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Biomedical subjects

H Kojima

Publications and source records attributed to H Kojima.

At least 523 records · Page 29Linked to original sources
PubMed1990

[A case of long surviving gastric cancer with an malignant acanthosis nigricans].

Reported the case of a 73 year old female who was diagnosed as having a gastric cancer with malignant acanthosis nigricans and had a long survival, totaling about 8 years 6 months after operation. Further, her skin lesion completely disappeared. In general, a gastric cancer with malignant acanthosis nigricans is said to have a very poor prognosis and an analysis of recent cases has indicated that the average survival is about 10 months. The reason for such a bad prognosis is thought to be that the diagnosis of a gastric cancer with malignant acanthosis nigricans is usually determined only after the cancer is far advanced.

Acanthosis Nigricans↗
PubMed1990

[A case of spontaneous regression of malignant lymphoma, complicated with miliary tuberculosis, liver dysfunction and pancytopenia].

An 82-year-old woman was admitted to Iwamizawa Rosai Hospital, Cardiovascular Medicine, for detailed examination of an aneurysm of abdominal aorta. CT scan revealed marked swelling of para-aortic lymph nodes which regressed spontaneously in three months. She was re-admitted to our hospital because of general malaise and gait disturbance. Her chest X-ray on the second admission revealed miliary disseminated shadows, which were confirmed to be tuberculous granuloma by lung biopsy. She was initially well controlled with anti-tuberculosis drugs, followed by severe liver dysfunction and pancytopenia, and died of respiratory and cardiac failure. At autopsy, wide-spread malignant lymphoma and miliary tuberculosis of the lung were found. The cause of liver dysfunction was strongly suspected to be due to infiltration of the lymphoma cells to portal triads of the liver. Hemophagocytosis found in the bone marrow, spleen and liver might be consistent with clinically so-called "hemophagocytic syndrome", causing pancytopenia, associated with infection.

Aged↗
PubMed1990

[Metastatic Grawitz's tumor to the cauda equina: case report].

A case of Grawitz's tumor metastasizing to the cauda equina is presented. A 51-year-old male was hospitalized due to severe low back pain radiating to the left lower extremity. Neurological examination showed only hyporeflexia of the left patella reflex and positive Lasegue's sign. MRI showed intradural mass at the L4 level. Preoperatively, we diagnosed a cauda equina tumor. A laminectomy of both L3 and L4 was performed, and total removal of the cauda equina tumor was performed. Microscopically, the tumor cells were large, the appearance of the cytoplasm ranging from optically clear with sharply outlined boundaries, to deeply granular, with many transitional forms. These histological findings were typical findings of Grawitz's tumor, and were the same as those of this patient's renal tumor. Finally, we diagnosed Grawitz's tumor metastasizing to the cauda equina. Metastatic cauda equina tumor from outside the central nervous system is very rare and only 7 cases have been reported. This case is the first one of Grawitz's tumor spreading to the cauda equina.

Carcinoma, Renal Cell↗
PubMed1990

[Factors in the prognosis of early gastric cancer].

Prognosis factors for 1,012 subjects who underwent gastrectomy for early gastric cancer were studied over a 21-year period from 1965 to 1985. We divided submucosal cancer (sm) into two subgroups, classifying the one as sm II-1 with small cancerous nests in the submucosa and the other as sm II-2. Our cases of early gastric cancer fell into the following groups: m(mucosal cancer), 451 cases; sm II-1, 106; sm II-2, 396 and multiple cancer, 59. The rate of lymph node metastasis was 1.1% in the m group, 5.7% in the sm II-1 group, 24.5% in the sm II-2 group and 6.8% in the multiple group. Gastrectomy with removal of the second-group lymph node proved adequate for sm II-2 group. The five year survival rate was 94.5% in the m group, 94.9% in sm II-1 group, 93.6% in the sm II-2 group and 91.7% in the multiple cancer group. The rate of recurrence in m group was 0.9%, against 3.3% for sm II-2 group. The sm II-2 with histologically well-differentiated type, n(+) and macroscopically Borrmann type are high-risk groups. Adjuvant chemotherapy is necessary to obtain improved surgical results for the high risk group. There was a total of 21 non-curative resection cases among which distant metastases were observed. Cases of early gastric cancer exist which are beyond help by surgical means.

