Biomedical subjects

K Okamura

Publications and source records attributed to K Okamura.

At least 55 records · Page 3Linked to original sources

PubMed2001

Integration of a picture archiving and communication system with videocapture and computed radiography in a dental hospital.

A method for the integration of a picture archiving and communication system (PACS) at Kyushu University Dental Hospital with radiological information (RIS) and hospital information (HIS) systems is described. CT, US and DSA from different manufacturers were integrated by videocapture and then subsequently integrated with computed radiography (CR) by means of DICOM. The approximate amount of data stored each month on optical discs is 2 GB. The system does not incorporate intra-oral radiography.

Angiography, Digital Subtraction↗

PubMed2001

New approach for weight reduction by a combination of diet, light resistance exercise and the timing of ingesting a protein supplement.

We have reported that ingesting a meal immediately after exercise increased skeletal muscle accretion and less adipose tissue accumulation in rats employed in a 10 week resistance exercise program. We hypothesized that a possible increase in the resting metabolic rate (RMR) as a result of the larger skeletal muscle mass might be responsible for the less adipose deposition. Therefore, the effect of the timing of a protein supplement after resistance exercise on body composition and the RMR was investigated in 17 slightly overweight men. The subjects participated in a 12-week weight reduction program consisting of mild energy restriction (17% energy intake reduction) and a light resistance exercise using a pair of dumbbells (3-5 kg). The subjects were assigned to two groups. Group S ingested a protein supplement (10 g protein, 7 g carbohydrate, 3.3 g fat and one-third of recommended daily allowance (RDA) of vitamins and minerals) immediately after exercise. Group C did not ingest the supplement. Daily intake of both energy and protein was equal between the two groups and the protein intake met the RDA. After 12 weeks, the bodyweight, skinfold thickness, girth of waist and hip and percentage bodyfat significantly decreased in the both groups, however, no significant differences were observed between the groups. The fat-free mass significantly decreased in C, whereas its decrease in S was not significant. The RMR and post-meal total energy output significantly increased in S, while these variables did not change in C. In addition, the urinary nitrogen excretion tended to increase in C but not in S. These results suggest that the RMR increase observed in S might be associated with an increase in body protein synthesis.

Adult↗

PubMed2001

Growth fractions of human renal cell carcinoma defined by monoclonal antibody Ki-67. Predictive values for prognosis.

BACKGROUND: We used immunohistochemical techniques to elucidate the role of growth fractions of renal cell carcinoma in the clinicopathology of the condition and patient survival. METHODS: Fifty-two fresh-frozen nephrectomy specimens were immunostained with Ki-67 monoclonal antibody. Ki-67 indexes were determined to examine the relationship between tumor size, grade, stage and survival curve. This study included 43 men and nine women with the mean age 58.4 +/- 11.7 years, who had been followed up for 39 +/- 25 months. RESULTS: The Ki-67 index ranged from 0.6 to 14.1%, averaging 4.6 +/- 5.8%. It was 2.8 +/- 2.4% in tumors <5 cm, 4.7 +/- 3.6% in tumors > or =5 cm and 7.1 +/- 9.0% in tumors > or =10 cm. The Ki-67 index of grades 1, 2 and 3 tumors was 2.3 +/- 1.1%, 3.3 +/- 2.7% and 12.0 +/- 10.4%, respectively. Grade 3 tumors had a significantly higher Ki-67 index than grade 1 or grade 2 tumors. There was no correlation between the Ki-67 index and tumor stage. Patients with a Ki-67 index < 5.6% had a better prognosis than those with an index > 5.6% (P=0.029). However, multivariate analysis demonstrated that tumor size (P=0.034) and grade (P=0.038) were higher in hazard ratio than the Ki-67 index. CONCLUSIONS: Most renal cell carcinomas had low growth fractions. Although a high Ki-67 index should indicate a poor prognosis, Ki-67 did not correlate to metastasis. We believe it is necessary to investigate the factors, other than growth potential, that affect metastasis.

Adult↗

PubMed2001

Detection of a biorhythm of human fetal autonomic nervous activity by a power spectral analysis.

