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Biomedical subjects

H Hokanishi

Publications and source records attributed to H Hokanishi.

16 recordsLinked to original sources
PubMed1993

The effect of nicardipine on maternal and fetal hemodynamics and uterine blood flow in chronically instrumented pregnant goats.

This study was designed to clarify the maternal and fetal hemodynamics of nicardipine (0.02 mg/kg) administered intravenously to unanesthetized, chronically instrumented pregnant goats. Nicardipine produced a significant increase in maternal heart rate and cardiac output, and a significant decrease in maternal mean arterial blood pressure and systemic vascular resistance. These changes persisted for about 30 minutes. There were no consistent changes in maternal pulmonary hemodynamics. Uterine arterial blood flow (UBF) decreased significantly (about 15%) after 5 minutes of the injection and returned to the control value within 30 minutes. A significant correlation between the decreases in UBF and maternal diastolic blood pressure was observed after 5 minutes of the injection. The fetal heart rate, blood pressure and acid-base status did not change after the injection of nicardipine. These observations of pregnant goats suggest that nicardipine might be a useful agent for the treatment of acutely hypertensive crises in pregnant patients.

Animals↗
PubMed1993

Premature rupture of the membranes--aggressive versus conservative approach: effect of tocolytic and antibiotic therapy.

The purpose of this randomized, prospective study was to evaluate the efficacy of tocolytic and antibiotic therapy in the prolongation of pregnancy and neonatal outcome in the treatment of premature rupture of the membranes without clinical labor. Delivery was delayed for 48 h, 7 days and beyond 35 weeks of gestation in 87, 39 and 18%, respectively, of patients in the treated group (n = 39) compared with 50, 12 and 17% of patients in the nontreated group (n = 42). The incidence of a low Apgar score (< 7 at 5 min), requiring artificial ventilation, and infectious morbidity was more common in the treated group than in the nontreated group (18 vs. 0, 41 vs. 17 and 39 vs. 17%, respectively). There was no significant cost difference in survivors between the treated and nontreated groups, although the mothers in the treated group were significantly more expensive. From these observations, it appears that tocolysis and antibiotics are not effective in PROM cases.

Adult↗
PubMed1993

[Long time survival after combination chemotherapy with cisplatin, vinblastine and peplomycin for cervical cancer].

Twenty seven patients with cervical cancer were treated with PVP therapy including cisplatin 50mg/m2, vinblastine 4mg/m2 and peplomycin 15mg/body during the period from 1984 to 1989. Fourteen patients had a primary lesion. Five of 14 patients were treated with PVP as the primary therapy because of pathological findings which suggested no radiotherapy effect. Nine patients had a radio-resistant lesion and were treated following PVP. Twelve of 14 cases responded and median survival time was 32.5 months (2-101 months). Thirteen patients were treated with PVP because of recurrent cervical cancer. Five of those which recurred after radiotherapy and other 8 cases had been treated with radical hysterectomy and radiotherapy. Two of 5 cases with previous radiotherapy responded and one of 2 patient is still alive with no evidence of disease, but the patients treated with radical hysterectomy and pelvic irradiation showed no sign of a PVP effect and all of them died within 1 year. Primary cases responded even after radiation and some are still alive after more than 5 years. But PVP had no effect on the in patients which there was recurrence. It is necessary to determine which regimen is better, how to select the dose of cisplatin and how to combine the chemotherapy and other therapy. Patients who responded survived for a long time and PVP is an effective therapy. To obtain a better prognosis for advanced cervical cancer, we need a prospective randomized study of radio-chemotherapy or chemo-radiotherapy.

Adult↗
PubMed1993

[The efficacy of prophylactic antibiotic and tocolytic therapy for premature rupture of the membranes--a prospective randomized study].

A comparative study in patients with premature rupture of the membranes (PROM) from 25 to 34 weeks of gestation was carried out, prospectively. Group 1 (34 patients) was given aggressively intrauterine therapy including the administration of tocolytic agents (ritodrine and/or magnesium sulfate) and prophylactic antibiotics (AB-PC 2g/day). Group 2 (41 patients) was managed conservatively with bed rest only. At the time of admission to the study, there were no clinical signs of infection, fetal distress, or active labor in either group. All patients were delivered if the pregnancy had reached 35 weeks of gestation or later, had established labor, or developed evidence of chorioamnionitis or fetal distress. Prolongation for more than 72 hours was greater in group 1 than in group 2. There was no difference in the incidence of chorioamnionitis, postpartum endometritis, or placental infection in the groups. However, the incidence of a low Apgar score (7 < at 5 min), requiring artificial ventilation, and infection was more common in group 1. It is concluded that the use of antibiotics and tocolytics might make the management of PROM more complicated.

