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Biomedical subjects

M Kaji

Publications and source records attributed to M Kaji.

At least 91 records · Page 5Linked to original sources
PubMed1998

Influence of immobilization on bone mass and bone metabolism in hemiplegic elderly patients with a long-standing stroke.

Significant bone mass reduction occurs in stroke patients on the hemiplegic side compared with the intact side, correlating with the degree of paralysis and vitamin D deficiency. To evaluate the influence of long-standing immobilization on this osteopenia, we measured various serum markers of bone metabolism in 93 hemiplegic elderly patients with a long-standing stroke and in 37 controls. The bone mineral density (BMD) of the second metacarpal was determined bilaterally. The scoring of the stroke patients activity was based on the Barthel Index (BI). The serum ionized calcium was higher in the patients than in the controls, correlating negatively with the BI in the patients. The concentrations of parathyroid hormone (PTH), pyridinoline cross-linked carboxy-terminal telopeptide of type I collagen and bone Gla protein were normal or low. The serum 25-hydroxyvitamin D level was low in the patients, correlating positively with the BMD on both sides. The serum 1,25-dihydroxyvitamin D (1,25-[OH]2D) level was markedly reduced in the patients. Hemiplegia from a stroke can result in immobilization hypercalcemia which inhibits PTH secretion and 1,25-[OH]2D production. Bone remodelling may have almost reached an equilibrium, resulting in a steady rate of bone loss. This and the hypovitaminosis D appear to be the dominant causes of immobilization-induced osteopenia in elderly, long-standing hemiplegic stroke patients.

Aged↗
PubMed1998

[Intrathoracic vagal nerve schwannoma preoperative diagnosis is correct because of clinical and characteristic CT findings--a case report and review of the literature].

A 60-year-old man was operated with the clinical diagnosis of intrathoracic vagal nerve schwannoma because of characteristic CT findings and no symptom of neurofibromatosis. Thoracoscopic surgery was performed and it was confirmed pathologically. Intrathoracic vagal nerve tumor is rare, so preoperative diagnosis seems to be difficult. We review the intrathoracic vagal nerve tumors reported in Japan (52 cases of schwannoma and 9 cases of neurofibroma), and analyzed the tumor location, furthermore, the relationship of neurofibromatosis and schwannoma and neurofibroma on vagal nerve tumor.

Humans↗
PubMed1998

Diagnostic value of atypical lymphocytes in cerebrospinal fluid from adults with enteroviral meningitis.

We have noted two morphologically distinct types of atypical lymphocytes (AL) in the cerebrospinal fluid (CSF) of adult patients with meningitis: one, which we designate type-I AL, with multilobulated nuclei resembling those of the abnormal cells in adult T-cell leukaemia (ATL); and another, type-II AL, characterized by large lymphocytes with basophilic cytoplasm and nuclei containing coarse chromatin. Type-I AL were detected in 25 of 39 patients (64%) with enteroviral and in 11 of 109 (11%) with aseptic meningitis presumed to be caused by other viruses, but not in meningitis resulting from Cryptococcus neofirmans (n = 14), Mycobacterium tuberculosis (n = 19) or acute bacterial infection (n = 49). Type-I AL were not seen in herpes zoster (n = 15) aseptic meningeal reactions (n = 15), or in leptomeningeal carcinomatosis (n = 14). Type-II AL were often present in meningitis of various aetiologies and in aseptic meningeal reactions, but not in leptomeningeal carcinomatosis. The presence of type-I AL in the CSF was found to be indicative of enteroviral meningitis with the highest predictive value (69%), while type-II AL had a lower diagnostic positive predictive value in meningitis of the five aetiologies above. Type-I AL immunostained for CD4, while type-II AL were stained for CD8. The presence of type-I AL in CSF strongly suggests enteroviral meningitis, which warrants careful follow-up without antifungal, antituberculous or antibacterial agents. However, type-I AL, which are likely to be virally transformed lymphocytes, must be distinguished from ATL cells, which frequently involve the meninges.

