoagulant (LA), clinical and laboratory features in 22 female patients with SLE. In the SLE patients, PT was significantly shortened, while A-PTT was prolonged. PLG, PC activity and antigen, and total PS were significantly increased, and free PS levels were decreased in SLE. The shortened PT and decreased free PS suggest hypercoagulable states in SLE patients. A significant prolongation of A-PTT and a decrease of F VIII activity were observed in the six LA-positive SLE patients, and the results were considered as known effects of LA. Furthermore, vWF: Ag, AT-III and PC antigen levels were significantly increased in the LA-positive patients as compared with LA-negative patients. These changes indicate both vascular endothelial cell damages and a compensatory increase in coagulation inhibitors in the LA-positive patients.

Adult↗
PubMed1990

[Clinical evaluation of sulbactam/cefoperazone in lower respiratory tract infections].

Clinical evaluation, safety and kinetics in serum of sulbactam/cefoperazone (SBT/CPZ) in patients with lower respiratory tract infections have been studied in a multicenter trial participated by 28 institutions in Kyushu area during a period of 13 months from March 1987 to March 1988. 1. Mean peak serum levels of SBT and CPZ in 35 patients up to 4 hours after intravenous infusion of 2 g of SBT/CPZ were 38.2 +/- 17.3 micrograms/ml for SBT and 104.3 +/- 31.4 micrograms/ml for CPZ. Serum half-lives of SBT and CPZ were 0.76 hour and 1.53 hours, respectively. These results were in similar ranges to those reported elsewhere for SBT/CPZ. 2. Serum half-lives of SBT and CPZ after intravenous infusion of 2 g of SBT/CPZ were not significantly prolonged in patients with moderate liver or kidney dysfunctions. 3. Clinical efficacy rates of SBT/CPZ in 217 patients were 93.1% (81/87) for pneumonia, 93.3% (14/15) for lung abscess, 78.9% (15/19) for acute exacerbation of chronic bronchitis, 57.1% (4/7) for diffuse panbronchiolitis, 72.4% (21/29), 74.4% (32/43) and 100% (9/9) for infections concurrent to bronchiectasis, chronic respiratory disease and pulmonary emphysema, respectively. Those were 50% (1/2) for bronchitis associated with lung cancer and 66.7% (4/6) for empyema. The overall efficacy rate was 83.4% (181/217). 4. Clinical efficacy rate of SBT/CPZ for pneumonia in patients with underlying diseases such as lung cancer, pulmonary tuberculosis and pneumoconiosis, etc, was 85.3% (29/34) and was not significantly different from the efficacy rate of 98.1% (52/53) in patients without these underlying diseases. 5. Of 30 patients who failed to respond of previous antibiotic treatments, 21 were effectively treated by SBT/CPZ. 6. Bacteriological eradication rates against Pseudomonas aeruginosa, Haemophilus influenzae and Streptococcus pneumoniae were 42.9% (9/21), 87.5% (14/16) and 100% (5/5), respectively. The overall eradication rate in all cases including polymicrobial infections was 72.8% (67/92). 7. The high levels of peak serum concentration of CPZ, and the difference between serum levels of SBT and of CPZ seemed to contribute to the high clinical efficacy. 8. Adverse reactions occurred in 2.8% (6/217) of the patients, and consisted primarily of rash and diarrhea. Laboratory abnormalities were observed in 8 patients during the study. These were elevations of S-GOT and S-GPT, and eosinophilia. 9. SBT/CPZ is a very useful drug in the treatment of lower respiratory tract infections as it has become available just in time when increase in resistant organisms to beta-lactams is notable.

Adult↗
PubMed1990

[A case of pulmonary tuberculosis associated with adult respiratory distress syndrome during corticosteroid treatment of rheumatoid arthritis].

We reported a case of 64 year-old female patient of pulmonary tuberculosis associated with ARDS during corticosteroid treatment of Rheumatoid Arthritis. On admission her chief complaints were fever, fatigue and dyspnea. A chest roentgenogram showed diffuse alveolar infiltration consistent with pulmonary edema. Arterial blood gas studies showed severe hypoxemia. We clinically diagnosed so-called ARDS. Smears of sputum for acid fast bacilli were negative, but transbronchial lung brushing by bronchofiberscope revealed many acid fast bacilli. Intensive therapy with anti-tuberculosis drugs (INH, RFP, SM), high dose corticosteroid (methylprednisolone) therapy and mechanical ventilation was started. During the following 2 weeks, the PaO2 rose gradually and the alveolar infiltration on the chest roentgenogram disappeared. The experience of this case to emphasized the importance of suspecting this condition because pulmonary tuberculosis is a potentially curable cause of ARDS and it should also be emphasized that the good treatment effect could be expected with combined use of high dose corticosteroid and mechanical ventilation.

Arthritis, Rheumatoid↗
PubMed1990

[Allergic individuals to Japanese cedar or orchard grass consist of two subgroups based on the sensitization to Dermatophagoides pteronyssinus].

