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Biomedical subjects

M Sudo

Publications and source records attributed to M Sudo.

At least 91 records · Page 5Linked to original sources
PubMed1996

Ultrasonography for the detection of ureteric reflux in infants with urinary infection.

Several less harmful methods than voiding cysto-urethrography for detecting significant ureteric reflux have been proposed. The present prospective study investigated whether ultrasonography was effective in identifying ureteric reflux in infants with their first febrile urinary infection. The subjects were 27 infants (24 boys and 3 girls) aged from 0 to 8 months. The urinary tract was scanned when the bladder was full, and before and during induced voiding. Infants with abnormal ultrasound findings underwent voiding cysto-urethrography. The other infants were followed and those who had a recurrence of urinary infection underwent voiding cystography. Ten children underwent cysto-urethrography, with eight refluxing ureters identified in six boys. Ultrasound revealed transient dilatation of the renal pelvis on voiding in five kidneys, transient dilatation of distal ureters in 12 and hydro-ureteronephrosis in two. Each of the five kidneys with pelvic dilatation on voiding was associated with ureteric reflux grades III or IV. Of the 17 children who did not undergo cysto-urethrography, only one had recurrence of urinary infection and was diagnosed with ureteric reflux. This girl was one of the three babies who were not scanned during voiding. More than half of the infants with febrile urinary infection were excluded from invasive examination without having recurrence of urinary infection. Thus, ultrasound scanning during voiding was effective for screening infants with their first urinary infection to detect significant ureteric reflux.

Diagnosis, Differential↗
PubMed1996

A case of ureteral reflux identified by ultrasound.

Reflux nephropathy is known to be a major cause of renal failure in children. Vesico-ureteral reflux is usually diagnosed by voiding cysto-urethrography (VCG). However, it has been observed that conventional VCG is not always reliable for the diagnosis of ureteral reflux. In the case of a 5 year old girl with recurrent febrile urinary tract infection, VCG showed no ureteral reflux. Urodynamic study revealed a large bladder capacity and significant residual urine. Renal scintigram delineated a right renal scar. Simple ultrasound examination with videotape recording during voiding definitely demonstrated the presence of significant ureteral reflux when she voided, that is, there was marked dilatation of the right distal ureter and ballooning of the right renal pelvis on voiding, and quick refilling of the bladder concomitantly with the disappearance of the pelvic ballooning. Therefore, an ultrasound during voiding may be useful for diagnosing ureteral reflux in patients where a VCG does not reveal reflux.

Child, Preschool↗
PubMed1996

Renal functional measurements in young rats with chronic inhibition of nitric oxide synthase.

The purpose of the present study was to examine renal functional changes caused by chronic blockade of nitric oxide (NO) synthesis in young rats. Two types of NO synthase inhibitor were used: NG-nitro-L-arginine methyl ester (L-NAME) as a non-selective inhibitor and aminoguanidine (AG) as a selective inhibitor of the inducible isoform. Oral administration of L-NAME (20-80 mg/dL of drinking water), not AG (400 mg/dL), for 4 weeks induced systemic hypertension in the treated rats. Both inhibitors caused a significant reduction in urinary excretion of NO2-/NO3-. Rats treated with L-NAME developed proteinuria and tubular enzymuria (high excretion of N-acetyl-beta-D-glucosaminidase) in a dose-dependent fashion, with normal serum levels of creatinine, albumin and cholesterol. Chronic AG administration did not alter the urinary levels of protein and N-acetyl-beta-D-glucosaminidase or serum laboratory values. Overall, these observations highlight the importance of the continuous generation of NO by the constitutive isoform in the control of vascular tone and the maintenance of renal glomerular and tubular function. Oral administration of L-NAME may serve as a model of chronic NO-deficient hypertension with renal injury in young rats.

Animals↗
PubMed1996

Effect of nitric oxide synthase inhibitors on bone metabolism in growing rats.

