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Biomedical subjects

Y Ohtsuka

Publications and source records attributed to Y Ohtsuka.

At least 145 records · Page 8Linked to original sources

Three cases of idiopathic interstitial pneumonia with bullae seen in schoolteachers.

We encountered three patients with chronic interstitial pneumonia with many bullae in the lower lung fields whose lifetime occupation was teaching school. Pathological examination of autopsy lungs of these patients revealed interstitial pneumonia and multiple bullae throughout the lungs, including the lower lobe. Since blackboard chalk has been used as a popular writing material among teachers in Japan, the mineral contents in the lungs of two of the three cases and four control cases with idiopathic interstitial pneumonia (IIP) (whose occupations were not teaching) were analyzed. The amount of deposition of total dust, inorganic dust, non-SiO2 inorganic dust, and calcium was significantly higher in the lungs of two schoolteachers compared with those of the control lungs. The amount of free silica in case 1 and alpha-quartz in case 3 were also significantly higher than in the controls. Two thirds of the chalk produced in Japan is still made from gypsum and involves small amounts of silica and other minerals, in addition to calcium. These findings indicated the deposition of chalk in the lungs of these patients with interstitial pneumonia and multiple bullae.

Blister↗

Thermal stress and diabetic complications.

Activities of erythrocyte aldose reductase were compared in 34 normal subjects, 45 diabetic patients, and nine young men following immersion in water at 25, 39, and 42 degrees C. Mean basal enzyme activity was 1.11 (SEM 0.12) U/g Hb and 2.07 (SEM 0.14) U/g Hb in normal controls and diabetic patients, respectively (P < 0.0001). Activities of the enzyme showed a good correlation with hemaglobin A1 (HbA1) concentrations (P < 0.01) but not with fasting plasma glucose concentrations. After immersion at 42 degrees C for 10 min, enzyme activity was increased by 37.6% (P < 0.01); however, the activity decreased by 52.2% (P < 0.005) after immersion for 10 min at 39 degrees C and by 47.0% (P < 0.05) at 25 degrees C. These changes suggest that heat stress might aggravate diabetic complications, and body exposure to hot environmental conditions is not recommended for diabetic patients.

Adult↗

Elevated levels of heat-shock protein 70 (HSP70) in the mononuclear cells of patients with non-insulin-dependent diabetes mellitus.

Increased free radicals and reduced levels of antioxidants have been reported in diabetes mellitus. Since heat-shock protein 70 (HSP70) is a stress-induced protein and is suggested to play a protective role against oxidative stress, we have investigated whether HSP7O acts as one of the defense systems against this stress. We separated mononuclear cells from diabetic patients (N=12) and age- and sex-matched healthy controls (N =12), and detected HSP70 by western blot analysis. The results were expressed by the ratio of the density determined by laser densitometry, to that of 10 mu g of purified HSP70. HSP70 levels in the mononuclear cells of diabetic patients (0.78 + or- 0.56) were significantly high, compared with healthy subjects (0.43 + or - 0.23) (P < 0.05). No correlation was found between HSP7O and hemoglobin A1c, fasting plasma glucose, duration of diabetes or diabetic complications except age. A negative correlation was found between HSP70 and age (r = -0.658, P < 0.05). These results suggest that HSP70 levels in the mononuclear cells are elevated reflecting increased oxidative stress in patients with diabetes.

Adult↗

Monozygotic twin patients with congenital ichthyosis, microcephalus, spastic quadriplegia, myoclonus, and EEG abnormalities.

A pair of monozygotic twins manifested widespread ichthyosis on the trunk and extremities, mainly on the extensor surface of the lower legs. Both patients had severe developmental retardation, microcephalus, spastic quadriplegia, myoclonus, and hearing impairment. Cranial computed tomography and magnetic resonance imaging revealed diffuse cortical atrophy. Electroencephalography documented diffuse slow wave dysrhythmia and marked epileptic discharges, namely bilateral occipital dominant, and low-voltage multifocal spikes which appeared asynchronously as a burst, mainly during sleep. Skin biopsy revealed hyperkeratosis with parakeratosis. Granular cell layer was not thickened and diminished. Papillomatosis was absent. Electron microscopy did not reveal any distinctive abnormalities. Sjögren-Larsson syndrome and other known ichthyosis syndromes were excluded because of the difference in localization of skin lesions, skin manifestations, lack of papillomatosis, the nature and severity of neurologic symptoms and marked electroencephalographic abnormalities.

