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Biomedical subjects

T Yamabe

Publications and source records attributed to T Yamabe.

At least 55 records · Page 3Linked to original sources
PubMed1994

Prognostic significance of histopathological subtypes in stage I pure yolk sac tumour of the ovary.

The correlation between histological subtype [endodermal sinus (ES), polyvesicular vitelline (PV), glandular (G) and hepatoid (H) subtypes] and the prognosis of pure yolk sac tumours (YSTs) of the ovary was investigated. From 1964 to 1989, 35 patients with YSTs were treated with primary surgery and adjuvant chemotherapy. The prevalence of histological subtypes was as follows: 14 patients had a single subtype, either ES (12) or G (2); 12 patients had two subtypes, ES+G (4), ES+PV (3), ES+H (4) or G+H (1); six patients had three subtypes, ES+P+H (4) or ES+G+H (2); and three patients had all four subtypes. Multivariate analysis showed that important predictors were FIGO stage, chemotherapeutic regimen and residual tumour size. However, for stage I, multivariate analysis showed that the histological subtype was a superior predictor to the subclassification of FIGO stage I, age or chemotherapeutic regimen (P = 0.03). Kaplan-Meier analysis showed that YSTs composed of an admixture of three or four subtypes was associated with a better prognosis than those composed of one or two subtypes (P < 0.01), other variables being constant.

Adolescent↗
PubMed1994

[The predictive factor of postpartum impaired glucose tolerance in pregnant women with abnormal glucose tolerance].

To determine factors predictive of impaired glucose tolerance (IGT) in the postpartum period, we examined the maternal and perinatal characteristics of fifty-eight women with abnormal glucose tolerance during pregnancy. A 75g oral glucose tolerance test (OGTT) was performed on the women again around 4 weeks after delivery. Forty women who had a 2-hour plasma glucose level of 140mg/dl or more were defined as IGT in postpartum (group IGT), and the other eighteen women with a 2-hour plasma glucose level lower than 140mg/dl were defined as having normalized glucose tolerance (group N). The women in group IGT weighed more during pregnancy than those in group N (p < 0.05). Insulin secretion during the antepartum OGTT was lower in group IGT than in group N. On the basis of the prepregnant body mass index (BMI) for the obese group (BMI > or = 24), the women in group IGT weighed much more during pregnancy than those in group N (p < 0.03). In the non-obese group, the women in group IGT had higher glucose levels and lower insulin responses than those in group N. We concluded that, in obese women, excessive weight gain during pregnancy is predictive of postpartum IGT, while in non-obese women, the severity of glucose intolerance during pregnancy is related to poor postpartum prognosis.

Adult↗
PubMed1994

[The evaluation of ovarian tumor associated with pregnancy by the ultrasonographical method and serum CA125 levels].

We examined and evaluated ovarian tumor during pregnancy using ultrasonography. The CA 125 level was measured in 21 cases in the first and second trimesters. For a total of 65 cases of ovarian tumor considered to be tumor-like lesions (corpus luteum cyst, etc) the longitudinal and transverse diameters were measured, and the shape was assumed to be ellipsoid. Disappearance of the tumor was confirmed in 40 of the 65 cases. The disappearance occurred by the 16th week of gestation (mean time = 13 weeks and 2 days) in 32/39 (82%) cases, and the maximum diameter (size) did not exceed 10cm (50cm2) at any gestational week. Also the diameter (size) did not exceed 7cm (30cm2) after 15 weeks of gestation in the tumor-like lesions. Surgery performed during pregnancy (9-24 weeks) in 22 cases revealed 19 tumors (16 benign, one borderline malignant and two malignant tumors). The remaining 3 were chocolate cysts and did not require surgery because the diagnosis had been confirmed before pregnancy. There was no difference in the CA 125 level in benign and malignant tumors (15 were benign, 3 were chocolate cysts, one was borderline malignant and two were malignant tumors). Cases in which the maximum diameter (size) of an ovarian tumor increases or remains unchanged during the gestational period may need surgery for benign or occasionally malignant ovarian tumors.

Adult↗
PubMed1994

Hourly fetal urine production rate in the fasting and the postprandial state of normal and diabetic pregnant women.

OBJECTIVE: To examine whether maternal meal ingestion affects fetal urine production in normal and diabetic pregnancies and whether fetal urine production is increased in diabetic pregnancy. METHODS: The hourly fetal urine production rate was measured before and after breakfast in 17 fetuses of diabetic mothers and 14 of women with normal glucose tolerance. The rate was calculated by taking serial measurements of fetal bladder volume at 2-3-minute intervals by ultrasonography. RESULTS: In the control group, the hourly fetal urine production rate was significantly greater during the 2 hours after breakfast than that in the fasting state (P < .0005). In the diabetic group, the rate also tended to increase after breakfast (P = .07). In the postprandial state, the hourly fetal urine production rate was not significantly different between the groups. However, in the fasting state, it was significantly greater in the diabetic group than in the control group (P < .03). CONCLUSIONS: Maternal meal ingestion should increase fetal urine production. The increased fetal urine production in the fasting state in diabetics is assumed to be one cause of hydramnios.

