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Biomedical subjects

K Miyai

Publications and source records attributed to K Miyai.

At least 289 records · Page 16Linked to original sources

Solid phase fluoroimmunoassay for 11-deoxycortisol in serum using 21-amino-17-hydroxyprogesterone.

Solid phase fluoroimmunoassay of serum 11-deoxycortisol (17,21-dihydroxy-4-pregnene-3,20-dione) was established using fluorescein isothiocyanate-labelled 11-deoxycortisol and anti-11-deoxycortisol antibody-conjugated polyacrylamide beads. 21-Amino-17-hydroxyprogesterone (21-amino-17-hydroxy-4-pregnene-3,20-dione) was synthesized as a useful derivative for preparing the fluorescent dye conjugate. Serum 11-deoxycortisol was measured with this assay system after extraction and purification by Sephadex LH-20 column chromatography. The minimal amount of 11-deoxycortisol detected was 40 pg/tube and the measurable range was from 0.04 to 5.0 microgram/dl. Intra- and inter-assay coefficients of variation were 8.3% (n=6) and 9.8% (n=5), respectively. 11-deoxycortisol values determined by the present assay correlated well with those determined by radioimmunoassay. The present assay is particularly suitable for estimating the conditions of the pituitary and adrenocortical functions.

17-Hydroxycorticosteroids↗

Correlation of hepatic and portal wedged venography and manometry with histology in alcoholic cirrhosis and periportal fibrosis.

Histologic, manometric, and direct magnification venographic studies of four patients with portal fibrosis and 10 patients with alcoholic cirrhosis were compared before and for variable periods after portacaval shunt procedures. Unique to this investigation was the availability of postoperative wedged portal vein manometry and venography. In periportal fibrosis (presinusoidal obstruction), portal studies demonstrated portal venular atrophy and occlusions, with egress of contrast material from hepatic sinusoids via hepatic veins; hepatic studies were near normal. The reverse was observed in patients with cirrhosis (postsinusoidal obstruction). The degree of elevation of portal vein pressures did not enable clear discrimination of pre- and postsinusoidal obstruction. Results support classical concepts of pre-and postsinusoidal obstructive disease and confirm the utility of wedge hepatic and portal venography in differentiating these two entities.

Blood Pressure↗

Aggravation of thyrotoxicosis in early pregnancy and after delivery in Graves' disease.

The effect of pregnancy on the clinical course of Graves' disease was examined by studies on 41 pregnancies in 35 patients with Graves' disease, who were considered to be in a state of remission or near remission and were not receiving antithyroid drugs, during and after delivery. Eighteen of the 41 cases (44%) showed transient increases in the serum free T4 index (FT4 index) during weeks 10--15 of pregnancy, but normal thyroid function in the second and third trimesters. Similar transient increases in the serum free T3 index (FT3 index) were observed in early pregnancy in these patients. These early increases in the FT4 and FT3 indexes were specific to Graves' disease and were not observed in Hashimoto's disease. Two to 4 months postpartum, 32 cases (78%) developed various degrees of thyrotoxicosis, which was divided into 3 types: 1) persistent thyrotoxicosis with high radioactive iodine (RAIU) (10 cases), 2) transient thyrotoxicosis with normal or high RAIU) (10 cases), and 3) destruction-induced thyrotoxicosis with low RAIU (12 cases). An increase in the FT4 index in early pregnancy was significantly (P less than 0.001) associated with relapse of stimulation-induced thyrotoxicosis of either the persistent or transient type. Patients who developed destruction-induced thyrotoxicosis after delivery had significantly higher titers of antithyroid microsomal antibodies (P less than 0.001) and a longer euthyroid period before pregnancy (P less than 0.01) than patients who had recurrent persistent thyrotoxicosis. These data indicate that Graves' disease is aggravated in early pregnancy and after delivery and ameliorates in the latter half of pregnancy. Postpartum relapse of persistent hyperthyroidism could be predicted from an early increase in the FT4 index during pregnancy.

Adult↗

Decrease of immunoglobulin G-Fc receptor-bearing T lymphocytes in Graves' disease.

