Can brain impairment be detected by in utero behavioural patterns?

Fetal behavioural patterns were examined to test whether they could be used to localise sites of brain damage antenatally. Decreased fetal movement, persistent nonreactive fetal heart rate (FHR) pattern, and/or central nervous system malformation were used as indicators of possible neurological impairment. Ten fetuses tested in this way underwent further ultrasound examination observing movement of the extremities, chest wall (breathing), and eye and mouth, and active/quiet FHR patterns.

Clinical experience of assisted circulation with a centrifugal pump at Tokyo Women's Medical College.

In postpericardiotomy patients, the use of pulsatile pumps is limited in a semielective fashion to patients whose postoperative marginal hemodynamics are expected preoperatively. Since 1989, 25 patients have undergone assisted circulation with a centrifugal pump: 15 (60%) were weaned from the pump, and 7 (28%) survived. In 1988, we heparin-coated the Bio-Pump using the Carmeda technique and developed a totally heparin-coated left heart bypass system together with heparin-coated cannulas and tubing.

Phase II study of Tc-99m MAG3 in patients with nephrourologic diseases.

Tc-99m-labeled mercaptoacetyltriglycine (Tc-99m MAG3) is a recently introduced radioagent that is excreted by tubular function. The aim of this study was to test Tc-99m MAG3 as an imaging agent for renal scintigraphy and renal plasma flow measurement. Image quality was tested with four different administered doses of Tc-99m MAG3, 100 MBq, 200 MBq, 300 MBq and 400 MBq, in four patients each.

[Clinical evaluation of flutamide, a pure antiandrogen, in prostatic cancer phase II dose-finding study].

The phase II study of flutamide, a pure anti-androgen, was performed to estimate the clinical doses on 165 hormone untreated or treated patients with prostatic cancer. The hormone-untreated patients were given orally flutamide of 90, 375, 750 or 1,125 mg/day in three divided doses daily for 12 weeks. Responses were not observed at the 90 mg/day dose except for improvement of clinical symptoms.

The superoxide generation of neutrophils in normal and preeclamptic pregnancies.

Objective: To determine whether preeclampsia enhances superoxide generation of neutrophils.

Methods: Samples were obtained from 12 normal nonpregnant, 15 normal pregnant, and 11 preeclamptic women. The superoxide production of neutrophils was measured by the superoxide dismutase-inhibitable reduction of ferricytochrome C at 550-540 nm using a dual-wavelength spectrophotometer.

[A right internal thoracic artery graft to the left anterior descending artery].

From 1987 to 1991, 48 patients received a right internal thoracic artery (RITA) to the left anterior descending artery (LAD). No operative death occurred, but two patients (4.2%) died during hospitalization due to graft versus host disease, and congestive heart failure.

[Coronary artery bypass grafting with all arterial grafts using the internal thoracic, the gastroepiploic and the inferior epigastric arteries].

CABG with all arterial grafts using both the internal thoracic artery (RITA, LITA), the right gastroepiploic artery (GEA) and the inferior epigastric artery (IEA) was performed in 26 patients from July 1989 to August 1991. There were no early and late deaths. Early postoperative coronary angiography in all patients revealed that the best choice of anastomosis was RITA to LAD, LITA to LCX or DIA, and GEA to RCA (type A).

Cecoureterocele: experience of three cases with special reference to the relevance of endoscopic incision.

We report three cases of cecoureterocele to emphasize the salient features of this rare clinical entity. The differentiation of it from the usual ectopic ureterocele requires careful examination of the urethra by voiding cystourethrography and cystourethroscopy. We describe the management of these three cases with special reference to the endoscopic incision of the obstructing tissue.

[Preoperative cystometric analysis of benign prostatic hyperplasia--special reference to the natural history and postoperative outcomes].

Four hundred and thirty-seven patients with benign prostatic hyperplasia selected for elective prostatectomy underwent preoperative cystometry. Of these patients 263 (60.2%) had bladder instability, who tended to be more irritative and more obstructive in their preoperative objective assessment than the others.

Abnormal behavioral patterns in the human fetus at term: correlation with lesion sites in the central nervous system after birth.

We describe three fetuses at term that demonstrated abnormal behavioral patterns in utero when observed using real-time ultrasound. The abnormal patterns turned out to have neurologic correlations after birth. In case 1, despite a normal breathing pattern, no movement in any of the four extremities was observed, thus suggesting the existence of a spinal cord lesion at the rostral end, located at C4 or C5.

Experience with one-stage repair of severe proximal hypospadias: operative technique and results.

Our experience with one-stage repair of severe proximal hypospadias in children is reported. The operative technique, which makes one-stage repair of hypospadias and associated bifid scrotum feasible, is described in detail. A 45% chance of secondary repair notwithstanding, we recommend our one-stage repair for all children with severe hypospadias.

Prenatal evaluation and obstetrical management of fetuses at risk of developing lung hypoplasia.

The aim of this study was to measure the fetal lung area of normal human fetuses using ultrasound and them to test the predictive values of a nomogram in the identification of fetal lung hypoplasia. A nomogram for ultrasound-measured fetal lung area were constructed from 264 normal fetuses from 17 to 39 weeks of gestation. In 19 cases running the risk of developing lung hypoplasia, the sensitivity, specificity, and positive and negative predictive values of lung area measurements below the mean -2 SD were 75%, 100%, 94% and 100%, respectively, with total lung area showing a significant relation to the combined lung weight (Y = -1.

Susceptibility of renal tubular cells to lymphokine-activated killer (LAK) cells: application of culture system using a collagen gel matrix.

Monolayer cultures of renal tubular (hKEC) cells were established. These cells formed empty spheroids after 2-3 weeks of culture in a collagen gel matrix. A subcellular polarity from the apex to basement was induced in these "spheroidal" hKEC cells.

