Biomedical subjects

Shigeki Matsubara

Publications and source records attributed to Shigeki Matsubara.

12 recordsLinked to original sources

PubMed2003

Woman with postpartum ventricular tachycardia and hypomagnesemia.

A 28-year-old Japanese woman who had received continuous intravenous infusion of magnesium sulfate from 24 weeks of pregnancy until delivery underwent cesarean section at 30 weeks and gave birth to twins. Serum magnesium sharply declined to a subnormal level of 1.5 mg/dL on postpartum day 4. The patient exhibited sinus bradycardia (48 b.p.m.) with intermittent supraventricular contraction on postpartum day 2, intermittent ventricular bigeminy on postpartum day 3, and frequent selfterminated polymorphic ventricular tachycardia on postpartum day 4. The electrocardiogram (ECG) disclosed that the patient had prolonged QTc of 0.45-0.67. Correction of serum magnesium improved ECG findings promptly, resulting in the disappearance of arrhythmias. Hypomagnesemia due to postpartum diuresis may have played a role causing ventricular tachyarrhythmia in this patient.

Adult↗

PubMed2003

Effect of maternal age on blood loss during parturition: a retrospective multivariate analysis of 10,053 cases.

OBJECTIVE: An extensive study as to whether maternal age itself is a risk factor for blood loss during parturition. METHOD: A total of 10,053 consecutive women who delivered a singleton infant were studied. The excess blood loss was defined separately for women with vaginal and cesarean deliveries as > or = 90th centile value for each delivery mode. The effects of 13 potential risk factors on blood loss were analyzed using multivariate analysis. RESULTS: The 90th centile value of blood loss was 615 ml and 1,531 ml for women with vaginal and cesarean deliveries, respectively. A low lying placenta (odds ratio [OR], 4.4), previous cesarean (3.1), operative delivery (2.6), leiomyoma (1.9), primiparity (1.6), and maternal age > or = 35 years (1.5) were significant independent risk factors for excess blood loss in women with vaginal delivery. Placenta previa (6.3), leiomyoma (3.6), low lying placenta (3.3), and maternal age > or = 35 years (1.8) were significant independent risk factors for excess blood loss in women with cesarean sections. CONCLUSION: A maternal age of > or = 35 years was an independent risk factor for excess blood loss irrespective of the mode of delivery, even after adjusting for age-related complications such as leiomyoma, placenta previa, and low lying placenta.

Adult↗

PubMed2003

Symphysis-fundus height and weight gain pattern in Japanese women with twin pregnancies.

OBJECTIVE: To determine the normogram for symphysis-fundus height and weight gain pattern in Japanese women with twin pregnancies and to examine whether fundus height and weight gain pattern are altered in women who give birth to twin infants complicated by fetal growth restriction (FGR). STUDY DESIGN: A retrospective review of the medical records of 186 twin gestations that had been followed at our institution together with 229 singleton pregnancies as a control. We examined maternal symphysis-fundus height, body weight gain and increase in body mass index (BMI) according to gestational age and compared them between women with and without FGR. RESULTS: As compared to women with singleton pregnancies, those with twins exhibited larger fundus height, larger weight gain and larger increase in BMI, all of which were observed from as early as 16-18 weeks of gestation until delivery. Mothers of twins with at least one FGR infant showed smaller fundus height, smaller weight gain and smaller increase in BMI as compared to those without. CONCLUSION: We constructed the normogram for symphysis-fundus height and weight gain pattern in Japanese twin gestations and determined the characteristic change in these parameters in FGR in women with twins. These results may be of use in identifying mothers of twins with FGR.

Adult↗

PubMed2002

Glucose-6-phosphate dehydrogenase and mouse Kupffer cell activation: an ultrastructural dual staining enzyme-cytochemical study.

