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Biomedical subjects

S Kusakawa

Publications and source records attributed to S Kusakawa.

At least 19 recordsLinked to original sources

Two inbred strains of mice with high and low mammary tumor potentials established from the same basal stock of Swiss albino (SHN and SLN): history of mammary tumorigenesis and reproduction after the 30th generation of full-sib mating.

We established SHN and SLN strains of mice with a high and a low mammary tumor potentials from the same basal stock of Swiss albino. The selection history of females (mothers) for subsequent generations, mammary tumorigenesis and reproduction up to recent generations are presented and compared with the results up to F30 published in 1979. The changes with generation of each parameter varied in both strains except the conditions of female (mother) selection for subsequent generations, which were generally constant. However, the fluctuations in parameters up to F30 became generally smaller with advancing generations. Based on the fluctuations from generation to generation of mammary tumorigenic and reproductive parameters, an interdependency between mammary tumor potential and reproductivity is suggested in SLN, but less so in SHN. The pup growth rate was increased and associated with selection for mammary tumorigenesis in SHN; this parameter is usually used as an indicator of mother lactational performance in mice. The significance of selection for mammary tumor potential in association with reproductivity was further discussed.

Aging↗

Accidental poisoning of children in Japan: a report from the Japan Poison Information Center.

The Japan Poison Information Center (JPIC) was founded only 6 years ago as a result of co-operation between the Ministry of Health and Welfare, the Japanese Association for Acute Medicine, the Japan Pediatric Society and other related medical organizations. The JPIC is the only poison information center admitted by the Ministry of Health and Welfare to provide toxicological information to medical personnel and the general public, and has two offices on duty in alternating 24 h shifts. Every year, JPIC receives about 30,000 inquiries. About 82% of these inquiries are from the general public and 84% of the patients are children 5 years and younger. We contrasted the data in the fiscal year 1991 with the data of the American Association of Poison Control Centers (AAPCC). Child poison exposure in Japan is characterized by a high exposure rate of children under 1 year of age to (mostly) household products. The JPIC also analyzed the cause of tobacco ingestion. It is considered that the Japanese lifestyle causes differences from those reported by AAPCC. We report the accidental poisoning of children in Japan.

Accidents↗

Collateral circulation in Kawasaki disease with coronary occlusion or severe stenosis.

Forty patients with Kawasaki disease with severe coronary sequelae were investigated. All had at least a 90% reduction in the diameter of the major coronary artery. Collateral vessels were seen in 32 of 33 (97%) patients with total occlusion. All patients with severe stenosis but not total occlusion had no or poorly developed collateral vessels. Analysis according to the presence or absence of collateral vessels showed no significant differences in the results of treadmill stress testing and myocardial imaging between these two groups. In patients treated surgically, the abnormalities recognized by these tests were normalized or improved when the bypass was patent. These data indicate that collateral circulation in patients with Kawasaki disease cannot be seen angiographically unless there is total occlusion and the presence of collateral circulation cannot provide protection against stress-induced myocardial ischemia.

Arterial Occlusive Diseases↗

Sequence characterization of the matrix protein genes of parainfluenza virus types 4A and 4B.

The complete nucleotide sequences of the matrix protein (M) genes of parainfluenza virus types 4A and 4B (PIV-4A and -4B) were determined from cDNA of the mRNA, and found to be 1548 bases in length, exclusive of poly(A) sequences. The sequences contained a large open reading frame of 1146 nucleotides encoding 362 amino acids. A high degree of identity (96.1%) was observed between the amino acid sequences of PIV-4A and PIV-4B M. These M sequences were compared with those of 10 other paramyxoviruses and a phylogenetic tree was constructed.

Amino Acid Sequence↗

Long-term prognosis of Kawasaki disease patients with coronary artery obstruction.

The prognosis of coronary artery obstruction was studied in patients with Kawasaki disease. Between May 1973 and December 1987, coronary artery obstruction was diagnosed by coronary angiography in 30 patients (21 males, 9 females), of whom, only 8 (26.7%) had clinical symptoms. One patient died after 9 years of illness. Two complained of frequent chest pain, which disappeared after bypass surgery in one case and spontaneously in the other. Five had symptomatic myocardial infarction. Myocardial ischemia was diagnosed in 31.8% by treadmill stress testing, but was well demonstrated in 85.7% by thallium-201 myocardial tomography. Frequent ventricular premature beats, Wenckebach-type atrioventricular block, and ST-segment depression accompanied by chest pain were recognized by 24-h Holter monitoring. In the past, the methods used to determine the prognosis of Kawasaki disease patients with coronary artery obstruction were not adequate. However, the examinations used in this study revealed an improved ability to determine the prognosis in this disease. Myocardial tomography, in particular, provided a more accurate evaluation of myocardial damage. Ventricular arrhythmias seem to be a serious problem in these patients. Therefore, careful observation using these tests, especially myocardial tomography and Holter monitoring, should be done even if the patients are free of symptoms.