Peripheral immunoglobulin G (IgG)-Fc receptor-bearing T lymphocytes (T gamma cells) in patients with autoimmune thyroid diseases and destruction-induced thyrotoxicosis were assayed by measuring erythrocyte antibody-rosette formation using a microplate technique. In untreated patients with Graves' disease, the percentage of T gamma lymphocytes (mean +/- SD, 8.9 +/- 3.9%; n = 15) was significantly lower (P less than 0.001) than that in normal controls (21.7 +/- 9.1%; n = 35). A similar decrease was found in thyrotoxic patients with Graves' disease under antithyroid drug therapy (12.1 +/- 5.6%; n = 11; P less than 0.01). Normal percentages were observed in euthyroid patients with Graves' disease under antithyroid drug therapy or in remission. In patients with Hashimoto's disease and destruction-induced thyrotoxicosis, the percentage of T gamma lymphocytes was similar to that in normal controls. The percentage of T gamma lymphocytes was significantly correlated inversely with the serum T4 level, the free T4 index, the T3 level, and the free T3 index in patients with autoimmune thyroid diseases, excluding those with Hashimoto's disease with destructive thyrotoxicosis. There were no correlations between T gamma lymphocytes and other variables, such as goiter size, the titer of antithyroid antibodies, or proptosis, in a group of untreated cases of autoimmune thyroid disease. The decreased proportion of T gamma lymphocytes in thyrotoxic patients with Graves' disease may be related to the perpetuation of thyrotoxicosis in patients with Graves' disease.

Adolescent↗

Radioimmunoassay of "free thyroxin" in dried blood spots on filter paper - preliminary observations on the effective differentiation of subjects with congenital hypothyroidism from those with subnormal thyroxin-binding globulin and normal subjects.

In this sensitive, simple method for measuring "free thyroxin" (FT4) in eluates of dried blood spots on filter paper by use of a radioimmunoassay kit (Amerlex Free T4 RIA), the measurable range of FT4 is 1.8 to 57 ng/L (equivalent to the concentration in serum), or 7 to 237 fg/tube. The mean coefficients of variation for within assay-within spots, within assay-between spots, and between assays were 5.3%, 5.0%, and 6.2%, respectively. FT4 in blood spotted on filter paper is stable for at least a month when dried and kept at either -20 degrees C, 4 degrees C, room temperature (about 25 degrees C), or 37 degrees C. The results for FT4 in dried blood spots correlated closely with the free-T4 concentration in serum (r = 0.99). The method can be used to differentiate cases of primary and secondary hypothyroidism from normal subjects and those with subnormal thyroxin-binding globulin. This method may be useful in screening for congenital hypothyroidism, because sample-retesting is not necessary.

Adolescent↗

Enzyme immunoassay of thyroxin-binding globulin.

We describe a new double-antibody enzyme radioimmunoassay for thyroxin-binding globulin (TBG) in serum. A TBG-beta-D-galactosidase complex was prepared with m-maleimidobenzoyl N-hydroxysuccinimide ester. The mean analytical recovery of TBG added to serum was 99%, sample volume and TBG value were linearly related, and values for TBG determined by this method and those determined by radioimmunoassay correlated well (r = 0.98). Coefficients of variation averaged 7.6% within assay, 6.6% between assay. The measurable range of TBG in the serum was 3.3 to 52 mg/L, but higher TBG concentrations could be measured by diluting the test serum with TBG-free serum. Mean (and SD) serum TBG concentrations as determined by this method were as follows: for 20 normal subjects, 21.2 (3.7) mg/L; for 10 pregnant women, 50.1 (9.5 mg/L; and for 10 patients with TBG deficiency, not detectable.

Female↗

Hypervitaminosis A unmasked by acute viral hepatitis.

A case of acute hypervitaminosis A complicating viral hepatitis is reported. Twenty days after presenting with hepatitis B, a 42-yr-old vegetarian developed acute hypervitaminosis A in the absence of recent, massive exposure to the vitamin. Findings included headache, confusion, skin desquamation, and hypercalcemia. Prior to developing hepatitis, he had ingested supplemental vitamin A without recognized ill effect. Liver and serum vitamin A without recognized ill effect. Liver and serum vitamin A levels were both elevated; the liver biopsy showed abundant, lipid-filled Ito cells and perisinusoidal fibrosis. This case demonstrates that patients with excessive hepatic stores of vitamin A may develop hypervitaminosis A during acute, intercurrent liver disease. Levels of retinol binding protein are reduced in hepatitis. This phenomenon may account for the findings in this case, since vitamin A is more toxic when not specifically bound to retinol binding protein. The size of the population at risk for this complication of hepatitis in unknown, but presumably it is growing with the widespread use of supplemental vitamin A.

