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Biomedical subjects

M Kitao

Publications and source records attributed to M Kitao.

At least 19 recordsLinked to original sources
PubMed1997

Decrease in tumor volume and histologic response to intraarterial neoadjuvant chemotherapy in patients with cervical and endometrial adenocarcinoma.

Our purpose was to evaluate the utility of clinicopathological and biological markers prior to treatment in predicting the immediate response to chemotherapy in cervical and endometrial adenocarcinomas. Twelve patients with locally advanced cervical adenocarcinomas and 16 patients with endometrial adenocarcinomas received intraarterial neoadjuvant chemotherapy (NAC) consisting of cisplatin and doxorubicin before surgical resection. The decrease in tumor volume on magnetic resonance imaging (MRI) ([tumor volume before NAC - tumor volume after NAC]/tumor volume before NAC x 100) and the histologic response to NAC were assessed. Five factors prior to NAC (nuclear grade, pretreatment tumor volume, PCNA index, p53 protein expression, and DNA ploidy) were analyzed for correlation with the decrease in tumor volume and histologic response in cervical and endometrial adenocarcinoma, respectively. In cervical adenocarcinoma, patients with higher PCNA index tumor (> or = 40.2%) showed a significantly greater decrease in tumor volume than those with lower PCNA index (P < 0.05). In patients with endometrial adenocarcinoma, those with a smaller tumors (< 30.3 cm3) showed a significantly greater decrease than those with a larger tumors (P < 0.001). Tumors with higher PCNA index (> or = 31.5%) and negative p53 protein expression appeared to respond better than other tumors, but the difference was not statistically significant. Nuclear grade and DNA ploidy were not correlated with decrease in tumor volume either in cervical adenocarcinoma or in endometrial adenocarcinoma. Four cases of effective histologic response (2 complete responses [no microscopic residual tumor] and 2 marked responses [no macroscopic residual tumor]) were noted only in patients with endometrial adenocarcinoma who had a smaller tumor, higher PCNA index, and negative p53 protein expression. Pretreatment tumor volume and PCNA index were the only significant predictive factors (P < 0.05). Results suggest that the PCNA index in cervical and endometrial adenocarcinomas and the pretreatment tumor volume in endometrial adenocarcinoma appeared to be potentially useful in predicting the immediate response to the chemotherapy.

Adenocarcinoma↗
PubMed1997

Doppler ultrasound in a patient with ovarian Brenner tumor of low malignant potential: comparison with Gray-scale ultrasound, magnetic resonance imaging and tumor marker suggesting malignancy.

We present a postmenopausal patient with giant lower abdominal tumor. Gray-scale ultrasound and magnetic resonance imaging showed typical abnormal morphology suggesting malignancy. The serum CA 125 level was 69 U/ml, and that of CA 19-9 was 2,097 ng/ml. Transvaginal color and pulsed Doppler sonography of the tumor vasculature demonstrated low peak systolic velocity (6.7 cm/s) with low pulsatility (resistance index: 0.49). Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. Histological diagnosis was ovarian Brenner tumor of low malignant potential. Transvaginal Doppler findings seemed to give specific information for the diagnosis in this case.

Aged↗
PubMed1997

Antenatal diagnosis of aberrant umbilical vessels.

OBJECTIVE: To evaluate the antenatal screening of aberrant umbilical vessels and assess the association of fetal abnormality with these entities. STUDY DESIGN: 444 pregnant women were studied with routine obstetric ultrasound and Doppler color flow imaging in late second trimester or early third trimester. Fetal growth and anomaly, and the number of umbilical cord vessels were screened. RESULTS: Out of 444 subjects, 3 cases with discordant umbilical artery, 2 with four vessels in the umbilical cord, and 1 with single umbilical artery were detected (1.4%). Fetal anomaly was noted in 2 of 6 cases with aberrant umbilical vessels (33.3%). CONCLUSION: These results suggest that antenatal screening of umbilical cord vessels is necessary for detection of fetal anomalies.

