Henoch-Schönlein purpura nephritis associated with methicillin-resistant Staphylococcus aureus infection.
Explore the source record for details and available documents.
Antibodies, Bacterial↗
Biomedical subjects
S Iwabuchi
Publications and source records attributed to S Iwabuchi.
Effect of a 7.2% hypertonic saline solution infusion on arterial blood pressure, serum sodium concentration and osmotic pressure in normovolemic heifers.
The effects of an intravenous (i.v.) infusion of a small volume (5 ml/kg) or large volume (15 ml/kg) of hypertonic saline solution (HSS; 7.2%, 2,400 mOsmol/kg.H2O) and those of an i.v. infusion of 5 ml/kg isotonic saline solution (ISS; 300 mOsmol/kg.H2O) on plasma volume, arterial blood pressure, serum sodium concentrations and osmotic pressure were investigated in conscious heifers. Nine heifers (3 heifers/group) were monitored for 120 min after the initiation of fluid replacement. The relative plasma volume (rPV) in the 5 ml/kg HSS and 15 ml/kg HSS progressively increased to 137.7 +/- 2.4% at t = 5 min and 145.2 +/- 5.4% at t = 15 min, respectively. The expanding plasma volume in the 5 ml/kg HSS group remained at an up to 10% higher level until 120 min, but not in the 15 ml/kg HSS group. The 5 ml/kg HSS infusion induced transit high-osmotic (305.3 +/- 4.0 mOsmol/kg.H2O) and sodium levels (155.7 +/- 3.5 mM/l) at t = 5 min. However, the 15 ml/kg HSS infusion induced constant high-osmotic level (321.7-336.7 mOsmol/kg.H2O) and hypernatremia (162.8-170.0 mM/l) from t = 10 min to the rest of the experiment period. In the ISS and 5 ml/kg HSS groups, no changes in PaO2 were observed. The 15 ml/kg HSS infusion induced a significant decrease in the partial pressure of oxygen at the t = 30 min compared to the t = 0 min values. On the basis of these findings, a small volume (5 ml/kg) HSS infusion can be rapidly and safely administered to cattle for expanding the plasma volume without inducing hypernatremia. A 5 ml/kg HSS infusion is thus recommended for the initial field resuscitation of cattle.
Animals↗
Effect of infusion of hypertonic saline solution of conscious heifers with hypoxemia caused by endotoxin infusion.
OBJECTIVE: To compare effects of i.v. infusion of a small volume (5 ml/kg of body weight) of hypertonic saline (7.2% NaCl) solution (HSS) and i.v. infusion of an equivalent volume of isotonic saline (0.9% NaCl) solution (ISS) on arterial blood gases in conscious heifers with hypoxemia caused by endotoxin infusion. ANIMALS: 9 Holstein heifers. PROCEDURE: All heifers received 2.0 microg of endotoxin/kg, i.v., during a 5-minute period. Twenty-five minutes after endotoxin infusion, 3 heifers received ISS, 3 received HSS, and the remaining 3 did not receive fluids (control). Heifers were monitored for 150 minutes after initiation of fluid replacement. Arterial blood gases, blood pressure, and serum electrolyte concentrations were measured. RESULTS: Endotoxin administration had a profound effect on pulmonary function, causing severe hypoxemia accompanied by a significant decrease in the partial pressure of oxygen (PaO2) and a significant increase in the arterial-alveolar O2 gradient (P[A-a]O2). Cattle in the HSS group had progressive and significant increases in PaO2 and O2 saturation, compared with the other groups. The P(A-a)O2 values for the control and ISS groups were slightly decreased until 150 minutes after initiation of fluid replacement; however, HSS infusion induced a progressive and significant decrease in P(A-a)O2 for the remainder of the experimental period. CONCLUSIONS AND CLINICAL RELEVANCE: Rapid infusion of HSS can successfully resuscitate conscious cattle with induced pulmonary dysfunction. Infusion of HSS may be beneficial for initial resuscitation of cattle with naturally developing bovine respiratory disease complex.
Animals↗
[Disturbance of deep sensation in medial medullary syndrome. Topographical localization of medial lemniscus in the medulla oblongata].