Adolescent↗
PubMed1998

Studies to determine the usefulness of the zinc clearance test to diagnose marginal zinc deficiency and the effects of oral zinc supplementation for short children.

OBJECTIVE: To evaluate the usefulness of the body zinc clearance test in the diagnosis of marginal zinc deficiency and to estimate the efficacy of oral zinc supplementation on growth in short children. METHODS: Zinc status was evaluated in 30 (19 boys and 11 girls) Japanese children with short stature using the body zinc clearance test. Changes in growth after oral zinc supplementation (ZnSO4,7H2O; 5 mg/kg/day in two divided doses) were studied. RESULTS: Basal serum zinc concentrations were 75.0 +/- 12.7 micrograms/dl and zinc clearance values were 19.1 +/- 5.8 ml/kg/hour in the 30 subjects. The correlation coefficient between serum zinc concentrations and zinc clearance values was as small as -0.36. There were nine cases whose body zinc clearance values were high and serum zinc concentrations were low, indicating definite zinc deficiency. There were nine cases whose body zinc clearance values were high, despite normal serum zinc concentrations, indicating marginal zinc deficiency. The mean height velocity for males was 5.3 cm/year before zinc supplementation and 7.8 cm/year after the therapy; and the mean SD score for height for age improved from -1.85 to -1.53. The mean height velocity for females was 5.1 cm/year before zinc supplementation and 5.9 cm/year after the therapy, and the mean SD score for height for age changed from -2.02 to -2.03. CONCLUSION: The body zinc clearance test was much more useful than serum zinc concentrations in diagnosing marginal zinc deficiency. Oral zinc supplementation improved the height velocity in short males, but not in short females.

Administration, Oral↗
PubMed1998

Uniparental and functional X disomy in Turner syndrome patients with unexplained mental retardation and X derived marker chromosomes.

We analysed parental origin and X inactivation status of X derived marker (mar(X)) or ring X (r(X)) chromosomes in six Turner syndrome patients. Two of these patients had mental retardation of unknown cause in addition to the usual Turner syndrome phenotype. By FISH analysis, the mar(X)/r(X) chromosomes of all patients retained the X centromere and the XIST locus at Xq13.2. By polymorphic marker analysis, both patients with mental retardation were shown to have uniparental X disomy while the others had both a maternal and paternal contribution of X chromosomes. By RT-PCR analysis and the androgen receptor assay, it was shown that in one of these mentally retarded patients, the XIST on the mar(X) was not transcribed and consequently the mar(X) was not inactivated, leading to functional disomy X. In the other patient, the XIST was transcribed but the r(X) appeared to be active by the androgen receptor assay. Our results suggest that uniparental disomy X may not be uncommon in mentally retarded patients with Turner syndrome. Functional disomy X seems to be the cause of mental retardation in these patients, although the underlying molecular basis could be diverse. In addition, even without unusual dysmorphic features, Turner syndrome patients with unexplained mental retardation need to be investigated for possible mosaicism including these mar(X)/r(X) chromosomes.

Base Sequence↗
PubMed1998

Increased bone resorption during the first year after stroke.

BACKGROUND AND PURPOSE: Significant bone mineral density (BMD) reduction occurs in stroke patients on the hemiplegic side compared with the intact side. To elucidate the pathogenesis of hip fractures in this population, we measured serum markers of bone metabolism and BMD in the stroke patients within 1 year (early group) and between 1 and 2 years after onset of hemiplegia (long-term group). METHODS: Sera were collected from 51 patients from the early group and 93 patients from the long-term group. All patients had hemiplegia. Sera were assayed for pyridinoline cross-linked carboxy-terminal telopeptide of type I collagen (ICTP; a bone resorption marker) and bone Gla protein (a bone formation marker). The z score of BMD was determined in both second metacarpals. RESULTS: Serum ICTP concentrations (ng/mL) were higher in the early group (15.4+/-4.1) than in the long-term group (6.7+/-4.4). Bone Gla protein was normal or low in both groups. Multiple regression analysis identified Barthel Index, degree of hemiplegia, and illness duration as independent determinants of ICTP in the early group, whereas Barthel Index, degree of hemiplegia, and serum calcium were determinants of ICTP in the long-term group. There were statistically significant correlations between the z score of the hemiplegic side and age, Barthel Index, degree of hemiplegia, illness duration, 25-hydroxyvitamin D (25-OHD), and ICTP in the early group and between the z score and degree of hemiplegia and 25-OHD level in the long-term group. CONCLUSIONS: The pathogenesis of reduced BMD differed between the early and long-term stroke groups. These results suggest that in the early group, increased bone resorption caused by immobilization was responsible for osteopenia on the hemiplegic side, whereas the degree of hemiplegia and 25-OHD level were the determinants of osteopenia in the long-term group.

