Biomedical subjects

Osamu Hasegawa

Publications and source records attributed to Osamu Hasegawa.

8 recordsLinked to original sources

PubMed2006

Development and progression of retinopathy after inpatient management of diabetes.

OBJECTIVE: To examine factors that affect the development of retinopathy after short-term inpatient management of diabetes. PATIENTS AND METHODS: The subjects were 143 patients with type 2 diabetes who were admitted for inpatient management of diabetes, and did not have retinopathy of the right eye at admission, and had an HbA1c level of > or =8.0%. We studied the characteristics of patients who developed retinopathy within one year after discharge. RESULTS: Between the admission date and one year after discharge, twenty-six patients developed retinopathy and the retinopathy subsequently regressed in 5 patients. The 26 patients who developed retinopathy had a significantly longer duration of diabetes (p<0.005), had a higher fasting blood glucose level at admission (p=0.06), and received insulin therapy during the admission at a higher rate (p=0.06) than the 117 patients without retinopathy. The magnitude of the reduction in HbA1c level at 3 months after discharge was smaller in the 13 patients who developed retinopathy within 3 months after discharge than in the 130 patients who did not. Among the 26 patients who developed retinopathy, the HbA1c level at one year after discharge of the 5 patients whose retinopathy regressed was lower than that of the 21 patients whose retinopathy did not regress (p=0.06). CONCLUSIONS: A long duration of diabetes, high fasting blood glucose level at admission, and treatment with insulin were associated with the development of retinopathy. Patients with these characteristics should undergo frequent fundus examinations after correction of hyperglycemia. The retinopathy was likely to improve if patients maintained strict glycemic control after discharge.

Adult↗

PubMed2005

An incremental network for on-line unsupervised classification and topology learning.

This paper presents an on-line unsupervised learning mechanism for unlabeled data that are polluted by noise. Using a similarity threshold-based and a local error-based insertion criterion, the system is able to grow incrementally and to accommodate input patterns of on-line non-stationary data distribution. A definition of a utility parameter, the error-radius, allows this system to learn the number of nodes needed to solve a task. The use of a new technique for removing nodes in low probability density regions can separate clusters with low-density overlaps and dynamically eliminate noise in the input data. The design of two-layer neural network enables this system to represent the topological structure of unsupervised on-line data, report the reasonable number of clusters, and give typical prototype patterns of every cluster without prior conditions such as a suitable number of nodes or a good initial codebook.

Algorithms↗

PubMed2005

[Changes in the clinical features of MPGN type-I in childhood over three decades].

UNLABELLED: This retrospective study was conducted to evaluate changes in the clinical features of MPGN type I in childhood during a 30-year period from 1970 through 1999. Renal biopsies were performed on 2,260 children with glomerulonephritides, among whom were 71 patients with MPGN type-I. Changes in the mode of onset were investigated in patients separated according to the period of onset into two groups by 1974 in which school urinary screening had been widespread. The difference in symptoms after onset was examined between patients with the onset in the 1980s and 1990s under the same circumstances of school urinary screening and of our steroid regimen. Finally, the incidences of this disease in each of the three decades were analyzed. Chance proteinuria and/or hematuria increased (p=0.0107) and acute nephritic syndrome decreased (p=0.0237) in the ratio of the initial symptom on and after 1974. Regarding the clinical presentation after onset, non-nephrotic range proteinuria increased (p=0.0415) and nephrotic syndrome decreased (p=0.0415) in the 1990s, in comparison with the respective rates in the 1980s. The incidence of this disease decreased (p<0.01) in chronological order. CONCLUSION: The clinical features of this disease definitely changed over three decades suggesting that the clinical presentation has ameliorated in recent years, regardless of effective palliation of severe symptoms afforded by our steroid regimen.

Child↗

PubMed2005

[Intermediate medullary infarction: a case report].

A 68-year-old man presented with right eye pain and vertigo. Thereafter, he gradually leaned rightward, then laid down. He felt nausea and vomited. His right upper eyelid drooped and he felt dysethesia of the right hand. On neurological examination, ptosis of his right eye with slightly miotic right pupil, paresis of the right soft palate and hoarseness were noted. Arm deviation test demonstrated rightward deviation. He presented sensory ataxia of the right upper and lower extremities: finger nose test showed mild dysmetria of the right upper extremity, heel knee test demonstrated dysmetria of right lower extremity and these findings worsened when he closed his eyes. He showed mild bending of his bilateral ring and little fingers when he did rapid alternative movement. He leaned rightward when he sat and closed his eyes. Position sense of his right upper and lower extremities was decreased and sometimes he could not answer correctly when asked on which direction his finger pointed. Pinprick sensation was mildly decreased on the left side not including the face. Touch and vibration sense were normal. SEP findings on upper and lower extremity stimulation were normal. MRI of the brain showed T2 high intensity and partially T1 low intensity lesion at the right medulla (Figure). MR angiography showed no apparent lesion of major arteries such as dissection of the vertebral arteries. He complained and presented with hiccup initially. On MRI, the lesion was thought to involve the spinothalamic tract, medial lemniscus and inferior olivary nucleus. Ambiguus nucleus was in the lesion and solitary nucleus near the lesion. There is no report that seems to describe clinical features of a lesion like that in this case. Intermediate medullary infarction may present dissociated sensory disturbance like Brown-Sequard syndrome and position sensory disturbance without disturbance of vibration sense.