Adolescent↗

Long-term prognosis of giant coronary aneurysm in Kawasaki disease: an angiographic study.

The incidence of coronary obstruction subsequent to giant coronary aneurysm in Kawasaki disease was studied. In 20 cases, aneurysms with a maximal diameter greater than 8 mm were identified by coronary angiography 2 to 120 months (mean 16.9 months) after onset. There were 25 giant aneurysms among these 20 patients, all of whom underwent coronary angiography between 12 and 134 months (mean 31.7 months) after initial examination. Coronary obstruction occurred in six cases (30.0%), all within 4 years of onset of disease. There were five obstructive aneurysms in the right coronary artery (5/12; 41.7%) and two in the left coronary artery (2/13; 15.4%). One of these patients developed symptomatic myocardial infarction. Two had abnormal electrocardiographic findings suggesting myocardial infarction. In five cases, persistent perfusion defects were found by myocardial imaging. On the other hand, in two patients giant aneurysms persisted without obstructive changes for greater than 10 years. In both cases the aneurysm was in the left coronary artery and obstruction of the right coronary artery was found at initial angiography. These results seem to indicate the limited efficacy of antiplatelet therapy for giant coronary aneurysms in Kawasaki disease and that giant aneurysms are likely to progress to become obstructive within a few years even if antiplatelet therapy is given. Other forms of treatment, including surgery, should therefore be considered in such patients.

Angiography↗

Myocarditis with myocardial infarction like findings in a 3-year old girl.

A 3 year-old Japanese girl had an acute onset associated with vomiting. The electrocardiogram (ECG) indicated changes similar to those of acute myocardial infarction (MI); there was no past history of kawasaki disease. Selective coronary angiography taken on the 28th day of illness revealed no abnormality. Thallium 201 scintigraphy was also performed and it revealed that the area of absent myocardial uptake was in the anterior wall. In serological findings, antibody titers against Coxsackie B-3 virus had risen significantly; therefore acute myocarditis caused by Coxsackie B-3 virus infection was diagnosed.

Antibodies, Viral↗

Effects of fatness on the electrocardiogram in children aged 12-15 years.

Using the 4-Lead Set Japanese Pediatric ECG Screening Criteria Proposal, the effects of fatness on the electrocardiograms were analyzed in 1025 junior high school children, aged 12-15 years (of whom 114 were obese). As the results show, significant differences were detected by the 1% two-sided test between the averages of the nonfat group and the middle- and high-fat groups with regard to S amplitude in leads V1-V3 for boys and girls, R amplitude in leads V4 and V5, SV1 + RV6, SV1 + RV5, and SV3 + RV3 for boys, and S amplitude in leads V4-V6 for girls. High R amplitudes were observed in leads V3 and V4 for the middle- and high-fat group of girls. When applying conventional ECG criteria for left ventricular hypertrophy to the middle- and high-fat groups of boys, the value of SV1 + RV6 greater than or equal to 4.5 mV instead of SV1 + RV6 greater than or equal to 5.0 mV is recommended.

Adipose Tissue↗

Immunological studies on Kawasaki disease. I. Appearance of Hanganutziu-Deicher antibodies.

