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Biomedical subjects

M Okuyama

Publications and source records attributed to M Okuyama.

At least 127 records · Page 7Linked to original sources
PubMed1983

A solid phase radioimmunoassay for the detection of anti-insulin antibodies.

A solid phase radioimmunoassay for the detection of anti-insulin antibodies has been developed and evaluated. After coating round-bottomed wells of polyvinyl chloride with porcine monocomponent insulin, 50 microliters of serum from either insulin-treated diabetics or non diabetic controls was added to the wells, followed by the addition of 125I-protein A, and then the radioactivity of the bound 125I-protein A on the wells was counted. This solid phase radioimmunoassay is very simple, does not require centrifugal steps and the results correlated well with those of previously published immune precipitation methods (r = 0.68, p less than 0.01). Our present method requires only 50 microliters of serum and 4 hours for the assay, if the wells are coated with insulin in advance. Therefore, this procedure is thought to be suitable for clinical use.

Chemical Precipitation↗
PubMed1983

Age- and sex-related differences of serum thyroxine binding globulin (TBG) in healthy subjects.

Serum concentrations of thyroxine binding globulin (TBG) were measured in healthy adult subjects aged 20-79 years (152 males and 148 females) by radioimmunoassay. In contrast to previous reports, there were no significant age-related differences in either sex. Significant sex-related differences were observed only in the fourth decade, being higher in females than males (P less than 0.01).

Adult↗
PubMed1983

Diabetic gangrene in Japan: analysis of 487 cases.

Diabetic gangrene was thought of as a rather rare complication in Japan. Since the first report in 1917, only 16 cases were reported up to 1945. However, the number of reports increased rapidly in the manner of a geometric series after 1965. Sex and age distributions of the syndrome in Japan corresponded closely with those of Western countries. A distinct tendency in the inducement of gangrene was found, i.e. thermal trauma had preceded 43.6% of the cases. This might be the result of the local habit of warming the feet using hot-water bottles or foot warmers. The number of patients with normal pulses in the affected extremities in Japan was distinctly higher compared with that reported in Western countries. But functional and morphological changes in large peripheral vessels were frequently demonstrated when more detailed examinations were conducted. The cause for the rapid increase in the incidence of diabetic gangrene has not been elucidated, but changes in lifestyle may be partly responsible. The most conspicuous change was the increase in meat and fat intake during the 1960's. The changes in total calorie, total protein or sugar intake over this period were inconspicuous. Changes in dietary habits seem to be responsible, but further research will be necessary to clarify the details.

Aged↗
PubMed1983

[Therapeutic effect of paromomycin sulfate on the 13th case of Mesocestoides lineatus infection found in Japan].

Mesocestoides tapeworm is a common cestode in carnivorous mammals, but human infection with the tapeworm of this genus have been infrequent. We have recently observed the 13th case of human infection with Mesocestoides lineatus in Japan. A 35-year-old man living in Gifu prefecture was admitted to our University Hospital with chief complaints of general fatigue and discharge of cestode segments in his stool. The patient gave a history of drinking blood and eating the raw liver of a snake Agkistrodon halys for medicinal purposes as same as the previous cases of all reported in Japan. The segments were identified as those of M. lineatus. He was treated orally 3 g of paromomycin sulfate. Stool examination after treatment with paromomycin sulfate revealed no evidence of parasitism. The present case may be the 2nd to have been successfully treated with paramomycin sulfate and the 21st case of Mesocestoides tapeworm infection in man described in the literature.

Adult↗
PubMed1982

[A study on anti-T3 and anti-T4 autoantibodies found in two sisters with juvenile hypothyroidism due to Hashimoto's thyroiditis: II. The effect of treatment with L-thyroxine].

