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Biomedical subjects

Y Hitsuda

Publications and source records attributed to Y Hitsuda.

18 recordsLinked to original sources
PubMed2003

Measuring subepithelial thickness using endobronchial ultrasonography in a patient with asthma: a case report.

The chronic inflammation of bronchial asthma is characterized by swelling of the subepithelial mucosa. However, it is difficult to assess subepithelial edema clinically. We report the case of a patient with asthma whose subepithelial edema was evaluated by endobronchial ultrasonography. Receiving montelukast 10 mg/day for 2 weeks, a 42-year-old man with mild, persistent asthma had his symptoms controlled by beta2-inhalation alone. Pretreatment endobronchial ultrasonography revealed subepithelial thickening in the right main stem bronchus, with a low absorption area suggestive of edema. Two weeks of montelukast therapy diminished the amount of subepithelial edema. Endobronchial ultrasonography is a promising technique for determining subepithelial edema in the asthmatic airway.

Adult↗
PubMed2001

[Lung cancer metastasis to the gingiva].

A 70-year-old man was referred to our hospital complaining of left gingival tumors with bleeding, halitosis and impediments to eating and speaking. Tumors were also found in both lungs, the stomach, the intestines and the right adrenal gland. Biopsies of the gingiva and the stomach pointed to undifferentiated carcinoma. Although the patient was treated with carboplatin plus 5-fluorouracil, the gingival tumors did not change in size. Subsequently, the gingival tumors were irradiated with a total dose of 39 Gy, and disappeared completely. The patient died 78 days later of hemorrhage of the digestive tract. Postmortem examination revealed that the primary tumor was in the left lung. Nineteen cases of lung cancer metastatic to the gingiva have been reported. The prognosis in all was very poor, and the QOL was compromised. However, several cases have improved with therapy to the gingiva. We believe that initial therapy should be directed at metastatic gingival tumors of the lung.

Adenocarcinoma↗
PubMed2001

[A case of advanced non-small-cell lung cancer responding remarkably to weekly chemotherapy with paclitaxel].

We report a case of advanced non-small-cell lung cancer showing remarkable response to weekly administration of paclitaxel. The patient was a 63-year-old man who had IIIB advanced lung adenocarcinoma. Though he received one course of cisplatin and etoposide, the tumor was not reduced. In addition, because of his nauseous response, he no longer wanted to receive that chemotherapy. The chemotherapy regimen was therefore changed to weekly administration of vinorelbine, but this was not effective. Next, after changing the regimen to the weekly administration of paclitaxel, the tumor was remarkably reduced following 3 courses. This case shows that weekly administration of paclitaxel may be an effective chemotherapy for non-small cell lung cancer not responsive to first-line chemotherapy.

Adenocarcinoma↗
PubMed2000

[A study of the minimum number of slices required for quantification of pulmonary emphysema by computed tomography].

We attempted to determine the minimum number of slices required for quantification of overall emphysema by computed tomography (CT). Forty-nine patients underwent CT scanning with a 15-mm slice interval, and 13 to 18 slices per patient were obtained. The percentage of low attenuation area (LAA%) per slice was measured with a method that we reported on previously, utilizing a CT program and NIH image. The average LAA% values for 1, 2, 3, and 6 slices evenly spaced through the lungs [LAA% (1), LAA% (2), LAA% (3), and LAA% (6)] were compared with those for all slices [LAA% (All)]. The correlation coefficients for LAA% (1), LAA% (2), LAA% (3), and LAA% (6) with LAA% (All) were 0.961, 0.981, 0.993, and 0.997, respectively. Mean differences +/- SD were -3.20 +/- 4.21%, -2.32 +/- 3.00, -0.20 +/- 1.84, and -0.16 +/- 1.26, respectively. From these results, we concluded that overall emphysema can be quantified by using at least three slices: one each of the upper, middle, and lower lung.

Adult↗
PubMed2000

[The value of serum C-reactive protein as a survival determinant in patients with advanced non-small-cell lung cancer].

We retrospectively reviewed the information in our data base concerning 127 patients with advanced non-small-cell lung cancer. Seventeen pretreatment clinical variables including serum C-reactive protein (CRP) were analyzed to determine the factors related to survival using Cox's proportional hazards model. Univariate analysis revealed that eleven explanatory variables were significant. In multivariate statistical technique for those variables, six were selected as significant factors. The highest hazard ratio was observed in the serum CRP (3.82). The other factors were therapy (2.52), serum lactate dehydrogenase (2.41), serum total protein (2.20), white blood cell counts (1.98) and performance status (1.80). Median survival times estimated by the Kaplan-Meier procedures in patients with normal CRP (CRP < 0.2 mg/dl) and high positive CRP (CRP > or = 3.0 mg/dl) were 24.9 months and 3.7 months, respectively. These results suggest that serum CRP is an independent survival determinant in advanced non-small-cell lung cancer.

Adult↗
PubMed1999

Functional assay of NF-kappaB translocation into nuclei by laser scanning cytometry: inhibitory effect by dexamethasone or theophylline.

