Biomedical subjects

T Rikimaru

Publications and source records attributed to T Rikimaru.

At least 55 records · Page 3Linked to original sources

PubMed1998

Prognostic significance of febrile episodes in lung cancer patients receiving chemotherapy.

The prognostic significance of neutropenic fever in lung cancer patients receiving chemotherapy with or without radiotherapy was investigated. Male patients and patients with squamous cell lung cancer had a higher incidence of febrile episodes than female patients and patients with other cell types, but the differences were not significant. Patients with a poor performance status had a significantly higher incidence of febrile episodes. An indwelling central venous catheter was an important risk factor for febrile episodes, indicating that bacteremia was one of the major causes of fever. The median survival time of the patients who developed febrile episodes during chemotherapy was significantly shorter than that of patients without fever (6.1 vs 12.0 months), whether or not cases of early death within 3 months were excluded (8.9 vs 13.1 months). The prevention of infectious complications during anticancer treatment by the use of rh G-CSF and the early initiation of antimicrobial chemotherapy, although the results are inconclusive, may be worthwhile.

Aged↗

PubMed1998

Humoral and cell-mediated immunity in malnourished children in Ghana.

OBJECTIVE: To examine the relationship between immunological variables and the different types and severity of malnutrition in Ghanaian children. DESIGN: Case-control study. SETTING: The study was done at Princess Marie Louise Hospital, Accra, Ghana. SUBJECTS: One hundred and seventy children, aged 8-36 months, were recruited at the clinical ward and public health service section of the hospital: 61 normal children, 49 moderately malnourished (underweight) children and 60 severely malnourished children (19 kwashiorkor, 30 marasmus, and 11 marasmic kwashiorkor children). METHOD: The children underwent clinical observations, anthropometric measurements and blood sampling for biochemical analysis to evaluate their nutritional and immunological status. Serum immunoglobulins (IgA subclasses, IgG subclasses and IgM), complements (C3 and C4) and lymphocyte subpopulations (T cells, B cells, CD4+, CD8+, NK cells and HLADR) were determined for the assessment of humoral and cell-mediated immunity. RESULTS: Serum levels of IgA1, IgA2 and C4 tended to be higher in severely malnourished children than in normal children, while serum level of C3 and the proportion of B cells were significantly lower in the severely malnourished children than in the normal children (P < 0.05). There were no notable differences in most immunological parameters among the three severely malnourished groups. No differences were observed in the immunological parameters except for the proportion of B cells between normal and moderately malnourished children. Factor analysis revealed that C3 levels were positively correlated with a factor which was strongly associated with weight-for-height z-score and biochemical indicators for evaluating protein nutrition. In addition, IgA2, IgG1 and IgM levels were positively correlated with a factor which was associated with C-reactive protein. CONCLUSION: Several immunological variables responded positively or negatively with the different levels of severity of malnutrition, but most variables did not on the different types of malnutrition. The changes of C3 level were more associated with the severity of malnutrition.

Antibody Formation↗

PubMed1998

[Inflammatory reactions and microorganisms cultured from sputum and blood in association with terminal stage infection of patients with lung cancer].

We reviewed our experience with terminal stage infections in patients with lung cancer over an 11 year period at Kurume University Hospital. In patients with end-stage lung cancer, the infection is common and a mortal disease. We examined the clinical features and significance of pathogenic microbes isolated from sputum and blood in patients with lung cancer during their last month. Bacteriological examinations from blood done frequently in patients with episodes of fever revealed that bacteremia was one of the most important disease in terminal stage infection. In the blood cultures from the 22 patients various species of pathogenic microbes were recovered, and nine of which were fungi; five Candida albicans, three Candida tropicalis and one Candida parapsilosis. The major species of bacteria isolated from sputum were Staphylococcus aureus, including methicillin-resistant strain, and Gram-negative bacilli; P. aeruginasa, A. calcoaceticus, K. pneumoniae and E. cloacae, which are known to be frequently involved in hospital-acquired infections. However, S. pneumoniae and H. influenzae which were well known to be microbes of respiratory infections were rare. We concluded that we had to reveal the feature of terminal stage infection in order to reduce the fee for medical treatment and improve the QOL of patients with terminal stage lung cancer.

Bacteremia↗

PubMed1998

Cyfra 21-1 as a marker of lung cancer.

The utility of cytokeratin fragment (Cyfra) 21-1, a new tumor marker, was investigated in 100 patients with lung cancer. Sandwich enzyme immunoassay detected Cyfra 21-1 in the sera of 60% of patients. Sensitivity of this marker was especially high (86.4%) for squamous cell carcinoma, exceeding that of a similar marker, squamous cell carcinoma antigen (SCC, 54.5%). In contrast, sensitivity of Cyfra 21-1 was relatively low for adenocarcinoma (52.6%) and for small cell carcinoma (50%). We conclude that Cyfra 21-1 is of value in diagnosis of lung cancer, particularly squamous cell carcinoma.

