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Yoshihiro Honda

Publications and source records attributed to Yoshihiro Honda.

At least 19 recordsLinked to original sources
PubMed2006

Surgical repair of the common arterial trunk in a neonate with a downsized valve allograft.

In the present report we describe a neonate with the common arterial trunk who underwent reconstruction of the right ventricular outflow tract with a downsized value allograft. Our experience and results suggest that reducing the size of the allograft is a promising surgical option for young infants in whom reconstruction of the nonregurgitant pulmonary circulatory system is absolutely needed for a smooth postoperative recovery.

Child, Preschool↗
PubMed2006

Clinical predictors for the detection of community-acquired pneumonia in adults as a guide to ordering chest radiographs.

OBJECTIVE: To identify sensitive clinical predictors for the detection of community-acquired pneumonia in adults as a guide to when to order a CXR. METHODS: In total, 79 outpatients presenting with at least one of the following clinical features of pneumonia: fever, cough, sputum, chest pain, dyspnoea and coarse crackles and who underwent CXR to detect pneumonia were examined retrospectively. The relationship between these clinical features and the presence of pneumonia on CXR was determined. RESULTS: A total of 24 patients (30.4%) had radiological evidence of pneumonia. In total, 22 presented with four clinical signs: fever, cough, sputum and coarse crackles. The sensitivity and the specificity of detecting pneumonia based on these four clinical signs mentioned was 91.7% and 92.7%, respectively. CONCLUSIONS: As a diagnostic strategy, the ordering of CXR to confirm a diagnosis of community-acquired pneumonia in adults is recommended when patients have the following four clinical signs: fever, cough, sputum and coarse crackles.

Adolescent↗
PubMed2006

[Clinical effect of continuous infusion of meropenem on bacterial pneumonia in the elderly].

We studied the clinical effect of continuous infusion over 24 hours of meropenem (MEPM) on bacterial pneumonia in the elderly (over 65). The subjects were 26 patients (community-acquired pneumonia: moderate, n = 9; severe, n= 4; hospital-acquired pneumonia: group III, n = 13) whose performance status was 3 or 4. MEPM 1.0g/day was infused continuously for 7-14 days, and its clinical efficacy, bacteriological efficacy, and side effects were examined prospectively. It was effective in 23 of the 26 patients (community-acquired pneumonia: moderate, 8/9; severe, 3/4; hospital-acquired pneumonia: group III, 12/13; efficacy rate: 88.5%). Bactericidal effects were obtained in 3 strains of Klebsiella pneumoniae, 2 strains of Streptococcus pneumoniae, 2 strains of methicillin-sensitive Staphlococcus aureus, 1 strain of Streptococcus agalactiae and 1 strain of Proteus mirabilis, but not in 2 strains of methicillin-resistant S. aureus, 1 strain of Pseudomonas aeruginosa and 1 strain of Serratia marcescens. Mild abnormal laboratory findings were observed in 2 patients: elevation of GPT, gamma-GTP, BUN and elevation of ALP. Based on the above, continuous infusion of MEPM on bacterial pneumonia in the elderly obtained excellent clinical effects. Further study is needed to compare the efficacy of continuous versus intermittent administration of MEPM.

Aged↗
PubMed2005

Clinical effect of intravenous ciprofloxacin on hospital-acquired pneumonia.

The effect of intravenous ciprofloxacin (CPFX) on hospital-acquired pneumonia was examined. The subjects were 32 patients with hospital-acquired pneumonia classified as being in group I, group II, and group III, based on The Japanese Respiratory Society Guidelines for management of hospital-acquired pneumonia. None of the patients had received antibiotic treatment for the pneumonia. CPFX 300 mg was intravenously infused twice daily for 3-14 days, and its clinical effect, bacterological effect, and side effects were examined. Intravenous CPEX was clinically effective in 21 of the 32 patients, with an efficacy rate of 65.6%. With regard to bacteriological efficacy, 4 of 5 strains of methicillin-sensitive Staphylococcus aureus, 2 of 3 strains of Klebsiella pneumoniae, 1 of 2 strains of Streptococcus pneumoniae, 1 of 2 strains of Streptococcus agalactiae, 1 of 2 strains of Pseudomonas aeruginosa, 1 of 2 strains of Serratia marcescens, and the 1 strain of Klebsiella oxytoca were eradicated, with an eradication rate of 42.3% (11 of 26 strains whose fate was confirmed eradicated). Abnormal laboratory findings (side effects) were observed in 11 of the 32 patients (34.4%), but all side effects were mild. Based on the above data, intravenous CPFX may be the drug which should be recommended as the first choice for hospital-acquired pneumonia.

