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Takeshi Maruo

Publications and source records attributed to Takeshi Maruo.

At least 73 records · Page 4Linked to original sources
PubMed2003

Successful medical treatment with danazol after failed embolization of uterine arteriovenous malformation.

BACKGROUND: Transcatheter arterial embolization has been the therapy of choice for uterine arteriovenous malformations, whereas medical therapy has not been popular because of patient propensity to bleed. CASE: A 29-year-old woman, gravida 3, para 0, was diagnosed with uterine arteriovenous malformation. Because initial treatment with uterine artery embolization was unsuccessful, she was ultimately treated with danazol. Resolution of the lesion after 2 weeks of danazol therapy was observed. As of follow-up at 16 months, she has remained free from further abnormal bleeding episodes and recurrence of the lesion. CONCLUSION: Danazol has the potential for medical management of uterine arteriovenous malformations in hemodynamically stable patients who do not respond to embolization.

Adult↗
PubMed2003

Vaginoplasty with Interceed absorbable adhesion barrier for complete squamous epithelialization in vaginal agenesis.

OBJECTIVE: The purpose of this study was to present our experiences of an innovative surgical approach for vaginal agenesis with the use of Interceed absorbable adhesion barrier (Ethicon) to achieve a satisfactory neovagina. STUDY DESIGN: The current study involved 10 subjects who were diagnosed with vaginal agenesis. After the creation of a vaginal tunnel, a mold that had been wrapped with Interceed was placed in the neovagina. RESULTS: No operative and postoperative complications were encountered. The duration of the operation was < or =30 minutes, and blood loss was minimal. The postoperative hospital stay was only 2 days. Epithelialization of the neovagina was achieved 1 to 4 months after the operation, and all patients were satisfied with the outcome. The neovagina that was created with this procedure was not much different from the normal adult vagina as far as histologic and physiologic conditions are concerned. CONCLUSION: This innovative surgical procedure may be a potential alternative approach for the therapy of vaginal agenesis with the use of the absorbable adhesion barrier Interceed with excellent results.

Adolescent↗
PubMed2003

Abundant expression of sodium-potassium-activated adenosinetriphosphatase alpha 1 subunit in corpus luteum of porcine ovary.

Follicular development is accompanied by the accumulation of follicular fluid. During corpus luteum formation, follicular fluid is diminished and antrum is replaced by lutein cells. These dynamic changes in fluid distribution suggest the existence of control mechanism of fluid transport and membrane permeability. One of the major factors regulating membrane permeability is the sodium-potassium-activated adenosinetriphosphatase (Na(+)-K(+)-ATPase). To elucidate the possible involvement of Na(+)-K(+)-ATPase in follicular growth and luteinization, immunohistochemical localization of Na(+)-K(+)-ATPase alpha1 subunit and enzyme activity in porcine ovary were investigated. In primordial follicles, Na(+)-K(+)-ATPase alpha1 subunit immunostaining was localized only in the oocyte and the surrounding stromal cells. In preantral follicles, immunostaining for Na(+)-K(+)-ATPase alpha1 subunit became apparent in granulosa and theca cells. As the follicle matured, the staining intensity in the oocyte, theca, and granulosa cells increased, which corresponded with the enzyme activity. Na(+)-K(+)-ATPase alpha1 subunit immunostaining became most abundant in granulosa and theca lutein cells in corpus luteum, and decreased in the regressing corpus luteum. Enzyme activity in corpus luteum was significantly higher than that in the follicles. This is the first study indicating that Na(+)-K(+)-ATPase alpha1 subunit expression is augmented in granulosa cells by follicular growth and most abundant in lutein cells in the corpus luteum, suggesting its possible involvement in corpus luteum formation.

Animals↗
PubMed2003

Expression of Fas/Fas-ligand, Bcl-2 protein and apoptosis in extravillous trophoblast along invasion to the decidua in human term placenta.

