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K Nezu,
M Yoshikawa,
T Yoneda,
K Kushibe,
T Kawaguchi,
M Kimura,
A Kobayashi,
H Takenaka, A Fukuoka,
N Narita,
S Taniguchi
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ABSTRACT: Although candidates for lung reduction surgery (LRS) include malnourished patients with severe chronic obstructive pulmonary disease (COPD), the impact of preoperative nutritional status on surgical outcome has not been clearly elucidated.
We investigated the relationship between preoperative nutritional status and postoperative morbidity in 23 consecutive patients undergoing LRS. The percentage of ideal body weight (%IBW) and body mass index (BMI) were calculated, and fat-free mass (FFM) and fat mass (FM) were measured using a bioelectrical impedance analyzer. FFM and FM were expressed as height-normalized indices, FFM index [FFM (kg)/height (m)(2), or FFMI] and FM index [FM (kg)/height (m)(2), or FMI]. Serum levels of total protein and albumin were also determined.
8 patients had major complications. Preoperative %IBW and FFMI were significantly lower among patients with major complications, while no significant differences were observed in pulmonary function, FMI or serum protein. The complication rate was significantly higher among patients with low FFMI (FFMI < or = 16) but not with low %IBW or BMI.
These results suggest that FFM depletion is an excellent predictor of unacceptable postoperative complication following LRS.
The Thoracic and Cardiovascular Surgeon 08/2001; 49(4):216-20. · 0.88 Impact Factor
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ABSTRACT: To investigate the distribution of reduction in lean body mass (LBM) and whether LBM in legs (LBMlegs) can be a determinant of maximal exercise performance in COPD patients.
Thirty-eight male outpatients with COPD (mean +/- SD FEV1, 47.4 +/- 24.0% of predicted) who underwent complete pulmonary function testing were classified into two groups according to FEV1 expressed as a percentage of predicted value. Group A comprised 21 patients with mild-to-moderate airflow limitation (FEV(1) > or =35% predicted), and group B comprised 17 patients with severe airflow limitation (FEV1 < 35% predicted). LBM, which represents skeletal muscle mass, was measured by dual energy x-ray absorptiometry (DXA) and was assessed separately in arms, legs, and trunk. Maximal oxygen uptake VO2max was measured during maximal exercise on a cycle ergometer.
LBM in each region was expressed as a percentage of ideal body weight (IBW). LBM in arms (LBMarms)/IBW, LBMlegs/IBW, and LBM in trunk (LBMtrunk)/IBW were significantly depleted in group B compared with group A (p < 0.01). LBMlegs expressed as a percentage of total LBM (LBMlegs/total LBM) was significantly lower in group B (p < 0.05), although there was no significant difference in LBMarms/total LBM and LBMtrunk/total LBM between the two groups. VO2max correlated significantly with LBMlegs/IBW in group A, but not in group B. By stepwise regression analysis, LBMlegs/IBW appeared to be a significant predictor of VO2max in group A, while not in group B.
LBMlegs was a significant predictor of maximal exercise performance in patients with mild-to-moderate airflow limitation, but not in patients with severe airflow limitation who had disproportional reduction in LBMlegs.
Chest 01/2001; 119(1):93-8. · 5.25 Impact Factor
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ABSTRACT: To assess the factors determining maximum exercise performance in patients with chronic obstructive pulmonary disease (COPD), we examined nutritional status with special reference to body composition and pulmonary function in 50 stable COPD patients. Nutritional status was evaluated by body weight and body composition, including fat mass (FM) and fat-free mass (FFM) assessed by bioelectrical impedance analysis (BIA). Exercise performance was evaluated by maximum oxygen uptake (Vo(2max)) on a cycle ergometer. A total of 50 patients (FEV(1) = 0.98 L) was divided randomly into either a study group (group A, n = 25) or validation group (group B, n = 25). Stepwise regression analysis was performed in group A to determine the best predictors of Vo(2max) from measurements of pulmonary function and nutritional status. Stepwise regression analysis revealed that Vo(2max) was predicted best by the following equation in group A: Vo(2max) (mL/min) = 10.223 x FFM (kg) + 4.188 x MVV (L/min) + 9.952 x DL(co) (mL/min/mmHg) - 127.9 (r = 0.84, p < 0. 001). This equation was then cross-validated in group B: Measured Vo(2max) (mL/min) = 1.554 x Predicted Vo(2max) (mL/min) - 324.0 (r = 0.87, p < 0.001). We conclude that FFM is an important factor in determining maximum exercise performance, along with pulmonary function parameters, in patients with COPD.
