Biomedical subjects

H Sugimori

Publications and source records attributed to H Sugimori.

At least 55 records · Page 3Linked to original sources

PubMed1998

Adjuvant chemotherapy after radical hysterectomy for cervical carcinoma: a comparison with effects of adjuvant radiotherapy.

OBJECTIVE: To compare the efficacy of adjuvant chemotherapy after radical hysterectomy with that of adjuvant radiotherapy. METHODS: One hundred one women with invasive cervical carcinoma (stage IB through early stage IIB) underwent radical hysterectomy at Saga Medical School Hospital. Of these patients, 53 with squamous or adenosquamous carcinoma were classified as high risk, based on the presence of one or more of the following high-risk factors for recurrence: 1) lymph node metastasis, 2) deep cervical stromal invasion (greater than 3/4 thickness), and 3) parametrial invasion. Adjuvant chemotherapy with a combination of cis-diamminedichloroplatinum (CDDP), vincristine, mitomycin C, and peplomycin (POMP), was prescribed. The outcome was compared with that for 127 patients who were classified as high risk under the same criteria and who received adjuvant radiotherapy at Kyushu University Hospital. RESULTS: The 5-year survival rates were much the same: 83.0% for adjuvant chemotherapy and 81.7% for adjuvant radiotherapy. In the chemotherapy group, intra- and extrapelvic recurrences accounted for 85 and 23% of all recurrences, respectively, whereas recurrences were noted for 38 and 71% in the radiotherapy group, respectively (P < .01). CONCLUSION: The use of adjuvant chemotherapy reduces extrapelvic recurrences. The combination of both adjuvant therapies may improve the prognosis for high-risk patients.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1998

Health risk assessment for diabetes mellitus based on longitudinal analysis of MHTS database.

This study was designed with a follow up of 16 years to provide the epidemiological model evaluating the risk of developing diabetes mellitus in Japan. A cohort of 2573 subjects (1851 males and 722 females) from a MHTS in Tokyo, who were nondiabetic (fasting blood glucose (FBS) less than 110 mg/dl) in the initial year, were selected. This cohort was followed every year to identify the occurrence of diabetes mellitus. Diabetes Mellitus was defined as fasting blood glucose over 110 mg/dl, or the initiation of diabetic therapy. We compared two prognosis groups (a normal group and a diabetic group) in terms of age, examination findings, and prevalence of health risks (lifestyle, stress, and working form). We also assessed family history of diabetes and past histories including hypertension, hypercholesterolemia, and hyperuricemia. After assessing each variable by univariate analysis (t-test, chi 2 test), we employed Cox's proportional hazards model analysis. We used stepwise model adopting risk factors. The diabetic group had significant differences compared to the normal group in age, BMI (body mass index), FBS, smoking, drinking, not eating breakfast, dairy intake, hypertension, hypercholesterolemia, hyperuricemia, and family history by univariate analysis. According to proportional hazards model analysis, FBS, age, family history, hypertension, smoking, and BMI were incorporated into significant risk factors for diabetes in males, and not eating breakfast, FBS, age, drinking, and hypertension were incorporated in females. Diabetes seemed to be related to fixed factors (age), or genetic factors (family history and FBS) in males. For females, lifestyle (not eating breakfast and drinking habit) seemed to play an important role. It will be worthwhile to assess the risks of developing diabetes mellitus by this epidemiological model.

Adolescent↗

PubMed1998

Anthropometric and other risk factors for ovarian cancer in a case-control study.

Because it has been suggested that an environmental factor may play a role in the etiology of ovarian cancer, a case-control study was conducted to assess some environmental and other risk factors for ovarian cancer from 1994 to 1996 in northern Kyushu, Japan. We analyzed the data of 89 cases with epithelial ovarian cancer and 323 controls without any cancer or ovarian disorder. After controlling for the effect of potential confounders, the odds ratios of ovarian cancer across increasing quartiles of the heaviest body weight were 1.00, 1.15, 1.71, 2.29 (P = 0.008, test for trend). Significantly increased risks were noted for a history of diabetes mellitus (P < 0.05), and for a family history of ovarian cancer (P < 0.05). Significantly decreased trends for risk were obtained for the number of pregnancies (P < 0.01) and the number of live births (P < 0.001). This study provides additional support for an association between obesity and the risk of ovarian cancer. This relationship may at least partly explain the recent increase in the incidence of ovarian cancer in Japan, although possible contributions of other factors can not be ruled out.

