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Biomedical subjects

M Kaji

Publications and source records attributed to M Kaji.

At least 163 records · Page 9Linked to original sources
PubMed1991

Non-Menkes-type copper deficiency with regression, lactic acidosis, and granulocytopenia.

A 2-year-old girl with granulocytopenia developed fever followed by truncal ataxia and progressive neurologic regression. CT demonstrated symmetric low-density areas in the cerebral white matter. Sural nerve biopsy revealed axonal degeneration. Blood lactate levels were high, and serum levels of copper and ceruloplasmin and urinary excretion of copper were low. Cultured skin fibroblasts showed normal copper uptake. Treatment with oral copper administration normalized serum copper and ceruloplasmin levels, blood lactate levels, and granulocyte count. However, copper levels in the CSF were still low, and the patient showed no clinical improvement. We speculated that copper transport across the intestinal wall and across the blood-brain barrier was impaired.

Acidosis, Lactic↗
PubMed1991

Subcutaneous and mediastinal emphysema associated with hypersensitivity pneumonitis.

We report a rare case of a patient in whom severe subcutaneous and mediastinal emphysema occurred in association with summer-type hypersensitivity pneumonitis and in whom overdistention or disruption of alveoli with obliteration of the respiratory bronchioles was revealed on open lung biopsy. This case suggests that obstructive bronchiolitis with hypersensitivity pneumonitis is an etiologic factor of mediastinal emphysema.

Adult↗
PubMed1991

[Efficacy and safety of percutaneous endoscopic gastrostomy in the elderly].

Percutaneous endoscopic gastrostomy (PEG) was performed in 32 patients with nasogastric feeding (NGF) or total parenteral nutrition (TPN), who were unable to swallow. Our cases of PEG included 10 with dementia, 8 with cerebral infarction, 8 with cerebral bleeding, 3 with gastric cancer, and others. TPN was performed after PEG for a short time. Because of the combination of TPN and PEG, there was no mortality or major complication related to the procedure. Minor complications included subcutaneous abscess and TPN catheter fever. PEG can be safely and rapidly performed. Furthermore, painless life, better cosmetic features and physical condition can be obtained with this procedure. The majority of the patients are able to return home after PEG. PEG can improve the quality of life of the patients who cannot swallow but have an intact gut.

Abscess↗
PubMed1991

[Case of primary aorto-jejunal fistula caused by gram-positive cocci].

A 46 year-old man was transferred to our department with a pulsating abdominal mass and back pain. On arrival he suddenly developed hematemesis. CT suggested the presence of an infrarenal aortic aneurysm and the jejunum was filled with contrast medium. An emergency operation was done. We found an aorto-jejunal fistula at the branching point of the renal artery. We directly sutured the aortic wall laceration and the jejunum wall in two layers. Then we resected infrarenal pseudoaneurysm as completely as possible, with replacement by a Dacron Y-shaped prosthesis. Culture of the aortic wall showed gram-positive cocci, but the species could not be identified. Gram stain of the aortic wall also showed infection by gram-positive cocci. The patient is alive and well 3 months after surgery.

Aorta, Abdominal↗
PubMed1991

[Management of pain after thoracotomy: experience of intercostal nerve block with alcohol during operation].

Post-thoracotomy wound pain in 11 patients who underwent thoracic operation was controlled by intercostal nerve block with alcohol and thoracic epidural anesthesia. The intercostal nerve block was performed just before the closure of the thoracotomy wound. Epidural anesthesia was employed from the 1st to 5th post operative day. This method alleviated post-thoracotomy pain and obviated postoperative pulmonary complication in all patients in early post operative periods. In late post operative periods after discharge, intercostal nerve block could maintain excellent analgesia in 9 of 11 patients, only 2 patients required analgesic drugs or re-block of the intercostal nerve. Thus, intercostal nerve block with alcohol is an effective and simple option to control recalcitrant post-thoracotomy wound pain in thoracic surgery.

Adult↗
PubMed1990

[Influenza].

Explore the source record for details and available documents.

Adult↗
PubMed1990

GM1 ganglioside reduces edema and monoaminergic neuronal changes following experimental focal ischemia in rat brain.

Seventy-two hours following a middle cerebral artery occlusion, the associated increase in water content on the ischemic side was significantly reduced by the exogenous administration of monosialoganglioside GM1 (30 mg/kg, i.p.). The levels of dopamine and serotonin on the ischemic side were approximately 50% and 80% of those on the contralateral non-ischemic side, respectively. Treatment with GM1 (5 times during the first 48 h after occlusion) produced a significant reduction in the levels of dopamine and serotonin loss. The present findings are compatible with the observed protective action of the exogenously administered GM1 following ischemic brain injury.

Animals↗
PubMed1990

Effect of protein C and activated protein C on coagulation and fibrinolysis in normal human subjects.

