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Biomedical subjects

S Takei

Publications and source records attributed to S Takei.

At least 19 recordsLinked to original sources
PubMed2001

Etanercept therapy in children with treatment-resistant uveitis.

OBJECTIVE: To evaluate the safety and efficacy of the tumor necrosis factor fusion protein etanercept in children with treatment-resistant uveitis. METHODS: Ten children with chronic active uveitis (7 girls and 3 boys, mean age 7.5 years [range 3-12 years]) were enrolled in this prospective study. In 7 children, uveitis was associated with pauciarticular juvenile rheumatoid arthritis. Five children were antinuclear antibody positive. All patients had failed previous therapy with topical steroids and methotrexate and/or cyclosporine. All were treated with etanercept at a dosage of 0.4 mg/kg twice weekly for the first 3 months, and then, if eyes did not improve, with 25 mg twice weekly (mean 1.1 mg/kg) for at least 3 additional months. RESULTS: At the beginning of the trial, uveitis affected 18 eyes in the 10 children. Within 3 months, 10 of 16 affected eyes (63%; P = 0.017) showed a rapid decrease in anterior chamber cell density, including remission of uveitis in 4 eyes. In children with visual acuity of less than 20/25, 4 of 10 eyes (40%) improved. An exacerbation of uveitis during etanercept therapy occurred in only 1 child (1 of 14 eyes [7%]). Other ocular outcome parameters, such as intraocular pressure, synechia formation, and lens clarity, remained unchanged. Following a dosage increase to an average of 1.1 mg/kg after 3 months in 7 children, no further improvement was noted. CONCLUSION: Our data suggest that etanercept injected subcutaneously twice a week has a beneficial effect on treatment-resistant chronic uveitis in children. Further controlled studies with etanercept in systemic or topical form are necessary to confirm its efficacy and optimal mode of administration.

Administration, Topical↗
PubMed2001

Sub-wavelength region spectroscopy and local morphology of individual mesoscopic quantum systems.

Results of reflection microscopy and local reflection spectroscopy of J-aggregates of two pseudoisocyanine dyes in a thin film polymer matrix are reported. The individual J-aggregates assemble into fibre-like shapes of large structural heterogeneity. Reflectance spectra obtained at different samples, different locations on one sample and even at different positions of the same aggregate fibre reveal a wide distribution of optical properties. The shapes and absolute reflectivities of the spectra are suggested to originate from varying strengths of exciton-photon interaction and from the effect of finite thickness of the aggregate fibres. Polarization dependence measurements of local reflectivities provide orientations of the exciton transition dipole moments at 572 nm and 540 nm with respect to the orientation of the aggregate fibres. Furthermore, modified synthesis of capped semiconductor nanocrystals of CdSe is presented. The method yields high quality quantum dots suitable for microscopic imaging and spectroscopy.

Journal Article↗
PubMed2001

Anti-alpha-fodrin antibodies in Sjögren's syndrome in children.

OBJECTIVE: To investigate the prevalence of anti-alpha-fodrin antibody specific for adult Sjögren's syndrome (SS) in patients with juvenile onset SS. METHODS: Serum anti-alpha-fodrin antibody was examined in 15 patients with juvenile SS (11 cases of primary SS and 4 secondary SS) and in 16 children with systemic lupus erythematosus (SLE) by Western blot analysis using a recombinant 120 kDa alpha-fodrin fusion protein. RESULTS: All the 15 serum samples from patients with SS reacted with a recombinant alpha-fodrin fusion protein in Western blot analysis. In contrast, reactivity was found in only 2 of the 16 patients with SLE. The clinical features of the 15 patients with juvenile onset SS were very specific; only 4 patients complained of dryness, while 6 had abnormal excretion ability. Salivary gland enlargement was the most common clinical manifestation. Characteristic laboratory findings in juvenile onset SS included a higher prevalence of antinuclear antibodies, anti-SSA/Ro antibodies, and rheumatoid factor, as well as increased erythrocyte sedimentation rate and hypergammaglobulinemia. CONCLUSION: The pathogenesis of juvenile SS seems to be the same as that of adult SS, although subjective symptoms of dryness are less frequent in juvenile cases. This discrepancy may indicate that SS is a slowly progressive disease with a long time span. The anti-alpha-fodrin antibody is likely to be a reliable diagnostic marker for juvenile SS.

