Biomedical subjects

Y Kuwabara

Publications and source records attributed to Y Kuwabara.

At least 73 records · Page 4Linked to original sources

PubMed1999

Comparison of anesthetic methods for microlaparoscopy in women with unexplained infertility.

STUDY OBJECTIVE: To evaluate the effectiveness of ketamine compared with fentanyl as analgesia or sedation for microlaparoscopy. DESIGN: Prospective, randomized study (Canadian Task Force classification I). SETTING: University-affiliated hospital. PATIENTS: Forty-one infertile women. INTERVENTIONS: Twenty-one patients were randomly assigned to have analgesia with fentanyl and 20 sedation with ketamine during microlaparoscopy. Maximum doses were 0.2 and 200 mg, respectively. Local anesthesia was provided with 0.25% bupivacaine 5 ml injected into cannula sites. MEASUREMENTS AND MAIN RESULTS: Abnormal findings such as endometriosis and periadnexal adhesions were identified in 24 patients. Ablation, coagulation, and adhesiolysis were easily performed in 14 (82.4%) of 17 women receiving ketamine, but difficulties were encountered in operating on 16 patients receiving fentanyl. Ketamine was administered to 10 patients (47.6%) in the fentanyl group because anxiety and pain were not sufficiently controlled by fentanyl. There were no significant differences in visual analog scale scores and recovery time between groups. On questionnaire, 19 (95%) of 20 patients receiving ketamine indicated they would choose the same anesthesia again if offered, compared with only 4 (19%) of 21 receiving fentanyl (p <0.001). CONCLUSION: Microlaparoscopy in infertile women was performed more effectively under sedation with ketamine than with fentanyl.

Analgesia↗

PubMed1999

Fertilization, embryonic development, and offspring from mouse eggs injected with round spermatids combined with Ca2+ oscillation-inducing sperm factor.

Round spermatids, precursor male gametes, are known to possess the potential to achieve fertilization and embryonic development when injected into eggs. However, injection of spermatids alone seldom activates eggs in the mouse, as spermatids by themselves cannot induce an increase in intracellular Ca2+, a prerequisite for egg activation. We injected a mouse round spermatid into an egg simultaneously with partially purified sperm factor from differentiated hamster spermatozoa. The combined injection produced repetitive Ca2+ increases (Ca2+ oscillations) lasting for at least 4 h as observed at fertilization, and induced activation in 92% of eggs. This method provided 75% fertilization success associated with male and female pronucleus formation and development to 2-cell embryos, while only 7% of eggs were fertilized by injection of a spermatid alone. Of the 2-cell embryos, approximately 50% developed to blastocysts during 5 days of culture in vitro, while no blastocysts were obtained following injection of sperm factor alone. Furthermore, the 2-cell embryos, that were created by spermatids and sperm factor and transplanted into foster mothers, developed into normal offspring, although the percentage was only 22%. All infants grew into healthy adults carrying normal chromosomes. The sperm factor served as a complementary factor for successful fertilization by round spermatid injection.

Animals↗

PubMed1999

Mucha-Habermann disease-like eruptions due to Tegafur.

The first case of Mucha-Habermann disease-like drug eruptions due to Tegafur is reported. A 59-year-old man noticed various skin lesions after he had taken 300 mg of Tegafur daily for about 200 days. The patient had papulonecrotic eruptions on his trunk and extremities. The histology from a papular lesion revealed epidermal necrosis surrounded by spongiosis, perivascular inflammatory infiltrations composed of lymphocytes and erythrocytes, and endothelial swelling. The etiology of Mucha-Habermann disease is not known, but an immune mechanism may be supported by our case.

Antimetabolites, Antineoplastic↗

PubMed1999

Sexual transmission and reinfection of group B streptococci between spouses.

