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Biomedical subjects

T Ishimaru

Publications and source records attributed to T Ishimaru.

At least 91 records · Page 5Linked to original sources
PubMed1995

Local injection of methotrexate dissolved in saline versus methotrexate suspensions for the conservative treatment of ectopic pregnancy.

To compare the local injection of methotrexate (MTX) dissolved in saline and MTX suspensions for the laparoscopic treatment of ectopic pregnancy in terms of success rate and postoperative tubal patency. A total of 26 patients with unruptured ectopic pregnancies were selected from among 60 women with ectopic pregnancies admitted to the Nagasaki University clinic. Of these patients, 12 were treated with MTX dissolved in saline solution (solution group) and 14 with MTX suspensions consisting of lipiodol (LPD) with phosphatidylcholine (PC) added as a dispersing stabilizer (suspension group). Except for one case treated under transvaginal guidance, all the patients were treated by laparoscopy. Persistent ectopic pregnancy was recognized in seven cases (58%) in the solution group but in only two cases (14%) in the suspension group. Moreover, rupture occurred in two cases in the solution group but in no case in the suspension group. A patent treated tube was found in seven of 10 cases in the saline group and in 10 of 12 cases in the suspension group. During the follow-up period of 6-31 months, five women in the saline group and three women in the suspension group had an intrauterine pregnancy. In this study, the local injection of MTX is considered to be a reasonable method for the treatment of unruptured ectopic pregnancy, and the MTX suspension seems to be more effective and useful than MTX solution.

Adolescent↗
PubMed1995

A new approach to methotrexate and lipiodol suspensions for ectopic pregnancy: preliminary in vitro and animal experiments.

OBJECTIVES: To measure and evaluate the in vitro release of MTX from suspensions of methotrexate (MTX) and lipiodol (LPD), and to investigate the MTX concentration and fertility rate using an animal model. METHODS: This study was divided into three components: a) An in vitro Release Study, b) Animal Study No. 1 (concentration of tissue and plasma levels), and c) Animal Study No. 2 (fertility rate after MTX suspension). RESULT: The releasing rate in vitro was more rapid with MTX-S (MTX dissolved in saline) than with either MTX-LPD (MTX dissolved in lipiodol) or MTX-LPD-PC (MTX suspended in lipiodol and phosphatidylcholin, i.e., MTX suspension). The tissue concentration tended to be higher with an MTX suspension than with MTX-S. There was no significant difference in the fertility rate or the nidation index among the 3 groups (Groups 1, 2, and 3). CONCLUSION: The injection of an MTX suspension is useful for increasing the tissue concentration and maintaining the long-term effectiveness of MTX, and this technique might offer a new approach in the treatment of ectopic pregnancy (EP) or in second-line therapy for persistent EP.

Animals↗
PubMed1995

[Comparative examinations of serum pepsinogen I, II and gastric area using computed radiography in the atrophic gastritis].

The relationship between serum PG I, PG II levels and extent of atrophic gastritis was examined. On 64 patients (male: 32, female: 32, 51.9 years old on average) with established diagnosis of either atrophic gastritis or normal. In the X-ray gastric examination, Fuji Computed Radiography (FCR) was used to obtain clear-cut images of the gastric area. Concerning the serum PG I level, patients in the group with atrophic gastritis showed lower levels than those of the people in the group with no atrophic change, but the variation was wide, and no definite tendency was seen in the relationship between the atrophic change and the serum PG I levels. Concerning the serum PG II level, as the atrophic change progresses, the serum PG II level tended to increase gradually. A significant reduction in the PG I/II ratio was seen in the group with atrophic changes (p < 0.01) in comparison with the group with no atrophic changes, and the PG I/II value tended to decrease. In conclusion, as a relationship between the atrophic change and the serum PG levels had a wide variation, we considered to be difficult by to measure the serum PG level to understand the presence and extent of the atrophic gastritis.

Disease Progression↗
PubMed1995

[The relationship between blood flow redistribution in umbilical artery and middle cerebral artery and fetal growth in intrauterine growth retardation].

The aim of this study was to evaluate the usefulness of umbilical artery and middle cerebral artery PI and the ratio of these values as predictors of fetal growth-retardation and adverse perinatal outcome. In 100 normal fetuses and 105 intrauterine growth-retarded fetuses Doppler velocity waveforms were recorded from the umbilical artery and middle cerebral artery, and we calculated the incidence of low birth weight, gestational age at delivery, fetal distress and umbilical artery blood gas. The results were as follows: 1. There were moderate correlations between umbilical PI and birth weight (r = -0.43, p < 0.0001) and between middle cerebral artery PI and birth weight (r = 0.37, p < 0.0001) and a close correlation between cerebral-umbilical PI ratio and birth weight (r = 0.71, p < 0.0001). 2. There was a significant association between the cerebral-umbilical PI ratio and the HC/AC ratio (r = -0.46, p < 0.0001). 3. The cerebral-umbilical PI ratio was the best predictor of birth weight, fetal distress and neonatal mortality compared with umbilical artery PI and middle cerebral artery PI. In growth retarded fetuses, high umbilical artery PI and low middle cerebral artery PI, the so called "brain sparing effect" was demonstrated. The cerebral-umbilical PI ratio provided a better predictor of IUGR and adverse perinatal outcome than umbilical artery PI and middle cerebral artery PI alone.

