Biomedical subjects

A Yajima

Publications and source records attributed to A Yajima.

At least 163 records · Page 9Linked to original sources

PubMed1994

Funipuncture for evaluation of hematologic and coagulation indices in the surviving twin following co-twin's death.

OBJECTIVE: To examine the changes in hematologic and coagulation indices in the surviving twin when the co-twin dies because of the twin-twin transfusion syndrome. METHODS: Fetal blood was obtained by funipuncture in seven surviving twins upon the death of their co-twins. Five of them were monochorionic. In one case at 32 weeks' gestation, two repeated funipunctures were done in both twins before and in the surviving twin after the death of the co-twin. Fetal blood was examined for blood coagulation factors as well as complete blood counts. RESULTS: Although coagulation factors were not abnormal, three of the five monochorionic surviving twins had cerebral abnormalities postnatally. The fetal blood profile revealed anemia in the surviving twin, especially in the cases in which funipunctures were performed within 24 hours after the co-twin's death. This demonstrates that acute anemia in the surviving twin was induced by hemorrhage from the larger to the smaller twin at the time of death. CONCLUSION: Following the death of one twin, morbidity in the surviving twin can be produced by hypotensive ischemia of the brain due to hemorrhage through placental vascular anastomoses.

Blood Coagulation↗

PubMed1994

Immunological characterization of human decidual mononuclear cells: natural killer activity, response to interleukin-2 and distribution of interleukin-2 receptor subunits.

We investigated the immunological character of mononuclear cells obtained from the decidua in the first trimester of normal pregnancy. These cells showed in vitro cytotoxicity against NK cell targets, although with lower activity than that of the peripheral blood mononuclear cells. Response to IL-2 was dose-dependent. Since decidual CD56-positive cells express two IL-2 receptor subunits, p55 and p75, it is concluded that these cells have high-affinity receptors to IL-2. Peripheral blood CD56-positive cells, which express p75 alone, might have intermediate-affinity IL-2 receptors. These results indicate that the decidual mononuclear cells have a function resembling that of the peripheral blood NK cells in vitro, moreover, that even low levels of IL-2 can affect the character of the decidual mononuclear cells through the high-affinity IL-2 receptor. It is considered that the NK activity of decidual mononuclear cells is suppressed in conditions of low IL-2 levels to permit the maintenance of pregnancy, but can be rapidly elicited by intrauterine infections or abortion, both of which elicit the secretion of IL-2.

Cytotoxicity, Immunologic↗

PubMed1994

Brain natriuretic peptide and atrial natriuretic peptide levels in normal pregnancy and preeclampsia.

Brain natriuretic peptide (BNP) was increased in many hypertensive subjects. In this study, we have evaluated maternal, umbilical plasma and amniotic fluid BNP and atrial natriuretic peptide (ANP) in 19 normotensive pregnant women and in 35 preeclamptic patients. The maternal plasma and umbilical cord plasma ANP (p < 0.05) and BNP (p < 0.005) levels were significantly higher than those in normal pregnancy. There was no significant correlation among ANP level, BNP level, clinical symptoms and laboratory examinations. It is suggested that ANP and BNP may be rather a sequel to preeclamptic pathophysiological changes, and may not play an important role as the etiological factor of preeclampsia.

Amniotic Fluid↗

PubMed1994

Serum collagen IV and laminin levels in preeclampsia.

Collagen IV is the main collagenous component localized in the trophoblast and glomerular basement membrane. Serum collagen V reflects degradation of basement membrane collagen. In this study, we measured collagen IV levels in maternal serum, umbilical cord serum and amniotic fluid, both from preeclamptic and normal pregnant women, by radioimmunoassay. The serum collagen IV levels in the preeclamptic group were significantly (p < 0.05) higher than those in the normal pregnant group. The amniotic fluid collagen IV level at term was found to be higher than maternal serum collagen IV. We postulate that collagen IV may have an important role in the maintenance of pregnancy. There was a significant positive correlation between maternal serum collagen IV levels and serum laminin levels. There was no significant correlation between maternal serum collagen IV level and blood pressure, urinary protein concentration, or any other laboratory data. These results suggest that there is early damage of endothelial cells in preeclampsia.

