Biomedical subjects

K Mikasa

Publications and source records attributed to K Mikasa.

At least 73 records · Page 4Linked to original sources

PubMed1994

[The role of viral infection in adults with bronchopulmonary infections].

We isolated the virus from the respiratory specimens of 16 patients (7.9%) when we investigated the bronchopulmonary infections of 203 adult patients by the viral isolation method for the diagnosis of the viral infection and transtracheal aspiration (TTA) for taking directly the specimen from the lower respiratory tract. The bronchopulmonary infections, isolated the virus, consisted of acute bronchitis (3 cases), pneumonia (8 cases) and the acute exacerbation of chronic lower respiratory infection (5 cases). The positive viral isolation consisted of Rhinovirus (11 strains), Herpes simplex virus I (3 strains), Parainfluenza virus III (1 strain) and Respiratory syncytial virus (1 stain). There were 9 transtracheal aspirates, 8 pharyngeal swabs and 5 nasal washings in the positive viral specimens. We experienced 5 cases who had the same virus isolated from both the upper respiratory tract and the lower respiratory tract. H. influenzae, P. aeruginosa and other bacteria were found in 14 of the 16 TTA cultures. These results suggest that the role of the viral infection is important either independently or relating the bacterial infection in the adult bronchopulmonary infections.

Adult↗

PubMed1994

[A clinical study of Pseudomonas pneumonia diagnosed by transtracheal aspiration].

We performed a clinical study of 16 cases (18 episodes) of Pseudomonas pneumonia by transtracheal aspiration (TTA) from April 1983 to March 1993. The isolation rate of Pseudomonas aeruginosa (P. aeruginosa) among 235 episodes of pneumonias with positive microorganism by TTA was 7.7%. All patients had one or more underlying disease. The most frequent underlying disease was chronic lower respiratory tract infection, followed by lung epidermoid cell carcinoma. More than half of the cases had been given antibiotics prior to the occurrence of pneumonia, and administration of adrenal corticosteroid, heavy smoking habit, and aspiration were seen as other predisposing factors concerning the onset of pneumonias. Monomicrobial infection of P. aeruginosa was 61.1%, and polymicrobial infection containing P. aeruginosa was 38.9%. Community-acquired pneumonia was 61.1% and hospital-acquired pneumonia was 38.9%; the rates of polymicrobial infections and prior administration of antibiotics were higher in the latter group. Mortality due to Pseudomonas pneumonia was 27.8% and the levels of serum albumin and total protein at the onset of pneumonia were significantly lower in the fatal cases than in the recovered cases. It was considered that not only general underlying disease which weaken the immunological resistance of the host, but local bronchial lesion was also important to the onset of the Pseudomonas pneumonia. Also, nutrition is an important prognostic factor on the host's side.

Adult↗

PubMed1994

[Determination of neutrophil function in respiratory infection by chemiluminescence (CL). II: Changes in neutrophil's CL by chemotherapy against chronic lower tract infection].

Neutrophil's CL (CL-index) in were assayed in 18 patients with chronic lower tract infection (13 cases in the exacerbated phase and five cases in the stable phase) three times per case: before, during and after chemotherapy. Before the initiation of chemotherapy, the CL-index.N (neutrophil numbers x CL-index) in patients with exacerbation remained higher than in those without exacerbation. At the exacerbated phase, the CL-index of nine patients and the CL-index.N of 10 patients fell lower than those obtained before treatment. AT the stable phase, the CL-index and the CL-index.N did not change remarkably during and after chemotherapy.

Adult↗

PubMed1994

[Clinical study of pneumonia in elderly patients using transtracheal aspiration (TTA)].

A clinical study was conducted to clarify the clinical state of pneumonia in elderly patients using transtracheal aspiration (TTA). Without prior administration of antibiotics, S. pneumoniae was the most clinically significant in both elderly and non-elderly groups whether the onset of pneumonia was hospital acquired pneumonia or community acquired pneumonia. Compared to the non-elderly group, multiple pathogens were isolated more frequently in the elderly group. Analysis about host factors showed that the number of underlying diseases per patient was more along those with poorer general conditions in the elderly group. The Brinkmann Index was also significantly higher in the elderly group. Clinical examinations before onset of pneumonia indicated that serum total protein, albumin and DNCB skin reaction were significantly lowered in the elderly group. Over the clinical course, the prognosis was poorer and the incidence of adverse reactions of antibiotics tended to be more in the elderly group. These results suggest that a complex clinical background exists for pneumonia of elderly people, related to poorer prognosis. Therefore, more cautious and meticulous care should be provided to elderly patients with pneumonia.

