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Biomedical subjects

K Yabuta

Publications and source records attributed to K Yabuta.

At least 73 records · Page 4Linked to original sources
PubMed1994

A case report suggesting a common pathogenesis for IgA nephropathy and Henoch-Schönlein purpura.

A 7-year-old boy who had been followed for asymptomatic haematuria and elevated serum IgA levels developed Henoch-Schönlein purpura (HSP) after a streptococcal infection of the tonsils. Findings on renal biopsy were compatible with mild IgA nephropathy (IgAN); tonsillectomy was also performed as he had chronic tonsillitis. This case suggests that there is a common pathogenesis for IgAN and HSP, at least in some patients.

Child↗
PubMed1994

Pentoxifylline and intravenous gamma globulin combination therapy for acute Kawasaki disease.

We compared the efficacy of oral administration of pentoxifylline (PTX) and intravenous infusions of gamma globulin (IVGG) combination therapy with that of IVGG in reducing the frequency of coronary-artery lesions (CAL) in children with Kawasaki disease (KD), in a randomized trial. All patients with KD received acetylsalicylic acid (30 mg/kg per day), until the 30th day, after the onset of fever, followed by daily acetylsalicylic acid at a dose of 3-5 mg/kg per day there-after, and intravenous IVGG, 200 mg/kg per day, for 5 consecutive days. In addition, patients randomly assigned to PTX and IVGG combination therapy groups received oral PTX at a dosage of 10 mg/kg per day (low-dose) or 20 mg/kg per day (high-dose), in three divided doses until the 30th day. Patients with KD were all free from CAL prior to treatment. We assessed the presence of CAL by two-dimensional echocardiography which was also done prior to treatment and then twice a week after hospital admission. We detected CAL in 3 of 18 patients (16.7%) in the IVGG therapy group, as compared with 2 of 18 patients (11.1%) in the low-dose PTX and IVGG combination therapy group. There were no significant difference between the two groups. In the next study, we detected CAL in 3 of 21 patients (14.3%) in the IVGG therapy group, as compared with none of 22 patients (0%) in the high-dose PTX and IVGG combination therapy group (chi 2 = 6.4, P < 0.02). No adverse side-effects were observed in 79 patients with KD.(ABSTRACT TRUNCATED AT 250 WORDS)

Aspirin↗
PubMed1994

Serum levels of p60 soluble tumor necrosis factor receptor during acute Kawasaki disease.

To evaluate the role of tumor necrosis factor alpha (TNF-alpha) during acute Kawasaki disease, we measured p60 soluble tumor necrosis factor receptor (sT-NF-R) shedding into the circulation in 48 patients with acute Kawasaki disease, all of whom received intravenous infusions of gamma-globulin. Of the 48 patients, 5 had coronary artery lesions. Serum concentrations of p60 sTNF-R and TNF-alpha were measured by a sandwich enzyme immunoassay. Patients with Kawasaki disease had increased serum levels of p60 sTNF-R. We found a positive correlation between serum levels of p60 sTNF-R and levels of TNF alpha during acute Kawasaki disease. Moreover, patients with coronary artery lesions had higher levels of sTNF-R than did those without coronary artery lesions. Our findings indicate that p60 sTNF-R levels in serum may be useful for determining the severity of vascular damage during acute Kawasaki disease, and that patients with Kawasaki disease and high sTNF-R levels seem to be susceptible to coronary artery lesions even if they receive therapy with intravenous infusions of gamma-globulin.

Acute Disease↗
PubMed1994

Fecal IgE levels in infants at 1 month of age as indicator of atopic disease.

Fecal IgE levels were investigated in 165 asymptomatic infants at 1 month of age under two nutritional regimens, breast-feeding and formula feeding, and the possibility of predicting by fecal IgE levels the onset of atopic disease was studied in these infants. IgE levels were measured by time-resolved fluoroimmunometric assay. IgE antibodies are detectable in fecal extracts, and we have already reported that IgE levels are increased in food-allergy patients after administration of food allergens, and this increase in fecal IgE levels may be a specific consequence of the local immune response to food-allergen stimulation in the gut mucosa. The presence of atopic disease and the feeding method during the nursing period were surveyed by questionnaire in 89 of these 165 infants when they were 18 months old. In an analysis of the present results, IgE values above 0.015 U/ml, the lower limit of measurement, were considered to be high. Forty-eight (29%) of the 165 subjects showed a high fecal IgE level. Thirty-seven (35%) of 105 formula-fed infants had high fecal IgE levels, whereas only 11 (18%) of 60 breast-fed infants had high levels (P < 0.05). With respect to atopic family history, 30 (39%) of the 77 infants with atopic family history had high fecal IgE levels, as compared with 18 (20%) of the 88 infants without atopic family history (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Biomarkers↗
PubMed1994

Impaired increase of prostaglandin E2 in gastric juice during steroid therapy in children.

To investigate the aetiology of steroid-induced peptic ulcers in children, prostaglandin E2 (PGE2) release and acid secretion into gastric juice was evaluated in 10 children receiving a corticosteroid before and after injection of pentagastrin. The concentration of luminal PGE2 was measured by radio-immunoassay. The basal levels of PGE2 concentration and acid secretion in gastric juice did not differ significantly between the steroid therapy group and control group. After stimulation with pentagastrin, acid secretion increased significantly (P < 0.01) in both groups and PGE2 concentration increased significantly (P < 0.01) only in the control group. Prostaglandin E2 concentration was significantly lower in the steroid therapy group than in the control group 20-40 and 40-60 min after pentagastrin stimulation (P < 0.01 and P < 0.05, respectively). Since PGE2 has a cytoprotective effect on the gastric mucosa, the results of impaired increase of PGE2 in response to increased acid secretion during steroid therapy may indicate causality with the development of steroid-induced peptic ulcers.

