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Y Kojima

Publications and source records attributed to Y Kojima.

At least 127 records · Page 7Linked to original sources
PubMed1999

Double cancer of the gallbladder and common bile duct associated with an anomalous pancreaticobiliary ductal junction without a choledochal cyst: report of a case.

We report herein the case of a 37-year-old woman found to have double cancer of the gallbladder and common bile duct associated with an anomalous pancreaticobiliary ductal junction (APBDJ) without a choledochal cyst (CC). Abdominal ultrasonography showed an isoechoic mass in the gallbladder, and percutaneous transhepatic biliary drainage tubography revealed incomplete obstruction in the upper portion of the common bile duct and APBDJ. The patient underwent cholecystectomy, partial hepatic resection, pancreatoduodenectomy, and portal vein reconstruction. Pathological examination of the tumors from the gallbladder and bile duct revealed papillary carcinoma and poorly differentiated adenocarcinoma, respectively, and direct continuity was not observed between the tumors. A review of the literature on six cases of multiple primary carcinoma of the biliary tract associated with APBDJ without CC is presented following this case report. Double cancer of the biliary tract was found synchronously in five patients and metachronously in one. Gallbladder cancer showed subserosal invasion in four patients, while bile duct cancer invaded the pancreas in one patient and reached the serosa in two patients. Considering the potential for cancer to arise in the biliary tract and the difficulties associated with monitoring it, cholecystectomy and resection of the extrahepatic common bile duct may be the most appropriate treatment for patients with an APBDJ without a CC.

Adenocarcinoma↗
PubMed1999

Phylogenetic study of methanogens associated with rumen ciliates.

The phylogeny of methanogenic archaea associated with ciliate protozoa in a sheep rumen was investigated. Ruminal ciliate protozoa were exhaustively washed and mixtures of genomic DNA extracted. Archaea-specific nested PCR amplification was conducted with the ciliate genomic mixture. The resultant small subunit (16S) ribosomal RNA gene (ssu rDNA) was cloned into Escherichia coli JM 109. Many methanogens were still observed on and/or in ciliate cells by fluorescent microscopy even after exhaustive washing with buffer. Partial sequences of ssu rDNA close to Methanobrevibacter smithii were dominant in the retrieved sequences. RFLP analyses on the retrieved sequences revealed the absence of Methanobrevibacter ruminantium in the protozoal preparation. The association of Methanobrevibacter spp. with ruminal ciliate protozoa was demonstrated by the isolation of archaeal ssu rDNA phylogenetically close to that of M. smithii.

Animals↗
PubMed1999

White coat hypertension in two adolescents.

We describe two adolescent boys with white coat hypertension. Both patients had significantly high blood pressure documented on more than three occasions at clinic. No cause for hypertension or target organ damage was demonstrated. Twenty-four-hour mean ambulatory blood pressure values were normal for height and sex, which led to the diagnosis.

Adolescent↗
PubMed1999

Endoscopic urease sensor system for detecting Helicobacter pylori on gastric mucosa.

BACKGROUND: It is now accepted that the curing of Helicobacter pylori infection will result in healing of chronic active gastritis and will change the natural history of gastroduodenal ulcer disease. Both endoscopic observation and evaluation of H. pylori status of the stomach are necessary for diagnosis and treatment of such patients. We carried out a clinical evaluation of an endoscopic tube type urease sensor system for the detection of H. pylori on the gastric mucosa. The differential output of two pH-sensitive field effect transistors at the tip of the endoscopic tube reflects the pH change in a urea solution depending on the existence of urease. METHODS: In vitro experiments and clinical evaluation of the system were performed. Fifty-one patients who were suspected to have a gastroduodenal disorder were examined for H. pylori infection with this system, using the combination of histologic and bacteriologic examinations and rapid urease test as the references. RESULTS: Clinical sensitivity and specificity of this system were 26 of 28 (92.9%) and 22 of 23 (95.7%), respectively. A measurement at 1 site is completed in about 1 minute. Repetition of the procedure provides multi-site measurements. CONCLUSIONS: The present system makes possible quick on-site detection of H. pylori under endoscopic observation, with satisfactory sensitivity and specificity.

