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Biomedical subjects

K Hashiguchi

Publications and source records attributed to K Hashiguchi.

At least 19 recordsLinked to original sources
PubMed1992

Seroprevalence of Chlamydia pneumoniae infections in otolaryngeal diseases.

We studied the seroprevalence of antibodies to Chlamydia pneumoniae, the third species of chlamydia, in patients with acute infections in otolaryngeal sites. The patients were divided into five diagnostic groups, i.e. sinusitis, otitis media, tonsillitis, laryngitis and bronchitis group. Antibodies were measured by the microimmunofluorescent method. Antibodies confirming past infection with C. pneumoniae were found 46.2 per cent of the patients in the diagnostic groups and 44.7 per cent of the subjects in the control group. The difference between these two groups was not statistically significant. Acute or recent antibodies were detected in 10.5 per cent (2/19) of these patients with sinusitis, 19.2 per cent (10/52) of those with tonsillitis, 23.5 per cent (8/34) of those with otitis media, 18.2 per cent (6/33) of those with laryngitis and 22.8 per cent (13/57) of those with bronchitis, whereas only one member of the control group had acute antibodies. These data suggested that C. pneumoniae is an important and common pathogen of otolaryngeal disease.

Acute Disease↗
PubMed1992

Recovery of Chlamydia pneumoniae, in six patients with otitis media with effusion.

Six cases of otitis media with effusion associated with Chlamydia pneumoniae, a currently recognized respiratory tract pathogen, are presented. The organism was isolated from the middle ear fluids and serological evidence confirmed it as the infectious agent. The study population is small; however, these reports suggest C. pneumoniae as a causative agent of middle ear diseases.

Adult↗
PubMed1992

[A case of chronic myelogenous leukemia with pulmonary aspergillosis diagnosed by the detection of circulating Aspergillus antigen].

Immunocompromised hosts usually develop invasive mycotic disease. Among many pathogenic fungi. Aspergillus spp, is the most common pathogen of respiratory infection. Early diagnosis of invasive type pulmonary aspergillosis is still difficult, and the treatment is usually difficult. Many investigations have recently suggested that detection of Aspergillus antigen from sera of the patients is useful for early diagnosis to save their lives. We have experienced a case diagnosed by the detection of circulating Aspergillus antigen by Pastorex Aspergillus, who was a 64-year-old female with the blastic crisis chronic myelogenous leukemia. After anti-leukemic chemotherapy, she suffered from pneumoniae with pleural effusions and severe hypoxia, which did not respond to antibiotics. At this point, her serum sample showed positive Aspergillus antigen by Pastorex Aspergillus. She was treated by intensive antifungal chemotherapy, and thereafter improved quickly. Titers of Pastorex Aspergillus were well correlated with her clinical course. The sensitivity of the test requires further improvement, but the specificity of the test is considered to be high enough for clinical use.

Antigens, Fungal↗
PubMed1992

[Isolation of Chlamydia pneumoniae and antibodies to the agent in patients with acute bronchitis].

Isolation of Chlamydia pneumoniae and serologic tests were performed on 85 children and adults patients with acute bronchitis admitted to the Kitasato Institute Hospital from January 1989 to May 1991. C. pneumoniae was isolated from sputa or tonsillar swabs in 11 of 57 (19%) patients examined. Of these, 10 patients were tested serologically and 9 (90%) had 16 or higher titer of IgG antibody. A total of 68 patients were tested serologically, and 17 (25%) revealed positive; 14 had a fourfold rise or more in the titer of IgG antibody, or IgM titer of 16 or more, and 3 had IgG antibody with a titer of 512 or greater. In 34 patients, sera were tested for evidence of acute infections not only with C. pneumoniae, but also with Mycoplasma pneumoniae, influenza A virus, influenza B virus, adenovirus, respiratory syncytial virus, coxackie A9 virus, parainfluenza virus type I, II, and III. Two of the 34 patients were associated with influenza A virus, 4 with influenza B virus, whereas 6 were associated with C. pneumoniae. The data available suggest that C. pneumoniae cause bronchitis much more than has been suspected, and also confirm earlier suggestions that the agent played an important role in respiratory tract infections. Chlamydia trachomatis was recovered from sputa and tonsillar swabs in 6 adults patients with acute bronchitis. Studies are needed for a better understanding of the epidemiology and clinical relevance of this microorganism to lower respiratory tract diseases in adults.