Adolescent↗
PubMed1994

A new oral margarine loading test in children.

Margarine (2g/kg) was orally administered to 39 children with normal fat digestion and absorption (control group) and 17 children with abnormal fat digestion and absorption (malabsorbed group). The serum triglyceride (TG) level was serially determined by capillary blood sampling. In the control group, the TG level was significantly elevated after 2, 3 and 4 h as compared with the level before margarine ingestion (basal TG). The maximum TG elevation rate [MTER = (maximum TG-basal TG)/basal TG x 100] was > 50% in all but three children. In contrast, a significant increase in TG was not observed in the malabsorbed group after margarine ingestion, and the MTER was < 50% in all but two children. The MTER was significantly lower in children with a high microscopic score of fecal fat than that in children with a low score. This oral margarine loading test is a simple and semi-quantitative evaluation of fat digestion and absorption, and is considered to be useful for the assessment of the presence or severity of fat maldigestion and malabsorption in children.

Adolescent↗
PubMed1994

The regulation of intestinal hypersensitivity reactions to ovalbumin by omega-3 fatty acid enriched diet: studies of IEL and LPL in mucosal damage.

In order to clarify the mechanisms of food-sensitive enteropathy, a food hypersensitive model was generated by feeding ovalbumin to female BALB/c mice after intraperitoneal injection of cyclophosphamide and morphological and immunological changes in the gut mucosa were investigated. Villus atrophy, crypt hyperplasia and increased numbers of intra-epithelial lymphocytes (IEL) were confirmed in this model, as seen in food-sensitive enteropathy in humans. Subpopulations of IEL and lamina propria lymphocytes were enumerated by immunohistochemical observation. CD8-positive cells were increased both in epithelium and lamina propria, whereas CD4-positive cells were decreased in lamina propria. We document here that orally administered food antigen actually induces food-sensitive enteropathy and mucosal damage is generated by lymphocytes that infiltrate the intestinal mucosa. We also investigated the effect of feeding an omega-3 fatty acid-enriched diet in this model and found that it was efficient in attenuating mucosal damage.

Animals↗
PubMed1994

Absence of anti-neutrophil cytoplasmic antibody (ANCA) in Henoch-Schönlein purpura and immunoglobulin A nephropathy.

We have studied the presence of anti-neutrophil cytoplasmic antibodies (ANCA) in 16 patients with Henoch-Schönlein purpura (HSP) and 10 patients with immunoglobulin A nephropathy (IgAN). An indirect immunofluorescence test using ethanol-fixed neutrophils as a source of antigen and an enzyme-linked immunosorbent assay using purified proteinase-3 and myeloperoxidase as antigens were used. Neither immunoglobulin G nor immunoglobulin A (IgA) ANCA were found in any of the patients studied. It was shown that fluorescein-isothiocyanate conjugated anti-human IgA antibodies bound to ethanol-fixed normal human neutrophils non-specifically, suggesting the possibility that false positive staining was responsible for the previous reports. We conclude that ANCA does not play an important role in the pathogenesis of HSP and IgAN.

Adolescent↗
PubMed1994

A sibship with recurrent Kawasaki disease and coronary artery lesion.

Although epidemiologic studies of Kawasaki disease suggest an infectious etiology, the cause of this mysterious disease remains unclear. We describe the occurrence of five episodes of Kawasaki disease over a six-year period in three siblings. Two of the three children experienced recurrent Kawasaki disease and developed coronary artery lesions, which included giant coronary artery aneurysms in the youngest child. The non-contemporaneous occurrence of the disease in these three children emphasizes the importance of a genetic basis and/or environmental factors in the etiology of Kawasaki disease.

Child, Preschool↗
PubMed1994

Severe hyponatremia in a patient with renovascular hypertension: case report.

We report a 2-year-old boy with renovascular hypertension caused by stenosis of the left renal artery that was successfully treated by percutaneous transluminal angioplasty (PTA). He initially presented with severe hyponatremia, hypokalemia, polyuria, transient proteinuria and weight loss. This phenomenon is known to occur in patients with renovascular and malignant hypertension, called hyponatremia hypertensive syndrome, but was thought to be rare in children. Renovascular hypertension should be considered as a cause of hyponatremia in children. In addition, PTA is an appropriate treatment even in very young children with renovascular hypertension.

Angioplasty, Balloon↗
PubMed1993

Carbamazepine-induced thrombocytopenia and leucopenia complicated by Henoch-Schönlein purpura symptoms.

A rare case of carbamazepine-induced leucopenia and thrombocytopenia complicated by Henoch-Schönlein purpura (HSP) symptoms is presented. Laboratory findings suggested that leucopenia and thrombocytopenia could be due to bone marrow suppression and HSP symptoms to an allergic reaction to carbamazepine. To the best of our knowledge this is the first report that carbamazepine may cause haematological disorders associated with symptoms of HSP by different mechanisms at the same time in the same patient.

Bone Marrow↗
PubMed1993

Successful balloon mitral commissurotomy in a small child: use of small Inoue balloon catheter.

A 15-month-old girl weighing 5.8 kg, in whom congestive heart failure developed due to congenital mitral stenosis, was successfully treated by percutaneous transluminal mitral commissurotomy using a small Inoue balloon catheter. Percutaneous transluminal mitral commissurotomy using a small Inoue balloon catheter may be a first-choice treatment for small children with congenital mitral stenosis.

Catheterization↗