Adult↗

PubMed1998

Diurnal variation in baseline heart rate of anencephalic fetuses.

The diurnal change in baseline fetal heart rate (FHR) of four anencephalic fetuses at 20, 23, 24 and 30 weeks of gestation were examined. The mean baseline FHR in 00.00-06.00 h, 06.00-12.00 h, 12.00-18.00 h and 18.00-24.00 h were compared by one-factor ANOVA and Scheffe's test in each case. The diurnal variations in baseline FHR were recognized in all subjects (P < 0.01). In 3/4 subjects, the lowest values were at 00.00-06.00 h. The diurnal variation in baseline FHR might be caused by maternal factors because it was present even in the anencephalic fetuses that had no central nervous system having the oscillators of the circadian rhythm.

Anencephaly↗

PubMed1998

Resistance index of uterine artery and placental location in intrauterine growth retardation.

BACKGROUND: Our aim was to investigate the relationship between placental location and resistance index (RI) of uterine arteries in cases with intrauterine growth retardation (IUGR). METHODS: Placental location and flow velocity waveforms of uterine arteries in 86 normal and 20 IUGR cases from 33 to 38 weeks of gestation were examined using a combined real-time scanner and pulsed Doppler ultrasonography. The location of placenta was classified as lateral when most of it was located to either the right or the left side of the uterine midline. Otherwise it was called central. Cases where the placenta was located in the uterine fundus or in the lower segment were not included. RI values were calculated from the uterine arteries on the placental side, on the non-placental side and in case of central placentas as a mean of both uterine arteries. In normal cases, the calculations were done every second week from 33 to 38 weeks of gestation, and the difference in variance among three gestational ages in each artery was tested by a one-way ANOVA. In IUGR cases, a standard deviation score (SDS) was calculated individually in each artery as (RI - normal mean)/normal SD. Differences in SDS between three categories of uterine arteries were examined by non-parametric tests. RESULTS: In normal cases, there was no significant difference in variance of RIs among three gestational ages in each category of arteries. In IUGR cases, SDSs on the placental side were higher than those on the non-placental side and those in central placenta, (p<0.01, Wilcoxon's and Mann Whitney's tests, respectively). SDSs in five of eight cases with central placentas were below 1.0. Two of 12 cases with lateral placentas had higher SDSs on the non-placental side than on the placental side and resulted in abruptio placentae. CONCLUSIONS: Deviation of RIs in uterine arteries with IUGR could be affected by the pathologic conditions of the utero-placental blood flow on the placental side of lateral placenta rather than in central placenta and might be done by dramatic increase in resistance to flow of the myometrial vessels on the non-placental side.

Female↗

PubMed1998

HRA model for hypercholesterolemia based on a longitudinal health database.

To evaluate the risk factors for hypercholesterolemia, we examined 4,371 subjects (3,207 males and 1,164 females) who received medical checkups more than twice at an AMHTS in Tokyo during the period from 1976 through 1991; and whose serum total cholesterol was under 250 mg/dl. The mean follow-up duration was 6.6 years. A self-registering questionnaire was administered at the time of the health checkup. The endpoint of this study was the onset of hypercholesterolemia when the level of serum total cholesterol was 250 mg/dl and over. We compared two prognosis groups (normal and hypercholesterol) in terms of age, examination findings and lifestyle. After assessing each variable, we employed Cox's proportional hazards model analysis to determine the factors related to the occurrence of hypercholesterolemia. According to proportional hazards model analysis, total cholesterol, triglyceride and smoking at the beginning, and hypertension during the observation period were selected in males; and total cholesterol at the beginning and age were selected in females to determine the factors related to the occurrence of hypercholesterolemia.

Adult↗

PubMed1998

[Early phase II trial of oral etoposide administered for 21 consecutive days in patients with cervical or ovarian cancer. ETP 21 Study Group--Cervical-Ovarian Cancer Group].

