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Biomedical subjects

M Fujimura

Publications and source records attributed to M Fujimura.

At least 253 records · Page 14Linked to original sources
PubMed1995

Repeated inhalation challenge with exogenous and endogenous histamine released by acetaldehyde inhalation in asthmatic patients.

We previously reported that inhaled acetaldehyde, a metabolite of ethanol and a main factor in alcohol-induced asthma, causes bronchoconstriction indirectly through endogenously released histamine in asthmatic subjects. No study has examined the difference between tachyphylaxis in response to endogenous as opposed to exogenous histamine. Therefore, we examined tachyphylaxis occurring in response to repeated inhalation of histamine or acetaldehyde in nine asthmatic subjects. The mean acetaldehyde concentration causing a 20% decrease in FEV1 increased significantly from 18.4 (geometric standard error of the mean (GSEM = 0.14) to 45.2 (GSEM = 0.14) mg/ml over a period of 1 h (p < 0.002), whereas the mean histamine concentrations causing a 20% decrease in FEV1 were identical. No correlations were observed between the change in bronchial responsiveness to each solution and the change in baseline FEV1. These results suggest that tachyphylaxis in response to histamine is observed only when the latter is released endogenously. We believe that this is the first report suggesting tachyphylaxis caused by endogenous histamine.

Acetaldehyde↗
PubMed1995

Effect of thromboxane A2 synthetase inhibitor, OKY-046, on sputum in chronic bronchitis and diffuse panbronchiolitis.

The mechanisms of excessive sputum production are only partially understood. We speculated that a selective thromboxane (Tx) A2 synthetase inhibitor, OKY-046, now used in the treatment of asthma in Japan, could decrease excess sputum production in patients with chronic airways disease. To test this hypothesis, we carried out a double-blind, placebo-controlled study of the effects of OKY-046, administered orally at 400 mg.day-1, on the sputum of patients with chronic bronchitis and patients with diffuse panbronchiolitis. Patients treated with OKY-046 showed a significant decrease (22%) in sputum volume after 1 month, and a 39% decrease after 3 months. Although the rheological properties of the sputum and the concentrations of fucose and immunoglobulin (Ig) A in the sputum remained unchanged, significant decreases were observed in the concentrations of total protein, albumin, sialic acid and phospholipid. Since albumin and fucose are chemical markers of plasma exudation and mucus secretion, respectively, whilst sialic acid and phospholipid are derived both from serum and mucus, our results indicate that this TxA2 synthetase inhibitor reduced sputum volume by inhibiting microvascular leakage in the airway. OKY-046 may, therefore, be of value in the treatment of chronic bronchitis and diffuse panbronchiolitis.

Adult↗
PubMed1995

Ganglioglioma in the basal ganglia totally resected by a trans-distal Sylvian approach.

A patient with a ganglioglioma in the basal ganglia is presented. An 18-year-old man presented with involuntary movement in his right hand and right homonymous hemianopsia. Computed tomography and magnetic resonance imaging revealed a cystic tumor with an enhancing nodule in the basal ganglia extending into the thalamus. The mass was totally resected by a trans-distal Sylvian approach and was histologically proven to be a ganglioglioma. This is a rare case of midline ganglioglioma in a patient who underwent gross total resection.

Adolescent↗
PubMed1995

Plasma levels of retinol, retinol-binding protein, all-trans beta-carotene and cryptoxanthin in low birth weight infants.

In neonatal medicine, it is thought that retinol is useful for preventing CLD and for fetal development. However, beta-carotene had other vitamin A precursors have not been studied in neonates with CLD or others disorders. Cord blood of neonates including ELBW and VLBW infants was assayed for plasma levels of retinol, RBP, beta-carotene and cryptoxanthin. Plasma beta-carotene levels in ELBW and VLBW were lower than that in term infants, but plasma cryptoxanthin levels in ELBW and VLBW were about the same as in term infants. Plasma retinol and RBP levels showed almost same levels during 23-41 gestational weeks. Maternal smoking reduced plasma beta-carotene but not cryptoxanthin, retinol, or RBP levels. IUGR was associated with increased cryptoxanthin levels in cord blood. Serious neonatal diseases, including CLD and ROP manifested no significant effects on the cord blood vitamin levels. Thus, the occurrence of these diseases at birth could not be predicted by examination of vitamin levels in cord blood.