Anti-Bacterial Agents↗
PubMed1992

[Recent advances in ovarian cancer chemotherapy].

The standard approach for epithelial ovarian cancer has been maximum cytoreductive surgery followed by combination therapy. Several prospective control studies individually failed to demonstrate improved survival advantage for the Adriamycin containing combination compare with cisplatin plus cyclophosphamide. The two drug combination of carboplatin plus cyclophosphamide will be thought to become the treatment of choice, because it is equally effective as and less toxic than a regimen of cisplatin plus cyclophosphamide. Clinical trials are also in progress with more dose-intense regimens based on considerable retrospective evidence that survival is correlated with the dose intensity of platinum compounds. Currently, high dose carboplatin plus Gm-CSF, two-drug combination of carboplatin and cisplatin and super high dose carboplatin combined with autologous bone marrow transplantation are undergoing clinical trials. Taxol and taxotere, most important cancer drugs after emergence of cisplatin compound, has been shown to have clinical activity in drug resistant ovarian cancer patients. Majority of patients even with advanced germ cell tumors of the ovary is now cured because of the development of effective platinum-based combination chemotherapy of PVB or BEP.

Antineoplastic Agents, Phytogenic↗
PubMed1991

Effects of ranitidine on maternal gastric juice and neonates when administered prior to caesarean section.

Ranitidine hydrochloride, a histamine H2-receptor antagonist, was intravenously administered to 61 pregnant women at a dose of 50 mg as premedication for caesarean section; its effects on gastric secretion were studied in the mother and the newborn. The volume of the maternal gastric juice collected immediately after the induction of anaesthesia averaged 14.0 +/- 10.0 ml with pH 3.48 +/- 1.70, and at the time of extubation, 3.6 +/- 2.8 ml with pH 4.19 +/- 1.79, respectively. Forty-four full-term neonates whose mothers had received ranitidine were selected to investigate the effects of ranitidine. Another 45 full-term normal newborns delivered vaginally, and 14 by caesarean section, served as controls. No effects of ranitidine infusion in the mothers were detected in the newborn children. The gastric pH of the newborn at birth and 24 hours after birth, gastrointestinal symptoms and the general growth checked at the regular one-month work-up after birth did not differ in test and control groups.

Anesthesia, Obstetrical↗
PubMed1990

Ectopic nesidioblastosis.

We observed one case of ectopic nesidioblastosis. A solitary nesidioblastoma was observed in the anterior wall of the duodenum. Ectopic nesidioblastosis has not been previously reported, but our experience suggests the necessity of examination for ectopic pancreas in cases of SIDS or its near-miss.

Blood Glucose↗
PubMed1990

[Evaluation of antiemetic effect of clonazepam, metoclopramide, dexamethasone and diphenhydramine for prevention of cisplatin-induced vomiting].

In prospective alternative crossover test, we confirmed significant superiority of a three-drug combination of clonazepam (C) lorazepam (L) and dexamethasone (D) to (L) and (D) to control vomiting induced by 50 mg/m CDDP containing chemotherapy for gynecological malignancies (p less than 0.001). Vomiting frequency in initial 24 hours was 2.28 +/- 2.21 and 6.00 +/- 3.80 times a day respectively. According to this result, clonazepam, dexamethasone, metoclopramide and diphenhydramine (B) were used as a second regimen to control the vomiting in 80 mg/m CDDP containing chemotherapy for ovarian cancer patients. Clonazepam (2 mg 2 times p.o. -4 and 0 hrs before CDDP drip), dexamethasone (8 mg 5 times iv from -3 hrs each 3 hrs), metoclopramide (2.5 mg/kg iv loading from -2 hrs with 0.4 mg/kg/hr continuous infusion for 9 hrs) and diphenhydramine (30 mg/body 2 times im -2.6 hrs) were chosen to control CDDP-induced nausea and vomiting. These four drugs (C+L+D+B) prominently inhibited the chemo-induced vomiting up to 0.44 +/- 1.50 times a day, and 87.5% of courses was completely satisfactory.

