Biomedical subjects

Kotaro Fukushima

Publications and source records attributed to Kotaro Fukushima.

13 recordsLinked to original sources

PubMed2006

Simplified ultrasound screening for fetal brain function based on behavioral pattern.

Despite the longstanding conclusion that behavior can reveal aspects of underlying anatomy and function, no generalized antenatal behavior screening has been developed to identify fetuses that may have central nervous system defects requiring further evaluation. We devised a brief ultrasound examination to distinguish fetuses with compromised central nervous system function from the general population and evaluated it with this study. The study design compared behavioral findings obtained by retrospectively reviewing the ultrasound examinations of 5 fetuses that had abnormal behavior with prospectively obtained findings of 29 normal fetuses. Median time for brief examination criteria was 50 min (range, 30-60 min). The only case undetectable by this brief ultrasound examination has an eye-movement period significantly longer than the normal upper limit. Using this method as a screening test may make it possible to include assessment of fetal brain function as part of routine antenatal care.

Central Nervous System↗

PubMed2006

Neutrophil function during pregnancy: is nitric oxide production correlated with superoxide production?

PROBLEM: Oxygen radical formation by neutrophils during pregnancy is not well studied. METHOD OF STUDY: We studied neutrophil-derived superoxide anion (O) and nitric oxide (NO) values in 75 normal pregnant women, 12 postpartum women, and 10 non-pregnant women. O production was measured by the superoxide dismutase-inhibitable reduction of ferricytochrome c. NO production was measured by accumulation of the stable end product nitrite using a modified Griess reaction method. RESULTS: O production of neutrophils stimulated by chemotactic peptide was significantly enhanced in the early second trimester of pregnancy. l-arginine analogue-inhibitable nitrite production was induced in neutrophils from pregnant women, but not from postpartum and non-pregnant subjects. In third-trimester subjects but not non-pregnant subjects, neutrophils pre-treated with l-arginine analogues enhanced O production compared with untreated neutrophils. CONCLUSION: These findings indicate that O and NO production by neutrophils during pregnancy were modulated separately, whereas neutrophil-derived NO might function as a regulator of O.

Case-Control Studies↗

PubMed2006

Pleural fluid/serum immunoglobulin ratio is a diagnostic marker for congenital chylothorax in utero.

OBJECTIVE: To distinguish congenital chylothorax from other causes of hydrothorax in utero. METHODS: Serum and pleural fluid samples from 8 fetuses with congenital chylothorax and 5 control fetuses with other causes of hydrothorax were tested for total protein, albumin, IgG, IgA, and IgM. RESULTS: Fetuses with congenital chylothorax had higher levels of IgG in pleural fluid, but not the other four proteins, than control fetuses (P<0.05). There were no significant differences in serum proteins among fetuses. When we examined pleural fluid to serum ratios, the IgG ratio in fetuses with congenital chylothorax was significantly higher than that of control fetuses (P<0.05). The IgG ratio in chylothorax was greater than 0.6 regardless of lymphocyte count. CONCLUSION: Pleural fluid/serum IgG ratio may be a diagnostic marker for congenital chylothorax in utero.

Albumins↗

PubMed2005

Generation of reactive oxygen species by neutrophils and endothelial cell injury in normal and preeclamptic pregnancies.

The aim of this study was to investigate the role of neutrophil-derived reactive oxygen species on endothelial cell dysfunction in preeclampsia. We first assessed the correlation between nitrite and superoxide anion production in normal nonpregnant (n=10), normal pregnant (n=15), and preeclamptic women (n=12). We then examined neutrophil-mediated oxygen radical damage to human umbilical vein endothelial cells in vitro. Neutrophil superoxide release was measured by cytochrome C reduction; nitrite release was measured by the modified Griess reaction, and endothelial cell injury was measured by 51Cr release. N-formyl-methionyl-leucyl-phenylalanine-stimulated superoxide release by neutrophils was significantly increased in women with preeclampsia compared with the other 2 groups. Nitrite release by neutrophils was significantly decreased in preeclampsia compared with normal pregnancy. When neutrophils were pretreated with superoxide dismutase, nitrite release by neutrophils did not differ between normal pregnancy and preeclampsia, suggesting that excess superoxide anion in preeclampsia could reduce bioavailability of nitric oxide through neutrophil autocrine function. Neutrophil-mediated endothelial cell injury was significantly greater in women with preeclampsia than in the other 2 groups. Hydrogen peroxide was important in neutrophil-mediated endothelial cell injury in preeclampsia as catalase inhibited endothelial cell injury. When neutrophils were pretreated with NG-nitro-L-arginine methyl ester, neutrophil-mediated endothelial cell injury in preeclampsia was decreased, indicating a role for peroxynitrite formation as a mechanism of endothelial cell injury. In conclusion, the modulation of neutrophils causing superoxide production to dominate over nitrite release provides a reasonable explanation for endothelial cell dysfunction in preeclampsia.

