[Acute interstitial pneumonia (AIP)].
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Acute Disease↗
Biomedical subjects
Hiroyuki Taniguchi
Publications and source records attributed to Hiroyuki Taniguchi.
Acute interstitial pneumonia: comparison of high-resolution computed tomography findings between survivors and nonsurvivors.
This study compared high-resolution computed tomography (CT) findings between 10 survivors and 21 nonsurvivors of acute interstitial pneumonia and evaluated whether the CT findings were predictive of patients' response to treatment. The survivor and nonsurvivor groups with pathologically or clinically diagnosed acute interstitial pneumonia were similar in age, sex, disease duration, and lung injury score. Retrospective, subjective evaluations of the CT scans were conducted by two independent observers without knowledge of patient outcomes. CT findings were graded on a one to six scale corresponding to consecutive pathologic phases as follows: areas of (1) normal attenuation, (2) ground-glass attenuation, (3) consolidation, (4) ground-glass attenuation associated with traction bronchiolectasis or bronchiectasis, (5) consolidation associated with traction bronchiolectasis or bronchiectasis, and (6) honeycombing. An overall score was obtained by quantifying the extent of each abnormality in three lung zones in each lung. The extent of ground-glass attenuation or consolidation associated with traction bronchiolectasis or bronchiectasis was less in survivors than nonsurvivors (p = 0.004 and p = 0.009, respectively). Architectural distortion was less frequent, and ground-glass attenuation or consolidation without traction bronchiolectasis or bronchiectasis was more extensive in survivors than in nonsurvivors (p = 0.007, p = 0.002, and p = 0.029, respectively). Overall CT scores of survivors were significantly lower than those of nonsurvivors (p = 0.0003). A CT score of less than 245 had an 80% positive and a 90% negative predictive value for survival. There was good interobserver agreement in the assessment of the CT findings (Kappa 0.75). The results indicate that CT assessment is potentially helpful in predicting patient prognosis in acute interstitial pneumonia regardless of the degree of physiologic abnormality.
Acute Disease↗
Effects of anti-ulcer agents on ethanol-induced gastric mucosal lesions in D-galactosamine-induced hepatitis rats.
Patients with hepatic injury have an increased incidence of gastric ulcers and erosions. In this study, the effect of D-galactosamine(GalN)-induced hepatitis on ethanol-induced gastric mucosal lesions and the protective effect of anti-ulcer agents in rats were examined. Subcutaneous injection of GalN (1 g/kg) remarkably increased serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities suggesting induction of hepatic injury. Gastric mucosal lesions induced by ethanol were significantly aggravated in GalN-induced hepatitis rats. Orally administered ecabet (CAS 86408-72-2; 20-200 mg/kg) dose dependently inhibited ethanol-induced gastric mucosal lesions in GalN-induced hepatitis rats. Sucralfate (CAS 54182-58-0) tended to inhibit the gastric mucosal lesions at a dose of 200 mg/kg but teprenone (CAS 6809-52-5), cimetidine (CAS 51481-61-9) and rebamipide (CAS 90098-04-7) had little effect. All anti-ulcer agents had no effect on the serum ALT and AST activities increased by GalN pretreatment. These results indicate that the gastric mucosa of GalN-induced hepatitis rats is more susceptible to injury induced by luminal irritants such as ethanol. Ecabet potently inhibited gastric mucosal lesions suggesting its clinical utility for the gastric mucosal damage in patients with hepatic injury.
Abietanes↗
Effects of the anti-ulcer agents ecabet sodium, cimetidine and sucralfate on acetylsalicylic acid-induced gastric mucosal damage deteriorated by renal failure in rats.
Renal failure including post-renal transplantation increases the susceptibility of the upper gastrointestinal mucosa to injury. The aim of this study was to confirm the influence of renal failure on gastric mucosal barrier and the protective effect of various anti-ulcer agents in rats. Renal failure (RF) was induced by 45-min left renal artery clamping and right-uninephrectomy. Four days after surgery, gastric mucosal lesions were induced by intragastric administration of acetylsalicylic acid (ASA, CAS 50-78-2) (100 mg/kg). Anti-ulcer agents were given orally 30 min before ASA administration. RF induced moderate gastric mucosal damages, but significantly worsened the ASA-induced gastric lesions. Ecabet sodium (CAS 86408-72-2) and cimetidine (CAS 51481-61-9) significantly inhibited ASA-induced gastric lesions in RF rats, whereas sucralfate (CAS 54182-58-0) tended to inhibit it. ASA and all of these anti-ulcer agents had no effect on the serum creatinine and blood urea nitrogen levels increased by RF. The gastric mucosa of RF rats is more susceptible to damage induced by ASA. Ecabet and cimetidine potently inhibited gastric lesions in RF rats suggesting its utility for the gastric mucosal damage in patients with RF including post-renal transplant.