Amniotic Fluid↗

PubMed1994

The frequency of human parvovirus B19 infection in nonimmune hydrops fetalis.

Intrauterine infection of human parvovirus B19 has recently been identified as an etiology for nonimmune hydrops fetalis (NIHF) and fetal death. To examine the frequency of B19 infection in cases of NIHF, forty two cases of NIHF of unknown cause were tested for the presence of B19 antibodies by enzyme-linked immunosorbent assay (ELISA) and B19 DNA by polymerase chain reaction (PCR). Three maternal sera were positive for B19 IgM antibody and one fetal serum was positive for B19 DNA. Overall, four (10%) of the 42 cases were positive for B19 infection. All of the four cases positive for B19 infection were found during or just before an outbreak of erythema infectiosum and the incidence was calculated at 36% if only cases found during the outbreak were collected. In all four cases of B19 infection, NIHF was diagnosed at 20 to 23 weeks of gestation, which suggested that B19 infection might be a particular threat to the fetus during this stage of gestation. In conclusion, B19 infection may contribute to 10% of cause unknown NIHF and the incidence may be higher if cases during outbreaks are exclusively collected.

Antibodies, Viral↗

PubMed1994

Monoamine oxidase activity in rat organs during pregnancy.

To elucidate the involvement of MAO activity in rat pregnancy, female rats exhibiting at least 3 consecutive 4-day estrous cycles were used. The day of sperm-positive smears was designated as day 0 of pregnancy. The rats were sacrificed on day 2 of diestrus (diestrus-2) and days 7, 14 and 21 of gestation. The organs were collected and weighted, and mitochondrial fractions were prepared for MAO analysis with kynuramine dihydrobromide as substrate. Specific activity (pmol/mg of protein/min) in the ovary is significantly lower in rats on diestrus-2 (792 +/- 127) (mean +/- S.D.) than on day 14 (1,038 +/- 140) and day 21 (1,580 +/- 61) of pregnancy. However, the levels of MAO activity in the uterus of rats on diestrus-2 (899 +/- 266) is higher than on day 21 (570 +/- 80) of pregnancy. The MAO activity in the placenta on day 21 (644 +/- 82) was higher than day 14 (356 +/- 88) of pregnancy. Total MAO activity per organ (nmol/min) of ovary on day 21 (27.2 +/- 5.2) is higher than on diestrus-2 (8.7 +/- 3.0) and on day 14 (14.2 +/- 3.6). Our results suggest that MAO activity in rat reproductive organs such as uterus, ovary, and placenta might fluctuate significantly near term, in correlation with steroid levels, tissue catecholamine contents and so on, in order to maintain pregnancy.

Animals↗

PubMed1994

Influence of HLA antigens on reproduction among Japanese population: study of haplotypes in 247 families.

Although an increased incidence of shared HLA antigens among couples experiencing recurrent spontaneous abortion or infertility has been observed, antigenic effects remain to be clarified. These effects, which are suspected to exist among fertile couples, were examined in this study. A group of 247 healthy Japanese families and their 682 children, whose HLA antigen haplotypes could be determined, were studied. Haplotypes of the fathers were compared with those of the mothers, and the combination of HLA antigens in the A, B, C and DR loci was determined as antigenic patterns against the mother. Patterns inherited by children were examined and deviations of the patterns were studied according to the natural rule that either of the haplotypes should be inherited at equal rates. Lower rates of children with antigens common with those of the mother, which may show a result of reproductive selection, were observed among only the first born children in the A (p < 0.05) and DR loci (p < 0.01), but rates similar to those expected were observed among the second born and later children. Lower rates were also observed in the B and C loci among all children with no significant difference between groups of the children. The necessity of differing antigenic factors in order to achieve pregnancy in the population was shown. Important effects of HLA antigenicity in reproductive failure are suggested.

Adult↗

PubMed1994

Is treatment of long-term and consecutive use of clomiphene citrate effective in anovulatory patients? Results of multi-centric retrospective studies.