There are two local subtypes of extravillous trophoblast (EVT): one is the proliferative phenotype of EVT, which primarily consists of proximal cells and the other is the invasive phenotype of EVT, which is composed mainly of distal cells of cell columns. The mechanism of invasion of EVT to the decidua remains obscure. In order to elucidate the potential role of apoptosis along the invasion of EVT to the decidua, we have assessed the expression of apoptosis-regulating proteins including Fas antigen (Fas), Fas-ligand (Fas-L) and Bcl-2 protein, and apoptosis in the proliferative phenotype of EVT and the invasive phenotype of EVT in term (37 to 38 wk) placenta Fas, Fas-L and Bcl-2 protein expression were examined by avidin/biotin immunoperoxidase method. Apoptosis was assessed by in situ DNA 3'-end labeling method. Appearance of apoptotic nuclei in EVT was also examined by transmission electron microscopy. Mean percentage of apoptosis-positive nuclei in the invasive phenotype of EVT was significantly higher than that in the proliferative phenotype of EVT. Transmission electron microscopy revealed the presence of apoptotic nuclei in the invasive phenotype of EVT. Immunohistochemical analyses revealed that Fas and Fas-L expression in the invasive phenotype of EVT were more abundant than those in the proliferative phenotype of EVT, while Bcl-2 protein expression in the invasive phenotype of EVT was less abundant than that in the proliferative phenotype of EVT. The present findings suggest that Fas/Fas-L and Bcl-2 protein expression participate in the regulation of apoptosis in EVT along the invasion to the decidua, and that the increased occurrence of apoptosis in the invasive phenotype of EVT may be attributable to the increased expressions of Fas and Fas-L and decreased expression of Bcl-2 protein in those cells in term placentas.

Adult↗
PubMed2003

Bioelectrical impedance analysis in the clinical management of preeclamptic women with edema.

OBJECTIVE: The aim of this study was to correlate bioelectrical impedance analysis (BIA) with the clinical course of preeclampsia with edema. DESIGN: 440 pregnant women with apparently normal, single pregnancy participated in this longitudinal study. Anthropometric measurements and BIA were performed during pregnancy and postpartum period. RESULTS: All of the measurements were completed in 333 of the women; 279 of the women had a normal pregnancy (control group). The remaining 54 women developed edema during the third trimester of pregnancy. Of these, 40 women had only edema, and 14 women had edema followed by hypertension and/or proteinuria (preeclampsia group). The BIA index (the height squared divided by resistance) in the control group increased significantly towards late pregnancy, compared to that in early pregnancy. The indexes in the edema group were significantly higher during the third trimester compared to those of the control group at the same gestational week. The index in the preeclampsia group was higher relative to that in the control group. Moreover, a substantial increase in the index preceded the development of edema in the cases in which pregnancy was terminated due to deterioration of preeclampsia. CONCLUSIONS: Our results show that BIA is a useful method for monitoring longitudinal changes in total body water in pregnant women, and that BIA may be a powerful predictor of deterioration of preeclampsia preceded by edema.

Adult↗
PubMed2003

Minireview: Up-date management of non responder to clomiphene citrate in polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is a heterogeneous disorder in which chronic anovulation is a common feature despite the presence of multiple micro- structures in the ovaries. A growing body of evidence has suggested that serum hyperinsulinemia contributes to the excess ovarian androgen secretion observed in women with PCOS. The standard therapy for anovulatory women with PCOS is oral administration of clomiphene citrate (CC). However, a significant proportion of women with PCOS fail to ovulate with the use of standard dosage of CC and are called CC-resistant PCOS. The recent introduction of the insulin-sensitizing agents as adjuvants to clomiphene citrate and gonadotropins has changed the treatment strategy. This is a comprehensive review of the literature, with an emphasis on the role of hyperinsulinemia in the pathogenesis of PCOS and on randomized controlled trials of the medical and surgical treatment options for women with CC-resistant PCOS. Although both standard and novel treatments were addressed in the present review, special attention was paid to the evidence in support of the recent introduction of insulin-sensitizing agents in the management of anovulatory woman with CC-resistant PCOS.