Adult↗

PubMed1998

Risk factors for the prevalence of malnutrition among urban children in Ghana.

A case-control study was completed at the Princess Marie Louise Hospital in Accra, Ghana, to identify risk factors for the prevalence of underweight and severe malnutrition in urban African children. A total of 170 children, aged 8 to 36 mo, with normally nutritional status (> or = 80% W/A of NCHS reference), underweight (moderate malnutrition) (60-80% W/A), or severe malnutrition (< 80% W/A and presence of edema, or < 60% of W/A) were recruited at the clinical ward and at the public health service section of the hospital. Anthropometric measurements and physical examinations were completed, and the guardians were interviewed about their children's health status, birth weight, child care, and household conditions. The severely malnourished children were more likely to have young mothers (p < 0.05) and low weight at birth (p < 0.05). The underweight children were also observed to have low birth weight (p < 0.05). The severely malnourished group showed the tendencies of less feeding frequency (p < 0.01), less access to breast-feeding (p < 0.01), and less support by both parents (p < 0.05). Moreover, the parents of the severely malnourished children had lower educational levels and lower income jobs, compared with those of the normal children (mother's education, p < 0.001; father's education, p < 0.001; mother's occupation, p < 0.05; father's occupation, p < 0.001). No significant differences in most variables existed between the normal and underweight groups. Multivariable analysis resulted in the conclusion that the Z-score of weight-for-age, birth weight, and mother's educational level were highly associated with one another. We conclude that low birth weight is one of the important risk factors for the prevalence of underweight and severe malnutrition and that the lack of a mother's education is also a risk factor for the prevalence of severe malnutrition in the urban children in Ghana.

Adolescent↗

PubMed1998

Diagnostic features and therapeutic outcome of erosive and ulcerous endobronchial tuberculosis.

SETTING AND OBJECTIVE: Erosive and ulcerous endobronchial tuberculosis (EBTB) is distinct from pulmonary tuberculosis in some aspects. We evaluated the clinical features of 56 patients (26 males and 30 females) with EBTB to characterize the clinical features of the disease. RESULTS: The chief complaint in 70% of patients was intractable cough, particularly in those with tracheal tuberculosis. The predominant radiological features were patchy bi-apical infiltrates of variable intensity without cavitation; for six patients, however, plain radiographs revealed no abnormalities. The ulcerous lesions could be classified into three stages: active, healing and scarring. Furthermore, we divided scarring stage into two subtypes, polypoid and non-polypoid. Most of the patients were treated with isoniazid, rifampin, and streptomycin (SM) or ethambutol. Approximately one-third of the patients, not randomly selected, were treated with aerosolized SM and corticosteroids in addition to conventional oral therapy. CONCLUSION: EBTB involves typical clinical and radiographic features. In this uncontrolled series, it was our impression that the period of time to healing of ulcerous lesions seemed to be shorter in those treated with aerosol therapy including streptomycin and corticosteroids.

Adolescent↗

PubMed1998

[A study of sialylated carbohydrate antigen in patients with benign bronchopulmonary disease].

We studied the levels of carbohydrate antigen (CA 19-9, SLX, CA 50, Span-1, and Dupan-2) in serum, bronchoalveolar lavage fluid, and tissue from patients with benign bronchopulmonary disease. Patients had bronchiectasis, healed pulmonary tuberculosis, pulmonary fibrosis, or other diseases. Bronchoalveolar lavage fluid levels and immunohistochemical findings for lung tissue samples, in the absence of digestive and other diseases, suggested that elevated serum sialylated Lewis(A) (CA 19-9, CA 50, and Span-1) and Lewis(X) (SLX) antigen in patients with benign broncho-pulmonary disease are due to marked production of sialylated carbohydrate antigen in respiratory bronchioles. Common features of patients with benign bronchopulmonary disease include elevated serum carbohydrate antigen levels and bronchiectasis.

Aged↗

PubMed1997

Bactericidal activities of povidone-iodine against Mycobacterium.

Three standard strains of Mycobacterium (M. tuberculosis H37Rv, M. avium ATCC15769 and M. kansasii ATCC12478) and 15 clinical isolates of Mycobacterium (7 M. tuberculosis, 2 M. avium, 3 M. kansasii, 1 M. intracellulare, 1 M. chelonae subsp. abscessus and 1 M. gordonae) were selected in order to study the bactericidal activities of povidone-iodine (PVP-I) drug substance and a commercially available PVP-I solution (Isodine solution) against Mycobacterium. After the bacilli had been exposed to the disinfectant solution at concentrations of 0.1 or 0.02% with 2% human serum for various incubation periods from 30 to 120 s, the PVP-I drug substance was inactivated by addition of 0.5% sodium thiosulfate. In the case of the commercially available PVP-I solution, a mixture of 10% Tween 80, 3% soybean lecithin and 0.5% sodium thiosulfate was used as inactivator. It was demonstrated that the 3 standard strains were completely inactivated within 30 s by 0.1% PVP-I drug substance and that the 15 clinical isolates were almost killed by 0.1% commercially available PVP-I solution within 60 s. As a result, the commercially available PVP-I product appeared to be a useful agent as disinfectant against all the tested species of Mycobacterium.

