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Biomedical subjects

Y Niki

Publications and source records attributed to Y Niki.

At least 73 records · Page 4Linked to original sources
PubMed1997

[A case of pulmonary zygomycosis caused by Cunninghamella bertholletiae].

Cunninghamella bertholletiae, a rare causative agent of human deep seated mycosis, has been reported with increased frequency in the Western countries, in recent years. We experienced a case of Cunninghamella bertholletiae pulmonary infection in a 63-year-old male with pulmonary fibrosis and mild diabetes mellitus. In spite of intensive anti-fungal chemotherapy following clinical diagnosis, he died of exacerbation of the underlying diseases. Postmortem examination showed Cunninghamella infection in the cavity of the lung and massive pulmonary fibrosis. There was no fungal invasion outside the cavity. This is the third report of Cunninghamella human infection in Japan.

Aged↗
PubMed1997

In vitro and in vivo antichlamydial activities of HSR-903, a new fluoroquinolone antibiotic.

The in vitro and in vivo antichlamydial activities of HSR-903 were investigated. The MICs of HSR-903 for different species of chlamydia were 0.016 to 0.063 microg/ml, which were superior to those of conventional fluoroquinolones. The therapeutic effect of HSR-903 in experimental mouse Chlamydia psittaci pneumonia was also excellent and almost equal to that of minocycline and superior to that of ofloxacin. These results indicate that HSR-903 may be useful in the treatment of respiratory infections caused by chlamydiae.

Animals↗
PubMed1997

In vitro and in vivo activities of AM-1155, a new fluoroquinolone, against Chlamydia spp.

The in vitro and in vivo activities of AM-1155, a new quinolone, against Chlamydia spp. were investigated. The MIC of AM-1155 for 10 standard strains of different Chlamydia spp. and 25 wild-type strains of Chlamydia pneumoniae isolated in Japan, which were morphologically different from clinical isolates from the United States, ranged from 0.063 to 0.125 microg/ml. Its activity was almost the same as those of sparfloxacin and tosufloxacin and was 4 and 16 times superior to those of levofloxacin and ciprofloxacin, respectively, but lower than those of clarithromycin and minocycline (range for each, 0.016 to 0.031 microg/ml). The minimal chlamydiacidal concentration of AM-1155 ranged from 0.063 to 0.125 microg/ml, while those of clarithromycin and minocycline ranged from 0.016 to 0.031 microg/ml and 0.016 to 0.063 microg/ml, respectively. The therapeutic effect of a 7-day course of AM-1155 at doses of 5 and 10 mg/kg of body weight administered orally twice daily to mice with experimental Chlamydia psittaci pneumonia was excellent, with a 100% survival rate at 21 days after infection. The efficacy was equal to those of clarithromycin and minocycline and higher than those of ciprofloxacin and ofloxacin.

Animals↗
PubMed1997

Intraorbital subperiosteal hematoma due to paranasal mucocele--case report.

A 68-year-old female was admitted with a rare intraorbital subperiosteal hematoma manifesting as sudden orbital pain, progressive blepharoptosis, and diplopia. Computed tomography showed a biconvex high density mass in the superomedial part of the left orbit, which was recognized to be a subperiosteal hematoma intraoperatively. The eroded orbital roof between the frontal sinus and orbit was a result of mechanical compression by the mucocele. Infection extending into the orbit was important in causing the hemorrhage.

Aged↗
PubMed1997

[Acute eosinophilic pneumonia induced by cigarette smoke].

An 18-year-old man was admitted to our hospital because of a dry cough and high fever of acute onset. A chest radiograph revealed diffuse bilateral infiltrates, mainly in peripheral lung zones. Laboratory data showed hypoxemia and leukocytosis, and no eosinophilia. The diagnosis was acute eosinophilic pneumonia, and was based on examination of a transbronchial lung biopsy specimen and on the clinical course. The patient was treated with a corticosteroid and responded quickly. We suspected that the disease was related to smoking because the patient had started smoking two days before the onset of the symptoms. Therefore, a challenge test was done in which the patient smoked cigarettes. By 15 hours after the challenge, he had become severely hypoxemic and by 21 hours after the challenge his pulmonary function had decreased. In this patient, smoking cigarettes appeared to have induced acute eosinophilic pneumonia.

