Updated on 2021/12/12

写真a

 
MASUYAMA Hisashi
 
Organization
Faculty of Medicine, Dentistry and Pharmaceutical Sciences Professor
Position
Professor
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Degree

  • 医学博士 ( 岡山大学 )

Research Interests

  • Obstetrics and Gynecology

  • Molecular Biology

  • 産婦人科学

  • 分子生物学

Research Areas

  • Life Science / Obstetrics and gynecology

  • Life Science / Molecular biology

Education

  • Okayama University   医学研究科   産科婦人科学

    - 1995

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    Country: Japan

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  • Okayama University    

    - 1995

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  • Okayama University   医学部   医学科

    - 1987

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    Country: Japan

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  • Okayama University    

    - 1987

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Research History

  • - Professor,Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,Okayama University

    2017

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  • - 岡山大学医歯薬学総合研究科 教授

    2017

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  • Associate Professor,University Hospital of Medicine and Dentistry,Okayama University

    2008 - 2017

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  • Okayama University   Okayama University Hospital

    2008 - 2017

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  • ケースウエスタンリザーブ大学 文部科学省在外研究員

    2000 - 2001

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  • セントルイス大学 研究員

    1995 - 1997

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  • Researcher

    1995 - 1997

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Professional Memberships

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Committee Memberships

  • 日本産科婦人科学会   理事  

    2021.6   

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  • 日本糖尿病・妊娠学会   理事  

    2020   

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  • 日本婦人科腫瘍学会   理事  

    2019.5   

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    Committee type:Academic society

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  • せとうち臨床遺伝研究会   副理事長  

    2019   

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  • 日本胎盤学会   理事  

    2019   

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  • 日本女性栄養・代謝学会   理事  

    2019   

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    Committee type:Academic society

    日本産婦人科栄養代謝研究会

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  • 中国四国生殖医療学会   理事  

    2018   

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    Committee type:Academic society

    中国四国生殖医療学会

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  • 日本産婦人科手術学会   常務理事  

    2018   

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    Committee type:Academic society

    日本産婦人科手術学会

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  • 腎と妊娠研究会   理事  

    2018   

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    Committee type:Academic society

    腎と妊娠研究会

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  • 中国四国産科婦人科学会   理事  

    2017   

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    Committee type:Academic society

    中国四国産科婦人科学会

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  • 日本臨床栄養学会   評議員  

    2009   

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    Committee type:Academic society

    日本臨床栄養学会

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  • 日本産婦人科手術学会   保険委員会委員  

    2009   

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    Committee type:Academic society

    日本産婦人科手術学会

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  • 日本産婦人科手術学会   編集委員会委員  

    2009   

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    日本産婦人科手術学会

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  • 米国内分泌学会(Endocrine Society)   会員  

    2009   

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    Committee type:Academic society

    米国内分泌学会(Endocrine Society)

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  • 日本内分泌学会   代議員  

    2009   

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    日本内分泌学会

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  • 日本産科婦人科学会   代議員、中央専門医制度委員会委員、広報委員会委員、教育委員会委員、コンプライアンス委員会委員、第64回日本産科婦人科学会学術講演会プログラム委員会委員長、第65回日本産科婦人科学会学術講演会プログラム委員会委員、第69回日本産科婦人科学会学術講演会プログラム委員会委員  

    2007   

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    日本産科婦人科学会

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  • 日本内分泌学会   代議員  

    2000   

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    Committee type:Academic society

    日本内分泌学会

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  • 日本産婦人科手術学会   理事  

    2000   

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    Committee type:Academic society

    日本産婦人科手術学会

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  • 日本周産期・新生児学会   評議員、会員  

    1998   

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    Committee type:Academic society

    日本周産期・新生児学会

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  • 米国内分泌学会   会員  

    1998   

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    米国内分泌学会

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Papers

  • Spontaneous labor curve based on a retrospective multi-center study in Japan. International journal

    Ryosuke Shindo, Shigeru Aoki, Toshihiro Misumi, Sayuri Nakanishi, Takeshi Umazume, Takeshi Nagamatsu, Hisashi Masuyama, Atsuo Itakura, Tomoaki Ikeda

    The journal of obstetrics and gynaecology research   47 ( 12 )   4263 - 4269   2021.12

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    AIM: In Japan, the criteria of the latent and active phases of the first stage of labor have not been decided. The Japan Society of Obstetrics and Gynecology (JSOG) Perinatal Committee conducted a study to construct a spontaneous labor curve in order to determine the point of onset of the active phase. METHODS: The participants were women who had spontaneous deliveries at four health facilities in Japan between September 1, 2011, and September 31, 2019. Spontaneous delivery was defined as the spontaneous onset of labor at term (37 weeks, 0 days to 41 weeks, 6 days) with vaginal delivery of a mature fetus in a cephalic position without uterotonic agents or epidural analgesia. The time points for each "cm" of dilation were collected starting from the time of full dilation retrogradely. The relationship between time since labor onset and cervical dilation was expressed as a curve using a smoothing B-spline. RESULTS: A total of 4215 primiparous and 5266 multiparous women were included in this study. The spontaneous labor curve showed that in both primiparous and multiparous women, labor progress was slow until 5 cm cervical dilation, accelerating between 5 and 6 cm dilation, and steadily progressed after 6 cm dilation. CONCLUSION: We propose that the active phase of the first stage of labor be defined as starting at 5 cm dilation of the cervix, and that it be divided into an acceleration phase (5-6 cm dilation) and a maximal phase (>6 cm dilation).

    DOI: 10.1111/jog.15053

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  • Surgically treated genital chronic graft-versus-host disease in women: A report of three cases. International journal

    Yasuhiko Kamada, Rie Kusumoto, Chiaki Kashino, Kotaro Kubo, Takashi Mitsui, Hisashi Masuyama

    The journal of obstetrics and gynaecology research   47 ( 11 )   4122 - 4126   2021.11

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    Hematopoietic stem cell transplantation (HSCT) is a crucial treatment for hematological malignancy. Gonadal dysfunction occurs at an early stage after this treatment, and such patients may require hormone replacement therapy. Genital chronic graft-versus-host disease is a lesser-known complication of HSCT that begins with vulvar discomfort and dysuria and progresses to sexual dysfunction and retention of menstrual blood due to vaginal stenosis and obstruction; thus, significantly impairing the patient's quality of life. We describe three women who underwent vaginal reconstruction because of genital chronic graft-versus-host disease. We discuss the surgical techniques, including double cross plasty that were performed in each case. Surgical interventions enabled the continuation of HRT and facilitated sexual intercourse. In conclusion, gynecologists should be aware that genital chronic graft-versus-host disease can occur after HSCT, and that surgical treatment options are available to improve patients' symptoms and quality of life.

    DOI: 10.1111/jog.15005

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  • Inflammation of the adipose tissue in the retroperitoneal cavity adjacent to pelvic endometriosis. International journal

    Kotaro Kubo, Yasuhiko Kamada, Toru Hasegawa, Ai Sakamoto, Mikiya Nakatsuka, Takashi Matsumoto, Hisashi Masuyama

    The journal of obstetrics and gynaecology research   47 ( 10 )   3598 - 3606   2021.10

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    AIM: Peritoneal endometriosis is a chronic inflammatory disease particularly associated with macrophages. Of note, adipose tissues with fibrotic changes in the context of peritoneal endometriotic lesions are often observed during surgery. However, the characteristics of fibrotic adipose tissues in endometriosis are still unknown. In this study, we investigated the inflammatory status of retroperitoneal adipose tissues adjacent to pelvic endometriotic lesions. METHODS: Thirty-two patients who underwent surgical treatment were assigned to either the endometriosis (n = 16) or the control (n = 16) groups. Retroperitoneal adipose tissues around the uterus were collected from patients in both groups. Fibrosis was evaluated via Masson's trichrome staining. Macrophage infiltration, the expression of fatty acid-binding protein 4 (FABP4), and angiogenesis in the retroperitoneal adipose tissues were evaluated via immunohistochemistry. The mRNA expression levels of cytokines was also evaluated in the adipose tissues using real-time PCR. RESULTS: There was more fibrosis and angiogenesis in the adipose tissues adjacent to the endometriotic lesions with a significantly higher level of infiltration of macrophages and a predominance of the M1 type in the endometriosis group compared to the control group. In addition, FABP4 positivity in the adipose tissues of the peritoneum was significantly higher in the endometriosis group versus the control group. Moreover, the mRNA expression levels of FABP4, VEGF, and proinflammatory cytokines were also significantly higher in the endometriosis group. CONCLUSION: Altogether, our results showed that the adipose tissue adjacent to endometriotic lesions are inflamed with fibrosis and angiogenesis.

    DOI: 10.1111/jog.14958

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  • Evaluation of the clinical performance of noninvasive prenatal testing at a Japanese laboratory. International journal

    Yuna Sasaki, Takahiro Yamada, Shiro Tanaka, Akihiko Sekizawa, Tatsuko Hirose, Nobuhiro Suzumori, Takashi Kaji, Satoshi Kawaguchi, Yasuyuki Hasuo, Haruki Nishizawa, Keiichi Matsubara, Haruka Hamanoue, Akimune Fukushima, Masayuki Endo, Masayuki Yamaguchi, Yoshimasa Kamei, Hideaki Sawai, Kiyonori Miura, Masaki Ogawa, Shinya Tairaku, Hiroaki Nakamura, Ayako Sanui, Masahito Mizuuchi, Yoko Okamoto, Michihiro Kitagawa, Yukie Kawano, Hisashi Masuyama, Jun Murotsuki, Hisao Osada, Ryuhei Kurashina, Osamu Samura, Mayuko Ichikawa, Rumi Sasaki, Kazuhisa Maeda, Yasuyo Kasai, Tomomi Yamazaki, Reiko Neki, Naoki Hamajima, Yukiko Katagiri, Shunichiro Izumi, Setsuko Nakayama, Norio Miharu, Yuko Yokohama, Masaya Hirose, Kosuke Kawakami, Kiyotake Ichizuka, Masakatsu Sase, Kohei Sugimoto, Takeshi Nagamatsu, Tomomi Shiga, Lena Tashima, Takeshi Taketani, Mariko Matsumoto, Hironori Hamada, Takafumi Watanabe, Tetsuya Okazaki, Sadahiko Iwamoto, Daisuke Katsura, Nobuo Ikenoue, Toshiyuki Kakinuma, Hiromi Hamada, Makiko Egawa, Atsushi Kasamatsu, Akinori Ida, Naohiko Kuno, Naoaki Kuji, Mika Ito, Hiroko Morisaki, Shinji Tanigaki, Hiromi Hayakawa, Akinori Miki, Shoko Sasaki, Makoto Saito, Naoki Yamada, Toshiyuki Sasagawa, Toshitaka Tanaka, Fumiki Hirahara, Shinji Kosugi, Haruhiko Sago

    The journal of obstetrics and gynaecology research   47 ( 10 )   3437 - 3446   2021.10

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    AIM: We aimed to evaluate the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of noninvasive prenatal testing (NIPT) in high-risk pregnant women. METHODS: Pregnant women who underwent GeneTech NIPT, the most commonly used NIPT in Japan, between January 2015 and March 2019, at Japan NIPT Consortium medical sites were recruited for this study. The exclusion criteria were as follows: pregnant women with missing survey items, multiple pregnancy/vanishing twins, chromosomal abnormalities in the fetus other than the NIPT target disease, and nonreportable NIPT results. Sensitivity and specificity were calculated from the obtained data, and maternal age-specific PPV and NPV were estimated. RESULTS: Of the 45 504 cases, 44 263 cases fulfilling the study criteria were included. The mean maternal age and gestational weeks at the time of procedure were 38.5 years and 13.1 weeks, respectively. Sensitivities were 99.78% (95% confidence interval [95% CI]: 98.78-99.96), 99.12% (95% CI: 96.83-99.76), and 100% (95% CI: 88.30-100) for trisomies 21, 18, and 13, respectively. Specificities were more than 99.9% for trisomies 21, 18, and 13, respectively. Maternal age-specific PPVs were more than 93%, 77%, and 43% at the age of 35 years for trisomies 21, 18, and 13, respectively. CONCLUSION: The GeneTech NIPT data showed high sensitivity and specificity in the detection of fetal trisomies 21, 18, and 13 in high-risk pregnant women, and maternal age-specific PPVs were obtained. These results could provide more accurate and improved information regarding NIPT for genetic counseling in Japan.

    DOI: 10.1111/jog.14954

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  • 当院における無痛分娩についての検討

    坂田 周治郎, 谷 和祐, 三苫 智裕, 横畑 理美, 三島 桜子, 大平 安希子, 牧 尉太, 衛藤 英理子, 早田 桂, 増山 寿

    現代産婦人科   69 ( Suppl. )   S74 - S74   2021.9

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  • 高齢者に発症した排尿障害を伴う会陰癒着症の1例

    西田 康平, 岡本 和浩, 入江 恭平, 松岡 敬典, 依田 尚之, 小川 千加子, 中村 圭一郎, 増山 寿

    現代産婦人科   69 ( Suppl. )   S83 - S83   2021.9

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  • 月経直後の子宮ファイバースコピー所見と病理組織学的な慢性子宮内膜炎診断との関連

    澤井 雄大, 光井 崇, 樫野 千明, 久保 光太郎, 長谷川 徹, 鎌田 泰彦, 中塚 幹也, 増山 寿

    現代産婦人科   69 ( Suppl. )   S86 - S87   2021.9

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  • 妊娠高血圧症候群の母体より出生した児の3歳までの身体発育の調査 SGA児の発育への影響因子の検討

    光井 崇, 三島 桜子, 谷 和祐, 増山 寿

    現代産婦人科   69 ( Suppl. )   S26 - S26   2021.9

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  • 母体骨形成不全症合併妊娠の1症例

    谷岡 桃子, 樫野 千明, 横畑 理美, 久保 光太郎, 長谷川 徹, 光井 崇, 衛藤 英理子, 鎌田 泰彦, 中塚 幹也, 増山 寿

    現代産婦人科   69 ( Suppl. )   S64 - S65   2021.9

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  • 産科危機的出血搬送例に救急外来で緊急大動脈内バルーン遮断を使用し救命し得た2症例

    栗山 千晶, 牧 尉太, 三苫 智裕, 横畑 理美, 三島 桜子, 大平 安希子, 谷 和祐, 衛藤 英理子, 早田 桂, 増山 寿

    現代産婦人科   69 ( Suppl. )   S48 - S48   2021.9

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  • MSI-Highを有する再発子宮体癌に対してペムブロリズマブを使用し、髄膜脳炎を発症した一例

    長谷井 稜子, 松岡 敬典, 入江 恭平, 岡本 和浩, 依田 尚之, 小川 千加子, 中村 圭一郎, 増山 寿

    現代産婦人科   69 ( Suppl. )   S54 - S54   2021.9

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  • 死戦期帝王切開 死戦期帝王切開を院内で考える時代の到来 PMCDシミュレーションの有用性

    谷 和祐, 三苫 智裕, 横畑 理美, 三島 桜子, 大平 安希子, 牧 尉太, 衛藤 英理子, 早田 桂, 増山 寿

    現代産婦人科   69 ( Suppl. )   S39 - S39   2021.9

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  • 帝王切開に起因する合併症の軽減に向けて 帝王切開創部菲薄化を回避するために

    増山 寿

    現代産婦人科   69 ( Suppl. )   S40 - S40   2021.9

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  • がんゲノム入門 がんゲノムプロファイリング検査を行うために必要な知識と実例

    小川 千加子, 入江 恭平, 岡本 和浩, 松岡 敬典, 依田 尚之, 中村 圭一郎, 増山 寿

    現代産婦人科   69 ( Suppl. )   S29 - S29   2021.9

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  • 災害医療 妊産婦緊急搬送システム"iPicss"を用いた情報収集の有用性 被災時の連携体制構築と災害想定訓練

    牧 尉太, 増山 寿

    現代産婦人科   69 ( Suppl. )   S34 - S34   2021.9

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  • Kidney cyst infection through a fistula between bladder and retroperitoneal abscess in a polycystic kidney disease patient. International journal

    Takato Nakadoi, Kenji Tsuji, Takehiro Iwata, Eriko Eto, Hisashi Masuyama, Koji Tomita, Takao Hiraki, Shinji Kitamura, Hitoshi Sugiyama, Jun Wada

    Nephrology (Carlton, Vic.)   2021.8

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    DOI: 10.1111/nep.13966

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  • A randomized phase 3 trial evaluating antithrombin gamma treatment in Japanese patients with early-onset severe preeclampsia (KOUNO-TORI study): Study protocol. International journal

    Shigeru Saito, Kenichi Takagi, Junji Moriya, Takao Kobayashi, Naohiro Kanayama, Hiroshi Sameshima, Mamoru Morikawa, Haruhiko Sago, Tomoko Adachi, Akihide Ohkuchi, Satoru Takeda, Hisashi Masuyama, Hiroyuki Seki

    Contemporary clinical trials   107   106490 - 106490   2021.8

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    INTRODUCTION: Preeclampsia is a leading cause of maternal and perinatal morbidity and mortality. Several studies have demonstrated the beneficial effects of antithrombin replacement in patients with preeclampsia. Here, we describe the study protocol of KOUNO-TORI (KW-3357 randOmized, mUlti-center, double-bliNd, placebO-controlled phase 3 sTudy in patients with early Onset pReeclampsIa) to evaluate recombinant human antithrombin gamma (rhAT-gamma) for the treatment of early-onset severe de novo preeclampsia. MATERIAL AND METHODS: Patients with early-onset severe de novo preeclampsia who are ≥24 to <32 weeks pregnant at the time of registration and have an antithrombin activity of ≤100% at screening are included. The target population is selected based on a reanalysis of the data of a previous plasma-derived antithrombin phase 3 study. Primary endpoint is the prolongation of pregnancy from the initiation of rhAT-gamma treatment to the pregnancy termination. Secondary endpoints include gestational age in terms of achievement of 32- and 34-weeks'gestation, and gestational age in terms of achievement of 28 weeks' gestation for patients enrolled at <28 weeks' gestation. Maternal, fetal, and neonatal outcomes will be assessed. DISCUSSION: As we have selected a specifically defined target population based on reanalysis of data of a previous plasma-derived antithrombin phase 3 study, the results of our study are expected to provide efficacy and safety data concerning rhAT-gamma treatment in Japanese patients. This study could help identify an effective novel treatment for such patients with early-onset severe preeclampsia for whom appropriate treatment is unavailable.

    DOI: 10.1016/j.cct.2021.106490

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  • Clinical Course of 60 Cesarean Scar Pregnancies.

    Takashi Mitsui, Sakurako Mishima, Kazumasa Tani, Jota Maki, Eriko Eto, Kei Hayata, Hisashi Masuyama

    Acta medica Okayama   75 ( 4 )   439 - 445   2021.8

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    Early diagnosis and therapy are important in a cesarean scar pregnancy (CSP), which can cause uterine rupture with resultant massive bleeding. However, there are some reports of CSPs continued to term. The optimal management of CSPs remains unclear; therefore, we investigated the clinical courses of CSPs diagnosed and treated at perinatal institutions in the Chugoku and Shikoku regions of Japan. We enrolled 60 women diag-nosed with CSP at 21 institutions from January 2006 to December 2015. Of the 60 women diagnosed with CSP, 57 were treated. Pregnancy was terminated in 48 women and continued in 9. Thirteen women underwent transabdominal hysterectomy; they experienced no postoperative complications or allogeneic blood transfu-sion. Nine women received therapies such as dilation and curettage, and 26 received non-surgical therapies such as methotrexate and topical administration of potassium chloride. Among 9 women who chose to con-tinue with their CSP, 7 successfully delivered newborns, 2 had uterine ruptures in the second trimester, and all women required transabdominal hysterectomy. Diagnosis and therapy in the first trimester of pregnancy are important in the management strategy of a CSP. When continuing a CSP, the risk of uterine rupture and trans-abdominal hysterectomy must be considered.

    DOI: 10.18926/AMO/62395

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  • The Spiral Trial: A multicenter, randomized, controlled trial of Spiral thread sutures versus conventional thread sutures to prevent thinning of uterine scars following elective cesarean section. International journal

    Jota Maki, Hikari Nakatou, Kazumasa Tani, Eriko Eto, Kei Hayata, Dan Yamamoto, Kenji Kai, Takashi Tamada, Kazuyo Akamatsu, Kunihiro Kawanishi, Keiichiro Nakamura, Hisashi Masuyama

    Contemporary clinical trials   107   106449 - 106449   2021.8

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    BACKGROUND: The aim of this randomized controlled trial (RCT) is to investigate whether Spiral-thread sutures are superior to conventional sutures (0-Vicryl) for preventing uterine scar thinning following elective cesarean section. METHODS: This multicenter, parallel-group RCT will be conducted in four hospitals across three medical regions in Japan to assess 200 women (≥20 years old) with singleton pregnancies who are scheduled to undergo cesarean sections. Eligible women will be randomly assigned (1:1 ratio) to receive either the conventional uterine suture continuous absorption thread, which is most commonly used in Japan, or the Spiral thread. The primary endpoint is the degree of scar thinning, measured by transvaginal ultrasonography 6-7 months postoperatively, to evaluate the position of the uterus (anterior or posterior tilt) and myometrial wound thickness. The degree of thinning will be compared between the groups, and four measurements (mm) of the thinning area, including caudal distance, depth of the depression, remaining thickness of the myometrium on the serous side of the most depressed area, and width of the depression, will be recorded in the sagittal view on transvaginal ultrasound. Secondary endpoints will include total operative time, suture application time (from birth to the end of uterine suturing), operative blood loss, number of additional Z-sutures or continuous sutures required to stop bleeding, maternal abnormality frequency (surgical complications and postoperative infections), surgeon's years of experience, and clinical interpretation of individual subscale scores. DISCUSSION: This study shall provide important evidence on the optimal suture for preventing hysterotomy wound thinning after the first cesarean section. TRIAL REGISTRATION: National Institute of Public Health, Japan: jRCT1062200001 (May 7, 2020; https://rctportal.niph.go.jp/en/detail?trial_id=jRCT1062200001) and Okayama University Certified Review Board: CRB6180001 (April 9, 2020, version 3.0).

    DOI: 10.1016/j.cct.2021.106449

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  • 【専攻医必携! 術中・術後トラブル対処法-予期せぬ合併症で慌てないために】産科編 帝王切開術

    増山 寿, 早田 桂

    臨床婦人科産科   75 ( 7 )   620 - 626   2021.7

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    <文献概要>●綿密な術前診察・検査にてリスク評価を行い,想定されるさまざまな状況に備えて対処法を熟知し,さらに次の手を考えておくことが重要である.●日頃から迅速,確実な手術手技を目指したトレーニングと周術期の評価および管理に習熟し,手術ごとに振り返り,考え,研鑽を積んでいくことが手術上達のコツである.

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  • Short-term prediction of preeclampsia using the sFlt-1/PlGF ratio: a subanalysis of pregnant Japanese women from the PROGNOSIS Asia study. International journal

    Akihide Ohkuchi, Shigeru Saito, Tatsuo Yamamoto, Hisanori Minakami, Hisashi Masuyama, Keiichi Kumasawa, Jun Yoshimatsu, Takeshi Nagamatsu, Angela Dietl, Sonja Grill, Martin Hund

    Hypertension research : official journal of the Japanese Society of Hypertension   44 ( 7 )   813 - 821   2021.7

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    Two prospective multicenter studies demonstrated that a soluble fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio cutoff of ≤38 can rule out preeclampsia within 1 week with a negative predictive value (NPV) of 99.3% (PROGNOSIS) and 98.6% (PROGNOSIS Asia). We report a subanalysis of the Japanese cohort from the PROGNOSIS Asia study. Pregnant women with suspected preeclampsia between gestational weeks 18 + 0 days and 36 + 6 days were enrolled at eight Japanese sites. Primary objectives: Assess the performance of the Elecsys® sFlt-1/PlGF ratio cutoff ≤38 to rule out preeclampsia within 1 week and of the cutoff >38 to rule in preeclampsia within 4 weeks. Key secondary objectives: Prediction of maternal and fetal adverse outcomes (MAOs/FAOs) and their relationship with duration of pregnancy. Of 192 women enrolled, 180 (93.8%)/175 (91.1%) were evaluable for primary/combined endpoint analyses. Overall preeclampsia prevalence was 13.3%. A sFlt-1/PlGF ratio of ≤38 provided an NPV of 100% (95% confidence interval [CI], 97.5-100) for ruling out preeclampsia within 1 week, and a ratio of >38 provided a positive predictive value of 32.4% (95% CI, 18.0-49.8) for ruling in preeclampsia within 4 weeks. The area under the curve for the prediction of preeclampsia/maternal/fetal adverse outcomes within 1 week was 94.2% (95% CI, 89.3-97.8). After adjusting for gestational age and final preeclampsia status, Cox regression indicated a 2.8-fold greater risk of imminent delivery for women with a sFlt-1/PlGF ratio >38 versus ≤38. This subanalysis of Japanese women with suspicion of preeclampsia showed high predictive value for a Elecsys sFlt-1/PlGF ratio cutoff of 38 for short-term prediction of preeclampsia.

    DOI: 10.1038/s41440-021-00629-x

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  • 副鼻腔真菌症の内視鏡下鼻内副鼻腔手術後に改善を認めたアレルギー性気管支肺アスペルギルス症例

    荒井 秀寿, 増山 敬祐

    耳鼻咽喉科臨床   114 ( 7 )   527 - 532   2021.7

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    症例は59歳女性で、アレルギー性気管支肺アスペルギルス症の診断で経過観察中、膿性鼻漏や鼻閉が出現した。単純CTでは左上顎洞や篩骨洞、前頭洞に軟部陰影を認め、左肺舌区と右肺中葉S5末梢に新たな浸潤影が出現していた。血液検査では好酸球数増多と血清総IgE値の上昇を認め、特異的IgE抗体値はアスペルギルスを含む検査したすべての真菌陽性を示した。アレルギー性真菌性鼻副鼻腔炎の疑いで内視鏡下鼻内副鼻腔手術(ESS)を施行し、病理組織検査所見でアスペルギルスによる慢性非浸潤性副鼻腔真菌症と診断した。ESSの1週間後の胸部CTで両側肺野の浸潤影は縮小し、血液検査でも好酸球数・血清総IgE値も低下傾向を認め、イトラコナゾール内服治療を開始した。ESSの1年後の胸部CTで浸潤影は改善傾向にあり、好酸球数・血清総IgE値もさらに低下し、ステロイド内服治療を追加することなく経過している。

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  • Economic evaluation of the sFlt-1/PlGF ratio for the short-term prediction of preeclampsia in a Japanese cohort of the PROGNOSIS Asia study. International journal

    Akihide Ohkuchi, Hisashi Masuyama, Tatsuo Yamamoto, Takashi Kikuchi, Naoko Taguchi, Cyrill Wolf, Shigeru Saito

    Hypertension research : official journal of the Japanese Society of Hypertension   44 ( 7 )   822 - 829   2021.7

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    The PRediction of short-term Outcomes in preGNant wOmen with Suspected preeclampsIa Study (PROGNOSIS) Asia validated the use of the soluble fms-like tyrosine 1/placental growth factor (sFlt-1/PlGF) ratio cutoff value of ≤38 to rule out the occurrence of preeclampsia in the short term in Asian women. We assessed the economic impact of the introduction of the sFlt-1/PlGF ratio test for predicting preeclampsia in Japan using data from the Japanese cohort of PROGNOSIS Asia. The cost analysis was developed with estimates in either a no-test scenario, with clinical decisions based on standard diagnostic procedures alone, or a test scenario, in which the sFlt-1/PlGF ratio test was used in addition to standard diagnostic procedures. For both scenarios, rates of hospitalization and other test characteristics were obtained from the results for the Japanese cohort in PROGNOSIS Asia. The total cost per patient was the main outcome of this cost analysis model. Introduction of the sFlt-1/PlGF ratio test using a cutoff value of 38 resulted in a reduced hospitalization rate compared with the rate in the no-test scenario (14.4% versus 8.7%). The reduction in the rate of hospitalizations led to an estimated 16 373 JPY reduction in healthcare costs per patient. The sFlt-1/PlGF ratio test is likely to reduce the unnecessary hospitalization of women at low risk of developing preeclampsia in the short term while also identifying high-risk individuals requiring appropriate management. Reducing unnecessary hospitalizations would result in significant cost savings in the Japanese healthcare system.

    DOI: 10.1038/s41440-021-00624-2

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  • Involvement of BMP-15 in glucocorticoid actions on ovarian steroidogenesis by rat granulosa cells. International journal

    Chiaki Kashino, Toru Hasegawa, Yasuhiro Nakano, Nahoko Iwata, Koichiro Yamamoto, Yasuhiko Kamada, Hisashi Masuyama, Fumio Otsuka

    Biochemical and biophysical research communications   559   56 - 61   2021.6

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    To elucidate the impact of glucocorticoids on ovarian steroidogenesis and its molecular mechanism by focusing on bone morphogenetic proteins (BMPs), we examined the effect of dexamethasone (Dex) on estradiol and progesterone synthesis by using primary culture of rat granulosa cells. It was revealed that Dex treatment dose-dependently decreased estradiol production but increased progesterone production induced by follicle-stimulating hormone (FSH) by granulosa cells. In accordance with the effects of Dex on estradiol synthesis, Dex suppressed P450arom mRNA expression and cAMP synthesis induced by FSH. Dex treatment in turn enhanced basal as well as FSH-induced levels of mRNAs encoding the enzymes for progesterone synthesis including P450scc and 3βHSD but not StAR and 20αHSD. Of note, Dex treatment significantly upregulated transcription of the BMP target gene Id-1 and Smad1/5/9 phosphorylation in the presence of BMP-15 among the key ovarian BMP ligands. It was also found that Dex treatment increased the expression level of BMP type-I receptor ALK-6 among the type-I and -II receptors for BMP-15. Inhibitory Smad6/7 expression was not affected by Dex treatment. On the other hand, BMP-15 treatment upregulated glucocorticoid receptor (GR) expression in granulosa cells. Collectively, it was revealed that glucocorticoids elicit differential effects on ovarian steroidogenesis, in which GR and BMP-15 actions are mutually enhanced in granulosa cells.

    DOI: 10.1016/j.bbrc.2021.04.085

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  • 当院における多職種連携死戦期帝王切開シミュレーションの実際

    谷 和祐, 横畑 理美, 三苫 智裕, 三島 桜子, 大平 安希子, 牧 尉太, 衛藤 英理子, 早田 桂, 増山 寿

    日本周産期・新生児医学会雑誌   57 ( Suppl. )   P267 - P267   2021.6

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  • 骨形成不全症合併妊娠の一例

    横畑 理美, 衛藤 英理子, 三苫 智裕, 三島 桜子, 大平 安希子, 谷 和祐, 牧 尉太, 早田 桂, 増山 寿

    日本周産期・新生児医学会雑誌   57 ( Suppl. )   P243 - P243   2021.6

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  • 院内発症の死戦期帝王切開と院外発症の死戦期帝王切開を経験して

    三苫 智裕, 早田 桂, 横畑 理美, 三島 桜子, 大平 安希子, 谷 和祐, 牧 尉太, 光井 崇, 衛藤 英理子, 増山 寿

    日本周産期・新生児医学会雑誌   57 ( Suppl. )   P267 - P267   2021.6

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  • 妊娠高血圧症候群の母体より出生したSGA児のcatch-upに影響する因子

    三島 桜子, 光井 崇, 三苫 智裕, 横畑 理美, 大平 安希子, 谷 和祐, 牧 尉太, 衛藤 英理子, 早田 桂, 鷲尾 洋介, 吉本 順子, 塚原 宏一, 増山 寿

    日本周産期・新生児医学会雑誌   57 ( Suppl. )   P218 - P218   2021.6

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  • 広汎子宮頸部摘出術から10年の経過で妊娠し、産後に晩期再発した一例

    石橋 めぐみ, 花岡 有為子, 鎌田 恭輔, 香西 亜優美, 山本 健太, 天雲 千晶, 伊藤 恵, 新田 絵美子, 森 信博, 田中 宏和, 金西 賢治, 光井 崇, 増山 寿

    日本周産期・新生児医学会雑誌   57 ( Suppl. )   P237 - P237   2021.6

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  • 妊娠高血圧症の母親から生まれた児における3歳の肥満有病率および関連リスク因子

    光井 崇, 谷 和祐, 三島 桜子, 鷲尾 洋介, 吉本 順子, 塚原 宏一, 増山 寿

    日本周産期・新生児医学会雑誌   57 ( Suppl. )   P158 - P158   2021.6

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  • 分娩後出血時のダイナミック造影CTは治療選択に必要不可欠である

    早田 桂, 三苫 智裕, 横畑 理美, 三島 桜子, 大平 安希子, 谷 和祐, 牧 尉太, 衛藤 英理子, 増山 寿

    日本周産期・新生児医学会雑誌   57 ( Suppl. )   P209 - P209   2021.6

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  • COVID-19 周産期緊急搬送システム"iPicss"を用いた救急隊と搬送連携/災害発生後やCOVID-19妊婦の連携体制の構築

    牧 尉太, 三苫 智裕, 横畑 理美, 三島 桜子, 大平 安希子, 谷 和祐, 衛藤 英理子, 早田 桂, 増山 寿

    日本周産期・新生児医学会雑誌   57 ( Suppl. )   P110 - P110   2021.6

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  • 妊娠中の母体体組成量および安静時代謝量の変化と出生児体重の関係

    衛藤 英理子, 三苫 智裕, 横畑 理美, 三島 桜子, 大平 安希子, 谷 和祐, 牧 尉太, 早田 桂, 増山 寿

    日本周産期・新生児医学会雑誌   57 ( Suppl. )   P153 - P153   2021.6

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  • 胎児超音波スクリーニングで検出された動脈管走行異常の1例

    許 春花, 福本 悟, 赤松 信雄, 黒崎 智美, 福本 俊, 田中 友美, 増山 寿

    現代産婦人科   69 ( 2 )   183 - 186   2021.6

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    妊娠20週の超音波スクリーニングで走行不明な動脈管を経験した。その後の精査により、大動脈弓の右背側に回り反転することが判明した。下行大動脈との結合部は通常位置であるが、やや右よりであった。妊娠経過異常なく、出生2日目で血流は消失した。妊娠後半で動脈管の蛇行を確認することは多いが、このような極端な症例の報告は見られない。心エコー施行時、かかるvariationがあることは留意されるべきものと思われる。(著者抄録)

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  • 過去10年間に37週以降で分娩となった母体における低出生体重児のリスク因子の変遷

    假谷 奈生子, 光井 崇, 三島 桜子, 大平 安希子, 谷 和祐, 牧 尉太, 衛藤 英理子, 早田 桂, 増山 寿

    現代産婦人科   69 ( 2 )   213 - 218   2021.6

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    【目的】当院では妊娠37週以降の低出生体重児の出生率が増加傾向である。そこで当院の妊娠37週以降に低出生体重児を分娩した母体のリスク因子を検討し、その増加の原因を明らかとすることを目的とした。【方法】2009年から2018年に当院で妊娠37週以降に低出生体重児を分娩した妊婦223例を対象とし、母体や出生児の情報および母体のリスク因子を後方視的に検討した。低出生体重児の増加の原因を、2009年から2013年の5年間(前期群)と2014年から2018年の5年間(後期群)に分類し検討した。また、light-for-date(LFD)およびsmall-for-date(SFD)のみでの検討も行った。本研究は、当院の倫理委員会の承認を得て行った。【結果】2009年から2018年に当院で妊娠37週以降に低出生体重児を分娩した223例のリスク因子を検討した結果、妊娠中の体重増加不良が99例(44.4%)と最も多く、次に母体年齢35歳以上が73例(32.7%)、非妊娠時BMI18.5未満が64例(28.7%)の順に多かった。年代別に比較検討した結果、前期群に比較し、後期群ではLFDが28例(30.7%)から65例(49.2%)、SFDが18例(19.8%)から32例(24.2%)と増加していた。リスク因子に関しては、いずれも妊娠中の体重増加不良、母体年齢35歳以上、非妊娠時BMI18.5未満の順に多く、過去10年間と同様の傾向を認めた。しかし、SFDを分娩した母体のみでリスク因子を検討すると、前期群と比較して後期群では妊娠中の体重増加不良を有する妊婦の有意な増加を認めた。【結論】当院の過去10年間における妊娠37週以降の低出生体重児を出産した母体のリスク因子として、やせや妊娠中の体重増加不良、高齢出産の妊婦が多かった。これらを改善するため、妊娠出産適齢期の女性の妊娠前からの体重管理や妊娠中の適切な体重増加を指導する必要があると考えられる。(著者抄録)

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  • 完全子宮脱合併妊娠の経腟分娩の経験 頸管裂傷の縫合治癒課程の詳細

    牧 尉太, 早田 桂, 三島 桜子, 谷 和祐, 衛藤 英理子, 増山 寿

    産婦人科手術   ( 32 )   147 - 147   2021.6

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  • hCG values and gestational sac size as indicators of successful systemic methotrexate treatment in cesarean scar pregnancy. International journal

    Takashi Mitsui, Sakurako Mishima, Akiko Ohira, Kazumasa Tani, Jota Maki, Eriko Eto, Kei Hayata, Hisashi Masuyama

    Taiwanese journal of obstetrics & gynecology   60 ( 3 )   454 - 457   2021.5

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    OBJECTIVE: To retrospectively investigate cesarean scar pregnancy (CSP) patients who received systemic methotrexate (MTX) and to clarify the criteria for administering systemic MTX to CSP patients. MATERIALS AND METHODS: Fifteen CSP patients who were initially treated with systemic MTX (50 mg/m2/week) were included. Nine patients, who needed a uterine artery embolization (UAE) or a laparotomy, including a transabdominal hysterectomy (TAH), were defined as the unsuccessful MTX group. Six patients who did not require UAE or a laparotomy were defined as the successful MTX group. Furthermore, the hCG cut-off value and the GS cut-off size at the time of CSP diagnosis, which differentiated successful and unsuccessful patients, were defined. MTX success rates were investigated by combining the hCG and gestational sac (GS) size cut-off values. RESULTS: The hCG cut-off value was 17757.0 mIU/mL, and the GS cut-off size was 10.4 mm. In patients with hCG values less than 17757.0 mIU/mL, the MTX success rate was 75.0%. Fewer patients needed UAE or a laparotomy compared to patients with hCG values higher than 17757.0 mIU/mL (P = 0.007). In patients with a GS size less than 10.4 mm, the MTX success rate was 80.0%. Fewer patients among them needed UAE or a laparotomy compared to those among patients with a GS size greater than 10.4 mm (P = 0.089). In patients with hCG values and GS sizes lower than the cut-off values, the MTX success rate was 80.0%. Fewer patients among them needed UAE or a laparotomy compared to those among patients with hCG values and/or GS sizes higher than the cut-off values, respectively (P = 0.010). CONCLUSION: Patients with hCG values less than 17757.0 mIU/mL and GS sizes less than 10.4 mm may have a greater chance of successful systemic MTX treatment when it is used as the first line of treatment for CSP.

    DOI: 10.1016/j.tjog.2021.03.011

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  • DNA mismatch repair deficiency and p53 abnormality are age-related events in mixed endometrial carcinoma with a clear cell component. International journal

    Naoyuki Ida, Keiichiro Nakamura, Masayuki Saijo, Atsuko Nasu, Tadashi Yoshino, Hisashi Masuyama, Hiroyuki Yanai

    Pathology, research and practice   220   153383 - 153383   2021.4

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    Mixed endometrial carcinoma (MEC) is defined as a tumor composed of two or more spatially distinct subtypes, at least one of which is serous or clear cell carcinoma. In this study, the clinicopathological features of 15 MEC cases containing a clear cell component (MEC-C) were investigated. The ages of patients ranged from 32 to 83 years (median, 61 years). The combinations of carcinoma components observed were endometrioid and clear cell in ten patients; endometrioid, clear cell and serous in three; and clear cell and serous in two. Immunohistochemically, nine had DNA mismatch repair (MMR) protein deficiency (MMR-d), nine had loss of ARID1A and three cases had aberrant p53 expression. MMR-d and loss of ARID1A showed a strong correlation. Only one case showed both MMR-d and aberrant p53 expression. The patients with MMR-d were younger than those without MMR-d (median; 58 years vs. 71 years). Loss of ARID1A also showed significant predilection for younger women than ARID1A intact cases. In conclusion, MMR-d was observed in 60 % of MEC-C, showed predilection for young women, and was associated with ARID1A loss. In contrast, non- MMR-d MEC-C occurred in elder women and some tumors may associate with TP53 mutation. These findings suggest that MEC-C develop via two different molecular mechanisms and they are age-related events.

