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Biomedical subjects

S Tateno

Publications and source records attributed to S Tateno.

At least 37 records · Page 2Linked to original sources
PubMed1996

Steroid therapy during the early stage of progressive IgA nephropathy. A 10-year follow-up study.

This study was undertaken to clarify the effect of corticosteroids on the long-term clinical course of the early stage of progressive IgA nephropathy. The early stage of progressive IgA nephropathy was defined as having moderate proteinuria between 1 and 2 g/day, creatinine clearance values of 70 ml/min or more, and a histological severity score of 7 or more. The number of patients who fulfilled these three conditions during 12 years from 1972 and then were continuously followed up for 10 years or more in our renal unit was 46. Twenty of them received steroid treatment for an average period of 18 months, and the remaining 26 patients had no steroid treatment. The initial data of proteinuria, creatinine clearance values, frequency of hypertensive cases, and histological scores of 7 or more were not different between the two groups: 1.4 +/- 0.4 vs. 1.3 +/- 0.3 g/day, 85 +/- 14 vs. 88 +/- 13 ml/min, 25 vs. 38%, and 10.7 +/- 2.5 vs. 11.0 +/- 3.0, respectively. During the follow-up period of 10 years, the renal survival rate was significantly different between the two groups (100 vs. 84% 5 years after starting therapy and 80 vs. 34% 10 years later; p < 0.001). The final creatinine clearance values were significantly different between the two groups (54 +/- 35 vs. 20 +/- 29 ml/min; p < 0.005). On the other hand, the patient groups with mild histological changes or decreased renal function due to moderate proteinuria showed no significant differences in the final outcome. These results indicate that corticosteroids are beneficial in stabilizing the renal function for a long time during the early stage of progressive IgA nephropathy, although this study was not a randomized one.

Adult↗
PubMed1995

Arterial-injection chemotherapy for hepatocellular carcinoma using monodispersed poppy-seed oil microdroplets containing fine aqueous vesicles of epirubicin. Initial medical application of a membrane-emulsification technique.

BACKGROUND: Iodized poppy-seed oil (IPSO) has a property of depositing itself selectively in the cells of hepatocellular carcinoma (HCC). A mixture of anticancer agents and IPSO has been used widely because IPSO accumulates in tumors, but its usefulness appears limited because the anticancer agents become separated easily from IPSO and do not remain in the tumor. The authors prepared a long term inseparable, water-in-oil-in-water emulsion (W/O/W) for use in arterial-injection therapy for patients with HCC and evaluated its clinical usefulness. METHODS: The W/O/W was prepared by a membrane-emulsification technique using a controlled pore glass with 10.6-microns pores. From December 1992 to January 1994, the W/O/W containing 8-60 mg of epirubicin was applied to the hepatic arterial-injection therapy for 21 patients with HCC to determine its antitumor and side effects. RESULTS: After arterial infusions with W/O/W, an evident antitumor effect was observed in all 13 patients treated with W/O/W containing 40 mg or more of epirubicin with or without gelatin-sponge particles used simultaneously. In the group treated with the W/O/W containing a high dose (40 mg or more) of epirubicin, even though the gelatin-sponge particles were not used, tumor size was reduced in six of seven patients, and a 50% or greater decrease of initial alpha-fetoprotein (AFP) levels within 14 days was observed in all four patients who showed abnormal levels of serum AFP before treatment. One partial necrosis and two complete necroses of three resected tumors were confirmed histopathologically. Fever (in all patients), nausea (in two), pain in the right upper quadrant of the abdomen (in two), and slight cough (in one) were noted as minor side effects. CONCLUSIONS: To the authors' knowledge, this is the first clinical trial using this emulsion prepared by the membrane-emulsification technique. Emulsification using a fine-pore glass membrane of equal pore size (i.e., controlled-pore glass membrane) is a new technique for preparing lipid microdroplets of equal size (monodispersed) containing aqueous fine microdroplets to form W/O/W: This technique of chemoembolization can be used to treat patients with HCC.

