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Biomedical subjects

M Obana

Publications and source records attributed to M Obana.

At least 55 records · Page 3Linked to original sources
PubMed1994

Cause of death in 81 autopsied patients with rheumatoid arthritis.

OBJECTIVE: To evaluate the cause of death and complications in a series of autopsied patients with rheumatoid arthritis (RA). METHODS: A clinicopathological study of 81 autopsied patients with RA was performed. RESULTS: In order of frequency, the causes of death were infection (23.5%), heart disease (17.3%), respiratory failure (9.9%), renal failure (9.9%), and gastrointestinal disease (9.9%). Observed complications of RA were systemic angiitis in 25 cases (30.8%), systemic amyloidosis in 17 cases (21.0%), and pulmonary fibrosis in 28 cases (34.6%). No patient had both angiitis and amyloidosis simultaneously. The prevalence of systemic angiitis tended to decrease during the study period (1960-1990), while systemic amyloidosis tended to increase. CONCLUSION: The cause of death in RA is difficult to analyze accurately because RA itself is a chronic systemic inflammation disease.

Aged↗
PubMed1993

[Case report: suppurative arthritis due to group B Streptococcus in a patient with rheumatoid arthritis].

A 62-year-old woman, who had been diagnosed as having rheumatoid arthritis (RA) with systemic amyloidosis and diabetes mellitus, was admitted to our hospital because of polyarthralgia on October 1, 1987. She had some subcutaneous nodules and rheumatic pleural effusion. Therefore she was treated with 20 milligrams of prednisolone (PSL) daily. On the ninth day after the beginning of steroid therapy, she complained of severe pain and a new swelling in her right knee joint. The knee joint aspirate on arthrocentesis yielded a pure growth of group B Streptococcus (GBS). Blood culture was also positive for GBS. Her suppurative arthritis gradually improved by treatment with penicillin G. However, after the discontinuance of PSL, her pleural effusion deteriorated and she died on January 10, 1988. To our knowledge, there have been no prior reports of group B streptococcal suppurative arthritis complicating RA in Japan.

Arthritis, Infectious↗
PubMed1993

[A case of vivax malaria in which remission was achieved by primaquine at 1.5 times the standard dose after two earlier relapses].

A 22-year-old male student, who had been to Indonesia, was admitted to our hospital because of a high grade fever on October 12, 1990. On admission, vivax malaria parasites were detected in his blood smears and the antibody titers against Plasmodium vivax and P. falciparum antigen were respectively 1:1024 and 1:64 by the indirect fluorescent antibody test. Therefore, he was diagnosed as having vivax malaria and was treated with sulfadoxine/pyrimethamine (Fansidar), followed by primaquine at 15 mg/day for 14 days. However, relapse occurred twice after treatment with the above-mentioned standard dose of primaquine. After his second relapse, he was treated with primaquine at 22.5 mg/day for 14 days and remission was finally achieved without any adverse reactions. The antibody titer against P. vivax did not re-increase during the first and second relapses.

Adult↗
PubMed1992

[Clinical studies on the treatment of Campylobacter enteritis--emergence of quinolone-resistant Campylobacter jejuni after treatment with new quinolones].

In recent years, new quinolones such as ofloxacin (OFLX) and tosufloxacin (TFLX) have been frequently used in the treatment of bacterial enteritis caused by unknown organisms. The agent of first choice for the treatment of Campylobacter enteritis is one of the macrolides, but new quinolones are often administered accidentally to adult patients with Campylobacter enteritis. We have detected quinolone-resistant strains of Campylobacter jejuni (C. jejuni) after the treatment of some patients with new quinolones, and accordingly we reviewed the treatment of Campylobacter enteritis. We experienced 178 adult patients with Campylobacter enteritis from January 1989 to November 1991 at our hospital. From them, we selected 52 patients (32 males and 20 females) in whom stool culture were performed both before and after treatment. The initially administered antimicrobial agent was a macrolide (rokitamycin, RKM) in 6 cases, a new quinolone in 22 cases, and kanamycin (KM) in 24 cases. The new quinolone used was OFLX in 17 cases, TFLX in 3 cases, and norfloxacin (NFLX) in 2 cases. Fifty-one of the 52 C. jejuni strains isolated before treatment were susceptible to OFLX and erythromycin (EM) according to antimicrobial disc susceptibility tests. C. jejuni was eradicated in all patients treated with RKM or KM. However, treatment failed to achieve bacteriological cure in 8/22 (36.4%) patients given new quinolones. In these patients, the strains of C. jejuni isolated before treatment were susceptible to OFLX, but the strains isolated after treatment were all resistant to OFLX according to disc susceptibility tests.(ABSTRACT TRUNCATED AT 250 WORDS)

4-Quinolones↗
PubMed1992

The association of serum hepatitis C virus RNA with serum aminotransferase activities.

Serum samples from 71 patients with hepatitis C virus infection at various stages were studied to determine the clinical significance of the detection of hepatitis C virus RNA by the polymerase chain reaction. There was a significant correlation of serum HCV RNA with elevation of the serum aminotransferase levels. These data suggest that the detection of HCV RNA in the serum might be useful for evaluation of the extent of ongoing liver damage.

Base Sequence↗
PubMed1991

[Comparison of clinical efficacy of rokitamycin (RKM) and ofloxacin (OFLX) for the treatment of Campylobacter enteritis by a double-blind method. The Research Committee for the Effect of Rokitamycin, Research Group for Infectious Enteritis].

