PubMed Health⌕ Search

Biomedical subjects

O Ishiko

Publications and source records attributed to O Ishiko.

At least 55 records · Page 3Linked to original sources

Hormone replacement therapy plus pelvic floor muscle exercise for postmenopausal stress incontinence. A randomized, controlled trial.

OBJECTIVE: To investigate the effects of the combination of pelvic floor muscle exercise (PFME) and estriol on postmenopausal stress incontinence (SI). STUDY DESIGN: Sixty-six patients with postmenopausal SI were randomized to a group treated with a combination of estriol (1 mg/d) and PFME (group A, n = 32) and a group treated with PFME alone (group B, n = 34). Efficacy was evaluated every three months based on stress scores obtained from a urinary incontinence (UI) questionnaire. RESULTS: A significant decrease in stress score was observed in mild and moderate UI patients in both groups three months after the commencement of therapy (A and B, P < .0001). The therapeutic effect in group A was more prominent for up to 18 months in mild UI and for up to 12 months in moderate UI (A vs. B, P < .05). Kaplan-Meier analysis showed that the cumulative morbidity rate in mild SI patients was significantly lower in group A (0%) than in group B (12%, P < .005). CONCLUSION: Combination therapy with estriol plus PFME was effective and is capable of serving as first-line treatment for mild SI.

Combined Modality Therapy↗

Microwave endometrial ablation at a frequency of 2.45 GHz. A pilot study.

OBJECTIVE: To investigate the clinical application of a microwave tissue coagulator at 2.45 GHz with a needle electrode customized for endometrial ablation. STUDY DESIGN: In a pilot clinical study, endometrial ablation was performed under intravenous thiopental anesthesia on five women suffering from hypermenorrhea caused by aplastic anemia (3), von Willebrand's disease (1) and a submucosal myoma (1) using a microwave tissue coagulator at 2.45 GHz. RESULTS: Four patients were amenorrheic after endometrial ablation. The patient with the submucosal myoma experienced minor menstrual bleeding. No notable complications were observed during or after ablation. CONCLUSION: Endometrial ablation using a microwave tissue coagulator at 2.45 GHz is a simple and useful method of treating hypermenorrhea.

Adult↗

Effect of cyclic plasma perfusion on apoptosis regulatory proteins in primary tumors of VX2-carcinoma-bearing rabbits.

Although the mechanism of cancer cachexia is unknown, in previous studies we reported that cyclic plasma perfusion through non-coated charcoal was effective in preventing cancer cachexia. In the present study we investigated the effect of cyclic plasma perfusion on VX2 carcinoma. Sixteen tumor-bearing rabbits were divided into two groups: i) a group subjected to cyclic plasma perfusion (n=8, group PP) and ii) a group subjected to sham-perfusion (n=8, group SP), and changes in body weight, tumor size, and morphological findings were investigated. Body weight loss and tumor growth were significantly suppressed in group PP. The tumor cells in group PP showed apoptosis and a high Bax/Bcl-2 ratio, and the survival rate was significantly higher than in group SP. These results suggest that cyclic plasma perfusion is effective not only in preventing cancer cachexia but in suppressing tumor growth and improving outcome.

Animals↗

Effects of cocaine and ethanol on mouse fetuses.

In the presence of ethanol, cocaine is metabolized to its ethyl homolog, cocaethylene. To investigate the embryotoxic effects of cocaethylene, pregnant ICR mice receiving ethanol orally during pregnancy were treated with 50 mg/kg/day cocaine i.p. on days 7, 8 and 9 of gestation. Treatment with either cocaine or ethanol alone did not affect the fetal mortality rate or the mean fetal body weight. Concurrent cocaine and ethanol treatment increased the fetal mortality rate, and decreased the mean fetal body weight, although teratogenicity was not noted. These results suggest that concurrent use of cocaine and ethanol during pregnancy is more harmful to fetal body weight gain and their lives than the use of either drug alone, at least in the present experimental settings.

Animals↗

Case of hemorrhagic shock due to hypermenorrhea during anticoagulant therapy.

