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Biomedical subjects

M Fujimura

Publications and source records attributed to M Fujimura.

At least 289 records · Page 16Linked to original sources
PubMed1994

[A case of liver cirrhosis presenting with right pleural fluid without ascites].

A 80-year-old man was admitted to our hospital complaining of appetite loss, dry cough, and dyspnea on exertion. Chest X-ray film showed massive right pleural effusion. On physical examination, the right thorax was dull to percussion, and breath sounds of the right lung field were diminished. Examination of the cardiovascular system was unremarkable. Hepatosplenomegaly and ascites were not evident. The character of the pleural fluid was transudative. Cytological findings were negative and culture of the pleural fluid was normal. First, the pleural fluid was diminished by thoracic drainage. But, after the cessation of drainage, the pleural fluid soon reaccumulated. Abdominal ultrasonography showed typical liver cirrhosis pattern without ascites. An intraperitoneal injection of 99mTc-sulfur colloid was followed by positive uptake of radioactivity in the right pleural cavity from 1 hour after the injection, demonstrating the existence of a direct perito-pleural communication. Thus, the diagnosis of liver cirrhosis presenting with right pleural fluid, without ascites was made. This case indicates that the absence of ascites cannot exclude cirrhosis as the etiologic cause of pleural effusion.

Aged↗
PubMed1994

[A case of miliary tuberculosis with high-grade fever that remitted without antituberculosis therapy].

A 23-year-old man was admitted with a persistent high-grade fever of 20 days duration. Chest roentgenogram showed diffuse miliary shadows in both lung fields, highly suggestive of miliary tuberculosis. Sputum, gastric juice, and bronchoalveolar lavage fluid did not, however, reveal acid-fast bacilli on smears. A bone marrow aspirate and a transbronchial lung biopsy were also negative for caseating granulomas and tubercule bacilli. After admission, the high-grade fever remitted in several days without continuous antibiotic, antituberculosis or antipyretic therapy. Levels of inflammatory markers (CRP, ESR, alpha 2-globulin dropped simultaneously. Despite the atypical clinical course, miliary tuberculosis was suspected. We therefore carried out an open lung biopsy. The presence of caseating granulomas and acid-fast bacilli confirmed the diagnosis of miliary tuberculosis. The remission of miliary tuberculosis without treatment is very rare and the details of this case are presented herein with a discussion of the pertinent literature.

Adult↗
PubMed1994

[A case of pneumonitis induced by PL granules].

We report a case of pneumonitis induced by PL granules. A 45-year-old man took PL granules and other drugs for fever and headache. Because he subsequently developed high grade fever, cough and diarrhea, he was admitted to our hospital. His chest X-ray film revealed multiple patchy shadows in both lung fields. Analysis of bronchoalveolar lavage fluid (BALF) disclosed a high number of cells (total), lymphocytes, and a high CD4/CD8 ratio. Microscopic examination of transbronchial lung biopsy (TBLB) specimens showed infiltration of mononuclear cells and thickening of the alveolar wall. After discontinuation of drugs, his condition (symptoms, laboratory data, and chest X-ray findings) promptly improved. Lymphocyte stimulation tests (LST) for PL granules and acetaminophen were positive and an oral challenge test with PL granules was also positive. Based on these findings, we diagnosed this as a case of pneumonitis and enteritis due to PL granules. To our knowledge, this is the first reported case of pneumonitis due to PL granules.

Acetaminophen↗
PubMed1994

[Spontaneous regression of small cell lung cancer].

An 82-year-old man was admitted for evaluation of dry cough and low grade fever. A chest roentgenogram obtained on admission revealed an abnormal mass shadow at the left hilus. Trans-bronchial lung biopsy was used to make a diagnosis of small cell lung cancer. This tumor regressed spontaneously.

Aged↗
PubMed1994

Inhibitory effect of aerosol administration of a sulfidopeptide leukotriene antagonist on bronchoconstriction induced by antigen inhalation in guinea pigs.

The effects of inhalation of the sulfidopeptide leukotriene antagonist AS-35 (9-[(4-Acetyl-3-hydroxy-2-n-propyl-phenoxy)methyl]-3-(1H- tetrazol-5-yl)-4H-pyrido [1,2-a]pyrimidin-4-one, CAS 108427-72-1) on bronchoconstriction induced by aerosol antigen, histamine, and leukotriene C4, D4 (LTC4, D4) were investigated in anesthetized and artificially ventilated guinea pigs. The increase in pressure at the airway opening (P(ao)) was measured as an index representing the grade of bronchial response. The bronchoconstriction induced by aerosol antigen was suppressed dose-dependently by pretreatment with inhaled AS-35 (0.1 mg and 1 mg) through a pressurized meter-dosed inhaler in the passively sensitized animals pretreated with diphenhydramine hydrochloride. But the histamine-induced bronchoconstriction was not altered by the pretreatment with AS-35 inhalation. On the other hand, LTC4- and LTD4-induced bronchoconstriction was inhibited by the pretreatment with aerosol AS-35 in a dose-dependent manner. The deposited dose of inhaled AS-35 in the peripheral airways was 3.5 micrograms and 6.5 micrograms when 0.1 mg and 1 mg of the drug was inhaled, respectively. These results suggest that sulfidopeptide leukotrienes (s-LTs) play an important role in the allergic bronchoconstriction in guinea pigs pretreated with antihistamine, and AS-35 inhalation may be beneficial in the treatment of asthma.

