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R Soejima

Publications and source records attributed to R Soejima.

At least 19 recordsLinked to original sources
PubMed1992

[A case of chronic myelogenous leukemia with pulmonary aspergillosis diagnosed by the detection of circulating Aspergillus antigen].

Immunocompromised hosts usually develop invasive mycotic disease. Among many pathogenic fungi. Aspergillus spp, is the most common pathogen of respiratory infection. Early diagnosis of invasive type pulmonary aspergillosis is still difficult, and the treatment is usually difficult. Many investigations have recently suggested that detection of Aspergillus antigen from sera of the patients is useful for early diagnosis to save their lives. We have experienced a case diagnosed by the detection of circulating Aspergillus antigen by Pastorex Aspergillus, who was a 64-year-old female with the blastic crisis chronic myelogenous leukemia. After anti-leukemic chemotherapy, she suffered from pneumoniae with pleural effusions and severe hypoxia, which did not respond to antibiotics. At this point, her serum sample showed positive Aspergillus antigen by Pastorex Aspergillus. She was treated by intensive antifungal chemotherapy, and thereafter improved quickly. Titers of Pastorex Aspergillus were well correlated with her clinical course. The sensitivity of the test requires further improvement, but the specificity of the test is considered to be high enough for clinical use.

Antigens, Fungal↗
PubMed1992

[Studies on risk factors influencing delayed resolution of pneumonia].

Among 61 patients admitted to our hospital because of bacterial pneumonia during the last six years, we investigated several risk factors influencing delayed resolution of pneumonia shadows, such as age, extent of the lesion, period of fever and sputum production after antibiotic therapy, WBC, CRP and PaO2 values on admission, the period of increased values of WBC and CRP, the presence or absence of etiological pathogens, the period from the appearance of symptoms to admission, and the period of drug therapy. In our series, the period from appearance of symptoms to admission (r = 0.62) and that of increased WBC (r = 0.35) significantly correlated with the period of pneumonia shadows to the time of their resolution. Similar results were obtained from the multiple variate analysis of various factors. These results suggest that the duration period (nontherapy period) of inflammation closely associated with leukocytosis plays a crucial role in the delayed resolution of pneumonia shadows.

Adult↗
PubMed1992

[A case of organizing pneumonia which had to be treated with steroids in the early phase of the disease against delayed resolution of severe pneumonia occurring even after antibiotic therapy].

A 58-year-old male was referred to our division because of antibiotic-resistant pneumonia. A chest X-ray film revealed severe pneumonia over the left lung field but laboratory data showed no leukocytosis. Transbronchial lung biopsy findings showed the evidence consistent with organizing pneumonia. One-month prednisolone therapy produced a disappearance of the pneumonia shadow, but a giant bulla was found at the same site. It was considered that it was necessary to treat this case with a combination of effective antibiotics and steroids in the early phase of the disease.

Anti-Bacterial Agents↗
PubMed1992

[Development of serodiagnostic kit "HITAZYME Chlamydia Ab" for Chlamydia trachomatis infections using extracted antigen].

To develop EIA kit with low cross-reactivity for the quantitative detection of anti-chlamydial antibodies, we examined the preparation of trachomatis antigens and its specificity to mouse antisera and human sera. The chlamydial elementary body (EB) purified from C. trachomatis L2/434/Bu strain was treated by Sarkosyl, dithiothreitol and SDS by turns to obtain the soluble EB outer membrane (COMC). SDS-PAGE showed that the major components of the COMC were 96K, 60K and 39.5 KDa peptides. The reactivity of the COMC immobilized to 96 wells microtiter plate to mouse anti-serum to C. trachomatis was higher than the other two mouse anti-sera to C. psittaci and pneumoniae. In human sera, the cut off values were calculated from an average optical density plus its two-fold standard deviation obtained by the testing of 100 samples of healthy human sera. We evaluated the specificity of the kit to 17 anti-C. pneumoniae, 9 C. trachomatis and 4 C. psittaci antibodies positive patients' sera judged by the MFA method respectively. The results showed that the concordance ratio of IgG and IgA were 88%, 100% in anti-C. pneumoniae, 89%, 78% in anti-C. trachomatis and 50%, 50% in anti-C. psittaci respectively. From the results obtained in this study, we concluded that the HITAZYME method which had a very low cross-reactivity to C. pneumoniae is clinically useful in the serodiagnosis of C. trachomatis infections, even if it has a little common antigenicity with C. psittaci antigen.