Aged↗
PubMed1994

Magnetic resonance imaging of heterotaxia in infants.

OBJECTIVES: This study assessed the usefulness and safety of magnetic resonance imaging (MRI) for systematically diagnosing heterotaxia in infants. BACKGROUND: Although it is important to diagnose and treat infants with heterotaxia, which is associated with viscerobronchial cardiovascular anomalies, systematic diagnosis of these anomalies by a single imaging technique is difficult. METHODS: Twenty patients with heterotaxia were evaluated. The infants ranged in age from 21 days to 12 months (average 5.2 months, average body weight 4.3 kg). Electrocardiographically gated MRI was performed by spin echo imaging techniques operating at 0.5 tesla. RESULTS: In all 20 patients, MRI results were sufficient to evaluate these anomalies without serious complications. In 17 patients, neither a spleen nor splenules were detected, but in 3 patients, a polymorphous spleen was visualized. In all 20 patients, bronchial anatomies were clearly visualized (bilateral eparterial bronchi in 14 patients, bilateral hyparterial bronchi in 2 and normal bronchial patterns in 4). Additionally, in a comparison of 149 observations of cardiovascular anatomy by MRI with those by angiography, discrepancies were found in only 10 observations (6.7%). CONCLUSIONS: Magnetic resonance imaging was found to be safe and very useful for the systematic diagnosis of heterotaxia in infants.

Abnormalities, Multiple↗
PubMed1994

A case of sarcoidosis revealed in the course of IgA nephropathy.

A 36 year old man, who had been proteinuric for 14 years due to immunoglobulin A (IgA) nephropathy, was admitted because of an acute exacerbation in renal dysfunction with hypercalcemia. He had presented with aortic regurgitation and increased pulmonary marking by chest X-ray, but laboratory examinations had failed to make an exact diagnosis. On admission, noncaseating epithelioid granulomas were disclosed by muscle and skin biopsies. Ophthalmological evaluation revealed old uveitis and retinal changes consistent with sarcoidosis. In this case, IgA nephropathy was thought to be the initial manifestation of sarcoidosis that developed latently. Sarcoidosis should be considered in a differential diagnosis of IgA nephropathy.

Adult↗
PubMed1994

Renal thrombotic microangiopathy in a patient with rheumatoid arthritis and antiphospholipid syndrome: successful treatment with cyclophosphamide pulse therapy and anticoagulant.

A female patient with a history of migraines and chorea developed polyarthralgia at age 24 and was diagnosed with rheumatoid arthritis. In 1991 she was hospitalized because of impaired renal function and hypertension. Examination revealed thrombocytopenia and the presence of lupus anticoagulant. Antinuclear antibody was weakly positive, but anti-DNA antibody was negative, and no decrease in leukocyte count or complement level was observed. Rheumatoid arthritis with antiphospholipid syndrome was diagnosed. Renal biopsy showed renal thrombotic microangiopathy. This renal lesion was considered to be associated with antiphospholipid syndrome. Cyclophosphamide pulse therapy and anticoagulation therapy decreased proteinuria and improved renal function.

Adult↗
PubMed1994

[Renal manifestations in sarcoidosis].

Clinically distinct renal disease is said to be rare in sarcoidosis, but autopsy reveals an incidence of renal involvement is 23 or 26% in Japanese studies. There are three categories of renal disease in sarcoidosis: 1) renal changes by abnormal calcium metabolism, 2) interstitial nephritis or granulomatous nephritis and 3) glomerulonephritis. Some investigators add renal angiitis to the three categories. In some patients without clinical renal disorders, renal involvement is discovered by chance at the time of autopsy or renal biopsy. Renal disease may develop during the course of sarcoidosis, preceding the diagnosis of sarcoidosis, or may be found simultaneously with extrarenal involvements at the time of diagnosis. Renal involvement should always be considered for exact diagnosis and appropriate treatment.