Sera of patients with Kawasaki disease were studied for heterophile antibodies by means of enzyme immunoassay (EIA) with enzyme conjugated antisera to human IgM, IgG, IgA and IgE. Antibodies of IgM (43%), IgG (3%), IgA (11%) and IgE (49%) classes were demonstrated that combined with high molecular weight glycoprotein (HMWGP) of bovine red blood cells (BRBC) one of the antigenic preparations of the Hanganutziu-Deicher (H-D) heterophile system. Studies on sequential sera of the patients revealed that HMWGP antibodies of IgM and IgE classes began to appear in the second week, reached their peaks in the third week of the disease and declined gradually thereafter. Absorption studies on the positive sera showed that the HMWGP antibody activities were abolished by BRBC, sheep red blood cells and guinea-pig kidney tissues, confirming H-D specificity of these antibodies. EIA inhibition studies showed that the antibody activity was inhibited by HMWGP and partially by asialo-HMWGP and NGNA ganglioside rich preparation of BRBC but not by purified Paul-Bunnell or Forssman antigens. These results indicate that the H-D antibodies under investigation consist of antibodies of two different specificities; one directed against asialo-HMWGP and the other NGNA ganglioside of BRBC. Circulating immune complexes (IC) were demonstrated in 23% of the patients by means of anti-antibody inhibition test. Evidence was presented that IC in the sera of five patients were composed of H-D (HMWGP) antigen and its corresponding antibodies.

Antibodies, Heterophile↗

The throat culture in Kawasaki disease.

Recently, Kawasaki disease has been attracting more attention as a new acquired heart disease in pediatrics, but the etiology of this disease has still not been established. In this study, the authors performed throat cultures not only on the patients themselves but also on their parents in order to investigate its etiology. No abnormal and specific bacterium was found in the present study. However, there have been many reports which may suggest bacterial or viral involvement at the onset of this disease. Therefore, it may be necessary to continue bacteriological analysis more systematically.

Bacteria↗

Development of a heart disease screening system for school children and its results in the Tokyo area in 1980.

After the revision of the School Health Law in Japan the systems for heart disease screening for school children showed a great advance and the computerized devices for automatic evaluation of selected leads ECG and PCG were developed rapidly and have been improved in Japan. Two systems of heart disease screening for school children have been developed, that is, the Tokyo system and the "ECG-PCG for all children system". The Tokyo system utilizes a questionnaire, a physical examination by school physicians and a chest X-ray for the primary screening procedure and ECG-PCG for the secondary procedure. The "ECG-PCG for all children system" utilizes a questionnaire, a chest X-ray and ECG-PCG. The superiority of the ECG-PCG system was shown in comparison with the Tokyo system. Nearly twice as many cases of congenital heart disease were detected by the ECG-PCG system as compared with the Tokyo system, and many cases were disclosed for the first time. The "ECG-PCG for all children system" will probably be more popular in the near future in accordance with the advance of computerized systems.

Adolescent↗

Early and late postoperative studies in coronary arterial lesions resulting from Kawasaki's disease in children.

From October, 1976, to February, 1980, eight children with coronary arterial lesions resulting from Kawasaki's disease underwent surgical treatment--aorta-coronary bypass, aorta-coronary bypass combined with right coronary aneurysmectomy, and aorta-coronary bypass combined with left ventricular aneurysmectomy. The autogenous saphenous vein was used for the bypass grafts. Selective angiography preformed 1 month after the operation revealed an early patency rate of 85%. Seven patients are now leading a normal school life, but one patient died suddenly during relatively strenuous exercise 3 years after the operation. Angiography performed in five patients 1 to 3 years after the operation and autopsy examination in one decreased patient revealed the late patency rate to be 56%. The relatively higher attrition rate of the grafts in the later stage might be ascribed to the smaller caliber of the coronary artery and saphenous vein, to possible inflammatory changes in both the graft and coronary arteries, or to unknown metabolic differences between children and adults.

Adolescent↗

Cardiac surgery of eight children with Kawasaki disease (mucocutaneous lymph node syndrome).

The coronary arterial lesions of Kawasaki disease are characterized by multiple stenoses and aneurysms, which might lead to myocardial ischemia, myocardial infarction, mitral insufficiency due to ischemic papillary muscle dysfunction, ventricular aneurysm, etc. Eight children aged 6 to 13 years with Kawasaki disease underwent surgical treatments. These were coronary bypass surgery, coronary bypass surgery combined with right coronary aneurysmectomy and coronary bypass surgery combined with left ventricular aneurysmectomy. The postoperative course was smooth in all the patients. The selective angiography performed 1 month after the operation revealed the patency rate of 85% of the bypass grafts. However, 1 patient died suddenly during strenuous exercise 3 years after the surgery. Several points to be considered in the aortocoronary bypass in the patients with Kawasaki disease are discussed. These include the unknown fate of saphenous vein grafts and the possibility of higher incidences of graft failure in the growing children. Since the long-term postoperative results are as yet not fully understood, close follow-up of the patients treated by aortocoronary bypass surgery would be mandatory.

Adolescent↗