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Biomedical subjects

E Okamoto

Publications and source records attributed to E Okamoto.

At least 181 records · Page 10Linked to original sources
PubMed1990

[A clinicopathological study of pulmonary metastases in carcinoma of the uterine cervix].

Carcinoma of the uterine cervix was evaluated in 1,121 patients at Kure National Hospital, Hiroshima, between 1969 and 1987. The patients were retrospectively evaluated for the presence of pulmonary metastases. On chest radiography, 35 patients were found to have metastases. Pulmonary metastases were seen in 3.1% of patients with carcinoma of the cervix. Thirty-two patients out of 35 could be evaluated about their clinical stage, histology, and disease course: 3 patients were classified into stage Ib, 10 were stage II, 15 were stage III, and 4 were stage IV. Histologically, 27 patients were squamous cell carcinoma, 2 were adenocarcinoma, and 3 were others. Mean interval from initial disease staging to detection of lung metastases was 17.1 months. Once pulmonary spread was discovered, half of them expired within 4 months. Twenty-two patients had other focus of metastasis besides lung.

Adenocarcinoma↗
PubMed1990

Prognostic factors after hepatectomy for hepatocellular carcinomas. A univariate and multivariate analysis.

The current study determines the prognostic factors after hepatectomy for hepatocellular carcinomas. The 295 patients who underwent hepatectomy from 1973 through 1987 were included for a univariate and a Cox multivariate analysis. The favoring conditions were determined as follows. The essential requirements are (1) the absence of tumor thrombi; (2) no intrahepatic metastasis, but even when present, it should be close to the main tumor and removed with a massive resection; and (3) retention rate of indocyanine green dye (ICG) at 15 minutes should be within 14 +/- 4.2% (M +/- SD) to allow that resection. The desired requirement is that the tumor size should preferably be less than 5 cm; a wider free margin from tumors (greater than or equal to 1 cm) is recommended, but not determining factor. The eligible patients, having no thrombi, no intrahepatic metastasis, a tumor size of 5 cm or less, negative surgical margin (greater than or equal to 1 cm), had achieved a 5-year survival of 78%. In conclusion, resection therapy is the first option for patients with those requirements.

Adult↗
PubMed1990

Relationship between general or specific immunoreactivity and prognosis in postoperative patients with hepatocellular carcinoma.

The levels of a variety of immunological parameters were examined in 203 preoperative patients with hepatocellular carcinoma (HCC) at various stages (I-IV). The changes in the peripheral blood lymphocyte (PBL) count, the serum level of immunosuppressive acidic protein and the degree of the skin reaction to purified protein derivative were associated significantly with the stage of HCC progression. However, the percentages of lymphocyte subsets, mitogenic responsiveness of PBL and serum immunoglobulin concentration remained at the levels of stage I. Further study demonstrated that in patients undergoing hepatic artery ligation, there were statistically significant correlations between the PBL count, immunosuppressive acidic protein concentration and intensity of the skin reaction to purified protein derivative, assayed 1 month after surgery, and the prognosis. HCC-specific immunity was examined in 34 patients treated by hepatic resection or hepatic artery ligation using in vitro responses of PBL to HCC extracts (ATS test). This test was performed using culture medium containing added arginine. None of the PBL from the patients showed a positive response to allogeneic HCC extracts, but the PBL from 12 patients (9 hepatic resections, 3 hepatic artery ligations) were stimulated significantly (SI greater than or equal to 2.5) with autologous HCC extracts. In 7 of 9 hepatic resection patients who were positive in the ATS test, tumor recurrence was identified. Statistical analysis indicated that the ATS test result was significantly correlated with tumor recurrence in hepatic resection patients. Autologous-PBL-stimulating activities were isolated in a fraction at pH 8.3 and in fractions at pH 6.7-7.0 by chromatofocusing of the crude extract. Although identification of the HCC-specific antigen remains to be done, use of the above fractions may simplify the ATS test procedure and improve its sensitivity.

Carcinoma, Hepatocellular↗
PubMed1990

Expression of the corticotropin-releasing hormone (CRH) gene in human placenta and amniotic membrane.

Immunoreactive corticotropin-releasing hormone (IR-CRH) in maternal plasma increases progressively during pregnancy and decreases rapidly after delivery, suggesting that IR-CRH is produced in the placenta. We studied the expression of the CRH gene in developing human chorionic tissue, the amniotic membrane, the uterine myometrium and a fresh surgical specimen of hydatidiform mole by Northern blot analysis. Our results were as follows: (1) CRH mRNA was demonstrated in the placenta in the third trimester and at term, but under detectable level in the first and second trimesters. (2) CRH mRNA expression was observed in the amniotic membrane, but its expression in the myometrium in normal pregnancy was under detectable level at term. (3) CRH mRNA was also under detectable level in trophoblasts of a hydatidiform mole. These results suggest that the sources of the increased level of IR-CRH in human plasma and amniotic fluid during pregnancy are the placenta and amniotic membrane, and that gene expression of placental CRH increases during pregnancy.