Adolescent↗
PubMed1992

[A case of endobronchial fibroma associated with recurrent pneumonia].

We present a case of endobronchial fibroma in a 59-year-old man admitted for repeated pneumonia, successfully treated by endoscopic Nd-YAG laser. His chest X-ray showed an infiltrative shadow in the right lower lung field and a mass shadow within the truncus intermedius. Bronchoscopy revealed a polypoid mass with lobulated whitish surface, obstructing 90% of the lumen. A biopsy taken from the tumor was suggestive of fibroma histologically. Two previous case reports stated that endobronchial fibroma readily detaches from the bronchial wall during removal. The tumor was successfully removed without dropping any tumor fragment to obstruct the distal bronchus by means of biopsy forceps manually attached to an endoscope with endoscopic Nd-YAG laser. The resected tumor was mainly composed of collagen fibers with scanty spindle-shaped fibroblastic cells, which was considered consistent with endobronchial fibroma. Endobronchial fibroma is a rare benign lung tumor, and only seven cases have been reported in the Japanese literature. There was no recurrence at three years and nine months.

Bronchial Neoplasms↗
PubMed1991

A significant reduction of putative transmitter amino acids in cerebrospinal fluid of patients with Parkinson's disease and spinocerebellar degeneration.

We evaluated the concentrations of the putative transmitter amino acids in the cerebrospinal fluid, and found a significant reduction of glutamate, aspartate, gamma-aminobutyric acid (GABA), and glycine concentrations in parkinsonian patients. There was no difference in amino acid concentrations between parkinsonian patients receiving L-DOPA and those not receiving L-DOPA. A similar decrease of glutamate and aspartate concentrations was found in patients with spinocerebellar degeneration. Concentrations of asparagine, glycine and taurine were also significantly decreased in patients with late cortical cerebellar atrophy.

Adult↗
PubMed1991

A prospective study of tardive dyskinesia in Japan.

A large-scale, prospective study of tardive dyskinesia (TD) was performed in 11 psychiatric facilities in Japan. A total of 1595 psychiatric patients were enrolled in this study in 1987. The progress of these patients, with the exception of 490 dropouts, has now been followed up to 1988. The prevalence of TD at study entry was 7.6%, the annual incidence rate was 3.7% and the annual remission rate was 28.7%. Newly developed TD patients tended to be older, to have undergone more psychosurgery, and to have had lower neuroleptic doses than the patients who had not developed TD, whereas no specific variable could be detected as a factor associated with remission of TD. The results suggest that the incidence of TD is lower in Japan than that in Europe and North America.

Antipsychotic Agents↗
PubMed1991

Relationship between fetal hypoxia and endothelin-1 in fetal circulation.

The role of endothelin-1 (ET-1), a potent vasoconstrictor peptide secreted by endothelial cells, in fetal circulation was investigated in relation to fetal hypoxia. Umbilical venous blood was obtained from 23 subjects who delivered between 36 and 41 weeks of gestation. In all cases, pH of umbilical venous blood was measured immediately after the delivery of placenta. ET-1 was extracted from the umbilical venous plasma by an Amprep C2 column and determined by a specific radioimmunoassay. Immunoreactive ET levels in the umbilical cord plasma (pg/ml, mean +/- SEM) from subjects with umbilical venous blood pH levels below 7.30 (n = 9) were 12.53 +/- 2.03, significantly higher than those with pH levels above 7.30 (6.44 +/- 1.11, n = 14). These results indicate that ET-1 in the fetal circulation may be involved in the regulation of the circulation in response to changes in acid-base balance related to fetal hypoxia.

Adult↗
PubMed1991

[Acute upper respiratory tract infections associated with Chlamydia pneumoniae].

