Faculty Profiles - MASUYAMA Hisashi

Papers - MASUYAMA Hisashi

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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

Language：Japanese Publisher：(株)東京医学社

＜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

Language：Japanese Publisher：(株)東京医学社

＜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

Language：Japanese Publisher：(一社)日本周産期・新生児医学会

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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Cavernous malformation of the optic chiasm with continuous hemorrhage in a pregnant woman: A case report

Yusuke Tomita, Kentaro Fujii, Kazuhiko Kurozumi, Ryoji Imoto, Takashi Mitsui, Sakurako Mishima, Kenichi Inagaki, Hisashi Masuyama, Isao Date

Interdisciplinary Neurosurgery 18 100489 - 100489 2019.12

Language：English Publishing type：Research paper (scientific journal) Publisher：Elsevier BV

Background: Cavernous malformation of the anterior visual pathway is rare, especially in pregnant woman. Planning a treatment strategy with cross-disciplinary specialists is important.Case description: A 27-year-old pregnant woman presented with acute hemorrhage around the right optic nerve and chiasm, manifesting as poor vision in both eyes. Examination revealed right-eye deteriorated acuity and bilateral temporal hemianopsia. Computed tomography showed an oval high-density mass in the suprasellar region. Gradient echo-based T2-weighted magnetic resonance imaging showed the lesion to be hypointense (possibly a hematoma) and mainly in the optic chiasm. Fluid attenuated inversion recovery imaging showed a bilateral optic tract surrounding the lesion, which enlarged over 1 week, increasing the loss of visual function. Five days after admission, she delivered a healthy > 2500-g baby by cesarean section (CS). Right frontotemporal craniotomy was performed 7 days after CS. Incision of the right optic nerve's lateral surface revealed clotted blood with abnormal vascular construction from the right side of the chiasm. We removed the hematoma and vascular lesion. Visual evoked potentials were detected only after optic chiasm decompression. Histological evaluation revealed a hematoma-like lesion with capsules and hemosiderin deposition, suggesting cavernous malformation. Her postoperative recovery was uneventful, with right visual acuity returning to normal, and her visual field not deteriorating any more.Conclusion: Devising a treatment strategy with the obstetrician was important in this case to manage the hematoma and cavernous malformation safely.

DOI： 10.1016/j.inat.2019.100489

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平時に全県下で使用している妊産婦緊急搬送補助アプリシステムの災害時使用への応用

牧尉太, 塚原紘平, 早田桂, 福原健, 山下範之, 杉原弥香, 増山寿

Japanese Journal of Disaster Medicine 24 ( 3 ) 303 - 303 2019.12

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

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

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

Language：English Publishing type：Research paper (scientific journal) Publisher：LIPPINCOTT WILLIAMS & WILKINS

Endometrial carcinosarcoma (ECS) is a rare and aggressive mixed-type epithelial and mesenchymal tumor. This study focused on the histologic appearance, loss of DNA mismatch repair (MMR) protein expression, and aberrant p53 expression in the epithelial component, and overall prognosis of 57 cases with ECS. Histologically, 21 and 36 cases exhibited low-grade (endometrioid grade 1 and 2) and high-grade (others) epithelial components, respectively. In a Kaplan-Meier analysis, patients with a high-grade epithelial component exhibited worse progression-free survival (PFS), compared with those with a low-grade component. Although the former group also exhibited worse overall survival, the difference was not significant. Thirty-six cases exhibited aberrant p53 expression. Of these, 5 cases exhibited focally aberrant p53 expression in carcinomatous components with diffuse aberrant p53 expression in mesenchymal components. Aberrant expression of p53 did not show significant association with prognosis. Six patients with MMR deficiency exhibited relatively better PFS. In conclusion, a low-grade epithelial component is a superior predictor of the PFS of ECS, compared with MMR protein and p53 expression status. In some cases of ECS, TP53 mutation may be a late event associated with histogenesis of the sarcomatous component.

DOI： 10.1097/PAS.0000000000001353

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

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

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

Language：English Publishing type：Research paper (scientific journal) Publisher：SPANDIDOS PUBL LTD

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

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

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

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

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

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

Language：Japanese Publisher：日本遺伝カウンセリング学会

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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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

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

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

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

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

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

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

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

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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