Adolescent↗

PubMed1993

Restoration of the acute phase response after infection in cyclophosphamide-treated mice by granulocyte colony-stimulating factor.

The therapeutic effect of granulocyte colony-stimulating factor (G-CSF) against intramuscular infection with Pseudomonas aeruginosa in cyclophosphamide (CY)-treated mice was analyzed by measuring plasma levels of amyloid P-component (APC) and proinflammatory cytokine levels. CY (100 mg/kg) treatment of mice significantly suppressed plasma concentrations of APC and tumor-necrosis factor-alpha (TNF-alpha) following infection with P. aeruginosa, in associated with enhanced susceptibility of the treated mice to this bacterium. A 4-day treatment of CY-treated mice with recombinant human G-CSF (rhG-CSF) increased resistance of CY-treated mice, together with the marked restoration of APC and TNF-alpha productions. The capacity to produce interleukin 1-beta and TNF-alpha of peritoneal macrophages and also that to produce IL-6 of spleen cells were significantly enhanced by the in vivo administration of rhG-CSF in CY-treated mice. These results indicate that G-CSF may increase the functions of monocytes/macrophages directly or indirectly in vivo. Therefore, the therapeutic effect of rhG-CSF seems to consist of not only increases in the number and functions of neutrophils but also enhancement of monocyte/macrophage functions.

Acute-Phase Reaction↗

PubMed1993

Alterations of host response by a long-term treatment of roxithromycin.

Roxithromycin (10 mg/kg) was administered once-daily for seven or 28 days to mice intragastrically and its effects on cytokine synthesis were studied. Administration of roxithromycin for 28 days resulted in increased synthesis of interleukin (IL)-1 and tumour necrosis factor (TNF-alpha) production by macrophages, and the production of IL-2, IL-4 and interferon gamma by splenocytes. In contrast, 7 day administration of roxithromycin did not affect these parameters. Furthermore, clindamycin treatment did not significantly increase the capacity of host cells to produce cytokines, irrespective of the duration of treatment, when compared with the solvent control receiving 0.9% ethanol solution or the untreated controls. In addition, the supernatant of a 7 day culture of splenocytes with roxithromycin showed suppression of the production of TNF-alpha and prostaglandin E2 by mitogen-stimulated macrophages, and this suppressive activity was impaired by a monoclonal antibody to murine IL-4. Thus, this data suggests that roxithromycin may not only enhance the host defence system through increased cytokine synthesis by host cells, but also exhibit anti-inflammatory activity by including an anti-inflammatory cytokine, IL-4.

Adjuvants, Immunologic↗

PubMed1993

[A clinical study of chronic lower respiratory tract infections with Pseudomonas aeruginosa by transtracheal aspiration].

We investigated the yearly changes of the incidence of Pseudomonas aeruginosa (P. aeruginosa) isolated from chronic lower respiratory tract infections (CLRTI), and also performed a clinical study on CLRTI with P. aeruginosa by transtracheal aspiration (TTA) to clarify the recent trend of P. aeruginosa infection in CLRTI and the predisposing clinical factors to the acute exacerbation. The isolation rate of P. aeruginosa among the total isolated bacteria in CLRTI between December 1978 and March 1983 was 8.4%, but it increased to 23.1% between April 1988 and March 1993. In 69 episodes (40 cases) of P. aeruginosa isolated from CLRTI between April 1983 and March 1993, monomicrobial infections of P. aeruginosa were 42 episodes (60.9%) and polymicrobial infections were 27 episodes (39.1%). When the diseases were classified into acute exacerbated and non-exacerbated phases, polymicrobial infections were seen more in the former phase, and the principal organisms detected with P. aeruginosa were Haemophilus influenzae and Streptococcus pneumoniae. In the acute exacerbated cases, predisposing conditions concerning the exacerbation were divided into four patterns: 1. polymicrobial infections with H. influenzae or S. pneumoniae, 2. after acute upper respiratory tract infections due to viral superinfection, 3. early phase from bacterial replacement by P. aeruginosa, 4. immunocompromised states such as adrenal corticosteroid administration or systemic underlying diseases. These results suggest that the importance of P. aeruginosa in CLRTI is increasing year by year and we must pay attention to the fact that P. aeruginosa alone may also cause acute exacerbation in the latter 2 patterns of the condition.