Amnion↗
PubMed1990

Development of an implantable motor-driven assist pump system.

A motor-driven artificial pump and its transcutaneous energy transmission (TET) system have been developed. The artificial pump consists of a high-speed dc brushless motor driving a ball screw and magnetic coupling mechanism between the blood pump and ball screw. The ball screw transfers high-speed rotary motion into low-speed rectilinear motion by a single component. Magnetic coupling enables active blood filling without applying an excess negative pressure to the pump. The transcutaneous transformer is formed from a pair of concave/convex ferrite cores. This design minimizes lateral motion of the external core. Information on motor voltage is transmitted through the skin by infrared pulses. The motor voltage is regulated by controlling the duty ratio of the square pulse supplied to the primary coil. Pump flow of 5.6 l/min was obtained with a mean outlet pressure of 100 mmHg at a drive rate of 100 bpm under preload of 15 mmHg. The performance of synchronous pumping has been very satisfactory. Continuous pumping was maintained by the backup battery in the case of interruption of TET. 24 W were transmitted by TET system with 78 percent of efficiency. Temperature rise of the internal core was 0.2 C. The developed system is promising as an implantable assist pump system.

Animals↗
PubMed1990

Clinical evaluation of a direct colorimetic method for determination of amniotic phospholipids.

Evaluation of amniotic phospholipids, which are a parameter of fetal lung maturation, is important in the management of premature infants. The method available for measuring the lecithin/sphingomyelin (L/S) ratio, which appears to provide an index to fetal lung maturity, is laborious, involving determinations of phospholipids, and so is unsuitable for rapid quantitative measurement of phospholipids in the amniotic fluid in the perinatal period. We developed a simple, sensitive colorimetric assay for phospholipids without their extraction. This assay is based on the fact that phospholipids form stable hydrophobic complexes with Co(SCN)4, Fe(SCN)2- and Fe(SCN)3 within about 1 hr. Amniotic fluid samples (n = 115) were collected from women with normal and abnormal pregnancies in week 16-41 of pregnancy, and these samples were examined both by thin layer chromatography (TLC) and by our method of phospholipid determination. Good correlations were observed between the L/S ratio determined by TLC and the values obtained by this method. Moreover the distributions of the dipalmitoylphosphatidylcholine (DPPC) content and DPPC/sphingomyelin (SM) ratio were similar to those of the PC content and L/S ratio. This method was proved to be more accurate than other methods such as TLC and the shake test for predicting neonatal RDS.

Amniotic Fluid↗
PubMed1990

[Study on function of aganglionic colon musculature of Hirschsprung's disease murine model].

This study examined the function in vitro of aganglionic colon musculature in mice with hereditary aganglionosis--a strain of animals used as a model of Hirschsprung's disease. Double sucrose gap recordings from the muscle strips of both normal and aganglionic colon showed bursts of spike potentials with muscle contraction. Intracellular recordings of the membrane potentials of the circular muscle cells of normal, aganglionic and oligo-ganglionic colon had no statistical difference. Microelectrode recordings from the circular muscle cells of normal siblings, in the presence of nifedipine, irregular ongoing fluctuations in membrane potential, which were abolished by tetrodotoxin and reduced by d-tubocurarine or apamin. The fluctuations were less effected by atropine. These observations suggest that there is ongoing inhibitory neural activity to the circular smooth muscle of normal colon. These ongoing fluctuations were not recorded from the cells of aganglionic and oligo-ganglionic colon of affected animals. Although transmural stimulation of the intrinsic nerves produced cholinergic excitatory and inhibitory junction potentials in normal colon, no junction potentials were evoked by transmural stimulation in aganglionic colon. It was concluded that the ongoing tonic inhibitory activity may contribute to the compliance of the normal mouse colon and lack of the compliance may affect functional intestinal obstruction of the aganglionic colon in Hirschsprung's disease.

Animals↗
PubMed1990

[Comparison of factors related to hospitalization versus home care of elderly].

