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Biomedical subjects

H Hoshiai

Publications and source records attributed to H Hoshiai.

At least 37 records · Page 2Linked to original sources
PubMed1997

Immunohistochemical studies on matrix metalloproteinase-9 (MMP-9) and type-IV collagen in endometrial carcinoma.

Immunohistochemical staining of MMP-9 and the type-IV collagen was performed on paraffin sections of endometrial carcinoma. Immunostaining in 129 cases of endometrial cancer detected MMP-9 in 19.0% of the cases. MMP-9 positive was shown in 30% of the cases with vessel invasion, and in 12.7% of the cases without vessel invasion (p < 0.05). MMP-9 showed positive in many cases with poor differentiation and lymph node metastasis, but still failed to achieve statistical significance. MMP-9 staining did not correlate with disease outcomes. We can not clarify that MMP-9 is associated with tumor-cell invasion and metastasis. Type-IV collagen deposition at the tumor-stromal border was studied in 58 cases of endometrial carcinoma in which disruptions were seen in varying degrees. The type-IV collagen in the primary lesion decreased as the differentiation decreased. Even in the lymph node metastasis lesions, the type-IV collagen was stained and was almost in agreement with the primary lesions. In the primary lesions, there was no relationship between MMP-9 staining and the type-IV collagen. It was suggested that the type-IV collagen observed in endometrial carcinoma was more concerned with the differentiation of the tumor than with the degradation by MMP-9.

Adenocarcinoma↗
PubMed1997

Tubal endometriosis diagnosed within one month after menarche: a case report.

A 13-year-old nulligravida girl, 158.5 cm in height and 76.0 kg in body weight, came to our department complaining of continuous right lower abdominal pain. One month earlier, an ovarian cyst in the right ovary, about 3 cm in diameter, was found when she underwent appendectomy at another hospital, but was left untreated. Menarche occurred at the age of 13 years and 1 month, which was after the appendectomy and 24 days before the present operation. Right hematosalpinx with peripheral obstruction and a para-ovarian serous cyst on the same side were diagnosed, and therefore right salpingectomy with para-ovarian cyst resection was performed. The bilateral ovaries and uterus were completely normal by inspection. The post operative histological examination confirmed hematosalpinx and revealed tubal endometriosis.

Adolescent↗
PubMed1997

Danazol induced thrombocytopenia.

A 34-year-old woman with a left ovarian cyst (clinically diagnosed as endometrial cyst) was treated with 400 mg of danazol per day. On the next day, after a total dose of only 600 mg of danazol, gingival bleeding and purpura occurred. Her laboratory findings were as follows: platelet count 1000/ mm3 hematocrit 39%, WBC 7300/mm3 and RBC 466 x 10(4)/mm3. Immune thrombocytopenic purpura (ITP) was diagnosed, and she was treated with 40 mg of methylprednisolone per day for 19 days. Her platelet count increased to 130,000/ mm3. Her left ovarian cyst was extirpated surgically, and the histological diagnosis was endometrial cyst. Danazol at 400 mg per day was therefore again administered. On the next day, she complained of gingival bleeding and purpura again, and her platelet count was 5000/mm3. We diagnosed this case as danazol induced thrombocytopenia.

Adult↗
PubMed1996

The prognostic significance of vascular invasion by endometrial carcinoma.

BACKGROUND: Recently, invasion of vascular spaces by endometrial carcinoma has received particular attention as a prognostic factor. The goal of the current investigation was to re-examine the effect of vascular invasion on tumor recurrence and survival in patients with endometrial carcinoma. METHODS: Surgical specimens from 238 patients with endometrial carcinoma were examined for the presence of vascular invasion by tumor cells. Vascular invasion was compared with clinicopathologic features and postoperative survival. Survival curves by vascular invasion were evaluated by the Kaplan-Meier method. RESULTS: In a histopathologic review of 238 cases of endometrial carcinoma, 82 neoplasms demonstrated vascular invasion. Vascular invasion significantly correlated with the extension of primary tumor, depth of myometrial invasion, and histologic grade. Patients with lymph node metastasis had a significantly higher incidence of vascular invasion. Survival at 5 years for patients with vascular invasion was 73.4%. This was significantly lower than the survival rate of 91.5% for women without this finding (P < 0.001). Among patients with lymph node metastasis, 80.2% of the patients with vascular invasion survived for 5 years compared with 95.3% of the patients without vascular invasion (P < 0.05). Ten of 47 patients with no lymph node metastasis but with vascular invasion developed recurrent carcinoma. Nine of these ten patients apparently had extrapelvic recurrences. CONCLUSIONS: The presence of vascular invasion is a reliable prognostic indicator. Recording of tumor recurrence pattern may lead to a better selection of patients for adjuvant systemic therapy after surgery.