OBJECTIVE: This study describes a 24-hour assay of autonomic nervous system activity in human fetuses with the use of a power spectral analysis of heartbeat intervals. STUDY DESIGN: The study included 6 normal fetuses and 11 growth-restricted fetuses, 3 of which were hypoxemic. Fetal heartbeats were continuously recorded for 24 hours, and a power spectral analysis was performed on the beat interval data. A low frequency domain of beat intervals was identified (0.025-0.125 cycles/beat) and evaluated at regular intervals over the 24-hour period. The cosinor method was used to detect rhythmic fluctuations in the resulting low frequency areas. The same procedures were also performed with the mothers of the fetuses. RESULTS: We observed 2 diurnal rhythms of heartbeat activity (1 with a 12-hour period and another with a 24-hour period) in the normal and growth-restricted fetuses without hypoxemia. In contrast, these rhythms were not observed in the hypoxemic fetuses. In the mothers, only the 24-hour rhythm was observed. CONCLUSION: The 12-hour cycle of autonomic nervous activity is present in normal fetuses.

Autonomic Nervous System↗

PubMed2001

Possibility of sialographic sonography: a Doppler phantom study.

OBJECTIVES: The purpose of this study was to develop a new diagnostic method that has the merits of both sialography and sonography. STUDY DESIGN: Saline solution and various contrast media (Urografin 76%; 100%, 90%, and 67% Lipiodol Ultra-Fluide; 5% and 1% barium sulfate; and Levovist) were injected into thin tubes at a rate of approximately 0.001 to 0.1 mL/s. The relationship between the Doppler signal intensity and the kind, concentration, and velocity of the fluid was analyzed. RESULTS: Levovist, 90% and 67% Lipiodol Ultra-Fluide, and the barium sulfate solutions produced Doppler signals. The mixture of Lipiodol Ultra-Fluide and saline solution produced high signals at any concentration, in contrast with the barium sulfate solutions. Signals could be observed at any speed, from the speed of normal sialography down to 0.001 mL/s, and there was a proportional relationship between signal intensity and velocity for all fluids producing signals. CONCLUSION: The fact that we could obtain high signals with several fluids indicates potential clinical diagnostic usefulness of sialographic sonography.

Barium Sulfate↗

PubMed2001

The combined use of US and MR imaging for the diagnosis of masses in the parotid region.

PURPOSE: To evaluate the usefulness of the combination of the two non-invasive modalities US and MR imaging to diagnose masses in the parotid region. MATERIAL AND METHODS: The US and MR findings of 21 patients with parotid masses were analyzed retrospectively by two radiologists without any clinical or histopathological information. The specific points evaluated were location, shape, margin, internal architecture, and intensity level on both US and MR, posterior echo enhancement on US, and capsule-like lining of the tumor on MR. RESULTS: The findings concerning the shape and margin on US and MR were in fairly good agreement. Concerning the findings of the internal architecture, US could reveal the minute structures of the tumor while MR demonstrated differences in the signal intensities of histological tissue types of the various tumors. The posterior echo enhancement on US and the capsule-like lining on MR of the tumors were also useful for the diagnosis. CONCLUSION: Our results suggest that the combination of US and MR is useful for examining soft tissue masses in the parotid region to make a more accurate diagnosis, and not just differentiate malignant lesions from those which are benign.

Adolescent↗

PubMed2001

Erythropoietin concentrations are elevated in the peritoneal fluid of women with endometriosis.

Erythropoietin (Epo) is an important regulator of erythropoiesis and stimulates the proliferation of early erythroid precursors as well as the differentiation of late erythroid precursors of the erythroid lineage. However, recent studies have indicated that Epo also has angiogenic properties and plays an important role in the oestrogen-dependent cyclical angiogenesis within the mouse uterus. It was therefore postulated that Epo may be an important angiogenic factor in endometriosis. In order to address this hypothesis the concentration of Epo in peritoneal fluid (PF) was determined in patients with or without endometriosis. PF was collected from patients with endometriosis (n = 42) or without endometriosis (n = 18). Detectable concentrations of Epo were found in all PF samples analysed. The concentration of Epo in PF from patients with endometriosis was significantly higher than that in the control group (13.1 +/- 1.2 mIU/ml versus 7.2 +/- 0.7 mIU/ml, mean +/- SE respectively, P < 0.01). Furthermore, in patients with endometriosis the Epo concentrations in PF from patients with stage I disease (n = 17, 16.6 +/- 3.0 mIU/ml) were significantly higher than those with stage II (n = 8, 10.7 +/- 1.2 mIU/ml, P < 0.03), III (n = 13, 8.4 +/- 1.0 mIU/ml, P < 0.01), IV disease (n = 7, 7.5 +/- 1.0 mIU/ml, P < 0.01). These data suggest that Epo may play a role in the pathogenesis of endometriosis particularly in the initiation of the disease.

