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Hama N, Sunaga Y, Ochiai H, Kokaze A, Watanabe H, Kurosawa M, Azukizawa H, Asada H, Watanabe Y, Yamaguchi Y, Aihara M, Mizukawa Y, Ohyama M, Hashizume H, Nakajima S, Nomura T, Kabashima K, Tohyama M, Hasegawa A, Takahashi H, Mieno H, Ueta M, Sotozono C, Niihara H, Morita E, Brüggen MC, Feingold IM, Jeschke MG, Dodiuk-Gad RP, Oppel EM, French LE, Chen WT, Chung WH, Chu CY, Kang HR, Ingen-Housz-Oro S, Nakamura K, Sueki H, Abe R. Development and Validation of a Novel Score to Predict Mortality in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: CRISTEN. J Allergy Clin Immunol Pract 2023; 11:3161-3168.e2. [PMID: 37429419 DOI: 10.1016/j.jaip.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 06/13/2023] [Accepted: 07/02/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening, severe mucocutaneous adverse reactions. Severity prediction at early onset is urgently required for treatment. However, previous prediction scores have been based on data of blood tests. OBJECTIVE This study aimed to present a novel score that predicts mortality in patients with SJS/TEN in the early stages based on only clinical information. METHODS We retrospectively evaluated 382 patients with SJS/TEN in a development study. A clinical risk score for TEN (CRISTEN) was created according to the association of potential risk factors with death. We calculated the sum of these risk factors using CRISTEN, and this was validated in a multinational survey of 416 patients and was compared with previous scoring systems. RESULTS The significant risk factors for death in SJS/TEN comprised 10 items, including patients' age of ≥65 years, ≥10% body surface area involvement, the use of antibiotics as culprit drugs, the use of systemic corticosteroid therapy before the onset, and mucosal damage affecting the ocular, buccal, and genital mucosa. Renal impairment, diabetes, cardiovascular disease, malignant neoplasm, and bacterial infection were included as underlying diseases. The CRISTEN model showed good discrimination (area under the curve [AUC] = 0.884) and calibration. In the validation study, the AUC was 0.827, which was statistically comparable to those of previous systems. CONCLUSION A scoring system based on only clinical information was developed to predict mortality in SJS/TEN and was validated in an independent multinational study. CRISTEN may predict individual survival probabilities and direct the management and therapy of patients with SJS/TEN.
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Affiliation(s)
- Natsumi Hama
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yuma Sunaga
- Department of Dermatology, Showa University School of Medicine, Tokyo, Japan; Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hirotaka Ochiai
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Akatsuki Kokaze
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hideaki Watanabe
- Department of Dermatology, Showa University School of Medicine, Tokyo, Japan
| | - Michiko Kurosawa
- Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, Tokyo, Japan
| | | | - Hideo Asada
- Department of Dermatology, Nara Medical University, Nara, Japan
| | - Yuko Watanabe
- Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Yukie Yamaguchi
- Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Michiko Aihara
- Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Yoshiko Mizukawa
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Manabu Ohyama
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Hideo Hashizume
- Department of Dermatology, Iwata City Hospital, Shizuoka, Japan
| | - Saeko Nakajima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takashi Nomura
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kenji Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Mikiko Tohyama
- Department of Dermatology, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
| | - Akito Hasegawa
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hayato Takahashi
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Hiroki Mieno
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Mayumi Ueta
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Chie Sotozono
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroyuki Niihara
- Department of Dermatology, Shimane University Faculty of Medicine, Shimane, Japan
| | - Eishin Morita
- Department of Dermatology, Shimane University Faculty of Medicine, Shimane, Japan
| | - Marie-Charlotte Brüggen
- Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland; Faculty of Medicine, University of Zurich, Zurich, Switzerland; Christine Kühne Foundation for Allergy Research and Education (CK Care), Davos, Switzerland
| | | | - Marc G Jeschke
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Roni P Dodiuk-Gad
- Technion-Israel Institute of Technology, Haifa, Israel; Department of Dermatology, Emek Medical Center, Afula, Israel; Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Medicine, University of Toronto, Ontario, Canada
| | - Eva Maria Oppel
- Department of Dermatology and Allergy, University Hospital, LMU, Munich, Germany
| | - Lars E French
- Department of Dermatology and Allergy, University Hospital, LMU, Munich, Germany; Dr. Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Fla
| | - Wei-Ti Chen
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Keelung, Linkou, Taipei, Taiwan
| | - Wen-Hung Chung
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Keelung, Linkou, Taipei, Taiwan
| | - Chia-Yu Chu
- Department of Dermatology, National Taiwan University Hospital and National Taiwan College of Medicine, Taipei, Taiwan
| | - Hye-Ryun Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Saskia Ingen-Housz-Oro
- Department of Dermatology, AP-HP, Henri Mondor Hospital, Créteil, France; Univ Paris Est Créteil EpidermE, Créteil, France; Reference Center for Toxic Bullous Diseases TOXIBUL, Créteil, France
| | - Kazutoshi Nakamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hirohiko Sueki
- Department of Dermatology, Showa University School of Medicine, Tokyo, Japan
| | - Riichiro Abe
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
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Sunaga Y, Hama N, Ochiai H, Kokaze A, Lee ES, Watanabe H, Kurosawa M, Azukizawa H, Asada H, Watanabe Y, Yamaguchi Y, Aihara M, Mizukawa Y, Ohyama M, Abe R, Hashizume H, Nakajima S, Nomura T, Kabashima K, Tohyama M, Takahashi H, Mieno H, Ueta M, Sotozono C, Niihara H, Morita E, Sueki H. Risk factors for sepsis and effects of pretreatment with systemic steroid therapy for underlying condition in SJS/TEN patients: Results of a nationwide cross-sectional survey in 489 Japanese patients. J Dermatol Sci 2022; 107:75-81. [DOI: 10.1016/j.jdermsci.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 06/23/2022] [Accepted: 07/10/2022] [Indexed: 11/27/2022]
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Shirasawa T, Ochiai H, Yoshimoto T, Nagahama S, Kobayashi M, Ohtsu I, Sunaga Y, Kokaze A. Associations between normal weight central obesity and cardiovascular disease risk factors in Japanese middle-aged adults: a cross-sectional study. J Health Popul Nutr 2019; 38:46. [PMID: 31849344 PMCID: PMC6918653 DOI: 10.1186/s41043-019-0201-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 11/05/2019] [Indexed: 05/22/2023]
Abstract
BACKGROUND Several studies have shown that normal weight central obesity (NWCO) is associated with cardiovascular disease (CVD) risk factors. However, studies conducted in the Japanese population have been very limited. Thus, the relationships between normal weight central obesity, classified using body mass index (BMI), the waist-to-height ratio (WHtR), and CVD risk factors in middle-aged Japanese adults were investigated. METHODS The participants were Japanese adults aged 40-64 years who had undergone periodic health examinations in Japan during the period from April 2013 to March 2014. The participants were categorized into the following four groups: normal weight (BMI 18.5-24.9 kg/m2) and no central obesity (WHtR < 0.5) (NW); normal weight and central obesity (WHtR ≥ 0.5) (NWCO); obesity (BMI ≥ 25 kg/m2) and no central obesity (OB); and obesity and central obesity (OBCO). Hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or taking medication for hypertension. Dyslipidemia was defined as LDL-C ≥ 140 mg/dl, HDL-C < 40 mg/dl, triglyceride ≥ 150 mg/dl, or taking medication for dyslipidemia. Diabetes was defined as fasting plasma glucose ≥ 126 mg/dl, random plasma glucose ≥ 200 mg/dl, HbA1c ≥ 6.5%, or receiving medical treatment for diabetes mellitus. A logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for hypertension, dyslipidemia, and diabetes. RESULTS A total of 117,163 participants (82,487 men and 34,676 women) were analyzed. The prevalence of NWCO was 15.6% in men and 30.2% in women. With reference to NW, the ORs for hypertension (adjusted OR 1.22, 95% CI 1.17-1.27 in men, 1.23, 1.16-1.31 in women), dyslipidemia (1.81, 1.74-1.89 in men, 1.60, 1.52-1.69 in women), and diabetes (1.35, 1.25-1.46 in men, 1.60, 1.35-1.90 in women) were significantly higher in NWCO. CONCLUSIONS Normal weight with central obesity was associated with CVD risk factors, such as hypertension, dyslipidemia, and diabetes, compared with normal weight without central obesity, regardless of sex. It is important to focus on normal weight with central obesity for the prevention of CVD in Japanese middle-aged adults.
