[Mixed connective tissue disease: discussion].
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Humans↗
Biomedical subjects
T Okai
Publications and source records attributed to T Okai.
Characteristic changes in sleep patterns during pregnancy in rats.
The purpose of this study was to evaluate changes in sleep patterns during pregnancy to better understand sleep regulation during pregnancy. We uninterruptedly recorded electroencephalogram (EEG), electromyogram (EMG), and brain temperature (Tbr) throughout pregnancy in rats. The duration of non-rapid eye movement (non-REM) sleep decreased after day 5 of pregnancy associated with an inverse increase in the number of non-REM sleep episodes. Thus, the amount of total non-REM sleep time remained constant throughout pregnancy. The amount of total REM sleep time decreased on day 17 of pregnancy after which the reduced state was sustained. That was mainly due to a decrease in the number of REM sleep episodes. Brain temperature (Tbr) gradually decreased as pregnancy advanced, reaching its lowest value 3 days before delivery. These observations provide a better understanding of the sleep patterns during pregnancy, and useful information for investigation of mechanisms of sleep regulation during pregnancy.
Animals↗
Cruveilhier-Baumgarten syndrome in which venous hum disappeared following endoscopic variceal sclerotherapy.
We report a case of Cruveihier-Baumgarten syndrome associated with portal vein thrombosis that developed, slowly during a 2-year period after endoscopic variceal sclerotherapy. The thrombosis led to the disappearance of the venous hum and the dilated abdominal wall veins characteristic of this syndrome. A 73-year-old woman was hospitalized for treatment of esophageal varices in April 1988. Her spleen was markedly enlarged, and the histologic findings of her liver were not consistent with hepatic cirrhosis, but with idiopathic portal hypertension. A venous hum was audible in the upper abdomen. Superior mesenteric angiography revealed a porto-systemic shunt vessel under the abdominal wall, originating from the umbilical vein. She was injected four times with a sclerosant, and this brought about disappearance of the esophageal varices. Two years after the first admission, the venous hum was no longer audible, but there was a recurrence of the esophageal varices. More than 2 years later (4 years after the first admission), ultasonographic study, computed tomography, and angiography showed a large thrombus, which completely obstructed the portal vein at the origin of the umbilical vein, and the development of collateral vessels, seen as a "cavernous transformation."
Aged↗
Allo-non-specific elevation of maternal killer cell activity in intrauterine growth restriction.
OBJECTIVE: In order to gain insight into the pathogenesis of intrauterine growth restriction (IUGR) of the fetus, we evaluated the cytotoxic activity of lymphocytes towards fetal cells in pregnancies complicated by IUGR. METHODS: We performed a cytotoxic assay using the maternal lymphocyte-derived lymphokine activated killer (LAK) cells as the effector cells. Cord vessel endothelial cells were used as the target cells. RESULTS: LAK cells in pregnancies complicated by IUGR demonstrated higher killer cell activities against IUGR fetus-derived endothelial cells compared with LAK cells from uncomplicated pregnancies against the same endothelial cells. However, when non-IUGR fetus-derived endothelial cells were used as the target cells, LAK cells of pregnant women with IUGR exhibited essentially the same activities as those of normal pregnant women. CONCLUSION: The results suggest that lymphocytes in pregnancies complicated by IUGR may have enhanced killer cell activities towards the IUGR fetus in an allo-non-specific way.
Adult↗
Influence of compression of the inferior vena cava in the late second trimester on uterine and umbilical artery blood flow.
OBJECTIVE: To evaluate the inferior vena cava compression and its influence on the uterine and umbilical artery blood flow in the late second trimester when the mother is supine. METHODS: The inferior vena cava diameter was measured by ultrasound B mode scan, and Doppler flow velocimetry of the uterine and umbilical artery was performed in 90 women at 24-27 weeks in the supine and complete left lateral position. RESULTS: The inferior vena cava diameter in the supine position was significantly smaller than that in the lateral position. The degree of the vena cava compression was associated with an elevation in the uterine artery RI in the supine position. The umbilical artery RI did not couple with either the degree of the compression or the changes in the uterine artery RI. CONCLUSION: The inferior vena cava is compressed in the majority of pregnant women in the second trimester, and the compression may affect the uterine artery blood flow but not the fetal circulation.
