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Biomedical subjects

J Kabe

Publications and source records attributed to J Kabe.

At least 37 records · Page 2Linked to original sources
PubMed1996

[The usefulness of induced sputum in the diagnosis of pulmonary tuberculosis].

This study was designed to compare the results of culture for tubercle bacilli using induced sputum by an ultrasonic nebulizer and gastric aspirates from same patients who were suspected of having active tuberculosis with little or no sputum and had received no prior chemotherapy. 22 patients included in this series were either culture positive for tubercle bacilli or showed unequivocal radiographic improvement after three months of therapy with three anti-tuberculosis drugs. Induced sputum from 17 patients and gastric aspirates from seven patients were culture positive for M.tuberculosis. This difference is significant (p < 0.01). Paired induced sputum and gastric aspirates were both positive for tubercle bacilli in seven patients. The finding of acid-fast bacilli on microscopy or tubercle bacilli in culture in four of the seven patients were available much earlier with induced sputum than with gastric aspirates. Positive gastric aspirates and negative induced sputum for tubercle bacilli was not seen. These results suggest that induced sputum by an ultrasonic nebulizer is superior to gastric aspirates in terms of high sensitivity and early finding for tubercle bacilli and induced sputum and gastric aspirates do not supplement each other.

Adolescent↗
PubMed1996

[Repeated pneumonia in the middle lobe caused by congenital bronchoesophageal fistula].

A 52-year-old woman was admitted to our hospital because of repeated episodes of pneumonia in the middle lobe. She had also experienced coughing during meals. The history and chest CT findings suggested the presence of a bronchoesophageal fistula. An upper GI series revealed a fistula between an esophageal diverticulum and the superior segment bronchus of the right lower lobe. Fiberoptic bronchoscopy done immediately after the upper GI series revealed barium sulfate leaking from the superior segment bronchus of the right lower lobe into the middle lobe bronchus. These findings indicated that the repeated pneumonia in the middle lobe was caused by a congenital bronchoesophageal fistula. Examination of the resected fistula showed that it was a Braimbridge type I bronchoesophageal fistula. Although of at least 49 cases of congenital bronchoesophageal fistulas with esophageal diverticula have been reported in the Japanese medical literature, we know of no previous case in which such a fistula was associated with middle-lobe pneumonia.

Bronchial Fistula↗
PubMed1996

[Selenium deficiency associated with cardiac dysfunction in three patients with chronic respiratory failure].

We encountered three patients with chronic respiratory failure who had heart failure of cardiac arrhythmias and low levels of serum selenium. All three had tracheostomies and had received long-term parenteral nutrition that had not included selenium. All three also had refractory cardiac dysfunction, which was manifested in edema, heart failure, and various tachycardias. We suspected that selenium deficiency had caused their cardiac dysfunction. Serum selenium concentrations were found to be much lower than normal in all three, so 100 micrograms/day of selenium was administered in addition to their tube feedings. Cardiac function improved after replacement of selenium. These cases show the need for preventing selenium deficiency in patients with chronic respiratory failure during long-term administration of parenteral nutrition.

Aged↗
PubMed1996

[A comparison of asthma deaths and near-fatal asthma attacks].

This study compares the characteristics of fatal asthma patients and those of near-fatal asthma patients who had experienced severe life threatening attacks. Data from 67 fatal asthma patients and 80 near-fatal asthma patients were analyzed. The mean age of fatal asthma cases were older than near-fatal asthma cases, 51.9 yrs and 44.3 yrs, respectively. Similarities of the two cases were seen in sex, type of asthma and severity of asthma. The experiences of previous life-threatening asthma did not differ in both groups (43.3% of fatal vs 40.0% of near-fatal). From the viewpoint of type of development of severe exacerbation, rapid exacerbation was more frequent in fatal cases than near-fatal cases, but acute exacerbation after unstable asthma was more in near-fatal asthma. Seventy-six percent of all asthma deaths occurred at home or on the way to the emergency department. The rate of delay of receiving medical care was significantly higher in fatal cases (72%) than near-fatal cases (26%). There was no significant difference in the frequency of medical management before fatal or near-fatal episode such as oxygen therapy, mechanical ventilation. Use of ambulance, visiting emergency department, previous hospitalization between the two groups. The profile of fatal cases was almost same to that of near-fatal cases except delay of receiving medical care. In conclusion, the analysis of near-fatal cases was very important to make clear the causes of asthma death.

Adult↗
PubMed1995

[Clinical evaluation of cefpodoxime proxetil, a new oral cephem, in the treatment of respiratory tract infections with the special reference to community-acquired Streptococcus Pneumoniae infections].

