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S Fujimoto

Publications and source records attributed to S Fujimoto.

At least 1,225 records · Page 68Linked to original sources

Efficacy of maternal serum screening in the prenatal detection of fetal chromosome abnormalities in Japanese women.

OBJECTIVE: This prospective study assesses the efficacy of maternal serum screening for use in prenatal diagnosis of fetal anomaly and chromosome imbalance in Japanese women. METHODS: Maternal serum alpha-fetoprotein, human chorionic gonadotropin, and unconjugated estriol were measured in 1,055 singleton pregnant women between 14 and 20 weeks of gestation. A calculated risk for trisomy 21 of >/=1/299 or alpha-fetoprotein >/=2.5 multiples of the median was adopted as positive. RESULTS: Three hundred and seventy-eight of the 1, 055 women screened (35.8%) were identified as positive. Sensitivity, false-positive rate, and positive predictive value in women aged <35 years were 60.0, 10.6, and 6.8%, respectively, and these values were 87.5, 49.3, and 4.2%, respectively, in women aged >/=35 years. The false-positive rate in women aged <35 years was significantly lower than that for women aged >/=35 years (p < 0.001). Chromosomal abnormalities were identified in 21 cases, including 10 with trisomy 21, 5 with trisomy 18, 2 with trisomy 13, and 4 with other chromosomal disorders. Seventeen of the 21 cases (81.0%) showed screen-positive results, and among these all 10 cases with trisomy 21 were detectable. Two cases with trisomy 18, 1 with trisomy 13 and 1 with isochromosome X showed extremely low human chorionic gonadotropin levels (0.4 +/- 0.1 multiples of the median, mean +/- SE), although they were screen negative. Of the 264 women who did not undergo amniocentesis, none had any clinical findings consistent with aneuploidy after birth. CONCLUSIONS: Our results suggest that the evaluation of each serum marker, as well as of the calculated risk, was significantly important in the prenatal detection of fetal aneuploidy.

Adult↗

A study on the lectin reactivity of alpha-fetoprotein produced by hepatoid adenocarcinomas and yolk sac tumors.

The carbohydrate structure of glycoproteins is considered to be tissue-specific or cell type-specific, but there have been no reports on the differences of the carbohydrate structure of alpha-fetoproteins (AFPs) produced by histologically identical tumors in different tissues. The lectin affinity electrophoresis of hepatoid adenocarcinomas and yolk sac tumors from different organs suggested that either the tumor heterogeneity or the tissue specificity is possibly involved, the lectin reactivity of the AFP sugar chain structure produced by the tumors in different tissues.

Adenocarcinoma↗

Persistent detection of alfa-fetoprotein in the vagina without overt preterm premature rupture of the membranes. Clinical and chemical characterizations.

OBJECTIVES: The objectives of this study were to clinically characterize and seek risk factors for the patients with persistently detected alfa-fetoprotein (AFP) in the vagina without showing overt preterm premature rupture of the membranes (PROM). STUDY DESIGN: The cohort study was undertaken using vaginal-cervical specimens collected consecutively between 21 and 40 weeks of gestation from 25 consenting women. Demographic, obstetric, neonatal, and laboratory data from patients with persistent positive results of AFP kit tests without showing overt leakage of amniotic fluid were compared to those from controls. Cervical levels of interleukin-1 alpha, interleukin-1 beta, interleukin-6, interleukin-8, and granulocyte elastase were measured by immunoassay, and the uterine cervix was assessed by transvaginal ultrasonography. Statistical analysis involved Fisher's exact test and Mann-Whitney U test. RESULTS: The incidence of overt preterm PROM was significantly higher in the patients with persistently detected AFP in preterm (3 in 4 cases) than in controls (3 in 21 controls). At sampling before determination of persistently detected AFP, patients with persistently detected AFP had significantly higher cervical levels of interleukin-6 and significantly shorter cervical length than controls. CONCLUSIONS: Patients with persistently detected AFP in the vagina without showing overt preterm PROM have the risk of overt preterm PROM. Increased levels of interleukin-6 in cervical specimens and short cervical length may be risk factors for the occurrence of persistent detection of AFP in the preterm.

Cervix Uteri↗

The deeper the negativity of the T waves recorded, the greater is the effectiveness of reperfusion of the myocardium.