Glucose-6-phosphate dehydrogenase (G6PD) plays an important role in Kupffer cell function, especially in phagocytosis activity. Although it was suggested that Kupffer G6PD may be upregulated in Kupffer phagocytosis/activation, direct morphological evidence has been lacking. Acid phosphatase (ACP), a representative lysosomal enzyme, can be used as a cytochemical marker for phagocyte activation. Using an ultrastructural enzyme-cytochemical dual staining method, I simultaneously localized G6PD and ACP activity in mouse Kupffer cells on a cell-by-cell basis, and examined whether or not cytochemically detectable G6PD activity increases in phagocytosing/activated mouse Kupffer cells. Glucose-6-phosphate dehydrogenase labelings were observed in the cytoplasm and on the cytosolic side of the endoplasmic reticulum, and ACP labelings were seen in the lysosomes. In phagocytosing Kupffer cells, in which ACP deposits were observed not only in the lysosomes but also on the phagosomal membranes and phagosomal contents, G6PD labelings were denser than dormant Kupffer cells. Enzyme-cytochemically detectable G6PD activity increases in phagocytosing/activated mouse Kupffer cells. Kupffer cell G6PD, activated in phagocytosing Kupffer cells, may play an important role not only in liver defense but also in liver disease pathogenesis/pathophysiology.

Acid Phosphatase↗

PubMed2002

Role of tissue interaction between pineal primordium and neighboring tissues in avian pineal morphogenesis studied by intraocular transplantation.

Tissue interactions play an essential role in organogenesis during embryonic development. However, virtually no attempts have been made to study the role of tissue interaction in pineal development. In the present study we examined the inductive role of the epidermis and mesenchyme in the morphogenesis of quail pineal glands. The pineal rudiment is first observed at embryonic day 2 (E2: 2 days of incubation) at the dorsal midline of the diencephalon as a short semi-spherical protrusion. Electron microscopic observations revealed that no mesenchymal cells are found between the epidermis and the distal end of the E2 pineal primordium but that a thin layer of mesenchymal cells separate the epidermis from the pineal primordium at E3. Small pieces containing pineal rudiment were cut off from E2 or E3 embryos. They were treated with enzymes to eliminate the epidermis and/or mesenchyme, grafted into E5 chicken eyes, and cultured there for 1 week. When E3 pineal rudiment was treated with Dispase to remove the epidermis, the pineal gland developed normally. When the rudiment was further treated with collagenase to remove the surrounding mesenchymal cells, a multi-follicular structure was still formed, but to a lesser extent than when rudiments were treated with Dispase alone. When E2 quail pineal rudiment with the epidermis was grafted without any treatment, a multi-follicular structure developed which morphologically resembled embryonic pineal organs. When the epidermis was removed from E2 rudiments by Dispase, a single large vesicular structure was formed. These results suggest that the overlying epidermis and/or mesenchymal cells play some inductive role in the initial pineal development, while the mesenchymal tissue plays an important role in pineal follicular formation later during development. Since only a few experimental studies have been done to examine pineal morphogenesis, the present study provides fundamental insights into avian pineal development.

Animals↗

PubMed2002

Glucose-6-phosphate dehydrogenase in rat hepatic stellate cells: an ultrastructural enzyme-cytochemical study.

Glucose-6-phosphate dehydrogenase (G6PD) is the key enzyme of the pentose phosphate pathway in carbohydrate metabolism. This enzyme plays an important role in various cell functions, including cell proliferation, lipid/retinol metabolism, etc. Although marked cell proliferation and retinol metabolism take place in hepatic stellate cells (HSCs), it has not been determined whether cytochemically detectable G6PD is present in HSCs. The distribution pattern of G6PD within these cells, if it is present, is also unknown. The purpose of this study was to investigate the subcellular localization of G6PD in rat HSCs using a newly developed enzyme-cytochemistry (copper-ferrocyanide) method. Electron-dense precipitates indicating G6PD activity were clearly visible in the cytoplasm and on the cytosolic side of the endoplasmic reticulum of HSCs. The cytochemical controls ensured specific detection of the enzyme activity. HSCs possessed enzyme-cytochemically detectable G6PD activity. This enzyme may play a role in normal liver biology and liver disease pathophysiology, by supplying HSCs with NADPH and ribose-5-phosphate as a substance/substrate/co-factor for cell proliferation, oxidoreductase enzymes, and retinol metabolism, respectively.

