Seiichi Nakamura

Publications (15)11.25 Total impact

• Article: [A case of sarcoidosis with an endobronchial polypoid lesion].

  Hitoshi Saitoh, Tatsuji Enomoto, Rituko Narato, Yasuhiro Shibuya, Michio Tanaka, Seiichi Nakamura
  [show abstract] [hide abstract]
  ABSTRACT: A 59-year-old woman complained of impaired vision. She visited an ophthalmologist and glaucoma was diagnosed. In July 200X, she was admitted to our hospital for further examination. Chest radiography and CT showed lymphadenopathy in the mediastinum and bilateral hilum. Bronchofiberscopy revealed mucosal hypervascularity and a polypoid lesion at the orifice of the left B8a. A transbronchial biopsy specimen of the polypoid lesion showed non-caseating epithelioid cell granuloma. On bronchoalveolar lavage, both the proportion of lymphocytes and the CD 4/8 ratio had increased. We diagnosed sarcoidosis with an endobronchial polypoid lesion. The patient has been observed without therapy since, and after a year the polypoid lesion is the same size on 3D CT scans. This is a very rare case of endobronchial sarcoidosis presenting as a polypoid lesion.
  Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 08/2010; 48(8):589-94.
• Article: [Detection of pleural plaques on chest X-ray film by chest physicians].

  Tatsuji Enomoto, Aki Matsumoto, Hitoshi Saito, Ritsuko Narato, Akiko Shingu, Midori Sugisaki, Seiichi Nakamura, Toshiaki Takeda, Koichiro Nomura
  [show abstract] [hide abstract]
  ABSTRACT: With increasing awareness about health damage due to asbestos exposure, the number of people presenting with non-occupational exposure has increased remarkably. Consequently, chest physicians in general hospitals must read the chest X-ray films of patients with asbestos exposure. Can non-specialized chest physicians, who may have little experience of occupational medicine, diagnose pleural plaques accurately? The study subjects were 44 consecutive patients who were admitted to our hospital, under the Japanese medical health check system for workers employed in dangerous work. Their chest X-ray films were checked by 4 chest physicians, who were independently informed that the patients had a high suspicion of asbestos exposure. The detection rate of chest Xray for pleural plaques was compared with computed tomography (CT) results as the gold standard. The sensitivity was 0.818 and the specificity was 0.393. The sensitivity of the presence of pleural plaques was lower in anterior and posterior sites, and on the pleura adjacent to the mediastinum, pericardium and vertebral (0.429, 0.348, 0.217), while specificity was lower on lateral sites (0.610). Chest physicians in general hospitals must be trained in the manifestation of asbestos-related diseases.
  Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 04/2010; 48(4):267-73.
• Article: Differences in the clinical characteristics of Pneumocystis jirovecii pneumonia in immunocompromized patients with and without HIV infection.

  Tatsuji Enomoto, Arata Azuma, Ayumi Kohno, Kazuyo Kaneko, Hitoshi Saito, Minako Kametaka, Jiro Usuki, Akihiko Gemma, Shoji Kudoh, Seiichi Nakamura
  [show abstract] [hide abstract]
  ABSTRACT: The incidence of Pneumocystis jirovecii pneumonia (PCP) in patients with predisposing immunodeficiencies other than AIDS is growing. Knowing the different characteristics and outcomes of PCP according to HIV status would help physicians manage and treat patients with PCP. The medical charts of all patients with a proven first episode of PCP, diagnosed between 1997 and 2007 were retrospectively reviewed, and clinical and laboratory data abstracted. Of the 35 patients with PCP, 18 were HIV-positive and 17 were HIV-negative with other immunosuppressive conditions. HIV-negative patients were significantly older than HIV-positive patients. The WCC (10 952 +/- 5669 vs 9750 +/- 3133/microL; P = 0.015), neutrophil counts (9631 +/- 5421 vs 5680 +/- 2628/microL; P = 0.01) and CD4+ lymphocyte counts (329 +/- 502 vs 47 +/- 50/microL; P < 0.001) were significantly higher in HIV-negative patients. Six of the 17 HIV-negative patients had a CD4+ lymphocyte count >300/microL. Serum IgG levels were lower in HIV-negative patients (943 +/- 379 vs 1635 +/- 657 mg/dL; P = 0.017). Mortality was higher in HIV-negative (52.9%) than in HIV-positive patients (0%). On univariate analysis, risk factors for mortality from PCP were the presence of underlying pulmonary disease (odds ratio 4.000, 95% CI: 1.501-10.658) and HIV-negative status (odds ratio 2.125, 95% CI: 1.283-3.518). The characteristics and outcomes of PCP differ significantly depending on HIV status. The existence of underlying pulmonary diseases may be associated with the prognosis of HIV-negative patients with PCP.
  Respirology 11/2009; 15(1):126-31. · 2.42 Impact Factor
• Article: [Clinical analysis of patients with tuberculosis admitted on an emergency cases].