    DOI: 10.1016/j.prp.2021.153383

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  • グルココルチコイドによる卵胞ステロイド合成調節とBMP分子の関与

    樫野 千明, 長谷川 徹, 中野 靖浩, 山本 紘一郎, 長尾 聡子, 岩田 菜穂子, 鎌田 泰彦, 増山 寿, 大塚 文男

    日本内分泌学会雑誌   96 ( 4 )   1076 - 1076   2021.4

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  • グルココルチコイドによる卵胞顆粒膜細胞のステロイド合成調節とBMP-15の関与

    樫野 千明, 長谷川 徹, 中野 靖浩, 岩田 菜穂子, 山本 紘一郎, 鎌田 泰彦, 増山 寿, 大塚 文男

    日本内分泌学会雑誌   97 ( 1 )   359 - 359   2021.4

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  • 妊娠高血圧症候群up to date

    増山 寿

    日本周産期・新生児医学会雑誌   56 ( 4 )   642 - 644   2021.4

  • 視床下部性無月経と甲状腺機能低下症を呈した同胞例

    光井 崇, 楠元 理恵, 樫野 千明, 久保 光太郎, 鎌田 泰彦, 増山 寿

    日本内分泌学会雑誌   97 ( 1 )   362 - 362   2021.4

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  • BRAF変異大腸癌における臨床病理学的特徴と発癌経路に関する検討

    加藤 寿一, 馬場 正道, 中島 晋, 増山 守, 重松 忠, 森谷 鈴子, 九嶋 亮治

    日本病理学会会誌   110 ( 1 )   306 - 307   2021.3

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  • Trabectedinの血管外漏出により重篤な皮膚障害を生じた1例

    依田 尚之, 中村 圭一郎, 松岡 敬典, 原賀 順子, 春間 朋子, 小川 千加子, 増山 寿

    日本婦人科腫瘍学会雑誌   39 ( 1 )   372 - 372   2021.1

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  • エストロゲン症状を伴う巨大多房性嚢胞腫瘤として発見された輪状細管を伴う性索腫瘍の一例

    春間 朋子, 角南 華子, 松岡 敬典, 依田 尚之, 原賀 順子, 小川 千加子, 中村 圭一郎, 柳井 広之, 増山 寿

    日本婦人科腫瘍学会雑誌   39 ( 1 )   424 - 424   2021.1

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  • 子宮頸癌サバイバーにおける治療後筋肉・脂肪量変化の検討

    坂井 裕樹, 中村 圭一郎, 松岡 敬典, 依田 尚之, 原賀 順子, 久保 光太郎, 春間 朋子, 小川 千加子, 鎌田 泰彦, 増山 寿

    日本婦人科腫瘍学会雑誌   39 ( 1 )   348 - 348   2021.1

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  • 【新 経腟分娩を成功させる29の提言】筋腫核出術後

    増山 寿

    周産期医学   51 ( 1 )   97 - 100   2021.1

  • 放射線治療患者におけるShear Wave Elastography超音波を用いた腫瘍硬度の検討

    松岡 敬典, 中村 圭一郎, 坂井 裕樹, 依田 尚之, 原賀 順子, 久保 光太郎, 春間 朋子, 小川 千加子, 鎌田 泰彦, 増山 寿

    日本婦人科腫瘍学会雑誌   39 ( 1 )   346 - 346   2021.1

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  • 【助産力アップ!周産期のガイドライン 深掘りドリル200問『産婦人科診療ガイドライン:産科編2020』に準拠 難易度別助産ケア&最新エビデンスが満載!】(第1章)妊娠期 妊娠糖尿病『妊婦の糖代謝異常 診療・管理マニュアル』より出題

    牧 尉太, 増山 寿

    ペリネイタルケア   ( 2021新春増刊 )   89 - 102   2021.1

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  • The assessment of the fetal heart function using two-dimensional speckle tracking with a high frame rate. International journal

    Akiko Ohira, Kei Hayata, Sakurako Mishima, Kazumasa Tani, Jota Maki, Takashi Mitsui, Eriko Eto, Hisashi Masuyama

    Early human development   151   105160 - 105160   2020.12

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    BACKGROUND: Two-dimensional (2D) speckle tracking echography (STE) is a new diagnostic modality that allows for the assessment of myocardial deformation. The present study assessed the feasibility of fetal 2D-STE at a high frame rate and determined the reference values for left ventricular (LV)- and right ventricular (RV)- global longitudinal strain (GLS). METHODS: In this prospective study, 109 fetuses with gestational ages ranging from 18 to 38 weeks underwent 2D echocardiography between August 2018 and December 2019. All recordings were performed using the Aplio i800 (CANON Medical Systems Corporation, Tochigi, Japan) and a convex probe (4 MHz) for fetuses. RESULTS: Longitudinal peak systolic strain measurements were obtained in 98 of 109 healthy fetuses (90%). All ultrasound videos were recorded with a median frame rate of 172 (range, 100-274) frames/s. The LV-GLS was almost constant, regardless of the number of weeks since the second trimester (r = -0.0087, p = ns). The RV-GLS decreased significantly with gestational age (r = 0.39, p < 0.01). CONCLUSIONS: STE may be useful for quantifying the systolic myocardial function in a fetus.

    DOI: 10.1016/j.earlhumdev.2020.105160

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  • 内視鏡下副鼻腔手術後に改善したアレルギー性気管支肺アスペルギルス症の1例

    荒井 秀寿, 増山 敬祐

    耳鼻咽喉科臨床 補冊   ( 補冊155 )   127 - 127   2020.12

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  • 【周産期の薬】産科編 疾患に対する薬剤の選び方・使い方・注意点 妊娠中のマイナートラブル 花粉症

    増山 寿, 三島 桜子

    周産期医学   50 ( 増刊 )   254 - 257   2020.12

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  • 子宮頸癌サバイバーにおける治療後筋肉・脂肪面積変化の検討

    坂井 裕樹, 中村 圭一郎, 松岡 敬典, 依田 尚之, 原賀 順子, 久保 光太郎, 春間 朋子, 小川 千加子, 増山 寿

    現代産婦人科   69 ( 1 )   11 - 17   2020.12

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    癌治療の発展によりがんサバイバーが増え、治療後の生活の質がますます重要になっている。そこで今回、子宮頸癌治療後における経時的な身体的変化を着目し、検討した。当科で広汎性子宮全摘術及び同時化学放射線治療(concurrent chemoradiotherapy:CCRT)を行った子宮頸癌患者27名を対象とし、治療前後(治療前、治療直後、治療後1年、治療後3年、治療後5年)のCT画像を用いて、第三腰椎レベルの骨格筋面積(skeletal muscle index:SMI)、腸腰筋面積(iliopsoas muscle index:IMI)、皮下脂肪面積(subcutaneous fat mass index:SFMI)、内臓脂肪面積(visceral fat mass index:VFMI)を計測し、経時的変化を検討した。治療前平均SMI、IMI、SFMI、VFMIは35.56±3.61、3.67±0.76、51.56±19.76、34.88±17.89cm2/m2であった。治療後、筋肉・脂肪面積が20%以上減少した症例は治療直後ではIMI 3例(11.1%)、SFMI 4例(14.8%)、VFMI 12例(44.4%)、治療後1年IMI 2例(7.4%)、SFMI 9例(33.3%)、VFMI 11例(40.7%)、治療後3年IMI 3例(11.1%)、SFMI 3例(11.1%)、VFMI 7例(25.9%)、治療後5年IMI 6例(22.2%)、SFMI 6例(22.2%)、VFMI 8例(29.6%)であった。治療後における筋肉・脂肪面積変化は下肢リンパ浮腫や消化管・排尿障害の有害事象と関連はなく、治療後生活向上に向け、さらなる身体・精神面の解明が必要である。(著者抄録)

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  • 【不妊・不育症女性の合併症・併存疾患をどう扱う?】やせ,肥満

    増山 寿

    産婦人科の実際   69 ( 13 )   1615 - 1621   2020.12

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    <文献概要>わが国における妊娠可能年齢の女性の体格は,やせの頻度が高止まりし,さらに高度肥満も増加傾向にある。また,平均出生体重は減少し,低出生体重児の割合が増加している。わが国でも妊娠前体格や妊娠中の体重増加量が,胎児発育だけでなく周産期経過に大きく影響するといったデータが集積されてきた。やせでは,胎児発育不全,早産の頻度が高くなる。肥満では,胎児発育過剰や妊娠高血圧症候群,妊娠糖尿病の発症頻度が高くなる。さらに,母体栄養状態の不良による子宮内環境の悪化は,世代を超えて児の将来の様々な疾患の発症リスクにも深く関与していることが知られている。医療的介入のチャンスである不妊治療時のプレコンセプションケアは非常に重要である。

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    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J00535&link_issn=&doc_id=20201221180010&doc_link_id=10.18888%2Fsp.0000001569&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fsp.0000001569&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

  • 当院における子宮体癌に対する低侵襲手術の変遷

    久保 光太郎, 楠元 理恵, 依田 尚之, 岡本 和浩, 松岡 敬典, 春間 朋子, 小川 千加子, 中村 圭一郎, 増山 寿

    日本産科婦人科内視鏡学会雑誌   36 ( Suppl.I )   [O - 410]   2020.11

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  • 当院の早期子宮体がんにおける低侵襲手術の現況

    依田 尚之, 久保 光太郎, 岡本 和浩, 松岡 敬典, 春間 朋子, 小川 千加子, 中村 圭一郎, 増山 寿

    日本産科婦人科内視鏡学会雑誌   36 ( Suppl.I )   [O - 464]   2020.11

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  • 胎児心エコーを用いたストレイン値の基準値作成と、フレームレート数の必要性について

    大平 安希子, 早田 桂, 三島 桜子, 谷 和祐, 牧 尉太, 光井 崇, 衛藤 英理子, 増山 寿

    超音波医学   47 ( Suppl. )   S366 - S366   2020.11

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  • 当院での腹腔鏡併用卵管鏡下卵管形成術(FT)に関する検討

    楠元 理恵, 久保 光太郎, 樫野 千明, 鎌田 泰彦, 増山 寿

    日本産科婦人科内視鏡学会雑誌   36 ( Suppl.I )   [O - 274]   2020.11

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  • 胎児先天性心疾患症例への産科医、小児循環器科医の関わりと倫理的配慮

    衛藤 英理子, 三島 桜子, 大平 安希子, 谷 和祐, 牧 尉太, 光井 崇, 早田 桂, 増山 寿, 近藤 麻衣子, 馬場 健児

    超音波医学   47 ( Suppl. )   S363 - S363   2020.11

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  • 当院における血液疾患に対する妊孕性温存の現状

    樫野 千明, 楠元 理恵, 久保 光太郎, 光井 崇, 鎌田 泰彦, 中塚 幹也, 増山 寿

    日本生殖医学会雑誌   65 ( 4 )   343 - 343   2020.11

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  • 妊娠高血圧症候群up to date

    増山 寿

    日本周産期・新生児医学会雑誌   56 ( Suppl. )   48 - 48   2020.11

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  • アスピリン・ヘパリン療法中に深部静脈血栓を発症した抗リン脂質抗体症候群合併妊娠の1例

    久保 光太郎, 楠元 理恵, 樫野 千明, 光井 崇, 鎌田 泰彦, 中塚 幹也, 増山 寿

    日本生殖医学会雑誌   65 ( 4 )   310 - 310   2020.11

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  • リハビリテーション科における経営改善の取り組み(第2報) 目標設定等支援・管理料算定による減算回避へ

    松本 恭平, 村上 寿一, 内田 妥美, 坂本 一樹, 梶原 佳奈, 増山 信吾, 中川 恭兵, 平岡 香菜

    国立病院総合医学会講演抄録集   74回   P - 551   2020.10

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  • 治療法の再整理とアップデートのために 専門家による私の治療 異所性妊娠

    増山 寿

    日本医事新報   ( 5029 )   44 - 45   2020.9

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  • グルココルチコイドによる卵胞ステロイド合成への影響とBMPの関与

    樫野 千明, 長谷川 徹, 中野 靖浩, 長尾 聡子, 岩田 菜穂子, 鎌田 泰彦, 増山 寿, 大塚 文男

    日本内分泌学会雑誌   96 ( 1 )   376 - 376   2020.8

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  • 【[必携]専攻医と指導医のための産科診療到達目標】病態・疾患編【合併症妊娠】婦人科腫瘍 子宮筋腫

    増山 寿, 谷 和祐

    周産期医学   50 ( 8 )   1419 - 1421   2020.8

  • 多嚢胞性卵巣症候群患者のインスリン抵抗性と妊娠に関する検討

    衛藤 英理子, 樫野 千明, 三島 桜子, 大平 安希子, 谷 和祐, 牧 尉太, 玉田 祥子, 光井 崇, 早田 桂, 増山 寿

    糖尿病と妊娠   20 ( 2 )   S - 52   2020.8

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    多嚢胞性卵巣症候群(polycystic ovary syndrome:PCOS)は生殖年齢の約5%に認められる比較的多い疾患であり、インスリン抵抗性が病態の基盤である。当科で管理したPCOS患者163例を対象に、インスリン抵抗性、妊娠との関連を調べた。PCOS全体の34%が肥満であり、分娩に至った例でもその割合は同等であった。PCOS分娩例を肥満群(非妊時BMI≧25)23例と非肥満群(<25)45例に分けて比較検討すると、肥満群の方がインスリン抵抗性の指標は上昇しており、高コレステロール血症、脂質異常症も多かった。また周産期合併症の頻度も肥満群で高値であったPCOSと肥満どちらが母体の耐糖能や周産期予後に対する影響度が大きいか調べた結果、肥満はPCOSそのものよりもインスリン抵抗性、周産期合併症のリスクをさらに増大させる因子であった。PCOS肥満妊婦はハイリスク妊婦と認識すべきである。(著者抄録)

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  • Spiral糸による帝王切開創部の縫合 豚心臓子宮モデルシミュと92XXXX水頭症例の体部横切開での使用経験

    牧 尉太, 早田 桂, 大平 安希子, 谷 和祐, 光井 崇, 衛藤 英理子, 増山 寿

    産婦人科手術   ( 31 )   200 - 200   2020.8

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  • DOHaD update 肥満・耐糖能異常関連素因の世代間連鎖の解明

    増山 寿

    糖尿病と妊娠   20 ( 2 )   S - 27   2020.8

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    母体肥満は妊娠糖尿病や妊娠高血圧症候群などの妊娠合併症や胎児過剰発育に加えて、児成長後の肥満や糖尿病の発症リスクを増加させる。母体の妊娠合併症による子宮内環境の悪化が、胎児過剰栄養・過剰発育または栄養不足・発育不全をもたらし、ともに児の将来の肥満・生活習慣病発症リスクが上昇する。母体肥満による子宮内環境悪化はアディポサイトカイン遺伝子のエピゲノム変化を介して世代をこえて肥満・耐糖能異常発症リスク増加に深く関与すると考えられた。母親の授乳期過栄養や父親の栄養状態も相加的に影響する可能性が示唆された。母体に加えて、児の肥満・メタボリック症候群の発症予防に向けて、胎児期から成人期に到る継続的な管理による世代を越えたヘルスケアが求められている。(著者抄録)

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  • 処女膜閉鎖に対する術式として処女膜切除術(切開術)は必要十分か

    鎌田 泰彦, 樫野 千明, 久保 光太郎, 増山 寿

    産婦人科手術   ( 31 )   181 - 181   2020.8

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  • 当院でのロボット支援下子宮体癌手術の現況

    中村 圭一郎, 久保 光太郎, 原賀 順子, 松原 侑子, 松岡 敬典, 小川 千加子, 増山 寿

    産婦人科手術   ( 31 )   196 - 196   2020.8

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  • 若手産婦人科医が自信をもって子宮頸管縫縮術を行うために 予防的頸管縫縮術から緊急症例、TACまで

    早田 桂, 増山 寿

    産婦人科手術   ( 31 )   156 - 156   2020.8

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  • 産科医療補償制度に基づく原因分析により、新生児の脳性麻痺に起きた変化とは?【明確なデータはないが、発症件数は減少傾向にあると考えられる】

    下屋 浩一郎, 増山 寿

    日本医事新報   ( 5023 )   52 - 53   2020.8

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  • Invasive non-typeable Haemophilus influenzae infection due to endometritis associated with adenomyosis. International journal

    Yoshito Nishimura, Hideharu Hagiya, Kaoru Kawano, Yuya Yokota, Kosuke Oka, Koji Iio, Kou Hasegawa, Mikako Obika, Tomoko Haruma, Sawako Ono, Hisashi Masuyama, Fumio Otsuka

    BMC infectious diseases   20 ( 1 )   521 - 521   2020.7

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    BACKGROUND: The widespread administration of the Haemophilus influenzae type b vaccine has led to the predominance of non-typable H. influenzae (NTHi). However, the occurrence of invasive NTHi infection based on gynecologic diseases is still rare. CASE PRESENTATION: A 51-year-old Japanese woman with a history of adenomyoma presented with fever. Blood cultures and a vaginal discharge culture were positive with NTHi. With the high uptake in the uterus with 67Ga scintigraphy, she was diagnosed with invasive NTHi infection. In addition to antibiotic administrations, a total hysterectomy was performed. The pathological analysis found microabscess formations in adenomyosis. CONCLUSIONS: Although NTHi bacteremia consequent to a microabscess in adenomyosis is rare, this case emphasizes the need to consider the uterus as a potential source of infection in patients with underlying gynecological diseases, including an invasive NTHi infection with no known primary focus.

    DOI: 10.1186/s12879-020-05193-2

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  • Molecular Characterization of Second Primary Endometrial Cancer. International journal

    Junko Haraga, Keiichiro Nakamura, Tomoko Haruma, Akihiro Nyuya, Takeshi Nagasaka, Hisashi Masuyama

    Anticancer research   40 ( 7 )   3811 - 3818   2020.7

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    BACKGROUND/AIM: The objective of this study was to determine the molecular and clinicopathological features, as well as the prognosis of patients with endometrial cancer (EC) having prior malignancy (second primary EC: SPEC) compared with those without a history of prior malignancy (first primary EC: FPEC). MATERIALS AND METHODS: We enrolled 294 FPEC patients and 32 SPEC patients who had undergone surgical resection with curative intent. EC was divided into four groups according to Cancer Genome Atlas Research Network (TCGA) classification. RESULTS: SPEC patients having greater than a 10-year interval from prior malignancy had risk factors including type II histology, deeper myometrial invasion, cervical invasion, and copy number high (CNH) phenotype compared with patients having less than a 10-year interval (p=0.007, p=0.002, p=0.015 and p=0.001). CONCLUSION: SPEC patients having greater than a 10-year interval from prior malignancy possessed numerous high-risk factors for EC.

    DOI: 10.21873/anticanres.14370

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  • Seromucinous borderline tumorにおける術前検査所見の後方視的検討

    清水 かれん, 原賀 順子, 松原 侑子, 松岡 敬典, 小川 千加子, 中村 圭一郎, 増山 寿

    現代産婦人科   68 ( 2 )   239 - 244   2020.6

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    2014年6月に女性生殖器腫瘍のWHO分類第4版が刊行され、新たにseromucinous tumorという分類が加えられた。改訂後5年が経過し、しばしば症例を経験するが、術前診断は容易ではない。そこで、我々はseromucinous borderline tumor(SMBT)の術前診断における画像検査や血液検査の特徴を示すことを目的とし、検討を行った。方法は、2006年3月から2019年4月までに当院で手術を行い、病理組織診断でSMBT、もしくは2014年改定によりSMBTに包括されたmullerian mixed-epitherial borderline tumor、endocervical-like mucinous borderline tumorと診断された21例を対象とし、診療録を参照し後方視的に検討した。対象年齢の年齢は中央値49歳、病期はI期20例(95.2%)、III期1例(4.8%)であった。血清中CA125は中央値63.2U/mLであり、35U/mL以上の異常高値を示した例は13例(61.9%)であった。腫瘍径は中央値6.0cmであった。MRI所見では15例(71.4%)において嚢胞内容液はT1強調画像で高信号を示し、子宮内膜症の存在を反映していた。T2強調画像では充実部分の低信号のコアとその周囲の高信号がSMBTの特徴とされるが、その所見を認めたのは8例(38.1%)であった。造影効果については既存の報告と同様に、様々な造影強度であった。今回SMBT21例の画像所見を中心に検討を行ったが、一定の特徴はあるものの非典型例も多数認めた。術前診断の精度向上にはさらなる症例の蓄積が望まれる。(著者抄録)

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  • 当院の不育症患者に対するステロイド治療の検討

    久保 光太郎, 鎌田 泰彦, 樫野 千明, 中塚 幹也, 増山 寿

    現代産婦人科   68 ( 2 )   201 - 205   2020.6

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    【緒言】抗リン脂質抗体症候群など不育症の治療法として、現在は低用量アスピリンとヘパリンカルシウムの併用療法が主流となっている。しかしながら抗凝固療法だけでは流産を反復する難治性の症例も存在する。当院で施行している不育症患者に対するステロイド治療につき検討する。【対象】2008年4月から2018年12月までに当院不育症外来を受診し、妊娠中にプレドニゾロンの投与を行った60症例について倫理委員会の承認のもと後方視的に検討した。患者の背景、スクリーニング検査で施行した不育症リスク因子の検査、妊娠が成立した場合の妊娠予後や妊娠中の合併症、流産した場合の染色体異常の有無につき検討した。【結果】症例の年齢は36.7±4.0(mean±SD)歳、妊娠回数4.1±2.4回、流産回数3.6±2.5回、生児の数は0.30±0.5人であった。生化学妊娠は妊娠回数から除外した。妊娠予後として、妊娠経過が判明した51症例のうち、34症例は生児を得られた。17症例は流産となり、そのうち6症例には染色体異常を認めた。染色体異常を除いた全体の生児を得た率としては75.6%であった。また当院では治療方針としてのステロイドの内服量を妊娠前に決定しているが、プレドニゾロンの内服量として5mgと10mg、20mgの症例が存在した。それぞれの染色体異常による流産を除いた生児獲得率としては81.8%、71.4%、75.0%となった。全体として、1例に早産を認め、6例に妊娠糖尿病を認めた。【結語】抗凝固療法のみでは生児を得られていなかった症例においても、副腎皮質ステロイドを併用することで生児を得られており、不育症の患者に対するステロイド治療の有用性が示された。易感染性による切迫早産や、耐糖能異常などのリスクに注意して投与することが必要であるが、通常の治療法では流産を反復する難治性の症例などについては治療のステップアップとしてステロイド治療を提示することが可能と考えられる。(著者抄録)

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  • 5年8ヵ月間にわたる保存的管理を行った機能性子宮を有する腟欠損の1例

    鎌田 泰彦, 樫野 千明, 久保 光太郎, 酒本 あい, 衛藤 英理子, 平松 祐司, 増山 寿

    現代産婦人科   68 ( 2 )   133 - 138   2020.6

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    【緒言】機能性子宮を有する性分化疾患は、子宮および腟への月経血貯留を伴う周期的な下腹部痛を呈するため、診断後早期の治療介入が必要となる。しかし患者は若年で病状認識に乏しく、拙速な根治手術は術後管理の不備から容易に術後腟狭窄をもたらすため、その対応に苦慮することが多い。今回、5年8ヵ月間にわたる保存的管理を行なった後に根治手術(造腟術)を施行した腟欠損症例につき報告する。【症例】初診時12歳。2年前より腹痛を自覚していたが放置していた。腹痛の増強と嘔吐を主訴に前医を受診。月経モリミナの精査加療目的で、X年1月当院紹介された。2次性徴を認めるも初経未発来。MRI検査にて子宮体部から頸部にかけて7×5cmの血腫および腟欠損を認めた。両親同席のもとに治療方針について話し合い、保存的管理として偽妊娠療法による月経抑制をしながら定期的に穿刺排液術を施行し、可及的に根治手術を延期するという方針に同意された。入院の上、全身麻酔下に腟入口部より血腫を穿刺し、粘稠な血性内容を吸引除去した。以降は外来でエストロゲン・プロゲストーゲン配合剤による偽妊娠療法を施行し、症状は安定した。計画的な消退出血後の穿刺排液術を繰り返したが、下腹部痛のため、X+4年1月の穿刺排液術後からGnRHアゴニストによる偽閉経療法へと変更した。最終的に根治手術までに計8回の穿刺排液術を施行した。X+5年4月、大学進学と同時にダイレータによる腟入口部の自己圧迫法を開始し、X+5年9月に根治手術としてGranjon手術を施行した。腟は子宮頸部下端を覆う膜状組織として存在した。そして腹腔鏡下に、癒着剥離術および子宮内膜症病変焼灼術を追加した。術後1年の時点で、定期的な自己拡張を施行しているが、新生腟長は6cmで狭窄は認めない。【結語】薬物療法や計画的な穿刺排液術による保存的管理を経て、18歳時に根治手術として造腟術を施行することができた。(著者抄録)

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  • 妊娠性エプーリスからの大量出血で母体管理のため帝王切開を選択した一例

    白河 伸介, 牧 尉太, 三島 桜子, 大平 安希子, 谷 和祐, 玉田 祥子, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿

    現代産婦人科   68 ( 2 )   139 - 143   2020.6

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    今回、我々は妊娠性エプーリスが急性増悪し、口腔内大量出血をきたしたため、耳鼻咽喉科による姑息的な止血手術を一時的に施行した。その後、母体管理のために選択的帝王切開術を施行した一例を経験した。【症例】19歳、女性。1妊0産。自然妊娠成立し妊娠11週に近医受診。同時期に歯肉腫脹を自覚した。近医歯科で歯肉炎と診断され、終診となっていた。妊娠25週に歯肉腫脹が増悪し、当院口腔外科を紹介受診となった。当院口腔外科にて腫脹箇所の切除の選択肢も提示されたが希望されず、経過観察の方針となった。妊娠35週0日、歯肉腫脹の増悪と持続的な強出血を認め、止血困難で救急搬送となった。来院時ショックバイタルであり、右下5舌側歯肉臼後部から動脈性の出血を認めた。病変は3cm程度で臨床所見から妊娠性エプーリスを疑った。緊急腫瘍摘出術を施行し止血は得られたが、根治手術は難しく姑息的手術となった。ICU入室後、再出血を認めず経過した。病変の再出血時は止血困難となる可能性を考慮し、早期の妊娠終了を協議の上決定し、妊娠35週4日に選択的帝王切開術を施行した。女児、2308g、アプガースコア9点/9点(1分/5分)の生児を得た。術後口腔内出血を認めず、残存腫脹は消退し産後9日目に退院した。【結語】妊娠性エプーリスは妊婦の1%程度に認め、その程度・出現時期・形態は多岐に渡る。本例では母体適応で35週の帝王切開術の方針としたが、分娩後は自然に縮小・消失することが特徴で正期産まで経過観察する選択肢も上げられる。母児両方の状態を考慮し治療方針を決定する必要性がある。(著者抄録)

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  • NIPTを契機に判明したモザイク型21トリソミーと18q欠失症候群症例について

    早田 桂, 三島 桜子, 大平 安希子, 谷 和祐, 牧 尉太, 光井 崇, 衛藤 英理子, 小川 千加子, 増山 寿

    日本遺伝カウンセリング学会誌   41 ( 2 )   89 - 89   2020.6

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  • 【妊娠糖尿病の理解を深めよう】持続血糖測定を用いた血糖測定の実際 Reviewed

    増山 寿, 牧 尉太

    産科と婦人科   87 ( 5 )   577 - 584   2020.5

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    インスリン療法中の患者の血糖変動は大きく、血糖自己測定を行わない時間帯の血糖値および、血糖変動傾向などの把握が困難で高血糖や低血糖に対する事前の対策の困難さが臨床的な問題である。持続血糖測定(CGM)は、昨今見過ごされていた高血糖や低血糖などの血糖変動を視覚化でき、とりわけ妊娠期間中はCGMを用いると母体の血糖変動が改善し、母児の周産期合併症の発症リスクも減少させることが報告されている。本稿では持続血糖測定とデータの見方、今後の見通しについて解説する。(著者抄録)

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  • 上行結腸癌手術時に偶発的に発見切除したMeckel憩室腺癌の1例

    飯高 大介, 高嶋 祐助, 越智 史明, 中島 晋, 藤山 准真, 加藤 寿一, 馬場 正道, 増山 守

    日本消化器外科学会雑誌   53 ( 5 )   449 - 455   2020.5

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    症例は76歳の男性で,ふらつきのため当院に救急搬送された.著明な貧血と腹部造影CTで上行結腸癌とその背側の膿瘍を認めた.経皮的に膿瘍ドレナージし,腹腔鏡下結腸右半切除術を施行した.術中に小腸間膜に播種結節を認めたため他部位の小腸を検索したところ,Meckel憩室を認め同時切除した.Meckel憩室には腫瘍を認め,術後病理検査でMeckel憩室腺癌と診断された.周囲には異所性膵組織を認め腫瘍との連続性や免疫染色検査から異所性膵組織から発生した腺癌であると診断された.術後,腹膜播種・肝転移を認め化学療法を施行したが術後2年3ヵ月でBSCの方針となった.Meckel憩室の腺癌は極めてまれであり本邦では自験例をあわせて21例の報告のみである.今回,我々は免疫染色検査を用いて病理組織学的に異所性膵組織が発生母地であることを確認したMeckel憩室腺癌の症例を経験したので報告する.(著者抄録)

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    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J01117&link_issn=&doc_id=20200609430008&doc_link_id=10.5833%2Fjjgs.2019.0038&url=https%3A%2F%2Fdoi.org%2F10.5833%2Fjjgs.2019.0038&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • 【妊娠糖尿病の理解を深めよう】持続血糖測定を用いた血糖測定の実際

    増山 寿, 牧 尉太

    産科と婦人科   87 ( 5 )   577 - 584   2020.5

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    Language:Japanese   Publisher:(株)診断と治療社  

    インスリン療法中の患者の血糖変動は大きく、血糖自己測定を行わない時間帯の血糖値および、血糖変動傾向などの把握が困難で高血糖や低血糖に対する事前の対策の困難さが臨床的な問題である。持続血糖測定(CGM)は、昨今見過ごされていた高血糖や低血糖などの血糖変動を視覚化でき、とりわけ妊娠期間中はCGMを用いると母体の血糖変動が改善し、母児の周産期合併症の発症リスクも減少させることが報告されている。本稿では持続血糖測定とデータの見方、今後の見通しについて解説する。(著者抄録)

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    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J00525&link_issn=&doc_id=20200511100015&doc_link_id=%2Fae4sanke%2F2020%2F008705%2F016%2F0577-0584%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fae4sanke%2F2020%2F008705%2F016%2F0577-0584%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • Pregnancy with Fontan circulation: A report of case series in Japan. Reviewed

    Eriko Eto, Jota Maki, Teiji Akagi, Hiroshi Ito, Hisashi Masuyama

    Journal of cardiology cases   21 ( 4 )   161 - 163   2020.4

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    Owing to new surgical procedures and medications, more women who have undergone the Fontan procedure reach childbearing ages. We report five cases of pregnancy with Fontan circulation. Case 1 had subchorionic hematoma (SCH), fetal growth restriction (FGR), and preterm labor (PTL). She delivered a 1073 g infant via cesarean section at gestation week 28 because of hemorrhagic shock. Case 2 delivered 2142 g and 2232 g infants at gestation weeks 37 and 36, respectively. She had FGR, PTL, and postpartum hemorrhage (PPH). Case 3 had SCH, PTL, and heart failure. At 36 weeks, labor was induced and she delivered a 2546 g infant by vacuum extraction with epidural analgesia. Cases 4 and 5 resulted in miscarriage. All subjects experienced obstetrical complications. This report discusses pregnant women with Fontan circulation by focusing on affected Japanese women. <Learning objective: More women who have undergone the Fontan procedure reach childbearing ages due to the new surgical procedures and medications. We report five cases and all of them experienced obstetrical complications. Anticoagulation might be one of the causes of postpartum hemorrhage. Labor epidural analgesia could contribute to minimized dynamic circulatory changes during labor. This report can be the literature regarding pregnant women with Fontan circulation in Japan.>.

    DOI: 10.1016/j.jccase.2019.12.005

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  • 当院での外来子宮鏡検査(子宮ファイバースコピー)の現状

    岡田 真紀, 樫野 千明, 久保 光太郎, 鎌田 泰彦, 中塚 幹也, 増山 寿

    日本生殖医学会雑誌   65 ( 1-2 )   94 - 94   2020.4

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  • Increased Plasma Levels of Platelet Factor 4 and β-thromboglobulin in Women with Recurrent Pregnancy Loss.

    Sayoko Kotani, Yasuhiko Kamada, Keiko Shimizu, Ai Sakamoto, Mikiya Nakatsuka, Yuji Hiramatsu, Hisashi Masuyama

    Acta medica Okayama   74 ( 2 )   115 - 122   2020.4

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    Thrombosis in decidual vessels is one of the mechanisms of pregnancy loss. However, few studies have assessed the relation between platelet activation, which is known to cause of thrombosis, and recurrent pregnancy loss (RPL). We investigated platelet activation in women with RPL compared to controls by measuring plasma levels of platelet factor 4 (PF4) and β-thromboglobulin (βTG), and assessed correlations between PF4/βTG and coagulative risk factors associated with RPL. The study group included 135 women who had experienced two or more consecutive pregnancy losses. The control group included 28 age-matched healthy women who had never experienced pregnancy loss. PF4 and βTG plasma levels were significantly higher in the women with RPL than controls (PF4: 14.0 [8.0-20.0] vs. 9.0 [6.0-12.0] ng/ml, p=0.043; βTG: 42.0 [24.3-59.8] vs. 31.5 [26.6-36.4] ng/ml, p=0.002). There was a significant association between βTG and anti-phosphatidylethanolamine antibody immunoglobulin M (aPE IgM) (p=0.048). Among the women with RPL, 18 of those who were positive for PF4 (45%) and 18 of those who were positive for βTG (37%) were negative for all known coagulative risk factors associated with RPL. Measurements of PF4 and βTG may be important because they help identify women who are at risk of RPL.

    DOI: 10.18926/AMO/58269

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  • The presence of chronic diseases contributes to the occurrence risk factors for gynecological cancers in Japan. International journal

    Kazuhiro Okamoto, Keiichiro Nakamura, Hirofumi Matsuoka, Yuko Matsubara, Junko Haraga, Chikako Ogawa, Hisashi Masuyama

    Molecular and clinical oncology   12 ( 4 )   336 - 342   2020.4

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    The aim of the present study was to determine whether chronic diseases (CD), such as hypertension, diabetes mellitus, dyslipidemia, heart diseases and cerebrovascular diseases, are occurrence risk factors and affect the survival of patients with gynecological cancers (GC). The correlations between CD and the characteristics and survival of 1,590 GC patients [685 with cervical cancer (CC), 613 with endometrial cancer (EM) and 292 with ovarian cancer (OV)] were investigated in the present study. Of the CD patients, 189 had CC (27.6%), 265 had EM (43.2%) and 72 had OV (24.7%). The incidence of CD increased with age in GC patients. The number of CD patients aged ≥70 years, was 8.6-fold higher in the CC group, 3.0-fold higher in the EM group, and 9.6-fold higher in the OV group compared with those aged <50 years. CD and excess body weight were associated with GC regardless of patient age. However, there was no correlation between CD and survival at any age in GC patients. These findings indicate that CD contribute to >24% of the occurrence risk factors in GC patients in Japan.

    DOI: 10.3892/mco.2020.1989

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  • Risk of Gynecologic Cancer as Second versus First Primary Cancer in Japan.

    Chikako Ogawa, Keiichiro Nakamura, Hirofumi Matsuoka, Yuko Matsubara, Junko Haraga, Hisashi Masuyama

    Acta medica Okayama   74 ( 2 )   109 - 114   2020.4

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    This study aimed to determine whether the risk conferred by gynecologic cancer (GC) as second primary cancer (SPC) differs from that associated with GC as first primary cancer (FPC). We investigated the correlations between FPC/SPC and the characteristics and prognoses of 1,645 GC patients (701 with cervical cancer [CC], 641 with endometrial cancer [EM], and 303 with ovarian cancer [OV]). The χ2 test and the Kaplan-Meier method were used to determine whether FPC/SPC and the characteristics and prognoses of GC patients. Of the SPC patients, 26 (3.7%) had CC, 53 (8.3%) had EM, and 31 (10.2%) had OV. The most common previous cancer type in SPC of GC patients was breast cancer, which was observed in 13 patients (50.0%) with CC, 23 (43.4%) with EM, and 16 (51.6%) with OV. In all patients with CC, EM, and OV as SPC, the stage was significantly associated with recurrence. There were no significant differences in the morbidity or mortality of CC, EM, or OV patients between those with FPC and those with SPC. The risk of SPC development in GC patients varied, ranging from 3.5% (CC) to 10.3% (OV) of patients.

    DOI: 10.18926/AMO/58268

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  • 特発性肺高血圧症合併妊娠の一例 Reviewed

    三島 桜子, 光井 崇, 楠元 理恵, 大平 安希子, 谷 和祐, 牧 尉太, 衛藤 英理子, 早田 桂, 増山 寿

    日本産科婦人科学会雑誌   72 ( 臨増 )   S - 418   2020.3

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  • A case of subclinical Cushing's syndrome in pregnancy with superimposed preeclampsia. Reviewed International journal

    Eriko Eto, Takashi Mitsui, Shoko Tamada, Jota Maki, Kei Hayata, Hisashi Masuyama

    Clinical case reports   8 ( 3 )   481 - 483   2020.3

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    When we see preexistent hypertension in pregnancy, subclinical Cushing's syndrome should be considered in the differential diagnosis since this disorder can cause perinatal complications. MRI can be useful for identifying adrenal incidental tumors during pregnancy.

    DOI: 10.1002/ccr3.2592

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  • 当院における妊娠37週以降の低出生体重児の母体背景の検討 Reviewed

    假谷 奈生子, 光井 崇, 三島 桜子, 大平 安希子, 谷 和祐, 牧 尉太, 衛藤 英理子, 早田 桂, 増山 寿

    日本産科婦人科学会雑誌   72 ( 臨増 )   S - 551   2020.3

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  • 妊娠22週未満の治療的流産における胎盤位置に関する出血量の検討 Reviewed

    白河 伸介, 牧 尉太, 三島 桜子, 大平 安希子, 谷 和祐, 玉田 祥子, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿

    日本産科婦人科学会雑誌   72 ( 臨増 )   S - 506   2020.3

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  • 当院における前置胎盤の検討 Reviewed

    上田 菜月, 玉田 祥子, 三島 桜子, 大平 安希子, 谷 和祐, 牧 尉太, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿

    日本産科婦人科学会雑誌   72 ( 臨増 )   S - 506   2020.3

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  • 周産期からの先制医療 お母さんの健康長寿と健やかな次世代育成に向けて

    増山 寿

    福井県産婦人科医会学術集会抄録集   ( 11 )   5 - 5   2020.3

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  • ヒドロキシクロロキンによる抗SS-A抗体陽性妊婦での先天性房室ブロックの再発抑制 多施設共同医師主導臨床試験(J-PATCH)

    本多 泉, 馬場 慎司, 谷垣 伸治, 薄井 里英, 増山 寿, 光井 崇, 玉田 祥子, 沖本 直輝, 長井 裕, 船越 徹, 北代 祐三, 長瀬 寛美, 伊東 宏晃, 幸村 友季子, 成味 恵, 横川 直人, J-PATCH

    日本産科婦人科学会雑誌   72 ( 臨増 )   S - 541   2020.3

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  • 当院における妊娠37週以降の低出生体重児の母体背景の検討

    假谷 奈生子, 光井 崇, 三島 桜子, 大平 安希子, 谷 和祐, 牧 尉太, 衛藤 英理子, 早田 桂, 増山 寿

    日本産科婦人科学会雑誌   72 ( 臨増 )   S - 551   2020.3

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  • 当院における前置胎盤の検討

    上田 菜月, 玉田 祥子, 三島 桜子, 大平 安希子, 谷 和祐, 牧 尉太, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿

    日本産科婦人科学会雑誌   72 ( 臨増 )   S - 506   2020.3

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  • 妊娠22週未満の治療的流産における胎盤位置に関する出血量の検討

    白河 伸介, 牧 尉太, 三島 桜子, 大平 安希子, 谷 和祐, 玉田 祥子, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿

    日本産科婦人科学会雑誌   72 ( 臨増 )   S - 506   2020.3

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  • 特発性肺高血圧症合併妊娠の一例

    三島 桜子, 光井 崇, 楠元 理恵, 大平 安希子, 谷 和祐, 牧 尉太, 衛藤 英理子, 早田 桂, 増山 寿

    日本産科婦人科学会雑誌   72 ( 臨増 )   S - 418   2020.3

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  • hCGの下降が非順調型であった肺転移を伴う侵入奇胎の1例

    兼森 雅敏, 久保 光太郎, 松原 侑子, 松岡 敬典, 原賀 順子, 小川 千加子, 中村 圭一郎, 増山 寿

    日本産科婦人科学会雑誌   72 ( 臨増 )   S - 452   2020.3

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  • 【やさしくわかる 産科婦人科検査マスターブック】(第2章)婦人科腫瘍分野 がん化学療法のQOL評価

    中村 圭一郎, 原賀 順子, 増山 寿

    産科と婦人科   87 ( Suppl. )   195 - 199   2020.3

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  • 妊娠糖尿病の診断基準改訂による意義や有用性、母児の予後に関する新知見は? 軽症GDM妊婦への介入、産後の母体GDMおよび出生児の肥満・DM発症など検討課題は多い

    増山 寿, 成瀬 勝彦

    日本医事新報   ( 5005 )   49 - 49   2020.3

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  • IgA腎症に対する口蓋扁桃摘出術94例の検討

    渡辺 浩介, 松岡 伴和, 小田切 奨太, 荒井 秀寿, 増山 敬祐

    耳鼻咽喉科臨床   113 ( 3 )   149 - 154   2020.3

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    2009年4月〜2018年3月に当科でIgG腎症に対し扁摘パルス(口蓋扁桃摘出術とステロイドパルスの併用)を行った94例(男性40例、女性54例、平均年齢34.7歳)について検討した。推定罹病期間の中央値は24ヵ月で、ステロイドパルスの実施時期は扁摘前が32例、扁摘後が62例であった。扁摘の後出血率は5.3%であり、術後疼痛はほとんどの症例が術後3日目までに経口摂取可能な程度に改善していた。

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  • 子宮頸癌治療後における筋肉量(骨格筋量・腸腰筋量)変化の検討

    松岡 敬典, 中村 圭一郎, 松原 侑子, 原賀 順子, 小川 千加子, 増山 寿

    日本産科婦人科学会雑誌   72 ( 臨増 )   S - 314   2020.3

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  • グルココルチコイドとBMPによる卵胞ステロイド合成調節への影響

    樫野 千明, 長谷川 徹, 中野 靖浩, 長尾 聡子, 岩田 菜穂子, 鎌田 泰彦, 増山 寿, 大塚 文男

    日本内分泌学会雑誌   95 ( 4 )   1556 - 1556   2020.2

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  • 持続血糖モニタリングによる1型糖尿病合併妊婦の血糖管理 正常耐糖能妊婦、妊娠糖尿病妊婦の分娩前血糖変動の比較検討 Reviewed

    渡邉 真由, 牧 尉太, 片山 晶博, 勅使川原 早苗, 利根 淳仁, 江口 潤, 片岡 仁美, 増山 寿, 和田 淳

    糖尿病と妊娠   20 ( 1 )   19 - 24   2020.2

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    [目的]1型糖尿病(type 1 diabetes mellitus:T1DM)合併妊婦ではcontinuous glucose monitoring(CGM)の有用性が検討された報告が散見される。本研究ではT1DM妊婦と正常耐糖能(normal glucose tolerance:NGT)妊婦および妊娠糖尿病(gestational diabetes mellitus:GDM)妊婦の分娩前血糖変動を比較した。[方法]NGT妊婦(n=17)、GDM妊婦(n=12)、T1DM妊婦(n=9)の分娩活動期直前のCGMデータを解析した。[結果]T1DM群ではNGT群およびGDM群と比較して、SDやJ-indexが有意に高値であったが、0時から17時の血糖140mg/dL以上の曲線下面積や、血糖値70mg/dL未満の曲線上面積、MeanとM値といった一部の血糖変動の指標に有意差は認めず、周産期合併症(妊娠高血圧症候群、早産、帝王切開、肩甲難産)や新生児合併症(胎児機能不全、形態異常、巨大児)においても有意差は認めなかった。[考察]既報ではT1DM合併妊婦においてCGM併用によって、HbA1c値やSDなど血糖変動指標が改善し、新生児合併症率の低下を認めるなど、その有用性が示され、CGMによる血糖コントロール指標も報告された。本研究の分娩前CGMデータではT1DM群の血糖管理は良好であった。また、T1DM妊婦とNGT妊婦およびGDM妊婦と分娩前血糖変動に関して比較を行い、一部の血糖変動の指標に有意差は認めず、重篤な合併症においても有意差がなく、その有用性が示唆された。[結語]T1DM合併妊婦において、CGMを用いることで正常耐糖能妊婦と分娩前の一部の血糖変動に有意差を認めない程度に血糖管理が可能であった。(著者抄録)

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  • ACHDハイリスク患者の妊娠・出産管理 ACHDハイリスク妊娠管理 人工弁術後・抗凝固療法中の妊娠・出産 Reviewed

    赤木 禎治, 杜 徳尚, 横濱 ふみ, 衛藤 英理子, 牧 尉太, 増山 寿, 伊藤 浩

    日本成人先天性心疾患学会雑誌   9 ( 1 )   184 - 184   2020.1

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  • 【周産期超音波検査バイブル-エキスパートに学ぶ技術と知識のエッセンス】産科超音波検査の応用編 妊娠初期での染色体疾患のリスク評価

    早田 桂, 増山 寿, 佐々木 愛子

    臨床婦人科産科   74 ( 1 )   72 - 78   2020.1

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    <文献概要>●NT測定をはじめとした染色体疾患の超音波検査によるリスク評価には技術が必要であり,いくつか計測上のポイントがある.●適切な画像でNT計測がされていないなかで,染色体疾患をはじめとした胎児疾患との関連を強調しすぎないような配慮が必要である.●NIPTが普及している昨今,諸外国においてNT計測は,単に染色体数的異常の検出を目的としたものではなく,心構築異常や胎児形態異常を診断するツールに移行してきている.