Nuclear factor-kappa B (NF-kappaB)/Rel transcription factors play an important role in the inducible regulation of a variety of cytokine genes in epithelial cells. We assessed accumulation of fluorescence-stained NF-kappaB into propidium iodide-stained nuclei using laser scanning cytometry. "Activity-specific" antibodies to the Rel A (p65) and NF-kappaB1 (p50) subunits of NF-kappaB were detected in the nuclei of A549 cells (an immortalized human type II alveolar epithelial cell line). Exposure to TNF-alpha caused p65 and p50 to translocate into nuclei in a dose- and time-dependent manner. Preincubation with dexamethasone for 24 h or 30 min, or with theophylline for 30 min before TNF-alpha stimulation attenuated the nuclear translocation of Rel A and p50. These findings suggest that theophylline, as well as dexamethasone, may inhibit translocation of NF-kappaB.

Antineoplastic Agents, Hormonal↗
PubMed1999

[Relationship between cancer chemotherapeutic drug-induced delayed emesis and plasma levels of substance P in two patients with small cell lung cancer].

We investigated the relationship between delayed emesis caused by cisplatin (CDDP) based chemotherapy and plasma levels of serotonin, 5-hydroxy-indoleacetic acid (5-HIAA), and substance P in two patients with small cell lung cancer. In each of the cases, we used the 5-HT3 receptor antagonist ramosetron every morning on day 1-4 of the chemotherapy. In case 1, plasma levels of serotonin were low, whereas substance P levels increased since 24 hours after the injection of CDDP. The increase in substance P levels paralleled the onset of vomiting. In this case, however, substance P levels decreased and yet vomiting occurred. Similarly, in case 2, plasma levels of serotonin were low, whereas substance P levels increased since 24 hours. The increase in plasma levels of substance P and the onset of vomiting were observed at the same time 2-3 days after cisplatin administration. In this case, however, vomiting was not observed during the 5 days when the substance P was highest. Therefore, we suggested that substance P was closely associated with CDDP-induced delayed emesis, though some chemical mediators other than substance P might also be related to the emesis.

Adult↗
PubMed1999

[Utilization of NIH image for quantification of emphysema by computed tomography].

The percentage of the low attenuation area (LAA%) is understood to be the most accurate index in quantifying emphysema by computed tomography (CT). To date, CT scanners with enhanced post-processing programs have been used for measurements of LAA%. In this study, we sought develop a method of LAA% determination using a conventional density mapping program for CTs and NIH Image, an image-analysis software package for personal computers. Our results for overall LAA%, together with the correlations between overall LAA% and pulmonary function tests, agreed well with the findings of earlier reports. In reproducibility trials utilizing our method interoperator error for LAA% was within +/- 2%. A phantom experiment indicated that there was little difference between LAA% values obtained by this method and the values obtained by direct CT measurements. Therefore, we concluded that this method is sufficiently reliable for clinical use and capable of facilitating LAA% measurements with CT scanners that are not equipped with enhanced post-processing software.

Aged↗
PubMed1997

[Primary pulmonary aspergilloma presenting as an isolated nodular shadow].

A 55-year-old man was admitted to our hospital because of an abnormal shadow at the right hilum on a chest radiograph. The chest radiograph and the chest CT scan showed a nodular showed in the right S6. There was no air-crescent sign in the shadow, but CT-guided percutaneous needle biopsy led to the diagnosis of pulmonary aspergillosis. Anti-fungal agents (miconazole, fluconazole, and itraconazole) were given but the patient's condition did not improve. Surgical resection was done and the postoperative course was uneventful. The resected lung had a bronchiectatic area with a fungus ball. Attempts to culture the fungus ball were not successful. Histologic examination revealed conidial heads characteristic of Aspergillus fumigatus. This case is interesting because the pulmonary aspergilloma appeared as an isolated nodular shadow. This might have been a case of primary pulmonary aspergilloma.

Aspergillosis↗
PubMed1997

Expression of adhesion molecules on mononuclear cells from individuals with stable atopic asthma.

Activated mononuclear cells (lymphocytes and monocytes) (MNCs) circulate in peripheral blood and accumulate in the airways of individuals with steady-state asthma. The expression of adhesion molecules on MNCs of 10 patients with steady-state atopic asthma and 10 non-atopic control subjects was measured by flow cytometry. The mean fluorescence intensity of CD23 (P = 0.0003), CD11a (P = 0.034), and very late antigen-4 (VLA-4) (P = 0.016) was increased on lymphocytes of asthmatic patients relative to those of controls. Although the expression of CD16 (P = 0.002) and CD23 (P = 0.002), which are associated with differentiation into macrophages, was increased on monocytes of patients relative to those of controls, monocyte expression of VLA-4 (P = 0.006) and sialyl Lewis x (P = 0.005) was reduced. The concentration of interleukin-4 (IL-4) in serum was significantly higher in asthmatic patients than in normal subjects (P = 0.023), and a significant correlation was apparent between the serum concentration of IL-4 and the expression of VLA-4 on lymphocytes (p = 0.71, P = 0.03) or on monocytes (p = -0.72, P = 0.03) in asthmatic patients. Results suggest that IL-4 may contribute to the priming of adhesion molecule expression on lymphocytes even in steady-state conditions in individuals with chronic allergic inflammation.

