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Biomedical subjects

R Yoneda

Publications and source records attributed to R Yoneda.

At least 19 recordsLinked to original sources
PubMed1992

Changes in muscarinic acetylcholine receptors in the isolated duodenum from repeatedly cold-stressed rats and the effect of neurotropin.

In rats repeatedly cold-stressed by specific alternation of rhythm in environmental temperature (SART-stressed rats), the contractile response to acetylcholine (ACh) of the isolated duodenum was remarkably decreased, whereas the contractile responses to K+, Ba2+ and Ca2+ were comparable to those in non-stressed rats. The amount of [3H]quinuclidinyl benzilate in the duodenum of SART-stressed rats was about 50% of that in non-stressed rats, but the KD value remained unchanged. Long-term administration of hexamethonium prevented the changes in SART-stressed rats. The daily treatment with Neurotropin, an extract isolated from inflamed rabbit dermis inoculated with vaccinia virus, dose-dependently prevented the changes in SART-stressed rats. However, Neurotropin had no effect on the ACh-induced decrease in muscarinic ACh receptor (m-ACh.R) in cultured vas deferens of guinea pig. These results suggest that down-regulation of m-ACh.R in duodenum by SART stress may be associated with enhanced activity in the parasympathetic center. Moreover, Neurotropin is thought to prevent the down-regulation of m-ACh.R throughout the central nervous system.

Acetylcholine↗
PubMed1992

[Clinical criteria for definition of idiopathic interstitial pneumonia (IIP)].

Clinical criteria for definition of IIP proposed in 1991 by the Project Team for Diffuse Lung Diseases Organized by Japanese Ministry of Health and Welfare are reviewed. After the clinical roentgenological, and pathological researches of 92 IIP patients, we concluded that IIP patients were grouped into two clinical types, acute and chronic, by their clinical courses and characteristic pathological findings. The latter is, moreover, grouped into two types, typical and atypical, by their morphological characteristics. The acute type are represented by alveolitis with marked edema and cell infiltration of alveolar wall, and by hyaline membrane formation. "Typical" of chronic types only have typical pathologic changes of interstitial pneumonia and/or fibrosis represented by honeycombing. "Atypical" have both those interstitial changes and intra-alveolar scar formation and fibrosis due to organized pneumonia and secondarily occurred emphysema such as bulla as well. The continuity in clinical courses between acute and chronic types are still obscure.

Acute Disease↗
PubMed1992

[A case of inflammatory bronchial polyp associated with pulmonary and bronchial tuberculosis].

A 67-year-old man was admitted to our hospital because of cough and sputum. Chest X-ray revealed cavity and consolidation in the right upper lobe. Microscopical examination of stained specimens of sputum disclosed acid-fast bacilli (Mycobacterium tuberculosis). Cough and sputum resolved and cultures of sputum did not yield M. tuberculosis a month after administration of antituberculosis agents. However, a mass shadow in the right upper lobe was found 3 months later. Bronchofiberscopy revealed a polyp with a stalk at the orifice of right upper bronchus, which was elastic, soft in consistency, smooth surfaced, and movable. The pathological findings of the polyp showed non-specific inflammatory granulation which suggested to be inflammatory bronchial polyp. It was appeared in the healing process of bronchial tuberculosis.

Aged↗
PubMed1992

[A case of Hand-Schüller-Christian disease with pulmonary fibrosis].

A 42-year-old man was admitted with dyspnea and abnormal shadows on chest roentgenogram, which showed bilateral reticulonodular shadows, multiple pulmonary cysts, and pleural effusion. A month after admission, he developed severe respiratory failure and chest X-ray revealed exacerbation of reticulonodular shadows. Steroid pulse therapy improved the symptoms and chest X-ray. He had atrophy of the mandible. Bone scintigram revealed multiple hot lesions. Bone biopsy of the right tibia showed lipogranuloma, and the diagnosis of Hand-Schüller-Christian disease (HSC) was made. The percentage of OKT6-positive cells (Langerhans cells) found by immunofluorescence was 16.1% of all cells in bronchoalveolar lavage fluid, indicating pulmonary involvement due to HSC. This is a rare case of Hand-Schüller-Christian disease with pulmonary fibrosis.