Adult↗

PubMed1993

[Clinical study of anaerobic respiratory infection].

This clinical study involved 35 cases, anaerobic bacteria were detected by TTA (transtracheal aspiration) or percutaneous lung aspiration, or pleural puncture. These cases were treated over the last 8 years in our department. There were 9 empyema, 9 pneumonitis, 5 lung abscess, 1 necrotizing pneumonia and 11 chronic lower airway infection. In 13 cases (37%), anaerobic bacteria alone were detected, whereas both anaerobic and aerobic bacteria were observed in the other 22 cases (63%). Of all bacteria detected. Bacteroids and Peptostreptococcus were the most common. With respect to host factors involved in the pathogenesis of pleural and parenchymal infection, aspiration was though to be a major trigger in only 11 out of the 24 cases (46%). The other 13 cases (54%) showed no evidence of aspiration, indicating that some other triggers was responsible. In further study, these 13 cases were found either to be heavy smokers with Brinkman index of more than 600, or to show sign of chronic lower airway infection. Both conditions were characterized by an inhibition of the mucociliary transport in the lower airway. Therefore, this study suggested that in the case without apparent aspiration the failure of local defense mechanisms in the airway, as a result of heavy smoking and/or chronic lower airway infection are involved in the pathogenesis of anaerobic respiratory infection.

Adult↗

PubMed1993

[Clinical study of acute bacterial bronchitis].

Eighty-two episodes (77 cases) in which any pathogens were isolated from transtracheal aspiration (TTA) and which satisfied the new clinical criteria of acute bacterial bronchitis were clinically evaluated. Major pathogens isolated from TTA included H. influenzae, S. pneumoniae and B. catarrhalis. Fever developed in 91.5% of the patients. Sputum volume averaged 16.3 +/- 14.9 ml per day. All the patients suffered from coughs, which were so severe as to disturb sleep in 8.5% of the patients. Inflammatory indices included WBC 9738.0 +/- 3158.5/microliter, CRP 10.1 +/- 7.9 mg/dl and ESR 69.0 +/- 38.8 mm/hr on average, PaO2 fell in most cases. Compared to the group of patients with acute bacterial bronchitis from which a single pathogen was isolated, the numbers of elderly patients and smokers were significantly more in the group of multiple pathogens isolated from TTA. Prior episodes related to the development of acute bacterial bronchitis were upper respiratory inflammation in 46.3% and undergoing bronchoscopy in 4.9% of the patients. Antibiotics therapy cured acute bacterial bronchitis in 96.3% of the patients. In spite of treatment, 3 patients developed pneumonia and died.

Acute Disease↗

PubMed1993

[Pneumonia due to respiratory syncytial virus diagnosed by transtracheal aspiration in an adult].

A healthy-looking 44-year-old female was admitted to our hospital complaining of fever and hemosputum. The chest roentgenogram on admission showed patchy infiltrates of the segment 3 and 8 of the right lung. Laboratory studies showed a leukocyte count of 9700/microliters, erythrocytes sedimentation rate of 55 mm/hour and C reactive protein of 8.7 mg/dl. The arterial PO2 was 71.9 torr while the patient was breathing room air. Transtracheal aspiration was performed on admission, and strains and culture for bacteria, acid fast bacilli, fungi and mycoplasma were negative. Respiratory syncytial virus was isolated from transtracheal aspirates. The RSV complement fixing antibody titers rose from 1:40 to 1:16. She became afebrile on the fourth day after admission and her chest roentgenogram improved gradually. RSV infection should be considered in the differential diagnosis of atypical adult pneumonias.

Adult↗

PubMed1993

[Effect of erythromycin on production of cytotoxin and attachment factors of bacteria].