Endometrial Neoplasms↗
PubMed1995

Dysplasia and HPV infection initially detected by DNA analysis in cytomorphologically normal cervical smears.

OBJECTIVE: We examined the relationship between the risk of dysplasia and human papillomavirus (HPV) infection initially detected by DNA analysis in Japanese women with cytomorphologically normal cervical smears. METHOD: We applied the polymerase chain reaction method to detect HPV DNA in 800 women and subsequently followed up 49 women positive for HPV DNA. RESULTS: HPV 16 or HPV 18 DNA was detected in 53 (6.6%) of 800 women with normal smears (negative). During the follow-up period (23 months), the presence of HPV DNA could not be detected in 41 (83.7%) of 49 women after its initial presence. The remaining eight women had repeated HPV DNA, and four of these eight women had lesions that progressed to mild dysplasia. CONCLUSION: The results indicated that some women with cytomorphologically normal smears may have HPV DNA which can be transient, and persistence of HPV types 16 or 18 DNA plays an important role in the pathogenesis of cervical dysplasia.

Adolescent↗
PubMed1995

Apoptosis in the degeneration process of unfertilized mouse ova.

In mammals, ova which are not fertilized undergo degeneration. Thus, it seems that the ovum is programmed to die unless fertilization and embryogenesis occur, but little is known about the mechanism of such degeneration. To investigate this process, we observed the morphological changes of cultured unfertilized ova and stained DNA fragmentation by the modified TUNEL method (treating floating samples in liquid reagents) to detect apoptosis. Ova were collected from the oviducts of superovulated mice and cultured for observation. The number of morphologically abnormal ova with shrinkage of the ooplasm and cytoplasmic fragmentation, which are typical features of apoptosis, showed a significant gradual increase from 24 to 32 hr (p < 0.05) and an abrupt increase from 40 hr of incubation (p < 0.001). DNA fragmentation, which is one of the biological changes seen in apoptosis, was observed in the ooplasm of both intact and abnormal ova, cells with cytoplasmic fragmentation, and in the first polar body at the time of ovum collection as well as after incubation. These findings demonstrate that apoptosis is related to the process of degeneration in the mouse ovum and first polar body.

Animals↗
PubMed1995

[Prognostic factors in uterine cervical and corpus cancer].

We have studied the prognostic factors for cancer of uterine cervix and corpus. Prognostic factors for cervical cancer include clinical stage, histological type, pelvic and paraaortic lymph node metastasis and CPL classification of carcinoma. Prognostic factors for cancer of uterine corpus are concerned with clinical stage, histological type and histological differentiation, muscle invasion, lymph node metastasis, perineal washing cytology and so forth. The clinical stage of course, reflects the prognosis. Although one of the important prognostic factors is lymph no metastasis, there may be recurrence in patients with a poor prognosis in cases in which lymph node metastasis has not been observed. In order to distinguish such cases and to improve their prognosis, it is important to provide treatment individually but combined chemotherapy or radiation therapy, for example, with efforts to detect various prognostic factors.

Female↗
PubMed1994

Influence of HLA antigens on reproduction among Japanese population: study of haplotypes in 247 families.