Diseases in Twins↗

Involvement of alpha 1 and alpha 4 integrins in gut mucosal injury of graft-versus-host disease.

We have investigated the involvement of adhesion molecules in the lymphocyte infiltration associated with acute intestinal graft-versus-host disease (GVHD) induced by injection of C3H lymph node cells into irradiated (C3H x DBA/2)F1 mice. First we analyzed the expression profile of adhesion molecules including alpha 1, alpha 2, alpha 4, alpha 5, alpha 6, alpha L and beta 7 integrins, CD44 and L-selectin of lymphocytes from lymph nodes and gut mucosa in normal mice. In normal mice, intraepithelial lymphocytes (IEL) and lamina propria lymphocytes (LPL) uniquely showed increased expression of alpha 1, alpha 2 and beta 7 integrins, and decreased expression of L-selectin compared with that of lymphocytes of the lymph nodes and Peyer's patches. In mice with GVHD, IEL and LPL of donor lymph node cells origin underwent phenotypic changes characterized by the increased expression of alpha 1, alpha L and beta 7 integrins, and the loss of L-selectin. The expression profile of adhesion molecules on IEL and LPL of GVHD mice resembled that of normal mice except for the lack of alpha 2 integrin. Treatment of GVHD mice with anti-alpha 1, -alpha 4 or -beta 7 integrin antibody alone partially prevented the mucosal pathology of intestinal GVHD, whereas only mice treated with anti-alpha 1 showed reduced donor lymphocytic infiltration into the intestinal mucosa. In contrast, treatment with anti-alpha L or anti-CD44 antibody did not affect the intestinal GVHD. Furthermore, dual blockade of both alpha 1 and alpha 4 integrins completely inhibited the mucosal pathology and donor lymphocyte infiltration of intestinal GVHD.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Quantitative analysis and immunohistochemical studies on small intestinal mucosa of food-sensitive enteropathy.

Quantitative analysis and immunohistochemical studies of small intestinal mucosa were performed to investigate the mechanism of mucosal damage in 10 patients with food-sensitive enteropathy. Jejunal biopsy specimens were taken before and after treatment and after clinical relapse following a challenge test. The low villous height of untreated patients normalized after introduction of an elimination diet but declined again to subnormal level after a challenge test. Several other types of cells were significantly increased in the untreated patients in comparison to controls. These included HLA-DR+ (DR+) CD4+ cells in the lamina propria and intraepithelial CD8+ cells. Moreover, those cell patterns, such as increased DR+ CD4+ cells and CD8+ cells, normalized with treatment but regressed to pretreatment levels when the patients were challenged. These findings suggest that activated CD4+ cells in the lamina propria of the small intestinal mucosa, probably by releasing cytokines, may play an important role in contributing to mucosal damage in patients with food-sensitive enteropathy.

Animals↗

Lennox-Gastaut syndrome: a new vista.

Lennox-Gastaut syndrome (LGS) is regarded as a model of the epileptic syndrome because of its specific clinicoelectrical manifestation. However, a close investigation reveals that its outline is somewhat vague, having the borderland around it. Precise diagnosis in an individual case is not always easy. In this paper, the diagnostic criteria of LGS are described. According to these criteria, cases with LGS were subclassified into the typical and the atypical cases, and also cases in the borderland of LGS were reviewed. On the other hand, our prospective long-term follow-up study revealed that cortical mechanisms played an important role in the pathophysiology, clinical features and refractoriness of LGS. Secondary bilateral synchrony (SBS) is supposed to be a mode of expression of cortical mechanisms of LGS. A newly developed method with coherence and phase analysis demonstrated that the pathophysiology was based on SBS in 33% of the typical LGS cases. This finding is not only crucial for the choice of rational treatment including epilepsy surgery, such as callosotomy, but also contributes to a more refined subclassification of LGS.