[Localization of androgen receptor in male sex organ, accessory sex organs and external genital skin].

Previously, we established an anti-androgen receptor (AR) monoclonal antibody. Using the antibody, we investigated immunohistological AR localization in human testes, epididymides, seminal vesicles and scrotal skins. The testes, epididymides and scrotal skins were obtained from a prostate cancer patient without pre-hormonal therapy undergoing bilateral orchiectomy.

[Flow cytometric analysis of the DNA content in the urinary bladder cancers treated by radical cystectomy and pre-operative irradiation].

The DNA ploidy of bladder cancers treated by radical cystectomy following pre-operative irradiation was analyzed by flow cytometry using paraffin embedded samples. The DNA ploidy and its changes by irradiation were studied. We used flow cytometry in 30 patients with transitional cell carcinoma of the bladder who received pre-operative irradiation (40 Gy in 24 patients, 20 Gy in 5 patients and 60 Gy in one) with follow-up for at least 3 years.

[Study of 54 renal allograft recipients in the cyclosporin A era. What influences acute rejection episode and long-term graft survival?].

During the past 5-year period from 1986 to 1991, a total of 54 patients received living-related renal allograft and has been managed with vagaries of cyclosporin A (CYA) immunosuppressive regimen. In order to determine the ideal form of induction regimen, combination drugs with CYA, the initial dosage of CYA and its blood trough level were retrospectively analyzed with particular reference to the possible factors relevant to the occurrence of acute rejection episode in the first three post-transplant months and graft survival. The combination drugs with CYA were prednisolone (PRD) in 10 patients, PRD + azathioprine (AZA) in 19 and PRD+mizoribine (MIZ) in 25.

Changes in pupillary diameter in relation to eye-movement and no-eye-movement periods in the human fetus at term.

Objective: The aim of our study was to reveal whether pupils dilate and constrict in a time sequence in the human fetus and to assess the relationship between changes in pupillary diameter and eye-movement-no-eye-movement periods.

Study Design: We simultaneously observed pupil and eye movement with real-time ultrasonography in 30 human fetuses at 36 to 41 weeks' gestation. Eighteen were excluded because of data loss.

[Combination therapy with natural type human tumor necrosis factor (MHR-24) and human lymphoblastoid interferon-alpha (MOR-22) against renal cell carcinoma--a multiclinic cooperative, early phase II study. Subcommittee on Urogenital Malignancy, Committee on MHR-24 against Tumors].

The combination therapy with natural type human tumor necrosis factor (n-TNF; MHR-24) and human lymphoblastoid interferon-alpha (n-IFN-alpha; MOR-22) was investigated for antitumor effect against renal cell carcinoma in a multiclinic cooperative study throughout Japan. The "Response criteria of Japan Society for Cancer Therapy" were followed for the handling of subjects and the evaluation of antitumor effect. MHR-24 was administered at a daily dosage of 5,000-10,000 JRU by intravenous drip and MOR-22 at a dosage of 5,000,000 IU daily was administered intramuscularly at the same time.

[Single-dose captopril test and captopril renal scintigraphy in the evaluation of renovascular hypertension].

The effectiveness of single-dose captopril test (CP-T) and captopril renal scintigraphy with 99mTc-DTPA (CP-RG) in the diagnosis of renovascular hypertension (RVH) was evaluated in 27 patients with (Group I, 16 patients) or without (Group II, 11 patients) renal vascular disease. Group I consisted of RVH in 8 patients (bilateral in 3, unilateral in 5), arteriovenous malformation in 3, renal artery aneurysm in 4, including 2 with essential hypertension, and asymptomatic renal artery stenosis in 1. Group II consisted of 6 hypertensive patients (2 with essential hypertension and 4 with renal hypertension) and 5 normotensive patients.

The possible role of endothelial cells in hypertensive disorders during pregnancy.

Objective: To clarify the role of endothelial cells in pregnancy-related hypertensive disorders, we studied the cytotoxic effect of sera from normal pregnant women and from gravidas with various hypertensive complications of pregnancy.

Methods: We obtained serum samples from 84 Japanese women: 17 with preeclampsia, ten with gestational hypertension, six with chronic hypertension, five with chronic hypertension with superimposed preeclampsia, 21 normal gravidas, and 25 healthy nonpregnant women. Endothelial cell injury was measured by the release of radiolabeled chromium from the cells into the culture medium.

How blood viscosity influences changes in circulation during pregnancy?

The changes of whole blood viscosity and plasma viscosity were studied in 15 normal non-pregnant women, and 120 normal pregnant women ranging from 8 to 39 weeks of gestation. The values of whole blood viscosity during normal pregnancy were significantly lower from 20 to 31 weeks of gestation than those in the other periods of gestation, and there was a positive correlation between whole blood viscosity and hematocrit. Plasma viscosity, however, did not change significantly during pregnancy.

The temporal relationship between the onset of rapid eye movement period and the first micturition thereafter in the human fetus with advance in gestation.

The objective of this study was to investigate whether micturition occurs, temporally related to the onset of the rapid eye movement (REM) period, in the human fetus. The study was made on 139 fetuses at 33-36 weeks and 153 at 37-41 weeks gestation. The discrepancies between the expected (F(exp)) and observed (F(obs)) frequencies of time lag between the onset of the REM period and the first micturition thereafter were assessed using the goodness-of-fit test.

[Sequential coronary artery bypass using gastroepiploic artery].

We carried out sequential coronary bypass grafting using the gastroepiploic artery (GEA) as an in situ graft in seven patients. Four patients had sequential graft from the right coronary to the circumflex. Three patients were anastomosed to two or three peripheral branches of the right coronary artery.