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Biomedical subjects

A Iwase

Publications and source records attributed to A Iwase.

At least 19 recordsLinked to original sources
PubMed1999

[Epidemiology of Japanese cedar pollinosis: result of the survey in Mibu-machi].

The prevalence rate of Japanese cedar pollinosis has increased since 1979. We conducted a survey of the residents of Mibu-mach, Tochigi, in 1988 and 1996 using a questionnaire to determine the prevalence rate of cedar pollinosis. Results showed its rate was 15.6% in 1988, and 25.6% in 1996. Age distribution analysis of patients with Japanese cedar pollinosis showed the highest prevalence in patients between the ages of 10 to 49 years in 1988, and between the ages of 10 to 59 years old in 1996. Within these age groups, the majority of the patients were females, but males were more prevalent than females in the age group under 19 years old. The prevalence rate of patients by age group revealed the same pattern as the age distribution of the patients. Age distribution of cedar pollinosis showed a peak in patients in their thirties both in 1988 and 1996. In conclusion, the numbers of patients with Japanese cedar pollinosis has been increasing remarkably in Mibu-mach. As climate or environmental conditions are varied in different geographical regions in Japan, further epidemiological studies in various regions of the country are required to clarify the actual prevalence rate of cedar pollinosis.

Adolescent↗
PubMed1998

Double infection with Giardia lamblia and Salmonella paratyphi A associated with acute renal failure.

While traveling in India, a previously healthy twenty-year-old man had febrile diarrhea. The patient was prescribed medical therapy, and all symptoms were resolved. Fourteen days later, however, similar symptoms recurred. The patient was admitted to a local hospital, but was transferred to our department because of oliguria. Salmonella paratyphi A was isolated from blood and stool specimens, and Giardia lamblia was identified in his stool. The patient's condition was complicated by acute renal failure. The patient received tosufloxacin and metronidazole. Renal function recovered completely without hemodialysis. Paratyphoid fever and giardiasis were resolved. It is suggested that giardiasis exacerbated the paratyphoid fever.

Acute Kidney Injury↗
PubMed1997

Alveolar macrophages produce the Env protein of a human endogenous retrovirus, HERV-E 4-1, in a subgroup of interstitial lung diseases.

We investigated whether intraalveolar inflammatory cells such as alveolar macrophages or lymphocytes produced the gene product of a type-C human endogenous retrovirus (HERV), HERV-E 4-1, which might initiate an immune response resulting in interstitial lung disease. We evaluated HERV-E 4-1 Env protein production by bronchoalveolar lavage fluid (BALF) cells and PBL in 109 patients with sarcoidosis, idiopathic pulmonary fibrosis (IPF), lung cancer, and rheumatoid lung disease as well as 26 normal control individuals. Production of HERV-E 4-1 Env protein by alveolar macrophages was observed using indirect immunofluorescence in 3 IPF patients and 3 sarcoidosis patients (6/135). No peripheral blood lymphocytes showed HERV-E 4-1 Env protein production. Antibodies to HERV-E 4-1 Env protein were detected in the BALF of all six patients by immunoblot analysis, while none of the normal control individuals showed HERV-E 4-1 Env protein antibody in the BALF. All examined BALF cells showed HERV-E 4-1 env mRNA transcript expression by reverse transcription-polymerase chain reaction. No significant influence of point mutation or DNA polymorphism on HERV-E 4-1 Env protein production was recognized. In conclusion, local production of HERV-E 4-1 Env protein and defective tolerance of HERV gene products with resultant antibody production may contribute to the pathogenesis of IPF or sarcoidosis in some patients.

Amino Acid Sequence↗
PubMed1997

[Interstitial pneumonia in an HTLV-I carrier].

A 31-year-old woman was admitted to our hospital because of dyspnea on exertion. She had had the same symptom a few years earlier. A chest radiograph revealed ground-glass-like shadows on both sides, and the arterial PaO2 was 54 Torr when the patient was breathing room air. We first suspected hypersensitivity pneumonitis, but the dyspnea and hypoxemia did not resolve during treatment in the hospital, and returned home. She felt no obvious changes in symptoms while at home. We found no antibodies to Tricosporon cutaneum in her serum. Computed tomography of the chest revealed diffuse pan-lobular areas of high density. Bronchoalveolar lavage was done and the total cell count was 9.6 X 10(7). About three quarters (73%) of the recovered cells were lymphocytes. Examination of a transbronchial biopsy specimen showed alveolar thickening with infiltration of small mononuclear cells. No granulomas or Massons bodies were seen, and no antibodies specific to collagen-vascular disease were detected. We therefore excluded the diagnosis of hypersensitivity pneumonitis, idiopathic interstitial pneumonia and collagen-associated pneumonitis. There was no evidence of drug-induced pneumonitis. She was seropositive for HTLV-I. We suspected that this was a case of HTLV-1-associated pneumonitis.

Adult↗
PubMed1997

[An autopsy case of severe tuberculosis associated with anal fistula and intestinal perforation].