Beiträge zur Klinik der Tuberkulose 01/2000; 178(2):119-27. · 1.90 Impact Factor
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H Okamura,
K Tsukaguchi,
M Ikuno,
A Kobayashi, A Fukuoka,
H Takenaka,
C Yamamoto,
Y Okamoto,
A Fu,
M Yoshikawa,
T Yoneda,
N Narita
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ABSTRACT: We examined physical and blood statuses of 24 patients with pulmonary M. avium complex disease who entered our hospital from April 1993 to March 1997. Ten patients (41.7%) were diagnosed as primary infection type and 14 patients (58.3%) as secondary infection type. Twenty-four patients were classified to the following two groups: Group A was 14 patients who converted to MAC negative within six months after the admission and group B was 10 patients who continued to excrete MAC for more than six months after the admission. We made a comparison between group A and group B as to the results of physical and blood examinations on admission. Mean value of %IBW in group B was significantly lower (group B:74.4 +/- 8.9%, group A:82.9 +/- 12.7%, p < 0.05) than that of group A. The level of serum albumin in group B was significantly lower (group B: 3.39 +/- 0.53 g/dl, group A: 3.99 +/- 0.45 g/dl, p < 0.01) than that of group A. ChE in group B was significantly lower (group B: 321.2 +/- 94.5 IU/l, group A: 442.9 +/- 148.4 IU/l, p < 0.05) than that of group A. Group B was nutritionally depleted than group A. In conclusion, these findings suggested that nutritional support should be taken into consideration in combination with conventional chemotherapy in treating chronic, intractable MAC disease.
Kekkaku: [Tuberculosis] 05/1999; 74(4):341-5.
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ABSTRACT: The oxygen contents in YBa2Cu4Oz samples have been determined by two wet chemical redox methods, i.e. by Coulometric and iodometric titrations. Three different samples, synthesized by sol-gel, LiF catalyst and O2 hot-isostatic-press (HIP) techniques, are studied. The results of the two titration methods agree well with each other for all samples. The oxygen content z appears to be dependent on the oxygen pressure applied during the synthesis, since z values slightly below the stoichiometric number of 8.00 have been obtained for the samples prepared under 1 atm oxygen pressure, while for the O2 HIP treated sample the observed oxygen content is Z=8.00+or-0.01.
Superconductor Science and Technology 12/1998; 8(8):673. · 2.66 Impact Factor
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ABSTRACT: Several methods of chemical analysis, for example various redox titrations and thermogravimetric approaches, have been adapted to establish the oxygen content in superconducting cuprates and to determine the higher oxidation states of copper and other mixed-valent metals. The present review discusses and complements the authors' own experimental results on the oxygen content and metal valence analyses, but literature data from about 150 other references are reviewed as well.
Superconductor Science and Technology 12/1998; 9(3):121. · 2.66 Impact Factor
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ABSTRACT: A novel wet chemical method based on the redox chemistry of the Cu(I)/Cu(II) couple and potentiostatic electrolyses is proposed for the determination of high metal valences in thallium cuprates. The sum of the extra oxidation states above +II for copper and +I for thallium, and thus the oxygen content of the sample, is obtained by reducing both Cu(III) and Tl(III) with CuCl. The excess of Cu(I) is electrolysed as a final analysis step. The quantitativity of the proposed method was demonstrated using YBa2Cu3Oz and Tl2O3 as reference materials for Cu(III) and Tl(III) respectively. Additionally, the oxygen content was determined in a single-phase superconducting sample with a nominal composition of Tl2Ba2CaCu2Oz.