Constriction, Pathologic↗
Isolated 'contractions' of the uterine cervix in a patient with incompetent cervix.
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Adult↗
Three-dimensional ultrasound is useful in diagnosing the fetus with abdominal wall defect.
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Abdominal Muscles↗
Detection of K-ras point mutations at codon 12 in pure pancreatic juice for the diagnosis of pancreatic cancer by PCR-RFLP analysis.
The present study was undertaken to detect K-ras point mutations at codon 12 in pure pancreatic juice (PPJ) for the diagnosis of pancreatic cancer (PC) using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. PPJ was collected through a cannula under a duodenal fiberscope from 26 patients with PC and 32 patients with chronic pancreatitis (CP). DNA was extracted from PPJ and was used as the template for PCR. Analysis of PPJ by PCR-RFLP with BstNI revealed that the incidence of K-ras point mutations at codon 12 was 81% (21/26) in patients with PC and 6% (2/32) in those with CP. With reference to the location of PC, the incidence of K-ras mutations was 79% (11/14) in the head, 86% (6/7) in the body, and 80% (4/5) in the tail of the pancreas. The incidence of K-ras mutants was 50% (1/2) in tumor size 1 (TS1; < or = 2.0 cm in size), 71% (5/7) in TS2 (2.1 to < or = 4.0 cm), 89% (8/9) in TS3 (4.1 to < or = 6.0 cm), and 88% (7/8) in TS4 (> 6.1 cm). These results suggested that analysis of K-ras point mutations at codon 12 in PPJ using the PCR-RFLP method is a promising new genetic test for the diagnosis of PC.
Adult↗
Detection of K-ras point mutations at codon 12 in pancreatic juice for the diagnosis of pancreatic cancer by hybridization protection assay: a simple method for the determination of the types of point mutation.
The present study was undertaken to detect K-ras oncogene point mutations at codon 12 in pure pancreatic juice (PPJ) by the hybridization protection assay (HPA) method for the diagnosis of pancreatic cancer (PC). This assay can be carried out within 30 min and can determine not only the presence of a mutation, but also the mutational type of K-ras at codon 12. The minimal ratio of mutant DNA detectable by the HPA was 5-10% of the total DNA. PPJ was collected through a cannula under duodenal fiberscope control from 20 patients with PC and 20 patients with chronic pancreatitis (CP). Analysis of PPJ by the HPA revealed that the incidence of K-ras point mutations at codon 12 was 55% (11/20) in patients with PC and 0% (0/20) in those with CP. Mutational types of K-ras at codon 12 in PC were aspartic acid (Asp) in nine cases, both Asp and cysteine in one case, and arginine in one case. Analysis of K-ras point mutations at codon 12 in PPJ using the HPA method seems promising as a new genetic test for the diagnosis of PC, because the HPA method is simple, and can easily determine the mutational type.
Base Sequence↗
Pulmonary embolism associated with Sjögren's syndrome in pregnancy.
The occurrence of pulmonary embolisms in patients having circulating lupus anticoagulant has been reported. Lupus anticoagulant has been noticed in association with autoimmune diseases and early-onset severe preeclampsia. We report a case of Sjögren's syndrome with circulating lupus anticoagulant in a patient who developed a pulmonary embolism and severe preeclampsia at 29 weeks of gestation.
Adult↗
Altered expression of human leukocyte antigen G (HLA-G) on extravillous trophoblasts in preeclampsia: immunohistological demonstration with anti-HLA-G specific antibody "87G" and anti-cytokeratin antibody "CAM5.2".
PROBLEM: Human leukocyte antigen-G (HLA-G) is suggested to be at play in the materno-fetal immune relationship during pregnancy. In the light of current concept that disruption of the materno-fetal immune relationship could account for several complications of pregnancy, including preeclampsia, we asked whether the expression of HLA-G protein on the trophoblasts is altered in preeclampsia. METHOD: The presence of HLA-G protein in the extravillous trophoblasts in placenta obtained from five preeclamptic patients and seven uncomplicated pregnant women was determined by means of an immunohistochemical technique. RESULTS: All of the extravillous trophoblasts, which were stained for cytokeratin, were stained for HLA-G protein in every woman with an uncomplicated pregnancy. In contrast, clusters of extravillous trophoblasts were insularly devoid of the staining for HLA-G in all the preeclamptic patients. CONCLUSION: The attenuated expression of HLA-G protein on the extravillous trophoblasts could be at play in the pathophysiology of preeclampsia.