The clinical usefulness of cefpodoxime proxetil (CPDX-PR) was investigated in the treatment of pneumonia and chronic airway infections occurring in patients first visiting our outpatient clinic or those being treated at the outpatient clinic. CPDX-PR was orally administered twice a day after meals at a dose of 100-200 mg for acute respiratory tract infections and at a dose of 200 mg for chronic respiratory tract infections. Excellent, good, fair, and poor responses were observed in 20, 33, 10, and 3 of 66 patients (4 with acute bronchitis, 27 with pneumonia, and 35 with acute exacerbation of chronic airway infection), respectively, demonstrating an 80.3% efficacy rate (53/66). Causative organisms, including Streptococcus pneumoniae, were all eradicated from the patients whose causative organisms were examined over time, although 2 of the patients were superinfected with Pseudomonas aeruginosa. There were no serious adverse reactions or abnormal changes in laboratory test results. It was concluded that CPDX-PR could be used as a first-choice drug for the treatment of respiratory tract infections at an outpatient clinic, and that this drug should acquire greater importance in particular consideration of recent increases in infections with S. pneumoniae.

Adult↗
PubMed1995

[Legionella pneumonia diagnosed by urinary antigen detection].

A 63-year-old man with dyspnea and high fever was admitted to the hospital. A pneumonic shadow in the right lower lung field was observed. After administration of rifampicin and clarithromycin, his symptoms were gradually alleviated. Although Legionella pneumonia was highly suspected, Legionella pneumophila was not isolated from his sputum specimens and the serum level of indirect immunofluorescent antibody titer was not significantly elevated. However, we believe it is very likely that he had Legionella pneumonia, because we detected a high density of urinary Legionella pneumophila serogroup 1 antigen by antigen capture EIA.

Antigens, Bacterial↗
PubMed1995

[Inhaled beclomethasone in long-term management of asthma: optimal dose and optimal duration of treatment].

We studied the usefulness of 24 weeks of therapy with inhaled beclomethasone dipropionate (BDP) in the management of mild and moderately severe asthma in adults. To determine the optimal dose and treatment duration, the patients were divided into three groups. Patients in group I (n = 10) were treated with bronchodilators but no BDP. Patients in group II (n = 12) received bronchodilators and 450 micrograms/day of BDP. Patients in group III (n = 17) received bronchodilators and 900 micrograms/day of BDP. BDP was inhaled via a large spacer (Volumatic). Asthma scores were measured before treatment began, and again every 2 weeks for the duration of the study (26 weeks). Peak expiratory flows (PEF) were measured before treatment began, 2 weeks after treatment had begun, and again every four weeks until the end of the study. Vital capacity, FEV1, and bronchial reactivity to methacholine were measured before treatment began, and again 12 weeks and 24 weeks after it had begun. Adrenocortical function in patients in group III was measured with a rapid ACTH test, at the same time as the pulmonary functions were measured. The results were: 1) Asthma scores decreased more in patients who received the higher dose of BDP than in those who received the lower dose, especially during the second 12 weeks. 2) After two weeks of treatment, %PEF had increased significantly in both groups that received BDP, but after six weeks of treatment there was no further improvement. %PEF did not improve in the group given bronchodilators only. 3) In the patients whose baseline %PEF was less than 80%, only the higher dose of BDP significantly increased %PEF. 4) Only the higher dose of BDP increased the %VC, the FEV1%, and the PD20 for methacholine. 5) Asthma type and severity were not related to the usefulness of BDP therapy. 6) Results of the rapid ACTH test indicated that the higher dose of BDP did not suppress adrenocortical function. These data indicate that 900 micrograms of BDP per day is more effective than 450 micrograms/day as initial therapy for long-term management of mild or moderate asthma in adults, and that the dose of BDP should be reviewed after 3 months of treatment. Patients in whom asthma is well-controlled may tolerate a reduction in dose, and those in whom asthma is not well-controlled may require a higher dose.

Administration, Inhalation↗
PubMed1995

[Pulmonary involvement in immunoblastic lymphadenopathy: case reports and review of literature published in Japan].