Calcium Metabolism Disorders↗
PubMed1994

[Prognostic significance of persistent massive proteinuria in progressive IgA nephropathy--a long-term follow-up study].

The most reliable factors predicting a long-term prognosis in individual progressive IgA nephropathy patients were evaluated. Ninety-eight cases who showed moderate to severe histological alterations (total score of 7 or more) and were continuously followed up for 10 years or more from the first biopsy were the subjects of this study. During the follow-up period of 10 years, 52 of the 98 cases went into hemodialysis treatment (HD). All 24 cases who had a higher total score of 17 or more, or severe renal dysfunction of less than 60 ml/min in their initial Ccr values went into HD. The remaining 74 cases who showed both a total score below 16 and initial Ccr values of 60 ml/min or more were divided into two groups in their clinical courses: 28 (group I) of the 74 cases went into HD and the other 46 (group II) did not. The degree of initial proteinuria was significantly different between groups I and II, but the degree of individual proteinuria was in a similar range from 0.5 to 2.5 g/day in most cases of both groups. Therefore, in order to clarify a more precise factor associated with the individual prognosis, the % duration of massive proteinuria (% DP) was calculated in individual cases. The % DP was more significantly different between groups I and II (82.6 +/- 26.1 vs 19.6 +/- 27.3%, p < 0.01). Moreover, all cases but one in group I showed 30% or more in % DP and 35 of 46 cases in group II showed 30% or less.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

The significance of tubulointerstitial nephritis in IgA nephritis.

The occurrence of significant tubulointerstitial nephritis (TIN) was observed in 6 (18.3%) of 32 patients with IgA nephritis registered in 1991. T lymphocytes and macrophages in the interstitium were seen to invade the tubulus through injured tubular basement membrane (TBM), then were seen in the intercellular spaces of tubular cells which showed degeneration, single cell necrosis or detachment. Thus some tubular components were seen destroyed and had disappeared resulting in interstitial fibrosis, and others showed a regeneration process forming a renewed TBM on the innerside of the original TBM. However the recurrence of cellular inflammation was again observed in these regenerated tubuli. Thus the progression of nephron loss by TIN was seen to be independent of the glomerular changes and TIN is considered to be one of the important factors in predicting the prognosis of IgA nephritis.

Adolescent↗
PubMed1994

[Damus-Kaye-Stansel procedure following Van Praagh (PA-descending Ao shunt) for complete transposition of the great arteries, hypoplastic aortic arch and coarctation].

A newborn baby with d-TGA, straddling AV valve, large VSD, hypoplastic ascending aorta and coarctation of the aorta had congestive heart failure and oliguria on the 3rd day after birth. Van Praagh's operation (main pulmonary artery to descending aorta bypassing with synthetic graft) was performed on 4 days of age through a lateral thoracotomy. At the age of 2 months, the patient underwent left pulmonary artery banding because of respiratory insufficiency requiring prolonged ventilatory support. The patient subsequently underwent Damus-Kaye-Stansel procedure without enlargement of the arch, and the pulmonary patch angioplasty with right modified BT shunt on the age of 5 months. This baby was discharged on 4 months after the operation. Two-dimensional echocardiography has shown aortic and pulmonary competence postoperatively.

Anastomosis, Surgical↗
PubMed1993

Cerebello-oculo-hepato-renal syndrome with possible mitochondrial dysfunction.