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Affiliation(s)
- Takako Shirasawa
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan
| | - Hirotaka Ochiai
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan
| | - Takahiko Yoshimoto
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan
| | - Satsue Nagahama
- All Japan Labor Welfare Foundation, 6-16-11 Hatanodai, Shinagawa-ku, Tokyo, 142-0064 Japan
| | - Mariko Kobayashi
- All Japan Labor Welfare Foundation, 6-16-11 Hatanodai, Shinagawa-ku, Tokyo, 142-0064 Japan
| | - Iichiro Ohtsu
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan
| | - Yuma Sunaga
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan
| | - Akatsuki Kokaze
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan
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Koizumi K, Hosiai M, Katsumata N, Toda T, Kise H, Hasebe Y, Kono Y, Sunaga Y, Yoshizawa M, Watanabe A, Moriguchi T, Matsuda K, Sugita K. P3794Plasma exchange regulates CD14+CD16+ activated monocytes and CD4+CD25+FOXP3+ regulatory T cells in Kawasaki disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- K Koizumi
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - M Hosiai
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - N Katsumata
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - T Toda
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - H Kise
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - Y Hasebe
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - Y Kono
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - Y Sunaga
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - M Yoshizawa
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - A Watanabe
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
| | - T Moriguchi
- Faculty of Medicine, University of Yamanashi, Department of Emergency and Critical Care Medicine, Chuo, Yamanashi, Japan
| | - K Matsuda
- Faculty of Medicine, University of Yamanashi, Department of Emergency and Critical Care Medicine, Chuo, Yamanashi, Japan
| | - K Sugita
- Faculty of Medicine, University of Yamanashi, Department of Pediatrics, Chuo, Yamanashi, Japan
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Shirasawa T, Ochiai H, Yoshimoto T, Matoba M, Sunaga Y, Hoshino H, Kokaze A. Effects of eating dinner alone on overweight in Japanese adolescents: a cross-sectional survey. BMC Pediatr 2018; 18:36. [PMID: 29415682 PMCID: PMC5803896 DOI: 10.1186/s12887-018-1041-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 01/30/2018] [Indexed: 11/10/2022] Open
Abstract
Background The decrease in the frequency of family meals among Asian youth is often lamented. In Japan, adolescents who eat breakfast alone might have an unhealthy diet, which increases the risk of overweight or obese. However, there are few studies on the relationship between eating dinner alone and overweight in Japanese adolescents. Here, we investigated if eating dinner alone is associated with being overweight in Japanese adolescents of each sex. Methods The participants consisted of 890 seventh graders (12–13 years of age) from the junior high schools of Ina, Japan who were recruited from 2011 to 2012. Information about eating dinner alone was obtained using a self-reported questionnaire, which was given to each participant. The participants were classified into the following three groups: does not eat alone, eats alone 1–2 times/week, or eats alone ≥3 times/week. A logistic regression model was used to examine the relationship between eating dinner alone and being overweight. The height and weight of each participant were measured. Childhood overweight status was defined using the body mass index cutoff points proposed by the International Obesity Task Force. Results When compared with girls who did not eat dinner alone, a significantly increased odds ratio (OR) was observed among girls who ate dinner alone ≥1 time/week (adjusted OR = 2.78; 95% confidence interval = 1.21–6.38). In contrast, there was no statistically significant difference between eating dinner alone and being overweight among boys. Conclusion The present study found that eating dinner alone is associated with being overweight among adolescent girls in this community in Japan. Therefore, reducing the frequency of eating dinner alone might contribute to decreasing the risk for becoming overweight or obese among adolescent girls.
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Affiliation(s)
- Takako Shirasawa
- Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan.