Medial medullary infarction is characterized by ipsilateral hypoglossal nerve palsy with contralateral hemiparesis and disturbance of deep and discriminative sensory perception. We examined the extent and distribution of disturbances in deep sensation and compared the findings with the lesion location in the medial lemniscus detected by MRI in 3 patients with medial medullary infarction. We classified the lesion location into 2 groups; type I and type II. Type I was ventral to the middle medial lesion of the medial lemniscus, and type II was ventral to the dorsal medial lesion. In our series, type I (Case 1) impairment of the three kinds of deep sensations was more severe in the lower extremities than in the up-per extremities. In type II (Cases 2, 3) the severity or impairment in the upper extremities was moderate or severe and nearly equal to that in the lower extremities. There was no difference in the severity of impairment for the four kinds of discriminative sensations. In the literature, type I (8 patients) impairment of position sense in deep sensation was found in 1 of 7 patients in the upper extremities and 5 of 7 patients in the lower extremities. Impairment of vibration sense was found in 1 of 7 patients in the upper extremities and in all patients in the lower extremities. In type II (14 patients) severe impairment of position and vibration sense in deep sensation was found in 3 patients in the upper extremities equal to that in the lower extremities. There was no tendency in the severity of impairment of four kinds of discriminative sensations. Including our 3 cases and 22 in the literature, impairment of deep sensation was more severe in the lower extremities than in the upper extremities in type I (9 patients) and the extent was none (7), mild or moderate (2) in the upper extremities, mild (2), moderate (1), severe (2), obscure (4) in the lower extremities, while in type II (16 patients) the severity in the upper extremities was nearly equal to that in the lower extremities and the extent was none (1), mild or moderate (1), severe (5), obscure (9) in the upper extremities, none (2), mild or moderate (1), severe (6), obscure (7) in the lower extremities. It is concluded that hemiparesis appeared with lesions located in the pyramidal tract of the medulla, hemiparesis and disturbance of deep sensation in the upper and lower extremities, predominantly in the lower extremities with the lesion of the pyramidal tract to the middle of medial lemniscus in the medulla, hemiparesis and disturbance of the upper and lower extremities deep sensation with lesions of the pyramidal tract to the whole of the medial lemniscus in the medulla. Evaluating deep sensation of the upper and lower extremities is useful for speculation of the lesion location in the medial lemniscus in medial medullary infarction.
Cerebral Infarction↗
Simultaneous topographic and fluorescence imagings of recombinant bacterial cells containing a green fluorescent protein gene detected by a scanning near-field optical/atomic force microscope.
A scanning near-field optical/atomic force microscope (SNOAM) system was applied for simultaneous topographic and fluorescence imaging of biological samples in air and liquid. The SNOAM uses a bent optical fiber simultaneously as a dynamic mode atomic force microscopy cantilever and as a scanning near-field optical microscopy probe. Optical resolution of this system was about 50-100 nm in fluorescence mode for fluorescent latex beads on a quartz glass plate. Green fluorescent protein (GFP) is a convenient indicator of transformation and should allow cells to be separated by fluorescence-activated cell sorting. The gene coding to GFP was cloned in recombinant Escherichia coli. The SNOAM system used 458- or 488-nm irradiation from a multiline Ar ion laser for excitation of GFP, since a native GFP has been known to give a maximum at 395 nm and a broad absorption spectrum until 500 nm. Topographic and fluorescence images of recombinant E. coli were obtained simultaneously with a high spatial resolution which was apparently better than that of a conventional confocal microscope. A nanoscopic GFP fluorescence spectrum was obtained by positioning the optical fiber probe above the bright area of the E. coli cells. Comparing topographic and fluorescence images, it can be seen that individual E. coli cells expressed different fluorescence intensities. Fluorescence obtained by SNOAM indicated that GFP oxidation possibly occurred near the cell surface. A SNOAM system also indicated the possibility of precise imaging of native cells in liquid.
Escherichia coli↗
Simultaneous detection of near-field topographic and fluorescence images of human chromosomes via scanning near-field optical/atomic-force microscopy (SNOAM).