To investigate pulmonary involvement in immunoblastic lymphadenopathy (IBL), we report five cases of IBL and 21 other reports from the literature published in Japan. Three of the present patients had respiratory symptoms and showed hypoxemia on admission. Radiographic findings in the present cases showed bilateral mediastinal and hilar lymphadenopathy (LA: 4/5), pleural effusion (PE: 5/5), interstitial shadow (Int S: 1/5), alveolar shadow (A1S: 2/5), and atelectasis (1/5). In the present cases and those previously reported in Japan, the following radiographic findings were observed; LA (56%), PE (40%), Int S (52%), and A1S (24%). Atelectasis was reported only in the present cases. The nine patients with Int S consisted of four with interstitial pneumonia and five with bronchopneumonia. Four of five patients with bronchopneumonia had an opportunistic infection (three had pneumocystis carinii and one had cytomegalovirus). Among the five patients with A1S, two had interstitial pneumonia and the others had bronchopneumonia. Pulmonary involvement was frequently seen in patients with IBL, and may be an important determinant of the outcome of the disease.

Aged↗
PubMed1995

[Metastatic lung cancer from renal cell carcinoma effectively treated by bronchial artery embolization].

A 55-year-old man was admitted to the International Medical Center of Japan because of obstructive pneumonia in the right middle and lower lobes. His left kidney had been removed 3 years earlier because of renal cell carcinoma. Metastatic lung cancer from renal cell carcinoma was diagnosed. Bronchial artery embolization was done twice with sponges, because the tumor was thought to be resistant to interferon. Three days after the second embolization, the tumor was removed through the trachea, and atelectasis was relieved. Bronchial artery embolization may be useful for treatment of metastatic lung cancer from renal cell carcinoma.

Bronchial Arteries↗
PubMed1994

Efficacy of recombinant human granulocyte-macrophage colony-stimulating factor for chemotherapy-induced leukopenia in patients with non-small-cell lung cancer.

To assess the feasibility and efficacy of rhGM-CSF in ameliorating chemotherapy-induced leukopenia in patients with advanced non-small-cell lung cancer, we conducted a double-blind placebo controlled phase III study in a multicenter setting. Patients were eligible if they had cytologically or histologically proven cancer, no prior chemotherapy, stage IIIB or IV disease, an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2, an age of less than 76 years, and no symptomatic brain metastasis, disseminated bone metastasis, or previous vertebral/pelvic irradiation. The chemotherapy regimen consisted of mitomycin given at 8 mg/m2 on day 1, cisplatin given at 100 mg/m2 on day 1, and vindesine given at 3 mg/m2 i.v. on days 1 and 8 (MVP). If the granulocyte nadir count recorded after the first cycle of MVP was less than 1,000/mm3, patients were randomly assigned to receive recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) or placebo during the second cycle of MVP. The dose of rhGM-CSF was 125 micrograms/m2 given daily s.c. for 14 consecutive days starting on day 2. Of the 52 patients enrolled, 45 were evaluable. The nadir of granulocytes was significantly lower in the placebo group (P = 0.007). The period during which the granulocyte count was less than 1,000/mm3 was significantly longer in the placebo group (median, 6 vs 10 days; P = 0.04). The incidence of adverse effects related to rhGM-CSF, such as fever (> or = 38 degrees C) and skin rash, was significantly higher in the rhGM-CSF group (P = 0.011). The rate of response to chemotherapy did not significantly differ between the two groups. In conclusion, rhGM-CSF reduced the duration of chemotherapy-induced granulocytopenia. The clinical usefulness of this agent may be deminished because of the adverse effects encountered when it is used in combination with a moderately myelotoxic chemotherapy regimen.

Adult↗
PubMed1994

[Evaluation of the streptomycin twice weekly with INH and RFP for initial therapy of pulmonary tuberculosis].

For the purpose to compare the effectiveness of SM and EB as a third drug in the standard regimens and to know whether the addition of SM twice weekly to INH and RFP could be acceptable for the treatment of pulmonary tuberculosis, the efficacy, adverse effects and results of long-term follow-up of the groups consisting of 105 patients treated with SM twice weekly for 6 months in addition to INH and RFP for 9 months (S2 group) and 107 patients treated with EB for 6 months in addition to INH and RFP for 9 months (E group) were observed. The speed of negative conversion of sputum and that of X-ray findings improvement were slightly faster in S2 group than E group but the difference was statistically not significant. The incidence of adverse effects such as elevation of serum transaminase values, gastrointestinal troubles, drug allergy and others was not similar in two groups. The relapse was observed in 2 cases of S2 group and 5 cases of E group. We concluded that SM twice weekly to INH and RFP is similarly effective as EB in combination with INH and RFP, and the this regimen could be used as standard regimen for pulmonary tuberculosis.

Adult↗
PubMed1994

[The clinical investigation of so-called "pleural tuberculoma" in the last 3 years].