Cryptoxanthins↗
PubMed1995

Inhibitory effect of terfenadine, a selective H1 histamine antagonist, on alcoholic beverage-induced bronchoconstriction in asthmatic patients.

We wanted to evaluate the effect of terfenadine, a selective H1-receptor antagonist, on alcoholic beverage-induced bronchoconstriction. Eight patients with alcohol-induced asthma received terfenadine (60 mg, twice on the test day) or placebo, with the last dosing 2 h before the test in a double-blind, randomized, cross-over manner. On two separate study days, each subject drank the same brand and volume of alcoholic beverage (beer or Japanese saké), and bronchoconstriction was assessed as change in peak expiratory flow (PEF) over 120 min postchallenge. Inhalation challenges were performed with the same alcoholic beverage with which they had been orally challenged. The mean (SEM) percentage fall in PEF 15, 30, 45, 60, 90 and 120 min after the oral alcohol challenge was significantly reduced from 12.0 (3.1), 17.0 (1.7), 15.8 (2.3), 15.2 (3.4), 16.6 (4.8) and 14.7 (5.2)%, to 2.6 (1.8), 2.1 (1.6), 3.9 (1.2), 5.7 (2.2), 6.5 (2.6), 5.1 (1.6)%, respectively, by terfenadine. No significant bronchoconstriction was observed after the inhalation challenge. We conclude that the release of histamine makes a major contribution to alcoholic beverage-induced bronchoconstriction in Japanese asthmatic patients, and that histamine H1 antagonists may be effective in preventing alcoholic beverage-induced bronchoconstriction.

Adult↗
PubMed1995

[A case of Legionella pneumonia successfully treated with roxithromycin].

A 56-year-old man was admitted to our hospital because of a high fever. An abnormal shadow was seen on his chest X-ray film. He was treated with piperacillin, isepamycin, and minocycline, but his fever remained and the abnormal shadow got worse. Because he had proteinuria, a severe headache, hyponatremia, and hypophosphatemia, Legionella pneumonia was suspected. A skin test for erythromycin was positive, so roxithromycin was given orally. By the next day the fever had remitted, the appearance of the chest X-ray film had improved, and his symptoms were promptly relieved. This case suggests that roxithromycin can be effective against Legionella pneumonia.

Administration, Oral↗
PubMed1995

[A case of chronic persistent cough caused by gastro-esophageal reflux].

Although gastro-esophageal reflux (GER) is one of the major causes of chronic persistent cough (CPC) in the USA and in Europe, it is a rare cause of CPC in Japan. We report a rare case of CPC caused by GER, in which treatment with an H2-blocker or with a proton pump inhibitor was successful. A 65-year-old woman had complained of coughing for over 25 years. Her coughing was not alleviated by treatment with a bronchodilator (beta 2-adrenoceptor agonist), an anti-allergic agent, a corticosteroid, or a sedative. GER was considered as a possible cause of her coughing because exacerbation of the coughing was associated with the development of gastrointestinal symptoms (heartburn). Fiberoptic esophagoscopy showed esophagitis and esophageal herniation of the sliding type. Twenty four-hour monitoring of distal esophageal pH showed that the coughing occurred when the pH dropped below 4, and that the pH was less than 4 for about 7% of the whole monitoring time. An H2-blocker or a proton pump inhibitor completely eliminated the symptoms. Therefore, CPC caused by GER was diagnosed. We found that coughing could be induced by instillation of 0.1 N hydrochloric acid at the distal esophagus, and that the coughing was partially inhibited by inhalation of an anti-muscarinic agent (ipratropium bromide) and by esophageal instillation of 4% xylocaine. These data support the "reflex theory". Although CPC caused by GER is rare in Japan, we should remember that GER can be a cause of CPC even in Japanese patients.

Aged↗
PubMed1995

[Cavernostomy and muscle plombage with the pedicled latissimus dorsi and serratus anterior flap for recurrent large bullae with infection: a case report].