Scanning near-field optical/atomic-force microscopy (SNOAM) provided us with simultaneous topographical and optical images of human chromosomes using a sharp and bent optical fiber as a near-field optical probe. Native chromosomes were spread out onto a coverslip using the surface-spreading whole-mount method. The SNOAM system does not need pretreatment of samples such as metal coating or chemical immobilization. Near-field topographic and fluorescence images provided useful information on native chromosome structure.
B-Lymphocytes↗
Clonotypic analysis of T cells in patients with autoimmune and viral hepatitis.
The immunopathogenesis of autoimmune hepatitis (AIH), and the role of T cells in the onset and maintenance of this disease, are still unclear. Since T cells expand clonally after stimulation by an antigen, it is important to analyze the behavior of T cells at a clonal level. We have established recently a novel system, using reverse transcriptase-polymerase chain reaction (RT-PCR) and subsequent single-strand conformation polymorphism (SSCP) that allows the identification of clonal accumulation of T cells in a lymphocyte population. Using this system, we demonstrated that oligoclonal T cells were accumulated in the liver of patients with AIH, and that identical T-cell clonotypes were detected in two different regions of the liver, although these features were also observed in cases with viral hepatitis. Only in cases with AIH, however, nearly all identical T cells were found to belong to CD8+ subset and there were very few CD4+ T cells in this population. Our results suggest that common antigens presented to CD8+ T cells in the context of HLA class I molecule are distributed diffusely in the liver of AIH. These findings also suggest that antigens recognized by CD4+ T cells may be relatively heterogeneous in the liver with AIH.
Adult↗
Iatrogenic paraplegia caused by surgicel used for hemostasis during a thoracotomy: report of a case.
A 46-year-old Japanese woman underwent a right lower lobectomy through a posterolateral incision made in the fifth intercostal space under general and epidural anesthesia on January 23, 1995. During the procedure, oxidized regenerated cellulose (Surgicel) was used to prevent postoperative rebleeding from the dorsal branch of the fifth intercostal artery. The following day it became evident that complete paraplegia had developed below the Th5 level, the cause of which was revealed by an emergency laminectomy, performed within 20 h after the thoracotomy, to be the Surgical treatment. By 50 days after the operation the patient had begun to show improvement, and was able to move her lower extremities against gravity. Her condition is continuing to improve.
Cellulose, Oxidized↗
Response to interferon-alpha 2a in patients with e antigen-negative chronic hepatitis B.
Sixty-eight consecutive patients with chronic hepatitis B received 702 million units of recombinant interferon-alpha 2a. Of the 24 patients negative for hepatitis B e antigen (HBeAg) in serum, the normalization of serum transaminase occurred in 14 (58%) at the completion of interferon therapy and in 13 (54%) at 12 months thereafter; it was normalized in 17 (39%) and 13 (30%), respectively, of the 44 HBeAg-positive patients. Of the HBeAg-negative patients, hepatitis B virus DNA was cleared from serum in six (25%) at the completion and in one (4%) at 12 months thereafter, in contrast to only one (2%, p < 0.05) and none of the HBeAg-positive patients, respectively. The 1896th nucleotide of G (G1896) for codon 28 for tryptophan or A (A1896) for the stop codon 28 in the precore region was determined by restriction fragment length polymorphism. The ten HBeAg-negative patients with A1896 only in the precore region had lower pretreatment levels of viral markers, which decreased more rapidly and extensively after interferon than in the 14 HBeAg-negative patients with a mixture of G1896 and A1896 or in the 44 HBeAg-positive patients. These results indicate that patients with HBeAg-negative chronic hepatitis B may respond better to interferon than HBeAg-positive patients, and that the precore mutant with the stop codon 28 may be sensitive to interferon.
Adult↗
Vasoactive intestinal peptide causes nitric oxide-dependent pulmonary vasodilation in isolated rat lung.
