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PubMed1998

Effect of daily vaginal disinfection on duration of gestation after premature rupture of the membranes and on infant outcome.

OBJECTIVES: We examined the effects of daily vaginal disinfection on the interval between premature rupture of the membranes (PROM) and delivery and on infant outcome. METHODS: Daily vaginal disinfection with povidone iodine was performed on 43 women with PROM. The control group consisted of 59 women with PROM who did not undergo vaginal disinfection. In both groups, the infants born to these women were followed until 1 year of corrected age. RESULTS: The degree of cervical dilatation, the leukocyte count, and the serum C-reactive protein level on admission did not differ between the 2 groups. Although there was no difference in the gestational week at delivery between the groups, the interval between PROM and delivery was significantly longer in the disinfectant group than among the control subjects (9.5 +/- 14.9 days vs. 3.9 +/- 5.1 days, p < 0.01). There was no difference in infant outcome between the 2 groups. CONCLUSIONS: These findings suggest that daily vaginal disinfection with povidone iodine prolongs the duration of gestation in women with PROM and dose not have an adverse effect on the fetus.

Adolescent↗
PubMed1996

Respiratory effects of CO2 pneumoperitoneum during transperitoneal laparoscopic urological surgery.

OBJECTIVE: To evaluate the effects of CO2 pneumoperitoneum on respiratory function during urological laparoscopic surgery with exposure of the retroperitoneal space in the lateral decubitus position. METHODS: Arterial blood gas analysis and measurements of the partial pressure of CO2 in exhaled gas (PetCO2) were performed during CO2 pneumoperitoneum in 12 patients who underwent transperitoneal laparoscopic surgery for the retroperitoneal organs (the retroperitoneal group): the results were compared to those of 11 patients who underwent laparoscopic varicocelectomy (the varicocele group) with the same anesthesia and intra-abdominal pressure. RESULTS: The increase in PaCO2 and PetCO2 and the decrease in arterial pH during CO2 insufflation were significantly greater in the retroperitoneal group than in the varicocele group. PaCO2, PetCO2 and arterial pH continued to change in the retroperitoneal group, whereas these values reached a plateau at 30 min after the beginning of CO2 insufflation in the varicocele group. CONCLUSIONS: The respiratory effects of CO2 pneumoperitoneum are more pronounced during laparoscopic urological surgery with opening of the retroperitoneum. It is possible that exposure of the retroperitoneal space increased CO2 absorption during insufflation.

Adult↗
PubMed2001

Tubular osteopontin expression in patients with ANCA-associated glomerulonephritis.

OBJECTIVE: To elucidate the role of osteopontin (OPN) in monocyte recruitment in crescentic glomerulonephritis, we investigated immunohistochemical localization of OPN in the kidney and its correlation with clinical and histopathologic parameters in biopsy specimens of patients with myeloperoxidase antineutrophil cytoplasmic autoantibody- (MPO-ANCA) associated glomerulonephritis. METHODS: Twelve patients with MPO-ANCA-associated glomerulonephritis were enrolled in this study. Clinical parameters such as creatinine clearance and urinary protein excretion of each patient were obtained at the time of biopsy. Paraffin-embedded sections were used for immunohistochemical staining using the LSAB method. Five cortical interstitial fields randomly selected at original magnification x 200 were assessed using a computer-assisted color image analyzer. Tubular OPN expression was assessed as the percentage of positive area in the tubulointerstitium. Double immunofluorescent staining using antibodies against OPN and alpha(v)beta3 was performed. RESULTS: In all of the cases studied, OPN was occasionally localized within the glomeruli, and expressed slightly in proximal tubular epithelium and significantly in distal tubular epithelium. Tubular OPN expression tended to be promoted in the interstitium infiltrating by numerous monocytes/macrophages. The extent of tubular OPN expression was positively correlated with serum ANCA titers and urinary OPN concentrations. Enhanced alpha(v)beta3 expression appeared in the distal tubular epithelium expressing OPN. CONCLUSION: These results suggest that inducible expression of OPN and alpha(v)beta3 in the tubular epithelium seems to be associated with interstitial moncyte infiltration and subsequent tubulointerstitial changes in human MPO-ANCA-associated glomerulonephritis.