Gastrectomy↗
PubMed1990

[Chronic myelogenous leukemia with marked thrombocytosis--comparison with essential thrombocythemia with Ph1 in its megakaryokinetics].

A case of chronic myelogenous leukemia (CML) with marked thrombocytosis and its megakaryokinetics were reported. Patient was 57-year old woman who had a marked thrombocytosis (1,413 x 10(3)/microliters) and a bone marrow megakaryocytosis. Bone marrow karyotype demonstrated Ph1 chromosome in all cells examined. However, on physical examination, there was no splenomegaly. CBC showed no immature myeloid cells, and neutrophil alkaline phosphatase was elevated. These manifestations were consistent with so called essential thrombocythemia (ET) with Ph1 chromosome reported by Nissenblatt. To know the megakaryokinetics of this case, we examined the number of colony forming unit-megakaryocyte (CFU-M), platelet glycoprotein (PGP) IIb/IIIa positive cells, cytoplasmic area, and DNA content, comparing with those of normal subjects, CML, and ET. We found a marked increase of CFU-M and PGP IIb/IIIa positive cells, but in contrast, decreased DNA content and cytoplasmic area. This pattern of megakaryokinetics was consistent with that of CML. We conclude that ET with Ph1 chromosome may be a variant of CML rather than ET itself.

Adolescent↗
PubMed1990

Increased plasma plant sterol levels in heterozygotes with sitosterolemia and xanthomatosis.

Plasma sterol levels in a family of sitosterolemia and xanthomatosis were determined by a high performance liquid chromatography. Three affected siblings manifested marked xanthomatosis including subcutaneous soft tissues and generalized atherosclerosis. Two other siblings as well as children of the patients did not show such clinical symptoms and signs. Plasma levels of cholesterol, sitosterol, campesterol, and cholestanol in three affected subjects were 190 +/- 18.5, 25.9 +/- 11.6, 16.1 +/- 7.8, 1.84 +/- 0.92 mg/dl (mean +/- SD), respectively. Four daughters of the affected subjects, who should be considered as obligatory heterozygotes, showed moderately increased levels of these sterols (195 +/- 41.7, 1.33 +/- 0.44, 1.56 +/- 0.69, 0.80 +/- 0.28 mg/dl), which were significantly higher than those of normal subjects. Treatment with cholestyramine had little effect on the increased plasma plant sterol levels, but markedly decreased plasma cholestanol concentrations in two affected siblings. This report presents the clinical features of the patients with sitosterolemia and xanthomatosis and also demonstrates that heterozygotes with this disorder have increased plasma levels of plant sterols as well as cholestanol, and suggests that this rare disease might be inherited as an autosomal co-dominant trait in certain cases. The data also indicate that cholestyramine administration was not effective in this family for treatment of sitosterolemia.

Adult↗
PubMed1990

[The influence of reflux of bile and pancreatic juice on gastric carcinogenesis in rats].

The effect of reflux of the duodenal contents on the development of gastric stump carcinoma without carcinogen in rats was studied. At the first experiment, seventy male Wistar rats were subjected to gastrojejunostomy for the diversion of duodenal contents into the resected stomach through the afferent and the efferent loops. The incidence of adenocarcinoma in the afferent anastomosis were 0/8 (0%) at the 10th week, 3/16 (18.8%) at the 20th week and 7/20 (35%) at the 40th week, so the incidence was apt to rise in parallel to the time. In the second experiment, ninety rats were divided into 4 groups: Group I received the same operation as the first experiment, group II received the operation with Braun's anastomosis, group III received the operation for reflux of bile alone to the remnant stomach, and group IV received the operation for reflux of pancreatic juice alone. Animals surviving after surgery were sacrificed at the 40th week. The incidence were 33.3% in group I, 0% in group II, 0% in group III, and 8.3% in group IV, respectively. These findings suggest that reflux of duodenal contents (both bile and pancreatic juice) is an important factor in the gastric stump carcinogenesis.