Adult↗
PubMed1989

The value of the sinusoidal tcPO2 pattern in the evaluation and management of cyanotic congenital heart disease with ductus dependent lesions.

A characteristic sinusoidal tcPO2 pattern was observed in 17(27%) of 62 patients with congenital heart disease manifested by cyanosis or heart failure during the neonatal period. All of these 17 patients were definitively diagnosed by cardiac catheterization, as having 8 PPA; 3 ToF; 2 TGA + VSD + PA; 2 asplenia with PA; 1 TGA + VSD + PS; and 1 TA (no TGA type). The transcutaneous oxygen pressure pattern of these patients showed a sinusoidal change with a cycle length of 6-20 min with the maximum pressure not exceeding 50 torr and the minimum pressure occasionally close to 0 torr. This sinusoidal tcPO2 pattern was associated with various types of ductus-dependent congenital heart diseases and hence may be of diagnostic value. Transcutaneous oxygen pressure monitoring is also useful in evaluating the ductal response to PG. Other possible mechanisms underlying this phenomenon including biological oscillation should be considered.

Alprostadil↗
PubMed1989

[Combination therapy of intravenous ritodrine and magnesium sulfate to inhibit premature labor].

Thirty-seven patients in premature labor with intact membranes were treated as follows. Ritodrine was given as a primary tocolytic agent and magnesium sulfate was added adjunctively when the uterine contractions could not be controlled even when the administration of ritodrine exceeded 250mmg/min (14 of 37 cases) (combination therapy group). Prolongation of pregnancy for more than 48 hours and delivery beyond 37 weeks were achieved in 89% and 68% respectively. These results were more satisfactory than those obtained with the isoxsuprine treated group (122 cases). The incidence of discomfort due to nasal obstruction was low in the ritodrine group, but side effects such as palpitation and hot flush occurred more commonly in the combination group. No life-threatening side effects were observed throughout this study. Twelve out of 37 cases (32%) were delivered before 37 weeks. Neonatal morbidity was more frequent in this group delivered before 33 weeks of gestation. These included respiratory distress, hypotension, hypoglycemia, and hypocalcemia. Moreover, two babies born from mothers treated with ritodrine and magnesium had ileus-like symptoms. These data suggest that this combination therapy is effective as far as the tocolytic purpose is concerned. However, special attention must be paid to adverse maternal and neonatal effects as well.

Adult↗
PubMed1988

[The effect of amniocentesis on pregnancy prolongation in patients of threatened premature labor with intact membranes].

The effects of amniocentesis on the prolongation of the gestational period was retrospectively reviewed in patients, in premature labor with intact membranes between 24 and 36 weeks of gestation. Amniocentesis was performed on 55 patients (study group) to evaluate fetal lung maturity and to detect subclinical intraamniotic infection, while the remaining 170 patients (control group) did not receive this procedure. Isoxsuprine was used as the primary tocolytic agent in all the patients. There was no difference in the incidence of spontaneous rupture of the membranes during tocolysis (3/55 vs. 7/170), cesarean deliveries (3/55 vs. 10/170), and adjunctive use of magnesium sulfate with isoxsuprine (11/55 vs. 31/170). A statistical analysis of the time interval from amniocentesis to vaginal delivery at each score of the tocolysis index failed to show any evidence that amniocentesis might induce labor. Moreover, no maternal or neonatal morbidity was attributable to amniocentesis. These data suggest that the use of amniocentesis may be a helpful procedure in the management of premature labor with intact membranes with minimum effect on the outcome of the clinical course.

Adult↗
PubMed1986

[The perinatal factors associated with the development of neonatal RDS in cases of placenta previa].