This study was done to identify factors affecting present hospitalization versus home care in 4,578 elderly subjects representing 87.1% of the elderly population living in S. city near Osaka. Subjects or their families were asked by interviews regarding the age of the subjects, the kind of persons living together in the family unit, the kind of housing, the number of rooms in the family dwelling, and health conditions. Subjects were also asked whether he or she could walk unassisted and whether home care would be preferred in case of an illness. Among the 153 hospitalized subjects, ability to walk, age, and the number of rooms were all significant factors, in decreasing order. Among the 1,193 persons who preferred home care in case of an illness, the number of rooms, age, ability to walk, and the size of the family unit were all significant factors, in decreasing order. Among subjects who could not walk unassisted, the number of rooms was the main factor determining their admission and not preferring home care if their condition worsened. Thus, although the ability to walk is the major factor among the factors we investigated, housing conditions are also important if home care is to be possible.

Aged↗
PubMed1990

[A study of attitudes toward illness and its effect on mortality in patients with Parkinson's disease].

The standardized mortality ratio (SMR), i.e. the ratio of observed to expected deaths, was investigated among 433 patients with Parkinson's disease (172 males and 261 females), who had been visited by public health nurses for a period of more than one year between 1978 and 1987 in Osaka Prefecture. The mean age of the patients was 58.7, and the average duration of the disease was 6.1 years at study entry. The follow-up period averaged 4.1 years during which sixty eight deaths were observed. The SMR of the patients was 2.54 relative to the general population of Osaka Prefecture. The SMR of those who were able to walk without assistance at study entry was 1.73, while that of patients with severe gait disturbance was 3.81. Patients were divided into three groups according to the extent of daily physical exercise performed to maintain their remaining function. Among patients who had been able to walk, those doing daily physical exercise showed the lowest SMR of 1.46. Among those with severe gait disturbance, the SMR of the exercising group was also the lowest at 1.72. These results indicate that daily physical exercise affects the mortality of Parkinsonian patients independently of the grade of disability. Participation in daily exercise was strongly influenced by the patient's will to battle his illness, and was significantly related to the presence of a spouse, economic situation of household, and the number of rooms in their dwelling.

Adult↗
PubMed1989

[Clinico-pathological study of elderly women with malignant ovarian tumors].

Twenty-five elderly women (those 70 years or older) with borderline and malignant ovarian tumors during the past 20 years were reviewed clinico-pathologically in comparison with 160 younger women (those 69 years or younger). The following results were obtained: 1) The incidence rate of elderly women for all patients of borderline and malignant ovarian tumors was 13.5%, and did not tend to increase in the past several years. 2) The rate that the elderly woman visited first at the other department excepting the department of obstetrics and gynecology was 36%, and which was statistically higher than that of the younger woman (p less than 0.01). 3) Fifty-two % of elderly patients had some complications and the incidence was significantly higher than that (23.1%) of younger patients (p less than 0.005). 4) Histopathologically in elderly patients, 9 patients (36%) were of serous cystadenocarcinoma and 17 patients (68%) were of malignant epithelial tumor (primary ovarian cancer and malignant Brenner tumor). 5) Of elderly patients, 8 (47.1%) were in Stage III and IV, and it was higher incidence than that (33.3%) of younger patients. In advanced cases, the histological grades became more poorly. 6) The survival rate of elderly patients in Stage III and IV was significantly lower than that in Stage I and II. The various treatment for Stage III and IV patients did not demonstrate the correlation in prognosis. In contrast, the survival rate for the group treated surgically in Stage I and II was significantly higher than that of non-surgical group (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

[Criteria of curability in the resection therapy for hepatocellular carcinoma].

The present study was aimed at determining a criteria for curability of hepatic resection in the treatment of hepatocellular carcinomas. The 239 patients hepatectomized from 1973 through 1987 were included for analysis. The patients with the tumor thrombi(V) or intrahepatic metastasis(IM) scattered over the unilateral lobe(IM2) showed very poor prognosis in spite of macroscopically complete resections. Consequently, these conditions were categorized into non-curative group(NC). The 5-year survival rate of the tumors less than 2 cm was 42%, which was much better than that of 5 cm or more group but no better than that of 2 to 5 cm group. When the prognosis was compared by an extent of resection among the patients with the tumors of less than 5 cm in size and V(-), the patients with lobectomy showed a 5-year survival rate of 84%, much better than 45% of those with segmentectomy or less range. The surgical margin (SM) negative patients showed a better prognosis than the SM positive patients with a slight difference. The tumor backgrounds of the 39 patients who survived three years with disease free condition were as follows: V(-) in all, no intrahepatic metastasis(IM0) in 79%, no IM2, massive resection for all IM1 in whom IM was confined to the area close to the main tumors, a tumor size of 5 cm or less in 82%, SM(-) in 62%. From the findings described above, we defined a complete resection for V(-) and IM0-1 as a curative condition, of which absolute curative resections(AC) corresponded to the patients with the tumors of 5 cm or less and SM(-), and relative curative ones(RC) to the remainders.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Hepatocellular↗
PubMed1989

Conditions favoring long-term survival after hepatectomy for hepatocellular carcinomas.