Adult↗
Intracervical US with a high-frequency miniature probe: a method for diagnosing early invasive cervical cancer.
PURPOSE: To determine whether intracervical ultrasound (US) with a high-frequency miniature probe can depict cervical neoplasms, especially in early invasive stages. MATERIALS AND METHODS: Forty-eight women with cervical cancer underwent preoperative transvaginal and intracervical US. US scans were compared with findings from histologic examination or surgery. RESULTS: Intracervical US was completed in 45 of the 48 patients. Both intracervical and transvaginal US were unable to depict preinvasive cancer. Intracervical US depicted the lesion in eight of 16 patients (50%) in whom the depth of cancer invasion was less than or equal to 5 mm, whereas transvaginal US failed to depict the lesion in all 16 patients. Intracervical US depicted the lesions in all 19 patients in whom the depth of cancer invasion was more than 5 mm, whereas transvaginal US was successful only in 14 (74%). CONCLUSION: Intracervical US is useful for evaluating invasive cervical cancer and is especially suitable for detecting early invasion in the endocervix.
Adult↗
Preoperative diagnosis of mucinous gastric adenocarcinoma by endoscopic ultrasonography.
OBJECTIVES: The aims of this study were to investigate the characteristic features of mucinous gastric carcinoma on endoscopic ultrasonography (EUS) and to demonstrate the usefulness of EUS in the preoperative diagnosis of this disease. METHODS: Twelve patients with mucinous gastric carcinoma who underwent EUS examination between April 1984 and April 1995 were enrolled in this study. All patients subsequently underwent surgery. Histopathologically, tumors were classified according to the mucin content (high or moderate) and the glandular formation of the tumor cells (well or poorly differentiated). Finally, the histological and endosonographic features were compared. RESULTS: In all patients, the infiltrated wall appeared echogenic because of diffusely distributed, reticular, highly echoic speckles in the submucosa and muscularis propria. The presence of mucinous lakes surrounded by reactive fibrous tissue correlated well with reticular, highly echoic speckles on EUS. There was an increase in echogenicity and thickness of the muscularis propria, depending on the invasion of the mucin. Although the boundary between submucosa and muscularis propria was distinct and the five-layered gastric wall structure was generally preserved, the mucosal layer was not discriminated in patients with poorly differentiated mucinous carcinoma with high mucin content. CONCLUSIONS: As a preoperative diagnostic procedure, EUS may be useful in recognizing the mucinous component of gastric tumors and may facilitate the differentiation of mucinous carcinoma from other gastric epithelial tumors.
Adenocarcinoma, Mucinous↗
Measurement of serum PSP/reg-protein concentration in various diseases with a newly developed enzyme-linked immunosorbent assay.
An enzyme-linked immunosorbent assay, based on two monoclonal antibodies (Hreg1-1 and Hreg101-1) specific for pancreatic stone protein (PSP)/reg-protein, was developed to determine the concentration of this protein in serum from individuals with various diseases. The serum concentration of PSP/reg-protein was significantly higher in patients with various pancreatic diseases than in normal controls, and was also significantly higher in patients with acute pancreatitis or chronic relapsing pancreatitis than in patients with chronic pancreatitis. Furthermore, the serum PSP/reg-protein concentration was also significantly increased in liver cirrhosis, choledocholithiasis, and various cancers of the digestive system, and was extremely high in all patients tested with chronic renal failure. A significant correlation was apparent between the serum concentration of PSP/reg-protein and elastase-I in 68 patients with chronic pancreatitis or pancreatic cancer. Whereas only 7 of these patients showed a normal serum PSP/reg-protein concentration and a significantly increased elastase-I concentration, 15 of these patients showed a significantly increased serum PSP/reg-protein concentration and a normal serum elastase-I concentration. These results indicate that the serum PSP/reg-protein concentration may reflect pancreatic damage, especially in acute pancreatitis, and may be a sensitive a marker for such damage as elastase-1, although false positivity was apparent in renal failure and in some patients with hepatic dysfunction or digestive system malignancies.