Adult↗
PubMedDate not supplied

Biological analysis of gastrointestinal stromal tumors.

The biological behaviour of a gastrointestinal stromal tumor (GIST) cannot be easily predicted from preoperative clinical examination alone. As a result, there is little standardization in the surgical treatment of GIST. In this study, we analyzed the clinicopathology and immunohistochemistry of 20 cases of GIST to clarify factors associated with tumors showing malignant potential. Immunohistochemical analysis of KIT, CD34, vimentin, alpha-smooth muscle actin (SMA), s-100, p53, ki-67, bcl-2 and bax expression was performed on 20 surgically resected GIST. An apoptotic index (AI) was calculated for each sample using a TdT-mediated dUTP-biotin nick end-labeling method. With regard to bcl-2, t(14;18) translocations were also investigated using a polymerase chain reaction based method. Finally, the relationship between these biological results and clinicopathological data was analyzed. Of the 20 cases studied, two patients died due to lung or liver metastasis. All cases stained positive for vimentin, nine cases were positive for alpha-SMA and three cases positive for s-100. All cases were stained for both KIT and CD34, which tended to correlate with malignant potential. There was significant difference in frequency of bcl-2 overexpression (p<0.05) and trend in Ki-67 labeling index (p=0.098) between benign and malignant cases. However, with regard to bcl-2, no chromosomal t(14;18) translocations were detected in four analyzed cases. In GIST, overexpression of bcl-2 may play an important role in increasing malignant potential. Furthermore, Ki-67 L.I. and bcl-2 overexpression may be useful in predicting malignant potential, and therefore help to determine the surgical treatment, follow-up manner, and the necessity of adjuvant therapy.

Adult↗
PubMed1994

[Effect of low calcium diet on blood pressure and pressure natriuresis response in rats: role of the renin-angiotensin system].

Dietary Ca is an important modulator of arterial blood pressure in humans and rats. Since the kidney plays a key role in the pathogenesis of hypertension, the effect of a low Ca diet (0.01%Ca) on blood pressure and pressure natriuresis response was studied in Sprague-Dawley rats. In addition, a possible role of the renin-angiotensin system in the development of hypertension and an altered pressure natriuresis response resulting from low dietary Ca intake was investigated. In the low Ca diet group, systolic blood pressure determined by the tail-cuff method was significantly higher than in the normal Ca diet group (1.1%Ca) 1 week after the diet (113.0 +/- 7.1 vs. 105.0 +/- 9.5 mmHg, p < 0.05). Furthermore, low dietary Ca treatment significantly inhibited the water and sodium excretory responses to acute elevation of renal perfusion pressure. Treatment with an inhibitor of angiotensin converting enzyme, captopril (30 mg/kg/day), attenuated both the development of hypertension and the reduced pressure natriuresis response observed in Ca-deficient rats. Although plasma renin activity was not different between the low and normal Ca diet groups after the 2-week dietary regimen, the pressor response to angiotensin II injection was significantly greater in the low Ca diet group. These results indicate a possible involvement of the renin-angiotensin system in the development of hypertension and the inhibitory effects of the pressure natriuresis response caused by low dietary Ca intake, via enhanced sensitivity to angiotensin II.

Animals↗
PubMed1987

Intravascular survival of leukemic cells labeled with indium-111-oxine.

A method for labeling leukemic cells in vitro with 111In-oxine is described. Intravascular survival data and organ distribution of 111In-oxine-labeled leukemic cells in patients with acute leukemia are presented. No evidence of diminished cell viability or significant elution of the label could be found by the in vitro studies. Disappearance curves of 111In-labeled leukemic cell radioactivity in the circulation were a single exponential with average T1/2 value of 15.3 +/- 2.5 hr (mean +/- SEM), which was found to be prolonged when compared with the results of 4 hematologically normal subjects (7.0 +/- 0.8) and those of previously reported DF32P studies. Migratory patterns of the labeled leukemic cells, obtained by a scintillation camera, demonstrated sequestration in the lungs 5 min after the infusion, and thereafter, the uptake into the spleen and liver gradually increased. We believe that the properties of 111In-oxine might overcome many of the difficulties of studying leukemic cell kinetics with cells labeled with tritiated thymidine.

