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Biomedical subjects

M Kojima

Publications and source records attributed to M Kojima.

At least 739 records · Page 41Linked to original sources
PubMed1986

[Residual gastric carcinoid complicated with multiple endocrine neoplasia and Cushing's syndrome--a case report].

A 51-year-old man had had his stomach resected 10 years earlier due to gastric ulcer. Ten months before the present illness, he complained of a puffy face and edema of the both lower extremities. Hyperparathyroidism with a high level of parathyroid hormone (0.75 ng/ml) was diagnosed. A submucosal tumor was noted at the residual stomach, and histologically, carcinoid was preoperatively confirmed by endoscopic study. Total gastrectomy with radical lymphadenectomy was performed, and concomitantly a small tumor noted at the body of the pancreas was also extirpated. In addition, three and a half of all four parathyroid glands were resected. Histologically, the pancreatic tumor was adenoma, with the parathyroid glands showing only hyperplastic changes. Subsequently, during the postoperative course, Cushing's syndrome was further diagnosed, and the patient is now under follow-up study.

Adenoma↗
PubMed1986

[CT findings of growth hormone secreting pituitary adenomas].

The value of high-resolution computed tomography (CT) in the diagnosis of pituitary adenoma has recently been stressed, especially of the coronal view with contrast enhancement. Analysis of the CT scans of 33 growth hormone (GH) secreting pituitary adenomas was done (11 cases of microadenomas, 7 cases of intrasellar adenomas and 15 cases of macroadenomas with suprasellar extension). In macroadenomas, the density was high in five cases, high with isodense portion in two cases, mixed in four cases, isodense in three cases, and isodense and low dense in one case. Six adenomas showed homogeneous density and nine were heterogeneous. After contrast enhancement, two cases showed marked enhancement, ten cases mild and three cases ring enhancement. Margin of adenoma was smooth in nine cases and irregular in six. Among seven cases of intrasellar adenoma one accompanied primary empty sella. In microadenomas ten of eleven cases had hypodense mass inside the normally enhanced pituitary gland. The margin was ill-defined in seven cases and well-defined in three. Eight cases had pituitary height 7 mm or more. Upper surface of the pituitary gland was convex upward in five cases, flat in four and concave in two. Deviation of pituitary stalk was found in seven cases. Bony changes of sellar floor were recognized in three cases. There was a tendency that serum GH level increased with the increment of the size of adenoma. Serum GH levels in adenomas with ring enhancement were lower than those in the homogeneously enhanced adenomas of similar size. One case with marked enhancement showed the highest GH level among all adenomas of the presented series.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗
PubMed1986

Immunoglobulin class switch from IgG to IgA in a patient with smoldering multiple myeloma.

Serum of a 67-year-old male patient with smoldering multiple myeloma was shown to contain two monoclonal immunoglobulins, IgG and IgA. For the initial seven months, monoclonal IgG was predominantly elevated. During the next one year and eight months, however, serum concentration of the monoclonal IgA increased, with a concomitant decrease of IgG. N-terminal amino acid sequences of heavy and light chains separated from monoclonal IgG and IgA were analyzed. Both light chains were lambda-type and showed identical amino acid sequences of variable regions. The heavy chains also had the same N-terminal amino acid sequence between IgG and IgA. These results strongly suggest that two monoclonal proteins, IgG and IgA, in this patient were produced by B lymphocytes within a clone and that class switch from IgG to IgA in immunoglobulin production during B cell differentiation has taken place in the clinical course of this case.

Aged↗
PubMed1986

[Penetration of cefoperazone into the exudate of the retroperitoneal space after (semi-)radical hysterectomy].

The purpose of the study was to examine the penetration of cefoperazone (CPZ) into the exudate of retroperitoneal space after (semi-)radical hysterectomy in patients with uterine carcinoma and to evaluate the suitability of its prophylactic use. Two grams of CPZ was administered by intravenous infusion over 1 hour just after the operation and the same dose was repeated every 12 hours for 3 consecutive days. The exudate was collected from the abdominal drainage for every 3 hours for measurements of hemoglobin, total protein and CPZ levels. Concentrations of CPZ in exudate samples were found to remain above the MICs for major causative organisms of the inflammation in both groups of patients of radical (14 cases) and semiradical (5 cases) hysterectomy. On the operative and 1st days, exudate CPZ level in the group of semiradical hysterectomy patients showed higher than that in the group of radical hysterectomy patients. But on the 2nd day, there was no significant difference in exudate CPZ level between these 2 groups. The above results indicated that the presence of blood in the retroperitoneal space might affect the concentration of the antibiotic in the exudate. From these findings, it is concluded that the present dosage regimen is efficient to prevent the postoperative infection after (semi-)radical hysterectomy.

Bacterial Infections↗