Congenital Abnormalities↗
PubMed1996

Intratumoral blood flow analysis in endometrial cancer: does it differ among individual tumor characteristics?

To evaluate whether intratumoral blood flow analysis in endometrial cancer provides individual tumor characteristics, 36 patients with endometrial cancer (5 in stage IA, 14 in stage IB, 5 in stage IC, 4 in stage II, and 8 in stage III) underwent transvaginal color and pulsed Doppler ultrasound before surgery. Histologically, there were 18 patients with well-differentiated adenocarcinoma, 8 with moderate differentiated adenocarcinoma, 4 with poorly differentiated adenocarcinoma, 4 with adenoacanthoma, and 2 with carcinosarcoma. Intratumoral blood flow was recorded, and peak systolic velocity (PSV) and resistance index (RI) were calculated. Endometrial thickness (ET) was also measured. There were no significant differences among PSV and RI values for each stage. There were also no significant differences among PSV and RI values for each histological diagnosis. ET in stages IA, IB, and II was significantly thinner than that in stage III (P < 0.05). Moreover, ET in stage IA was significantly thinner than that in stage IC (P < 0.05). There were significant differences in ET for some histological diagnoses. These results suggest that intratumoral blood flow analysis in endometrial cancer could not predict the tumor staging and histological diagnosis. However, in view of the small number of patients, these observations must be considered preliminary.

Adenocarcinoma↗
PubMed1996

Magnetic resonance imaging and serum CA-125 in evaluating patients with endometriomas prior to medical therapy.

OBJECTIVE: To determine whether magnetic resonance imaging (MRI) and serum levels of CA-125 can be used to evaluate patients with endometriomas before initiating medical treatment. DESIGN: Comparative study before and after medical treatment. SETTING: Shimane Medical University Hospital, Izumo, Japan. PATIENTS: Eleven consecutive patients with at least one endometrioma > 10 mm in maximal diameter that was diagnosed by laparoscopy and treated with 900 micrograms/d buserelin acetate for 6 months. INTERVENTIONS: Magnetic resonance imaging and blood sampling was performed < 2 weeks before laparoscopy. MAIN OUTCOME MEASURES: Signal intensity of edometrioma/signal intensity of gluteus maximum muscle on T2-weighted image (T2SI:MSI); volume of endometrioma and serum CA-125. RESULTS: There was a positive linear correlation (r = 0.787) between T2SI:MSI before treatment and the extent of decrease in the volume of endometrioma. There was a negative linear relationship between serum CA-125 before treatment and the mean extent of decrease in the cyst volume (r = 0.678). The reduction in volume of endometrioma and T2SI:MSI before treatment related to the outcome of patients. CONCLUSION: The T2SI:MSI on MRI and serum CA-125 may be useful for estimating the outcome of patients with endometriomas before initiating medical treatment.

Adult↗
PubMed1996

Effect of dehydroepiandrosterone sulfate on maternal cardiac function in term pregnancy.

To search for possible effect of dehydroepiandrosterone sulfate (DHAS) on maternal cardiac function in term pregnancy, impedance cardiographic assessments were made on 15 normal full-term pregnant women before and 5, 10, 15, 20, 25, and 30 minutes after the administration of a 200 mg intravenous dose of DHAS in 20 mL of 5% dextrose. The cardiac output, stroke volume, heart rate, and mean arterial pressure were recorded. Maternal cardiac output increased from baseline by 20% (p < 0.05) after 15 minutes and the mean increase in stroke volume was 25% (p < 0.05) after 15 minutes. No change was found in heart rate or mean arterial blood pressure. DHAS induces a significant increase in both maternal stroke volume and cardiac output without change in heart rate or mean arterial pressure, which suggests a possible increase in cardiac contractility in term pregnancy.

Blood Pressure↗
PubMed1996

Mathematical modeling of fetal foot growth: use of the Rossavik growth model.

