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Biomedical subjects

M Kaji

Publications and source records attributed to M Kaji.

At least 181 records · Page 10Linked to original sources
PubMed1990

[Effects of antacids on absorption, excretion and metabolism of cefteram pivoxil].

Effects of various antacids (sodium bicarbonate, aluminium hydroxide gel) and an H2-blocker (cimetidine) on the absorption and excretion of a new cephem drug for oral use, cefteram pivoxil (CFTM-PI), were studied in healthy adult volunteers. 1. No significant differences were found in serum levels of CFTM and CFTM-A (an inactive isomer of cefteram (CFTM)) or their urinary excretion levels (concentration, recovery rate) between the group given CFTM-PI in combination with sodium bicarbonate and that given CFTM-PI alone. 2. There were no significant differences in serum levels of CFTM and CFTM-A or their urinary excretion levels (concentration, recovery rate) between the group given CFTM-PI in combination with aluminium hydroxide gel and that given CFTM-PI alone. 3. In contrast, serum levels of CFTM and its urinary recovery rate were significantly less in the group given the drug in combination with cimetidine than in that given a single administration 2-3.5 hours and 2-4 hours after administration, respectively. Clinical considerations remain.

Absorption↗
PubMed1990

[A case of pulmonary tuberculosis associated with adult respiratory distress syndrome during corticosteroid treatment of rheumatoid arthritis].

We reported a case of 64 year-old female patient of pulmonary tuberculosis associated with ARDS during corticosteroid treatment of Rheumatoid Arthritis. On admission her chief complaints were fever, fatigue and dyspnea. A chest roentgenogram showed diffuse alveolar infiltration consistent with pulmonary edema. Arterial blood gas studies showed severe hypoxemia. We clinically diagnosed so-called ARDS. Smears of sputum for acid fast bacilli were negative, but transbronchial lung brushing by bronchofiberscope revealed many acid fast bacilli. Intensive therapy with anti-tuberculosis drugs (INH, RFP, SM), high dose corticosteroid (methylprednisolone) therapy and mechanical ventilation was started. During the following 2 weeks, the PaO2 rose gradually and the alveolar infiltration on the chest roentgenogram disappeared. The experience of this case to emphasized the importance of suspecting this condition because pulmonary tuberculosis is a potentially curable cause of ARDS and it should also be emphasized that the good treatment effect could be expected with combined use of high dose corticosteroid and mechanical ventilation.

Arthritis, Rheumatoid↗
PubMed1990

[A case of subacute necrotizing lymphadenitis with localized interstitial pneumonia].

A 16-year-old male was admitted with a history of cervical lymph node swelling, high fever, cough and hemosputum. On admission, bilateral cervical lymph nodes swelling and fine crackles in the right lower lung field were noted. A chest X-ray film showed an infiltrative shadow in the right lower lung field and right hilar enlargement. Cervical lymph node biopsy specimens revealed wide areas of necrosis with nuclear debris. Transbronchial lung biopsy showed infiltration of lymphocytes in the interstitium and bronchoalveolar lavage fluid showed increased T-lymphocytes and a decreased T4/T8 ratio. The patient was diagnosed to have subacute necrotizing lymphadenitis with T-lymphocyte alveolitis. Additionally, antinuclear antibodies were positive, and anti HTLV-I antibody was false positive. These findings suggested an immunological abnormality in this case. His cervical lymph node swelling and infiltrative shadow on chest X-ray film improved with steroid therapy. Our case may be the first case of subacute necrotizing lymphadenitis with T-lymphocyte alveolitis.

Adolescent↗
PubMed1989

Japanese encephalitis in the Kurume region of Japan: CT and MRI findings.

Neurological, computed tomography (CT) and magnetic resonance imaging (MRI) findings were recorded from 13 patients with Japanese encephalitis (JE) in the Kurume region diagnosed by serological criteria. The patients averaged 63 years of age, and 5 were older than 70 years. The serological data mostly indicated a primary response. Hemiplegia and tetraplegia were common, together with extrapyramidal signs. A few cases had a stroke-like onset and cerebral haemorrhage during the course of JE. CT and MRI in 7 cases revealed abnormalities in the thalamus and basal ganglia including the putamen. The CT and MRI findings from the acute stage to the convalescent stage were considered to be characteristic of JE.