We examined the effects of chronic nitric oxide (NO) blockade on bone mineral status in growing rats. Oral administration of NG-nitro-L-arginine methyl ester (L-NAME) for 4 wk caused hypertension and a significant reduction in urinary NO2- and NO3- excretion. Four-week oral aminoguanidine (AG, 400 mg/dl of drinking water) did not alter blood pressure but caused a significant decrease in urinary NO2- and NO3-. Rats treated with L-NAME at doses of 20 and 50 mg/dl had normal bone mineral mass in the lumbar spine, but the highest dose (80 mg/dl) caused a slight decrease in bone mass. Chronic AG induced a significant spine osteopenia. This effect of AG was abolished by the simultaneous administration of L-arginine (2.0 g/dl). AG-induced osteopenia was associated with a significant increase in urine excretion of collagen cross-links with normal serum osteocalcin. These findings indicate that chronic AG administration can cause an imbalance between bone resorption and formation, resulting in a decrease in bone mass in growing rats, and suggest that NO produced by inducible NO synthase plays an important role in basal osteoclast bone degradation activity in vivo.

Absorptiometry, Photon↗
PubMed1996

Ultrasonographic findings of acute tubulointerstitial nephritis.

Three children were diagnosed as having acute renal failure due to acute tubulointerstitial nephritis (TIN) associated with Yersinia pseudotuberculosis infection. The kidneys were observed ultrasonically during the disease course. The subjects presented with remittent fever, vomiting or diarrhea, and nonoliguric acute renal failure with sterile pyuria and tubular reabsorptive dysfunction. Ultrasound examination delineated marked enlargement of the kidneys with diffuse hyperechogenicity in the cortex, suggesting the diagnosis of TIN. The renal swelling was marked in the descending order of width, depth and length, respectively, and reached more than 200% in volume in 1 of the children who was examined at the culminating stage of acute renal failure. The enlarged kidneys reduced in size in parallel as the elevated serum creatinine levels decreased. However, the enlarged kidneys did not seem to return to their original sizes: the kidney size in 1 of the children remained well above the upper allowance limit of the body-height-related normals and in the other 2 they were only a little smaller than the upper limits. These ultrasound findings should help with the diagnosis and follow-up of the disease.

Acute Disease↗
PubMed1996

Urinary selenium excretion in infancy: comparison between term and preterm infants.

We evaluated the urinary excretion of selenium (Se), an essential component of glutathione peroxidase, in infants aged 1 week and 1, 4, and 7 months and examined the relationship between urinary Se and renal function. Daytime spot urine samples from a total of 80 infants were analyzed. The Se concentration in urine was measured by fluorometry, while the beta 2-microglobulin content, an index of renal tubular function, was determined by radioimmunoassay. In healthy term infants, the urinary Se excretion showed a peak level at 1 month of age. In contrast, the urinary Se concentration rapidly decreased in preterm infants from 1 week to 7 months postnatally. The level at 1 week in preterm infants was significantly higher than that in term infants, although the mean levels at 1, 4, and 7 months were lower in preterm infants. The level of urinary Se did not correlate significantly with the beta 2-micro-globulin concentration, either in term or preterm infants at any age investigated. Our results suggest that the renal excretion of Se probably reflects the body stores of Se and is not related directly to the renal function in infants. Urinary Se, a noninvasive marker of the Se status, may be used for diagnosis and follow-up of Se deficiency in infants.

Aging↗
PubMed1996

Prenatal diagnosis of organic acidemias based on amniotic fluid levels of acylcarnitines.