Adolescent↗
PubMed1992

Stimulants from gardeniae fructus for cultured endothelial cell proliferation.

Bioassay-guided fractionation of Gardeniae Fructus extract (GFE), which stimulates the proliferation of cultured endothelial cells, led to the isolation of glycerol and D-mannitol. Both compounds significantly increased the incorporation of [3H]thymidine and [14C]leucine into the acid-insoluble fraction of bovine aortic endothelial cell layers in culture. This clearly indicated that glycerol and D-mannitol are active components of GFE on endothelial cell proliferation. On the other hand, they did not change the number of cultured vascular smooth muscle cells from bovine aorta. Glycerol and D-mannitol may be beneficial drugs for vascular disorders.

Animals↗
PubMed1992

Atelectatic lung escaping radiation pneumonitis.

An 80-year-old man was admitted to our division because of hemosputum, cough, and chest pain for three months. A chest roentgenogram, chest CT scanning, and bronchoscopic examinations revealed adenocarcinoma of the lung with atelectasis of the right upper lobe. The patient developed radiation pneumonitis after receiving radiation therapy (5,100 cGy) for lung cancer. At the same time, the right upper lobe atelectasis improved and movement of infiltrates consistent with radiation pneumonitis to the middle lung fields occurred. A chest roentgenogram taken when the atelectasis had improved revealed the absence of pneumonitis shadows in the right upper lobe, suggesting that the atelectatic lung escaped radiation pneumonitis.

Aged↗
PubMed1992

Host defense activity in various hosts. Human neutrophil NADPH oxidase activity.

The superoxide generation of neutrophil NADPH oxidase from healthy subjects, patients with respiratory infections, and patients receiving effective therapy with antibiotics or steroids was investigated. In young healthy nonsmokers the mean oxidase activity of neutrophils in women was significantly lower than that in men. In healthy women the mean oxidase activity was significantly lower in young nonsmokers than in young smokers or the elderly. In young nonsmokers, oxidase activity significantly increased during respiratory infections; however, in elderly nonsmokers, no significant increase in oxidase activity was observed during respiratory infections. The mean oxidase activity in patients receiving steroids was very low. In in vitro experiments using cell-free activation systems of NADPH oxidase, steroids were found to injure the membrane-bound components of the oxidase enzyme. These results suggest that decreased superoxide generation in patients receiving steroids may result from steroid-induced damage in the membrane-bound components of the NADPH oxidase system. The inhibitory effect of steroids on superoxide production may reduce bactericidal action of neutrophils, ie, one defense mechanism of the body against many kinds of pathogens. Therefore, long-term therapy with steroids in the elderly should be avoided at all costs.

Adult↗
PubMed1992

Acute and chronic eosinophilic pneumonia: clinical evaluation and the criteria.

The clinical courses of 11 cases of eosinophilic pneumonia which were clinico-pathohistologically diagnosed and found to be unassociated with organic disorders producing peripheral blood eosinophilia were extensively investigated and compared with various types of eosinophilic pneumonia previously reported. Five cases of acute eosinophilic pneumonia fulfilled the following criteria: 1) less than a one-month history of symptoms prior to diagnosis, 2) a short clinical course and 3) no recurrence. Six cases of chronic eosinophilic pneumonia fulfilled the following criteria: 1) more than a two-month history of symptoms prior to diagnosis, 2) a prolonged clinical course and 3) recurrence. The results suggested that various types of previously reported eosinophilic pneumonia classified by sex, the presence or absence of peripheral blood eosinophilia, the degree of clinical symptoms or peripheral blood eosinophilia, and the degree of abnormalities on chest X-ray films should be extensively reevaluated.

Acute Disease↗
PubMed1992

[A case of endobronchial fibroma associated with recurrent pneumonia].