Acute Disease↗
PubMed2001

AgNOR count in resting cells (resting NOR) is a new prognostic marker in invasive bladder tumor.

PURPOSE: We have previously demonstrated that the AgNOR count in proliferating cells is a predictor of tumor recurrence in superficial bladder tumor (J. Urol. 162 (1999), 63-68). In the present study, we evaluate the type of AgNOR associated with cell cycles as a prognostic factor in invasive bladder tumor using a double staining technique employing both AgNOR and MIB-1 labelling. MATERIALS AND METHODS: Forty-four paraffin sections of invasive bladder tumors were stained simultaneously with AgNOR and MIB-1. The number of AgNORs in proliferating (MIB-1 positive) or resting (MIB-1 negative) cells were counted from a total of 100 nuclei. Correlations between MIB-1 associated AgNOR count and clinicopathological parameters were statistically analyzed. RESULTS: The AgNOR count in proliferating cells (proliferating NOR) was significantly higher than that in resting cells (resting NOR) (p<0.01). The resting NOR in tumors with distant metastases was significantly higher than that in tumors without metastases (p<0.05). Patients with a low resting NOR tumor had a better prognosis than those with a high resting NOR tumor, whereas the proliferating NOR was not associated with survival. Survival analysis revealed that the resting NOR was the most powerful prognostic marker in patients with invasive bladder tumor (p<0.05). CONCLUSIONS: Resting NOR had a predictive value in the prognosis of patients with invasive bladder tumor.

Adult↗
PubMed1996

Spectral analysis of hemodynamics during left ventricular assistance.

In order to analyze the autonomic nervous system during left ventricular (LV) assistance, fluctuations in hemodynamic derivatives were evaluated by a spectral analyzing method using a fast fourier transform (FFT) methodology. After the left pleural cavity was opened through the fourth intercostal space under general anesthesia, a pneumatically driven ventricular assist system was implanted as in left heart bypasses in chronic animal experiments, using three healthy adult goats. Hemodynamic parameters with and without LV assistance were recorded on a magnetic tape in the awake condition then analyzed in a computer system through an A-D convertor. Power spectral analysis was performed on a beat-to-beat basis for the evaluation of the fluctuations. During copulsation mode LV assistance, Mayer wave fluctuations (0.1 Hz) were significantly increased compared with counterpulsation mode LV assist, suggesting an increase in sympathetic tone. Co-pulsation mode LV assist is reported to increase the afterload of the natural left ventricle, thus, the sympathetic tone may be increased to maintain a natural heart output.

Analysis of Variance↗
PubMed1988

S phase fraction of human bladder tumor measured in situ with bromodeoxyuridine labeling.

A total of 18 patients with transitional cell bladder cancer was given a 0.5-hour intravenous infusion of bromodeoxyuridine at the time of endoscopic biopsy or transurethral resection to label tumor cells in the deoxyribonucleic acid synthesis phase (S phase). The tumor specimens were fixed with 70 per cent ethanol, embedded in paraffin, sectioned and stained by an indirect immunoperoxidase method with anti-bromodeoxyuridine monoclonal antibody as the first antibody. The bromodeoxyuridine labeling index, S phase fraction, was determined by counting the number of bromodeoxyuridine-labeled cells in the tissue sections. All grade 1 tumors had an S phase fraction of lower than 10 per cent. The average S phase fractions for noninvasive (11 cases) and invasive (7) tumors were 9.8 and 20.0 per cent, respectively. Two distant metastatic bladder tumors showed an average S phase fraction of 25.3 and 30.0 per cent. Thus, transitional cell bladder cancers with an S phase fraction of greater than 10 per cent appears to grow faster and be more invasive more often than those with an S phase fraction of less than 10 per cent. The higher S phase fraction may indicate greater biological malignancy. Our preliminary results suggest that measurement of the bromodeoxyuridine labeling index in bladder tumors may be a new objective and quantitative assay of biological potential of individual tumors.

Adult↗
PubMed2004

Effect of left atrial-coronary sinus musculature connections on the coronary sinus activation pattern via retrograde conduction in patients with WPW syndrome.