We conducted multi-site early phase II trial or oral etoposide administered for 21 consecutive days in patients with cervical or ovarian cancer in cooperation with 19 institutes. Fifty mg/body of oral etoposide was administered daily for 21 consecutive days. Cycles were repeated every 28 days. In cervical cancer, 24 patients were enrolled and 17 of them were evaluated. The overall response rate including CR and PR was 23.5% (4/17). In ovarian cancer, 18 patients out of 21 enrolled were evaluated. The overall response rate was 16.7% (3/18). The primary toxicity observed was myelosuppression such as leukopenia, neutropenia, hemoglobin decrease and thrombocytopenia. Other adverse effects were anorexia, nausea, vomitting, fatigue, alopecia and stomatitis. From these results we concluded that oral etoposide administered for 21 consecutive days was effective against cervical cancer.

Administration, Oral↗

PubMed1998

[The effect of quality of life in Behçet disease patients on subjective life satisfaction].

The purpose of this study is to elucidate the relationships between subjective life satisfaction and the following 8 factors of quality of life: physical condition, daily living activities, working condition, economic status, social status, medical status, marriage status, mental status. One hundred and fifty-four male and 116 female Behçet patients in 13 medical facilities were analyzed in this study. Mantel-Haenszel's odds ratio method and stepwise logistic regression analysis were applied to evaluate the influence of quality of life on subjective life satisfaction in Behçet disease patients. Males had higher problem scores than females in the following: physical condition, daily living activities, working condition, economic status, social status, marriage status, mental status. With regard to the effect on subjective life satisfaction, physical condition, daily living activities, working phase, economic phase, social phase, marriage relations, mental phase showed significantly high odds ratio in male, while physical condition, working phase, economic phase, social phase, medical phase, marriage relations, mental phase showed significantly high odds ratios in females by Mantel-Haenzel age-adjusted method. Physical condition, daily living activities, working phase, economic phase, social phase, and mental phase showed significantly high odds ratios in males after adjusting for active disease symptom periods, while physical condition, working phase, economic phase, social phase, medical phase, marriage relations, mental phase showed significantly high odds ratio in females after adjusting for active disease symptom. By stepwise logistic regression analysis, working phase and mental phase in males, economic phase and mental phase in females were shown to be significant. Improvement of quality of life including mental phase and working phase appear to raise the life satisfaction in Behçet's disease patients.

Adult↗

PubMed1997

Changes in responsiveness of freshly isolated longitudinal muscle cells from rat uterus towards oxytocin during gestation: contractility and calcium signaling.

Changes in responsiveness of freshly isolated longitudinal muscle cells from rat uterus to oxytocin during gestation were investigated through measuring contractility as well as intracellular free calcium concentration. We have demonstrated the pregnant stage-dependent contraction of freshly isolated myometrial cells in response to an extracellular hormone, oxytocin, in Ca2+-containing medium. The oxytocin effect appeared to be through oxytocin receptor since the effect could be blocked by a specific oxytocin antagonist. The magnitude of the contraction of the isolated cells in response to extracellular oxytocin was in the order of 21 day >> 18 day > 15 day pregnant rat longitudinal muscle cells. In a concentration dependent manner, oxytocin elicited a rapid increase in [Ca2+]i of longitudinal muscle cells isolated from different stages of the pregnant rat uterus, especially at the term of pregnancy. The time (4-5 s) required to reach a maximum increase in [Ca2+]i of the isolated longitudinal muscle cells in response to oxytocin was the shortest among all previously reported studies. The results also indicated that the freshly prepared longitudinal muscle cells maintained their functional calcium signaling system. The order of the responsiveness of the isolated longitudinal muscle cells to oxytocin was 21 day >> 18 day > 15 day pregnant rats in terms of rate, affinity and magnitude. Oxytocin appears to transmit its signal mainly through stimulating a voltage-dependent and/or receptor operated nonselective calcium channel. However, the possibility that a part of the oxytocin action occurs through stimulating the release of calcium from intracellular store sites of longitudinal muscle still remains.