OBJECTIVE: To study how GBS infection takes place between pregnant GBS-carriers and their husbands. METHODS: Pregnant women in whom GBS infections could be detected during 26 to 30 weeks of pregnancy and their husbands were studied during the two periods of August 1994 through May 1995 (Period A, 243 couples) and June through September 1997 (Period B, 141 couples). A urine sample was collected from a husband in the same morning when the vagina of his wife was tested for GBS. GBS were also classified according to their serotypes in 34 couples during Period A and B. RESULTS: In the two periods, GBS was detected in 18.1 and 19.3% of the wive's vaginal cultures, and in 19.1 and 17.0% of husbands' urinary cultures, respectively. There were no significant differences of the rate of GBS detection between the spouses, and also between the two trials. A high possibility of GBS infection was found in a couple when either of the spouses was possible to GBS. The serotypes of 31 of the 34 couples (91.2%) were identical. CONCLUSION: It is suggested that GBS can be sexually transmitted, and cause reinfection between spouses in spite of antepartum medication.

Adult↗

PubMed1999

Immunoadsorption plasmapheresis as a treatment for pregnancy complicated by systemic lupus erythematosus with positive antiphospholipid antibodies.

PROBLEM: Our purpose was to study the effect of maternal immunoadsorption plasmapheresis (IA) on the outcome of pregnancies complicated by systemic lupus erythematosus (SLE) with positive antiphospholipid antibodies, which were known to have a strong correlation with abortion or stillbirth. METHOD OF STUDY: Eight pregnancies in 7 patients with SLE were treated according to our protocol. They were all positive for the lupus anticoagulant. The treatments provided in these cases were as follows: an oral low-dose steroid; oral low-dose aspirin; and IA. The outcomes of the pregnancies were then studied. RESULTS: Of eight pregnancies, seven resulted in preterm deliveries, and cesarean sections were performed at 26-36 weeks of gestation. In one case, intrauterine fetal death occurred at 24 weeks of gestation. The other seven pregnancies resulted in live births (survival rate of 87.5%). CONCLUSION: IA improves the outcome of pregnancy complicated by SLE with positive antiphospholipid antibodies, without increasing steroid dosage.

Adult↗

PubMed1999

[In vitro susceptibility of Streptococcus agalactiae clinical isolates to beta-lactam antibiotics].

The susceptibility of Streptococcus agalactiae (S. agalactiae) clinical isolates of Juntendo University Urayasu Hospital, and type strain ATCC 13813 to beta-lactam antimicrobial agents was evaluated by means of macro-broth dilution MIC determination, killing kinetics and population analysis. When 10(6) cells of S. agalactiae were inoculated and cultured in Todd-Hewitt broth containing two-fold serial dilutions of penicillin, the viable cell count showed that about 10(2) cells survived irrespective of the penicillin concentration which ranged from 0.063 to 128 micrograms/ml. The result indicated that S. agalactiae had tolerance to penicillin (MICs were around 0.063 microgram/ml). Furthermore, the S. agalactiae strains were found to have a paradoxical response to penicillin in an acidic condition (pH 5.5). When the cell counts were performed at pH 5.5, about 10(2) cells survived at penicillin concentrations from 0.016 to 0.125 microgram/ml, while about 10(4) cells survived at the concentrations of 1 to 8 micrograms/ml. The antibiotic tolerance and paradoxical effects of S. agalactiae were also observed in killing kinetics. The ATCC 13,813 and 10 out of 11 clinical strains showed slow response to penicillin-mediated killing at pH 7.8 and ATCC 13,813 and one of the clinical strains showed a reduced response with increase in penicillin concentration at pH 5.5. These results suggested that the tolerance and paradoxical effect of S. agalactiae cells to beta-lactam antibiotics may be one of the reasons for frequent re-colonization of S. agalactiae at the time of delivery after the chemophylaxis in the 2nd trimester.

Anti-Bacterial Agents↗

PubMed1999

Goat fetuses disconnected from the placenta, but reconnected to an artificial placenta, display intermittent breathing movements.