  Toru Okada, Yasuhiro Shibuya, Hitoshi Saito, Tatsuji Enomoto, Seiichi Nakamura
  [show abstract] [hide abstract]
  ABSTRACT: A retrospective study was made of 75 patients with tuberculosis and tuberculous pleurisy who received medical care in our hospital from 2002 through 2006. Of the 75 patients, 9 were admitted as tertiary emergency cases, and 12 patients were admitted by ambulance as secondary emergency cases. We studied the reason for their emergency medical admission, and the process of diagnosing 21 patients as tuberculosis. In some cases, the reasons for emergency admission were cardiorespiratory arrest, loss of consciousness, and injury resulting from a traffic accident, not common symptoms of tuberculosis such as dyspnea, hemoptysis and bloody sputum. Chest radiographic findings of most patients showed tuberculosis, and other cases were likely to be diagnosed as tuberculosis from their medical history or back-ground such as being homeless, previous tuberculosis, and receiving for therapy of tuberculosis. It was not so difficult to diagnose our cases as tuberculosis, nevertheless we may have an unconscious patient with normal chest radiograph. These data suggest that any patients visiting the emergency room may possibly have tuberculosis even if they are without respiratory symptoms.
  Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 09/2008; 46(8):620-6.
• Article: [Clinical statistics of outpatients investigated for asbestos-related lung diseases at a general hospital in Tokyo].

  Kazuyo Kaneko, Tatsuji Enomoto, Makiko Yomota, Ayumi Kohno, Ritsuko Narato, Hitoshi Saitoh, Seiichi Nakamura
  [show abstract] [hide abstract]
  ABSTRACT: We evaluated 122 outpatients who visited our hospital for examination of asbestos-related diseases between November, 2005 and October, 2006. Patients were divided into three groups; occupational exposure, non-occupational exposure and non-exposure groups. The occupational exposure group showed a significantly higher rate of asbestos-related abnormal findings than the non-occupational exposure plus the non-exposure group (33% vs. 5%, respectively; P = 0.001). Pleural plaque was the most common abnormal finding related to asbestos. Only four of 24 patients with pleural plaques could obtain personal health records for workers enjoyed in dangerous work, whereas the rest of them were not able to mainly because they were self-employed. A health support system is necessary to also cover non-employees.
  Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 08/2008; 46(7):522-5.
• Article: [A case of bird related hypersensitivity pneumonitis had a progressive course].

  Ayumi Kohno, Tatsuji Enomoto, Kazuyo Kaneko, Hitoshi Saitoh, Ritsuko Narato, Makiko Yomota, Michio Tanaka, Tamiko Takemura, Seiichi Nakamura
  [show abstract] [hide abstract]
  ABSTRACT: A 50-year-old woman was admitted due to productive cough continuing for 3 years. A chest computed tomography showed appearance of nonspecific interstitial pneumonia (NSIP). Thoracoscopic lung biopsy specimens showed mainly a pattern of NSIP with multinucleated cells and cholesterol clefts. She was not a bird fancier, but had indirect exposure to birds in her living environment, and had been using feather-filled duvets for a long time. We established a diagnosis of bird-related hypersensitivity pneumonitis based on antibodies in serum positive to pigeon dropping extracts. She was treated by coadministration of corticosteroids and immunosuppressants, and avoidance of bird-related antigens, but had a progressive course and died of respiratory failure.
  Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 08/2008; 46(7):558-63.
• Article: [Risk factors associated with the duration of hospitalization in emergency admitted patients with aspiration pneumonia].