Animals↗

PubMed1997

Telomerase activity in gynecologic tumors.

The standard telomeric repeat assay protocol (TRAP) was used to examine telomerase activity in 16 ovarian tumors, 16 cervical carcinomas, 4 uterine tumors, and 3 vaginal tumors. Telomerase activity was detected in 95% of these tumors, 88% of ovarian malignancies, and 100% of cervical, endometrial, and vaginal malignancies. In contrast, telomerase activity was not evident in normal tissues or in benign proliferative lesions, such as leiomyomas, condyloma acuminata, and simple endometrial hyperplasia. These results suggest that telomerase activation is associated with immortalization or malignant transformation of gynecologic tumors.

Adolescent↗

PubMed1997

Correlation between human papillomavirus positivity and p53 gene overexpression in adenocarcinoma of the uterine cervix.

In the pathogenesis of cervical squamous cell carcinoma, an inverse correlation between human papillomavirus (HPV) infection and mutation of the p53 anti-oncogene has been suggested. Much less is known of a possible correlation in the case of adenocarcinoma of cervix. Twenty-five cervical adenocarcinomas and 7 adenosquamous carcinomas were analyzed for presence of HPV DNA sequences and overexpression of the p53 gene. Polymerase chain reaction revealed that 11 were positive for HPV DNA (34%). Seven were positive for HPV 16 and 5 for HPV 18. A mixed infection with HPV 16 and 18 was observed in 1 case. Patients with HPV-positive carcinoma were significantly younger than those with HPV-negative carcinoma (43 +/- 13.3 years versus 57 +/- 17.4 years, P = 0.01). Immunohistochemical staining showed that p53 was overexpressed in 11 of 32 cases (34%). Overexpression of the p53 gene was found in only 1 of 11 HPV-positive cases (9%) yet was evident in 10 of 21 HPV-negative cases (48%). This inverse association was statistically significant (P < 0.05). Prognostic analysis revealed that HPV-negative adenocarcinomas had a poorer prognosis than HPV-positive cases (P < 0.01) and that tumors with p53 overexpression also had a poorer prognosis than those without such overexpression (P < 0.01). Our observations suggest that HPV-negative or p53-positive adenocarcinomas may be a biologically distinct subset with a poorer prognosis.

Adenocarcinoma↗

PubMed1997

The prognostic value of semiquantitative nuclear grading in endometrial carcinomas.

The objective of this study was to evaluate the prognostic value of a convenient nuclear grading system based on only the proportion of nuclei measuring more than 10 microm in length at the shortest axis in endometrial carcinomas. Of the 235 cases reviewed, 9 serous and 5 clear cell adenocarcinomas and 2 small cell carcinomas were eliminated, resulting in a study population of 219 cases of endometrial adenocarcinoma. The architectural grade was determined by the FIGO system. The criteria for nuclear grade were as follows: grade 1, no nucleus measuring more than 10 microm in length at the shortest axis; grade 2, nuclei measuring more than 10 microm in length at the shortest axis seen in percentages ranging between 0 and 10% of tumor cells in active areas; and grade 3, more than 10% of tumor cells in active areas with nuclei measuring more than 10 microm in length at the shortest axis. The criteria for combined grades were as follows: the tumors were graded according to the architectural grade, but high-grade nuclear abnormalities increased the grade by one for architectural grade 1 and 2 tumors. The cumulative 10-year survival rates for architectural grades 1, 2, and 3 were 92.4, 82.6, and 65.2%, respectively (chi2 = 17.9, P = 0.001). The survival rates for nuclear grades 1, 2, and 3 were 96.2, 76.1, and 70.1%, respectively (chi2 = 21.6, P < 0.001), while for combined grades 1, 2, and 3 the survival rates were 98.3, 83.2, and 65.2%, respectively (chi2 = 26.9, P < 0.001). Even when the cases were limited to the 147 stage I endometrial carcinomas examined, the prognostic value of the combined grading system was still found to be superior to that of the architectural grading system. Our observations therefore supported the FIGO recommendation for nuclear grade not only in stage I endometrial carcinomas, but also in all stages of endometrial carcinomas.

