Toshinori Kawanami

University of Occupational and Environmental Health, Kitakyūshū, Fukuoka, Japan

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Publications (75)166.57 Total impact

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    ABSTRACT: Background: Pneumonia is now the third leading cause of death in Japan, and the number of patients with pneumonia is expected to increase with the progression of aging of the country. Higher dosage of antibiotics has recently been used, and high-dose doripenem (DRPM; 3 g daily) was approved for use in Japan in April 2011. However, there is a lack of data regarding the efficacy and safety of high-dose DRPM in Japan. This study prospectively assessed the clinical efficacy and safety of high-dose DRPM in Japanese patients with refractory pneumonia. Methods: This study was performed at University of Occupational and Environmental Health, Japan and affiliated hospitals. The efficacy and safety of DRPM in patients with pneumonia treated with 3 g daily of DRPM, including those in whom DRPM dosage was increased from 1.5 g to 3 g daily, were evaluated. Results: The safety evaluations included 56 patients, and the efficacy was evaluated in 51 patients. DRPM (3 g daily) treatment showed the response rate of 92.2% (47/51). Adverse effects of DRPM (3 g daily) were observed in 11 of 56 patients (19.7%), and all of these patients improved after DRPM cessation. Two patients had to stop DRPM administration due to elevated aminotransferase levels. The efficacy of DRPM in patients with pneumonia in whom DRPM was increased from 1.5 g daily to 3 g daily was 84.6% (11/13). Conclusions: High-dose DRPM (3 g daily) treatment is effective and relatively safe in Japanese patients with pneumonia.
    No preview · Article · Jan 2016 · Journal of Infection and Chemotherapy
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    ABSTRACT: Background The Streptococcus anginosus group (SAG) play important roles in respiratory infections. It is ordinarily difficult to distinguish them from contaminations as the causative pathogens of respiratory infections because they are often cultured in respiratory specimens. Therefore, it is important to understand the clinical characteristics and laboratory findings of respiratory infections caused by the SAG members. The aim of this study is to clarify the role of the SAG bacteria in respiratory infections. Methods A total of 30 patients who were diagnosed with respiratory infections which were caused by the SAG bacteria between January 2005 and February 2015 were retrospectively evaluated. Results Respiratory infections caused by the SAG were mostly seen in male patients with comorbid diseases and were typically complicated with pleural effusion. Pleural effusion was observed in 22 (73.3%) patients. Empyema was observed in half of the 22 patients with pleural effusion. S. intermedius, S. constellatus and S. anginosus were detected in 16 (53.3 %), 11 (36.7 %) and 3 (10.0 %) patients, respectively. Six patients had mixed-infections. The duration from the onset of symptoms to the hospital visit was significantly longer in “lung abscess” patients than in “pneumonia” patients among the 24 patients with single infections, but not among the six patients with mixed-infection. The peripheral white blood cell counts of the “pneumonia” patients were higher than those of the “lung abscess” patients and S. intermedius was identified significantly more frequently in patients with pulmonary and pleural infections (pneumonia and lung abscess) than in patients with bacterial pleurisy only. In addition, the patients in whom S. intermedius was cultured were significantly older than those in whom S. constellatus was cultured. Conclusions Respiratory infections caused by the SAG bacteria tended to be observed more frequently in male patients with comorbid diseases and to more frequently involve purulent formation. In addition, S. intermedius was mainly identified in elderly patients with having pulmonary infection complicated with pleural effusion, and the aspiration of oral secretions may be a risk factor in the formation of empyema thoracis associated with pneumonia due to S. intermedius.