Adult↗
PubMed1994

[A multicenter cooperative study on supplementary chemotherapy of uterocervical cancer. The Kyushu UFT Study Group of Uterocervical Cancer].

A randomized study was carried out by means of multicentered cooperation in respect to 5-FU and UFT administration, which was used as the supplementary chemotherapy after treatment of uterocervical cancer. Five years later, the improvement in prognosis was examined. Out of all the cases with radical operation + supplementary chemotherapy as well as with radical operation + postoperative radiotherapy + supplementary chemotherapy, 98 cases were ratable. The analysis of 98 cases led to no significant difference in the survival rate between the 5-FU administration group and the UFT administration group. As to the cases with supplementary chemotherapy + postoperative radiotherapy only, the survival rate was significantly higher in the UFT administration group than in the 5-FU administration group. During the administration, severe adverse side effects developed neither in the 5-FU administration group nor in the UFT administration group. These results suggest that UFT may be useful as a factor in supplementary chemotherapy of uterocervical cancer in combination with radiotherapy.

Administration, Oral↗
PubMed1994

[Long-term administration of carmofur as a post-operative adjuvant chemotherapy for cervical adenocarcinoma. Cervical Adenocarcinoma Cooperative Research Association].

Cervical adenocarcinoma and adenosquamous cell carcinoma are low in radiation sensitivity, and the prognosis is said to be inferior to that of squamous cell carcinoma. Eleven facilities nationwide participated in the historical control study on the recurrence prevention effect of carmofur (HCFU) administered at 300 mg/day for more than two years postoperatively as an adjuvant chemotherapy to patients with cervical adenocarcinoma or adenosquamous cell carcinoma for which radical operation is possible. Registered for the study was a total of 252 patients: 77 patients for whom administration of carmofur was begun during the period from January 1987 and March 1989, 71 patients (control 1) who were treated for the cancer after January 1982 but did not receive adjuvant chemotherapy, and 104 patients who received adjuvant chemotherapies with other than carmofur (control 2). In analyses with the Kaplan-Meier method, the carmofur administration group demonstrated a better cumulative survival rate and disease free rate than control 1 (no adjuvant chemotherapy), suggesting carmofur was effective in preventing the recurrence of cervical adenocarcinoma and adenosquamous cell carcinoma.

Adenocarcinoma↗
PubMed1994

Intervention of maternal transmission of HTLV-1 in Nagasaki, Japan.

Seroepidemiological and laboratory virological evidences strongly suggested that endemicity of HTLV-1 in Nagasaki Japan depends on maternal infant infections via breast milk. The most obvious way to prove this concept was an intervention study with refraining from breast-feeding by carrier mothers. Most infected babies seroconverted by the age of 12 months, which made it possible to diagnose the infection at the age of 12 months for the statistical purpose. Serology and PCR on both adults and children were consistent each other, suggesting the absence of seronegative carriers. The intervention study revealed that approximately 80% of maternal infection was prevented by refraining from breast feeding by carrier mothers. The remaining fraction of infections in formula-fed babies suggested an alternative infection pathway. Although intrauterine infections has been suggested by others to explain the PCR-positive cord blood samples. However, groups of cord blood-positive children and seroconverted children were distinct each other. Therefore, the presence of HTLV-1 provirus in the cord blood can not be a marker of intrauterine infection. Mothers who infected a child has approximately 10 times higher risk of another infection for the next baby than those who did not.

Breast Feeding↗
PubMed1993

Left ventricular diastolic pressure-volume response immediately after successful percutaneous transvenous mitral commissurotomy.