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  • Robson分類を用いた当院の帝王切開症例の特徴と適応症例の妥当性評価 Reviewed

    三苫 智裕, 光井 崇, 早田 桂, 谷 和祐, 牧 尉太, 江口 武志, 玉田 祥子, 衛藤 英理子, 増山 寿

    現代産婦人科   68 ( 1 )   65 - 70   2019.12

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    今日、世界的に帝王切開率は上昇傾向にあるため、世界保健機関は帝王切開術が施行された症例を分娩歴、分娩開始、胎位、胎数、妊娠週数により10グループに分類するRobson分類を用いて検討することを推奨している。今回、当院の帝王切開症例をRobson分類を用いて当院の帝王切開症例の特徴および適応症例の妥当性評価を検討したので報告する。2013年から2017年に当院で分娩した1933例を対象とした。Robson分類に従って分類し、各グループの帝王切開数及び帝王切開率を後方視的に検討した。本研究は、本学の倫理委員会の承認を得て施行された。5年間における当院の帝王切開率は全体で36.3%(702/1933例)であり、既往帝王切開症例(グループ5)の帝王切開数が最も多く206例であり、全帝王切開症例の29.3%を占めていた。グループ1とグループ2を合計したTSCN(term、single、cephalic、nulliparous)の帝王切開数は185例と全帝王切開症例の26.4%であり、2番目に多く、グループ2の中で予定帝王切開術となった症例は子宮手術歴、前置胎盤、胎児疾患の順に多かった。当院では、既往帝王切開症例及びTSCN症例の帝王切開数が全分娩件数に占める割合が高い。国内の既存の報告と比較検討すると、当院では正期産、単胎、頭位の妊婦での予定帝王切開率が高かった。帝王切開後経腟分娩の適応症例及びTSCN症例への帝王切開術の適応をより慎重に行うことによって、帝王切開率を改善することが期待できるのではないかと考えられた。Robson分類は、当院における帝王切開症例の分類ごとの数や比率を把握することができ、問題点を抽出し、改善点を検討することができることに関して有用であった。また、今後施設間のRobson分類による帝王切開症例の比較検討を行うことにより施設や地域ごとの特性を知り、地域ごとの医療水準の向上に繋がるツールになることが期待できる。(著者抄録)

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  • 【周産期相談310 お母さんへの回答マニュアル 第3版】産科編 妊娠中期 おなかがかゆいのですが?

    増山 寿

    周産期医学   49 ( 増刊 )   164 - 165   2019.12

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    <回答のポイント>1)かゆみの原因は多岐にわたるが多くは妊娠前から存在するそう痒性皮膚疾患であり、自己判断での外用薬の減少、中断が誘因となる。2)妊娠に特異的な皮膚疾患では、胎児への影響はなく、妊娠終了後には自然軽快することがほとんどである。3)治療はクーリング、保湿に加えて、クロタミトン軟膏や副腎皮質ステロイド軟膏の外用が中心となる。症状が強い場合は、抗ヒスタミン薬や抗アレルギー薬、時に副腎皮質ステロイドの内服も併用する。4)感染症に伴う多形紅斑や薬疹などの可能性も考える必要があるため、全身症状のチェックや服薬などの問診も重要である。(著者抄録)

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  • 【周産期相談310 お母さんへの回答マニュアル 第3版】産科編 妊娠後期 胎児が痙攣様の動きをします。異常でしょうか?

    増山 寿

    周産期医学   49 ( 増刊 )   188 - 189   2019.12

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    <回答のポイント>1)胎動とは、胎児躯体の部分的、全身的運動であり、胎児のwell-beingや中枢神経系の発達過程を知る重要な胎児情報である。2)痙攣様の動きとは、胎児のhigh-frequency movementやしゃっくり様運動と考えられ、胎児の正常な運動のひとつと考えられる 3)fetal brain death syndromeなどの中枢神経系の異常や障害では、痙攣様の動きをすることが報告されており、超音波検査などで胎児異常の有無を検査することは重要である。(著者抄録)

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  • 中心静脈栄養管理を要する重症妊娠悪阻に対してOlanzapineが奏効した一例

    兼森 美帆, 関 典子, 衛藤 英理子, 平野 由紀夫, 増山 寿

    日本周産期・新生児医学会雑誌   55 ( 4 )   1042 - 1046   2019.12

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    症例は35歳で、妊娠10週時に妊娠悪阻の診断で補液管理を開始したが改善に乏しく、妊娠14週からTPNを開始した。甲状腺機能検査や頭部MRI、消化器エコー検査を行ったが異常所見は認められなかった。心療内科で妊娠に伴う適応障害・うつ状態と診断されたため、抗うつ作用と制吐作用の両方を期待してOlanzapine内服を開始し、翌日から症状は改善した。

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  • Histologic Appearance and Immunohistochemistry of DNA Mismatch Repair Protein and p53 in Endometrial Carcinosarcoma: Impact on Prognosis and Insights Into Tumorigenesis. Reviewed

    Saijo M, Nakamura K, Ida N, Nasu A, Yoshino T, Masuyama H, Yanai H

    The American journal of surgical pathology   43 ( 11 )   1493 - 1500   2019.11

  • GDM妊婦は分娩第2期が遷延するほど直線的な血糖値の上昇を引き起こす Reviewed

    牧 尉太, 衛藤 英理子, 平松 祐司, 増山 寿

    糖尿病と妊娠   19 ( 3 )   S - 109   2019.11

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  • 多嚢胞性卵巣症候群患者のインスリン抵抗性と妊娠に関する検討 Reviewed

    衛藤 英理子, 樫野 千明, 牧 尉太, 三島 桜子, 大平 安希子, 谷 和祐, 玉田 祥子, 光井 崇, 早田 桂, 増山 寿

    糖尿病と妊娠   19 ( 3 )   S - 86   2019.11

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  • DOHaD update 肥満・耐糖能異常関連素因の世代間連鎖の解明

    増山 寿

    糖尿病と妊娠   19 ( 3 )   S - 46   2019.11

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  • Pre-treatment psoas major volume is a predictor of poor prognosis for patients with epithelial ovarian cancer. International journal

    Yuko Matsubara, Keiichiro Nakamura, Hirofumi Matsuoka, Chikako Ogawa, Hisashi Masuyama

    Molecular and clinical oncology   11 ( 4 )   376 - 382   2019.10

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    Low skeletal muscle mass (sarcopenia) is an important prognostic risk factor for the outcome of a variety of cancer types. The current study investigated whether skeletal muscle area (SMA), psoas area (PA) and psoas major volume (PV) are associated with progression-free survival (PFS) and overall survival (OS) in patients with epithelial ovarian cancer (OC). A total of 92 OC patients were enrolled in the present study. Pre-treatment with SMA and PA was assessed using computed tomography (CT) and PV was calculated using a three-dimensional-CT (3D-CT). The clinical factors associated with sarcopenia and prognosis were retrospectively evaluated. For all patients, the median PFS and OS were 19 and 32 months, respectively. Patients exhibiting lower PV (<195.6 cm3) had significantly poorer PFS and OS compared with patients exhibiting higher PV (≥195.6 cm3; P=0.018 and P=0.006), while those with low SMA (<92.92 cm2) had significantly worse OS than patients with higher SMA (≥92.92 cm2; P=0.030). PV was also demonstrated to be superior to SMA and PA in prognosis prediction. PV by 3D-CT can serve as an indicator of poor prognosis in patients with OC.

    DOI: 10.3892/mco.2019.1912

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  • GDM妊婦の産後フォローアップ対策がもたらす影響とフォローの弊害に関する検討 Reviewed

    牧 尉太, 光井 崇, 鎌田 泰彦, 増山 寿

    日本女性医学学会雑誌   27 ( 1 )   136 - 136   2019.10

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  • Relationship between Intracellular Signaling of the (Pro)renin Receptor and the Pathogenesis of Preeclampsia. Reviewed

    Shoko Tamada, Takashi Mitsui, Akiko Ohira, Kazumasa Tani, Jota Maki, Takeshi Eguchi, Eriko Eto, Kei Hayata, Hisashi Masuyama

    Acta medica Okayama   73 ( 5 )   433 - 440   2019.10

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    An association between preeclampsia and (pro)renin was recently reported. Intracellular signaling of the (pro) renin receptor [(P)RR] increases the expressions of TGF-β and PAI-1. In this study we sought to clarify the involvement of (pro)renin in the pathogenesis of preeclampsia via the intracellular signaling of (P)RR on preeclampsia placentas. Activated (pro)renin plasma concentrations were compared between pregnant women with (n=15) and without (n=28) preeclampsia. The placentas were immunohistochemically evaluated with anti-HIF-1α and anti-(P)RR antibodies. HTR-8/SVneo cells were cultured under hypoxic conditions and treated with human recombinant (pro)renin. The mRNA expressions of HIF-1α, (P)RR, PAI-1, TGF-β, and ET-1 were also examined by real-time RCR. The activated (pro)renin plasma concentration was significantly higher in the third vs. the second trimester in the preeclampsia patients. HIF-1α and (P)RR expressions were significantly increased in the preeclampsia placentas. The mRNA expressions of PAI-1, TGF-β, and ET-1 were significantly increased in the experiments using recombinant (pro)renin vs. hypoxic conditions. (P)RR expression in preeclampsia placentas is increased by persistent hypoxia through the second and third trimesters, and PAI-1, TGF-β, and ET-1 production is increased via (P)RR. Our results suggest that ET-1 production via the intracellular signaling of (P)RR is important in the pathogenesis of preeclampsia.

    DOI: 10.18926/AMO/57374

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  • 羊水検査で18トリソミーとロバートソン転座を認め、診断告知から夫婦の保因者診断まで経時的に遺伝カウンセリングを行った1例 Reviewed

    早田 桂, 大平 安希子, 谷 和祐, 牧 尉太, 江口 武志, 玉田 祥子, 光井 崇, 衛藤 英理子, 小川 千加子, 吉本 順子, 増山 寿

    日本遺伝カウンセリング学会誌   40 ( 3 )   109 - 113   2019.10

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    羊水検査で18トリソミーとロバートソン転座を認め、2度の出産を経て両親の保因者診断まで継続対応した症例を報告する。36歳、初妊婦。妊娠30週に羊水染色体検査を行い、46,XX,inv(9)(p12q13)、der(14;22)(q10;q10)、+18が判明したが、18トリソミーのみ開示した。その後、女児を死産した。産褥期にロバートソン転座につき追加開示したが、保因者診断は希望せず、4ヵ月後に第2子を自然妊娠した。出生前遺伝学的検査は行わず、妊娠38週に男児を出産した。産褥期に自ら保因者診断を希望し、母46,XX、父45,XY、inv(9)、der(14;22)(q10;q10)より、父親由来のロバートソン転座が判明したが、両親は結果について受容可能な心理状況になっていた。開示時期と検査時期に配慮した遺伝カウンセリングが必要であると考えられた。(著者抄録)

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  • 不育症患者に対するステロイド治療

    久保 光太郎, 樫野 千明, 岡田 真紀, 鎌田 泰彦, 中塚 幹也, 増山 寿

    日本生殖医学会雑誌   64 ( 4 )   304 - 304   2019.10

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  • 急性骨髄性白血病の女性患者に対し、妊孕性温存を目的とし卵巣凍結保存を施行した1例

    樫野 千明, 岡田 真紀, 久保 光太郎, 鎌田 泰彦, 中塚 幹也, 増山 寿

    日本生殖医学会雑誌   64 ( 4 )   440 - 440   2019.10

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  • 腟再建術を要した造血幹細胞移植後の性器慢性移植片対宿主病(GVHD)の3例

    鎌田 泰彦, 杉井 裕和, 岡田 真紀, 樫野 千明, 久保 光太郎, 増山 寿

    日本女性医学学会雑誌   27 ( 1 )   134 - 134   2019.10

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  • 妊娠高血圧症候群の母体より出生した児の3歳までの身体発育調査 Reviewed

    光井 崇, 三島 桜子, 大平 亜希子, 谷 和祐, 牧 尉太, 玉田 祥子, 衛藤 英理子, 早田 桂, 増山 寿

    日本女性栄養・代謝学会学術集会プログラム・抄録集   43回   84 - 84   2019.9

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  • Assessment of glucose kinetics with real-time continuous glucose monitoring during labor. Reviewed International journal

    Jota Maki, Eriko Eto, Shoko Tamada, Takashi Mitsui, Kei Hayata, Keiichiro Nakamura, Yuji Hiramatsu, Hisashi Masuyama

    The journal of obstetrics and gynaecology research   45 ( 9 )   1851 - 1859   2019.9

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    AIM: Changes in glucose levels during labor have not been sufficiently investigated in pregnant women. Using real-time continuous glucose monitoring, we aimed to assess glucose kinetics during labor among pregnant women with gestational diabetes mellitus (PwGDM), and those with normal glucose tolerance (PwNGT). METHODS: Japanese PwGDM and PwNGT who had planned a transvaginal delivery at Okayama University Hospital were enrolled. The correlation between changes in glucose levels during labor among the PwGDM and PwNGT groups at four time periods was assessed: (i) active phase of 1st stage of labor; (ii) 2nd stage of labor; (iii) postpartum 0-12 h; and (iv) postpartum 12-48 h. RESULTS: In total, 18 and 22 PwGDM and PwNGT, respectively, were enrolled. During labor, both groups had similar changes in glucose levels over time, which peaked during period 3. The main effect of glucose level changes was the labor period (P < 0.001), not the presence of gestational diabetes mellitus. Furthermore, differences in glucose levels in the PwGDM group were observed between periods 1 and 2 (P = 0.037), 1 and 3 (P = 0.024), 3 and 4 (P = 0.005); differences in glucose levels in the PwNGT group were observed between periods 3 and 4 (P = 0.024). CONCLUSION: During labor, both PwGDM and PwNGT groups showed similar changes in glucose levels over time. During delivery, the PwGDM who regularly measured their own glucose levels could be managed using the same nutritional management methods as those for PwNGT.

    DOI: 10.1111/jog.14058

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  • 妊娠性エプーリスからの大量出血で母体管理のため帝王切開を選択した一例 Reviewed

    白河 伸介, 牧 尉太, 三島 桜子, 大平 安希子, 谷 和祐, 光井 崇, 玉田 祥子, 衛藤 英理子, 早田 桂, 増山 寿

    現代産婦人科   68 ( Suppl. )   S52 - S52   2019.9

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  • Seromucinous borderline tumorにおける術前検査所見の後方視的検討

    清水 かれん, 原賀 順子, 松原 侑子, 松岡 敬典, 小川 千加子, 中村 圭一郎, 増山 寿

    現代産婦人科   68 ( Suppl. )   S60 - S60   2019.9

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  • 妊娠中にネフローゼ症候群を発症し、ステロイドを投与しながら妊娠を継続した一例

    假谷 奈生子, 光井 崇, 上野 麻美, 西脇 麻里子, 北川 正史, 三島 桜子, 大平 安希子, 谷 和祐, 牧 尉太, 玉田 祥子, 衛藤 英理子, 早田 桂, 増山 寿, 杉山 斉, 和田 淳

    現代産婦人科   68 ( Suppl. )   S51 - S51   2019.9

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  • 当科における前置癒着胎盤症例の検討

    上田 菜月, 玉田 祥子, 三島 桜子, 大平 安希子, 谷 和祐, 牧 尉太, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿

    現代産婦人科   68 ( Suppl. )   S44 - S44   2019.9

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  • 前置癒着胎盤のCesarean hysterectomyに総腸骨動脈バルーン閉塞術(CIABO)を併用し総腸骨動脈解離を発症した一例

    築澤 良亮, 衛藤 英理子, 牧 尉太, 玉田 祥子, 光井 崇, 早田 桂, 中村 圭一郎, 増山 寿

    現代産婦人科   68 ( Suppl. )   S46 - S46   2019.9

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  • 妊孕性温存のため卵巣凍結を行った急性骨髄性白血病の2症例

    兼森 雅敏, 久保 光太郎, 樫野 千明, 岡田 真紀, 酒本 あい, 鎌田 泰彦, 中塚 幹也, 増山 寿

    現代産婦人科   68 ( Suppl. )   S69 - S69   2019.9

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  • 女性の生涯に関わる疾患としてのPCOS 妊娠とPCOS インスリン抵抗性と周産期予後

    衛藤 英理子, 増山 寿

    日本女性栄養・代謝学会学術集会プログラム・抄録集   43回   33 - 33   2019.9

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  • 静脈血栓塞栓症(VTE)予防における分娩後抗凝固療法の有無と、D-dimer値の関係について

    川西 貴之, 早田 桂, 谷 和祐, 牧 尉太, 江口 武志, 玉田 祥子, 光井 崇, 衛藤 英理子, 増山 寿

    現代産婦人科   68 ( Suppl. )   S55 - S56   2019.9

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  • リアルタイムContinuous Glucose Monitoringを用いた陣痛発来後から産褥早期までの血糖動態の検討 Reviewed

    牧 尉太, 衛藤 英理子, 平松 祐司, 増山 寿

    糖尿病と妊娠   19 ( 2 )   S - 75   2019.8

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    [目的]分娩時血糖の動向をリアルタイムContinuous Glucose Monitoring(CGM)で評価し、分娩中における血糖動態を解明する。またAbnormal glucose tolerance(AGT)群とNormal glucose tolerance(NGT)群の平均血糖値(SG)を比較検討し、分娩時期による血糖値の差異から判明した結果をもとに分娩時の血糖管理法を選定する。[方法]検討期間に当院で経腟分娩を施行したAGT群:18例、NGT群:22例。ガイドライン並び、当院の管理指針を用い、必要時自由に飲食を摂り陣痛発来時から分娩期間を4段階(I期からIV期)に分け、分娩後48時間までの血糖変動をリアルタイムCGMで測定し解析。[結果]出生児背景に有意差無し。陣痛初来後のインスリン使用は、潜伏期と活動期で全症例のインスリン合計使用量は29単位から6単位へ減少。産後の使用無し。次にSGの分割プロットデザインの分散分析の結果、SGは分娩期間の主効果には有意差が認められたが[F(2.1,80.7)=5.915,P<0.01]耐糖能異常の有無の主効果、および期間と耐糖能異常の交互作用は認められなかった。T検定(ボンフェローニ法による修正)を用いた下位検定では、分娩期間別では4期の耐糖能異常の有無間(P<0.05)に有意差を認めた。耐糖能異常有無別の検討では、NGT群で3期と4期(P<0.05)に有意差を認めた。[結論]2群間比較からSGに差が認めず、児娩出後早期のSGが最大値を示した。その後NGT群のSGはAGT群に比し急峻に正常化することが示された、AGT群の分娩管理は絶食状態・補液・インスリン持続投与が現在推奨されるが、血糖測定下であれば正常群と同様の管理方法を用いて分娩を行うことが可能であるかもしれない。(著者抄録)

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  • 前置胎盤帝王切開時に経腟エコーを用いて、胎盤剥離時期を判断する Reviewed

    早田 桂, 牧 尉太, 大平 安希子, 谷 和祐, 江口 武志, 玉田 祥子, 光井 崇, 衛藤 英理子, 増山 寿

    産婦人科手術   ( 30 )   143 - 143   2019.8

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  • 前置胎盤帝王切開術の応用 経腟超音波ドプラ法と手術室画像モニターの工夫 Reviewed

    牧 尉太, 早田 桂, 大平 安希子, 江口 武志, 玉田 祥子, 光井 崇, 衛藤 英理子, 増山 寿

    産婦人科手術   ( 30 )   142 - 142   2019.8

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  • 周産期からはじまる先制医療

    増山 寿

    岡山医学会雑誌   131 ( 2 )   79 - 82   2019.8

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    妊娠糖尿病(GDM)や妊娠高血圧症候群(HDP)合併妊娠では厳重な周産期管理に加えて、将来糖尿病やメタボリック症候群を発症する頻度が高いため産後の長期フォローアップが重要である。さらに母体の妊娠合併症による子宮内環境の悪化が、胎児過剰栄養・過剰発育または栄養不足・発育不足をもたらし、児の将来の肥満・生活習慣病発症リスクが上昇する。GDMおよびHDPの母児への長期的影響について概説し、周産期からの先制医療の重要性に言及した。

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  • ロボット支援下子宮悪性腫瘍手術における助手の重要性

    久保 光太郎, 松原 侑子, 松岡 敬典, 原賀 順子, 小川 千加子, 鎌田 泰彦, 中村 圭一郎, 増山 寿

    日本産科婦人科内視鏡学会雑誌   35 ( Suppl.I )   123 - 123   2019.8

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  • 処女膜閉鎖に対する標準術式につき再考する

    鎌田 泰彦, 三島 桜子, 岡田 真紀, 久保 光太郎, 増山 寿

    日本産科婦人科内視鏡学会雑誌   35 ( Suppl.I )   195 - 195   2019.8

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  • 腟再建術を要した造血幹細胞移植後の性器慢性移植片対宿主病(GVHD)の2症例

    鎌田 泰彦, 久保 光太郎, 長谷川 徹, 酒本 あい, 増山 寿

    産婦人科手術   ( 30 )   156 - 156   2019.8

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  • 糖尿病合併妊婦と妊娠糖尿病妊婦の妊娠経過に伴う安静時代謝量の変化

    衛藤 英理子, 大平 安希子, 谷 和祐, 牧 尉太, 江口 武志, 玉田 祥子, 光井 崇, 早田 桂, 増山 寿

    糖尿病と妊娠   19 ( 2 )   S - 57   2019.8

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    糖尿病合併妊婦と妊娠糖尿病妊婦において,安静時代謝量(resting energy expenditure;REE)の動向に違いがあるか検討することを目的とした。DM群14例とGDM群27例において,妊娠前期,中期,後期および産後にREEを測定した。DM群では妊娠前期から産後にかけてREEが減少傾向にあったが,GDM群では妊娠前期から後期にかけてREEが増加し産後に減少していた。非肥満妊婦のREEはDM群では全期間を通して有意な変化はなかったものの減少傾向にあった。一方でGDM群では妊娠後期に向けて有意な上昇を認めた。肥満妊婦ではDM群で産後に向かっての減少傾向が強く、GDM群でも後期にかけての上昇はみられなかった。(著者抄録)

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  • 【漢方の今、これから】漢方療法の適用を見直す 下肢痛・しびれに対する疎経活血湯の効果 婦人科手術既往症例

    関 典子, 平野 由紀夫, 増山 寿

    産科と婦人科   86 ( 8 )   987 - 992   2019.8

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    疎経活血湯は、体力中等度の人の腰部・下肢の関節痛、筋肉痛に用いられる漢方薬で、整形外科領域で頻用されるが、経験的に外科手術の既往のある患者への有効性が指摘されている。婦人科手術は東洋医学的には慢性的なお血、血虚の状態と考えられるが、疎経活血湯は駆お血剤、利水剤、抗炎症鎮痛剤などがバランスよく配合され、婦人科手術既往のある頑固な下肢痛やしびれに有効な可能性がある。今回、婦人科手術既往があり、頑固な下肢痛やしびれを訴える症例に疎経活血湯が奏効した症例を経験したため報告する。(著者抄録)

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  • Short-Term Prediction of Adverse Outcomes Using the sFlt-1 (Soluble fms-Like Tyrosine Kinase 1)/PlGF (Placental Growth Factor) Ratio in Asian Women With Suspected Preeclampsia. International journal

    Xuming Bian, Arijit Biswas, Xianghuang Huang, Kyoung Jin Lee, Thomas Kwok-To Li, Hisashi Masuyama, Akihide Ohkuchi, Joong Shin Park, Shigeru Saito, Kok Hian Tan, Tatsuo Yamamoto, Angela Dietl, Sonja Grill, Wilma D J Verhagen-Kamerbeek, Jae-Yoon Shim, Martin Hund

    Hypertension (Dallas, Tex. : 1979)   74 ( 1 )   164 - 172   2019.7

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    Current diagnostic criteria have limited clinical value for prediction of preeclampsia and fetal adverse outcomes. The prediction of short-term outcome in pregnant women with suspected preeclampsia study in Asia (PROGNOSIS Asia) was a prospective, multicenter study designed to investigate the value of the sFlt-1 (soluble fms-like tyrosine kinase 1)/PlGF (placental growth factor) ratio for predicting adverse outcomes in pregnant Asian women with suspected preeclampsia. Seven hundred sixty-four pregnant women at gestational week 20+0 days (18+0 days in Japan) to 36+6 days were enrolled at 25 sites in Asia. The primary objectives were to demonstrate the value of the sFlt-1/PlGF ratio for ruling out preeclampsia within 1 week and ruling in preeclampsia within 4 weeks. The value of the ratio for predicting fetal adverse outcomes was also assessed. Seven hundred patients were evaluable for primary end point analysis. The prevalence of preeclampsia was 14.4%. An sFlt-1/PlGF ratio of ≤38 had a negative predictive value of 98.6% (95% CI, 97.2%-99.4%) for ruling out preeclampsia within 1 week, with 76.5% sensitivity and 82.1% specificity. The positive predictive value of a ratio of >38 for ruling in preeclampsia within 4 weeks was 30.3% (95% CI, 23.0%-38.5%), with 62.0% sensitivity and 83.9% specificity. An sFlt-1/PlGF ratio of ≤38 had a negative predictive value of 98.9% (95% CI, 97.6%-99.6%) for ruling out fetal adverse outcomes within 1 week and a ratio of >38 had a positive predictive value of 53.5% (95% CI, 45.0%-61.8%) for ruling in fetal adverse outcomes within 4 weeks. The sFlt-1/PlGF ratio cutoff of 38 demonstrated clinical value for the short-term prediction of preeclampsia in Asian women with suspected preeclampsia, potentially helping to prevent unnecessary hospitalization and intervention.

    DOI: 10.1161/HYPERTENSIONAHA.119.12760

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  • 血族結婚の家系で出現した血小板無力症の幼少期から分娩までの経過

    前口 武志, 大平 安希子, 谷 和祐, 牧 尉太, 玉田 祥子, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿

    日本遺伝カウンセリング学会誌   40 ( 2 )   98 - 98   2019.7

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  • 夫が均衡型相互転座を有し、NIPTで21番染色体長腕の部分欠失が疑われたためマイクロアレイ解析を追加実施した1例

    早田 桂, 三島 桜子, 大平 安希子, 谷 和祐, 牧 尉太, 玉田 祥子, 光井 崇, 衛藤 英理子, 増山 寿, 吉本 順子, 酒本 あい

    日本遺伝カウンセリング学会誌   40 ( 2 )   106 - 106   2019.7

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  • 【妊娠糖尿病のクリニカルクエスチョン〜GDM完全理解までの12の質問〜】肥満を伴った妊娠糖尿病の管理

    増山 寿

    月刊糖尿病   11 ( 1 )   46 - 51   2019.7

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  • 当院におけるlate preterm児の転帰と早期新生児予後

    大平 安希子, 谷 和祐, 牧 尉太, 江口 武志, 玉田 祥子, 光井 崇, 衛藤 英理子, 早田 桂, 森本 大作, 岡村 朋香, 鷲尾 洋介, 吉本 順子, 増山 寿

    日本周産期・新生児医学会雑誌   55 ( 2 )   644 - 644   2019.6

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  • 糖尿病モデルマウス(KK/TaJcl)の胎盤におけるHIF-1α及び血漿中のsFlt-1とPlGFの産生に関する検討 Reviewed

    光井 崇, 大平 安希子, 谷 和祐, 牧 尉太, 江口 武志, 玉田 祥子, 衛藤 英理子, 早田 桂, 増山 寿

    日本女性栄養・代謝学会誌   25   41 - 42   2019.6

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  • 妊娠肥満マウスを用いた肥満・耐糖能異常関連素因の世代間連鎖の解明 Reviewed

    増山 寿, 大平 安希子, 谷 和祐, 牧 尉太, 江口 武志, 玉田 祥子, 光井 崇, 衛藤 英理子, 早田 桂

    日本周産期・新生児医学会雑誌   55 ( 2 )   463 - 463   2019.6

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  • 周産期緊急搬送システム"iPicss"を用いた周産期搬送連携および災害発生後の連絡体制の構築 Reviewed

    牧 尉太, 早田 桂, 大平 安希子, 谷 和祐, 江口 武志, 玉田 祥子, 光井 崇, 衛藤 英理子, 増山 寿

    日本周産期・新生児医学会雑誌   55 ( 2 )   506 - 506   2019.6

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  • 放線菌感染症による浸潤性骨盤部腫瘤と診断し保存的加療にて改善し得たIUD非挿入症例

    有澤 理美, 牛尾 友紀, 増山 寿

    現代産婦人科   67 ( 2 )   297 - 301   2019.6

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    放線菌症は嫌気性〜微好気性の放線菌属の細菌(Actinomyces.israeliiが最も頻度が高い)により引き起こされ、多発膿瘍、肉芽形成や線維化を起こす稀な慢性化膿性肉芽腫性疾患である。婦人科領域においては、その原因として子宮内避妊具(intrauterine device:以下IUD)との関連性が注目されているが、IUD非挿入例における症例は極めて稀である。我々は、画像診断にて放線菌症を疑い、保存的加療が奏功したIUD非挿入症例を経験した。症例は72歳、2妊2産、45歳で閉経されており既往歴は虫垂炎のみであった。下腹部痛、腹部膨満感を主訴に前医受診、整腸剤で経過観察されていたが2ヵ月経過しても改善乏しく、精査加療目的に当科へ紹介された。当科初診時には帯下の増加、夜間発熱、体重減少の主訴もみられた。内診・腟鏡診で特記事項はなく、bulkyな腫瘍は認めなかった。経腟超音波では子宮体部45.3×44.3mm(辺縁不整で境界不明瞭)、子宮内膜4mm、右卵巣27.6×21.9mm、左卵巣は確認できなかった。右尿管は径2cmと水尿管を呈していた。血液検査ではWBC13,700/μL(好中球77.8%)、CRP8.42mg/dLと炎症反応の上昇を認めた。骨盤腹膜炎や悪性腫瘍の可能性を考え、早急の骨盤内精査が必要と判断し、腹部造影CTを施行したところ子宮やその周囲に浸潤する広範囲な炎症所見を認めた。放線菌症を疑い、子宮内容物の病理学的検査(Grocott染色)で放線菌を確認し、放線菌感染症と診断した。AMPC内服で治療は奏功し、速やかに症状の改善及び炎症反応の低下を認めた。AMPC内服を約2ヵ月半施行し、腹部造影CTで炎症像の著明な縮小を確認したのち治療終了とした。IUD非挿入例でも、画像検査で充実成分主体の膿瘍形成を認め、周囲に浸潤傾向のある所見をみれば、放線菌症も念頭に鑑別を行い、必要であればGrocott染色やグラム染色なども考慮すべきである。(著者抄録)

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  • 治療前サルコペニアは子宮頸癌の予後を反映しない

    松岡 敬典, 中村 圭一郎, 松原 侑子, 依田 尚之, 西條 昌之, 西田 傑, 小川 千加子, 増山 寿

    日本婦人科腫瘍学会雑誌   37 ( 3 )   477 - 477   2019.6

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  • 当院で縮小手術を施行した75歳以上の子宮体癌患者の検討

    依田 尚之, 中村 圭一郎, 松原 侑子, 西條 昌之, 松岡 敬典, 西田 傑, 小川 千加子, 増山 寿

    日本婦人科腫瘍学会雑誌   37 ( 3 )   503 - 503   2019.6

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  • 子宮全摘子宮頸癌放射線治療後残存に対するSalvage Surgeryの8例

    小川 千加子, 松原 侑子, 松岡 敬典, 依田 尚之, 西田 傑, 中村 圭一郎, 増山 寿

    日本婦人科腫瘍学会雑誌   37 ( 3 )   475 - 475   2019.6

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  • 当院における新定義による妊娠高血圧症候群の周産期背景に関する後方視的検討

    谷 和祐, 三島 桜子, 大平 安希子, 牧 尉太, 江口 武志, 玉田 祥子, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿

    日本周産期・新生児医学会雑誌   55 ( 2 )   664 - 664   2019.6

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  • 当院の子宮頸癌症例におけるFIGO2018分類での検討

    松原 侑子, 中村 圭一郎, 松岡 敬典, 西條 昌之, 依田 尚之, 西田 傑, 小川 千加子, 増山 寿

    日本婦人科腫瘍学会雑誌   37 ( 3 )   443 - 443   2019.6

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  • チョコレート嚢胞破裂を保存的加療後に帝王切開同時片側附属器切除術を施行した血小板無力症合併妊娠の1例

    江口 武志, 早田 桂, 大平 安希子, 谷 和祐, 牧 尉太, 玉田 祥子, 光井 崇, 衞藤 英理子, 増山 寿

    日本周産期・新生児医学会雑誌   55 ( 2 )   432 - 432   2019.6

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  • 分娩後出血時の下腹部造影CTは治療選択に有用か

    早田 桂, 三島 桜子, 大平 安希子, 谷 和祐, 牧 尉太, 玉田 祥子, 光井 崇, 衛藤 英理子, 増山 寿

    日本周産期・新生児医学会雑誌   55 ( 2 )   587 - 587   2019.6

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  • 後腹膜に発生した巨大Lipoleiomyomaの一例

    片山 沙希, 久保 光太郎, 松岡 敬典, 依田 尚之, 西田 傑, 小川 千加子, 中村 圭一郎, 増山 寿

    現代産婦人科   67 ( 2 )   341 - 345   2019.6

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    Lipoleiomyomaは稀な良性腫瘍であり、その多くは子宮体部発生であり後腹膜発生は稀である。今回我々は、術中に後腹膜由来と判明したLipoleiomyomaの1例を経験したので文献的考察を交えて報告する。症例は58歳女性、1ヵ月前より急速に進行する腹部膨満感を主訴に前医を受診した。MRI検査にて、腹腔内を占める30cm超の巨大腫瘤を指摘された。卵巣癌が疑われ、当院を紹介受診された。当院で画像を再読影し、画像所見から子宮筋腫変性が第一に疑われたが発生由来臓器は特定できなかった。治療と診断目的にて開腹手術の方針となった。腫瘍は柔らかく後腹膜腔に存在しており、子宮との連続性は認められなかった。腫瘍は内容液を含め10kgを超えていた。子宮と両側付属器は肉眼的に異常所見を認めなかったが、腫瘍が子宮由来である可能性も考慮し、子宮全摘出術と両側付属器切除を施行した。術中出血は1250mlと多く、輸血を必要とした。術後病理検査ではLipoleiomyomaであり、術後経過は良好であった。Lipoleiomyomaは閉経前後の女性に多く認められ、急速増大した症例報告も認められている。後腹膜発生の症例も報告されているが、画像診断のみでは発生由来の判別は困難な場合もある。脂肪組織を含有する巨大な骨盤内腫瘍を認めた場合には当疾患も念頭において、十分な準備の後に手術を選択する必要がある。(著者抄録)

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  • 分娩時のアロマテラピー使用の有用性について

    高原 悦子, 衛藤 英理子, 早田 桂, 増山 寿, 平松 祐司

    アロマテラピー学雑誌   20 ( 2 )   22 - 27   2019.6

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    古来より経験的に用いられてきたエッセンシャルオイルであるが、近年医療現場でもいろいろな目的で用いられるようになってきた。産科領域では分娩後などにサービスとしてトリートメントの提供を行っている産院も多くある。しかし、補完療法の一環として用いている病院は少ないと思われる。今回エッセンシャルオイルを分娩時に用い疼痛緩和や血圧低下、分娩時間の短縮が得られるかを検討した。疼痛緩和、分娩時間の短縮は認め、分娩時の被験者のリラクゼーションや満足度にはつながった。血圧変化、出血量の減少は認めず、今後データの蓄積が必要と思われた。産科領域でのアロマテラピーの使用は、治療というよりサービスの提供を希望する被験者が多く、現時点では補完療法としてのアロマテラピーは発展途上にあると考えられた。(著者抄録)

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  • 【心疾患合併妊娠と心エコー】わかりやすく解説! 妊娠に伴う血行動態の変化

    増山 寿

    心エコー   20 ( 5 )   450 - 453   2019.5

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  • レプチン・グレリンによる卵胞ステロイド合成系への影響

    長谷川 徹, 樫野 千明, 中野 靖浩, 長尾 聡子, 細谷 武史, 岩田 菜穂子, 鎌田 泰彦, 増山 寿, 大塚 文男

    日本内分泌学会雑誌   95 ( 1 )   499 - 499   2019.4

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  • Successful Delivery after Abdominal Radical Trachelectomy, Using Transabdominal Cerclage in Early Pregnancy. Reviewed

    Shoko Tamada, Hisashi Masuyama, Kei Hayata, Eriko Eto, Takashi Mitsui, Takeshi Eguchi, Jota Maki, Kazumasa Tani

    Acta medica Okayama   73 ( 2 )   173 - 176   2019.4

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    Radical trachelectomy (RT) is a fertility-sparing surgery for cervical cancer. Postoperative pregnancies have a high risk of abortion and prematurity. To prevent this, a procedure involving transabdominal cerclage (TAC) was devised for shortened cervical canals post-RT. Here we describe the successful management of a pregnancy after abdominal RT (ART). The 34-year-old patient was gravida 1, para 0. When she was 27, she underwent ART for stage Ib1 cervical cancer, and she became pregnant 7 years later. Because her cervical canal was 16.7 mm during early pregnancy, we performed TAC at 12 weeks of pregnancy. Post-surgery, we administered an infusion of ritodrine hydrochloride for tocolysis. A selective caesarean section was performed at 36 weeks, with the delivery of a healthy infant.

    DOI: 10.18926/AMO/56653

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  • グルココルチコイドによる卵胞ステロイド合成に与える影響とその機序の検討

    樫野 千明, 長谷川 徹, 中野 靖浩, 長尾 聡子, 岩田 菜穂子, 西山 悠紀, 細谷 武史, 鎌田 泰彦, 増山 寿, 大塚 文男

    日本内分泌学会雑誌   95 ( 1 )   500 - 500   2019.4

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  • HER2陽性大腸癌における形質発現および遺伝子変異の不均一性の検討

    加藤 寿一, 馬場 正道, 中島 晋, 増山 守, 重松 忠, 森谷 鈴子, 九嶋 亮治, 杉原 洋行

    日本病理学会会誌   108 ( 1 )   373 - 373   2019.4

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  • 低悪性度リンパ腫の一例

    加藤 寿一, 馬場 正道, 北村 憲一, 古屋 彩, 口分田 美奈, 平本 秀一, 増山 守, 森谷 鈴子, 九嶋 亮治

    済生会滋賀県病院医学誌   28   59 - 59   2019.4

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  • 【どうする?妊娠合併婦人科腫瘍の管理】妊娠合併婦人科腫瘍の周術期管理とフォローアップ

    増山 寿

    産科と婦人科   86 ( 3 )   359 - 365   2019.3

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    妊娠に伴い、母体には著しい解剖学的、生理的変化が起こることを理解したうえで周術期管理を行う。手術による流早産の可能性がある場合は、早産による児の予後も含めて術前に十分なICを行う。また胎児、胎盤や子宮収縮を必ず評価する。術後は子宮収縮予防からも積極的な鎮痛が必要である。血栓塞栓症の発症リスクが非常に高いことから、脱水予防や早期離床に加えて、リスク分類に応じて間欠的空気圧迫法や未分画または低用量低分子ヘパリン投与を行う。子宮収縮にも注意が必要である。(著者抄録)

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    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J00525&link_issn=&doc_id=20190222210013&doc_link_id=%2Fae4sanke%2F2019%2F008603%2F014%2F0359-0365%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fae4sanke%2F2019%2F008603%2F014%2F0359-0365%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • Sarcopenia Is Not a Prognostic Factor of Outcome in Patients With Cervical Cancer Undergoing Concurrent Chemoradiotherapy or Radiotherapy. International journal

    Hirofumi Matsuoka, Keiichiro Nakamura, Yuko Matsubara, Naoyuki Ida, Takeshi Nishida, Chikako Ogawa, Kuniaki Katsi, Susumu Kanazawa, Hisashi Masuyama

    Anticancer research   39 ( 2 )   933 - 939   2019.2

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    BACKGROUND/AIM: The objective of this study was to determine if sarcopenia was a predictor of poor prognosis in patients with cervical cancer (CC) undergoing concurrent chemoradiation therapy (CCRT) or radiation therapy (RT). MATERIALS AND METHODS: A total of 236 patients with CC undergoing CCRT or RT were retrospectively examined. We determined if clinical characteristics and survival were correlated with pretreatment sarcopenia, measured as psoas muscle index (PI) or skeletal muscle index (SMI). RESULTS: Pretreatment PI and SMI were related to parametrial involvement with CC undergoing CCRT or RT (p=0.002, and, p=0.034, respectively). The median progression-free survival (PFS) and overall survival (OS) times in patients undergoing CCRT or RT were 29.0 and 34.5 months, respectively. Neither PI nor SMI were prognostic predictors in patients with CC undergoing CCRT or RT. CONCLUSION: Sarcopenia is not a predictive factor of outcome in patients with CC undergoing CCRT or RT.