We report the case of a patient with uterine myoma who developed uncontrollable massive hemorrhage from the uterus during anticoagulant therapy after cardiac valve replacement and required hysterectomy. There was a discrepancy between the laboratory findings regarding the blood coagulation system and the clinical manifestations, suggesting a combination of multiple factors, such as a hormonal imbalance. This was a case that demanded strict attention to the management of the uterine lesions during the conduct of anticoagulant treatment.

Anticoagulants↗

Classification of female urinary incontinence by the scored incontinence questionnaire.

OBJECTIVES: Our purpose was to investigate whether urinary incontinence (UI) severity could be graded by UI scores. METHODS: The study included 168 UI patients diagnosed by conventional procedures as stress incontinence (SI, n=108) or urge incontinence (URI, n=60). A questionnaire containing 15 items scored for stress-score (s-s) and urge-score (u-s) was administered to patients to assess the correlation between pad test values (PTVs) and s-s in SI and u-s in URI. RESULTS: Significant correlations were found between log[PTVs] and both s-s and u-s: log[PTV(SI)]=0.051s-s-0.207 (r=0.830, P<0.0001) and log[PTV(URI)]=0.064u-s-0.459 (r=0.827, P<0. 0001). Based on theoretical PTVs obtained using these equations, s-s of 26-24, 23-18, and 17-10 in SI were equivalent to severe, moderate, and mild, respectively, and u-s of 22-19 and 18-12 in URI were equivalent to moderate and mild, respectively, according to the classification of the International Continence Society. CONCLUSION: The UI score should be a simple and useful procedure for use by general gynecologists to grade UI severity clinically.

Aged↗

beta(2)-adrenergic agonists and pelvic floor exercises for female stress incontinence.

OBJECTIVE: We compared beta(2)-adrenergic agonist therapy with clenbuterol (DT) and physiological therapy (PT) in a randomized study to establish the first line therapy for stress incontinence (SI). METHOD: The clinical efficacy of DT (group A), PT (group B), and a combination of DT and PT (group C) was investigated in 61 patients with SI by means of a 12-week randomized controlled study. The frequency and volume of SI and the patients' own impressions were used as the basis for the assessment of efficacy. RESULTS: The SI improvement rates in groups A, B, and C were 76.9, 52.6, and 89. 5%, respectively (P=0.0361). A significant therapeutic effect on the frequency of SI was observed in group B and group C at 2 weeks after the start of treatment (both P<0.05), and in all groups at 6 weeks (all P<0.01). The efficacy rates based on the patients' own impressions in groups A, B, and C were 84.6, 31.6, and 68.4%, respectively (P=0.0064). CONCLUSION: The beta(2)-adrenergic agonist appeared to be clinically useful as a drug of choice for SI.

Adrenergic beta-Agonists↗

The urinary incontinence score in the diagnosis of female urinary incontinence.

OBJECTIVE: Our purpose was to determine whether the urinary incontinence (UI) score is significantly useful in evaluating the clinical status of UI. METHOD: The questionnaire was administered to 198 UI patients (27-73 years of age) diagnosed by conventional procedures. It consisted of 15 questions, and the answers were assigned points divided into a stress score (s-s) and urge score (u-s) according to severity. RESULTS: The patients were classified into a stress incontinence group (SI; 125 cases), urge incontinence group (URI; 29 cases), mixed incontinence group (MI; 41 cases), and overflow incontinence group (3 cases). Classification by questionnaire yielded 110 SI cases, 31 URI cases, and 46 MI cases, accuracy of 83.2%, 86.2%, and 61.0%, respectively. A significant correlation was observed with s-s of SI (r = 0.669, P < 0.001) and u-s of URI (r = 0.583, P < 0.005). CONCLUSION: The UI score will be a simple, clinically effective diagnostic procedure for UI for use by general gynecologists.

Adult↗

Transmission of symptomatic parvovirus B19 infection by fibrin sealant used during surgery.