We have investigated on the clinical features of pleural nodular lesions which have appeared during chemotherapy of tuberculous pleurisy. Such lesions were observed in more than 10% of the cases of tuberculous pleurisy. This type of lesion occurred more frequently in the pleurisy patients whose chest X-ray did not show any tuberculous lesion in lung field and whose sputum was negative of tubercle bacilli. Most of the patients with such lesion were young. From these results, it was suggested that such lesion might develop during the course of primary tuberculosis. Single nodular lesion was more common but multiple nodular lesions were not rare. They had occurred in 2-4 months after the start of anti-tuberculous chemotherapy including RFP, usually accompanied with chest pain. They had disappeared within 6-12 months without any additional therapy. In summary, pleural nodular lesions, which occurred during chemotherapy of tuberculous pleurisy, were not rare, but the clinical course and prognosis of such lesion were favourable and improved without any additional therapy. The etiology of such lesion has remained to be clarified.

Adolescent↗
PubMed1992

[Assessment and management of acute severe asthma].

In the management of acute severe asthma it is very important to start the treatment as soon as possible, by appropriate evaluation of the physical status and signs of airflow obstruction. We propose a guideline to be used by patients with asthma, emergency car crews, physicians and nurses to evaluate the severity and to choose the appropriate management of acute asthma, including intubation and mechanical ventilation, by the assessment of clinical features, as well as blood gas analysis and pulmonary function test. Several researchers have demonstrated that the additional administration of aminophylline to inhaled or subcutaneous beta 2-agonist bronchodilator during the first 4 hours of an attack provides no additional benefit compared to the administration of beta 2-agonist alone. In our retrospective study of 68 episodes of acute severe asthma in the last 5 years at our institute, however, the additional administration of aminophylline with beta 2-agonists was clearly shown to be effective with infrequent minor side effects.

Acute Disease↗
PubMed1992

[Proposal of a new classification of adult bronchial asthma--child onset asthma, adult onset asthma and adult relapse asthma. Project Team for Research into Adult Bronchial Asthma in Japan].

The first nationwide research into adult bronchial asthma in Japan proposed a new classification of adult asthma. Adult asthma was categorized into child onset asthma, adult onset asthma and adult relapse asthma. The frequency of child onset asthma, adult onset asthma and adult relapse asthma in adult asthma was 11.2%, 77.3% and 3.7%, respectively. The frequency of child onset asthma decreased markedly in the older age group. On the other hand, the frequency of adult onset asthma increased, and reached more than 90%, in the older age group. The frequency of the following factors: atopic asthma, complications with other atopic diseases, mild asthma, male patients, experience of mechanical ventilation, visits to night clinics and oxygen therapy on acute attack, was significantly higher in the child onset asthma group than in the adult onset asthma group. The frequency of infectious type, aspirin intolerance, steroid dependent asthma, severe asthma and regular medication was significantly higher in the adult onset asthma group. Adult relapse asthma seemed to fall between these two groups. Based on the above observations, we proposed a new classification of adult asthma which includes child onset asthma, adult onset asthma and adult relapse asthma.

Asthma↗
PubMed1991

[A case of small cell carcinoma originating at the site of pneumoplication of giant bulla five years later].

A 64 year-old man was performed pneumoplication for his left-sided giant bulla on December 15, 1983. After five years, consciousness loss and right hemiplegia occurred. Brain CT revealed a cystic lesion with enhancement in the left occipital lobe. Brain biopsy disclosed metastatic small cell carcinoma. Lung biopsy showed the same histopathology, so primary lesion was considered to be from the site of the previous pneumoplication. Lung cancer associated with emphysematous bulla have been mostly characterized by tumor shadow or niveáu in the bulla. In this case, the postoperative infiltrating shadow of pneumoplication had made early diagnosis difficult.

Carcinoma, Small Cell↗
PubMed1990

[Experimental hypersensitivity pneumonitis and enhancement of granuloma formation by low dose irradiation with increased interleukin-1 activity of granuloma in genetically low responder mouse (C3H)].

Possible enhancing effects by low dose total body irradiation on pulmonary granuloma formation induced by intratracheal injection of ovalbumin-coupled beads in low responder C3H mouse were studied. The low dose (3.5 Gy) irradiation increased the size of granuloma in low responder C3H mouse as large as the granuloma formed in high responder C57BL/10 mouse. The resolution of granuloma which usually disappeared within 9 days was also prolonged by the irradiation. Increase in IL-1 activity of lung extracts but not IL-2 activity was parallel to the enhancement of granuloma formation and/or the delayed resolution of granuloma. These results indicated that the radiation-sensitive cells might regulate IL-1 producing cell, possibly macrophages which made pulmonary granuloma.

Alveolitis, Extrinsic Allergic↗