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Biomedical subjects

H Kashima

Publications and source records attributed to H Kashima.

At least 55 records · Page 3Linked to original sources
PubMed1986

[An anatomo-clinical case of sequelae of acute encephalopathy. Infantile spasm with hypsarrhythmia].

Clinico-pathological studies of West syndrome are rather rare. A case of sequelae of acute encephalopathy which involved a nine-month-old boy with post-mortem data is reported. Birth and postnatal development had been normal until the onset of illness. Laboratory examinations ruled out bacterial or viral meningo-encephalitis and metabolic disorders. After the recovery from a coma lasting several days, spastic quadriplegia, severe mental retardation and intractable epileptic attacks were present. The latter were made of tonic spasms and myoclonic seizures. EEG records showed hypsarrhythmia. Neuropathological examination revealed almost symmetrical bilateral cystic cavities in the pontine tegmentum and lateral nuclei of both thalami. The corpus callosum was very thin. No finding suggested a congenital anomaly. In a search of the pathological basis for infantile spasms, this case was compared with the published data. It would appear that the lesions of the pontine tegmentum play a significant role in the pathogenesis of hypsarrhythmia or infantile spasms.

Acute Disease↗
PubMed1985

Identification of genital tract papillomaviruses HPV-6 and HPV-16 in warts of the oral cavity.

Warty lesions of the oral cavity were examined for etiologic association with genital tract papillomaviruses HPV-6, HPV-11, and HPV-16. DNAs extracted from ten oral biopsies were screened for HPV genomic sequences by Southern transfer hybridization with 32P-labeled viral DNA probes. Nonstringent hybridization with an HPV-6 probe revealed papillomavirus DNA sequences in four of seven tissues with histologic evidence of papillomatosis, in none of two tissues without histologic evidence of papillomatosis, and in one tissue that was not examined by histology. Stringent hybridization tests with HPV-6 and HPV-16 probes identified the genome in one tissue as being HPV-16, in a second tissue as being HPV-6 subtype a, and in a third tissue as HPV-6 (subtype unidentified); papillomavirus DNA sequences in two tissues are as yet not identified. An additional case of HPV-6 or HPV-11 related oral cavity lesion was diagnosed by in situ hybridization of paraffin sections with a 35S-labeled, mixed HPV-6 + HPV-11 probe. The hybridization in the positive section was extensive and confined to epithelial nuclei. The oral lesions associated with genital tract papillomaviruses were asymptomatic, multiple or single, and were located in different parts of the oral cavity, for example, on the gingivae, on the tongue, on the lip, on the tonsillar pillar, and on the floor of the mouth.

Adolescent↗
PubMed1985

The Swallowing Center: concepts and procedures.

This paper describes the purpose and organization of a dedicated center at The Johns Hopkins Medical Institutions for the evaluation of swallowing problems. The multidisciplinary approach outlined will permit a better understanding and more accurate diagnosis of the functional or organic lesions affecting the swallowing mechanisms. Illustrative cases are presented.

Adult↗
PubMed1985

Pulmonary manifestations of juvenile laryngotracheal papillomatosis.

Juvenile laryngotracheal papillomatosis spreads to involve the lungs in less than 1% of cases, and when this occurs, the prognosis is poor. In seven such cases, the lung lesions, which appeared either solid or cystic on radiographs, proved to be benign squamous cell proliferations or papillomas, with central cavities containing debris or air. They seemed to grow centrifugally, using the alveolar walls as scaffolding with central coalescence and lung destruction. Papillomas spread inferiorly from the larynx by direct extension as far as the major bronchi, but rarely beyond. However, the parenchymal lesions were widely scattered, and some were subpleural. This discrepancy suggests that fragments become detached, particularly during endoscopic resection, and are carried down the airways by airflow. Those that lodge proximal to the respiratory bronchioles may be removed by mucociliary action and cough. Those that travel more distally are poorly cleared and may grow. If enough lung parenchyma is destroyed, the patient can develop symptoms of restrictive lung disease in addition to signs of upper airway obstruction.

Adolescent↗
PubMed1985

[An autopsy case with peculiar acidophilic bodies in the dentate nucleus and brain stem, associated with degeneration of the pyramidal-extrapyramidal systems].

