Kawasaki disease in a father and daughter.
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Biomedical subjects
Publications and source records attributed to A Hosaka.
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A report is presented of a girl with Graves' disease, which was diagnosed at the age of 1.7 years. The mother had no thyroid disease. The patient developed signs of hyperthyroidism shortly before her first birthday, and the most prominent manifestations were accelerated skeletal maturation and linear growth, and dilatation of the brain ventricles. The latter manifestation, which has not been reported previously, was reversible upon normalisation of thyroid function with antithyroid treatment for three years.
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We describe two children who after cardiopulmonary arrest developed hypernatremia at the terminal stage. Urinary antidiuretic hormone concentration was very low, indicating central diabetes insipidus. These cases illustrate the necessity of alertness to the development of central diabetes insipidus in patients with severe hypoxic brain damage.
A very rare occurrence of adult granulosa cell tumor of the ovary (not of the juvenile type) causing precocious pseudopuberty in a six-year-old girl is described. An additional feature of interest was that the tumor appeared entirely cystic. To our knowledge, this condition in such a young premenarchal patient has not been reported previously.
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We induced myopia by eyelid suturing in one eye each of six 9-month-old cynomolgus monkeys to elucidate the condition by studying changes in the ocular structure and the blood-ocular barrier (BOB) permeability. Optical elements were measured by A-mode ultrasonography; vitreous fluorophotometry was carried out to document BOB permeability before eyelid suturing and 3, 10, 16, and 28 months after suturing. The axial length of the sutured eyes increased significantly compared with that of the non-sutured contralateral eyes at 10 months after suturing and continued to lengthen with time. The dioptric power (D) of the sutured eyes changed in the same way. (mean, -3.08D 28 months after suturing). The permeability of the blood-retinal barrier of the sutured eyes significantly increased from 10 months after suturing compared with that of the fellow eyes, and continued to increase over the period of observation. The permeability index of the blood-aqueous barrier also increased significantly from only 16 months after suturing further increasing as the period of observation lengthened. We hypothesize that in the transition from emmetropia to myopia, the permeability of the BOB rises, and continue to rise as myopia develops. Thus, the breakdown of the BOB, i.e., the breakdown of the ocular homeostasis, is considered to be closely related to the occurrence and the development of myopia.
Vitreous fluorophotometry (VFP) was performed for myopic eyes induced by unilateral eyelid suturing of six young cynomolgus monkeys in order to study the permeability of the blood-ocular barrier. The eyelid fusion was temporarily cut and opened at about five-month intervals, and the dioptric power and axial length of test and control eyes were measured. VFP was carried out before and after intravenous injections of fluorescein-Na. The inward permeability of the blood-retinal barrier (P(in)) was estimated by our computer simulation method, and the index of permeability of the blood-aqueous barrier (AQ) was also obtained. Significant prolongation of the length of the vitreous cavity was first seen 10 months after suturing, with the degree of myopia progressing subsequently. P(in) and AQ values increased as myopia progressed: significant increases were observed at 10 and 16 months after suturing, respectively. These results indicate a close relationship between the occurrence and progress of myopia and increased permeability of the blood-ocular barrier.
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A 3-year-old girl with status asthmaticus developed a grand mal seizure in association with hyponatraemia after 16 h of fluid therapy. Urinary arginine vasopressin (AVP) was elevated during the attack and rose strikingly before the onset of the convulsion. In 13 of 17 other patients with moderately severe asthmatic attacks, increases in urinary AVP levels occurred before the initiation of treatment. Dilutional hyponatraemia (water intoxication) must be prevented in patients with severe asthmatic attacks in whom diuretic capacity is impaired.
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From Japanese population studies the following is summarized: 1) The refractive condition in each person is mainly determined by the axial length. 2) The axial length of the eye depends mainly on the length of vitreous cavity. 3) The anterior part of the eye, that is from the corneal surface to the posterior surface of the lens, may differ from individual to individual. 4) However, the differences found are rather small, and anterior segment axial distances do not play an important role regarding refractive value.