We evaluated the time course of QT intervals and the amplitude of T waves, and their relationship to subsequent left ventricular regional wall motions in 88 patients with successfully reperfused acute myocardial infarction (MI). The QTc intervals and the amplitude of inverted T waves of lead V3 in patients with anterior MI and of lead III in patients with inferior MI were measured for 1 month after MI. Patients were classified as having severe T wave inversion or mild T wave inversion within 3 days of MI, based on a measurement of 0.5 mV in the anterior MI cases and 0.3 mV in the inferior MI cases. Chronicphase left ventriculography was performed 5 months later, and hypokinesis of the infarct site was measured using the centerline method. The T waves inverted after reperfusion in 86 patients (98%). The inverted T waves deepened twice, with the first negative peak about 48 h and the second negative peak about 18 days after MI. QTc intervals became prolonged as the T waves deepened. The extent of hypokinesis in the chronic phase correlated with the amplitude of inverted T waves and QTc intervals when the T waves were deepest. The group with severe T wave inversion had less extensive hypokinesis, a lower maximum serum creatine kinase level and a shorter time to reperfusion from the onset of symptoms than the group with mild inversion. We conclude that the degree of T wave inversion 48 h after MI is predictive of abnormalities in left ventricular regional wall motions in the chronic phase. A deep inverted T wave in the acute phase of MI indicates an abundantly stunned myocardium.

Aged↗

Relation between clinical and histologic outcome of intraperitoneal hyperthermic perfusion for patients with gastric cancer and peritoneal metastasis.

In 15 patients with refractory gastric cancer and peritoneal metastasis, the relationship among histologic outcome of intraperitoneal hyperthermic perfusion (IPHP), extent of peritoneal metastasis, and cause of death was studied. The IPHP treatment did not kill all the gastric cancer cells which had penetrated deeply into subperitoneal layers. In contrast, gastric cancer cells in the abdominal effusion and/or lavage vanished. Three patients with peritoneal metastasis, deeply invaded and spread all over the peritoneum, died of peritoneal recurrence and 1 died of pericardial metastasis. In the remaining 11 patients with a lesser extent of peritoneal metastasis, 5 are living without recurrence and among the other 6, 4 died of recurrence of the disease and 1 died of other causes.

Adenocarcinoma↗

Pregnancy complicated by Ebstein's anomaly: oxygen administration to mother for chronic fetal hypoxemia. A therapeutic case report.

For chronic fetal hypoxia due to maternal Ebstein's anomaly, oxygen was administered daily to the mother by mask for 105 days. At 20 weeks of gestation, umbilical venous blood gases in room air showed pH 7.42, PO2 25.7 mm Hg, PCO2 33.7 mm Hg and O2 saturation 48.7%, and changed to 7.45, 39.1 mm Hg, 25.9 mm Hg and 77.4% on 3 liters/min of oxygen inhalation by mask, respectively. The PO2 of the maternal arterial blood gases increased to 30 mm Hg on oxygen administration at 15 weeks of gestation, but at 25 weeks of gestation the PO2 increased by only about 10 mm Hg. At 30 weeks, intrauterine growth retardation was suspected. Just after the second puncture of the umbilical cord at 31 weeks and 3 days of gestation, 80 bpm fetal bradycardia occurred for several minutes without recovery and emergency cesarean section was done under the general anesthesia.

Adult↗

Body fluid oxygen tension and prognosis in patients with ruptured aneurysm.

Body fluid gas pressure and electrolytes of patients with ruptured aneurysm were continuously analyzed. Intracranial pressure (ICP) was regulated at the level of 120-100 mm H2O by cerebral ventricular drainage. There was no significant change in the pH, PCO2, HCO3-, Na+, K+, Ca++ in the cerebrospinal fluid (CSF) of patients with slight or moderate disturbance of consciousness (lethargic-drowsy state). The PcsfO2 of the patients with marked disturbances of consciousness (semicoma-coma) was significantly low. PcsfO2 of the patients with cerebral vasospasm was significantly lower than for those without vasospasms. PcsfO2/PaO2 was 0.27 +/- 0.01 in the patients with vasospasm and 0.50 +/- 0.01 in those with vasospasm. PcsfO2 tended to decrease in patients with markedly bloody CSF. When the bloody CSF was cleared by ventricular drainage, PcsfO2 increased. PcsfO2 did not return to a normal value in the patients with marked disturbances of consciousness despite sufficient arterial oxygen tension. This suggests that PcsfO2 and PcsfO2/PaO2 should provide a convenient index for the prognosis of patients with ruptured aneurysm.