    DOI: 10.21873/anticanres.13196

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  • 前置胎盤症例に対する術中経腟エコーの有用性について Reviewed

    早田 桂, 大平 安希子, 牧 尉太, 谷 和祐, 江口 武志, 玉田 祥子, 光井 崇, 衛藤 英理子, 増山 寿

    日本産科婦人科学会雑誌   71 ( 臨増 )   S - 393   2019.2

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  • 当院における帝王切開症例のRobson分類による検討

    三苫 智裕, 光井 崇, 早田 桂, 谷 和祐, 牧 尉太, 江口 武志, 玉田 祥子, 衛藤 英理子, 増山 寿

    日本産科婦人科学会雑誌   71 ( 臨増 )   S - 463   2019.2

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  • 上皮性卵巣癌患者の筋肉量と予後予測について

    松原 侑子, 中村 圭一郎, 松岡 敬典, 西條 昌之, 依田 尚之, 西田 傑, 小川 千加子, 増山 寿

    日本産科婦人科学会雑誌   71 ( 臨増 )   S - 604   2019.2

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  • 仙骨前面low grade fibromyxoid sarcomaの1例

    飯高 大介, 芝本 純, 高嶋 祐助, 中島 晋, 藤山 准真, 加藤 寿一, 馬場 正道, 増山 守

    日本臨床外科学会雑誌   80 ( 2 )   422 - 427   2019.2

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    Low grade fibromyxoid sarcoma(以下,LGFMSと略記)は稀な軟部腫瘍であり,長期的に転移再発をきたす悪性の臨床像を呈する.今回,骨盤内LGFMSの1例を経験したので報告する.症例は43歳の男性で,便通異常を主訴に来院した.腹部造影CTにて仙骨前面に約11cm大の腫瘤性病変を認めた.術前に経直腸的に穿刺生検を施行したが確定診断は得られなかった.経仙骨および経腹アプローチで剥離断端を確保し腫瘍摘出,直腸低位前方切除術を施行した.病理組織所見では線維成分と粘液腫様成分の混在より成っており,免疫染色でMUC4陽性であることを併せてLGFMSと診断した.術後経過は良好で術後3年を経て再発を認めていない.仙骨前面のLGFMSは極めて稀ではあるが,軟部腫瘍の鑑別診断として考慮すべきであり,またその再発までの期間は長期にわたるため経過観察が必要である.(著者抄録)

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    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J03156&link_issn=&doc_id=20190306040031&doc_link_id=10.3919%2Fjjsa.80.422&url=https%3A%2F%2Fdoi.org%2F10.3919%2Fjjsa.80.422&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • 子宮頸部腺癌に対する同時化学放射線療法に関する多施設共同調査研究

    長井 裕, 三上 幹男, 武隈 宗孝, 喜多川 亮, 長尾 昌二, 戸澤 晃子, 西尾 真, 小林 栄仁, 生水 真紀夫, 宮城 悦子, 横田 治重, 笠松 由佳, 青木 陽一, 岩瀬 春子, 山口 聡, 苛原 稔, 横山 正俊, 八重樫 伸生, 増山 寿, 竹原 和宏, 中村 俊昭, 青木 大輔, 早瀬 良二, 中村 和人, 田畑 務, 上浦 祥司, 岩佐 尚美, 平澤 猛, 杉野 法広, 塩沢 丹里, 小林 浩, 松元 隆, 森重 健一郎, 北 正人, 板持 広明, 菊池 朗, 杉浦 真弓, 藤原 葉一郎, 徳山 治, 大石 徹郎, 小林 裕明, 渡利 英道, 水野 美香, 吉田 好雄, 村上 文洋, 高橋 慶行, 横井 猛, 楢原 久司, 小寺 宏平, 横山 良仁, 沖 明典, 中西 慶喜, 水之江 知哉, 杉山 徹

    日本産科婦人科学会雑誌   71 ( 臨増 )   S - 324   2019.2

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  • 当院におけるトリソミー児の診断とその転帰について

    大平 安希子, 谷 和祐, 牧 尉太, 江口 武志, 玉田 祥子, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿

    日本産科婦人科学会雑誌   71 ( 臨増 )   S - 653   2019.2

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  • 腹腔鏡下両側付属器切除後に判明した正常大卵巣の明細胞境界悪性腫瘍の一例

    片山 沙希, 久保 光太郎, 松岡 敬典, 依田 尚之, 西田 傑, 小川 千加子, 中村 圭一郎, 増山 寿

    日本産科婦人科学会雑誌   71 ( 臨増 )   S - 625   2019.2

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  • 当院における胎児診断された胎児心構築異常の分娩転機の検討

    江口 武志, 大平 安希子, 牧 尉太, 谷 和祐, 玉田 祥子, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿

    日本産科婦人科学会雑誌   71 ( 臨増 )   S - 651   2019.2

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  • 異なる転帰をたどった成熟嚢胞性奇形腫を伴う抗NMDA受容体抗体脳炎の2症例

    西田 傑, 松原 侑子, 依田 尚之, 松岡 敬典, 西條 昌之, 小川 千加子, 中村 圭一郎, 増山 寿

    日本産科婦人科学会雑誌   71 ( 臨増 )   S - 527   2019.2

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  • Classification of factors involved in nonreportable results of noninvasive prenatal testing (NIPT) and prediction of success rate of second NIPT. Reviewed International journal

    Nobuhiro Suzumori, Akihiko Sekizawa, Eri Takeda, Osamu Samura, Aiko Sasaki, Rina Akaishi, Seiji Wada, Haruka Hamanoue, Fumiki Hirahara, Hiroko Kuriki, Hideaki Sawai, Hiroaki Nakamura, Takahiro Yamada, Kiyonori Miura, Hideaki Masuzaki, Takahiro Yamashita, Yoshimasa Kamei, Akira Namba, Jun Murotsuki, Tomohiro Tanemoto, Akimune Fukushima, Kazufumi Haino, Shinya Tairaku, Keiichi Matsubara, Kazutoshi Maeda, Takashi Kaji, Masanobu Ogawa, Hisao Osada, Haruki Nishizawa, Yoko Okamoto, Takeshi Kanagawa, Aiko Kakigano, Masayuki Endo, Michihiro Kitagawa, Masaki Ogawa, Shunichiro Izumi, Yukiko Katagiri, Naoki Takeshita, Yasuyo Kasai, Katsuhiko Naruse, Reiko Neki, Hisashi Masuyama, Maki Hyodo, Yukie Kawano, Takashi Ohba, Kiyotake Ichizuka, Takeshi Nagamatsu, Atsushi Watanabe, Naomi Nishikawa, Naoki Hamajima, Nahoko Shirato, Junko Yotsumoto, Miyuki Nishiyama, Keiko Koide, Tatsuko Hirose, Haruhiko Sago

    Prenatal diagnosis   39 ( 2 )   100 - 106   2019.1

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    OBJECTIVE: To evaluate the reasons for nonreportable cell-free DNA (cfDNA) results in noninvasive prenatal testing (NIPT), we retrospectively studied maternal characteristics and other details associated with the results. METHODS: A multicenter retrospective cohort study in pregnant women undergoing NIPT by massively parallel sequencing (MPS) with failed cfDNA tests was performed between April 2013 and March 2017. The women's data and MPS results were analyzed in terms of maternal characteristics, test performance, fetal fraction (FF), z scores, anticoagulation therapy, and other details of the nonreportable cases. RESULTS: Overall, 110 (0.32%) of 34 626 pregnant women had nonreportable cfDNA test results after an initial blood sampling; 22 (20.0%) cases had a low FF (<4%), and 18 (16.4%) cases including those with a maternal malignancy, were found to have altered genomic profile. Approximately half of the cases with nonreportable results had borderline z score. Among the women with nonreportable results because of altered genomic profile, the success rate of retesting using a second blood sampling was relatively low (25.0%-33.3%). Thirteen (11.8%) of the women with nonreportable results had required hypodermic heparin injection. CONCLUSIONS: The classification of nonreportable results using cfDNA analysis is important to provide women with precise information and to reduce anxiety during pregnancy.

    DOI: 10.1002/pd.5408

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  • Mott cellの目立つ低悪性度B細胞リンパ腫の1例

    加藤 寿一, 馬場 正道, 北村 憲一, 平本 秀一, 増山 守, 加藤 元一, 杉原 洋行, 森谷 鈴子, 九嶋 亮治

    診断病理   36 ( 1 )   52 - 56   2019.1

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    腹痛を主訴に来院した70代女性。CTにて腹腔内リンパ節腫脹を認め、リンパ節生検が施行された。リンパ節では好酸性顆粒を有するリンパ球様細胞の増生がみられた。免疫組織化学やin situ hybridizationの結果、これらの細胞はRussell bodyに富むB細胞性の腫瘍細胞であり、いわゆる「Mott cells」であることが分かった。最終的にlow-grade B-cell lymphoma rich in Mott cellsと診断した。Mott cellを持つ低悪性度B細胞リンパ腫について、若干の文献的考察をまじえてその特徴に言及した。(著者抄録)

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  • 妊娠中断直後に卵子凍結保存を行った重症筋無力症合併胸腺腫症例の経験

    酒本 あい, 樫野 千明, 久保 光太郎, 長谷川 徹, 鎌田 泰彦, 本田 徹郎, 中塚 幹也, 増山 寿

    日本がん・生殖医療学会誌   2 ( 1 )   129 - 129   2019.1

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  • 妊娠20週に急性大動脈解離、大動脈弁輪拡張症を発症し生児を得たMarfan症候群の一例(A case of acute aortic dissection and annulo-aortic ectasia in a pregnant woman with Marfan syndrome at the 20th week of gestation)

    三島 桜子, 森川 恵司, 石田 理, 入江 恭平, 清水 かれん, 築澤 良亮, 久保 倫子, 植田 麻衣子, 片山 陽介, 原賀 順子, 関野 和, 依光 正枝, 上野 尚子, 中西 美恵, 児玉 順一, 牧 尉太, 増山 寿

    日本成人先天性心疾患学会雑誌   8 ( 1 )   150 - 150   2019.1

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  • 当院で経験した先天性心疾患合併妊娠症例についての検討(Evaluation of cases of pregnancy with adult congenital heart disease)

    入江 恭平, 三島 桜子, 上野 尚子, 清水 かれん, 築澤 良亮, 久保 倫子, 森川 恵司, 植田 麻衣子, 片山 陽介, 原賀 順子, 関野 和, 依光 正枝, 中西 美恵, 石田 理, 児玉 順一, 牧 尉太, 増山 寿

    日本成人先天性心疾患学会雑誌   8 ( 1 )   151 - 151   2019.1

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  • ご当地ACHDセンター診療の実際;上手くいってることはもちろん、そうでないことも全て見せます 岡山大学病院ACHDセンターの試み(ACHD Management System of Okayama University Hospital)

    赤木 禎治, 杜 徳尚, 大月 審一, 増山 寿, 大西 秀樹, 木野村 賢, 大森 一弘, 笠原 真悟, 伊藤 浩

    日本成人先天性心疾患学会雑誌   8 ( 1 )   79 - 79   2019.1

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  • ACHD患者の妊娠・出産そして授乳の問題を考える ACHD患者の分娩管理(The management of delivery in patients with ACHD)

    衛藤 英理子, 増山 寿

    日本成人先天性心疾患学会雑誌   8 ( 1 )   86 - 86   2019.1

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  • A Case of Nager Syndrome Diagnosed Before Birth Reviewed

    Hayata Kei, Masuyama Hisashi, Eto Eriko, Mitsui Takashi, Tamada Shoko, Eguchi Takeshi, Maki Jota, Tani Kazumasa, Ohira Akiko, Washio Yosuke, Yoshimoto Junko, Hasegawa Kosei

    ACTA MEDICA OKAYAMA   73 ( 3 )   273 - 277   2019

  • 糖尿病合併妊婦と妊娠糖尿病妊婦の妊娠経過に伴う安静時代謝量の変化 Reviewed

    衛藤 英理子, 大平 安希子, 谷 和祐, 牧 尉太, 江口 武志, 玉田 祥子, 光井 崇, 早田 桂, 増山 寿

    糖尿病と妊娠   18 ( 3 )   S - 83   2018.11

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  • リアルタイムCGMを用いた陣痛発来後から産褥早期までの血糖動態の検討 Reviewed

    牧 尉太, 衛藤 英理子, 中村 圭一郎, 平松 祐司, 増山 寿

    糖尿病と妊娠   18 ( 3 )   S - 92   2018.11

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  • 1型糖尿病妊婦と正常妊婦および妊娠糖尿病妊婦の分娩前CGMデータを用いた比較検討 Reviewed

    渡邉 真由, 牧 尉太, 片山 晶博, 勅使川原 早苗, 利根 淳仁, 江口 潤, 増山 寿, 和田 淳

    糖尿病と妊娠   18 ( 3 )   S - 90   2018.11

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  • GDM妊婦の産後フォローアップ対策による改善の状況とフォローの弊害に関する検討 Reviewed

    瀬尾 里奈, 牧 尉太, 衛藤 英理子, 増山 寿

    糖尿病と妊娠   18 ( 3 )   S - 89   2018.11

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  • 急性・慢性心不全診療ガイドライン(2017年改訂版) ステージ分類における診断・治療のポイント

    原田 和昌, 斎藤 能彦, 坂田 泰史, 増山 理

    臨床医のための循環器診療   ( 29 )   3 - 16   2018.11

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  • 低酸素条件下のヒト絨毛細胞株HTR-8/SVneoにおけるEG-VEGFとMMPsの産生

    谷 和祐, 大平 安希子, 牧 尉太, 江口 武志, 玉田 祥子, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿

    日本妊娠高血圧学会雑誌   25   113 - 113   2018.11

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  • 胎児発育不全児の分娩既往のある女性における不育症のリスク因子

    樫野 千明, 小谷 早葉子, 久保 光太郎, 長谷川 徹, 酒本 あい, 鎌田 泰彦, 増山 寿, 中塚 幹也

    Reproductive Immunology and Biology   33 ( 1-2 )   111 - 111   2018.11

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  • 婦人科がんサバイバーは健康的な生活を心掛けている Reviewed

    中村 圭一郎, 松岡 敬典, 牧 尉太, 西條 昌之, 依田 尚之, 増山 寿

    日本女性医学学会雑誌   26 ( Suppl. )   237 - 237   2018.10

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  • Mott cellの目立つ低悪性度リンパ腫の一例

    加藤 寿一, 馬場 正道, 北村 憲一, 平本 秀一, 増山 守, 加藤 元一, 杉原 洋行, 森谷 鈴子, 九嶋 亮治

    臨床病理   66 ( 補冊 )   228 - 228   2018.10

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  • The Influence of Chemotherapy-Induced Peripheral Neuropathy on Quality of Life of Gynecologic Cancer Survivors. Reviewed

    Matsuoka H, Nakamura K, Matsubara Y, Ida N, Saijo M, Ogawa C, Masuyama H

    International journal of gynecological cancer : official journal of the International Gynecological Cancer Society   28 ( 7 )   1394 - 1402   2018.9

  • 妊婦の緊急搬送体制改善に向けた院内改革と県下の取り組み 搬送システムOKAYAMA Picssと搬送補助アプリiPicss Appの開発 Reviewed

    牧 尉太, 早田 桂, 大平 安希子, 谷 和祐, 玉田 祥子, 江口 武志, 光井 崇, 衛藤 恵理子, 増山 寿

    現代産婦人科   67 ( Suppl. )   S50 - S50   2018.9

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  • Upregulation of Angiogenic Factors via Protein Kinase C and Hypoxia-induced Factor-1α Pathways under High-glucose Conditions in the Placenta. Reviewed

    Takashi Mitsui, Kazumasa Tani, Jota Maki, Takeshi Eguchi, Shoko Tamada, Eriko Eto, Kei Hayata, Hisashi Masuyama

    Acta medica Okayama   72 ( 4 )   359 - 367   2018.8

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    Abnormal glucose metabolism during pregnancy is an established risk factor for preeclampsia (PE). Disruption of the balance between placental angiogenic factors is linked to PE pathophysiology. We examined whether hypoxia-induced factor-1α (HIF-1α) and protein kinase Cβ (PKCβ) are involved in the regulation of placental angiogenic factors under high-glucose conditions in vitro. The human choriocarcinoma cell lines BeWo and JEG-3, and the human trophoblast cell line HTR-8/SVneo were cultured with 10 and 25 mmol/L glucose [control glucose group (CG) and high-glucose group (HG), respectively]. We examined the changes in HIF-1α, soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and vascular endothelial growth factor (VEGF) expression in the CG and HG by real-time PCR and ELISA. PKC activation was also measured by ELISA. The expressions of HIF-1α, sFlt-1, PlGF, and VEGF were significantly higher in the HG than in the CG. PKC activity was significantly increased in the HG. High glucose affected the expression of angiogenic factors in choriocarcinoma cells via the PKCβ and HIF-1α pathways, suggesting their involvement in PE pathogenesis.

    DOI: 10.18926/AMO/56171

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  • オレキシンによるBMPシグナルの抑制と卵胞プロゲステロン産生への影響

    藤田 志保, 長谷川 徹, 西山 悠紀, 藤澤 諭, 細谷 武史, 中野 靖浩, 岩田 菜穂子, 鎌田 泰彦, 増山 寿, 大塚 文男

    日本生殖医学会雑誌   63 ( 3 )   309 - 309   2018.8

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  • 本邦におけるGDMは本当に2型糖尿病になりやすいのか?その頻度は?フォローアップを確実に行うためには? Time to Act GDM既往女性のフォローアップ率の低さに対する対策 当院の改革 Reviewed

    牧 尉太, 衛藤 英理子, 平松 祐司, 増山 寿

    糖尿病と妊娠   18 ( 2 )   S - 32   2018.8

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    昨今、本学会でも各施設におけるフォローアップ向上を目指す取り組みが発表されている。岡山大学でも2016年夏以降、糖代謝異常合併妊婦の産前・産後の抜けのないFollowを行うため5つの策"OKAYAMA Method"を開始した。チーム一丸でGDM既往女性のDM発症を予防するために講じた策の詳細を紹介する。(著者抄録)

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  • Interaction between orexin A and bone morphogenetic protein system on progesterone biosynthesis by rat granulosa cells Reviewed

    Shiho Fujita, Toru Hasegawa, Yuki Nishiyama, Satoshi Fujisawa, Yasuhiro Nakano, Takahiro Nada, Nahoko Iwata, Yasuhiko Kamada, Hisashi Masuyama, Fumio Otsuka

    Journal of Steroid Biochemistry and Molecular Biology   181   73 - 79   2018.7

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    The involvement of orexins in reproductive function has been gradually uncovered. However, the functional role of orexins in ovarian steroidogenesis remains unclear. In the present study, we investigated the effects of orexin A on ovarian steroidogenesis by using rat primary granulosa cells that express both OX1 and OX2 receptors for orexins. Treatment with orexin A enhanced progesterone, but not estradiol, biosynthesis induced by FSH, whereas it did not affect basal levels of progesterone or estradiol. In accordance with the effects on steroidogenesis, orexin A increased the mRNA levels of progesterogenic enzymes, including StAR, P450scc and 3βHSD, but not P450arom, and cellular cAMP synthesis induced by FSH. Under the condition of blockage of endogenous BMP actions by noggin or BMP-signaling inhibitors, orexin A failed to increase levels of progesterone synthesis induced by FSH treatment, suggesting that endogenous BMP activity in granulosa cells might be involved in the enhancement of progesterone synthesis by orexin A. Treatment with orexin A impaired Smad1/5/9 activation as well as Id-1 mRNA expression stimulated by BMP-6 and BMP-7, the latter of which was reversed by treatment with an OX1 antagonist. It was also found that orexin A suppressed the mRNA expression of both type-I and -II receptors for BMPs and increased that of inhibitory Smad6 and Smad7 in granulosa cells. On the other hand, treatments with BMP-6 and -7 suppressed the expression of OX1 and OX2. Collectively, the results indicated that orexin A enhances FSH-induced progesterone production, at least in part, by downregulating BMP signaling in granulosa cells. Thus, a new role of orexin A in facilitating progesterone synthesis and functional interaction between the orexin and BMP systems in granulosa cells were revealed.

    DOI: 10.1016/j.jsbmb.2018.03.004

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  • Assessment of resting energy expenditure and body composition in Japanese pregnant women with diabetes. Reviewed

    Eriko Eto, Jota Maki, Shoko Tamada, Takashi Mitsui, Kei Hayata, Yuji Hiramatsu, Hisashi Masuyama

    Journal of diabetes investigation   9 ( 4 )   959 - 966   2018.7

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    AIMS/INTRODUCTION: To measure longitudinal changes in resting energy expenditure and body composition of Japanese pregnant women with or without diabetes. MATERIALS AND METHODS: The study population consisted of women who had delivered a live singleton neonate after 22 weeks' gestation at Okayama University Hospital from July 2013 to June 2017. Resting energy expenditure and body composition were measured in the first trimester, second trimester, third trimester and postpartum. RESULTS: A total of 144 women participated in this study: 103 with normal glucose tolerance and 41 with diabetes. The resting energy expenditure (kcal/day) of pregnant women with normal glucose tolerance was significantly higher in the third trimester (1,644 ± 234) than in the first (1,461 ± 215) and second trimesters (1,491 ± 219), and postpartum (1,419 ± 254), whereas that of pregnant women with diabetes did not significantly change during all periods (1,568 ± 404, 1,710 ± 332, 1,716 ± 251, 1,567 ± 249). The resting energy expenditure of women with good glycemic control was lower than that of women with poor control. Fat-free mass was closely correlated with resting energy expenditure. CONCLUSIONS: The resting energy expenditure of Japanese pregnant women with normal glucose tolerance was significantly increased in the third trimester. The resting energy expenditure of women with good glycemic control was lower than that of women with poor control. Resting energy expenditure and fat-free mass are potential indexes for medical nutrition therapy in pregnant women with diabetes.

    DOI: 10.1111/jdi.12795

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  • この症例をどうするか?:妊娠、出産へのアプローチ Fontan手術後に挙児希望をされているが、低酸素血症が持続している1症例 Reviewed

    杜 徳尚, 赤木 禎治, 黒子 洋介, 馬場 健児, 板谷 慶一, 牧 尉太, 小谷 恭弘, 大月 審一, 増山 寿, 笠原 真悟, 伊藤 浩

    日本小児循環器学会雑誌   34 ( Suppl.1 )   s1 - 156   2018.7

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  • 【妊娠糖尿病まるわかり 妊娠中・分娩時・産後&新生児の管理に関する最新アプローチ】産婦が意識消失、どう対応する? 母体急変対応 Reviewed

    牧 尉太, 増山 寿

    ペリネイタルケア   37 ( 7 )   652 - 656   2018.7

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  • 成人先天性心疾患センターにおけるハイリスク妊娠に対するアプローチ 妊娠中の抗凝固療法管理はどうあるべきか?

    赤木 禎治, 杜 徳尚, 高橋 生, 増山 寿, 伊藤 浩

    日本小児循環器学会雑誌   34 ( Suppl.1 )   s1 - 191   2018.7

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  • 血糖モニター(リアルタイムCGM)を用いた糖代謝異常妊婦の陣痛発来後の血糖動態および血糖管理方法の検討 Reviewed

    牧 尉太, 谷 和祐, 玉田 祥子, 江口 武志, 光井 崇, 衛藤 英理子, 早田 桂, 平松 祐司, 増山 寿

    日本周産期・新生児医学会雑誌   54 ( 2 )   655 - 655   2018.6

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  • 全前脳胞症に22q11.2欠失症候群を合併した1例 Reviewed

    谷 和祐, 牧 尉太, 江口 武志, 玉田 祥子, 岡村 朋香, 光井 崇, 衛藤 英理子, 早田 桂, 鷲尾 洋介, 吉本 順子, 増山 寿

    日本周産期・新生児医学会雑誌   54 ( 2 )   720 - 720   2018.6

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  • 糖尿病合併妊婦と妊娠糖尿病妊婦の妊娠経過に伴う安静時代謝量の変化 Reviewed

    衛藤 英理子, 谷 和祐, 牧 尉太, 江口 武志, 玉田 祥子, 早田 桂, 増山 寿

    日本周産期・新生児医学会雑誌   54 ( 2 )   656 - 656   2018.6

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  • Fetal cell-free DNA fraction in maternal plasma for the prediction of hypertensive disorders of pregnancy. Reviewed International journal

    Nobuhiro Suzumori, Akihiko Sekizawa, Takeshi Ebara, Osamu Samura, Aiko Sasaki, Rina Akaishi, Seiji Wada, Haruka Hamanoue, Fumiki Hirahara, Haruna Izumi, Hideaki Sawai, Hiroaki Nakamura, Takahiro Yamada, Kiyonori Miura, Hideaki Masuzaki, Takahiro Yamashita, Takashi Okai, Yoshimasa Kamei, Akira Namba, Jun Murotsuki, Tomohiro Tanemoto, Akimune Fukushima, Kazufumi Haino, Shinya Tairaku, Keiichi Matsubara, Kazutoshi Maeda, Takashi Kaji, Masanobu Ogawa, Hisao Osada, Haruki Nishizawa, Yoko Okamoto, Takeshi Kanagawa, Aiko Kakigano, Michihiro Kitagawa, Masaki Ogawa, Shunichiro Izumi, Yukiko Katagiri, Naoki Takeshita, Yasuyo Kasai, Katsuhiko Naruse, Reiko Neki, Hisashi Masuyama, Maki Hyodo, Yukie Kawano, Takashi Ohba, Kiyotake Ichizuka, Takeshi Nagamatsu, Atsushi Watanabe, Nahoko Shirato, Junko Yotsumoto, Miyuki Nishiyama, Tatsuko Hirose, Haruhiko Sago

    European journal of obstetrics, gynecology, and reproductive biology   224   165 - 169   2018.5

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    OBJECTIVE: The purpose of this study is to compare the fetal fractions during non-invasive prenatal testing (NIPT) in singleton pregnancies according to gestational age and maternal characteristics to evaluate the utility of this parameter for the prediction of pregnancy complications including gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP). STUDY DESIGN: This study was a multicenter prospective cohort study. The present data were collected from women whose NIPT results were negative. The relationships between the fetal fractions and the gestational age, maternal weight and height, and incidences of miscarriage, preterm delivery, and pregnancy complications including GDM, HDP and placental abruption were assessed. RESULTS: A total of 5582 pregnant women with verified NIPT negative results were registered in the study. The demographic characteristics of the study populations were statistically analyzed, and the women with HDP tended to have a low fetal fraction in samples taken during early gestation. The area under the curve (AUC) in a receiver operating characteristic curve (ROC) analysis was 0.608 for women with HDP. CONCLUSION: A low fetal fraction on NIPT might be correlated with future HDP. However, predicting HDP during early pregnancy in women with a low fetal fraction might be difficult.

    DOI: 10.1016/j.ejogrb.2018.03.048

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  • Treatment of premenstrual mood changes in a patient with schizophrenia using dienogest: A case report Reviewed

    Yasuhiko Kamada, Ai Sakamoto, Sayoko Kotani, Hisashi Masuyama

    Journal of Obstetrics and Gynaecology Research   44 ( 4 )   797 - 800   2018.4

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    Dienogest is a fourth-generation progestin that is used for the treatment of endometriosis. We report a case of premenstrual mood changes in a patient with schizophrenia who was unresponsive to conventional treatment but successfully managed with dienogest. A 37-year-old Japanese woman with schizophrenia was referred to our hospital and diagnosed with premenstrual exacerbation of schizophrenia or coexisting premenstrual dysphoric disorder with schizophrenia. She had already taken maximal doses of selective serotonin reuptake inhibitors and combined oral contraceptives produced intolerable side effects. Gonadotropin-releasing hormone agonist treatment was effective but was not suitable for long-term use. Dienogest was initiated to treat pelvic endometriosis and produced subsequent improvements in mental status. The patient was able to return to work and did not indicate any adverse effects. This case suggests that dienogest may be useful for managing premenstrual mood changes in patients with schizophrenia, that it can be safely administered over long periods of time.

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  • Clinical impact of endometrial cancer stratified by genetic mutational profiles, pole mutation, and microsatellite instability Reviewed

    Tomoko Haruma, Takeshi Nagasaka, Keiichiro Nakamura, Junko Haraga, Akihiro Nyuya, Takeshi Nishida, Ajay Goel, Hisashi Masuyama, Yuji Hiramatsu

    PLoS ONE   13 ( 4 )   e0195655   2018.4

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    Background The molecular characterization of endometrial cancer (EC) can facilitate identification of various tumor subtypes. Although EC patients with POLE mutations reproducibly demonstrate better prognosis, the outcome of patients with microsatellite instability (MSI) remains controversial. This study attempted to interrogate whether genetic stratification of EC can identify distinct subsets with prognostic significance. Materials and methods A cohort of 138 EC patients who underwent surgical resection with curative intent was enrolled. Sanger sequencing was used to evaluate mutations in the POLE and KRAS genes. MSI analysis was performed using four mononucleotide repeat markers and methylation status of the MLH1 promoter was measured by a fluorescent bisulfite polymerase chain reaction (PCR). Protein expression for mismatch repair (MMR) proteins was evaluated by immunohistochemistry (IHC). Results Extensive hypermethylation of the MLH1 promoter was observed in 69.6% ECs with MLH1 deficiency and 3.5% with MMR proficiency, but in none of the ECs with loss of other MMR genes (P &lt
    .0001). MSI-positive and POLE mutations were found in 29.0% and 8.7% EC patients, respectively. Our MSI analysis showed a sensitivity of 92.7% for EC patients with MMR deficiency, and a specificity of 97.9% for EC patients with MMR proficiency. In univariate and multivariate analyses, POLE mutations and MSI status was significantly associated with progression-free survival (P = 0.0129 and 0.0064, respectively) but not with endometrial cancer-specific survival. Conclusions This study provides significant evidence that analyses of proofreading POLE mutations and MSI status based on mononucleotide repeat markers are potentially useful biomarkers to identify EC patients with better prognosis.

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  • 前置胎盤症例に対する術中経腟エコーの有用性について Reviewed

    早田 桂, 牧 尉太, 谷 和祐, 江口 武志, 玉田 祥子, 光井 崇, 衛藤 英理子, 増山 寿

    超音波医学   45 ( Suppl. )   S731 - S731   2018.4

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  • 妊娠と糖尿病 胎生発育を巡る課題 巨大児・低出生体重児発生予防のための産科管理と産後フォローアップ Reviewed

    牧 尉太, 増山 寿, 平松 祐司

    糖尿病   61 ( Suppl.1 )   S - 71   2018.4

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  • RAS遺伝子変異を示す大腸癌と形質発現、p53およびHER2過剰発現との関連性

    加藤 寿一, 馬場 正道, 中島 晋, 増山 守, 重松 忠, 加藤 元一, 森谷 鈴子, 九嶋 亮治, 杉原 洋行

    日本病理学会会誌   107 ( 1 )   423 - 423   2018.4

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  • Prognostic nutritional index as a predictor of survival in patients with recurrent cervical cancer. Reviewed

    Ida N, Nakamura K, Saijo M, Kusumoto T, Masuyama H

    Molecular and clinical oncology   8 ( 2 )   257 - 263   2018.2

  • 静脈血栓塞栓症(VTE)予防における分娩後抗凝固療法の有用性は,D-dimer値で評価可能か

    早田 桂, 谷 和祐, 牧 尉太, 江口 武志, 玉田 祥子, 光井 崇, 衛藤 英理子, 増山 寿

    日本産科婦人科学会雑誌   70 ( 2 )   796 - 796   2018.2

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  • 初期子宮体癌低侵襲手術における術式に関する検討

    楠本 知行, 依田 尚之, 西條 昌之, 西田 傑, 原賀 順子, 小川 千加子, 中村 圭一郎, 増山 寿

    日本産科婦人科学会雑誌   70 ( 2 )   764 - 764   2018.2

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  • 再発リスクを有する子宮体癌において,POLE変異/MSIは予後良好因子である

    原賀 順子, 永坂 岳司, 春間 朋子, 西田 傑, 中村 圭一郎, 増山 寿

    日本産科婦人科学会雑誌   70 ( 2 )   646 - 646   2018.2

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  • 子宮体癌における遺伝子変異やメチル化変異の検討

    西田 傑, 中村 圭一郎, 原賀 順子, 西條 昌之, 依田 尚之, 小川 千加子, 楠本 知行, 増山 寿

    日本産科婦人科学会雑誌   70 ( 2 )   655 - 655   2018.2

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  • 腹式広汎子宮頸部摘出術後に自然妊娠し,妊娠初期に経腹的頸管縫縮術を施行した一例

    光井 崇, 谷 和祐, 牧 尉太, 江口 武志, 玉田 祥子, 衛藤 英理子, 早田 桂, 増山 寿

    日本産科婦人科学会雑誌   70 ( 2 )   1035 - 1035   2018.2

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  • 岡山県におけるがん生殖医療の取り組み がんと生殖医療ネットワークOKAYAMA

    酒本 あい, 鎌田 泰彦, 増山 寿, 羽原 俊宏, 林 伸旨, 藤井 伸治, 枝園 忠彦, 中塚 幹也

    日本がん・生殖医療学会誌   1 ( 1 )   105 - 105   2018.2

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  • 婦人科悪性腫瘍手術後患者における大建中湯の有用性

    藤田 志保, 関 典子, 西條 昌之, 依田 尚之, 大道 千晶, 原賀 順子, 西田 傑, 小川 千加子, 楠本 知行, 鎌田 泰彦, 中村 圭一郎, 増山 寿

    日本産科婦人科学会雑誌   70 ( 2 )   968 - 968   2018.2

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  • 帝王切開時筋腫核出術を施行した36例の検討

    谷村 吏香, 衛藤 英理子, 牧 尉太, 玉田 祥子, 光井 崇, 早田 桂, 増山 寿

    日本産科婦人科学会雑誌   70 ( 2 )   973 - 973   2018.2

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  • 胎児期に心臓に高エコー域を認め出生後Fetal cardiac calcificationと診断された1例

    谷 和祐, 牧 尉太, 江口 武志, 玉田 祥子, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿

    日本産科婦人科学会雑誌   70 ( 2 )   913 - 913   2018.2

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  • サルコペニアは同時化学放射線療法を施行した子宮頸癌患者の予後不良因子になる

    清時 毅典, 中村 圭一郎, 依田 尚之, 西條 昌之, 大道 千晶, 原賀 順子, 西田 傑, 小川 千加子, 楠本 知行, 増山 寿

    日本産科婦人科学会雑誌   70 ( 2 )   948 - 948   2018.2

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  • 当院での悪性腫瘍手術における希釈式自己血輸血の現状

    大平 安希子, 原賀 順子, 関 典子, 依田 尚之, 西條 昌之, 大道 千晶, 西田 傑, 小川 千加子, 楠本 知行, 中村 圭一郎, 増山 寿

    日本産科婦人科学会雑誌   70 ( 2 )   776 - 776   2018.2

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  • Sarcopenia is an important prognostic factor in patients with cervical cancer undergoing concurrent chemoradiotherapy Reviewed

    Takanori Kiyotoki, Keiichiro Nakamura, Junko Haraga, Chiaki Omichi, Naoyuki Ida, Masayuki Saijo, Takeshi Nishida, Tomoyuki Kusumoto, Hisashi Masuyama

    International Journal of Gynecological Cancer   28 ( 1 )   168 - 175   2018.1

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    Objective This study aimed to investigate the correlation of sarcopenia findings with prognostic factors in patients with cervical cancer (CC) undergoing concurrent chemoradiotherapy (CCRT). Methods We retrospectively collected data on body composition and clinicopathological features from the medical records of 60 patients with CC who underwent CCRT and analyzed correlations between prognosis and changes in body composition as measured by computed tomography (skeletal muscle and iliopsoas muscle [IM]). Statistical analyses were performed using the Mann-Whitney U test. Progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. Cox proportional hazard regression was used for univariate and multivariate analyses. Results The median follow-up for all patients who were alive at the last follow-up was 33.5 months (range, 1-104 months). The PFS and OS rates were worse for patients with at least 15.0% than for those with less than 15.0% loss of skeletal muscle and IM from baseline (P &lt
    0.001 for both). Furthermore, multivariate analyses showed that at least 15.0% loss of IM was an independent prognostic factor for PFS and OS (P = 0.002 for both). Conclusions Sarcopenia (≥15.0% loss of IM from baseline) was revealed to be an important prognostic factor in patients with CC undergoing CCRT.

    DOI: 10.1097/IGC.0000000000001127

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  • 常位胎盤早期剥離の搬送、システム 常位胎盤早期剥離の搬送体制改善に向けた院内改革と県下の現状 搬送システムOKAYAMA Perinatal Integrated Conveying Sheet System"Okayama Picss"の構築 Reviewed

    牧 尉太, 早田 桂, 玉田 祥子, 江口 武志, 光井 崇, 衛藤 英理子, 平松 裕司, 増山 寿

    日本周産期・新生児医学会雑誌   53 ( 別冊 )   32 - 33   2018.1

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  • 本邦におけるGDMは本当に2型糖尿病になりやすいのか?その頻度は?フォローアップを確実に行うためには? Time to Act GDM既往女性のフォローアップ率の低さに対する対策 当院の改革 Reviewed

    牧 尉太, 衛藤 英理子, 平松 祐司, 増山 寿

    糖尿病と妊娠   17 ( 3 )   S - 48   2017.11

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  • OKAYAMA搬送シート運用から1年 振り返りと今後 県内母体搬送システムの構築に向けた活動 Reviewed

    牧 尉太, 早田 桂, 谷 和祐, 江口 武志, 玉田 祥子, 光井 崇, 衛藤 英理子, 増山 寿, 平松 祐司

    現代産婦人科   66 ( Suppl. )   S45 - S45   2017.9

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  • 5年8ヵ月間の保存的管理後に根治術を施行した腟欠損を伴う子宮留血症の1例

    鎌田 泰彦, 宮原 友里, 松岡 敬典, 藤田 志保, 久保 光太郎, 酒本 あい, 小谷 早葉子, 楠本 知行, 増山 寿

    日本産科婦人科内視鏡学会雑誌   33 ( Suppl.I )   879 - 879   2017.8

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  • 正しい層で手術操作を行うためのトレーニング

    久保 光太郎, 楠本 知行, 鎌田 泰彦, 増山 寿, 岡本 和浩, 橋本 佳子, 佐伯 愛, 松本 貴

    日本産科婦人科内視鏡学会雑誌   33 ( Suppl.I )   1502 - 1502   2017.8

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  • 腹腔鏡下子宮筋腫核出術後に生じた巨大parasitic myomaの一例

    原賀 順子, 玉田 祥子, 田中 梓菜, 楠本 知行, 中村 圭一郎, 増山 寿, 平松 祐司

    日本産科婦人科内視鏡学会雑誌   33 ( Suppl.I )   1164 - 1164   2017.8

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  • 腹腔鏡下子宮体がん手術 単一施設同一術者での経験から

    楠本 知行, 依田 尚之, 西條 昌之, 原賀 順子, 大道 千晶, 西田 傑, 小川 千加子, 中村 圭一郎, 増山 寿

    日本産科婦人科内視鏡学会雑誌   33 ( Suppl.I )   352 - 352   2017.8

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  • 周産母子施設における妊娠22週未満の分娩方法と胎盤位置に関する出血量の検討 Reviewed

    牧 尉太, 早田 桂, 岡本 和浩, 谷 和祐, 玉田 祥子, 江口 武志, 光井 崇, 衛藤 英理子, 増山 寿, 平松 祐司

    日本周産期・新生児医学会雑誌   53 ( 2 )   485 - 485   2017.6

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  • 当院搬送院外発症常位胎盤早期剥離症例における母児の転帰に関する検討 Reviewed

    甲斐 憲治, 牧 尉太, 相本 法慧, 清時 毅典, 谷 和祐, 岡本 和浩, 江口 武志, 玉田 祥子, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿, 平松 祐司

    日本周産期・新生児医学会雑誌   53 ( 2 )   609 - 609   2017.6

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  • 妊娠中の75gOGTTから産後の糖尿病発症を予測できるか? Reviewed

    衛藤 英理子, 牧 尉太, 甲斐 憲治, 清時 毅典, 岡本 和浩, 谷 和祐, 江口 武志, 玉田 祥子, 光井 崇, 早田 桂, 増山 寿, 平松 祐司

    日本周産期・新生児医学会雑誌   53 ( 2 )   604 - 604   2017.6

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  • 卵管妊娠における当院での管理方法に関する検討 Reviewed

    相本 法慧, 牧 尉太, 甲斐 憲治, 清時 毅典, 谷 和祐, 玉田 祥子, 江口 武志, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿, 平松 祐司

    日本周産期・新生児医学会雑誌   53 ( 2 )   548 - 548   2017.6

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  • 岡山大学病院における心疾患を有する女性の周産期妊娠転帰と将来に向けて(The Perinatal Outcomes of Pregnancy in Women with Heart Disease in Okayama University Hospital and Towards the Future) Reviewed

    牧 尉太, 増山 寿, 赤木 禎治, 伊藤 浩, 平松 祐司

    日本循環器学会学術集会抄録集   81回   PL09 - 2   2017.3

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  • 妊娠により急性増悪した常染色体優性多発性嚢胞腎合併妊娠の1例 Reviewed

    杉井 裕和, 牧 尉太, 岡本 和浩, 江口 武志, 玉田 祥子, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿, 平松 祐司

    日本産科婦人科学会雑誌   69 ( 2 )   894 - 894   2017.2

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  • 左心低形成症候群における胎児心臓超音波所見と新生児経過の比較 新生児仮死との関連について Reviewed

    江口 武志, 牧 尉太, 岡本 和浩, 玉田 祥子, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿, 平松 祐司

    日本産科婦人科学会雑誌   69 ( 2 )   1011 - 1011   2017.2

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  • 当院における超緊急帝王切開術 シミュレーションの成果とその後の変化 Reviewed

    玉田 祥子, 岡本 和浩, 牧 尉太, 江口 武志, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿, 平松 祐司

    日本産科婦人科学会雑誌   69 ( 2 )   966 - 966   2017.2

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  • 当院での心疾患合併妊娠の転帰と今後に向けて Reviewed

    牧 尉太, 増山 寿, 赤木 禎治, 佐藤 浩, 平松 祐司

    日本成人先天性心疾患学会雑誌   6 ( 1 )   123 - 123   2017.1

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  • Emergency Caesarean Section Saved Both an Anti-MuSK Antibody-positive Myasthenia Gravis Mother with Pregnancy-induced Hypertension and Her Premature Baby Reviewed

    Yoshiaki Takahashi, Toru Yamashita, Ryuta Morihara, Yumiko Nakano, Kota Sato, Mami Takemoto, Nozomi Hishikawa, Yasuyuki Ohta, Kei Hayata, Hisashi Masuyama, Tomoka Okamura, Yosuke Washio, Koji Abe

    INTERNAL MEDICINE   56 ( 24 )   3361 - 3364   2017

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    We herein report the case of a 46-year-old pregnant woman with anti-muscle specific kinase (MuSK) antibody-positive myasthenia gravis (MG) who showed pregnancy-induced hypertension and developed respiratory failure at 30 weeks and 5 days of pregnancy, and who underwent an emergency caesarean section (CS). Her MG symptoms gradually improved in the subsequent weeks. The premature baby with positive MuSK antibodies was successfully delivered, but the male baby required temporary artificial ventilation. However, his condition also gradually improved over time. The present case suggests that an emergency CS could rescue both the mother, who was in critical condition, and the prematurely born baby, even when suffering from acute respiratory insufficiency.

