[Problems in the diagnosis of congenital hypothyroidism detected by mass-screening (author's transl)].
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Biomedical subjects
Publications and source records attributed to H Inomata.
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The effects of tetraethylammonium (TEA) on the action potential in cultured chick embryonic heart muscle cells were investigated. The onset of prolongation of the action potential occurred within 10 min following intracellular iontophoretic application of TEA, but after more than 50 min following extracellular application. These facts suggest the major site of action of TEA is on the inner surface of the membrane these cells.
The optimal daily requirement of L-T4 in replacement therapy for hypothyroidism was evaluated in evaluated in 24 cases of congenital hypothyroidism and 3 of juvenile myxedema, ranging from 3 to 30 years of age. The optimal dose of L-T4, defined as the minimal dose necessary to suppress the serum concentration of TSH into the normal range, was determined in each patient. The optimal dose of L-T4 between 3 and 5 years of age was 5-7 microgram/kg/day, which was higher than a level of 2-4 microgram/kg/day in adult. All patients appeared clinically euthyroid, and their serum concentration of T4 and T3 remained within the normal range while the optimal dose of L-T4 was being administered. These observations imply that physiologic requirement of L-T4 are lower than previously recommended dosages. Further studies to establish more precise therapeutic guidelines are needed.
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Frequency of pigmentary degeneration of the retina (PDR) among patients with degenerative and heredodegenerative neurological diseases (HDNDs) was estimated based on the hospital statistics. PDR was detected in 3% of 176 inpatients with HDNDs by careful ophthalmologic examination. On the other hand, out of 30 consecutive cases of PDR seen in our Department of Neurology, 15 patients were associated with some form of HDNDs. Atypical PDR were more frequently associated with HDNDs than typical PDR. Among neurological manifestations in those 15 cases of PDR associated with HDNDs, mental deficiency, hearing disturbance, spasticity, progressive ophthalmoplegia and ataxia were most frequently encountered. Four cases with unusual symptomatology were presented. Clinical analysis of cases of PDR associated with HDNDs in the present series as well as in the relevant literature revealed an extreme variety of clinical manifestations and underlying metabolic disorders, suggesting a possible participation of multiple factors in the pathogenesis of PDR. Importance of careful ophthalmologic examination in HDNDs was stressed from the prognostic point of view.
1. The actions of Sr2+ on the smooth muscle of the guinea-pig taenia coli have been studied under constant-current and voltage-clamp conditions. 2. In replacing Ca2+, Sr2+ (2.5 mM) prolongs the duration of the action potential by slowing the rate of repolarization, but increases the steady-state membrane conductance. These changes occur in preparations in Krebs solution as well as in preparations in a Na+-free tetraethylammonium medium. 3. When [Sr2+]o is increased to 20 mM, the amplitude of the spike is increased, and the duration shortened. 4. Under voltage-clamp conditions, Sr2+ carries the early inward current (Ia). Increasing [Sr2+]o increases the maximum Ia and shifts its reversal potential (Ea) towards more positive voltages, without affecting the conductance, ga. 5. Sr2+ does not affect the steady-state inactivation of Ia, but markedly slows the rate of inactivation. 6. In all concentrations, Sr2+ enhances the late outward current (Ib, chiefly Ik), by increasing the conductance, gb. The degree of increase is greater in higher [Sr2+]o. 7. Ca2+ at concentrations of 1 or 2.5 mM added to Sr2+ solutions partially reverses the above effects, suggesting the presence of some competition for the same channel or binding sites or both. 8. The results indicate that in the taenia coli, there is a component of the K+-conductance system which is sensitive to [Sr2+]o and to [Ca2+]o. 9. They also suggest that the inactivation of the early inward current is an important mechanism underlying the repolarization of the action potential, and that IK probably has a delayed and gradual onset.
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A 41-year-old Japanese male with a new type of primary familial amyloidosis was reported. The patient developed vitreous opacities, and later, disturbances in the gastrointestinal and nervous systems. At autopsy, amyloid was observed in the vitreous and the retinal vessels. There were extensive cerebral infarcts and heavy meningo-vascular amyloid deposition. Although the postmortem study revealed slight peripheral nerve degeneration in the lower extremities secondary to amyloid deposition, there was no clinical evidence of polyneuropathy.
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Peripheral neuropathy was not found even six to ten years after the onset of visual symptoms in a family with primary amyloidosis, except in the propositus at the terminal stage. The propositus had mainly ocular and CNS involvement. An ocular manifestation, the vitreous opacity, was the only involvement in the family members, in spite of the long clinical course. This family may have a different type of familial primary amyloidosis from that previously reported.
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A simple method for measuring digital arterial pressure and its recording on usual EKG heat-writing paper was devised. The method enabled us to measure exactly the digital systolic as well as diastolic blood pressure without providing the calibrating scale of pressure, since the pressure scale is recorded on the paper automatically as pulse signals at the interval of 10mmHg. The pulse waves are also registered on the same paper by means of the finger plethysmograph. By use of a right-angled triangle transparent rule, we could estimate the value of digital systolic pressure at which the pulse wave began to appear when the cuff pressure for compressing the artery was gradually lowered. Estimated values of the digital arterial pressures were compared with those obtained by another method of Mendlowitz and his coworkers.