Although an increased incidence of shared HLA antigens among couples experiencing recurrent spontaneous abortion or infertility has been observed, antigenic effects remain to be clarified. These effects, which are suspected to exist among fertile couples, were examined in this study. A group of 247 healthy Japanese families and their 682 children, whose HLA antigen haplotypes could be determined, were studied. Haplotypes of the fathers were compared with those of the mothers, and the combination of HLA antigens in the A, B, C and DR loci was determined as antigenic patterns against the mother. Patterns inherited by children were examined and deviations of the patterns were studied according to the natural rule that either of the haplotypes should be inherited at equal rates. Lower rates of children with antigens common with those of the mother, which may show a result of reproductive selection, were observed among only the first born children in the A (p < 0.05) and DR loci (p < 0.01), but rates similar to those expected were observed among the second born and later children. Lower rates were also observed in the B and C loci among all children with no significant difference between groups of the children. The necessity of differing antigenic factors in order to achieve pregnancy in the population was shown. Important effects of HLA antigenicity in reproductive failure are suggested.

Adult↗
PubMed1993

Laparoscopic evaluation of the onset and progression of endometriosis.

OBJECTIVE: To clarify the pathogenesis of endometriosis on the basis of analysis of primary lesion sites, age at onset, rate of progression, and response to drug treatment. STUDY DESIGN: The clinical records of 690 women with laparoscopically confirmed endometriosis were retrospectively analyzed based on the revised American Fertility Society point system. RESULTS: The primary site of endometriosis was the uterosacral ligament and pelvic peritoneum/pouch of Douglas in 73% of patients with stage I disease, whereas only 16% had ovarian lesions. However, disease progression was associated with an increasing frequency of ovarian lesions. In terms of the revised American Fertility Society score, endometriosis progressed at a mean rate of 0.3 point per month. Thus the earliest onset of endometriosis was estimated at 3 to 4 years after menarche. Drug therapy improved the revised American Fertility Society score by about 50%. Patients with a low response to an initial cycle of therapy generally showed further improvement after an additional treatment cycle. CONCLUSIONS: Because endometriosis may occur as early as 3 to 4 years after menarche and gradually progresses, drug therapy, including long-term treatment, should be carried out in women with definitive evidence of endometriosis who must maintain their reproductive potential.

Adolescent↗
PubMed1993

Is pelvic endometriosis always associated with chronic pain? A retrospective study of 618 cases diagnosed by laparoscopy.

OBJECTIVE: To establish a relationship between pelvic pain and the stage and severity of pelvic endometriosis determined according to the revised American Fertility Society classification. STUDY DESIGN: Retrospective study of 618 cases diagnosed by laparoscopy as endometriosis at the Tohoku University Hospital from 1984 to 1991. RESULTS: Pelvic pain did not appropriately reflect the stage and severity of pelvic endometriosis in 40% of patients. Although the pain in some patients in stage IV showed some correlation with the stage and severity of the disease, others had either no symptoms or paradoxically complained of less pain than those patients with stage I or II endometriosis. CONCLUSIONS: With the present revised American Fertility Society classification of endometriosis we cannot evaluate the severity of pelvic pain.

Chronic Disease↗
PubMed1993

Oily contrast medium as a therapeutic agent for infertility because of mild endometriosis.

OBJECTIVE: To investigate the utility of using oily contrast medium (Lipiodol; Kodama, Tokyo, Japan) to treat infertility because of mild endometriosis. DESIGN: Macrophages in the peritoneal cavity of ICR mice (Japan SLC, Shizuoka, Japan) were induced by administering OK-432 to simulate the condition of the peritoneal cavity of patients with mild endometriosis, and the pregnancy rate was examined after administration of Lipiodol and/or danazol (Bonzol; Tokyo Tanabe, Tokyo, Japan). Interleukin-1 beta (IL-1 beta), prostaglandin (PG)F2 alpha (PGF2 alpha), and PGE2 levels in the supernatant were measured after incubating macrophages of mice with Lipiodol and/or danazol. MAIN OUTCOME MEASURES: Pregnancy rate (PR) and IL-1 beta, PGF2 alpha, and PGE2 levels. RESULTS: The PR of the Lipiodol group was significantly increased compared with that in control mice. Prostaglandin F2 alpha level in the supernatant was significantly increased, whereas that of IL-1 beta was reduced after incubation with Lipiodol. CONCLUSIONS: Lipiodol may elevate PGF2 alpha level and reduce IL-1 beta level in the peritoneal cavity, and this drug may increase the PR of ICR mice.