Adult↗

PubMed2001

Human sperm aster formation and pronuclear decondensation in bovine eggs following intracytoplasmic sperm injection using a Piezo-driven pipette: a novel assay for human sperm centrosomal function.

In human fertilization, the sperm introduces the centrosome; the microtubule-organizing center and microtubules are organized within the inseminated egg from the sperm centrosome. These microtubules form a radial array, called the sperm aster, the functioning of which is essential to pronuclear movement for union of male and female genome. The sperm centrosomal function is considered to be necessary for the normal human fertilization process. Therefore, the dysfunction of sperm centrosome is a possible cause of human fertilization failure. However, little information is available regarding human sperm centrosomal function during fertilization in clinically assisted reproductive technology. To assess the human sperm centrosomal function, we examined sperm aster formation and pronuclear decondensation following intracytoplasmic sperm injection (ICSI) with human sperm into the bovine egg using a Piezo-driven pipette and ethanol activation of eggs. After human sperm incorporation into bovine egg, we observed that the sperm aster was organized from sperm centrosome, and that the sperm aster was enlarged as the sperm nuclei underwent pronuclear formation. The sperm aster formation rate at 6 h post-ICSI and the male pronuclear formation rate at 8-12 h post-ICSI were 60.0% and 83.3%, respectively. No difference of the sperm aster formation rate and the male pronuclear formation rate was observed between eggs activated with ethanol and eggs without artificial activation. We concluded that this heterologous Piezo-ICSI system into bovine egg can be a novel assay for human sperm centrosomal function, and it is possible to explicate a course of fertilization failure that was unknown until now.

Animals↗

PubMed2001

Characterization of control and immobilized skeletal muscle: an overview from genetic engineering.

To elucidate the molecular basis of muscle atrophy, we have performed the serial analysis of gene expression (SAGE) method with control and immobilized muscles of 10 rats. The genes that expressed >0.5% in muscle are involved in the following three functions: 1) contraction (troponin I, C and T; myosin light chain 1-3; actin; tropomyosin; and parvalbumin), 2) energy metabolism (cytochrome c oxidase I and III, creatine kinase, glyceraldehyde-3-phosphate-dehydrogenase, phosphoglycerate mutase, ATPase 6, and aldolase A), and 3) housekeeping (lens epithelial protein). Muscle atrophy appears to be caused by changes in mRNA levels of specific regulators of proteolysis, protein synthesis, and contractile apparatus assembling, such as polyubiquitin, elongation factor 2, and nebulin. Immobilization has produced a decrease more than threefold in gene expression of enzymes involved in energy metabolism, especially ATPase, cytochrome c oxidase, NADH dehydrogenase, and protein phosphatase 1. Differential gene expressions of selenoprotein W and uroporphyrinogen decarboxylase, which can be involved in oxidative stress, were also observed. Other genes with various functions, such as cholesterol metabolism and growth factors, were also differentially expressed. Moreover, novel genes regulated by immobilization were discovered. Thus, the current study allows a better understanding of global muscle characteristics and the molecular mechanisms of sedentarity and sarcopenia.

Animals↗

PubMed2001

Expression of 5alpha-reductases in human epithelial ovarian cancer: its correlation with androgen receptor status.