To investigate whether placental factors are involved in the intermittent breathing movements in goat fetuses, we assessed electrocortical activity (ECoA) and tracheal pressure in 5 fetuses (124-135 days) separated from the placenta and connected for 48 h to an extrauterine fetal incubation system that provided umbilical arteriovenous extracorporeal membrane oxygenation. The fetal physiological condition on this system was almost the same as that in utero for at least 48 h after the preparation. All fetuses showed intermittent low-voltage ECoA and breathing movements. The breathing movements occurred almost exclusively during periods of low- voltage ECoA. The proportions of time spent in low-voltage ECoA and breathing movements were 48-57% and 46-56%, respectively. In conclusion, breathing movements of fetuses on the extrauterine incubation system were episodic, suggesting that intermittent breathing movements are intrinsic to fetuses, independent of placenta-derived factors.

Animals↗

PubMed1999

Differential diagnosis of thymic tumors using a combination of 11C-methionine PET and FDG PET.

UNLABELLED: We assessed the usefulness of PET studies in making a differential diagnosis of thymic tumors by using 11C-methionine (MET) and 18F-fluorodeoxyglucose (FDG). METHODS: We examined 31 patients with thymic tumors, including 14 patients with thymic cancer, 9 with invasive thymoma, 5 with noninvasive thymoma and 3 with thymic cysts. The histological diagnosis was confirmed by either surgery or biopsy. MET PET and FDG PET were performed in 28 and 29 patients, respectively. Both the MET and FDG uptakes were evaluated by the standardized uptake value (SUV). RESULTS: MET uptake was not substantially different among thymic cancer (4.8 +/- 1.4), invasive thymoma (4.3 +/-1.1) and noninvasive thymoma (4.5 +/- 1.2), bat MET uptake in thymic cysts (0.9 +/- 0.1) was lower than that in the other three tumors (P < 0.01). The FDG uptake in thymic cancer (7.2 +/- 2.9) was higher than that in invasive thymoma (3.8 -/+ 1.3), noninvasive thymoma (3.0 +/- 1.0) and thymic cysts (0.9) (P < 0.01). MET uptake in thymic tumors correlated with the FDG uptake (r = 0.65), whereas MET uptake in thymic cancer was lower than FDG uptake (FDG/MET ratio = 1.52 +/- 0.52) but was higher than FDG uptake in both invasive and noninvasive thymoma (FDG/ MET ratio = 0.86 +/- 0.33). To differentiate thymic cancer from thymoma, a receiver operating characteristic (ROC) analysis was performed. The area under the curve of FDG PET was 0.90, whereas the FDG/MET ratio was 0.87. CONCLUSION: The MET PET, FDG PET and the FDG/MET ratios were unable to differentiate benign thymic tumors from malignant ones, although FDG PET was considered to be useful in the differential diagnosis between thymic cancer and thymoma. Although the difference in the uptake ratio between FDG and MET suggests a different origin of the tumors, the FDG/MET ratio is not considered to be useful as a complementary method for the differential diagnosis of thymic tumors.

Adult↗

PubMed1999

Prediction of the chemosensitivity of lung cancer by 99mTc-hexakis-2-methoxyisobutyl isonitrile SPECT.

UNLABELLED: 99mTc-hexakis-2-methoxyisobutyl isonitrile (MIBI) has been reported to accumulate in various tumors and to be a transport substrate for P-glycoprotein (Pgp). The aim of this study was to evaluate the usefulness of 99mTc-MIBI SPECT for in vivo assessment of lung cancer chemosensitivity. Also examined was the relationship between 99mTc-MIBI uptake and Pgp expression. METHODS: Ten lung cancer patients who had undergone surgery were examined. Before surgery, 99mTc-MIBI SPECT was performed 15 and 120 min after injection, and the early uptake (L/Ne), delayed uptake (L/Nd) and washout rate (L/Nwr) of 99mTc-MIBI were calculated by the count ratio of lesion to contralateral normal lung tissue. The results were then compared with chemosensitivity determined by the succinate dehydrogenase inhibition test using six antitumor drugs (doxorubicin, mitomycin C [MMC], vindesine, etoposide [VP-16], cyclophosphamide and cisplatin). Pgp expression was determined by immunohistochemical staining. RESULTS: Sensitivity to MMC correlated significantly with L/Ne (P < 0.01) and L/Nwr (P < 0.05). Sensitivity to VP-16 correlated weakly and insignificantly with L/Nwr. L/Nd showed no correlation with sensitivity to any drug. Neither L/Ne, L/Nd nor L/Nwr was significantly different between the Pgp-positive group (n = 2) and the Pgp-negative group (n = 8). CONCLUSION: The results suggest that 99mTc-MIBI SPECT, a noninvasive in vivo examination, can predict the chemosensitivity of lung cancer to MMC and VP-16 independently of Pgp expression.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMed1999