Case S.S. 59 years of age, male. At the age of 25, he had admitted to sanatorium for 7 years because of pulmonary tuberculosis. After his discharge, at the age of 45, he had started complaining of depressive mood or the idea of suicide and admitted to a mental hospital. Psychiatric diagnosis was depression and slight mental retardation. Shortly after, his depressive mood was improved, but his hypochondriac attitude was unchanged. No tendency toward dementia was proven. At the age of 54, he became enable to walk. Neurologically, pyramidal and some sort of extrapyramidal signs, dysarthria, disturbance of swallowing, fecal and urinary incontinence became apparent. Laboratory data showed scarcely any abnormality. At the age of 59, he died of bronchopneumonia. Neuropathologically, moderate degeneration of dentate nucleus, slight degeneration of pyramidal tract from medulla oblongata to spinal cord, striatum, substantia nigra were found. Neither senile plaques nor neurofibrillary changes could be seen throughout central nervous system. The most important finding is the presence of peculiar acidophilic bodies. They are round or oval, 10 approximately 20 mu in diameter and distributed in dentate nucleus, oculomotor nucleus, central grey of midbrain, superior colliculus, putamen, pallidum, subthalamic nucleus, Zona incerta, hypothalamus, Locus coeruleus, reticular formation of midbrain and pons, pontine nucleus, raphe nucleus, vestibular nucleus, inferior olive in order of number of the bodies. These bodies are scattered in so-called ground substance, and have no relations to any cell bodies or cell processes.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Stem↗
PubMed1985

Recurrent respiratory papillomatosis.

Recurrent respiratory papillomatosis is a disease caused by a virus in the Papovaviridae family. It tends to recur in the laryngotracheal tree, and treatment is surgical removal with a CO2 laser and suspension microlaryngoscopy. Some patients may require these procedures every few weeks, and a systemic agent to control disease would be ideal for them. Care must be taken in the selection of an agent, as these lesions, similar to other papova virus-induced lesions, are most susceptible to malignant degeneration in the presence of a carcinogen. Eight patients were given 10 courses of polyriboinosinic-polyribocytidylic acid [poly(I,C)-LC] in an attempt to control their disease. The three who were tested were able to produce good titers of interferon. The rate of disease progression was probably slowed in four patients, as reflected by a decrease in the requirement for surgery; however, the medication appeared to be relatively toxic in effective doses. Four of 10 courses were held for hepatotoxicity, and mild hepatotoxicity occurred in four more. One course was held for thrombocytopenia associated with bleeding at the tracheostomy site. We conclude that in its presently available form, poly(I,C)-LC is too toxic to be administered long term for control of this disease.

Adult↗
PubMed1984

Association of human papillomavirus subtype and clinical course in respiratory papillomatosis.

The relationship of human papillomavirus type 6 (HPV-6) subtypes to the clinical manifestations of respiratory papillomatosis was investigated. DNA was isolated from biopsy specimens of 21 patients and the viral genome analyzed by molecular hybridization. Four subtypes, designated HPV-6c through HPV-6f, were distinguishable by restriction endonuclease cleavage patterns of the viral genome. Patient records were reviewed to identify associations between viral subtype and sex, race, age at onset of papilloma, duration of disease, frequency of operations, history of tracheotomy and anatomical extension of papilloma. HPV-6c was present in 13 cases which were characterized by extensive anatomical spread of disease, higher frequency of operations, and a need for tracheotomy. HPV-6d occurred in 4 black patients with juvenile onset papilloma. HPV-6c was found in 2 white patients--1 with juvenile onset and 1 with adult onset papilloma. HPV-6f was identified in 2 white patients with adult onset disease.

Adolescent↗
PubMed1984

Carcinoma of the cervical esophagus: diagnosis, management, and results.

Nine of 168 patients (5.3%) with carcinoma of the esophagus had primary tumors in the cervical esophagus. The principal symptoms and signs of carcinoma of the cervical esophagus were dysphagia, hoarseness, neck mass, and weight loss. The esophagogram was a very reliable study, revealing the abnormality in all nine patients. The true extent of the disease was better delineated by computerized tomography which demonstrated not only the intraluminal mass but also the extraesophageal spread. Endoscopic examination of the cervical esophagus was the definitive procedure to establish the diagnosis. All nine patients were treated with definitive radiotherapy, three surviving two to five years. The major cause of death was the failure to control local disease.

Carcinoma, Squamous Cell↗
PubMed1982

Demonstration of papillomavirus antigen in paraffin sections of laryngeal papillomas.

A papillomavirus antigen has been identified in tissue sections of laryngeal papillomata removed at endoscopic operations. The demonstration of the papillomavirus antigen was achieved using the peroxidase-anti-peroxidase test of Sternberger after a broadly cross-reactive rabbit antiserum to the papillomavirus capsid antigen was incubated with the tissue sections. The antigen was detected in specimens from 7 of 15 patients with juvenile-onset laryngeal papillomas, but could not be demonstrated in the specimens from 6 patients with adult-onset papillomas. In all, 73 biopsy specimens from 21 patients were selected for study; 18% (11/61) of the sections from the juvenile-onset patients and 0% (0/12) of the sections from the adult-onset patient specimens exhibited the papillomavirus antigen.