Vasoactive intestinal peptide (VIP) is one of the chief neurotransmitters of nonadrenergic noncholinergic nerve fibers. In this study, we investigated the effect of VIP on the pulmonary circulation in isolated perfused rat lungs. Baseline pressures of the pulmonary artery for the isolated rat lungs were not affected by 3 x 10(-8) M VIP. VIP caused dose-dependent pulmonary vasodilation when the pulmonary vascular bed was constricted with 20 mM KCl. This vasodilative effect of VIP was inhibited by 1 x 10(-6) M L-n omega-nitro-arginine, an endothelium-derived relaxing factor (nitric oxide) inhibitor, and was restored by the addition of 10(-4) M L-arginine, a substrate of nitric oxide. VIP also caused suppression of the ANG II pressor response, and this VIP-induced suppressive effect was reduced when L-N omega-nitro-arginine or 3 x 10(-6) M meclofenamate was added to the perfusate. These results indicate that VIP causes pulmonary vasodilation in isolated rat lung and suggest the possible involvement of NO and/or cyclooxygenase metabolites in VIP-induced pulmonary vasodilation.
Angiotensin II↗
Comparison of commercial isotonic fluids intravenously administered to rehydrate fasted bullocks.
Holstein bullocks were used in this study to compare the effectiveness of five commercial parenteral fluids (saline IS, Hartmann's IH, 5%-glucose 5G, Ringers IR, and 1/2 Ringer's and 2.5% glucose combination solutions RG) in correcting the disturbances associated with dehydration induced by fasting for 48 hr. These five commercial fluids (30 ml/kg) were given to bullocks with dehydration induced by fasting for 48 hr. Arterial and venous blood samples were taken before fasting, and at 0, 15, 30, 45, 60, 90, 120, 240, 360 min, and 24 hr after initiation of fluid administration. Fasting for 48 hr induced significant reductions in body weight and relative plasma volume (rPV), of approximately 7.72 and 21.93%, respectively. During the administration period, rPV showed a progressive increase from approximately 88.1% after fasting to 113.0% with no significantly differences between groups. A rapid decrease of rPV when fluid administration has been finished was observed in the 5G and RG groups. The results of the fluid administration trial showed that the 1/2 Ringer's and 2.5% glucose combination solution inhibited the acidification of the blood, produced no change in the electrolyte balance of serum, and induced a proper reabsorption rate of glucose in the renals, and was therefore considered the best choice for the rehydration of adult cattle which have had no appetite for over 2 days.
Animals↗
[A case of mediastinal goiter with hyperthyroidisms].
A 65-years-old woman admitted to the hospital in order to treat of the mediastinal tumor, but she suffered from palpitation, slight fever, sweating, uneasiness, sleeplessness and weightloss. On the physical examination, she was experiencing tachycardia, fevering (37.2 approximately 37.6 degrees C). Skin was moist but had no exophtalmos or neck tumor. Chest X-ray showed an abnormal shadow in the upper mediastinum. On chest CT, a tumor mass (9 x 5 x 4 cm) with cystic regions and scattered calcifications occupied from anterior to posterior mediastinum. The tumor compressed trachea to the left and right brachiocephalic vein and SVC to the right. Lower portion of the tumor intruded into behind of the trachea. Lymph node swelling of mediastinum was also detected. Results of general laboratory examination were within normal limits. Thyroid function test revealed hyperthyroidism; T3U 58%, free T3 24.4 pg/ml, free T4 6.0 ng/dl and thyroglobulin 967 mg/dl, but TSH was < 0.01 microIU/ml. After daily administration of methimazole (300 mg/day) for 4 weeks, thyroid function became to normal level and symptoms of hyperthyroidism was disappeared. The tumor was completely extirpated with right hemithyroidectomy and lymph node dissection under neck colla incision and median sternotomy. Pathological finding of the tumor showed follicular-fetal adenoma of thyroid with hyaloid degeneration and cystic change. There was no finding suspected of Graves' disease. She is well without any complications for 8 months after operation. Some discussion of the literature was mentioned.
Adenoma↗
[Cryoglobulinemia associated with hepatitis C-related chronic liver disease in Japan].