Blood Flow Velocity↗
PubMed1994

Influence of ovarian endometrioma on fertility.

OBJECTIVE: This study examines the influence of ovarian endometrioma on fertility. STUDY DESIGN: For 117 infertile women who were diagnosed as having endometriosis by laparoscopy and who underwent danazol therapy, we examined (1) the relationship between ovarian endometrioma and level of bead-phagocytotic macrophages in ascites and the interleukin-1 beta level, (2) the relationship between ovarian endometrioma and pregnancy rate during the 36 months after danazol therapy, and (3) the relationship between ovarian endometrioma and pregnancy rate, considering the severity of the lesion on the bilateral tubes and the pelvic peritoneum. RESULTS: (1) The levels of bead-phagocytotic macrophages in patients with or without ovarian endometrioma were 68% and 67%, respectively (not significant). Similarly, no significant difference was seen in the interleukin-1 beta positive rate between the two groups. (2) The pregnancy rates of the former group and the latter group were 36% and 43%, respectively (not significant). (3) The existence or absence of ovarian endometrioma made no significant difference in the pregnancy rate in a group of patients with no lesions in the bilateral tubes or in another group with no lesions and scattered endometriotic implants on the peritoneum. CONCLUSIONS: It seems unlikely that ovarian endometrioma itself significantly impedes fertility after danazol therapy.

Adult↗
PubMed1994

[The predictive factor of postpartum impaired glucose tolerance in pregnant women with abnormal glucose tolerance].

To determine factors predictive of impaired glucose tolerance (IGT) in the postpartum period, we examined the maternal and perinatal characteristics of fifty-eight women with abnormal glucose tolerance during pregnancy. A 75g oral glucose tolerance test (OGTT) was performed on the women again around 4 weeks after delivery. Forty women who had a 2-hour plasma glucose level of 140mg/dl or more were defined as IGT in postpartum (group IGT), and the other eighteen women with a 2-hour plasma glucose level lower than 140mg/dl were defined as having normalized glucose tolerance (group N). The women in group IGT weighed more during pregnancy than those in group N (p < 0.05). Insulin secretion during the antepartum OGTT was lower in group IGT than in group N. On the basis of the prepregnant body mass index (BMI) for the obese group (BMI > or = 24), the women in group IGT weighed much more during pregnancy than those in group N (p < 0.03). In the non-obese group, the women in group IGT had higher glucose levels and lower insulin responses than those in group N. We concluded that, in obese women, excessive weight gain during pregnancy is predictive of postpartum IGT, while in non-obese women, the severity of glucose intolerance during pregnancy is related to poor postpartum prognosis.

Adult↗
PubMed1994

[The evaluation of ovarian tumor associated with pregnancy by the ultrasonographical method and serum CA125 levels].

We examined and evaluated ovarian tumor during pregnancy using ultrasonography. The CA 125 level was measured in 21 cases in the first and second trimesters. For a total of 65 cases of ovarian tumor considered to be tumor-like lesions (corpus luteum cyst, etc) the longitudinal and transverse diameters were measured, and the shape was assumed to be ellipsoid. Disappearance of the tumor was confirmed in 40 of the 65 cases. The disappearance occurred by the 16th week of gestation (mean time = 13 weeks and 2 days) in 32/39 (82%) cases, and the maximum diameter (size) did not exceed 10cm (50cm2) at any gestational week. Also the diameter (size) did not exceed 7cm (30cm2) after 15 weeks of gestation in the tumor-like lesions. Surgery performed during pregnancy (9-24 weeks) in 22 cases revealed 19 tumors (16 benign, one borderline malignant and two malignant tumors). The remaining 3 were chocolate cysts and did not require surgery because the diagnosis had been confirmed before pregnancy. There was no difference in the CA 125 level in benign and malignant tumors (15 were benign, 3 were chocolate cysts, one was borderline malignant and two were malignant tumors). Cases in which the maximum diameter (size) of an ovarian tumor increases or remains unchanged during the gestational period may need surgery for benign or occasionally malignant ovarian tumors.

Adult↗
PubMed1994

Hourly fetal urine production rate in the fasting and the postprandial state of normal and diabetic pregnant women.