Acute Disease↗
PubMed1997

[Levels of serum KL-6 in a patient with drug-induced pneumonitis].

We describe a 67-year-old man in who serum KL-6 levels were measured during drug-induced pneumonia. The patient was hospitalized, because of coughing, fever, and dyspnea on exertion after administration of Sho-saiko-to (herbal medicine). After he was hospitalized, his symptoms were relieved, and the infiltration shadow on chest X-ray films resolved, but after re-administration of Sho-saiko-to, fever and hypoxemia developed. The serum KL-6 level was again high one day after oral re-administration of the drug. However, the level of lactate dehydrogenase in serum was not high after the re-administration. After treatment with on oral steroid drug the serum KL-6 level decreased gradually, symptoms were relieved the previously high level of c-reactive protein in serum decreased, the previously high white blood cell count decreased, and radiographic findings returned to normal. The diagnosis of drug-induced pneumonia is difficult, because specific diagnostic measures have not been developed. In the present case the serum KL-6 level increased rapidly after re-administration of the drug, and therefore measurement of serum KL-6 level may be helpful in the diagnosis of drug-induced pneumonia.

Aged↗
PubMed1997

[A case of acute eosinophilic pneumonia due to Sho-saiko-to].

A 16-year-boy who had taken a common over-the-counter cold remedy containing Sho-saiko-to, presented with fever, severe cough, sputum and dyspena. Two days later, he was admitted because a negative density, pulmonary edema-like shadow was noted on chest X-ray. A diagnosis of drug-induced pneumonia was strongly suspected, because an arterial blood gas analysis showed severe hypoxemia and leukocytosis with eosinophilia, and the chest X-ray showed a diffuse negative density pulmonary edema like shadow bilaterally. The findings on microscopic examination of transbronchial lung biopsy specimens were compatible with eosinophilic pneumonia. The eosinophil percentage in the bronchoalveolar lavage fluid was high. The result of a lymphocyte-stimulation test was positive for Sho-saiko-to, and Sho-saiko-to-induced pneumonia was strongly suspected. The patient ceased taking the cold remedy, and prednisolone was given. The clinical symptoms, severe hypoxemia, and chest X-ray findings markedly improved. To the best of our knowledge, there have been no previous reports of acute eosinophilic pneumonia induced by Sho-saiko-to.

Acute Disease↗
PubMed1996

Continuous isolation and characterization of Chlamydia pneumoniae from a patient with diffuse panbronchiolitis.

We succeeded in isolating Chlamydia pneumoniae organisms continuously from a 70-year-old man who had received chemotherapeutic treatment with low dosages of erythromycin for five years to improve diffuse panbronchiolitis (DPB). He had two episodes of acute exacerbation of DPB and a total of six strains of C. pneumoniae were isolated at different stages during the past 13 months. The morphological properties and protein profiles of the elementary bodies of all the C. pneumoniae isolates were similar to each other. Interestingly, his serological response against C. pneumoniae in immunoblotting tests was differed between two episodes. The sera collected during the first episode reacted weakly to the major outer membrane protein (MOMP), whereas those collected during the second episode reacted strongly to the 60-kDa protein and weakly to MOMP. These facts suggest that the two different episodes occurred as a result of different mechanisms. Additionally, in spite of the low antibody titer by micro-immunofluorescence test in the second episode as compared with that of the first episode, the immune response against 60-kDa immunodominant protein increased markedly in the second episode, and we suspect that the second episode was due to an allergic reaction caused by this 60-kDa protein. These findings suggest that repeated or prolonged exposure to C. pneumoniae may be associated with acute exacerbations of chronic obstructive pulmonary disease, and that the patient should be noted as a possible source of C. pneumoniae infection.

Aged↗
PubMed1996

Evaluation of a direct fluorescent antibody assay for detection of Chlamydia pneumoniae.