Adenocarcinoma, Clear Cell↗

PubMed1997

Telomerase activation in in vitro and in vivo cervical carcinogenesis.

Telomerase activity is found in the majority of human cancers, but not in most normal tissues. It is generally accepted that there is a multistep process in human carcinogenesis. Studying the role of telomerase activation in this process may provide new information to further our understanding of the pathological process of clinical lesions. In the present study, telomerase activity was found in HPV-immortalized and cigarette smoke condensate (CSC)-transformed malignant cell lines established in a cervical carcinogenesis model and in cell lines derived from cervical intraepithelial neoplasias (CINs) and carcinomas. With exfoliated cell samples, telomerase activity was detected in 3 of 41 (7%) normal cervices, 10 of 25 (40%) CINs, and all 20 (100%) carcinomas. Telomerase activation was significantly higher in CINs than in normal cervices (chi2 = 7.42, P < 0.01) and was much higher in invasive carcinomas than in CINs (chi2 = 18.00, P < 0.005). Our observations suggest that telomerase activation is a relatively early-stage event in cervical carcinogenesis, and this activation is associated with the initiation and progression of cervical lesions. Detection of telomerase activity may serve as a tool for diagnosis and prognosis of cervical neoplasias.

Carcinoma↗

PubMed1997

Apoptotic index in ovarian carcinoma: correlation with clinicopathologic factors and prognosis.

The apoptotic index (apoptotic cells/1000 tumor cells, AI) was evaluated in 71 ovarian carcinomas, all surgically resected. Apoptosis was examined by modified terminal deoxynucleotidyltransferase-mediated deoxyuridine triphosphate-biotin nick end-labeling (TUNEL) method in histologic sections. High AI (>/=2.8) significantly correlated with high mitotic index (P = 0.05), high histologic grade of the tumor (P = 0. 018), and short overall survival (P = 0.017). An inverse relationship between AI and bcl-2 protein expression was also observed (P = 0.007). In addition, AI was assessed in 5 ovarian epithelial tumors of borderline malignancy, and all were categorized as low AI (<2.8). No significant correlation was found between AI and other clinicopathologic factors, such as age, clinical stage, lymph node metastasis, tumor size, histology of the tumor, and expression of p53 protein. Multivariate survival analysis showed that only clinical stage (P = 0.0395) and mitotic index (P = 0.0387) had independent prognostic value, whereas AI did not. Our results suggest that counting apoptosis can be useful for predicting the patient survival in ovarian carcinoma, although AI is not an independent prognostic factor. It is also suggested that bcl-2 protein is an important regulator of apoptosis in ovarian carcinoma.

Apoptosis↗

PubMed1997

The effect of behavioral states on fetal heart rate and middle cerebral artery flow-velocity waveforms in normal full-term fetuses.

OBJECTIVES: To evaluate the effect of fetal behavioral states on the relationship between fetal heart rate (FHR) and middle cerebral artery resistance index (MCA RI) in normal fetuses. METHODS: The FHR and MCA RI of 10 normal cases from 37 to 40 weeks of gestation were recorded consecutively over a 45-min period. Correlations between the MCA RI and FHR during resting and active phases, classified by an actocardiotocogram, were analyzed by simple regression analysis. RESULTS: The mean FHR and MCA RI were significantly higher during the active phase (140.3 +/- 6.6 bpm, 0.79 +/- 0.06) than those during the resting phase (137.4 +/- 6.8 bpm, 0.75 +/- 0.07, P < 0.01, two sample t-test). There was a significant negative correlation (r = - 0.22, n = 2642, P < 0.01) between RI and FHR during the active phase and a significant positive correlation (r = 0.28, n = 2066, P < 0.001) during the resting phase. CONCLUSIONS: The relationship between FHR and the MCA RI during the resting phase is different from during the active phase.

Behavior↗

PubMed1997

Age-related ischemia in the brain following bilateral carotid artery occlusion--collateral blood flow and brain metabolism.

