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Biomedical subjects

T Okai

Publications and source records attributed to T Okai.

At least 73 records · Page 4Linked to original sources
PubMed1998

Metabolic and endocrine responses to cold exposure in chronically incubated extrauterine goat fetuses.

To investigate developmental aspects of metabolic and endocrine responses to cold exposure in fetuses, we conducted experiments on six goat fetuses, three aged 95-116 d of gestation (dGA; group I), and three aged 122-134 dGA (group II), using an extrauterine fetal incubation system that provided arterio-venous extracorporeal membrane oxygenation (A-V ECMO). The fetuses were cannulated via the umbilical vessels, and their blood gas exchange was totally supported by A-V ECMO, while they were maintained in an isothermal incubator containing artificial amniotic fluid. After confirming that fetuses were in metabolically stable condition in the extrauterine incubation system, fetal core temperature was lowered by 2 degrees C over 2 h by decreasing the temperature of incubating fluid from 39.5 degrees C. During and after cold exposure, fetal heart rate and arterial blood pressure remained unchanged. We observed significant increases in oxygen consumption and plasma concentrations of norepinephrine, epinephrine, adrenocorticotropic hormone, and cortisol in group II but not in group I fetuses. In addition, based on regression analysis, maximal changes of these parameters during cold exposure were linearly correlated with gestational age significantly, and the regression lines were found to intersect the x (gestational age) axis at around 98-106 dGA. These results suggest that metabolic and endocrine responses to cold exposure develop with gestational age in the goat fetus, the responses being manifested around 100 dGA.

Animals↗
PubMed1998

Infrequent expression of p21 is related to altered p53 protein in pancreatic carcinoma.

This study is designed to investigate the expression of p21 and its relation to altered p53 protein in pancreatic carcinoma (PC). Immunohistochemical staining of formalin-fixed, paraffin-embedded tissue sections of PC was performed using a monoclonal antibody against p21 (187), with a parallel examination of altered p53 protein. The expression of p21 was only found in 12 of 58 (20.7%) PCs and, moreover, was mainly restricted to the well-differentiated ductal epithelium. Sixty-four % (37 of 58) of PCs showed positive p53 staining, and this change was significantly related to the absence of p21 expression (P < 0.01). In a subgroup, the proportion of the undetectable p21 expression and the expression of p53 were increased with increasing tumor grade but decreased with advancing clinical stage. The results of the present study suggest that the absence of p21 expression is very common in PCs and appears to relate to altered p53 protein. Moreover, the abnormalities involving the expression of p21 and p53 may play a more important role in the development than in the progression of this malignancy.

Adult↗
PubMed1997

Intrauterine sonography for preoperative assessment of cervical invasion in endometrial carcinoma.

Cervical involvement is one of the major prognostic factors in carcinoma of the endometrium confined to the uterus. The purpose of this study was to determine whether intrauterine ultrasound with a high-frequency miniature probe can depict the degree of cervical involvement of the disease. Thirty-two women with endometrial carcinoma underwent preoperative transvaginal and intrauterine sonography. By both scans, the degree of cervical involvement was prospectively evaluated. Sonograms were compared with the findings from histologic examination. Intrauterine sonography was completed in 30 of the 32 patients. In these 30 patients, the degree of cervical involvement (none, endocervical gland, or cervical stroma) based on transvaginal scan was correct in 23 cases (77%), and that based on intrauterine scan was correct in 26 cases (87%). Three tumors with endocervical glandular involvement were correctly diagnosed by intrauterine sonography, whereas they were incorrectly diagnosed by transvaginal scan. The specificity and positive predictive value of intrauterine sonography for the assessment of the presence of cervical stromal invasion are 100% (26/26 and 3/3, respectively). Although this study is preliminary, our experience with intrauterine sonography shows that it has potential for assessing cervical stromal invasion in endometrial carcinoma.

Aged↗
PubMed1997

Sclerosing pancreatitis showing rapidly progressive changes with recurrent mass formation.

CONCLUSION: Sclerosing pancreatitis might develop repeatedly or might rapidly extend to the whole pancreas with recurrent mass formation. BACKGROUND: Nothing is known concerning course or development of sclerosing pancreatitis. METHODS: A 63-yr-old male was followed up for 2.5 yr. RESULTS: The patient was admitted because of a tumor in the body and tail of the pancreas. Serum pancreatic enzymes were transiently elevated, but tumor markers were all negative. Imaging studies showed a tumor 7 cm in size. The main pancreatic duct was normal in the head and obstructed at the body on endoscopic retrograde pancreatography (ERCP). The K-ras oncogene mutation was positive in pure pancreatic juice. Distal pancreatectomy was performed because pancreatic cancer was highly suspected. Pathological findings showed that the tumor was a densely fibrotic mass without malignant cells. Inflammatory cell infiltration was observed in the stroma. One year later, another mass 3 cm in size was noted in the remnant pancreatic head. ERCP revealed diffuse irregular narrowing of the main pancreatic duct, its branches, and the common bile duct. Liver dysfunction improved and an elevation of serum pancreatic enzymes subsided without any specific treatment, and the mass diminished in size. The patterns of various imaging studies on the second tumor were the same as those of the previous resected mass. Corticosteroid was not administered.