Androgen metabolism and possible actions are considered to play some roles in human epithelial ovarian neoplasms, but the details have not been well studied. We have examined the expression of 5alpha-reductase type 1 and type 2, which catalyze the conversion of testosterone to more active androgen, 5alpha-dehydrotestosterone, and androgen receptor (AR), using immunohistochemistry (104 cases) and reverse transcription-polymerase chain reaction (RT-PCR) (16 cases) as a first step toward understanding the metabolism and possible actions of androgens in human common epithelial ovarian carcinoma. 5alpha-Reductase type 1 was immunopositive in 75 / 104 cases (72.0%), and 5alpha-reductase type 2 in 52 / 104 cases (50.0%) (P < 0.001). There was no significant correlation between patterns of immunolocalization and clinicopathological parameters examined. Median labeling index (LI) for AR was 17.8% (range 0 - 84.4%) which was significantly higher in serous carcinoma than other histological types (P < 0.001). There was a significant positive correlation between 5alpha-reductase type 1 immunoreactivity and AR LI (P = 0.0027), but no significant correlation was detected in 5alpha-reductase type 2. Results of RT-PCR analysis were also consistent with those of immunohistochemistry. The relatively wide distribution of 5alpha-reductase type 1, and its correlation to AR status in human epithelial ovarian malignancies suggest that this isozyme plays important roles in androgen metabolism and actions in these tumors.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗

PubMed2001

Observed versus expected rates of unbalanced fetal karyotype at second trimester amniocentesis when one parent carries a balanced translocation.

Our purpose is to evaluate a model proposed by Stene et al. for estimating the risk of unbalanced progeny at the time of second trimester amniocentesis for 114 pregnancies of 71 couples, who are carriers of a reciprocal translocation. The overall estimated risk was 18%, 1.26 times higher than the observed risk (14%). There were no unbalanced fetuses in the 19 pregnancies of the no-risk group. In the low-risk group, the observed risk was highly correlated with the estimated risk. However, the estimated risks in the medium- and high-risk groups were much higher than the observed risks (2- and 1.5-fold). In the group ascertained through spontaneous abortions, the average estimated risk was 1.9 times higher than the observed risk. Although the model is useful in estimating individual empirical risks, it may be necessary to consider the type of ascertainments and add some modifications to calculate the risks in the second trimester.

Adult↗

PubMed2001

The analyses of 17beta-hydroxysteroid dehydrogenase isozymes in human endometrial hyperplasia and carcinoma.

Intratumoral metabolism and synthesis of estrogens are considered to play very important roles in the pathogenesis and development of human endometrial adenocarcinoma. The 17beta-hydroxysteroid dehydrogenase (17beta-HSD) isozymes catalyze the interconversion of estradiol (E2) and estrone and thereby serve to modulate the tissue levels of bioactive E2. To elucidate the possible involvement of this enzyme in human endometrial carcinoma, we first examined the expression of 17beta-HSD type 1 and type 2 in 20 normal cycling human endometria, 36 endometrial hyperplasia, and 46 endometrial endometrioid adenocarcinoma using immunohistochemistry, and we then studied immunoreactivity of 17beta-HSD type 2 using immunoblotting analyses, the activity of 17beta-HSD type 1 and type 2 using thin-layer chromatography and their expression using RT-PCR in endometrial endometrioid adenocarcinoma. We correlated these findings with various clinicopathological parameters to examine the biological significance of 17beta-HSDs in human endometrial disorders. 17beta-HSD type 2 immunoreactivity in normal endometrium was present in all cases of secretory phase (n = 14), but not in any endometrial mucosa of proliferative phase (n = 6). In addition, 17beta-HSD type 2 immunoreactivity was detected in 27 of 36 (75%) endometrial hyperplasia and 17 of 46 (37%) carcinoma cases. 17beta-HSD type 1 immunoreactivity was not detected in all the cases examined. In both endometrial hyperplasia and carcinoma cases there were significant positive correlations between 17beta-HSD type 2 and progesterone receptor labeling index (LI). In carcinoma cases, a significant inverse correlation was detected between 17beta-HSD type 2 immunoreactivity and age. In addition, 17beta-HSD type 2 immunoreactivity was also correlated with 17beta-HSD type 2 enzymatic activity, and semiquantitative analyses of 17beta-HSD type 2 messenger RNA. No significant correlations were detected between 17beta-HSD type 2 and estrogen receptor LI, Ki67 LI, amount of aromatase messenger RNA or histological grade. These data indicated that the expression of 17beta-HSD type 2 in hyperplastic and/or neoplastic endometrium may represent altered cellular features through hyperplastic and neoplastic transformation. However, 17beta-HSD type 2 may also play some protective and/or suppressive roles toward unopposed estrogenic effects through inactivating E2 in situ, especially in premenopausal patients.

