Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0026916 (MAC)
 5,226 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In two groups, A and B, both composed of 10 mongrel dogs, we studied the cardiac electrophysiologic effects of 1 and 1.5 MAC isoflurane administered by liquid injection in a closed circuit. In group B the study was done under pharmacological autonomic blockade (AB). With electrode catheters for programmed pacing and endocavitary potential recordings, we determined during the anesthesia with 1 and 1.5 MAC isoflurane: RR, spontaneous and paced AH, and HV intervals, corrected sinus recovery time (CSRT), Wenckebach point (WP), functional and effective refractory periods of atria (AFRP, AERP) and AV node (AVNFRP, AVNERP), and ventricular effective refractory period (VERP), these were compared to the ones obtained with a previous thiopental control. In group A, 1 MAC isoflurane increased over control: AERP and AH interval (p < 0.05), AFRP (p < 0.005), RR and AH paced intervals, WP, AVNFRP and VERP (p < 0.001), adding to these CSRT (p < 0.01) in 1.5 CAM. This level did not show differences with 1 MAC. In group B, 1 MAC isoflurane increased over control: AH (p < 0.05), RR, paced AH intervals, WP and AVNFRP (p < 0.001), adding to these AFRP and AERP (p < 0.05) in 1.5 MAC. This level increased with regard to 1 MAC: AFRP, AERP, AH paced interval and AVNERP (p < 0.05), and AVNFRP (p < 0.005). Isoflurane alone or with AB increased parameters of sinusal automaticity, atrial refractoriness, AV nodal conduction and refractoriness, increasing only without AB ventricular refractoriness and CSRT. With AB atrial and AV nodal refractoriness increased in an anesthetic depth dependent way.
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PMID:[Effect of the inhalation ++ anesthetic isoflurane on heart electrophysiology]. 143 71

Reagents that recognize antigens on lymphoid cells in fixed and wax-embedded sections have been applied to a series of cases of non-Hodgkin's lymphomas. The panel consisted of MB1, 4KB5 (CD45r), LN1, L26 and MB2 which recognize antigens expressed predominantly on B-lymphocytes; UCHL1 and MT1 which recognize antigens expressed on T-lymphocytes and myeloid cells; antibodies recognizing the non-lineage antigens LeuM1 (CD15), BerH2 (CD30), anti-EMA; anti-lysozyme and MAC 387 which detect antigens present on some macrophages; and finally TAL1B5 (class II MHC), CAM 5.2 (low molecular weight cytokeratin) and PD7/26 + 2B11(CD45). Two hundred and four cases of non-Hodgkin's lymphoma have been studied, of which 158 had been fully characterized on frozen sections. The series was biased towards high-grade (n = 108) and T-cell (n = 44) tumours and these were largely prospectively accrued. It was found that discrimination between B-cell and T-cell lymphomas can be reliably achieved using these reagents and that a small panel (CD45, L26, MB2, MT1, UCHL1) is adequate for this purpose. Using the full range of reagents it is not possible to subdivide cases into groups that correspond with morphological subtypes of lymphoma. Although paraffin section immunohistochemistry is of value, the diagnosis of lymphoproliferative disorders must still be based upon the assessment of well fixed, carefully prepared tissue sections using conventional tinctorial methods.
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PMID:Paraffin section immunohistochemistry. I. Non-Hodgkin's lymphoma. 326 64

