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Biomedical subjects

J Kudo

Publications and source records attributed to J Kudo.

At least 37 records · Page 2Linked to original sources
PubMed1992

Nodular regenerative hyperplasia of the liver with portal vein thrombosis and hyperplasia of the adrenal gland.

Nodular regenerative hyperplasia (NRH) of the liver is an uncommon entity of unknown origin and pathogenesis. We report here a case of NRH of the liver which was associated with portal vein thrombosis and adrenal hyperplasia. A 48-year-old man who was admitted for further examination of portal hypertension and splenomegaly, died of acute myocardial infarction. Autopsy revealed an enlarged heart with occluded coronary arteries and fresh multiple necrosis in the myocardium. The spleen and the liver were enlarged. In the liver diffusely distributed nodules of regenerative hyperplasia were noted. Organized thrombi of the portal vein and adenomatous hyperplasia of the left adrenal gland were also noted. Antinuclear antibody was positive in the serum.

Adrenal Glands↗
PubMed1992

[Effective continuous hemofiltration and plasma exchange for the treatment of subacute type fulminant hepatic failure].

By combination of continuous hemofiltration (CHF) with plasma exchange therapy we successfully treated a patient with subacute type fulminant hepatitis to keep her consciousness alert. The patient was a 55-year-old woman who admitted because of severe jaundice. On the 51st day after the onset she had consciousness disturbance and was transferred to our hospital. We started the therapy of CHF and plasma exchange at the patient's hepatic coma grade 4. On the 5th day her consciousness level recovered to grade 2 and we could keep the level for almost 2 weeks. This combination therapy seemed good not only for the improvement of consciousness of patients in hepatic coma but also to support the hepatic function of almost ahepatic patients.

Female↗
PubMed1992

[An autopsy case of citrullinemia type II complicated with chronic pancreatitis].

A 34-year-old woman had developed frequent episodes of disorientation at night since a year ago. Her blood ammonia level was found to be markedly increased. Serum amino acid pattern and biochemical analysis of urea cycle enzymes in the liver indicated type II citrullinemia. Pancreatolithiasis was found by ultrasonography and CT scan. After a short remission following treatment by protein restriction and oral administration of sodium benzoate, she had disturbed consciousness due to exaggerated hyperammonemia and died of severe brain edema. In this report, efficacy of the treatment for hyperammonemia and histopathological findings are discussed.

Adult↗
PubMed1992

[A patient with liver cirrhosis manifesting various symptoms including cerebellar ataxia due to germanium intoxication].

A patient with hepatitis B virus-associated cirrhosis manifested various symptoms such as anemia, renal damage and neurological signs including cerebellar ataxia due to long-term administration of germanium-containing food. The patient was a 40-year-old male who had taken germanium containing mineral cheese for 26 months after he was diagnosed as having cirrhosis. Twenty four months after beginning to take the mineral cheese, he began manifesting paresthesia of the extremities, dysarthria and gait ataxia. Laboratory findings revealed anemia and renal damage. Biopsy of the peripheral nerve revealed loss of the large sheathed nerve, a characteristic feature of germanium intoxication. A high concentration of germanium (GeO2) was detected in patient's hair and urine. Cerebellar ataxia was characteristic in this patient, which was not reported in the previous papers.

Adult↗
PubMed1991

Sonographic assessment and grading of spleen size.

Ultrasonography was used to evaluate spleen size in patients with various clinical conditions including those of the liver, blood, collagen, or autoimmune disease. To express spleen size, a spleen index (SI), the product of the transverse diameter and its perpendicular diameter measured on the maximum cross-sectional image of the spleen, was used. SI correlated well with the volumes of resected spleens. Splenomegaly was present in high percentages of patients with liver, blood, collagen, and autoimmune disease, even though a majority of these spleens were not large enough to palpate. By grading the SI, characteristic distributions of SI were obtained for patients with different types of diseases. Obtaining and grading the SI by the use of ultrasound appears to be a significant supplemental aid for evaluating spleen size, especially in patients whose spleens are not palpable.

