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Biomedical subjects

R Kudo

Publications and source records attributed to R Kudo.

At least 37 records · Page 2Linked to original sources
PubMed2001

[Feasibility, activity, and change in the level of blood paclitaxel concentration after weekly paclitaxel therapy for a patient with recurrent ovarian cancer].

The patient was a 59-year-old woman with recurrent ovarian cancer. A CT scan of the abdomen showed enlargement of abdominal para-aortic lymph nodes (PAN) after the primary operation and 8 cycles of the combination chemotherapy with paclitaxel (TXL) and carboplatinum (CBDCA). As a second line chemotherapy for the patient, weekly administration of TXL (60 mg/m2/week x 3 weeks) was given. The toxicity was acceptable and less pronounced than with the standard TXL + CBDCA therapy. Peak blood TXL concentration, about 90 ng/ml, was achieved 4 hours after the administration of TXL. The blood TXL concentration was below the detectable limit 48 h after the administration of TXL. An almost 50% shrinkage in the size of the PAN was obtained after 2 cycles of treatment. Good QOL is being maintained without any repeated aggravation of the tumor.

Adenocarcinoma, Clear Cell↗
PubMed2000

The relationship between serum nitrate and endothelin-1 concentrations in preeclampsia.

Recently it was suggested that abnormal endothelial function may contribute to the pathophysiological changes observed in preeclampsia (PE). Both nitric oxide (NO) and endothelin-1 (ET-1) are vasoactive substances produced by endothelial cells. NO is a vasodilator and has been believed to be decreased in PE. ET-1 is a vasoconstrictor and has been reported to be increased in PE. We simultaneously measured NO metabolites and ET-1 in sera from women with PE and investigated the correlation of NO and ET-1 concentrations. We obtained serum samples from 11 healthy nonpregnant (NP) women, 16 normotensive pregnant (NTP) women and 17 women with PE. In this study, the serum ET-1 level was assayed by the ET-1 RIA system, and serum NO metabolites were assayed by measuring nitrite (NO2-) and nitrate (NO3-) simultaneously in an HPLC-Griess reaction system. There was a significant correlation between NOx (nitrite + nitrate) and ET-1 in sera from all 44 women (NP, NTP and PE groups) (p<0.001). Nitrite and ET- in sera from each group were not significantly correlated. Nitrate and ET-1 in sera from the NP and NTP groups did not significantly correlate. However, there was a significant correlation between nitrate and ET-1 in sera from the PE group (p<0.05). The serum ET-1 and nitrate concentration in the PE group was significantly higher than in the NP and NTP groups (p<0.05 and p<0.001. respectively). These findings suggest that increased production of nitrate in PE may contribute to homeostatic vasodilation against vasoconstriction caused by a higher ET-1 concentration.

Endothelin-1↗
PubMed2000

Expression of various matrix proteases and Ets family transcriptional factors in ovarian cancer cell lines: correlation to invasive potential.

OBJECTIVES: The aim of our study was to determine the important molecules responsible for the invasive activity of ovarian cancer cells. METHODS: We compared the biological characteristics, that is, growth rate, motility, and invasive activity, of five ovarian cancer cell lines with the gene expression of various matrix proteases (matrix metalloproteinase-1 [MMP-1], MMP-2, MMP-9, membrane-type MMP type 1 [MT1-MMP], MT2-MMP, MT3-MMP, urokinase plasminogen activator [uPA]), their inhibitors (tissue inhibitor of metalloproteinase type 1 [TIMP-1], TIMP-2, plasminogen activator inhibitor type 1, [PAI-1], and PAI-2), and the potential transcriptional regulators E1AF and Ets-1. RESULTS: There was no clear correlation in the growth rate, motility, and invasion, suggesting that there are independent properties for malignant potential in ovarian cancer cells. However, HTBOA, a poorly differentiated cancer cell line, exhibited highly invasive activity, rapid growth, and increased motility. This cell line also expressed both Ets transcriptional factors, E1AF and Ets-1, and many matrix-degrading enzymes. Three cell lines that expressed E1AF showed rapid cell growth. The highly invasive cell lines, HTBOA and HTOA (well-differentiated serous cystadenocarcinoma), produced either MMP-2 or MMP-1, and both cell lines expressed MT1-MMP and uPA. Furthermore, the active forms of pro-MMP-2 and pro-MMP-1 were detected in HTBOA and HTOA by zymography. CONCLUSION: We conclude that activated MMP-2 and MMP-1 are important in the invasive activity of these ovarian cancer cells.

Adenocarcinoma↗
PubMed2000

The expression of a novel natural killer inhibitory molecule, Cho-1, on the chorionic cytotrophoblast cells of successful pregnancy, but not of spontaneous abortion.