Growth of the fetal foot has been monitored by foot length (FL), from 12 to 41 weeks menstrual age in 173 normal Japanese fetuses. Growth curve for this parameter has been determined using a Rossavik growth model [p = c(t)k+s(t)]. R2 value of 98.0% was obtained for FL. Variability analysis indicated some progressive increase in variability with fetal age for this parameter. Variability data were used with the growth curve model to determine standard curve for this parameter. This standard curve provides a superior means for evaluating the normal fetal foot growth in the fetus and for assessing menstrual age in utero.

Embryonic and Fetal Development↗
PubMed1996

Magnetic resonance relaxation time in evaluating the cyst fluid characteristics of endometrioma.

To determine whether the cyst fluid characteristics of endometrioma can be evaluated by magnetic resonance imaging (MRI), 36 endometriomas obtained from 24 patients (age range 21-43 years; mean 34 years) were studied. MRI was performed < 2 weeks before laparoscopy or laparotomy. Comparative studies of the density and concentration of iron in the endometrioma and the signal intensity (SI) of MRI [calculated relaxation time T1 value, calculated relaxation time T2 value, signal intensity on a T1-weighted image (T1SI) and on a T2-weighted image (T2SI) of the cyst; T1SI/signal intensity of the gluteus maximus muscle (MSI), and T2SI/MSI of the cyst] were performed. The density of the cyst fluid and its iron concentration were found to be directly proportional. There was a significant relationship between the concentration of iron and the T2SI, T2SI/MI and calculated T2 values. In particular, the concentration of iron and the ration of T2SI/ MSI were inversely proportional. Therefore, T2SI/MSI reflected the concentration of iron in endometriomas without recourse to measurement of the calculated T2 value, which suggests that the MRI and T2 signal intensity may be useful for evaluating the cyst fluid characteristics of endometriomas.

Adult↗
PubMed1996

Prognostic application of magnetic resonance imaging in patients with endometriomas treated with gonadotrophin-releasing hormone analogue.

We evaluated the usefulness of magnetic resonance imaging (MRI) for assessing the response of patients with endometriomas to medical therapy. MRI was performed before and after treatment in 20 consecutive patients with at least one endometrioma with a maximal diameter >10 mm diagnosed by laparoscopy who received 900 microg of buserelin acetate daily for 6 months. Patients were categorized as good responders (group I, n = 13) and poor responders (group II, n = 7) depending on the results of a third-look laparoscopy performed 6 months after treatment. We determined the ratio of the signal intensity (SI) of the endometrioma to the SI of the gluteus maximus muscle on T2-weighted images [T2SI/M (muscle) SI] and the volume of the endometrium. The volume decreased by >50% in 61.5% of the good-response group and 57.1% of the poor-response group. There was no significant difference between the two groups. The T2SI/MSI decreased in 12 of 13 patients in group I but in only one of seven patients in group II, a significant difference (P < 0.05) between the two groups. In the good-response group, there was a positive linear correlation between the decrease in the volume of the endometrioma and the decrease in the T2SI/MSI after treatment (r = 0. 561, P < 0.05). Therefore, the T2SI/MSI determined from MR images may be useful in assessing the therapeutic response of patients with endometriomas.

Adult↗
PubMed1996

Interleukin-1 receptor antagonist in cord blood: effects of labor and fetal distress.

OBJECTIVE: To evaluate the effect of labor pains or fetal distress on concentrations of interleukin-1 receptor antagonist (IL-1ra) in cord blood. METHODS: Umbilical cord interleukin-1 beta (IL-1 beta) and IL-1ra were measured in 24 normal appropriately grown newborns delivered vaginally (VD group), 10 normal appropriately grown newborns delivered by elective cesarean section (ECS group), and 5 appropriately grown newborns with fetal distress (FD group). Umbilical cord arterial blood pH and PO2 were also measured. RESULTS: Umbilical artery blood pH and PO2 in the VD group were not significantly different from those in the ECS group. Umbilical artery blood pH and PO2 in the FD group were significantly lower than those in the VD group (p < 0.05). Umbilical artery blood pH in the FD group was significantly lower than that in the ECS group (p < 0.05), but no significant difference for umbilical artery blood PO2 was found between the FD and ECS groups. IL-1 beta levels were undetectable in the three groups of neonates. There were no significant differences for concentrations of IL-1ra in cord blood among the groups. CONCLUSION: These results suggest that the labor pain or fetal distress does not affect concentrations of IL-1ra in cord blood.