Sixty-two cases of preterm placenta previa were managed in our hospital since September, 1979 through August, 1983. These were reviewed and analysed retrospectively for the perinatal factors in terms of the development of respiratory distress syndrome (RDS). Conservative management was employed in 56 cases (90%), which consisted of antepartum blood transfusion (7 cases: 11.3%), tocolysis for inhibition of premature labor (37 cases: 59.7%), and prenatal steroid administration (8 cases: 12.9%). Nineteen cases (31%) were delivered from 28 to 33 weeks, 20 cases (32%) from 34 to 36 weeks, and 23 cases (37%) after 37 weeks. When regular uterine contractions occurred at less than 10 minute intervals at the initiation of tocolysis, the majority of the cases had to be delivered within 7 days or less. Ten of the 39 preterm neonates in this study developed clinical RDS. All of these were delivered at between 28 and 33 weeks, associated with neonatal asphyxia. Three perinatal factors were significantly associated with the development of clinical RDS in comparison with the control group of non-RDS preterm neonates. These were neonatal asphyxia, maternal bleeding (greater than 500 ml) and no prenatal steroid administration.

Abruptio Placentae↗
PubMed1984

[Comparative pharmacokinetic study between UFT and FT-207 suppo and phase II studies in gynecological malignancies].

Plasma pharmacokinetics and accumulation into tissues were comparatively examined between UFT and FT-207 suppo and 7 gynecological malignancies were treated by UFT in a phase-II study. FT-207 suppo, the maximum level was attained. After administration, UFT plasma FT reached its maximum level at 2-3 hr, but for 0.5-1 hr after administration. On the other hand, plasma 5-FU concentration reached its peak 1-2 hr or 3-4 hr after UFT administration and revealed very low levels after FT-207 suppo administration. 5-FU accumulation in normal tissue (NT) was not proportional to administered doses of UFT, but in cancerous tissue (CT) it was dependent on total UFT dose. The CT/NT ratio with respect to 5-FU concentration was 5.36 after UFT administration. The same ratio after FT-207 suppo administration was 2.63. The specificity of 5-FU accumulation into cancerous tissue after UFT administration was significantly demonstrated. According to the Evaluating Criteria for cancer chemotherapy in solid tumors by the Japanese Society for Cancer Therapy, we obtained results of PR 2, NC 2 and PD 3 using a 600 mg/day administration of UFT for 7 gynecological malignancies consisting of 6 cervical carcinomas and 1 endometrial carcinoma.

Aged↗
PubMed1984

[Intraperitoneal and intrapleural two channel chemotherapy by cisplatinum (DDP) and sodium thiosulfate for the treatment of ovarian cancer].

We administrated cis-platinum 70-100 mg/m2 bolus, intraperitoneally or intrapleurally without diluting in saline, simultaneously combined with intravenous injection of sodium thiosulphate 1 gr/hr for 12 hours continuously or additional loading of sodium thiosulphate 4-6 g bolus on the initiation. The procedure does not require transfusion of specific hydration and keeps urine volume at a certain level, much less diuretics. For the treatment of 6 gynecological malignancies (2 primary ovarian carcinoma, 1 recurrent ovarian carcinoma, 1 pseudomyxoma peritonei, 1 clear cell carcinoma of cul de sac and 1 metastatic pleuritis carcinomatosa due to uterine cervical carcinoma) 12 courses treatments have been performed, without inducing nephrotoxicity except mild vomiting. All six cases are evaluable for efficacy according to Saito-Koyama criteria at this time: 4 CRs including 2 CRs for ascites and pleural effusion, 1 NC and 1 PD. This Two-Channel Chemotherapy (TCC) seems to be an important modality of chemotherapy for ovarian carcinoma in future.

Adenocarcinoma↗
PubMed1982

[Changes of ADCC activity, IgG Fc receptor-positive T-lymphocytes, and lymphocyte subpopulations in the peripheral blood of pregnant women].

In peripheral blood of human pregnancies at various gestational weeks, we have measured antibody-dependent cell-mediated cytotoxicity (ADCC) activity by the microtest plate assays with sheep erythrocytes as target cells and population of T-cells bearing Fc receptors for IgG (T gamma-cells) as well as T, B lymphocyte and monocyte subpopulation by double rosette test. Twenty-two healthy adults served as control. The materials were divided into four groups by each 10 weeks period of gestation. The results were as follows: The ADCC activity, the population of T gamma-cells and T-cell subpopulation were significantly depressed as compared to the controls (p less than 0.001) in every period of pregnancy, while the relative number of B-cells was increased gradually from the second period to the term. The percent population of monocytes and double marker cells were increased significantly only in the first period of pregnancy (p less than 0.001). The percent population of null-cells was depressed significantly except the third period (p less than 0.01).

Adolescent↗