Biomedical subjects
O Kitada
Publications and source records attributed to O Kitada.
[Regional pulmonary function test--pulmonary nuclear medicine].
Pulmonary nuclear medicine has been dominated by techniques that depict the distribution of pulmonary ventilation and perfusion. At present, there are three commercially available methods of performing a ventilation study. One of the methods utilizes xenon-gas 133Xe, one utilizes radioactive krypton gas, 81mKr, and the last is performed with a radioactive aerosol, usually the radio aerosol of 99Tc human serum albumin (HSA). Ventilation studies with 133Xe usually consist of an image taken after inhalation of a single breath, which can be followed by a serial image. After a rebreathing period of 3 to 5 minutes, the tracer (133Xe) is washed out of the lungs. The washout portion of the 133Xe study is the most reliable and sensitive to detect of the slow compartments. Krypton-81m has a very short physical half-life of 13 seconds. Thus, ventilation scans can be obtained in desired projections, and the rapid disappearance of the tracer from lungs will allow ventilation studies to be performed before and after medications and exercise. Radioaerosols also provide a means for investigating regional ventilation. Radioaerosols are small particles, rather than gases, and are deposited in the lung by impaction, sedimentation and random contact. With the recent development of new radiopharmaceuticals and refinement of current imaging techniques, especially quantitative techniques and single-photon emission computed tomography of the lung, pulmonary nuclear medicine has expanded its horizons.
[Superoxide dismutase suppressed asthmatic response with inhibition of manganese superoxide induction in rat lung].
To investigate the involvement of oxygen radicals in the development of asthma, we examined the time course of changes in the expression of superoxide dismutases (SODs) both at mRNA and protein levels in the rat model of allergic asthma. We then examined the effects of recombinant-human SOD (r-hSOD) on these expressions and on the late asthmatic response (LAR). 1) In situ hybridization histochemistry and immunocytochemistry revealed that non-sensitized and sensitized rats before challenge had a very low level of manganese SOD (MnDOS) in the bronchial epithelial cells, although they showed a significant level of copper-zinc SOD (CuZnSOD). 2) All of the animals displayed LAR within 7 hours after the challenge, when they showed dramatic induction of MnSOD, but not of CuZnSOD, in the epithelial cells. 3) Treatment with r-hSOD almost completely suppressed LAR, with abolishment of MnSOD induction. This study suggests that the oxygen radical plays an important role in the inflammatory state of bronchial asthma, during which some cytokines induce the expression of MnSOD in the lung.
[Sulpyrine inhalation challenge test monitored continuously by respiratory impedance and 81mKr ventilation image].
Continuous changes of respiratory impedance by the oscillation method using Asthograph and 81mKr ventilation image during saline and sulpyrine solution (100 mg/ml, 250 mg/ml) provocation were simultaneously measured in 15 adult asthmatics and 7 normal individuals. Estimation of airway obstruction by respiratory impedance using Asthograph was difficult during sulpyrine inhalation, since respiratory impedance increased gradually. In addition to the measurement of respiratory impedance, images of 81mKr ventilation were also obtained to estimate the regional ventilatory distribution. Estimation of the airway obstruction was easily obtained. Another advantage of 81mKr ventilation image is that it can estimate the regional ventilatory distribution. The site of airway obstruction provoked by sulpyrine was observed predominantly in the lower lung field. The results of our present study were as follows. 1) In 3 patient, increase of respiratory impedance and defect of 81mKr ventilation image were observed. Two cases in this group were clinically diagnosed as having aspirin-induced asthma. 2) In 7 patients, a defect of 81mKr ventilation image was observed, but no increase of respiratory impedance was observed. Five cases in this group could not be clinically diagnosed as having aspirin-induced asthma. 3) In 5 patients, neither defect of 81mKr ventilation image nor increase of respiratory impedance could be detected. These results suggest that 81mKr ventilation image on sulpyrine inhalation challenge test is a useful method for evaluating regional ventilatory distribution, but should be further investigated for application to aspirin-induced asthma.
[Physiopathology and diagnosis of allergic bronchopulmonary aspergillosis].
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[A case of alveolar hydatid disease of the lung in the Kansai district of Japan].
A 78-year-old man was admitted to hospital because of episodes of high grade fever and multiple nodular shadows on chest roentgenogram. He had a past history of percutaneous drainage and partial resection of the left lobe of the liver for liver abscess of unknown origin in 1987. The high grade fever was secondary to sepsis due to Citrobacter freundii. The sepsis improved with antibiotic therapy, but the abnormal shadows on chest roentgenogram did not improved. Immunoserological tests indicated a probable diagnosis of alveolar hydatid disease of the lung, which is very rare in the Kansai district of Japan. Open lung biopsy was performed and the diagnosis of alveolar hydatid disease of the lung was confirmed.
[A case of sustained-release theophylline (Theodur)-induced asthma].
Theophylline is used as a prophylactic agent for controlling bronchospasm in patients with asthma. Sustained-release theophylline (Theodur) is widely used for this purpose. In this report, we describe a patient who developed asthma due to administration of Theodur. A 38-year-old man was referred to our hospital for assessment of the relationship between his respiratory symptoms and theophylline. He had been admitted to the hospital several times for dyspneic attacks. Theophylline ethylenediamine (Aminophylline) and hydrocortisone sodium succinate had been administered intravenously for the acute phase, followed by Theodur orally. Following administration of Theodur, he had developed dyspnea, chest tightness and dizziness. An inhalation challenge test with sulpyline showed a negative reaction. Although an oral challenge test with theophylline also showed a negative reaction, that with Theodur evoked an asthmatic response. We were unable to determined any possible cause or the mechanism for this reaction. We concluded that the vehicle or preservative (i.e., inactive ingredients) contained in Theodur were likely to be related to his asthmatic response.
