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Toyomitsu Sawai

Publications and source records attributed to Toyomitsu Sawai.

11 recordsLinked to original sources

A case of Mycobacterium nonchromogenicum pulmonary infection showing multiple nodular shadows in an immunocompetent patient.

Mycobacterium nonchromogenicum is generally considered nonpathogenic. However, M. nonchromogenicum rarely causes human disease; particularly, pulmonary disease is extremely rare. The common finding of M. nonchromogenicum pulmonary infection on chest X-ray is a solitary cavity. The present report describes an unusual case of M. nonchromogenicum primary pulmonary infection showing multiple nodular shadows.

Adult↗

Tubular adenocarcinoma of the thymus: case report and review of the literature.

Primary carcinomas of the thymus are rare. A variety of histologic patterns have been reported, and the most common are squamous cell carcinoma, lymphoepithelioma like carcinoma, and basaloid carcinoma. Adenocarcinomas of the thymus are extremely rare. As determined from a literature search, a pure tubular adenocarcinoma has never been previously described, and thus, this is first case report of tubular adenocarcinoma of the thymus. A combined resection of the superior vena cava and pericardium was performed. Immunohistochemically, the tumor cells were positive for CD5.

Adenocarcinoma↗

[A case of systemic sarcoidosis diagnosed initially by tonsillar biopsy, with discontinuous nodules in a straight line in the subcutaneous tissue of the upper arm].

A 31-year-old woman was admitted due to swollen cervical lymph nodes and swollen tonsils. These did not respond to treatment by antibiotics, and histological findings of epithelioid cell granulomas were obtained by tonsillar biopsy. After corticosteroid therapy in the subcutaneous tissue of the upper arm 5 nodules were found discontinuously in a straight line. A biopsy of one of these nodules revealed non-caseous epithelioid cell granuloma with Langhans giant cells in the superficial lymph nodes. Her older brother was strongly suspected to have neurogenic sarcoidosis. Familial sarcoidosis was considered related to this case.

Adult↗

[A case of brain metastasis discovered after surgery for lung cancer based on changes in CEA, in which long-term survival was obtained by repeated gammaknife irradiation].

A 58-year-old man underwent right lower lobectomy for lung adenocarcinoma in June 1998. Since a high level of tumor marker CEA persisted after surgery, chemotherapy was additionally performed, and the CEA level subsequently normalized. However, the CEA level increased in April 1999, and brain metastasis was found in the left occipital lobe, and the first gammaknife irradiation was performed. Multiple brain metastases were found when CEA increased again in August 1999, and the second gammaknife irradiation was performed. Moreover, brain metastases were found in the left frontal and occipital lobes in February 2000, and the third gammaknife irradiation was performed. CEA normalized thereafter, but increased in February 2001. Brain metastasis was found in the right occipital lobe, and the fourth gammaknife irradiation was performed. CEA has remained within the normal range for about 4 years thereafter. Long-term survival was possible by repeated gammaknife irradiation for brain metastases. Monitoring of CEA played an important role in finding recurrent brain metastasis in this patient.

Adenocarcinoma↗

[Clinical evaluation of transbronchial needle aspiration for histological specimens].

Specimens were obtained from 10 patients with radiological abnormalities involving mediastinal or hilar areas, for histological examination using 19 G transbronchial needle aspiration (TBNA). The tissues examined proved diagnostic in 6 patients (60%) including one with a benign condition (sarcoidosis). Clinical characteristics (sex, age, puncture site, number of specimens, size of radiological abnormalities) in the 6 positive patients were compared with those for the 4 negative patients. No significant differences in the number of specimens or the size of radiological abnormalities were observed between groups. However, a punctured trachea was seen in significantly more cases in the negative group (3/4, 75%) than in the positive group (1/6, 17%; p<0.05). Few minor complications were encountered. The use of a 19 G TBNA appears effective for obtaining tissue for histological examination and diagnosis of benign conditions. Training in this technique should increase the diagnostic utility of the histology needle.

Adult↗

[Thoracic actinomycosis: clinical, radiological, and pathological findings in 11 cases].