The left ventricular (LV) diastolic pressure-volume response after percutaneous transvenous mitral commissurotomy (PTMC) was investigated to determine whether it was related to the baseline conditions of the left ventricle. Left ventriculography was performed, and the measurements of LV pressure were obtained in 32 patients before and after PTMC. Mitral valve area increased from 1.0 +/- 0.3 to 1.9 +/- 0.4 cm2 (p < 0.005) after PTMC, which caused a decrease in left atrial mean pressure (14.8 +/- 5.9 to 7.4 +/- 2.7 mm Hg; p < 0.005). LV end-diastolic pressure increased in all patients 5 minutes after PTMC. However, patients could be divided into 2 groups according to the following changes in LV end-diastolic pressure 20 minutes after PTMC: In 22 patients, LV end-diastolic pressure returned to the near-baseline level 20 minutes after PTMC (before 5.0 +/- 2.2, 5 minutes after 8.6 +/- 3.1, and 20 minutes after 6.3 +/- 2.5 mm Hg) with a significant increase in LV end-diastolic volume index (64 +/- 12 to 74 +/- 14 ml/m2; p < 0.001) and augmentation of LV stroke volume index (39 +/- 9 to 47 +/- 11 ml/m2; p < 0.001). However, in the remaining 10 patients with a larger LV volume (> 80 ml/m2) and reduced ejection fraction (< 50%) at baseline, LV end-diastolic pressure further increased 20 minutes after PTMC (before 5.5 +/- 2.8, 5 minutes after 7.8 +/- 2.7, and 20 minutes after 11.0 +/- 2.9 mm Hg) without significant changes in LV volume.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Relationship between the prognosis of conception and the location of pelvic involvement in endometriosis: significance of the TOP (tube, ovary, peritoneum) classification.

To determine the main factors that affect the prognosis for conception in endometriosis-associated infertility, 99 infertile patients with laparoscopically confirmed endometriosis were classified according to the new TOP classification, which we have developed to evaluate the severity of endometriosis by site, i.e., fallopian tubes (T), ovaries (O) and the peritoneum (P). According to the TOP classification, a negative correlation between the pregnancy rate after treatment and the severity of lesions was noted in case of tubal and peritoneal involvement, but not when the ovaries were involved. If there was no tubal involvement or only unilateral tubal involvement, high pregnancy rates were achieved for patients with ovarian endometrioma (87%) and for those with partial or complete posterior cul-de-sac obliteration (83%). The results suggest that for endometriosis-associated infertility, the treatment modality should be selected according to the severity of tubal involvement, which is considered to contribute to infertility more than ovarian or peritoneal lesions.

Adult↗
PubMed1993

Rapid increase in plasma endothelin concentrations during percutaneous balloon dilatation of the mitral valve in patients with mitral stenosis.

OBJECTIVE: To investigate the relation between plasma concentrations of immunoreactive endothelin and haemodynamic variables before and after percutaneous transvenous balloon dilatation of the mitral valve. DESIGN: Prospective study. SETTING: National cardiovascular centre. PATIENTS: 25 patients with mitral stenosis and 26 healthy volunteers. MAIN OUTCOME MEASURES: Plasma concentrations of immunoreactive endothelin were measured in the pulmonary artery, left atrium, ascending aorta, and femoral vein before and after balloon dilatation of the mitral valve. RESULTS: Peripheral venous concentrations (mean (SD)) of endothelin were higher in the patients with mitral stenosis than in the healthy volunteers (1.76 (0.51) v 1.37 (0.45) pg/ml, p < 0.05) and they correlated with the mean left atrial pressure (r = 0.74, p < 0.01). Balloon dilatation of the mitral valve reduced the mean left atrial pressure without changing the mean right atrial pressure, systemic arterial pressure, heart rate, or cardiac index. Concentrations of plasma endothelin in the femoral vein increased from 1.76 (0.51) to 3.39 (2.46) (p < 0.01), 4.82 (2.34) (p < 0.001), and 2.43 (0.52) pg/ml (p < 0.05) at 15 and 30 minutes and 24 hours after the procedure. The concentration of endothelin in the pulmonary artery also increased from 1.85 (0.85) to 4.32 (1.58) pg/ml (p < 0.01) 30 minutes after the dilatation, whereas there were no appreciable changes in endothelin concentration in the left atrium or ascending aorta. CONCLUSIONS: Plasma endothelin concentrations were higher in patients with mitral stenosis than in healthy volunteers and the increase was proportional to left atrial pressure. After balloon dilatation of the mitral valve there was an abrupt rise in endothelin in the femoral vein and pulmonary artery but no change in left atrial or aortic blood samples. These findings suggest that endothelin may be another vasoactive substance involved in congestive heart failure.

Adult↗
PubMed1992

Maternal transmission of HTLV-1 other than through breast milk: discrepancy between the polymerase chain reaction positivity of cord blood samples for HTLV-1 and the subsequent seropositivity of individuals.

