Biomedical subjects
Publications and source records attributed to S Sakamoto.
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Primary amenorrhea, in which serum concentrations of gonadotropins are low or normal, has been considered to be relatively rare. Recent analysis in our outpatient clinic revealed that the incidence of hypothalamic primary amenorrhea is higher than previously appreciated, comprising 26.7% of the total primary amenorrheas. Endocrinological functions of the hypothalamo-hypophyseo-ovarian axis in these patients were therefore investigated. Studies on gonadotropin secretion indicated that a disturbance in LH-RH secretion and a lack of estrogen positive feedback were principle features of this disease. In addition to the dysfunction of gonadotropin secretion, the control of PRL secretion was disturbed in this disease since there was a poor PRL response to chlorpromazine in spite of normal responsiveness to TRH. Thus, "isolated gonadotropin deficiency" hitherto used to describe this disease is not pertinent. Furthermore, these results suggest that PRL might be involved in the onset of puberty in humans. Clinically, the induction of ovulation with HMG (Human Menopausal Gonadotropin) is possible in hypothalamic primary amenorrhea, although the ovarian responsiveness to gonadotropin is poor. Therefore, an endocrinologically precise diagnosis of hypothalamic primary amenorrhea is important in the gynecological clinic because fertility has been considered to be almost impossible in primary amenorrhea.
A newly synthesized 16, 16-dimethyl trans delta 2 PGE1 methyl ester (ONO 802) was clinically applied in the form of a vaginal suppository for therapeutic abortion of second trimester pregnancies. Its effects were studied in a double-blind test comparing it with an inactive placebo suppository. The study was conducted at 12 Japanese university hospitals. The number of patients was 125 in total, i.e. 63 receiving ONO 802 vaginal suppository (containing 1.0 mg ONO 802) and 62 receiving inactive placebo suppository. ONO 802 was more effective than placebo with a success rate of 87% (complete (71%) and incomplete (16%) abortions). The onset of uterine contractions was observed in 154.3+/-18.1 min. and the onset of uterine bleeding in 323.6+/-41.0 min. The expulsion of the fetus and placenta was observed in 955.4+/-97.0 and 961.6+/-97.0 min., respectively. The cervix dilating effect of ONO 802 was observed in 63.5% of the patients at 3 hours after the start of administration. Nausea, vomiting, abdominal cramps, diarrhea and pyrexia were noticed. However, all these side effects were transient and mild, requiring no treatment. No abnormality was observed in the puerperal course, duration of uterine bleeding or onset of subsequent menstruation following the therapeutic abortion. Therefore, the present study demonstrated that ONO 802 vaginal suppository was an effective and valuable drug for therapeutic abortion of second trimester pregnancies.
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A case of giant aneurysm arising from the right main renal artery of a 6-year-old boy with severe renin-dependent hypertension is presented. As simple aneurysmectomy was hardly performed because of tight adhesion to the surrounding tissues, the aneurysm was removed with the kidney. The blood pressure was normalized 10 days after surgery. The size of the aneurysm was 8.0 cm in diameter. This is the biggest one among the child cases reported so far.
Early phase hyperglycemia, associated with increased rates of insulin and C-peptide secretion after oral administration of 100 g glucose, was observed among patients with pulmonary tuberculosis who were taking rifampicin. This early phase hyperglycemia appeared shortly after rifampicin was started and it disappeared completely a few days after rifampicin was discontinued. No difference in oral glucose tolerance was noted between healthy normal subjects and patients with pulmonary tuberculosis who were not taking any medications. Antituberculous drugs other than rifampicin did not induce early phase hyperglycemia. Because intravenous glucose tolerance was normal in patients treated with rifampicin, it is suggested that rifampicin produces an early phase hyperglycemia possibly by augmenting intestinal absorption of glucose.