Adult↗
PubMed1999

Correction of completely buried penis using the modified preputial island pedicle flap method.

The buried penis is a rare congenital abnormality caused by a deficiency of penile shaft skin and abnormal attachments of the dartos fascia to Buck's fascia. The basis for surgical correction is directed at freeing the penile shaft from abnormal dartos attachments, refixing dartos fascia to Buck's fascia to prevent retraction of the penis, and providing adequate shaft skin coverage with the inner preputial skin. The authors report a modified preputial island pedicle flap method for correcting the completely buried penis performed on 2 patients (ages 9 months and 1 year) at Nagoya City University Medical School.

Humans↗
PubMed1999

An electrophysiological study of the corticospinal projections in amyotrophic lateral sclerosis.

OBJECTIVE: To elucidate the pattern of corticospinal tract involvement in patients with amyotrophic lateral sclerosis (ALS), we analyzed motor evoked potential (MEP) waveforms and their relationship to the behaviour of single motor units using the peristimulus time histogram (PSTH) technique. METHODS: Abnormality of the corticospinal pathways was studied in 35 ALS patients using MEPs. PSTHs were also constructed to assess the effect of magnetic cortical stimulation on the discharge pattern of a voluntarily activated motor unit. RESULTS: MEPs showed a complex waveform in 10 out of 18 (56%) ALS patients with upper motor neuron signs (UMN). PSTHs revealed double primary peaks (PPs), PP1 and PP2, in 6 out of 16 motor units (38%) in ALS with UMN, as compared to only 2 out of 16 (13%) motor units in multiple sclerosis or cerebrovascular disease with UMN. None of the patients with lower motor neuron diseases or ALS without UMN had these abnormalities. The late component of complex MEPs showed a good correlation to PP2 (P < 0.0001), both probably being mediated by relatively preserved slower conducting corticospinal volleys. CONCLUSIONS: These findings suggest preferential involvement of the fast conducting direct corticospinal tracts, sparing the slower or polysynaptic projections in ALS.

Adult↗
PubMed1999

Importance of individual activated protein C cleavage site regions in coagulation factor V for factor Va inactivation and for factor Xa activation.

Activated protein C (APC) cleavage of Factor Va (FVa) at residues R506 and R306 correlates with its inactivation. APC resistance and increased thrombotic risk are due to the mutation R506Q in Factor V (FV). To study the effects of individual cleavages in FVa by APC and the importance of regions near the cleavage sites, the following recombinant (r) human FVs were prepared and purified: wild-type, Q306-rFV, Q506-rFV, and Q306Q506-rFV. All had similar time courses for thrombin activation. Q506-rFVa was cleaved by APC at R306 and was moderately resistant to APC in plasma-clotting assays and in prothrombinase assays measuring FVa residual activity, in agreement with studies of purified plasma-derived Q506-FVa. Q306-rFVa was cleaved by APC at R506 and gave a low APC-resistance ratio similar to Q506-rFVa in clotting assays, whereas unactivated Q306-rFV gave a near-normal APC-resistance ratio. When FVa residual activity was measured after long exposure to APC, Q306-rFVa was inactivated by only < or = 40% under conditions where Q506-rFVa was inactivated > 90%, supporting the hypothesis that efficient inactivation of normal FVa by APC requires cleavage at R306. In addition, the heavy chain of Q306-rFVa was cleaved at R506 much more rapidly than activity was lost, suggesting that FVa cleaved at only R506 is partially active. Under the same conditions, Q306Q506-rFVa lost no activity and was not cleaved by APC. Therefore, cleavage at either R506 or R306 appears essential for significant inactivation of FVa by APC. Modest loss of activity, probably due to cleavage at R679, was observed for the single site rFVa mutants, as evidenced by a second phase of inactivation. Q306Q506-rFVa had a low activity-to-antigen ratio of 0.50-0.77, possibly due to abnormal Factor Xa (FXa) binding. Furthermore, Q306Q506-rFV was very resistant to cleavage and activation by FXa. Q306Q506-rFV appeared to bind FXa and inhibit FXa's ability to activate normal FV. Thus, APC may downregulate FV/Va partly by impairing FXa-binding sites upon cleavage at R306 and R506. This study shows that R306 is the most important cleavage site for normal efficient inactivation of FVa by APC and supports other studies suggesting that regions near R306 and R506 provide FXa-binding sites and that FVa cleaved at only R506 retains partial activity.