Animals↗
PubMed1992

The spontaneous LH surge in ovarian hyperstimulation for assisted reproductive technology.

Thirty-seven patients who underwent assisted reproductive technology programme, in vitro fertilisation or embryo transfer and gamete intra-fallopian transfer, were randomised into two groups in order to evaluate frequency of premature spontaneous LH surge when stimulated with different type of hMG. An hMG (FSH:LH = 1:1) was administered for eighteen patients (group A) and the different highly purified hMG (FSH:LH = 19:1) was administered for nineteen patients (group B). Blood samples are drawn from day 3 of the cycle until hCG administration, and serum LH level are measured in the frozen samples. There were no statistical difference in the total amount of hMG used before hCG injection, days of hMG injection and the number of oocytes retrieved between two groups. The premature spontaneous LH surge occurred only one patient in group A (5.6%), but more frequent LH surge was observed in group B (42.1%) (p < 0.05). It is suggested that the different FSH/LH ratio may be the reason for the difference of the incidence of premature spontaneous LH surge.

Chorionic Gonadotropin↗
PubMed1990

Fitz-Hugh-Curtis syndrome: three cases confirmed by laparoscopy.

There were 3 cases of Fitz-Hugh-Curtis syndrome,--pelvic inflammatory disease (PID) complications and perihepatitis,--caused by Chlamydia trachomatis infection. All 3 patients complained of sudden right upper quadrant pain in addition to PID symptoms. Enzyme immunoassay of uterine cervical specimens revealed that the positive chlamydial antigen and serum antibody titer against anti-Chlamydia trachomatis were also high. In all cases the laparoscopy revealed findings of perihepatitis on the anterior surface of the right hepatic lobe. In 2 cases, typical violin-string adhesions were also observed between the liver capsule and parietal peritoneum. In both cases, adhesiolysis was conducted during the laparoscopy.

Adult↗
PubMed1989

Inhibin: a new circulating marker of hydatidiform mole?

OBJECTIVE: To define the concentrations of inhibin in serum and tissue of patients with hydatidiform mole and assess their value as a clinical marker of the condition. DESIGN: Prospective study of new patients with hydatidiform mole, comparison of paired observations, and case-control analysis. SETTING: A university hospital, two large public hospitals, and a private women's clinic in Japan. PATIENTS: Seven consecutive referred patients seen over four months with newly diagnosed complete hydatidiform mole, including one in whom the mole was accompanied by viable twin fetuses (case excluded from statistical analysis because of unique clinical features). All patients followed up for six months after evacuation of molar tissue. END POINT: Correlation of serum inhibin concentrations with trophoblastic disease. MEASUREMENTS AND MAIN RESULTS: Serum concentrations of inhibin, human chorionic gonadotrophin, and follicle stimulating hormone were compared before and seven to 10 days after evacuation of the mole. Before evacuation the serum inhibin concentrations (median 8.3 U/ml; 95% confidence interval 2.4 to 34.5) were significantly greater than in 21 normal women at the same stage of pregnancy (2.8 U/ml; 2.1 to 3.6), and inhibin in molar tissue was also present in high concentrations (578 U/ml cytosol; 158 to 1162). Seven to 10 days after evacuation inhibin concentrations in serum samples from the same patients declined significantly to values (0.4 U/ml; 0.1 to 1.4) similar to those seen in the follicular phase of normal menstrual cycles. None of the four patients whose serum inhibin concentrations were 0.4 U/ml or less after evacuation developed persistent trophoblastic disease. Though serum human chorionic gonadotrophin concentrations declined after evacuation (6.6 x 10(3) IU/l; 0.8 x 10(3) to 32.6 x 10(3], they remained far higher than in non-pregnant women. Serum follicle stimulating hormone concentrations remained suppressed. CONCLUSIONS: In this small study serum inhibin concentrations higher than those found in the early follicular phase one to two weeks after evacuation of a hydatidiform mole seemed to be specific for persistent trophoblastic disease. Further data are needed to confirm these promising results.

Adolescent↗