Epidemiologic study of systemic lupus erythematosus in Fukuoka population.
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Biomedical subjects
Publications and source records attributed to S Kameda.
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We treated a Japanese man with Rendu-Osler-Weber disease and a recurrent encephalopathy with hyperammonemia concomitant with recurrent epistaxis, G-I bleeding, congestive heart failure with aortic and mitral regurgitation, and chronic renal failure. At peritoneoscopy, several telangiectasia were noted on the surface of the liver. Angiographical studies revealed widened and tortuous hepatic arteries with early filling of hepatic veins and small pools of contrast medium scattered throughout the parenchyma. The recurrent encephalopathy was attributed to the porto-systemic shunt formed in the liver.
Cefuzonam (CZON), a new cephem antibiotic agent, was studied in terms of its pharmacokinetics and clinical efficacy in the field of obstetrics and gynecology, and the results were summarized as follows. 1. The absorption and the tissue penetration of CZON into intrapelvic genital organs were good. The peak serum level in uterine artery after an intravenous drip infusion of 1.0 g was 49.0 micrograms/ml, and the highest peak level of 23.0 micrograms/g in tissues was obtained. After drip infusion of 2.0 g, the peak serum level in uterine artery was 137 micrograms/ml and the highest peak tissue concentration was 54.6 micrograms/g. Tissue concentrations of the drug changed in a similar pattern to serum levels and a dose-dependent response was recognized. 2. The penetration of CZON into intrapelvic dead space exudate was good. The level reached a peak of 8.17 micrograms/ml 4 hours after and intravenous drip infusion of 1.0 g and diminished slowly. 3. The clinical efficacy of CZON at a daily dose of 2 g was evaluated in 21 cases of obstetrics and gynecologic infections. The efficacy rate was 85.7% (18/21 cases). Bacteriologically, the eradication rate obtained was 93.3%. No side effects or abnormal laboratory values were observed.
The authors studied mortality among 2513 relatives of 56 Japanese patients with systemic lupus erythematosus. The observed deaths in 142 relatives were compared with the expected number of deaths. The observed number of deaths was significantly less among relatives of patients with systemic lupus erythematosus (p less than 0.01). Deaths from malignant neoplasms and senility (senescence) were significantly lower than the expected number of deaths among relatives (p less than 0.05).
The capacity to solubilize immune complexes formed in vitro was measured in 25 patients with Behcet's disease. Both the level of circulating immune complexes and that of complement are increased in these patients. The solubilization capacity appeared to increase, paralleling the rise of serum complement levels in patients with Behcet's disease. Thus, increased capacity to solubilize immune complexes may be attributed to complement that is increased in these patients. The relationship between the capacity to solubilize complexes and the pathogenesis of Behcet's disease is discussed.
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The phagocytic activity of peripheral blood leukocytes was assayed by means of oxygen consumption in 28 patients with systemic lupus erythematosus (SLE) and 22 normal individuals. The method in which zymosan was added to a small volume of whole blood enabled us to assay quantitatively and rapidly both the phagocytosis-connected oxygen consumption and the opsonizing time. The degree of oxygen consumption by phagocytes from SLE patients was not significantly different from that in normals. Opsonizing time of zymosan by autologous serum in SLE patients did not differ from that in normals either. It should be emphasized, however, that the opsonizing time of zymosan in SLE patients was inversely correlated with serum complement level, especially C3 level (coefficient of correlation = -0.76, p less than 0.001). This raises the possibility that the phagocytosis may be delayed in SLE patients with low titers of C3.
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An attempt was made to elucidate the pathogenesis of hepatoma. The material comprises 20 cases which were followed up more than 3 years after diagnosed liver cirrhosis and verified by autopsy. Hepatoma was found in 10 out of these 20 cases (50%). The follow-up period of these 10 cases with hepatoma was from 3 to 9.5 years (the mean value; 5.5 years). All 10 cases were not heavy drinkers, and showed liver cirrhosis of the mixed type by autopsy. HBsAG was positive in 6 out of 8 cases by RIA method (75%), and alpha-f was also detected in 5 of 7 cases by RIA method (70%). On the contrary, only 2 out of 10 cases without hepatoma were HBsAG positive (20%). The present results indicate that HBsAG positive liver cirrhosis of the mixed type is closely related to hepatoma in our country.
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An attempt was made to find reliable indices for the early recognition of fatal cases of acute viral hepatitis, using the values of serum proteins with rapid turnover. Prealbumin and alpha2-HS-glycoprotein were measured in the sera of 44 cases by immunodiffusion method before the appearance of hepatic coma and/or gastrointestinal bleeding. The difference of the mean values of prealbumin between fatal and surviving cases of subacute form of fulminant hepatitis was not statistically significant. In contrast to this, there was statistically significant difference between both groups in the mean values of alpha2-HS-glycoprotein (p less than 0.05). The present results indicate the possibility of differentiating fatal cases from surviving ones at an early stage, using the reduction of alpha2-HS-glycoprotein by a simple and reproducible immunodiffusion method.
An attempt was made to find reliable indices for early diagnosis of fatal cases of acute viral hepatitis, using the values of serum proteins with rapid turnover. Of the subfractions of serum protein, prealbumin, alpha2-HS-glycoprotein and Normotest were measured simultaneously before the appearance of hepatic coma/or gastrointestinal bleeding in 78 cases of acute viral hepatitis, verified by biopsy or necropsy. The mean value of prealbumin with a very short half-life of one or two days, was 6.0 mg/dl in fatal cases, 7.4 mg/dl in surviving ones of subacute form of fulminant hepatitis. The difference between fatal and surviving cases was not statistically significant. In contrast to this, the values alpha2-HS-glycoprotein with a comparatively short halflife of four to six days, showed statistically significant difference between fatal (21.9 mg/dl) and surviving cases (37.4 mg/dl). Normotest was also depressed in fatal (10.7%) and surviving cases (45.3%). The difference was statistically significant. The present results indicate the possibility of differentiating fatal cases from surviving ones at an early stage, using the reduction of alpha2-HS-glycoprotein and the value of Normotest.
BACKGROUND: High levels of foreign gene expression in mouse hepatocytes can be achieved by rapid tail vein injection of a large volume of a naked DNA solution, the 'hydrodynamics-based procedure'. Rats are more tolerant of the frequent phlebotomies required for monitoring blood parameters than mice, and thus are better for some biomedical research. METHODS: We tested this technique for the delivery of a therapeutic protein in normal rats, using a rat erythropoietin (Epo) expression plasmid vector, pCAGGS-Epo. RESULTS: We obtained maximal Epo expression when the DNA solution was injected in a volume of 25 ml (approximately 100 ml/kg body weight) within 15 s. We observed a dose-response relationship between serum Epo levels and the amount of injected DNA up to 800 microg. Using quantitative real-time PCR, the vector-derived Epo mRNA expression was mainly detected in the liver. When a lacZ expression plasmid was injected similarly, beta-galactosidase was exclusively detected in the liver, mainly in hepatocytes. Toxicity attributable to the technique was mild and transient, as assessed by histochemical analysis. Epo gene expression and erythropoiesis occurred with Epo gene transfer in a dose-dependent manner, and persisted for at least 12 weeks, the last time point examined. Repeated administration of the plasmid DNA also effectively led to erythropoiesis. CONCLUSIONS: These results demonstrate that gene transfer into the liver via rapid tail vein injection can easily be achieved in the rat, which is more than 10 times larger than the mouse, and has significant value for gene function analysis in rats.