Biomedical subjects

T Ikenoue

Publications and source records attributed to T Ikenoue.

At least 91 records · Page 5Linked to original sources

PubMed1993

Premature rupture of the membranes--aggressive versus conservative approach: effect of tocolytic and antibiotic therapy.

The purpose of this randomized, prospective study was to evaluate the efficacy of tocolytic and antibiotic therapy in the prolongation of pregnancy and neonatal outcome in the treatment of premature rupture of the membranes without clinical labor. Delivery was delayed for 48 h, 7 days and beyond 35 weeks of gestation in 87, 39 and 18%, respectively, of patients in the treated group (n = 39) compared with 50, 12 and 17% of patients in the nontreated group (n = 42). The incidence of a low Apgar score (< 7 at 5 min), requiring artificial ventilation, and infectious morbidity was more common in the treated group than in the nontreated group (18 vs. 0, 41 vs. 17 and 39 vs. 17%, respectively). There was no significant cost difference in survivors between the treated and nontreated groups, although the mothers in the treated group were significantly more expensive. From these observations, it appears that tocolysis and antibiotics are not effective in PROM cases.

Adult↗

PubMed1993

Effects of environmental factors on perinatal outcome: neurological development in cases of intrauterine growth retardation and school performance of children perinatally exposed to ionizing radiation.

We performed two studies to investigate environmental factors in relation to neurological development in infants. The first, a field study, examined the elementary school performance of 929 children who were born from mothers exposed to the atomic bombing of Hiroshima, Japan, August 6, 1945. The most severe mental retardation was observed in the group exposed between 8 and 15 weeks following fertilization, and the second most severely damaged group was exposed between 16 and 25 weeks. The second, a clinical investigation, examined infants in the perinatal center who survived intrauterine growth retardation (IUGR). Those who survived with abnormal neurological development had a mean growth arrest corresponding to a uterine height of 27 weeks of gestation. This was at an earlier stage than those who survived with normal neurological development and had a mean growth arrest corresponding to 29-30 weeks of gestation. A smaller head circumference at birth was closely correlated with abnormal neurological sequelae. These results indicate that the brain development of the fetuses may have been affected by neurotoxic events similar to ionizing radiation. We emphasize the importance of avoiding neurotoxic stress to pregnant women when the fetus is in the critical period of neuronal development, before 27 weeks of gestational age.

Child↗

PubMed1993

[The efficacy of prophylactic antibiotic and tocolytic therapy for premature rupture of the membranes--a prospective randomized study].

A comparative study in patients with premature rupture of the membranes (PROM) from 25 to 34 weeks of gestation was carried out, prospectively. Group 1 (34 patients) was given aggressively intrauterine therapy including the administration of tocolytic agents (ritodrine and/or magnesium sulfate) and prophylactic antibiotics (AB-PC 2g/day). Group 2 (41 patients) was managed conservatively with bed rest only. At the time of admission to the study, there were no clinical signs of infection, fetal distress, or active labor in either group. All patients were delivered if the pregnancy had reached 35 weeks of gestation or later, had established labor, or developed evidence of chorioamnionitis or fetal distress. Prolongation for more than 72 hours was greater in group 1 than in group 2. There was no difference in the incidence of chorioamnionitis, postpartum endometritis, or placental infection in the groups. However, the incidence of a low Apgar score (7 < at 5 min), requiring artificial ventilation, and infection was more common in group 1. It is concluded that the use of antibiotics and tocolytics might make the management of PROM more complicated.

Anti-Bacterial Agents↗

PubMed1992

The effects of a 5-lipoxygenase inhibitor, AA-861, on PGI2-like substance production in guinea-pig lungs.

To determine the effects of AA-861 on PGI2 production in guinea-pig lungs, 3 g of guinea-pig lung was chopped in 4 ml of buffer (control group), in buffer with 4 micrograms/ml indomethacin (indomethacin group) and in buffer with 2.5 x 10(-5)M AA-861 (AA-861 group). The chopped lungs were incubated for 30 min. 250 microliters of incubation medium from each group was assessed before and after 3, 5, 10, 15, 20, 25 and 30 min of incubation. The incubation medium was centrifuged and the supernatant was tested for a PGI2-like substance (PGI2) by platelet aggregation inhibition. PGI2 was produced mainly during the initial 3-5 min of incubation and was decreased thereafter. PGI2 production was almost completely inhibited in the indomethacin group at all of the incubation times and was partially inhibited in the AA-861 group during the initial 3-5 minutes. Endogenous 5-lipoxygenase products generated in the early stages of incubation seem to be involved in PGI2 production in guinea-pig lungs.