    DOI: 10.2169/internalmedicine.8636-16

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  • 糖代謝異常妊婦のエネルギー変化から食事指導を考える Reviewed

    衛藤 英理子, 岡本 和浩, 柏原 麻子, 牧 尉太, 江口 武志, 玉田 祥子, 光井 崇, 早田 桂, 増山 寿, 平松 祐司

    糖尿病と妊娠   16 ( 3 )   S - 67   2016.10

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  • SAP systemを使用し分娩中の血糖管理を行った1型糖尿病合併妊娠の症例 Reviewed

    土井 沙紀, 牧 尉太, 伊佐 千代, 牧 明日可, 妻鳥 桃子, 高取 佐智子, 衛藤 英理子, 藤澤 諭, 利根 淳仁, 増山 寿, 平松 祐司

    糖尿病と妊娠   16 ( 3 )   S - 86   2016.10

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  • 安心・安全な周産期医療のシステム県下統一に向かって OKAYAMA母体搬送・産後出血チェックシートの導入 Reviewed

    牧 尉太, 岡本 和浩, 柏原 麻子, 玉田 祥子, 江口 武志, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿, 平松 祐司

    現代産婦人科   65 ( Suppl. )   S59 - S59   2016.9

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  • 妊娠高血圧における腎機能検査と胎児発育についての検討 Reviewed

    延本 悦子, 牧 尉太, 岡本 和浩, 柏原 麻子, 玉田 祥子, 江口 武志, 光井 崇, 平野 友美加, 衛藤 英理子, 早田 桂, 増山 寿, 平松 祐司

    日本周産期・新生児医学会雑誌   52 ( 2 )   500 - 500   2016.6

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  • 「分娩第3期の予防的介入の効果」と「分娩後出血のリスク因子の解析及び予想モデルの検討」 Reviewed

    牧 尉太, 岡本 和浩, 柏原 麻子, 玉田 祥子, 江口 武志, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿, 平松 祐司

    日本周産期・新生児医学会雑誌   52 ( 2 )   558 - 558   2016.6

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  • 除細動器植え込み術後の閉塞性肥大型心筋症患者の妊娠を継続し、生児を得た一例 Reviewed

    光井 崇, 増山 寿, 江尻 健太郎, 江口 武志, 玉田 祥子, 平野 友美加, 衛藤 英理子, 早田 桂, 伊藤 浩, 平松 祐司

    超音波医学   43 ( Suppl. )   S836 - S836   2016.4

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  • NIPT陽性9例に施行した胎児超音波検査所見について Reviewed

    早田 桂, 牧 尉太, 江口 武志, 玉田 祥子, 光井 崇, 平野 友美加, 衛藤 英理子, 延本 悦子, 増山 寿, 平松 祐司

    超音波医学   43 ( Suppl. )   S849 - S849   2016.4

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  • 診断に難渋した先天性サイトメガロウイルス感染症の一例 Reviewed

    玉田 祥子, 牧 尉太, 江口 武志, 光井 崇, 平野 友美加, 衛藤 英理子, 延本 悦子, 早田 桂, 増山 寿, 平松 祐司

    超音波医学   43 ( Suppl. )   S855 - S855   2016.4

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  • 有嚢性横隔膜ヘルニアの2例 Reviewed

    牧 尉太, 平野 友美加, 玉田 祥子, 江口 武志, 光井 崇, 延本 悦子, 早田 桂, 増山 寿, 平松 祐司

    超音波医学   43 ( Suppl. )   S854 - S854   2016.4

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  • Advanced Life Support in Obstetrics(ALSO)受講者における成人教育の指導方法に関する検討 Reviewed

    牧 尉太, 岡本 和浩, 柏原 麻子, 玉田 祥子, 江口 武志, 平野 友美加, 衛藤 英理子, 延本 悦子, 早田 桂, 増山 寿, 平松 祐司

    日本産科婦人科学会雑誌   68 ( 2 )   707 - 707   2016.2

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  • 妊娠初期診断GDMの特徴と診断における有用性と意義 JAGS trialによる検討 Reviewed

    牧 尉太, 平松 祐司, 玉田 祥子, 光井 崇, 平野 友美加, 延本 悦子, 早田 桂, 増山 寿

    糖尿病と妊娠   15 ( 2 )   S - 43   2015.10

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    Language:Japanese   Publisher:(一社)日本糖尿病・妊娠学会  

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  • 妊婦の糖代謝異常の診断時期による臨床像の差異について Reviewed

    平野 友美加, 牧 尉太, 玉田 祥子, 江口 武志, 光井 崇, 衛藤 英理子, 高原 悦子, 早田 桂, 瀬川 友功, 増山 寿, 平松 祐司

    糖尿病と妊娠   15 ( 2 )   S - 62   2015.10

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  • 胎児心疾患における染色疾患及び心外奇形合併について Reviewed

    平野 友美加, 牧 尉太, 玉田 祥子, 江口 武志, 光井 崇, 衛藤 英理子, 高原 悦子, 早田 桂, 瀬川 友功, 増山 寿, 平松 祐司

    現代産婦人科   64 ( Suppl. )   S45 - S45   2015.9

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  • ALSO in Okayama開催から始まる地域の枠を超えた安心・安全な周産期医療実現を目指して 受講者アンケートを通じて Reviewed

    牧 尉太, 江口 武志, 玉田 祥子, 光井 崇, 平野 友美加, 衛藤 英理子, 高原 悦子, 早田 桂, 増山 寿, 平松 祐司

    現代産婦人科   64 ( Suppl. )   S52 - S52   2015.9

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  • PNH形質血球検査で再生不良性貧血合併妊娠後の症状増悪化を示唆しえた症例 Reviewed

    牧 尉太, 江口 武志, 光井 崇, 増山 寿, 平松 祐司

    日本妊娠高血圧学会雑誌   22   77 - 77   2015.8

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  • Effect of Oncostatin M on Uridine Diphosphate-5 &apos;-Glucuronosyltransferase 1A1 through Cross Talk with Constitutive Androstane Receptor Reviewed

    Hisashi Masuyama, Hideki Nakatsukasa, Yuji Hiramatsu

    MOLECULAR ENDOCRINOLOGY   24 ( 4 )   745 - 753   2010.4

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:ENDOCRINE SOC  

    Hyperbilirubinemia remains a common condition in neonates. The constitutive androstane receptor (CAR) is an orphan nuclear receptor that has been shown to participate in the activation of the uridine diphosphate-5&apos;-glucuronosyltransferase 1A1 (UGT1A1) gene, which plays an important role in bilirubin clearance. Oncostatin M (OSM), a member of the IL-6 family, is involved in the maturation of fetal hepatocytes. We have demonstrated that low OSM levels are a potential indicator of neonatal jaundice and the need for phototherapy. In this study we examined the effects of OSM on CAR-mediated signaling to investigate its potential role in neonatal jaundice via the CAR-UGT1A1 pathway. We observed that OSM positively augmented the CAR and UGT1A1 expressions and CAR-mediated signaling in vivo and in vitro, through cross talk between the nuclear CAR receptor and the plasma membrane OSM receptor, via the MAPK cascade. These data suggest that OSM might play a role in bilirubin metabolism via the CAR-UGT1A1 pathway. (Molecular Endocrinology 24: 745-753, 2010)

    DOI: 10.1210/me.2009-0478

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Books

  • IPSJ SIG Technical Report(情報処理学会研究報告)

    情報処理学会  2017 

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  • IPSJ SIG Technical Report(情報処理学会研究報告)

    情報処理学会  2017 

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  • 改訂第2版 産婦人科手術スタンダード

    メジカルビュー社  2017  ( ISBN:9784758317436

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  • 改訂第2版 産婦人科手術スタンダード

    メジカルビュー社  2017  ( ISBN:9784758317436

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  • 産科婦人科疾患最新の治療2016-2018

    南江堂  2016  ( ISBN:9784524258499

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  • 産科婦人科疾患最新の治療2016-2018

    南江堂  2016  ( ISBN:9784524258499

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  • 産科診療Q&A 一つ上を行く診療の実践

    中外医学社  2015  ( ISBN:9784498060784

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  • 研修ノートNo. 96 子宮筋腫

    公益社団法人 日本産婦人科医会  2015 

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  • 妊婦の糖代謝異常 診療・管理マニュアル

    メジカルビュー社  2015  ( ISBN:9784758317306

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  • 妊婦の糖代謝異常 診療・管理マニュアル

    メジカルビュー社  2015  ( ISBN:9784758317306

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  • 研修ノートNo. 96 子宮筋腫

    公益社団法人 日本産婦人科医会  2015 

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  • 女と男のディクショナリーHUMAN+

    公益社団法人 日本産科婦人科学会  2014 

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  • OGS NOW13 機能温存の手術 疾患治療と妊娠・性機能の予後に配慮して

    メジカルビュー社  2013  ( ISBN:9784758312127

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  • 平成24年度特定妊婦・新生児虐待防止対策緊急強化事業評価報告書

    国立大学法人 岡山大学  2013 

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  • 産科婦人科疾患最新の治療2013ー2015

    南江堂  2013  ( ISBN:9784524268962

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  • 「妊娠と糖尿病」母児管理のエッセンス

    金芳堂  2013  ( ISBN:9784765315678

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  • 子育ては胎児から 産科から切れ目のない子育て支援のために

    岡山大学大学院保健学研究科「妊娠中からの母子支援」即戦力育成プログラム事務局  2013 

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  • 2013 TODAY’S THERAPY 今日の治療指針

    医学書院  2013  ( ISBN:9784260016445

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  • 平成23年度安心こども基金地域子育て創生事業 安心すこやか産後の早期サポート事業報告書

    国立大学法人 岡山大学  2012 

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  • HANDBOOK臨床産婦人科

    金芳堂  2010  ( ISBN:9784765314220

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  • HANDBOOK臨床産婦人科

    金芳堂  2010  ( ISBN:9784765314220

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  • HANDBOOK臨床産婦人科

    金芳堂  2010  ( ISBN:9784765314220

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  • OGS NOW 4 産科手術 必須術式の完全マスター

    メジカルビュー社  2010  ( ISBN:9784758312035

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  • HANDBOOK臨床産婦人科

    金芳堂  2010  ( ISBN:9784765314220

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  • HANDBOOK臨床産婦人科

    金芳堂  2010  ( ISBN:9784765314220

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  • 平成17年度〜19年度科学研究費補助金(基盤研究(C))研究成果報告書

    2008 

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  • コア・ローテイション産婦人科〔改訂2版〕

    金芳堂,京都  2007 

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  • コア・ローテイション産婦人科〔改訂2版〕

    金芳堂,京都  2007 

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  • コア・ローテイション産婦人科〔改訂2版〕

    金芳堂,京都  2007 

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  • コア・ローテイション産婦人科〔改訂2版〕

    金芳堂,京都  2007 

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  • コア・ローテイション産婦人科〔改訂2版〕

    金芳堂,京都  2007 

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  • 産科臨床ベストプラクティス 上級編

    医学書院,東京  2006 

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  • 産科臨床ベストプラクティス 上級編

    医学書院,東京  2006 

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  • 産科臨床ベストプラクティス<上級編>

    医学書院  2006 

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  • 産科臨床ベストプラクティス<上級編>

    医学書院  2006 

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  • 産婦人科手術スタンダード

    メジカルビュー社,東京  2005 

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  • 平成14年度〜15年度科学研究費補助金(基盤研究(C)(2))研究成果報告書

    2004 

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  • コア・ローテイション産婦人科

    金芳堂,京都  2004 

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  • コア・ローテイション産婦人科

    金芳堂,京都  2004 

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  • コア・ローテイション産婦人科

    金芳堂,京都  2004 

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  • NEW産婦人科学

    南江堂,東京  2004 

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  • コア・ローテイション産婦人科

    金芳堂,京都  2004 

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  • コア・ローテイション産婦人科

    金芳堂,京都  2004 

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  • 平成12年度〜13年度科学研究費補助金(基盤研究(C)(2))研究成果報告書

    ,  2002 

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  • 厚生科学研究平成13年度研究報告書

    ,  2002 

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  • 新女性医学大系,第7巻産婦人科薬物療法

    中山書店  2000 

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  • 臨床エビデンス産科学

    メジカルビュー社  1999 

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  • Vitamin D: Chemistry, Biology and Clinical Applications of the Steroid Hormone

    Walter de Gruyter, Inc., Hawthorne NY  1997 

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MISC

  • 【帝王切開-明日からできる工夫と留意点-】術前に判明している場合 6.子宮筋腫合併

    増山 寿, 衛藤 英理子, 谷村 吏香

    産科と婦人科   88 ( 10 )   1191 - 1196   2021.10

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    Language:Japanese   Publisher:(株)診断と治療社  

    子宮筋腫は婦人科疾患の中で最も一般的であり、子宮筋腫合併妊娠の頻度は、超音波検査の診断技術向上と晩産化に伴い、最近の報告では10%を超えている。まず、妊娠初期の子宮筋腫の評価(個数、大きさ、位置)が大切である。そのうえで妊娠中や分娩・産褥期に起こり得る合併症に注意を払う必要がある。子宮筋腫合併妊娠の帝王切開では、子宮筋腫および胎盤の正確な位置把握に基づく娩出ルート設定による安全な児娩出が最優先である。さらに適切な手術操作での同時の子宮筋腫摘出術も十分可能である。(著者抄録)

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  • 卵巣癌のSister Mary Joseph's nodule(SMJN)に対して臍切除を行った3例

    小川 麻理子, 依田 尚之, 入江 恭平, 岡本 和浩, 松岡 敬典, 小川 千加子, 中村 圭一郎, 増山 寿

    現代産婦人科   69 ( Suppl. )   S90 - S90   2021.9

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  • 腹腔鏡下に予防的性腺摘出術を施行した完全型アンドロゲン不応症(complete androgen insensitivity syndrome、CAIS)の1例

    篠崎 真里奈, 久保 光太郎, 樫野 千明, 光井 崇, 長谷川 徹, 鎌田 泰彦, 中塚 幹也, 増山 寿

    現代産婦人科   69 ( Suppl. )   S88 - S88   2021.9

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  • 【胎児超音波診断を活かす-産科医と新生児科医からの情報提供-】腹部臓器疾患 腹壁破裂・臍帯ヘルニア

    早田 桂, 吉本 順子, 増山 寿

    周産期医学   51 ( 9 )   1345 - 1350   2021.9

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    Language:Japanese   Publisher:(株)東京医学社  

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  • 妊娠高血圧症候群up to date

    増山 寿

    母性衛生   62 ( 3 )   61 - 61   2021.9

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    Language:Japanese   Publisher:(公社)日本母性衛生学会  

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  • 出産前診断が困難であった不全型Cantrell五徴症の一例

    谷 和祐, 三島 桜子, 大平 安希子, 牧 尉太, 衛藤 英理子, 早田 桂, 増山 寿

    超音波医学   48 ( Suppl. )   S750 - S750   2021.4

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  • 先天性横隔膜ヘルニアによる胸部異所性腎を出生前診断した1例

    杉原 花子, 光井 崇, 谷 和祐, 三島 桜子, 大平 安希子, 牧 尉太, 衛藤 英理子, 早田 桂, 増山 寿

    日本産科婦人科学会雑誌   73 ( 臨増 )   S - 621   2021.3

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  • Spiral糸による連続縫合は帝王切開創部の菲薄化を予防する

    中藤 光里, 牧 尉太, 三島 桜子, 大平 安希子, 谷 和祐, 衛藤 英理子, 早田 桂, 増山 寿

    日本産科婦人科学会雑誌   73 ( 臨増 )   S - 366   2021.3

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  • 中心静脈栄養および抗凝固療法にて生児を得た抗リン脂質抗体陽性クローン病合併双胎妊娠の1例

    樫野 千明, 楠元 理恵, 久保 光太郎, 光井 崇, 衛藤 英理子, 鎌田 泰彦, 中塚 幹也, 増山 寿

    日本産科婦人科学会雑誌   73 ( 臨増 )   S - 355   2021.3

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  • 当院の子宮体癌に対する低侵襲手術の検討

    久保 光太郎, 依田 尚之, 岡本 和浩, 松岡 敬典, 春間 朋子, 小川 千加子, 中村 圭一郎, 増山 寿

    日本産科婦人科学会雑誌   73 ( 臨増 )   S - 401   2021.3

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  • 高エストロゲン血症を伴う卵巣偽粘液腫の一例

    川口 優里香, 小川 千加子, 松岡 敬典, 岡本 和浩, 依田 尚之, 春間 朋子, 中村 圭一郎, 増山 寿

    日本産科婦人科学会雑誌   73 ( 臨増 )   S - 331   2021.3

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  • 卵巣がんの破裂を契機に腹部コンパートメント症候群をきたした1症例

    谷 佳紀, 依田 尚之, 岡本 和浩, 松岡 敬典, 久保 光太郎, 春間 朋子, 小川 千加子, 中村 圭一郎, 増山 寿

    日本産科婦人科学会雑誌   73 ( 臨増 )   S - 329   2021.3

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  • 抗凝固療法中に下肢静脈血栓症を発症した抗リン脂質抗体症候群合併妊娠の一例

    大石 恵一, 久保 光太郎, 楠元 理恵, 樫野 千明, 光井 崇, 衛藤 英理子, 早田 桂, 鎌田 泰彦, 中塚 幹也, 増山 寿

    日本産科婦人科学会雑誌   73 ( 臨増 )   S - 350   2021.3

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  • 完全中隔子宮・完全腟中隔の術後に経腟分娩に至ったが分娩時に大量出血を来たした一例

    楠元 理恵, 光井 崇, 三島 桜子, 樫野 千明, 久保 光太郎, 鎌田 泰彦, 増山 寿

    日本産科婦人科学会雑誌   73 ( 臨増 )   S - 338   2021.3

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  • 産科危機的出血時の造影CTは治療選択に必須である

    大前 彩乃, 早田 桂, 三島 桜子, 大平 安希子, 谷 和祐, 牧 尉太, 衛藤 英理子, 増山 寿

    日本産科婦人科学会雑誌   73 ( 臨増 )   S - 363   2021.3

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  • 当院の子宮頸癌IB2期の検討

    依田 尚之, 岡本 和浩, 松岡 敬典, 春間 朋子, 小川 千加子, 中村 圭一郎, 増山 寿

    日本産科婦人科学会雑誌   73 ( 臨増 )   S - 308   2021.3

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  • Shear Wave Elastographyは子宮頸癌に対する放射線治療の効果予測に有用である

    松岡 敬典, 中村 圭一郎, 岡本 和浩, 依田 尚之, 久保 光太郎, 春間 朋子, 小川 千加子, 増山 寿

    日本産科婦人科学会雑誌   73 ( 臨増 )   S - 312   2021.3

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  • 完全子宮脱合併妊娠の経腟分娩の経験 頸管裂傷の縫合治癒過程の詳細

    牧 尉太, 中藤 光里, 三島 桜子, 大平 安希子, 谷 和祐, 衛藤 英理子, 早田 桂, 増山 寿

    日本産科婦人科学会雑誌   73 ( 臨増 )   S - 615   2021.3

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  • TC療法を受ける婦人科癌患者におけるSF36を活用したQOL調査

    春間 朋子, 岡本 和浩, 松岡 敬典, 依田 尚之, 久保 光太郎, 小川 千加子, 中村 圭一郎, 増山 寿

    日本産科婦人科学会雑誌   73 ( 臨増 )   S - 280   2021.3

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  • 周産期からの先制医療 世代を越えたヘルスケア

    増山 寿

    日本産科婦人科学会雑誌   73 ( 臨増 )   S - 51   2021.3

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  • A case of XXX women who had a fetal diagnosis of osteogenesis imperfecta and had difficulty in genetic counseling

    衛藤英理子, 三苫智裕, 横畑理美, 三島桜子, 大平安希子, 谷和祐, 牧尉太, 早田桂, 長谷川高誠, 吉本順子, 大月審一, 増山寿

    日本遺伝カウンセリング学会誌   42 ( 2 )   2021

  • グルココルチコイドによる卵胞顆粒膜細胞のステロイド合成調節とBMP-15の関与

    樫野千明, 長谷川徹, 中野靖浩, 岩田菜穂子, 山本紘一郎, 鎌田泰彦, 増山寿, 大塚文男

    日本内分泌学会雑誌   97 ( 1 )   2021

  • グルココルチコイドによる卵胞ステロイド合成への影響とBMPの関与

    樫野千明, 長谷川徹, 中野靖浩, 長尾聡子, 岩田菜穂子, 鎌田泰彦, 増山寿, 大塚文男

    日本内分泌学会雑誌   96 ( 1 )   2020

  • がん遺伝子パネル検査受検を契機にHBOCが判明し本人および血縁者介入につながった一例

    十川麗美, 小川千加子, 蓮岡佳代子, 冨田秀太, 井上博文, 松原岳大, 二川摩周, 浦川優作, 河内麻里子, 河内麻里子, 山本英喜, 増山寿, 平沢晃, 平沢晃

    日本遺伝性腫瘍学会学術集会プログラム・抄録集   26th   2020

  • グルココルチコイドによる卵胞ステロイド合成調節とBMP分子の関与

    樫野千明, 長谷川徹, 中野靖浩, 山本紘一郎, 長尾聡子, 岩田菜穂子, 鎌田泰彦, 増山寿, 大塚文男

    日本内分泌学会雑誌   96 ( 4 (Web) )   2020

  • リキッドバイオプシーでBRCA1の生殖細胞系列病的バリアントが示唆され遺伝カウンセリングを通じて確定診断に至った一例

    十川麗美, 小川千加子, 蓮岡佳代子, 冨田秀太, 井上博文, 松原岳大, 二川摩周, 江見裕美, 浦川優作, 河内麻里子, 河内麻里子, 増山寿, 平沢晃, 平沢晃

    日本人類遺伝学会大会プログラム・抄録集   64th   2019

  • 血栓症 術後管理

    関 典子, 平松 祐司, 小西 郁生, 正岡 直樹, 増山 寿, 寺尾 泰久, 田中 京子

    産婦人科手術   ( 29 )   105 - 108   2018.6

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  • 血栓症 術前管理

    田中 京子, 平松 祐司, 増山 寿, 正岡 直樹, 寺尾 泰久, 小西 郁生, 日本産婦人, 編集委員会

    産婦人科手術   ( 29 )   97 - 103   2018.6

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  • 【PIHからHDPへ-妊娠高血圧症候群up to date-】 妊娠高血圧症候群母体より生まれた児の予後

    増山 寿, 光井 崇

    産婦人科の実際   67 ( 6 )   649 - 654   2018.6

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    <文献概要>妊娠高血圧症候群(HDP)は,母体は早産,子癇,常位胎盤早期剥離など,児は胎児発育不全(FGR)を合併しやすい重要な周産期疾患である。HDP罹患女性は将来のメタボリック症候群や心血管疾患の発症リスクが上昇することが知られている。さらにHDPはFGR出生母体リスク因子のトップであり,HDP発症母体から出生した児は,将来メタボリック症候群や心血管疾患発症リスクが高いと報告されている。特にFGR児の急激なcatch upは学童期や成人期の肥満や高血圧などの生活習慣病に関与する可能性があり,ハイリスク群として継続的なフォローアップおよび介入により発症を抑える予防医療に向けた取り組みが必要である。

    DOI: 10.18888/sp.0000000463

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  • 機能性子宮を有する腟中隔・腟欠損症例の腹腔内所見

    鎌田 泰彦, 宮原 友里, 松岡 敬典, 藤田 志保, 久保 光太郎, 長谷川 徹, 酒本 あい, 小谷 早葉子, 増山 寿, 平松 祐司

    産婦人科手術   ( 29 )   166 - 166   2018.6

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  • JAGSを用いたGDM妊婦とOGTT60分値の関連性の検討

    牧 尉太, 衛藤 英理子, 平松 祐司, 杉山 隆, 豊田 長康, 増山 寿

    糖尿病   61 ( 5 )   331 - 331   2018.5

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  • 生殖補助医療にて妊娠,生児を得たリベド血管症の1例

    角南 華子, 小谷 早葉子, 長谷川 徹, 酒本 あい, 鎌田 泰彦, 中塚 幹也, 平松 祐司, 増山 寿

    産婦人科の実際   67 ( 5 )   585 - 589   2018.5

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    <文献概要>リベド血管症は下肢を中心に疼痛を伴う網状斑を生じ,潰瘍を形成する原因不明の疾患である。その病態には血栓形成による血行障害との関連が示唆されている。今回,リベド血管症で治療中の症例に生殖補助医療を行い,妊娠および生児を得た1例を経験した。症例は36歳女性,未経妊。28歳時にリベド血管症の診断を受け,治療開始された。生殖補助医療を希望して当院紹介となる。採卵後に卵巣過剰刺激症候群を発症し,入院加療を要したが,ホルモン補充周期の凍結融解胚移植で妊娠成立した。リベド血管症に対する治療を継続したことで,臨床症状が増悪することなく順調な妊娠経過をたどり,生児を得た。リベド血管症と妊娠,分娩についての報告例はいまだ少なく,今後の症例の蓄積が望まれる。

    DOI: 10.18888/sp.0000000445

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  • 先天性心疾患複雑性が入院イベントに及ぼす影響 コホート研究(Impact of disease complexity on Hospitalization in Adult Patients with Congenital Heart Disease: retrospective cohort study)

    高橋 生, 赤木 禎治, 杜 徳尚, 高谷 陽一, 笠原 真悟, 馬場 健児, 中村 進一郎, 木野村 賢, 増山 寿, 大森 一弘, 中川 晃志, 西井 伸洋, 伊藤 浩

    日本成人先天性心疾患学会雑誌   7 ( 1 )   158 - 158   2018.1

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  • オレキシンによるBMPシグナルの抑制と卵胞プロゲステロン産生への影響

    藤田志保, 長谷川徹, 西山悠紀, 藤澤諭, 細谷武史, 中野靖浩, 岩田菜穂子, 鎌田泰彦, 増山寿, 大塚文男

    日本生殖医学会雑誌   63 ( 3 )   2018

  • Reply to "Letter to the Editor" by M.Saijo et al. "Glasgow prognostic score is predictive of prognosis for patients with endometrial cancer"

    Masayuki Saijo, Keiichiro Nakamura, Hisashi Masuyama, Naoyuki Ida, Tomoko Haruma, Tomoyuki Kusumoto, Noriko Seki, Yuji Hiramatsu

    EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY   216   260 - 260   2017.9

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    Language:English   Publishing type:Rapid communication, short report, research note, etc. (scientific journal)   Publisher:ELSEVIER SCIENCE BV  

    DOI: 10.1016/j.ejogrb.2017.07.036

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  • Current status of non-invasive prenatal testing in Japan

    Osamu Samura, Akihiko Sekizawa, Nobuhiro Suzumori, Aiko Sasaki, Seiji Wada, Haruka Hamanoue, Fumiki Hirahara, Hideaki Sawai, Hiroaki Nakamura, Takahiro Yamada, Kiyonori Miura, Hideaki Masuzaki, Setsuko Nakayama, Takashi Okai, Yoshimasa Kamei, Akira Namba, Jun Murotsuki, Tomohiro Tanemoto, Akimune Fukushima, Kazufumi Haino, Shinya Tairaku, Keiichi Matsubara, Kazuhisa Maeda, Takashi Kaji, Masanobu Ogawa, Hisao Osada, Haruki Nishizawa, Yoko Okamoto, Takeshi Kanagawa, Aiko Kakigano, Michihiro Kitagawa, Masaki Ogawa, Shunichiro Izumi, Yukiko Katagiri, Naoki Takeshita, Yasuyo Kasai, Katsuhiko Naruse, Reiko Neki, Hisashi Masuyama, Maki Hyodo, Yukie Kawano, Takashi Ohba, Kiyotake Ichizuka, Yasuhiro Kido, Toshiyuki Fukao, Norio Miharu, Takeshi Nagamatsu, Atsushi Watanabe, Naoki Hamajima, Masaya Hirose, Ayako Sanui, Nahoko Shirato, Junko Yotsumoto, Miyuki Nishiyama, Tatsuko Hirose, Haruhiko Sago

    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH   43 ( 8 )   1245 - 1255   2017.8

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    AimThe purpose of this study was to report the 3-year experience of a nationwide demonstration project to introduce non-invasive prenatal testing (NIPT) of maternal plasma for aneuploidy, and review the current status of NIPT in Japan.
    MethodsTests were conducted to detect aneuploidy in high-risk pregnant women, and adequate genetic counseling was provided. The clinical data, test results, and pregnancy outcomes were recorded. We discuss the problems of NIPT on the basis of published reports and meta-analyses.
    ResultsFrom April 2013 to March 2016, 30613 tests were conducted at 55 medical sites participating in a multicenter clinical study. Among the 30613 women tested, 554 were positive (1.81%) and 30021 were negative (98.1%) for aneuploidy. Of the 289, 128, and 44 women who tested positive for trisomies 21, 18, and 13, respectively, and underwent definitive testing, 279 (96.5%), 106 (82.8%), and 28 (63.6%) were determined to have a true-positive result. For the 13481 women with negative result and whose progress could be traced, two had a false-negative result (0.02%). The tests were performed on the condition that a standard level of genetic counseling be provided at hospitals.
    ConclusionHere, we report on the 3-year nationwide experience with NIPT in Japan. It is important to establish a genetic counseling system to enable women to make informed decisions regarding prenatal testing. Moreover, a welfare system is warranted to support women who decide to give birth to and raise children with chromosomal diseases.

    DOI: 10.1111/jog.13373

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  • 口唇裂をきっかけに出生前診断された分葉型全前脳胞症の一例

    玉田 祥子, 岡本 和浩, 牧 尉太, 江口 武志, 光井 崇, 衛藤 英理子, 早田 桂, 増山 寿, 平松 祐司

    超音波医学   44 ( Suppl. )   S577 - S577   2017.4

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  • Discrepancy between Non-invasive Prenatal Genetic Testing (NIPT) and Amniotic Chromosomal Test due to Placental Mosaicism: A Case Report and Literature Review

    Kei Hayata, Yuji Hiramatsu, Hisashi Masuyama, Eriko Eto, Takashi Mitsui, Shoko Tamada

    ACTA MEDICA OKAYAMA   71 ( 2 )   181 - 185   2017.4

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    We experienced a case of advanced maternal age in which a fetus was found to be positive for trisomy 18 at re-examination following indeterminate non-invasive prenatal genetic testing (NIPT), the amniotic fluid chromosomal test revealed a normal karyotype, and confined placental mosaicism (CPM) was observed in an SNP microarray analysis of the placenta. The child was born with no defects or complications. In the present case, the result of the original NIPT at week 15 of pregnancy was indeterminate and the subsequent re-examination result was positive; since the definitive normal diagnosis was not reported until the latter half of week 21, the pregnant patient was subjected to psychological stress for a long period of time. The problem with NIPT is that most of the fetus-derived cell-free DNA in the maternal blood is not derived directly from the fetus but from the villus cells of the placenta, leading to indefinite diagnoses; for that reason, the pregnant patient was subjected to psychological stress for a long period of time. Of the 18,251 cases undergoing NIPT in the past 2 years in Japan, 51 had indeterminate results; this was the second case in which a subsequent re-examination gave a positive result for trisomy 18.

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  • Comparison of Kidney Function between Gestational Hypertension and Preeclampsia

    Etsuko Nobumoto, Hisashi Masuyama, Jota Maki, Takeshi Eguchi, Shoko Tamada, Takashi Mitsui, Eriko Eto, Kei Hayata, Yuji Hiramatsu

    ACTA MEDICA OKAYAMA   71 ( 2 )   161 - 169   2017.4

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    Although gestational hypertension (GH) is thought to be different from preeclampsia (PE), in Japan GH and PE are usually treated as the same disease (i.e., pregnancy-induced hypertension). Here we sought to determine whether there are any differences in fetal growth and maternal kidney function between pregnancies with PE and those with GH. We retrospectively analyzed 61 GH patients and 60 PE patients with singleton pregnancies who delivered at Okayama University Hospital (2008-2015). We compared maternal and perinatal outcomes and maternal kidney function parameters between the GH and PE pregnancies. The mean values of maternal age (p=0.01), gestational age at delivery (p&lt;0.0001), placental weight (p=0.002), birth weight and height (p&lt;0.0001, p=0.0001), and head circumference standard deviation score (p=0.007) of newborns of the GH group were significantly higher than those of the PE group. The duration until termination of PE or GH was not significantly correlated with kidney function. The birth weight percentile was significantly correlated with kidney function in PE but not GH. However, GH patients with poor kidney function and small-for-gestational age infants showed perinatal outcomes similar to those of the PE group. Monitoring kidney function is thus important for determining the severity of PE and GH.

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  • Comparison of Kidney Function between Gestational Hypertension and Preeclampsia

    Etsuko Nobumoto, Hisashi Masuyama, Jota Maki, Takeshi Eguchi, Shoko Tamada, Takashi Mitsui, Eriko Eto, Kei Hayata, Yuji Hiramatsu

    ACTA MEDICA OKAYAMA   71 ( 2 )   161 - 169   2017.4

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    Although gestational hypertension (GH) is thought to be different from preeclampsia (PE), in Japan GH and PE are usually treated as the same disease (i.e., pregnancy-induced hypertension). Here we sought to determine whether there are any differences in fetal growth and maternal kidney function between pregnancies with PE and those with GH. We retrospectively analyzed 61 GH patients and 60 PE patients with singleton pregnancies who delivered at Okayama University Hospital (2008-2015). We compared maternal and perinatal outcomes and maternal kidney function parameters between the GH and PE pregnancies. The mean values of maternal age (p=0.01), gestational age at delivery (p&lt;0.0001), placental weight (p=0.002), birth weight and height (p&lt;0.0001, p=0.0001), and head circumference standard deviation score (p=0.007) of newborns of the GH group were significantly higher than those of the PE group. The duration until termination of PE or GH was not significantly correlated with kidney function. The birth weight percentile was significantly correlated with kidney function in PE but not GH. However, GH patients with poor kidney function and small-for-gestational age infants showed perinatal outcomes similar to those of the PE group. Monitoring kidney function is thus important for determining the severity of PE and GH.

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  • Discrepancy between Non-invasive Prenatal Genetic Testing (NIPT) and Amniotic Chromosomal Test due to Placental Mosaicism: A Case Report and Literature Review

    Kei Hayata, Yuji Hiramatsu, Hisashi Masuyama, Eriko Eto, Takashi Mitsui, Shoko Tamada

    ACTA MEDICA OKAYAMA   71 ( 2 )   181 - 185   2017.4

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    Language:English   Publishing type:Book review, literature introduction, etc.   Publisher:OKAYAMA UNIV MED SCHOOL  

    We experienced a case of advanced maternal age in which a fetus was found to be positive for trisomy 18 at re-examination following indeterminate non-invasive prenatal genetic testing (NIPT), the amniotic fluid chromosomal test revealed a normal karyotype, and confined placental mosaicism (CPM) was observed in an SNP microarray analysis of the placenta. The child was born with no defects or complications. In the present case, the result of the original NIPT at week 15 of pregnancy was indeterminate and the subsequent re-examination result was positive; since the definitive normal diagnosis was not reported until the latter half of week 21, the pregnant patient was subjected to psychological stress for a long period of time. The problem with NIPT is that most of the fetus-derived cell-free DNA in the maternal blood is not derived directly from the fetus but from the villus cells of the placenta, leading to indefinite diagnoses; for that reason, the pregnant patient was subjected to psychological stress for a long period of time. Of the 18,251 cases undergoing NIPT in the past 2 years in Japan, 51 had indeterminate results; this was the second case in which a subsequent re-examination gave a positive result for trisomy 18.

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  • 当院で経験したNager症候群の1例

    早田 桂, 牧 尉太, 江口 武志, 玉田 祥子, 衛藤 英理子, 増山 寿, 平松 祐司

    超音波医学   44 ( Suppl. )   S552 - S552   2017.4

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  • Successful pregnancy located in a uterine cesarean scar: A case report. International journal

    Shoko Tamada, Hisashi Masuyama, Jota Maki, Takeshi Eguchi, Takashi Mitsui, Eriko Eto, Kei Hayata, Yuji Hiramatsu

    Case reports in women's health   14   8 - 10   2017.4

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    Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy. Because CSP carries a high risk of uterine rupture and life-threatening bleeding, the pregnancy should be terminated upon confirmation of diagnosis. There have been few reports of CSP with successful delivery. We present a case of CSP under expectant management, with delivery via planned cesarean section at 35 weeks of gestation. This report suggests that successful pregnancy outcome can be achieved in some women with uterine cesarean scar, but further analysis and additional studies are required in order to describe the optimal protocol of expectant management in CSP.

    DOI: 10.1016/j.crwh.2017.03.003

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  • Beckwith-Wiedemann症候群を合併した間葉性異形成胎盤の一例

    衛藤 英理子, 岡本 和浩, 谷 和祐, 牧 尉太, 江口 武志, 玉田 祥子, 光井 崇, 早田 桂, 増山 寿, 平松 祐司

    超音波医学   44 ( Suppl. )   S677 - S677   2017.4

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  • 院内・県下の周産期救急の連携にむけて 緊急帝王切開シミュレーションとOKAYAMA母体搬送・産後出血チェックシートの導入

    牧 明日可, 牧 尉太, 妻鳥 桃子, 山村 香織, 高取 佐智子, 早田 桂, 増山 寿, 平松 祐司

    岡山県母性衛生   ( 33 )   36 - 37   2017.3

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  • 他科合同シミュレーションによって顕在化した部署間の意義の差について

    妻鳥 桃子, 牧 尉太, 早田 桂, 飯守 美和, 小野 夕貴, 山村 香織, 高取 佐智子, 増山 寿, 平松 祐司

    岡山県母性衛生   ( 33 )   34 - 35   2017.3

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  • Glasgow prognostic score is a prognosis predictor for patients with endometrial cancer

    Masayuki Saijo, Keiichiro Nakamura, Hisashi Masuyama, Naoyuki Ida, Tomoko Haruma, Tomoyuki Kusumoto, Noriko Seki, Yuji Hiramatsu

    EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY   210   355 - 359   2017.3

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    Objective: This study investigated whether the inflammation-based Glasgow prognostic score (GPS) predicted the prognosis of patients with endometrial cancer (EC) in terms of progression-free survival (PFS) and overall survival (OS).
    Study design: Pretreatment GPS was examined to determine the correlations with recurrence and survival in 431 patients with EC. Statistical analyses were performed using the Mann-Whitney U test. PFS and OS were analyzed using the Kaplan-Meier method. Cox's proportional hazard regression was used for univariate and multivariate analyses.
    Results: Median PFS and OS were 49.7 and 52.7 months, respectively. The follow-up range was I to 140 months. Kaplan-Meier analysis revealed that patients with EC cancer and high GPS (GPS 2) had a shorter PFS and OS than those with lower GPS (GPS 0 + 1) (PFS: P &lt; 0.001; OS; P &lt; 0.001). On multivariate analysis, GPS (GPS 2) was an independent predictor of both recurrence (P &lt; 0.001) and survival (P &lt; 0.001) for all cases of EC.
    Conclusion: GPS can be useful as an indicator of poor prognosis in patients with EC. (C) 2017 Elsevier B.V. All rights reserved.