Antibodies, Monoclonal↗
Suppressed mixed lymphocyte reaction in couples with intrauterine growth retardation pregnancies.
OBJECTIVE: The objective of this study was to gain insight into the pathogenesis of intrauterine growth retardation (IUGR). METHOD: Immune reactivity against paternal MHC class-II antigens was determined in 18 women with IUGR pregnancies and 18 normal pregnant women, employing one-way mixed lymphocyte reaction (MLR). RESULTS: One-way MLR between the women with IUGR pregnancies and their husbands was significantly suppressed compared with that between the women with IUGR pregnancies and males unrelated to them. However the MLR of normal pregnant women was essentially similar regardless of whether stimulating cells were obtained from their husbands or not. The degree of HLA class-II antigen shared by IUGR couples was not related to the degree of specific suppression of MLR towards the husbands. CONCLUSION: IUGR may be associated with specifically suppressed patients' MLR towards their husbands, which may provide insight into the underlying pathophysiology of IUGR.
Adult↗
Intrauterine ultrasonography with a high-frequency probe: preliminary report.
Intrauterine ultrasonography was performed using miniature probes and high-frequency ultrasound to examine the possible clinical applications of this technique to gynecology. There were 44 women in the study population (age 19-76; ten with a normal uterus, nine fibromyoma, 15 endometrial cancer, ten cervical cancer). The probe was easily introduced into the endometrial cavity in 36 subjects (81.8%). No notable complications were encountered. In subjects with a normal uterus, the endometrium in the secretory phase showed a clearly demarcated hyperechoic area, and higher resolution was obtained than with transvaginal scanning. In patients with fibromyomas, myoma nodules were not clearly visualized because of the attenuation of ultrasound. Myometrial invasion of endometrial cancer was estimated correctly in ten of the 11 patients in which the lesion was visualized. In the subjects with cervical cancer, intracervical scanning was completed in only five cases, and an endocervical lesion was identified in three cases. Intrauterine ultrasonography with a high-frequency miniature probe may be a useful tool, especially in the preoperative evaluation of endometrial cancer and possibly in infertility practice. However, this modality does not appear to be satisfactory for cervical lesions.
Adult↗
Endosonographic evaluation of giant gastric folds.
Giant gastric folds develop in several benign and malignant diseases. We used endoscopic ultrasonography to evaluate giant gastric folds in 15 patients with Borrmann type IV scirrhous carcinoma, 8 patients with gastric lymphoma, 5 patients with anisakiasis, 1 patient with Menetrier's disease, and 6 normal subjects with simple gastric hyperrugosity. With a 7.5 MHz transducer, a five-layered gastric wall structure was imaged. The thickness of the gastric wall and each layer was measured and compared with the endosonographic findings of 16 healthy subjects. Endoscopic ultrasonography findings revealed that the second layer alone was thickened in Menetrier's disease, and the third layer alone enlarged in anisakiasis. Most of the patients with scirrhous carcinoma showed an abnormally enlarged third and fourth layer. The second layer together with the third layer was thickened in healthy subjects with simple hyperrugosity and also in patients with gastric lymphoma. However, the fourth ultrasound layer corresponding to the muscularis propria was significantly thickened only in malignant conditions. It is concluded that endoscopic ultrasonography can visualize the structure of giant gastric folds and may facilitate the differentiation of benign from malignant etiologies.
Adenocarcinoma, Scirrhous↗
Endosonography of a submucosal tumor-like gastric lesion caused by fibrotic ulcer healing.
A 61-year-old woman with a gastric antral ulcer scar had a lesion that showed a submucosal tumor-like appearance on endosonography, which proved at resection to represent dense submucosal fibrous tissue. The reason for this marked reaction has not yet been established. Although we felt that the endosonographic pattern most likely showed submucosal fibrosis, in view of her past medical history, malignant lymphoma or aberrant pancreas could not be ruled out with certainty.
Endoscopy, Gastrointestinal↗