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Biomedical subjects

Masahiro Nozaki

Publications and source records attributed to Masahiro Nozaki.

13 recordsLinked to original sources
PubMed2006

Sudden fetal death associated with both duodenal atresia and umbilical cord ulcer: a case report and review.

We encountered one case of duodenal atresia complicated by massive intrauterine hemorrhage due to the perforation of an umbilical cord ulceration (UCU). UCU is an extremely rare complication in the perinatal period. Although the prenatal diagnosis of upper intestinal atresia has been established, little is known about the association between UCU and upper intestinal atresia. In this article, we report our case, review past articles, and discuss the underlying pathophysiological mechanisms of the cause of an UCU. Given the characteristic sites of upper intestinal atresia, we speculate that regurgitation of gastric or intestinal juice into the amniotic fluid could be responsible for the development of UCU. We also believe that close observation is required for patients who have upper intestinal atresia.

Adult↗
PubMed2006

[SERM].

SERM is the abbreviation of the selective estrogen receptor modulator which is the synthetic ligands of estrogen receptor (ER) acting estrogenically or anti-estrogenically among various tissues through modifying the ER function. Clomifene, tamoxifen, toremifene and raloxifene are generally classified as SERM in the clinical use. The main cause of postmenopausal osteoporosis is estrogen deficiency and it was revealed that the continuous combined use of conjugated estrogen and medroxyprogesterone acetate reduced the relative risk of femoral neck fracture to 0.66, however increased the relative risk of cardiovascular event and breast cancer to 1.29 or 1.26, respectively. From the standpoint of safe and clinical compliance for the breast and uterine tissue, raloxifene is recommendable for middle aged postmenopausal osteoporosis.

Female↗
PubMed2005

Chronic treatment with 17beta-estradiol increases susceptibility of smooth muscle cells to nitric oxide.

The purpose of this study was to evaluate the role of estrogen as a vasodilator or relaxing modulator during vascular tonus through chronic estrogen treatment. Experiments were conducted using isolated basilar arteries from ovariectomized female rabbits divided into two groups (the with and without estrogen replacement groups, respectively). Both acetylcholine and carbachol relaxed the basilar arteries of rabbits in the with estrogen replacement group (pre-contracted by 30 mM K(+)) more strongly than in the without estrogen replacement group. Vasodilatation effects of (+/-)-(E)-4-methyl-2-[(E)-hydroxyimino]-5-nitro-6-methoxy-3 -hexenamide (NOR1) and S-nitroso-N-acetyl-penicillamine (SNAP) were greater in rabbits in the with estrogen replacement group than the without estrogen replacement both with endothelium-intact and denuded preparations. On the other hand, vasodilatation effects of nicardipine, 17beta-estradiol and membrane-permeable cyclic-GMP or cyclic-AMP were the same in both groups. These results suggest that chronic administration of estradiol potentiates reactivity to nitric oxide (NO) in smooth muscle cells, which could be a therapeutic target for cardiovascular diseases in postmenopausal women.

Acetylcholine↗
PubMed2005

Postpartum retroperitoneal fasciitis: a case report and review of literature.

We present a case of a postpartum female with iliopsoas fasciitis in the puerperium. Two days after a spontaneous vaginal delivery at 38 weeks without any complications, the patient complained of pain in the left thigh and hip, associated with a temperature of 38 degrees C. Consequently, she could not walk 4 days after delivery and her body temperature had increased to 39 degrees C. Extreme left flank pain and tenderness in the left pelvic wall were prominent, whereas the tenderness in the pelvis was moderate. Magnetic resonance imaging led us to diagnose iliopsoas fasciitis. This was complicated by sepsis but improved after a protracted antibiotic treatment without any surgical intervention. A literature review revealed that serious complications, including sepsis or permanent functional disturbance, could arise although retroperitoneal fasciitis and/or abscesses are very rare after vaginal delivery. Iliopsoas fasciitis could be considered when patients complain of extreme pain in the pelvic wall, sacroiliac joint region, or thigh-symptoms that are uncommon in uncomplicated endometritis.

Adult↗
PubMed2005

Short-term combinational therapy of low-dose estrogen with selective serotonin re-uptake inhibitor (fluvoxamine) for oophorectomized women with hot flashes and depressive tendencies.