Adult↗

PubMed2005

Tumor necrosis factor and vascular endothelial growth factor induce endothelial integrin repertories, regulating endovascular differentiation and apoptosis in a human extravillous trophoblast cell line.

Angiogenesis is crucial in human development. Extravillous trophoblast (EVT) cells mimic endothelial cells in angiogenesis during endovascular differentiation, inducing a remodeling of spiral arteries that increases blood flow toward the intravillous space. We have previously shown that tumor necrosis factor (TNF) alpha regulates expression of ITGA6 and ITGA1, which are involved in cell survival, in the human EVT cell line TCL1. To further investigate endovascular differentiation, we examined the effects of vascular endothelial growth factor (VEGF), TNF, and extracellular matrix (ECM) on TCL1 cells. Seeded on Matrigel, TCL1 cells show tube-like formation that specifically recalls morphological changes in endothelial cells. Anti-ITGAV/ITGB3 antibodies significantly reduced the size of the capillary network (P < 0.05) on Matrigel and also suppressed TNF-induced apoptosis (P < 0.05) in TCL1 cells. VEGF induced expression of ITGAV/ITGB3 subunits and protein aggregation, as in the case of TNF, which in turn, induces synthesis of VEGF in TCL1 cells. Soluble FLT1 suppressed these activities in TCL1 cells, indicating that signals involving VEGF axis are essential for endovascular differentiation. These results suggest that TNF, VEGF, and ECM collaboratively regulate EVT behavior, including cell survival and endovascular differentiation, through integrin signaling during establishment and maintenance of successful human pregnancies.

Apoptosis↗

PubMed2005

Postpartum retroperitoneal fasciitis: a case report and review of literature.

We present a case of a postpartum female with iliopsoas fasciitis in the puerperium. Two days after a spontaneous vaginal delivery at 38 weeks without any complications, the patient complained of pain in the left thigh and hip, associated with a temperature of 38 degrees C. Consequently, she could not walk 4 days after delivery and her body temperature had increased to 39 degrees C. Extreme left flank pain and tenderness in the left pelvic wall were prominent, whereas the tenderness in the pelvis was moderate. Magnetic resonance imaging led us to diagnose iliopsoas fasciitis. This was complicated by sepsis but improved after a protracted antibiotic treatment without any surgical intervention. A literature review revealed that serious complications, including sepsis or permanent functional disturbance, could arise although retroperitoneal fasciitis and/or abscesses are very rare after vaginal delivery. Iliopsoas fasciitis could be considered when patients complain of extreme pain in the pelvic wall, sacroiliac joint region, or thigh-symptoms that are uncommon in uncomplicated endometritis.

Adult↗

PubMed2005

Relationship between eye movement period and micturition in newborn infants differs from that of human fetuses at term.

AIM: To investigate the relationship between the onset of eye movement periods and micturition in human fetuses and in neonates with the intention of clarifying the transition in relationship during the perinatal period. METHODS: Data were acquired during 1-4 days and/or 1 month (29-33 days) from 6 normal neonates born at term. Eye movements, crying, and eye open periods were observed with a video recorder until micturition occurred. In 29 term fetuses, the time lag between the onset of an eye movement period and micturition was measured by real-time ultrasound instruments. RESULTS: The time lag between the onset of an eye movement period and micturition in neonates (2 minutes; range, 0-57 minutes) was significantly (P=0.027) different from the time lag for fetuses (14 minutes; range, 2-32 minutes) and the frequency of micturition occurring within 8 minutes (33) was significantly lower (P=0.017) than that seen for term fetuses (72%). CONCLUSION: The relationship between the onset of an eye movement period and micturition is different in term human fetuses and neonates of less than 1 month of age. This suggests that the neuronal relationship among brain centers for micturition, rapid-eye-movement sleep, and awakening is dramatically altered perinatally.

Arousal↗

PubMed2004

Fetal habituation correlates with functional brain development.

In this study, we divided 26 fetuses at 32-37 weeks of gestation into three groups using combined criteria of gestational age and behavioral indicators. We investigated fetal habituation to vibroacoustic stimulation (VAS). Fetuses showed habituation from at least 32 weeks of gestation. Furthermore, fetuses less developed from behavioral standpoint took significantly more trials to achieve habituation than developed fetuses even in the same gestational age. Taken together with these data, it was proved that there was a relationship between aspects of behavioral development and habituation.

Acoustic Stimulation↗

PubMed2003

A case of pregnancy complicated by the development of a tubo-ovarian abscess following in vitro fertilization and embryo transfer.