Adenocarcinoma↗
PubMed1990

[A case of condyloma accuminatum around the anus in a married man].

A 34-year-old man was admitted to our hospital with warts around the anus persisting for the past four months as the chief complaint. There was no history of anal intercourse. All laboratory examinations of syphilis, hepatitis, chlamydia trachomatis, acquired immunodeficiency syndrome and other sexually transmitted diseases (STD) were negative. After application of amantadine, the warts disappeared completely in about two weeks. With diversification of sexual encounters, such a case of anal warts as a type of STD may increase in the domain of urology as well.

Adult↗
PubMed1989

Plasma levels of atrial natriuretic peptide in patients with liver cirrhosis and its relation to ascites and renal function.

Plasma immunoreactive alpha-human atrial natriuretic polypeptide (Ir-alpha-hANP) was measured by radioimmunoassay in 21 cirrhotics and 10 normal subjects. Average of Ir-alpha-hANP level in cirrhotics was significantly higher than in normal subjects (125.8 +/- 79.6 versus 28.7 +/- 12.2 pg/ml, P less than 0.001). In cirrhotics without ascites, Ir-alpha-hANP levels were positively correlated with creatinine clearance (Ccr) and urinary sodium excretion, suggesting that alpha-hANP was closely related to renal circulation and sodium homeostasis. On the contrary, in cirrhotics with ascites Ir-alpha-hANP levels were negatively correlated with Ccr. Urinary sodium excretion in cirrhotics with ascites and Ccr more than 50 ml/min was positively correlated with Ir-alpha-hANP levels. However, cirrhotics with ascites and Ccr less than 50 ml/min excreted little sodium in spite of high Ir-alpha-hANP levels. On the basis of the Ir-alpha-hANP before and after treatment of ascites, cirrhotics with ascites were subdivided into 2 groups. In group I Ir-alpha-hANP decreased from high values and in group II it was further elevated from slightly high values by treatment. The difference in renal function and plasma volume may account for the difference in Ir-alpha-hANP changes in the 2 groups.

Adult↗
PubMed1989

Onuf's motoneuron is resistant to poliovirus.

Onuf's nucleus, located in the anterior horn of the sacral spinal cord, has been shown to innervate the striated muscles of the urethral and anal sphincters and is known to be well preserved in patients who have motoneuron disease. To answer the question whether the nucleus is also safe from motoneurotrophic virus infections, we examined the spinal cords of 3 individuals who had suffered severe poliomyelitis. In 2 of these which were acutely fatal cases, all motoneurons were damaged by neuronophagia, but Onuf's nucleus escaped the inflammatory degeneration. In a chronic case, neuronal loss in the anterior horn with replacement by gliosis was prominent below the thoracic cord down to the sacral cord, but Onuf's nucleus was well preserved. Thus, Onuf's nucleus appears to differ from other motoneurons with regard to susceptibility to poliovirus infection.

Child, Preschool↗
PubMed1989

Homozygous hypobetalipoproteinemia with spared chylomicron formation.