Bilateral retinal dysfunction with optic atrophy was evident in a 26-year-old man along with renal, hepatic and cardiac dysfunction. MRI showed undersized cerebellar vermis. Blood lactate and pyruvate were high, indicating possible mitochondrial dysfunction. In biopsied biceps muscle, some ragged red fibers were identified. In five usually congenital or inherited syndromes, Dandy-Walker, Joubert, Arima, Dekaban and COACH, the symptoms such as hypoplasia or aplasia of the cerebellar vermis with multiple ocular and systemic disorders serve as the basis for differential diagnosis. The present case showed numerous symptomatic similarities and a few specific differences with Arima, Dekaban and COACH syndromes. These three syndromes and the present case were thus given a single designation, cerebello-oculo-hepato-renal syndrome, although the present case was an adult patient with sporadic onset. Some systemic disorders not included in cerebello-oculo-hepato-renal syndrome were also noted in our case and may possibly be explained by mitochondrial dysfunction, as indicated by blood pyruvate and lactate levels and the presence of ragged red fibers in biopsied biceps muscle. The relationship between cerebello-oculo-hepato-renal syndromes and mitochondrial dysfunction is discussed.

Abnormalities, Multiple↗
PubMed1993

Modification of spleen phospholipid fatty acid composition by dietary fish oil and by n-3 fatty acid ethyl esters.

We have compared the effects of diets containing purified ethyl esters of either eicosapentaenoic acid, docosahexaenoic acid, or a mixture of both of these compounds, with diets containing either purified fish oil or beef tallow on spleen phospholipid fatty acid composition. Autoimmune mice, the (NZB x NZW)F1 strain, were fed with experimental diets for 14 weeks, after which spleen phospholipids were extracted and separated into classes by HPLC, and the alkenylacyl, alkylacyl, and diacyl subclasses of glycerylphosphatidylethanolamine and glycerylphosphatidylcholine were resolved as their benzoyl esters by HPLC. Fatty acids were analyzed by capillary gas-liquid chromatography of their methyl esters. Each of the marine lipid diets suppressed n-6 fatty acids and elevated n-3 fatty acids in all phospholipids. The eicosapentaenoic acid ethyl ester diets led to high levels of eicosapentaenoic acid and docosapentaenoic acid (C22:5n-3), but little or no increase in docosahexaenoic acid. The docosahexaenoic acid ethyl ester diets elevated docosahexaenoic acid, docosapentaenoic acid, and eicosapentaenoic acid in all phospholipids, indicating that extensive retroconversion of 22 carbon n-3 fatty acids had occurred. These results document changes in the fatty acid composition of mammalian phospholipids that are induced by dietary fish oil triglycerides and by dietary long chain n-3 fatty acid ethyl esters.

Animals↗
PubMed1993

Suppression of autoimmune disease by dietary n-3 fatty acids.

Previous studies have demonstrated that dietary fish oil preparations have anti-inflammatory effects in humans and in experimental animals, but the individual components of fish oils that are responsible for their anti-inflammatory effects have not been documented. We therefore investigated in (NZB x NZW)F1 mice, a model for human systemic lupus erythematosus, the effects of diets containing ethyl esters of two purified n-3 fatty acids, eicosapentaenoic acid (EPA-E) and docosahexaenoic acid (DHA-E), a refined fish oil triglyceride (FO) which contained 55% n-3 fatty acids, and beef tallow (BT) which contains no n-3 fatty acids. The diets were initiated prior to the development of overt renal disease at age 22 weeks, and continued for 14 weeks. The extent of the renal disease was quantified by light microscopy and by proteinuria. Diets containing either 10 wt% FO, 10% EPA-E, or 6% or 10% DHA-E alleviated the severity of the renal disease, compared to the BT diet, whereas diets containing either 3% or 6% EPA-E or 3% DHA-E were less effective. Two diets containing approximately 3:1 mixtures of EPA-E and DHA-E alleviated the renal disease to a greater extent than expected for either of these fatty acids given singly. We believe that these experiments provide the first demonstration of anti-inflammatory effects of individual dietary n-3 fatty acids. The results also indicate that the anti-inflammatory effects of fish oils depend on synergistic effects of at least two n-3 fatty acids.

Animals↗
PubMed1992

Analysis of pathogenicity by restriction-endonuclease digestion of amplified genomic DNA of Entamoeba histolytica isolated in Pernambuco, Brazil.