The clinical efficacy, safety and usefulness of Rokitamycin (RKM), a new macrolide antibiotic, were compared with those of Ofloxacin (OFLX) for the treatment of Campylobacter enteritis by a double blind method. The daily dose level of RKM or OFLX was 600 mg. They were orally administered in three divided doses for 5 days. Of 223 cases studied, 106 cases were diagnosed as Campylobacter enteritis. Ninety cases (RKM group: 50, OFLX group: 40) except for 16 excluded or drop-out cases were analysed. There was no significant difference between the two groups in any background factors. The effectiveness and usefulness was evaluated in 88 cases (RKM group: 48, OFLX group: 40). The results obtained were as follows: 1. In a total of 82 strains of Campylobacter jejuni/coli (RKM group: 42, OFLX group: 40), the bacteriological efficacy rate of RKM (95.2%) was superior to that of OFLX (70.0%) with a significant difference (p = 0.006). 2. In 76 symptomatic patients (RKM group: 42, OFLX group: 34) on the day of the beginning of drug administration, the clinical efficacy rate was 97.6% in the RKM group and 85.3% in the OFLX group with no significant difference between the two groups. 3. In 88 evaluable patients, the global clinical efficacy rate of RKM (95.8%) was superior to that of OFLX (67.5%) with a significant difference (p = 0.001). 4. Side effect was observed in 1 (1.9%) of the 54 patients in the RKM group and none of the 44 patients in the OFLX group. Slightly abnormal laboratory findings were seen in 4 (10.8%) of the 37 patients treated with RKM and 3 (9.7%) of the 31 patients treated with OFLX, but there was no significant difference between the two groups. 5. In 88 evaluable patients, the clinical usefulness of RKM (91.7%) was superior to that of OFLX (67.5%) with a significant difference (p = 0.01). From these results, RKM is considered to be a very useful agent for the treatment of Campylobacter enteritis.

Adolescent↗
PubMed1990

[A case of shigellosis due to Shigella dysenteriae 1 which was thought to be infected in domestic area].

A 43-year-old man was admitted to our hospital because of bloody diarrhea and abdominal pain on January 10, 1989. On laboratory examination S. dysenteriae 1 was isolated from his stool, therefore he was diagnosed as shigellosis. After the administration of ofloxacin was started, S. dysenteriae 1 was immediately eradicated. But his diarrhea persisted until the 19th day from the onset of the illness and his abdominal pain persisted until the 21st day. He had never been overseas and he had never eaten any imported uncooked food recently. Only 14 cases of shigellosis due to S. dysenteriae 1 were found in the last ten years in Japan. All of them were overseas travellers. Although we were not able to determine the source of infection in our case, we inferred that he was primarily infected with S. dysenteriae 1 in Japan.

Adult↗
PubMed1989

[A case of Plasmodium vivax malaria complicated with pancytopenia due to hypoplasia of the bone marrow].

The patient is a 39 year-old Japanese male who had traveled to Southeast Asia from March 14, 1987 and returned on April 2. On April 3 and 5, he had a high fever with chills and he was admitted to our hospital. Despite initial treatment with antibiotics, a high fever over 39 degrees C appeared with a 48 hour periodicity. On the 8th day after admission, malarial parasites were identified on the peripheral blood smear after repeated trials. Combined with a raised serum antibody titer, Plasmodium vivax malaria was diagnosed. He was successfully treated with the sulfadoxine 500 mg and pyrimethamine 25 mg (Fansidar) and body temperature was normalized after the 12th day. More interestingly, the patient showed pancytopenia without splenomegaly. The bone marrow aspiration revealed hypoplasia of erythroblasts, granulocytes and megakaryocytes. Because of this pancytopenia in the peripheral blood and hypoplasia of the bone marrow which improved after recovery from malarial infection, it was indicated that they were caused by the malarial infection. Generally, it is considered that anemia in malarial patients is caused by destruction of the blood cells by parasites and/or hypersplenism and compensatory hyperplasia of the bone marrow is seen. On the contrary, this case showed pancytopenia accompanied with hypoplasia of the bone marrow probably due to the malarial infection suggesting a new aspect of pathogenesis in the hematological abnormality of the malarial infection.

Adult↗
PubMed1989

[Chloroquine-resistant Plasmodium falciparum malaria confirmed by semi-micro sensitivity test for chloroquine seen in a person returned from Nigeria to Japan].

A 39-year-old Japanese male engineer who stayed in Nigeria from August 17, 1987 through January 22, 1988, presented chloroquine-resistant Plasmodium falciparum malaria. He was taking oral chloroquine prophylactically. But he suffered from P. falciparum malaria in November, 1987 and early January, 1988. He was treated in Nigeria. After his return to Japan, he was admitted to our hospital with a fever of 39 degrees C on January 29, 1988. The peripheral blood smear on admission showed the presence of ring form P. falciparum. He was diagnosed as recrudescence of P. falciparum malaria. Laboratory examination revealed severe thrombocytopenia and biologic false-positive serological tests of syphilis. The level of 50% inhibitory concentration was 0.44 nmol/ml by in vitro chloroquine sensitivity test of the strain of P. falciparum obtained from this patient. Clinically, chloroquine was not effective. The patient was treated with intravenous quinine dihydrochloride followed by sulfadoxine/pyrimethamine tablets and recovered completely. As far as we know through our survey this patient was the first case of chloroquine-resistant P. falciparum malaria brought to Japan from Nigeria.

Adult↗