Although no animal is a perfect skin model for the study of toxicological and therapeutic agents, structurally the pig may be superior to even non-human primates. Because our work involves effects of toxicological and therapeutic agents on the skin, we wanted to identify stains which may prove useful as well as determine cross-reactivity of some newer antihuman antibodies. We performed a battery of formalin-fixed skin from weanling pigs and minipigs. The battery of antibodies included LCA, CD3, OPD-4, CD34, UCHL-1, L-26, KP-1, MAC-387, Factor XIIIa, Leu-7, S-100 protein, HMB-45, GFAP, synaptophysin, neurofilament protein, ubiquitin, vimentin, type IV collagen, laminin, fibronectin, Factor VIII related antigen, Desmin-M, smooth muscle actin, cytokeratin 7, cytokeratin 20, AEI/AE3, CAM 5.2, EMA, GCDFP, Ki-67, and PCNA. Immunohistochemical stains for CD3, Leu-7, S-100 protein, type IV collagen, laminin, Factor VIII related antigen, GFAP, synaptophysin, neurofilament protein, ubiquitin, smooth muscle actin, vimentin, Desmin-M, cytokeratin 7, cytokeratin 20, AE1/AE3, CAM 5.2, Ki-67 and PCNA showed consistent cross-reactivity. In formalin-fixed tissue, only antibodies to lymphoreticular cells showed poor cross-reactivity. A high percentage of the remaining antibodies did show good cross-reactivity but with some interesting similarities and differences in specificity.
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PMID:Sensitivity of cross-reacting antihuman antibodies in formalin-fixed porcine skin: including antibodies to proliferation antigens and cytokeratins with specificity in the skin. 974 58

Moist pleurisy in patients with Mycobacterium avium Complex (MAC) is rarer than tuberculosis. We encountered an extremely rare case of MAC disease in a 75-year-old man who initially had only right pleural effusion. Gaffky VII was detected in the pleural effusion, and Mycobacterium avium was identified by culture and PCR. Although administration of antitubercular agents (RFP, INH, EB, and SM) + CAM and thoracic lavage were repeated, the Gaffky persisted strongly. Accordingly, pulmonary decortication and filling of the cavity with an omental flap were performed as surgical treatments. However, fistulas were formed between the remaining empyema cavity and the surgical wounds. Fenestration was also carried out. Postoperatively, centriacinar abnormalities appeared on computed tomography (CT). It has been reported that MAC disease begins with centriacinar abnormalities and the incidence of the lymphatic developmental pattern was low. Tuberculosis (the idiopathic pleuritis type) is considered to be caused this pattern from the primary infection focus. Therefore, the onset of unilateral effusion is extremely rare in patient with MAC disease, suggesting that the lymphatic developmental pattern occurs less frequently in patients with MAC disease. Furthermore, in this case, we speculated that centriacinar abnormalities were the MAC infection foci and could be detected by CT due to surgical invasion.
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PMID:[Development of a case of Mycobacterium avium complex disease from right pleural effusion]. 1110 10

We retrospectively investigated the clinical appropriateness of combined chemotherapy following the Japanese Society for Tuberculosis guidelines corresponding with those of the American Thoracic Society guideline for MAC pulmonary disease including a comparison with the past treatment for MAC pulmonary disease. The subjects of this study were 159 patients at several hospitals surveyed by the Chugoku-Shikoku Research Committee on Mycobacterium who were diagnosed as having MAC pulmonary disease between April 1995 and March 2001. Among them, 102 patients were treated using a regimen of antituberculous drugs with CAM, 33 patients received antituberculous drugs without CAM, and 24 patients were treated using other regimens. With a regimen of antituberculous drugs plus CAM, the sputum conversion rate was 45.1%, the relapse rate was 39.1% and clinical improvement was obtained in only 29.4%. On a regimen of only antituberculous drugs, the sputum conversion rate was 30.3%, the relapse rate was 70.0% and clinical improvement was obtained in 12.1%. Among the 102 patients receiving the regimen of antituberculous drugs plus CAM, 41 patients were treated with RFP, EB, SM and CAM following exactly the guidelines. The sputum conversion rate was 58.5%, the relapse rate was 37.5% and clinical improvement was obtained in 36.6%. Among 61 patients treated with other antituberculous drugs plus CAM, the sputum conversion rate was 36.1%, the relapse rate was 40.9% and clinical improvement was obtained in 24.6%. The clinical effect of the combined chemotherapy (RFP, EB, SM and CAM) was better than that of the other regimens throughout this study. However, the efficacy of this combined chemotherapy was unsatisfactory compared with the clinical effect for pulmonary tuberculosis. Therefore, the development of new companion drugs for the disease with mycobacteria other than M. tuberculosis is needed.
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PMID:[Effect of combined chemotherapy following the guidelines on treatment for Mycobacterium avium complex pulmonary disease]. 1213 97