Journal Article↗

PubMed2002

Antithrombin III activity and platelet count are more likely to decrease in twin pregnancies than in singleton pregnancies.

BACKGROUND: It is not known whether antithrombin III activity and platelet count are more likely to decrease in women with twin pregnancies than singleton pregnancies. METHODS: We enrolled 56 consecutive women with twin pregnancies and 692 consecutive women with singleton pregnancies. Antithrombin III activity and platelet count were determined at 26-31 weeks and again at 32-40 weeks of gestation. Thrombin-antithrombin complex, and plasmin-alpha2 plasmin inhibitor complex were measured simultaneously in some women. RESULTS: In twin pregnancies, both antithrombin III activity (111 +/- 8.2%) and platelet count (244 +/- 60 x 109/l) at 28.6 +/- 1.0 weeks decreased over time to 91 +/- 12% and 205 +/- 59 x 109/l, respectively, at 35.2 +/- 1.2 weeks; these decreases were significantly greater than in singleton pregnancies. However, a small number of women with singleton pregnancies had a significant decrease in antithrombin III activity in the absence of preeclampsia. The serum thrombin-antithrombin complex was significantly higher in twin pregnancies than in singleton pregnancies (9.7 +/- 4.2 ng/ml vs. 6.7 +/- 4.4 ng/ml, respectively, p < 0.01), and this increase correlated significantly with the decrease in antithrombin III activity in twin pregnancies (r = -0.459, p < 0.001). CONCLUSIONS: Antithrombin III activity and platelet count show a greater decrease in twin than in singleton pregnancies, perhaps due to a greater increase in thrombin generation.

Adult↗

PubMed2002

Relationship between blood pressure level in early pregnancy and subsequent changes in blood pressure during pregnancy.

BACKGROUND: It is not known whether women with high blood pressure in the first trimester are likely to exhibit a large increase in blood pressure during pregnancy. METHODS: We conducted a retrospective, longitudinal study of 1599 pregnant women, among whom 29 women (1.8%) received antihypertensive medication during pregnancy. The blood pressure levels measured during the first (7.9 +/- 2.4 weeks), second (20.7 +/- 1.2 weeks) and third trimesters (38.4 +/- 1.7 weeks) were analyzed. The obstetric outcomes were examined in five subgroups divided according to the quintile of the first-trimester mean arterial pressure level. RESULTS: The net change in blood pressure levels (third-trimester value minus first-trimester value) was significantly inversely correlated with the first-trimester blood pressure levels irrespective of the use or lack of use of antihypertensive drugs. Women with the highest quintile first-trimester mean arterial pressure had the largest body weight, exhibited a fall in blood pressure and had the smallest increase in body weight during pregnancy, and were significantly more likely to have a growth-restricted infant. CONCLUSIONS: Women with high initial blood pressure tended to exhibit a fall in blood pressure, whereas women with low initial blood pressure tended to exhibit a large increase in blood pressure during pregnancy. Women with high initial blood pressure and a small increase in body weight during pregnancy tended to have growth-restricted infants.

Adolescent↗

PubMed2002

Changes in the number of polymorphonuclear leukocytes and concentrations of IL-8 and granulocyte elastase in the vaginas of normal pregnant women.

PROBLEM: It is unknown whether the number of vaginal polymorphonuclear leukocytes (vPMNs) of healthy pregnant women changes during pregnancy. METHOD OF STUDY: We studied 23 women after 14.7 +/- 3.6 weeks, 37 women after 25.2 +/- 3.1 weeks, and 26 women after 32.9 +/- 2.0 weeks of gestation. Numbers of total vPMNs, viable vPMNs, dead vPMNs, percentage viability of vPMNs, and concentrations of IL-8 and elastase activity were determined in vaginal washings. RESULTS: The vPMNs, including viable and dead vPMNs, significantly increased with advancing gestation from 9.9 +/- 8.6 x 10(5) to 13.1 +/- 13.4 x 10(5), and to 27.1 +/- 26.6 x 10(5) (r=0.315, P < 0.01). Vaginal IL-8 significantly increased with advancing gestation. However, increases in vaginal elastase activity did not occur. CONCLUSIONS: These results suggested that an increase in vPMNs is an early event, and that the increase in vaginal elastase activity is a late event in relation to the ripening of the uterine cervix.

