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Biomedical subjects

Hisanori Minakami

Publications and source records attributed to Hisanori Minakami.

At least 19 recordsLinked to original sources
PubMed2003

Live birth rate varies with gestational history and etiology in women experiencing recurrent spontaneous abortion.

OBJECTIVES: The aims of this study were to assess pregnancy outcome in relation to etiologic factors of recurrent spontaneous abortion (RSA). STUDY DESIGN: The pregnancies from consecutive 216 RSA women were assessed for live birth rates (LBR) according to etiology. The LBR in 110 pregnancies from RSA women with unexplained etiology was investigated according to various therapies. An attempt to karyotype the abortuses was made. RESULTS: Excluding pregnancies ending in abortion with abnormal karyotype, the LBR in primary recurrent spontaneous aborters (68.8%) who experienced three or more abortions was significantly lower than that in primary repeated aborters (82.4%) who experienced two abortions. The LBR ranged from 50 to 100% according to the etiology. In RSA women with unexplained etiology, the LBR in those undergoing massive intravenous immunoglobulin (MIVIg) therapy (100%) was significantly higher than those with low dose aspirin (57.1%) and luteal support therapy (67.3%). CONCLUSIONS: Excluding pregnancies ending in abortion with abnormal karyotype, we found that LBR varied with abortion history and etiologic factors of RSA.

Abortion, Habitual↗
PubMed2003

Superoxide radical generation and Mn- and Cu-Zn superoxide dismutases activities in human leukemic cells.

Mn- and Cu-Zn superoxide dismutase (SOD) activities and generation of superoxide radicals (O(2) (-)) were assessed in leukemic cells from 10 patients with acute myeloid or monocytic leukemia (AML) and 10 patients with acute lymphoblastic leukemia (ALL), using a sensitive, specific chemiluminescence method. Leukemic cells were classified according to the French-American-British classification. M4 AML cells from two patients produced some O(2) (-) upon stimulation with opsonized zymosan (OZ), phorbol myristate acetate (PMA) or N-formyl-methionyl-leucyl-phenylalanine (FMLP), but less than normal granulocytes or monocytes. M5b AML cells from one patient produced as much O(2) (-) in response to these stimulants as normal monocytes. No O(2) (-) generation was induced in other types of leukemic cells. Total SOD activity in AML cells was significantly greater in normal granulocytes, but was only half of the activity in ALL cells. Mn-SOD in AML cells was very low or undetectable. These results suggest that except in M5b cells, decreased O(2) (-) production may contribute to susceptibility to infections in AML patients. Decreased Mn-SOD activity in AML cells may predispose them to oxidative stress.

Adult↗
PubMed2003

Intravenous immunoglobulin treatment in women with recurrent abortions: increased cytokine levels and reduced Th1/Th2 lymphocyte ratio in peripheral blood.

PROBLEM: The aim of this study was to investigate changes in peripheral blood Th1/Th2 cytokine levels and lymphocyte ratios after massive intravenous immunoglobulin (MIVIg) treatment for women with recurrent spontaneous abortion (RSA) of unexplained etiology. METHOD OF STUDY: Serum Th1 (IFN-gamma, TNF-alpha) and Th2 cytokine (IL-4, IL-10) levels were assessed by ELISA methods (n = 9) and peripheral blood Th1/Th2 lymphocyte ratios (n = 4) by flow cytometry before and after MIVIg treatments in women with four or more consecutive RSA. RESULTS: Pre-treatment serum IFN-gamma (0.06 +/- 0.09 pg/mL, mean +/- SD), TNF-alpha (0.21 +/- 0.45 pg/mL), IL-4 (0.70 +/- 1.16 pg/mL), and IL-10 (1.12 +/- 1.67 pg/mL) increased to 0.17 +/- 0.16 pg/mL, 0.77 +/- 0.28 pg/mL, 1.82 +/- 0.89 pg/mL, and 3.44 +/- 0.48 pg/mL, respectively, after MIVIg treatments (P < 0.05). CD4-positive IFN-gamma/IL-4 lymphocyte ratios (17.3 +/- 9.1) were reduced to 11.5 +/- 7.1 after treatment (P < 0.05). CONCLUSIONS: Massive intravenous immunoglobulin treatments increased peripheral blood cytokine levels and decreased Th1/Th2 lymphocyte ratios; thus, MIVIg treatments modify the peripheral Th1/Th2 balance.