BACKGROUND: Double potential (DP) activation patterns observed in coronary sinus (CS) electrograms recorded during left lateral atrial pacing, were explained by an initial low-frequency left atrial (LA) activation potential and secondary high-frequency CS musculature activation potential in canine hearts. Moreover, the connections between the LA and CS musculature vary greatly in size and location in the human heart. The purpose of this study was to investigate the relationship between the CS activation pattern during retrograde conduction via an accessory pathway (AP) and the location of left-sided APs. METHODS AND RESULTS: Fifty-one patients (31 males, mean age 48.6 years) who underwent radiofrequency catheter ablation of left-sided APs were divided into two groups according to the successful ablation site. The CS electrograms during retrograde AP conduction were classified into 3 types; single, fractionated, and DP activation patterns. A DP pattern was identified in 10 of 12 patients (83.3%) with posteroseptal to posterolateral APs, and in particular, 9 had a divergent sequence. Twenty-six of 39 patients (66.7%) with lateral to anterolateral APs, demonstrated a single pattern. The number of radiofrequency applications was significantly higher in patients with a DP pattern than in those with a single pattern (3.4 +/- 3.3 vs. 7.8 +/- 6.8, p < 0.01). CONCLUSION: Misleading information obtained when mapping for optimal ablation sites might result from DP patterns with a divergent sequence produced by discrete muscular connections between the LA and CS musculature. Ablation around left posterior APs may require meticulous observation of the CS activation patterns.

Action Potentials↗
PubMed2001

p53 Mutation in bladder cancer patients in Japan and inhibition of growth by in vitro adenovirus-mediated wild-type p53 transduction in bladder cancer cells.

BACKGROUND: Altered expression of p53 has been described in nearly half of bladder cancers, and p53 mutations are presumed to play a role in the multistep progression of these tumors. MATERIALS AND METHODS: The incidence of mutation in the p53 gene and its correlation with histopathologic findings and patient survival were evaluated in 105 Japanese patients with bladder cancer. Laboratory experiments were also performed to confirm the infectivity and efficacy in tumor growth inhibition of an adenovirus expressing wild-type p53 in EJ bladder cancer cells. RESULTS: Mutations of p53 were observed in 38 bladder cancer specimens (36%), with a significantly higher incidence of mutation being seen in tumors of higher stage and grade. The overall survival was worse in patients with the p53 mutation. In laboratory experiments, adenoviral vectors infected bladder cancer cells in a dose- and cell density-dependent manner. The adenovirus-mediated transduction of wild-type p53 resulted in dose-dependent growth inhibition of bladder cancer cells in vitro. No significant cytotoxicity was observed after infection by a control adenovirus. CONCLUSION: Transduction of wild-type p53 might be a potential therapeutic option for bladder cancer.

Adenoviridae↗
PubMed2006

A novel hydroxyapatite fiber mesh as a carrier for recombinant human bone morphogenetic protein-2 enhances bone union in rat posterolateral fusion model.

STUDY DESIGN: An experimental study, in which spinal fusion in rats was conducted using a hydroxyapatite fiber mesh (HAM) as a carrier for recombinant human bone morphogenetic protein (rhBMP)-2. OBJECTIVES: To study the usefulness of the HAM as a carrier and seek the possibility of clinical application in spinal fusion. SUMMARY OF BACKGROUND DATA: Several biomaterials have been used as a carrier for BMP to achieve spine fusion, however, to our knowledge, the most effective carrier has not been established. METHODS: In experiment No. 1, HAMs and the controls (commercially available hydroxyapatite ceramic body), loaded with rhBMP-2, were immersed in phosphate-buffered saline to evaluate the time course of the release of rhBMP-2. In experiment No. 2, posterolateral fusion was conducted in rats using HAM and the control loaded with rhBMP-2. The fusion status was evaluated radiologically and histologically after surgery. RESULTS: In experiment No. 1, HAMs released a larger amount of rhBMP-2 for up to 28 days than the controls (49.5% vs 7.8%). In experiment No. 2, the fusion rate was significantly higher in the HAM group (>80%) than in the control group (20%). Dense new bone formed close to the spine, and the HAMs were markedly absorbed compared with the controls. CONCLUSION: HAM provided more solid fusion mass than the control, suggesting that HAM is an efficient carrier for BMP.