  Masaki Ishii, Tatsuji Enomoto, Yasuhiro Shibuya, Seiichi Nakamura, Shinji Teramoto, Yasuyoshi Ouchi
  [show abstract] [hide abstract]
  ABSTRACT: We retrospectively analyzed risk factors which affect the duration of hospitalization of patients who were given diagnoses of aspiration pneumonia and admitted on an emergency basis for 24 hours because of acute events in emergency. The research was conducted on 67 hospitalized patients aged 25-99. who were admitted because of aspiration pneumonia from March 2002 to May 2004. We analyzed the relationships between the duration of hospitalization and factors such as age, sex, severity of pneumonia, number of lobes with inflammation and the duration of tracheal intubation. The mean duration of hospitalization was 24.8 days which was approximately 1.6 times as long as that of all diseases in our hospital. Simple regression analysis suggested that the mean duration of hospitalization correlates significantly with age and the duration of hospitalization, while multiple regression analysis indicates that age is the only significant factor related to duration of hospitalization. However, there was no significant correlation between the duration of hospitalization and the severity of pneumonia. These data indicate that the duration of hospitalization is considerably affected by age, but not the treatment of pneumonia itself. Therefore we should pursue not only the appropriate treatment for aspiration pneumonia but also make an effort for early intervention in the support plan for discharge based on the social background of each elderly patient.
  Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 08/2007; 45(7):521-5.
• Article: [A case of successful bronchial artery embolization for primary racemose hemangioma with massive hemoptysis].

  Ritsuko Narato, Tatsuji Enomoto, Hiroshi Ono, Kumiko Baba, Yoshitoshi Komazaki, Natsu Uemura, Hitoshi Saito, Yasuhiro Shibuya, Tetsuya Yokosuka, Toshiko Kobayashi, Seiichi Nakamura
  [show abstract] [hide abstract]
  ABSTRACT: We encountered a case of primary racemose hemangioma treatment with successful bronchial artery embolism for massive hemoptysis. A 56-year-old woman with massive hemoptysis was transported to our hospital. The source of the massive hemoptysis was observed to be from around a non-pulsatile polyp covered by normal mucosa occluding the truncus intermedius by fiberoptic bronchoscopy. We stopped the bleeding temporarily using differential lung ventilation, and then bronchial artery angiography was performed. The main right bronchial artery was enlarged, and enlarged and convoluted right peripheral bronchial vessels were also observed. We diagnosed the massive bleeding to be due to racemose hemangioma. A successful bronchial artery embolization (BAE) was performed with gelforms and metallic coils for the treatment of racemose hemangioma. There has been no recurrence of hemoptysis for one year after BAE. There have been many reports on massive hemoptysis as in this patient who were treated by lobectomy, nevertheless we would like to state BAE should be considered as a suitable treatments for primary racemose hemangioma with hemoptysis if there is no recognizable shunt artery.
  Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 10/2006; 44(9):641-6.
• Article: Delirium in inpatients with respiratory diseases.

  Takashi Takeuchi, Eisuke Matsushima, Hirobumi Moriya, Masahiro Shintani, Seiichi Nakamura
  [show abstract] [hide abstract]
  ABSTRACT: The features of delirium in patients being hospitalized due to respiratory diseases were investigated. From the inpatients in the respiratory medical ward of Tokyo Metropolitan Hiroo General Hospital over the course of 1 year, the patients who had delirium were diagnosed by a semistructured interview. The total number of subjects was 454, and patients with delirium were 43. Various clinical factors were compared between the delirium group and non-delirium group. In the delirium group, there were many elderly patients of 70 years or older. Moreover, there were many patients who had a chronic respiratory disease, patients in which the respiratory diseases were mutually complicated, and patients in whom other diseases combined with the respiratory disease in the delirium group. There were also many patients in the Intensive Care Unit (ICU), and patients with an endotracheal intubation or extubation. Based on the results of a multiple logistic regression analysis, for age, ICU accommodation, and endotracheal intubation, the value of the delirium group was more significant than that of the non-delirium group. In half of the patients from the delirium group, delirium developed within 1 week after hospitalization. In the patients who died in the hospital, however, delirium often developed days after they had been hospitalized. It was suggested that the later developed delirium had a relation to the prognosis.
  Psychiatry and Clinical Neurosciences 07/2005; 59(3):253-8. · 2.13 Impact Factor
• Article: Pulmonary Langerhans cell histiocytosis associated with lingual carcinoma.