Tubo-ovarian abscess is an uncommon complication in pregnant women. In this report, we present a patient who developed a tubo-ovarian abscess during pregnancy following in vitro fertilization and embryo transfer (IVF-ET). Despite treatment with intravenous antibiotics she delivered at 22 weeks of gestation. After delivery, she underwent a left salpingo-oophorectomy. Review of the literature revealed only 26 reported cases of tubo-ovarian or pelvic abscess during pregnancy. Pelvic inflammatory disease, previous laparotomy, and structural genital anomalies are known risk factors for pelvic abscess during pregnancy. Pelvic abscess resulting as a complication of vaginal oocyte retrieval has been reported. Therefore, although enabling women with organic pelvic disease such as endometriosis and hydrosalpinx to achieve pregnancy, assisted reproductive techniques may potentially result in pelvic infection during pregnancy. This case suggests that a preconception evaluation and treatment for such conditions should be considered for women undergoing treatment for infertility.

Abscess↗

PubMed2003

[Can we predict the premature labor in patients with placenta previa?; a retrospective study on maternal symptoms during pregnancy].

OBJECTIVES: This study aimed to predict the gestational weeks by characterizing maternal genital bleeding and uterine contraction during pregnancy in patients with placenta previa. METHODS: Included in this study were 87 patients with placenta previa, diagnosed at the time of delivery at our institution. Genital bleeding and uterine contraction characteristics and clinical data from mothers who delivered at < 37 weeks were compared to that of mothers who delivered at > or = 37 weeks. RESULTS: There were 37 deliveries (42.5%) at < 37 gestational weeks and 50 deliveries (57.4%) at > or = 37 gestational weeks. In 69 of 87 cases (79.3%), genital bleeding was recognized during pregnancy, and in 63 cases (72.4%) genital bleeding was the first symptom to occur during pregnancy. Uterine contraction during pregnancy was recognized in 48 cases (55.2%), including 36 (41.4%) that occurred as the first symptom of pregnancy. Logistic regression analysis revealed that when genital bleeding occurred at < 29 and < 31 weeks, patients were at high risk for delivery at < 34 and < 37 weeks, respectively, and when first uterine contraction occurred at < 29 weeks, they were at high risk for delivery at < 34 weeks. CONCLUSION: In patients with placenta previa, the number of gestational weeks to the occurrence of the first genital bleeding can be used as a predictor of the number of weeks to term.

Adult↗

PubMed2002

TNFalpha-induced apoptosis and integrin switching in human extravillous trophoblast cell line.

Differentiation of extravillous trophoblast cells (EVT) to an invasive phenotype plays an essential role in establishing and maintaining feto-placental organization during human pregnancy. A switch in integrin expression occurs during this differentiation and is accompanied by changes in the extracellular matrix (ECM). Alteration of EVT behavior is also modulated by cytokines. To investigate the molecular interactions involved in the EVT differentiation, we examined the effects of cytokines and ECM on the human EVT cell line, TCL1 cells. We found that tumor necrosis factor alpha (TNFalpha) induced apoptosis in TCL1 cells but not in JEG3 cells derived from choriocarcinoma while the addition of interleukin-1beta, leukemia inhibitory factor, or transforming growth factor had no effect on TCL1 cells. This apoptosis was suppressed when TCL1 cells were seeded on fibronectin (Fn), collagen type I (C1), collagen type IV (C4), or laminin (Ln). Wortmannin, a specific PI3 kinase inhibitor, inhibited this suppression. Spreading assays and adhesion blocking assays indicated that TCL1 cells express integrin-alpha5 and -alpha6 and beta1 and beta4 subunits. Adhesion on Fn is mediated by alpha5beta1, and adhesion on C1, C4, or Ln is mediated by alpha6beta1 integrins. TNFalpha suppressed alpha6 integrin expression and enhanced alpha1 integrin expression in a dose-dependent manner. In addition, aggregation of beta1 subunits on C4 was detected after addition of TNFalpha. Taken together, these results suggest that TNFalpha and ECM, through activation of PI3 kinase mediated by beta1 integrin signaling, might collaboratively regulate differentiation of trophoblast cells through integrin signaling in establishing and maintaining successful pregnancy.

Apoptosis↗

PubMed2002

IGF-related proteins at birth in a case of antenatally diagnosed Silver-Russell syndrome.

We report here a case with severe intrauterine growth restriction from the first trimester and clinical features of Silver-Russell syndrome including microcephaly, low-set ear, atrial septum defect, ventricular septum defect, diaphragmatic relaxation, and rocker bottom feet. Silver-Russell syndrome is thought to result from deletion of the distal long arm of chromosome 15 on which the IGF-I receptor (IGF-IR) gene is located. We measured both the maternal and cord blood levels of GH, IGF-I, and IGF-binding protein and performed an immunohistochemical study of IGF-IR in the placenta to investigate whether these IGF-related proteins were affected in this patient. The hormonal level of these proteins did not significantly differ from normal neonates, and immunohistochemical analysis suggested IGF-IR protein levels in the placenta were comparable to normal term neonates. These results support the hypothesis that growth insufficiency could occur in patients with monosomy of the distal long arm of chromosome 15 and suggest a critical threshold for IGF-related fetal growth in early pregnancy.

Abnormalities, Multiple↗

PubMed2002

[Fetal monitoring].

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Central Nervous System↗