We used a nested polymerase chain reaction (PCR) to diagnose HTLV-1 carriers. The DNA isolated from the nuclear extract obtained from frozen whole blood was found appropriate for PCR study both qualitatively and quantitatively. The use of freshly frozen whole blood made the field work much easier, and the use of a nuclear extraction procedure allowed DNA isolation in just 4 microcentrifuge tubes. We could not attain sufficient sensitivity to detect a single molecule with single-step PCR, but nested PCR was confirmed to detect a single molecule/reaction. All samples of the seropositive group including 94 blood donors, 66 mothers, and 13 children were positive in the nested PCR, while none of the seronegative group, including 198 blood donors and 285 children, was positive. Although 18/717 (2.5%) cord blood samples obtained from babies born to carrier mothers were PCR-positive, none of 5 formula-fed children tested who had been PCR-positive in the cord blood gave evidence of infection later on. Furthermore, all of 4 seropositive infected children who were formula-fed had been PCR-negative in their cord blood. The results are not consistent with intrauterine infection, but suggest the presence of a perinatal or postnatal infection route other than through breast milk.

Base Sequence↗
PubMed1992

Sporadic appearance of luteal-phase defect in prospective assessment.

We studied the sporadic appearance of luteal-phase defect in the prospective assessment of consecutive cycles. Basal body temperature (BBT) was recorded in 36 women (20-35 years of age) for at least 3 consecutive cycles (total of 194 cycles). These BBT records were analyzed for pattern and luteal-phase length (LPL). Furthermore, the relationship was investigated between the BBT and luteal function in terms of serum hormonal levels and endometrial dating in the luteal phase. The length of the transitional period from the hypothermic to the hyperthermic phase was also studied in relation to luteal function in 59 women (21-33 years of age). The results were as follows: (1) Different BBT patterns and LPLs in consecutive cycles occurred in 36 and 67% of the observed cycles, respectively. (2) Cycles with abnormal steroid levels and endometrial dating were observed sporadically. (3) The length of the transitional period appeared useful for prospective evaluation of luteal function. These findings suggest that the conditions of the luteal function do not appear in every cycle of each woman. Therefore, assessing the function of one cycle seems of little use in predicting the function of the next or future cycles.

Adult↗
PubMed1992

Vulvar dystrophy: a clinical follow-up.

The vulvar dystrophy is an enigma and one of the most controversial topic as for the pathogenesis, clinical outcome and particularly the malignant potentiality. There has been very few systematic studies regarding vulvar dystrophy in Japan. Vulvar dystrophy with dysplasia is said to be a pre-malignant condition of the vulva. So in our institute a prospective follow-up of 5 months to 4 years was obtained in vulvar dystrophic patients after a conservative protocol of treatment. The initial histological diagnosis revealed 17 patients with squamous hyperplasia (9 patients with dysplasia and 8, without dysplasia), lichen sclerosus in 5 and other dermatoses in 1 patient. "Itching" was the most frequent complaint, encountered in 20 (69%) of the study patient. Amongst these patients 4/5 of lichen sclerosus and 16/18 of squamous hyperplasia and other dermatoses had complete symptomatic relief with testosterone and corticosteroid respectively. Morphologically 22/23 (96%) had more than 50% decrease of the total lesion. In squamous hyperplasia with dysplasia after treatment, the re-biopsy revealed improvement of the dysplasia in all the cases with total disappearance in the mild dysplasia group. So far, vulvar carcinoma did not develop in any of the patient followed in our study who received treatment for vulvar dystrophy. So, for vulvar dystrophy, a benign squamous epithelial disorder of the vulva, steroid hormone therapy is indeed a logical and a consistent one.

Adult↗
PubMed1992

Association between chlamydial infections and pelvic lesions.

Chlamydia trachomatis usually causes asymptomatic cervicitis, but it sometimes ascends into the uterine cavity, fallopian tubes, or peritoneal cavity, causing pelvic inflammatory disease and infertility. In this study, we examined endocervical chlamydial antigens and serum chlamydial antibodies in infertile women and laparoscopically evaluated pelvic lesions according to our pelvic scoring system. In patients testing positive for a chlamydial infection, the total pelvic score was significantly higher than in patients testing negative. When each area examined was assessed separately, however, only the tubal score was significantly higher in the chlamydia infected patients. These findings may indicate that tubal lesions are the major cause of infertility in women with chlamydial infections.

Adult↗
PubMed1992

[Phase III study of DWA2114R for ovarian cancer].

A phase III study of DWA2114R for ovarian cancer was carried out in CAP regimen by a cooperative study group consisting of 42 institutions. The response rate of 31 cases for DWA2114R regimen was 38.7% and out of 30 cases for CDDP regimen 46.7%. No significant differences were observed between the two regimens in efficacy, adverse reactions, and abnormalities in laboratory findings except for red blood cell and creatinine clearance, but the incidence of thrombocytopenia was likely to be lower in DWA2114R than in CDDP regimen. Since the DWA2114R regimen did not need hydration, or require diuretics, DWA2114R is more useful in the treatment of ovarian cancer than cisplatin.

Adult↗