Child↗

Patterns of 24 h intragastric acidity in duodenal ulcers in children: the importance of monitoring and inhibiting nocturnal acidity.

The objective of this study was to compare the gastric acidity patterns of patients with duodenal ulcers and normal children. Eight patients with duodenal ulcer had their intragastric pH monitored for two consecutive 24 h periods using intragastric glass electrodes. The first 24 h period elucidated pH patterns in the absence of treatment and the second period evaluated the acid suppressive effect of 15 mg/kg of cimetidine when given in three divided doses. Results showed that the ulcer patients were hyperacidic, particularly at midnight. This finding was in marked contrast to the results obtained in the study of normal controls. The mean pH of normal children was above 3 around midnight. This phenomenon is known as intragastric pH inversion. The mean pH 3 time (the cumulative duration of the time for which gastric pH is maintained at > or = pH 3) was significantly shorter in patients with ulcers. However, pH 3 time of these patients significantly increased throughout the 24 h recording period during the daytime and at night after the introduction of cimetidine. This resulted in an induction of apparent nocturnal intragastric pH inversion for the ulcer patients. This study demonstrates the usefulness of 24 h continuous intragastric pH monitoring in children. The data showed that there was a pattern of gastric hyperacidity in pediatric ulcer patients which is clearly distinct from that of normal children, particularly in the patterns occurring at midnight. Cimetidine at 15 mg/kg per day in three divided doses was effective in suppressing secretion even at night.

Adolescent↗

Neuroepidemiological study of childhood epilepsy by application of international classification of epilepsies and epileptic syndromes (ILAE, 1989).

A population-based survey of childhood epilepsy was made in 1975 on the total population of children aged < 10 years living in Okayama Prefecture (n = 2,378 patients). Using the data obtained, we attempted to reclassify the various types of epilepsy according to the international classification (ILAE, 1989). Reclassification was possible in 1,872 (78.7%) of the 2,378 cases. The 1,872 cases consisted of 1,045 (55.8%) with localization-related epilepsies, 824 (44.0%) with generalized epilepsies, and 3 (0.2%) with epilepsies undetermined whether focal or generalized. Classification of the epilepsies in a population-based survey using the international classification involves difficulties, because both clinical and EEG findings are essential. However, if an appropriate area is selected, classification of epilepsies and epileptic syndromes in a population-based survey is possible by referring to all medical records stored at every hospital and practitioner's clinic that administers treatment to patients with epilepsy in the area.

Age Factors↗

Can interstitial pneumonia as the sole presentation of collagen vascular diseases be differentiated from idiopathic interstitial pneumonia?

We prospectively followed 68 patients diagnosed as idiopathic interstitial pneumonia (IIP) over a period of 1-11 years. Thirteen patients (19%) subsequently developed systemic manifestations of collagen vascular diseases (CVD) and were diagnosed as having had interstitial pneumonia as the sole presentation of CVD (CVD-IP). Compared with the 55 IIP patients, the 13 CVD-IP patients were relatively younger, predominantly female, and had a lower incidence of dust inhalation in their history. They also had a higher erythrocyte sedimentation rate, higher incidence of the x-ray finding of discoid atelectasis in the lower lung fields, and a better prognosis than the IIP patients. However, these features did not clearly distinguish the two groups. We conclude that the patients clinically and/or histologically defined as suffering from IIP cannot be distinguished from CVD-IP patients before systemic signs of CVD appear in the latter group.

Adult↗

Dairy farmers have increased methacholine bronchial responsiveness independent of sensitization to mold antigens.