Aged↗
PubMed1998

Examination of prognostic factors after resection of pulmonary metastasis of osteosarcoma by multivariate analysis.

Prognostic factors for the case of pulmonary metastasis of osteosarcoma was examined using the multivariate analysis. 1) The 3-year survival rate after operation of primary focus in 23 cases was 34.8% and the 5-year survival rate was 30.4%. The 3-year survival rate after the first operation of pulmonary metastasis was 30.4% and the 5-year survival rate was 12.2%. No deaths attributed to operation were found. 2) Gender, age, histological type, solitary or multiple pulmonary metastasis, laterality, number of pulmonary metastatic tumors, TDT and DFI were examined, and the laterality, number of pulmonary metastatic tumors and DFI were considered to be useful prognostic factors. DFI among them was most closely associated with postoperative survival days. 3) A significant difference in the number of excised nodules was found between the DFI less than 90 days group and the DFI not less than 90 days group, and the number in the former group was significantly larger. 4) It was suggested that postoperative observation and close examination for pulmonary metastasis at about 3 months intervals after of primary focus are important, and also, positive or negative pulmonary metastasis as the time of examination, particularly, the number metastatic nodules of less than 5 or not less than 5, are reflected in the prognosis. 5) Expected survival time after the first operation pulmonary metastasis appeared possible to estimate as 3.0 x DFI days.

Adolescent↗
PubMed1998

A case of pulmonary metastases of synovial sarcoma surviving for a long period after active surgery.

The patient was a 24-year-old woman. She underwent marginal excision of synovial sarcoma originating in the right femoral soft tissue at the age of 18, followed by local radiation therapy and chemotherapy. At the age of 20, abnormal shadow was indicated in bilateral lungs on plain roentgenography of the chest, and she underwent open-chest surgery for excision of bilateral pulmonary metastatic tumors. She was subjected to bilateral thoracotony repeatedly thereafter for a total of 5 times, and all of the metastatic foci detected in each operation were resected. Consequently, she has been surviving for a long period of about 7 years. The therapeutic outcome of tumor of bone soft tissue is greatly affected by its pulmonary metastasis. Although the therapeutic outcome has recently been improved by large dose chemotherapy and active excision of metastatic foci in the lung, survival time in the case of synovial sarcoma, giant cell sarcoma and Ewing's sarcoma is not very long yet. In the present study, we observed a patient who had lung metastasis of synovial sarcoma of which prognosis is generally considered poor has been surviving for a long time of 7 years owing to active excision of pulmonary metastatic foci. The relation of the present prognostic factors to those in the past were compared.

Adult↗
PubMed1998

[Effects of long-term preoperative administration of low-dose erythromycin on warm ischemia-reperfusion pulmonary injury].