We previously reported that two sisters with juvenile hypothyroidism due to Hashimoto's thyroiditis (Case 1: 13 years old, Case 2: 10 years old) had antibodies against thyroid hormones. Treatment was started with 12.5 micrograms of L-T4 per day in Jan. 1980. The doses were gradually increased, and after 1 year of treatment, both patients were clinically euthyroid on 100 micrograms of L-T4 per day, and the heights of Case 1 and of Case 2 had increased by 9 cm and by 10 cm, respectively. Serum TSH levels were decreased from 1088 microU/ml to 1.7 microU/ml in Case 1, and from 1300 microU/ml to 2.1 microU/ml in Case 2. The titers of antithyroglobulin antibodies as measured by solid phase RIA decreased in both patients after the treatment. The bindings of 125I-T3 and of 125I-T4 to sera in the presence of 8-anilino-1-naphthalene sulfonic acid to block binding to TBG (non-treated sera) were markedly higher in the two patients before therapy than those in ten normal controls (11.8% and 52.3% in Case 1, 46.8% and 21.5% in Case 2, and 5.9 +/- 0.6% and 4.1 +/- 0.5% (mean +/- SD) in the controls, respectively). After the 1 year treatment, the bindings of 125I-T3 and 125I-T4 decreased to normal levels in Case 1 (5.8% and 3.8%, respectively). In Case 2, the 125I-T4 binding decreased to the normal level (4.7%), whereas the 125I-T3 binding decreased but still remained above the normal level (10.6%). In order to exclude the interference of endogenous and/or therapeutic thyroid hormones with the binding of labelled hormones to sera, the sera were treated with dextran-coated charcoal at pH3.0 (acid-treated sera). The bindings of 125I-T3 and 125I-T4 to acid-treated sera were clearly higher in both patients before therapy than those in ten normal controls (16.9% and 60.7% in Case 1, 75.0% and 46.4% in Case 2, and 6.9 +/- 0.7% and 6.8 +/- 0.7% (mean +/- SD) in the controls, respectively), and these values were compatible with those from non-treated sera. After the 1 year treatment, however, the results of acid-treated sera were different from those of non-treated sera. That is, the bindings of 125I-T3 and of 125I-T4 to acid-treated sera from both patients decreased but remained above normal levels (9.3% and 26.5% in Case 1, and 29.4% and 22.5% in Case 2, respectively). These results indicate the presence of antibodies against thyroid hormones even in the euthyroid state during L-T4 treatment, and also the data obtained from the non-treated sera were affected by endogenous and/or therapeutic thyroid hormones. The importance of acid-charcoal treatment for the detection of anti-thyroid hormone antibodies during thyroid hormone administration was suggested. In the serum from another sister of the reported patients, we also found unusual T4-binding proteins which were only detected by the acid-charcoal treatment. The implications of decrement of anti-thyroglobulin antibodies and of anti-thyroid hormone antibodies were discussed.

Adolescent↗
PubMed1982

[A case with Bartter's syndrome associated with type II hyperlipidemia, increased fluidity of plasma VLDL and abnormal configuration of peripheral erythrocytes (author's transl)].

A 34-year-old female complaining of numbness and weakness of the extremities was examined. Consanguineous marriage was contracted between mother and father. She was of short stature (149 cm), and her blood pressure was normal (118/60 mmHg). Her serum potassium concentration had decreased to a level between 2.5 and 3.2 mEq/L, and hypokalemic alkalosis was present. Potassium clearance had increased and urinary concentrating capacity was impaired. Plasma renin activity was high at 25 ng/ml/hr but plasma aldosterone concentration was normal. Hypertensive response to angiotensin II (50 ng/kg/min) was weak but improved to nearly the normal value after the administration of indomethacin for 17 days at a dose of 50 mg/day. A slight elevation in blood pressure was observed during the infusion of norepinephrine (250 ng/kg/min). A decrease in blood pressure was observed during the infusion of 1-sarcosine, 8-isoleucine angiotensin II (600 ng/kg/min) with concomitant increase of plasma renin activity. Twenty-four hour urinary excretion of prostaglandin E decreased somewhat (225 approximately 252 ng/day), and hyperplasia of the juxtaglomerular cells and increased JG index were demonstrated in the biopsy specimens of the right kidney. From the findings, the present case were diagnosed as Bartter's syndrome. Although mild enlargement of the sella turcica was found in skull x-ray films, no abnormalities in pituitary function were demonstrated. Other unusual complications, i.e. hyperlipidemia (type II, beta-dominant) and abnormal configuration of peripheral erythrocytes, were demonstrated. Phospholipid composition of the erythrocyte membrane was normal. The fluidity of plasma VLDL examined by electron spin resonance was increased. Hypokalemia and hyperreninemia were improved through the administration of indomethacin. However, because of headache as an adverse effect, further administration could not be accepted. The patient's complaints were resolved by the rectal application of indomethacin with oral administrations of spironolactone and triamterene. Changes in serum lipid levels did not occur with the above mentioned treatment. alpha-tocopheryl nicotinate lowered the levels of serum lipids and normalized the configuration of peripheral erythrocytes. But increased fluidity of plasma VLDL remained, and phospholipid composition of erythrocyte membrane was also unchanged. The relationship between the rare complications mentioned above and the pathophysiology of Bartter's syndrome is still obscure.

Adult↗
PubMed1982

[A study on anti-T3 and anti-T4 autoantibodies found in two sisters with juvenile hypothyroidism due to Hashimoto's thyroiditis (author's transl)].

Anti-thyroid hormone autoantibodies were found in two sisters of short stature (case 1: 13 years old, case 2: 10 years old). Physical examination revealed clinical findings of hypothyroidism with diffuse goiter. A diagnosis of Hashimoto's thyroiditis was made by open biopsy of the thyroid gland in both patients. Serum levels of T3 and T4 were assayed by double antibody radioimmunoassay. In case 1, serum T3 level was 16 ng/dl and serum T4 level was 2.0 microgram/dl. In case 2, serum T3 levels were high (range, 375 approximately 1660 ng/dl), while serum T4 remained at a very low level (0.9 microgram/dl). On the other hand, the level of T3 in case 2 as well as the level of T4 in case 1 was not detectable by a single antibody radioimmunoassay using dextran-coated charcoal or polyethylene glycol separation. In each case, the serum TSH level measured by double antibody radioimmunoassay was extremely high (255 microunits/ml in case 1, 240 microunits/ml in case 2), which was compatible with the clinical features of primary hypothyroidism. Sera from both patients were incubated with 125I-T3 and 125I-T4, followed by precipitation with polyethylene glycol. The binding of 125I-T3 with serum from case 2 and the binding of 125I-T4 with serum from case 1 were markedly high, suggesting the presence of T3- and T4-binding substance(s) in the sera. IgG prepared from the sera of both cases showed marked and specific binding with T3 in case 2 and T4 in case 1. The association constant for T4-antibody in case 1 was 5.2 x 10(8) M-1 and for T3-antibody in case 2 was 5.0 x 10(9) M-1. The binding capacity for T4 was 1.2 ng/ml.IgG and for T3 was 0.3 ng/mg.IgG.