Animals↗
PubMed2005

Changes in serum lipid concentrations in patients with chronic hepatitis C virus positive hepatitis responsive or non-responsive to interferon therapy.

BACKGROUND: Changes in serum lipid concentrations during the administration of interferon to patients with chronic hepatitis C virus (HCV) infection have not been fully investigated. The present study was designed to compare changes in serum lipid concentrations before, during and after interferon therapy in responders and non-responders to treatment. METHODS: In total, 101 patients with chronic HCV positive hepatitis were enrolled in this study. High dose interferon alpha was given on alternate days for 6 months. Six months after the end of treatment patients were assessed for the presence or absence of HCV RNA to determine the results of interferon treatment. The time courses of changes in serum lipid concentrations were measured in all patients. RESULTS: The total cholesterol level increased gradually during and after interferon therapy, and its pattern of change coincided with that of serum cholinesterase activity. Pretreatment serum cholesterol concentrations did not differ between responders and non-responders to interferon therapy. The serum triglyceride concentration, conversely, showed a sharp increase during interferon administration and returned to its basal level after the end of treatment. Responders to interferon therapy tended to have higher pretreatment triglyceride concentrations than did non-responders. CONCLUSIONS: We clarified that serum cholesterol and triglyceride levels showed different patterns of change during interferon therapy.

Adolescent↗
PubMed1995

Particle size studies for subcutaneous delivery of poly(lactide-co-glycolide) microspheres containing ovalbumin as vaccine formulation.

The primary objectives of the present study were to produce poly(lactide-co-glycolide) (PLGA) microspheres with different diameters, to characterize these microspheres which were loaded with a model antigen, ovalbumin and to evaluate the effect of microsphere particle size on the serum antibody levels following administration to mice. Four kinds of ovalbumin-loaded PLGA microspheres with different diameters (1.2, 3.5, 7.0 and 14.3 microns as mean volume diameter) were manufactured by a w/o/w emulsion/solvent evaporation method. Low loading percent (0.08%-0.25% w/w) and efficiencies (8-25% w/w) were observed. Examination using scanning electron photomicrographs showed smooth spherical particles. The in-vitro release of ovalbumin from microspheres showed an expected burst release with all batches and the extent of the burst release increased with decreasing diameters of spheres; PLGA microspheres with the smallest diameter (1.2 microns) showed an 80% burst release within one day. Approximately 10-60% of ovalbumin remained unreleased 30 days later. The single subcutaneous administrations of ovalbumin-loaded PLGA microspheres with different diameters to mice induced good antibody responses above ovalbumin saline negative controls at 3, 6, 9, and 12 weeks after inoculation. Especially, 0.16% ovalbumin-loaded PLGA microspheres having mean volume diameter of 3.5 microns exhibited the best immune responses with values greater than those obtained after inoculation with adjuvants such as complete Freund's adjuvant or alum as positive control. The strong adjuvant activity of PLGA microspheres as vaccine formulation was suggested.

Alum Compounds↗
PubMed1997

Preparation and characterization of polylactic acid microspheres containing bovine insulin by a w/o/w emulsion solvent evaporation method.

The objective of this study was to produce polylactic acid (PLA) microspheres containing bovine insulin as a sparingly water soluble model drug using a water-in-oil-in-water (w/o/w) emulsion solvent evaporation method. The preparative conditions were optimized. Employment of smaller internal aqueous phase volume (50 microliters or 100 microliters) in the manufacturing process, resulted in the high loading efficiency (over 95% of theoretical insulin loading efficiency). The addition of 10% (w/v) NaCl to the external aqueous phase (0.5% polyvinyl alcohol solution) reduced loading efficiency compared to the case where no NaCl was added to the external phase. The mean volume diameter for prepared PLA microspheres was in the region of 15-25 microns in all cases. PLA microspheres containing 5% and 10% insulin theoretically exhibited burst release in the initial stage. After a three week dissolution test, the surface of the microspheres became more porous due to the degradable characteristics of PLA polymer itself. Nevertheless, about 80% of the insulin still remained undegraded in PLA microspheres. Finally, insulin-loaded PLA microspheres (corresponding to 4 I.U. insulin) were administered to normal rats subcutaneously, and the pharmacological effect (a decrease in serum glucose level) was demonstrated.