    Full-text · Article · Dec 2015 · BMC Pulmonary Medicine
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    ABSTRACT: Angiosarcoma originates from the vascular endothelium and accounts for only 1-2% of all sarcomatous malignancies. The skin is one of the most common primary sites. However, primary pulmonary angiosarcoma is rare, and only 31 cases of primary pulmonary angiosarcoma have been reported. A 79-year-old Japanese female developed bloody sputum, and chest X-ray and chest computed tomography (CT) showed consolidation with ground-glass opacity (GGO) on the right middle and lower lung fields. The bronchoscopic findings demonstrated bleeding from the right B(4) and B(5), and bronchial arterial embolization was subsequently performed. However, the CT findings demonstrated new pulmonary nodules with GGO in the left lung, and she presented with hemosputum and a progression of anemia. Right hemothorax also occurred, and surgical lung resection was performed to control the bleeding. The pathological analysis of the resected lung revealed the focal growth of atypical alveolar epithelioid-like cells that were positive for CD31 and negative for epithelial membrane antigen, and these atypical cells were replacing the endothelium of the pulmonary artery. Based on these findings, the patient was diagnosed with pulmonary angiosarcoma, which might originate from the endothelium of the pulmonary artery. No abnormal findings were observed except for the pulmonary involvement on systemic CT scanning. However, the patient passed away due to respiratory failure with compression of the brainstem caused by brain metastasis three months after the first visit. Early surgical resection is the important treatment for patients with angiosarcoma. In addition, we review the literature reporting the patients with primary pulmonary angiosarcoma.
    Preview · Article · Nov 2015 · The Tohoku Journal of Experimental Medicine
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    ABSTRACT: A 75-year-old Japanese man underwent thoracic surgery to treat a large lung cancer lesion in the left upper lobe with calcified pleural thickening. Postoperatively, viable Mycobacterium tuberculosis was detected in the margin of the resected thickened calcified pleural lesion. Therefore, an infection control investigation of medical staff who had come in contact with the patient was conducted. Consequently, two of the 14 healthcare professionals who had been in the operating room were diagnosed with latent tuberculous infections. Therefore, strict precautions against airborne infections are required to prevent the in-hospital transmission of M. tuberculosis in such cases.
    Full-text · Article · Oct 2015 · Internal Medicine
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    ABSTRACT: A 75-year-old man with interstitial pneumonia and enlarged mediastinal lymph nodes underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). He developed a high-grade fever seven days after EBUS-TBNA was performed; laboratory and radiologic findings showed intense inflammatory reactions, with swelling of the mediastinal lymph nodes on chest computed tomography. Mediastinal lymph node abscess was diagnosed, and it worsened in spite of systemic antibacterial treatment. Surgical treatment using a median sternotomy was performed, and the cultivation of surgically obtained mediastinal lymph node abscess fluid revealed Streptococcus intermedius. Combined treatment with antibiotics and surgical treatment was effective, leading to remission.
    Preview · Article · Oct 2015 · Internal Medicine
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    ABSTRACT: We herein report a case of pulmonary Mycobacterium avium complex (MAC) infection with pulmonary multiple nodules and the "halo sign" on chest computed tomography (CT) in which the patient showed rapid exacerbation seven years after undergoing bone marrow transplantation (BMT). A 68-year-old Japanese female visited our hospital due to a productive cough and dyspnea. She had undergone allogeneic BMT for acute myelocytic leukemia and received both prednisolone (2 mg/day) and cyclosporine (30 mg/day). Chest CT demonstrated no abnormal findings on admission; however, multiple pulmonary nodules and the "halo sign" were detected three weeks later. Although a fungal infection was initially suspected, a bronchoscopic examination revealed pulmonary MAC infection. In the present case, pulmonary MAC infection exhibited rapid progression with unique CT findings. Physicians should consider MAC infection in the differential diagnosis in patients who receive BMT and/or immunosuppressive agents, even if the clinical and radiological findings are atypical of the disease.