A 70-year-old male, who suffered from infection by MRSA and Aspergillus of the recurrent large bullae, was operated on cavernostomy for space sterilization. About three months later he underwent muscle plombage with the pedicled latissimus dorsi and serratus anterior flap. These muscles are ideal to place in open wound in the thorax because of the following reasons: These have the ability to eliminate local infection, a sufficient length and volume to obliterate an open cavity. And transposition of these muscles cause minimal functional upper extremity disability. Therefore, we considered that this technic was useful for the case of an infectious intrathoracic cavity with many bronchial fistulas.

Aged↗
PubMed1995

[Congenital protein C deficiency with pulmonary infarction].

A 45-year-old man was admitted with left chest pain and hemoptysis. Chest CT on admission showed multiple areas of wedge-shaped consolidation in both lung fields. A perfusion lung scintigram showed bilateral deficits in both lungs, whereas a ventilation scintigram was normal. The serum concentration and the functional activity of protein C were 41% and 42%, respectively. The same results were obtained from studies of the patient's mother and two sons, which indicated that this was a case of congenital protein C deficiency with pulmonary infarction.

Humans↗
PubMed1995

[Idiopathic interstitial pneumonia (type B) with subacute progressively enlarged bullae].

A 70-year-old man with a 10-year history of seal engraving presented with exertional dyspnea and dry coughing. Chest roentgenograms showed an interstitial shadow and bilateral progressively enlarging bullae. Open lung biopsy led to the diagnosis of idiopathic interstitial pneumonia (Type B). The size of bullae usually does not change, so cases such as this are rare because the bullae continued to expand subacutely. Persistent stimulation by the inhaled A1 and Si may have played a role in the pathogenesis of this condition.

Aged↗
PubMed1995

[A case of intra-pulmonary lymph nodes presenting as multiple small nodular lesions in both lungs].

A 59-year-old man came to our hospital for further examination of multiple small nodular lesions in both lungs. Chest CT scan revealed multiple nodular lesions in rt-S6, It-S5, and It-S9 (two lesions). All of these nodules measured about 10 mm or less and those in It-S9 had spicula. Bronchoscopic examination did not yield a definitive diagnosis, so open lung biopsy was done. The open lung biopsy specimen revealed intra-pulmonary lymph nodes with anthracosis and pulmonary emphysema. Intrapulmonary lymph nodes are very difficult to distinguish from small lung tumors by radiographic examination alone, so the possibility that small nodules in the lungs may be intra-pulmonary lymph nodes should be kept in mind.

Chronic Disease↗
PubMed1995

[A case of Rendu-Osler-Weber syndrome and pulmonary arteriovenous fistula].

A 65-year-old man with Rendu-Osler-Weber syndrome was admitted to the department of brain surgery at our hospital because of left hemiplegia and a right cerebral mass seen on a computerized tomogram of the brain. A brain abscess was found during surgery. Then the patient had pneumonia. He received antibiotics and recovered, but his PaO2 remained low. He was transferred to our department for evaluation of hypoxia. Thoracic computerized tomography showed a nodular lesion connected to a vascular shadow. Angiographic examination showed a pulmonary arteriovenous fistula and other vascular abnormalities. He was not dyspneic or cyanotic, but his hypoxia, low diffusing capacity, and brain abscess were thought to be caused by the pulmonary arteriovenous fistula. The fistula was embolized with coils via a percutaneous catheter, after which oxygenation and diffusing capacity improved.

Aged↗
PubMed1995

[Pulmonary non-Hodgkin's lymphoma that arose in mucosa-associated lymphoid tissue of the salivary gland and was diagnosed at autopsy].

A 70-year-old woman complained of a dry mouth and swelling in the area of the left parotid gland for 6 years, and was admitted for evaluation of an abnormal shadow on chest X-ray film. She underwent a lip biopsy and a 99mTcO4- scintigram of the salivary gland, and Sjögren's syndrome was diagnosed. Histopathological examination of the percutaneous lung biopsy specimen showed pseudolymphoma, and examination of a specimen of the left parotid gland tumor showed myoepithelial sialadenitis. The patient died of respiratory failure due to a right pleural effusion 4 years later. Autopsy revealed pulmonary non-Hodgkin's lymphoma (diffuse, large, B cell, IgG) with monotonous infiltration of centrocyte-like cells. A retrospectively resected specimen of the left parotid gland tumor showed non-Hodgkin's lymphoma similar to that found in the autopsied lung. This patient probably had pulmonary non-Hodgkin's lymphoma that arose in mucosa-associated lymphoid tissue of the salivary gland and was associated with Sjögren's syndrome.