Anovulation↗
PubMed2003

Thyroid hormone synergizes with follicle stimulating hormone to inhibit apoptosis in porcine granulosa cells selectively from small follicles.

To investigate the effect of thyroid hormone on the proliferative activity and apoptosis of granulosa cells at the varying stages of follicular growth, porcine granulosa cells obtained from small (1-2 mm), medium (3-5 mm) and large (6-11 mm) follicles were cultured under a serum-free condition in the presence or absence of follicle stimulating hormone (FSH; 20 ng/ml), with or without triiodothyronine (T3; 10-8M). Relative viability, proliferative activity, and apoptosis of cultured granulosa cells were evaluated with 3-(4.5-dimethylahiazol-2-yl)-2,5-diphenyltetrazolium bromide [MTT] assay, Ki67 expression and activated caspase-3 protein expression, respectively. MTT assay showed that T3 had no significant effect on the relative viability of granulosa cells regardless of the follicle size. Ki67-positive rate in small follicle granulosa cells was augmented by treatment with FSH whereas it was not affected by T3. Furthermore, FSH treatment decreased activated caspase-3 protein-positive rate of small follicle granulosa cells. Relative to the treatment with FSH alone, concomitant treatment with FSH and T3 resulted in further decrease in caspase-3 protein-positive rate in small follicle granulosa cells. Treatment with T3 alone did not affect the caspase-3 protein-positive rate. These results suggest that thyroid hormone synergizes with FSH to inhibit apoptosis in small follicle granulosa cells without affecting the proliferative potential of those cells.

Analysis of Variance↗
PubMed2002

Vaginal rings delivering progesterone and estradiol may be a new method of hormone replacement therapy.

OBJECTIVE: To determine whether a low dose of P delivered together with E(2) from a vaginal ring on a continuous schedule can prevent endometrial proliferation and yield a bleeding pattern dominated by amenorrhea. DESIGN: Longitudinal clinical study. SETTING: Three university hospitals. PATIENT(S): Fifty-five women 45 to 75 years of age, not hysterectomized, with E(2) levels of <20 pg/mL and hot-flash incidence of two or more per day in the past week. INTERVENTION(S): A vaginal ring delivering approximately 150 microg/d of 17beta-E(2) and approximately 5 mg/d or approximately 9 mg/d of P used continuously for 4 and 6 months. MAIN OUTCOME MEASURE(S): Endometrial thickness, bleeding pattern, and hot flash incidence. RESULT(S): Endometrial proliferation was prevented by both P doses. Bleeding incidence decreased. In months 4, 5, and 6, 8 of 12 women had no bleeding. Incidence of hot flashes and night sweats decreased quickly and significantly. CONCLUSION(S): A vaginal ring delivering E(2) and a low dose of P merits further study as a method for long-term hormone replacement therapy.

Adult↗
PubMed2002

Increased apoptosis in the syncytiotrophoblast in human term placentas complicated by either preeclampsia or intrauterine growth retardation.

OBJECTIVE: This study was undertaken to determine whether preeclampsia and intrauterine growth retardation are associated with an increase in placental apoptosis. STUDY DESIGN: Tissue specimens from 7 normal term placentas and each of 7 term placentas complicated by severe preeclampsia or intrauterine growth retardation were analyzed. Fas antigen and Bcl-2 protein expression were examined by the avidin/biotin immunoperoxidase method, whereas apoptosis was assessed by the terminal deoxynucleotidyl transferase deoxy-UTP-nick end labeling (TUNEL) method and transmission electron microscopy. RESULTS: Fas antigen was immunolocalized in syncytiotrophoblasts in all placentas examined. No changes in the intensity of Fas antigen immunostaining in syncytiotrophoblasts were apparent among those placentas. Bcl-2 protein was abundantly immunolocalized in syncytiotrophoblasts in normal term placentas, but least abundant in term placentas complicated by severe preeclampsia or intrauterine growth retardation. Apoptosis was apparent in the nuclei of both cytotrophoblasts and syncytiotrophoblasts. The apoptosis positive rate of syncytiotrophoblast nuclei in severe preeclamptic and intrauterine growth retardation term placentas was significantly higher than that in normal term placentas (severe preeclampsia, P <.001; intrauterine growth retardation, P <.01). Transmission electron microscopy revealed the appearance of apoptotic nuclei in trophoblasts in severe preeclamptic term placenta. CONCLUSION: Decreased expression of Bcl-2 protein in syncytiotrophoblasts in severe preeclamptic and intrauterine growth retardation placentas may result in the increase in apoptosis in syncytiotrophoblasts in those placentas.