From March 1990 to January 1991, a total of 46 outpatients with acute upper respiratory infections (URTI) were studied to determine the etiological role of Chlamydia pneumoniae. Sera from 40 patients were tested by micro-IF method for evidence of recent or past infections of this organism, and swab specimens from tonsilar crypt from 26 were cultured. Sera from 20 patients without any evidence of acute infectious disease were selected as controls. The seroprevalence of antibodies to C. pneumoniae was 52.5% in patients group and 30.0% in the control group. No statistical difference was found in seroprevalence between patients and controls. Serological evidence of acute infections with C. pneumoniae was found in 7 (17.5%) patients with acute URTI, but was not found in any of the control group. Of 26 patients, three (11.5%) had C. pneumoniae isolated from a tonsilar crypt swab specimen. Therefore ten of the 46 patients with acute URTI were associated with C. pneumoniae. It is suggested that C. pneumoniae is a common pathogen in acute upper respiratory infections without any evidence of lower respiratory tract symptoms.

Acute Disease↗
PubMed1991

[Recovery of Chlamydia pneumoniae and Chlamydia trachomatis in a patient with recurrent tonsillitis, bronchitis and otitis media with effusion].

We report a case of recurrent tonsillitis and otitis media with effusion (OME) from which Chlamydia trachomatis was isolated. Chlamydia pneumoniae, a newly recognized species of Chlamydia, was also recovered from the tonsillar and bronchial swabs. A 8-year-old girl was seen on February 23, 1988, because of a running nose, a productive cough and bilateral hearing difficulty. She had a history of recurrent tonsillitis. The diagnosis was acute sinusitis with tubal obstruction, then cefixime was prescribed. Her symptoms were once resolved, for the time being but she came back to the hospital a week later with a bilateral ear-ache. The tympanic membranes were injected and characteristically retracted. Her left ear showed type B tympanogram (effusion). Tympanocentesis was performed to remove middle-ear effusion, from which C. trachomatis but no ordinary bacterium was isolated. Therefore rokitamycin 300 mg/day was administered for a week. Her condition improved, however, a rhinorrhea, a plugged ear sensation and a hacking cough returned in a month. She was admitted to the hospital on May 10, for tympanostomy and grommet insertion, but from the day before admission, she had a sore throat with fever (39.2 degrees C). The surgery was withheld until May 26. When adenotonsillectomy and grommets insertion were undertaken, C. trachomatis had disappeared from the middle-ear effusion, but C. pneumoniae was recovered from both tonsillar and bronchial swabs. Readministration of rokitamycin was performed and to date (June, 1990) she remains well.

Bronchitis↗
PubMed1991

[Respiratory tract diseases due to Chlamydia pneumoniae].

A newly recognized chlamydial species, Chlamydia pneumoniae causes acute respiratory infections including pneumonia, bronchitis and pharyngitis. In this paper, eight cases of bronchitis and tonsillitis associated with C. pneumoniae are presented. Three cases came to the clinic because of persistent cough and productive sputum. C. pneumoniae was isolated from sputum of a patient and cultured in HeLa 229 cells. Other two patients were diagnosed serologically; Antibodies were measured by microimmunofluorescence using formalized elementary bodies of C. pneumoniae. A titer of 512 in the IgG class was detected. Four patients had sore throat. C. pneumoniae was isolated and cultured from tonsillar swabs in all of them. A patient with sore throat and cough diagnosed as pharyngolaryngitis was sero-positive. Antibodies to C. pneumoniae in IgG and IgM class were 128 and 32, respectively. All the patients were treated with macrolide antibiotics (erythromycin and rokitamycin), and clinical symptoms subsided. In five patients from whom the organism was isolated, the agents were eradicated by the treatment. However, clinical courses of those patients revealed that patient takes a long time to recover from the illness, if diagnosis and first choice of antimicrobial agent are not appropriate.

Adult↗
PubMed1991

[Bronchial asthma associated with primary lung cancer--comparison of extrathoracic malignancies].