The present study was aimed at answering the question of what patients with hepatocellular carcinomas could obtain long-term benefits from resectional therapy. The 239 patients hepatectomized from 1973 through 1986, with 33 tumor-free, 3-year survivors, were the subjects of the study. The following criteria for long-term survival were determined. (a) It is essential that there are no macroscopic tumor thrombi in any of the vessels. (b) It is desirable that there is no daughter lesion and a tumor size of less than 5 cm. (c) When there are daughter lesions, they should be confined to the region adjacent to the main tumor and only few in number. (d) Resection should be performed on a large scale within the limit of safety, especially for the tumors with daughter lesions. (e) The surgical margin should be free of tumor though the exposure of the tumor capsule is not always incompatible with long survival.

Adult↗
PubMed1989

Transcatheter arterial embolization in the management of gynecological neoplasms.

Six patients were treated with transcatheter arterial embolization (TAE). Three patients suffered from intractable genital bleeding; the other three patients were preoperative cases of a stage III adenocarcinoma of the uterine cervix and two of these had gestational trophoblastic disease. Bleeding was stopped in all three cases of intractable hemorrhage; one patient rebled after 6 days. In the three preoperative cases, transcatheter arterial embolization was thought to be effective in decreasing intraoperative blood loss. There are no other reports of application of this technique to preoperative cases to decrease intraoperative blood loss in gynecological cases.

Adenocarcinoma↗
PubMed1989

Immunoreactive corticotropin-releasing hormone, adrenocorticotropin and cortisol in human plasma during pregnancy and delivery and postpartum.

The activity of the hypothalamo-pituitary adrenal axis was examined, by measuring the levels of immunoreactive (IR) corticotropin-releasing hormone (CRH), adrenocorticotropin (ACTH) and cortisol (F) in human plasma during normal pregnancy and after delivery with or without complications and during normal postpartum using a specific RIA. The level of IR-CRH in maternal plasma increased progressively during pregnancy, increased further at delivery and declined rapidly to the non-pregnant level on the 1st day postpartum. The level of IR-F in maternal plasma also increased progressively during pregnancy, increased further at delivery, but decreased slowly postpartum, not returning to the non-pregnant level within 5 days. Significant correlations were found between the level of IR-CRH and IR-ACTH, IR-CRH and IR-F, and IR-ACTH and IRF in maternal plasma both during pregnancy and after delivery. It is noteworthy that the concentration of IR-CRH in the maternal plasma at delivery was higher in multiple pregnancy than in normal pregnancy, and that the level of IR-CRH in the umbilical cord in uncomplicated cases was much lower than that in the maternal plasma, and was significantly lower than those in the umbilical cord plasma in cases of asphyxia, IUGR or premature delivery. The level of IR-F, not IR-CRH and IR-ACTH, at normal vaginal delivery was significantly higher than that at elective cesarean section. On these results, we investigated the feto-maternal-hypothalamo-pituitary adrenal axis during pregnancy and delivery, in which CRH plays an important role.

Adrenocorticotropic Hormone↗
PubMed1989

Plasma concentrations of human atrial natriuretic peptide at vaginal delivery and elective cesarean section.

The change in plasma concentration of atrial natriuretic peptide (hANP) at delivery was examined by measuring the concentrations of hANP in plasma samples from 21 subjects after 36 weeks of normal pregnancy, 22 subjects after normal spontaneous delivery and 20 subjects after elective cesarean section. The maternal plasma concentration of hANP after normal delivery (38.0 +/- 8.2 fmol/ml, mean +/- S.E.M.) was significantly higher than that after 36 weeks of normal pregnancy (16.8 +/- 2.3 fmol/ml), but its concentration after cesarean section was not different from that after 36 weeks of pregnancy. After normal delivery, the plasma concentration of hANP in the umbilical artery (66.9 +/- 11.8 fmol/ml) was also significantly higher than that in the umbilical vein (35.1 +/- 7.3 fmol/ml). In contrast, after elective cesarean section, the hANP levels in the umbilical artery and vein were not significantly different. These results suggest that hANP secretion into the maternal and fetal circulation may be stimulated by the dynamic movement of the mother in labour and the stress of the fetus at delivery, respectively.

Adult↗