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T Kojima

Publications and source records attributed to T Kojima.

At least 685 records · Page 38Linked to original sources
PubMed1990

Secondary reconstruction by temporoparietal free fascial flap for ring avulsion injury.

We report the secondary reconstruction of an amputated finger following a ring avulsion injury using a temporoparietal fascial flap (TPFF). There have been reports of preserving degloved fingers using a cross-finger flap and an abdominal flap, but it is difficult to obtain good results with these procedures. The TPFF is an ideal, thin flap that gives excellent results, preserving movement of the phalangeal joint.

Amputation, Traumatic↗
PubMed1990

Ultrasonographic monitoring of the placenta in patients with bleeding during the first and second trimesters.

Thirteen patients with vaginal bleeding in the first and second trimester, in 730 pregnancies confirmed with live fetuses, were diagnosed as having subchorionic hematoma at the perivillous or periplacental region by a real-time B-mode scan device. In 9 of the 13 patients, the hematoma disappeared within 1 to 3 months after detection, while in 2 patients it increased in size. Seven of the 13 pregnancies progressed to full term (53.8%), 3 ended in premature deliveries (23.1%) and 3 in spontaneous abortions (23.1%). In 5 of the 13 patients, PROM occurred. Pathological examinations revealed 5 circumvallate (38.5%) and 2 circummarginate (15.4%) placentas. Since our clinical observation indicates that subchorionic hematoma and marginal separation of the placenta may be important causes of bleeding during pregnancy, monitoring of the placenta and fetus by ultrasound was used to obtain precise information in order to manage patients with bleeding. It might be speculated that extrachorial placenta results from subchorionic hematoma or its absorption.

Adult↗
PubMed1990

Effects of tetraethylammonium and 4-aminopyridine on outward currents and excitability in canine tracheal smooth muscle cells.

1. The effects of tetraethylammonium (TEA) and 4-aminopyridine (4-AP) on membrane currents and on single channel K currents in smooth muscle cells isolated from canine trachea were examined by use of tight seal whole cell- and patch-clamp techniques. 2. Depolarizing current applied through a recording pipette did not elicit an action potential under current clamp. A strong outward rectification was observed. 3. In most cells under voltage-clamp, only an outward current was observed upon depolarization from -60 mV when a pipette solution contained mainly KCl. The outward current consisted of three components; a large initial transient, a following sustained component and an additional component of irregular small transients on the sustained one. The two transient components were almost abolished when extracellular and pipette solutions contained 2.2 mM Cd2+ (0 mM Ca2+) and 10 mM EGTA, respectively. The sustained component was well maintained under these conditions. 4. TEA at low concentrations (less than 1 mM) effectively decreased the transient components and made the outward current smooth; it also suppressed the sustained component at higher concentrations. In outside-out patches, external 1 mM TEA reduced the single channel conductance of Ca-activated K channels by about 87% whereas 3 mM 4-AP did not. 4-AP at low concentrations (less than 3 mM) selectively reduced the sustained component of the outward current. 5. A Ca current recorded after the suppression of outward current by internal Cs+ had a peak of approximately 200 pA at +10 mV (holding potential: -60 mV). The half inactivation voltage in the steady-state was approximately -30 mV. 6. Simultaneous application of 1 mM TEA and 4-AP reduced the outward current and unmasked a Ca current. Under these conditions, an action potential with overshoot was easily elicited under current clamp. 7. It is concluded that the low excitability of canine tracheal smooth muscle cell upon depolarization is due to a large outward K current which consists of Ca-dependent and Ca-independent components. The peak amplitude of the Ca current is similar to that in highly excitable smooth muscle cells such as those of the ureter.

4-Aminopyridine↗
PubMed1990

Immuno-light and electron microscopic features of chronic hepatitis D.

A morphologic study with immunohistochemical detection of the viral antigens of hepatitis B and Delta was performed on 36 liver specimens from patients with delta positive chronic viral hepatitis B. Electron microscopy was performed in 9 cases. No light microscopic or ultrastructural features specific for hepatitis D were observed. Lymphocytic infiltration occurred more often close to hepatocytes containing either hepatitis Delta antigen or hepatitis B core antigen in the cytoplasm, suggesting an involvement of cellular immune mechanisms in chronic hepatitis D as well as in hepatitis B. The simultaneous expression of both HBcAg and Delta antigen in occasional specimens over longer time periods indicates the possible co-existence of both viruses without mutual inhibition.

