PubMed Health⌕ Search

Biomedical subjects

S Miyagi

Publications and source records attributed to S Miyagi.

At least 19 recordsLinked to original sources
PubMed1998

[Chemotherapy of Hansen's disease in Japan--present status].

In order to know leprosy chemotherapy status in Japan, three recently conducted Government-supported nation-wide survey, namely chemotherapy research group survey (Takizawa, 1994, 71 cases) follow up result of Takizawa's study (Miyagi, 1997, 59 cases) and leprosy patient registry (Goto, 1996, 130 cases) were compared and analyzed. For most fresh and relapse cases, multi-drug therapy were applied, among them rifampicin/dapsone or rifampicin/dapsone/clofazimine combinations were selected in about half of new cases and about 1/3 of relapse cases. In many cases dose and intervals were based on WHO protocol, however smaller dosage was used in some cases. Quinolone (ofloxacin) was used in 40% of cases during the therapy. Reversal reaction was observed in 7/71 cases and erythema nodosum leprosum was observed in 6/71 cases. In order to prevent chemotherapy-induced deformities, we propose a modified protocol for new cases accompanied by reactional status, which starts with clofazimine monotherapy and followed by WHO/MB.

Anti-Infective Agents↗
PubMed1997

Sequence requirement for replication initiation at the rat aldolase B locus implicated in its functional correlation with transcriptional regulation.

Transcription promoter of the aldolase B gene was previously shown to be centered on an initiation region of DNA replication in rat hepatoma cells in vivo. Here, we defined an essential region required for replication in a plasmid form upon transfection. Deletion analyses around the origin region revealed that the proximal 200 bp promoter was necessary, but not sufficient for replication as flanking sequence restored replication activity. Therefore, the 200 bp region seemed to cooperate with the flanking sequence to play an important role in replication. Electrophoretic mobility shift assays using nuclear extracts from synchronously growing hepatoma cells showed that some protein factors bound to this region in a cell cycle-regulated manner. Since transcription of the aldolase B gene is repressed in the hepatoma cells, the cell cycle-regulated protein-binding is considered to be involved in regulation of replication initiation.

Animals↗
PubMed1996

Effects of dietary phosphatidylcholine on memory in memory deficient mice with low brain acetylcholine concentration.

Data concerning the effect of phosphatidylcholine (PCh) administration on the improvement of memory in senile dementia of Alzheimer type are inconsistent, probably due to the different conditions under which studies were conducted. Animal studies provide a good model, but data on this is limited. We studied the effect of PCh on memory in memory deficient mice (Dull mice) with low brain acetylcholine (ACh) concentration and normal mice. Mice were fed 24% casein diet (control) or this diet supplemented with 2 or 8% egg yolk PCh from gestation (Experiment 1) and after weaning (Experiment 2). Memory acquisition and retention were studied by step-down type passive avoidance performance at 8 and 10 weeks old, respectively. Control group of Dull mice had poorer memories than that of the normal mice in Experiments 1 and 2. On the 2% PCh diet, Dull mice improved memory acquisition and retention in Experiment 1 and retention in Experiment 2. On the 8% PCh diet in Dull mice there was improvement of memory and retention in Experiment 1, but no effect was observed in Experiment 2 (P > 0.05). In the normal mice, the 2% PCh diet did not affect memory acquisition and retention, however on the 8% PCh diet, there was no or adverse effect. These results suggest that dietary supplementation of egg yolk PCh improves memory of Dull mice, particularly when given from gestation and that the 2% PCh diet elicits better response than the 8% PCh diet.

Acetylcholine↗
PubMed1996

Simple detection of the 5S ribosomal RNA of Pneumocystis carinii using in situ hybridisation.