We examined the utility of the direct immunofluorescent antibody test kit, IMAGEN (DAKO Diagnostic Co., Ltd.). The stainability of inclusions and purified elementary bodies (EBs) of all the Chlamydia pneumoniae strains used in this study was highly specific. Immunoelectron microscopy and light microscopy of stained EBs revealed the target antigen of IMAGEN to be located on the surface of the EB outer membrane. In a clinical study, we tested oropharyngeal swab specimens obtained from 41 patients (45 specimens). The results were compared with those obtained by isolation in cell culture, the indirect immunofluorescent antibody (IFA) assay and serum antibody titration. C. pneumoniae was isolated from six specimens (13.3%), and the organisms were detected in 11 specimens (24.4%) with IMAGEN and nine specimens (20%) with IFA. A diagnosis of C. pneumoniae infection was made in six patients (13.3%) by the serological examination. Six specimens positive in isolation were positive in the IMAGEN but there were three cases which seemed to be false-positive by the IMAGEN. We conclude that the use of IMAGEN is an easy, rapid and sensitive method for detecting C. pneumoniae when there is a large amount of chlamydial antigen in the clinical specimen and when identification of the chlamydial species forming inclusions in cell cultures is required.

Adult↗
PubMed1996

[A case of Legionella micdadei pneumonia].

A 60-year-old male with type C chronic hepatitis was admitted to Kibikogen Rehabilitation Center with high fever, cough and general fatigue. Chest X-ray film on admission showed consolidation in the left middle and lower lung lung field. Initial treatment with intravenous ceftazidime, imipenem/cilastatin and clindamycin were ineffective due to continuous high fever and cough and spread of the pneumonia shadow. Administration of minocycline was started for suspected non-bacterial pneumonia whereupon his symptoms improved and the pneumonia shadow began to decrease in size. However, his symptoms and pneumonia shadow worsened after taking him off of minocycline due to progressive pancytopenia and liver dysfunction. He was transferred to our hospital and intravenous erythromycin treatment was initiated for suspected Legionell pneumonia because of the elevation of Legionella micdadei serum antibody titer. Immediately after starting treatment, his symptoms improved and the pneumonia shadow decreased in size. Erythromycin was stopped after the 14th day of administration. In this case, diagnosis of L. micdadei pneumonia was made because of the positive results of the polymerase chain reaction test and elevation of the L. micdadei serum antibody titer (from 0 to 1,024). This is the second report of a L. micdadei pneumonia case here in Japan.

Antibodies, Bacterial↗
PubMed1996

[An adult case of pneumonia due to Mycoplasma pneumoniae and Chlamydia psittaci].

A 18-year-old male was admitted to another hospital complaining of his chest X-ray. After transfer to our hospital, increased serum antibody titers to simultaneous M. pneumoniae and C. psittaci were noted. These antibody titers decreased after about four months. Positive results for M. pneumoniae was obtained by Polymerase chain reaction in the right pleural effusion. Based on these findings, this case was diagnosed as M. pneumoniae and C. psittaci pneumonia. A transbronchial lung biopsy and a bronchial biopsy revealed rare histological findings, including histiocytic intra-alveolar pneumonia with palisaded granuloma and small foci of necrosis in the left upper lobe and eosinophilic bronchitis in the right middle bronchus. His chest X-ray and chest CT showed a nodular shadow, obstructive pneumonia and pleural effusion which are rare in M. pneumoniae and C., psittaci pneumonia.

Adolescent↗
PubMed1996

[Detection of lesions in bone marrow for the diagnosis of miliary tuberculosis: reliability of bone marrow aspiration and biopsy in view of distribution pattern of lesions in autopsy cases].