Acylcarnitines in amniotic fluid samples were analyzed for the prenatal diagnosis of propionic acidemia, methylmalonic aciduria, isovaleric acidemia, and glutaric aciduria by electrospray tandem mass spectrometry. Although the levels of the specific acylcarnitine between affected and unaffected cases showed an overlap, the ratios of propionylcarnitine to 4-carbon acylcarnitine levels for propionic acidemia and methylmalonic aciduria, those of isovalerylcarnitine to propionylcarnitine for isovaleric acidemia, and those of glutarylcarnitine to propionylcarnitine for glutaric aciduria type I were shown to be reliable indicators in the prenatal diagnosis. In addition, it is suggested that the combination of the ratios of glutarylcarnitine, isovaleryl-carnitine, and hexanoylcarnitine to propionylcarnitine may be useful for the prenatal diagnosis of glutaric aciduria type II.

Acetylcarnitine↗
PubMed1996

Developmental changes in folding of the human eustachian tube.

Histologic sections of human temporal bone with Eustachian tube attached were examined to investigate the changes that occur in folding of the Eustachian tube (ET) as it develops postnatally. Study of 45 specimens from individuals aged 3 months to 88 years of death, including 5 cases with chronic otitis media (OM) with perforation and 5 with OM with effusion, showed that the folds in the tube decreased significantly as age increased up to 20 years, after which no significant change with age was found. These results suggest that folding in the ET is important to its function in infants and children. Folding provides a relatively greater surface area for the tube, allowing for a greater abundance of ciliated cells, which would promote clearance of the middle ear through the ET. Greater folding might also support the tube's protective function by keeping the lumen narrow.

Adolescent↗
PubMed1996

[Trends in asthma-related death among adults in Japan, 1986-1991--analysis of responses to questionnaires sent to hospitals with at least 200 beds].

The death rate among patients with asthma in Japan has been reported by Japan's Ministry of Health and Welfare to approximately 5/100,000 population. Over the past 15 years, this rate has remained relatively constant, but it is higher than that in western countries. To clarify recent trends in adult asthma mortality, the Japan Asthma Death Investigation Committee studied the clinical characteristics of 649 patients who died of asthma between 1986 and 1991. The annual number of deaths decreased slightly: from 145 in 1986 to 89 in 1991. There was a large difference between sexes: the male:female ratio was 3:2. Most patients ranged in age from 50 to 70 years old. It is noteworthy that in one third of the patients death was caused by asphyxic-type asthma, while status asthmaticus was the cause in only 23.7%. The number of patients with mild or moderate asthma was slightly increased, although patients with severe asthma accounted for at least 70% of all deaths. The main causes of fatal asthma attacks were airway infections, fatigue, and stress. Other responses on the questionnaires indicated the following areas of concern: deficiencies in patient education, delays in treatment with corticosteroids and other antiasthma drugs, and delays in provision of emergency treatment.

Adolescent↗
PubMed1996

[A comparison of asthma deaths and near-fatal asthma attacks].

This study compares the characteristics of fatal asthma patients and those of near-fatal asthma patients who had experienced severe life threatening attacks. Data from 67 fatal asthma patients and 80 near-fatal asthma patients were analyzed. The mean age of fatal asthma cases were older than near-fatal asthma cases, 51.9 yrs and 44.3 yrs, respectively. Similarities of the two cases were seen in sex, type of asthma and severity of asthma. The experiences of previous life-threatening asthma did not differ in both groups (43.3% of fatal vs 40.0% of near-fatal). From the viewpoint of type of development of severe exacerbation, rapid exacerbation was more frequent in fatal cases than near-fatal cases, but acute exacerbation after unstable asthma was more in near-fatal asthma. Seventy-six percent of all asthma deaths occurred at home or on the way to the emergency department. The rate of delay of receiving medical care was significantly higher in fatal cases (72%) than near-fatal cases (26%). There was no significant difference in the frequency of medical management before fatal or near-fatal episode such as oxygen therapy, mechanical ventilation. Use of ambulance, visiting emergency department, previous hospitalization between the two groups. The profile of fatal cases was almost same to that of near-fatal cases except delay of receiving medical care. In conclusion, the analysis of near-fatal cases was very important to make clear the causes of asthma death.