Thirteen members of a family carrying a gene for pedigree of hypobetalipoproteinemia were analyzed for lipoprotein compositions, apolipoprotein (apo) B levels, and apo B isoforms. Judging from low density lipoprotein (LDL)-cholesterol (Chol) and apo B levels, a 75-year-old proband, a father who died of unknown fever, thrombopenia, and anemia, and his wife were heterozygous for hypobetalipoproteinemia. The proband had ataxic movement of hands and gait disturbance in later life. Three of four living siblings had extremely low levels of LDL-Chol (6 mg/dL) and LDL-apo B (2 mg/dL), and were postulated to have homozygous hypobetalipoproteinemia. Electrophoresis revealed marked deficiency of apo B-100, although trace amounts were noted in LDL. In contrast, apo B-48 was present in chylomicrons obtained after a fatty meal in the two patients with homozygous hypobetalipoproteinemia, indicating a selective deficiency of apo B-100 but not apo B-48. The defect in these patients seemingly is different from abnormal apo B-37 reported recently for a family with hypobetalipoproteinemia. Clinically, acanthocytotic red blood cells (8% to 12%), fatty liver, and low levels of serum lipid-soluble vitamins A and D were noted in homozygotes. One heterozygous sibling had 26 mg/dL LDL-Chol and 5 mg/dL LDL-apo B levels. All seven subjects in the third generation had low levels of Chol (85 to 140 mg/dL), LDL-Chol (40 to 63 mg/dL) and LDL-apo B (10 to 20 mg/dL). They also showed mild acanthocytosis (0.5% to 2%) and a decrease of fat-soluble vitamins in plasma.(ABSTRACT TRUNCATED AT 250 WORDS)

Acanthocytes↗
PubMed1989

Propagation of hepatitis A virus in hybrid cell lines derived from marmoset liver and Vero cells.

To establish monkey liver cell lines with a high susceptibility to hepatitis A virus (HAV), marmoset (Saguinus labiatus) liver cells were fused with Vero cells deficient in hypoxanthine-guanine phosphoribosyltransferase and the resulting hybrid cells were selected in HAT medium. Of four hybrid cell lines obtained (S. 1a/Ve-1 to -4), three (S. 1a/Ve-1, -3 and -4) were equally susceptible to HAV infection. When inoculated with a virus isolated from marmoset liver tissue (10% liver tissue extract) or a faecal virus (10% stool extract) from a human hepatitis A patient, all susceptible cell lines showed a significant elevation of viral antigen activity as seen in radioimmunoassay and/or immunofluorescent antibody assays, at 4 to 6 weeks post-infection (p.i.) with the liver-derived inoculum and at 6 to 8 weeks p.i. with the stool-derived inoculum. In S. 1a/Ve-1 cells, a representative of the susceptible hybrid cell lines, full adaptation of HAV (liver tissue virus concentrate) to cell culture was attained after four serial passages. Thereafter, the virus grew to a plateau titre of 10(8.5) TCID50/ml at 7 days p.i. in a growth experiment. The infected cells showed no cytopathic effects but eventually a persistent infection was established when a saturated level of virus growth was reached.

Animals↗
PubMed1989

Subcellular distribution of the transmissible agent in Creutzfeldt-Jakob disease mouse brain.

To determine the intracellular localization of the Creutzfeldt-Jakob disease (CJD) agent in mouse brain, cerebrum tissue of the mouse brain affected with the Fukuoka-1 strain was separated into six subcellular fractions (microsome, nerve ending, myelin, mitochondria, nucleus, and soluble fractions) by differential sucrose density gradient, and then the CJD infectivity of these fractions was examined. Serially diluted samples of each subfraction were inoculated intracerebrally into groups of BALB/c mice, and the infectivity was determined as to end point titration value, incubation period, and number of affected mice. On the basis of the protein content, the highest CJD infectivity was observed in the microsomal fraction. The nerve ending (synaptic plasma membrane) and myelin fractions were also infective. The mitochondria and nucleus fractions showed the lower infectivity. The infectivity of the soluble fraction was the lowest among the six subcellular fractions. From the findings obtained in this study two possibilities as to the intracellular localization of CJD agent were suggested: 1) the transmissible agent of CJD is closely associated with surface membranes of neuronal and/or glial cells, including their processes; 2) the CJD agent is diffusely present intracellularly, including in the surface membranes, but for manifestation of infectivity the agent needs membrane components as prerequisite factors.

Animals↗