Adolescent↗
PubMed1982

[Laboratory and clinical studies on ceftizoxime in the field of pediatrics (author's transl)].

Ceftizoxime, a new cephalosporin preparation, was evaluated for its antibacterial activity, absorption, excretion and clinical effectiveness, and the following results were obtained. The minimum inhibitory concentrations (MICs) of ceftizoxime against 211 clinical isolates were determined in comparison with those of cefazolin, cefmetazole, cefotiam and 6059 S. Against S. pyogenes (50 strains), ceftizoxime was 1 tube inferior to cefazolin inoculum size of 10(8) cells/ml, but was 2--3 tubes superior to cefmetazole and 6059-S. Against E. coli (50 strains), ceftizoxime and 6059-S were significantly more active than the other drugs. The susceptibility pattern of Klebsiella sp. (50 strains) to ceftizoxime was similar to that to cefotiam and 6059-S. Against Proteus sp. (50 strains), cefotiam and 6059-S were more active than the other drugs. Ceftizoxime was intermediate in activity, and cefazolin was the least active. Against H. influenzae (11 strains), ceftizoxime was the most active, with concentrations of 0.1 mcg/ml required to inhibit 100% of strains with an inoculum size of 10(8) cells/ml and 10(6) cells/ml. A dose of ceftizoxime 10 mg/kg or 20 mg/kg was administered to 15 patients aged from 5 years to 12 years, and serum levels and urinary excretion of the drug were measured. Intravenous bolus injection of the drug in dose of 10 mg/kg and 20 mg/kg yielded mean serum levels of 26.6 mcg/ml and 55.7 mcg/ml at 30 minutes, respectively. The serum levels of the drug, thereafter, declined gradually but still remained 1.3 mcg/ml and 2.7 mcg/ml at 6 hours. The serum half-lives (T 1/2) were estimated to be 1.17 hours in dose of 10 mg/kg and 1.31 hours in dose of 20 mg/kg. When a dose of 20 mg/kg was infused over a period of 30 minutes, the serum levels attained the peak of 72.4 mcg/ml to 82.4 mcg/ml (mean 79.4 mcg/ml) at the end of infusion. The levels, thereafter, tapered to mean levels of 45.3 mcg/ml at 30 minutes, 24.7 mcg/ml at 1 1/2 hours, and 3.6 mcg/ml at 5 1/2 hours, with a T 1/2 of 1.22 hours. Meanwhile, when the same dose was infused over 1 hour, the serum levels attained the peak of 59.4 mcg/ml to 68.5 mcg/ml (mean 64.2 mcg/ml). The mean serum levels after the end of infusion were 41.3 mcg/ml at 30 minutes, 21.6 mcg/ml at 1 hour and 1.9 mcg/ml at 5 hours, with a T 1/2 of 0.97 hours. Urinary recovery of the drug was 69.2% to 79.9% after intravenous injection and 62.3% to 79.9% after drip infusion, most of the given drug was excreted in the first 2 hours after administration. In our clinical study, 27 children with moderate or severe infections (12 cases of bronchopneumonia or bronchitis, 5 of pyelonephritis, 3 of purulent meningitis, etc.) were treated with ceftizoxime at the daily dose of 30--309 mg/kg for 3--23 days. Clinical response was excellent in 10, good in 9, fair in 5 and poor in 3. The drug was proved to be very effective against infections due to H. influenzae K. pneumoniae, E. coli and S. aureus. No serious side effects were observed in any case.

Age Factors↗
PubMed1981

Carbohydrate metabolism in subacute thyroiditis: effect of acute elevation of thyroid hormones.

Carbohydrate metabolism was studied in nine patients with subacute thyroiditis before treatment and after recovery. The mean fasting free fatty acid level before treatment was significantly higher than that after the recovery, although the mean fasting blood glucose and insulin levels were not significantly different. Seven out of nine patients showed glucose intolerances. They returned to normal after the recovery except two cases with family histories of diabetes mellitus, whose glucose intolerances remained even 6 months after the recovery. Glucose area during oral glucose tolerance test was significantly correlated with the elevated thyroxine (r = 0.8, p less than 0.01), and triidothyronine (r = 0.66, p less than 0.05). The results indicated the importance of follow-up study of glucose tolerance in subacute thyroiditis as well as similarity of carbohydrate metabolism abnormalities in hyperthyroidism.

Adult↗