AIMS: To investigate the effectiveness of digoxigenin incorporated double stranded DNA probes produced by the polymerase chain reaction (PCR), for the detection of Pneumocystis carinii, using in situ hybridisation (ISH). METHODS: Formalin fixed, paraffin wax embedded sections of 26 human lung samples from 11 patients with P carinii pneumonia (PCP), and 15 with various types of fungal and viral pneumonia, were obtained during necropsy or transbronchial lung biopsy. Three additional PCP induced rat lung samples were also tested. PCR probes were prepared using the digoxigenin labelling mixture, and they were amplified from the DNA of a PCP induced rat lung after administration of dexamethasone, on the basis that 5S ribosomal RNA sequences are identical in human and rat P carinii. ISH was performed using this probe, and visualised using the digoxigenin nucleic acid detection kit. An immunohistochemical study using anti-human Pneumocystis monoclonal antibody was also carried out in parallel. RESULTS: ISH positively stained eight (of eight) lung necropsy specimens from patients with PCP, three (of three) transbronchial lung biopsy specimens from patients with PCP, and none of the three PCP induced rat lung specimens. In contrast, none of the specimens from patients with pneumonia caused by Aspergillus sp (n = 5), Candida sp (n = 4), Cryptococcus sp (n = 2), mucormycosis (n = 2), or cytomegalovirus (n = 2) were positive on ISH or immunohistochemistry. CONCLUSIONS: Using a digoxigenin labelled PCR probe for the entire 5S rRNA sequence in conjunction with conventional staining, ISH is highly reactive and specific for the diagnosis of PCP.

Animals↗
PubMed1996

[Clinical evaluation on causes of death in patients with active pulmonary tuberculosis].

Seventy one patients with active pulmonary tuberculosis who died during the past 5 years (1989 to 1993) were evaluated on their causes of death. Twenty two patients (31%) died directly of tuberculosis, and among them, 18 patients (81%) of 22 patients who died of tuberculosis) had very advanced tuberculosis. The majority of them (64%) were old age over 70 years and were bedridden due mostly to cerebrovascular injuries. The serum level of albumin was low in all 17 patients in whom it was measured. Establishment of diagnosis of tuberculosis was delayed over one month after the onset of symptoms in 59% of patients who died of severe disease. Sixty one percent (11/18) of patients died within the first month after the initiation of chemotherapy and about 90% (16/18) died within 3 months. Two patients died from massive hemoptysis and other patients died of either respiratory failure or tuberculosis meningitis. From these observations it was found that very advanced tuberculosis was the major cause of death in patients who died of tuberculosis and that the advanced disease was chiefly caused by the delay on the establishment of diagnosis, and it was most important to detect tuberculosis as early as possible, with regular check up of chest X-ray and frequent examination for AFB (acid-fast bacilli) for tuberculosis suspected patients. On the other hand, the majority of patients (49/71) died of complicating medical problem unrelated to tuberculosis. Seventeen patients died from malignancy (seven lung cancer, four lymphoma, two laryngeal cancer, etc). Ten deaths were the result of bacterial superinfection. Other patients died from respiratory failure due to COPD, arteiosclerotic heart disease, or cerebrovascular injuries, etc. Two patients of old age died of hepatic failure possibly caused by adverse reaction of TB chemotherapy. It was found that diseases unrelated to tuberculosis were the cause of death in approximately 70% of patients with active tuberculosis, and it should be emphasized to detect early and to treat these diseases, in particular malignancy. And it is also imperative that the chemotherapy for TB must be instituted very carefully with frequent monitoring of liver function in patients with old age.

Adult↗
PubMed1996

[A comparison of asthma deaths and near-fatal asthma attacks].

This study compares the characteristics of fatal asthma patients and those of near-fatal asthma patients who had experienced severe life threatening attacks. Data from 67 fatal asthma patients and 80 near-fatal asthma patients were analyzed. The mean age of fatal asthma cases were older than near-fatal asthma cases, 51.9 yrs and 44.3 yrs, respectively. Similarities of the two cases were seen in sex, type of asthma and severity of asthma. The experiences of previous life-threatening asthma did not differ in both groups (43.3% of fatal vs 40.0% of near-fatal). From the viewpoint of type of development of severe exacerbation, rapid exacerbation was more frequent in fatal cases than near-fatal cases, but acute exacerbation after unstable asthma was more in near-fatal asthma. Seventy-six percent of all asthma deaths occurred at home or on the way to the emergency department. The rate of delay of receiving medical care was significantly higher in fatal cases (72%) than near-fatal cases (26%). There was no significant difference in the frequency of medical management before fatal or near-fatal episode such as oxygen therapy, mechanical ventilation. Use of ambulance, visiting emergency department, previous hospitalization between the two groups. The profile of fatal cases was almost same to that of near-fatal cases except delay of receiving medical care. In conclusion, the analysis of near-fatal cases was very important to make clear the causes of asthma death.