Most cases of thoracic actinomycosis (TA) have been surgically diagnosed and treated, since it is difficult to distinguish this condition from lung cancer. To clarify the features that are useful for the radiological diagnosis of TA, we analyzed the correlation between the radiological and pathological findings. TA was histologically diagnosed in the 11 patients of the present study, who were admitted to our hospital between 1976 and 2001. In the chest CT, consolidation was observed in 5 cases, a mass-like shadow in 4, a central low attenuation area (LAA) in 7, and bronchial and bronchiolar dilatation in 6. In the pathological findings, all cases showed bronchial dilatation and abscess formation in the bronchi, as well as peribronchial granulation. The evaluation of radiological and pathological correlation revealed that the central LAA in the chest CT corresponded to the abscess formation composing of actinomyces, and the cavity corresponded to the bronchial dilatation. These results suggest that radiological findings, such as LAA and bronchial and bronchiolar dilatation, are characteristic for TA, and can be useful in making a diagnosis of TA.

Actinomycosis↗

Effect of clarithromycin on chronic respiratory infection caused by Pseudomonas aeruginosa with biofilm formation in an experimental murine model.

Fourteen-membered macrolides (e.g. clarithromycin and erythromycin), but not 16-membered macrolides (e.g. josamycin), are effective in diffuse panbronchiolitis. However, there are no studies that have compared the effects of 14- and 16-membered macrolide antibiotics on biofilm formation. Treatment with high-dose clarithromycin (100 mg/kg) resulted in a significant decrease in the number of viable bacteria in an experimental murine model. Josamycin at a dose of up to 100 mg/kg had no effect on the number of viable bacteria in the lung. Our results may explain, at least in part, the clinical efficacy of 14-membered macrolide antibiotics in patients with chronic pneumonia caused by Pseudomonas aeruginosa.

Animals↗

Efficacy of linezolid against methicillin-resistant or vancomycin-insensitive Staphylococcus aureus in a model of hematogenous pulmonary infection.

We investigated the activities of linezolid, vancomycin, and teicoplanin in a murine model of hematogenous pulmonary infection with Staphylococcus aureus. Our results demonstrate that linezolid clearly reduced bacterial numbers in the methicillin-resistant S. aureus hematogenous infection model and significantly improved the survival rate of immunocompromised mice infected with vancomycin-insensitive S. aureus compared with vancomycin and teicoplanin. The pharmacokinetic profiles also reflected the effectiveness of linezolid.

Acetamides↗

Mycobacterium avium complex pleuritis.

Non-tuberculous mycobacterium infection is rarely accompanied by pleural involvement. We report a very rare case of Mycobacterium avium-intracellurare complex (MAC) pleuritis with massive pleural effusion. The patient was a non-compromised 67-year-old female and had been treated for pulmonary non-tuberculous mycobacterium infection. She was admitted to hospital because of general malaise, low-grade fever and right pleural effusion. Cytological examination of the effusion did not show malignant cells. MAC was only identified by culture and PCR. No other bacteria were detected. Complete resolution of the pleural effusion occurred after administration of anti-tubercular agents (isoniazid, rifampin, ethambutol) and clarithromycin.

Aged↗

Pulmonary nocardiosis with bilateral diffuse granular lung shadows in a patient with subcutaneous panniculitic T-cell lymphoma.

A 40-year-old woman undergoing prednisolone and cyclosporine therapy for subcutaneous panniculitic T-cell lymphoma complained of a cough for a few weeks. A chest X-ray revealed bilateral diffuse granular shadows. Additionally, the patient was discovered to have multiple subcutaneous abscesses. Gram-stained smears of sputum and pus from the abscess showing branched gram-positive rods led to a diagnosis of pulmonary nocardiosis with dissemination to the lungs and subcutaneous tissues. Combination therapy consisting of sulfamethoxazole/trimethoprim and panipenem/betamipron produced rapid improvement of radiographic abnormalities. It is suggested that pulmonary nocardiosis should be considered in the differential diagnosis of diffuse granular shadows on chest X-rays, especially in immunocompromised patients.

Adult↗