17-Hydroxysteroid Dehydrogenases↗

PubMed2001

An elderly patient with gastric carcinoma developing multiple metastasis in skeletal muscle.

We present a 70-year-old man with gastric carcinoma developing multiple metastasis in skeletal muscle. He had a right supraclavicular lymph node swelling. Brain, chest and abdomen CT scans revealed metastatic lesions in the brain, lung, liver and bilateral adrenal glands. Further, CT showed a ring enhanced soft-tissue mass in the left lumbar muscle. Needle aspirate of the mass in both the left lumbar muscle and the right enlarged supraclavicular lymph node revealed cells suggestive of poorly differentiated adenocarcinoma. Upper gastrointestinal endoscopic evaluation demonstrated an advanced gastric carcinoma. Two months after admission, the tumor in the left lumbar muscle had grown and some new lesions in the left iliopsoas muscles appeared. Intramuscular metastasis from gastric carcinoma is an extremely rare phenomenon.

Adenocarcinoma↗

PubMed2001

Asymptomatic pyuria in diabetic women.

The aim of the present study was to determine the prevalence of and the host factors for asymptomatic pyuria (ASP) in women with type 2 diabetes. The study included 179 type 2 diabetic women and consecutive 455 non-diabetic women attending as out-patients in 1996. Patients with symptoms of a urinary tract infection were excluded. ASP was defined as the presence of more than 10 leukocytes/high-power field in a random urine sample. Diabetic women more often had ASP than non-diabetic women (27.9 vs. 15.8%, P<0.001). The prevalence of ASP was significantly increased in patients with a duration of diabetes exceeding 15 years (0 approximately 4 years; 20.3%, 5 approximately 9 years; 24.3%, 10 approximately 14 years; 23.8%, and > or =15 years; 46.3%). No differences were evident in HbA(1C) between diabetic patients without ASP and those with ASP. Diabetic women with ASP more often had diabetic retinopathy, neuropathy, nephropathy, cerebrovascular disease, ischemic heart disease, and hyperlipidemia than those without ASP. However, no statistically significant differences were evident in the prevalence of hypertension, constipation, or dementia. As the degree of neuropathy increases, it is accompanied by an increasing prevalence of ASP (none, 21.4%; blunt tendon reflexes, 24.5%; symptomatic, 50.0%; and gangrene, 66.6%). The prevalence of ASP was significantly increased in the patients with proliferative diabetic retinopathy (none, 23.2%; background, 29.4%; pre-proliferative, 18.2%; and proliferative, 50.0%). As the degree of nephropathy increases, it is accompanied by an increasing prevalence of ASP (none, 20.0%; microalbuminuria, 31.9%; macroalbuminuria, 37.0%; and renal failure, 60.0%). Thus, the prevalence of ASP is increased in women with diabetes and increased with longer duration of diabetes but was not affected by glucose control. The incidence of ASP increases significantly as diabetic microangiopathy becomes severer.

Aged↗

PubMed2001

The current status of gynecological laparoscopic surgery in educational facilities in Japan.

A questionnaire survey was administered by Tohoku University hospital to investigate the current status of gynecological laparoscopic operations in teaching hospitals in which residents were trained as obstetricians and gynecologists. Thirty-eight senior doctors in 18 hospitals were sent a postal questionnaire. The response rates of facilities and doctors were 94.4% and 76.3% respectively. Diagnostic and operative laparoscopy was performed in all of the hospitals surveyed, however only a few hospitals performed more than 100 laparoscopies per year, and many surgeons did not perform advanced laparoscopic operations including hysterectomy, myomectomy and lymphadenectomy. Half of the doctors performed minilaparotomy, which is a so-called "open" technique. The standard surgical style involved the use of a carbon dioxide (CO2) pneumoperitoneum and an endoscope 10 mm in diameter. Unipolar endocoagulating instruments were generally used for hemostasis and incision. Most of the doctors surveyed thought that operative laparoscopy would become a necessary procedure in gynecological field, and half of them hoped to receive training in the technique. Instruction of expert endoscopic surgeons is necessary, especially in teaching hospitals, for the spread of safe and advanced laparoscopic surgery. An educational and training system for established surgeons as well as for young residents is urgently needed in Japan.