Aged↗
PubMed1989

Wilms tumour in a patient with growth hormone replacement therapy.

Wilms tumour was found in a Japanese boy aged 5 years 9 months with isolated growth hormone (GH) deficiency and some congenital anomalies. He had received pituitary GH replacement therapy from the age of 2 years 1 month to 4 years 7 months and after a 1 year interval he received biosynthetic GH for 2 months until the tumour became clinically apparent. This was the sixth known patient with GH deficiency to develop a malignant neoplasm during or after GH replacement therapy and the first with a solid tumour in Japan since 1975, when treatment with pituitary GH for patients with GH deficiency was introduced.

Child, Preschool↗
PubMed1989

Developmental changes of plasma ganglioside concentration during the neonatal period.

We investigated the developmental changes of plasma ganglioside concentration during the neonatal period. The mean plasma ganglioside concentration at birth was 8.22 +/- 3.70 nmol lipid-bound sialic acid (LBSA)/ml, significantly lower than the value in adults (12.05 +/- 1.36 nmol LBSA/ml, P less than 0.02). However, it increased rapidly early in the neonatal period and reached its maximum level at 14 days of age (16.25 +/- 6.04 nmol LBSA/ml), which was higher than that of adults (P less than 0.05); then it decreased slowly to the adult level at one month of age. The mean plasma ganglioside concentration in preterm infants (gestational age less than 37 weeks) was 6.65 +/- 3.35 nmol LBSA/ml, somewhat lower than that of fullterm infants (gestational age greater than or equal to 37 weeks, 9.90 +/- 3.39 nmol LBSA/ml, P less than 0.02) at birth. After birth, it increased much more rapidly in preterm infants and there was no significant difference between these two groups at 5 days of age. Plasma ganglioside concentration at birth increased gradually in correlation with gestational age. Our investigations show that plasma ganglioside concentration may reflect the development and maturation of the central nervous system to some degree, at least early in the neonatal period.

Adult↗
PubMed1989

Y chromosome specific DNA probe in the diagnosis of a patient with mos 45,X/46,XYnf.

In a patient with mos 45,X/46,XYnf, the diagnosis was confirmed with a Y chromosome-specific DNA probe, Y-190. The patient was a phenotypic female without Turner syndrome stigmata other than short stature. She showed some evidence of virilization and high serum testosterone. Her peripheral blood karyotype was mos 45,X/46X, +mar. Although this marker chromosome resembled a Y chromosome, there was no quinacrine bright region on its long arm. Southern blot analysis of her peripheral blood mononuclear cell DNA with Y-190 as a probe showed strong hybridization with this probe. Gonadectomy was performed, and bilateral gonadoblastomas were found.

Adolescent↗
PubMed1989

HTLV-I-associated myelopathy and adult T-cell leukemia cases in a family.

Familial cases of HTLV-I-associated myelopathy (HAM) and adult T-cell leukemia (ATL), developing in a daughter and father, respectively, are reported. The coexistence of both diseases in a family has not been reported before. This supports the recent findings that ATL and HAM may be brought about by an identical virus on an apparently different immunogenetic background.

Adult↗
PubMed1989

Lupus anticoagulant as a risk factor for cerebral infarction and habitual abortions.

A case involving a 34-year-old female with a progressive hemiparesis is described. She had a history of repeated spontaneous abortions. The CT and magnetic resonance imaging (MRI) showed a multiple cerebral infarction. A 99mTc perfusion lung scintigram demonstrated diffuse bilateral perfusion defects in the lungs. The presence of lupus anticoagulant (LA) was detected from the laboratory data and the thrombosis in the genital organ. The repeated abortions were probably due to thrombosis in the placental vessels caused by LA. High dose steroid therapy was effective in suppressing the LA activity and in preventing progression of the clinical symptoms.

Abortion, Habitual↗
PubMed1989

Cerebral embolism and hyperthyroidism.