Abietanes↗
[The utility of the Pneumonia PORT prediction rule for evaluating the severity of community-acquired pneumonia in Japan. The relationship between disease severity and drug-resistant Streptococcus pneumoniae].
To examine the utility of the Pneumonia PORT prediction rule for evaluating the severity of community-acquired pneumonia (CAP) in Japan, 127 consecutive patients with CAP admitted during one-year period were recruited and stratified by the rule. The relationship between CAP severity determined by the rule and drug-resistant Streptococcus pneumoniae was also investigated. The number of the patients classified into each class was 20 (15.7%) in class I, 32 (25.2%) in class II, 32 (25.2%) in class III, 31 (24.4%) in class IV, and 12 (9.4%) in class V, respectively. Risk class-specific mortality rate was 0% in class I and II, 3.1% in class III, 3.2% in class IV, and 41.7% in class V, respectively. Twenty-seven patients (21.3%) were diagnosed as pneumococcal pneumonia. In terms of penicillin-susceptibility of Streptococcus pneumoniae, 19 strains (70.4%) were penicillin-susceptible Streptococcus pneumoniae (PSSP). Five (18.5%) were penicillin-intermediate Streptococcus pneumoniae (PISP), and 3 (11.1%) were penicillin-resistant Streptococcus pneumoniae (PRSP). Highly resistant pneumococci with penicillin MIC > or = 4.0 micrograms/mL was not observed. For severity of drug-resistant pneumococcal pneumonia, 3 patients infected with PISP were classified as class IV, 2 with PISP were as class V, 2 with PRSP were as class IV, and 1 with PRSP was as class V. The patients with drug-resistant pneumococcal pneumonia were classified as high risk classes (class IV to V), however, the mortality rate was low (0%). In conclusion, the Pneumonia PORT prediction rule is effective for evaluating the severity of CAP in Japan, especially in classifying the class V patients who are related to high mortality. The mortality rate of the patients with drug-resistant pneumococcal pneumonia was low.
Aged↗
Nonspecific interstitial pneumonia: correlation between thin-section CT findings and pathologic subgroups in 55 patients.
PURPOSE: To characterize thin-section computed tomographic (CT) findings of pathologic subgroups of nonspecific interstitial pneumonia (NIP) in a sizeable number of patients. MATERIALS AND METHODS: The study included 55 cases of pathologically proven NIP. The 55 cases were categorized histologically into four grades: grade 1, interstitial inflammation without fibrosis (n = 6); grade 2, interstitial inflammation predominating over fibrosis (n = 16); grade 3, fibrosis predominating over inflammation (n = 5); and grade 4, fibrosis only (n = 28). Two independent observers evaluated the presence, extent, and distribution of various CT findings. Thin-section CT findings and histologic grades were compared by using the Spearman rank correlation coefficient. Observer agreement was assessed. RESULTS: Areas with ground-glass attenuation and architectural distortion were present in all 55 patients. Traction bronchiectasis and intralobular reticular opacities were seen in 52 and 48 patients, respectively. The extent of traction bronchiectasis (r = 0.68; P <.001) and intralobular reticular opacities (r = 0.35; P <.05) correlated with the histologic grade. Honeycombing was seen in 12 (43%) of 28 patients with grade 4 NIP and in three (11%) of the remaining 27 patients (chi(2) test, P <.001). There was good agreement between the observers for the presence (kappa = 0.7-1.0) and extent (Spearman rank correlation; r = 0.87-0.98; P <.001) of various abnormalities. CONCLUSION: The extent of traction bronchiectasis and intralobular reticulation at thin-section CT correlates with increased fibrosis in NIP. Honeycombing is seen almost exclusively in patients with fibrotic NIP.
Adult↗
Phase I/II trial of docetaxel and carboplatin as a first-line therapy in patients with stage IV non-small-cell lung cancer.