The usefulness of the serial section method was investigated in four bone marrow aspirates, four biopsies and nine autopsy specimens obtained from patients with miliary tuberculosis who were admitted to our hospital between 1974 and 1994. In original sections, granulomas consistent with tuberculosis were found in two out of four aspirate specimens (50%) but in none of the four bone marrow biopsies. By using serially out sections, however, granulomas were detected in two more aspirate specimens and two biopsies which were negative in original sections. Consequently four of four aspirates (100%) and two of four biopsies ((50%) became positive. In addition, the distribution of granulomas was investigated using vertebral bone marrows obtained from 12 autopsy cases. We divided the vertebral bone marrows obtained from 12 autopsy cases. We divided the vertebra into the peripheral and central portions. Granulomas were more frequently found in the peripheral portions than in the central. The higher detection rate of granulomas in the peripheral bone marrow when the biopsy and aspiration needles easily reach, suggests that bone marrow aspiration and/or biopsy would be a useful procedure for the diagnosis miliary tuberculosis. Therefore if serial sections were utilized for such samples in the miliary tuberculosis patients, the detection rate is expected to became much higher.

Aged↗
PubMed1996

Evaluation of the sensitivity and specificity of a ligase chain reaction test kit for the detection of Chlamydia trachomatis.

The sensitivity and specificity of a newly developed ligase chain reaction (LCR) test kit were examined by the use of highly purified elementary bodies (EBs) and in situ inclusions containing reticulate bodies only. The performance of the LCR kit was compared with a commercially available polymerase chain reaction (PCR) test kit, AMPLICOR Chlamydia trachomatis. The number of EBs and inclusions of C trachomatis, respectively, at the detection limit of both kits were two EBs and one inclusion per assay. Neither kit cross-reacted with C pneumoniae, C psittaci and C pecorum EBs or reticulate bodies.

Chlamydia trachomatis↗
PubMed1996

Recurrence of sarcoidosis following interferon alpha therapy for chronic hepatitis C.

We report a 67-year-old male patient with a known history of sarcoidosis in remission who had recurrent sarcoidosis following a five-month administration of interferon alpha (IFN-alpha) for chronic hepatitis C. He developed bilateral swelling of the parotid glands and bilateral diffuse reticulonodular pulmonary parenchymal opacities on chest roentgenograms. Serum angiotensin converting enzyme (ACE) levels and soluble IL-2 receptor levels were high and a transbronchial lung biopsy revealed noncaseating granulomas. The abnormalities on both laboratory data and chest roentgenograms were resolved after administration of oral prednisolone.

Aged↗
PubMed1996

[Four cases of pulmonary tuberculosis resembling pulmonary abscess with a so-called niveau-like shadow in a medical school hospital: discussion concerning the formation mechanism of niveau-like shadows].

Four cases of pulmonary tuberculosis resembling pulmonary abscess radiographically were reviewed from their clinical features, chest X-ray and chest CT, and the mechanism of formation of so-called niveau-like shadows was discussed. Only one case showed a newly formed tuberculous cavity with air fluid level on chest X-ray, however, even in this case, the possibility of the infection with tubercle bacilli of an emphysematous bulla of the lung could not be completely excluded as several bulla were found on chest CT. The remaining three cases showed a slightly different mechanism of the formation of niveau-like shadows. Namely, mycobacterium tuberculosis spread into an existed bulla and a tubercle bacilli infected bulla was formed. Regarding the clinical features, no remarkable findings were detected and we could find no differences with common tuberculosis. Based on these experiences, the presence of pulmonary tuberculosis resembling the shadow of pulmonary abscess should be emphasized.

Aged↗
PubMed1996

[Posterior fossa dural arteriovenous fistula with progressive disorder of cerebellar circulation; case report].

A rare case of posterior fossa dural arteriovenous fistula with cerebellar circulation disorder is reported. A 64-year-old male was admitted to a hospital with complaints of nausea, vertigo and mild headache. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed cerebellar infarction. Then, he was sent to our hospital. He had complaints of cerebellar signs and nystagmus. Cerebral angiography showed dural AVF of the posterior fossa and occlusion of the left transverse-sigmoid sinuses. Because his condition deteriorated, embolization of the left middle meningeal artery, ascending pharyngeal artery and occipital artery was performed selectively on August 18. Subsequently, isolation of dural AVF was performed on August 19. After the operation he improved and was able to walk with a stick. Controlled angiography revealed the disappearance of dural AVF. This case suggested that AV shunt is essential for the progression of venous infarction.

Arteriovenous Fistula↗