Adult↗
PubMed1994

Acute pneumonitis presumed to be silicone embolism.

A 39-year-old housewife who underwent intramammary injections of a proprietary silicone fluid mixture showed clinical and novel transbronchial lung biopsy (TBLB) findings. She presented with complaints of progressive dyspnea, dry cough, and pleuritic chest pain 2 days after the last silicone injections. The chest X-ray and CT scan showed diffuse interstitial infiltrates. TBLB demonstrated translucent, presumably silicone globules embolized within the pulmonary capillaries. The documentation of intramammary injections, the clinical and radiographic features of acute pneumonitis, and the histopathologic evidence by TBLB, may support the causal relationship between illicit injections and the silicone embolism. We discuss the pathogenesis and urge that this potentially toxic source of pulmonary embolism be removed.

Acute Disease↗
PubMed1994

[Pulmonary emergency medicine at Okinawa Chubu Hospital, including care of patients with primary, secondary, and tertiary emergency problems].

In the emergency department of Okinawa Chubu Hospital, 32,088 patients were seen between November 1992 and October 1993. Of these patients, 19,306 were over 16 years old. About 20% of the patients seen in the emergency department had pulmonary diseases. In decreasing order of frequency, the five most commonly seen conditions were: upper respiratory tract infections (19%), bacterial pneumonia (12%), acute bronchitis, acute exacerbation of chronic obstructive pulmonary disease, and chest trauma. Medical (i.e. nonsurgical) treatment was required by 10,034 patients. Thirty five percent of those had pulmonary disorders, and the mortality rate was 0.9%. A total of 747 patients were hospitalized, and 65 were admitted to the intensive care unit. Of those admitted to the intensive care unit, 9% died of respiratory problems. Surgical treatment was required by 5587 patients. Only 5.1% of them had pulmonary problems, and the mortality rate was 3.5%. However, the mortality rate among the 25 patients admitted to the intensive care unit for surgical pulmonary problems was 8%. Among patients with medical problems who were hospitalized via the emergency department, 36% had pulmonary disorders (mainly pneumonias, asthmatic attacks, acute bacterial bronchitis, and acute exacerbation of chronic obstructive pulmonary disease), but only 7% of patients with surgical problems had chest trauma (mainly due to traffic accidents of falls).

Adolescent↗
PubMed1993

Alpha replacement method for the displaced Swan neck catheter.

We have developed a new method for the displacement of the Swan neck straight (SNS) catheter and have named it the "alpha replacement method." The procedure is to insert a 1.5 mm flexible metal guide wire into the transfer tube, passing it through the catheter tip until it touches the mesenterium. Continued gentle pressure will cause the guide wire to make a big loop in the abdomen, and as the loop increases in size, the catheter will move into the minor pelvic space. The guide wire is pulled out by pressing down on the lower abdomen, and the catheter remains in the minor pelvic space. The procedure is then complete. The alpha replacement method was successful in all 8 patients, with the manipulation time being about 15 minutes. No complications have occurred.

Catheterization↗
PubMed1991

[Diagnosis and significance of ARDS].