Abortion, Habitual↗
PubMed2003

Woman with postpartum ventricular tachycardia and hypomagnesemia.

A 28-year-old Japanese woman who had received continuous intravenous infusion of magnesium sulfate from 24 weeks of pregnancy until delivery underwent cesarean section at 30 weeks and gave birth to twins. Serum magnesium sharply declined to a subnormal level of 1.5 mg/dL on postpartum day 4. The patient exhibited sinus bradycardia (48 b.p.m.) with intermittent supraventricular contraction on postpartum day 2, intermittent ventricular bigeminy on postpartum day 3, and frequent selfterminated polymorphic ventricular tachycardia on postpartum day 4. The electrocardiogram (ECG) disclosed that the patient had prolonged QTc of 0.45-0.67. Correction of serum magnesium improved ECG findings promptly, resulting in the disappearance of arrhythmias. Hypomagnesemia due to postpartum diuresis may have played a role causing ventricular tachyarrhythmia in this patient.

Adult↗
PubMed2003

Decreased serum levels of macrophage migration inhibition factor in miscarriages with normal chromosome karyotype.

BACKGROUND: The aim of this study was to determine serum concentrations of macrophage migration inhibition factor (MIF) during normal pregnancies, and to assess whether serum MIF concentrations early in pregnancies predict the subsequent outcome in women with recurrent miscarriage (RM). METHODS: Serum MIF concentrations were measured by ELISA. Sera were collected from normal women in the first (Group I, n = 29), second (Group II, n = 25) and third trimester (Group III, n = 26) and from 78 RM women at 4-6 weeks gestation. Eleven of these 78 pregnancies subsequently ended in first trimester miscarriage with normal fetal chromosome karyotype (MsNK), seven ended in first trimester miscarriage with abnormal karyotype (MsAK), and three ended in biochemical pregnancy. The other 57 pregnancies ended in live birth (LB) between 32-41 weeks gestation, and only one woman developed preeclampsia. RESULTS: Median MIF concentrations in Group I, II and III were similar at 17.6, 16.4 and 15.1 ng/ml respectively. MIF concentrations during early gestation in RM women with subsequent MsNK, MsAK and LB were 8.1, 11.4 and 16.4 ng/ml respectively. MIF concentrations in RM women with MsNK were significantly lower than those in RM women with LB (P < 0.01) and than those in Group I (P < 0.01), II (P < 0.05) and III (P < 0.05). CONCLUSIONS: Decreased serum MIF concentrations during early gestation were found in RM women with MsNK, and might be related to the aetiology of miscarriage.

Abortion, Spontaneous↗
PubMed2003

Prenatal diagnosis and fetal therapy of congenital cystic adenomatoid malformation type I of the lung: a report of five cases.

We experienced five pregnancy cases with type I congenital cystic adenomatoid malformation (CCAM) of fetuses and summarized here their clinical characteristics, pregnancy outcomes, and fetal therapies. Four of five cases were prenatally diagnosed using magnetic resonance imaging (MRI) as having lung abnormality, and the remaining case was prenatally diagnosed as having congenital diaphragmatic herniation (CDH). One fetus underwent the puncture of cysts in the lung, and two fetuses received in utero thoracoshunts between cysts and the amniotic fluid cavity (thoracoamniotic shunt). One pregnancy ended in artificial termination at 17 gestational weeks, and 4 pregnancies succeeded in live births. All these 4 infants underwent surgical operations for CCAM, and 1 infant underwent an additional operation for CDH. The MRI examinations were useful to prenatally identify CCAM, and the in utero thoracoamniotic shunt appears to be beneficial in preventing lung hypoplasia in the affected fetuses.

Adult↗
PubMed2003

Effect of maternal age on blood loss during parturition: a retrospective multivariate analysis of 10,053 cases.

OBJECTIVE: An extensive study as to whether maternal age itself is a risk factor for blood loss during parturition. METHOD: A total of 10,053 consecutive women who delivered a singleton infant were studied. The excess blood loss was defined separately for women with vaginal and cesarean deliveries as > or = 90th centile value for each delivery mode. The effects of 13 potential risk factors on blood loss were analyzed using multivariate analysis. RESULTS: The 90th centile value of blood loss was 615 ml and 1,531 ml for women with vaginal and cesarean deliveries, respectively. A low lying placenta (odds ratio [OR], 4.4), previous cesarean (3.1), operative delivery (2.6), leiomyoma (1.9), primiparity (1.6), and maternal age > or = 35 years (1.5) were significant independent risk factors for excess blood loss in women with vaginal delivery. Placenta previa (6.3), leiomyoma (3.6), low lying placenta (3.3), and maternal age > or = 35 years (1.8) were significant independent risk factors for excess blood loss in women with cesarean sections. CONCLUSION: A maternal age of > or = 35 years was an independent risk factor for excess blood loss irrespective of the mode of delivery, even after adjusting for age-related complications such as leiomyoma, placenta previa, and low lying placenta.