Regarding 249 bronchial asthma patients having been admitted to our division for the recent 9 years, clinical manifestations of 8 bronchial asthma with primary lung cancer (group A; squamous cell carcinoma--5 cases, adenocarcinoma--2 cases, small cell carcinoma--1 case; 3.2% of 249 cases) and 8 asthma patients with extrathoracic malignancy (group B; gastric cancer--3 cases, malignant lymphoma--2 cases, bladder cancer--1 case, laryngeal cancer--1 case, prostatic cancer--1 case) were investigated. In group A, the mean of asthmatic history was 19 years and all cases were associated with respiratory tract infections. Three of 8 patients, were mild type and other 5 were moderate type. In group B, the mean of asthmatic history was 20 years and all cases were involved with respiratory tract infections. Five of 8 patients were mild type and other 3 were moderate type. The mean smoking (Brinkmann) index (1194) in group A was significantly higher than that (166) in 241 asthmatic patients without lung cancer or that (169) in group B. The median survival duration (more than 26 months) of group A patients was significantly lower than that (more than 77 months) of group B. These results suggested that, in many bronchial asthma patients accompanied by primary lung cancer who have adult-typed infectious asthmatic history, smoking exposure and aging are deeply related to the development of lung cancer.

Adenocarcinoma↗
PubMed1991

[A case of oral gold tablet-induced interstitial pneumonitis].

A 76-year-old woman was admitted with exertional dyspnea and chest roentgenographical abnormal shadows appearing after oral gold therapy (total 720 mg) for rheumatoid arthritis. Based on the patient's clinical course, chest roentgenograms, chest CT and pathological findings of TBLB specimens, gold pneumonitis was diagnosed. Steroid therapy improved symptoms and pulmonary function and cotton-like shadows on chest roentgenograms and chest CT scanning. However, linear and large ringed shadows on chest roentgenograms and chest CT scan remained, even after steroid therapy. This case is the first case of oral gold tablet-induced pneumonitis. Although the mechanism of oral gold tablet-induced pneumonitis is considered to be almost the same that of gold injection therapy-induced pneumonitis, this case suggested that fibrotic changes in oral gold tablet-induced pneumonitis may be delayed over a long period.

Administration, Oral↗
PubMed1990

Otitis media with effusion associated with Chlamydia trachomatis infection in children.

In an attempt to discover the role of Chlamydia trachomatis in the pathogenesis of middle ear diseases, we examined middle ear effusions (MEEs) from 69 patients with otitis media with effusion (OME) for the presence of C. trachomatis and antibodies to the organism. Age distribution was 1 to 14 years (mean age 6.1 years). C. trachomatis was isolated by the culture method from MEE of 11 of 31 (35.5%) patients and from 2 of 5 (40.0%) nasopharyngeal specimens. Chlamydial antigen, however, was found in 29 MEEs from 57 patients (50.9%) using an immunofluorescent method (Syva, 'MicroTrak'). Antibodies to the agent were found in 23 MEEs of 40 patients (57.5%) using the Micro-IF test. Antigen and antibodies were determined at the same time and both were detected in 20 of 40 (50.0%) patients. Although the isolation rate for C. trachomatis from MEE was low, antigen and antibodies were detected in 50.0% of patients with OME. These results suggest the possibility that immune complexes are formed with C. trachomatis in the middle ear, and that these immune complexes cause the mucosal damage responsible for chronic middle ear mucosal irritation.

Adolescent↗
PubMed1990

[Tonsillitis associated with Chlamydia trachomatis and antimicrobial therapy with rokitamycin].

Tonsillitis is the most common disease in the otorhinolaryngeal location. For most patients, tonsillitis is attributed to a group A streptococcal infection if the throat culture is positive for that organism or to a viral infection if the throat culture is negative. However, recent studies have shown that Chlamydia trachomatis can produce tonsillar infection. In this study, we evaluated the efficacy of Rokitamycin, a 16-membered ring macrolide antibiotic agent, in the treatment of tonsillitis associated with C. trachomatis. In 26 of 28 (92.9%) patients from whom C. trachomatis was isolated, the organism was eradicated by antimicrobial treatment with Rokitamycin of five days to three weeks' duration. In 25 of the 26 patients, they were totally free of tonsillar symptoms.

Adult↗