[The problems of treatment of neonatal cretinism detected by mass screening (author's transl)].
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Biomedical subjects
Publications and source records attributed to H Yabuuchi.
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A specific competitive protein binding assay for 24,25-dihydroxyvitamin D by Sephadex LH-20 column chromatography, followed by high pressure liquid chromatography with normal rat kidney cytosol as the binding protein, was developed. The mean concentrations of serum 24,25-dihydroxyvitamin D of the cord, in newborn infants and in infants under 12 months of age were 0.90 +/- 0.40 (S.D.) ng/ml, 0.52 +/- 0.21 (S.D.) ng/ml and 1.20 +/- 0.38 (S.D.) ng/ml, respectively. These concentrations were significantly lower than those in children aged 1-15 years (1.96 +/- 0.83 (S.D.) ng/ml). The serum levels in the acute stage of the nephrotic syndrome were significantly reduced, and they increased in remission. These results show that patients wioth nephrotic syndrome have low levels of serum 24,25-dihydroxyvitamin D. This is probably due to its loss in the urine.
Nine oligosaccharide fractions were purified from the urine of mannosidosis patients by Bio-Gel P-4 column chromatography, paper chromatography, and paper electrophoresis. Studies using exoglycosidase digestion, methylation analysis, periodate oxidation, and acetolysis revealed that most of the fractions were mixtures of two or three isomeric oligosaccharides. The structures of a total of 16 oligosaccharides were elucidated to be as follows: (formula: see text).
A five-year-old boy with hepatoblastoma, who showed a severe hypoglycemia as an initial symptom, was studied. After resection of tumors, hypoglycemia disappeared and did not recur despite recurrence of tumor. A high concentration of insulin-like activity (ILA) was found in preoperative serum and in the tumor extract. Hypoglycemia in this patient seemed to depend mainly on ILA and in part on liver enzyme activities related to carbohydrate metabolism.
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Plasma 1,25-dihydroxyvitamin D [1,25-(OH)2-D] was measured in cord serum, newborns, infants, and children. The mean for the values obtained from the six cords was significantly higher than the mean for the older children (6-15 years). The mean for the six newborns (0-1 week) was significantly higher than that for the older children. The mean for the nine infants (1 week-6 months) and the 14 younger children (6 months-6 years) was significantly higher than that for older children. The present study suggests that the perinatal period is associated with a marked increase in 1,25-(OH)2-D.
Using the technique of iontophoretic microinjection of horseradish peroxidase, the present study disclosed the complexity and high degree of the topographic organization in the forebrain subcortical afferents to the different regions of rat hippocampus, e.g. diagonal band, posterior (PH), dorsomedial and rostral lateral hypothalamic nuclei chiefly project to the rostrodorsal part (DRA) and caudal gyrus dentatus including CA3, the supramammillary area predominantly to the rostroventral area (VRA), the area lateral to PH to the DRA and VRA, substantia innominata and some thalamic nuclei (n. reuniens, n. lateralis thalami, n. anterior ventralis and n. lateralis thalami pars posterior) to the dorsal subiculum, respectively.
The cerebellums of two children with late infantile metachromatic leukodystrophy were investigated by light and electron microscopy. These observations showed that the morphological abnormalities were comprised not only of severe demyelination and presence of metachromatic granules but also marked loss of Purkinje cells and granule cells. The depletion of Purkinje cells is considered to have resulted from demyelination of their myelinated axons. On the other hand, the reduction of granule cells is considered to be caused by the loss of Purkinje cells and presynaptic elements such as mossy fibers and glomerular collaterals of climbing fibers. The depletion of these neurons induced destruction of synaptic connection in the cerebellum.
A patient with incontinentia pigmenti achromians was reported. She displayed other abnormalities such as a saddle nose, malformed auricles, growth retardation, convulsions and abnormal EEG. Histopathologically, a partial decrease in melanin granules in the basal layer and the presence of melanocytes which showed a weak dopa reaction were the main findings. The hypofunction of melanin production was detected by electron microscopy.
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Plasma levels of 1,25 dihydroxy-vitamin D (1,25-(OH)2-D) were low in 3 children with hypophosphataemic vitamin D-resistant rickets (HVDRR) during childhood, but increased after very large doses (0.5 to 2 micrograms/kg per day) of 1 alpha-hydroxy-vitamin D (1 alpha-OH-D3). This treatment has two advantages. Firstly, hypercalcaemia is easily controlled by reducing the dose of 1 alpha-OH-D3 because of its short half-life. Secondly, the administration of 1 alpha-OH-D3 to patients with HVDRR can enhance the tubular reabsorption of phosphate, and this seems desirable in treating HVDRR.
Plasma levels of 1,25-(OH)2-D were low in children with hypophosphatemic vitamin D-resistant rickets (HVDRR), but increased after very large doses of 1 alpha-OH-D3. These results suggest that the metabolism of 1,25-(OH)2-D is accelerated in HVDRR. In addition, the lower level of plasma 1,25-(OH)2-D in untreated HVDRR was correlated with the lower level of serum phosphate and renal threshold phosphate concentration (TmP/GFR). The administration of 1 alpha-OH-D3 to the patients with HVDRR could enhance the renal threshold phosphate concentration.
Urinary excretion of the organic acids in patients with type I and III glycogenosis was investigated. In all patients with type I glycogenosis, urinary alpha-ketoglutarate concentration ws about 10 times the normal value. alpha-Ketoglutaric aciduria was not improved by the acute or prolonged administration of a large dose of factors for pyruvate- and alpha-ketoglutarate dehydrogenase complex. On the other hand, the level of alpha-ketoglutarate in the urine from type I patients decreased in conjunction with the decrease of plasma lactate and pyruvate concentration after repeated oral glucose loading. Oral citrate loading brought an increased excretion of alpha-ketoglutarate in type I glycogenosis. It is possible that alpha-ketoglutarate dehydrogenase in the rate-limiting step in tricarboxylic acid cycle and in patients with glycogenosis type I, the excessive excretion of alpha-ketoglutarate may be caused by the limited activity of alpha-ketoglutarate dehydrogenase with excessive substrate.
For the purpose of preventing spread of infection to high risk children whose immunities were severely impaired by intensive chemotherapy or for some other reason, when cases of varicella occurred in a children's ward or in a family, healthy adults (mothers and a doctor) were immediately given live varicella vaccine, blood was collected from these adults 5 to 7 days after vaccination and the whole blood or plasma including the buffy coat was transferred in the high risk children. Subsequently the children showed little or no clinical reaction, and follow-up studies by the neutralizing test and skin test with varicella antigen indicated that their inapparent or subclinical varicella infection occurred in them and that their immunity to varicella was lasting. Skin tests with varicella antigen showed that booster reaction occurred in adults with a previous history of varicella as early as 5 to 7 days after vaccination. The cellular immunity thus induced in the donors may have played a role in preventing a clinical reaction in the high risk children. Thus passive transfer of vaccine-induced immunity seems a convenient and effective method for preventing infection in subjects whose immune capacities are severely impaired.
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