Antigens, Viral↗
PubMed1990

In vitro activity of AT-4140 against quinolone- and methicillin-resistant Staphylococcus aureus.

Eighty-nine clinical isolates of Staphylococcus aureus that were resistant to both ciprofloxacin (MIC, greater than or equal to 3.13 micrograms/ml) and methicillin (MIC, greater than or equal to 12.5 micrograms/ml) were divided into two groups with respect to their susceptibilities to AT-4140. Most isolates that were moderately resistant to ciprofloxacin (MICs, 3.13 to 12.5 micrograms/ml) or ofloxacin (MICs, 0.78 to 6.25 micrograms/ml) were susceptible to AT-4140 (MICs, 0.05 to 0.2 microgram/ml). Most isolates that were highly resistant to ciprofloxacin (MIC, greater than or equal to 25 micrograms/ml) or ofloxacin (MIC, greater than or equal to 12.5 micrograms/ml) were resistant to AT-4140 (MICs, 3.13 to 25 micrograms/ml). The appearance of spontaneous single-step, quinolone-resistant mutants of S. aureus P-20, a methicillin-resistant isolate, was more frequent than was that of S. aureus 209P JC-1, a susceptible laboratory strain. Spontaneous single-step, quinolone-resistant mutants of P-20 were not selected by AT-4140, and those selected by existing fluoroquinolones were susceptible to AT-4140. Spontaneous double-step, quinolone-resistant mutants of P-20 were selected by various fluoroquinolones. All second-step mutants selected by AT-4140 or ofloxacin from P-20-C, a spontaneous single-step mutant of P-20 selected by ciprofloxacin, were resistant to all the quinolones. All second-step mutants selected by nonfloxacin were resistant to all existing fluoroquinolones but were less resistant to AT-4140. There was a close resemblance between the resistance profiles of spontaneous quinolone-resistant mutants and those of clinically isolated quinolone- and methicillin-resistant S. aureus.

4-Quinolones↗
PubMed1990

Congenital factor XIII deficiency with treatment of factor XIII concentrate and normal vaginal delivery.

The outcome of all pregnancies complicated by congenital factor XIII (F XIII) deficiency has resulted in abortion without replacement therapy. We experienced a case with this disease and succeeded in normal vaginal delivery after treatment with weekly F XIII concentrate (Fibrogammin P, Behringwerke AG) during pregnancy. This 20-year-old woman, gravida 1, para 0, was found to have an F XIII level of 0% at age 6 and was treated with F XIII concentrate occasionally when she suffered from massive bleeding. In 1986 she became pregnant and was hospitalized at 6 weeks' gestation because of genital bleeding. Subsequent to this episode, F XIII concentrate was administered every week. At 37 weeks' gestation a 2,646-gram girl with a 1-min Apgar score of 9 was delivered. Postpartum blood loss was 260 ml. One year after delivery neither the mother nor the infant were found to have hepatitis B, nonA, nonB hepatitis, ATL or HIV. F XIII concentrate proved effective in such cases without any risk of viral infection.

Adult↗
PubMed1990

Changes in vasopressin, atrial natriuretic factor, and water homeostasis in the early stage of bronchopulmonary dysplasia.

Arginine vasopressin (AVP), atrial natriuretic factor, and water balance were examined in the infants with or without bronchopulmonary dysplasia (BPD) during the first 4 wk of life. Fourteen premature infants, nine in the early stage of BPD secondary to respiratory distress syndrome (BPD infants) and five healty low birth wt infants (LBW infants), were the subjects of this study. The water and sodium balance, renal function, and plasma AVP and atrial natriuretic factor concentrations were determined during the first 4 wk of life. Plasma AVP and atrial natriuretic factor levels of BPD infants at the 4th wk of life were higher than those of LBW infants at the corresponding age. Urine osmolality was higher and free water clearance was lower in BPD infants at the 4th wk of life when compared with each parameter in LBW infants, respectively. Paco2 of BPD infants at the 4th wk of life was more elevated than that of LBW infants. These results suggest that elevated plasma AVP level may be related with pulmonary abnormalities and that atrial natriuretic factor may hence compensate the water retention resulted from the functionally activated AVP in the early stage of BPD.