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The effect of the decidualization induced by the administration of sex steroid hormones on the human endometrial PRL contents and the mechanism of synthesis and secretion of PRL in this decidualized endometrium of non-pregnant women were investigated. The PRL contents increased in proportion to the degree of decidualization. In vitro secretion of PRL in decidualized human endometrium was inhibited by the protein synthesis inhibitors, while TRH, dopamine, and bromocriptine did not have any effects on PRL secretion in incubation experiments. These data suggest that the production and secretion of PRL in the human endometrium have no relation to the presence of conceptus, and furthermore, they are regulated by mechanism different from the pituitary PRL.
This study was designed to determine how distal vasodilatory stimuli can alter coronary hemodynamics and the appearance of myocardial ischemia in the presence of severe coronary stenosis. In anesthetized open chest dogs, left circumflex coronary artery (LCx) flow, distal LCx perfusion pressure (DCPP), heart rate, and aortic pressure were monitored and regional myocardial ischemia was estimated from ST segment deviation in the epicardial and intramyocardial electrograms obtained from the electrodes located in the area supplied by LCx. In the presence of severe LCx constriction, intracoronary administration of adenosine (0.01 mg/Kg/min) and dipyridamole (0.05 mg/Kg) failed to augment LCx flow and induced further reduction in DCPP without changing systemic hemodynamics. In parallel with these hemodynamic changes, significant ST elevation was observed in the inner layer of the area supplied by the LCx. These results show that subepicardial vasodilation following vasodilatory stimuli can induce transmural flow redistribution and lead to subendocardial ischemia in the presence of severe coronary stenosis.
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Flow pattern within the main pulmonary artery was analysed by pulsed Doppler echocardiography in a case of coronary artery-pulmonary artery fistula. An asymptomatic 32-year-old female was referred to our hospital for evaluation of a continuous murmur in the second interspace at the left sternal border. Other physical findings, chest roentgenograms and electrocardiograms were normal. Two-dimensional echocardiography did not play an important role in the diagnosis. However, pulsed Doppler echocardiography revealed an antegrade turbulent flow along the antero-lateral wall of the main pulmonary artery from early diastole to early systole. The direction and distribution of this abnormal flow was judged to be different from that of patent ductus arteriosus. Coronary arteriography showed a fistula from the both coronary arteries to the proximal portion of the main pulmonary artery. However, its shunt was so small that it could not be detected by oxymetry or by hydrogen-platinum electrode method. This case suggests that Doppler method is very sensitive in shunt detection and possibly useful for non-invasive diagnosis of coronary artery-pulmonary artery fistula.
In order to elucidate the mechanism of estrogen action at the anterior pituitary level, the effects of estradiol on the number of binding sites of LH-RH receptor in the anterior pituitary as well as its effects on the anterior pituitary responsiveness to LH-RH were studied in castrated adult female rats. Daily sc injections of 20 micrograms of 17 beta-estradiol for 2 and 4 days increased both LH-RH receptor levels and the responsiveness of the pituitary to LH-RH. This result indicates that estrogen modulates the sensitivity of the anterior pituitary to LH-RH by changing its LH-RH receptor.
Ninety women with genital herpes were studied clinically and virologically. From a clinical standpoint, these patients could be classified into 3 clinical types--acute, recurrent, and provoked. When herpes simplex virus (HSV) strains isolated from these patients and asymptomatic virus secretors were typed, 36 strains were determined to be type 1 (HSV-1) and the remaining 54 to be type 2 (HSV-2). The acute type was caused by primary infection of HSV-1 or HSV-2 as well as by infection of HSV-2 in the absence of heterologous antibody. In addition, 35 of 40 HSV strains isolated from recurrent, provoked, and asymptomatic virus secretors were identified as HSV-2, suggesting that HSV-2 may play a major role in establishing latent infection in the female genital region.
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Normal and malignant hematopoietic cell lines, with the exception of MOLT-3, were unable to grow in the methionine-depleted medium which was supplemented with homocysteine. Normal lymphocytes were less stimulated by mitogens in the medium containing homocysteine. Colony-forming units in culture from normal bone marrow cells were not formed in the medium in which homocysteine was substituted for methionine. These data suggest that there are no differences in the methionine requirement for cell growth between normal and malignant hematopoietic cells.