The effects of long-term preoperative administration of low-dose erythromycin (EM) were experimentally examined in relation to the treatment of reperfusion disorders following pulmonary thermal ischemia. EM was administered at a dose of 100 mg/day for 1 month to adult mongrel dogs with an average weight of about 12 kg (EM group). A control group that did not receive EM was also enrolled. Using a pulmonary autograft model, collapse-thermal ischemia of the lungs was performed on each animal for 60 minutes. In the early stage of reperfusion, the following measurements were assessed: gas-exchange potency in the left lung, hemodynamics, water content, adhesion of neutrophils to vascular endothelium, and concentration of blood eicosanoids. The results for the 2 groups were then compared. In the control group, the blood level of leukotriene B4 (LTB4) increased shortly after reperfusion, neutrophils migrated toward the vascular endothelium and adhered to it, and pulmonary edema developed after 1 hour. However in the EM group, the blood level of thromboxane B2 was significantly suppressed before and after hilar stripping, and the increase in the blood LTB4 level and the migration of neutrophils shortly after reperfusion in thermal ischemia were suppressed. Eventually alleviation of pulmonary edema was indicated and significantly improved gas exchange was maintained. In conclusion, pulmonary injury during detachment of the hilum of the lung, as well as warm ischemia-reperfusion pulmonary injury, may be alleviated by preoperative administration of low-dose EM on a long-term basis.

Animals↗
PubMed1997

Antibody efficacy as a keen index to evaluate influenza vaccine effectiveness.

The efficacy of the influenza vaccine is often understimated, due to the dilution of the outcome by noninfluenzal illnesses. We thus explored the methodology to evaluate the effect of the inactivated influenza vaccine under the following strict conditions: an assessment of the effectiveness on clinical illness among healthy adults in a small-scale mixed epidemic during the 1991-1992 season. The vaccine antigens included were A/Yamagata/32/89 (H1N1), A/Beijing/352/89 (H3N2), and B/Bangkok/163/90. Two indices were analyzed: "vaccine efficacy", a comparison between the vaccinees and the nonvaccinees; and "antibody efficacy", a comparison between those with and those without a protective level of pre-epidemic hemagglutination-inhibition (HAI) antibody. The odds ratio (OR) and its 95% confidence interval (95% CI) was calculated by the logistic regression model. A decrease in the age-adjusted OR of vaccination was not statistically significant: 0.54 (95% CI: 0.19-1.53) corresponding to vaccine efficacy (1-OR) of 46% (-53% to 81%). Among the vaccinees, a significantly decreased OR in those with a higher titer to A/Beijing was observed: 0.14 (0.02-0.92) adjusted for the mutual effects of pre-epidemic antibodies to different vaccine antigens. The adjusted ORs thus calculated for A/Yamagata and B/Bangkok were not found to be statistically significant. The antibody efficacy (1-OR) was estimated to be 86% (8% to 98%) against illnesses related to A/Beijing-like viruses. The product of antibody efficacy (86%) and the proportion of those who achieved a protective level of antibody after vaccination (73% for A/Beijing strain) was 63%, which is theoretically equivalent to the vaccine efficacy. Thus, the antibody efficacy is considered to be an important index, while the vaccine efficacy against clinical illnesses is easily disturbed by extraneous factors in the field trials.

Adult↗
PubMed1997

A case of dyshormonogenetic goiter complicated with growth hormone deficiency.

A 17-year-old male patient with dyshormonogenetic goiter complicated with follicular adenoma and growth hormone deficiency is described. He had short stature (-2.3 SD), diffuse goiter and a particularly large nodule in the right lobe of the thyroid gland. The endocrinological studies revealed slight hypothyroidism. He underwent surgical removal of the tumor, diagnosed histopathologically as follicular adenoma, embryonal type; and the diffuse goiter was diagnosed as dyshormonogenetic goiter. It was speculated that long-term hypersecretion of thyroid stimulating hormone (TSH) caused adenoma in the thyroid gland. Although the goiter disappeared after oral thyroxine replacement therapy, his height gain remained poor. Then, he was diagnosed partial growth hormone deficiency, and growth hormone therapy improved his height gain. It has been reported that a high percentage of patients with congenital hypothyroidism have additional anomalies. This is, however, the first reported case of dyshormonogenetic goiter complicated with growth hormone deficiency.

Adenoma↗
PubMed1997

[Adenovirus CNS infections].