Adult↗

PubMed2002

Perioperative changes in plasma antithrombin activity and platelet counts in patients undergoing gynecologic surgery.

The relationships among perioperative changes in plasma antithrombin (AT) activity, platelet counts, and clinical risk factors for postoperative thromboembolism has not been studied extensively in gynecologic patients. AT activity and platelet counts were determined preoperatively and on postoperative days 1 and 7 in 74 patients who underwent gynecologic surgery. The relationships between each clinical risk factor for postoperative thromboembolism and the decrease in AT activity and platelet count were analyzed using a univariate logistic regression model. No clinically significant thromboembolism occurred in any patient. AT activity and platelet counts decreased significantly on postoperative day 1 and exceeded preoperative levels on day 7. Postoperative patients with malignancy were more likely to exhibit decreased AT activity. AT activity decreased significantly with increases in operating time and blood loss. Known risk factors for postoperative thromboembolism did not appear to be associated with postoperative decreases in platelet counts. Transient hyperconsumption of AT and platelets occurs immediately after gynecologic surgery. Surgery-induced AT deficiency may contribute to postoperative thromboembolism in patients with long operating times and significant blood loss.

Adult↗

PubMed2002

Recurrence risk of preterm birth due to preeclampsia.

There may be an increased risk of preterm birth due to preeclampsia among women whose previous pregnancies ended in preterm birth due to preeclampsia. We studied 1,130 women who delivered 2 successive singleton infants in our hospital, excluding women who delivered an abnormally formed infant during the study period. We reviewed the gestational week at delivery in these 2,260 pregnancies and found a total of 182 preterm deliveries (8.1%) by 156 women. The causes of preterm birth were reviewed. Failed tocolysis, including premature rupture of membranes and clinical chorioamnionitis, and preeclampsia accounted for 135 (74.2%) and 30 (16.5%) of the 182 preterm deliveries, respectively. Women whose 1st delivery was preterm had a 3.26 times (95% CI 2.21-4.79) higher risk of a subsequent preterm delivery than women whose 1st delivery was term (26/96 vs. 60/1,034). The risk of preeclampsia-related preterm delivery was 54.4 times (17.2 to 172.5) higher in women with a previous preeclampsia-related preterm delivery than in women with a previous term delivery (5/19 vs. 5/1034). Women who had a history of preeclampsia-related preterm birth had a greater risk of preeclampsia-related preterm birth in a subsequent pregnancy as compared with women with a previous term birth.

Adult↗

PubMed2002

Vaginal lactobacilli and preterm birth.

OBJECTIVE: To assess the relationship between the absence of vaginal lactobacilli and preterm birth at < 33 weeks of gestation. METHODS: A prospective study of the vaginal flora in the second trimester was undertaken in 1958 women with singleton pregnancies. The contribution of various microorganisms to preterm delivery was analyzed using a multivariate-logistic regression model. RESULTS: Lactobacillus species were not cultured from 28% of 118 women who delivered at < 33 weeks, 10% of 224 women who delivered between 33 and 36 weeks, and 5% of 1616 women who delivered at > 37 weeks of gestation. Lactobacilli (odds ratio and 95% confidence interval: 0.15 [0.09 to 0.24]), Mycoplasma hominis (2.3 [1.0 to 5.4]), and glucose non-fermentative gram-negative rods (2.1 [1.0 to 4.2]) were identified as independent risk factors for preterm delivery at < 33 weeks of gestation. Absence of lactobacilli (sensitivity and positive predictive value: 28% and 25%) was a better predictor of preterm delivery at < 33 weeks of gestation than the presence of Mycoplasma hominis (7% and 13%, respectively) or glucose non-fermentative rods (9% and 11%). CONCLUSIONS: Although this was not a cohort study, results suggest that tests for determining the presence of vaginal lactobacilli may be clinically useful tools for identifying women at an increased risk of preterm delivery at < 33 weeks of gestation.

Adult↗