Anti-Infective Agents, Local↗

PubMed1996

[Effect of macrolides on cytokine mRNA expression in human whole blood model].

Recently, low dose and long term use of Macrolides (Mls) has been reported to be effective in treatment of chronic lower respiratory tract infections, however its mechanism is still obscure. We evaluated the effect of Mls (EM, AZM, RKM) on cytokine mRNA expressions. We preincubated the whole blood with several concentrations of Mls and removed the Mls and then stimulated human whole blood with LPS as an experimental vivo model. In order to examine cytokine mRNA expressions, we used the RT-PCR method. Cytokine mRNA expressions were suppressed significantly (p < 0.05) by pretreatment with EM, AZM; moreover, the suppression was peaked at low concentrations (0.04 approximately 0.2 microgram/ml). Although, Cytokine mRNA expressions were not suppressed by pretreatment with RKM. These results suggest that EM, AZM have suppression on Cytokine mRNA expressions, and consequently, this suppression has a reasonable effect for DPB patients.

Anti-Bacterial Agents↗

PubMed1995

Purification and characterization of a non-hemorrhagic metalloprotease from Agkistrodon halys brevicaudus venom.

A non-hemorrhagic metalloprotease (protease L4) was purified from the venom of Chinese Mamushi (Agkistrodon halys brevicaudus) by gel filtration and anion-exchange chromatography. Protease L4 has the molecular weight of 22,000 and its optimum pH was 8.5. The protein was stable in the pH range of 5-9 and below 40 degrees C. The proteolytic activity was inhibited by metal-chelating agents and some metal ions. Calcium ion activated the activity dose-dependently, but had only a minor effect on the thermal and pH stability. L4 showed fibrinogenase activity, hydrolyzing only the A alpha chain of fibrinogen. The protease cleaved preferentially at the N-terminal of Leu and His residues of some peptides.

Agkistrodon↗

PubMed1995

Production of granulocyte colony-stimulating factor by malignant mesothelioma.

We present the case of a male patient, aged 45 yrs, with malignant mesothelioma producing granulocyte colony-stimulating factor (G-CSF). The diagnosis was established by histopathological examination of the autopsied pleural tissues. Production of G-CSF was confirmed by immunoperoxidase staining, using a specific monoclonal antibody against recombinant G-CSF (rhG-CSF).

Granulocyte Colony-Stimulating Factor↗

PubMed1995

Hormone receptors in pulmonary lymphangiomyomatosis.

Biochemical assays have demonstrated the existence of hormone receptors in lung tissue from patients with pulmonary lymphangiomyomatosis (LAM). This finding is the biologic corollary to the finding that LAM responds to hormonal therapy. We have examined lung tissue from two patients with LAM for estrogen and progesterone receptors by immunohistochemistry and a biochemical assay. Although specimens from both patients were negative for estrogen receptor activity by the biochemical assay, positive stain of estrogen receptors was observed in both patients with immunohistochemistry.

Adult↗

PubMed1995

[Microorganisms cultured from sputum and blood in association with episodes of fever during anti-cancer therapy in patients with lung cancer].

We examined the clinical features and significance of pathogenic microbes isolated from sputum and blood of patients with lung cancer during anti-cancer therapy. Pathogenic bacteria were more likely to be isolated from patients with episodes of fever than from afebrile patients. The major species of bacteria isolated from sputum were Staphylococcus aureus, including methicillin-resistant strains, and Gram-negative bacilli, which are known to be frequently involved in hospital-acquired infections. The presence of an indwelling central venous catheter for intravenous hyperalimentation was an important risk factor for the development of a febrile episode, which indicates that bacteremia was a major cause of fever. In one quarter of the blood cultures from the patients with persistent fever, various species of pathogenic microbes were recovered, one-third of which were fungi. Bacteriological examinations done before and after the introduction of granulocyte-colony stimulating factor (G-CSF) revealed that strains of Klebsiella spp. decreased and those of methicillin-resistant S. aureus increased. There was no firm evidence that G-CSF decreased the incidence of episodes of fever. However, remains G-CSF may a allow the dose intensity of anti-cancer agents to be increased, which would lead to severe leukocytopenia. However, more detailed investigation is needed to clarify the role of G-CSF against bacterial infection during anti-cancer therapy.