| | - Hirotaka Ochiai
- Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Takahiko Yoshimoto
- Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Masaaki Matoba
- Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Yuma Sunaga
- Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Hiromi Hoshino
- Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Akatsuki Kokaze
- Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
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Uemura H, Kosaka T, Sumitomo M, Harada K, Sugimoto M, Hayashi N, Yoshimura K, Fukasawa S, Ecstein-Fraisse E, Sunaga Y, Oya M. Cabazitaxel plus prednisolone with primary prophylaxis with pegfilgrastim (PEG) in Japanese patients with metastatic castration-resistant prostate cancer: An open label prospective phase 2 study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx676.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Yamazaki K, Satoh T, Komatsu Y, Taguchi T, Sunaga Y, Yoshino T. Impact of KRAS mutational status and primary tumor location on the efficacy of aflibercept plus FOLFIRI in Japanese patients with metastatic colorectal cancer: An exploratory analysis in a phase II study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx659.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kuré K, Sunaga Y, Hatano S, Imagawa T. Experimentelle und pathologische Studien über die progressive Muskelatrophie. ACTA ACUST UNITED AC 2016. [DOI: 10.1007/bf02622793] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kuré K, Imagawa T, Hatano S, Sunaga Y. Experimentelle und pathologische Studien über die progressive Muskelatrophie. ACTA ACUST UNITED AC 2016. [DOI: 10.1007/bf02622792] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sunaga Y, Anan M, Takahashi M, Shinkoda K. Body segment inertial parameters estimation of the lower trunk of pregnant Japanese women aimed at practical using in motion analysis. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kido S, Yu W, Nakajima Y, Tanaka T, Miyasaka T, Shirogane S, Yamanaka Y, Sunaga Y, Maruoka H, Takayanagi K. Effects of combined training with breathing resistance and sustained physical exertion on cardiorespiratory endurance in middle-aged and elderly subjects. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.3611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kishida N, Sakoda Y, Isoda N, Matsuda K, Eto M, Sunaga Y, Umemura T, Kida H. Pathogenicity of H5 influenza viruses for ducks. Arch Virol 2005; 150:1383-92. [PMID: 15747052 DOI: 10.1007/s00705-004-0473-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2004] [Accepted: 11/22/2004] [Indexed: 10/25/2022]
Abstract
Four H5N1 highly pathogenic avian influenza (HPAI) viruses and an avirulent reassortant H5N1 virus were tested for their pathogenicity in domestic ducks. A/chicken/Yamaguchi/7/04 (H5N1) (Ck/Yamaguchi/04) isolated from a dead bird during the HPAI outbreak in Japan and A/duck/Yokohama/aq-10/03 (H5N1) (Dk/Yokohama/03) isolated from duck meat at a quarantine inspection for importation from China replicated in multiple organs including the brain of ducks. The ducks infected with Ck/Yamaguchi/04 did not show any clinical signs, while those infected with Dk/Yokohama/03 showed neurological signs. The ducks infected either with A/Hong Kong/483/97 (H5N1) or A/tern/South Africa/61 (H5N3), or with an avirulent H5N1 reassortant, did not show any clinical signs. Virus-specific antibodies were detected in the sera of the ducks infected with each of the five strains tested, indicating that all of the viral strains infected and replicated in the birds. Dk/Yokohama/03 grew in multiple organs more rapidly than did Ck/Yamaguchi/04. Considerable titers of virus were detected in the brain of the ducks infected with Dk/Yokohama/03 and these birds showed neurological signs. The present results demonstrate that the pathogenicity of influenza viruses for ducks does not correlate with that for chickens and that replication of the virus in the brain is critical for ducks to show neurological signs.
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Affiliation(s)
- N Kishida
- Laboratory of Microbiology, Department of Disease Control, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan
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Kishida N, Sakoda Y, Eto M, Sunaga Y, Kida H. Co-infection of Staphylococcus aureus or Haemophilus paragallinarum exacerbates H9N2 influenza A virus infection in chickens. Arch Virol 2004; 149:2095-104. [PMID: 15503199 DOI: 10.1007/s00705-004-0372-1] [Citation(s) in RCA: 124] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2004] [Accepted: 05/24/2004] [Indexed: 10/26/2022]
Abstract
H9N2 influenza viruses are frequently isolated from chicken meat and bone marrow imported from China to Japan since 2001. These isolates were experimentally inoculated into specific pathogen-free chickens intranasally. Viruses were recovered from the meat and bone marrow of birds showing no overt signs. On the other hand, chickens co-infected with H9N2 virus and either Staphylococcus aureus or Haemophilus paragallinarum showed clinical signs severer than those shown by birds infected only with the virus alone or each of the bacteria alone. In addition, H9N2 viruses were more efficiently recovered from the chickens co-infected with S. aureus or H. paragallinarum than those from the birds infected with only the virus. The present results indicate that co-infection of H9N2 influenza virus with S. aureus or H. paragallinarum enhances the replication of the virus in chickens, resulting in exacerbation of the H9N2 virus infection.
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Affiliation(s)
- N Kishida
- Laboratory of Microbiology, Department of Disease Control, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan
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Sunaga Y, Gonoi T, Shibasaki T, Ichikawa K, Kusama H, Yano H, Seino S. The effects of mitiglinide (KAD-1229), a new anti-diabetic drug, on ATP-sensitive K+ channels and insulin secretion: comparison with the sulfonylureas and nateglinide. Eur J Pharmacol 2001; 431:119-25. [PMID: 11716850 DOI: 10.1016/s0014-2999(01)01412-1] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Mitiglinide (KAD-1229), a new anti-diabetic drug, is thought to stimulate insulin secretion by closing the ATP-sensitive K+ (K(ATP)) channels in pancreatic beta-cells. However, its selectivity for the various K(ATP) channels is not known. In this study, we examined the effects of mitiglinide on various cloned K(ATP) channels (Kir6.2/SUR1, Kir6.2/SUR2A, and Kir6.2/SUR2B) reconstituted in COS-1 cells, and compared them to another meglitinide-related compound, nateglinide. Patch-clamp analysis using inside-out recording configuration showed that mitiglinide inhibits the Kir6.2/SUR1 channel currents in a dose-dependent manner (IC50 value, 100 nM) but does not significantly inhibit either Kir6.2/SUR2A or Kir6.2/SUR2B channel currents even at high doses (more than 10 microM). Nateglinide inhibits Kir6.2/SUR1 and Kir6.2/SUR2B channels at 100 nM, and inhibits Kir6.2/SUR2A channels at high concentrations (1 microM). Binding experiments on mitiglinide, nateglinide, and repaglinide to SUR1 expressed in COS-1 cells revealed that they inhibit the binding of [3H]glibenclamide to SUR1 (IC50 values: mitiglinide, 280 nM; nateglinide, 8 microM; repaglinide, 1.6 microM), suggesting that they all share a glibenclamide binding site. The insulin responses to glucose, mitiglinide, tolbutamide, and glibenclamide in MIN6 cells after chronic mitiglinide, nateglinide, or repaglinide treatment were comparable to those after chronic tolbutamide and glibenclamide treatment. These results indicate that, similar to the sulfonylureas, mitiglinide is highly specific to the Kir6.2/SUR1 complex, i.e., the pancreatic beta-cell K(ATP) channel, and suggest that mitiglinide may be a clinically useful anti-diabetic drug.
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Affiliation(s)
- Y Sunaga
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University 1-8-1 Inohana, Chuo-ku, 260-8670, Chiba, Japan
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Sunaga Y, Hata T, Sunaga M, Tsuda N. [An 81-year-old man with a hilar mass demonstrated by computed tomography]. J Cardiol 2000; 36:411-4. [PMID: 11190585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- Y Sunaga
- Department of Internal Medicine, Kori Hospital, Kansai Medical University, Korihondori-cho 8-45, Neyagawa, Osaka 572-8551
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16
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Ozaki N, Shibasaki T, Kashima Y, Miki T, Takahashi K, Ueno H, Sunaga Y, Yano H, Matsuura Y, Iwanaga T, Takai Y, Seino S. cAMP-GEFII is a direct target of cAMP in regulated exocytosis. Nat Cell Biol 2000; 2:805-11. [PMID: 11056535 DOI: 10.1038/35041046] [Citation(s) in RCA: 361] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although cAMP is well known to regulate exocytosis in many secretory cells, its direct target in the exocytotic machinery is not known. Here we show that cAMP-GEFII, a cAMP sensor, binds to Rim (Rab3-interacting molecule, Rab3 being a small G protein) and to a new isoform, Rim2, both of which are putative regulators of fusion of vesicles to the plasma membrane. We also show that cAMP-GEFII, through its interaction with Rim2, mediates cAMP-induced, Ca2+-dependent secretion that is not blocked by an inhibitor of cAMP-dependent protein kinase (PKA). Accordingly, cAMP-GEFII is a direct target of cAMP in regulated exocytosis and is responsible for cAMP-dependent, PKA-independent exocytosis.