Adolescent↗
PubMed1991

Assessment of abdominal involvement of adult T-cell leukemia/lymphoma by ultrasonography: comparison among four clinical types.

Adult T-cell leukemia/lymphoma (ATLL) is an HTLV-I associated lymphoid malignancy frequently seen in Japan. Abdominal involvement in 40 patients with ATLL were assessed by ultrasonography and the findings seen in four clinical types, acute, chronic, lymphoma and smoldering, were compared. Splenomegaly was frequently found in the cases of acute and lymphoma types, and the sizes of the spleens measured by ultrasonography correlated well with the disease activity. Hepatomegaly was also found more frequently in acute and lymphoma types, and hepatosplenomegaly was proved to be due to the infiltration by ATL cells. Nodular lesions in spleen and liver and abdominal lymph node swelling were also found frequently in the lymphoma type but rarely in the other types. Ascites, pleural effusion, and pericardial effusion were found in the active stage of acute and lymphoma types. Ultransonography also could detect findings associated with therapies. Thus, ultrasonography studies were found to be very useful for assessing the clinical classification, examining various pathological conditions associated with ATLL, and monitoring the disease activity.

Abdominal Neoplasms↗
PubMed1991

Fulminant hepatic failure during perinatal period in a pregnant woman with Wilson's disease.

Wilson's disease associated with hepatic failure is not common and the underlying mechanism triggering the event is not known at present. We treated a 28-year-old Japanese woman with Wilson's disease who developed hepatic failure associated with hemolytic crisis just after delivery. She was diagnosed as having Wilson's disease at 12 years of age, at which time she started taking D-penicillamine. She had previously delivered two children without difficulty. When she found out she was pregnant this time, she stopped taking D-penicillamine in contrast to taking it faithfully during her first two pregnancies. On the day of delivery of her full-term baby, jaundice developed accompanied with severe hemolytic crisis. Plasma exchanges and blood transfusion were performed and D-penicillamine administration was started again. She gradually recovered and apparently was following a good clinical course. However, on day 30 the second hemolytic crisis occurred and subsequent liver failure led her to death on day 50. At autopsy her liver was cirrhotic and showed massive necrosis. Prophylactic oral administration of D-penicillamine and careful observation are therefore recommended to prevent hemolytic crisis during the perinatal period.

Adult↗
PubMed1991

[Pulsatile administration of LH-RH for hypogonadotropic hypogonadism].

A case of hypothalamic-pituitary failure is reported. A 28-year-old man who had been treated with testosterone for hypogonadism for two years was admitted to our hospital with the chief complaint of sexual problems. The serum level of gonadotropins was very low and hypophysial responses to luteinizing hormone-releasing hormone (LH-RH) were good. Treatment was started with subcutaneous pulses of 10 micrograms LH-RH every 120 minutes using a portable infusion pump. Gradually, his potency improved and ejaculation returned. The serum concentration of FSH, LH and testosterone increased to the normal range of adult males and the testicular volume increased rapidly from 5 ml to 14 ml after 13 weeks of treatment. Sperms appeared in the ejaculated fluid after 25 weeks and, after following 16 weeks, the concentration of sperms increased up to 20 x 10(6)/ml. Prolonged pulsatile subcutaneous administration of a low-dose of LH-RH at a physiologic frequency was an effective therapy for pubertal induction and maturation in hypogonadotropic hypogonadism due to hypothalamic-pituitary failure.

Adult↗
PubMed1991

[Severe alcoholic cirrhosis associated with spur cell anemia and DIC].

A 29-year-old male who had a 15-year history of alcohol drinking was admitted with a 5-month history of jaundice in July 1989. Laboratory examinations revealed that he had hemolytic anemia and severe liver damage. Erythrocytes of peripheral blood showed typical spiculated cells on light microscopic and scanning electron microscopic studies. Free-cholesterol/phospholipid ratio of the erythrocyte membrane was elevated, and the level of chenodeoxycholic acid increased in serum. The patient was diagnosed as having advanced alcoholic cirrhosis associated with spur cell anemia. Two months after admission, he was complicated with chronic disseminated intravascular coagulopathy (DIC). Anemia, hepatic failure and DIC progressed, and the patient died six months after admission. The mechanism of the formation of spur cells was discussed.