One hundred and twenty-six allergic subjects were divided into three groups based on the RAST results for Dermatophagoides pteronyssinus (D.p) and Japanese cedar (J.C.). We compared sex, age of examination for RAST, serum IgE, family history of allergic diseases, prevalence rate of bronchial asthma (BA) and allergic rhinitis (AR), and onset of AR among three groups. No significant difference in the other variables except serum IgE and prevalence rate of BA was found between the group with D.p-positive and J.C.-positive RAST and the group with D.p-positive and J.C.-negative RAST. The group with positive RAST for D.p and J.C. showed lower age of the examination, higher serum IgE, higher incidence of allergic family history, higher prevalence rate of BA, and lower onset age of AR than the group with negative RAST for D.p and positive RAST for J.C. We suggested that in J.C. RAST-positive group there might be two different subgroups distinguished by RAST result for D.p Similar results were obtained from the assessment of RAST for Orchard grass instead of J.C.

Adolescent↗
PubMed1990

[Methylprednisolone-pulse therapy in a patient with rheumatoid arthritis and diffuse interstitial pneumonia/pulmonary fibrosis].

A forty-eight year-old female with rheumatoid arthritis developed cough, sputum and dyspnea. Chest X-ray film demonstrated bilateral diffuse interstitial pneumonia and pulmonary fibrosis. Laboratory findings were as follows: ESR 29 mm/h, CRP 3.86 mg/dl, RA test (+), RAHA (-) and WBC 7200/mm3. Marked hypoxemia (po(2)45 Torr) was demonstrated by blood gas analysis. Asymptomatic pulmonary fibrotic lesions which preceded articular symptoms were identified on her previous chest X-ray films. Methylprednisolone-pulse therapy (1g/day, for 3 days) was repeated three times with a 2-week interval. The treatment rapidly improved both pulmonary symptoms and chest X-ray findings. Although the fibrotic shadows on chest X-ray did not completely disappear, her conditions have been maintained well under the treatment with prednisolone (10mg/day) plus D-penicillamine (200mg/day).

Arthritis, Rheumatoid↗
PubMed1990

[Low dose methotrexate therapy in rheumatoid arthritis].

Twenty-three patients were included in this prospective study about the safety and efficacy of oral low dose methotrexate (MTX) in the treatment of refractory rheumatoid arthritis. Patients received a mean dosage of 6.6 +/- 1.8 (SD) mg weekly over a mean duration of 16.6 +/- 12.5 months. Patients improved significantly in all clinical parameters of efficacy. There were significant reductions in Lansbury joint scores (p less than 0.001), duration of morning stiffness (p less than 0.001), sedimentation rates (p less than 0.001), C-reactive protein (p less than 0.01), IgG(p less than 0.01), rheumatoid factor (p less than 0.01) and significant increase in grip strength (p less than 0.001), hemoglobin (p less than 0.05) after 17 months of treatment with MTX. Radiographic progression of joint disease were assessed using global scoring method. The mean rate of development of erosions and joint-space narrowing during MTX therapy was significantly less than the rate of radiographic progression before MTX therapy (8.1 +/- 7. 9/year vs. 1.9 +/- 3.8; p less than 0.05). Adverse reactions during MTX therapy included transient transaminase elevation (17.4%). Five patients (21.7%) were withdrawn because of leukopenia (2), interstitial pneumonitis (1), stomatitis (1), skin rash (1). We conclude that low-dose methotrexate is effective for the management of clinical disease activity in patients with refractory rheumatoid arthritis and may be a disease-modifying anti-rheumatic drugs (DMAR-Ds) by roentgenographic criteria.

Adult↗
PubMed1990

[Successful pregnancy outcome in a patient with HbE/beta (0)-thalassemia].

Successful pregnancy outcome is described in a patient with hemoglobin E/beta(0)-thalassemia which is expressed as thalassemia major. A 21 year-old Laotian female complicated by severe anemia became pregnant. The diagnosis of hemoglobin E/beta (0)-thalassemia was made by hemoglobin analysis. The fetal weight estimated by abdominal echogram decreased during pregnancy. She received blood transfusions, in order to improve intrauterine growth retardation. Hemoglobin concentration was maintained at the level greater than 9 g/dl. Fetal growth was improved by the treatment. A normal full-term male infant was born by a caesarean section, and splenectomy was performed at the same time.

Adult↗
PubMed1990

[A case of subacute necrotizing lymphadenitis with localized interstitial pneumonia].

A 16-year-old male was admitted with a history of cervical lymph node swelling, high fever, cough and hemosputum. On admission, bilateral cervical lymph nodes swelling and fine crackles in the right lower lung field were noted. A chest X-ray film showed an infiltrative shadow in the right lower lung field and right hilar enlargement. Cervical lymph node biopsy specimens revealed wide areas of necrosis with nuclear debris. Transbronchial lung biopsy showed infiltration of lymphocytes in the interstitium and bronchoalveolar lavage fluid showed increased T-lymphocytes and a decreased T4/T8 ratio. The patient was diagnosed to have subacute necrotizing lymphadenitis with T-lymphocyte alveolitis. Additionally, antinuclear antibodies were positive, and anti HTLV-I antibody was false positive. These findings suggested an immunological abnormality in this case. His cervical lymph node swelling and infiltrative shadow on chest X-ray film improved with steroid therapy. Our case may be the first case of subacute necrotizing lymphadenitis with T-lymphocyte alveolitis.

Adolescent↗