Adult↗

Hepatotoxicity of bile acids in rabbits: ursodeoxycholic acid is less toxic than chenodeoxycholic acid.

The hepatotoxic effects of cholelitholytic bile acids, ursodeoxycholic and chenodeoxycholic acids, were compared with each other and with those of lithocholic acid, a known hepatotoxic bile acid, in the rabbit. Male New Zealand white rabbits were fed regular laboratory chow containing ursodeoxycholic, chenodeoxycholic, or lithocholic acid at a concentration of 0.5 per cent (w/w) for 14 days. The control group was fed the chow without added bile acids. The mortality rate was highest (six of 12) in the lithocholate group, intermediate (two of eight) in the chenodeoxycholate group, and lowest (none of six) in the ursodeoxycholate group. Light microscopy of the liver revealed fibrosis, inflammation, and bile duct proliferation in the portal regions in the three experimental groups; however, the lesions in the lithocholate and chenodeoxycholate groups were more severe and often associated with periportal extension of fibrosis and focal necrosis of the parenchyma. In addition, electron microscopy revealed distortion of bile canaliculi, conspicuous bundles of intermediate-sized filaments, expansion of pericanalicular cytoplasmic matrix due to apparent accumulation of microfilaments, prominence of lysosomes, and fragmentation of cisternae of the rough endoplasmic reticulum. These ultrastructural changes were less marked and often absent in the ursodeoxycholate group. The serum L-alanine aminotransferase activity increased 5- to 6-fold in the lithocholate and chenodeoxycholate groups, whereas it remained less than 2-fold of the control level in the ursodeoxycholate group on day 14. The serum lithocholate concentration was markedly elevated to comparable levels in all three groups, whereas ursodeoxycholate was highly increased in the ursodeoxycholate group but undetectable in the other groups at the time of sacrifice. It is concluded that (1) although the oral administration of three bile acids induces hepatic injuries in the rabbit, ursodeoxycholate causes less severe injury than do the other two, (2) the advantage of ursodeoxycholate versus chenodeoxycholate is probably relative rather than absolute, (3) lithocholate formed through metabolic conversion from ursodeoxycholate may be responsible for the most part for hepatotoxicity, and (4) it is possible that the concurrent presence of ursodeoxycholate may mitigate lithocholate's hepatotoxicity.

Animals↗

Ultrastructural localization of cholesterol by enzyme histochemistry.

The histochemical localization of cholesterol using oxidized diaminobenzidine as the final reaction product was studied at the electron microscopical level and compared with the digitonin method of cholesterol localization based on cholesterol digitonide as the final reaction product. Tissue chopper sections of fixed rat adrenal glands were incubated at 37 degrees C in a medium consisting of 0.8 units/ml cholesterol oxidase, 1.4 units/ml cholesterol ester hydrolase, 50 units/ml horseradish peroxidase, 0.5 mg/ml diaminobenzidine, 0.1% v/v Triton X-100 (or Surfal) and an endogenous peroxidase inhibitor in 0.1 M phosphate buffer, pH 7.0. An electron-dense osmiophilic reaction product was observed in many lipid droplets, intracellular vesicles and focally around mitochondria. Appropriate control experiments indicated that deposition of reaction product depended on the presence of cholesterol and the necessary enzymes. Comparison studies using digitonin confirmed the presence of cholesterol in the lipid droplets, but ultrastructural distortion limited the resolution of the more discrete deposits of cholesterol than the digitonin method because it does not cause distortion of cellular ultrastructure attributed to the formation of cholesterol digitonide. The enzyme method or a combination of enzyme and digitonin enable localization of free, esterified or total cholesterol.

3,3'-Diaminobenzidine↗