Adult↗
PubMed1990

Expression of the thymosin beta 4 gene during differentiation of hematopoietic cells.

Thymosin beta 4 (T beta 4) was originally isolated as a thymic hormone. Its functional properties remain obscure; however, the N-terminal peptidic sequence could have a regulatory function on hematopoietic stem cell proliferation. To investigate the mechanism of T beta 4 expression, we studied T beta 4 gene expression in various leukemic cells and in established cell lines. Among leukemic cell samples obtained from leukemia patients, the T beta 4 gene was highly expressed in a lymphoid lineage, especially in adult T-cell leukemia (ATL) cells, rather than in a granulocyte lineage. The T beta 4 gene was more transcriptionally active in chronic B-cell leukemia than in acute B-cell leukemia, while it was inactive in plasma cell leukemia. We also found that cells from one of the ATL patients transcribed a heterogeneous message. T beta 4 messenger RNA increased in MOLT-3 during differentiation by 12-O-tetradecanoylphorbol-13-acetate (TPA), in HL60 cells induced by TPA or dimethylsulfoxide and K562 cells stimulated by cytosine arabinoside or hemin. The genomic sequence of T beta 4 is considered to be highly conserved. Only 1 of 20 genomes from normal or hematopoietic malignant cells showed restriction fragment length polymorphism. These findings, along with previous data, suggest that T beta 4 may be a new marker of differentiation of hematopoietic cells.

Adult↗
PubMed1990

Spontaneous remission from acute exacerbation of chronic adult T-cell leukemia.

Spontaneous remission without any anti-cancer therapy in a 57-year-old woman with adult T-cell leukemia (ATL) is reported. The patient was referred to our department because of persistent cough and appearance of abnormal lymphocytes in the peripheral blood, and she was diagnosed as having chronic ATL. Eight months later, she was re-admitted because of cystitis, watery diarrhea and worsening of respiratory symptoms with an increase of ATL cells (WBC 31 x 10(9)/l with 56% ATL cells). Acute exacerbation of ATL was diagnosed. Interestingly, antibiotic therapy for the pulmonary and urinary tract infections brought about spontaneous reduction of the ATL cell count. Spontaneous remission of ATL continued for one year without chemotherapy. The role of infection as a trigger of acute exacerbation and spontaneous remission of ATL is discussed.

Amphotericin B↗
PubMed1990

Secretion of an interleukin 1-like activity by acute monocytic leukemia cells which inhibits growth of fibroblasts.

Acute monocytic leukemia cells (AMoL cells), obtained by leukapheresis, were cultured in vitro. In response to lipopolysaccharide, AMoL cells produced a large amount of thymocyte proliferation activity. The crude supernatants from AMoL cells inhibited fibroblast growth, in a dose-dependent manner. Upon gel filtration, the thymocyte proliferation activity had a molecular mass of 37,000 and 17,000 daltons, and was heat labile and fairly resistant to freezing and thawing. The fractions containing thymocyte proliferation activity additionally possessed an inhibitory activity for the growth of fibroblasts. These results suggest that AMoL cells may participate in the progress of the disease (leukemia), by secreting these cytokines.

Adult↗
PubMed1990

[Adult T-cell leukemia/lymphoma associated with unusual positivity of anti-ATLA (adult T-cell leukemia-cell-associated antigen) antibodies].