    DOI: 10.1016/j.ejogrb.2017.01.024

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  • Prenatal diagnosis of umbilical arteriovenous malformation

    Izumi Suzui, Hisashi Masuyama, Yumika Hirano, Takeshi Nishida, Kei Hayata, Yuji Hiramatsu

    JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE   30 ( 1 )   85 - 87   2017.1

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    Umbilical arteriovenous malformation (AVM) is a rare congenital malformation. We report a case of umbilical AVM that was prenatally diagnosed by further color Doppler ultrasonography because of fetal cardiomegaly. At 35 weeks gestation, a male newborn was delivered by emergent cesarean section because of rapid progress of cardiomegaly and breech presentation. Three-dimensional reconstructed computed tomography after birth demonstrated the shunt was spontaneously closed. This is the first case report of umbilical AVM, which was prenatally diagnosed, and the boy was successfully delivered, suggesting that, when fetal cardiomegaly is identified, umbilical AVM must be taken into consideration.

    DOI: 10.3109/14767058.2016.1163542

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  • Radical Hysterectomy Plus Concurrent Chemoradiation/Radiation Therapy Is Negatively Associated With Return to Work in Patients With Cervical Cancer

    Keiichiro Nakamura, Hisashi Masuyama, Naoyuki Ida, Tomoko Haruma, Tomoyuki Kusumoto, Noriko Seki, Yuji Hiramatsu

    INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER   27 ( 1 )   117 - 122   2017.1

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    Objective: Cervical cancer is one of the most common malignant diseases in working-age women. This study investigated the influence of adverse effects of various treatment modalities on return to work in women with cervical cancer.
    Methods: Questionnaires and clinical data from medical records of 97 patients with early stage (stages I and II) cervical cancer were collected and assessed by treatment received. The following treatment groups were analyzed for correlations between time to return to work and various adverse effects: radical hysterectomy (RH) alone, RH group (n = 29); concurrent chemoradiation therapy (CCRT)/radiation therapy (RT) alone, CCRT/RT group (n = 21); and RH + CCRT/RT group (n = 47). The chi(2) test was used to determine the significance of the correlations.
    Results: The mean age at the time of diagnosis was 43.0 years and the average interval since treatment was 4.5 years. The RH + CCRT/RT group was the most strongly negatively associated with return towork in employed patients who had undergone CCRT/RT group of cervical cancer (P = 0.012). There was a significant association between failure to return to work and lower extremity lymphedema (P = 0.049). A more than-6-month interval between treatment and return towork and reduced personal income occurred in a significantly higher percentage of patients in the RH + CCRT group than in the CCRT/RT group (P = 0.034 and P = 0.034).
    Conclusions: Of the treatments assessed, RH + CCRT/RT has the greatest negative effect on return to work in women with cervical cancer.

    DOI: 10.1097/IGC.0000000000000840

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  • Prenatal diagnosis of umbilical arteriovenous malformation

    Izumi Suzui, Hisashi Masuyama, Yumika Hirano, Takeshi Nishida, Kei Hayata, Yuji Hiramatsu

    JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE   30 ( 1 )   85 - 87   2017.1

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    Umbilical arteriovenous malformation (AVM) is a rare congenital malformation. We report a case of umbilical AVM that was prenatally diagnosed by further color Doppler ultrasonography because of fetal cardiomegaly. At 35 weeks gestation, a male newborn was delivered by emergent cesarean section because of rapid progress of cardiomegaly and breech presentation. Three-dimensional reconstructed computed tomography after birth demonstrated the shunt was spontaneously closed. This is the first case report of umbilical AVM, which was prenatally diagnosed, and the boy was successfully delivered, suggesting that, when fetal cardiomegaly is identified, umbilical AVM must be taken into consideration.

    DOI: 10.3109/14767058.2016.1163542

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  • 特集『当院の超音波検査を”最新”にしている理由』 先進のアプリケーションを有する最新US装置がもたらす臨床的・運用的メリット.

    早田 桂, 牧 尉太, 玉田祥子, 衛藤英理子, 増山 寿

    月刊新医療   44 ( 8 )   95 - 99   2017

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  • 特集 ここが知りたい 産婦人科周術期管理 [周産期領域]4.糖代謝異常合併妊娠.

    増山 寿, 牧 尉太, 平松祐司

    産科と婦人科   84 ( 2 )   147 - 151   2017

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  • 子宮内膜癌再発に対する妊孕性温存治療後、生殖補助医療で妊娠し生児を得た一例.

    矢野肇子, 酒本あい, 安藤まり, 樫野千明, 松岡敬典, 長谷川徹, 早田 桂, 小谷早葉子, 楠本知行, 鎌田泰彦, 中村圭一郎, 関 典子, 増山 寿, 中塚幹也, 平松祐司

    現代産婦人科   65 ( 2 )   217 - 221   2017

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  • 胎児完全房室ブロックに対してデキサメタゾン内服と塩酸リトドリン点滴にて治療を行った抗SS-A抗体陽性初産婦の一例.

    三島桜子, 玉田祥子, 岡本和浩, 谷 和祐, 牧 尉太, 江口武志, 光井 崇, 衛藤英理子, 早田 桂, 増山 寿, 平松祐司, 沖本直輝

    現代産婦人科   65 ( 2 )   223 - 227   2017

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  • The influence of adverse effects on quality of life of survivors of gynecologic cancer.

    Omichi C, Nakamura K, Haraga J, Ida N, Saijo M, Nishida T, Kusumoto T, Masuyama H

    International Journal of Gynecological Cancer   27 ( 9 )   2014 - 2019   2017

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  • 骨盤腎と全身性強皮症を合併し治療方針の決定に難渋した子宮頸癌の1例.

    秋定 幸, 春間朋子, 原賀順子, 依田尚之, 楠本知行, 中村圭一郎, 関 典子, 増山 寿, 平松祐司

    現代産婦人科   66 ( 1 )   109 - 115   2017

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  • 婦人科がん治療後における就労生活の現状.

    中村圭一郎, 原賀順子, 西田 傑, 大道千晶, 春間朋子, 楠本知行, 関 典子, 増山 寿, 平松祐司

    産婦人科の実際   66 ( 2 )   211 - 215   2017

  • 妊娠糖尿病.

    増山 寿

    日本産科婦人科学会雑誌   69 ( 9 )   1835 - 1840   2017

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  • DOHaDを踏まえた妊娠高血圧症候群の母体より生まれた児の発育.

    増山 寿, 光井 崇, 平松祐司

    産科と婦人科   84 ( 10 )   1203 - 1207   2017

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  • 【産科編】その他の疼痛 042 背部痛.

    増山 寿

    周産期医学 母と子の診断羅針盤   47 ( 増刊号 )   237 - 240   2017

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  • 瘢痕部妊娠について.

    増山 寿, 光井 崇, 玉田祥子, 平松祐司

    産婦人科の実際   66 ( 2 )   153 - 157   2017

  • A survey on awareness of genetic counseling for non-invasive prenatal testing: the first year experience in Japan

    Junko Yotsumoto, Akihiko Sekizawa, Nobuhiro Suzumori, Takahiro Yamada, Osamu Samura, Miyuki Nishiyama, Kiyonori Miura, Hideaki Sawai, Jun Murotsuki, Michihiro Kitagawa, Yoshimasa Kamei, Hideaki Masuzaki, Fumiki Hirahara, Toshiaki Endo, Akimune Fukushima, Akira Namba, Hisao Osada, Yasuyo Kasai, Atsushi Watanabe, Yukiko Katagiri, Naoki Takeshita, Masaki Ogawa, Takashi Okai, Shunichiro Izumi, Haruka Hamanoue, Mayuko Inuzuka, Kazufumi Haino, Naoki Hamajima, Haruki Nishizawa, Yoko Okamoto, Hiroaki Nakamura, Takeshi Kanegawa, Jun Yoshimatsu, Shinya Tairaku, Katsuhiko Naruse, Hisashi Masuyama, Maki Hyodo, Takashi Kaji, Kazuhisa Maeda, Keiichi Matsubara, Masanobu Ogawa, Toshiyuki Yoshizato, Takashi Ohba, Yukie Kawano, Haruhiko Sago

    JOURNAL OF HUMAN GENETICS   61 ( 12 )   995 - 1001   2016.12

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    The purpose of this study is to summarize the results from a survey on awareness of genetic counseling for pregnant women who wish to receive non-invasive prenatal testing (NIPT) in Japan. As a component of a clinical study by the Japan NIPT Consortium, genetic counseling was conducted for women who wished to receive NIPT, and a questionnaire concerning both NIPT and genetic counseling was given twice: once after pre-test counseling and again when test results were reported. The responses of 7292 women were analyzed. They expressed high satisfaction with the genetic counseling system of the NIPT Consortium (94%). The number of respondents who indicated that genetic counseling is necessary for NIPT increased over time. Furthermore, they highly valued genetic counseling provided by skilled clinicians, such as clinical geneticists or genetic counselors. The vast majority (90%) responded that there was sufficient opportunity to consider the test ahead of time. Meanwhile, women who received positive test results had a poor opinion and expressed a low-degree satisfaction. We confirmed that the pre-test genetic counseling that we conducted creates an opportunity for pregnant women to sufficiently consider prenatal testing, promotes its understanding and has possibilities to effectively facilitate informed decision making after adequate consideration. A more careful and thorough approach is considered to be necessary for women who received positive test results.

    DOI: 10.1038/jhg.2016.96

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  • Prenatal Diagnosis of Interrupted Aortic Arch: Usefulness of Three-Vessel and Four-Chamber Views

    Yumika Hirano, Hisashi Masuyama, Kei Hayata, Eriko Eto, Etsuko Nobumoto, Yuji Hiramatsu

    ACTA MEDICA OKAYAMA   70 ( 6 )   485 - 491   2016.12

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    Interrupted aortic arch (IAA) is fatal if not diagnosed. Prenatal diagnosis is helpful, but it is difficult to detect IAA and even more so to differentiate types A and B prenatally. Our objectives were to find a way to detect IAA using 2 views-three-vessel view (3VV) and four-chamber view (4CV)-and to differentiate between types A and B. We retrospecthely analyzed fetal echocardiographic images and medical records of eight IAA patients. All eight patients had a ventricular septal defect (VSD) on 4CV. The aorta/main pulmonary artery (Ao/MPA) diameter ratio on 3VV was significantly low, which is characteristic of type B IAA. The left/right ventricular diameter (LV/RV) ratio on 4CV was 0.61 0.17 for type A and almost 1.0 for type B. The thymus was not observed on 3VV in some type B IAA patients. These findings suggest that we could increase the number of prenatal diagnoses of INN using the Ao/MPA ratio on 3VV and the presence of VSD on 4CV. Additionally, we could differentiate types A and B with the IN/RV ratio on 4CV, the Ao/MPA ratio, and the presence of a thymus on 3VV, which results in better management of IAA after birth.

    DOI: 10.18926/AMO/54812

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  • Sex differences in early growth during the first three years of life in offspring from mothers with pregnancy-induced hypertension

    Takashi Mitsui, Hisashi Masuyama, Takeshi Eguchi, Shoko Tamada, Eriko Eto, Kei Hayata, Yuji Hiramatsu

    PREGNANCY HYPERTENSION-AN INTERNATIONAL JOURNAL OF WOMENS CARDIOVASCULAR HEALTH   6 ( 4 )   361 - 366   2016.10

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    Objectives: Newborns born to mothers with pregnancy-induced hypertension (PIH) are thought to be at high risk for lifestyle-related diseases, such as obesity and hypertension, in adulthood.
    Study design: A longitudinal study of 78 pregnant women with PIH and their newborns, who visited Okayama University Hospital from 2009 to 2013.
    Main outcome measures: We investigated the change in growth of offspring born to mothers with PIH and compared it with the standard growth curve in Japanese to examine whether there was rapid catch-up growth during the first 3 years of life.
    Results: Subjects were 78 pregnant women with PIH and their offspring, who visited Okayama University Hospital from 2009 to 2013. Valid responses were obtained from 29 of 78 (37.1%) women. Body weight and length at birth were at the third percentile or less in females, and at the 10th percentile or less, in males. When body weight and length were compared at 6 months, 18 months, and 3 years old between male and female toddlers, male toddlers slowly caught up until 3 years old, but female toddlers rapidly caught up in the first 6 months. Furthermore, in newborns with fetal growth restriction caused by the intrauterine environment of PIH, differences in physical development between male and female toddlers were more remarkable.
    Conclusions: There is a significant sex difference in catch-up growth during the first 3 years, which might be involved in lifestyle-related diseases in adulthood, suggesting continuous follow-up is necessary, especially for female offspring. (C) 2016 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.

    DOI: 10.1016/j.preghy.2016.08.238

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  • Differences in uterine artery blood flow and fetal growth between the early and late onset of pregnancy-induced hypertension

    Takashi Mitsui, Hisashi Masuyama, Jota Maki, Shoko Tamada, Yumika Hirano, Eriko Eto, Etsuko Nobumoto, Kei Hayata, Yuji Hiramatsu

    JOURNAL OF MEDICAL ULTRASONICS   43 ( 4 )   509 - 517   2016.10

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    We continuously measured bilateral uterine artery (UA) blood flow and compared differences in UA blood flow to investigate the differences in pathophysiology between early- and late-onset pregnancy-induced hypertension (PIH) and the usefulness of continuous monitoring of UA blood flow for the prediction of early-onset PIH.
    The subjects were 76 PIH patients. The mean pulsatility index of bilateral UA (UAPI), an early diastolic notch in the velocity waveform, and regression curves were retrospectively examined and compared between early- and late-onset groups and the groups with and without fetal growth restriction (FGR).
    Regression curves of the UAPI in the early-onset group persisted at +2.0 standard deviations or more from the second to third trimester, while the UAPI in the late-onset group stayed within the normal range. A significantly higher mean UAPI with a high frequency of an early diastolic notch was observed in the early-onset group compared with the late-onset group in all pregnancy trimesters. There was a significant difference in UA resistance between the mild and severe groups and between the FGR and non-FGR groups, but to a small extent compared with the onset period.
    There was a difference in pathophysiology between early- and late-onset PIH. Continuous monitoring of UA blood flow might be useful for the prediction of early-onset PIH if high UA resistance has been observed.

    DOI: 10.1007/s10396-016-0729-6

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  • Differences in uterine artery blood flow and fetal growth between the early and late onset of pregnancy-induced hypertension

    Takashi Mitsui, Hisashi Masuyama, Jota Maki, Shoko Tamada, Yumika Hirano, Eriko Eto, Etsuko Nobumoto, Kei Hayata, Yuji Hiramatsu

    JOURNAL OF MEDICAL ULTRASONICS   43 ( 4 )   509 - 517   2016.10

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    We continuously measured bilateral uterine artery (UA) blood flow and compared differences in UA blood flow to investigate the differences in pathophysiology between early- and late-onset pregnancy-induced hypertension (PIH) and the usefulness of continuous monitoring of UA blood flow for the prediction of early-onset PIH.
    The subjects were 76 PIH patients. The mean pulsatility index of bilateral UA (UAPI), an early diastolic notch in the velocity waveform, and regression curves were retrospectively examined and compared between early- and late-onset groups and the groups with and without fetal growth restriction (FGR).
    Regression curves of the UAPI in the early-onset group persisted at +2.0 standard deviations or more from the second to third trimester, while the UAPI in the late-onset group stayed within the normal range. A significantly higher mean UAPI with a high frequency of an early diastolic notch was observed in the early-onset group compared with the late-onset group in all pregnancy trimesters. There was a significant difference in UA resistance between the mild and severe groups and between the FGR and non-FGR groups, but to a small extent compared with the onset period.
    There was a difference in pathophysiology between early- and late-onset PIH. Continuous monitoring of UA blood flow might be useful for the prediction of early-onset PIH if high UA resistance has been observed.

    DOI: 10.1007/s10396-016-0729-6

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  • JAGSおよび当院のGDM妊婦とOGTT60分値の関連性の検討

    牧 尉太, 増山 寿, 田村 奈悠, 衛藤 英理子, 杉山 隆, 豊田 長康, 平松 祐司

    糖尿病と妊娠   16 ( 3 )   S - 58   2016.10

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  • Inhibition of pregnane X receptor pathway contributes to the cell growth inhibition and apoptosis of anticancer agents in ovarian cancer cells

    Hisashi Masuyama, Keiichiro Nakamura, Etsuko Nobumoto, Yuji Hiramatsu

    INTERNATIONAL JOURNAL OF ONCOLOGY   49 ( 3 )   1211 - 1220   2016.9

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    Epithelial ovarian cancer remains the most devastating gynecologic cancer with drug resistance and rapid recurrence. Pregnane X receptor (PXR) is a nuclear receptor that affects drug metabolism/efflux and drug-drug interaction through control of multiple drug resistance 1 (MDR1), which implies a major role in multidrug resistance, and other genes. We examined whether the inhibition of PXR-mediated pathway using siRNA interference and an antagonist for PXR could influence the paclitaxel and cisplatin cytotoxicity in ovarian cancer cells. PXR agonists, phthalate and pregnenolone had significant positive effects on cytochrome P450 (CYP) 3A4 expression and PXR-mediated transcription through the CYP3A4 promoter, whereas MDR1 expression and PXR-mediated transcription though the MDR1 promoter were significantly increased in the presence of paclitaxel or cisplatin. Downregulation of PXR suppressed the augmented MDR1 expression and PXR-mediated transcription by PXR ligands, and significantly enhanced cell growth inhibition and apoptosis in the presence of paclitaxel or cisplatin. Additionally, ketoconazole, a PXR antagonist, suppressed the augmented MDR1 expression and PXR-mediated transactivation by paclitaxel and cisplatin, and enhanced cell growth inhibition and apoptosis in their presence. In conclusion, inhibition of PXR-mediated pathways could be a novel means of augmenting sensitivity, or overcoming resistance to anticancer agents for ovarian cancer.

    DOI: 10.3892/ijo.2016.3611

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  • Dimethylesculetin ameliorates maternal glucose intolerance and fetal overgrowth in high-fat diet-fed pregnant mice via constitutive androstane receptor

    Hisashi Masuyama, Takashi Mitsui, Jota Maki, Kazumasa Tani, Keiichiro Nakamura, Yuji Hiramatsu

    MOLECULAR AND CELLULAR BIOCHEMISTRY   419 ( 1-2 )   185 - 192   2016.8

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    The constitutive androstane receptor (CAR) has been reported to decrease insulin resistance along with obesity. 6,7-dimethylesculetin (DE) is an active component of Yin Zhi Huang which is a traditional Asian medicine used to treat neonatal jaundice via CAR. In this study, we examined whether DE could affect the expression of gluconeogenic and lipogenic genes via human CAR pathway using human HepG2 cells in vitro. We also studied whether DE treatment during pregnancy could prevent maternal hypertension, glucose intolerance and hyperlipidemia, and fetal overgrowth in high-fat diet (HFD)-induced obese pregnant mice. Dimethylesculetin suppressed the mRNA expression of gluconeogenic genes, phosphoenolpyruvate carboxykinase and glucose-6-phosphatase, and lipogenic genes, sterol regulatory element-binding protein 1 and stearoyl-CoA desaturase 1, and enhanced CAR-mediated transcription. Blocking the CAR-mediated pathway abolished the effect of DE in vitro. DE treatment during pregnancy could prevent maternal hypertension, glucose intolerance and hyperlipidemia, and fetal overgrowth in HFD-induced obese pregnant mice in vivo. Our data indicate that DE might be a potential therapeutic agent for obese pregnant patients with insulin resistance through CAR to prevent the perinatal outcomes such as preeclampsia, gestational diabetes, and macrosomia. Further analysis of possible complications and side effects using animal models is required.

    DOI: 10.1007/s11010-016-2772-4

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  • 妊娠初期診断GDMの特徴と診断における有用性と意義"JAGS trialによる再検討"

    牧 尉太, 平野 友美加, 増山 寿, 杉山 隆, 豊田 長康, 平松 祐司

    糖尿病と妊娠   16 ( 2 )   132 - 136   2016.8

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    [目的]妊娠初期GDMスクリーニングの有用性および初期診断GDMと中期診断GDMの病態の差異を検討する。[方法]JAGS trialデータ2993例から対象患者を抽出し妊娠初期、中期の75gOGTTの検査結果の比較検討を行った。なお2015年8月制定の新GDM診断基準に合わせデータ修正を行った。[結果]OGTT対象症例数は初期1783例および中期2915例。2回OGTT施行症例数は1699例。データ検証可能な初期OGTT施行804例(45.0%)に対し母体背景および検査結果12項目に関し多変量解析を施行した。初回随時血糖≧100mg/dl、BMI≧25が有意なGDM発症リスク因子であった。初期1point異常GDM群(1P)118例中83例(70.3%)は中期検査で正常化を示した。同様に初期2point以上異常群(2P)36例中18例(50.0%)は中期に正常化し、6例(26.8%)は1Pへ軽症化した。2回OGTT施行例で正常-正常群(1481例)、正常-1P(43例)、および正常-2P(11例)の初期OGTT 60分値における平均値は116.2mg/dl、137.2mg/dl、134.8mg/dlであり、正常-正常群と比較し他2群では有意な高値を示した(p<0.05)。初期(102例)および中期(130例)のGDM症例の臨床像36項目を2項比較した結果、母体体重増加≧12kgの項目のみ中期診断群で有意に高値であった。[考察]初期診断GDMの70%の症例で中期の血糖値改善が認められ、初期OGTT-60分値は中期発症GDM予測因子になる可能性が示唆され、早期治療介入がリスク軽減する可能性が考えられた。一方、初期からの厳格な栄養管理によって母体体重増加が制限されている可能性があった。(著者抄録)

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  • Return to work after cancer treatment of gynecologic cancer in Japan

    Keiichiro Nakamura, Hisashi Masuyama, Takeshi Nishida, Junko Haraga, Naoyuki Ida, Masayuki Saijo, Tomoko Haruma, Tomoyuki Kusumoto, Noriko Seki, Yuji Hiramatsu

    BMC CANCER   16   2016.7

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    Background: Gynecologic cancer is one of the most common malignant diseases in working-age women. This study investigated whether several characteristics influence return to work after treatment of gynecologic cancer.
    Methods: We investigated the correlations between return to work and several other characteristics in 199 gynecologic cancer survivors. Questionnaires were distributed to patients with cancer (&gt;= 1 year after treatment and age of &lt;65 years) who visited Okayama University. Logistic regression analysis and receiver operating characteristic curves were used to determine whether each characteristic influenced return to work (no return to work or job change) in these gynecologic cancer survivors.
    Results: For all patients, the mean age at the time of diagnosis was 47.0 years, and the average number of years after treatment was 4.5. Forty-four patients (53.7 %) who were non-regular employees continued to be employed at the same workplace. Non-regular employment had a significantly higher area under the curve (AUC) (0.726) than other characteristics in terms of negatively affecting return to work. Additionally, non-regular employment tended to have a higher AUC (0.618) than other characteristics in terms of job changes.
    Conclusions: Non-regular employment was the variable most likely to negatively affect return to work and job changes in employed patients who underwent treatment for gynecologic cancer.

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  • Return to work after cancer treatment of gynecologic cancer in Japan

    Keiichiro Nakamura, Hisashi Masuyama, Takeshi Nishida, Junko Haraga, Naoyuki Ida, Masayuki Saijo, Tomoko Haruma, Tomoyuki Kusumoto, Noriko Seki, Yuji Hiramatsu

    BMC CANCER   16 ( 1 )   2016.7

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    Background: Gynecologic cancer is one of the most common malignant diseases in working-age women. This study investigated whether several characteristics influence return to work after treatment of gynecologic cancer.
    Methods: We investigated the correlations between return to work and several other characteristics in 199 gynecologic cancer survivors. Questionnaires were distributed to patients with cancer (&gt;= 1 year after treatment and age of &lt;65 years) who visited Okayama University. Logistic regression analysis and receiver operating characteristic curves were used to determine whether each characteristic influenced return to work (no return to work or job change) in these gynecologic cancer survivors.
    Results: For all patients, the mean age at the time of diagnosis was 47.0 years, and the average number of years after treatment was 4.5. Forty-four patients (53.7 %) who were non-regular employees continued to be employed at the same workplace. Non-regular employment had a significantly higher area under the curve (AUC) (0.726) than other characteristics in terms of negatively affecting return to work. Additionally, non-regular employment tended to have a higher AUC (0.618) than other characteristics in terms of job changes.
    Conclusions: Non-regular employment was the variable most likely to negatively affect return to work and job changes in employed patients who underwent treatment for gynecologic cancer.

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  • Fetal cell-free DNA fraction in maternal plasma is affected by fetal trisomy

    Nobuhiro Suzumori, Takeshi Ebara, Takahiro Yamada, Osamu Samura, Junko Yotsumoto, Miyuki Nishiyama, Kiyonori Miura, Hideaki Sawai, Jun Murotsuki, Michihiro Kitagawa, Yoshimasa Kamei, Hideaki Masuzaki, Fumiki Hirahara, Juan-Sebastian Saldivar, Nilesh Dharajiya, Haruhiko Sago, Akihiko Sekizawa

    JOURNAL OF HUMAN GENETICS   61 ( 7 )   647 - 652   2016.7

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    The purpose of this noninvasive prenatal testing (NIPT) study was to compare the fetal fraction of singleton gestations by gestational age, maternal characteristics and chromosome-specific aneuploidies as indicated by z-scores. This study was a multicenter prospective cohort study. Test data were collected from women who underwent NIPT by the massively parallel sequencing method. We used sequencing-based fetal fraction calculations in which we estimated fetal DNA fraction by simply counting the number of reads aligned within specific autosomal regions and applying a weighting scheme derived from a multivariate model. Relationships between fetal fractions and gestational age, maternal weight and height, and z-scores for chromosomes 21, 18 and 13 were assessed. A total of 7740 pregnant women enrolled in the study, of which 6993 met the study criteria. As expected, fetal fraction was inversely correlated with maternal weight (P&lt;0.001). The median fetal fraction of samples with euploid result (n=6850) and trisomy 21 (n=70) were 13.7% and 13.6%, respectively. In contrast, the median fetal fraction values for samples with trisomies 18 (n=35) and 13 (n=9) were 11.0% and 8.0%, respectively. The fetal fraction of samples with trisomy 21 NIPT result is comparable to that of samples with euploid result. However, the fetal fractions of samples with trisomies 13 and 18 are significantly lower compared with that of euploid result. We conclude that it may make detecting these two trisomies more challenging.

    DOI: 10.1038/jhg.2016.25

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  • The effects of paternal high-fat diet exposure on offspring metabolism with epigenetic changes in the mouse adiponectin and leptin gene promoters

    Hisashi Masuyama, Takashi Mitsui, Takeshi Eguchi, Shoko Tamada, Yuji Hiramatsu

    AMERICAN JOURNAL OF PHYSIOLOGY-ENDOCRINOLOGY AND METABOLISM   311 ( 1 )   E236 - E245   2016.7

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    Recent studies have demonstrated that epigenetic changes resulting from malnutrition might play important roles in transgenerational links with metabolic diseases. Previously, we observed that exposure to a high-fat diet (HFD) in utero caused a metabolic syndrome-like phenomenon through epigenetic modifications of the adiponectin and leptin genes that persisted for multiple generations. Recent etiological studies indicated that paternal BMI had effects on offspring BMI that were independent of but additive to maternal BMI effects. Thus, we examined whether paternal HFD-induced obesity affected the metabolic status of offspring through epigenetic changes in the adiponectin and leptin genes. Additionally, we investigated whether a normal diet during subsequent generations abolished the epigenetic changes associated with paternal HFD exposure before conception. We observed the effects of paternal HFD exposure before conception over multiple generations on offspring metabolic traits, including weight and fat gain, glucose intolerance, hypertriglyceridemia, abnormal adipocytokine levels, hypertension, and adiponectin and leptin gene expression and epigenetic changes. Normal diet consumption by male offspring during the subsequent generation following paternal HFD exposure diminished whereas consumption for two generations completely abolished the effect of paternal HFD exposure on metabolic traits and adipocytokine promoter epigenetic changes in the offspring. The effects of paternal HFD exposure on offspring were relatively weaker than those following HFD exposure in utero. However, paternal HFD exposure had an additive metabolic effect for two generations, suggesting that both paternal and maternal nutrition might affect offspring metabolism through epigenetic modifications of adipocytokine genes for multiple generations.

    DOI: 10.1152/ajpendo.00095.2016

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  • Glasgow prognostic score is an independent marker for poor prognosis with all cases of epithelial ovarian cancer

    Chiaki Omichi, Keiichiro Nakamura, Junko Haraga, Hisashi Masuyama, Yuji Hiramatsu

    CANCER MEDICINE   5 ( 6 )   1074 - 1080   2016.6

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    Inflammatory markers are important prognostic factors in various cancers. This study investigated whether inflammatory markers of the Glasgow prognostic score (GPS) predicted progression-free survival (PFS) and overall survival (OS) for patients with all cases of epithelial ovarian cancer (OC). Pretreatment GPS was examined for the correlations with PFS and OS in 216 patients in all stages of epithelial OC. Statistical analyses were performed using the Mann-Whitney U-test. PFS and OS were analyzed using the Kaplan-Meier method. Cox's proportional hazard regression was used for univariate and multivariate analyses. For all patients, the median PFS was 35.1 months, and median OS was 46.7 months; follow-up range was 1-162 months. Kaplan-Meier analysis revealed that patients with high GPS (GPS 2) at pretreatment had a shorter PFS and OS than did patients with lower GPS (GPS 0 + 1) in for early, advanced, and all-stages of OC (PFS: P &lt; 0.001 for early-, advanced- and all-stages; OS; P &lt; 0.001 for early- and all-stage, P = 0.015 for advanced-stage). GPS (GPS 2) was also found to be an independent predictor of both recurrence (P = 0.002) and survival (P = 0.001) of all cases of epithelial OC by a multivariate analysis. GPS can serve as an indicator of poor prognosis in patients with all stages of epithelial OC, including early-stage disease and regardless of histology.

    DOI: 10.1002/cam4.681

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  • 有嚢性横隔膜ヘルニアの2例

    牧 尉太, 平野 友美加, 玉田 祥子, 江口 武志, 光井 崇, 延本 悦子, 早田 桂, 増山 寿, 平松 祐司

    現代産婦人科   64 ( 2 )   193 - 197   2016.5

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    最近当科で経験した有嚢性横隔膜ヘルニア(CDH)の2例を報告する。【症例1】初産、38週3日、胎児心奇形を疑い当科に紹介受診し、超音波精査でCDH、完全口唇口蓋裂、及び総肺静脈還流異常症(TAPVC)が疑われた。MRI検査では横隔膜の挙上が認められた。肺胸郭断面積比は0.22-0.28であり他科との相談の上、経腟分娩可能と判断、39週3日2,552g、女児、AP-s 3/3点自然分娩で出生。46XX、dup(5)q31.1-q33.1部分トリソミー、出生後大動脈離断症(IAA)、心室中隔欠損(VSD)、卵円孔開存(PFO)、動脈管開存症(PDA)と診断。Stabilization後、日齢1、開腹下で縫縮術を施行、術後診断は左有嚢性CDHであった。日齢20、心臓手術施行、術後経過良好。現在経過観察中である。【症例2】1経妊1経産。在胎9週3日多発性海綿状血管腫合併妊娠のため、当科紹介受診。その後FGR傾向が認められたが、明らかな胎児異常は認められず、38週3日母体適応による選択的帝王切開を施行。2,400g、女児、AP-s 8/8点、出生後呼吸状態が悪化し挿管となった。胸部CT検査で原因不明の左横隔膜挙上と左肺虚脱を認め、左横隔膜弛緩症が疑われ、日齢0、当院NICU入院。日齢2、胸腔鏡下で縫縮術を施行。術後診断は有嚢性CDHであった。経過良好で退院。【考察】高率で他の先天異常を合併し、出生後治療に向け画像検査で正確な評価が必要となるCDHに対し、予後判定に有用な指標が確立されつつある。症例1はその予後判定を行い、経腟分娩を選択し生児を得た後、CDH縫縮術及び心臓手術を無事施行できた。出生前診断が困難であったCDH単独発症の1例と併せ文献的考察を絡め報告する。(著者抄録)

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  • 胎児骨系統疾患の2例

    衛藤 英理子, 牧 尉太, 玉田 祥子, 江口 武志, 光井 崇, 平野 友美加, 延本 悦子, 早田 桂, 増山 寿, 平松 祐司

    現代産婦人科   64 ( 2 )   159 - 164   2016.5

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    【緒言】胎児骨系統疾患は非常に稀であり、疾患によって予後も様々であるため正確な出生前診断を行うことが重要である。2009年1月から2014年12月までの間に当院で周産期管理された胎児骨系統疾患の2例を報告する。【症例1】28歳、1経妊1経産。家族歴に骨系統疾患なし。妊娠17週に四肢短縮を指摘され妊娠22週に紹介初診となった。胎児超音波検査では四肢の全肢節に-6〜-8SD程度の短縮がみられ、全肢節重度短縮型骨系統疾患と考えられた。妊娠29週の胎児3D-CTでは大きな頭蓋冠と側頭部の膨隆、ベル型胸郭、長管骨の著しい彎曲短縮と受話器様大腿骨等を認め、タナトフォリック骨異形成症が強く疑われた。羊水過多による切迫早産のため妊娠30週より入院管理。骨盤位および児頭大横径の拡大のため妊娠38週1日に選択的帝王切開で身長39cm、体重2772g、頭囲38.5cm、胸囲28cmの男児をアプガースコア2/2点で出産した。児は出生後31分で死亡した。【症例2】37歳、3経妊2経産。家族歴に骨系統疾患なし。妊娠27週頃より胎児大腿骨の発育を認めないため妊娠31週に紹介初診となった。胎児超音波検査では中等度の四肢短縮を示し、特に上腕骨や大腿骨で-5SD程度の短縮がみられ、近位肢節短縮型骨系統疾患と考えられた。妊娠29週の胎児3D-CTでは頭蓋冠の拡大、長管骨骨幹端のcupping、大腿骨の軽度彎曲像等を認め、軟骨無形成症が疑われた。骨盤位のため妊娠39週2日に選択的帝王切開で身長46cm、体重2898g、頭囲36.5cm、胸囲28cmの男児をアプガースコア8/9点で出産した。新生児の遺伝子検査で4p16.3にあるFGFR3遺伝子に変異が認められ、軟骨無形成症と診断された。現在外来管理中である。【結語】胎児超音波検査や3D-CT検査、遺伝子診断により正確な出生前診断を行うことができた。(著者抄録)

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  • 胎児心臓腫瘍の3症例

    衛藤 英理子, 牧 尉太, 玉田 祥子, 江口 武志, 光井 崇, 平野 友美加, 高原 悦子, 早田 桂, 増山 寿, 平松 祐司

    超音波医学   43 ( 2 )   311 - 315   2016.3

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    稀な疾患である胎児心臓腫瘍を3例経験したので報告する.症例1は30歳の経産婦で,妊娠38週0日に当院へ紹介となった.胎児超音波検査では心室中隔から左心室内に径13mm大の高輝度腫瘤を認め一部が左室流出路に突出していた.妊娠39週1日3,966gの男児を経腟分娩した.日齢1に腫瘍切除術を行い組織診断は横紋筋腫であった.生後2ヵ月半の頭部MRI検査で結節性硬化症と診断され,てんかんを合併している.5歳の時点で腫瘍の再発は認めていない.症例2は30歳の経産婦で,妊娠29週5日に当院へ紹介となった.胎児超音波検査では左心室内,右心室内,右心房内にそれぞれ径14mm,17mm,5mm大の高輝度腫瘤を認めた.妊娠39週5日2,866gの女児を経腟分娩した.生後日齢3の頭部CT検査で結節性硬化症と診断され,てんかんを合併している.3歳の時点で腫瘍は不変である.症例3は36歳の初産婦で,妊娠19週5日当院へ紹介となった.胎児超音波検査では左心室内に径10mm大の高輝度腫瘤を認めた.妊娠37週4日に3,006gの女児を経腟分娩した.日齢13に心室頻拍を認め抗不整脈薬で治療を開始した.9ヵ月の時点で腫瘍は不変である.胎児心臓腫瘍の予後不良因子は腫瘍径20mm以上,胎児不整脈,胎児水腫といわれている.胎児診断の重要性を再認識するとともに,更なる予後因子の検討のためにも症例を蓄積することは意義深い.(著者抄録)

    DOI: 10.3179/jjmu.JJMU.A.52

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  • 広汎子宮全摘出術における手術手技とドレーン管理 アンケート調査(日本産婦人科手術学会企画)より.

    田中京子, 平松祐司, 増山 寿, 正岡直樹, 寺尾泰久, 小西郁生

    産婦人科手術   ( 27 )   91 - 97   2016

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  • 妊娠初期から低用量アスピリン投与をおこなった不育症では妊娠高血圧症候群の発症が少ない.

    平野友美加, 増山 寿, 平松祐司

    現代産婦人科   65 ( 1 )   21 - 27   2016

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  • 妊娠中に顕在化した緩徐進行1型糖尿病の1例.

    清時毅典, 延本悦子, 光井 崇, 衛藤英理子, 早田 桂, 増山 寿, 平松祐司

    現代産婦人科   65 ( 1 )   127 - 131   2016

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  • Pretreatment prognostic nutritional index is a significant predictor of prognosis in patients with cervical cancer treated with concurrent chemoradiotherapy.

    Haraga J, Nakamura K, Omichi C, Nishida T, Haruma T, Kusumoto T, Seki N, Masuyama H, Katayama N, Kanazawa S, Hiramatsu Y

    Molecular and Clinical Oncology   5 ( 5 )   567 - 574   2016

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  • 当院における胎児心疾患症例の現状と課題.

    衛藤英理子, 渋川昇平, 光井 崇, 延本悦子, 早田 桂, 瀬川友功, 増山 寿, 平松祐司, 吉本順子

    現代産婦人科   64 ( 2 )   229 - 233   2016

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  • 子宮頸管ポリープ切除を機に発見された子宮頸癌の検討.

    川井紗耶香, 春間朋子, 原賀順子, 西田 傑, 小川千加子, 楠本知行, 中村圭一郎, 関 典子, 増山 寿, 平松祐司

    現代産婦人科   64 ( 2 )   315 - 319   2016

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  • 急性膵炎を契機に発見された胃癌合併妊娠の一例.

    岡本和浩, 瀬川友功, 柏原麻子, 牧 尉太, 玉田祥子, 江口武志, 光井 崇, 衛藤英理子, 平野友美加, 延本悦子, 早田 桂, 増山 寿, 平松祐司

    現代産婦人科   64 ( 2 )   431 - 434   2016

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  • 婦人科腫瘍治療既往のある難治性の下肢痛・しびれに疎経活血湯が奏効した8症例.

    関 典子, 原賀順子, 春間朋子, 西田 傑, 小川千加子, 楠本知行, 中村圭一郎, 増山 寿, 後藤由佳, 奥田博之, 平松祐司

    痛みと漢方   26   85 - 90   2016

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  • Three histologically distinct cancers of the uterine corpus: A case report and review of the literature.

    Masuyama H, Haraga J, Nishida T, Ogawa C, Kusumoto T, Nakamura K, Seki N, Yanai H, Hiramatsu Y

    Molecular and Clinical Oncology   4   563 - 566   2016

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  • A Pregnancy with Severe Hypertrophic Obstructive Cardiomyopathy after Surgery for an Implantable Cardioverter Defibrillator: A Case Report and Literature Review. International journal

    Takashi Mitsui, Hisashi Masuyama, Kentaro Ejiri, Kei Hayata, Hiroshi Ito, Yuji Hiramatsu

    Case reports in obstetrics and gynecology   2016   4690790 - 4690790   2016

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    Hypertrophic obstructive cardiomyopathy (HOCM) is cardiac hypertrophy of ventricular myocardium with left ventricular outflow tract obstruction. We report a pregnancy with HOCM after defibrillator implantation surgery. The patient was a 33-year-old nulligravida and was categorized as New York Heart Association class II. Her brain natriuretic peptide (BNP) level was 724.6 pg/dL at preconception. She received careful pregnancy management. However, because frequent uterine contractions were observed at 25 weeks and 6 days of pregnancy, she was hospitalized, and magnesium sulfate was started as a tocolytic agent. At 27 weeks and 5 days of pregnancy, she had respiratory discomfort and orthopnea with a sudden decrease in peripheral oxygen saturation. Cardiac ultrasonography showed a worsened condition of HOCM and her BNP level was 1418.0 pg/mL. We performed an emergent cesarean section and she delivered a boy weighing 999 g. The Apgar score was 8 and 9 points at 1 and 5 minutes, respectively. The mother's heart failure quickly improved after birth and she was discharged at 10 days postoperatively. Fluctuations in circulatory dynamics during pregnancy may sometimes exacerbate heart disease. Therefore, the risks should be fully explained and careful assessment of cardiac function should be performed during pregnancy in patients with severe HOCM.

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  • 高アンドロゲン/高エストロゲン血症およびpseudo-Meigs症候群を呈し、性索間質性腫瘍が疑われた卵巣類内膜腺癌の一例.

    田中梓菜, 関 典子, 西田 傑, 春間朋子, 小川千加子, 楠本知行, 中村圭一郎, 増山 寿, 柳井広之, 平松祐司

    日本婦人科腫瘍学会雑誌   34 ( 2 )   112 - 118   2016

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  • Creation of a cerebellar diameter reference standard and its clinical application to the detection of cerebellar hypoplasia unique to trisomy 18

    Kei Hayata, Yuji Hiramatsu, Hisashi Masuyama, Eriko Etou, Etsuko Nobumoto, Takashi Mitsui

    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH   41 ( 12 )   1899 - 1904   2015.12

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    Aim: We created a new reference standard focusing on the hemispheric anteroposterior cerebellar diameter (APCD) in addition to the transverse cerebellar diameter (TCD) and discussed whether or not the cerebellar measurement was useful for the detection of trisomy 18 (T18).
    Material and Methods: In 150 normal fetuses between 14 and 36 weeks of gestational age (GA), the TCD and APCD were prospectively measured. In 26 cases with T18, the value was compared with the control.
    Results: At &lt;22weeks of gestation, the TCD reference standard was calculated as follows: TCD=(1.027xGA)-0.674 (R-2=0.97, P&lt;0.001). The reference standard of the APCD was calculated as follows: APCD=(0.682xGA)-3.925 (R-2=0.73, P&lt;0.001). In eight cases with T18, the TCD was below the 5th percentile value in 7/8 (88%) cases and the APCD was below the 5th percentile value in 8/8 (100%) cases. At &gt;22 weeks of gestation, the reference standard of the TCD was calculated as follows: TCD=(1.603xGA) - 13.216 (R-2=0.92, P&lt;0.001). The reference standard of the APCD was calculated as follows: APCD=(0.859xGA) - 7.30 (R-2=0.84, P&lt;0.001). In 18 cases with T18, the TCD was below the 5th percentile value in 14/18 (78%) cases and the APCD was below the 5th percentile value in 18/18 (100%) cases.
    Conclusion: APCD reference standard, divided by the gestational age of more or less than 22 weeks, might be useful to diagnose T18.