    Full-text · Article · Sep 2015 · Journal of UOEH

  • No preview · Article · Sep 2015 · European Respiratory Journal

  • No preview · Article · Sep 2015 · European Respiratory Journal
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    ABSTRACT: Streptococcus pneumoniae is one of the main causative bacteria in patients with pneumonia; however, there are no data regarding serotype changes in adult patients with pneumonia after the introduction of the pneumococcal vaccine (PCV7) for childhood immunization in Japan. We herein evaluated the serotype distribution in adult patients with pneumonia. This retrospective epidemiological study was performed at the University of Occupational and Environmental Health, Japan from January 2011 to December 2013. The serotypes of pneumococcal isolates obtained from patients with pneumonia were evaluated along with the patients' clinical information. A total of 81 patients with pneumococcal pneumonia (89 episodes) from whom S. pneumoniae was isolated were included. The numbers (percentages) of sample types were as follows: sputum 55 (61.8%), intratracheal tube suction 15 (16.9%), intrabronchial sampling 5 (5.6%) and bronchoalveolar lavage fluid 14 (15.7%). The PCV7 serotypes decreased significantly among the patients with pneumococcal pneumonia from 46.4% in 2011 to 20.0% in 2013 (p < 0.05). Conversely, PCV13 and 23-valent pneumococcal polysaccharide vaccination (PPSV23) serotypes other than PCV7 serotypes mildly increased during this period. In addition, the frequency of serotypes 19F, 23F and 4 (which are covered by PCV7) decreased annually; however, the changes in the frequencies of the other serotypes were not significant. This study demonstrated the yearly decrease of PCV7 serotypes in adult pneumococcal pneumonia patients after introducing PCV7 into the childhood immunization schedule in Japan. Continued surveillance of pneumococcal serotype changes is important for the proper use of different pneumococcal vaccines. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
    No preview · Article · Aug 2015 · Journal of Infection and Chemotherapy
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    ABSTRACT: A 65-year-old Japanese woman was introduced to our hospital for an examination of multiple pulmonary cystic lesions and a pulmonary nodule in the left lower lobe. She had a smoking history of 25 pack-years, and her two younger brothers had suffered from pneumothorax; one of them additionally had lung cancer with pulmonary multiple cystic lesions. A surgical biopsy specimen obtained from her left lower lobe revealed adenocarcinoma surrounded by a single epithelial layer that was covered with collagen fibers. The pathological features were compatible with the findings of the cystic lesions in the patients with Birt-Hogg-Dubé syndrome (BHDS). A diagnosis of BHDS was eventually made according to the detection of a folliculin gene mutation. This is the first report of a possible familial case of BHDS complicated with primary lung cancer. We herein reviewed the previously reported cases of BHDS with lung cancer and other tumors and discussed a potential mechanism of tumorigenesis and carcinogenesis in the lung in the patients with BHDS. Copyright © 2015. Published by Elsevier Ltd.
    No preview · Article · May 2015 · Respiratory medicine
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    ABSTRACT: Background: The causative pathogens of healthcare-associated pneumonia (HCAP) remain controversial, and the use of conventional cultivation of sputum samples is occasionally inappropriate due to the potential for oral bacterial contamination. It is also sometimes difficult to determine whether methicillin-resistant Staphylococcus aureus (MRSA) is a true causative pathogen of HCAP. Methods: We evaluated the bacterial diversity in bronchoalveolar lavage fluid (BALF) using molecular and cultivation methods in 82 HCAP patients. BALF specimens were obtained from the lesions of pneumonia using bronchoscopy. The bacterial flora was analyzed according to the clone library method using amplified fragments of the 16S ribosomal RNA gene with universal primers. In addition, sputum cultures and the above specimens were assessed. Results: Eighty (97.6%) of the 82 BALF samples obtained from the patients with HCAP showed positive polymerase chain reaction results. The predominant phylotypes detected in the BALF in this study included bacteria common in cases of community- and hospital-acquired pneumonia. In addition, the phylotypes of streptococci and anaerobes were detected in 19 (23.2%) and 8 (9.8%) cases, respectively. In particular, phylotypes of streptococci were highly detected among the patients 75 of age or older. Staphylococcus aureus was cultured in 23 (28.0%) cases using conventional cultivation methods and detected in only 6 (7.3%) cases as predominant phylotypes according to the clone library method. Conclusions: The clone library analysis of BALF in the HCAP patients detected heterogeneous bacteria and a high incidence of streptococci compared with that observed using cultivation methods. In addition, the results of our study may indicate a lower incidence of MRSA than previously expected in HCAP patients.
    Full-text · Article · Apr 2015 · PLoS ONE
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    ABSTRACT: Recent advances in cultivation-independent molecular biological modalities for detecting bacterial species have indicated that several bacterial species may play a role in the pathogenesis of certain infectious diseases. The aim of this study was to evaluate the role of bacterial flora in the pathogenesis of nontuberculous mycobacteriosis (NTM) using a bacterial floral analysis of bronchoalveolar lavage fluid (BALF) with 16S rRNA gene sequencing in patients with bronchiectasis. Fifty-eight patients with bronchiectasis evaluated using chest computed tomography were enrolled. BALF obtained from the most affected lung lesions was evaluated using culture and culture-independent methodologies. Approximately 600 bp of the bacterial 16S rRNA gene (E341F-E907R) was amplified via polymerase chain reaction using universal primers, and clone libraries were constructed. Nucleotide sequences of 96 randomly chosen clones for each specimen were determined, and the homology was searched using a basic local alignment search tool to determine the bacterial phylotypes and their proportions (bacterial floral analysis) in each specimen. Twenty-nine patients with bronchiectasis were diagnosed with NTM based on culture-based methods using Ogawa medium. The molecular method showed a significantly high rate of anaerobes among the patients with NTM compared with that observed in the bronchiectasis patients without NTM. In addition, findings of collapse/consolidation were significantly related to the proportion of Prevotella species in the BALF samples determined using the molecular method (P < 0.001). Given the results of the present study, anaerobes may play an important role in the pathogenesis of bronchiectasis in patients with NTM. © 2015 Asian Pacific Society of Respirology.