A 56-year-old female was admitted because of generalized lymphadenopathy. Based upon histological findings of biopsied lymph node, malignant lymphoma, diffuse large cell type was diagnosed. The surface marker analysis showed that malignant cells were positive for CD4 and CD2 but negative for CD8. Although anti-ATLA (adult T-cell leukemia associated antigen) antibody was negative with the use of a gelatin particle agglutination method (P.A.), other methods such as an indirect immunofluorescence assay (I.F.), an enzyme-linked immunosorbent assay (E.I.A.) and a Western blotting assay revealed the positivity for anti-ATLA antibody. Adult T-cell leukemia/lymphoma (ATL/L) was confirmed by the presence of monoclonal integration of HTLV-I proviral DNA in biopsied specimen. This case, showing a pattern of P.A. (-) and I.F. (+), is extremely unusual, because I.F. and P.A. show highly close correlation. Thus, it is important to employ different methods for screening of anti-ATLA antibodies in the diagnosis of ATL/L.

Agglutination Tests↗
PubMed1990

Sonographic diagnosis of venocclusive disease of the liver and danazol therapy for autoimmune thrombocytopenia in an autologous marrow transplant patient.

A 16-Year-old boy with lymphoblastic lymphoma underwent an autologous bone marrow transplantation (ABMT) after conditioning with high-dose busulfan and cyclophosphamide. On day 39 post-transplant, right upper quadrant pain occurred with an increase in the size of the liver. Liver function tests showed a subsequent deterioration. Ultrasonographic studies of the abdomen disclosed hepatosplenomegaly, ascites, thickening of the gall bladder wall and a failure to visualize the major hepatic veins. The venocclusive disease of the liver (VOD) diagnosis was confirmed from these findings. Ultrasonographic monitoring reflected the disease status well and demonstrated a complete recovery from the VOD. We emphasize, thus, that abdominal ultrasonography can be applied easily, being a non-invasive procedure, and is useful in diagnosing VOD. Furthermore, the procedure can be repeated serially for evaluating the severity of VOD. Although engraftment was confirmed with granulocytes exceeding 500/microliters, platelet recovery was delayed; the megakaryocytes had not decreased in bone marrow aspirates and platelet-associated IgG was significantly elevated. Since autoimmune thrombocytopenia was highly suspected, to prevent immunosuppression danazol was given as an immune modulator instead of prednisolone, and a complete recovery was obtained. Accordingly, danazol can be used as an alternative to prednisolone for the treatment of autoimmune thrombocytopenia after bone marrow transplantation.

Adolescent↗
PubMed1990

[Giant hepatic cyst effectively treated by transdermal transhepatic ethanol injection therapy. A case report].

Giant hepatic cysts were effectively treated by transhepatic ethanol injection therapy. A 68-year-old male and a 70-year-old female were admitted to Kyushu University Hospital because of epigastric fullness. Ultrasound and CT examination disclosed a giant cyst in the left lobe of the liver of both patients. 99% ethanol of about a quarter of volume of the cysts were infused through catheter transdermal. After retaining for 15 minutes the ethanol was discarded and this procedure repeated twice. The cysts have been keeping a minimum size and the patients are free from symptoms for over one year.

Aged↗
PubMed1990

[Abrupt onset and rapid deterioration in the course of congenital ornithine transcarbamylase deficiency: a case report].

We report a 17-year-old female case of ornithine transcarbamylase (OTC) deficiency who died of brain edema due to hyperammonemic attack. The patient had a brother with OTC deficiency who had died of hyperammonemia at 17 years of age. She firstly had a symptom of headache, nausea, vomiting and myalgia at 14 years old and twice thereafter. On admission she had a severe disorientation and vomiting. The plasma ammonia level was 89 micrograms/dl, then increased to 400 micrograms/dl in five hours. In addition to plasma exchange, hemodialysis and then peritoneal dialysis for next 5 days, parenteral sodium benzoate and arginine were administered. Although the plasma ammonia level improved gradually, her consciousness never returned and she died of severe brain edema with uncontrollable hypotension on day 8. Histology of a necropsy liver sample showed fatty metamorphosis of hepatocytes mainly with fine lipid droplets. Electron micrograph of hepatocytes showed crystalloid inclusions in mitochondria. Significance of the clinical course and the treatment during hyperammonemic crisis was discussed.

Acute Disease↗