Adolescent↗
PubMed2001

Safety and efficacy of high dose etanercept in treatment of juvenile rheumatoid arthritis.

OBJECTIVE: To evaluate safety and efficacy of high dose etanercept (> 0.8 mg/kg, maximum 25 mg subcutaneously twice weekly) (Enbrel) in children with juvenile rheumatoid arthritis (JRA) and inadequate prior response to standard dose etanercept. METHODS: Retrospective chart review of 8 children (6 girls, 2 boys, mean age 8.4 yrs, range 5-16 yrs). Five children had systemic onset, polyarticular course JRA; 2 had polyarticular onset; and one had pauciarticular onset, polyarticular course JRA. All children had failed at least 3 mo (mean 9 mo) treatment with standard dose etanercept (0.4 mg/kg SC twice a week). All 8 children had increase in the etanercept dose to at least 0.8 mg/kg (mean 1.1 mg/kg, maximum 25 mg SC twice weekly) for a mean of 7 mo (range 3-10 mo). Efficacy of high dose etanercept was evaluated by changes in joint count, laboratory data, and ability to decrease concomitant medication. RESULTS: Improvements in the joint count and laboratory findings (erythrocyte sedimentation rate, hemoglobin and platelet count) were observed in 2 of 8 (25%) children. In these 2, concomitant prednisone was reduced or discontinued. In contrast, no changes in disease activity or laboratory findings were observed in the other 6 children. Overall, high dose etanercept was well tolerated. No laboratory abnormalities were detected and no child withdrew because of adverse events. CONCLUSION: High dose etanercept is safe and well tolerated in children, but efficacy seems limited. In children with unsatisfactory response to standard dose etanercept, an increased dose or treatment prolongation may not offer any additional benefit.

Adolescent↗
PubMed2000

Destabilization of tumor necrosis factor-alpha mRNA by 5-alpha dihydrotestosterone in Jurkat cells.

The effect of a male steroid hormone, 5DHT, on the expression of TNF-alpha was examined using a human leukemia T cell line, Jurkat. Cells were treated with 5DHT in the presence or absence of PHA, and RNA was isolated followed by a reverse transcriptase - mediated PCR (RT-PCR) to measure the steady state levels of TNF-alpha mRNA. The treatment of cells with 5DHT resulted in a 50% of decrease in the level of TNF-alpha mRNA compared to that in untreated conditions (basal level). A similar level of reduction of the message by 5DHT was also observed in PHA-stimulated cells. The reduction of the steady state levels of TNF-alpha mRNA in Jurkat cells was a result of destabilization of the gene as demonstrated by actinomycin D treatment; a half-life of TNF-alpha message in 5DHT treated cells and non-treated cells was 1 hr and 2.5 hr, respectively, whereas that in 5DHT/PHA and PHA-treated cells was 3hr and 6hr, respectively.

DNA Primers↗
PubMed2000

The long-term outcome of hearing preservation following vestibular schwannoma surgery.

OBJECTIVE: The aim of this study is to describe the long-term outcome of preserved hearing after vestibular schwannoma surgery. METHODS: Subjects are 20 unilateral vestibular schwannoma patients whose class A hearing of the AAO-HNS classification was preserved successfully after tumor removal. Hearing preservation surgery was attempted via the middle cranial fossa (MCF) or the extended MCF approach. The follow-up periods ranged from 2 to 16 years. The outcome measures included the pure tone average (PTA) and speech discrimination score (SDS). RESULTS: PTA was maintained in less than 30 dB in 11 out of 20 patients within 2 years follow-up, six out of 13 patients within 4 years follow-up, and two out of five patients within 6 years follow-up, respectively. SDS was maintained in more than 70% in 17 out of 20 patients within 2 years follow-up, ten out of 13 patients within 4 years follow-up, and three out of five patients within 6 years follow-up, respectively. CONCLUSIONS: The preserved hearing maintained about more than 40% of the patients with the class A hearing in every 2 years follow-up. From this result, we can conclude that the hearing preservation surgery could be one of the best treatments for vestibular schwannoma patients with class A hearing. However, further study will be needed to clarify the mechanism of the deterioration in hearing after hearing preservation surgery.