The efficacy of long term consecutive treatment of clomiphene citrate (CC) was investigated in 608 infertile women associated with anovulatory disorders (classified as WHO group II amenorrhea). This study was performed in multi-centric facilities of obstetrics and gynecology by a retrospective randomized assessment. Infertile women associated with anovulation were treated by 50-150 mg of CC for five consecutive days in each treatment cycle. In this study, 200 pregnancies were observed and the total pregnancy rate was 32.9%. The number of abortions were 33 out of the 200 pregnancies (16.5%). The cumulative pregnancy rate within the pregnant subjects reached 90% in initial 10 treatment cycles and there was no difference between 50 mg and 100 mg of CC treatment. There were remarkable differences among the pregnancy rates achieved during consecutive treatments at the primary (clinics and hospital), secondary (regional center hospitals) and advanced facilities. Consecutive treatment by CC for infertile women associated with anovulation may be effective during initial 10 cycles. Although ovulation can be confirmed during the following cycles, the stimulation protocol should be reconsidered after 12 consecutive cycles therapy with CC, because cycle fecundity decreases. Hence, to improve pregnancy rates, it is important to check the previous administration of CC which reflects adversely on the subsequent conception rate especially in advanced facilities where these patients are referred to.

Anovulation↗

PubMed1994

The role of macrophage colony stimulating factor in the peritoneal fluid in infertile patients with endometriosis.

Macrophage colony stimulating factor (M-CSF) concentrations in the peritoneal fluid of 44 infertile patients were measured. The concentration of M-CSF was significantly higher in the patients with endometriosis than in those without endometriosis. There was no significant difference between the M-CSF concentration and stage of endometriosis classified by revised American Fertility Society (rAFS) classification in the 44 patients. However, in primary infertility patients with endometriosis there was a significant correlation between peritoneal M-CSF levels and rAFS points of endometriosis. We speculate that there is some relationship between the increased levels of M-CSF in the peritoneal cavity and the primary infertility associated with endometriosis especially progression of endometriosis.

Ascitic Fluid↗

PubMed1994

New concepts in the diagnosis and prognosis of endometrial carcinoma.

Several recently developed techniques have been applied to the study of endometrial lesions. These include the evaluation of K-ras abnormalities in patients with endometrial hyperplasia to identify those at high risk to develop carcinoma, the analysis of p53 abnormalities to distinguish between endometrial hyperplasia and carcinoma, the use of p53 for predicting clinical outcome in patients with endometrial carcinoma, and PCNA immunostaining of endometrial lesions with secretory activity. However, these studies should be regarded at this juncture as auxiliary, at best, to the cytological and histopathologic examination of human endometrial disorders.

Antigens, Neoplasm↗

PubMed1994

[A phase II study of BMS-181339 in patients with ovarian cancer. BMS-181339 Ovarian Cancer Study Group].

We conducted a multicenter Phase II study of BMS-181339 in patients with ovarian cancer. The facilities participating were 23 in number. The total number of cases registered for the study were 62; 57 of them entered for evaluation in drug efficacy, and 58 cases were evaluable in drug safety. All the cases were previously treated with chemotherapy including platinum-based drugs. The clinical responses of BMS-181339 were as follows: CR, 1 case; PR, 13 cases; MR, 3 cases; NC, 13 cases and PD, 27 cases. The response rate was 24.6% (95% CI: 14.1-37.8%). Histologically, the drug showed its efficacy on serous adenocarcinoma 28.2% (11/39), mucinous adenocarcinoma 20.0% (1/5) and clear cell adenocarcinoma 20.0% (1/5). In regional evaluation, the drug demonstrated its efficacy not only on endopelvic lesions 19.0% (4/21) and abdominal lesions 14.3% (2/14), but also on remote metastatic lesions such as hepatic metastasis 30.8% (4/13) and lung/pleura 33.3% (2/6). The drug also showed its efficacy on the cases 22.9% (8/35) refractory to the platinum-based drugs. Major adverse reactions were fever 63.8% (37/58), alopecia 59.3% (32/54), peripheral nerve disorders 28.1% (16/57) such as numbness of the extremities, nausea/vomiting 24.1% (14/58), arthralgia 20.7% (12/58) and diarrhea 20.7% (12/58) etc.. Abnormal alterations in laboratory test values were an incidence rates of 100% for both leukopenia and neutropenia. However, these symptoms were clinically manageable by transient withdrawal of medication, dose reduction and administration of antibiotics and G-CSF. In addition, decrease in hemoglobin 93.1% (54/58), decrease in platelet counts 31.0% (18/58), elevation in GOT 27.6% (16/58), in GPT 31.0% (18/58) and in LDH 20.7% (12/58) were seen, but no serious organopathy was observed. Thus, we confirmed that BMS-181339 was a clinically useful chemotherapeutic agent in patients with ovarian cancer.