Administration, Inhalation↗
PubMed1994

[A case of diffuse lung disease with bronchiolitis obliterans organizing pneumonia and chronic eosinophilic pneumonia pattern].

A 63-year-old male with a history of cement exposure visited our hospital in August of 1992 with chief complaints of yellow sputum and cough. Chest CT on admission revealed segmental fine nodular shadows in the right lower lobe and a band-like shadow in the left lower lobe. The transbronchial lung biopsy (TBLB) specimen showed alveolitis with a minimal degree of eosinophilic infiltration and organizing exudates in the dilated peripheral air spaces. The open lung biopsy specimens showed, in addition to the TBLB observations, lymphoid hyperplasia, dust deposition, and cystic dilatation of alveolar ducts. After treatment with corticosteroids, but not antibiotics, the abnormal opacities disappeared. This case appears to be characteristic of both bronchiolitis obliterans organizing pneumonia and a chronic eosinophilic pneumonia pattern.

Bronchiolitis Obliterans↗
PubMed1994

[A case report of rounded atelectasis on MRI].

A 73-year-old man was admitted to Toyama Red Cross Hospital, because of productive cough and right flank pain. His chest X-ray film and computed tomography (CT) showed pleural effusion and a mass shadow in the right lung area. On CT vessels and bronchi were seen curving toward the mass (comet tail sign), suggesting rounded atelectasis. Transthoracic lung biopsy under CT and echo guidance revealed suppurative pleuritis. MRI also showed the comet tail sign. Moreover, in the lesion, curling hypointense lines were observed on various slices. We describe how MRI facilitates the diagnosis of rounded atelectasis.

Aged↗
PubMed1994

[Two cases of pulmonary hypertrophic osteoarthropathy associated with primary lung cancer, in which symptoms were rapidly improved by resection of the primary lesions].

Pulmonary hypertrophic osteoarthropathy (PHO) is a syndrome of unknown etiology, presenting with osteitis of the long bones, arthritis, and clubbing of digits, associated with lung cancer or other chronic pulmonary or pleural diseases. Although about 3-10 percent of cases of lung cancer were reported to be associated with PHO in USA or Europe, reports of these cases are relatively rare in Japan. We report two cases of PHO associated with primary lung cancer, in which symptoms were rapidly improved by resection of the primary lesions. Both cases were poorly differentiated adenocarcinoma of the lung (pT2N0M0, Stage I). The bone and joint pain rapidly improved soon after the resection of the primary lesions. The abnormal findings of bone scan and bone X-ray film subsequently improved. In the 2nd case, radionuclide imaging more clearly revealed the presence and extent of subperiosteal activity than radiography. Radionuclide disclosure of PHO was considerably more sensitive than radiography.

Adenocarcinoma↗
PubMed1994

[A case report of aortic valve replacement after 16 years from repair of ruptured sinus Valsalva aneurysm].

A case of aortic valve replacement after 16 years from the repair of ruptured sinus valsalva aneurysm (RSVA) was reported. The patient has undergone direct closure of RSVA with VSD type I at 34 years old. At the operation, no attempt was made as to aortic valve regurgitation because of small regurgitation, Selloers 1 on aortography. At 50 years old, he developed dyspnea on exertion, to-and-fro murmur due to aortic valve regurgitation, Selloers 3. Aortic valve replacement, we confirmed the completely closure of right coronary sinus valsalva, and histopathologically observed the degenerative change of only right coronary cusp.

Aortic Aneurysm↗
PubMed1993

Restraint stress-induced changes in endogenous zinc release from the rat hippocampus.

Changes in the levels of endogenous zinc and amino acids released from rat hippocampus due to one-hour restraint stress were measured using brain microdialysis. The zinc concentration in the perfusate of restrained rats increased to 167.3% of the mean basal level during the first 15-min period. Similar data were obtained for glutamate (Glu) release, which was increased to 210.5% of the basal level by restraint stress. These results indicated that hippocampal zinc release could be stimulated by restraint stress, and that this release may be related to the excitatory amino acids of Glu release.