Aged↗

PubMed1994

Endoscopic classification of tracheobronchial tuberculosis with healing processes.

We established an endoscopic classification of tracheobronchial tuberculosis with healing processes. According to this classification, the period of time needed for healing was found to be shorter in patients who were treated by aerosolized streptomycin than in those treated with the conventional triple-drug oral regimen.

Aerosols↗

PubMed1994

Observations on aflatoxins and the liver status of Ghanaian subjects.

To find out if the presumed intake of dietary aflatoxins (AFB1 and AFG1) has adverse effect on the liver of Ghanaians, the toxins were measured in serum, urine and faecal specimens obtained from a group of apparently healthy Ghanaian adults. Liver status of the subjects was monitored with serum alphafeto protein (AFP), alpha-l-antitrypsin (AAT) and direct: total bilirubin ratio. Aflatoxin G1, AFB1 and AFQ1, AFM1 (both metabolites of AFB1) were detected in one or more of the body specimens in 35% of the subjects (AFB1+ group). Sixty-five percent (26 out of 40) of the subjects had only AFG1 in their body specimens (AFB1- group). Serum levels of AFP (greater than 20.0 ng/ml, AAT (greater than 170.0 mg/dl) and direct: total bilirubin ratio (greater than 0.5) which indicate absence of predisposition to liver cancer in all the subjects but suggestive of liver inflammation were noted in both the AFB1+ and AFB1- subjects. The pattern of distribution of the aflatoxins in the subjects suggests that the suspected liver inflammation may involve other factors and may not only be due to the present intake levels of aflatoxins.

Adult↗

PubMed1994

[Evaluation of aerosol therapy of streptomycin for tracheobronchial tuberculosis].

The clinical features of tracheobronchial tuberculosis are distinct from those of pulmonary tuberculosis in some aspects. Streptomycin (SM) is claimed by some investigators that it has a tendency to promote the development of bronchial stenosis. The purpose of the present investigation is to point out that aerosol therapy of SM is useful for patients with tracheobronchial tuberculosis. Prior to clinical application of the inhalation therapy, we confirmed that the therapy was not harmful. Serum concentration of SM, when inhaled, was measured in 9 volunteers. Before and after administration of SM aerosol, spirograms were examined in 4 volunteers, and no special abnormality was recognized. It seemed that serum concentration of SM after the administration was too low to evoke adverse reactions (less than 3.0 gamma). In 6 patients, blood gases were measured, and no obvious change was observed. In 41 patients with bronchial tuberculosis, bronchofiberscopic examinations were performed twice or more. We observed the ulcerous lesions of bronchial tuberculosis at various stages of healing, and could classify the ulcerous lesions into the following three stages. Active Stage: stage A; ulcer formation without regenerating epithelium, Healing Stage: stage H; ulcer formation with regenerating epithelium, Scarring Stage: stage S; and no ulcer formation. Only the lesions of stage A were observed before treatment. In many patients during the first and second month of treatment, the lesions were at stage A or H. It was found that healing of the lesions of tracheobronchial tuberculosis progressed through the stages A, H, and S, in this order.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗

PubMed1994

[A case of sarcoidosis presenting with hoarseness and dysphagia due to glossopharyngeal and vagus nerve paresis].

The patient was a 20-year-old female who complained of hoarseness and dysphagia. Chest X-ray showed bilateral hilar lymphadenopathy. Sarcoidosis was diagnosed histologically on the basis of granuloma without necrosis, by transbronchial lung biopsy (TBLB). Bronchofiberscopic findings revealed no granuloma of the vocal cords. Examination of the central nervous system with MRI identified no abnormalities. Hoarseness and dysphagia were thought to have been caused by glossopharyngeal and vagus nerve paresis. These signs improved markedly after two weeks of steroid therapy. This is a rare case of sarcoidosis associated with glossopharyngeal & vagus nerve paresis.

Adult↗

PubMed1993

Clinical studies of oral quinolone once daily in the treatment of lower respiratory tract infections.

The efficacy and safety of oral ofloxacin, 400 mg once daily, for the treatment of patients with lower respiratory tract infections were studied. The most common species recovered from the sputum specimens of these patients were Haemophilus influenzae, followed by Streptococcus pneumoniae (S. pneumoniae), Staphylococcus aureus (S. aureus), Gram positive cocci unidentified, Pseudomonas aeruginosa (P. aeruginosa), Morexella catarrhalis, Streptococcus epidermidis, and another Haemophilus species in this order. All these bacteria were susceptible to ofloxacin except for one strain of methicillin resistant S. aureus. A satisfactory clinical outcome was achieved in 34 of 40 patients (85%). It is concluded that ofloxacin, 400 mg once daily, is useful for patients with respiratory tract infections.

Administration, Oral↗