Genes, ras↗
PubMed1997

Undifferentiated (anaplastic) carcinoma of the pancreas showing sarcomatous change and neoplastic cyst formation.

CONCLUSION: Pancreatic undifferentiated (anaplastic) carcinoma contained two components: sarcomatous change of spindle-cell type and a neoplastic cyst. Immunohistochemical analysis suggested that both the sarcomatous and the cystic portions were of epithelial origin. This case showed a "dual" differentiation both into the sarcomatous change and into the cystic lesion. BACKGROUND: Pancreatic sarcoma or sarcomatous change is very rare. The origin of sarcomatous change is unknown. On the other hand, pancreatic adenocarcinoma sometimes shows necrosis and forms a cystic lesion during its growth, but a neoplastic cyst formation is very rare except for cystadenomas. METHODS: We report a case of pancreatic undifferentiated (anaplastic) carcinoma associated with sarcomatous change and neoplastic cyst formation. Clinicopathological and immunohistochemical analyses were performed. RESULTS: A 75-yr-old male was admitted because of low back pain and body weight loss. He died 7 d after admission presenting obstructive jaundice. Autopsy disclosed that the large mass was a poorly differentiated ductal adenocarcinoma, which mostly consisted of sarcomatous components of spindle-cell type. The cystic lesion was a neoplastic cysts with the wall composed of epithelial tumor cells. There was no necrosis or hemorrhage in the cystic cavity. Immunohistochemical analyses suggested that both the tumor and the cystic lesion were of epithelial origin. Sarcomatous changes were recognized also in the metastatic lesions in the liver and lymph nodes. The tumor is considered to be labeled undifferentiated (anaplastic) carcinoma of the pancreas.

Aged↗
PubMed1997

Prolonged intrahepatic cholestasis in acute-onset, severe autoimmune hepatitis.

A 72-year-old woman was admitted because of jaundice and hepatocellular dysfunction. She was diagnosed with autoimmune hepatitis from laboratory test results showing high titers of antinuclear antibodies and negativity for hepatitis viral markers. Steroid i.v. pulse therapy and oral administration of prednisolone were effective in improving the liver function test results, except for hyperbilirubinemia. Elevated serum bilirubin levels, of approximately 20 mg/dl persisted for more than 6 months, despite the administration of ursodeoxycholic acid. Insulin-glucagon therapy was given for normalization of transaminases and then withdrawn 3 weeks after admission, but it was resumed at 3 months, resulting in a dramatic decrease in serum bilirubin levels, which then normalized in 2.5 months. Liver biopsy 6 months after onset showed chronic active hepatitis with bile plugs. Insulin-glucagon therapy, because of its choleretic effect, may be worth continuing even after recovery of acute hepatic failure.

Acute Disease↗
PubMed1997

A homozygous kinase-defective mutation in the insulin receptor gene in a patient with leprechaunism.

We report a homozygous missense mutation at position 1092 (substitution of glutamine for arginine) in the tyrosine kinase domain of the insulin receptor in a patient with leprechaunism associated with severe insulin resistance and intrauterine growth retardation. Site-directed mutagenesis as well as analyses of the patient's lymphocytes revealed that this mutation causes a marked decrease in tyrosine kinase activity of the insulin receptor without any defect in insulin binding, which causes severe defects in insulin-stimulated glucose transport, glycogen synthesis and DNA synthesis. Thus, this is the first homozygous mutation resulting in a selective-kinase defect of the insulin receptor. Interestingly, the parents who are cousins and are heterozygous for the mutation have type A insulin resistance syndrome. This correlation between genotype and phenotype in a single pedigree suggests that the severity of the mutation will determine the phenotype. Based upon this assumption, we have been successful in prenatal diagnosis of the fifth child. Furthermore, we have demonstrated the effectiveness of clinical administration of insulin-like growth factor-I (IGF-I) in this patient and in vitro analysis of the patient's skin fibroblasts, suggesting that IGF-I can compensate for insulin action via the IGF-I receptor in a patient almost lacking functional insulin receptors.

Adult↗
PubMed1997

Doppler blood flow velocity waveforms of the umbilical artery during variable decelerations in labor.