Adenovirus infections are very common diseases, especially upper respiratory infections and diarrhea in infants. Moreover, adenoviruses can occasionally produce CNS infections. The common causative adenovirus is type 7 for them, and they have been associated with pneumonia and epidemics of adenovirus in family outbreaks. Reye-like syndrome has rarely been reported. As AIDS and other immunocompromised patients have increased, new reports of adenovirus CNS infections have also increased. Of course the immunosuppressed conditions have included lymphoma, transplant etc. In the near future, long term care for immunocompromised patients will have a crisis of adenovirus CNS infection. On the other hand, adenovirus CNS infections are difficult to diagnose precisely without special facilities, due to the need for adenovirus cultivation from CSF. In addition, the diagnosis may have limitations due to the many subtypes of adenovirus. Despite the benefits of PCR methods, standard laboratory testing procedures are still not established for diagnosis.

Adenoviridae Infections↗
PubMed1996

Papillary adenoma of type II pneumocytes might have malignant potential.

Papillary adenoma of type II pneumocytes is a rare tumour. It is considered to be a benign neoplasm and is derived from immature cells in the bronchioloalveolar epithelium, however, its biological nature has not been elucidated. We report a case of an adenomatous tumour; a papillary adenoma of type II pneumocytes, which we regard as possessing malignant potential. Light microscopically, as well circumscribed, papillary tumour of predominantly cuboidal cells resembling type II pneumocytes was found, but Clara type and ciliated cells were also present. Immunohistochemically, the tumour cells reacted positively with antibodies to surfactant apoproteins (A, B), carcinoembryonic antigen, cytochrome P-450 1A1-2 and 2B1-2. Ultrastructurally, many osmiophilic lamellar bodies and electron-dense granules were demonstrated. Semi-serial sections revealed signs of transbronchial dissemination and vascular invasion. Morphometry using 12-dimensional cluster analysis disclosed features of the tumour cells which resembled those of pneumocyte type II adenocarcinoma. These findings suggest that the present case has some malignant characteristics and originates from immature bronchiolar or alveolar cells, with a potential to develop into both type II pneumocyte and Clara cell type adenocarcinomas.

Adenoma↗
PubMed1996

The hemagglutination inhibition antibody responses to an inactivated influenza vaccine among healthy adults: with special reference to the prevaccination antibody and its interaction with age.

The immunogenicity of the trivalent split-virus influenza vaccine was investigated among 70 healthy adults (mean age: 48.5, range: 36-68). The vaccine antigens were: A/Yamagata/32/89 (H1N1); A/Beijing/352/89 (H3N2); and B/Bangkok/163/90. Regarding the entire sample, the vaccine induced a tenfold or more rise on the average in the hemagglutination inhibition (HAI) antibody to each antigen. The response rates (greater than or equal to a fourfold rise) were about 90% or more among those with a prevaccination titer < or = 1:64 (equivalent to < or = 1:16 on the Western scale; in Japan, the HAI titers are expressed by the final, and not the initial, dilution of the serum; from hereon our findings will be expressed using the Japanese scale), whereas they were 0-50% at > or = 1:128. Thus, the prevaccination titer was negatively associated with antibody induction. The achievement rates (postvaccination titer > or = 1:128) among those with a prevaccination titer < 1:16 remained at 48-68%. Regarding the analysis of variance, a significant effect on antibody induction was indicated for the prevaccination titer (P < or = 0.002), but not for age (P > or = 0.425). The interaction between the prevaccination titer and age was significant for A/Yamagata (P = 0.030), while it was also suggestive for A/Beijing (P = 0.054): as age increased, those with no preexisting antibody (< 1:16) showed greater titer rises, in contrast to the smaller rises among those with a titer > or = 1:16. Based on the attack survey conducted separately, the vaccine efficacy on influenza-like illnesses with fever < or = 37 degrees C and > or = 37.5 degrees C was calculated to be 16% (95% confidence interval: -66% to 57%) and 37% (-55% to 74%), respectively.

Adult↗