Aged↗
PubMed2005

Clinical effect of gatifloxacin, 200 mg daily, on bacterial community-acquired pneumonia in the elderly.

The clinical effect of gatifloxacin (GFLX) at 200 mg daily (half of common dosage) on bacterial community-acquired pneumonia in the elderly was examined. Subjects were 30 patients with bacterial community-acquired pneumonia aged 65 years or more (mild, 21 patients; moderate, 9 patients), and GFLX at 100 mg per dose was administered twice daily for 4-14 days. The results included clinical effectiveness in 21 of 21 mildly affected patients (efficacy rate, 100%), in 8 of 9 moderately affected patients (efficacy rate, 88.9%), and 29 of a total of 30 patients (efficacy rate, 96.7%). With regard to bacteriological effect, 28 of 29 strains were eradicated (eradication rate, 96.6%). Abnormal laboratory findings included mild elevations in GPT, GOT, and ALP in only 1 patient. Based on these findings, we concluded that administration of GFLX at 200 mg daily is recommended for bacterial community-acquired pneumonia in the elderly.

Aged↗
PubMed2005

[Q fever in acute exacerbation of chronic lower respiratory tract infection].

We studied the effect of Q fever in acute exacerbation of chronic lower respiratory tract infection. The subjects consisted of 80 cases with acute exacerbation of chronic lower respiratory tract infection treated during the period from March 2002 till October 2004. Q fever was diagnosed using a PanBio Coxiella burnetii ELISA test kit. Two cases (2.5%) were positive for IgM in the acute stage, and were diagnosed as having acute infection by C. burnetii. They were elderly women with bronchiectasis, aged 76 and 82. They had no history of keeping cats or dogs, but the onset of acute exacerbation of chronic lower respiratory tract infection was June and March which is the breeding seasons for cats and dogs. Acute exacerbation of chronic lower respiratory tract infection were considerd to be a mixed infection with Pseudomonas aeruginosa (the 76-year-case) and Haemophilus influenzae (the 82-year-case). It is concluded that C. burnetii can induce exacerbation of chronic lower respiratory tract infection, their cases were considerd to be mixed infection with C. burnetii and other bacteria.

Acute Disease↗
PubMed2004

[A case of pseudomembranous enterocolitis caused by methicillin-resistant Staphylococcus aureus].

A 47-year-old woman was hospitalized because of urinary-tract infection. She was treated with antibiotics for 6 days. However, severe watery diarrhea and pyrexia developed 6 days after stopping administration of antibiotics. Stool, throat and blood cultures were positive for methicillin-resistant Staphylococcus aureus (MRSA) and negative for Clostridium difficile DI toxin. In spite of administration of VCM, she died of septic shock. At autopsy, macroscopic observation revealed a pseudomembrane in the ileum. MRSA enterocolitis can occur in patients with antibiotic-related diarrhea, and physicians should be aware of its rapid clinical course and possible lethal outcome.

Cilastatin↗
PubMed2004

[Study of administration times and clinical efficacy of carbapenems in the treatment of moderate community-acquired bacterial pneumonia].

The half-lives of carbapenems are about 1 hour. It was expected that increasing the daily frequency of administration would improve the clinical effects. We therefore studied the clinical effects of increasing the daily administration frequency of meropenem in the treatment of community-acquired bacterial pneumonia. The subjects were patients with moderate community-acquired bacterial pneumonia who were aged less than 75 years. They were divided into a BID group (28 patients receiving 0.5 g morning and evening) and a TID group (27 patients receiving 0.25 g in the morning and about midday, and 0.5 g in the evening), and the clinical effects were reviewed prospectively. Clinical efficacy on the third day was 78.6% in the BID group and 85.2% in the TID group, and over-all clinical efficacy was 89.3% in the BID group and 88.9% in the TID group. Administration periods were 12.8 +/- 4.2 days in the BID group and 10.9 +/- 3.4 days in the TID group. These results show no statistically significant difference, and suggest that the excellent clinical effect of administration of MEPM 0.5 g twice a day on moderate community-acquired bacterial pneumonia is not improved by administration three times a day.

Adult↗
PubMed2004

[Clinical predictors for the detection of community-acquired pneumonia in adults as a guide to ordering chest radiographs].