    No preview · Article · Mar 2015 · Respirology
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    ABSTRACT: We report a rare case of pulmonary paragonimiasis caused by Paragonimus miyazakii that showed pulmonary manifestations and a long-term clinical course after infection. A 45-year-old Japanese male developed cough and dyspnea in 2004, and was diagnosed with eosinophilic pneumonia. He had been treated with low-dose oral corticosteroid for seven years. He recalled that he had consumed a large amount of raw freshwater crab (Geothelphusa dehaani), several weeks before he had been admitted for the first time, and that had been the only occasion when he had eaten this meat. The patient was referred to our hospital due to persistent hemoptysis, and his chest computed tomography scan showed pulmonary nodules and cavities, and his serum total IgE level was elevated. Bronchoscopy was performed, and ova were detected in the bronchoalveolar lavage fluid. The morphological examination of the ova and immunoserological examination yielded typical findings of P. miyazakii. Treatment with praziquantel improved his chest radiographic findings and a decrease of serum total IgE, as well as the values of immunoserological examination for P. miyazakii. The clinical course of this patient indicated that he had been infected with P. miyazakii for seven years at least, which is unusual for paragonimiasis miyazakii. Copyright © 2015. Published by Elsevier Ireland Ltd.
    Full-text · Article · Mar 2015 · Parasitology International
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    ABSTRACT: A 62-year-old Japanese man was admitted to our hospital for evaluation of bilateral chest abnormal shadow.His lacrimal, submandibular and parotid glands had been swollen for several years. His serum immunoglobulin G4 (IgG4) level was >1,500 mg/dl, and chest computed tomography showed bilateral reticular opacities with enlarged mediastinal lymph nodes. Transbronchial lung biopsy and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) results suggested IgG4-related disease. This is the first report, to our knowledge, in the English literature showing EBUS-TBNA to be useful for diagnosing IgG4-related disease.
    No preview · Article · Dec 2014 · Journal of UOEH
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    ABSTRACT: Introduction Pneumonia is the third leading cause of mortality in Japan. In 2011, the use of meropenem (MEPM) at 3 g daily was approved to treat refractory infections in Japan. However, little has been reported on the clinical efficacy and safety of this regimen in Japanese patients with refractory infections. Objectives This study prospectively assessed the clinical efficacy and safety of MEPM (3 g daily) in Japanese patients with refractory pneumonia and/or intrapleural infections. Methods This study was performed at our university hospital and affiliated hospitals. The plasma concentrations of MEPM before and one and four hours after MEPM administration were also evaluated. Results A total of 48 patients were enrolled for the efficacy and safety evaluations. The response rate to MEPM (3 g daily) treatment was 90.9% (40/44). Adverse drug reactions were observed in 17 of the 48 patients (20.8%), and all improved after the cessation of MEPM. The plasma MEPM concentration one hour after administering 1 g of MEPM was 44.9 ± 12.0 μg/ml. A pharmacokinetic analysis revealed that the percentage of time above the MIC/24 h for an MIC of 4 μg/ml or 8 μg/ml was more than 50% in 12 of 13 (92%) and in nine of the 13 patients (69%), respectively, indicating sufficient efficacy of 3 g daily of MEPM. Conclusion Treatment with MEPM (3 g daily) in Japanese patients with refractory pneumonia and/or intrapleural infections is effective, with sufficient plasma concentrations of MEPM, and the treatment has a relatively good safety profile.