A 55 year-old man was admitted to the department of the gastroenterology of the hospital because of severe weakness and appetite loss for the past one month. In the last two months, he has been suffering from recurrent fistula of the anus. He left his symptoms without therapy. A gastric ulcer was found out with gastric endoscopy. At the same time, chest X-ray film showed bilateral abnormal shadows, which were suspected of severe pulmonary tuberculosis by a chest physician. After the admission, the patient immediately developed respiratory failure. Both sputa and discharge from anal fistula were positive for acid fast bacillus. Despite of anti-tuberculosis therapy and mechanical ventilation, he died of respiratory failure. At the autopsy, severe pulmonary tuberculosis, tuberculous fistula of the anus, intestinal tuberculosis with perforation, miliary tuberculosis and peptic ulcer of the stomach were defined. We suspected that the extensive disease caused by hematogeneous spread and the late diagnosis of tuberculosis was owing to patient's delay.

Fatal Outcome↗
PubMed1997

[Bufferin-induced lung injury manifesting as acute eosinophilic pneumonia].

A 26-year-old woman was admitted to our hospital because of dyspnea and fever one day after taking medicines for the common cold. A chest roentgenogram and a computed tomogram revealed diffuse patchy infiltrates in both lung fields. Examination of a specimen obtained by transbronchial lung biopsy showed thickening of alveolar walls and infiltration of eosinophils. Bronchoalveolar lavage fluid had many eosinophils. DLST was positive for Bufferin, which the patient took one day before the dyspnea and fever began. We believe that this patient's pulmonary disease was caused by Bufferin. We should realize that this widely used analgesic can cause acute eosinophilic lung disease. The patient was not given corticosteroids, and her condition improved soon after she stopped taking Bufferin.

Adult↗
PubMed1997

[A case of humidifier lung characterized by histopathologic feature].

A 61-year-old man was discharged from our hospital after recovering from bilateral fractures in the neck of each femur. However, a productive cough, dyspnea, and a high grade fever occurred eight hours after returning home. He was thus admitted once more. At rehospitalization, there was radiographic evidence of bilateral infiltrates and hypoxemia. Hypersensitivity pneumonitis was strongly suggested by radiographic evidence, by the fact that no new drugs had been administered, and by a positive result after an environmental provocation test. A diagnosis of humidifier lung was confirmed by a positive precipitins test for humidifier water. Several microorganisms were isolated from humidifier water, and precipitins tests for the isolated microorganisms were mostly positive. Microscopic examination revealed focal alveolitis, bronchiolitis, and perivasculitis. Perivascular leucocytic infiltrations around venules suggested that inhaled antigens might have also caused humidifier lung via a vascular route. Humidifier lung may be due in part to soluble factors, such as endotoxin, present in humidifier water.

Alveolitis, Extrinsic Allergic↗
PubMed1996

Prognostic value of Ia+ T lymphocytes in bronchoalveolar lavage fluid in pulmonary sarcoidosis.

We investigated the value of the la+ T-lymphocyte (CD3+ HLA-DR+) ratio in bronchoalveolar lavage fluid (BALF) for predicting the outcome of pulmonary sarcoidosis. Analysis of the BALF la+ T% in 166 patients with pulmonary sarcoidosis by dual-color flow cytometry revealed a wide range of values, of from 0.5 to 85.3%. Although the majority of patients had less than 40% la+ T cells in their BALF, a minor peak was observed at 50 to 60%. The BALF la+ T% value was not influenced by smoking, sex, or age, thus differing from other BALF activation markers. Fifty patients could be followed up precisely for 3 yr after their initial bronchoalveolar lavage (BAL) to evaluate outcome with respect to chest X-ray findings, clinical symptoms, serum angiotensin converting enzyme (ACE) activity, and extrapulmonary involvement. The 50 patients were divided into two groups, with a BALF la+ T% < 40% (n = 34) and > or = 40% (n = 16), respectively. Serum ACE activity returned to normal within 1 yr in the < 40% group, but remained high for the entire follow-up period in the > or = 40% group. The significant difference was observed in the persistence of pulmonary involvement between the two groups except for four patients who showed Stage 0 disease (p < 0.02). Thirteen of 31 patients in the < 40% group showed normalization of chest X-ray findings after three years, whereas only one out of 15 patients in the > or = 40% group showed resolution of pulmonary involvement. Our results suggest that the BALF la+ T% may be a novel marker for predicting the long-term prognosis in pulmonary sarcoidosis.

Adolescent↗
PubMed1996

Localized fibrous mesothelioma with bronchogenic carcinoma.

We report a case of localized fibrous mesothelioma (LFM) of the pleura with bronchogenic carcinoma. LFM arose in the visceral pleura of the upper lobe in the left lung, and lung adenocarcinoma was located in the ipsilateral lower lobe. LFM is a rare mesenchymal tumor of the pleura. Concomitant occurrence with bronchogenic carcinoma has not been previously reported in the English literature.

Biopsy, Needle↗
PubMed1996

[Temporal modulation transfer function in normal-tension glaucoma patients].