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Affiliation(s)
- N Ozaki
- Department of Molecular Medicine, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
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17
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Ban N, Yamada Y, Someya Y, Ihara Y, Adachi T, Kubota A, Watanabe R, Kuroe A, Inada A, Miyawaki K, Sunaga Y, Shen ZP, Iwakura T, Tsukiyama K, Toyokuni S, Tsuda K, Seino Y. Activating transcription factor-2 is a positive regulator in CaM kinase IV-induced human insulin gene expression. Diabetes 2000; 49:1142-8. [PMID: 10909971 DOI: 10.2337/diabetes.49.7.1142] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Insulin plays a crucial role in the regulation of glucose-homeostasis, and its synthesis is regulated by several stimuli. The transcription of the human insulin gene, enhanced by an elevated intracellular concentration of calcium ions, was completely blocked by Ca2+/calmodulin-dependent protein kinase inhibitor. The activity of the transcription factor activating transcription factor-2 (ATF-2), which binds to the cAMP responsive elements of the human insulin gene, was enhanced by Ca2+/calmodulin-dependent protein kinase IV (CaMKIV). Mutagenesis studies showed that Thr69, Thr71, and Thr73 of ATF-2 are all required for activation by CaMKIV. CaMKIV-induced ATF-2 transcriptional activity was not altered by activation of cJun NH2-terminal protein kinase (JNK) or p38 mitogen-activated protein (MAP) kinase. Furthermore, when transfected into rat primary cultured islets, ATF-2 enhanced glucose-induced insulin promoter activity, whereas cAMP response element-binding protein (CREB) repressed it. These results suggest a mechanism in which ATF-2 regulates insulin gene expression in pancreatic beta-cells, with the transcriptional activity of ATF-2 being increased by an elevated concentration of calcium ions.
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Affiliation(s)
- N Ban
- Department of Metabolism and Clinical Nutrition, Graduate School of Medicine, Kyoto University, Japan
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18
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Abstract
We compared the effects of the two thiazolidinedione derivatives, troglitazone and pioglitazone, on ATP-sensitive K(+) (K(ATP)) channel activities. Pancreatic beta-cell type and cardiac type K(ATP) channels were reconstituted in COS-1 cells (SV 40-transformed African green monkey kidney (AGMK) cells) by heterologously expressing sulfonylurea receptor 1 (SUR1) plus Kir6.2 and sulfonylurea receptor 2A (SUR2A) plus Kir6.2, respectively. Troglitazone inhibited [86Rb(+)] efflux in both K(ATP) channel types in the presence of metabolic inhibitors, which was confirmed by electrophysiological techniques. The [86Rb(+)] efflux increased by the channel openers diazoxide and pinacidil was abolished by troglitazone. In contrast, pioglitazone did not affect these channel activities in either type K(ATP) channel. These results suggest that troglitazone modulates the various cellular functions including insulin secretion by inhibiting the K(ATP) channels, while pioglitazone has no effect on K(ATP) channel activity.
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Affiliation(s)
- Y Sunaga
- Department of Metabolism and Clinical Nutrition, Kyoto University Graduate School of Medicine, 54, Shogoin Kawahara-cho, Sakyo-ku, Kyoto, Japan
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19
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Watanabe R, Yamada Y, Ihara Y, Someya Y, Kubota A, Kagimoto S, Kuroe A, Iwakura T, Shen ZP, Inada A, Adachi T, Ban N, Miyawaki K, Sunaga Y, Tsuda K, Seino Y. The MH1 domains of smad2 and smad3 are involved in the regulation of the ALK7 signals. Biochem Biophys Res Commun 1999; 254:707-12. [PMID: 9920806 DOI: 10.1006/bbrc.1998.0118] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The biological responses of the transforming growth factor beta (TGF-beta) superfamily are induced by activation of a receptor complex and Smad proteins. We surveyed the TGF-beta superfamily receptors using the degenerate PCR strategy, and found activin receptor-like kinase 7 (ALK7) to be abundantly expressed in fetal rat pancreatic islets. ALK7 is also expressed in adult rat islets and pancreatic beta-cell-derived MIN6 cells. The constitutively active form of ALK7, ALK7(T194D), activated Smad3 and a chimeric Smad protein, Smad3-2, containing the MH1 domain of Smad3 and the MH2 domain of Smad2, and translocated them to nuclei and then induced activation of the human PAI-1 promoter. However, neither Smad2 nor Smad2-3 protein, containing the MH1 domain of Smad2 and the MH2 domain of Smad3 were activated. These results indicate that the ALK7 signal regulates nuclear localization and activation of Smad2 and Smad3, and the MH1 domain of Smad2 has inhibitory effects on the nuclear localization.
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Affiliation(s)
- R Watanabe
- Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Kyoto, 606-8507, Japan
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20
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Yamada Y, Sunaga Y. [ATP-sensitive potassium channel--sulfonylurea receptor]. Nihon Rinsho 1997; 55 Suppl:458-62. [PMID: 9392149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Y Yamada
- Department of Metabolism and Clinical Nutrition, Faculty of Medicine, Kyoto University
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21
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Kurosawa M, Sunaga Y, Tanaka T. Antipyretic effect of Lumbricus spencer in acetylsalicylic acid-induced asthma. Arzneimittelforschung 1996; 46:172-4. [PMID: 8720308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Lumbricus spencer, which has been used as an antipyretic in Chinese and Japanese folk medicine and whose antipyretic components are identified to be eicosatetraenoic acid and eicosapentaenoic acid, was given orally in a single dose of 500 mg to febrile patients with acetylsalicylic acid-induced asthma (AIA) in placebo-controlled design. The antipyretic effect of Lumbricus spencer was observed with no exacerbation of asthmatic symptoms. Single oral administration of 500 mg of Lumbricus spencer did not affect the respiratory functions in the patients. Moreover, there were no significant changes in symptom scores and airway lability as measured by daily variations in peak expiratory flow after one week administration of 1500 mg/d of Lumbricus spencer. This pilot study suggests that Lumbricus spencer can be administered safely to febrile patients with AIA without bronchospasm.