Adenocarcinoma, Clear Cell↗

PubMed1994

[Clinical significance of endocervical curettage (ECC) in predicting neoplastic lesions of the cervix].

Endocervical curettage (ECC) was routinely performed at the time of colposcopy on 200 cases with an abnormal PAP smear. Colposcopically, 77 cases were normal, 99 were abnormal, and 24 were unsatisfactory. Results of the directed biopsies were within normal limits for 84 cases, glandular dysplasia for 2, squamous dysplasia for 95, carcinoma in situ (CIS) for 17, and squamous cell carcinoma for 3. Histologic diagnoses of the ECC specimens were "tissue insufficient for diagnosis" for 11 cases, "benign endocervical tissue" for 167 including 9 squamous metaplasias and 3 cervical polyps, "fragments of dysplasia" for 12, CIS for 6, and squamous carcinoma for 4. Regarding 73 cases who underwent surgical treatment, the biopsy diagnosis had been either false negative in 6 cases or underestimated in 5 cases as compared to the confirmed diagnosis. That is to say, 11 cases might have been diagnosed incorrectly without ECC. The major lesion was located within the endocervix in most of such cases. It is therefore suggested that ECC improves the accuracy of the histologic diagnosis of premalignant and malignant lesions of the cervix and that ECC is an essential procedure especially in endocervical lesions.

Adenoma↗

PubMed1994

[A histopathological study on the biological behavior of carcinoma in situ of the uterine cervix].

Fifty-two cases of carcinoma in situ (CIS) of the uterine cervix were examined histopathologically and compared with seventeen cases of microinvasive carcinoma of the uterine cervix (restricted to the general rules for clinical and pathological management of uterine cervical cancer of the Japan Society of Obstetrics and Gynecology) in order to investigate the influence of the patient's age on the intraepithelial extension of CIS. The results were summarized as follows. 1. There was a positive correlation between circular spread and longitudinal spread of the lesion in CIS cases. 2. There was a positive correlation between circular spread and the depth of gland involvement of the lesion in CIS cases. 3. Circular spread of the lesion in microinvasive carcinoma cases was significantly more extensive than that in CIS cases. 4. Circular spread of the lesion in microinvasive carcinoma at menopause was significantly more extensive than that in microinvasive carcinoma at sexual maturity. These results suggest that CIS has intraepithelial extensibility, and that in CIS at sexual maturity there is a higher risk of invading stroma when circular spread of the lesion becomes greater than one fourth of the whole circle in the cervix, whereas CIS at menopause is more likely to invade the stroma when the circular spread of the lesion becomes greater than half of the whole circle in the cervix. In this respect we can find the influence of the patient's age on the biological behavior of CIS of the uterine cervix.

Adult↗

PubMed1994

[A histopathological study on intraepithelial extensivity of carcinoma in situ of the uterine cervix in the period of sexual maturity].

To investigate intraepithelial extension of CIS, thirty-two cases of carcinoma in situ (CIS) of the uterine cervix in the period of sexual maturity were examined histopathologically and compared with ten cases of microinvasive carcinoma of the uterine cervix (restricted to Japanese criteria). The results were summarized as follows. 1) A positive correlation was found between the circular spreads and longitudinal ones in the lesion in CIS cases. 2) A positive correlation was found between circular spread and the depth of gland involvement in the lesion in CIS cases. 3) Circular spread of the lesion in microinvasive carcinoma cases was significantly more extended than that in CIS cases. These results suggest that CIS in the period of sexual maturity is intraepithelially extensive and that there is a high risk possibility of invading stroma when circular spread of the CIS lesion is greater than one fourth of the whole circle of the uterine cervix.

Adult↗

PubMed1993

Sonographic findings and fetal chromosomal studies undertaken prenatally by fetal blood sampling using cordocentesis.