We sought to identify sensitive clinical predictors for the detection of community-acquired pneumonia in adults as a guide to the ordering of chest radiographs. The subjects were 79 outpatients with at least one clinical sign of fever, cough, sputum, chest pain, dyspnea and coarse crackle who underwent radiography of the chest to detect pneumonia. The relationship between these clinical signs and the presence of pneumonia was examined. Twenty-four patients (30.4%) had pneumonia. Twenty-two of these had 4 clinical signs: fever, cough, sputum and coarse crackle. Altogether, twenty-six of the 79 patients had these 4 clinical signs, and of them, 22 had pneumonia. Between the 4 clinical signs and the presence of pneumonia, the sensitivity was 91.7% and the specificity was 92.7%. On the basis of the above, as a diagnostic strategy, the ordering of chest radiographs to detect community-acquired pneumonia in adults was recommended when patients showed the 4 clinical signs of fever, cough, sputum and coarse crackle.

Adolescent↗
PubMed2004

[Molecular pathogenesis in tuberculosis complicated with AIDS].

HIV-1 infection is a major cause of worldwide epidemic of tuberculosis. There is increasing clinical evidence that coinfection with M. tuberculosis accelerates progression of AIDS. We found that, in vivo, HIV-1 load and mutation increase in involved lung segments in patients with pulmonary tuberculosis. We also reported that Mycobacterium tuberculosis stimulates HIV-1 replication by enhancing transcription on the 5' LTR in a macrophage cell line, THP-1, in vitro. In contrast, HIV-1 replication is suppressed by M. tuberculosis infection of monocytes derived macrophages (MDM) or differentiated monocytic THP-1 cells. We observed that HIV-1 5' LTR function was repressed in PMA differentiated THP-1 cells after co-infection with M. tuberculosis. Point mutations in C/EBP beta binding domains of the HIV-1 LTR negative regulatory element (NRE) abolished promoter repression. Monocyte-derived macrophages and differentiated THP-1 cells increased expression of the 16kDa inhibitory form of C/EBP after M. tuberculosis co-infection. Bronchoalveolar lavage cells obtained from normal controls and alveolar macrophages from uninflamed lung of tuberculosis patients also expressed the 16kDa inhibitory form of C/EBP. However, alveolar macrophages from lung segments involved with pulmonary tuberculosis had markedly reduced C/EBP expression. These data suggest that 16kDa isoform of C/EBP plays an important role for the control of HIV-1 replication in macrophages. We propose derepression of HIV-1 LTR mediated transcription as one mechanism for enhanced HIV-1 replication observed in pulmonary tuberculosis. Since the cellular immune response in pulmonary tuberculosis requires lymphocyte/macrophage interaction, a model system was developed in which lymphocytes were added to AM. Contact between lymphocytes and AM reduced inhibitory C/EBP beta, activated NF-kappaB and enhanced HIV-1 replication. If contact between lymphocytes and macrophages was prevented, inhibitory C/EBP beta expression was maintained and the HIV-1 long terminal repeat (LTR) was not maximally stimulated although NF-kappaB was activated. Antibodies which cross-linked macrophage expressed B-7, VCAM and CD-40 were used mimic lymphocyte contact. Cross-linking antibodies abolished inhibitory C/EBP beta expression; however, the HIV-1 LTR was not maximally stimulated and NF-kappaB was not activated. Maximal HIV-1 LTR stimulation required both lymphocyte derived soluble factors and cross-linking of macrophage expressed co-stimulatory molecules. These results demonstrate that neither contact nor soluble factor(s) are sufficient to maximally enhance HIV-1 LTR activity in macrophages. Contact between activated lymphocytes and macrophages is necessary to downregulate inhibitory C/EBP beta, thereby derepressing the HIV-1 LTR. Lymphocyte derived soluble factor(s) activate NF-kappaB, further enhancing the HIV-1 LTR.

AIDS-Related Opportunistic Infections↗
PubMed2002

Maximal HIV-1 replication in alveolar macrophages during tuberculosis requires both lymphocyte contact and cytokines.

HIV-1 replication is markedly upregulated in alveolar macrophages (AM) during pulmonary tuberculosis (TB). This is associated with loss of an inhibitory CCAAT enhancer binding protein beta (C/EBPbeta) transcription factor and activation of nuclear factor (NF)-kappaB. Since the cellular immune response in pulmonary TB requires lymphocyte--macrophage interaction, a model system was developed in which lymphocytes were added to AM. Contact between lymphocytes and AM reduced inhibitory C/EBPbeta, activated NF-kappaB, and enhanced HIV-1 replication. If contact between lymphocytes and macrophages was prevented, inhibitory C/EBPbeta expression was maintained and the HIV-1 long terminal repeat (LTR) was not maximally stimulated although NF-kappaB was activated. Antibodies that cross-linked macrophage expressed B-7, and vascular cell adhesion molecule and CD40 were used to mimic lymphocyte contact. All three cross-linking antibodies were required to abolish inhibitory C/EBPbeta expression. However, the HIV-1 LTR was not maximally stimulated and NF-kappaB was not activated. Maximal HIV-1--LTR stimulation required both lymphocyte-derived soluble factors, and cross-linking of macrophage expressed costimulatory molecules. High level HIV-1--LTR stimulation was also achieved when IL-1beta, IL-6, and TNF-beta were added to macrophages with cross-linked costimulatory molecules. Contact between activated lymphocytes and macrophages is necessary to down-regulate inhibitory C/EBPbeta, thereby derepressing the HIV-1 LTR. Lymphocyte-derived cytokines activate NF-kappaB, further enhancing the HIV-1 LTR.