The regulatory mechanism of the recognition and cytotoxicity by natural killer (NK) cells in placental tissue remains unclarified. Previous reports indicated that monoclonal antibody Cho-1-defined molecule (Cho-1 molecule) may act as the negative regulator in the cytotoxicity by human NK cells. The Cho-1 molecule is composed of non-covalently associated cell surface molecules of approximately 200 kDa and 40 kDa. In the present study we analyzed the expression of this novel molecule in extravillous cytotrophoblast cells, which are presumed to be exposed to the cytotoxic action by maternal NK cells, from clinical cases of successful pregnancy and spontaneous abortion. By using monoclonal antibody Cho-1, our immunohistochemical data indicated that the Cho-1 molecule is clearly expressed in the cytotrophoblast cells of the early phase of successful pregnancy, but only weakly expressed in those from spontaneous abortion. The cytotrophoblast cells in the late phase (9-10 months) of pregnancy also expressed this molecule. Fluorescence-activated cell sorter analysis also showed that it is expressed on the cytotrophoblast cell surface of successful pregnancy but not on that of spontaneous abortion, suggesting that Cho-1 antigen may act as a negative regulator of the cytotoxicity by NK cells in successful pregnancy of the fetus.

Abortion, Spontaneous↗
PubMed2000

Early normal menstrual cycle pattern and the development of uterine leiomyomas.

It is unclear if women who develop uterine leiomyomas have had menstrual regularity or irregularity in their reproductive life. This case-control study examines the recalled menstrual cycle patterns throughout the reproductive life among women requiring hysterectomy for myomas. One hundred twenty-two women with myomas and 244 age-matched healthy controls without myomas were enrolled in Japan. The incidence of normal menstrual cycle pattern in their teens among patients with myoma was significantly higher than that among healthy controls (p < 0.01). The subset results for parous women were the same as those for all subjects. The size of the uterus in myoma patients with teenage menstrual regularity was not larger than in those with teenage menstrual irregularity. Women who developed myomas later in life tended to have early normal menstrual cycle pattern. Early menstrual regularity may enhance leiomyoma growth in early reproductive life.

Adult↗
PubMed2000

Mutation of the SRC gene in endometrial carcinoma.

Recently, an activating mutation of the SRC gene has been implicated in about one-tenth of advanced colon cancers. The SRC 531 mutation results in truncation of SRC directly C-terminal to the regulatory Tyr 530 and appears to activate the Tyr 530. To investigate whether mutation of SRC plays an important role in the development and progression of gynecological tumors, we performed mutational analysis of the entire coding region of SRC in 70 ovarian carcinomas, 68 endometrial carcinomas and 3 endometrial stromal sarcomas by means of polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) followed by nucleotide sequencing and restriction fragment length polymorphism (RFLP) analysis. We found one truncated mutation at codon 531 (Gln to Stop) in an endometrial carcinoma. However, we found no mutation of this gene in ovarian carcinoma or endometrial stromal sarcoma. Our results suggest that mutation of SRC may be implicated in a small proportion of endometrial carcinomas.

Adult↗
PubMed2000

A single nucleotide polymorphism in the matrix metalloproteinase-1 promoter in endometrial carcinomas.

Recent studies demonstrated that a single guanine insertion polymorphism in a matrix metalloprotease-1 promoter created an Ets binding site and affected the elevation of the transcriptional level of matrix metalloproteinase-1 (MMP-1). Furthermore, in tumor cell lines derived from melanoma and breast cancer, the incidence of the 2G / 2G genotype was significantly higher than that in the normal population. To evaluate the contribution of this polymorphism in endometrial carcinomas, we genotyped 100 endometrial carcinomas and then analyzed immunoexpression of MMP-1 in these carcinomas. We found that endometrial carcinoma patients showed a significantly higher rate of 1G / 2G or 2G / 2G genotype than control individuals, and that tumors containing the 2G allele(a) expressed MMP-1 protein more frequently than those with 1G / 1G genotype. Therefore, the single nucleotide polymorphism at the MMP-1 promoter affected the expression level of the MMP-1 protein, which may result in the association with more aggressive character in endometrial carcinoma. Our result suggests that the presence of 2G polymorphism at the MMP-1 promoter may be one of the risk factors for the development and / or progression of endometrial carcinoma.

Base Sequence↗
PubMed2000

A case of a sclerosing stromal ovarian tumor that expresses VEGF.

A case of a sclerosing stromal tumor (SST) of the ovary is presented. One of the tumor's characteristics was its high vascularity. On immunohistochemical staining, the vascular endothelial growth factor (VEGF) was positive for both cellular and edematous areas in the tumor. VEGF was thought to be a factor that affected the clinicopathological features of this tumor.