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Affiliation(s)
- M Kurosawa
- Department of Medicine, Gunma University School of Medicine, Japan
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22
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Abstract
A 2-year-old boy, with the primary difficulties of nausea and vomiting, developed a staggering gait and dysarthria 10 days after varicella vaccination. Magnetic resonance imaging demonstrated multiple areas of high signal intensity in the white matter of the cerebellum, predominantly in the parieto-occipital white matter and both globus pallidi. He did not present any signs of myelitis or encephalitis and thus his cerebellar dysfunction was diagnosed as acute cerebellar ataxia, which is, generally speaking, not an etiologic entity but a clinical syndrome. Magnetic resonance imaging may reveal a variety of abnormalities of the central nervous system in acute cerebellar ataxia.
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Affiliation(s)
- Y Sunaga
- Department of Pediatrics, Gunma University School of Medicine, Japan
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23
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Abstract
We investigated potential renal functional impairment induced by chronic use of anti-epileptic drugs (AEDs) in 79 epileptic children. They were divided into five groups: valproic acid (VPA) monotherapy where the serum concentration (SC) of VPA was no less than 60 micrograms/ml (VPA [SC > or = 60]) (15 cases), VPA monotherapy where the SC VPA was less than 60 micrograms/ml (VPA [SC < 60]) (29 cases), phenobarbital monotherapy (PB) (7 cases), carbamazepine monotherapy (CBZ) (16 cases), and polytherapy containing VPA (12 cases). Urinalysis (proteinuria and hematuria) and serum creatinine were normal except for two cases of proteinuria and two cases of hematuria. The level of urinary excretion of N-acetyl-beta-glucosaminidase (u-NAG) was high in 29% of all patients, and 47% of VPA (SC > or = 60), 38% of CBZ, 25% of polytherapy, and 24% of VPA (SC < 60) groups. There was a significant positive correlation between serum concentration of VPA and u-NAG/urinary creatinine (u-Cr). The level of guanidinoacetic acid (u-GAA) excreted in the urine was normal except in one patient. U-NAG/u-Cr may be a more sensitive marker than u-GAA/u-Cr for renal functional impairment in AED therapy.
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Affiliation(s)
- T Otsuka
- Department of Pediatrics, Gunma University School of Medicine, Maebashi, Japan
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24
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Otsuka T, Ohshima Y, Sunaga Y, Nagashima K. Primary pulmonary choriocarcinoma in a four month old boy complicated with precocious puberty. Acta Paediatr Jpn 1994; 36:404-7. [PMID: 7942004 DOI: 10.1111/j.1442-200x.1994.tb03210.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A four month old boy with pulmonary choriocarcinoma, showing iso-sexual precocious puberty is reported. His serum human chorionic gonadotropin (HCG) was highly elevated. A round isolated tumor in the right lung, found by chest X-ray, magnetic resonance imaging and gallium scintigraphy, was removed surgically a month and a half after clinical manifestations were noticed. It was determined to be choriocarcinoma on the basis of histological findings and positive HCG on histochemical examination. Skull irradiation and chemotherapy (cisplatinum, vinblastine and bleomycin) had only a transient effect on reducing tumor size and normalizing the serum level of HCG. This case suggests that a more effective treatment regimen needs to be established.
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Affiliation(s)
- T Otsuka
- Department of Pediatrics, Gunma University School of Medicine, Japan
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25
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Abstract
To evaluate the cognitive function of epileptic children, we examined P300 in 50 patients, 32 with idiopathic generalized epilepsy (IGE) and 18 with temporal lobe epilepsy (TLE), and 39 normal children. There were significant negative correlations between age and P300 latencies at Pz and Cz in normal controls. For data analysis, we used the age-corrected latency, which was calculated as the interval between the actual and predicted P300 latencies. The predicted latency was calculated with the regression equation as the relationship between P300 latency and age in normal controls. The age-corrected P300 latencies recorded from Pz and Cz were significantly longer in patients with IGE (41.5 +/- 13.1, 42.0 +/- 12.5) than in control subjects (0 +/- 7.5, 0 +/- 7.9). There were no significant differences in age-corrected P300 latencies between patients with TLE (21.2 +/- 17.6, 31.5 +/- 17.0) and controls, or IGE and TLE. Recently, it was considered that the mesencephalic reticular formation and thalamus may play major roles in the genesis of generalized epilepsy, so we speculate that dysfunction of these systems may contribute to the prolongation of P300 in children with idiopathic generalized epilepsy.
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Affiliation(s)
- Y Sunaga
- Department of Pediatrics, Gunma University School of Medicine, Japan
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26
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Abstract
Two brothers, aged 6 and 4 years, with an unbalanced chromosome translocation (partial trisomy 1), and their mother, a balanced carrier of the translocation, t(1;3)(q42.3;p26.3), were described. Both patients show minor anomalies; a large head with a prominent forehead, low-set and soaring ears, a high-arched palate, a shallow nasal bridge, hypertelorism, and slender hands and feet. The manifestations in our cases were very mild compared to in the previously reported cases of partial trisomy 1. And our patients exhibit psychomotor retardation and ventricular dilatation on brain CT. We speculated that the amount of extra material reflects the phenotype. Our cases and previous reports indicate that the minimum clinical features of partial trisomy 1 are poor psychomotor development, a prominent forehead, and slender hands and feet. And many cases have macrocephaly with ventricular dilatation or hydrocephalus. So these features may be a key for the diagnosis of very mild partial trisomy 1.
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Affiliation(s)
- Y Sunaga
- Department of Pediatrics, Gunma University School of Medicine, Japan
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27
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Sunaga Y, Ohtsuka T, Fujinaga T. [A female child with Down syndrome complicated by spinal cord compression by atlanto-axial dislocation]. No To Hattatsu 1993; 25:65-9. [PMID: 8416698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
A 3-year-old girl with Down syndrome was admitted to our hospital, associated with hypotonia and dyspnea. She presented frog-posture and shallow breathing. The blood gas analysis revealed hypercapnic acidosis with pH 7.371, PO2 74.6 mmHg, PCO2 52.6 mmHg, and BE 3.5. The cervical X-ray films with flexion and extension of head showed anterior dislocation of the atlanto-axial articulation. Magnetic resonance imaging clearly showed a severe cord compression between C1 and C2. In children, spinal cord compression induced by dislocation of the atlanto-axial articulation is very rare. However, we should take into consideration of this insidious risk associated often with Down syndrome.