Apoptosis↗
PubMed2002

Detection of spatial repolarization abnormalities in patients with LQT1 and LQT2 forms of congenital long-QT syndrome.

The aim of this study is to detect the spatial current dispersion that appears in the T-wave of patients with congenital long-QT syndrome (LQTS). To observe this dispersion, magnetocardiograms (MCGs)--which have a high spatial resolution--of LQT1 patients (n = 7), LQT2 patients (n = 9) and a control group (n = 33) were recorded. The dispersion was evaluated by plotting current-arrow maps (CAMs) calculated from the MCG signals. In the case of LQT1, abnormal current arrows in the CAMs appeared above the inferior part of the heart in two LQT1 patients with a long corrected QT interval (QTc) (>0.6), and the current direction was from the left (origin side) to the right ventricular muscle (110 degrees). In six out of nine LQT2 patients, abnormal current arrows with angles below 20 degrees were observed above the right inferior part or lower septum; the current direction was from the right (origin side) to the left ventricular muscle. However, in the case of the LQT2 patients, the QTc values did not correlate with the abnormal current. These findings suggest that the origin of abnormal repolarization in LQT1 is the left ventricular muscle and the origin of that in LQT2 is the right ventricular muscle or lower septum. The estimation of the origin in LQTS patients can provide important information such as the risk factor of sudden death.

Adolescent↗
PubMed2002

p53 Tumor suppressor protein content in human uterine leiomyomas and its down-regulation by 17 beta-estradiol.

p53 protein, a tumor suppressor gene product, has been reported to play a crucial role in suppressing the growth of a variety of cancer cells. However, little information is currently available regarding the content of p53 protein in human leiomyomas. The present study was conducted to elucidate the p53 protein content in human leiomyomas and its regulation by sex steroid hormones. The content of p53 protein in leiomyomas was examined by immunohistochemical staining and Western blot analysis in comparison with that in the adjacent normal myometrium or leiomyoma specimens from GnRH agonist-treated patients. In addition, isolated human leiomyoma cells were subcultured in phenol red-free DMEM supplemented with 10% FBS for 120 h and then stepped down to serum-free conditions for an additional 72 h in the absence or presence of 17 beta-estradiol (E2; 10 ng/ml), progesterone (P4; 100 ng/ml), or E2 (10 ng/ml) plus P4 (100 ng/ml). The effects of sex steroids on p53 protein content in cultured leiomyoma cells were also assessed by Western immunoblot analysis. Immunohistochemical staining and Western blot analysis revealed that p53 protein content was highest in leiomyomas treated with GnRH agonist for 16 wk, lower in leiomyomas in the secretory, P4-dominated phase, and lowest in leiomyomas in the proliferative, E2-dominated phase of the menstrual cycle. There was no difference in p53 content between leiomyomas and the adjacent normal myometrium. Western blot analysis of cultured leiomyoma cell extracts revealed that E2 treatment significantly decreased p53 protein content compared with the control cultures, whereas either P4 treatment or combined treatment with E2 and P4 did not affect p53 protein content in cultured leiomyoma cells. The concentrations of sex steroid hormones used were within the physiological tissue concentrations in leiomyomas and myometrium described earlier. The present study suggests that E2 down-regulates p53 protein content, whereas P4 is ineffective in those cells. The E2-induced decrease in p53 protein content in leiomyoma cells leads us to propose that E2 may regulate human leiomyoma growth in part by down-regulating p53 tumor suppressor protein content in those cells.