Pulmonary non-tuberculous mycobacteriosis in Japan occurs more than about 5,000 cases annually. Among them, about 70% are occupied by Mycobacterium avium complex (MAC) infection. Considering the frequency and the difficulty of treatment, we discuss mainly on pulmonary MAC infection on this report. At National Tokyo hospital, secondary MAC infection after tuberculosis sequelae were 46.5% out of 170 pulmonary MAC cases since 1969 to 1985, but it decreased to 19.4% out of 268 cases since 1986 to 2000. In this same period, a type of MAC infection like middle lobe syndrome without recognizing preceding pulmonary disease, increased to 69.8% out of all pulmonary MAC cases (Fig. 1). Recently, this type of pulmonary MAC infection, which consists with scattered nodular lesion and local bronchiectasis in middle lobe or lingula, attracts attention. Why is there much frequency in women? Why does it originate from middle lobe or lingula? Although, it shows a characteristic X-ray pattern, ant it is still an interesting problem, the origin of the disease cannot be clarified. First diagnostic standard of nontuberculous mycobacteriosis in Japan was submitted in 1967, and the current diagnostic standard was made in 1985, through several times improvements. These contents are almost similar to that of American diagnostic standard in 1997, but the new revision that reflected chest CT findings and bronchoscopic sampling etc, is pressed now. In the treatment, INH or PZA, which is a key drug in tuberculous chemotherapy, is not a key drug in MAC chemotherapy. MAC chemotherapy is multidrugs combination chemotherapy including EB, CAM, RFP, and aminoglycosides. However, it is difficult to achieve complete regression with current drugs combinations, and an early surgical resection is the most effective in case of localized MAC lesion. We propose a guidance of treatment selection with age and disease severity (Table). Fig. 2 shows survival curves of 104 cases pulmonary MAC infection at National Tokyo Hospital.
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PMID:[Diagnosis and treatment of pulmonary nontuberculous mycobacteriosis]. 1260 41

A case of W-P-W syndrome complicated with pulmonary hypoplasia disclosed by pneumonectomy for pulmonary Mycobacterium avium complex infection associated with intractable pneumothorax was reported. A male patient aged 52 years consulted our clinic with chief complaints of cough and abnormal shadows on his chest radiogram, which was consistent with mycobacteriosis on his left lung. MAC infection was soon confirmed by sputum examination and he was treated with RFP, EB, INH combined with CAM. In spite of the chemotherapy, sputum examination of the patient remained positive. Furthermore, eleven months after initiating the treatment, an intractable pneumothorax concurrent with a large dead space at the left lower lung field was consistently observed on his chest radiogram. Therefore, he was first treated by video assisted thoracoscopic surgery, but soon relapsed which led to tention pneumothorax gradually. Consequently, a left pneumonectomy had to be performed and the following developmental abnormalities combined with pathological changes caused by MAC infection were disclosed: concerning the upper lobe, defect of lingula, formation of a peripheral type of congenital air-filled parenchymal cyst measuring 5 x 6 cm in S3, and atelectatic induration caused by MAC infection on the remaining part of the upper lobe where strong adhesion was seen between the chest wall and the lung. Concerning the lower lobe, congenital shortening of visceral pleura, mainly mediastinal surface, causing marked deformity of the lower lobe with elevation of margo inferior. This created a large dead space between the lower lobe and diaphragma, and formation of a walnut-sized nest of atelectatic induration caused by MAC infection in S6. The patient's post-operative clinical course was uneventful and his arterial blood gas was elevated from 76 torr to 99.2 torr. He was discharged three weeks after the operation. Several controversial issues relating to this case were discussed; the predisposition existing on the hypoplastic lung to MAC infection, the possible reason why the congenital pulmonary cyst was not involved in MAC infection, the location of perforation of the upper lobe that caused intractable pneumothorax, and the difficulty in diagnosing congenital air-filled bullous parenchymal cyst by current conventional chest radiogram.
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PMID:[An adult case of hypoplasia of the left lung disclosed by pneumonectomy for pulmonary M. avium complex infection associated with intractable pneumothorax]. 1467 47