OBJECTIVE: To investigate the changes in resistance indices of blood flow velocity waveforms of the umbilical artery (UmA-RIs) during variable decelerations (VDs) vs. early decelerations (EDs). METHODS: UmA-RIs were measured before and during uterine contractions in 30 cases with VDs, nine cases with EDs and 20 cases without decelerations. In 12 out of 30 cases with VDs, UmA-RI was determined at the following five stages of a VD; before the deceleration, downward, bottom, upward and resumption stages. RESULTS: UmA-RIs during VDs were significantly higher compared with those at preceding periods. UmA-RIs at downward and bottom stages of VDs were significantly higher than those at the upward stage, although no differences in heart rate were found between downward and upward stages. UmA-RIs during EDs or uterine contractions without decelerations did not differ from those preceding them. CONCLUSION: UmA-RIs increased during VDs, particularly at downward and bottom stages during which the cord seemed to be actually compressed.

Blood Flow Velocity↗
PubMed1997

Successful thoracoamniotic shunting using a double-flower catheter in a case of fetal cystic adenomatoid malformation associated with hydrops and polyhydramnios.

We describe a case of congenital cystic adenomatoid malformation treated by thoracoamniotic shunting using a double-flower catheter. An ultrasound examination at 25 weeks' gestation revealed a cystic mass within the fetal thoracic cavity, hydrops and polyhydramnios. Thoracoamniotic shunting under ultrasound guidance using a double-flower catheter was performed at 27 weeks. The procedure not only decompressed the lung cyst but also improved the secondary physiological changes, i.e. mediastinal shift, hydrops and polyhydramnios. A 2438-g male neonate was delivered at 37 weeks with no respiratory problems and resection of the right lower pulmonary lobe was successfully performed 24 h after birth.

Adult↗
PubMed1997

Developmental sequence of human fetal body movements in the second half of pregnancy.

To describe fetal body movements precisely and to clarify their developmental sequence in the second half of pregnancy, fetal body movements were observed in 31 normal fetuses between 20 and 41 weeks of pregnancy by using multiple ultrasonic machines. All movements of the whole trunk were able to be classified into six fundamental movements: flexion, stretch, rolling, startle, stepping, and writhing. Startle was always observed as a single movement, but others were more frequently observed as a part of combination rather than as a single movements. The incidence of flexion and stretch peaked at 28-31 weeks, whereas the incidence of startle and stepping lowered at the period. The incidence of rolling and upper half trunk movements increased at 40-41 weeks. Limb movements were frequent and did not exhibit characteristic change in the incidence. In conclusion, we classified fetal body movements into several fundamental movements instead of using the expression of "general movements" by focusing principally on movements of the trunk. In particular, some of the fundamental movements seem to appear in characteristic ways as related to gestational age. In view of that fetal behaviors are closely related to the neural activity, the present findings may contribute to an understanding of the developmental process of the central nervous system.

Abdomen↗
PubMed1997

Beta2-glycoprotein I-dependent anticardiolipin antibody in early recurrent spontaneous abortion.

The objective of this study was to assess the clinical significance of autoimmune anticardiolipin antibody that can react with cardiolipin only in the presence of beta2-glycoprotein I (beta2-glycoprotein I-dependent anticardiolipin antibody) in the pathogenesis of early recurrent abortion. A total of 72 early recurrent spontaneous aborters and 175 normal healthy women were analysed for the occurrence of beta2-glycoprotein I-dependent anticardiolipin antibody in serum samples by an enzyme-linked immunosorbent assay specific for the detection of beta2-glycoprotein I-dependent anticardiolipin antibody. The incidence of beta2-glycoprotein I-dependent anticardiolipin antibody in the early recurrent spontaneous aborters was essentially the same as that of normal women. Thus, the beta2-glycoprotein I-dependent anticardiolipin antibody seemed to have little, if any, implication in the pathogenesis of early recurrent spontaneous abortion.

Abortion, Habitual↗
PubMed1997

An evaluation of the system to control blood flow in maintaining goat fetuses on arterio-venous extracorporeal membrane oxygenation: a novel approach to the development of an artificial placenta.

We compared various methods to control blood flow for extrauterine incubation of goat fetuses without lung respiration using arterio-venous extracorporeal membrane oxygenation via umbilical vessels to develop a suitable system for a long-term life support system for premature neonates. In twenty-seven consecutive preparations of goat fetuses, 4 designs (System 1, manual flow control without a reservoir; System 2, manual flow control with an arterial open-top reservoir; System 3, semiautomatic flow control with an arterial open top reservoir; and System 4, semiautomatic flow control with a tube occluder and an arterial open top reservoir) were tested in terms of the duration of incubation periods during which fetuses were kept under stable conditions. The incubation periods became prolonged with the advancement of the system (System 1, 5.4 h; System 2, 11.6 h; System 3, 64.8 h; and System 4, 159.8 h medians of the incubation periods). The incubation periods with System 4 were significantly longer compared to those with System 1 and System 2. These results suggest that, for extrauterine incubation of goat fetuses using arterio-venous extracorporeal membrane oxygenation via umbilical vessels, the method to control blood flow is of utmost importance for long-term maintenance, and thus a control system with the fixed vascular resistance of the extracorporeal circuit is applicable to long-term maintenance of premature goat fetuses.