Amino Acids↗
PubMed1993

Effect of Y-20811, a thromboxane synthetase inhibitor, on photochemically induced cerebral embolism in rabbits.

The effect of Y-20811, a selective thromboxane A2 synthetase inhibitor, was investigated on cerebral embolism using a new model of embolic cerebral infarction in rabbits. Most of cerebral infarctions were observed in the hemisphere, ipsilateral to the irradiated carotid artery. Cerebral infarction, ranging from 0.2 to 1.0 mm in size, appeared only on the surface of the cortex. The platelet emboli were identified in the carotid artery and cortex arteriole by light microscopy. In our study, 83% of the control group had cerebral infarction. Y-20811 significantly suppressed the infarction number and the incidence at doses of 1 mg/kg and 10 mg/kg (p.o.), respectively. Aspirin significantly inhibited the infarction number at a dose of 10 mg/kg, but its inhibitory effect decreased at 30 mg/kg. Ticlopidine showed no effect even at a dose of 300 mg/kg. These results indicate that Y-20811 may be useful in preventing embolic cerebral infarction and transient ischemic attacks.

Animals↗
PubMed1993

The progression of retinopathy of prematurity and fluctuation in blood gas tension.

In this study, the relationship between the fluctuation in blood oxygen and carbon dioxide tension and the progression of acute retinopathy of prematurity (ROP) was evaluated. Eighteen extremely premature infants were selected on the basis of the following criteria: gestational age less than 26 weeks, oxygen supply or mechanical ventilation for more than 50 days, transcutaneous oxygen pressure (TcPO2) recorded almost once per hour, and arterial oxygen pressure (PaO2) and arterial carbon dioxide pressure (PaCO2) measured intermittently, for over 8 weeks after birth. All of these infants developed ROP, which ceased progressing in 7 infants (group I, stage 1 or 2 ROP, international classification), but advanced in 11 (group II, stage 3 or 3+). The fluctuations in TcPO2, PaO2, and PaCO2 are represented as coefficients of both variation (CV) and mean difference (D) in these two groups. The results demonstrate that both the CV and D values of TcPO2 are significantly elevated in group II infants compared with group I infants, in the first and second 3-weeks periods, and over the entire 9-week period after birth. The incidences of extreme hyperoxemia (TcPO2 > or = 100 mm Hg) and hypoxemia (TcPO2 < 30 mm Hg) in recorded TcPO2 time series show no significant differences between these two groups. We conclude that extremely premature infants with widely fluctuating arterial oxygen tension may have a greater chance of developing progressive ROP.

Blood Gas Monitoring, Transcutaneous↗
PubMed1993

Bronchodilator effects of oxitropium bromide, fenoterol, and their combination in normal subjects.

Oxitropium bromide is a quaternary anticholinergic compound based on the scopolamine molecule instead of atropine. The purpose of this study was to compare the bronchodilator effects of oxitropium, a beta 2-agonist fenoterol, and their combination, on basal bronchomotor tone in normal subjects. Partial flow-volume curve (PEF25), was measured as an index representing bronchomotor tone. The cumulative dose-response curve of oxitropium bromide inhaled from a metered-dose inhaler was determined in eleven normal subjects. Measurement of PEF25 was repeated every 1 h for 8 h after inhalation of oxitropium (200 micrograms), fenoterol (200 micrograms), their combination or placebo in six normal subjects in a randomized, single-blinded, placebo-controlled, cross-over manner. As the percentage increase in PEF25 by 200 micrograms of oxitropium (45 +/- 6%) was equivalent to nearly 80% of that by dose of 1,600 micrograms (58 +/- 8%), the dose of 200 micrograms is thought to be appropriate. The group mean percentage increase in the PEF25-time course curve was significantly greater after treatment with the combination than with placebo (p < 0.001) and fenoterol (p < 0.001) but not with oxitropium bromide, while the increase in PEF25 following the combination was significantly greater than that following oxitropium bromide after 2 and 3 h. These findings indicate that in normal subjects oxitropium has a powerful bronchodilator effect and that the addition of oxitropium to fenoterol caused greater bronchodilation in normal subjects.

Adult↗
PubMed1993

Comparison of the bronchodilator activities of oxitropium bromide, fenoterol, and their combination in patients with chronic obstructive pulmonary disease and bronchial asthma.