Delivery, Obstetric↗

PubMed2001

The present status of management for infertility in Miyagi Prefecture, Japan.

To summarize the current management of infertility in Japan, a questionnaire survey was administered. A mail-survey method was used, and surveys were sent to 126 obstetrical and/or gynecological medical facilities in Miyagi Prefecture. The respondents included 86 facilities (68.3%). The majority of participants employed routine assessments, and their records included basal body temperature (98.8%), semen analysis (88.8%), and tubal patency tests (78.8%). Laparoscopic diagnosis, however, was uncommon (15.8%). With respect to treatment, surgical procedures, especially endoscopic procedures, were not generally carried out in addition to medicinal treatment. Sixty-one percent of the respondents performed intrauterine insemination, however assisted reproductive technology (ART) was provided by a few participants, for example, in vitro fertilization-embryo transfer was available at 11.3% of facilities. In self-assessment, the median pregnancy rates for the group undergoing laparoscopy and that not were significant different (30% and 20%, respectively), and those of the group undergoing ART provided and that not were significant different (35% and 20%, respectively). In conclusion, there are various differentials in the methods of diagnosis and treatment of infertility in the medical facilities today, and the outcomes are not always satisfactory. For appropriate management of infertile couples, it will be necessary to more closely manage cooperation between primary care doctors and reproductive specialists.

Adult↗

PubMed2001

[Laparoscopic extraperitoneal bladder diverticulectomy: an initial case report].

We report a case with a large bladder diverticulum caused by the bladder outlet obstruction, which was successfully treated with laparoscopic extraperitoneal diverticulectomy. The patient was a 71-year-old man, who had had dysuria, micturition pain and cloudy urine. We found the patient to have benign prostatic hyperplasia and a large diverticulum of the bladder. We removed the diverticulum by laparoscopic procedure and then the prostate by transurethral resection on September 24th, 1998. Before the diverticulectomy, we placed a ureteral stent in the left ureter and 8Fr Foley catheters in the diverticulum and bladder. A working space was made by dilation using a balloon dilator. After removing the diverticulum, we made 5 stitches to close the bladder wall. After the surgery, a 22Fr Foley catheter was placed and removed on the 9th postoperative day. Patient had a satisfactory micturition and was discharged on the postoperative 15th day. Laparoscopic diverticulectomy might be a modality for symptomatic bladder diverticulum, because it is minimally invasive and can completely remove bladder diverticulum.

Aged↗

PubMed2001

[The effect of continuous intra-articular and intra-bursal infusion of lidocaine on postoperative pain following shoulder arthroscopic surgery].

We evaluated the effects of continuous intra-articular and intra-bursal infusion of lidocaine on postoperative pain following shoulder arthroscopic surgery. Forty-one ASA I-II patients scheduled for shoulder arthroscopic surgery, were allocated into following four groups. The patients, after intra-articular arthroscopic surgery, either received intra-articular lidocaine (Group I, n = 10) or did not (Group III, n = 10). The patients after extra-articular arthroscopic surgery either received intra-bursal lidocaine (Group II, n = 11) or did not (Group IV, n = 10). Group I and Group II received 8 ml of 1% lidocaine intra-articularly and intra-bursally, respectively, at the end of surgery, followed by continuous infusion of 1% lidocaine at the rate of 2 ml.hr-1 for 24 hours. The intensities of postoperative pain were evaluated by Visual Analogue Scale (VAS), 2, 5, 8, 12, 18 and 24 hours after surgery, and by the number of patients' request for supplemental analgesic for 24 hours. The VAS scores and the number of analgesic requests were significantly lower (P < 0.05) in Group I than Group III, and in Group II than Group IV throughout the postoperative observation period. No adverse effects were observed during this study. We conclude that continuous intra-articular and intra-bursal infusion of lidocaine provides effective postoperative pain relief for shoulder arthroscopic surgery.

Adult↗