Although protein C (PC) and activated protein C (APC) have been postulated to be useful for treating patients with thrombosis, their critical effect remains to be studied in human subjects. To examine whether purified PC or APC are useful for treating patients with thrombosis without showing any adverse effect, we studied effects on coagulation and fibrinolysis in normal human subjects. When highly purified human PC was administered intravenously to healthy subjects, plasma levels of immunoreactive PC decreased with a half-life of 10.9 h. Intravenously administered APC decreased with a half-life of 23 min as measured by prolongation of activated partial thromboplastin time (APTT). However, 1.7 h was obtained for the plasma half-life of APC when it was measured immunologically. These findings suggested that a significant fraction of the administered APC was rapidly inhibited by plasma inhibitor. Upon administration of APC, APTT was prolonged and plasma levels of clotting factor VIII (F-VIII) decreased transiently as measured by clotting assay. However, when determined by a chromogenic assay method in which 120-fold diluted plasma samples were used, plasma levels of F-VIII remained unchanged. Plasma levels of F-V did not decrease after APC administration. These findings suggested that prolongation of APTT and apparent decrease in plasma F-VIII clotting activity might be due to the in vitro-effect of APC present in plasma samples used. Diurnal fluctuation of plasminogen activator inhibitor in normal subject was not affected by administration of APC. Thus, PC or APC seems to function selectively at the site of thrombin-formation without lowering plasma levels of coagulation factors.

Adult↗
PubMed1990

[The changes in serum cold hemagglutinin titer in the clinical progress of diffuse panbronchiolitis].

Since the first description of Diffuse panbronchiolitis (DPB) was published, the elevation of serum cold hemagglutinin (CHA) titer in patients with DPB has been reported, but the mechanism of its elevation is not yet clear. We investigated the relationship between the CHA titer and the indexes of inflammation (CRP, ESR, WBC, alpha 2-gl, gamma-gl), immunoglobulin, bacterial species cultured from sputum in 24 cases with DPB. They were diagnosed clinically as DPB by the criteria of the Japanese Ministry of Health and Welfare. We found no correlation between CHA titer and CRP, ESR, WBC, alpha 2-gl, gamma-gl, but there were significant correlations between the change of CHA titer and IgA, IgM. Additionally, CHA titers which were measured when Pseudomonas aeruginosa was cultured from sputum in patients with DPB were markedly high levels. These results suggest that the elevation of CHA titer does not reflect the degree of inflammations, and it occurs by immunological abnormalities.

Adolescent↗
PubMed1990

[A case of Mycoplasma pneumoniae infection followed by Staphylococcus aureus bacteremia].

A 19-year-old young man was admitted to our hospital complaining of fever and general fatigue. There were infiltrative shadows and pleural effusions in the both lung fields. Mycoplasma pneumoniae infection was diagnosed because of the elevation of mycoplasma antibody titers in the serum and pleural fluid. There was no recovery in clinical symptoms in spite of the administration of the EM (1200 mg) and CLDM (1200 mg) combination chemotherapy. Three week after admission, a cavity-like shadow appeared in the lt. middle lung field on the chest X-ray film, suprative arthritis and penicillin resistant S. aureus by blood culture test were found. Mycoplasma pneumoniae infection followed by S. aureus bacteremia was diagnosed. After the administration of antibiotics (CTT, FMOX) the clinical symptoms and laboratory findings improved 2 month after admission. Clinical and basic studies about the dual infection between M. pneumoniae and several bacteria were discussed.

Adult↗
PubMed1990

Renal handling of fleroxacin in rabbits, dogs, and humans.

The renal handling of fleroxacin was studied by renal clearance and stop-flow techniques in rabbits and dogs and by analyzing the pharmacokinetics with and without probenecid in humans. In rabbits the excretion ratios (fleroxacin intrinsic renal clearance/glomerular filtration rate) were greater than unity (2.01) without probenecid and were decreased to a value below unity (0.680) with probenecid. In dogs, on the other hand, the excretion ratios were less than unity (0.608 and 0.456) both without and with probenecid, and so were not affected by probenecid. This fact suggested that fleroxacin was excreted into urine by both glomerular filtration and renal tubular secretion in rabbits, but only by glomerular filtration in dogs, accompanied by partial renal tubular reabsorption in both species; these mechanisms were also supported by stop-flow experiments. In humans probenecid treatment induced increases in the elimination half-life and area under the serum concentration-time curve and decreases in apparent serum clearance, renal clearance, and urinary recovery of fleroxacin. The excretion ratio without probenecid was 1.13, which was significantly decreased to 0.750 with probenecid. These results indicated that both renal tubular secretion and reabsorption contributed to renal excretion of fleroxacin in humans. The contribution of tubular secretion was species dependent and was extensive in rabbits, minimal in dogs, and moderate in humans. Renal tubular reabsorption was commonly found in every species. The long elimination half-life of fleroxacin in humans might be explained by its small total serum clearance and small renal clearance, which are attributed to less tubular secretion and more tubular reabsorption.