Animals↗

PubMed1992

Eicosanoids production in endometriosis.

In order to investigate the production of eicosanoids in human endometrium, myometrium, leiomyoma, adenomyosis, normal ovary, non-endometrial cyst and endometrial cyst, slices of each tissue were incubated. 6-Keto-prostaglandin (PG) F1 alpha, thromboxane (TX) B2, PGF2 alpha and PGE2 concentrations in the incubation medium were measured by direct RIA. 6-Keto-PGF1 alpha production of adenomyosis was significantly higher than that of endometrium, myometrium and leiomyoma, especially in the menstrual phase. The production of eicosanoids in endometrial cyst was significantly higher than that of non-endometrial cyst and normal ovary. These results suggest that endometriosis is associated with increased eicosanoid production in vivo.

6-Ketoprostaglandin F1 alpha↗

PubMed1992

Effects of saturated fatty acids on prostaglandin E 9-keto-reductase.

We examined the effects of three saturated fatty acids (myristic acid 14:0, palmitic acid 16:0, and stearic acid 18:0) on prostaglandin E 9-ketoreductase (PGE-9-KR, EC 1.1.1.189), which catalyzes the conversion of prostaglandin E2 (PGE2) into prostaglandin F2 alpha (PGF2 alpha). Palmitic acid inhibited PGE-9-KR activity dose-dependently, whereas the other two fatty acids had no effect. In spite of the structural similarity of these fatty acids, our findings suggest that, of the three, only palmitic acid has an inhibitory effect on PGE-9-KR.

Catalysis↗

PubMed1992

Amniotic fluid embolism and leukotrienes--the role of amniotic fluid surfactant in leukotriene production.

Surfactant rich lipid (lipid) was extracted from cell free 10,000 x g pellets of amniotic fluid. White blood cells (WBC) were isolated from human donors. 36 x 10(7) WBC and 5 g rabbit lung were incubated with pretreated lipid or dipalmitoyl lecithin (lecithin). Leukotrienes (LTs) were identified by high performance liquid chromatography (HPLC) and bioassay, and quantified by radioimmunoassay. Peaks of LTC4 and LTD4 on HPLC and guinea-pig ileum contraction could be identified in lipid and lecithin groups, but not in the control group. LTC4 production by lipid and lecithin groups was significantly higher than that by the control group. An involvement of amniotic fluid surfactant in leukotriene production is suggested.

1,2-Dipalmitoylphosphatidylcholine↗

PubMed1992

Correlation between dysmenorrheic severity and prostaglandin production in women with endometriosis.

The role of prostaglandins (PGs) in dysmenorrhea of endometriosis is poorly understood. The relationship between dysmenorrheic severity and prostaglandin production was investigated in endometriosis. Slices of normal myometrium, adenomyosis, normal ovary and endometrial cyst were incubated. 6-Keto-PGF1 alpha (a metabolite of PGI2), TXB2 (a metabolite of TXA2), PGF2 alpha, and PGE2 concentrations of the incubation medium were measured by RIA. The results showed that 6-keto-PGF1 alpha production in adenomyosis and endometrial cyst were significantly higher than those in normal myometrium and ovary. A direct relationship between the degree of dysmenorrheic severity and PGs production in tissue in endometriosis was observed.

6-Ketoprostaglandin F1 alpha↗

PubMed1992

Treatment for necrotizing enterocolitis perforation in the extremely premature infant (weighing less than 1,000 g).

The frequency of necrotizing enterocolitis (NEC) in the extremely premature infant (less than 1,000 g) is still high and it is very difficult for infants weighing less than 1,000 g with NEC perforation to survive. In our institutes, the management protocol for NEC perforation in infants weighing less than 1,000 g includes peritoneal drainage under local anesthesia, administration of coagulating factor XIII, and the usual treatment for septic shock. During the past 3 years, four infants weighing less than 1,000 g with NEC perforation have survived using this protocol without laparotomy. This management protocol is the treatment of choice in infants in very poor condition or infants weighing less than 1,000 g with NEC perforation.

Diseases in Twins↗

PubMed1992

Characterization of parathyroid hormone-related protein in the human term placenta.