  Takao Tsuji, Seiichi Nakamura, Michio Tanaka
  [show abstract] [hide abstract]
  ABSTRACT: A 57-year-old man who was a heavy smoker was admitted to our hospital for further evaluation of abnormal shadows on a chest X-ray film. Chest radiography and a computed tomography (CT) scan revealed nodular lesions and multiple thin-walled cysts in both lungs. Histopathological examination of one of these cystic lesions showed that the predominant cellular population was Langerhans cells, with the cytoplasm testing positive for S-100 protein and the cell membrane showing a positive reaction for CD1a. The pathological diagnosis was pulmonary Langerhans cell histiocytosis (LCH). A lingual carcinoma that had been detected simultaneously was treated with neoadjuvant therapy and the patient was advised to stop smoking. However, only limited improvement was seen on follow-up chest CT. In view of this, a radical resection of the lingual carcinoma was performed. There was a subsequent dramatic improvement in the pulmonary LCH. Langerhans cells may play a role in the immune response to tumors. In this patient, we suggest the possibility that both the habitual smoking and the lingual carcinoma may have contributed to the development of pulmonary LCH.
  Internal Medicine 09/2004; 43(8):713-7. · 0.94 Impact Factor
• Article: [Diagnostic use of bronchoscopy and bronchial biopsies in chronic obstructive pulmonary disease].

  Seiichi Nakamura
  [show abstract] [hide abstract]
  ABSTRACT: Studies examining the bronchial biopsy specimens taken from patients with chronic obstructive pulmonary disease(COPD) have shown that there is an inflammatory condition in which CD8+ T-lymphocytes and macrophages are predominated by using immunohistochemical staining. Although neutrophils are scanty in the airway wall, but are increased in the airway lumen. CD8+ cells exhibit a extensive distribution along the subepithelial zone of the airways. The number of CD8+ cells showed a significant negative correlation with FEV1 percentage of predicted. Patients with COPD examined during a mild exacerbation of the disease showed a prominent eosinophilia both in the airway wall and in the airway lumen. Studies of the bronchial biopsy have been provided more adequately information about the cellular and structural bases of COPD.
  Nippon rinsho. Japanese journal of clinical medicine 01/2004; 61(12):2158-62.
• Article: A living case of pulmonary ossification associated with osteoclast formation from alveolar macrophage in the presence of T-cell cytokines.

  Takao Tsuji, Seiichi Nakamura, Iwao Komuro, Masashi Mikami, Michiko Baba, Michio Tanaka
  [show abstract] [hide abstract]
  ABSTRACT: A 61-year-old woman had been coughing up blood-tinged sputum since May 1998. Chest radiography and computed tomography (CT) scans revealed a solitary mass (3 cm in greatest dimension) in the right lower field, accompanied by a surrounding area of ground glass and reticular appearance. Surgical lung biopsy was performed to the surrounding area. The pathological diagnosis was pulmonary ossification of the dendriform type. Alveolar macrophages obtained from her lung differentiated into tartrate-resistant acid phosphatase (TRAP)-positive multinucleated giant cells (MGCs) in the presence of autologous T cells or of macrophage colony stimulating factor (M-CSF) and interleukin-4 (IL-4). This results suggest the possibility that monocytes/macrophages may have the ability to form osteoclasts in the presence of cytokines that may be involved in the development of pulmonary ossification.
  Internal Medicine 10/2003; 42(9):834-8. · 0.94 Impact Factor
• Article: Effect of the proteolytic enzyme serrapeptase in patients with chronic airway disease.