Animals↗
PubMed1999

Accuracy of screening for gastric cancer using serum pepsinogen concentrations.

BACKGROUND/AIMS: The characteristics of pepsinogen screening for gastric cancer were investigated to establish a suitable cut off point for identifying gastric cancer, using endoscopic diagnosis as the yardstick. SUBJECTS/METHODS: Serum pepsinogen concentrations were measured in 5113 subjects who were also screened for gastric cancer by endoscopy. The cut off point for pepsinogen was determined using receiver operator characteristics curves. RESULTS: The most suitable cut off point was a pepsinogen I concentration of less than 70 ng/ml and a ratio of pepsinogen I to pepsinogen II of less than 3. 0. Using this cut off point, the sensitivity and specificity of pepsinogen screening for gastric cancer were 84.6% and 73.5% respectively. All cases of gastric cancer in patients with severe atrophic gastritis were detected. However, two of four cases of gastric cancer in patients with mild atrophic gastritis were overlooked. In subjects with mild atrophic gastritis, when gastric cancer arises within the fundic gland region, the size of the lesion determines whether it is possible to detect cancer by serum pepsinogen screening. CONCLUSION: Pepsinogen screening has many advantages, including its suitability for combination with other screening methods because it is simple and inexpensive.

Aged↗
PubMed1999

Small hepatocellular carcinoma: relationship of signal intensity to histopathologic findings and metal content of the tumor and surrounding hepatic parenchyma.

PURPOSE: To investigate the relationship between the metal content of hepatocellular carcinoma (HCC) and the signal intensity pattern on magnetic resonance images. MATERIALS AND METHODS: The signal intensity patterns of 59 HCCs 3 cm in diameter or smaller were correlated with histologic findings and metal content. RESULTS: HCCs with high signal intensity on T1-weighted images demonstrated more steatosis (P = .035) and higher copper content (P = .008) than did surrounding hepatic parenchyma. HCCs with high signal intensity on T2-weighted images demonstrated more clear cells (P = .001) than did surrounding hepatic parenchyma. The higher signal intensities on T1-weighted and T2-weighted images were related to a higher and a lower degree of histologic differentiation, respectively. Multivariate analysis showed that the contrast-to-noise ratio between the HCC and surrounding hepatic parenchyma was affected by intratumoral copper content (P = .0338), zinc content of surrounding hepatic parenchyma (P = .0379), and the degree of histologic differentiation on T1-weighted (P = .0031) and T2-weighted (P = .0062) images. CONCLUSION: The signal intensity of HCC on T1-weighted images is related to the degree of histologic differentiation, intratumoral copper content, and zinc content of surrounding hepatic parenchyma, whereas the signal intensity on T2-weighted images is related to the degree of histologic differentiation.

Adult↗
PubMed1999

49,XXXXY syndrome with hydronephrosis caused by intravesical ureterocele.

A 1-month-old boy was referred to our hospital with right hydronephrosis. Excretory urography showed poor visualization of the right kidney and a filling defect in the bladder. Chromosomal analysis of peripheral blood revealed a karyotype of 49,XXXXY, and a diagnosis of 49,XXXXY Klinefelter s syndrome associated with hydronephrosis caused by intravesical ureterocele was made. 49,XXXXY Klinefelter s syndrome with anomalies of the urinary tract is extremely rare, and only 2 cases have been reported so far.