[A case of hypereosinophilic syndrome associated with pulmonary infarction and hepatic vein obstruction (Budd-Chiari syndrome)].
A 21-year-old man was admitted in March 1987 with low grade fever and chest pain. Eosinophilia had been pointed out and PIE syndrome was diagnosed in another hospital a month before admission. Steroid therapy had been started. On the first admission, the chest roentgenogram showed bilateral pleural effusion and a nodular shadow in the left lower lung field. Open lung biopsy was performed and a diagnosis of pulmonary infarction was made. Eosinophilia, low grade fever and chest pain were improved by steroid therapy. He was discharged in April 1987. He was readmitted in September 1987 because of fever, back pain and abdominal distension. On the second admission, eosinophilia (4,510/mm3) was pointed out. The case was diagnosed as hepatic vein obstruction by hepatic vein angiography, liver biopsy and ultrasonic examination. He had transient remission on corticosteroid and anti-coagulant therapy. This case was considered as a rare case of hypereosinophilic syndrome associated with pulmonary infarction and Budd-Chiari syndrome.
Effects of hydrocortisone and aminophylline on plasma leukotriene C4 levels in patients during an asthmatic attack.
To study the role of leukotriene C4(LTC4) and the effect of hydrocortisone and aminophylline on plasma LTC4 levels in patients with asthmatic attacks, we measured LTC4 in plasma of 18 asthmatics during a wheezing attack and of 7 normal subjects. Blood samples were obtained before and after treatment with aminophylline and/or hydrocortisone injections. We extracted LTC4 using a Sep-Pak C18 cartridge for the measurement of LTC4 by radioimmunoassay. The plasma levels of immunoreactive LTC4 (i-LTC4) of the normal subjects were 142 +/- 25 pg/ml (n = 7), while those of nonatopic type asthmatic patients with wheezing attacks were 208 +/- 68 pg/ml (n = 15) (p less than 0.01). Before and after treatment with both hydrocortisone succinate (100 mg) and aminophylline (250 mg), 6 asthmatic patients with wheezing attacks had a mean plasma level of i-LTC4 181 +/- 24 and 132 +/- 18 pg/ml (p less than 0.01), respectively. On the other hand, the treatment with aminophylline 250 mg alone increased the i-LTC4 levels from 178 +/- 19 pg/mg to 213 +/- 16 pg/mg (n = 6)(p less than 0.05), while treatment with hydrocortisone succinate 100 mg decreased the i-LTC4 level 0.05 from 284 +/- 99 pg/ml to 249 +/- 85 pg/ml (n = 4)(p less than 0.05). In conclusion, the present study shows that the i-LTC4 level in venous blood of patients with asthmatic attacks is decreased significantly by treatment with hydrocortisone succinate.
[Severe bronchial reaction induced by hydrocortisone sodium succinate in an aspirin-sensitive asthmatic patient].
This is a report of a female patient who had an anaphylaxis-like reactions to hydrocortisone sodium succinate (Saxizon). A 31-year-old female with intrinsic bronchial asthma and aspirin sensitivity was admitted to our hospital because of an episode of asthmatic attack. The patient had had episodes of dyspnea since 1976, and had been treated with oral bronchodilators and intermittent corticosteroids. After admission, she was given 100 mg of hydrocortisone sodium succinate intravenously. A few minutes later she developed severe bronchospasm and lost consciousness. An endotracheal tube was inserted and she was mechanically ventilated for 2 hours. The patient recovered after 1 hour. An inhalation challenge test with Sulpyrin was positive. When the provocation challenge test with 100 mg of hydrocortisone sodium succinate (Saxizon) injection was performed, she developed subjective and objective evidence of bronchospasm. Intradermal skin test revealed positive immediate reactions to Saxizon, Solu-cortef, Predonine. It is suggested that she had immediate hypersensitivity to hydrocortisone sodium succinate, but the mechanism of this anaphylaxis-like reaction to steroids is not certain.
[A case of aortitis syndrome preceded by pulmonary artery involvement].
A 31-year-old woman was hospitalized with bloody sputum and chest pain in August 1985. The first angiographic examination demonstrated obstructions in the right upper and middle pulmonary arteries without any changes in the thoracic aorta or its branches. The case was, therefore, diagnosed as pulmonary embolism, and treated with some anti-coagulants. In June 1987, she was readmitted since systolic bruit became audible in her right supraclavicular areas. The second angiographic examination revealed narrowings of both the carotid and right vertebral arteries and extension of lesions in pulmonary artery. The diagnosis of aortitis syndrome was made. This case may be the first one in Japan in which a pulmonary lesion was verified by angiogram before remarkable involvement in the aorta or its branches.
[A case of chronic hyperventilation syndrome effectively treated by metoprolol].
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[A trial quantitative analysis or respiratory control system reproducibility through the use of variation coefficients of ventilatory parameters].
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[Studies on a comparison between continuous changes in respiratory impedance and in regional ventilatory distribution, and on the sites of airway obstruction induced by the methacholine provocation test].
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[Bronchial hyperreactivity: etiology and methods for detection].
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[Studies on uneven ventilation in chronic obstructive lung disease].
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[Studies on regional ventilation observed from a lateral side of the chest].
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[Studies on various factors affecting the body plethysmographic pressure-flow diagrams using a simulation method].
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