Aged↗

The protective effect of combined administration of anti-oxidants and perfluorochemicals on cerebral ischemia.

We previously published results of investigations which indicated that the combination of mannitol, which acts as a free radical scavenger, and perfluorochemicals (PFC), which have a strong oxygen-carrying capacity, can be therapeutic in cases of brain infarction. The present experiment tested the hypothesis that the effectiveness of such treatment could be increased by an optimal combination of such scavengers and other chemicals. Fifty-two dogs were used, employing the "canine model of a completely ischemic brain regulated with the perfusion method." A total of six drugs with free radical scavenger capacities were tested: mannitol, vitamin E, vitamin C, Nizofenone (Y-9197), dexamethasone (DEXA) and suloctidil (MY-103). These drugs were administered intravenously 15 minutes prior to the production of ischemia, when cerebral blood flow was reduced to one-tenth its normal volume. After one hour, recirculation was allowed and the recovery of electrical activity of the brain observed for three hours. Judged by the degree of recovery of brain electrical activity, five drugs were considered to have protective effect against brain ischemia: mannitol, vitamin E, MY-103, DEXA and Y-9197. Among these five drugs, mannitol, vitamin E and DEXA are known to be safe and easily used clinically. The combined administration of these three drugs, together with PFC, was also investigated. It was found that the speed and degree of recovery of brain electrical activity were greater when these drugs were given together than when one was administered alone.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Electrophysiologic evidence for involvement of acetylcholine as a neurotransmitter in the lateral vestibular nucleus.

Monosynaptic spike generation of lateral vestibular nucleus (LVN) neurons with vestibular nerve stimulation in cats was inhibited by microiontophoretic atropine and gamma-aminobutyric acid (GABA). Spontaneous firing of the LVN monosynaptic neuron was increased by iontophoretic acetylcholine and glutamate. Atropine inhibited acetylcholine-induced firing without affecting glutamate-induced firing, while GABA blocked spike generation produced by acetylcholine and glutamate. Acetylcholine probably plays a role in transmission from the vestibular nerve to the LVN monosynaptic neurons.

Acetylcholine↗

Augmented antitumour effects of combined treatment with hyperthermia and tumour necrosis factor on human gastric cancer xenotransplanted into nude mice.

Hyperthermia combined with recombinant human tumour necrosis factor (rH-TNF) was evaluated for antitumour efficacy in vivo. Use was made of human gastric cancer tissues xenografted into nude mice. When 100, 300, 600, and 1200 units of rH-TNF (2.4 x 10(6) units/mg protein) were given twice intraperitoneally, tumour regression did not occur in any animal. In contrast, a remarkable suppression of tumour growth was observed when 600 and 1200 units of rH-TNF was given in combination with hyperthermia at 43.5 +/- 0.1 degrees C. No effects were evident with the regimen of 100 and 300 units of rH-TNF plus hyperthermia at the same temperature, as compared with evidence obtained with hyperthermia alone. The tumoral blood flow, determined by the hydrogen diffusion method, decreased immediately after hyperthermia alone or hyperthermia plus 1200 units of rH-TNF, whereas a slight decrease was seen after rH-TNF alone. When hyperthermia plus 1200 units of rH-TNF were given, there was a remarkable delay in reversion to pretreatment values of tumoral blood flow, as compared to findings with rH-TNF only or heat only. These results are discussed in relation to the antitumour and side-effects of rH-TNF.

Animals↗

Prevention of scald injury on the peritoneo-serosal surface in advanced gastric cancer patients treated with intraperitoneal hyperthermic perfusion.