[Phase 2 clinical study of 123I-IBF, a dopamine D2 receptor imaging agent, to evaluate clinical efficacy and safety in Parkinson's disease and Parkinson syndromes].

A Phase 2 multicenter trial of 123I-IBF, (S)-5-iodo-7-N-[(1-ethyl-2- pyrrolidinyl)methyl]carboxamido-2,3-dihydrobenzofuran, was conducted to evaluate its clinical efficacy and safety in 158 patients with Parkinson's disease (PD) or Parkinson syndromes (PS). SPECT data were acquired at two hours (2H-SPECT), after intravenous injection of 123I-IBF (167 MBq). Additional SPECT scan at three hours (3H-SPECT) and dynamic SPECT scan at most until one hour were performed when possible. No severe side effects due to 123I-IBF injection were observed. The sensitivity, specificity and accuracy for discriminating PS from PD using the striatal specific binding count-to-frontal cortex count ratio (St/Fc-1) in 3H-SPECT were 72.7%, 81.0% and 78.1% in 64 clinically definite cases (i.e., typical cases), respectively. The putamen-to-caudate ratios were significantly lower in striatonigral degeneration compared with those in PD. The contralateral-to-ipsilateral ratios against the symptomatic side of tremor and/or rigidity in the patients with PD (Hoehn & Yahr I) were significantly higher than the left-to-right ratios in the normal controls. St/Fc-1 in 3H-SPECT was significantly lower in the patients showing a poor response to levodopa than in those showing a good response. The dopamine D2 receptor binding potential (k3/k4), obtained by dynamic SPECT based on compartment model analysis, correlated well with the striatal specific binding count-to-occipital cortex count ratio. These results suggest that 123I-IBF is a promising agent for differential diagnosis and pathophysiological evaluation of PD and PS.

Adult↗

PubMed1998

Heterogeneity of glucose metabolism in corticobasal degeneration.

A positron emission tomography (PET) study on the regional cerebral glucose metabolism (rCMRglc) was performed in six patients with corticobasal degeneration (CBD). The clinical features included asymmetrical parkinsonism with apraxia, were related to the cerebral cortical and basal ganglionic dysfunction. An MRI study showed all cases to have asymmetrical atrophy in the front-parietal cortex contralateral to the dominantly affected limb; however, no case was pathologically verified. A PET study revealed three cases to have asymmetrical glucose hypometabolism in the parietal lobe and thalamus, which was compatible with the results of previous reports. However, two patients demonstrated symmetrical glucose hypometabolism in the frontal lobe, striatum and parietal lobe while one case had a diffuse hypometabolism, in spite of a marked asymmetry of the neurological findings. These results therefore suggest the heterogeneity of the glucose hypometabolism in CBD based on the PET findings.

Aged↗

PubMed1998

Cerebral muscarinic acetylcholinergic receptor measurement in Alzheimer's disease patients on 11C-N-methyl-4-piperidyl benzilate--comparison with cerebral blood flow and cerebral glucose metabolism.