Superconductor Science and Technology 12/1998; 6(4):265. · 2.66 Impact Factor
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K Tsukaguchi,
H Okamura,
M Ikuno,
A Kobayashi, A Fukuoka,
H Takenaka,
C Yamamoto,
T Tokuyama,
Y Okamoto,
A Fu,
M Yoshikawa,
T Yoneda,
N Narita
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ABSTRACT: Diabetics are prone to bacterial infection in part, due to polymorphonuclear neutrophil dysfunction, but the precise mechanism is not yet fully explained. Of many complications, diabetes mellitus (DM) is one of the most common diseases, which causes pulmonary tuberculosis. To elucidate the mechanism of susceptibility to tuberculosis infection in patients with diabetes mellitus, we measured IFN-gamma, IL-12 and IL-10 productions by CD4+ alpha beta T cells and autologous monocytes stimulated with live BCG in patients with pulmonary tuberculosis complicated with DM (TB + DM) or without DM (TB) and healthy controls. The levels of IFN-gamma and IL-12 production in TB patients were significantly lower than those in the control. These cytokine productions were also lower in TB + DM patients than in TB patients significantly. The level of IL-10 production in TB patients were highest among these three groups. The production of this cytokine in TB + DM patients was lowest. The level of IFN-gamma production was significantly lower in TB + DM patients under poor DM control than in those patients under good DM control and showed a significant negative correlation to HbA1c, an indicator of diabetic control. The period for negative conversion of culture finding in TB + DM patients under poor control was prolonged when compared with those in TB patients. These results demonstrated the difference in cytokines secretion profile between TB patients and TB + DM patients, and suggest that the immunological mechanism underlying pathogenesis of tuberculosis might work differently between these two patients groups.
Kekkaku: [Tuberculosis] 12/1997; 72(11):617-22.
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M Nakaya,
T Yoneda,
A Kobayashi,
Y Onohara,
Y Ikoma, A Fukuoka,
K Tomoda,
H Takenaka,
H Okamura,
C Yamamoto,
K Fukuoka,
T Tokuyama,
Y Okamoto,
M Yoshikawa,
K Tsukaguchi,
N Narita
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ABSTRACT: Interferon-gamma (IFN-gamma) and interleukin-10 (IL-10)-producing ability of peripheral blood plastic-dish adherent cells and non-adherent cells obtained from patients with active pulmonary tuberculosis (N = 17) and healthy controls (N = 14) upon stimulation with purified protein derivatives (PPD) were assessed. Adherent cells and non-adherent cells were obtained two times from each patient with active pulmonary tuberculosis without any underlying diseases, on admission before the initiation of administering anti-tuberculous drugs and 2 months later from the negative conversion of Mycobacterium tuberculosis in sputum culture. ELISA was performed to measure IFN-gamma and IL-10 levels in culture media of adherent cells and non-adherent cells stimulated with PPD. IFN-gamma levels produced by non-adherent cells on admission were significantly higher than that of healthy controls (p < 0.001). Elevated IFN-gamma levels on admission was reduced after treatment for tuberculosis (p < 0.03), but still remained higher than that in healthy controls. IL-10 levels of non-adherent cells of patients were lower than those of healthy controls, although the difference was not significant. IL-10 levels produced by non-adherent cells on admission correlated with the time needed for negative conversion of bacilli in sputum culture (p < 0.05). IL-10 level produced by adherent cells from nutritionally normal patients were significantly higher than that of healthy controls (p < 0.05), and elevated IL-10 level was significantly reduced after therapy (p < 0.05). In the normonourished patients, the time needed for negative conversion of the bacilli in sputum culture of patients kept higher level of IL-10 of non-adherent cells (N = 5) was significantly longer than that of patients reduced IL-10 level after therapy. These results suggest that IL-10 produced by monocytes may diminish the TH1 responses of patients with pulmonary tuberculosis.
Kekkaku: [Tuberculosis] 06/1997; 72(6):403-10.
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ABSTRACT: We have determined the oxygen content and the Cu valence by iodometric titiration of single-phase HgBa2Can-1CunO2(n+1)+δ (n=2,3), Hg-1212 and Hg-1223, superconductors postannealed under various conditions in either a reducing or an oxidizing atmosphere. Their lattice parameters, Tc, resistivity, and the thermoelectric power have been systematically investigated as a function of Cu valence. Hg-1212 exhibits a parabolic or ``bell-shaped'' relationship between Tc and the Cu valence similar to that reported for HgBa2CuO4+δ (Hg-1201), while only a half of the parabola is observed for Hg-1223. The systematic variations in the resistivity and the thermoelectric power as well as the relationship between Tc and the Cu valence confirm that the Hg-1223 sample with the highest Tc of 135 K is almost optimally doped. Both Hg-1212 and Hg-1223 as well as Hg-1201 exhibit their maximum Tc values at the same nominal Cu valence of approximately 2.20 which is also comparable to those for other high-Tc cuprate superconductors. This coincidence of the Cu valence for optimally doped states suggests that the simple ionic model where each excess oxygen in the Hg-Oδ charge reservoir supplies two holes is appropriate in the present Hg-12(n-1)n samples.