Three different cases of cerebral embolism occurring in combination with hyperthyroidism are reported. Case 1; a healthy 37-year-old woman presented with sudden onset of left hemiparesis and left sided hypoesthesia of all modalities. Embolism in area of the right middle cerebral artery was confirmed by angiography and CT scan. Laboratory examination revealed hyperthyroidism and anemia. Antithyroid treatment brought about euthyroid function while slight hemiparesis remained present. Case 2; a 79-year-old woman who suffered from hypertension for one year had sudden onset of disorientation and left hemiparesis. Electrocardiogram showed atrial fibrillation. The CT scan indicated infarction in the right anterior and middle cerebral artery. The patient was diagnosed as having masked hyperthyroidism. Although antithyroid medication reduced it to euthyroid condition, the patient is now bedridden with hemiparesis. Case 3; a 45-year-old man who had partial thyroidectomy for Basedow's disease and had been treated with antithyroid and antiarrhythmic therapy for 10 years. Suddenly, he was in coma with dilated right pupil and left hemiplegia. Atrial fibrillation and hypothyroid function were observed. CT scan indicated hemorrhagic infarction in the territory of the middle cerebral artery with transtentorial herniation. He died on the 59th day of hospitalization following an episode of bronchopneumonia. On the basis of the cases presented here as well as on the basis of those described in the literature it appears that thyrotoxic patients with atrial fibrillation exhibit high incidence of cerebral embolism, and prophylactic anticoagulant therapy may be recommended.

Adult↗
PubMed1989

A case of interstitial pneumonia antedating rheumatoid arthritis.

We describe a case report of an interstitial pneumonia in which pulmonary involvement of the both lower lobes mimicked idiopathic interstitial pneumonia (IIP) or bronchiolitis obliterans organizing pneumonia (BOOP). Its appearance antedated clinically apparent rheumatoid arthritis by one month and a half.

Adult↗
PubMed1989

[Remission of a non-haemophilic patient with acquired factor VIII inhibitor treated with infusion of factor VIII and corticosteroid].

A 61-years old woman who had been healthy without history of abnormal bleeding, developed widely spread ecchymosis and intramuscular bleeding in March, 1987. She was hospitalized for this hemorrhagic diathesis in May, 1987 and the following laboratory data were revealed: activated partial thromboplastin time (APTT), 76.7 seconds; factor VIII procoagulant activity, 2%; factor VIII inhibitor, 27 Bethesda units/ml. The inhibitor was an immunoglobulin of IgG type. Her clinical data of the blood were normal, and tests for antibodies, such as RA test, LE test and thyroid test were negative. Physical examination revealed ecchymosis over her right arm and swelling and pain in the right arm. She was first treated with a large dose of factor VIII concentrates, but the effect was insufficient. Then prednisolone was given, which resulted in decreasing of the inhibitor and improvement of the coagulation profiles. This treatment appeared to offer effective control on severe hemorrhage in patients with factor VIII inhibitors.

Autoantibodies↗
PubMed1989

[Each one case of Vogt-Koyanagi-Harada disease with vestibular and cerebellar ataxia, and multiple cranial nerve palsies].

Two cases of Vogt-Koyanagi-Harada disease with rare neurological complications were reported, which are one case with vestibular and cerebellar ataxia, and one with multiple cranial nerve palsies. The first case, a 32-year-old man, was admitted to our ophthalmologic department because of visual impairment. Two weeks later, he complained of gait disturbance. Limb and truncal ataxia, vestibular dysfunction and perceptive deafness were observed. Ophthalmologic examination revealed typical findings of Vogt-Koyanagi-Harada disease. CSF showed elevated protein and mononuclear pleocytosis. After treatment with oral steroid therapy, vestibular and cerebellar ataxia, and visual impairment improved. The second case, a 22-years-old man, showed the VIIth, VIIIth, IXth, and Xth cranial nerve palsies with visual impairment, and he was diagnosed to have cranial nerve palsies associated with Vogt-Koyanagi-Harada disease. After steroid therapy, there was a marked clinical improvement. Vogt-Koyanagi-Harada disease is an autoimmune disease against the melanocytes and involving tissues containing melanocytes such as uvea, meningea, skin and inner ear, etc.. Neurological complications except for meningitis and perceptive deafness have been rarely reported in Japan. Related to the present cases, possible pathogenesis was discussed.