Adolescent↗
PubMed1995

[Chronic necrotizing pulmonary aspergillosis in a patient with chronic pulmonary emphysema].

A 67-year-old man with pulmonary emphysema was admitted to the hospital because of left back pain. Chest roentgenography revealed an infiltrate in the left upper lobe, with cavitation, Mycetoma-like shadows were seen in the cavities about 3 weeks later, and a test for the precipitating antibody to Aspergillus fumigatus was positive. Chronic necrotizing pulmonary aspergillosis (CNPA) was diagnosed, and fluconazole was given. A chest roentgenogram taken 4 weeks later showed resolution of both the mycetoma-like shadows and much of the infiltrate. Systemic immunosuppression was highly unlikely: the patient had not been undergoing corticosteroid therapy, and had no predisposing conditions, such as a chronic debilitating illness or diabetes mellitus. In that sense, this case is similar to another reported recently, in which CNPA was associated with chronic obstructive pulmonary disease in an immunocompentent patient.

Aged↗
PubMed1994

[Non-respiratory factors and pulmonary function tests].

Non-respiratory factors, especially circulating hormones, have been emphasized to contribute to circadian variations in pulmonary functions. Herein, these relationships are reviewed, along with data from my department. Cosinor summary of urinary adrenaline and noradrenaline excretion revealed that they were similar to that of PEFR and DLCO, respectively. The acrophase of serum triiodothyronine (T3) was at 10PM in asthmatics, suggesting that serum T3 may affect the increase in bronchial reactivity at night, because a previous study showed a significant positive correlation between the serum T3 concentration and the slope of airway conductance measured by methacholine inhalation tests. There was no significant difference between normal and asthmatic rhythms of plasma cortisol. In addition to circulating hormones, a number of non-respiratory factors have been assumed to collaborate in nocturnal exacerbation of asthma. However, the exact cause of circadian variations of pulmonary functions is far from understood. Further examinations are required in this field to establish the theoretical ground for the chronotherapy of asthma.

Catecholamines↗
PubMed1994

[A case of nodular type of muscular sarcoidosis with limitation of mandibular opening].

A 68-year-old woman who complained of limited mandibular opening and left buccal swelling was admitted to our department. Histological examination of muscle biopsy specimens from the left buccal region revealed noncaseating granulomas. MR examination showed diffuse swelling and high signal intensity of the left masticatory muscles on T1- and T2-weighted images. Palpable nodules were present in the muscles of the body and the limbs. The ACE value was high and the lung biopsy specimens showed non-caseating granulomas. From these findings, the patient was diagnosed as having nodular type of muscular sarcoidosis complicated by contracture of the left masticatory muscles. There are some previous reports of nodular type of muscular sarcoidosis with flexion contracture of the fingers. Therefore, contracture of the muscles is suggested to be an important cause of muscular dysfunction in the disease.

Aged↗
PubMed1987

[In vitro antibacterial activity and pharmacokinetics of ofloxacin in chronic respiratory tract infections].

Serum and sputum levels of ofloxacin (OFLX) were measured in 5 patients with chronic respiratory tract infections and were compared with antibacterial activity in vitro. Sputum OFLX levels higher than the MIC's against H. influenzae and K. pneumoniae were maintained during the period when daily oral administrations were continued. The MIC70 of OFLX against S. aureus was under 0.78 microgram/ml and the MIC70 of OFLX against P. aeruginosa was 1.56 micrograms/ml. The maximum OFLX levels in sputum were higher than these MIC's during the period when 200-300 mg X 2 times/day oral administrations were maintained. From these results, OFLX was considered to be effective and useful for the treatment of patients with chronic respiratory tract infections.

Anti-Bacterial Agents↗
PubMed1986

[Serum and sputum levels of cefotetan used in respiratory tract infections].

In 5 patients with respiratory tract infections, concentrations of cefotetan (CTT) in serum and sputum after 1 hour intravenous administration of 2 g of CTT to each patient were investigated, and following results were obtained. Serum levels of CTT The mean peak level of CTT was 232.0 +/- 16.2 micrograms/ml immediately after the 1 hour drip infusion, then declined gradually and was 48.0 +/- 8.8 micrograms/ml after 6 hours. Sputum levels of CTT Mean sputum levels of CTT were 2.15 +/- 0.19 micrograms/ml from 2 to 4 hours after the administration and 2.19 +/- 0.18 micrograms/ml from 4 to 6 hours. Clinical evaluation of CTT Clinical effects were excellent in 1 case, good in 3 cases and poor in 1 case. No side effects were observed.

Adult↗