Humans↗
PubMed1999

Mothers' adjustment to the birth of a second child: a longitudinal study on use of verbal and nonverbal behaviors toward two children.

4 mothers' skillful use of verbal and nonverbal behaviors to their first and second children was examined while each mother was playing with them for about one year after the birth of the second child. Analysis showed that maternal verbal interactions with the firstborn were frequently accompanied by nonverbal interactions toward the secondborn, especially during the first few months postpartum. The concurrent use of verbal and nonverbal behaviors with the two children may be a behavioral strategy for the mother to adjust to the birth of the second child.

Adult↗
PubMed1999

[Hepatitis B].

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed1999

[A case of arteriovenous fistula of the lung].

A 29-year-old male was admitted to our hospital for further evaluation of left sided paresis, cyanosis, clubbing finger. The laboratory data revealed polycythemia and hypoxemia. Cerebralarteriogram showed right middle cerebral artery occulusion. Cardiofunctional test showed atrial fibrillation, lower left ventricular function. Cardiac catheterization, pulmonary arteriography and three dimensions CT were performed. Right to left shunt rate was 20.4%. A single large pulmonary arteriovenous fistura with a feeding artery (A10) and a draining vein (V10) was found clearly. In this cases, arteriovenous fistula was large, blood flow was thought to be rapid. We thought transcatheter embolization was not useful. And we performed right lower lobectomy. Postoperative course was not eventful. Cyanosis disappeared, clubbing finger was cured.

Adult↗
PubMed1999

[A case of pulmonary dirofilariasis].

A 58-year-old man was admitted to our hospital for detailed examination of continuous cough. On a chest X-ray film, abnormal shadow was detected in the right lower lung field. Preoperative examination findings didn't lead to a definitive diagnosis. Under thoracoscopy partial resection of the lung was performed to rule out a malignant lesion. Intraoperative pathologic finding revealed a granulomatous lesion. And, final pathological diagnosis showed to be a pulmonary dirofilariasis. His postoperative course was not eventful. On 20 th day he discharged postoperatively. Now, under the Pet-boom the disease has been reported increasingly. But it is difficult to find the disease preoperatively. So, it is real to be operated for differentiate from a malignant lesion. Recently in many cases open lung biopsy, has been undergone with less invasive procedure such as thoracoscopy and VATS. It will be mainstream in future.

Dirofilariasis↗
PubMed1999

[A case of gustatory disturbance caused by ipsilateral pontine hemorrhage].

We reported a 71-year-old woman with sudden-onset hypogeusia. The patient showed no other neurological signs or symptoms except for the taste disturbance. She lost bitter, salty, sour or sweet sensation on the right half of the tongue. A brain CT scan revealed a small hemorrhage in the right tegmentum of the middle pons. The hematoma was adjacent to the forth ventricle, affecting the gustatory tract running from the nucleus solitalius to the pontine taste area (PTA) in the upper pons. The gustatory pathway is generally said to exist around the medial lemniscus and the reticular formation. In this case, however, the gustatory tract would lay in the dorsal portion near the forth ventricle, as no defect other than taste disturbance was accompanied.

Aged↗
PubMed1999

[Usefulness of POCT in critical care medicine].

The need for speedy and accurate test results is becoming increasingly urgent in the areas of emergency medicine and ICU. The form of emergency testing is changing from conventional testing conducted by laboratory technicians to point-of-care testing (POCT) performed by the doctor or nurse. Therefore, the skill and time of the technician, which used to be expended for emergency testing, is now utilized for maintenance and precision control of POCT equipment so that the doctors and nurses can conduct POCT with confidence at all times. We also attempted point of prehospital care testing (POPCT), comprised of prehospital care and POCT. Here, the laboratory technician rides with the doctor to provide patient information to the clinicians from the perspective of a laboratory technician in the field to support emergency treatment. This has not yet been made fully practical, but the usefulness of POCT in critical care medicine seems to be essential to the forthcoming advanced emergency medicine, considering its usefulness outside the hospital environment.

Critical Care↗