Isamu Sawaragi

Physiologic and anatomic assessment of patients with rectocele.

Clinical, physiologic, and anatomic assessments were carried out in 22 female patients with symptomatic rectocele (Group A), 15 patients with asymptomatic rectocele (Group B), and 14 subjects having no rectocele (Group C). Resting anal pressure, rectal pressure, rectal compliance, anorectal inhibitory reflex, and rectal sensation did not differ among the groups. Proctography revealed that the lengths of the rectocele during attempted defecation in groups A (1.6 [1.0–3.5] cm) (median and range) and B (1.6 [1.0–3.0] cm) were significantly greater than that in Group C (0.4 [0.1–0.9] cm) (P<0.001 in both groups). Median pelvic floor descent at rest in Groups A (4.3 [1.6–7.5] cm) (median and range) and B (4.3 [1.3–6.9] cm) were significantly greater than that in Group C (2.5 [1.2–5.0] cm) (P<0.001 andP<0.02, respectively). These results indicate that rectocele is not associated with any physiologic change apart from a significant increase of pelvic floor descent.

Plasma immunoreactive endothelin-1 concentration in human fetal blood: its relation to asphyxia.

ABSTRACT: To elucidate the effects of birth stress on immunoreactive endothelin-1 (irET-1) concentrations in fetal blood, we determined irET-1 levels in cord plasma in different modes of delivery associated with or without complications such as asphyxia. The irET-1 concentrations in both the umbilical artery and vein were significantly higher than those found in maternal venous blood at delivery, although there was no significant difference between preterm and full-term infants. When plasma irET-1 concentrations of healthy infants born by vaginal delivery and by cesarean section without labor were compared, the former had significantly (p < 0.05) higher levels than the latter (15.4 ± 4.9 pg/mL versus 11.1 ± 3.1 pg/mL). Furthermore, umbilical venous plasma obtained from vaginally delivered infants complicated by asphyxia showed significantly (p < 0.001) higher irET-1 levels (28.2 ± 9.4 pg/ mL) than those of nonasphyxiated infants (14.2 ± 4.5 pg/ mL). These data suggest that birth stress, especially asphyxia, may contribute to the increase in fetal circulating irET-1 levels.

Immunotherapy using the streptococcal preparation OK-432 for the treatment of uterine cervical cancer. Cervical Cancer Immunotherapy Study Group.

The effectiveness of immunotherapy using a streptococcal preparation, OK-432, was evaluated for cervical cancer. The 382 eligible patients were stratified by presence/absence of surgical operation and clinical stage, and then, in each stratum, were randomly divided into two groups: an OK-432 treatment group and a control treatment group. The 3-year recurrence-free rates of 221 patients in the OK-432 group and 161 patients in the control group were 71.9% and 58.6%, respectively. The intergroup difference was statistically significant (P less than 0.05). Delayed skin reactions to phytohemagglutinin (PHA) and Su-polysaccharide extracted from Streptococcus pyogenes Su-strain (Su-PS) and peripheral lymphocyte counts were reduced within two months after the initiation of therapy in both groups. The observed immunological changes were apparently reversed by 3 months after the start of the therapy in the OK-432 group, but this took at least one year in the control group, with significant intergroup differences at 6 and 12 months of the therapy (P less than 0.01). These results indicate that OK-432 can be considered as one of the most effective and useful immunotherapeutic agents for cervical cancer.

The occurrence of ‘maternity blues’ in Scottish and Japanese mothers

Abstract A self-report questionnaire including 18 items relating to ‘maternity blues’ was completed by 131 Japanese and 120 Scottish women within 8 days of delivery. Both groups experienced the blues, the Japanese to a significantly lesser extent. Examination of the content of responses showed that Scottish women reported significantly more symptoms related to depression than Japanese women, who expressed more concern for own appearance and well-being of the infant. Possible reasons for these differences are discussed.

The role of platelet-activating factor and platelet-activating factor acetylhydrolase in fetal and placental growth in rats

Summary The adverse effects of PAF on the growth of rat fetuses and placentae were investigated. Plasma PAF-AH activity in pregnant rats was also investigated during the later stages of pregnancy. The enzyme activity in pregnant rats decreased from 58.8±8.0 nmol/min/ml on 13 day of pregnancy to 36.5±6.6 nmol/min/ml on 19 day of pregnancy (p When pregnant rats were treated with either 0.1% BSA (control group) or a 1 nmol/kg, 2.5 nmol/kg, and 5 nmol/kg dose of PAF (PAF-treated group) from 16 day to 20 day of pregnancy, fetal body weight in three PAF-treated groups was significantly lower than that in control group (p These results suggest that some of the PAF in tissues and plasma escape from PAF-AH and PAF levels increase during the later stages of pregnancy. The increased PAF may affect uteroplacental circulation or normal growth of placenta, and then may cause IUGR, and IUFD.