Prenatal karyotyping was carried out on 206 pregnancies with sonographic abnormalities, including fetal malformations, growth retardation and disorders of the amniotic fluid volume. Overall, chromosomal aberrations were detected in 37 cases (18.0%), but the frequency of chromosomal aberrations was 8.2% in fetuses with a single anomaly and 52.7% in fetuses with multiple anomalies. The chromosomal risk was very high in malformations associated with growth retardation (81.8%) or with both growth retardation and disorders of the amniotic fluid volume (82.4%). High rates of chromosomal aberrations were observed in cases of heart anomalies, diaphragmatic hernia, urinary tract obstruction, hydrocephalus, intestinal atresia, abdominal wall defect and fetal effusion/hydrops. In fetuses at high risk of chromosomal aberrations, cordocentesis for rapid karyotyping is justified in the second or third trimester.

Journal Article↗

PubMed1993

Detection and typing of human papillomavirus DNA in the uterine cervix of Japanese women by nonradioactive dot blot and Southern blot hybridization.

HPV infection was examined with Cytobrush in exfoliated cervical cells sampled from 347 women. HPV DNA analysis was conducted in two steps. The presence of HPV DNA was demonstrated by dot blotting and typing of HPV DNA was made by Southern blotting using biotinylated probes. Of 167 cases with cervical intra-epithelial neoplasia (CIN) and cervical carcinoma, HPV DNA was detected and typed in 25 cases (15.0%). HPV 16, 18, and 33 were found mainly, and no HPV 6 or 11 was detected. The frequency of HPV DNA was 7.1% of CIN I, 28.6% of CIN II, 54.5% of CIN III, and 50.0% of invasive carcinoma. HPV occurred in patients newly diagnosed as CIN at 25.8% and in those of diagnosed as CIN in the past and followed up, 7.6%. Of 180 healthy women, the screening test of FO8830 was positive for HPV DNA in four women (2.2%). The present system proved to be useful for facilitating large-scale clinical research.

Blotting, Southern↗

PubMed1993

Is pelvic endometriosis always associated with chronic pain? A retrospective study of 618 cases diagnosed by laparoscopy.

OBJECTIVE: To establish a relationship between pelvic pain and the stage and severity of pelvic endometriosis determined according to the revised American Fertility Society classification. STUDY DESIGN: Retrospective study of 618 cases diagnosed by laparoscopy as endometriosis at the Tohoku University Hospital from 1984 to 1991. RESULTS: Pelvic pain did not appropriately reflect the stage and severity of pelvic endometriosis in 40% of patients. Although the pain in some patients in stage IV showed some correlation with the stage and severity of the disease, others had either no symptoms or paradoxically complained of less pain than those patients with stage I or II endometriosis. CONCLUSIONS: With the present revised American Fertility Society classification of endometriosis we cannot evaluate the severity of pelvic pain.

Chronic Disease↗

PubMed1993

Temporal and spatial localization of steroidogenic enzymes in premenopausal human ovaries: in situ hybridization and immunohistochemical study.

In situ hybridization and immunohistochemical localization of cytochrome P450 cholesterol side-chain cleavage (P450scc), 3 beta-hydroxysteroid dehydrogenase (3 beta HSD), cytochrome P450 17 alpha-hydroxylase (P450c17) and cytochrome P450 aromatase (P450arom) was performed in 50 morphologically normal human premenopausal ovaries, and correlated these findings with their endometrial phase. In general, mRNA expression of these enzymes examined by in situ hybridization were in good agreement with immunolocalization examined by immunohistochemistry. Expression of P450scc, 3 beta HSD and P450c17 was observed in large-sized preantral follicles, consisting of more than five layers of granulosa cells, preovulatory follicles, corpora lutea, and some degenerating corpora lutea and atretic follicles in all endometrial phases. Several follicles and/or corpora lutea positive for these enzymes were observed in the same ovary. Expression of P450arom was generally observed in only one follicle (antral or preovulatory follicle) or corpus luteum per case in mid proliferative to premenstrual phase, and was not observed in menstrual to early proliferative phase. These findings indicated that (1) expression of steroidogenic enzymes was associated with the continual human ovarian process including follicular development and atresia, and (2) especially, P450arom expression may occur only in a selected antral follicle and may have an important role in dominant follicular development.

3-Hydroxysteroid Dehydrogenases↗