Animals↗
PubMed1997

Presence of HLA-G-expressing cells modulates the ability of peripheral blood mononuclear cells to release cytokines.

PROBLEM: Human leukocyte antigen-G (HLA-G) is thought to be at play in maternal-fetal immune interplay during pregnancy. Whether the expression of HLA-G protein on the target cells altered the release of cytokines from effector mononuclear cells was questioned. METHOD OF STUDY: The amounts of cytokines released from peripheral blood mononuclear cells (PBMC) cocultured with or without HLA-G-expressing target cells were compared. RESULTS: When cocultured with HLA-G-expressing target cell lines, the amounts of interleukin-3 (IL-3) and interleukin-1 beta (IL-1 beta) released from PBMC were increased, whereas the amounts of tumor necrosis factor-alpha (TNF-alpha) were decreased. CONCLUSIONS: Mononuclear cells, if cultured with HLA-G-expressing cells, modulate their ability to release cytokines, suggesting a role of HLA-G in triggering maternal-fetal immune interplay and thereby maintaining pregnancy.

Cell Line↗
PubMed1997

Pathogenetic implication of interleukin-2 expressed in preeclamptic decidual tissues: a possible mechanism of deranged vasculature of the placenta associated with preeclampsia.

PROBLEM: The purpose of this study is to clarify whether IL-2 expressed in the decidua in preeclampsia affects the angiogenesis of the placenta. METHOD OF STUDY: We investigated the angiogenic substances released from human trophoblasts obtained from early pregnancy that had been pretreated with either IL-2, non-activated lymphocytes from peripheral blood mononuclear cells (PBMCs), decidual lymphocytes, or these lymphocytes activated by lymphokine (LAK cells). Angiogenic activity was determined by evaluating the ability of growth-promotion of cultured human microvascular endothelial cells (HMvECs) using MTT assay. RESULTS: Trophoblasts pretreated with IL-2 or non-activated lymphocytes, irrespective of their origin, released angiogenic factor similar to those without pretreatment. However, trophoblasts pretreated with LAK cells released less angiogenic factor compared with those without pretreatment. CONCLUSIONS: Interleukin-2 (IL-2) expressed in preeclamptic decidua might reduce the angiogenic substances arising from trophoblasts by inducing LAK-cells from decidual lymphocytes, which might be relevant to deranged vasculature of the placenta, a characteristic histology in preeclampsia.

Angiogenesis Inducing Agents↗
PubMed1997

Effect of niuche-shen-qi-wan on painful muscle cramps in patients with liver cirrhosis: a preliminary report.

Twelve patients with liver cirrhosis complaining of painful muscle cramps were treated with Niuche-Shen-Qi-Wan (TJ-107). Three patients were at the decompensated state. Muscle cramps disappeared in 4 weeks on the average after oral administration of TJ-107 in all 12 patients. During the period of TJ-107 administration, there was no significant improvement of hepatic function. One patient complained of mild epigastric discomfort after taking TJ-107, but there were no other adverse effects. Our results indicate that TJ-107 is useful for treatment of painful muscle cramps in cirrhotic patients.

Administration, Oral↗
PubMed1997

Real-time processable three-dimensional US in obstetrics.

Results with real-time processable three-dimensional ultrasound (US) were assessed in 57 normal fetuses and two fetuses with hydramnios. Volume scanning time was 4 seconds, and a complete three-dimensional fetal image was displayed at the end of scanning. Although this method was limited in some respects, such as viewing direction, it was very useful when performed in conjunction with conventional tomographic US because of its speed and because some components were depicted more clearly.

Female↗
PubMed1997

Frequent loss of p16 expression and its correlation with clinicopathological parameters in pancreatic carcinoma.

Expression of the p16 gene product in human primary pancreatic carcinoma (PC) was investigated in paraffin-embedded tissue using a monoclonal antibody against p16 protein, clone G175-405, by means of immunohistochemistry, and the correlation of results with various clinicopathological parameters was evaluated. All six cases of normal pancreas and all but 1 of 20 cases of chronic pancreatitis expressed p16 protein, whereas 37.5% (3 of 8) of cystadenomas and 41. 9% (26 of 62) of PCs lost p16 expression. There was a significant difference between chronic pancreatitis and PC for frequency of the loss of p16 expression (P < 0.01). Moreover, loss of p16 expression in pancreatic malignancy was significantly associated with histological grade (G1 versus G2 and G3, P < 0.01) but not with sex, age, clinical stage, tumor location, or resectability. The survival period was shorter and metastasis is more likely in those cases that did not show p16 expression than those that did.

Adenocarcinoma↗