The association between the actual status of cryoglobulins (CGs) expression in hepatitis C-related chronic liver disease (C-CLD) and different types of liver pathology, HCV-RNA titers and genotypes was investigated. Sixteen out of 1340 ordinary clinical specimens were CGs-positive (1%), and in 8 of them (50%) the patients blood was HCV-RNA positive. CGs was detected in 63% of C-CLD patients as a whole, but when compared with the histological findings in the liver, it was 88% in F3, and 92% in A3, and thus high percentages were detected in patients with progression of liver fibrosis and patients with strong activity. Serum IgG, IgM, transaminase and gamma-GTP levels were significantly higher in the patients with CGs, and their RA test and C3dCIC levels tended to be higher, but the differences were not significant, and no association was found with the anti-nuclear antibody positive level, or the HCV-RNA titers or genotypes. Based on the above, there was a clear involvement of HCV infection, especially the activity and histological progression of hepatitis in CGs formation in Japan as well, but there were few extrahepatic manifestations, suggesting differences in CGS levels and immune response to CGs from cases in Western countries.
Carrier State↗
A case of renovascular hypertension associated with neurofibromatosis.
We report a case of renovascular hypertension associated with neurofibromatosis complicated by moderate proteinuria. A 16-year-old female was admitted to Kensei General Hospital with a complaint of headache and a blood pressure of 230/120 mm Hg. She was referred to us for further evaluation of the hypertension. On examination, cafe-au-lait spots were seen over her extremities and flank, and a bruit was heard in the right upper abdomen. The urinary protein excretion was 2.1 g/day. The plasma renin activity (PRA) and plasma aldosterone concentration were high, but the levels of catecholamines were normal. The renogram was asymmetric and on venous sampling, the PRA in the right renal vein was 58.3 ng/ml/h and that in the left was 22.1 ng/ml/h. CT scan detected an approximately 10-mm mass in the proximal right renal artery. Arteriography disclosed severe stenosis in the right renal artery and the superior mesenteric artery. Therefore, we concluded that her hypertension resulted from stenosis of the right renal artery due to neurofibromatosis. Accordingly, she underwent an operation to reconstruct that artery. After the operation, her blood pressure and PRA normalized without administration of any anti-hypertensive drug and urinary protein disappeared.
Adolescent↗
[CABG operation with sequential bypass using arterial grafts].
We evaluated 39 cases where sequential anastomoses had been performed using arterial graft (AG) in coronary artery bypass grafting (CABG). Fourty three AGs were used, and anastomosed to 87 coronary arterial branches. The details of these anastomoses were: 25 right gastroepiploic arteries (RGEA) to 51 branches; 10 left internal thoracic arteries (LITA) to 20 branches; 8 right internal thoracic arteries (RITA) to 16 branches. The interrupted suture was employed for all anastomoses. The proxymal site was initially anastomosed in the parallel way to a native coronary artery, and then, the distal anastomosis was done. In CABG using RGEA, the number of cases receiving anastomoses to RCA and LCX was the largest as in 13 cases, and the patent rate was favorable. There were also 8 cases of anastomoses to LAD and Dx and these GEA'S grafts were all patent. But, in the 2 cases of astomoses to RCA and LAD, the GEA's grafts between RCA and LAD were occluded. Therefore, this combination was thought to be inadequate for sequential hypass. On the other hand, in the 10 cases using LITA, these grafts were all anastomosed to LCA system, and were all patent. In the 8 cases using RITA, 4 in-situ grafts and 4 free grafts were employed. There were 3 anastomoses to LAD and D1 in the former, and 2 cases each of anastomoses to LAD and D1, and LCx (segment 12) in the latter. The patency was excellent, 100%. Although there were 1 case of post-operative early death (renal failure) and 1 case of remote death (cerebral infarction), they were found not due to arterial sequential bypass. In the 37 cases of post-operative angiography, patency was recognized in 40 AGs out of the 41 (97.6%) and 78 anastomosed branches out of the 83 (94.0%). These satisfactory findings indicate that it is possible and effective to perform sequential bypass in multivessel GABG using AG.
Adult↗
Treatment of scalp arteriovenous malformation.