Aged↗

PubMed2004

Aneurysmal subarachnoid hemorrhage in a patient with Wegener's granulomatosis.

A 34-year-old Japanese man admitted to hospital with pneumonia had previously undergone surgery for paranasal sinusitis and also for the clipping of an aneurysm at the origin of the anterior choroidal artery after subarachnoid hemorrhage. Laboratory tests performed at the present admission showed renal insufficiency and serological findings of raised proteinase 3 antineutrophil cytoplasmic antibody level. A renal biopsy was performed that showed diffuse necrotizing glomerulonephritis with fibrocellular crescents. The diagnosis of Wegener's granulomatosis(WG) was confirmed on the basis of the clinical picture, laboratory findings, and biopsies of renal tissues. The disease responded to prednisolone and cyclophosphamide. The association of WG with a ruptured intracranial aneurysm is rare and has not previously been confirmed.

Adult↗

PubMed2004

Typical MPGN with few urinary abnormalities.

We describe the concurrent appearance of membranoproliferative glomerulonephritis (MPGN) in renal biopsy samples and normal urinary sediment without hematuria, proteinuria, or renal dysfunction in 1 child and asymptomatic microscopic hematuria without significant proteinuria or renal dysfunction in 2 children who were subsequently followed up for many years. The only other abnormality detected was hypocomplementemia. This is the first report of biopsy-proven typical MPGN in patients with few urinary abnormalities. A renal biopsy should be considered in children with hypocomplementemia, regardless of urinalysis findings, to exclude MPGN.

Biopsy↗

PubMed2004

[Clinical significance of the terminal complement complex in children with type I membranoproliferative glomerulonephritis].

We measured the concentrations of terminal complement complex (TCC) in plasma (n =25) and urine (n=13) using an enzyme-linked immunosorbent assay in pediatric patients with type I membranoproliferative glomerulonephritis(MPGN). Frozen tissue from 18 renal biopsies was evaluated for the presence of TCC by direct immunoperoxidase staining. In the acute phase of the disease, TCC concentrations in plasma were elevated above 0.5 AU/ml in 14 of 25 patients (High TCC group), while the remaining 11 patients showed less than 0.5 AU/ml (Low TCC group). In the High TCC group, TCC was deposited more diffusely and intensely in the glomerulus, compared to that in the Low TCC group (p= 0.034). Furthermore, urinary TCC concentrations in the High TCC group were higher than those in the Low TCC group (p=0.0001). The High TCC group showed not only a poorer response to steroid treatment, but also a poorer prognosis than the Low TCC group. These results suggest that, in pediatric patients with type I MPGN, TCC in circulation may play a certain role in TCC formation in the glomerulus and in urine. The TCC concentration in plasma could be used as a marker of responsiveness to steroid treatment and long-term prognosis.

Adolescent↗

PubMedDate not supplied

Terminal complement complexes in childhood type I membranoproliferative glomerulonephritis.

BACKGROUND: The role of terminal complement complexes (TCCs), which are the final products of complement activation, in the pathogenesis of human glomerulonephritis has not been completely elucidated. To clarify the clinical significance of TCCs in type I membranoproliferative glomerulonephritis (MPGN), we studied TCCs in plasma, renal tissue and urine in pediatric patients with this disease. PATIENTS AND METHODS: We measured the concentrations of TCC in plasma (n=25) and urine (n=13) using enzyme-linked immunosorbent assay. Frozen tissue from 18 renal biopsies were evaluated for the presence of TCC by direct immu-noperoxidase staining. RESULTS: At the early stage of the disease, TCC concentrations in plasma were elevated to above 0.5 arbitrary units (AU)/mL in 14 of 25 patients (high-TCC group), while the remaining 11 patients showed less than 0.5 AU/mL (low-TCC group). In the high-TCC group, TCCs were deposited more diffusely and intensely in the glomerulus, compared with those in the low-TCC group (p=0.034). Furthermore, urinary TCC concentrations in the high-TCC group were higher than those in the low-TCC group (p=0.0001). The high-TCC group showed not only a poorer response to steroid treatment, but also poorer prognosis than the low-TCC group. CONCLUSIONS: These results suggest that, in pediatric patients with type I MPGN, TCCs in circulation may play a particular role in TCC formation in the glomerulus and in urine. The TCC concentration in plasma could be used as a marker of responsiveness to steroid treatment and long-term prognosis.

Adolescent↗