Adult↗
PubMed1990

Neutrophilia in bronchoalveolar lavage fluid of diffuse panbronchiolitis.

The clinical and pathologic features of diffuse panbronchiolitis (DPB) have been well reported to date, although its pathogenesis remains unknown. In the present study, we performed bronchoalveolar lavage (BAL) on three patients with biopsy specimen-proven DPB and eight patients with highly probable DPB (six women and five men; one smoker and ten nonsmokers), nine patients with chronic bronchitis (all men, five smokers and four nonsmokers), and nine normal control subjects (six women and three men, all nonsmokers) to clarify the cell populations in the lower respiratory tract. Neutrophils comprised 55.3 +/- 24.4 percent of recovered cells by BAL in DPB patients but only 6.6 +/- 6.4 percent in chronic bronchitis patients, and 1.8 +/- 1.5 percent in normal control subjects (p less than 0.001, all comparisons). The DPB patients also exhibited a decreased percentage of alveolar macrophages (34.9 +/- 23.5 percent) compared with chronic bronchitis patients and normal control subjects (p less than 0.001, all comparisons). The percentage of lymphocytes of the recovered lavage cells in DPB patients did not differ from that in chronic bronchitis patients and normal control subjects. These results indicate that neutrophils play an important role in the pathogenesis of DPB. They also suggest that neutrophilia of BAL-recovered fluid is a common finding in diseases associated with bronchiolar inflammation despite some clinical and pathophysiologic differences.

Adult↗
PubMed1990

Neurohypophyseal function of an ectopic posterior lobe in patients with growth hormone deficiency.

We studied the neurohypophyseal function of 20 patients with complete GH deficiency owing to pituitary stalk transection by means of the water deprivation and the hypertonic saline infusion test. In T1-weighted magnetic resonance images, high-signal intensity of the posterior lobe of the hypophysis was missing in all the patients. An ectopic posterior lobe was observed at the proximal stump of the transected stalk in 17 patients, whereas the 3 patients without ectopic posterior lobe had overt diabetes insipidus or intractable nocturnal enuresis. After water deprivation, 3 patients with large ectopic posterior lobes (length along the pituitary stalk axis exceeding 5 mm) showed urinary osmolality and plasma AVP levels as high as those of 13 patients with partial GH deficiency in whom magnetic resonance images revealed no abnormalities. On the other hand, 14 patients with small ectopic posterior lobes (length less than 5 mm) showed significantly lower urinary osmolality and plasma AVP levels than the patients with large ectopic posterior lobes (p less than 0.01 and p less than 0.01, respectively) and the patients with partial GH deficiency (p less than 0.01 and p less than 0.01, respectively). Urinary osmolality in the patients with small ectopic posterior lobes, however, was higher than that in 3 patients without ectopic posterior lobes (p less than 0.01). During the hypertonic saline infusion test, peak plasma AVP levels in the patients with small ectopic posterior lobes were significantly lower than those in the patients with partial GH deficiency (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[Decrease of Leu7 positive cells in peripheral blood from patients with aseptic meningitis].

In order to clarify the role of natural killer cell in the central nervous system (CNS) infection, we examined Leu7 positive cells in peripheral blood of aseptic meningitis by flow cytometry. We studied 10 patients with aseptic meningitis (5 echo virus type 6 and 5 suspected viral meningitis). Also 3 patients with Japanese encephalitis, 3 with fungal meningitis, each one with bacterial meningitis, tuberculous meningitis and brainstem encephalitis were analyzed. Blood samples of acute phase and after recovery were obtained by the first examination on admission and the latest examination after normalization of cerebrospinal fluid findings, respectively. All aseptic meningitis patients showed decrease of Leu7 positive cells in acute phase (mean +/- SD = 6.8 +/- 3.12%, from 3 to 25 days of illness) and continued after recovery (8.3 +/- 4.27%, from 35 to 503 days of illness) in all but one. The number of the cells found in the aseptic meningitis patients during the acute phase and after recovery was significantly lower than in normal subjects (p less than 0.01). The change did not differ statistically between the acute phase and post recovery. The date suggest that decreased Leu7 positive cells is present before infection. As concerning other CNS infections, the positive cells decreased from acute phase to after recovery in two Japanese encephalitis and one tuberculous patients. But because of small number, it was not decided whether the decrease significantly was low value or not. Since natural killer cells is related to defence mechanism of viral infection in acute phase, it seems that low natural killer activity may develop the viral infection. Therefore the date raises the possibility that the people who has originally less the natural killer cells tend to be susceptible, as far as viral meningitis.

Adolescent↗