Patients with farmer's lung disease (FLD) and dairy farmers have nonspecific bronchial hyperresponsiveness. To examine the factors determining bronchial hyperresponsiveness among dairy farmers, we studied airway functions, airway responses to inhaled methacholine, serum total IgE levels, and antigen-specific IgE levels in 37 dairy farmers and 11 local control subjects. The 37 dairy farmers consisted of three groups; 12 farmers with episodes of FLD (FLD group), 13 farmers with serum antibody to Micropolyspora faeni (MF) and/or Thermoactinomyces vulgaris (TV) but without episodes of FLD (Ab(+) group), and 12 farmers without serum antibodies to MF and TV and without episodes of FLD (Ab(-) group). Pulmonary function tests showed small airways disorders among farmers (each of the three groups versus control subjects; p < 0.05). Methacholine provocation test, utilizing PD35Grs (a cumulative dose of methacholine that induces 35% reduction in respiratory conductance [Grs]), showed bronchial hyperresponsiveness in each group of dairy farmers compared with that in control subjects (Log PD35Grs, mean +/- SEM: 1.22 +/- 0.18, 1.00 +/- 0.17, and 1.20 +/- 0.20, respectively, versus 2.10 +/- 0.09; p < 0.001). However, there was no statistically significant difference in bronchial responsiveness among the three groups of dairy farmers. In addition, there was no significant difference in serum total IgE levels and specific IgE antibodies among the four groups. These results suggest that the bronchial hyperresponsiveness to methacholine among dairy farmers is not due to past episodes of FLD or sensitization to MF and/or TV, but is possibly due to the occupational environment of dairy farming.

Antibodies, Bacterial↗

Increased susceptibility to silicosis and TNF-alpha production in C57BL/6J mice.

Toxic oxygen species and several proinflammatory cytokines are involved in the pathogenesis of silicosis. In order to understand whether factors that lead to susceptibility to ozone are also important in silicosis or not, we examined ozone-sensitive C57BL/6J mice and ozone-resistant C3H/HeJ mice as models of silicosis. We also analyzed the production of proinflammatory cytokines in both the acute and the chronic phases. On Day 2 after silica injection, the ozone-resistant C3H/HeJ mice showed significantly higher cellular responses as recognized by bronchoalveolar lavage (BAL) cell counts than did the C57BL/6J mice. In the chronic phase (Day 28 after silica injection), the ozone-sensitive C57BL/6J mice showed significantly greater responses to instilled silica judged by total protein and cell number in BAL fluid, hydroxyproline content, and histology than the ozone-resistant C3H/HeJ mice. TNF-alpha production by BAL cells after silica exposure was significantly higher in C57BL/6J mice than in C3H/HeJ mice in the chronic phase, whereas there was no significant difference in IL-1 alpha production between both strains of silica-injected mice. Also, the control C57BL/6J mice had significantly higher secretions of TNF-alpha than did the control C3H/HeJ mice in the acute phase. These results suggest that ozone-sensitive C57BL/6J mice are also more susceptible to silicosis than are ozone-resistant C3H/HeJ mice, and that the initial lower cellular responses and increase in TNF-alpha production may be related to the higher level of inflammatory and fibrotic response in the C57BL/6J mice.

Animals↗

Localized myxedema, associated with increased serum hyaluronic acid, and response to steroid pulse therapy.

A 66-year-old man presented with Graves' disease and widespread localized myxedema. Extensive lesions were present on the legs, feet, hands, and face. TSH receptor antibody (TBII) was markedly positive and the serum hyaluronic acid level was very high. Intravenous steroid pulse therapy was followed by oral therapy with gradual tapering. This regimen markedly improved the skin lesions and resulted in a decrease of the serum hyaluronic acid level. The findings suggest that steroid pulse therapy is effective for the treatment of extensive localized myxedema. In addition, the serum hyaluronic acid level may be a useful parameter for the follow-up of patients with this condition.

Administration, Oral↗

Smoking promotes insidious and chronic farmer's lung disease, and deteriorates the clinical outcome.