Endothelial Growth Factors↗
PubMed2000

A case of stage-IVb cervical adenocarcinoma successfully treated by combination chemotherapy: case report.

A 54-year-old patient with a Stage IVb adenocarcinoma of the cervix was treated with combination chemotherapy. This regimen consisted of intravenous cisplatin (70 mg/m2) and aclacinomycin A (30 mg/m2) on Day 1, followed by mitomycin C (5 mg/m2) on Day 2 and 3. A pathologically complete response was achieved by this regimen. The patient is well and has been free of symptoms for 66 months.

Adenocarcinoma↗
PubMed2000

Dimeric inhibin A as a fourth marker for Down's syndrome maternal serum screening in native Japanese women.

OBJECTIVE: This study was conducted to assess the usefulness of dimeric inhibin A as a fourth marker for Down's syndrome screening in addition to AFP, hCG and uE3 markers for native Japanese women. METHODS: Serum specimens from 367 native Japanese women in the second trimester were assayed for dimeric inhibin A levels. Day specific dimeric inhibin A medians were established for gestational ages 15.0-21.9. Weekly median values for the native Japanese were compared with those of a U.S. population. Selected Japanese specimens from 15 diagnosed Down's syndrome and 3 trisomy 18 cases were also assayed for dimeric inhibin A. RESULTS: Dimeric inhibin A levels did not vary greatly over the gestational age range as expected. Median value comparison showed that native Japanese dimeric inhibin A medians are higher than the U.S. population medians by an average of 7.95%. Native Japanese dimeric inhibin A median values in this study are 1.77 times higher in Down's syndrome cases than in unaffected pregnancies. Trisomy 18 dimeric inhibin A levels show no significant difference from the unaffected pregnancies. CONCLUSIONS: This report shows for the first time that dimeric inhibin A can be informative as a fourth marker for Down's syndrome screening in native Japanese women. We expect the addition of dimeric inhibin A to a triple marker protocol will increase the accuracy of predicted risk for all pregnancies screened and increase the detection rate of Down's syndrome affected pregnancies.

Biomarkers↗
PubMed2000

Surgical management of genital prolapse: is chain cystourethrography useful for evaluating anatomical corrections and urinary symptoms after surgery?

OBJECTIVE: To evaluate the relationship between chain cystourethrography and surgery for genital prolapse and urinary symptoms. METHODS: A retrospective study of women with genital prolapse was conducted from January 1991 through December 1997. To assess the preoperative and postoperative anatomical situations objectively, chain cystourethrography was performed. RESULTS: Fifty-seven patients underwent surgical repairs for genital prolapse. All of them recovered from the genital prolapse both subjectively and objectively after surgery. Chain cystourethrography is useful for evaluating postoperative anatomical corrections. However, 6 patients (12%) suffered from a recurrent feeling of genital prolapse, and 14 patients (28%) had urinary symptoms postoperatively. CONCLUSIONS: Our treatment showed good anatomical corrections based on chain cystourethrography, and there were no prognostic differences among the surgical procedures. However, anatomical correction does not always mean improvement of urinary symptoms. Further studies are needed to clarify what factors contribute to the prognosis in such cases.

Adult↗
PubMed2000

Emergency postpartum hysterectomy in obstetric practice.

OBJECTIVES: To review cases of emergency postpartum hysterectomies performed in the setting of life-threatening hemorrhaging. METHODS: A retrospective study of 17 patients who underwent postpartum hysterectomies during January 1, 1985-December 31, 1998 was undertaken. Maternal characteristics, method of delivery, antenatal complications for hysterectomy, obstetric history, placental location, blood loss before hysterectomy and during operation, intraoperative and postoperative complications, and operative procedures were investigated, as was whether prostaglandin F2alpha and/or oxytocin were administrated during labor. The operative procedures also were examined. RESULTS: The incidence was 1 in 6,978 deliveries (0.014%). All patients were transported from affiliated clinics. The leading cause for a hysterectomy was uterine rupture (35.3%), followed by disseminated intravascular coagulation (DIC) due to placental abruption (29.4%), and uterine atony (23.5%). Failure of internal iliac-artery ligation occurred in 7 patients. CONCLUSIONS: Internal iliac-artery ligation is not effective for patients with massive blood loss. In such cases, it is desirable for the private physician to make an early decision for maternal transport.

Adult↗
PubMed2000

A report on more than 10,000 vaginal hysterectomies performed without ligation of the paracervical ligaments.