    DOI: 10.1111/jog.12814

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  • Pregnancy complications and glucose intolerance in women with polycystic ovary syndrome

    Mari Sawada, Hisashi Masuyama, Kei Hayata, Yasuhiko Kamada, Keiichiro Nakamura, Yuji Hiramatsu

    ENDOCRINE JOURNAL   62 ( 11 )   1017 - 1023   2015.11

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    Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by insulin resistance and hyperandrogenism. The interaction of these factors might result in increased risks of miscarriage and pregnancy complications such as gestational diabetes mellitus (GDM). To examine the pregnancy risks in women with PCOS, we compared obstetrical outcomes between patients with and without PCOS. We also studied the differences in maternal characteristics, glucose intolerance and pregnancy complications between PCOS patients with and without GDM, with and without obesity, and between successful pregnancies and miscarriages. We observed a high incidence of GDM and prevalence of GDM diagnosis in the first trimester in PCOS. Patients with GDM had higher body mass index (BMI) and lower homeostasis model assessment of beta-cell function (HOMA-beta) at preconception than those without GDM. Obese pregnant women with PCOS demonstrated a high incidence of GDM with severe insulin resistance, including high fasting insulin, HOMA of insulin resistance (HOMA-IR), and HOMA-beta at preconception compared with normal-weight patients. BMI was significantly correlated with HOMA-IR or HOMA-beta, and both indices were lower in PCOS patients with than without GDM for the same BMI. There were no significant differences in maternal characteristics (excluding maternal age) between PCOS patients with successful pregnancy and PCOS patients with miscarriages. Our data suggest that pregnant women with PCOS have an increased risk of GDM, especially if they have obesity and/or poorer insulin secretion. Measure of beta-cell function, such as HOMA-beta, at preconception might be a useful predictor of the risk of GDM in pregnant PCOS patients.

    DOI: 10.1507/endocrj.EJ15-0364

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  • TWO CASES OF CONGENITAL CYTOMEGALOVIRUS INFECTION

    Shoko Tamada, Jota Maki, Takeshi Eguchi, Takashi Mitsui, Yumika Hirano, Eriko Eto, Etsuko Nobumoto, Kei Hayata, Hisashi Masuyama, Yuji Hiramatsu

    PLACENTA   36 ( 10 )   A3 - A4   2015.10

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    Language:English   Publishing type:Research paper, summary (international conference)   Publisher:W B SAUNDERS CO LTD  

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  • Effect of the new diagnostic criteria for gestational diabetes mellitus among Japanese women

    Etsuko Nobumoto, Hisashi Masuyama, Yuji Hiramatsu, Takashi Sugiyama, Hideto Kusaka, Nagayasu Toyoda

    Diabetology International   6 ( 3 )   226 - 231   2015.9

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    Background: The new diagnostic criteria for gestational diabetes mellitus (GDM), proposed by the International Association of Diabetes and Pregnancy Study Groups in 2010, were recently accepted in Japan. Therefore, the frequency of GDM is four times higher than previously recorded. This means that GDM has become a more clinically important disease. This study aimed to assess how the number of patients with GDM as well as its complications have changed after adoption of the new criteria. Methods: A total of 3,610 pregnant women in the Japan Assessment of GDM Screening Trial and Okayama University Hospital were included. We analyzed the prevalence of GDM and its complications using the old and new criteria. Results: The prevalence of perinatal outcomes was increased by adopting the new criteria. There were many important perinatal complications in the additional new GDM criteria
    therefore, patients with mild GDM, such as one-point disorder patients, should have careful interventions. Admission to the neonatal intensive care unit was significantly increased (p = 0.01) according to the new GDM criteria because the old criteria were stricter than the new ones. GDM patients with obesity (BMI ≥ 25 kg/m&lt
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    2&lt
    /sup&gt
    ) had a high frequency of perinatal complications that could require active intervention and strict follow-up. Conclusions: Because the new GDM criteria greatly affect perinatal complications, intervention for GDM starting at an early stage and strict follow-up (especially GDM with obesity) are important for reducing complications as well as the incidence of diabetes and metabolic syndrome in the mother and child.

    DOI: 10.1007/s13340-014-0193-8

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  • The Glasgow Prognostic Score Determined During Concurrent Chemoradiotherapy Is an Independent Predictor of Survival for Cervical Cancer

    Takeshi Nishida, Keiichiro Nakamura, Junko Haraga, Chikako Ogawa, Tomoyuki Kusumoto, Noriko Seki, Hisashi Masuyama, Norihisa Katayama, Susumu Kanazawa, Yuji Hiramatsu

    INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER   25 ( 7 )   1306 - 1314   2015.9

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    Objective The Glasgow prognostic score (GPS) determined at pretreatment is important in the prediction of prognosis in various cancers. We investigated if the GPS used both at pretreatment and during concurrent chemoradiotherapy (CCRT) could predict the prognosis of patients with cervical cancer.
    Methods We collected GPS and clinicopathological data from the medical records of 91 patients who underwent CCRT for cervical cancer; their GPSs at pretreatment and during CCRT were retrospectively analyzed for correlations with recurrence and survival. Statistical analyses were performed using the Mann-Whitney U test. Disease-free survival (DFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. Cox's proportional hazard regression was used for univariate and multivariate analyses.
    Results The median follow-up for all patients who were alive at the time of last follow-up was 38.0 months (range, 1-108 months). The DFS and OS rates of patients with a high GPS during CCRT (GPS 1 + 2; 55 patients; 60.4%) were significantly shorter than those for patients with a low GPS (GPS 0; 36 patients; 39.6%) (DFS, P &lt; 0.001; OS, P &lt; 0.001). Furthermore, multivariate analyses showed that high GPS during CCRT was an independent prognostic factor of survival for OS (P = 0.008).
    Conclusions During CCRT, a high GPS was revealed to be an important predictor of survival for cervical cancer.

    DOI: 10.1097/IGC.0000000000000485

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  • The Effects of High-Fat Diet Exposure In Utero on the Obesogenic and Diabetogenic Traits Through Epigenetic Changes in Adiponectin and Leptin Gene Expression for Multiple Generations in Female Mice

    Hisashi Masuyama, Takashi Mitsui, Etsuko Nobumoto, Yuji Hiramatsu

    ENDOCRINOLOGY   156 ( 7 )   2482 - 2491   2015.7

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    Recent studies demonstrate that epigenetic changes under malnutrition in utero might play important roles in transgenerational links with metabolic diseases. We have previously shown that exposure to a high-fat diet (HFD) in utero may cause a metabolic syndrome-like phenomenon through epigenetic modifications of Adiponectin and Leptin genes. Because an association of obesity between mother and offspring endured in multiple generations, we examined whether HFD exposure in utero might affect the metabolic status of female offspring through multigenerational epigenetic changes of Adiponectin and Leptin genes and whether a normal diet in utero for multiple generations might abolish such epigenetic changes after exposure to a HFD in utero using ICR mice. We observed that the effect of maternal HFD on offspring over multiple generations in metabolic syndrome-like phenomenon such as weight and fat mass gain, glucose intolerance, hypertriglyceridemia, abnormal adiponectin and leptin levels, and hypertension, were accumulated with expression and epigenetic changes in Adiponectin and Leptin genes. A normal diet in utero in the subsequent generations after HFD exposure in utero diminished, and a normal diet in utero for 3 generations completely abolished, the effect of HFD in utero on weight and fat mass gain, insulin resistance, serum triglyceride, adiponectin, and leptin levels, with epigenetic changes of Adiponectin and Leptin genes. Exposure to a HFD in utero might affect glucose and lipid metabolism of female offspring through epigenetic modifications to Adiponectin and Leptin genes for multiple generations. Obesogenic and diabetogenic traits were abolished after a maternal normal diet for 3 generations.

    DOI: 10.1210/en.2014-2020

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  • Nationwide demonstration project of next-generation sequencing of cell-free DNA in maternal plasma in Japan: 1-year experience

    Haruhiko Sago, Japan NIPT consortium, Akihiko Sekizawa, Takahiro Yamada, Toshiaki Endo, Akimune Hukushima, Jun Murotsuki, Kamei Yoshimasa, Satoshi Nanba, Junko Yotsumoto, Hisao Osada, Yasuyo Kasai, Atsushi Watanabe, Yukiko Katagiri, Naoki Takesita, Masaki Ogawa, Tomohiro Tanemoto, Osamu Samura, Michihiro Kitagawa, Takashi Okai, Shun-Ichiro Izumi, Haruka Hamanoue, Fumiki Hirahara, Kazufumi Haino, Nobuhiro Suzumori, Naoki Hamajima, Yoko Okamoto, Hiroaki Nakamura, Takeshi Kanekawa, Jun Yoshimatsu, Hideaki Sawai, Shinya Tairaku, Katsuhiko Naruse, Hisashi Masuyama, Maki Hyodo, Takashi Kaji, Kazutoshi Maeda, Keiichi Matsubara, Masanobu Ogawa, Toshiyuki Yoshizato, Kiyonori Miura, Hideaki Masuzaki, Takashi Ohba, Yukie Kawano, Miyuki Nishiyama

    Prenatal Diagnosis   35 ( 4 )   331 - 336   2015.4

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    Objective: To report the 1-year experience of a nationwide demonstration project to introduce noninvasive prenatal testing of aneuploidy from maternal plasma and discuss how to implement this program in Japan. Methods: The test was conducted to detect aneuploidy in high-risk pregnant women with adequate genetic counseling. The clinical data, test results, and pregnancy outcomes were recorded. Results: Of the 7740 women tested, 142 (1.8%) had positive results, 7594 (98.1%) had negative results, and four (0.1%) had results that were not reportable. Of the 142 women who tested positive, 13 cases resulted in intrauterine fetal death, and three cases refused to undergo the invasive procedure. Of the 126 positive cases confirmed on karyotyping, a normal karyotype was observed for trisomy 21 in three cases, trisomy 18 in eight cases, and trisomy 13 in two cases. In the follow-up study of the negative cases (n=1638), only one false-negative case of trisomy 18 was detected. Conclusions: We described our nationwide 1-year experience with noninvasive prenatal genetic testing. It is expected that the present data will stimulate a debate regarding prenatal genetic testing and hopefully lead to improvements in the perinatal care system with respect to genetic counseling in Japan.

    DOI: 10.1002/pd.4539

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  • 先天性第Ⅴ因子欠乏症を合併した妊婦の一例.

    安藤まり, 瀬川友功, 佐藤麻夕子, 衛藤英理子, 延本悦子, 早田 桂, 増山 寿, 平松祐司, 木村吉宏

    現代産婦人科   64 ( 1 )   131 - 134   2015

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  • 特殊型子宮体癌(Mixed type、Pure type、類内膜腺癌Grade3)の臨床・予後因子に関する検討.

    甲斐憲治, 中村圭一郎, 西田 傑, 春間朋子, 小川千加子, 楠本知行, 関 典子, 増山 寿, 平松祐司

    現代産婦人科   63 ( 2 )   255 - 258   2015

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  • 腹腔鏡補助下に診断・治療を行った、高度肥満合併Meigs症候群の一例.

    久保光太郎, 楠本知行, 西田 傑, 長谷川徹, 春間朋子, 小川千加子, 中村圭一郎, 関 典子, 増山 寿, 平松祐司

    現代産婦人科   63 ( 2 )   361 - 365   2015

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  • 照射野内再発にIMRT(intensity-modulated radiation therapy)が著効した子宮頸癌の一例.

    小川千加子, 呉 隆進, 早田 裕, 西田 傑, 春間朋子, 楠本知行, 中村圭一郎, 関 典子, 増山 寿, 平松祐司

    現代産婦人科   63 ( 2 )   373 - 378   2015

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  • 胎児心拍数モニタリング.

    増山 寿, 平松祐司

    週刊 日本医事新報   ( 4733 )   49 - 49   2015

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  • DOHaD説.

    増山 寿, 平松祐司

    週刊 日本医事新報   ( 4735 )   51 - 51   2015

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  • Different fetal and neonatal growth between early- and late-onset preeclampsia.

    Mitsui T, Masuyama H, Eto E, Nobumoto E, Hayata K, Hiramatsu Y

    Open Journal of Obstetrics and Gynecology   5 ( 9 )   516 - 521   2015

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  • GDMに対するSMBGの保険適応拡大に向けて.

    平野友美加, 光井 崇, 渋川昇平, 衛藤英理子, 延本悦子, 早田 桂, 瀬川友功, 増山 寿, 平松祐司

    糖尿病と妊娠   15 ( 1 )   76 - 76   2015

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  • Pretreatment platelet-lymphocyte ratio is an independent predictor of cervical cancer recurrence following concurrent chemoradiation therapy.

    Nakamura K, Nishida T, Haruma T, Haraga J, Omichi C, Ogawa C, Kusumoto T, Seki N, Masuyama H, Hiramatsu Y

    Molecular and Clinical Oncology   3 ( 5 )   1001 - 1006   2015

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  • P3-35-6 妊娠17週にて子宮破裂を発症した既往帝王切開後妊娠の1例(Group137 子宮破裂 TOLAC,一般演題,公益社団法人日本産科婦人科学会第67回学術講演会)

    光井 崇, 西田 傑, 中村 圭一郎, 早田 桂, 谷 和祐, 河原 義文, 衛藤 英理子, 延本 悦子, 瀬川 友功, 増山 寿, 平松 祐司

    日本産科婦人科學會雜誌   67 ( 2 )   907 - 907   2015

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  • P1-33-8 妊娠中に顕在化した緩徐進行1型糖尿病の1例(Group33 合併症妊娠4,一般演題,公益社団法人日本産科婦人科学会第67回学術講演会)

    清時 毅典, 延本 悦子, 光井 崇, 衛藤 英理子, 早田 桂, 瀬川 友功, 増山 寿, 平松 祐司

    日本産科婦人科學會雜誌   67 ( 2 )   622 - 622   2015

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  • P2-58-1 18トリソミーに特徴的な小脳低形成検出を目的とした,小脳横径と小脳半球縦径の基準値作成と臨床応用(Group 99 胎児異常1,一般演題,公益社団法人日本産科婦人科学会第67回学術講演会)

    早田 桂, 渋川 昇平, 光井 崇, 平野 友美加, 衛藤 英理子, 延本 悦子, 瀬川 友功, 増山 寿, 平松 祐司

    日本産科婦人科學會雜誌   67 ( 2 )   805 - 805   2015

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  • P2-30-7 先天性アンチトロンビン3欠損症合併妊娠の2症例(Group 71 不育症 臨床,一般演題,公益社団法人日本産科婦人科学会第67回学術講演会)

    甲斐 憲治, 酒本 あい, 長谷川 徹, 久保 光太郎, 松田 美和, 小谷 早葉子, 瀬川 友功, 鎌田 泰彦, 増山 寿, 中塚 幹也, 平松 祐司

    日本産科婦人科學會雜誌   67 ( 2 )   726 - 726   2015

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  • P2-24-2 手術前に画像診断し得た静脈内子宮平滑筋腫の一例(Group 65 良性・悪性腫瘍 症例1,一般演題,公益社団法人日本産科婦人科学会第67回学術講演会)

    兼森 美帆, 中村 圭一郎, 西田 傑, 春間 朋子, 小川 千加子, 楠本 知行, 関 典子, 増山 寿, 平松 祐司

    日本産科婦人科學會雜誌   67 ( 2 )   711 - 711   2015

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  • P2-4-10 子宮頸癌再発のplatelet-to-lymphocyte ratio (PLR)は予後予測に有効である(Group45 子宮頸部腫瘍 症例検討,一般演題,公益社団法人日本産科婦人科学会第67回学術講演会)

    中村 圭一郎, 西田 傑, 春間 朋子, 小川 千加子, 楠本 知行, 関 典子, 増山 寿, 平松 祐司

    日本産科婦人科學會雜誌   67 ( 2 )   659 - 659   2015

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  • Efficacy of transarterial embolisation in the management of post-partum haemorrhage and its impact on subsequent pregnancies

    Seiji Inoue, Hisashi Masuyama, Yuji Hiramatsu

    AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY   54 ( 6 )   541 - 545   2014.12

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    BackgroundTransarterial embolisation (TAE) has been attracting attention as a treatment option for post-partum haemorrhage (PPH).
    AimsWe investigated cases in which TAE was performed for PPH to determine the efficacy of TAE for the treatment of PPH and its impact on subsequent pregnancies and childbirth in a multi-institutional case-series study.
    Materials and MethodsA total of 211 women who underwent emergency (n=161) or prophylactic (n=50) TAE for the management of PPH from 2002 to 2011 in the Chugoku and Shikoku regions of Japan were evaluated. Data on maternal background, treatment efficacy, adverse events in 113 cases followed up after TAE and subsequent pregnancies in 76 women were obtained.
    ResultsThe overall success rate of emergency and prophylactic TAE was 91.9 and 96.0%, respectively. The rate of complications such as infection, uterine necrosis and amenorrhoea was 13.3% among women followed up after TAE. Forty women became pregnant after TAE, and the pregnancy rate among those who desired fertility was 52.6%. Twenty-eight gave birth, including four preterm deliveries. Five (16.7%) were associated with a hysterectomy due to placenta accreta.
    ConclusionsTo reduce haemorrhage and avoid hysterectomy, TAE may be considered as a treatment option for PPH, however short and long terms complications are not uncommon.

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  • The inhibition of constitutive androstane receptor-mediated pathway enhances the effects of anticancer agents in ovarian cancer cells

    Yan Wang, Hisashi Masuyama, Etsuko Nobumoto, Guangmei Zhang, Yuji Hiramatsu

    BIOCHEMICAL PHARMACOLOGY   90 ( 4 )   356 - 366   2014.8

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    Background: Ovarian cancer is commonly treated with anticancer agents; however, many tumors become resistant. Resistance is regulated, in part, by P-glycoprotein, which is encoded by the gene multiple drug resistance 1 (MDR1) and functions as a transmembrane efflux pump for the elimination of anticancer agents. Constitutive androstane receptor (CAR) is a nuclear receptor that regulates drug metabolism through control of MDR1 and other genes.
    Purpose: We examined whether the inhibition of CAR-mediated pathway could influence the cytotoxicity of three anticancer drugs, cisplatin, paclitaxel, and arsenic trioxide, in ovarian cancer cells.
    Results: We observed that the cell proliferation of several ovarian cell lines expressing CAR significantly increased when CITCO was combined with anticancer agents compared with any anticancer agent alone. The up-regulation of MDR1 and UGT1A1 by anticancer agents was further enhanced in the presence of CITCO. We confirmed that combining CITCO with anticancer agents induced significantly lower levels of apoptosis than those achieved with any single anticancer drug. CAR down-regulation by RNA interference caused a significant increase in cell growth inhibition and enhancement of apoptosis in the presence of anticancer agents. Combination of CITCO with any anticancer agents significantly enhanced CAR-mediated transcription compared with any anticancer agents alone and CAR down-regulation completely inhibited the transcription in the presence of CITCO and/or anticancer agents.
    Conclusion: Inhibition of CAR pathway could be a novel therapeutic approach for the augmentation of sensitivity to anticancer agents, or to overcome resistance, in the treatment of ovarian cancer. (C) 2014 Elsevier Inc. All rights reserved.

    DOI: 10.1016/j.bcp.2014.06.003

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  • Additive Effects of Maternal High Fat Diet during Lactation on Mouse Offspring

    Hisashi Masuyama, Yuji Hiramatsu

    PLOS ONE   9 ( 3 )   e92805-e92805   2014.3

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    Recent reports indicated that nutrition in early infancy might influence later child health outcomes such as obesity and metabolic syndrome. Therefore, we examined the effects of maternal high fat diet (HFD) during lactation on the onset of a metabolic syndrome in their offspring. All offspring were cross-fostered by dams on the same or opposite diet to yield 4 groups: offspring from HFD-fed dams suckled by HFD-fed dams (OHH) and by control diet (CD)-fed dams (OHC) and CD-fed dams suckled by HFD-fed dams (OCH) and by CD-fed dams (OCC) mice. We examined several metabolic syndrome-related factors including body weight, blood pressure, glucose tolerance and adipocytokines. Mean body weights of OHH and OCH mice were significantly higher than those of OHC and OCC mice, respectively, with elevated systolic blood pressure. Moreover, OHH and OCH mice revealed significantly worse glucose tolerance compared with the OHC and OCC mice, respectively. Triglyceride and leptin levels were significantly increased and adiponectin levels were significantly reduced by the maternal HFD during lactation, with similar changes in leptin and adiponectin mRNA expression but without histone modifications in adipose tissues. In addition, maternal obesity induced by HFD during lactation increased and prolonged the leptin surge in the offspring and the gender differences of leptin surge were observed. Our data suggested that maternal HFD during lactation might have an additive effect on the onset of the metabolic syndrome in the offspring, irrespective of the nutritional status in utero through the modified leptin surge.

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  • 成熟嚢胞性奇形腫悪性転化3症例の検討.

    尾嶋真由子, 楠本知行, 江口武志, 大道千晶, 乃美志保, 原賀順子, 春間朋子, 小川千加子, 中村圭一郎, 関 典子, 増山 寿, 平松祐司

    現代産婦人科   63 ( 1 )   159 - 163   2014

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  • 開腹手術.

    平松祐司, 増山 寿, 早田 桂, 延本悦子

    産婦人科の実際   63 ( 10 )   1335 - 1341   2014

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  • 2.婦人科腫瘍における静脈血栓塞栓症の発症メカニズムとリスク因子.

    関 典子, 春間朋子, 福島千加子, 楠本知行, 中村圭一郎, 増山 寿, 平松祐司

    日本婦人科腫瘍学会雑誌   32 ( 2 )   147 - 153   2014

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  • 開腹良性婦人科疾患手術はどう変わったか?

    増山 寿, 平松祐司

    産婦人科の実際   63 ( 6 )   767 - 770   2014

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  • アディポサイトカインと女性医学(4)アディポサイトカインと妊娠高血圧症候群.

    増山 寿, 平松祐司

    HORMONE FRONTIER IN GYNECOLOGY   21 ( 3 )   51 - 57   2014

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  • 開腹手術、腹腔鏡下手術およびロボット支援下手術の割合に関する全国調査(2012年).

    増山 寿, 寺尾泰久, 藤井多久磨, 正岡直樹, 小西郁生, 平松祐司, 塩田 充

    産婦人科手術   ( 25 )   135 - 141   2014

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  • 短期間での貧血の進行を契機に慢性常位胎盤早期剥離を診断し得た1例.

    依田尚之, 早田 桂, 安藤まり, 岡本和浩, 樫野千明, 西條昌之, 谷 和祐, 松岡敬典, 衛藤英理子, 平野友美加, 延本悦子, 瀬川友功, 増山 寿, 平松祐司

    現代産婦人科   63 ( 1 )   59 - 62   2014

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  • 産科急性腹症の検討.

    岡本和浩, 瀬川友功, 安藤まり, 依田尚之, 樫野千明, 西條昌之, 谷 和祐, 松岡敬典, 衛藤英理子, 平野友美加, 延本悦子, 早田 桂, 増山 寿, 平松祐司

    現代産婦人科   63 ( 1 )   67 - 71   2014

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  • P3-2-5 高度肥満妊婦の周産期リスク(Group 99 ハイリスク妊娠2,一般演題,公益社団法人日本産科婦人科学会第66回学術講演会)

    衛藤 英理子, 平野 友美加, 延本 悦子, 早田 桂, 瀬川 友功, 増山 寿, 平松 祐司

    日本産科婦人科學會雜誌   66 ( 2 )   758 - 758   2014

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  • P3-41-6 早期子宮頸がん(1b期~2b期)に対する治療法と再発の検討(Group 138 子宮頸部腫瘍・治療4,一般演題,公益社団法人日本産科婦人科学会第66回学術講演会)

    楠本 知行, 福島 千加子, 佐藤 麻夕子, 春間 朋子, 関 典子, 中村 圭一郎, 増山 寿, 平松 祐司

    日本産科婦人科學會雜誌   66 ( 2 )   876 - 876   2014

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  • P3-45-6 治療前末梢血好中球リンパ球比高値は子宮体癌の予後不良因子である(Group 142 子宮体部腫瘍・予後1,一般演題,公益社団法人日本産科婦人科学会第66回学術講演会)

    春間 朋子, 中村 圭一郎, 福島 千加子, 楠本 知行, 関 典子, 増山 寿, 平松 祐司

    日本産科婦人科學會雜誌   66 ( 2 )   887 - 887   2014

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  • P1-26-2 産科急性腹症の検討(Group26 合併症妊娠4,一般演題,公益社団法人日本産科婦人科学会第66回学術講演会)

    岡本 和浩, 瀬川 友功, 衛藤 英理子, 平野 友美加, 延本 悦子, 早田 桂, 増山 寿, 平松 祐司

    日本産科婦人科學會雜誌   66 ( 2 )   539 - 539   2014

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  • P3-22-1 短期間での貧血の進行から慢性常位胎盤早期剥離を超音波診断し児を救命した1例(Group 119 胎盤1,一般演題,公益社団法人日本産科婦人科学会第66回学術講演会)

    依田 尚之, 早田 桂, 平野 友美加, 衛藤 英理子, 延本 悦子, 瀬川 友功, 増山 寿, 平松 祐司

    日本産科婦人科學會雜誌   66 ( 2 )   819 - 819   2014

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  • P3-16-3 分娩中に脳静脈洞血栓症をきたした一例(Group 113 合併症妊娠5,一般演題,公益社団法人日本産科婦人科学会第66回学術講演会)

    谷 和祐, 延本 悦子, 平野 友美加, 衛藤 英理子, 早田 桂, 瀬川 友功, 増山 寿, 平松 祐司

    日本産科婦人科學會雜誌   66 ( 2 )   803 - 803   2014

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  • P1-15-1 卵巣癌に対するConstitutive androstane receptorを介した抗癌剤効果増強,耐性克服に向けての新たな治療戦略(Group 15 卵巣腫瘍・基礎2,一般演題,公益社団法人日本産科婦人科学会第66回学術講演会)

    増山 寿, Wan Yang, 延本 悦子, 平松 祐司

    日本産科婦人科學會雜誌   66 ( 2 )   509 - 509   2014

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  • P2-42-6 癒着胎盤における治療法の工夫(Group 80 産科出血4,一般演題,第66回学術講演会)

    瀬川 友功, 平野 友美加, 衛藤 英理子, 延本 悦子, 早田 桂, 増山 寿, 平松 祐司

    日本産科婦人科學會雜誌   66 ( 2 )   701 - 701   2014

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  • P2-43-5 Trisomy18の胎内診断に有用となる胎児超音波所見の特徴(Group 81 出生前診断1,一般演題,第66回学術講演会)

    早田 桂, 平野 友美加, 衛藤 英理子, 延本 悦子, 瀬川 友功, 増山 寿, 平松 祐司

    日本産科婦人科學會雜誌   66 ( 2 )   705 - 705   2014

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  • P3-2-7 やせ妊婦における体重増加および胎盤と周産期予後の検討(Group 99 ハイリスク妊娠2,一般演題,公益社団法人日本産科婦人科学会第66回学術講演会)

    延本 悦子, 平野 友美加, 衛藤 英理子, 早田 桂, 瀬川 友功, 増山 寿, 平松 祐司

    日本産科婦人科學會雜誌   66 ( 2 )   759 - 759   2014

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  • つわり (妊婦の悩みに応えられる助産師になろう ビジュアルで学ぶマイナートラブル解決法)

    増山 寿, 平松 祐司

    ペリネイタルケア   32 ( 12 )   1145 - 1148   2013.12

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  • Pregnancy and delivery in patients with Fontan circulation: A report of two cases

    Seiji Inoue, Hisashi Masuyama, Teiji Akagi, Yuji Hiramatsu

    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH   39 ( 1 )   378 - 382   2013.1

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    Fontan operation is performed to provide palliation for patients with many forms of highly complex congenital heart disease that cannot support a biventricular circulation. Increasing numbers of women who have undergone these connections in childhood are now reaching their childbearing years, and some are becoming pregnant. The low flow and fixed cardiac output of a Fontan circulation poses a number of problems during pregnancy. Here, we report two cases of pregnancy and delivery with Fontan circulation. Case 1, who underwent Fontan procedure for congenital pulmonary atresia with intact vertical septum at age 7, delivered a male infant weighing 1073 g by cesarean section at 286/7 weeks due to massive genital bleeding. Case 2 underwent Fontan procedure for double inlet left ventricle and delivered by vacuum extraction a male infant weighing 2142 g, while monitoring central venous pressure at 375/7 weeks. The former had ascites and dose of diuretic had to be added at early pregnancy, and the latter had no adverse cardiac and obstetric events. These cases suggest that patients after adequate Fontan palliation could complete pregnancy without long-term cardiac sequelae, but might be complicated with cardiac or obstetrical events. Intensive care should be required with specialists, including a neonatologist, anesthesiologist and cardiologist. We have added a literature review of pregnancy with Fontan circulation, referring to previous reports.

    DOI: 10.1111/j.1447-0756.2012.01910.x

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  • Conservative management of cervical pregnancy: The utility of methotrexate treatment and uterine artery embolization.

    Masuyama H, Inoue S, Nobumoto E, Hayata K, Segawa T, Hiramatsu Y

    Open Journal of Obstetrics and Gynecology   3 ( 10 )   711 - 716   2013

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  • 当院におけるやせ妊婦の現状と周産期予後.

    延本悦子, 沖本直輝, 早田 桂, 井上誠司, 瀬川友功, 増山 寿, 平松祐司

    日本周産期・新生児医学会雑誌   49 ( 3 )   949 - 952   2013

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  • 統合失調症合併妊娠の周産期管理とその問題点.

    乃美志保, 井上誠司, 江口武志, 大道千晶, 尾嶋真由子, 原賀順子, 延本悦子, 沖本直輝, 瀬川友功, 増山 寿, 平松祐司

    現代産婦人科   61 ( 2 )   201 - 204   2013

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  • 当院における緊急産褥搬送の現状.

    井上誠司, 延本悦子, 早田 桂, 沖本直輝, 瀬川友功, 増山 寿, 平松祐司

    現代産婦人科   61 ( 2 )   223 - 226   2013

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  • 卵管妊娠破裂/頸管妊娠出血.

    増山 寿, 平松祐司

    臨床婦人科産科 産婦人科当直医マニュアル 慌てないための虎の巻   67 ( 4(増刊号) )   28 - 31   2013

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  • 最近の周術期管理について.

    寺尾泰久, 増山 寿, 藤井多久磨, 正岡直樹, 平松祐司, 小西郁生

    産婦人科手術   ( 24 )   111 - 115   2013

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  • 糖尿病と胎盤.

    増山 寿, 舛本明生, 洲脇尚子, 平松祐司

    産婦人科の実際   62 ( 8 )   1073 - 1078   2013

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  • 妊婦の悩みに応じられる助産師になろう ビジュアルで学ぶマイナートラブル解決法 5.つわり.

    増山 寿, 平松祐司

    ペリネイタルケア   32 ( 12 )   27 - 30   2013

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  • 2生児を出産した妊娠許可基準を満たさない慢性腎不全合併妊娠の1例.

    江口武志, 大道千晶, 尾嶋真由子, 乃美志保, 原賀順子, 沖本直輝, 延本悦子, 井上誠司, 瀬川友功, 増山 寿, 平松祐司

    現代産婦人科   62 ( 1 )   133 - 137   2013

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  • P3-26-7 当科における前置胎盤の臨床的検討(Group 131 胎盤2,一般演題,公益社団法人日本産科婦人科学会第65回学術講演会)

    丹羽 家泰, 延本 悦子, 沖本 直輝, 井上 誠司, 瀬川 友功, 増山 寿, 平松 祐司

    日本産科婦人科學會雜誌   65 ( 2 )   933 - 933   2013

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  • K2-7-3 高脂肪食飼育子宮内環境は,アディポサイトカイン遺伝子のエピゲノム変化を介して世代を超えてメタボリック症候群発症に関与する(高得点演題12 周産期医学3,一般演題,公益社団法人日本産科婦人科学会第65回学術講演会)

    増山 寿, 延本 悦子, 沖本 直輝, 早田 桂, 井上 誠司, 瀬川 友功, 平松 祐司

    日本産科婦人科學會雜誌   65 ( 2 )   693 - 693   2013

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  • P2-30-9 若年卵巣がん妊孕能温存手術後妊娠出産例の検討(Group 82 合併症妊娠4,一般演題,公益社団法人日本産科婦人科学会第65回学術講演会)

    関 典子, 増山 寿, 福島 千加子, 楠本 知行, 中村 圭一郎, 平松 祐司

    日本産科婦人科學會雜誌   65 ( 2 )   782 - 782   2013

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  • P2-35-4 先天性心疾患胎児における脳血流動態および頭部発育についての検討(Group 87 胎児奇形・先天異常3,一般演題,公益社団法人日本産科婦人科学会第65回学術講演会)

    沖本 直輝, 延本 悦子, 井上 誠司, 瀬川 友功, 増山 寿, 平松 祐司

    日本産科婦人科學會雜誌   65 ( 2 )   794 - 794   2013

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  • P1-37-8 精神科入院を要した統合失調症合併妊娠の周産期臨床像(Group 37 合併症妊娠2,一般演題,公益社団法人日本産科婦人科学会第65回学術講演会)

    乃美 志保, 井上 誠司, 延本 悦子, 沖本 直輝, 瀬川 友功, 増山 寿, 平松 祐司

    日本産科婦人科學會雜誌   65 ( 2 )   635 - 635   2013

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  • P3-28-5 低体温療法が有効であった臍帯真結節による重症新生児仮死の一例(Group 133 胎盤・羊水(症例)1,一般演題,公益社団法人日本産科婦人科学会第65回学術講演会)

    河合 清日, 増山 寿, 延本 悦子, 沖本 直輝, 井上 誠司, 瀬川 友功, 平松 祐司

    日本産科婦人科學會雜誌   65 ( 2 )   939 - 939   2013

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  • Treatment with constitutive androstane receptor ligand during pregnancy prevents insulin resistance in offspring from high-fat diet-induced obese pregnant mice

    Hisashi Masuyama, Yuji Hiramatsu

    AMERICAN JOURNAL OF PHYSIOLOGY-ENDOCRINOLOGY AND METABOLISM   303 ( 2 )   E293 - E300   2012.7

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    Masuyama H, Hiramatsu Y. Treatment with constitutive androstane receptor ligand during pregnancy prevents insulin resistance in offspring from high-fat diet-induced obese pregnant mice. Am J Physiol Endocrinol Metab 303: E293-E300, 2012. First published May 29, 2012; doi:10.1152/ajpendo.00167.2012.-The constitutive androstane receptor (CAR) has been reported to decrease insulin resistance even during pregnancy, while exposure to a high-fat diet (HFD) in utero in mice can induce a type 2 diabetes phenotype that can be transmitted to the progeny. Therefore, we examined whether treatment with a CAR ligand during pregnancy could prevent hypertension, insulin resistance, and hyperlipidemia in the offspring from HFD-induced obese pregnant mice (OH mice). We employed four groups of offspring from HFD-fed and control diet-fed pregnant mice with or without treatment with a CAR ligand. Treatment with a CAR ligand during pregnancy improved glucose tolerance and the levels of triglyceride and adipocytokine and restored the changes induced by HFD with amelioration of hypertension in the adult OH mice. This treatment also increased adiponectin mRNA expression, suppressed leptin expression in adipose tissues of OH mice, and abolished the effect of HFD on the epigenetic modifications of the genes encoding adiponectin and leptin in the offspring during immaturity and adulthood. Our data suggest that CAR might be a potential therapeutic target to prevent metabolic syndrome in adulthood of offspring exposed to an HFD in utero.

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  • Effects of a High-Fat Diet Exposure in Utero on the Metabolic Syndrome-Like Phenomenon in Mouse Offspring through Epigenetic Changes in Adipocytokine Gene Expression

    Hisashi Masuyama, Yuji Hiramatsu

    ENDOCRINOLOGY   153 ( 6 )   2823 - 2830   2012.6

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    The links between obesity in parents and their offspring and the role of genes and a shared environment are not completely understood. Adipocytokines such as leptin and adiponectin play important roles in glucose and lipid metabolism. Therefore, we examined whether the offspring from dams exposed to a high-fat diet during pregnancy (OH mice) exhibited hypertension, insulin resistance, and hyperlipidemia along with epigenetic changes in the expression of adipocytokine genes. OH mice were significantly heavier than the offspring of dams exposed to a control diet during pregnancy (OC mice) from 14 wk of age after an increased caloric intake from 8 wk. OH mice exhibited higher blood pressure and worse glucose tolerance than the OC mice at 24 wk. Total triglyceride and leptin levels were significantly higher and the adiponectin level was significantly lower in OH compared with OC mice at 12 wk of age. This was associated with changes in leptin and adiponectin expression in white adipose tissue. There were lower acetylation and higher methylation levels of histone H3 at lysine 9 of the promoter of adiponectin in adipose tissues of OH mice at 2 wk of age as well as at 12 and 24 wk of age compared with OC mice. In contrast, methylation of histone 4 at lysine 20 in the leptin promoter was significantly higher in OH compared with OC mice. Thus, exposure to a high-fat diet in utero might cause a metabolic syndrome-like phenomenon through epigenetic modifications of adipocytokine, adiponectin, and leptin gene expression. (Endocrinology 153: 2823-2830, 2012)

    DOI: 10.1210/en.2011-2161

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  • Severe Superimposed Preeclampsia with Obesity, Diabetes and a Mild Imbalance of Angiogenic Factors

    Hisashi Masuyama, Etsuko Nobumoto, Tomonori Segawa, Yuji Hiramatsu

    ACTA MEDICA OKAYAMA   66 ( 2 )   171 - 175   2012.4

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    Preeclampsia may be due to an excess of circulating anti-angiogenic growth factors derived from the placenta, but metabolic syndrome-like disorders may also set off a cascade of placental and systemic inflammation and oxidative stress. We present a case of severe superimposed preeclampsia with obesity, diabetes and a mild imbalance of angiogenic factors, in which diet therapy ameliorated the preeclamptic signs while improving the adiponectin level. A 41-year-old pregnant woman with obesity and diabetes was referred to our hospital because of severe proteinuria and hypertension at 22 weeks of gestation. After administration of insulin and hydralazine with diet therapy, her hypertension and proteinuria were ameliorated with a 15-kg weight loss. Her adiponectin level was low and her leptin level was high, but her angiogenic factor levels were within the normal ranges for pregnant women at admission. The diet therapy ameliorated her hypertension and proteinuria while improving her adiponectin level as she achieved weight loss. This case suggests that diet therapy for obese preeclampsia patients with a mild imbalance of anti-and pro-angiogenic factors may play an important role in managing preeclampsia. Measurements of maternal adipocytokines and angiogenic factors may be important to distinguish the main cause of preeclampsia, i.e., poor placentation or maternal constitutional factors, for managing preeclampsia in patients with obesity.

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  • Potential interaction of brain natriuretic peptide with hyperadiponectinemia in preeclampsia

    Hisashi Masuyama, Etsuko Nobumoto, Seiji Inoue, Yuji Hiramatsu

    AMERICAN JOURNAL OF PHYSIOLOGY-ENDOCRINOLOGY AND METABOLISM   302 ( 6 )   E687 - E693   2012.3

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    Masuyama H, Nobumoto E, Inoue S, Hiramatsu Y. Potential interaction of brain natriuretic peptide with hyperadiponectinemia in preeclampsia. Am J Physiol Endocrinol Metab 302: E687-E693, 2012. First published January 10, 2012; doi:10.1152/ajpendo.00548.2011.-Adiponectin was reported recently to have roles in the pathophysiology of preeclampsia. Moreover, elevation of adiponectin and brain natriuretic peptide (BNP) has been observed in preeclampsia. We examined the possible links between adiponectin and BNP in the pathophysiology of preeclampsia. We performed a cross-sectional study in 56 preeclampsia patients and 56 controls matched for gestational age and body mass index. The BNP, leptin, and adiponectin levels were measured by ELISA, and their mRNA expressions were evaluated in omental adipose tissue by real-time PCR. The effects of BNP on adiponectin and leptin mRNA expression and secretion were investigated in primary cultures of adipocytes from obese and normal-weight women. The BNP, adiponectin, and leptin levels were significantly higher in preeclampsia patients compared with controls. The adiponectin level was increased significantly in normal-weight preeclampsia patients compared with overweight preeclampsia patients. Adiponectin mRNA expression was increased significantly in adipose tissues of preeclampsia patients compared with controls and was also increased significantly in normal-weight preeclampsia patients compared with overweight preeclampsia patients, whereas leptin was not. BNP and adiponectin showed significant positive correlations in both normal-weight and overweight preeclampsia patients. BNP had a significantly weaker effect on adiponectin in overweight compared with normal-weight preeclampsia patients. Moreover, BNP had a weaker effect on adiponectin production in adipocytes from overweight women compared with adipocytes from normal-weight women using primary culture of human adipocytes. These data suggested that BNP may play a role in hyperadiponectinemia of preeclampsia patients. The weaker effect of BNP on adiponectin production may participate in the pathophysiology of overweight preeclampsia patients.