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Affiliation(s)
- Y Sunaga
- Department of Pediatrics, Gunma University School of Medicine
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28
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Sunaga Y, Hayashi K, Okubo N, Taniichi Y, Sugiura T, Tsuda N, Iwasaka T, Inada M. Transesophageal echocardiographic diagnosis of coronary sinus type atrial septal defect. Am Heart J 1992; 124:1657-9. [PMID: 1462940 DOI: 10.1016/0002-8703(92)90099-h] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Y Sunaga
- Second Department of Internal Medicine, Kansai Medical University, Osaka, Japan
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29
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Abstract
To evaluate the effect of chronic hypoxemia on brainstem maturation, auditory brainstem responses were examined in 70 children (32 with and 38 without cyanosis) who had congenital heart disease. Ninety-one age-matched normal children served as controls. At 1-3 months of age, the I-V interpeak latencies of cyanotic infants (mean +/- S.D.; 5.17 +/- 0.17 ms) were more prolonged than were those of controls (4.95 +/- 0.11 ms) and those without cyanosis (4.84 +/- 0.22 ms; P < .05; P < .01). At 4-11 months of age, the I-V interpeak latencies of cyanotic infants (4.85 +/- 0.13 ms) were more prolonged than were those of controls (4.67 +/- 0.19 ms) and those not experiencing cyanosis (4.5 +/- 0.17 ms; P < .05; P < .01). In the cyanotic children, there was a significant negative correlation between the I-V interpeak latency and oxygen partial pressure (P < .01) or oxygen saturation (P < .05). Three of the 70 patients (4.3%) with congenital heart disease had absent auditory brainstem response. These data indicate that chronic hypoxemia may be one of the factors in retarded brainstem maturation.
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Affiliation(s)
- Y Sunaga
- Department of Pediatrics, School of Medicine, Gunma University, Japan
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30
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Tamura H, Shimoyama S, Sunaga Y, Sakaguchi M, Kuroume T. Digoxin-like immunoreactive substance in urine of patients with mucocutaneous lymph node syndrome (MCLS). Angiology 1992; 43:856-65. [PMID: 1335703 DOI: 10.1177/000331979204301009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Levels of digoxin-like immunoreactive substance (DLIS) and dehydroepiandrosterone sulfate (DHEA) in urine from patients with mucocutaneous lymph node syndrome (MCLS) were measured by radioimmunoassay. Because DLIS of stored samples was often below the level of detection by conventional immunoassay, the authors used 80% ammonium sulfate and extraction with phosphate buffer and then 80% hot ethanol. To study the origin of raised levels of DLIS in urine, the synthesis of DLIS by cultured human umbilical vein endothelial cells (HUVEC) was tested in vitro. The correlation between DLIS and DHEA levels was not significant. Mean levels of urinary DLIS corrected for creatinine in the patients with MCLS were significantly higher than in both normal and diseased controls. The culture medium of HUVEC was found to contain DLIS activity. These results show that MCLS should be added to the clinical states associated with an increased urinary concentration of DLIS and that the endothelial cells are one source of DLIS in man.
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Affiliation(s)
- H Tamura
- Department of Pediatrics, Gunma University School of Medicine, Japan
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31
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Affiliation(s)
- Y Sunaga
- Second Department of Internal Medicine, Kansai Medical University, Osaka, Japan
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32
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Sunaga Y, Fujinaga T, Ohtsuka T. [MRI findings of moyamoya disease in children]. No To Hattatsu 1992; 24:375-9. [PMID: 1520515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Magnetic resonance imaging (MRI) findings were evaluated in two cases with moyamoya disease. A twelve-year-old girl and a five-year-old boy were admitted to our hospital with the complaints of transient ischemic attack. They were diagnosed as having moyamoya disease by cerebral angiogram. MRI clearly presented cerebral infarction by T2-weighted imaging and multiple small round or tortuous hypo_signal areas around the basal ganglia by proton density weighted imaging. These findings were consistent with moyamoya vessels shown by cerebral angiogram. Moyamoya vessels were visualized more clearly on proton density weighted imaging than on T1-weighted imaging. MRI is less invasive than cerebral angiogram and repeated safely. It might play an important role in a follow-up study of morphological changes on moyamoya vessels.
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Affiliation(s)
- Y Sunaga
- Department of Pediatrics, Gunma University School of Medicine
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33
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Inagaki M, Michimata H, Minato K, Sunaga Y, Kobayashi S, Tani G, Nakazawa T. [Inhibitory effect of amlexanox on asthmatic attacks in an aspirin sensitive asthmatic]. Nihon Kyobu Shikkan Gakkai Zasshi 1992; 30:1180-5. [PMID: 1507696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The anti-allergic action of amlexanox is reported to be associated with inhibition of the release of LTC4, LTD4 and histamine, and with antagonistic activity on leukotrienes. The patient was a 18-year-old female who had suffered from bronchial asthma since the age of fifteen. We diagnosed the case as aspirin sensitive asthma because of development of a severe asthmatic attack with syncope after oral administration of an analgesic for treatment of a common cold at the age of seventeen. She also had sensitivity to toothpaste. Three-minute aerosol inhalation challenge with 0.1, 1 and 10% solution of sulpyrine was performed as a stepwise increment at 20 minutes intervals. This inhalation test was positive and it evoked simultaneous increases of LTC4, LTD4 and histamine in the peripheral blood. Since the commencement of oral administration of 150 mg per day of amlexanox, the patient has had no attacks for about 8 months. In the second inhalation test, premedication with amlexanox elevated the threshold of sulpyrine and inhibited the release of LTC4, LTD4 and histamine. We report that amlexanox was of use to control asthmatic attacks in this aspirin-sensitive asthmatic patient.
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Affiliation(s)
- M Inagaki
- First Department of Internal Medicine, Gunma University School of Medicine
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34
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Sunaga Y, Taniichi Y, Okubo N, Hayashi K, Karakawa M, Sugiura T, Iwasaka T, Inada M. Biplane transesophageal echocardiographic study of left coronary artery to right atrium fistula. Am Heart J 1992; 123:1058-60. [PMID: 1549972 DOI: 10.1016/0002-8703(92)90719-c] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Y Sunaga
- Second Department of Internal Medicine, Kansai Medical University, Osaka, Japan
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35
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Sunaga Y, Fujinaga T, Tamura H. [Nemaline myopathy with type 2 fiber predominance; a case report]. No To Hattatsu 1991; 23:380-3. [PMID: 1651744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A 4-year-old boy was admitted to our hospital because of dyspnea and muscle-weakness. His developmental milestones were delayed. His face was long with opened mouth. He spoke with nasal voice. He had proximally dominant muscle weakness and his deep tendon reflexes were absent. Laboratory examination revealed normal serum creatine kinase level and a myopathic EMG pattern. Blood gas analysis revealed metabolic acidosis with PH 7.35, PCO2 55.4 mmHg, PO2 62.4 mmHg, BE 3.0, probably from the metabolic acidosis by respiratory muscle weakness. In the biopsied left biceps brachii muscle, there were scattered fibers with nemaline bodies and abnormal fiber type distribution; type 1, 2 A, 2 B and 2 C fibers comprised 7%, 70%, 21% and 2% respectively. Small type 1 fibers and type 1 fiber predominance are the characteristic and common histochemical findings in nemaline myopathy. Accordingly, type 2 fiber predominance in the present patient is a unique, rare phenomenon. The finding might result from a preferential loss of type 1 motoneurons or muscle fiber type transformation from type 1 to type 2 fibers due to a certain abnormal neuronal influence on developing muscles.