We report seven patients with scalp arteriovenous malformations, including two patients with lesions > 10 cm in diameter, who were successfully treated. The principal complaint of each patient was a deforming mass. Each of four patients had a history of blunt traumatic injury. The lesions, each consisting of the nidus, feeders, and draining veins, evolved in all patients. The nidus consisted of fistulae, which exhibited various angioarchitectures as revealed by angiography. A hemangiomatous component was histologically recognized in one patient. In five patients, in whom the lesions were relatively small and whose nidi included only large fistulae, the malformations were remedied by surgical intervention alone or were cured with embolization alone using liquid adhesives. In the two patients with lesions > 10 cm, the nidi consisted of numerous large fistulae and plexiform fistulae in one patient and plexiform fistulae and a hemangiomatous component in the other patient. These patients were treated with a combination of transarterial embolization and surgical intervention. Preoperative embolization greatly reduced blood loss during resection. Total excision and scalp reconstruction using a soft tissue expander were performed in both patients. The cosmetic results were excellent in all of the patients, and no recurrence has been recognized during the follow-up period, which ranges from 31 to 99 months. The treatment of scalp arteriovenous malformations should strive to improve deforming features and to attain a permanent cure. Because each nidus includes a variety of anomalous angioarchitectural features, there should be different means and a combination of treatments for each patient. Embolization alone could be adequate treatment in relatively small lesions, the nidi of which consist only of several large fistulae. For malformations with more extensive, large fistulae or with anomalous components other than large fistulae, a combined endovascular and surgical approach and scalp reconstruction seems to be the best treatment.
Adult↗
Core promoter mutations of hepatitis B virus for the response to interferon in e antigen-positive chronic hepatitis B.
OBJECTIVES: Mutations in the precore region are not always detected in hepatitis B virus (HBV) from patients with chronic hepatitis B who respond to interferon and lose hepatitis B e antigen (HBeAg) from serum. The other mutations may also be responsible for the loss of HBeAg and response. METHODS: Forty six consecutive patients with HBeAg-positive chronic hepatitis B received recombinant-alpha 2 a interferon (total dose: 702 MU). The mutation for stop codon 28 in the precore region was determined by restriction fragment length polymorphism, and mutations in the core promoter were searched for in five HBV DNA clones propagated from each patient. RESULTS: HBeAg was cleared at 6 months after interferon in 11 (61%) of 18 patients with the precore mutation and in 12 (43%) of 28 without it. Of these 28 patients, 19 with mutations in the core promoter in all five HBV DNA clones lost HBeAg more frequently than the remaining nine who had at least one clone among the five that lacked such mutations (58 vs 11%, p < 0.05). CONCLUSIONS: HBeAg-positive patients infected with HBV variants having mutations for an HBeAg-negative phenotype would respond better to interferon by clearing HBeAg from serum. Such mutations may not necessarily be in the precore region but also in the core promoter, which would interfere with the synthesis and secretion of HBeAg either at the translation or transcription level.
Adult↗
[Periodic decerebrate spasm with ocular dipping, Cheyne-Stokes respiration and hypersympathetic activity].
Decerebrate spasm is a generalized muscular spasm produced by some stimuli on decerebrate posture. Such spasm are called "tonic fit" or "decerebrate extensor spasm". We reported a 50-year-old man with periodic decerebrate spasm after cerebral hemorrhage. On admission, the patient was comatose. The pupils were round but anisocoric and did not react to light. Corneal reflexes were absent. The face, arms, and legs did not move voluntarily. Two weeks after admission, he was found in decerebrate rigidity. Periodic decerebrate spasms were also observed and were accompanied by ocular dipping. Cheyne-Stokes respiration, and hypersympathetic activity (transiently dilated pupils, hypertension, tachycardia). These symptoms persisted for two months and were induced by painful or sonic stimuli and suppressed by sleep, sedative or antiedematous drugs. The cycle was 0.6 approximately 0.7 per minute in accord with that of Cheyne-Stokes respiration. Magnetic resonance imaging revealed an area of low signal intensity in the midbrain to the bottom of the pons caused by the tentorial herniation on T1-weighted images. From the the clinical features and results of MRI studies, we considered that dysfunction of the midbrain to the pons in addition to diffuse cerebral dysfunction played some role in the manifestation of periodic decerebrate spasm with ocular dipping.
Cerebral Hemorrhage↗