    No preview · Article · Dec 2014 · Journal of Infection and Chemotherapy
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    ABSTRACT: A novel, rapid and noninvasive test (ODK0501, RAPIRUN®S. pneumoniae) uses polyclonal antibodies to detect C polysaccharide of Streptococcus pneumoniae derived from sputum samples using an immunochromatographic assay. We evaluated its usefulness in Japanese patients with pneumonia who exhibited positive urinary antigen tests for S. pneumoniae (BinaxNOW®Streptococcus pneumoniae).Patients and Methods Forty adult patients with pneumonia treated between May 2011 and August 2013 were enrolled. Bacterial cultures, Gram staining and ODK0501 assays of sputum as well as urinary antigen tests for S. pneumoniae using urine samples obtained from the same patients were performed upon admission, the fourth day after starting antimicrobial treatment and at the end of the antimicrobial treatment.ResultsTwenty-seven of the 40 patients were positive for ODK0501, while a negative result for ODK0501 was associated with low-quality sputum samples according to the Geckler classification of sputum. The sensitivity and specificity of the ODK0501 assay in the 40 patients were 90.9% and 61.1%, respectively, based on the culture results. The results obtained with this kit were more favorable than those observed on Gram staining. The ODK0501 assay also showed a rapid reaction to the disappearance of S. pneumoniae in the sputum samples, while approximately 80% of the patients exhibited persistent positive results on the urinary antigen detection tests at the end of treatment.Conclusions The ODK0501 test is a noninvasive, rapid and accurate tool for diagnosing respiratory infections caused by S. pneumoniae, although good quality sputum must be obtained prior to adequate treatment with antibiotics. (235 words)
    No preview · Article · Nov 2014 · Journal of Infection and Chemotherapy
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    ABSTRACT: Background: Increased expression of several types of nitric oxide synthases (NOS) and increased levels of plasma nitrite and nitrate (NOx) have been reported in patients with pulmonary fibrosis, suggesting that nitric oxide (NO) has important roles in the development of pulmonary fibrosis. However, the roles of the entire system including NO and NOS in the pathogenesis of pulmonary fibrosis has not still being fully elucidated. The aim of the present study was to clarify the roles of NO and NOS in pulmonary fibrosis using the mice lacking all of three NOS isoforms. Methods: Wild-type, single and triply NOS knockout (n/i/eNOS-/-) mice were treated with intraperitoneal administration of bleomycin (BLM, 8.0 mg/kg/day for 10 consecutive days). Two weeks after the last administration of BLM, fibrotic and inflammatory changes of the lung were pathologically evaluated. In addition, the effects of long-term treatment with isosorbide dinitrate, a NO donor, on the BLM-induced pulmonary fibrosis in n/i/eNOS-/- mice were studied. Results: The histopathological findings, collagen content and total cell numbers in bronchoalveolar lavage fluid were the highest in the n/i/eNOS-/- mice after BLM treatment. Long-term treatment with supplemental NO donor significantly prevented the progression of these histopathological findings and an increase of collagen contents in the lungs induced by BLM treatment in n/i/eNOS-/- mice. Conclusions: These results provide the first direct evidence that a lack of all three NOS isoforms led to a deterioration of pulmonary fibrosis in a BLM-treated murine model using n/i/eNOS-/- mice. We speculate that the entire system of endogenous NO and NOS plays an important protective role in the pathogenesis of pulmonary fibrosis.