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Affiliation(s)
- Y Sunaga
- Department of Pediatrics, Gunma University Medicla School, Maebashi
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36
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Hayashi K, Dote K, Sunaga Y, Sugiura T, Iwasaka T, Inada M. Evaluation of preload reserve during isometric exercise testing in patients with old myocardial infarction: Doppler echocardiographic study. J Am Coll Cardiol 1991; 17:106-11. [PMID: 1987211 DOI: 10.1016/0735-1097(91)90711-h] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
To estimate the preload reserve in response to an increase in afterload in patients with old myocardial infarction, the relation between the Doppler echocardiographic inflow velocity pattern and left ventricular end-diastolic pressure was investigated during isometric handgrip exercise testing. The study population consisted of 16 normal subjects and 40 patients with old myocardial infarction. The 40 patients were subdivided into two groups according to left ventricular end-diastolic pressure at rest: group I (22 patients), less than 18 mm Hg; group II (18 patients), 18 mm Hg or more. At rest, the ratio of peak velocity in atrial contraction phase to peak velocity in early diastolic filling phase (A/E) was significantly higher in the patients with old myocardial infarction than in normal subjects; values in the two subgroups of myocardial infarction did not differ significantly. The A/E ratio and left ventricular end-diastolic pressure increased significantly during exercise in group I. Conversely, the change in left ventricular end-diastolic pressure during exercise in group II was significantly greater than that in group I, and was associated with a decrease in the A/E ratio. Thus, an atrial compensatory mechanism operated effectively in response to the increase in afterload in patients with a normal left ventricular filling pressure, whereas this compensatory mechanism deteriorated in patients with elevated left ventricular filling pressure due to a limited preload reserve.
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Affiliation(s)
- K Hayashi
- Second Department of Internal Medicine, Kansai Medical University, Osaka, Japan
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37
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Sunaga Y, Fujinaga T, Tamura H. [A study on computed tomography of three cases of Reye syndromes]. No To Hattatsu 1991; 23:100-2. [PMID: 1994987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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38
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Sunaga Y, Taniguchi N, Hayashi K, Koito M, Inada M, Oyaizu N, Shikata N. [An autopsy case of extra-adrenal malignant pheochromocytoma]. Gan No Rinsho 1990; 36:2092-9. [PMID: 1977940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
An autopsy case of an extra-adrenal malignant pheochromocytoma in a 34-year-old woman is reported. On laparotomy, many advanced stage malignant tumors originating from the paraganglia along the abdominal aorta were found to have invaded the lumbar vertebrae. After a partial resection, Co60 radiation therapy of the paraganglia was instituted, as well as of the metastatic lesions, with little effect. It was found that alpha-methyl-tyrosine was effective in controlling the plasma catecholamine, but had to be discontinued because of an untoward effect (anxiety). The patient subsequently developed intractable hypertension and a paralytic ileus from excess catecholamine secretion. As an alpha 1 adrenergic blocker was not effective, we had to use large doses of phentolamine to control these complications. Despite various intensive therapies, however, the patient died of heart failure resulting from 4 years of severe hypertension.
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Affiliation(s)
- Y Sunaga
- 2nd. Dept. of Internal Med., Kansai Med. Univ
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39
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Yamanouchi H, Seki Y, Yanagisawa T, Sunaga Y, Shimizu N. [Two cases of brain infarction associated with hypertriglyceridemia]. No To Hattatsu 1990; 22:364-8. [PMID: 2205253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We reported two cases of brain infarction. They were cousins. Case 1 was a 12-year-old girl, who complained of aphasia, dyscalculia, right-left disorientation and right homonymous hemianopsia. CT showed low density areas in left superior and middle temporal gyri. Case 2 was a 15-year-old boy, who had left hemiplegia and hypesthesia to pain, temperature and touch on the left side of the body. CT showed low density areas from the genu of the internal capsule to the corona radiata, and from the posterior portion of putamen to the posterior limb of the internal capsule on the right side. Both cases had hypertriglyceridemia which might be associated with the etiology of infarction.
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Affiliation(s)
- H Yamanouchi
- Department of Pediatrics, Tone Central Hospital, Numata
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40
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Yoshioka K, Dote K, Uba T, Sunaga Y, Tsuda N, Sugiura T, Karakawa M, Kurimoto T, Inada M. [Effect of isometric hand-grip exercise on left ventricular diastolic filling in patients with effort angina: a pulsed Doppler echocardiographic study]. J Cardiol 1989; 19:433-43. [PMID: 2636625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
To detect myocardial ischemia and to estimate cardiac reserve in patients with effort angina pectoris without history of myocardial infarction, left ventricular diastolic filling was measured using Doppler echocardiography during isometric handgrip exercise. Nineteen patients with effort angina pectoris undergoing coronary angiography and 16 normal subjects were studied. The angina patients were categorized in two groups: 12 with single vessel disease (SVD) and seven with multiple vessel disease (MVD). Fifty percent maximum voluntary contraction isometric handgrip exercise was performed for two minutes. 1. The resting A/R in the angina group was significantly greater than that of the normal subjects (SVD: 1.20 +/- 0.24, MVD: 1.21 +/- 0.27, normal 0.85 +/- 0.10) (p less than 0.001). However, the values of many cases in these three groups overlapped. 2. In SVD, the A/R increased significantly during isometric handgrip exercise (1.20 +/- 0.24 to 1.96 +/- 0.66: p less than 0.001). The delta A/R (0.76 +/- 0.15) was significantly greater than that of patients in other groups (MVD: 0.10 +/- 0.13, normal: 0.09 +/- 0.01) (p less than 0.001). Consequently, the A/R after exercise clearly distinguished the SVD from the normal subjects. 3. In MVD, the A/R did not change significantly during exercise (1.21 +/- 0.27 to 1.31 +/- 0.41), and there were no significant differences in delta A/R as compared to the normal subjects (p less than 0.01). The A/R decreased during exercise in three of the seven patients, and this was markedly different from that of the normal subjects. These findings suggest that assessment of changes in left ventricular diastolic filling during isometric handgrip exercise is useful in detecting myocardial ischemia and in estimating cardiac reserve in patients with effort angina pectoris.