OBJECTIVE: To review 10,016 cases of total vaginal hysterectomy (TVH) performed in our department by a method without ligation of the paracervical ligaments. METHODS: From 1955 to 1997, a total of 10,016 TVHs without ligation of the paracervical ligaments were performed at the Department of Obstetrics and Gynecology, Sapporo Medical University Hospital. RESULTS: Of all 22,509 gynecological operations, 44.5% were TVHs, and 8.7% were total abdominal hysterectomies (TAHs). The operative time of our TVHs ranged from 31-60 minutes in 44.1% of the cases, and from 61-90 minutes in 35.3% of the cases. Blood loss was less than 300 ml in 85% of the cases. Abdominal conversion from the vaginal approach occurred in 110 cases (1%). Operative complications also occurred only in 0.7% (69) of the cases. CONCLUSION: TVH without ligation of the paracervical ligaments is a safe and convenient method that has very few complications and that can be utilized by many gynecologists.

Blood Loss, Surgical↗
PubMed2000

A case of uterine endometrial carcinoma 15 months post-partum.

A case of uterine endometrial carcinoma 15 months post-partum, who did have none of typical risk factors of uterine endometrial carcinoma, is presented. The occurrence of post-partum uterine endometrial carcinoma is extremely rare condition probably due to anti-carcinogenic effects of progesterone. Progesterone refractory cells in the uterine endometrium, which could be an origin of the endometrial carcinoma, might have existed.

Adenocarcinoma↗
PubMed2000

Triple marker screening for trisomy 21, trisomy 18 and open neural tube defects in singleton pregnancies of native Japanese pregnant women.

OBJECTIVE: To report the results of prenatal triple marker screening on a population of Japanese pregnant women. METHODS: From April 1994 through March 1999, a total of 32,925 native Japanese women with singleton pregnancies requested a triple marker-screening test. Multiples of the median values for 3 markers and individual risks for each patient were calculated following adjustment for the Japanese weight correction factor. The risk cut-off values used for Down syndrome (T21), open spina bifida (OSB) and trisomy 18 (T18) were 1: 295, 1: 290, and 1: 100, respectively. Follow-up information was collected postpartum and statistically analyzed. RESULTS: Detection rates (DR) of T21 for women less than 35 years, over 35 years and overall were 58, 94, and 83%, respectively. DR of T18 for women less than 35 years, over 35 years and overall were 75, 79, and 79%, respectively. DR of open neural tube defects (ONTD) was 100%. CONCLUSIONS: The first cumulative data of an intervention program and prospective follow-up studies in Japan have proven to be similar to other published reports. Individual risk values were calculated for each pregnancy for T21, T18 and ONTD. This screening program is more effective than age-dependent screening for detecting T21, T18 and ONTD pregnancies.

Adult↗
PubMed2000

Complete hydatidiform mole coexisting with a live fetus after gamete intrafallopian transfer. A case report.

BACKGROUND: Molar pregnancy with a coexisting live fetus is a rare occurrence. We report the only known case with a surviving coexistent fetus after gamete intrafallopian transfer (GIFT). CASE: After GIFT, a 28-year-old primary infertility patient was diagnosed as having a complete hydatidiform mole coexisting with a live fetus at 13 weeks of gestation. At 36 weeks of gestation, a cesarean section was performed due to elevated serum human chorionic gonadotropin (hCG) levels, and a male infant with a normal appearance and weighing 2,688 g was delivered. CONCLUSION: If the patient desires to try to carry the fetus to viability after counseling on the possible associated risks of malignancy, it is possible to achieve fetal viability if (1) there is decline in the serum hCG level after it peaks before the second trimester, (2) ultrasound reveals degeneration of the molar part, and (3) there are no complications of pregnancy.

Adult↗
PubMed2000

[A pilot trial of high dose CEP (cyclophosphamide, epirubicin, cis-platinum) therapy in patients with advanced and recurrent ovarian cancer].

We evaluated the feasibility of high-dose CEP (cyclophosphamide 750 mg/m2, epirubicin 90 mg/m2, cis-platinum 70 mg/m2) therapy, with granulocyte colony-stimulating factor support every 21 days, in 18 patients with advanced and recurrent ovarian cancer. Ten patients (56%) received 6 cycles of this regimen as planned. Toxicities more than grade 3/4 on' the WHO scale of neutropenia and thrombocytopenia were observed in all cases. Nausea, vomiting, mucositis, malaise, alopecia, hepatotoxicity, and fever were common adverse effects. The average relative dose intensity of cyclophosphamide, epirubicin, cis-platinum was 0.77, 0.77, 0.79 respectively, and each RDI decreased in the last two cycles. These data suggest that this regimen could be performed safely with careful consideration on hepatotoxicity and thrombocytopenia.

Adult↗