Cerebral blood flow (CBF) and cerebellar blood flow (CeBF) were measured and correlated with brain lactate, pyruvate and adenosine triphosphate concentrations from groups representing 3-week old suckling (n = 10), 18-22-week old adult (n = 9) and 70-week old aged (n = 7) Sprague-Dawley rats before and during bilateral carotid occlusion (BCO). The steal ratio, calculated as the ratio of %control CBF to %control CeBF, was 1.02 +/- 0.06 (mean +/- SEM) at 60 minutes of BCO in adult rats that exhibited normal levels of brain metabolites. By contrast, the ratios significantly decreased to 0.74 +/- 0.06 in suckling rats and 0.69 +/- 0.06 in aged rats with simultaneous increases by 2.4 to 2.9-fold of tissue lactate. Pyruvate and lactate/pyruvate ratio also increased by 1.4 to 1.8 times control in both suckling and aged rats. We conclude that there is age-related steal phenomenon occurring with blood flow during BCO. Ischemic derangement of the brain metabolism is in part related to poor blood supply from the posterior circulation in suckling and aged rats.

Adenosine Triphosphate↗

PubMed1997

Conservative treatment using a methotrexate-lipiodol emulsion containing non-ionic contrast medium for a cervical ectopic pregnancy.

We present a case in which a viable cervical pregnancy was successfully treated with preservation of the uterus. A 26 year old female presented with a 6 week cervical pregnancy with acute moderate bleeding. On the day of admission the patient underwent embolization of the descending uterine artery to decrease the bleeding. The following day, 4 mEq potassium chloride and methotrexate (MTX)(1 mg/kg) dissolved in saline was injected into the amniotic cavity using transvaginal sonographic guidance. The fetal heart beat ceased; however, the urinary beta-human chorionic gonadotrophin (HCG) concentration increased and the gestational sac size also increased. After a second injection of an emulsion of MTX (1 mg/kg) dissolved in a non-ionic contrast medium, iopamidol and lipiodol, the betaHCG concentration in the urine began to decrease. After a third injection with the same emulsion, the cervical mass became necrotic. The betaHCG concentrations in the urine and serum were undetectable and the external cervix returned to normal 44 days after admission. No vaginal bleeding or significant side effects of MTX were observed throughout the treatment. An in-vitro dissolution test revealed that the dissolution rate of MTX was slower from MTX-lipiodol-iopamidol with sonication than without sonication. The present study indicates that use of an MTX emulsion enables slow release of MTX and may be applicable for conservative treatment of ectopic pregnancies, including cervical pregnancy.

Adult↗

PubMed1997

Local immune response in endometrial carcinomas.

OBJECTIVE: To determine whether Langerhans cells act as antigen-presenting cells in endometrial carcinomas and their related lesions. SAMPLES: Frozen endometrial samples were obtained from 13 women with normal menstrual cycles, 3 postmenopausal women, 11 women with hyperplasia (simple 4, complex 4 and atypical 3) and 32 women with endometrial carcinomas. MAIN OUTCOME MEASURES: Langerhans cells (CD1), T lymphocytes (CD4 and CD8), B lymphocytes (CD22), natural killer (NK) cells (CD57) and HLA-DR were all quantitatively assessed in endometrial samples using immunohistochemical method. RESULTS: The numbers of Langerhans, CD4+, CD8+ and B cells were higher in the secretory phase than in the proliferative endometrium. The CD8+ cells appeared to be more plentiful than the CD4+ cells. When compared with the proliferative endometrium, the numbers of Langerhans cells were higher in hyperplasias and carcinomas. Most of Langerhans cells were HLA-DR+, showing a strong correlation with CD4+ cells in carcinomas. This suggests that MHC class II antigen restricted lymphocytes in carcinomas are activated by HLA-DR+ Langerhans cells. However, epithelial expression of HLA-DR in carcinomas did not show on association with high numbers of Langerhans and CD4+ cells. No correlation was observed between Langerhans cells and clinicopathologic features of carcinomas. In contrast, the number of NK cells significantly decreased in noninvasive carcinomas but increased in Grade 3 tumours. CONCLUSION: Based on the above findings, Langerhans cells are considered to act as antigen-presenting cells in carcinomas, but it was not shown that they were activated by epithelial expression of HLA-DR in carcinomas.

B-Lymphocytes↗