In attempts to avoid the side-effects derived from a scald on the peritoneo-serosal surface during intraperitoneal hyperthermic perfusion (IPHP) for advanced gastric cancer, a randomized study using cimetidine, a histamine H2-receptor antagonist, was carried out on 18 patients with advanced gastric cancer. Cimetidine, 50 mg/kg, was administered intravenously and immediately before IPHP. The background characteristics of the patients and the types of surgical treatment used were almost the same between each group of patients, whether or not cimetidine was given. The perfusion time in the cimetidine and control groups was 123 +/- 9 and 117 +/- 9 min, respectively. The inflow and outflow temperatures of the perfusate were 46.3 +/- 0.4 and 44.2 +/- 0.1 degrees C in the cimetidine group, respectively, whereas in the control group the temperatures were 46.0 +/- 0.3 and 44.1 +/- 0.2 degrees C, respectively. In the nine patients who were given cimetidine, the histamine concentrations in the peripheral blood increased significantly, compared to those in the nine controls; this resulted from the release of histamine into the circulating blood. Higher concentrations of protein were observed in the post-hyperthermic intraperitoneal exudate of the control group for 3-24 h after IPHP and, consequently, post-hyperthermic hypoproteinaemia was remarkable in the control group. These data suggest that when pre-IPHP cimetidine was prescribed for patients with gastric cancer treated with IPHP, the peritoneo-serosal surface was protected from scald injury and the side-effects of IPHP were reduced.

Blood Proteins↗

Clinical outcome of intraoperative pelvic hyperthermochemotherapy for patients with Dukes' C rectal cancer.

In attempts to prevent local recurrence after curative resection for rectal cancer, intraoperative pelvic hyperthermochemotherapy (IOPHC) was prescribed for 27 patients with Dukes' C cancer. The procedures used were as follows: immediately after amputation or resection of the rectum with extended lymphadenectomy, the pelvic cavity was filled with physiological saline containing 40 micrograms/ml mitomycin C, which was warmed at 45 degrees C for 90 min with an apparatus devised for IOPHC. Thirty-five patients who underwent surgery alone for Dukes' C rectal cancer within the same period served as controls. There was a local recurrence in three patients in the IOPHC group (11.1%), and in 13 in the control group (37.1%). With regard to hepatic or pulmonary metastasis, there was no difference between the two groups. There was no morbidity in the IOPHC treatment except for a large volume of exudate from the pelvic cavity. Thus, IOPHC can be considered as one option for limiting local recurrence after surgical resection of an advanced rectal cancer.

Aged↗

TNF-alpha and endotoxin serum levels in cancer patients undergoing intraperitoneal hyperthermic perfusion.

Intraperitoneal hyperthermic perfusion (IPHP) is performed as one treatment for patients with advanced gastrointestinal cancer complicated by peritoneal dissemination or carcinomatous peritonitis. However, the anticancer mechanism of IPHP and its safety have not yet been fully elucidated. It has been experimentally known that endotoxinemia occurs by high body temperature, and that endotoxin stimulates the macrophage, monocyte and endothelial cell to induce the production of TNF-alpha. TNF-alpha is one of cytokines to be induced at the initial phase as a host immune response and play an important role to initiate the systemic inflammatory response syndrome (SIRS). We have tested whether the serum concentrations of TNF-alpha and endotoxin are elevated following IPHP. Eleven patients with gastro-intestinal cancer underwent surgery combined with IPHP. Mixed venous blood obtained from pulmonary artery (PA-blood) was collected at four sampling points. TNF-alpha and endotoxin levels in the PA-blood were measured by ELISA and a limulus amoebocyte lysate assay respectively. In all patients the serum TNF-alpha levels in PA-blood were temporarily elevated following IPHP from less than 10 pg/ml before IPHP to 42.8 +/- 26.6 pg/ml; endotoxin levels were not altered. This study shows that IPHP has the ability to induce endogenous TNF-alpha not mediated by endotoxin.

Adult↗

Histologic evaluation of preventive measures for scald injury on the peritoneo-serosal surface due to intraoperative hyperthermic chemoperfusion for patients with gastric cancer and peritoneal metastasis.

To histologically assess the preventive efficacy of cimetidine against scald injury on the peritoneo-serosal surface during intraperitoneal hyperthermic chemoperfusion (IHCP) for advanced gastric cancer, a randomized histologic study using cimetidine, a histamine H2-receptor antagonist, was performed for 20 patients with advanced or recurrent gastric cancer and peritoneal metastasis. Cimetidine 50 mg/kg was administered intravenously to 10 patients just prior to the IHCP (cimetidine group), and the remaining 10 patients underwent the IHCP without cimetidine (control group). The background factors and IHCP treatments of these two groups were nearly the same. Although the antitumour efficacy of the IHCP was not histologically different between the two groups, the histological analysis revealed that the peritoneo-serosal surface in the cimetidine group was protected against scald injury, compared with the control group. This finding suggests that pre-IHCP cimetidine is of great benefit for protecting the peritoneo-serosal surface from scald injury due to IHCP.