We studied the effect of erythromycin (EM) on the attachment of Pseudomonas aeruginosa and Neisseria gonorrhoeae to HeLa and HT-177 cell and on cytotoxin production of P. aeruginosa. 1. EM inhibited attachment of these bacteria. 2. EM inhibited manifestation of the pili of these bacteria. 3. EM inhibited production of protein II, the second attachment factor of N. gonorrhoeae. 4. EM inhibited production of 66 K cytotoxin of P. aeruginosa. On the basis of these findings, it was suggested that EM might inhibit infection by repressing manifestation of the attachment factor and production of cytotoxin of the bacteria.

Bacterial Adhesion↗

PubMed1993

[Determination of neutrophil function in the respiratory infection by chemiluminescence (CL). I: Change in neutrophil's CL by chemotherapy against the bacterial pneumonia].

We measured neutrophil's CL (CL-index) in 12 patients of the bacterial pneumonia three times per each case: before, during and after chemotherapy. Before the initiation of chemotherapy. CL-index in the six patients remained higher than that in healthy controls, while the remaining six showed lower levels of CL-index compared to the controls. In the 11 cases, their CL-indexes fell to levels lower than those obtained before treatment. Additionally, in the 11 cases their CL-indexes increased after the termination of chemotherapy. Furthermore, in the nine cases the product of the neutrophil number and CL-index was decreased by chemotherapy, and the decrease in the product correlated with improvement in their clinical conditions.

Adolescent↗

PubMed1993

[A case of eosinophilic pneumonia with histologically proven mediastinal lymph node involvement].

Intrathoracic lymphadenopathy in eosinophilic pneumonia is very rare and few cases have been confirmed histologically. This is the first case of eosinophilic pneumonia with mediastinoscopic lymph node biopsy reported in Japan. The case is a 42-year-old man who was admitted to our hospital complaining of cough, general fatigue and dyspnea of one month's duration. Chest X-ray demonstrated bilateral hilar and mediastinal lymph node enlargement with interlobar pleural thickening and infiltrative shadows in right lower lung field. Computed tomography revealed infiltrative shadows at right S4, S5, S8 and S9 and S10 segments and #2, #3, #5, #6 lymph node enlargement. Biopsy of the lymph node via mediastinoscopy demonstrated that the architecture was preserved, sinusoids were filled with histiocytes and eosinophils, and lymphoid follicles were compressed. Immunohistochemical technique using monoclonal antibody EG2 which reacts with the secreted form of Eosinophilic Cationic Protein (ECP), demonstrated that eosinophils infiltrating the mediastinal lymph nodes were activated. The pathogenesis of mediastinal lymphadenopathy in eosinophilic pneumonia remains to be determined, but our case suggests that mediastinal lymph nodes may play a role in eosinophilic pneumonia.

Adult↗

PubMed1992

The anti-inflammatory effect of erythromycin in zymosan-induced peritonitis of mice.

The anti-inflammatory effect of erythromycin was investigated using zymosan-induced peritonitis in mice. When mice were given erythromycin 10 mg/kg/day po for 28 days, a marked suppression of inflammatory responses, including the reduced influx of leucocytes, plasma exudation and prostaglandin E2 synthesis, was observed. However, neither a 7-day treatment with erythromycin nor a 28-day treatment with clindamycin suppressed the response. The anti-inflammatory activity induced after a 28-day treatment with erythromycin was comparable to the anti-inflammatory effect conferred by a 2-day treatment with dexamethasone 40 microgram/mouse/day. Thus, these data confirm previous studies which show that erythromycin can exert an anti-inflammatory effect when used over long periods of time.

Animals↗

PubMed1992

[Long-term chemotherapy using erythromycin (EM) for chronic lower airway infection: effectiveness of clarithromycin in EM ineffective cases--the fourth report].

