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Biomedical subjects

Masao Nakabayashi

Publications and source records attributed to Masao Nakabayashi.

7 recordsLinked to original sources

Changes in plasma coagulation markers with prophylactic treatment of low molecular weight heparin after cesarean section.

Cesarean section has been identified as a major risk factor for thromboembolism, and additional risk factors place some women at a much higher risk during puerperium. Recently, low molecular weight heparins (LMWHs) have been used for thromboembolism prophylaxis after cesarean section. We investigated the effect of risk factors of thromboembolism on plasma coagulation markers when the LMWH dalteparin was used following cesarean section. Twenty-four women with risk factors other than cesarean section (high-risk group) and 13 without any other risk factors (low-risk group) received dalteparin starting immediately after cesarean section until the patients were mobilized. Sixteen women without any other risk factors served as controls (control group). Activated partial thromboplastin times, thrombin-antithrombin complex, alpha (2)-plasmin inhibitor-plasmin complex, and activated factor X levels were not different between the high-risk and the low-risk groups. However, fibrinogen/fibrin degradation products D-dimer levels were higher in the high-risk group than in the low-risk and control groups on days 3 and 7 after cesarean section. These findings suggest that the D-dimer levels may be elevated by some risk factors and that postoperative D-dimer determinations may be useful in assessing the risk of thromboembolism during LMWH treatment after cesarean section.

Adult↗

In situ androgen producing enzymes in human prostate cancer.

Androgens have been proposed to be actively produced in situ in human prostate cancer. These locally produced androgens have also been considered to play important roles in the pathogenesis and development of prostate cancer. Therefore, it is important to examine the status of this in situ androgen metabolism and/or synthesis in detail in order to improve the clinical response to hormonal therapy in patients diagnosed with prostate cancer. Several studies have previously demonstrated the expression of androgen-producing enzymes such as 5alpha-reductase types 1 and 2, and 17beta-hydroxysteroid dehydrogenase type 5 (17beta-HSD5), in human prostate carcinoma cells. However, their biological significance has remained largely unknown. In this study, we evaluated the immunoreactivities of these steroidogenic enzymes in human prostate cancer obtained from surgery (n = 70), and correlated the findings with clinicopathological features of the patients. 17Beta-HSD5 immunoreactivity was detected in 54 cases (77%), 5alpha-reductase type 1 in 51 cases (73%) and 5alpha-reductase type 2 in 39 cases (56%). 5Alpha-reductase type 2 immunoreactivity was significantly correlated with that of androgen receptor (AR), and 17beta-HSD5 positive cases were significantly associated with clinical stage (TNM stage pT3 vs pT2). These data all suggest that androgen-producing enzymes, such as 5alpha-reductase type 1 and type 2, and 17beta-HSD5 are expressed in a majority of prostate cancers, and are involved in the local production and actions of androgens in prostate cancers.

17-Hydroxysteroid Dehydrogenases↗

Expression of urocortin III/stresscopin in human heart and kidney.

Urocortin III (Ucn III)/stresscopin (SCP) is a novel peptide of the corticotropin-releasing factor (CRF) family and is a specific ligand for the CRF type 2 receptor. We wished to clarify whether Ucn III/SCP is expressed in the human heart and kidney. Immunoreactive Ucn III was detected by RIA in the human heart (0.74-1.15 pmol/g wet weight, mean +/- SEM; n = 4) and kidney (1.21 +/- 0.30 pmol/g wet weight), which were obtained at autopsy. These levels were comparable to the levels in pituitary (2.72 +/- 0.13 pmol/g wet weight; n = 3) and brain tissues ( approximately 1-2 pmol/g wet weight). Furthermore, immunoreactive Ucn III was present in human plasma (51.8 +/- 16.0 pmol/liter; n = 5) and urine (266 +/- 20 pmol/liter; n = 5) obtained from healthy subjects. Reverse-phase HPLC showed a broad peak of immunoreactive Ucn III eluting in the position of synthetic Ucn III in the heart, kidney, and hypothalamus. Material eluting in the position of SCP was also found in the HPLC analysis of these tissue extracts. Immunocytochemistry showed positive staining of Ucn III in the myocardium and the renal tubules, particularly distal tubules. RT-PCR showed expression of Ucn III mRNA in the brain, pituitary, heart, and kidney. The present study has shown expression of Ucn III/SCP in the human heart and kidney as well as brain and pituitary tissues and its presence in plasma and urine. Ucn III/SCP may therefore regulate the cardiac and renal function as a local factor and a circulating hormone.