Human parvovirus B19 infection has been shown to be transmissible by blood and blood products and to result in transient aplastic crisis in patients with rapid red cell turnover. We report three cases of iatrogenic parvovirus B19 infection resulting from the use of the same batch of fibrin sealant under operation. Fibrin sealant, which is a typical haemostatic agent produced from blood, has been used during surgery. Human parvovirus is resistant to existing virus-inactivating techniques, suggesting that infection may occur from blood products contaminated with it. Use of recombinant products for these proteins may thus be necessary.

Adult↗

Dimeric inhibin A as a fourth marker for Down's syndrome maternal serum screening in native Japanese women.

OBJECTIVE: This study was conducted to assess the usefulness of dimeric inhibin A as a fourth marker for Down's syndrome screening in addition to AFP, hCG and uE3 markers for native Japanese women. METHODS: Serum specimens from 367 native Japanese women in the second trimester were assayed for dimeric inhibin A levels. Day specific dimeric inhibin A medians were established for gestational ages 15.0-21.9. Weekly median values for the native Japanese were compared with those of a U.S. population. Selected Japanese specimens from 15 diagnosed Down's syndrome and 3 trisomy 18 cases were also assayed for dimeric inhibin A. RESULTS: Dimeric inhibin A levels did not vary greatly over the gestational age range as expected. Median value comparison showed that native Japanese dimeric inhibin A medians are higher than the U.S. population medians by an average of 7.95%. Native Japanese dimeric inhibin A median values in this study are 1.77 times higher in Down's syndrome cases than in unaffected pregnancies. Trisomy 18 dimeric inhibin A levels show no significant difference from the unaffected pregnancies. CONCLUSIONS: This report shows for the first time that dimeric inhibin A can be informative as a fourth marker for Down's syndrome screening in native Japanese women. We expect the addition of dimeric inhibin A to a triple marker protocol will increase the accuracy of predicted risk for all pregnancies screened and increase the detection rate of Down's syndrome affected pregnancies.

Biomarkers↗

Is measuring the posterior urethrovesical angle of clinical value for controlling pelvic organ Prolapse?. Retrospective analysis of 107 postoperative cases.

Vaginal total hysterectomy with vaginal plasty was performed in 107 patients with pelvic organ prolapse. The posterior urethrovesical angle (PUVA) was measured by chain urethrocystography. Bladder capacity, residual and incontinence urine volume were measured before and after surgery, and the data obtained were analyzed in relation to postoperative improvement and recurrence of urinary dysfunction. There were no significant differences between the background of patients with dysuria, incontinence, a mixture of dysuria and incontinence, and neither of these symptoms. Postoperative incontinence and residual urine volume decreased in all groups. However there was no correlation between the preoperative PUVA and either incontinence or residual urine volume. Measurement of PUVA was neither helpful in making the diagnosis nor predictive of the recurrence of urinary dysfunction.

Aged↗

Excellent results of postoperative radiotherapy for endometrial stromal sarcoma of low-grade malignancy.

Endometrial stromal sarcoma of low-grade malignancy (ESSL) is a rare neoplasm, and neither preoperative diagnostic procedures nor standard therapy have yet been established. We treated 3 cases of ESSL in the past 27 years, and we report here one of these cases that was classified as stage III (according to the FIGO classification of endometrial carcinoma). Postoperative radiotherapy was used to treat a residual tumor, and the patient showed a complete response.

Adult↗

New cervicoscopy with toluidine blue staining for superficial cervical invasion by endometrial carcinoma.

We developed a method of endocervical staining with toluidine blue solution during cervicoscopy that clearly discriminates between the endocervical region and the endometrium and allows easy detection of superficial cervical invasion by endometrial carcinoma. Toluidine blue staining cervicoscopy was used for preoperative histological diagnosis in 10 cases of endometrial carcinoma. The staining permitted a correct diagnosis in 3 cases in which conventional diagnostic methods were practically useless. Endocervical staining with toluidine blue is highly useful for diagnosis of superficial cervical invasion by endometrial carcinoma.

Cervix Uteri↗

Neutropenia accompanying parvovirus B19 infection after gynecologic surgery.