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Affiliation(s)
- K Yoshioka
- Second Department of Internal Medicine, Kansai Medical University, Moriguchi
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41
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Sunaga Y, Nishikawa M, Inaba K, Hirozane N, Inoue N, Shikata N, Inada M. [21-hydroxylase deficiency associated with adrenal tumor: case report of two brothers]. Nihon Naibunpi Gakkai Zasshi 1989; 65:525-36. [PMID: 2789151 DOI: 10.1507/endocrine1927.65.5_525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Described herein are two brothers with 21-hydroxylase deficiency (21-OHD) associated with adrenal tumors, and these possible mechanisms are discussed. A 34-year-old male was admitted on Jan. 9, 1984 because of an enlarged and tender left breast. Physical examination revealed short stature (152 cm, 76.5 kg), gynecomastia and shortening of metacarpal bone. His testes were small (2.6 X 1.6 X 1.9 cm). Urinary excretion of 17-OHCS was within normal range (5.9 mg/day), but those of 17-KS, 17-KGS and pregnanetriol were markedly increased (44.4, 110 and 22.6 mg/day, respectively). Plasma concentrations of progesterone and ACTH and urinary excretions of estrone, estradiol and estriol were also increased. Urinary excretions of 17-KS were decreased to 11.7 mg/day and 17-KGS to 22.3 mg/day after the ingestion of 2 mg/day dexamethasone for two days. The computed tomography and a scintigraphy with 131I-Adosterol revealed a tumor in the left adrenal gland, and the adrenal arteriography revealed a neovascularity and a tumor stain in the tumor. These data indicated that the patient was suffering from both 21-OHD and the left adrenal tumor. At this point, adenoma or adenocarcinoma of the adrenal gland was suspected. The left adrenal tumor (85 g) was resected on April 10, 1984, and the pathological diagnosis was adrenal adenoma. The patient's endocrinological abnormalities, however, did not improve after the operation. Urinary excretions of 17-KS and KGS were increased to 57.9 and 108.5 mg/day, respectively, in the patient's elder brother, and 63.3 and 127.9 mg/day, respectively, in his younger brother, indicating that they also had 21-OHD. Interestingly, an adrenal tumor was diagnosed by abdominal computed tomography in the elder brother who had the same HLA typing as the present case. The three brothers had 21-OHD, and two of them had both 21-OHD and adrenal tumor. To our knowledge, this is the first report documenting the co-existence of adrenal tumors in brothers with 21-OHD. This suggests that adenoma can be one of the complications of 21-OHD, probably due to the chronic stimulation by ACTH, and that a possible linkage to HLA may exist in such cases.
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Affiliation(s)
- Y Sunaga
- Second Department of Internal Medicine, Kansai Medical University
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Sugimoto H, Tokushima M, Kubota S, Takezawa J, Kon Y, Sunaga Y, Mori M, Ishida M, Yamada S, Higuchi T. [A case of limy bile associated with obstruction of common bile duct]. Nihon Shokakibyo Gakkai Zasshi 1987; 84:1135-9. [PMID: 3626105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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43
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Sunaga Y, Tanaka T, Kurosawa M, Nemoto T, Fueki R, Kobayashi S. [Effect of "Jiryu" on aspirin-induced asthma]. Nihon Kyobu Shikkan Gakkai Zasshi 1985; 23:655-9. [PMID: 4068400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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44
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Kameyama S, Ichikawa H, Sunaga Y, Nakata S, Saito Y, Eiki T, Watanabe S. Biochemical characteristics of cardiac myosin: the pH dependence of Ca-ATPase activity, and that of the absorption spectrum of 2,4,6-trinitrophenyl groups attached to myosin. J Biochem 1985; 97:625-32. [PMID: 3159719 DOI: 10.1093/oxfordjournals.jbchem.a135098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
For both cardiac and skeletal myosin, the Ca-ATPase activity of myosin at acidic pH was shown to be different from that at alkaline pH, in the susceptibility to heat-inactivation, the effects of organic solvents, and the effect of trinitrophenylation of the myosin. It is therefore suggested that there are two different types of Ca-ATPase of both cardiac and skeletal myosin. Differences in the Ca-ATPase activity were also found between cardiac and skeletal myosins. (a) The Ca-ATPase activity of cardiac myosin was more susceptible to heat-inactivation at alkaline pH than at acidic pH. In contrast, the activity of skeletal myosin was more susceptible to heat-inactivation at acidic pH than at alkaline pH. (b) Dioxane weakly stimulated the activity of cardiac myosin at acidic pH, but strongly activated that of skeletal myosin at acidic pH. Acetone very strongly inhibited the activity of cardiac myosin at alkaline pH, but not so strongly that of skeletal myosin at alkaline pH. (c) Trinitrophenylation of the myosin resulted in loss of the activity optimum at acidic pH with skeletal myosin but not with cardiac myosin. As reported by Srivastava et al. (J. Biochem. 86, 725-731, 1979), 1 mol of lysine residue per mol of cardiac myosin quickly reacted with 2,4,6-trinitrobenzene sulfonate (TNBS) either in the absence or presence of inorganic pyrophosphate (PPi). However, trinitrophenyl (TNP) groups bound to cardiac myosin in the presence of PPi were significantly different, in the pH dependence of the absorption spectrum, from those bound (to cardiac myosin) in the absence of PPi.(ABSTRACT TRUNCATED AT 250 WORDS)
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Sunaga Y, Yoshie Y, Nemoto T. [Beta-adrenergic receptor in bronchial asthma. Part 2. Human placental beta-adrenergic receptor in normal and asthmatic subjects]. Arerugi 1985; 34:88-95. [PMID: 2992425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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46
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Sunaga Y. [Beta-adrenergic receptor in bronchial asthma. Part 1. Pulmonary beta-adrenergic receptor in experimental konjac asthma of the guinea-pig]. Arerugi 1984; 33:1030-9. [PMID: 6100040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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47
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Sunaga Y, Tani F, Mukai K. Detection of Yersinia enterocolitica 09 infection in camels serodiagnosed as brucellosis. Nihon Juigaku Zasshi 1983; 45:247-50. [PMID: 6632460 DOI: 10.1292/jvms1939.45.247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Mori M, Sunaga Y, Otomo S, Aoki H, Tanaka S, Osawa Y, Kobayashi S, Kobayashi I. [S-type hyperamylasemia with symptoms resembling macroamylasemia]. Nihon Rinsho 1981; 39:1990-4. [PMID: 6171657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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49
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Ishikawa I, Karino K, Sasaki A, Sunaga Y, Takana A. [Nursing report. On nursing in the day care system - in clinical training in psychiatry]. Kango Tenbo 1979; 4:158-64. [PMID: 253848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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50
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Sunaga Y, Aoki H, Otomo S, Mori M, Osawa Y, Nemoto T, Nakazawa T, Honma S, Fueki R, Kobayashi S. [A case of hydrocortisone phosphate injection induced asthma (author's transl)]. Nihon Kyobu Shikkan Gakkai Zasshi 1978; 16:793-7. [PMID: 723025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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