Adult respiratory distress syndrome (ARDS) is defined as a syndrome of acute respiratory failure following generalized or localized catastrophic events, without a past history of underlying pulmonary diseases, which is manifested by acute onset of dyspnea, laboured breathing and non-cardiogenic lung edema. This syndrome is also characterized by preceding pulmonary or extrapulmonary insults, an almost normal lung function immediately after the catastrophic events, and acute and progressive hypoxemia, decreased pulmonary compliance with chest radiographs showing bilateral diffuse pulmonary infiltrates, associated with very poor outcome. The diagnostic modalities for obtaining pathognomonic findings indicative of ARDS are not established as yet, hence the only way to diagnose ARDS is to evaluate the pathophysiological status, as mentioned in the definition above, by various laboratory examinations. Although there are many reported modifications, the diagnostic criteria suggested by Petty, et al are still widely used in practice. However, it is unknown whether they are strictly followed or not. Nowadays, the significance of making a diagnosis of ARDS on the basis of the above criteria is questioned by some physicians. To address these questions, the authors reported on an overview of ARDS cases seen at ICU of our institute which is providing acute and emergency care services in Okinawa. In the past 10 years (1979-1988), 4500 patients were admitted to our ICU and 170 of them were diagnosed as either having ARDS or their course in ICU were complicated by ARDS. These cases were retrospectively studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Physical signs and lung function tests in patients with chronic obstructive pulmonary disease (COPD)].

We examined 40 consecutive patients with chronic obstructive pulmonary disease (COPD) admitted to our institute between April and September 1985 for acute exacerbation, when they recovered from acute exacerbation and became cooperative to undergo lung function tests. Additionally, a follow up study was also done 4 years later, for assessing whether the physical signs were indicative of poor prognosis or not, correlated with survival rate, frequency of acute exacerbations and mechanical ventilation required and application of home oxygen therapy (HOT). Four physical signs, including increased activity of strap muscle, recession of supraclavicular fossae in inspiration, loss of pump-handle movement and loss of bucket-handle movement were associated with significantly low values in all lung function parameters tested but other signs were correlated with only in 2 or 3 parameters. The long-term prognosis was poor in the patients with more physical signs (abnormality score), namely the patients, who were on HOT because of development of chronic respiratory failure had significantly more frequent episodes of acute exacerbation and mechanical ventilation, had definitely higher scores than others who did not need HOT.

Aged↗
PubMed1989

[New trends in home oxygen therapy (HOT) after the introduction of health insurance coverage in Okinawa and factors contributing to long-term survival].

A total of 179 cases given HOT after introduction of health insurance coverage in 1985 were reported from 12 medical institutes in Okinawa and were compared with 110 cases followed at Okinawa Chubu Hospital during 1976-1985, prior to insurance coverage. The number of patients on HOT have rapidly increased after insurance coverage not only in our institute but also in other institutes in Okinawa and the patients with emphysema formed the largest group. The oxygen enricher is now utilized more than the compressed gas system, accounting for about 70% of all patients compared with the previous figure of 7.3%. Average PaO2 on room air was higher (from 42 Torr to 49 Torr) and the levels of PaO2 maintained by HOT had 2 peaks, one in the 60-65 Torr range and the other in the 75-80 Torr range in patients newly given HOT. The patients with emphysema, who had the worst prognosis in the past, remarkably improved and showed no statistical difference from patients with chronic bronchitis or bronchiectasis in terms of long-term survival. The female patients had better prognosis than males, but the reason is still unclear to us. The absolute volume of FEV1.0 and the presence or absence of cor pulmonale have not affected the long-term survival. A group of the patients with CO2 retention (bronchitic in type) did not benefit from HOT in terms of long-term survival unless their PaO2 levels on room air were below 50 Torr and it was felt that PaO2 levels of 50-59 were too mild in severity for application of HOT.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

Cor pulmonale due to tumor cell microemboli. Report of a case with occult gastric carcinoma.

Progressive dyspnea developed in a 36-year-old woman. Physical examination and chest roentgenogram showed the signs of pulmonary hypertension. She died of respiratory failure in spite of treatment. Autopsy disclosed gastric carcinoma in the pylorus with metastases to the regional lymph nodes, left adrenal gland, and ovaries. There were no gross pulmonary emboli, but more than 50% of pulmonary microvasculature was occluded by tumor cell microemboli. No parenchymal metastases were found in the lung. This case was remarkable because cor pulmonale due to tumor cell microemboli to the lung was the initial and terminal manifestation of clinically occult, but pathologically advanced, gastric carcinoma.

Adenocarcinoma, Mucinous↗