Adult↗
PubMed1991

Difference in the phenotypes of bronchoalveolar lavage lymphocytes in patients with summer-type hypersensitivity pneumonitis, farmer's lung, ventilation pneumonitis, and bird fancier's lung: report of a nationwide epidemiologic study in Japan.

We performed a nationwide epidemiologic study of hypersensitivity pneumonitis (HP) in Japan by questionnaire and found that 835 cases of HP were recognized during the 1980s; 74.4% were summer-type HP, 8.1% farmer's lung, 4.3% ventilation pneumonitis, 4.1% bird fancier's lung, 2.3% other types, such as chemical worker's lung, and 6.8% of unknown causative agent. It was found that the CD4/CD8 ratios of bronchoalveolar lavage (BAL) lymphocytes were significantly different with the type of disease. The ratio was 0.6 +/- 0.1 (mean +/- SEM) in summer-type HP (N = 271), 4.4 +/- 0.7 in farmer's lung (N = 22), 1.6 +/- 0.3 in ventilation pneumonitis (N = 19), and 2.0 +/- 0.5 in bird fancier's lung (N = 19). In farmer's lung, the CD4/CD8 ratio in smokers was 6.2 +/- 1.9 (N = 6) in contrast with 3.4 +/- 0.7 for nonsmokers (N = 16) (p less than 0.05). It has been generally considered that the phenotypes of BAL lymphocytes in patients with HP are predominately CD8 cells. Our present results, however, indicate that the phenotypes of BAL lymphocytes vary with the type of HP, probably depending on factors such as causative agent, smoking, or staging of the disease.

Age Factors↗
PubMed1991

Sequential changes of perivascular edema cuffs in models of permeability and hemodynamic pulmonary edema.

The areas of perivascular edema cuffs surrounding pulmonary arteries and veins were sequentially measured as an index of the fluid transport unit in lung interstitium (FTULI) in epinephrine-induced and oleic acid-induced pulmonary edema in rats. The former edema represents a model of hemodynamic edema and the latter, permeability pulmonary edema, respectively. In epinephrine-induced pulmonary edema, both the ratio of edema cuff area to cross-sectional area of the pulmonary artery (Rr) and the ratio of lung weight to body weight (L/B) were increased in parallel, reached maximum levels at 0.5 h after the treatment, and returned to the control levels after 3 h. In oleic acid-induced pulmonary edema, the changes in Rr and L/B were not parallel, and the maximum levels were reached at different times, Rr at 3 h and L/B at 1.5 h. Rr returned close to the control level in 24 h but L/B remained elevated so that rate of recovery was delayed. The cuffs around the veins appeared similar to those around the arteries, but were very slight in both models. The difference in the time course of Rr and L/B in the two models may suggest that the recruitment of FTULI is insufficient in oleic acid-induced pulmonary edema; this limitation seems to be an important factor which makes the permeability edema refractory to treatment, together with the damage to the blood gas barrier.

Animals↗
PubMed1991

Long-term low-dose administration of erythromycin to patients with diffuse panbronchiolitis.

Although diffuse panbronchiolitis (DPB) has carried a poor prognosis, long-term low-dose administration of erythromycin (EM) is very effective. We administered EM at a daily dose of 400-600 mg to 19 DPB subjects for more than 2 months. Sixteen subjects were relieved from productive cough and dyspnea, and their chest X-ray pictures were improved. We performed a pharmacokinetic study of EM in 11 DPB subjects (8 responders; 3 nonresponders) after the long-term low-dose administration. The maximal serum and sputum levels of EM were below the MICs of clinically pathogenic H. influenzae and P. aeruginosa which were often isolated from the sputum of DPB patients. No difference was observed in the absorption of EM between responders and nonresponders. The results suggested that DPB patients might respond favorably to EM due to mechanisms other than antibacterial activity. Individual variation in the absorption of EM was observed. As EM was effective at very low serum and sputum levels, it was suggested that even 200 mg/day of EM would be effective in DPB patients who had high serum and sputum EM levels and it was necessary to monitor the concentrations of EM in serum and sputum for the treatment of DPB to determine the appropriate dose of EM individually.

Adult↗
PubMed1991

Japanese summer-type hypersensitivity pneumonitis. Geographic distribution, home environment, and clinical characteristics of 621 cases.