To characterize parathyroid hormone-related protein (PTHrP) in the human placenta, we measured PTHrP-like immunoreactivity (PRP-LI) in the term placenta and studied the elution profiles of placental tissue extracts on Sephadex G-75 chromatography with a specific RIA. We also examined the gene expression of PTHrP mRNA by Northern blot analysis and the localization of PRP-LI in the placenta by immunohistochemistry. The amount of PRP-LI in placental extracts (n = 7) was 20.9 +/- 2.2 pg/g wet tissue (mean +/- SE). Dilution curves of placental tissue ran parallel to those of synthetic PTHrP (1-34) standards. Sephadex G-75 gel chromatography demonstrated two major PRP-LI peaks; the first peak was eluted around the molecular size between 10 kilodaltons (Kda) and 20 Kda and the other around 5 Kda. Northern blot analysis of PTHrP mRNA extracted from placental tissues showed a major hybridization signal around 18S. PTHrP immunohistochemistry showed PRP-LI staining in the cytoplasm of syncytiotrophoblasts and stroma cells (Hofbauer cells) in the term placenta. These results suggest that syncytiotrophoblasts and stroma cells in the term placenta synthesize PTHrP in two major molecular forms, 10 Kda-20 Kda and around 5 Kda.

Adult↗

PubMed1992

Maternal cerebral hemodynamics in the supine hypotensive syndrome.

Cerebral hemodynamics were studied in eight nonpregnant women and 24 women in late pregnancy by internal carotid artery velocimetry with a 3.5-MHz continuous-wave Doppler system. Criteria for supine hypotensive syndrome were a mean blood pressure decrease of 15 mmHg and a 2-minute sustained increase in pulse of 20 beats per minute under postural change from the left lateral to supine position. Nonpregnant and normal pregnant controls not meeting these two criteria displayed decreases of 22.9 and 21.7%, respectively, in time-averaged mean peak velocity (mean velocity) in the supine position compared with the left lateral position. Five subjects with subclinical supine hypotensive syndrome who met one of the above criteria showed a 37.0% decrease in internal carotid artery mean velocity in the supine position. Two patients with supine hypotensive syndrome could not tolerate the supine position for more than 6 minutes, at which time internal carotid artery mean velocity fell below 10 cm/second, reverse flow was observed, and they complained of dizziness, nausea, and syncope. Internal carotid artery mean velocity in all women showed no change in the sitting position compared with the left lateral position. These results indicate that the supine position should be avoided in late pregnancy, especially by women with cerebrovascular complications.

Adult↗

PubMed1991

Effects of ranitidine on maternal gastric juice and neonates when administered prior to caesarean section.

Ranitidine hydrochloride, a histamine H2-receptor antagonist, was intravenously administered to 61 pregnant women at a dose of 50 mg as premedication for caesarean section; its effects on gastric secretion were studied in the mother and the newborn. The volume of the maternal gastric juice collected immediately after the induction of anaesthesia averaged 14.0 +/- 10.0 ml with pH 3.48 +/- 1.70, and at the time of extubation, 3.6 +/- 2.8 ml with pH 4.19 +/- 1.79, respectively. Forty-four full-term neonates whose mothers had received ranitidine were selected to investigate the effects of ranitidine. Another 45 full-term normal newborns delivered vaginally, and 14 by caesarean section, served as controls. No effects of ranitidine infusion in the mothers were detected in the newborn children. The gastric pH of the newborn at birth and 24 hours after birth, gastrointestinal symptoms and the general growth checked at the regular one-month work-up after birth did not differ in test and control groups.

Anesthesia, Obstetrical↗

PubMed1991

The relationship between clinical signs and hypercoagulable state in toxemia of pregnancy.

The hypercoagulable state in patients with toxemia of pregnancy was investigated in comparison with normal pregnant women using new coagulation parameters, mainly thrombin-antithrombin III (TAT) complexes, alpha 2-antiplasmin-plasmin complexes (PIP), and D-dimer FDP. When the patients were categorized by the classification of the WHO Study Group (1985), significant increases of TAT complexes and alpha 2-PIP complexes with decreases of the ATIII level were observed in the groups with preeclampsia and severe gestational hypertensive disease as compared to normal pregnant women. A significant increase of D-dimer FDP was observed in a group with severe gestational hypertensive disease. Additionally, the relationship between clinical signs and the hypercoagulable state in the patients was analyzed using canonical correlation analysis as a multivariate analysis. The clinical signs and coagulation parameters had a significantly high correlation of lambda 1 = 0.7219, p less than 0.01. The results showed that clinical signs were associated with simultaneous coagulation abnormalities. The indices obtained from the results of canonical correlation analysis, which were called the clinical index and the coagulation index, should be useful in evaluating the efficacy of anticoagulation therapy.