Blotting, Western↗
PubMed2002

Implication of maternal nitrogen balance in the regulation of circulating levels of insulin-like growth factor-I in human pregnancy.

Nutrition plays an important role in regulating the circulating levels of insulin-like growth factor-I (IGF-I). We have demonstrated that reduced nitrogen balance is related to changes in serum IGF-I levels but not serum growth hormone levels in pregnant rats. In the present study, we investigated the effects of changes in nitrogen balance on serum IGF-I levels in normal and malnourished pregnant women (defined as having negative nitrogen balance). Forty-eight pregnant women (threatened miscarriage and premature labor, 39; pre-eclampsia, 3; hyperemesis, 3; ileus, 2; bleeding from the colon, 1) and 19 non-pregnant women admitted in Kobe University Hospital were enrolled in this study. Blood samples of normal pregnant controls were also obtained from 172 healthy pregnant women attending the outpatient clinic. Serum IGF-I levels and nitrogen balance were measured serially in 9 pregnant women with threatened miscarriage and premature labor and 9 malnourished pregnant women out of 48 pregnant women. Serum IGF-I and urinary nitrogen levels were measured by radioimmunoassay with acid-ethanol extraction and the Dumas method, respectively. Nitrogen balance was expressed as the difference between daily nitrogen intake and nitrogen excretion assessed by urinary nitrogen levels. Serum IGF-I levels in normal pregnant controls significantly increased in the third trimester of pregnancy compared with non-pregnant controls. No difference in serum IGF-I levels in any trimester of pregnancy was observed between normal pregnant controls and pregnant women with threatened miscarriage and premature labor. There was no significant difference in nitrogen balance between the pregnant women with threatened miscarriage and premature labor and non-pregnant controls. In the longitudinal study, no correlation was found between the changes in serum IGF-I levels and those in nitrogen balance in the 9 pregnant women with threatened premature labor (daily nitrogen balance > 0 g/day) on the basis of linear regression analysis. On the other hand, the changes in serum IGF-I levels in the 9 malnourished pregnant women were significantly correlated with those in nitrogen balance (y = 1.72x + 17.5; r = 0.60; P < 0.05: linear regression analysis). These results indicate that maternal nutritional states have a major effect on serum IGF-I levels in malnourished pregnant women, but not in pregnant women with daily nitrogen balance > 0 g/day. Serum IGF-I levels can be a potent index of nutritional states under malnutrition during human pregnancy.

Adult↗
PubMed2002

Transient postpartum diabetes insipidus in twin pregnancy associated with HELLP syndrome.

Diabetes insipidus during pregnancy is an uncommon medical problem, and its cause is not entirely clear. We present a woman with twin pregnancy associated with HELLP syndrome, who developed diabetes insipidus during postpartum period. A hypertonic saline infusion study with measurement of plasma arginine vasopressin concentrations confirmed the diagnosis. She had mild response to 1-desamino-8-d-arginine-vasopressin (dDAVP) during the immediate postpartum period. On the 3rd postpartum day two doses of 100 microliters of dDAVP were administered, and her urinary volume gradually decreased. We could stop dDAVP on the 30th postpartum day. This exacerbation may result from increased vasopressinase activity caused by the excessive production in the placenta due to twin pregnancy, together with the insufficient degradation in the liver due to HELLP syndrome.

Adult↗
PubMed2002

Down-regulation of proliferation and up-regulation of apoptosis by gonadotropin-releasing hormone agonist in cultured uterine leiomyoma cells.