Female↗
PubMed1996

Mathematical modeling of fetal organ growth using the Rossavik growth model. V. Cerebellum.

Growth of the fetal cerebellum was monitored by transverse cerebellar diameter (CD) from 14 to 39 weeks menstrual age in 125 Japanese fetuses. The growth curve for this parameter was determine using a Rossavik growth model [p = c(t)k & (t)]. An R2 value of 95.5% was obtained for CD. Variability analysis indicated a progressive increase in variability with fetal age for this parameter. Variability data were used with the growth curve model to determine a standard curve for this parameter. This standard curve provides a superior means to evaluate normal fetal cerebellar growth in the fetus and to identify cerebellar abnormalities in utero.

Cerebellum↗
PubMed1996

Cord blood cytokines and soluble adhesion molecules in vaginal and cesarean delivered neonates.

OBJECTIVE: Our purpose was to evaluate the effect of labor pain on the concentrations of cytokines and soluble adhesion molecules in cord blood. METHODS: Umbilical cord interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-alpha), granulocyte elastase (GEL), intercellular adhesion molecule-1 (ICAM-1), and endothelial lymphocyte adhesion molecule-1 (ELAM-1) were measured in 21 normal appropriately grown newborns delivered vaginally (VD group), and 20 normal appropriately grown newborns delivered by elective cesarean section (ECS group). Umbilical cord arterial blood pH and PO2 were also measured. RESULTS: Umbilical artery blood pH and PO2 in the VD group were not significantly different from those in the ECS group. There were no significant differences for concentrations of IL-6, IL-8, TNF-alpha, GEL, ICAM-1, and ELAM-1 in cord blood between VD and ECS groups. CONCLUSION: These results suggests that labor pains do not affect the concentrations of cytokines and soluble adhesion molecules in cord blood.

Adult↗
PubMed1996

Interleukin-6, interleukin-8, and granulocyte elastase in newborns with fetal distress.

OBJECTIVE: Our purpose was to investigate the participation of cytokines and neutrophils in fetal distress. STUDY DESIGN: Umbilical cord serum interleukin-6 (IL-6), interleukin-8 (IL-8), and plasma granulocyte elastase (GEL) were measured in 30 normally grown newborns without fetal distress (Group A), 10 growth-retarded newborns without acute fetal distress (Group B), 5 normally grown newborns with fetal distress (Group C), and 5 growth-retarded newborns with fetal distress (Group D). Umbilical arterial blood pH and PO2 were also measured. RESULTS: Umbilical arterial blood pH and PO2 in either Group C or Group D were significantly lower than those in either Group A or Group B. The concentration of IL-6 in Group D was significantly higher than that in either Group A, B, or C. The level of IL-8 in either Group C or Group D was significantly higher than that in either Group A or Group B. The concentrations of GEL in Group D was significantly higher than that in either Group A or Group B. CONCLUSION: This study suggests that fetal distress in utero causes an elevation of immune factors such as IL-6, IL-8 and GEL.

Acidosis↗
PubMed1996

Cardiac output measurement by thoracic electrical bioimpedance in a patient with ovarian hyperstimulation syndrome.