Adolescent↗
PubMed2000

Early onset sarcoidosis masquerading as juvenile rheumatoid arthritis.

Symptoms of early onset sarcoidosis characterized by skin eruptions, arthritis, and uveitis mimic those of systemic type juvenile rheumatoid arthritis (JRA). We report 2 Japanese patients with early onset sarcoidosis, both of whom were initially diagnosed and treated as having JRA. Intermittent fever and synovial swelling may mask sarcoidosis in children less than 4 years old.

Arthritis, Juvenile↗
PubMed2000

[Efficacy of preventive treatment for complications in percutaneous endoscopic gastrostomy in elderly].

From September 1995 through May 1999, percutaneous endoscopic gastrostomy (PEG) was performed in 47 elderly patients, aged 65 to 93 (average 78.9). Several treatments were additionally performed to prevent serious complications in these cases, and their usefulness and problems were investigated. Gastropexy was performed to prevent peritonitis in cases of self-removal of tubes in the acute stage. Intraoperative fluoroscopy was used prevent perforation of the intestines. However, re-insertion of the endoscopic, which was necessary with the push method, was omitted to reduce the burden on the patients. In patients with tube troubles in the chronic stage such as the buried bumper syndrome or self-removal, the existing fistula was preserved and the gastrostomy was reconstructed using a narrow polyvinyl chloride tube and a flexible guide wire to prevent peritonitis by erroneous insertion of the tube. In terms of results, gastropexy was useful to prevent peritonitis in one patient with early self-removal of the tube. Data to evaluate the usefulness of fluoroscopy in preventing perforation of the intestine were insufficient, so more patients need to be studied in the future. Even when confirmation of the location of the internal bumper by endoscopy was omitted, there was no case of poor traction of the bumper, so this procedure seems unnecessary. Review of tube troubles, in the chronic stage revealed no case of peritonitis caused by erroneous insertion of tubes or erroneous injection of nutrients with our reconstruction methods, and complete reconstruction of the gastrostomy with preservation of the existing fistula appeared to be possible. However, those additional treatments require extension of the operation time and rise in cost with increased use of medical instruments, so the indications should be carefully considered.

Aged↗
PubMed1999

[A case report of systemic lupus erythematosus patient with severe lupus retinopathy and antiphospholipid antibody].

An eleven-year-old boy with systemic lupus erythematosus (SLE) developed severe bilateral lupus retinopathy when he was in active stage of SLE. The patient, who had suffered from SLE for 3 years, was admitted to our hospital because of high grade fever, systemic lymphadenopathy, leukopenia, elevation of erythrocyte sedimentation rate and hypocomplementemia. The dose of prednisolone was increased considering he was exacerbated of SLE, however, the convulsion as CNS lupus occurred to him. After the event he noted loss of vision in his bilateral eyes. The ophthalmologic examination revealed the lesions of cotton-wool spots, retinal vessel dilatations and diffuse occlusions of the retinal arterioles and venules which were compatible with lupus retinopathy. Although the coagulation time was normal, antiphospholipid antibodies were positive at the time of ocular involvement. Careful attention should be paid to the occurrence of lupus retinopathy when the patients with SLE developed in the active stage or CNS lupus, especially they have antiphospholipid antibodies.

Antibodies, Antiphospholipid↗
PubMed1999

Increased circulating vascular endothelial growth factor is correlated with disease activity in polyarticular juvenile rheumatoid arthritis.