Adult↗
PubMed2003

Symphysis-fundus height and weight gain pattern in Japanese women with twin pregnancies.

OBJECTIVE: To determine the normogram for symphysis-fundus height and weight gain pattern in Japanese women with twin pregnancies and to examine whether fundus height and weight gain pattern are altered in women who give birth to twin infants complicated by fetal growth restriction (FGR). STUDY DESIGN: A retrospective review of the medical records of 186 twin gestations that had been followed at our institution together with 229 singleton pregnancies as a control. We examined maternal symphysis-fundus height, body weight gain and increase in body mass index (BMI) according to gestational age and compared them between women with and without FGR. RESULTS: As compared to women with singleton pregnancies, those with twins exhibited larger fundus height, larger weight gain and larger increase in BMI, all of which were observed from as early as 16-18 weeks of gestation until delivery. Mothers of twins with at least one FGR infant showed smaller fundus height, smaller weight gain and smaller increase in BMI as compared to those without. CONCLUSION: We constructed the normogram for symphysis-fundus height and weight gain pattern in Japanese twin gestations and determined the characteristic change in these parameters in FGR in women with twins. These results may be of use in identifying mothers of twins with FGR.

Adult↗
PubMed2002

Platelet-activating factor activates two distinct effector pathways in human eosinophils.

In granulocytes, platelet-activating factor (PAF) shares many of its biological effects with other chemotactic factors, such as FMLP, complement fragments, and lipid mediators. Two unique effects are that PAF is relatively resistant to pertussis toxin (PTX) and that PAF activates the inflammatory functions of eosinophils more strongly than it activates those of neutrophils. To investigate the molecular mechanisms of the responses of eosinophils to PAF, we analyzed superoxide anion production by a chemiluminescence method that provides real-time kinetic data for the cellular responses. We found that PAF induced bimodal superoxide anion production in human eosinophils, consisting of an intense, but transient, first phase and a larger and sustained second phase. In contrast, PAF induced essentially a transient unimodal response in human neutrophils. The two phases of eosinophil response were mediated by distinct cellular mechanisms: the second phase was highly dependent on cellular adhesion and beta(2) integrins, but the first phase was independent of both adhesion and beta(2) integrins. The upstream signaling mechanisms were also different: the second phase was mediated by PTX-resistant G-protein(s) and through activation of phosphatidylinositol 3-kinase, while the first phase was mediated by PTX-sensitive G-protein(s). Furthermore, the second-phase response was approximately 100-fold more resistant to inhibition by a competitive PAF receptor antagonist than the first phase. Thus, eosinophils and neutrophils react differently to PAF, and PAF activates two separate and distinct effector pathways in human eosinophils. These two activation pathways may explain the eosinophils' strong and diverse biological responses to PAF.

Eosinophils↗
PubMed2002

Reproductive performance after ultrasound-guided transvaginal ethanol sclerotherapy for ovarian endometriotic cysts.

OBJECTIVE: Ultrasound-guided transvaginal ethanol sclerotherapy (TV-EST) has been widely practised in Japan for ovarian endometriotic cysts. We investigated the possible adverse effects of TV-EST for ovarian endometriotic cysts on reproductive performance. PATIENTS AND METHODS: We reviewed retrospectively medical records and compared clinical outcomes of 45 subfertile women who underwent TV-EST for ovarian endometriotic cysts (Study group) with those of 65 subfertile women without ovarian endometriotic cysts (Comparison group). Patients were followed up monthly for 24 months. Serum levels of LH, FSH, CA125 and CA19-9 were determined before and after TV-EST. RESULTS: No complications associated with TV-EST were observed. There were no differences in the numbers of pregnancies (47% (21/45) versus 39% (25/65)), term deliveries (76% (16/21) versus 76% (19/25)), abortions (19% (4/21) versus 24% (6/25)), retrieved oocytes, or quality of embryos between the Study and Comparison groups, respectively. The serum levels of LH and FSH did not increase after TV-EST. The serum levels of CA125 and CA19-9 did not significantly decrease after TV-EST. Ovarian cysts recurred in six (13.3%) of the 45 women 5.2+/-3.9 months after TV-EST. CONCLUSION: Although only a small number of women were studied, our observational study suggested that TV-EST appeared not to adversely affect reproductive performance in subfertile women with ovarian endometriotic cysts.