The effects of an antimuscarinic agent, oxitropium bromide (200 micrograms), a beta-2 adrenoceptor agonist, fenoterol (200 micrograms), and their combination, were compared in ten patients with chronic obstructive pulmonary disease and ten patients with bronchial asthma, in a placebo-controlled, single blind crossover trial. In patients with chronic obstructive pulmonary disease, oxitropium and fenoterol produced a significant and similar degree of bronchodilatation. The duration of the bronchodilator effect was 3 h after oxitropium and 4 h after fenoterol, respectively. The combination of oxitropium and fenoterol produced a significantly greater degree of bronchodilatation than either drug alone. The duration of bronchodilatation in combination was 7 h and was considerably longer than that of each drug alone. In patients with bronchial asthma, oxitropium and fenoterol also caused bronchodilatation. Their combination produced a significantly greater degree of bronchodilatation than when either drug was used. The duration of the bronchodilator effects were 5 h after oxitropium, 4 h after fenoterol and 5 h after the combination. We conclude that the combination of oxitropium and fenoterol causes greater bronchodilatation in patients with chronic obstructive pulmonary disease and bronchial asthma than when compared to each drug alone. In the former, the duration of bronchodilatation is additionally prolonged. These combination effects may be of value in the clinical management of these common respiratory disorders.

Aged↗
PubMed1993

Histochemical localization of nitric oxide synthase in rat enteric nervous system.

The localization of nitric oxide synthase, the enzyme responsible for producing the short-acting messenger nitric oxide, has been determined in the digestive tract of the rat using histochemistry for reduced nicotinamide adenine dinucleotide phosphate-diaphorase activity, a specific marker for neuronal nitric oxide synthase. Positively stained neurons were found throughout the entire digestive tract from the esophagus to the rectum. Positive neuronal somata were very common in the myenteric ganglia. Dense positive fibers were distributed in internodal strands, the secondary plexus, the tertiary plexus, and were particularly abundant in the deep muscular plexus, while very few were observed in the submucosal ganglia. The density of these positive structures was higher in the small and large intestine than in the esophagus and stomach. The pattern of distribution suggested that some of these positive cells innervate gut muscles. Double-staining revealed that in these enteric neurons, nitric oxide synthase does not co-localize with acetylcholinesterase. Instead, vasoactive intestinal polypeptide almost always coexists with nitric oxide synthase in the myenteric plexus. Thus, nitric oxide and vasoactive intestinal polypeptide may be co-transmitters in a population of non-adrenergic, non-cholinergic neurons in the enteric nervous system.

Acetylcholinesterase↗
PubMed1993

Role of leukotrienes and platelet activating factor in allergic bronchoconstriction and their interactions in guinea pig airway in vivo.

Membrane-derived lipid mediators have been considered to play a major role in pathogenesis of bronchial asthma. Recently specific antagonists and synthetase inhibitors of some chemical mediators have been developed and many studies on their anti-asthmatic effects are ongoing. But the importance of and the interactions of each mediator are still unclear. We examined the role of leukotrienes (LTs) and platelet activating factor (PAF) in immediate asthmatic response (IAR) and interactions between these lipid mediators in guinea pig airways in vivo using a specific LTs antagonist AS-35 and a specific PAF antagonist Y-24180. We confirmed the activity of each antagonist, as AS-35 and Y-24180 inhibited bronchoconstriction induced by respective agonist inhalation. AS-35 inhibition IAR but Y-24180 did not, indicating that LTs play a major role in IAR but PAF does not. AS-35 did not influence PAF-induced bronchoconstriction and Y-24180 did not inhibit LTs-induced bronchoconstriction, showing that there is no interaction between LTs and PAF.

Animals↗
PubMed1993

Effect of a leukotriene antagonist, ONO-1078, on bronchial hyperresponsiveness in patients with asthma.

To evaluate the involvement of sulphidopeptide leukotrienes on bronchial hyperresponsiveness in asthma, we examined the effects of a specific orally active leukotriene antagonist (ONO-1078) on bronchial responsiveness to methacholine in stable asthmatic subjects by a double-blinded, randomized, two-phase crossover study. Eleven asthmatic subjects received ONO-1078 (225 mg twice a day) or placebo. After 1 week administration of ONO-1078 or placebo, the subjects underwent methacholine challenge test. Test drug administrations were then discontinued for 1 week, and the subjects were then crossed over to the alternative treatment regimen. After 1 week of the alternate regimen, the subjects underwent a second methacholine challenge. Mean baseline values of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) and geometric mean value of provocative concentration of methacholine causing a 20% fall in FEV1 (PC20-FEV1) were equal between the first and the second methacholine test. The geometric mean value of PC20-FEV1 after the administration of ONO-1078 was 0.48 (geometric SEM, 1.48) mg ml-1, which was significantly (P < 0.01) greater than the value after the placebo administration (0.30 geometric SEM, 1.41 mg ml-1), but the baseline values of FVC and FEV1 were not altered by ONO-1078. We conclude that sulphidopeptide leukotrienes are significantly involved in the development of bronchial hyperresponsiveness in asthma but the degree of the involvement may be small.

Adult↗