    No preview · Article · Oct 2014 · Respirology
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    ABSTRACT: Background: Current development of treatment modalities in treating bronchial asthma reduces mortality of asthma and improves quality of life of asthmatic patients. There are several inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) combinations currently used to treat asthmatic patients, however, the clinical differences between these two ICS/LABA combinations have not been fully investigated. Therefore, we evaluated the switching effects of two ICS/LABA combinations (fluticasone propionate/salmeterol combined Discus inhaler; FP/SM, budesonide/formoterol Turbuhaler inhaler; BUD/FM) in a real-world setting. Patients and Methods: Asthmatic patients over 20 year-old treated with FP/SM or BUD/FM for more than two months with persisting asthmatic symptoms (scores of Asthma Control Test; ACT less than 25 or scores of Asthma Control Questionnaire 5; ACQ5 more than 0) were enrolled. FP/SM (250/50 μg bid) was switched to BUD/FM (160/4.5 μg two inhalations bid) and FP/SM (500/50 μg bid) was also switched to BUD/FM (160/4.5 μg four inhalations bid). Conversely, BUD/FM (160/4.5 μg two inhalations bid) was switched to FP/SM (250/50 μg bid) and BUD/FM (160/4.5 μg four inhalations bid) was switched to FP/SM (500/50 μg bid). The spirometric analysis including the values of the peak expiratory flow (PEF) and forced expiratory volume in one second (FEV1) at the time of 0, 4, 12 and 24 weeks after switching from FP/SM to BUD/FM or from BUD/FM to FP/SM, and the scores of the asthma control test (ACT) and asthma control questionnaire-5 item version (ACQ5) were also evaluated. Results: Sixty patients (35 and 25 patients had received medium- and high-dose ICS/LABA, respectively) were switched from FP/SM to BUD/FM, and 20 patients (10 and 10 patients had received medium- and high-dose ICS/LABA, respectively) were eligible for an evaluation after switching from BUD/FM to FP/SM. In patients switched from FP/SM to BUD, ACT and ACQ5 were significantly improved four and eight weeks after the switch to ICS/LABA treatments, and the spirometric analysis also revealed significant improvements of the values of the PEF and FEV1 after switching from FP/SM to BUD/FM. In patients switched from BUD/FM to FP/SM, asthmatic symptoms (ACT and ACQ) and the values of spirometric analysis were not significantly changed, except for FEV1 that showed significant improvement after switching ICS/LABA, but one patient dropped out because of an exacerbation of asthmatic symptom. Discussion: Switching of ICS/LABA combined inhalers can be an alternative treatment for asthma in symptomatic asthmatic patients.
    No preview · Article · Oct 2014 · Respirology
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    ABSTRACT: A 73-year-old Japanese man visited a local hospital due to palpitations and dyspnea. He was diagnosed as having lung cancer (adenocarcinoma, cT1aN2M1b (BRA), stage Ⅳ), but he did not want to receive any anticancer medications, and was simply being observed. Several months later, he was referred to our hospital due to exacerbation of the dyspnea. His chest computed tomography revealed massive pericardial effusion, therefore he was diagnosed as having cardiac tamponade due to carcinomatous pericarditis and was immediately hospitalized. Upon admission, pericardial fenestration was firstly applied in order to drain pericardial effusion, and intraoperative cardiac findings showed suspicion of myocardial and pericardial metastasis. Immediately after the pericardiotomy, he suffered from cardiac arrest caused by shock. In lung cancer patients with pericardial effusion, even though it is rare, myocardial metastasis in addition to carcinomatous pericarditis and pericardial metastasis should be kept in mind.
    No preview · Article · Sep 2014 · Journal of UOEH
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    ABSTRACT: Background Increased expression of nitric oxide synthase (NOS) and an increase in plasma nitrite plus nitrate (NOx) have been reported in patients with pulmonary fibrosis, suggesting that nitric oxide (NO) plays an important role in its development. However, the roles of the entire NO and NOS system in the pathogenesis of pulmonary fibrosis still remain to be fully elucidated.¿The aim of the present study is to clarify the roles of NO and the NOS system in pulmonary fibrosis by using the mice lacking all three NOS isoforms.Methods Wild-type, single NOS knockout and triple NOS knockout (n/i/eNOS¿/¿) mice were administered bleomycin (BLM) intraperitoneally at a dose of 8.0 mg/kg/day for 10 consecutive days. Two weeks after the end of the procedure, the fibrotic and inflammatory changes of the lung were evaluated. In addition, we evaluated the effects of long-term treatment with isosorbide dinitrate, a NO donor, on the n/i/eNOS¿/¿ mice with BLM-induced pulmonary fibrosis.ResultsThe histopathological findings, collagen content and the total cell number in bronchoalveolar lavage fluid were the most severe/highest in the n/i/eNOS¿/¿ mice. Long-term treatment with the supplemental NO donor in n/i/eNOS¿/¿ mice significantly prevented the progression of the histopathological findings and the increase of the collagen content in the lungs.Conclusions These results provide the first direct evidence that a lack of all three NOS isoforms led to a deterioration of pulmonary fibrosis in a BLM-treated murine model. We speculate that the entire endogenous NO and NOS system plays an important protective role in the pathogenesis of pulmonary fibrosis.
    Full-text · Article · Aug 2014 · Respiratory Research