Adult↗

Orexin-A expression in human peripheral tissues.

Orexin-A is a neuropeptide present in the brain and is known to regulate feeding and sleeping. In this study, we examined the systemic distribution of orexin-A in human tissues. Immunoreactivity for orexin-A was detected in ganglion cells of the thoracic sympathetic trunk, myenteric plexuses and endocrine cells of the gastrointestinal tract, islet cells of the pancreas and syncytiotrophoblasts and decidual cells of the placenta. In the gastrointestinal tract, orexin-A immunoreactivity was detected in the myenteric plexuses from 26 gestational weeks to birth. In double immunostaining in the pancreas, a great majority of insulin-positive cells was simultaneously positive for orexin-A. mRNA expression for prepro-orexin was also detected in the kidney, adrenal gland, pancreas, placenta, stomach, ileum, colon and colorectal epithelial cells. These results suggest the production of orexin-A in various human peripheral tissues and orexin-A may also play important roles in some peripheral organs.

Adolescent↗

Stage IVB uterine endometrial cancer successfully salvaged by chemoradiotherapy and surgery.

A case of stage IVB adenoacanthoma of the uterine corpus is described. The patient was admitted with a large amount of atypical genital bleeding. Computed tomography and magnetic resonance imaging revealed a large tumor accompanied by lymph node involvement in the left inguinal, multiple pelvic, and paraaortic regions. She was diagnosed as having stage IVB endometrial adenoacanthoma. Neoadjuvant chemotherapy with carboplatin (CBDCA) and 5-fluorouracil (5-FU) was performed, followed by radiotherapy. The tumor responded very well, but still remained in Douglas' pouch after treatment. The patient therefore underwent a simple hysterectomy, pelvic and paraaortic lymphadenectomy, and partial rectal resection. Histopathologically, viable cancer cells were observed only in the fundus of the uterus. The patient is alive with no evidence of recurrence 4 years after the initiation of chemoradiotherapy.

Adenocarcinoma↗

Treatment of severe preeclampsia with antithrombin concentrate: results of a prospective feasibility study.

The prospective feasibility study was designed to determine whether treatment with antithrombin (AT) concentrates could be used for patients with severe preeclampsia to provide clinical efficacy without the full systemic antihypertensive drug. Twenty-nine severe preeclamptic patients (24 to 36 weeks of gestation, gestosis index [GI] >/= 6 points) were randomized to receive AT (1500 U/day) or not. AT was given intravenously once daily for 7 consecutive days. Twenty-four hours of continuous infusion of 5000 U/day of unfractionated heparin was given simultaneously in both groups. There were no statistical differences in the clinical profiles of the two groups. Maternal symptoms were evaluated from the difference of GI before and after treatment, and fetal findings were evaluated from the changes of the biophysical profile score. Improvement was significantly greater in the AT group for both the GI ( P = 0.046) and the biophysical profile score ( P = 0.022). The improvement of coagulation parameters was also evaluated. The improvement of plasmin-plasmin inhibitor complex (PPIC), D-dimer levels, and platelet counts was observed in the AT group compared with the non-AT group. The coagulation index as a composite coagulation test parameter showed a significantly improvement in the AT group. No adverse events related to AT were observed. Given that AT plus heparin was significantly better than treatment with heparin alone for improvement of both GI and biophysical profile of infant, it is suggested that therapy with AT alone might be effective enough for severe preeclampsia.

Adult↗

Review of the ischemia hypothesis for ocular hypertension other than congenital glaucoma and closed-angle glaucoma.

Experimentally induced ischemia of the endothelial cells surrounding the aqueous drainage sites led to a rise in intraocular pressure (IOP) in monkey and pigeon eyes. Clinical conditions associated with a rise in IOP in human eyes, e.g. peripheral retinal detachments, subluxated lenses, and occlusion of the internal carotid artery, can result in ischemia of the endothelial cells lining Schlemm's canal. These findings led to the hypothesis that ischemia of the endothelial cells of Schlemm's canal induces hypertension in human eyes. Thus, the ischemia hypothesis should be considered in discussions of the etiology of age-related open-angle glaucoma.

Animals↗