Antineoplastic Agents↗

Induction of anti-tumor immunity by mouse tumor cells transfected with mouse interleukin-12 gene.

Interleukin-12 (IL-12) is a heterodimeric cytokine. In order to transduce both cDNAs for p35 and p40 of IL-12 in the tumor cells, a polycistronic retroviral vector was constructed by inserting the internal ribosome entry site gene of encephalomyocarditis virus between two cDNAs. On the other hand, two cDNAs were sequentially transfected in the tumor cells. Both polycistronic gene transfectants and double transfectants produced biologically active mouse IL-12. IL-12-expressing tumor cells were all rejected in syngeneic mice, and induced cytotoxic T lymphocyte activity. The capacity to induce anti-tumor memory may depend on the amount of IL-12 produced by the transfectants, because the relatively higher IL-12 producer tumor cell line induced the anti-tumor memory in the rejected mice, but the lower producer did not.

Animals↗

[A case of McLeod syndrome].

A 52-year-old man was admitted to our hospital in 1997 because of high serum creatine kinase (CK) level. Neurologic findings revealed chorea on the trunk and extremities, mild weakness of proximal muscles, and absence of deep tendon reflexes in four extremities. Serum CK was elevated to 3,494 U/l (normal, below 235). A peripheral blood smear showed acanthocytes in approximately 1% of the red blood cells (RBCs). Very weak expression of the Kell antigens (K2, K4, K5, and K7) on his RBCs led us to make a final diagnosis of McLeod syndrome. Muscle biopsy from the left biceps showed increased variability in fiber diameter, a few regenerating fibers, scattered fibers with internal nuclei, and mild fiber type grouping. Immunohistochemical analyses of dystrophin. merosin, and adhalin were normal. Although McLeod syndrome is a rare X-linked recessive disorder, it is clinically important for differential diagnosis of chorea acanthocytosis and hyperCKemia.

Acanthocytes↗

Frequent genotype changes at -308 of the human tumor necrosis factor-alpha promoter region in human uterine endometrial cancer.

This study was designed to test the hypothesis that genotypic changes of tumor necrosis factor alpha (TNF-alpha) promoter region are associated with endometrial cancer. TNF-alpha gene encodes a cytokine involved in angiogenesis and oncogenesis of several cancers. Some uncommon alleles are reported to be associated with increased production of TNF-alpha and the onset of various cancers. Studies of such alleles are lacking in endometrial cancer. In this study, we examined the genetic changes at the polymorphic 3 loci of TNF-alpha promoter regions (-238, -308 and 488) in 41 Japanese patients with uterine endometrial carcinomas (UEC). Nine of 41 UEC samples (22%) had genotype changes from GA to A at -308 promoter region of the TNF-alpha gene. There were no genotype changes at -238 and 488 regions of TNF-alpha in UEC samples. The results of our study demonstrate for the first time that genotype changes from GA to A in UEC patients. We conclude that the genotype changes at -308 promoter region of TNF-alpha may play an essential role in the malignant transformation of endometrial cells.

Cell Transformation, Neoplastic↗

[Enuresis as the initial manifestation of neuro-Behçet's disease. A case report].

A 20-year-old man noticed enuresis since the age of 18 years. He was also pointed out gait unsteadiness by his friends. Neurologic examination revealed spastic tetraparesis with mild cerebellar ataxia. The cerebrospinal fluid had mild pleocytosis containing neutrophils and brain magnetic resonance imaging showed mild pontocerebellar atrophy. Urodynamic study revealed uninhibited bladder and detrusor-sphincter dyssynergia. The diagnosis of neuro-Behçet's disease was made by the past history of recurrent genital and aphthous ulcers and positive HLA-B51. The frequency of enuresis was reduced by the oral administration of corticosteroid. We speculated the patient's enuresis was caused by the central nervous disinhibition at night together with uninhibited bladder.

Adult↗