A survey of hypersensitivity pneumonitis in Japan was carried out by nationwide questionnaire. A total of 835 cases of hypersensitivity pneumonitis was recognized during the last decade from 1980 to 1989. Of the 835 cases, 621 (74.4%) were summer-type hypersensitivity pneumonitis. The number of cases diagnosed doubled in the latter half of the 10-yr period. The residence of the patients was mostly in the western and southern parts of the country; the northernmost incidence was in Akita Prefecture at a latitude of 40 degrees north. Of the patients 86% experienced initial symptoms from June to September with a peak in July. Female patients were 2.0 times as numerous as male patients, probably as a result of more exposure to the offending antigen at home since 39.8% of the patients were female homemakers without an outside occupation. The frequency of family occurrence was 23.8%. The mean age of the patients' houses was 20.5 yr after building, and more than half had unsanitary conditions, such as shady, damp, or poorly ventilated rooms. Serum anti-Trichosporon cutaneum antibody activities were positive in 260 (99.2%) of the 262 cases examined. We conclude that summer-type hypersensitivity pneumonitis occupies the majority of hypersensitivity pneumonitis in the country and that to prevent the disease concentrated attention should be given to the home environment from the viewpoint of environmental medicine.

Age Factors↗
PubMed1991

Mechanism of hyperalgesia in SART stressed (repeated cold stress) mice: antinociceptive effect of neurotropin.

Exposing mice to 24 and 4 degrees C in alternate 1 hr periods in the day time and maintaining 4 degrees C at night for several days decreases the tail clamp pressure required to evoke pain behavior. This model is referred to as SART (specific alternation rhythm of temperature) stress. An extract from inflamed skin of rabbits inoculated with vaccinia virus (neurotropin) clearly normalized the hyperalgesia in this SART stress model. To clarify the mechanism of the hyperalgesia in SART mice and the mode of the antinociceptive action of neurotropin in this model, the influence of systemically administered neurotransmitter related drugs was studied. 1) Neurotropin, 5-hydroxytryptophan and L-dihydroxyphenylalanine significantly normalized the decrease in nociceptive threshold, and muscimol tended to inhibit it in nociceptive threshold in SART stressed mice. 2) Haloperidol, phenoxybenzamine, reserpine, bicuculline, scopolamine, physostigmine and naloxone alone did not influence the nociceptive threshold in SART stressed mice. 3) The antinociceptive effect of neurotropin was significantly attenuated by p-chlorophenylalanine, haloperidol and phenoxybenzamine; and it was completely inhibited by reserpine. 4) Naloxone, bicuculline, scopolamine and physostigmine had no influence on the antinociceptive effect of neurotropin. These results suggest that hypofunction mainly of the monoaminergic systems contributes to hyperalgesia in SART stressed mice and that neurotropin produces the antinociceptive effect by restoring these neural functions.

5-Hydroxytryptophan↗
PubMed1991

[Immunohistochemical findings in resected lung cancer].

The relationship between histological type and immunohistological findings was studied in total 141 cases of resected lung cancer. Adenocarcinoma was cytologically subtyped according to the ultrastructural findings. Immunohistochemical staining was performed on paraffin-embedding tissue using the avidin-biotin-peroxidase complex method for carcinoembryonic antigen (CEA), keratin, secretory component (SC), neuron specific enolase (NSE), lysozyme (Ly) and lactoferrin (La). Adenocarcinoma stained strongly positive with antibody against CEA and SC. There was no statistical difference among the different subtypes of adenocarcinoma, but in the cases of clara cell type, CEA staining was less intense and in goblet cell type, the intensity of SC staining was great. Goblet cell type characteristically stained positively with anti-Ly antibody, and Ly was a specific marker for differentiating adenocarcinoma of goblet cell type. La was positive not only in bronchial gland cell type, but also in other subtypes in adenocarcinoma. Squamous cell carcinoma showed more intense staining with anti-keratin antibody than other histological types. Small cell carcinoma extensively stained with anti-NSE antibody, but some of the other histological types also stained positively. NSE was a relatively good marker for small cell carcinoma but was not specific. It is concluded that immunohistochemical examination is a useful method for differentiation of different histological types of lung cancer.