Phys. Rev. B. 02/1997; 55(10).
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ABSTRACT: We investigated the serum level of IL-8 and TNF-alpha using ELISA in 16 patients with active pulmonary tuberculosis before administration of antituberculous drugs and in age-, smoking habit-matched 20 healthy controls. The mean level of serum IL-8 in patients with active pulmonary tuberculosis was significantly higher than that in healthy controls (P < 0.001). The mean level of serum TNF-alpha in tuberculosis patients was also high, while TNF-alpha was not detectable in the sera of healthy controls. We also examined the relationship between clinical pictures mainly defined by radiographic findings and the serum levels of IL-8 and TNF-alpha. The serum IL-8 level of 9 patients with tuberculous cavity is significantly higher than that of 7 patients without cavity. (P < 0.05) We classified the patients with cavities into two subgroups according to the radiographic classification of the Japanese Society of Tuberculosis. Four patients with advanced lesions on chest X-ray showed higher serum IL-8 level than 5 patients with moderate lesions (P < 0.05). On the other hand, there was no correlation between serum TNF-alpha level and radiographic findings. These results suggest that IL-8 appears to be involved in the formation of tuberculous cavitary lesion.
Kekkaku: [Tuberculosis] 08/1995; 70(8):461-6.
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ABSTRACT: We reported a 53-year-old female who was admitted due to partial loss of consciousness. She had been diagnosed as old pulmonary tuberculosis and diabetes mellitus. She was diagnosed as diabetic keto-acidosis on admission. We isolated Escherichia coli in the blood, transtracheal aspiration (TTA) and from the urine. We have experienced 6 cases where the same bacteria was isolated from the blood and TTA at the same time. In all 6 cases, we have found single bacteria in the blood and a few other bacteria in TTA. Blood culture is the most certain method to detect the origin of infectious diseases. But the compromised host, as in this case, has multifocal infections in many cases. In order to understand the pathological aspects of the infection, we must obtain many kinds of samples and as many as possible.
Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 03/1995; 69(2):208-12.
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ABSTRACT: The oxygen contents and valences of cations in various superconducting cuprates such as Bi2Sr2(Ca, Y)Cu2O
y
, Tl2Ba2Ca
n
–1Cu
n
O
y
, etc. which contain two kinds of multi-valence metals have been determined by novel wet chemical methods. The wet chemical methods are based on the differences in oxidation power of each cation and at the last step an electrochemical method is employed for measuring the amount of reducing agent, i.e., CuCl. For superconducting Bi-based cuprates, a modified constant-current coulometry has been developed. For the superconducting Tl-based cuprates a constant-potential electrolysis method which makes it easy to control the electrolysis potential has been applied. The results obtained for Bi2Sr2(Ca, Y)Cu2O
y
have shown that both Bi- and Cu-valences decrease with increasing Y, which is consistent with the results of earlier works. The results obtained for the double Tl-O layer superconductors show that the Tl valence is about +3 in all the thallium cuprates and different from the value obtained from XPS measurements of earlier works. The reason for this discrepancy is discussed.
Journal of Superconductivity 01/1995; 8(1):31-35.