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  • Treatment with a constitutive androstane receptor ligand ameliorates the signs of preeclampsia in high-fat diet-induced obese pregnant mice

    H. Masuyama, Y. Hiramatsu

    MOLECULAR AND CELLULAR ENDOCRINOLOGY   348 ( 1 )   120 - 127   2012.1

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    Constitutive androstane receptor (CAR) has been reported to decrease insulin resistance, while obesity and insulin resistance may also be involved in the pathogenesis of preeclampsia. We examined whether a CAR ligand, 1,4-bis(2-(3,5-dichloropyridyloxy)) benzene (TCPOBOP), can ameliorate the signs of preeclampsia in high-fat diet (HFD)-induced obese pregnant mice to examine a possibility of CAR as a therapeutic target. We employed six groups including non-pregnant, NED-fed or control diet-fed pregnant mice with or without TCPOBOP treatment (n = 6). In HFD pregnant mice, insulin resistance increased with increasing expression of gluconeogenic and lipogenic genes and abnormal adipocytokine levels. TCPOBOP treatment, which was once-weekly intraperitoneal injections (0.5 mg/kg) and started at day 0.5 of pregnancy, improved glucose tolerance with significant changes of gluconeogenic, lipogenic and adipocytokine genes. HFD pregnant mice had hypertension and proteinuria, while TCPOBOP treatment ameliorated these signs. Our data suggested CAR might be a potential therapeutic target for obese preeclampsia patients with insulin resistance. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

    DOI: 10.1016/j.mce.2011.07.047

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  • 7.子宮筋腫・子宮腺筋症合併妊娠.

    平松祐司, 井上誠司, 増山 寿

    産科と婦人科 産婦人科オフィス診療指針 ー保険診療上の留意点を含めて   79 ( 増刊号 )   43 - 48   2012

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  • PCOS合併妊娠の耐糖能異常と周産期予後.

    澤田麻里, 増山 寿, 鎌田泰彦, 松田美和, 清水恵子, 瀬川友功, 平松祐司, 中塚幹也

    日本産科婦人科栄養・代謝研究会誌   18   51 - 52   2012

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  • 新旧GDM診断基準による周産期合併症発現率の変化.

    延本悦子, 沖本直輝, 井上誠司, 瀬川友功, 増山 寿, 平松祐司, 杉山 隆, 日下秀人, 豊田長康

    糖尿病と妊娠   12 ( 1 )   50 - 53   2012

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  • 妊娠中のアディポサイトカインとインスリン抵抗性ー耐糖能異常、妊娠高血圧症候群の病態への関与と新たな治療標的の検討.

    増山 寿

    日本産科婦人科学会雑誌   64 ( 11 )   2279 - 2289   2012

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  • Superimposed Preeclampsia in Women with Chronic Kidney Disease

    Hisashi Masuyama, Etsuko Nobumoto, Naoki Okimoto, Seiji Inoue, Tomonori Segawa, Yuji Hiramatsu

    GYNECOLOGIC AND OBSTETRIC INVESTIGATION   74 ( 4 )   274 - 281   2012

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    Aim: To evaluate whether pregnant women with chronic kidney disease (CKD) adapt poorly to increases in renal blood flow. This can exacerbate renal function and impair perinatal outcome, as there is a major interplay between CKD and preeclampsia (PE). Methods: We analyzed the outcomes of 90 pregnant women with preexisting CKD. The estimated glomerular filtration rate (eGFR) was measured along with the levels of angiogenic factors, soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor, which might act in the pathophysiology of PE. Results: In pregnancies with CKD, PE and preterm delivery were increased and the increased blood pressure worsened the perinatal outcomes much more than the increased proteinuria. All pregnancies with severe renal insufficiency were delivered preterm because of impaired renal function. The eGFR was correlated significantly with 24-hour creatinine clearance (r = 0.830). Significant differences in sFlt-1 and placental growth factor levels were found between severe PE without any complications and severe superimposed PE (p &lt; 0.05), and between women with and without declining renal function in superimposed PE (p &lt; 0.01). Conclusion: Pregnancies with CKD have a high risk of obstetrical complications. The eGFR might serve for evaluating renal function during pregnancy. Angiogenic factors might be potential markers for a differential diagnosis between PE and worsening renal function. Copyright (C) 2012 S. Karger AG, Basel

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  • The Correlation of Maternal Uric Acid Concentration with Small-for-Gestational-Age Fetuses in Normotensive Pregnant Women

    Yoichiro Akahori, Hisashi Masuyama, Yuji Hiramatsu

    GYNECOLOGIC AND OBSTETRIC INVESTIGATION   73 ( 2 )   162 - 167   2012

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    Aim: Elevated maternal serum uric acid is associated with small-for-gestational-age (SGA) fetuses. We investigated whether uric acid concentrations in normotensive pregnant women are correlated with fetal growth and related to kidney function. Methods: We carried out a case-control study using 40 patients who delivered SGA fetuses identified from the perinatal database and 80 patients who delivered appropriate-for-gestational-age (AGA) fetuses as the controls at Okayama University Hospital. Blood pressure, serum uric acid and creatinine level were measured in the patients' third trimester. Results: Maternal serum uric acid (p = 0.0003) and creatinine (p &lt; 0.0001) concentrations, as well as systolic and diastolic blood pressures (p = 0.014 and 0.037, respectively), were significantly increased in the SGA group. There was a strong negative correlation between serum uric acid levels and birth weights (r = 0.59; p = 0.006) and a significant positive correlation between maternal serum uric acid and creatinine levels (r = 0.43; p &lt; 0.05) in cases of severe SGA (&lt;5th percentile). Multiple linear regression analysis indicated that uric acid is an independent risk factor for SGA. Conclusions: Increasing maternal uric acid concentrations were associated with slightly impaired kidney function and SGA in normotensive pregnant women. Copyright (C) 2012 S. Karger AG, Basel

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  • Three-dimensional ultrasound findings in cornelia de lange syndrome : A Case Report.

    Akahori Y, Masuyama H, Masumoto Y, Hiramatsu Y

    Case Reports in Obstetrics and Gynecology   2012   1 - 4   2012

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  • 先天性心疾患妊婦における血中BNP値測定の意義.

    井上誠司, 増山 寿, 沖本直輝, 瀬川友功, 平松祐司

    日本周産期・新生児医学会雑誌   48 ( 1 )   76 - 80   2012

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  • 子宮中隔で隔てられた二絨毛膜二羊膜双胎の一例.

    長谷川徹, 早田 裕, 久保光太郎, 黒川晴菜, 斎藤雅子, 西田 傑, 光井 崇, 杉山和歌菜, 沖本直輝, 井上誠司, 瀬川友功, 増山 寿, 平松祐司

    現代産婦人科   61 ( 1 )   1 - 4   2012

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  • Occlusion Balloonの適応と実際.

    正岡直樹, 草西多香子, 寺尾泰久, 増山 寿, 藤井多久磨, 平松祐司, 小西郁生

    産婦人科手術   ( 23 )   129 - 131   2012

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  • パワーソースの使用状況に関する全国調査.

    寺尾泰久, 増山 寿, 藤井多久磨, 正岡直樹, 平松祐司, 小西郁生

    産婦人科手術   ( 23 )   123 - 127   2012

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  • P3-41-8 胎盤ポリープの予後因子の解析(Group 153 胎盤2)

    沖本 直輝, 井上 誠司, 瀬川 友功, 増山 寿, 平松 祐司

    日本産科婦人科學會雜誌   64 ( 2 )   872 - 872   2012

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  • P2-33-4 自然妊娠により生児を得たWunderlich症候群の一例(Group89 合併症妊娠(症例)4,一般演題,第64回日本産科婦人科学会学術講演会)

    斎藤 雅子, 井上 誠司, 延本 悦子, 沖本 直輝, 瀬川 友功, 増山 寿, 平松 祐司, 中塚 幹也

    日本産科婦人科學會雜誌   64 ( 2 )   691 - 691   2012

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  • P2-38-2 先天性心疾患合併妊娠における妊娠前後の心機能の変化(Group94 合併症妊娠6,一般演題,第64回日本産科婦人科学会学術講演会)

    井上 誠司, 延本 悦子, 沖本 直輝, 瀬川 友功, 増山 寿, 平松 祐司

    日本産科婦人科學會雜誌   64 ( 2 )   705 - 705   2012

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  • P1-38-8 高度肥満,糖尿病を伴った加重型妊娠高血圧腎症の管理 : バイオマーカーの有用性(Group38 PIH・HELLP症候群(症例),一般演題,第64回日本産科婦人科学会学術講演会)

    延本 悦子, 増山 寿, 沖本 直輝, 井上 誠司, 瀬川 友功, 平松 祐司

    日本産科婦人科學會雜誌   64 ( 2 )   529 - 529   2012

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  • 3) 妊娠中のアディポサイトカインとインスリン抵抗性 : 耐糖能異常,妊娠高血圧症候群の病態への関与と新たな治療標的の検討(周産期「妊娠とインスリン抵抗性」,シンポジウム2,公益社団法人日本産科婦人科学会第64回学術講演会)

    増山 寿

    日本産科婦人科學會雜誌   64 ( 2 )   303 - 304   2012

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  • Effects of intermittent high glucose on BeWo choriocarcinoma cells in culture

    Akio Masumoto, Norio Takamoto, Hisashi Masuyama, Yoichiro Akahori, Seiji Inoue, Yuji Hiramatsu

    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH   37 ( 10 )   1365 - 1375   2011.10

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    Aim: The aim of this study was to investigate the cellular effects of intermittent high glucose on the human BeWo placental choriocarcinoma cell line, used as a model of the effects of glucose fluctuation in diabetic pregnancies.
    Materials and Methods: BeWo cells were subjected to three different glucose conditions for 48 h: 7 mmol/L (control), 42 mmol/L (high glucose), or 7 and 42 mmol/L glucose (intermittent, alternated every 6 h). Cell viability was assessed using cell counts, a cell proliferation assay, and a cell viability assay. Apoptosis was also studied using a terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling assay and by immunocytochemistry of fractin, the N-terminal fragment of actin, which can distinguish apoptotic from necrotic cells. Furthermore, the expression of the well-known survival factors of trophoblast cells, heparin-binding epidermal growth factor-like growth factor and leptin, was evaluated by real-time polymerase chain reaction and Western blot analyses.
    Results: Intermittent high-glucose conditions significantly decreased cell viability and enhanced apoptosis compared with control or continuous high-glucose conditions. Furthermore, the expression of heparin-binding epidermal growth factor-like growth factor, but not that of leptin, was significantly increased under intermittent high-glucose conditions compared to its expression under either control or continuous high-glucose conditions.
    Conclusions: These data indicate that intermittent high glucose is more deleterious to BeWo cells than continuous high-glucose conditions. Although further in vitro and in vivo study is necessary, excess fluctuation of glucose levels in the placental circulation might be involved in the impairment of placental development leading to the placental dysfunction.

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  • Potential role of estradiol and progesterone in insulin resistance through constitutive androstane receptor

    Hisashi Masuyama, Yuji Hiramatsu

    JOURNAL OF MOLECULAR ENDOCRINOLOGY   47 ( 2 )   229 - 239   2011.10

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    Normal pregnancy is characterized by insulin resistance, which contributes to the development of gestational diabetes mellitus and preeclampsia by incompletely understood mechanisms. The constitutive androstane receptor (CAR) may participate in insulin resistance in pregnancy, and sex steroids, estradiol (E(2)) and progesterone, may also be involved. We applied glucose and insulin tolerance tests and measured the expression of gluconeogenic and lipogenic genes in the livers of oophorectomized mice treated with E(2) and progesterone with or without CAR ligands. We also investigated how E(2) and progesterone affected CAR-mediated signaling and the activity of transcription factors in gluconeogenesis in vitro. Mice with the concentrations of E(2) and progesterone within normal physiological range during pregnancy exhibited increased insulin resistance along with increased expression of gluconeogenic and lipogenic genes, and CAR activation rescued the abnormal glucose metabolism. In HepG2 cells, CAR ligands suppressed the gluconeogenic and lipogenic gene expression in the presence of E(2) and/or progesterone. DNA affinity immunoblotting and chromatin immunoprecipitation assay revealed that CAR ligand enhanced the recruitment of the gluconeogenic transcription factors, forkhead box O1 (FOXO1) and hepatocyte nuclear factor 4 alpha (HNF4 alpha), but sex steroids suppressed these recruitments on the CAR responsive element. Moreover, CAR ligand suppressed the recruitment of FOXO1 and HNF4 alpha on their responsive element in gluconeogenic gene promoters and E(2) and progesterone augmented these recruitments on their responsive element. Taken together, these findings suggest that the activation of CAR-mediated signaling may ameliorate insulin resistance under relatively high concentrations of E(2) and progesterone, which were compatible with pregnancy via decreased activities of transcription factors in gluconeogenesis in combination with CAR. Journal of Molecular Endocrinology (2011) 47, 229-239

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  • 妊娠糖尿病新診断基準への対応 新旧GDM診断基準による周産期合併症発現率の変化

    延本 悦子, 沖本 直輝, 井上 誠司, 瀬川 友功, 増山 寿, 平松 祐司, 杉山 隆, 日下 秀人, 豊田 長康

    糖尿病と妊娠   11 ( 2 )   S - 30   2011.10

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  • Retinol-binding protein 4 and insulin resistance in preeclampsia

    Hisashi Masuyama, Seiji Inoue, Yuji Hiramatsu

    ENDOCRINE JOURNAL   58 ( 1 )   47 - 53   2011.1

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    Preeclampsia is characterized by the onset of high blood pressure and proteinuria during pregnancy, which results in substantial maternal and neonatal morbidity and mortality. Insulin resistance has been observed before the onset of preeclampsia, and is implicated in its pathophysiology. Recently, retinol-binding protein 4 (RBP4), which carries retinol in circulation, has been shown to be a potential regulator of insulin resistance originating from adipose tissue. Here we measured insulin resistance and RBP-4 levels in patients with preeclampsia and in women with normal pregnancies matched for gestational age and body mass index at Okayama University Hospital. Our aim was to examine the potential role of RBP4 in the pathophysiology of this disorder. There were no significant differences in RBP4 levels between all patients with preeclampsia and controls. However, the RBP4 level and homeostasis model assessment as an index of insulin resistance (HOMA-IR) in overweight patients with late-onset preeclampsia were significantly higher than in overweight controls carrying normal pregnancies and in normal weight women with late-onset preeclampsia. In contrast, there were no significant differences between the overweight and normal weight groups among patients with early-onset preeclampsia and in healthy pregnant women. These data suggest that RBP4 might act in the pathophysiology of late-onset preeclampsia via increased insulin resistance in obese women.

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  • 先天性心疾患児における出生時臍帯血液ガス分析と胎児心機能との関連性.

    井上誠司, 赤堀洋一郎, 岸本佳子, 沖本直輝, 増本由美, 瀬川友功, 増山 寿, 平松祐司

    産婦人科の実際   60 ( 4 )   631 - 636   2011

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  • 早産IUGRにおけるEUGR(Extrauterine Growth Restriction)発症の産科的リスク因子についての検討.

    井上誠司, 赤堀洋一郎, 岸本佳子, 沖本直輝, 瀬川友功, 増山 寿, 平松祐司

    日本産科婦人科栄養・代謝研究会誌   17 ( 1 )   33 - 34   2011

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  • 妊娠中のアディポサイトカインの動態とインスリン抵抗性への関与.

    増山 寿, 赤堀洋一郎, 岸本佳子, 沖本直輝, 井上誠司, 瀬川友功, 平松祐司

    日本産科婦人科栄養・代謝研究会誌   17 ( 1 )   37 - 38   2011

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  • 母体尿酸値からみた子宮内胎児発育の検討.

    赤堀洋一郎, 増山 寿, 岸本佳子, 沖本直輝, 井上誠司, 瀬川友功, 平松祐司

    日本産科婦人科栄養・代謝研究会誌   17 ( 1 )   75 - 76   2011

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  • 当院で経験したSLE合併妊娠の周産期臨床像.

    楯笑美子, 井上誠司, 赤堀洋一郎, 岸本佳子, 沖本直輝, 瀬川友功, 増山 寿, 平松祐司

    現代産婦人科   59 ( 2 )   129 - 133   2011

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  • 遺伝子組換え活性型血液凝固第Ⅶ因子製剤(ノボセブンR)を使用した産科出血の一例.

    延本悦子, 早田 裕, 大河原美幸, 岸本佳子, 赤堀洋一郎, 井上誠司, 増本由美, 舛本明生, 瀬川友功, 増山 寿, 平松祐司

    現代産婦人科   59 ( 2 )   145 - 150   2011

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  • ストレスを契機に発症したと考えられる周産期心筋症の2例.

    佐藤麻夕子, 沖本直輝, 早田 裕, 赤堀洋一郎, 岸本佳子, 井上誠司, 瀬川友功, 増山 寿, 平松祐司

    現代産婦人科   59 ( 2 )   233 - 238   2011

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  • 早産fetal growth restrictionにおけるsevere extrauterine growth restriction発症の産科的リスク因子についての検討.

    井上誠司, 沖本直輝, 瀬川友功, 増山 寿, 平松祐司

    周産期医学   41 ( 12 )   1633 - 1636   2011

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  • 糖尿病の母児に与える影響.

    平松祐司, 延本悦子, 増山 寿

    周産期医学   41 ( 12 )   1563 - 1566   2011

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  • -ここまでできる経腟分娩-子宮筋腫核出術既往妊娠.

    平松祐司, 増山 寿, 沖本直輝

    周産期医学   41 ( 7 )   951 - 955   2011

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  • 胎盤由来のプロラクチン.

    沖本直輝, 舛本明生, 増山 寿, 平松祐司

    HORMONE FRONTIER IN GYNECOLOGY   18 ( 3 )   39 - 45   2011

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  • 耐糖能異常と母乳栄養.

    平松祐司, 杉山和歌菜, 増山 寿

    月刊 糖尿病   3 ( 10 )   113 - 118   2011

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  • 常位胎盤早期剥離-ワンランク上の診断と治療 病因とリスク因子.

    平松祐司, 延本悦子, 増山 寿

    臨床婦人科産科   65 ( 11 )   1308 - 1312   2011

  • アディポサイトカインとインスリン抵抗性.

    増山 寿, 平松祐司

    月刊 糖尿病   3 ( 10 )   44 - 50   2011

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  • クリニカルディベート 3)生殖 ②挙児希望漿膜下子宮筋腫の管理 4)待機の立場に立って.

    増山 寿

    日本産科婦人科学会雑誌   63 ( 12 )   N173-N179   2011

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  • Angiogenic proteins and adipocytokines as markers for prediction of preeclampsia

    Hisashi Masuyama, Yuji Hiramatsu

    Expert Review of Obstetrics and Gynecology   5 ( 6 )   717 - 725   2010.11

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    Preeclampsia is characterized by the onset of high blood pressure and proteinuria in pregnancy, leading to substantial maternal and neonatal morbidity and mortality. It involves abnormal remodeling of the placental bed vasculature, placental ischemia and endothelial cell dysfunction. Defective placental development might reflect alterations in the levels of various biological markers. Affected patients show remarkable imbalances of angiogenic factors, including PlGF, soluble FMS-like tyrosine kinase 1, soluble endoglin and angiopoietin-2
    these factors could therefore be potential markers for predicting preeclampsia with or without uterine artery Doppler ultrasonography. However, use of these markers to predict preeclampsia has yet to achieve the positive and negative likelihood ratios necessary if they are to be used in clinical practice. Large-scale studies using known markers are likely to identify suitable candidates that will enable greatly improved perinatal care, including prevention and better outcomes for patients with preeclampsia. © 2010 Expert Reviews Ltd.

    DOI: 10.1586/eog.10.53

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  • Expression of Antiangiogenic Prolactin Fragments in the Placentas of Women with Pregnancy Induced Hypertension

    Akio Masumoto, Hisashi Masuyama, Norio Takamoto, Yoichiro Akahori, Yuji Hiramatsu

    ACTA MEDICA OKAYAMA   64 ( 4 )   249 - 255   2010.8

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    It has been reported that prolactin (PRL) is cleaved to 14 or 16 kDa fragments by cathepsin D in vitro and in vivo, and that such fragments exhibit antiangiogenic and proapoptotic properties. The aim of this study was to investigate the relationship between pregnancy induced hypertension (PIH) and the placental expression of antiangiogenic PRL fragments and cathepsin D. Placental expression of PRL fragments and cathepsin D was evaluated by Western blot analysis in a group of 9 pregnant women consisting of 5 normal pregnancies and 4 severe PIH cases. Antiangiogenic PRL fragments were detected in 4 placental samples from all PIH cases but not detected in those from normal pregnancies (p &lt; 0.05). The expression of cathepsin D in PIH placentas was significantly lower than that in those without PIH &lt; 0.05), while the placental expression of procathepsin D was significantly greater in PIH cases than in the normal pregnancies (p &lt; 0.05). These data suggest that antiangiogenic PRL fragments in the placenta may be present only in PIH cases, and that PRL fragments in the placenta might be implicated in the pathophysiology of PIH.

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  • Circulating Levels of Ciliary Neurotrophic Factor in Normal Pregnancy and Preeclampsia

    Yoichiro Akahori, Norio Takamoto, Akio Masumoto, Seiji Inoue, Hideki Nakatsukasa, Hisashi Masuyama, Yuji Hiramatsu

    ACTA MEDICA OKAYAMA   64 ( 2 )   129 - 136   2010.4

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    Ciliary neurotrophic factor (CNTF) has been shown to decrease food intake in mouse models of obesity and to improve insulin sensitivity. It is well known that tight regulation of glucose metabolism is essential for successful gestational outcomes (e.g. fetal growth), and that abnormal insulin resistance is associated with preeclampsia (PE). To investigate the possibility that CNTF might be involved in the regulation of insulin resistance during pregnancy, circulating levels of CNTF were assessed in nonpregnant, normal pregnant, postpartum, and pregnant women with PE. Sera from healthy nonpregnant women (n = 10), pregnant women (n = 30: 1st trimester; n = 10, 2nd trimester n = 10; 3rd trimester; n = 10), postpartum women (n = 10), and patients with PE (n = 11) were studied with Western blotting. Circulating CNTF was detected by Western blotting, and the levels of CNTF in pregnant women were decreased as compared with those in non-pregnant women, and tended to decrease as pregnancy progressed. A significant decrease was found in PE as compared with normal pregnancy. Circulating CNTF might be associated with physiological and abnormal insulin resistance during pregnancy.

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  • Pregnancy after living-related liver transplantation associated with severe preeclampsia and a review of the literature

    Hisashi Masuyama, Miwa Matsuda, Keiko Shimizu, Tomonori Segawa, Yuji Hiramatsu

    ARCHIVES OF GYNECOLOGY AND OBSTETRICS   281 ( 3 )   423 - 425   2010.3

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    Pregnancies after orthotropic liver transplantation (OLT) have demonstrated favorable perinatal outcomes. However, obstetrical complications in OLT recipients are more common than those in a normal population. In countries where the number of cadaveric donors is limited, living-related liver transplantation (LRLT) is a valuable procedure, but few pregnancies after LRLT have been reported.
    We present a case of a pregnant woman after LRLT who developed severe preeclampsia with fetal growth restriction (FGR), and a review of literature.
    A 34-year-old nulliparous woman was referred to our hospital as a LRLT recipient. She was admitted to our hospital at 25 weeks&apos; gestational age as she had developed severe preeclampsia, although her liver function was stable and there were no episodes for rejection or cholestasis. Emergency cesarean section was performed at 28 weeks&apos; gestational age because of FGR and non-reassuring fetal status. Although there is no Medline available report in English of a successful pregnancy after LRLT, there are 11 cases of successful pregnancies after LRLT in the Japanese literature. These cases suggested that the incidences of preeclampsia, FGR, preterm delivery and cesarean delivery in pregnancies after LRLT are similar to those after OLT, but liver dysfunction and/or cholestasis in pregnancies after LRTL might be more common compared with those after OLT.
    Careful observation is needed after LRLT and the potential for differences in risk with LRLT recipients in comparison to OLT recipients should be considered.

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  • Effect of oncostatin M on uridine diphosphate-5-glucuronosyltransferase 1A1 through crosstalk with constitutive androstane receptor

    Hisashi Masuyama, Hideki Nakatsukasa, Yuji Hiramatsu

    ENDOCRINE JOURNAL   57 ( 4 )   S612 - S612   2010.3

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    DOI: 10.1210/me.2009-0478

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  • Different profiles of circulating angiogenic factors and adipocytokines between early- and late-onset pre-eclampsia

    H. Masuyama, T. Segawa, Y. Sumida, A. Masumoto, S. Inoue, Y. Akahori, Y. Hiramatsu

    BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY   117 ( 3 )   314 - 320   2010.2

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    Language:English   Publisher:WILEY-BLACKWELL PUBLISHING, INC  

    Objective
    Circulating angiogenic factors have been shown to be important in the pathophysiology of pre-eclampsia. Blood levels of adipocytokines differ in pre-eclampsia relative to controls and may also play an important role in disease pathogenesis. Differences in the circulating levels of these molecules were compared between matched normotensive controls and women with pre-eclampsia with onset before or at/after 32 weeks, and according to whether the women were of normal weight (18.5 &lt; body mass index &lt; 25) or overweight.
    Design
    A cross-sectional study of 110 pregnant Japanese women who visited the Department of Obstetrics and Gynecology, Okayama University Hospital, Okayama, Japan.
    Setting
    Tertiary referral centre serving 2000 births.
    Methods
    Serum concentrations of soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PlGF), soluble endoglin (sEng), adiponectin and leptin were measured in women with pre-eclampsia and in normotensive controls matched for age, gestational week, parity and body mass index.
    Main outcome measures
    Serum levels of sFlt-1, PlGF, the sFlt-1/PlGF ratio, sEng, adiponectin and leptin.
    Results
    The sFlt-1/PlGF ratio in early-onset pre-eclampsia was significantly higher than that in late-onset pre-eclampsia (112.0 +/- 30.2 versus 45.4 +/- 43.8, P = 0.037). There was a significant elevation of leptin in both subtypes relative to controls (early: 58.6 +/- 18.3 ng/ml versus 26.0 +/- 6.7 ng/ml, P = 0.001; late: 39.5 +/- 9.2 ng/ml versus 22.0 +/- 4.3 ng/ml, P = 0.005), but adiponectin was increased only in late-onset pre-eclampsia (36.5 +/- 13.4 mu g/ml versus 12.0 +/- 4.3 mu g/ml, P = 0.003). Significant differences in angiogenic factors and adiponectin were found between normal and overweight women only in late-onset pre-eclampsia.
    Conclusions
    These data suggest that there are different profiles of angiogenic factors and adipocytokines between women who develop early- and late-onset pre-eclampsia.

    DOI: 10.1111/j.1471-0528.2009.02453.x

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  • 第二部 Ⅰ.周産期 11.婦人科腫瘍合併妊娠.

    平松祐司, 関 典子, 増山 寿

    産婦人科の実際   10 ( 臨時増刊号 )   1832 - 1837   2010

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  • 子宮筋腫合併妊産婦の取り扱い方.

    平松祐司, 井上誠司, 増山 寿

    産婦人科治療   100 ( 2 )   175 - 180   2010

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  • 子宮筋腫合併妊娠での帝切.

    平松祐司, 井上誠司, 瀬川友功, 赤堀洋一郎, 沖本直輝, 岸本佳子, 増山 寿

    産婦人科手術   ( 21 )   11 - 19   2010

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  • 開腹手術、腹腔鏡下手術の割合に関する全国調査(2008年度).

    塩田 充, 平松祐司, 三橋直樹, 正岡直樹, 藤井多久磨, 増山 寿, 寺尾泰久

    産婦人科手術   ( 21 )   127 - 131   2010

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  • 胎内診断された先天性心疾患症例における分娩様式の検討.

    井上誠司, 赤堀洋一郎, 岸本佳子, 増本由美, 瀬川友功, 増山 寿, 平松祐司

    産婦人科の実際   59 ( 1 )   127 - 131   2010

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  • 肺高血圧合併妊娠の二症例.

    衛藤英理子, 政廣聡子, 赤堀洋一郎, 岸本佳子, 松本由紀子, 沖本直輝, 井上誠司, 増本由美, 瀬川友功, 増山 寿, 平松祐司

    現代産婦人科   58 ( 2 )   131 - 135   2010

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  • 新しい妊娠糖尿病診断基準採用による妊娠糖尿病の頻度と周産期予後への影響.

    増本由美, 増山 寿, 杉山 隆, 豊田長康, 平松祐司

    糖尿病と妊娠   10 ( 1 )   88 - 91   2010

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  • 腎疾患合併妊娠における加重型妊娠高血圧腎症の検討.

    増山 寿, 赤堀洋一郎, 岸本佳子, 沖本直輝, 井上誠司, 増本由美, 瀬川友功, 平松祐司

    日本周産期・新生児医学会雑誌   46 ( 3 )   795 - 801   2010

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  • 重積発作にてterminationを余儀なくされたてんかん合併妊娠の一例.

    延本悦子, 岡﨑倫子, 政廣聡子, 岸本佳子, 赤堀洋一郎, 沖本直輝, 井上誠司, 増本由美, 瀬川友功, 増山 寿, 平松祐司

    現代産婦人科   59 ( 1 )   43 - 46   2010

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  • 妊婦健診における尿糖の意義.

    井上誠司, 赤堀洋一郎, 岸本佳子, 沖本直輝, 増本由美, 瀬川友功, 増山 寿, 平松祐司, 杉山 隆, 豊田長康

    腎と透析   69 ( 5 )   663 - 668   2010

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  • 悪性腫瘍手術後のリンパ嚢腫発生予防の工夫と管理.

    藤井多久磨, 平松祐司, 増山 寿, 正岡直樹, 寺尾泰久, 三橋直樹

    産婦人科手術   ( 21 )   133 - 138   2010

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  • 糖代謝異常合併妊婦に対する食育.

    増山 寿, 赤堀洋一郎, 岸本佳子, 沖本直輝, 井上誠司, 増本由美, 瀬川友功, 平松祐司

    日本産科婦人科栄養・代謝研究会誌   16 ( 1 )   9 - 10   2010

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  • 妊娠中のインスリン抵抗性へのアディポサイトカインの関与.

    増山 寿, 井上誠司, 赤堀洋一郎, 岸本佳子, 沖本直輝, 増本由美, 瀬川友功, 平松祐司

    糖尿病と妊娠   10 ( 1 )   36 - 39   2010

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  • Successful Management of Anti-Jr(a) Alloimmunization in Pregnancy: A Case Report

    Akio Masumoto, Hisashi Masuyama, Yumi Sumida, Tomonori Segawa, Yuji Hiramatsu

    GYNECOLOGIC AND OBSTETRIC INVESTIGATION   69 ( 2 )   81 - 83   2010

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    Language:English   Publisher:KARGER  

    Background: Hemolytic disease of the fetus/newborn due to Jr(a) immunization is very rare and considered to be mild, and only routine obstetrical care is recommended for pregnant women sensitized to the Jr(a) antigen. Case Report: A 20-year-old nulliparous woman was referred to our hospital for perinatal management. Her indirect Coombs test was positive for anti-Jr(a) antibody (1: 64). At 33 weeks&apos; gestational age, we observed that fetal growth was mildly restricted and the peak systolic velocity of the fetal middle cerebral artery (PSV-MCA) was above the upper limit of the reference range (1.55 multiples of the median). Amniocentesis was also carried out and the Delta OD450 value was in the lower mid-zone of the Liley curve. We continued to carefully observe the patient because we observed PSV-MCA values within 1.50-1.60 multiples of the median and no other findings of fetal anemia. She vaginally delivered a female infant weighing 2,136 g at 37 weeks&apos; gestational age. The infant received treatment with both iron and recombinant erythropoietin without developing hyperbilirubinemia and blood transfusion. Conclusion: PSV-MCA should be monitored for the detection of fetal anemia, even in pregnant women sensitized to some antigens for which only routine obstetrical care is recommended. Copyright (C) 2009 S. Karger AG, Basel

    DOI: 10.1159/000259724

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  • 子宮動脈塞栓術.

    平松祐司, 早田 裕, 井上誠司, 瀬川友功, 増山 寿

    産婦人科治療   100 ( 増刊 )   96 - 103   2010

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  • HAPO study基準を適応した場合のわが国妊娠糖尿病(GDM)の頻度と周産期予後の検討

    増本 由美, 岸本 佳子, 赤堀 洋一郎, 沖本 直輝, 井上 誠司, 瀬川 友功, 増山 寿, 杉山 隆, 豊田 長康, 平松 祐司

    糖尿病と妊娠   9 ( 2 )   S - 53   2009.10

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    Language:Japanese   Publisher:(一社)日本糖尿病・妊娠学会  

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  • Hyperreactio luteinalis with both markedly elevated human chorionic gonadotropin levels and an imbalance of angiogenic factors subsequently developed severe early-onset preeclampsia

    Hisashi Masuyama, Yoko Tateishi, Miwa Matsuda, Yuji Hiramatrsu

    FERTILITY AND STERILITY   92 ( 1 )   2009.7

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    Objective: To report a case of hyperreactio luteinalis (HL) with elevated levels of human chorionic gonadotropin (hCG) and a severe imbalance of angiogenic factors, which developed into severe, early onset preeclampsia (PE).
    Design: Case report.
    Setting: University perinatal center.
    Patient(s): A 32-year-old primigravida woman with HL, high hCG levels, and severe imbalance of angiogenic factors who subsequently developed severe PE.
    Intervention(s): Emergent cesarean section due to nonreassuring fetal status.
    Main Outcome Measure(s): Severe, early onset PE.
    Result(s): A case of HL was referred to our hospital for remarkably elevated hCG levels and bilaterally enlarged multicystic ovaries in the first trimester; the patient subsequently developed severe, early onset PE with a severe imbalance of angiogenic factors. Emergency cesarean section was performed, and she delivered a premature female infant weighing 1818 g at 32 week's gestational age. During her next pregnancy, the circulating levels of hCG and angiogenic factors remained normal, and she did not develop either PE or HL.
    Conclusion(s): Although HL complicated with PE is very rare, our case suggests that HL associated with both an elevated hCG level and an imbalance of angiogenic factors might be a risk/predictive factor for severe, early onset PE. (Fertil Steril(R) 2009;92:393.e1-e3. (C) 2009 by American Society for Reproductive Medicine.)

    DOI: 10.1016/j.fertnstert.2009.04.002

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  • Elevated level of serum retinol-binding protein 4 in pregnancy-induced hypertension

    Seiji Inoue, Norio Takamoto, Yoichiro Akahori, Akio Masumoto, Hideki Nakatsukasa, Hisashi Msuyama, Yuji Hiramatsu

    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH   35 ( 2 )   293 - 300   2009.4

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    Recent progress in adiposcience has revealed several important adipose-tissue-originated factors, so-called adipokines. Retinol-binding protein 4 (RBP4), a protein expressed and secreted by adipocytes, has been identified as a novel regulator of insulin resistance. Physiological insulin resistance occurs during the pregnancy of mammals to accommodate fetal growth, and it has been suggested that insulin resistance and hyperinsulinemia might also be associated with pregnancy-induced hypertension (PIH). In order to shed light on the role of RBP4 during pregnancy, we attempted to assess RBP4 levels during pregnancy. Fetal growth could be affected by aberrant regulation of RBP4 levels in fetal circulation per se, so we examined the RBP4 levels in cord blood samples of growth restricted cases.
    Circulating RBP4 levels were examined in non-pregnant and pregnant healthy women using Western blotting. Also, RBP4 levels in normal pregnancy and PIH were quantitated using Dot-blot analysis. RBP4 levels in cord blood samples also were evaluated in selected cases.
    RBP4 levels tended to decrease after early gestation with no obvious difference between mid- to late-gestation. RBP4 levels were increased in pregnant women with PIH compared with normal pregnancies (P &lt; 0.01). RBP4 levels were decreased in the cord blood of PIH pregnancies and light-for-dates infants without obvious causes for intrauterine growth restriction compared with normal pregnancies (P &lt; 0.01).
    These results suggest that circulating RBP4 could be elevated in PIH, where maternal glucose metabolism is perturbed, and that RBP4 levels in cord blood might be closely associated with fetal growth.

    DOI: 10.1111/j.1447-0756.2008.00950.x

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  • 低出生体重児を出産した母親への援助

    片山七穂, 大井伸子, 堀川容子, 藤岡まゆみ, 松井たみこ, 増山 寿

    岡山県母性衛生   ( 25 )   2009

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  • 緊急止血が必要となる産科疾患

    増山 寿, 瀬川友功, 平松祐司

    IVR会誌   24 ( 2 )   2009

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  • 妊娠高血圧症候群-日本における最近の動向と傾向

    平松祐司, 増山 寿, 井上誠司, 瀬川友功

    臨床婦人科産科   63 ( 10 )   2009

  • 早期発見へ診断法研究

    増山 寿

    山陽新聞   2009

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  • 子宮頸管妊娠の臨床的検討

    井上誠司, 清水恵子, 住田由美, 瀬川友功, 鎌田泰彦, 野口聡一, 増山 寿, 平松祐司

    産科と婦人科   76 ( 3 )   2009

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  • 当院で経験した脳腫瘍合併妊娠の周産期臨床像

    井上誠司, 赤堀洋一郎, 中務日出輝, 舛本明生, 住田由美, 瀬川友功, 増山 寿, 平松祐司

    日本周産期・新生児医学会雑誌   45 ( 1 )   2009

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  • 開腹手術時の腹膜縫合に関する全国調査

    平松祐司, 増山 寿, 正岡直樹, 寺尾泰久, 藤井多久磨, 三橋直樹

    産婦人科手術   ( 20 )   2009

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  • 妊娠中から始まる虐待予防

    増山 寿

    助産師のための母乳育児セミナー   2009

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  • Circulating leptin and angiogenic factors in preeclampsia patients

    Hideki Nakatsukasa, Hisashi Masuyama, Norio Takamoto, Yuji Hiramatsu

    ENDOCRINE JOURNAL   55 ( 3 )   565 - 573   2008.6

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    Language:English   Publisher:JAPAN ENDOCRINE SOC  

    Leptin, one of adipocytokines, plays a wide range of important roles in reproductive biology. We have previously reported that low hypo-adiponectinemia might be involved in the pathophysiology of overweight preeclampsia (PE) patients. Moreover, recent reports have underscored the importance of circulating angiogenic factors in the pathophysiology of PE. Here, we examined whether leptin in conjunction with adiponectin and/or angiogenic factors plays some role in the pathophysiology of PE. We performed a cross-sectional study in 34 PE patients and normal pregnancies matched for gestational age and body mass index as controls. We measured serum concentrations of leptin, adiponectin, the angiogenic factors vascular endothelial growth factor (VEGF), placental growth factor, and the soluble VEGF receptors sFlt-1 and sFlk-1. We observed that leptin levels in PE patients were significantly higher compared with those in controls, but did not observe significant differences between normal- and overweight patients in both groups. We also showed a significant negative correlation between leptin and adiponectin in controls, but not in PE patients. There was a significant correlation between leptin and sFlt-1 in PE patients, while there were significant differences of body mass index, mean blood pressure and proteinuria between high and low leptin/sFlt-1 ratio group in PE patients. Moreover, there was a significant difference of leptin level between IUGR and normal growth group in PE patients. These results suggest that the circulating increased leptin might be derived mainly from the placenta and regulated by the placental hypoxic condition, whereas adiponectin might be derived mainly from adipose tissue; and that leptin might play some role through insulin resistance, autonomic activation, or direct effect on endothelium with other angiogenic factors in pathophysiology of PE compared with the exaggerated release of adiponectin from adipose tissue.

    DOI: 10.1507/endocrj.K07E-136

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  • 出生直前に胸水除去を行った先天性乳び胸水の1例.

    赤堀洋一郎, 菊池由加子, 井上誠司, 松尾 環, 舛本明生, 清水恵子, 洲脇尚子, 住田由美, 瀬川友功, 高本憲男, 野口聡一, 増山 寿, 平松祐司

    産科と婦人科   75 ( 4 )   493 - 497   2008

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  • ワークショップ3「分娩時大量出血への対応」 当科で経験したUAE後に妊娠に至った症例についての検討.

    瀬川友功, 赤堀洋一郎, 井上誠司, 中務日出輝, 舛本明生, 住田由美, 増山 寿, 平松祐司

    日本周産期・新生児医学会雑誌   44 ( 4 )   987 - 991   2008

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  • 微弱陣痛.

    増山 寿, 平松祐司, 難波道子, 松井たみこ

    ペリネイタルケア   27 ( 12 )   1174 - 1178   2008

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  • 巨大子宮頸部筋腫.

    平松祐司, 守屋聡子, 増山 寿, 関 典子

    産婦人科手術   ( 19 )   33 - 39   2008

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  • 産婦人科手術における保険請求.

    落合和彦, 礒西成治, 平松祐司, 三橋直樹, 福地 剛, 正岡直樹, 増山 寿, 寺尾泰久

    産婦人科手術   ( 19 )   141 - 144   2008

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  • 心内膜床欠損症.

    住田由美, 笠原真悟, 大月審一, 増山 寿, 平松祐司

    周産期医学   38 ( 11 )   1383 - 1387   2008

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  • 微弱陣痛

    増山 寿, 平松祐司, 難波道子, 松井たみこ

    ペリネイタルケア   27 ( 12 )   1174 - 1178   2008

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  • 肥満女性の栄養代謝学的問題点とその管理妊娠、産褥期:肥満妊婦preeclampsia発症へのadipocytokineの関与.

    増山 寿, 中務日出輝, 平松祐司

    産婦人科の実際   57 ( 8 )   1225 - 1231   2008

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  • 心内膜床欠損症.

    住田由美, 笠原真悟, 大月審一, 増山 寿, 平松祐司

    周産期医学   38 ( 11 )   1383 - 1387   2008

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  • 巨大子宮頸部筋腫.

    平松祐司, 守屋聡子, 増山 寿, 関 典子

    産婦人科手術   ( 19 )   33 - 39   2008

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  • 産婦人科手術における保険請求.

    落合和彦, 礒西成治, 平松祐司, 三橋直樹, 福地 剛, 正岡直樹, 増山 寿, 寺尾泰久

    産婦人科手術   ( 19 )   141 - 144   2008

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  • 耐糖能異常やpreeclampsiaでのアディポサイトカインの動態と発症への関与

    洲脇尚子, 舛本明生, 住田由美, 高本憲男, 増山 寿, 平松祐司