The pathogenicity of 47 strains of Entamoeba histolytica isolated in Pernambuco, Brazil, was examined using the polymerase chain reaction (PCR) followed by restriction-endonuclease digestion. Electrophoretic patterns of PCR products digested with HinfI revealed that all strains were nonpathogenic. The results were entirely in accord with phenotypic properties such as isoenzyme patterns and the failure to bind a pathogenic-isolate-specific monoclonal antibody. When the sensitivity of PCR was examined, amplified products could be detected from template DNA equivalent to five trophozoites. These observations indicate that PCR amplification of genomic DNA and subsequent restriction-enzyme digestion is a useful strategy for obtaining a sensitive and accurate diagnosis. The present study also demonstrates that nonpathogenic strains of E. histolytica predominate in northeastern Brazil.

Animals↗
PubMed1992

Cultivation of the third-stage larvae of Necator americanus in vitro.

When filariform larvae of Necator americanus, enclosed within the second sheath, were cultured in various semi-defined media, the best larval development was achieved in Waymouth's MB 752/1 with 20% foetal calf serum (FCS). In this medium, most of the filariform larvae cast off the second sheath and developed into third-stage larvae with provisional buccal capsules and some larvae developed further; 26% were fourth stage after 49 days of culture. Of several supplements tested, only FCS supported such development and no further development occurred if the medium was further supplemented with human red blood cells, liver extract, intestinal extract or tryptose phosphate broth. Larval development stopped at or before early third stage in Eagle's Basal Medium, F-12, NCTC 135 and L-15, even when these media were supplemented with FCS.

Animals↗
PubMed1992

Immunogenic deposition and destruction of glomerulus in IgA nephritis.

The correlation between glomerular immune deposition and histological alteration was studied in serial paraffin sections of kidney biopsy specimens from patients with IgA nephritis using the peroxidase-antiperoxidase (PAP) method. IgA deposition was detected in preserved glomerular extracellular matrix or in newly formed interposed matrix along the capillary loops (mesangial interposition). On the other hand, deposition of IgA was scanty or absent in the distorted extracellular matrix where severe exudative inflammation or extracapillary escape of exudates was occurring segmentally. Ultrastructurally such extracellular matricial destruction was expressed as splitting or thinning of the lamina densa, as well as mesangial edema, reticulation or mesangiolysis of the axial matrix. Therefore it appears that at least two types of change in the extracellular matrix are induced by IgA immune complexes in IgA nephritis; immunogenic deposition and destruction.

Adolescent↗
PubMed1991

Study of lupus nephritis in males.

Clinical and pathological findings were studied in 23 male patients with lupus nephritis who were followed up for a period of 41 +/- 36 months after renal biopsy. Age at renal biopsy was 31 +/- 14 years and 19 patients (83 per cent) were between 15 and 50 years old. C3 and C4 levels were below normal in 23 (100 per cent) and 16 (70 per cent) respectively, CH50 was less than 25 u/ml in 67 per cent, and antinuclear and anti-DNA antibodies were found in 87 per cent and 82 per cent respectively. Serum albumin level increased from 2.9 +/- 0.8 g/dl to 3.7 +/- 0.8 g/dl during the follow up period (p less than 0.01), while urinary protein decreased from 2.0 +/- 2.3 g/day to 1.4 +/- 2.5 g/day. There was a significant improvement in the degree of haematuria (p less than 0.01), but serum creatinine levels showed no change (mean 1.5 mg/ml). Active proliferative lupus nephritis of moderate or severe degree was observed in 65 per cent of patients at the initial biopsy. A trend to regression in this activity was seen in most serial biopsies, but the chronicity index showed a slight increase. These data demonstrate that systemic lupus erythematosus in males, in comparison to our previous report of the disease in female patients, is accompanied by more active nephritis, but that it follows a benign course with therapy.

Adolescent↗