Adenocarcinoma↗
PubMed1991

[Case report of multiple myeloma associated with diffuse pulmonary calcinosis].

A case of multiple myeloma with diffuse metastatic calcinosis of the lung is presented. The patient was a 60-year-old male with IgA-kappa-myeloma who developed renal failure and hypercalcemia. Multiple small nodular shadows were observed both in plain chest films and CT films. The patient died of progressive respiratory failure. Postmortem examinations showed pulmonary infiltrations and massive pulmonary calcifications. Small nodular shadows were due to diffuse calcium deposits which were observed in and around the alveolar basement membranes of both the bronchioles and the blood vessels. It is generally believed that pulmonary calcinosis may not be detected by routine chest films; however, the nodular shadows observed in our patient seem to be pathognomonic and may indicate the severity of calcinosis.

Calcinosis↗
PubMed1991

[Management of cesarean section under replacement therapy with factor VIII concentrates in a pregnant case with congenital combined deficiency of factor V and factor VIII].

The congenital combined deficiency of Factor V and Factor VIII, a rare bleeding disorder, was identified in a 25-year-old woman. She was admitted to our hospital with a complaint of genital bleeding. Her prothrombin time and activated partial thromboplastin time were prolonged. She had low levels of Factor V coagulant activity (F. V:C) 14%, and Factor VIII coagulant activity (F. VIII:C), 12%, and normal levels of von Willebrand factor antigen (vWF:Ag), ristocetin cofactor (Rcof) and Protein C antigen. Her Protein C inhibitor level was slightly low. Her Rcof, vWF:Ag and F. VIII:C were elevated following administration of 1-deamino-8-D-arginine-vasopressin (DDAVP), but her F. V:C remained unchanged. Four years later, her F. VIII:C rose to 70% during the course of her pregnancy, but her F. V:C value remained low. It was expected that the vaginal delivery would be possible at the termination of pregnancy. Premature rupture of the membranes and an anomaly of rotation appeared in the course of delivery, however, and cesarean section was accomplished without excess bleeding under replacement therapy with Factor VIII concentrates. These findings suggested that DDAVP and Factor VIII concentrates were useful for management of her delivery. However the mechanisms of the rise of plasma F. VIII:C during pregnancy in a case with congenital combined deficiency of Factor V and Factor VIII are unclear.

Adult↗
PubMed1990

[Tuberculosis sequelae].

Although pulmonary tuberculosis decreased remarkably by antituberculous chemotherapy, we have had a lot of patients associated with sequelae who need medical treatment for many symptoms several or dozens years later. Moreover, in these days the delayed detection of pulmonary tuberculosis that is still an important problem may cause new sequelae. However, we have not had the clear definition of tuberculosis sequelae. Then I would like to definite the tuberculosis sequelae as follow. In a narrow sense, the sequelae is a pathological status that is caused by many patho-anatomical change in the healing process of pulmonary tuberculosis and need clinical treatment for many symptoms. The pulmonary tuberculosis sequelae include secondary infection such as aspergillosis, atypical mycobacteriosis and bacterial airway infection. In a broad sense, the sequelae also represent a pathological status with many symptoms after treatment that is caused by injuries in various organs with tuberculosis. I pointed out the problems of sequelae at this conference sixteen years ago. These problems may be beyond the category of tuberculosis study, but are extremely important for chest physicians.

Aspergillosis↗
PubMed1990

[Tuberculosis sequelae: secondary bacterial infections].