OBJECTIVE: To examine whether maternal meal ingestion affects fetal urine production in normal and diabetic pregnancies and whether fetal urine production is increased in diabetic pregnancy. METHODS: The hourly fetal urine production rate was measured before and after breakfast in 17 fetuses of diabetic mothers and 14 of women with normal glucose tolerance. The rate was calculated by taking serial measurements of fetal bladder volume at 2-3-minute intervals by ultrasonography. RESULTS: In the control group, the hourly fetal urine production rate was significantly greater during the 2 hours after breakfast than that in the fasting state (P < .0005). In the diabetic group, the rate also tended to increase after breakfast (P = .07). In the postprandial state, the hourly fetal urine production rate was not significantly different between the groups. However, in the fasting state, it was significantly greater in the diabetic group than in the control group (P < .03). CONCLUSIONS: Maternal meal ingestion should increase fetal urine production. The increased fetal urine production in the fasting state in diabetics is assumed to be one cause of hydramnios.

Adult↗
PubMed1993

Relationship between the prognosis of conception and the location of pelvic involvement in endometriosis: significance of the TOP (tube, ovary, peritoneum) classification.

To determine the main factors that affect the prognosis for conception in endometriosis-associated infertility, 99 infertile patients with laparoscopically confirmed endometriosis were classified according to the new TOP classification, which we have developed to evaluate the severity of endometriosis by site, i.e., fallopian tubes (T), ovaries (O) and the peritoneum (P). According to the TOP classification, a negative correlation between the pregnancy rate after treatment and the severity of lesions was noted in case of tubal and peritoneal involvement, but not when the ovaries were involved. If there was no tubal involvement or only unilateral tubal involvement, high pregnancy rates were achieved for patients with ovarian endometrioma (87%) and for those with partial or complete posterior cul-de-sac obliteration (83%). The results suggest that for endometriosis-associated infertility, the treatment modality should be selected according to the severity of tubal involvement, which is considered to contribute to infertility more than ovarian or peritoneal lesions.

Adult↗
PubMed1993

[Successful treatment of recurrent multiple lung metastasis from colon cancer with combination chemotherapy using methotrexate, 5-fluorouracil, and high-dose leucovorin: a case report].

A 66-year-old man, who had received sigmoidectomy for sigmoid cancer in 1985, was diagnosed as having multiple lung and liver tumors in September 1988. When celiac-angiography was performed, recurrent liver metastases from sigmoid cancer were suspected and he received a transarterial embolism with ADM 30 mg and MMC 20 mg. In addition, he was treated with a sequential chemotherapy with methotrexate (MTX), 1,200 mg intravenously (6 h-infusion) followed by 5-fluorouracil (5-FU), 600 mg/m2/day and leucovorin, 300 mg/body/day in continuous infusion for 5 days from day 2 with concomitant oral administration of dipyridamole (300 mg/day) over 14 days. Treatment was repeated every 28 days for two courses. For the third course, administration of only 5-FU, leucovorin and dipyridamole was performed. As a result, the size of pulmonary lesions was prominently reduced on computed tomography. Although mucositis, anal erosion, diarrhea and thrombocytopenia were noted, no severe side effects were observed. This sequential chemotherapy appears useful for metastatic lesions from colon cancer.

Aged↗
PubMed1992

Purification of Pneumocystis carinii trophozoites and identification of their circulating antigens.

We have developed a new method to isolate Pneumocystis carinii trophozoites from experimental rat bronchoalveolar lavage specimens by using a Percoll discontinuous gradient and have identified the circulating antigens in experimental rat P. carinii pneumonia. The antigenic components of the trophozoites were compared with those of cysts by immunoblotting. A major immunoreactive band of 90,000 Da and some others of lower molecular mass were found in trophozoites. On the other hand, bands of 110,000, 50,000, and 45,000 Da were observed in cysts. The band of 50,000 Da was not identified when antitrophozoite rabbit serum preabsorbed with P. carinii-infected rat serum was used for immunoblotting. These results suggest that the molecule of 50,000 Da is the major circulating antigen in P. carinii-infected rats.

Animals↗
PubMed1992

Sporadic appearance of luteal-phase defect in prospective assessment.

We studied the sporadic appearance of luteal-phase defect in the prospective assessment of consecutive cycles. Basal body temperature (BBT) was recorded in 36 women (20-35 years of age) for at least 3 consecutive cycles (total of 194 cycles). These BBT records were analyzed for pattern and luteal-phase length (LPL). Furthermore, the relationship was investigated between the BBT and luteal function in terms of serum hormonal levels and endometrial dating in the luteal phase. The length of the transitional period from the hypothermic to the hyperthermic phase was also studied in relation to luteal function in 59 women (21-33 years of age). The results were as follows: (1) Different BBT patterns and LPLs in consecutive cycles occurred in 36 and 67% of the observed cycles, respectively. (2) Cycles with abnormal steroid levels and endometrial dating were observed sporadically. (3) The length of the transitional period appeared useful for prospective evaluation of luteal function. These findings suggest that the conditions of the luteal function do not appear in every cycle of each woman. Therefore, assessing the function of one cycle seems of little use in predicting the function of the next or future cycles.

Adult↗