The non-tuberculous mycobacteriosis (NTM) is not a unitary disease. It is a general term for the bronchopulmonary diseases caused by any mycobacterium other than M. tuberculosis. We don't call the pulmonary "pseudomoniosis" for the diffuse bronchiectasis caused by Pseudomonas aeruginosa, though conditions of the disease looks like NTM. The name of NTM represents that the causativebacteria belong to the same species with M. tuberculosis which causes serious pulmonary infectious disease. The pulmonary diseases caused by M. kansasii or M. szulgai are usually treated by RFP, EB and INH, the same regimens with tuberculosis, which generally lead to sufficient results for patients. But for MAC diseases, the number of patients is top of NTM in Japan, recent treatment with new-macrolides and some anti-tuberculous drugs generally does not bring about the desired effect. The plenty clinical experiences for NTM in HIV positive patients have lead to such new regemens in the USA. For NTM caused by rare Mycobacterium detectedvery seldom, clinical experiences and knowledge are definitely insufficient. (1) Present state of therapy for pulmonary MAC disease (drug therapy): Yoshihiro KOBASHI (Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School, Kurashiki, Okayama Prefecture) Co-operative study of Research Committee of Mycobacterium in the Chugoku and Shikoku areas revealed that the combined therapy according to the guidline is clinically appropriate for pulmonary Mycobacterium avium complex (MAC) disease. (2) Relapse and chemotherapy duration of pulmonary Mycobacterium avium complex infection: Atsuyuki KURASHIMA (Division of Clinical Research, National Organization Tokyo National Hospital, Kiyose, Tokyo) Reviewing the 71 relapses out of 1170 pulmonary MAC infection cases, he indicated that 11.3% relapsed during the chemotherapy continuation, 23.9% after the reduction of chemotherapy, 64.8% after the termination of chemotherapy. In the last group, there is no correlation to the relapse period after the end of treatment with the preceding chemotherapy duration. It is supposed that the main cause of these relapses are enviromental re-infection. (3) Chemotherapy for pulmonary M. kansasii disease: Katsuhiro SUZUKI (Clinical Research Center, Nationl Organization Kinki-chuo Chest Medical Center, Sakai, Osaka) Analysis of 938 pulmonary mycobacteriosis in 2003 revealed that 244 (26%) patients suffered from NTM, in which 66 (27% of NTM) were M. kansasii disease. The 48 (73%) patients were male. From 2001 to 2004, in the 190 M. kansasii patients treated by anti-tuberculous drugs, H/R/E prescribed for 84 cases (44%), other 41% of prescriptions included CAM and (or) LVFX. Almost all patients were converted into bacilli negative in about 30 days with any prescription. (4) Treatment and management for NTM patients in aprivate clinic: Seiji MIZUTANI (Mizutani Respiratory Clinic, Nerima ward, Tokyo) Analysing clinical experiences, he emphasized that most NTM patients with some symptoms visits private clinics in the first place. In Japan, diagnosis of NTM with radiological and bacteriological examinations is not difficult, and most NTM patients can be controlled as the outpatients of the clinics. (5) Surgical Treatment for non-tuberculous mycobacteriosis: Kouji KIKUCHI (Division of Chest Surgery, Medical Center, Saitama Medical School, Iruma county, Saitama Prefecture) The 9 NTM cases surgically treated were analysed, 8 were MAC cases and 1 was M. kansasii case. The main reasons for sugical resection were, continuous hemoptisis, continuous productive cough, or exacerbation on chest X-ray features. The NTM bacilli were positive in 8 cases, another one was bacilli negative, though X-ray shadows increased. After the surgery, expectoration of bacilli converted to negative in 5 SPECIAL COMMENTARIES: Can pneumonectomy be an acceptable procedure for non-tuberculous mycobacterial infection?: Yuji SHIRAISHI (Division of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo) The 11 NTM patients were analysed, who underewent pneumonectomy. The median blood loss was 555 ml and there was no operative mortality. Bronchpleural fistula or empyema occured in 4 patients. The bacilli negative conditions were achieved in all patients after surgery. The NTM is not a legal epidemic disease and Japanese Tuberculosis Prevention Act doesn't cover this disease. The medical treatment insurance system doesn't contain the NTM in the list of applicable diseases in Japan. Though these some problems with increasing numbers of patients remain in clinical practice, chairpersons hope that this symposium will be a milestone for the generalized progress of treatment and management of NTM in Japan.
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PMID:[Treatment of non-tuberculous pulmonary mycobacteriosis]. 1647 99