A phase I/II study was conducted to determine the maximum-tolerated dose, the safety and tolerability, and the clinical efficacy of carboplatin and docetaxel in combination in patients with stage IV non-small-cell lung cancer. Patients with measurable, previously untreated, good performance status, and stage IV non-small-cell lung cancer were eligible. Increasing doses of docetaxel were given in combination with a fixed dose of carboplatin except at level 5. Cycles were repeated every four weeks. Seventy-seven patients were registered. In phase I, 27 patients were entered at five different dose levels. A docetaxel dose of 60 mg/m(2) and carboplatin area under the concentration time curve 6 was recommended for phase II, and an additional 50 patients were entered at this level for a total of 56 patients. Grade 3/4 neutropenia was the most common adverse event and occurred in 70% of the patients. Two patients had febrile neutropenia. Fifty-six patients were assessable for response; 21 partial responses were observed for an overall response rate of 37.5%. The median time to tumor progression was 4.0 months (range, 1.0-21.0 months), and the median survival was 12.9 months (range, 0.4-51.3 months). The one-year survival rate was 46.4%. The combination of docetaxel 60 mg/m(2) and carboplatin area under the concentration time curve 6 is feasible and effective in patients with stage IV non-small-cell lung cancer.
Adult↗
Familial idiopathic pulmonary fibrosis: serial high-resolution computed tomography findings in 9 patients.
OBJECTIVE: The purpose of this study was to assess the high-resolution computed tomography (CT) findings of familial idiopathic pulmonary fibrosis (IPF). METHODS: High-resolution CT scans obtained in 9 consecutive patients with biopsy-proven familial IPF were reviewed. The presence, distribution, and extent of various CT findings were evaluated. RESULTS: All 9 patients had ground-glass opacities, intralobular reticular opacities, and irregular thickening of the interlobular septa; 7 (78%) had traction bronchiectasis, 7 (78%) had small foci of consolidation; and 3 (33%) had honeycombing. The abnormalities involved mainly the lower lung zones in 6 patients and the upper lung zones in 2 patients and had no zonal predominance in 1 patient. Follow-up CT showed increased extent of disease in 8 patients. CONCLUSIONS: The high-resolution CT findings of familial IPF resemble those of nonfamilial IPF. Familial IPF has a lower prevalence of honeycombing and a lower prevalence of predominant lower lung zone distribution than nonfamilial IPF, however.
Adult↗
Pathologic subgroups of nonspecific interstitial pneumonia: differential diagnosis from other idiopathic interstitial pneumonias on high-resolution computed tomography.
OBJECTIVE: To determine whether the subtypes of nonspecific interstitial pneumonia (NSIP) could be differentiated from other idiopathic interstitial pneumonias (IIPs) on the basis of findings on high-resolution computed tomography (CT). METHODS: Two observers evaluated the high-resolution CT findings in 90 patients with IIPs. The patients included 36 with NSIP, 11 with usual interstitial pneumonia (UIP), 8 with cryptogenic organizing pneumonia (COP), 10 with acute interstitial pneumonia (AIP), 14 with desquamative interstitial pneumonia (DIP) or respiratory bronchiolitis-associated interstitial lung disease (RB-ILD), and 11 with lymphoid interstitial pneumonia (LIP). The NSIP cases were subdivided into group 1 NSIP (n = 6), group 2 NSIP (n = 15), and group 3 NSIP (n = 15). RESULTS: Observers made a correct diagnosis with a high level of confidence in 65% of NSIP cases, 91% of UIP cases, 44% of COP cases, 40% of AIP cases, 32% of DIP or RB-ILD cases, and 82% of LIP cases. Group 1 NSIP was misdiagnosed as AIP, DIP or RB-ILD, and LIP in 8.3% of patients, respectively. Group 2 NSIP was misdiagnosed as COP in 10% of patients, LIP in 6.7%, AIP in 3.3%, and DIP or RB-ILD in 3.3%. Group 3 NSIP was misdiagnosed as UIP in 6.7% of patients, COP in 6.7%, and DIP or RB-ILD in 3.3%. CONCLUSIONS: In most patients, NSIP can be distinguished from other IIPs based on the findings on high-resolution CT. Only a small percentage of patients with predominantly fibrotic NSIP (group 3 NSIP) show overlap with the high-resolution CT findings of UIP.
Adult↗