We studied the cerebral muscarinic acetylcholinergic receptor (mACh-R) by means of 11C-N-methyl-4-piperidyl benzilate (11C-NMPB) and positron emission tomography (PET) in Alzheimer's disease (AD) cases, and the findings were compared with the cerebral blood flow (CBF) and the glucose metabolism (CMRGlc) to evaluate the relationship between the mACh-R and the CBF or the CMRGlc. The subjects consisted of 18 patients with AD and 18 age and sex matched normal volunteers. The patients were clinically diagnosed according to the criteria of the NINDS-ADRDA as having "probable AD" and were thus classified into two groups (mild and moderate AD) according to the severity of dementia determined by DSM-III-R. The CBF was measured by 99mTc-HMPAO SPECT, and the CMRGlc was measured by 18FDG PET. The 11C-NMPB uptake was evaluated by the graphical method and the ratio method (ROIs/Cerebellum). A significant mACh-R decrease and more severe CMRGlc decrease in the cortical region was seen in mild and moderate AD. The decrease in the CBF was not as obvious as that in the mACh-R and the CMRGlc. Our study thus suggested that the mACh-R decreased in patients with AD, and that the 18FDG PET was the most sensitive method for detecting the degenerative regions in patients with AD.

Aged↗

PubMed1998

A comparative study of thallium-201 SPET, carbon-11 methionine PET and fluorine-18 fluorodeoxyglucose PET for the differentiation of astrocytic tumours.

Thallium-201, carbon-11 methionine (MET) and fluorine-18 fluorodeoxyglucose (FDG) have all been used to assess brain tumours. The aim of this study was to determine which of these tracers are of use for evaluating the histological grade and the extent of astrocytoma. 201Tl single-photon emission tomography (SPET), MET positron emission tomography (PET) and FDG PET were all performed in 23 patients (13 men, 10 women) with newly diagnosed astrocytic tumours [seven with astrocytoma (grade II), ten with anaplastic astrocytoma (grade III) and six with glioblastoma (grade IV)]. The 201Tl uptake of the tumours was evaluated by a lesion-to-normal region count ratio. Both MET and FDG uptake of the tumours was evaluated by a semiquantitative analysis using the standardized uptake value. 201Tl uptake was found to increase in rank order with histological grade and was significantly different among the three groups (grade II: 1.51+/-0.36; grade III: 2.58+/-1.50; grade IV: 7. 65+/-3.84). MET uptake in grade II (1.49+/-0.44) was also significantly lower than that in both grade III (3.29+/-1.44) and grade IV (3.20+/-0.92). FDG uptake was not significantly different among the three groups (grade II: 2.90+/-0.45; grade III: 3.86+/-1. 56; grade IV: 3.57+/-0.83). No significant correlation was observed between 201Tl uptake and either MET uptake or FDG uptake. In most patients, the extent of the increased MET uptake was the largest while that of the increased FDG uptake was the smallest. In patients with positive 201Tl uptake, the extent of the 201Tl uptake was equal to or smaller than that of gadolinium enhancement. For evaluation of histological grade of astrocytic tumours. 201Tl is therefore considered to be useful though the 201Tl uptake in some grade III astrocytomas was not different from that in grade II astrocytomas. MET was found to be highly useful for detecting astrocytomas, for differentiating between benign and malignant astrocytomas, and for evaluating the extent of astrocytomas; however, it was not sufficiently useful permit evaluation of the histological grade. FDG was not found to be useful either for evaluating the histological grade or for differentiating between benign and malignant astrocytomas.

Astrocytoma↗

PubMed1998

Liver bilirubin UDP-glucuronosyltransferase activity in chronic nonhemolytic unconjugated hyperbilirubinemia of adults.

Ten adult patients with chronic nonhemolytic unconjugated (indirect) hyperbilirubinemia were analyzed by determining bilirubin uridine diphosphate-glucuronosyltransferase activity according to a more physiological and sensitive method (9 control cases, 0.457 +/- 0.163 nmole/mg protein/min). There was no overlap of the enzyme activities of 2 cases with Crigler-Najjar syndrome (type II) (0.006 nmole/mg protein/min on average) and 6 cases with Gilbert's syndrome (0.051 +/- 0.016 nmole/mg protein/min). The enzyme activities in 2 patients with post-hepatitic hyperbilirubinemia were within the normal range. A new classification of nonhemolytic unconjugated hyperbilirubinemia in adults is proposed according to the results of this enzyme activity and the recent data on the gene mutation of this enzyme.