We present a case of endobronchial fibroma in a 59-year-old man admitted for repeated pneumonia, successfully treated by endoscopic Nd-YAG laser. His chest X-ray showed an infiltrative shadow in the right lower lung field and a mass shadow within the truncus intermedius. Bronchoscopy revealed a polypoid mass with lobulated whitish surface, obstructing 90% of the lumen. A biopsy taken from the tumor was suggestive of fibroma histologically. Two previous case reports stated that endobronchial fibroma readily detaches from the bronchial wall during removal. The tumor was successfully removed without dropping any tumor fragment to obstruct the distal bronchus by means of biopsy forceps manually attached to an endoscope with endoscopic Nd-YAG laser. The resected tumor was mainly composed of collagen fibers with scanty spindle-shaped fibroblastic cells, which was considered consistent with endobronchial fibroma. Endobronchial fibroma is a rare benign lung tumor, and only seven cases have been reported in the Japanese literature. There was no recurrence at three years and nine months.

Bronchial Neoplasms↗
PubMed1992

[Cefdinir].

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Animals↗
PubMed1992

[Age-dependent alterations in clinical features of pulmonary tuberculosis].

Age-related changes in clinical features of 182 patients diagnosed as having pulmonary tuberculosis from positive culture results of tubercle bacilli were extensively investigated. The percentage of cases detected using mass miniature radiophotography (MMR) was highest in the patients aged 30-39 years, and then decreased with increasing age. It was only 16-19% in those aged 60 years or older. Certain conditions, such as cardiovascular diseases, hypertension, diabetes mellitus, malignancy and other lung diseases, were common in the patients aged 60 years or older. Systemic symptoms, including weight loss and anorexia, and physical abnormalities, including fever and crackles, were common in these patients. Anemia tended to be predominant in the patients aged 60 years or older. The middle/lower lobes were involved more frequently in these patients, in whom the disease distribution was more than one lobe, or disseminated. Positive smear results and negative anergy were more frequently noted in the patients aged 60 years or older. The mortality from tuberculosis in these patients was 4% (7 cases). Although gastrointestinal disorder due to antitubercular drugs was more common in the patients aged 80 years or older, eosinophilia was less frequently observed. Today, improved conditions, better sanitation and the development of new chemotherapeutic agents have contributed to the decline of tuberculosis among the general population. But more efficient procedures that allow the early detection or diagnosis of pulmonary tuberculosis in the elderly should be achieved as soon as possible.

Adult↗
PubMed1991

[A comparative study between cefpirome (CPR) and ceftazidime (CAZ) in respiratory tract infections].

Efficacy and safety of a new injectable cephem antibiotic, cefpirome sulfate (hereafter, CPR), against respiratory tract infections were examined and compared with those of a control drug, ceftazidime (hereafter, CAZ). As a rule, CPR 0.5 g twice a day, 1.0 g twice a day, or CAZ 1.0 g twice a day (hereafter CPR 0.5 g group, CPR 1.0 g group, and CAZ group) was administered for 14 days and the following results were obtained. 1. The total number of cases was 470 (155 cases in the CPR 0.5 g group, 160 cases in the CPR 1.0 g group, and 155 cases in the CAZ group). Among them 390 cases were subjected to analyses of clinical efficacy by the efficacy evaluation committee (131 cases in the CPR 0.5 g group, 131 cases in the CPR 1.0 g group and 128 cases in the CAZ group). 2. Efficacy rates determined by the efficacy evaluation committee were 82.4% (108/131) for the CPR 0.5 g group, 81.7% (107/131) for the CPR 1.0 g group, and 83.6% (107/128) for the CAZ group. Efficacy rates determined by the physician in charge were 82.0% (105/128) for the CPR 0.5 g group, 80.5% (99/123) for the CPR 1.0 g group, and 88.5% (108/122) for the CAZ group. No statistically significant difference was observed among the 3 groups. In evaluation of equivalency, clinical efficacy for the CPR 0.5 g group and the CPR 1.0 g group determined by the clinical efficacy evaluation committee was proved to be statistically equivalent to that for the CAZ group. 3. In patients with pneumonia, efficacy rates determined by the efficacy evaluation committee were 87.1% (61/70) for the CPR 0.5 g group, 80.7% (71/88) for the CPR 1.0 g group, and 78.9% (56/71) for the CAZ group. Efficacy rates determined by the physician in charge were 85.3% (58/68) for the CPR 0.5 g group, 80.7% (67/83) for the CPR 1.0 g group, and 86.2% (56/65) for the CAZ group and no statistically significant difference was observed among the 3 groups. In patients with chronic respiratory tract infection, efficacy rates determined by the efficacy evaluation committee were 77.0% (47/61) for the CPR 0.5 g group, 83.7% (36/43) for the CPR 1.0 g group, and 89.5% (51/57) for the CAZ group. Efficacy rates determined by the physician in charge were 78.3% (47/60) for the CPR 0.5 g group, 80.0% (32/40) for the CPR 1.0 g group, and 91.2% (52/57) for the CAZ group. No statistically significant difference was observed among the 3 groups.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1991