OBJECTIVE: To elucidate the direct effects of gonadotropin-releasing hormone agonist (GnRHa) on the growth of human uterine leiomyoma cells, cell proliferation and apoptosis in cultured leiomyoma cells treated with GnRHa were investigated. METHODS: Isolated leiomyoma cells were subcultured in DMEM supplemented with 10% FBS for 5 days and stepped down to serum-free conditions for an additional 6 days in the presence or absence of graded concentrations of GnRHa (10(-9) mol/l to 10(-12) mol/l). The effects of GnRHa on the number of viable cells, expression of proliferating cell nuclear antigen (PCNA), Fas and Fas ligand, and apoptosis in cultured leiomyoma cells were examined by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrasodium bromide) assay, immunocytochemical analysis, Western blot analysis and TUNEL assay respectively. RT-PCR was performed to detect the expression of GnRH receptor mRNA in cultured leiomyoma cells. RESULTS: Treatment with GnRHa resulted in a decrease in the number of cultured viable leiomyoma cells assessed by MTT assay in a dose-dependent manner compared with that in control cultures (P<0.01). The growth inhibition of cultured leiomyoma cells treated with GnRHa in concentrations higher than 10(-10) mol/l was associated with the suppression of the proliferative potential characterized by a decrease in PCNA-positive rate of the cultured cells (P<0.01) and an increase in the apoptosis-positive rate assessed by TUNEL assay (P<0.05 and P<0.01). GnRHa markedly increased the expression of Fas and induced the expression of Fas ligand in the cultured leiomyoma cells on the basis of Western blot analysis. These direct effects of GnRHa on the number of viable cultured leiomyoma cells, PCNA-positive rate, apoptosis-positive rate and Fas/Fas ligand expression in the cultured leiomyoma cells were only attained after the 4-day treatment. RT-PCR analysis revealed that GnRH receptor mRNA was expressed in cultured leiomyoma cells. CONCLUSIONS: The present results demonstrate that GnRHa directly inhibits the growth of human uterine leiomyoma cells by suppressing cell proliferation and inducing apoptosis, which might be associated with the increase in Fas expression and the induction of Fas ligand expression in the cells.

Antineoplastic Agents, Hormonal↗
PubMed2002

Selective transarterial embolization and hysteroscopic removal of a placental polyp with preservation of reproductive capacity.

OBJECTIVE: To evaluate the role of transarterial embolization followed by hysteroscopic removal of a placental polyp with preservation of reproductive capacity. STUDY DESIGN: Three patients with placental polyps with abundant blood flow, suspected on ultrasonography with color Doppler imaging and on magnetic resonance imaging, were studied. They underwent transarterial embolization followed by hysteroscopic removal of the polyp. Transarterial embolization of the bilateral uterine arteries was carried out using an absorbable gelatin sponge. Selective removal via hysteroscopy was performed on the following day using a cutting loop without electrical stimulation. The polyp was gradually resected to the level of the surrounding endometrium. RESULTS: Complete removal of the placental polyp was achieved in all patients. The presence of a placental polyp was confirmed by pathologic examination. The operative time was ranged from 26 to 53 minutes. In all cases, no complications were noted, and bleeding was minimal during and immediately after the procedure. Postoperative ultrasonography demonstrated a uterine cavity free of residual mass in each case. CONCLUSION: Transarterial embolization of the uterine arteries followed by selective hysteroscopic removal is a safe and effective method of minimizing bleeding and preserves fertility in the treatment of placental polyps with an abundant blood flow.

Arteries↗
PubMedDate not supplied

Prenatal evaluation of bidirectional epignathus: comparison of ultrasonography and magnetic resonance imaging.

Epignathus is an unusual, benign, congenital teratoma of the hard palate. Most of these teratomas are unidirectional and protrude through the mouth. Hence, the prognosis depends on the size of the tumor and degree of face distortion and airway obstruction. Occasionally, intracranial extension of the tumor is present, involving and destroying the brain tissue, resulting in a poor prognosis. The authors describe 2 cases of bidirectional epignathus, showing the different findings on ultrasonography and magnetic resonance imaging.

Adult↗