Although the prevalence of serum precipitating antibodies for farmer's lung disease (FLD) is lower in smokers than in nonsmokers and FLD predominates in nonsmokers, the affects of smoking on the clinical course of the disease is not known. We compared the clinical findings and the prognosis between 12 smokers (SM-FLD) and 31 non-smokers with FLD (NS-FLD). There was no difference in age, sex, working years on farm, clinical symptoms, laboratory findings, radiographic findings, between the two groups. However, for the type of onset on the first visit for FLD, "acute single episode" type was less common, and "recurrent" and "insidious onset" types were more common in SM-FLD than in NS-FLD (8.3 vs 58.1, 91.7 vs 41.9%, respectively, p < 0.05). Although working status and mask wearing status were not significantly different between the two groups after the diagnosis of FLD, patients with symptoms and/or radiographic abnormalities of FLD of more than 6 months were found more frequently in SM-FLD than in NS-FLD (66.7 vs 19.4%, p < 0.005). And also SM-FLD had more recurrences of FLD than NS-FLD after the initial diagnosis of FLD (1.58 +/- 1.56 vs 0.47 +/- 1.07, p < 0.05). SM-FLD tended to have lower % VC than NS-FLD (73.6 +/- 7.4 vs 88.5 +/- 3.9%, respectively, p = 0.06). Regarding the prognosis, the 10-year survival rates were 70.7% in SM-FLD, and 91.5% in NS-FLD (p < 0.05). These results suggest that smoking may make FLD insidious and chronic, and deteriorates the clinical outcome.

Adolescent↗

[Small airway changes in acute interstitial pneumonia and acute exacerbation of chronic interstitial pneumonia].

To study pathologic changes in small airways in acute interstitial pneumonia (AI), changes in the terminal or respiratory bronchioles in one patient with AI and in three patients with acute exacerbations of chronic interstitial pneumonia (grouped together as the AI group) were compared to those in five patients with chronic idiopathic interstitial pneumonia (IIP) without acute exacerbation. Specimens obtained during autopsy were examined by light microscopy. In the AI group, mononuclear cells had infiltrated the lumen in 47 (23.7%) of the 198 bronchioles examined, and granulation tissue was found in 101 (51.0%). In the IIP group, no changes were found in 37 (97.4%) of the 38 bronchioles examined. Therefore, mononuclear cell infiltration and granulation tissue are common in the bronchioles of patients with acute interstitial pneumonia, but not in those of patients with chronic interstitial pneumonia without acute exacerbation.

Acute Disease↗

[Role of viral infections in acute exacerbation of idiopathic interstitial pneumonia].

To evaluate the possibility that viral infections can trigger acute exacerbations of idiopathic interstitial pneumonia (IIP), we analyzed data from 105 patients with IIP. Acute exacerbation was defined as an increase in dyspnea, a decrease in PaO2 by more than 10 Torr, and worsening of chest radiographic findings within one month. Viral infection was said to be involved when patients had more than a 4-fold change in viral antibody titer or viral inclusion bodies in sputum during the acute exacerbation. Of the 105 patients with IIP, 30 had acute exacerbations. Among these 30 patients, viral infection was said to be involved in 11 (37%). Presumptive viruses were influenza virus (n = 6), parainfluenza virus (n = 1), herpes simplex virus (n = 1), RS virus (n = 1), and cytomegalovirus (n = 2). The levels of serum immunoglobulin A (IgA) before acute exacerbations were significantly lower (p < 0.05) in patients in whom viral infection was said to be involved. These results suggest that viral infection associated with a low value of serum IgA is an important trigger of acute exacerbations of IIP.

Aged↗

[Pulmonary alveolar proteinosis with coincidental thoracic injury. Successful bronchoalveolar lavage with a modified fiberoptic bronchoscope].

A 65-year-old laborer suffered thoracic injury in an accident. Ribs were fractured and chest X-ray films showed coincidental ground-glass, like opacities in both lung fields. CT indicated the possibility of pulmonary alveolar proteinosis, which was confirmed by histological examination of the specimen obtained during therapeutic bronchoalveolar lavage. A modified fiberoptic bronchoscope with a wedge device was used for segmental bronchoalveolar lavage. The wedge derice on a pediatric flexible fiberoptic bronchosiope allowed irrigation of six independent pulmonary segments, with no complication. Six months after discharge, the patient had no evidence of relapse.

Aged↗