Arginine Vasopressin↗
PubMed1990

Is the thiobarbituric acid-reactivity of blood plasma specific to lipid peroxidation?

The fluorometric thiobarbituric acid (TBA) assay of blood plasma was performed under various conditions in order to assess whether the assay reflects lipid peroxidation. The TBA-reactivity of malonaldehyde was not dependent on the pH values of the reaction and was little affected by tert-butyl hydroperoxide (tert-BuOOH). The reactivity of 2,4-nonadienal and 2-hexenal, which was maximal at pH 3-4 and at above pH 4, respectively, was dramatically enhanced by tert-BuOOH and ferric ion, and suppressed by ethylenediaminetetraacetic acid (EDTA). The pigment formation from oxidized low-density-lipoprotein was maximal at about pH 5, markedly enhanced by ferric ion and suppressed by EDTA, indicating that the TBA-reactive substances in the oxidized lipoprotein were composed of malonaldehyde, alkadienals and alkenals originated from lipid peroxidation. The pigment formation from plasma and its phosphotungstic acid precipitate was maximal at pH 4 and at below pH 2, respectively. The effect of tert-BuOOH, ferric ion and EDTA was not significant. The major TBA-reactive substances from plasma may be compounds other than malonaldehyde, alkadienals, alkenals and those in the oxidized lipoprotein. The TBA-reactivity of plasma does not appear to be specific to lipid peroxidation.

Humans↗
PubMed1990

Major thiobarbituric acid-reactive substances of liver homogenate are alkadienals.

Thiobarbituric acid (TBA) assay of rat liver homogenate was performed by four general variations with 0.01% butylated hydroxytoluene. Development of red pigment was greatly dependent on the methods. The pigment formation by each method was dramatically increased by introduction of 2 mM t-butyl hydroperoxide (t-BuOOH). The pH values of the reaction mixtures greatly affected the pigment yield both in the absence and presence of t-BuOOH, and the maximal pigment yield was obtained at pH 3-4. These characteristic profiles of the pigment formation were similar to those from alkadienals and essentially different from those from malonaldehyde. Alkadienals were likely candidates for the TBA-reactive substances in the homogenate.

Aldehydes↗
PubMed1990

[The study of chemical mediators in the patients with allergic rhinitis. 1). Histamine, leukotriene and kinins in the nasal secretion during early phase response].

For the purpose of studying the roles of chemical mediators during early phase response of allergic rhinitis, the levels of histamine, leukotriene C4 (LTC4) and kinins in the nasal lavage fluid were measured before and after the nasal challenges with antigens. Seventeen patients with perennial allergic rhinitis with positive intradermal skin reactions to mite antigen extracts were included in this study. The nasal samples were obtained both by aspirating and instilling 5 ml of saline into patient's nostrils before and ten minutes after the nasal challenges. After the nasal challenge with control disk, the concentration of histamine in the nasal samples increased, and the concentrations of LTC4 and kinins did not increase significantly. After the nasal challenges with mite or house dust disk, the concentration of histamine increased as much the same as that after the nasal challenges with control disk, and the concentrations of LTC4 and kinins increased significantly compared with those after the nasal challenges with control disk. delta histamine and delta kinins (delta: net increments in the concentrations after the nasal challenge with antigen over values before the nasal challenge) were significantly correlated with delta albumin. The patients with severe nasal symptoms tended to present more remarkable net increments of chemical mediators than the patients with mild and moderate nasal symptoms. Similar tendencies were recognized in the relationships between the severity of nasal symptoms provoked by nasal challenge with antigen and net increments of chemical mediators. We suggest that the amounts of chemical mediators during the allergic reaction denoted the severity of nasal symptoms in allergic rhinitis patients.

Acute-Phase Reaction↗
PubMed1990

[Effect of rhG-CSF in the treatment of multiple hepatic abscesses in chronic granulomatous disease].