Adult↗
PubMed2002

Increased superoxide radicals generation from alveolar macrophages in immature guinea-pigs.

To study the effect of maturation on abilities of superoxide radicals (O-2) generation in the airways, we compared stimuli-induced O-2 generation by alveolar macrophages in immature (aged 10+/-2 days) and adult (aged 90+/-2 days) guinea-pigs. The production of O-2 was assayed by chemiluminescence method, using a Cypridina luciferin analog as a highly sensitive and specific probe for O-2. Whereas no significant difference in cell components of bronchoalveolar lavage fluid was observed between immature and adult animals, O-2 generation induced by stimulation of alveolar macrophages was greater in immature than in adult animals, with significant differences observed after platelet-activating factor (100 nM) or phorbol myristate acetate (0.5 micro g/ml). The results suggest that alveolar macrophages from immature animals are far more potent O-2 generators than the same cells of adult animals.

Age Factors↗
PubMed2002

Antithrombin III activity and platelet count are more likely to decrease in twin pregnancies than in singleton pregnancies.

BACKGROUND: It is not known whether antithrombin III activity and platelet count are more likely to decrease in women with twin pregnancies than singleton pregnancies. METHODS: We enrolled 56 consecutive women with twin pregnancies and 692 consecutive women with singleton pregnancies. Antithrombin III activity and platelet count were determined at 26-31 weeks and again at 32-40 weeks of gestation. Thrombin-antithrombin complex, and plasmin-alpha2 plasmin inhibitor complex were measured simultaneously in some women. RESULTS: In twin pregnancies, both antithrombin III activity (111 +/- 8.2%) and platelet count (244 +/- 60 x 109/l) at 28.6 +/- 1.0 weeks decreased over time to 91 +/- 12% and 205 +/- 59 x 109/l, respectively, at 35.2 +/- 1.2 weeks; these decreases were significantly greater than in singleton pregnancies. However, a small number of women with singleton pregnancies had a significant decrease in antithrombin III activity in the absence of preeclampsia. The serum thrombin-antithrombin complex was significantly higher in twin pregnancies than in singleton pregnancies (9.7 +/- 4.2 ng/ml vs. 6.7 +/- 4.4 ng/ml, respectively, p < 0.01), and this increase correlated significantly with the decrease in antithrombin III activity in twin pregnancies (r = -0.459, p < 0.001). CONCLUSIONS: Antithrombin III activity and platelet count show a greater decrease in twin than in singleton pregnancies, perhaps due to a greater increase in thrombin generation.

Adult↗
PubMed2002

Relationship between blood pressure level in early pregnancy and subsequent changes in blood pressure during pregnancy.

BACKGROUND: It is not known whether women with high blood pressure in the first trimester are likely to exhibit a large increase in blood pressure during pregnancy. METHODS: We conducted a retrospective, longitudinal study of 1599 pregnant women, among whom 29 women (1.8%) received antihypertensive medication during pregnancy. The blood pressure levels measured during the first (7.9 +/- 2.4 weeks), second (20.7 +/- 1.2 weeks) and third trimesters (38.4 +/- 1.7 weeks) were analyzed. The obstetric outcomes were examined in five subgroups divided according to the quintile of the first-trimester mean arterial pressure level. RESULTS: The net change in blood pressure levels (third-trimester value minus first-trimester value) was significantly inversely correlated with the first-trimester blood pressure levels irrespective of the use or lack of use of antihypertensive drugs. Women with the highest quintile first-trimester mean arterial pressure had the largest body weight, exhibited a fall in blood pressure and had the smallest increase in body weight during pregnancy, and were significantly more likely to have a growth-restricted infant. CONCLUSIONS: Women with high initial blood pressure tended to exhibit a fall in blood pressure, whereas women with low initial blood pressure tended to exhibit a large increase in blood pressure during pregnancy. Women with high initial blood pressure and a small increase in body weight during pregnancy tended to have growth-restricted infants.