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ABSTRACT: A survey on the nutritional status and cell-mediated immune function of 47 hospitalized patients with active pulmonary tuberculosis and healthy controls was conducted. In the patients group: 1) Anthropometric measurements, such as %ideal body weight (%IBW), %arm circumference (%AC), %arm muscle circumference (%AMC) and %triceps skin fold (%TSF), were significantly reduced. 2) Visceral proteins including serum albumin (Alb), transferrin (Tf), prealbumin (PA) and retinol binding protein (RBP) were significantly reduced. 3) The imbalance of plasma amino acids, which was characterized by the depression of Fischer ratio, a molar ratio of branched chain amino acids (BCAA) to aromatic amino acids (AAA), was observed. Fischer ratio was significantly correlated with anthropometric measurements (%IBW, %AC and %AMC). Delayed-type hypersensitivity to DNCB (2,4-dinitrochlorobenzene) and lymphocyte transformation to phytohemagglutinin (PHA) and concanavalin A (Con A) were significantly impaired in the patients group, whereas NK cell activity was higher than that of controls. Alb, PA, RBP and Fischer ratio were significantly lower in the patients with reduced DNCB reaction than in those with normal responses. Lymphocyte transformation was significantly correlated with Fischer ratio, and NK cell activity was significantly correlated with Alb, PA, RBP. These data may suggest that the imbalance of plasma amino acids represented by the reduction of Fischer ratio and the depletion of visceral proteins are closely related to the impairment of lymphocyte function in the patients with active pulmonary tuberculosis.
Kekkaku: [Tuberculosis] 05/1994; 69(4):307-16.
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K Nezu,
M Yoshikawa,
T Yoneda,
K Kushibe,
T Kawaguchi,
M Yasukawa,
A Kobayashi,
H Takenaka, A Fukuoka,
N Narita,
S Taniguchi
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ABSTRACT: The aim of this study was to examine the short-term effect of lung volume reduction surgery (LVRS) on body composition and other nutritional indicators in 28 patients with emphysema underwent thoracoscopic LVRS. Functional tests, body weight (BW), and body composition were measured before and 6 months after surgery. Mean daily caloric intake (CI) was estimated by 3-day dietary record as well. Fat-free mass (FFM) and fat mass (FM) were assessed by bioelectrical impedance analysis (BIA). FEV1.0 and VO2max have improved after LVRS by 35.2% and 23.8%, respectively. Preoperatively, 75% of patients were underweight (% ideal body weight (%IBW) <90) with the mean %IBW at 84.5%. BW, CI, and FFM increased significantly after LVRS, whereas FM was unchanged. The change in BW correlated significantly with the change in FEV1.0, MVV, and VO2max (p < 0.01) but not with CI. Bilateral LVRS results in an increase in FFM and functional improvement for underweight patients with severe emphysema, and it may contribute to the improvement in maximal exercise capacity.
Beiträge zur Klinik der Tuberkulose 178(6):381-9. · 1.90 Impact Factor
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ABSTRACT: The origin of superconductivity in samples of (Bi0.3+mCu0.7)Sr2-Y1-mCu2Oz (m = 0.2 and 0.3) was investigated and was found to be due to a small amount of Bi-2212 phase. A virtually single phase of Bi-based 1212-type materials was prepared with the nominal composition of (Bi0.3Cu0.7)Sr2YCu2Oz, which was insulating after sintering in air. Following high oxygen pressure annealing, the oxygen content z was greatly increased, and superconductivity was induced at Tonsetc = 18 K, and TR=0c = 15 K for z = 7.125. The superconducting volume fraction was found to be small, and the conductivity of non-metallic regions in the annealed samples follows the variable range hopping law, suggesting that carrier localization is still preponderant and more mobile holes are needed for getting both higher Tc and higher volume fraction in this system.
Physica C Superconductivity 219:33-38. · 1.01 Impact Factor
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ABSTRACT: The oxygen contents and metal valences have been determined in various (Bi, Pb)2Sr2(Ca, Y)Cu2Oz, Bi2Sr2Ca2Cu3O z and Pb2(Ba, Y, Ca)3Cu3Oz samples by a two-step coulometric titration method. The first titration experiment, which consists of the reactions of Cu(III), Bi(V) and Pb(IV) with CuCl followed by an anodic oxidation of the excess Cu(I), reveals the oxygen content of the sample. In the second experiment the valences of bismuth and lead are distinguished from the Cu-valence by taking advantage of the reaction with Fe(II). By performing the first experiment without adding CuCl it was even possible to evaluate the distinct valence values for crystallographically different copper atoms when the sample contained both Cu(III) and Cu(I) in separate layers. The applicability of the employed analysis procedures as well as the results obtained for the studied materials are discussed.
Physica C Superconductivity 208:130-136. · 1.01 Impact Factor