Adult↗
PubMed1989

[A case report of thoracic foreign body resembling fungus ball on chest X-P].

A case of a foreign body tumor resembling fungus ball pre-operatively diagnosed by bronchofiberscopic examination is reported. A 54-year-old male was referred with a complaint of fever. Chest X-ray and tomography showed a mass shadow with meniscus sign resembling fungus ball in the right lower lung field. Trans-bronchial lung biopsy revealed sulfur-granule of actinomycosis. In spite of local injection of sensitive antibiotics (ABPC) once a week for two months the mass shadow remained unchanged on X-ray. Bronchofiberscopic examination was performed again and a small piece of fibrous substance was obtained, which had been left in previous operation done 17 years before. Re-thoracotomy assured that the mass was a foreign body tumor caused by a gauze.

Bronchoscopy↗
PubMed1989

[A case of multiple sclerosis with high CSF antibody titer to HTLV-I].

A case of multiple sclerosis (MS) in a 39 year old Japanese female with high antibody titer to human T-lymphotropic virus type I (HTLV-I) in serum and cerebrospinal fluid (CSF) was reported. At the age of 15, gait and urinary disturbances accompanied by sensory impairment in the lower abdomen and lower extremities developed suddenly. The motor disturbance slowly progressed to tetraparesis over a period of 15 years with several remissions. At the age of 28 the patient suffered from an acute loss of visual acuity, unilateral initially, and became blind by the age of 34. On admission to our department in September, 1987, the patient was alert and had spastic paraparesis, the impairment of all sensory modalities below the level of Th 10 and urinary disturbance. Weakness of facial muscles, nystagmus, deviation of the tongue and dysarthria were also noted. By the PA method, the antibody titer to HTLV-I was measured x512 in the serum and x64 in the CSF. Western blotting analysis of the CSF disclosed the bands to p19, p24 and p28 of HTLV-I gag proteins. The CSF contained a few ATL-like atypical cells and showed mild lymphocytosis, but the total protein was not increased. The computed tomography revealed diffuse low density areas in the cerebral white matter. The magnetic resonance imaging disclosed high intensity signal areas in the cerebral white matter and in the dorsolateral portion of the medulla oblongata on the T2 weighted image. The link of HTLV-I infection to the pathogenesis of human demyelinating diseases was discussed.

Adult↗
PubMed1989

[The treatment of traumatic chylothorax].

Traumatic chylothorax is classified as follows; postoperative and nonsurgical. We have encountered 5 cases of traumatic chylothorax, 2 after resection of lung cancer, 2 after repair of congenital heart disease and 1 after blunt chest injury. The incidence of this complication was 0.2% after surgery for cardiovascular diseases, and 0.6% for lung cancer in our institute. We carried out operation two cases successfully, one after resection for lung cancer and the other for Tetralogy of Fallot. The treatment should be determined according to the condition of the underlying diseases. We choose conservative therapy at first which is generally recommended. When chylous discharge continues, conservative therapy should be carried out when new operative skin incision is necessary for the treatment of chylothorax. Operative therapy is desirable in cases with pulmonary resection which makes dead space in pleural cavity.

Adult↗
PubMed1988

Hepatitis B virus DNA polymerase activity and hepatitis B e antigen (HBeAg)/anti-HBe status among type B chronic liver diseases.

To investigate the relationship between hepatitis B virus (HBV) replication and chronic liver disease, age-specific prevalences of HBeAg, anti-HBe, and HBV DNA polymerase (DNAP) activity were studied in 295 asymptomatic HBV carriers and 183 patients with B-type chronic liver diseases. DNAP activity decreased with age, and there was no difference in the overall prevalence of DNAP activity between the asymptomatic carriers (27.8%) and the chronic liver disease patients (27.3%). The prevalence of DNAP activity in the 40-and-over age group was significantly higher for the chronic liver disease patients (17.5%) than for the asymptomatic carriers (1.7%). The prevalence of HBeAg in the 40-and-over age group was also significantly higher for the chronic liver disease patients (33.8%) than for the asymptomatic carriers (2.6%). These data suggest that viral replication decreased with age and that viral replication occurring in older persons closely related to chronic liver disease.

Age Factors↗