  Seiichi Nakamura, Yasushi Hashimoto, Masashi Mikami, Eiichi Yamanaka, Tomoyuki Soma, Mitsunori Hino, Arata Azuma, Shoji Kudoh
  [show abstract] [hide abstract]
  ABSTRACT: The proteolytic enzyme serrapeptase (SER) is widely used in clinical practice in Japan. We investigated the effect of SER on sputum properties and symptoms in patients with chronic airway diseases. This study was an open-labelled trial with a non-treatment control group. Patients were randomly assigned to oral treatment with (n = 15) and without (n = 14) SER 30 mg/day for 4 weeks. Patients collected sputum samples for about 4 h in the morning on the day the trial began and 4 weeks later. We measured the amount of sputum by weighing. Part of each sputum sample was weighed and then completely dried and reweighed. The percentage solid component, viscosity and elasticity of the sputum were measured. Mucociliary transportability index was measured using ciliated bovine trachea ex vivo. Sputum smears were also prepared to count sputum neutrophils. Patients' symptoms were assessed by a questionnaire that used a visual analogue scale. After 4 weeks of SER treatment, sputum weight in the morning, percentage solid component, viscosity and elasticity of sputum, sputum neutrophil count, frequency of coughing and frequency of expectoration significantly decreased. The mean mucociliary transportability index increased from 13.3 +/- 1.8 to 24.4 +/- 2.5 (P = 0.0103). SER may exert a beneficial effect on mucus clearance by reducing neutrophil numbers and altering the viscoelasticity of sputum in patients with chronic airway diseases.
  Respirology 10/2003; 8(3):316-20. · 2.42 Impact Factor
• Article: Influence of the rheological properties of airway mucus on cough sound generation.

  Yasushi Hashimoto, Akira Murata, Masashi Mikami, Seiichi Nakamura, Eiichi Yamanaka, Shoji Kudoh
  [show abstract] [hide abstract]
  ABSTRACT: There have been several reports regarding the role of airway mucus in cough sound generation, but the properties of the mucus that influence cough sound generation remain unclear. The aim of this study was to elucidate the influence of the rheological properties of airway mucus on cough sound generation. The acoustic properties of voluntary cough sounds from 15 patients with chronic productive cough and nine controls with dry cough were analyzed by dividing the energy envelope of the sounds into three phases and computing the root mean square values and the duration of each phase as a proportion of the total cough duration. The rheological properties of the airway mucus (yield value, ciliary transportability and spinability) were also measured. Differences between productive and dry cough sounds, and correlations between the acoustic properties of cough sounds and the rheological properties of the airway mucus, were analyzed. The acoustic properties of productive and dry cough sounds differed significantly (P < 0.05). The acoustic properties of second phase cough sounds correlated significantly with the yield value and ciliary transportability of the airway mucus (P < 0.05). The rheological properties of the airway mucus influenced cough sound generation.
  Respirology 04/2003; 8(1):45-51. · 2.42 Impact Factor
• Article: [A case of bronchopulmonary actinomycosis diagnosed by transbronchial biopsy of a bronchial polypoid tumor].

  Takao Tsuji, Michiko Baba, Iwao Komuro, Masashi Mikami, Yaeko Yokoshima, Michio Tanaka, Seiichi Nakamura
  [show abstract] [hide abstract]
  ABSTRACT: A 32-year-old man with history of dental caries had been coughing up blood-tinged sputum since Jan 2000. Chest radiography and computed tomography (CT) scans revealed a solitary nodule with a peripheral infiltrative shadow in the left S 6. Fiberoptic bronchoscopy was performed, but yielded no significant findings. In April 2000, because the nodule had increased in size, bronchoscopy was performed again, and revealed a white smooth-surfaced polypoid tumor in the left B 6 c. A transbronchial biopsy of the polypoid tumor was performed, and the histological findings show long Grocco-positive hyphae that are visible under sulfur granules. Bronchopulmonary actinomycosis was diagnosed. The solitary nodule with a peripheral infiltrative shadow in the left S 6 was eliminated by antibiotic therapy including ABPC/SBT. ABPC and LVFX. This case is important, because there are few reports concerning diagnosis of bronchopulmonary actinomycosis using transbronchial biopsy of a bronchial polypoid tumor.
  Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 07/2002; 40(6):508-12.