The effectiveness of long-term chemotherapy using Erythromycin (EM) for chronic lower airway infection has been practically proved. However, there still exist some ineffective cases, or cases in which the clinical effect was scarcely seen. In the present study was administered Clarithromycin (CAM) to such cases and found that CAM was effective in alleviating symptoms in some of them. The results were presented along with clinical findings and other basic studies. The subjects were 4 cases in which EM was either ineffective or low in its clinical effect. The subjects consisted of 1 case of DPB and 3 cases of bronchiectasis. EM was clinically ineffective in 2 cases and slightly effective in the two others. The pathogen was Pseudomonas aeruginosa in all cases. The dosage of EM was 200-1200 mg/day. The period of administration ranged from 2 years to 6 years 9 months. CAM was given orally after meals at a dose of either 200 or 400 mg/day. Chemotherapy had continued for 3-8 months at the time of final observation (Feb. 1992). Clinical effectiveness was evaluated on the basis of sputum volume and PaO2 examination, as well as evaluation by the patients themselves. As a result, in all 4 cases, reduction in sputum volume and improvement of PaO2 were observed. All subjects evaluated CAM therapy as being more effective than EM therapy. Moreover, it was found that CAM inhibited both the elastase and leucocidin produced in one of the ineffective cases by P. aeruginosa, whereas EM didnt.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

[The 5th report on long-term chemotherapy using erythromycin (EM) for chronic lower airway infection--cases followed over 7 years].

Clinical studies were made over 7 years on 9 cases to whom long-term chemotherapy with EM was administered for chronic airway infection. 1) Clinical effectiveness: Highly effective in 8 cases; Improvement in QOL was observed in 8 cases. Bacteriological effect: In 7 cases, pathogenic bacteria disappeared. 2) No side effects were observed. 3) Changes in PaO2 levels with the passage of time: In most cases, PaO2 reached a plateau within 1 year. Although in some cases, there was subsequent elevation. 4) The frequency of catching cold over the 7 years period was low with an average of 1.2 times/year per subject. In only 2 cases were subject hospitalized due to acute exacerbation triggered by a cold. 5) Mucociliary transport improved in 7 out of 8 cases examined. However, only 4 of these recovered normal transport. The effect of EM in the other cases in which clinical improvement was not demonstrated was deemed slightly effective. On the basis of the above findings, it was suggested that long-term chemotherapy using EM was clinically efficacious. This is based on the fact that its efficacy, including amelioration of QOL appeared within one year of the initiation of therapy, and continued without decline for over 7 years.

Administration, Oral↗

PubMed1992

[A clinical study of respiratory tract infection due to Staphylococcus aureus detected by transtracheal aspiration].

A clinical study of 24 patients with respiratory tract infection due to S. aureus detected by transtracheal aspiration (TTA) was conducted, and the following results were obtained. 1) The detection frequency of S. aureus was relatively low (4.6%). 2) Pneumonia was the principal clinical manifestation. 3) Approximately one half of the patients had previously received antimicrobials. 4) Multiple organisms were frequently detected, particularly in cases of hospital-acquired infection. H. influenzae was the most frequently simultaneously detected organism. 5) On sputum examination, approximately 20 ml of purulent sputum was found in most cases, and S. aureus was detected in sputum specimens from 20 of the patients. 6) The largest number of cases was found in 1987. Onset was most common from autumn to spring. 7) Undernutrition was the most frequently associated host factor. As indicated by the above findings, the clinical expression of S. aureus infection is variable, and it is important that it be diagnosed accurately.

Adult↗

PubMed1992

[The long-term chemotherapy with erythromycin (EM) in chronic lower respiratory tract infections--third report: clinical study of cases administered EM over 3 years].

An investigation was made of the use of EM therapy which began in 1986 or earlier in 31 cases with chronic lower respiratory tract infections. 1) Of the 20 cases in which EM (Erythromycin stearate) administration (600-1200 mg/day) was continued for 3 years or more and its usefulness could be evaluated, treatment with this agent was judged markedly effective in three, effective in 14, somewhat effective in two, and ineffective in one. This amounted to an effectiveness rate (effective or better) of 85%. 2) Improved QOL was observed in 15 of the 20 cases. 3) In the Pseudomonas infected cases, a discrepancy was seen between the effectiveness rate of 87.5% and the disappearance rate of the organism (12.5%), while in the Haemophilus cases no such discrepancy was found (75%). 4) EM administration was stopped in 11 cases because of side effects in two (stomatitis, gastrointestinal disorder) death in five, desire of the patient in three, and transfer to another hospital in one. The cause of death cases had no connection with administration of EM. 5) In the three patients who stopped EM on their own, the agent was again administered because of exacerbation of symptoms, although this readministration proved ineffective in two of the cases. The above results suggest that long term EM therapy is useful and that its continued administration is important.

Adult↗