Bacterial infections is one of the most important complications in the patients with pulmonary tuberculosis. We reported the causative microorganisms in these cases with special reference to various clinical features and presented the recommended treatment and prophylaxis against respiratory bacterial infections in the patients with pulmonary tuberculosis sequelae. In 1988 and 1989, 63 patients with tuberculosis sequela were demonstrated to have been infected with respiratory pathogenic bacteria by the quantitative sputum culture method (greater than or equal to 10(7)/ml) in Tokyo National Chest Hospital. The male/female ratio of these patients was 3.5, and their average age was 62.5 years. Causative microorganisms of the secondary infections in the patients with tuberculosis sequela were essentially similar in those with other lower respiratory tract infections, i.e., chronic bronchitis, bronchiectasis, diffuse panbonchiolitis, chronic pulmonary emphysema, etc. Pseudomonas aeruginosa, other glucose-nonfermentative Gram-negative bacilli (GNF-GNB), and glucose-fermentative Gram-negative bacilli (GF-GNB) were the major pathogenic bacteria responsible for the chronic respiratory failure and/or fatal outcome in the post-tuberculous patients. Patients with complications, including aspergillosis, atypical mycobacteriosis, bronchial asthma, and so forth, showed no specific causative microorganism for the secondary infections except frequent isolation of Haemophilus influenzae. Our clinical observations clearly demonstrated that there were differences between the causative microorganisms in patients hospitalized during 1988 to 1989 and those in patients without admission. Gram-negative bacilli, including P. aeruginosa, GNF-GNB and GF-GNB, and Staphylococcus aureus were predominant in hospitalized patients. On the contrary, Streptococcus pneumoniae, H. influenzae, and Branhamella catarrhalis were major pathogenic bacteria in patients without hospitalization.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[A neuron-specific enolase (NSE) positive leiomyosarcoma].

A 40-year-old woman with multiple skin tumors was admitted to our hospital on September 5, 1989. Extensive studies by means of light and electron-microscopic examination and immunohistochemical analysis revealed a neuron-specific enolase (NSE) positive leiomyosarcoma. The level of her elevated serum NSE decreased after receiving her initial chemotherapy, but after the fourth session of chemotherapy, the NSE began to elevate again and she died on December 25, 1989. NSE appears to be a useful marker for determining if the neuronal and neuroendocrine cells are normal. This rare case, however, seems to demonstrate that abnormal, nonneuronal cells like a sarcoma also open metabolic pathways to synthesize NSE.

Adult↗
PubMed1990

[B-chronic lymphocytic leukemia/prolymphocytic leukemia (CLL/PL)--a case report].

A 48-year-old male was admitted to our hospital on April 20, 1989 because of general fatigue and abdominal fullness. Physical examination showed hepatomegaly, massive splenomegaly, and systemic lymphadenopathy. Hematological findings revealed WBC 73,000/microliters, RBC 289 x 10(4)/microliters, Hb 8.0g/dl, and platelet 9.1 x 10(4)/microliters. WBC differential count demonstrated a mixture of 63% matured small lymphocytes and 32% prolymphocytoid cells. Bone marrow aspiration was unsuccessful with a dry tap. Surface marker analysis of peripheral blood lymphoid cells disclosed that they were positive for anti-HLA-DR, CD 5, CD 19, CD 20, CD 21, CD 25, Sm-IgM, Sm-IgD, and Sm-K. He was diagnosed as B-CLL/PL, and treated with VEPA with partial remission. CLL/PL which was advocated by Melo in 1986 is regarded as a distinct clinical entity intermediate between CLL and PLL in clinical and laboratory features. Our case is interesting with regard to good response to combination chemotherapy, though most cases of CLL/PL have a resistance to standard chemotherapy.

Antigens, CD↗
PubMed1989

[A clinical study of fluconazole in pulmonary aspergillosis].

Fluconazole is a novel triazole antifungal agent. Its in vitro antifungal activity against Aspergillus spp. is rather weak, but in vivo animal protection studies in mice with Aspergillus infections showed that the activity of fluconazole was about 15 times as potent as that of ketoconazole. We have studied the clinical efficacy and the safety of fluconazole given to 6 patients with chronic intractable respiratory disease, pulmonary aspergillosis, at an oral dose of 400 mg once daily for 23 days to 110 days (70 days on the average). Patients were selected from those who fulfilled 2 of the following 3 criteria: 1) those with chest X-ray evidence of fungus ball, 2) those from whom Aspergillus was continuously isolated through culture of their sputum, 3) those with evidence of serum precipitinogen against Aspergillus. Clinical efficacies were good in 2 patients out of 6 with marked contraction of fungus balls, fair in 2 with slight contraction of fungus balls or improvement of clinical symptoms, and failed in 2. Side effects and laboratory parameter abnormalities possibly considered to be related to fluconazole were not observed in any of the patients enrolled in the study, suggesting the safety in a long-term usage of the drug.

Administration, Oral↗