AIM: To examine whether low-dose and short-term estrogen-replacement therapy (ERT) plus selective serotonin re-uptake inhibitor (SSRI) treatment is effective or not in the treatment of climacteric disorders, hot flashes and depressive symptoms, in oophorectomized women. METHOD: Forty-two oophorectomized women with hot flashes and depressive symptoms were assigned randomly to two groups. We examined the efficacy rates of climacteric disorders, particularly hot flashes and depressive symptoms in 21 women on low-dose ERT (conjugated equine estrogens [CEE] 0.3125 mg/day) and 21 women on low-dose ERT (CEE 0.3125 mg/day) plus SSRI (fluvoxamine 50 mg/day) treated for 8 weeks. We used questionnaires to evaluate the efficacy for depression, namely the Self-rating Depression Scale (SDS) and the Self-rating Questionnaire for Depression (SRQ-D), and for anxiety with the State-Trait Anxiety Inventory (STAI). In the statistical analysis, in the mixed-effect model, for the score against time and adjusted with age, treatment and treatment as the fixed effects. RESULTS: The average scores on the SDS in both groups were decreased by the treatment (P < 0.001). But the efficacy of the ERT + SSRI group in the time x treatment SDS and SRQ-D scores was significantly higher compared with those of ERT (P = 0.0025, 0.0162) and there was a significant difference in the decrease in the frequency of hot flashes by 8 weeks between the two groups (P = 0.036). CONCLUSIONS: A combination of low-dose and short-term ERT + SSRI is more effective than low-dose estrogen alone in relieving the depressive symptoms and hot flashes of oophorectomized women.

Adult↗
PubMed2005

Regional difference of endothelium-dependent contractility in human umbilical artery.

To investigate whether vascular reactivity of the umbilical artery influences differences in Doppler waveform depending on the sampling site along the cord, we studied a regional difference of endothelium-dependent vascular contractility in human umbilical artery using mechanical responses to the quick stretch of vascular smooth muscle strips. The umbilical artery resistance index (RI) values for the fetal end were significantly higher than those for the placental end. In endothelium-intact strips, stretch-induced contraction of the umbilical artery appears to decrease from the fetal to the placental end of the umbilical artery. No significant differences were noted between strips from the two locations when endothelial cells were rubbed, indicating that this regional difference is related to endothelial cell function. Indo-methacin decreased the stretch-induced contraction of endothelium-intact strips, but tetrodotoxin did not affect this association, suggesting that arachidonic acid metabolism via the cyclooxygenase pathway contributes to modulation of human umbilical artery responsiveness to stretch. These findings suggest that the difference in Doppler waveform of the umbilical artery depending on the sampling site is related to differences in vascular resistance that result from endothelium-related function.

Biomechanical Phenomena↗
PubMed2004

Positive effects of conjugated equine estrogen on triglyceride metabolism in oophorectomized women based on a stratification analysis of pretreatment values.

OBJECTIVE: To evaluate the effects of conjugated equine estrogen (CEE) on the triglyceride (TG) metabolism in oophorectomized women based on a stratified analysis. DESIGN: Randomized, clinical study. SETTING: Menopause Clinic of Kyushu University Hospital. PATIENT(S): Three hundred oophorectomized women. INTERVENTION(S): Three hundred oophorectomized women were randomly divided into two groups and treated by the following regimens for a year: group 1 received calcium alone, group 2 received 0.625 mg/day of CEE and calcium. MAIN OUTCOME MEASURE(S): The changes in serum lipid profile were analyzed according to the individual initial levels in each group. Apolipoprotein E was also measured. RESULT(S): A greater reduction in low-density lipoprotein cholesterol (LDL-C) levels was observed in group 2 women with higher initial levels. For high-density lipoprotein cholesterol (HDL-C) a greater increase was observed in group 2 women with lower initial levels. Although TG levels increased as a whole in group 2, a reduction was observed in the high-TG groups. The initial values of apolipoprotein E were higher in the high-TG groups and decreased to greater amounts in group 2 patients. CONCLUSION(S): Administration of CEE induced positive changes in the serum lipid profile according to the individual initial levels, including levels of TG. Therefore, changes in the TG levels shown by the stratification may be related to the apolipoprotein E changes that are observed following CEE replacement.

Apolipoproteins E↗
PubMed2004

Hormone replacement therapy and breast cancer risk in Kyushu University Hospital: supporting the Women's Health Initiative study.

AIM: The influence of hormone replacement therapy (HRT) on breast cancer has not been clarified in Japan, however the Women's Health Initiative (WHI) trial recently showed breast cancer risk according to use of estrogen plus progestin. We assessed retrospectively the incidence of breast cancer in postmenopausal women who received HRT at our outpatients clinic. METHODS: Among the patients registered at the postmenopausal clinic in Kyushu University Hospital from 1990 to 2003, 917 women who received HRT (estrogen plus progestin, 507 patients; estrogen only, 410 patients) after informed consent were examined by mammography or breast ultrasound tomography. RESULTS: Breast cancer occurred in nine patients: five patients who received estrogen plus progestin and four who received estrogen only. Four of five the patients who used estrogen plus progestin received HRT for more than 5 years. CONCLUSION: Breast cancer risk in patients who used estrogen plus progestin for more than 5 years seemed to be higher than those who used it for less than 5 years. This tendency is similar to the results of the WHI. In addition, breast cancer incidence in patients treated with HRT in our clinic seemed to be higher than the incidence in average Japanese women. Therefore, patients need to be given sufficient information before undergoing HRT.