A 19-year-old male was diagnosed as having chronic granulomatous disease (CGD) based on negative NBT reduction in January, 1988. He was admitted with a chief complaint of high fever in November, 1988. As abdominal echogram and CT scan established a diagnosis of multiple hepatic abscesses, he was treated with various kinds of antibiotics. Since the therapy was ineffective, the number of circulating neutrophils was decreased, and the abscesses further grew, intravenous drip infusion of rhG-CSF 100 micrograms was initiated in addition to several antibiotics (sulfamethoxazole-trimethoprim, rifampicin, isoniazide, etc). At day 3 on rhG-CSF, the fever began to resolve and on day 15 the body temperature fell below 37 degrees C. The hepatic abscesses also tended to decrease in size and the CT scan performed 2 months later (March 17), disclosed only calcification in the liver. The neutrophil function test indicated that superoxide anion (O2-) and hydrogen peroxide (H2O2) production was slightly increased during rhG-CSF therapy. Combination therapy with rhG-CSF and potent antibiotics showed a favorable therapeutic effect on CGD complicated by multiple hepatic abscesses as a fatal infection.

Adult↗
PubMed1990

Reverse vascular pedicle hypothenar island flap.

The vascular supply of the skin of the hypothenar region was investigated using 12 cadavers and 24 hands. The ramifications of the proper palmar digital artery of the little finger were also investigated by angiogram in 20 hands. It was found that it is possible to raise the hypothenar skin as an island flap, using the reverse vascular pedicle of the proper palmar digital artery of the little finger. We applied this island flap in three cases. With the result of these anatomical and radiological studies, the details of three cases are described.

Adult↗
PubMed1990

[Clinical analysis of malignant meningiomas].

It seems generally accepted that meningiomas are benign tumors, and that malignant meningiomas are not common. The pathological criteria for judging whether meningiomas are malignant or not are controversial. Hemangiopericytic type, high cellularity, brain invasion, high mitotic rate, necrotic foci, and papillary type are regarded as histological characteristics of malignant meningiomas. Of a series of 105 patients with surgically treated meningioma, 25 patients demonstrated malignant characteristics (24%). The overall recurrence rate in our patients was 14%. The incidence of recurrence in 25 patients with pathologically malignant characteristics, and recurrence in 80 patients with pathologically benign characteristics were 32% and 9%, respectively. In comparison with benign meningiomas, recurrent factors in malignant ones included Simpson grade II operation, attachment of skull base, and no radiation-therapy. In conclusion, our criteria for malignant meningiomas have proved to be acceptable, and these cases should be treated with radiation therapy after surgery.

Adult↗
PubMed1990

Hemangioma of the fingers.

Fingers often suffer trauma and the clinician is continuously faced with the difficult task of clarifying the distinction between a hemangioma and a traumatic lesion. This study was undertaken to examine ten cases in which a small skin mass located on a finger had been diagnosed preoperatively as hemangioma. Our results showed that seven masses were confirmed pathologically as hemangioma (five cavernous hemangiomas and two capillary hemangiomas), two as traumatic thrombosis and one varix. The clinical manifestations of the two cases of traumatic thrombosis were related to those of hemangioma. In the varix, endothelial proliferation was observed in the area of the thrombosis. This phenomenon is called "intravascular papillary endothelial hyperplasia", and can confuse the differential diagnosis between a vascular neoplasm and a traumatic thrombosis. Our findings demonstrate that since the traumatic lesions were firmer than the hemangiomas, hardness on physical examination may be a helpful indicator in the differential diagnosis of a hemangioma and a traumatic lesion.

Adolescent↗
PubMed1990

[Efficacy of a 48-hour infusion of 5-fluorouracil in patients with stage IV gastric cancer after palliative gastrectomy].

Efficacy of a 48-hour infusion of 5-FU in patients with stage IV gastric cancer was investigated. A one-cycle regimen consisted of a 48-hour infusion of 5-FU (30 mg/kg/24 hours) every week for 6 weeks. Fourteen patients with stage IV gastric cancer who underwent absolutely non-curative gastrectomy, received 5-FU infusion postoperatively. Ten of the 14 received more than 2 cycles. Survival rates in these patients (group I) were evaluated by Kaplan-Meier method and compared with those of matched pair controls (group II) who received other anticancer agents. Side effects were generally mild. Nausea during infusion was observed in only 3 cases. The 50% survival period was 393 days in group I and 135 days in group II, respectively. The survival curve in group I was significantly higher than in group II (p = 0.05). From these results, this treatment is considered to be very effective.

Aged↗