Adolescent↗
PubMed2002

Changes in the number of polymorphonuclear leukocytes and concentrations of IL-8 and granulocyte elastase in the vaginas of normal pregnant women.

PROBLEM: It is unknown whether the number of vaginal polymorphonuclear leukocytes (vPMNs) of healthy pregnant women changes during pregnancy. METHOD OF STUDY: We studied 23 women after 14.7 +/- 3.6 weeks, 37 women after 25.2 +/- 3.1 weeks, and 26 women after 32.9 +/- 2.0 weeks of gestation. Numbers of total vPMNs, viable vPMNs, dead vPMNs, percentage viability of vPMNs, and concentrations of IL-8 and elastase activity were determined in vaginal washings. RESULTS: The vPMNs, including viable and dead vPMNs, significantly increased with advancing gestation from 9.9 +/- 8.6 x 10(5) to 13.1 +/- 13.4 x 10(5), and to 27.1 +/- 26.6 x 10(5) (r=0.315, P < 0.01). Vaginal IL-8 significantly increased with advancing gestation. However, increases in vaginal elastase activity did not occur. CONCLUSIONS: These results suggested that an increase in vPMNs is an early event, and that the increase in vaginal elastase activity is a late event in relation to the ripening of the uterine cervix.

Adult↗
PubMed2002

Gestational thrombocytopenia and pregnancy-induced antithrombin deficiency: progenitors to the development of the HELLP syndrome and acute fatty liver of pregnancy.

The syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome) and of acute fatty liver of pregnancy (AFLP) do not have an abrupt onset. Thrombocytopenia or reduced antithrombin activity, or both, seen at presentation do not result from these complications. There are a small number of pregnant women who exhibit a gradual antenatal decline in platelet counts or antithrombin activity, or both, irrespective of the presence or absence of preeclampsia. Those who develop a profound decrease in either platelet counts or antithrombin activity are at an increased risk for developing perinatal aspartate aminotransferase (AST) elevation. Thrombocytopenia or reduced antithrombin activity, or both, precede the onset of these diseases. Therefore, monitoring of platelet counts and antithrombin activity during pregnancy is clinically useful for identifying women at an increased risk of the HELLP syndrome and AFLP. Because women with twin pregnancies are likely to exhibit a decrease in platelet counts or antithrombin activity, or both, compared with women with singleton pregnancies, HELLP syndrome and AFLP are more likely to occur in women with twin pregnancies.

Acute Disease↗
PubMed2002

Perioperative changes in plasma antithrombin activity and platelet counts in patients undergoing gynecologic surgery.

The relationships among perioperative changes in plasma antithrombin (AT) activity, platelet counts, and clinical risk factors for postoperative thromboembolism has not been studied extensively in gynecologic patients. AT activity and platelet counts were determined preoperatively and on postoperative days 1 and 7 in 74 patients who underwent gynecologic surgery. The relationships between each clinical risk factor for postoperative thromboembolism and the decrease in AT activity and platelet count were analyzed using a univariate logistic regression model. No clinically significant thromboembolism occurred in any patient. AT activity and platelet counts decreased significantly on postoperative day 1 and exceeded preoperative levels on day 7. Postoperative patients with malignancy were more likely to exhibit decreased AT activity. AT activity decreased significantly with increases in operating time and blood loss. Known risk factors for postoperative thromboembolism did not appear to be associated with postoperative decreases in platelet counts. Transient hyperconsumption of AT and platelets occurs immediately after gynecologic surgery. Surgery-induced AT deficiency may contribute to postoperative thromboembolism in patients with long operating times and significant blood loss.

Adult↗
PubMed2002

Decreased expression of L-selectin on peripheral blood polymorphonuclear leukocytes in neonates with severe asphyxia.

The expression of adherent leukocyte surface molecules, L-selectin (CD62L), and Mac-1 (CD11b/CD18) in peripheral blood polymorphonuclear leukocytes (PMNs) was studied in 48 neonates and 24 healthy adults using fluorescence flow cytometry. L-selectin expression was decreased significantly in neonates, especially those with severe asphyxia (n = 10) compared with adults. Mac-1 expression was significantly increased in neonates compared with adults, but did not differ between 24 normal neonates, 14 neonates with mild asphyxia, and 10 neonates with severe asphyxia. These results suggest that the magnitude of the decrease in L-selectin expression reflects the severity of asphyxia in neonates.

Adult↗