A 31-year-old woman developed severe ovarian hyperstimulation syndrome (OHSS) after exogenous gonadotropin stimulation for an in vitro fertilization program. Because of refusal of invasive monitoring, thoracic electrical bioimpedance (TEB) was performed to evaluate cardiac function and volume status. TEB pointed out decreased cardiac output (CO: 4.23 liters/min), cardiac index (CI: 2.63) and stroke volume (SV: 57.5 ml/beat). Serial monitoring of hemodynamic variables was then performed. After the data were obtained, fluid management was performed, and the patient recovered from abnormal homeostasis in 3 days. The hemodynamic variables returned to the normal range (CO: 6.85 liters/min, CI: 4.25, SV: 100.5 ml/beat) within the first 24 h. There were no complications such as life-threatening multiple organ failure. We discuss the usefulness of TEB for the fluid management of severe OHSS, as well as its implications.

Adult↗
PubMed1996

Studies on the detection of small endometrial implants by magnetic resonance imaging using a fat saturation technique.

To assess the usefulness of fat-saturated magnetic resonance (MR) imaging in detecting small endometrial implants, 258 pigmented lesions of endometriosis from 80 consecutive patients with histopathologically diagnosed pelvic endometriosis were compared using fat-saturated and conventional MR imaging. MR imaging was performed with a 1.5-tesla superconducting magnet with spin echo T1-, T2-, and fat-saturated T1-weighted images. Both conventional MR images and fat-saturated MR images permitted identification of almost all endometriomas > 10 mm in diameter. With conventional MR imaging, 29 endometrial implants measuring < 10 mm in diameter were detected. One hundred and seven lesions were detected by fat-saturated MR imaging. However, conventional MR images demonstrated only 4 lesions among these 111 small endometrial implants that measured < 5 mm in diameter. The addition of fat-saturated MR imaging increased the detection rate to 55 of 111 lesions. Fat-saturated MR imaging can, therefore, be useful in detecting small endometrial implants.

Adult↗
PubMed1996

Fetal ophthalmic artery blood flow velocity waveforms.

OBJECTIVE: To evaluate alterations in vascular impedance of the fetal ophthalmic artery (OA) with advancing gestation. STUDY DESIGN: Color Doppler flow imaging and pulsed Doppler ultrasonographic assessment were performed on 28 normal fetuses, at gestational ages ranging from 21 to 40 weeks. The pulsatility index (PI) was calculated for the OA and the middle cerebral artery (MCA). Optimal models for these PI values were determined by regression analysis. A normal range of PI values for both arteries was generated. RESULTS: In the OA, the model showed a parabolic pattern during pregnancy, as was the case for MCA. The predicted PI values for the OA were always lower than those for the MCA. CONCLUSION: Our study is the first to demonstrate alterations in regional vascular impedance of the fetal OA with advancing gestation. These data provide a foundation for the evaluation of fetal ocular circulation in normal and abnormal pregnancies.

Blood Flow Velocity↗
PubMed1996

Effect of dehydroepiandrosterone sulfate on fetal middle cerebral artery flow velocity waveforms in term pregnancy.

OBJECTIVE: To investigate whether bolus injection of dehydroepiandrosterone sulfate (DHAS) is associated with changes in fetal middle cerebral artery flow velocity waveforms in term pregnancy. METHODS: Ten normal full-term pregnant women received the administration of a 200-mg intravenous dose of DHAS in 20 ml of 5% dextrose. Ten normal full term pregnant women received 20 ml 5% dextrose as controls. Color Doppler flow imaging and pulsed Doppler ultrasonographic assessments were made on fetuses in each group before and 10 min, 30 min, 60 min, 90 min. and 120 min after DHAS or dextrose administration. The pulsatility index (PI) values for the middle cerebral artery, and umbilical artery, and fetal heart rate were recorded. RESULTS: In the DHAS group, middle cerebral artery PI decreased from baseline by 24% (p<.05) after 10 min, and the mean reduction was 22% (p<.05) after 30 min. The PI returned to the baseline value 60 min later. In the control group, there was no change in middle cerebral artery PI. No change was found in umbilical artery PI or fetal heart rate in the control or DHAS group. CONCLUSION: DHAS induces a significant decrease in the fetal middle cerebral artery PI, which suggests a possible decrease in fetal cerebral vascular impedance in term pregnancy.

Adult↗