In an attempt to detect patients in an early stage of glaucoma, a new screening test, the Flicker System, by which temporal modulation transfer function is evaluated, was performed in 64 normal-tension glaucoma patients and 65 normal eyes. The early stage of glaucoma, i.e., stage 0-1 of Aulhorn-Greve's classification, showed a significant decrease of the modulation in the range from 20 to 45 Hz in comparison with normal eyes (p value < 0.05). The moderate stage of glaucoma of stages 2-3 also revealed significantly decreased values of the modulation in the range from 14 to 55 Hz. In the range from 25 to 45 Hz, the reduction of modulation in the glaucoma with diffuse visual defect was more profound than in glaucoma with localized or mixed defects. The results seem to be compatible with the presence of diffuse visual function deficit in glaucoma.

Adult↗
PubMed1996

[Interstitial pneumonia associated with mixed connective tissue disease--marked improvement with azathioprine].

A 55-year-old man who complained dyspnea on exertion was given a diagnosis of interstitial pneumonia associated with mixed connective tissue disease, based on symptoms and on physical and laboratory findings. Soon afterward, he experienced an acute exacerbation of the interstitial pneumonia. He was given three courses of steroid pulse therapy and cyclophosphamide, but his condition worsened. After administration of azathioprine in addition to corticosteroids, his respiratory status improved. The dose of corticosteroids was tapered and the patient has been free of disease for two years. Pulmonary involvement in mixed connective tissue disease has been considered to be relatively benign and easily treated with corticosteroids. Recently, however, many cases of corticosteroid-resistant disease with poor outcome have been reported. Azathioprine was very effective against the interstitial pneumonia in this case, but general conclusions about the most effective type of immunosuppressive agent and the timing of its administration must await the results of further study.

Azathioprine↗
PubMed1995

[Diagnosis of Churg-Strauss syndorme with trans-bronchial lung biopsy].

A 69-year-old woman was hospitalized several times because of asthma attacks. Laboratory data revealed an increase in eosinophils and elevation of serum IgE. Both chest radiographs and computed tomography showed fine nodular shadows in both lung fields. Tissue samples obtained by trans-bronchial lung biopsy (TBLB) revealed extra-vascular granuloma. The patient complained of numbness of the extremities and neuron conduction velocity was low. Based on these findings, Churg-Strauss syndrome was diagnosed. Prednisolone improved the patient's symptoms. Patients with this syndrome reportedly respond well if it is diagnosed and treated with corticosteroids early. Chest roentgenography reveals various abnormal shadows in patients with this syndrome. For early diagnosis, TBLB is helpful and comparatively safe. This case was unusual because extra-vascular granuloma was found by TBLB.

Aged↗
PubMed1994

[Retroviral infection as a putative pathogen for sarcoidosis].

Sarcoidosis is a granulomatous disorder of unknown etiology. Accumulated data suggest that one or several exogenous or altered self antigens participate in producing pathophysiological change in sarcoidosis. Recently, analysis of retroviruses such as HTLV-1 and HIV-1 revealed that these viruses would produce autoimmune disease like symptoms including interstitial lung disease like pulmonary manifestation. We hypothesized novel type retrovirus or retrovirus related antigens might be a putative pathogen for sarcoidosis. Syncytial cell formation or cytopathic effect was observed in 6 of 24 patients (25%) after coculture of sarcoid BALF cells with U937 cells. Five of 18 culture supernatant showed moderate reverse transcriptase activity. Expression of clone 4-1 env protein, one of the endogenous retroviral elements, was also observed in alveolar macrophages of sarcoidosis. These data encourages the further investigation of retrovirus as the pathogen of sarcoidosis.

Adult↗
PubMed1993

[A case of limited form of Wegener's granulomatosis without detection of anti-neutrophil cytoplasmic antibody].

A 52-year-old woman was admitted to our hospital because of high fever and productive cough. Her chest X-ray showed multiple cavitary nodules in both lungs. Although we suspected Wegner's granulomatosis (WG), anti-neutrophil cytoplasmic antibody (ANCA) was not detected in her serum. Finally, an open lung biopsy was performed, and the limited form of Wegener's granulomatosis was diagnosed. With cyclophosphamide and steroid treatment, she markedly improved. We conclude that in patients suspected of having WG, it is necessary to perform open lung biopsy regardless of the detection of ANCA.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed1992

[Three cases of surgical treatment of dumbbell neurogenic tumor of the mediastinum--evaluation of intraspinal extension in cases without clinical symptoms].

Three cases of dumbbell neurogenic tumor of the posterior mediastinum are reported. None of these cases had any clinical symptoms, and an abnormal mass shadow of the mediastinum had been detected on routine chest roentgenogram. In these three cases, however, myelogram and/or CT findings were suggestive of tumor extension to the spinal canal in various degrees. Two tumors were resected in two-stage operations with combined thoracic and neurosurgical approaches, and the other case was treated by one-stage operation with the combined two approaches. All tumors were completely resectable without serious complications such as hemorrhage, leakage of spinal fluid, or neurologic deficit. Even in asymptomatic patients with neurogenic tumor located in the paravertebral region, it should be determined whether or not the tumor extends to the spinal canal through the intervertebral foramen, prior to planning the surgical procedure.

Adult↗