Adult↗
PubMed1995

Hyporesponsiveness to nitrovasodilators in rat aorta incubated with endotoxin and L-arginine.

We studied the effect of L-arginine on relaxation responses to sodium nitroprusside or SIN-1 (3-morpholinosydonimine-N-ethyl-carbamine) in the rat thoracic aorta incubated with endotoxin. Sodium nitroprusside or SIN-1 produced a reproducible relaxation in the aorta incubated for 12 h with endotoxin. However, the response to both nitrovasodilators was remarkably attenuated when the aorta was preincubated for 12 h with endotoxin and L-arginine. D-Arginine could not substitute for L-arginine. The attenuated response to sodium nitroprusside or SIN-1 was partially restored by the inhibition of nitric oxide (NO) production with N omega-nitro-L-arginine. Cycloheximide prevented the inhibitory effect of preincubation with L-arginine. These results suggest that the prolonged exposure to muscle-derived NO induces hyporesponsiveness to nitrovasodilators.

Animals↗
PubMed1995

Acute tubulointerstitial nephritis in association with Yersinia pseudotuberculosis infection.

A 4-year-old girl was diagnosed as having acute renal failure due to tubulointerstitial nephritis. The girl presented with remittent fever, vomiting and non-oliguric acute renal failure with sterile pyuria and tubular reabsorptive dysfunction. Ultrasound examination revealed that the kidneys were markedly enlarged with diffuse hyperechogenicity in the cortex when the abnormal renal function was present and were restored in size and echogenicity when the renal function normalised. A diagnosis of Yersinia pseudotuberculosis infection was based on a rise in haemagglutination titres against the organism.

Acute Disease↗
PubMed1995

Ultrasonographic evaluation of bladder volume in young children.

We investigated by ultrasonography the bladders of 30 young children (26 boys, 4 girls) without established bladder control immediately before voiding cystourethrography. The anterior/posterior (D), superior/inferior (H) and transverse dimension (W) of the bladder were determined. The small children had a significantly greater H value compared with D and W than older children in our previous study in 1993. The regression equation for D x H x W and actual bladder volume in 30 infants was calculated as y = 0.49 x + 3 (Eq. 1). When bladder volume of the 30 infants was estimated from D x H x W, the mean percentage error was much lower with Eq. 1 than with Eq. 2 (y = 0.68 x + 4), which had been determined for older children (mean +/- SD 16.8% +/- 10.7% vs. 44.7% +/- 26.2%) (P < 0.01). Thus, infants have a different bladder shape than older children and their bladder volume should be estimated using a specific formula designed for them.

Child, Preschool↗
PubMed1995

The frequencies of disease names with the natural language used in the hospital information system.

The statistical behavior of disease names referred by physicians with the natural language in a large hospital information system is little known despite the theoretical and practical interest. To address this issue, we reviewed and investigated the usage-frequencies of 18,274 disease names, 10,288 for outpatient care and 7986 for inpatient care, referred from October 1983 to June 1992 with the notation of the natural language in Japanese by the use of the registration-retrieval system of disease names at Fukui Medical School, Japan. Consequently, we found that the investigated distributions did not conform to the Poisson distribution, but conformed well to the Polya-Eggenberger distribution in both cases of outpatient and inpatient care. It implies that the disease names with the natural language are possibly referred by physicians with some interrelations.

Disease↗
PubMed1995

Effects of ACTH on brain midline structures in infants with infantile spasms.

Changes of the midline structures of the brain, including the pons, cerebellar vermis, and corpus callosum, induced by adrenocorticotropic hormone (ACTH) therapy in 7 infants with infantile spasms were investigated using magnetic resonance imaging. Decreased volume of these parts of the brain was induced in almost all infants. Decreased volume of the pons was thought to be closely related to sleep disturbance during ACTH therapy. These results may demonstrate that the cessation of convulsive episodes in infants with infantile spasms treated with ACTH is due to its direct action on the brainstem.

Adrenocorticotropic Hormone↗