Aged↗
PubMed1995

Prostanoids and cough response to capsaicin in asthma and chronic bronchitis.

Cyclooxygenase products are released by chronic airway inflammation. Our working hypothesis for the present study was that prostanoids augment airway cough sensitivity. The effects of a cyclooxygenase inhibitor, indomethacin (100 mg.day-1 for 4 days), and a thromboxane synthesis inhibitor, OKY-046 (400 mg.day-1 for 4 days), on cough response to inhaled capsaicin were examined in eight patients with asthma, 10 patients with chronic bronchitis, and 10 normal subjects. Capsaicin cough threshold, the lowest concentration of capsaicin eliciting five or more coughs, was measured as an index of airway cough sensitivity. In asthmatics, the cough thresholds with indomethacin treatment (15.7 (GSEM 1.38) microM) and OKY-046 (10.2 (GSEM 1.20) microM) were significantly greater than the value with placebo (6.05 (GSEM 1.25) microM). In patients with chronic bronchitis, the cough threshold was significantly greater with indomethacin (5.94 (GSEM 1.50) microM) than with placebo (3.41 (GSEM 1.33) microM and OKY-046 2.97 (GSEM 1.43) microM). In normal subjects, the capsaicin cough threshold was not altered by indomethacin or OKY-046 treatment. These results support our hypothesis and suggest that thromboxane A2 may be one of the cyclooxygenase products augmenting airway cough sensitivity in asthma, but not in chronic bronchitis.

Adult↗
PubMed1995

[Classification of asthma according to etiology, pathophysiology, and treatment: effects of antiallergic drugs].

Selective inhibitors of mediators are among recently developed antiallegic drugs. Studies of the effects of these inhibitors on different types of asthmatic reactions can clarify the heterogeneity of asthma. Heterogeneity may be found both among patients and among types of asthmatic reactions. Although the differences among patients with regard to mediators of spontaneous asthma attacks is still unclear, the differences among asthmatic reactions induced by some well-defined stimuli are known. For example, leukotrienes are dominant in asthmatic reactions induced by analgesics, and histamine is dominant in bronchoconstriction induced by alcohol. Types of asthma may be classified according to the main contributing mediator.

Anti-Allergic Agents↗
PubMed1995

[Effect of clarithromycin on symptoms and mucociliary transport in patients with sino-bronchial syndrome].

The effect of clarithromycin on symptoms and on mucociliary transport (as assessed by the saccharin test) were studied in 32 patients with sino-bronchial syndrome. Before treatment with clarithromycin, the nasal clearance time was significantly longer in these patients (70.3 +/- 64.7 min, mean +/- SD) than in control subjects (11.9 +/- 5.3 min, p < 0.001). By the end of 4 weeks of treatment with oral clarithromycin (400 mg/day), nasal clearance time in the patients had improved significantly (30.4 +/- 39.5 min, p < 0.001). Before clarithromycin therapy, bacteria were found in cultures of sputum from 15 patients. After clarithromycin therapy, bacteria were found in cultures of sputum from only 3 of those 15 patients. Cough frequency, volume of sputum, and dyspnea on exertion were significantly improved by clarithromycin therapy. These findings suggest that mucociliary transport is abnormal in patients with sino-bronchial syndrome, and that clarithromycin can be clinically useful in these patients.

Adult↗
PubMed1995

[Bilateral simultaneous spontaneous pneumothoraces associated with Alport's syndrome].

A 45-year-old man with Alport's syndrome presented with chest pain and dry coughing. A chest roentgenogram showed bilateral simultaneous spontaneous pneumothoraces. Possible causes such as pulmonary bullae were not detected. A partial defect in type IV collagen, which is involved in repair of the basement membrane, may have played a role in the etiology of pneumothoraces in this patient.

Collagen↗