Adult↗
PubMed1982

Viral etiology of juvenile- and adult-onset squamous papilloma of the larynx.

Juvenile- and adult-onset laryngeal papillomas were examined for the presence of a human papillomavirus (HPV) genome and capsid antigens. DNA was isolated from a portion of tissue removed for therapeutic purposes, and the presence of a papillomavirus genome was detected by Southern transfer analysis. The viral DNA found in the 12 juvenile-onset and the 8 adult-onset laryngeal papillomas examined was identified as HPV-6 on the basis of size, restriction endonuclease digestion patterns, and homology detected under stringent conditions. Restriction endonuclease analysis of the viral genomes revealed at least four different subtypes, designated HPV-6c through HPV-6f. The most common subtype, HPV-6c, was detected in over half of the papillomas studied, including both juvenile and adult types. The remaining tissue was fixed and processed for immunocytochemistry. The immunoperoxidase technique was used with an antiserum that reacts with capsid antigen(s) common to all HPV serotypes. HPV antigen was found in two of the juvenile-onset papillomas and two of the adult-onset papillomas. The antigen was localized to the nucleus and was distributed in the superficial layers of the epithelium. HPV capsid antigen had not previously been detected in cases of adult-onset papilloma, and the HPV genome in both juvenile- and adult-onset laryngeal papillomas had not been characterized. Despite the absence of detectable viral antigen in most of the specimens examined, the presence of the HPV genome provides strong evidence for the papillomavirus etiology of these tumors.

Adolescent↗
PubMed1981

Introduction of the Janus flap. A modified pectoralis major myocutaneous flap for cervical esophageal and pharyngeal reconstruction.

The pectoralis major myocutaneous flap (PMMF), with its design and modified applications, is a versatile and reliable method for the reconstruction of large defects that result from surgical ablation or trauma. Defects of the cervical esophagus (two cases) and pharynx (one case) were repaired. In three cases, a technique variation of "banked skin" (the Janus flap) was used to repair through-and-through defects that required two epithelial surfaces. In two cases, the PMMF was harvested after a previous ipsilateral deltopectoral flap. The flap survived preoperative or postoperative radiation in all of the cases. Pharyngoesophageal function was restored in an average of 19 days, with the exception of one case of persistent carcinoma (63 days). There were no major complications or flap failures.

Esophagus↗
PubMed1980

Subclinical reduction in airflows after Teflon injection of vocal cord.

Results of intracordal Teflon injection for symptoms of unilateral vocal cord paralysis have been excellent. There seems to be no significant long-term foreign body reaction or limitation to maximum airflows. However, acute inflammatory reactions and airflow obstruction have been reported. The objective of the present study was to evaluate the frequency, extent, and duration of airway obstruction following Teflon injection. Forced inspiratory and expiratory airflows were measured in seven consecutive patients before, 24 hours, and 10 days after Teflon injection. Significant variable upper airway obstruction, as demonstrated by an increase in the ratio of forced expiratory airflows at 50% Vital Capacity to the forced inspiratory airflows at the same lung volume (VE50/VI50), was found in each subject. At 24 hours after the injection this ratio increased from a baseline of .098 +/- 0.50 (mean +/- S.D.) to 1.41 +/- 0.67 (P less than 0.01), and returned to baseline values in 10 days (0.95 +/- 0.14). We conclude that Teflon injection into a paralyzed vocal cord creates a significant inspiratory airway obstruction that is reversible in 10 days.

Adult↗
PubMed1979

Neutral lipid and sphingolipid composition of the brain of a patient with membranous lipodystrophy.

Lipids were extracted from brains of a patient with membranous lipodystrophy (ML) and three normal patients and the neutral lipid and sphingolipid constituents were investigated. The storage of a large amount of free fatty acid was observed in the ML brain, but no cholesterol ester was found. Total lipid, cholesterol and cerebroside contents were slightly decreased in the white matter of the ML brain. The composition of free and sphingolipid fatty acids did not differ between ML and normal brains.

Adult↗
PubMed1979

Upper airways obstruction with bilateral vocal cord paralysis.

In ten patients with bilateral vocal cord paralysis, we demonstrated variable extrathoracic airway obstruction. The ratio of forced expiratory flow at 50 percent vital capacity to forced inspiratory flow at the same lung volume (VE50/VI50) was 1.65 +/- 0.77 (mean +/- 1 SD). There was marked variability of inspiratory flow obstruction with a mean VI50 of 1.63 +/- 0.75 liters/ sec and a range from 0.9 liters/sec to 3.2 liters/sec. Nine of the ten patients required tracheostomy for symptoms of dyspnea. Follow-up flow volume loops were obtained to document the effects of surgical intervention and tracheostomy.

Adult↗