The hematologic data and symptoms of 7 patients seropositive for parvovirus B19 IgM antibody after gynecologic surgery were analysed. Parvovirus may have been transmitted by fibrin glue prepared from heat-treated human plasma and used for hemostasis during surgery. The peripheral blood neutrophil count decreased to below 1 x 10(9)/l between postoperative day (POD) 10 and 18, but recovered spontaneously to within the normal range. G-CSF injection was effective in preventing neutropenia or obtaining a prompt recovery. The reticulocyte count fell below 10 x 10(9)/l between POD 13 and 19, and also recovered spontaneously. A slapped-cheek rash was not observed in any of the 7 patients.

Adolescent↗

Anemia-inducing substance is related to elimination of lipolytic hyperactivity by cyclic plasma perfusion in human cancer cachexia.

We previously reported that cyclic plasma perfusion suppressed lipolytic activity in malignant tumor-bearing animals and reversed their body weight loss. In this study we investigated the relation between this phenomenon and interleukin (IL)-1 alpha, IL-1 beta, IL-6, interferon-gamma, leukemia inhibitory factor, tumor necrosis factor-alpha, and anemia-inducing substance (AIS) in vitro by examining changes in their levels in the plasma of advanced ovarian cancer patients. When the patients' plasma was incubated with noncoated charcoal for one hour, its lipolytic activity decreased by 39.0 +/- 2.4%, which was similar to the results obtained with the plasma of healthy subjects. IL-1 alpha, IL-1 beta, interferon-gamma, leukemia inhibitory factor, and tumor necrosis factor-alpha did not adsorb the charcoal. IL-6 was 3.7% adsorbed, but this did not cause a significant difference (p = 0.131). Nor was the recombinant form of these cytokines adsorbed to the charcoal. AIS, however, was 98.1% adsorbed. These results indicate that AIS is strongly associated with the reduction in lipolytic activity by cyclic plasma perfusion through noncoated charcoal resin.

Adult↗

A novel technique for myomectomy. Intranodal surgery with an electromechanical tissue borer.

OBJECTIVE: To investigate the possibility of clinical application of a new technique for myomectomy that involves morcellating the myoma within the myometrium with a new instrument that minimizes invasion of the myometrium and abdominal wall. STUDY DESIGN: In a pilot clinical study, myomectomy was performed on five women with uterine myomas and a normal menstrual cycle using a microwave coagulator and electromechanical tissue borer of our invention. The length of the surgical incisions in the abdominal wall and myometrium, operating time and blood loss were measured. RESULTS: The mean length of the surgical incisions was 6.3 cm in the abdominal wall and 3.5 cm in the myometrium. The mean operating time was 167 minutes, and the mean blood loss was 312 mL. The length of the incisions in the abdominal wall and myometrium per centimeter of the maximal diameter of the myoma was 0.78 and 0.42 cm, respectively. The incision tended to become smaller in successive operations. CONCLUSION: This new technique of myomectomy significantly reduced invasion of the abdominal wall and uterus.

Adult↗

Metabolic and morphologic characteristics of adipose tissue associated with the growth of malignant tumors.

Changes in total body fat and the metabolic and morphologic characteristics of adipose tissue were sequentially investigated in individual rabbits implanted with VX2 tumors to elucidate the pathology of the fat reduction in animals with malignant tumors as compared with that of diet-restricted rabbits. Lipogenesis in normal, VX2-implanted, and diet-restricted rabbit groups on day 40 after the start of the experiments was 19.1 +/- 2.9, 13.3 +/- 3.5, and 41.7 +/- 6.0 x 10(5) cpm/g/h, respectively, and glycerol liberation by their adipose tissue was 199 +/- 21, 528 +/- 94, and 301 +/- 45 nmol/g/h, respectively. In addition, apoptotic cells were noted in the adipose tissue of VX2-implanted rabbits on days 20-30 after implantation, but not in diet-restricted rabbits. The results showed clear differences between the total body fat reduction profiles of VX2-implanted rabbits and diet-restricted rabbits, suggesting a characteristic lipid metabolism with enhanced lipolysis and diminished lipogenesis in VX2-implanted rabbits. The results strongly suggest that adipocyte apoptosis might be involved in these phenomena.

Adipose Tissue↗