[An optimum dose-finding study of HR810 (CPR) in chronic respiratory tract infections].

In order to determine the optimal dose of cefpirome sulfate (HR810, CPR) against respiratory tract infections (RTI), an optimal dose-finding study was conducted on cases of chronic RTI, and the clinical properties of the drug were compared with those of ceftazidime (CAZ). Inpatients with chronic RTI were randomly assigned to 3 groups: an HR 0.5 g group, receiving 0.5 g X 2/day of CPR an HR 1.0 g group, receiving 1.0 X 2/day of CPR and a CAZ group, receiving 1.0 g X 2/day of CAZ. As a rule, the drugs were administered by intravenous drip infusion for 14 days, after which period clinical efficacy, bacteriological response, safety, and utility were investigated. Of the total 121 cases, 106 were subject to analysis of clinical efficacy, including 38 cases in the HR 0.5 g group, 32 in the HR 1.0 g group, and 36 in the CAZ group. Efficacy rates in the assessment by the committee were 84.2% for the HR 0.5 g group, 75.0% for the HR 1.0 g group, and 86.1% for the CAZ group, without any significant difference between the 3 groups. The bacterial elimination rates were 73.9%, 75.0% m and 88.5%, respectively, without any significant difference between the 3 groups. Associated reactions were noted in 2 of 36 cases in the HR 1.0 g group (eruption and diarrhea), but not in the other 2 groups. The incidence of abnormal clinical laboratory findings was 23.1% in the HR 0.5 g group, 22.2% in the HR 1.0 g group, and 22.5% in the CAZ group, without any significant difference between the 3 groups. Utility rates were 84.2% for the HR 0.5 g group, 74.2% for the HR 1.0 g group, and 86.1% for the CAZ group, without any significant difference between the 3 groups. The HR 0.5 g and 1.0 groups showed no difference in clinical efficacy, bacteriological response, safety, and utility against RTI, and the results of both groups were about equal to those of the CAZ group.

Adolescent↗
PubMed1991

[Bronchial asthma associated with primary lung cancer--comparison of extrathoracic malignancies].

Regarding 249 bronchial asthma patients having been admitted to our division for the recent 9 years, clinical manifestations of 8 bronchial asthma with primary lung cancer (group A; squamous cell carcinoma--5 cases, adenocarcinoma--2 cases, small cell carcinoma--1 case; 3.2% of 249 cases) and 8 asthma patients with extrathoracic malignancy (group B; gastric cancer--3 cases, malignant lymphoma--2 cases, bladder cancer--1 case, laryngeal cancer--1 case, prostatic cancer--1 case) were investigated. In group A, the mean of asthmatic history was 19 years and all cases were associated with respiratory tract infections. Three of 8 patients, were mild type and other 5 were moderate type. In group B, the mean of asthmatic history was 20 years and all cases were involved with respiratory tract infections. Five of 8 patients were mild type and other 3 were moderate type. The mean smoking (Brinkmann) index (1194) in group A was significantly higher than that (166) in 241 asthmatic patients without lung cancer or that (169) in group B. The median survival duration (more than 26 months) of group A patients was significantly lower than that (more than 77 months) of group B. These results suggested that, in many bronchial asthma patients accompanied by primary lung cancer who have adult-typed infectious asthmatic history, smoking exposure and aging are deeply related to the development of lung cancer.

Adenocarcinoma↗