Blotting, Western↗
PubMed2002

Clarithromycin suppresses lipopolysaccharide-induced interleukin-8 production by human monocytes through AP-1 and NF-kappa B transcription factors.

Erythromycin and other macrolides are effective for the treatment of chronic inflammatory airway diseases such as diffuse panbronchiolitis (DPB) and chronic sinusitis. The effect of macrolides in DPB is suggested to be anti-inflammatory rather than antibacterial. We investigated the effects of clarithromycin on interleukin-8 (IL-8) production using human peripheral monocytes and the human monocytic leukaemia cell line, THP-1. Bacterial extracts from Escherichia coli, Pseudomonas aeruginosa and Helicobacter pylori, as well as E. coli-derived lipopolysaccharide (LPS), induced IL-8 production. Clarithromycin suppressed this production in a dose-dependent manner in both monocytes and THP-1 cells (49.3-75.0% inhibition at 10 mg/L). A luciferase reporter gene assay with plasmids containing a serially deleted IL-8 promoter fragment showed that both the activator protein-1 (AP-1) and/or the nuclear factor-kappa B (NF-kapp aB) binding sequences were responsible for the LPS and clarithromycin responsiveness of the IL-8 promoter. Consistently, in an electromobility shift assay, LPS increased the specific binding of both AP-1 and NF-kappaB, whereas clarithromycin suppressed it. Moreover, LPS and clarithromycin regulated three other promoters that have either the NF-kappa B or the AP-1 binding sequences: two synthetic (pAP-1-Luc and pNF-kappa B-Luc) and one naturally occurring (ELAM-Luc). Our results indicate that clarithromycin modified inflammation by sup-pressing IL-8 production and that clarithromycin may affect the expression of other genes through AP-1 and NF-kappa B. In addition to treatment of airway diseases, the anti-inflammatory effect of macrolides may be beneficial for the treatment of other inflammatory diseases such as chronic gastritis caused by H. pylori.

Anti-Bacterial Agents↗
PubMed2002

[Diagnosis of bacterial pneumonia by serum beta-globulin demarcation].

We studied whether the consolidation whose serum beta-globulin demarcation showed more than 12% was bacterial pneumonia or not. The materials were the patients with fever (> or = 37 degrees C) and the consolidation on chest-X ray film, the value of serum beta-globulin demarcation was more than 12% from 1995 to 2000. There were 5 cases with drug-induced pneumonitis, 5 cases with BOOP, 2 cases with eosinophilic pneumonia, 1 case with lung cancer (adenocarcinoma), and 1 case with interstitial pneumonia with dermatomyositis. No one had bacterial pneumonia. These results suggested the consolidation with fever whose serum beta-globulin demarcation showed more than 12% was not bacterial pneumonia.

Aged↗
PubMed2002

Accessory hepatic vein complicating extra-cardiac total cavopulmonary connection.

We encountered unexpected, severe hypoxia after the right heart bypass operation in a patient with isomerism. A 2-year-old girl with polysplenia had a complex cardiac anomaly consisting of a single atrium, single ventricle, pulmonary stenosis, absence of the right superior vena cava, hemiazygos continuation of the left inferior vena cava, and d-malposition of the great arteries. After a total cavopulmonary shunt, we performed an extra-cardiac total cavo-pulmonary connection with a 14 mm tube graft. The postoperative course was complicated by severe hypoxia. Angiography performed 20 days after the operation showed that contrast medium in the conduit poured into the hepatic vein, and through the intrahepatic communications, it passed into a left-sided accessory hepatic vein, which was connected directly to the left side of the aspect of the atrium. As the intrahepatic communication was adequate, we ligated the accessory hepatic vein within the pericardial cavity. The SpO2 returned to normal and no hepatic dysfunction was detected. We conclude that surgeons performing extra-cardiac total cavopulmonary connection need to pay closer attention to the possibility that an accessory hepatic vein might exist.

Child, Preschool↗