OBJECTIVE: To investigate the relevance of vascular endothelial growth factor (VEGF) in the pathogenesis of juvenile rheumatoid arthritis (JRA). METHODS: Serum VEGF levels in 58 patients with JRA (systemic in 17, polyarticular in 29, pauciarticular in 12) were measured by ELISA and compared with those of 21 patients with infectious diseases and 50 healthy children. Correlations of VEGF levels with number of joints with active arthritis, erythrocyte sedimentation rate (ESR), and hyaluronic acid (HA) were examined. RESULTS: Serum levels of VEGF in patients with JRA were significantly higher than in healthy controls. Patients with systemic and polyarticular JRA showed statistically higher levels of VEGF than those with infectious diseases. VEGF levels correlated statistically with C-reactive protein (CRP) in patients with both infectious diseases and polyarticular JRA, but the regression slope (VEGF/CRP) was much steeper in polyarticular JRA than in infectious diseases. Serum VEGF levels correlated with disease activity variables such as the number of joints with active arthritis, ESR, and serum HA levels in polyarticular JRA. CONCLUSION: The correlation of serum VEGF levels and disease activity in polyarticular JRA suggests that VEGF may take an active part in joint inflammation.

Adolescent↗
PubMed1998

Transient low T cell response to streptococcal pyrogenic exotoxin-C in patients with Kawasaki disease.

Superantigens (SAs) are known to induce transient anergy followed by T cell activation. Recent reports have suggested that SAs are involved in the pathogenesis of Kawasaki disease (KD). In the present study, we investigated the peripheral T cell response to SAs by measuring proliferation and IL-2 production to determine whether the T cell anergy is induced by SAs in patients with KD. T cells were obtained from 45 Japanese patients with KD in different stages of the disease and were stimulated by streptococcal pyrogenic exotoxin (SPE)-A, SPE-C, and toxic shock syndrome toxin-1 (TSST-1). T cells from patients with KD in the acute or convalescent stage up to 2 mo showed significantly lower proliferation and IL-2 production than did T cells from healthy control subjects stimulated by SPE-C, but not SPE-A or TSST-1. The T cell response to SPE-C normalized within 1 y. The low T cell response to SPE-C in the acute stage correlated with a peak platelet count and the C-reactive protein-positive period. These findings suggest that the transient low T cell response to SPE-C in patients with KD may have been related to SA-induced anergy or disappearance of SPE-C-responding cells from the circulation. The present results suggested that SPE-C may be involved in the pathogenesis of KD.

Acute Disease↗
PubMed1998

Increased serum levels of vascular endothelial growth factor in Kawasaki disease.

Vascular endothelial growth factor (VEGF) is an angiogenic mitogen that specifically targets vascular endothelial cells. The objective of this study was to evaluate the role of VEGF in Kawasaki disease (KD), the most common cause of systemic vasculitis in childhood. Serum VEGF levels were measured by ELISA in 22 patients with KD, 22 febrile children with infection, and 19 healthy children. Samples from KD patients were divided into three groups: acute stage (n = 20), subacute stage (n = 13), and convalescent stage (n = 15). The results showed that KD patients in the acute and subacute stages had significantly higher levels of VEGF than did patients with infectious diseases and the healthy control subjects. When compared with the VEGF levels of patients with and without coronary artery lesions (CAL), significantly higher levels of VEGF were observed in the subacute stage in patients with CAL and in patients without CAL in the acute stage. Serial examination revealed that the serum VEGF levels in KD patients with CAL increased from a relatively low level in the acute stage to an extremely high level in the subacute stage. In contrast, patients without CAL were found to have extremely high levels of VEGF only in the acute stage of KD. In KD patients, the serum VEGF levels did not correlate with the inflammatory markers and clinical symptoms. Our results raise the possibility that VEGF is involved in the pathogenesis of KD, especially in the development of CAL. Further study is needed to clarify the biologic effect of VEGF on coronary arteries in KD.

Acute Disease↗