Adolescent↗

PubMed1998

Adenophostin, a potent agonist of the inositol 1,4,5-trisphosphate receptor, is useful for fertilization of mouse oocytes injected with round spermatids leading to normal offspring.

Precursor male gametes such as round spermatids and secondary spermatocytes are known to possess the potential to achieve fertilization and embryonic development when injected into mature oocytes, but in previous studies, injected mouse spermatids did not activate the oocytes. In this study, we confirmed that this was the case because spermatids by themselves could not induce an increase in intracellular Ca2+ concentration ([Ca2+]i) of oocytes, the pivotal signal in oocyte activation. Repetitive rises in [Ca2+]i (Ca2+ oscillations), lasting for at least 3 h as observed at fertilization, were produced by a single injection of adenophostin B isolated from fungal products, a novel nonmetabolizable agonist of the inositol 1,4,5-trisphosphate receptor (InsP3r), which mediates Ca2+ release from the endoplasmic reticulum. Ca2+ oscillations were blocked by an antibody against the type 1 InsP3r. About 95% of oocytes were activated by adenophostin (0.3-0.4 microM in the oocyte). Simultaneous injection of a round spermatid and adenophostin resulted in 55% fertilization success in association with male and female pronucleus formation and development to two-cell embryos. Furthermore, 25% of two-cell embryos that were transplanted to foster mothers developed to normal offspring. All infants grew into adults that reproduced healthy second generations. Adenophostin will be useful for parthenogenetic oocyte activation in the biotechnology of animal reproduction. Injection combined with precursor spermatozoa may be applicable to assisted conception therapy for patients with defective spermatogenesis.

Adenosine↗

PubMed1998

Auditory evoked neuromagnetic response in cerebrovascular diseases: a preliminary study.

OBJECTIVES: Magnetoencephalography (MEG) measures aspects of the function of the auditory cortex of the human brain with high spatial resolution. The objective was to determine whether MEG also accurately identifies the auditory cortex of the brain in patients with ischaemic stroke. METHODS: The auditory evoked magnetic field (AEF) was examined after stimuli of 1 kHz tone bursts in 24 stroke patients without apparent infarcts in the auditory cortex, and compared the topography of sources of 50 ms (P50m) and 100 ms latency deflections (N100m), the most prominent components of middle and long latency AEFs, with that of 12 normal subjects. Cerebral haemodynamics in and around the auditory cortex were evaluated using PET. RESULTS: In nine of 24 stroke patients, the accurate magnetic sources of P50m or N100m were not identified. The distribution of P50m sources varied more widely than N100m. Eight of these nine patients had severe stenotic lesions in the carotid or middle cerebral arterial trunks. Patients with abnormal P50m responses had decreased supratemporal and hemispheric blood flow compared with patients with normal P50m responses. CONCLUSIONS: These findings suggest that large vessel disease with disturbed cerebral haemodynamics in and near the auditory cortex tend to affect AEFs, especially the middle latency components. This is the first combined study of MEG and PET to show a significant correlation between AEF responses in stroke patients and their PET indices.

Adult↗

PubMed1998

Beneficial effects of verapamil on intestinal ischemia and reperfusion injury: pretreatment versus postischemic treatment.

We studied the effect of verapamil on intestinal ischemia and reperfusion (I/R) injury. Intestinal ischemia was induced by clamping the superior mesenteric artery for 30 min followed by reperfusion. Magnetic resonance spectroscopy was employed as a marker of the changes in the energy metabolism. Further, histological changes and the changes of water contents were evaluated. Recovery rates of energy metabolism after intestinal I/R were improved by verapamil, administered before and after ischemia, and tissue edema was significantly reduced with verapamil. These findings suggest that verapamil results in an improved recovery of the energy metabolism and cellular preservation, presumably by reducing the intracellular calcium influx.

Animals↗

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↗