Animals↗
PubMed2006

Study of the predictors and lesion characteristics of ischemic heart disease patients with false negative results in stress myocardial perfusion single-photon emission tomography.

BACKGROUND: The predictors and lesion morphology of patients with ischemic heart disease testing false negative results in stress myocardial perfusion single-photon emission computed tomography (SPECT) was investigated. METHODS AND RESULTS: Subjects were 58 consecutive patients who underwent coronary angiography (CAG), even though they showed normal findings in stress myocardial perfusion SPECT. Age, gender, methods of stress, perfusion agent, coronary risk factors, angina symptoms, and electrocardiographic changes were investigated as predictors by multivariate analysis. For lesion morphology, significant stenotic lesions were studied for morphological characteristics and reference diameter (RD), percentage diameter stenosis (%DS), minimum lumen diameter (MLD), and lesion length (LL) were measured. CAG revealed 30 significant stenotic lesions in 18 patients. Logistic regression analysis revealed significant predictors to be age (odds ratio (OR) 1.118, p<0.05), typical anginal pain (OR 21.09, p<0.01), and hypertension (OR 8.336, p<0.05). For lesion morphology, there were only 2 diffuse lesions and the mean RD, %DS, MLD, and LL were 3.03+/-0.9 mm, 63.1 +/-9.3%, 1.13+/-0.49 mm, and 13.2+/-7.0 mm, respectively. CONCLUSION: Sufficient caution is believed necessary in the interpretation of normal findings of stress myocardial perfusion SPECT when the patient is elderly, complains of typical anginal pain, or has hypertension. In regard to characteristics of lesion morphology, there were hardly any diffuse lesions.

Age Factors↗
PubMed2000

[Clinical evaluation of the Heidelberg Retina Tomograph II].

PURPOSE: To evaluate the usefulness of Heidelberg Retina Tomograph (HRT) II prototype, which is an easily handled model for routine optic disc examination in glaucoma clinics. METHODS: Ten eyes of 10 normal volunteers and 18 eyes of 18 open-angle glaucoma patients followed at Gifu University were studied. The reproducibility of three consecutive optic disc measurements with a 15 degrees x 15 degrees field using HRT II and with a 10 degrees x 10 degrees field using HRT (version 2.01) were evaluated by the same examiner on the same day. We also examined the correlation of the main topographic parameters (disc area, cup area, cup/disc area ratio, rim area, cup volume, rim volume, cup shape measure) between HRT II and HRT. RESULTS: The mean (+/- standard deviation) reproducibility of optic disc measurements with HRT II and HRT were 17.5 +/- 7.6 microns and 19.3 +/- 9.6 microns, respectively. This difference was not significant. All topographic parameters obtained from HRT II and HRT (R = 0.86-0.98, p < 0.01) showed statistically significant correlations with each other. CONCLUSION: The HRT II has high reproducibility of measurements and reliable stereometric parameters comparable to the conventional HRT.

Glaucoma, Open-Angle↗
PubMed1995

[Correlation analysis between patlak plot and DAR using 11C-methionine PET].

Seven patients were studied with positron emission tomography (PET) using 11C-methionine. All had non-Hodgkin's lymphoma but one, who had Hodgkin's disease. By assuming a simple three-compartment model for dynamic data analysis, we used the graphic method proposed by Patlak et al., where Ki (K2K3/(K1+K3)) was compared with DAR (differential absorption ratio). Trichloroacetate was added to each plasma sample, and the activity of the acid-soluble fraction was counted to eliminate the influence of the protein-bound fraction of injected activity. Patlak data plots, using this acid-soluble fraction as an input factor, showed good linearity over the time of data collection. All tumors showed clear 11C-methionine accumulation. Tumor activity reached almost a plateau within 10 min and was kept at the same level for at least 30 min. Ki and DAR were 0.070 +/- 0.035 and 4.64 +/- 1.85 (mean +/- SD), respectively. There was no apparent correlation between histological type and Ki or DAR, while the correlation efficient between Ki and DAR was 0.875. Our conclusion is that DAR will give almost the same result as dynamic data in the analysis of methionine metabolism using PET.

Aged↗