A 74-year-old woman was admitted to our hospital in December, 2003 because of anorexia and weight loss lasting from August, 2003. Chest CT scan showed empyema with a niveau in the right lung and infiltrative and nodular shadows in the left lung. Acid-fast bacilli were detected in pleural effusion. Polymerase chain reaction (PCR) test was negative for Mycobacterium tuberculosis (M. tuberculosis) but positive for Mycobacterium avium (M. avium). PCR test for M. avium was also positive in bronchial lavage fluid, and many colonies of M. avium complex ( MAC) were cultured from pleural effusion. After we administered 4 drugs including RFP, EB, SM, and CAM, cultured colonies of M. avium decreased, the inflammatory reaction improved, and infiltrates in the left upper lobe has disappeared. These improvements confirmed the diagnosis of empyema caused by M. avium. Since nontuberculous mycobacteria induced empyema has rarely been reported, the clinical features of this disease should further be examined.
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PMID:[A case of pyothorax caused by Mycobacterium avium]. 1722 5

Three important statements for Japanese pulmonary nontuberculous mycobacteriosis (NTM) were published in 2008. The first one is a new diagnostic criteria for pulmonary NTM, which was organized in association with the task force for nontuberculous mycobacteriois of the Japanese Society for Tuberculosis and the section for infectious disease and tuberculosis of the Japanese Respiratory Society. The second is a treatment guideline for pulmonary nontuberculous mycobacteriosis also which was made by the same joint working. The third is a sugical treatment guideline for pulmonary nontuberculous mycobacteriosis. The reason for the task of immediate importance is the number of pulmonary Mycobacterium avium complex (MAC) disease keeps increasing in our country and the disease cannot be disregarded widely in municipal hospitals or clinics. The morbidity rate of pulmonary MAC disease is assumed to be about 3.5 in the north American area. A lot of European nations are presumed that do not reach 1.0. Most of Asian researchers reply to our E-mail questions with the recent increasing of pulmonary MAC disease. Japanese estimated morbidity rate of this disease seems to be over 6.0 in 2007. It has been not clarified why a lot of this disease cases are in particular in Japan. In this situation, a concise diagnostic criteria is required from even a doctor who is not respiratory medicine specialists. The diagnosis can be confirmed by twice culture from sputa or one culture in case of bronchoscopic examination regardless of the bacterial strain. Moreover, it is possible to correspond to wider varieties of radiographic findings than 2007 diagnostic criteria of the United States. This disease became possible to diagnose before the consciousness syndrome appeared by the advancement of today's excellent imaging technology and nuclear acid amplification method. Therefore, the diagnosis confirmation and the beginning of chemotherapy time has become separated. In 2008, on Japanese medical insurance, the prescription of two drugs has become possible officially for pulmonary NTM due to the efforts of many stakeholders. However, pulmonary NTM is a disease to obtain a constant improvement at last continuing combination chemotherapy for a long term. Three drugs regiment of CAM as a main axis, adding EB, RFP or RBT is now a de facto international standard. New Japanese guideline for treatment describes the adverse events by a long-term administering more in detail than the previous one. However, it is difficult to control only by an internal therapy. In case of a localized lesion, we have recommended an appropriate surgical treatment. But a surgery treatment without combination of chemotherapy could not achieve an enough result. A multidisciplinary approach is important. The guideline of surgical treatment that reflected these content was also published in 2008.
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PMID:[Japanese new guidelines for nontuberculous mycobacterial pulmonary disease]. 2022 21


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