Aged↗
PubMed2004

[Effects of raloxifene on other organs without bone: uterus].

Tamoxifen and Toremifene act as agonistic on uterine myometrium and endometrium. Tamoxifen leads re-enlargement of uterine myomas, recurrence of adenomyosis, atypical genital bleeding for endometrial hyperplasia and endometrial carcinoma in postmenopausal women. Therefore, it is necessary to evaluate the stage of pathological change on myometrium and endometrium, both before and during the period of administration of tamoxifen or toremifene. Unlike these drugs, raloxifene has an antagonistic action on uterine myometrium and endometrium. From these standpoints, we consider that raloxifene use lower the risks of uterine myomas, adenomyosis, endometrial hyperplasia and endometrial carcinoma.

Breast Neoplasms↗
PubMed2003

Predicting the effects of estrogen replacement therapy on lumbar bone mineral density in oophorectomized women: analysis of a 10-year longitudinal study.

The purpose of this study was to investigate whether it is possible to predict the long-term effects of estrogen replacement therapy (ERT) on lumbar bone mineral density (BMD) of oophorectomized women based on changes in BMD. In this study, we retrospectively investigated the changes in lumbar BMD of 70 oophorectomized women under ERT for more than 10 years, and examined whether it was possible in the early stage of ERT to predict the amount of lumbar BMD based on various parameters. Seventy oophorectomized Japanese women (56.8+/-3.9 years old) treated with conjugated equine estrogen (oral) at a dosage of 0.625 mg/day for 10 years were enrolled. Lumbar (L2-L4) BMD was measured annually by dual-energy X-ray absorptiometry (DXA; CV<1.0%). The correlation between changes in BMD after 10 years on ERT (DeltaBMD10) and several clinical factors was examined using a stepwise multiple regression model. The change in BMD after 1 year on ERT (%DeltaBMD1) was the only independent factor that correlated with changes in BMD after 10 years on ERT; the coefficient of correlation was R(2)=0.557 ( R=0.750, P<0.001). Based on the %DeltaBMD1, the 70 women were divided into two groups: women with a positive change in the 1st year (%DeltaBMD1 >or=0%) in group A ( n=40) and those with a negative value in the first year ( %DeltaBMD1<0%) in group B ( n=30). We investigated the sensitivity and specificity in the coincidence of %DeltaBMD1 changes in BMD after 10 years on ERT. The %DeltaBMD1 coincided with changes in BMD after 10 years on ERT; the sensitivity was 92.5% and specificity was 70.0%. In conclusion, changes in lumbar BMD on ERT can be predicted from the changes in lumbar BMD at the end of the 1st year.

Bone Density↗
PubMed2003

A case of pregnancy complicated by the development of a tubo-ovarian abscess following in vitro fertilization and embryo transfer.

Tubo-ovarian abscess is an uncommon complication in pregnant women. In this report, we present a patient who developed a tubo-ovarian abscess during pregnancy following in vitro fertilization and embryo transfer (IVF-ET). Despite treatment with intravenous antibiotics she delivered at 22 weeks of gestation. After delivery, she underwent a left salpingo-oophorectomy. Review of the literature revealed only 26 reported cases of tubo-ovarian or pelvic abscess during pregnancy. Pelvic inflammatory disease, previous laparotomy, and structural genital anomalies are known risk factors for pelvic abscess during pregnancy. Pelvic abscess resulting as a complication of vaginal oocyte retrieval has been reported. Therefore, although enabling women with organic pelvic disease such as endometriosis and hydrosalpinx to achieve pregnancy, assisted reproductive techniques may potentially result in pelvic infection during pregnancy. This case suggests that a preconception evaluation and treatment for such conditions should be considered for women undergoing treatment for infertility.

Abscess↗
PubMed2002

[Bone metabolism in hypo-estrogenic young women].

Hypo-estrogenic state induces the increased bone turnover finally into osteoporosis. Most typical case of hypo-estrogenic bone metabolism is that of postmenopausal women. We pay attention to other bone metabolism in hypo-estrogenic state women; (1) Amenorrhea patients in young women; (2) Oophorectomized young women; (3) Patients on GnRH analogue therapy. These patients should be evaluated their bone metabolism carefully. It is also important to prevent their bone loss with hormone replacement therapy.

English Abstract↗