Adult↗

PubMed1991

Effects of longitudinal maternal glucose control on infants of diabetic mothers.

Between 1980 and 1987, 45 pregnant women with diabetes mellitus who required insulin therapy were delivered at Kagoshima Municipal Hospital. The perinatal mortality rate in the present study was zero. Twelve infants were large for gestational age, ten were small for gestational age, and 23 were appropriate for gestational age. Tight maternal glucose control (fasting values of less than 100mg/dl and 2 hours post-prandial values of less than 120mg/dl) obtained before 32 weeks of gestation significantly decreased the incidence of large for gestational age infants. However, longitudinal control patterns of maternal glucose during pregnancy have little effect on the incidence of small for gestational age infants and neonatal complications. The former was more closely related to maternal vascular complications. Congenital malformations were found in two cases.

Birth Weight↗

PubMed1990

Ectopic nesidioblastosis.

We observed one case of ectopic nesidioblastosis. A solitary nesidioblastoma was observed in the anterior wall of the duodenum. Ectopic nesidioblastosis has not been previously reported, but our experience suggests the necessity of examination for ectopic pancreas in cases of SIDS or its near-miss.

Blood Glucose↗

PubMed1990

Interstitial deletion of long arm of chromosome 2(q31q33).

We describe the case of a 4-month-old girl with interstitial deletion of the long arm of chromosome 2(46,XX,del(2) (q31q33]. Clinical features included intrauterine growth retardation, psychomotor delay, antimongoloid slanting of the palpebral fissures, hypertelorism, low set ears, cleft palate, micrognathia, luxatio coxae and pes varus. It is suggested that the gene for soluble isocitrate dehydrogenase (IDH1) is located on 2q33.3. The activity of serum IDH1 was in the normal range in this patient.

Abnormalities, Multiple↗

PubMed1989

The value of the sinusoidal tcPO2 pattern in the evaluation and management of cyanotic congenital heart disease with ductus dependent lesions.

A characteristic sinusoidal tcPO2 pattern was observed in 17(27%) of 62 patients with congenital heart disease manifested by cyanosis or heart failure during the neonatal period. All of these 17 patients were definitively diagnosed by cardiac catheterization, as having 8 PPA; 3 ToF; 2 TGA + VSD + PA; 2 asplenia with PA; 1 TGA + VSD + PS; and 1 TA (no TGA type). The transcutaneous oxygen pressure pattern of these patients showed a sinusoidal change with a cycle length of 6-20 min with the maximum pressure not exceeding 50 torr and the minimum pressure occasionally close to 0 torr. This sinusoidal tcPO2 pattern was associated with various types of ductus-dependent congenital heart diseases and hence may be of diagnostic value. Transcutaneous oxygen pressure monitoring is also useful in evaluating the ductal response to PG. Other possible mechanisms underlying this phenomenon including biological oscillation should be considered.

Alprostadil↗

PubMed1989

[Combination therapy of intravenous ritodrine and magnesium sulfate to inhibit premature labor].

Thirty-seven patients in premature labor with intact membranes were treated as follows. Ritodrine was given as a primary tocolytic agent and magnesium sulfate was added adjunctively when the uterine contractions could not be controlled even when the administration of ritodrine exceeded 250mmg/min (14 of 37 cases) (combination therapy group). Prolongation of pregnancy for more than 48 hours and delivery beyond 37 weeks were achieved in 89% and 68% respectively. These results were more satisfactory than those obtained with the isoxsuprine treated group (122 cases). The incidence of discomfort due to nasal obstruction was low in the ritodrine group, but side effects such as palpitation and hot flush occurred more commonly in the combination group. No life-threatening side effects were observed throughout this study. Twelve out of 37 cases (32%) were delivered before 37 weeks. Neonatal morbidity was more frequent in this group delivered before 33 weeks of gestation. These included respiratory distress, hypotension, hypoglycemia, and hypocalcemia. Moreover, two babies born from mothers treated with ritodrine and magnesium had ileus-like symptoms. These data suggest that this combination therapy is effective as far as the tocolytic purpose is concerned. However, special attention must be paid to adverse maternal and neonatal effects as well.

Adult↗