Faculty Profiles - MASUYAMA Hisashi

MISC - MASUYAMA Hisashi

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A case of dichorionic diamniotic twins separated by a septate uterus

HASEGAWA Toru, HAYATA Yu, KUBO Kotaro, KUROKAWA Haruna, SAITO Masako, NISHIDA Takeshi, MITSUI Takashi, SUGIYAMA Wakana, OKIMOTO Naoki, INOUE Seiji, SEGAWA Tomoyuki, MASUYAMA Hisashi, HIRAMATSU Yuji

61 ( 1 ) 1 - 4 2012

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

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

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

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

International Association of Diabetes and Pregnancy Study Groups(IADPSG)がHAPO studyをもとに決定した世界統一の妊娠糖尿病gestational diabetes mellitus(以下GDMと略す)診断基準を発表し、わが国においても26年ぶりの大改定がなされ、2010年7月より新GDM診断基準の使用が開始された。GDMの頻度は約4倍に増加し、今後の妊娠管理において非常に重要なものになると考えられる。今回、新GDM診断基準採用による周産期合併症の発現率の変化につき検討した。糖耐能異常に特異的な周産期合併症について検討すると、すべての周産期合併症は、新GDM群で数の増加を認めた。新GDM群と旧GDM群の比較では、低カルシウム血症、肥厚性心筋症(JAGS trialの表記による)、NICU入院でのみ有意差を認め、他の合併症では差を認めなかった。これは、旧GDM診断基準の方が新GDM診断基準より厳しいためと考えられる。新GDM群の中にも、周産期合併症を起こす症例が多く認められた。周産期合併症のうち主要な巨大児、低血糖、胎児奇形、妊娠高血圧症候群(以下PIHと略す)について検討すると、それぞれ75gOGTTの1ポイント異常であっても発症しており、新基準による妊娠管理は重要と考えられた。PIH症例の検討では、BMI 25kg/m2以上の肥満症例が多く、PIH、GDM、肥満の関連性が示唆され、肥満症例では積極的に介入する必要があると考えられた。妊娠中は耐糖能異常を発見するうえで絶好の機会であり、これらに介入し治療することは周産期合併症減少だけでなく、将来の母児の糖尿病予防、メタボリックシンドローム予防、さらには医療経済的にも意義があると考えられた。(著者抄録)

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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

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

Language：English Publisher：KARGER

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 < 0.05), and between women with and without declining renal function in superimposed PE (p < 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

DOI： 10.1159/000339935

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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

Language：English Publisher：KARGER

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 < 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 < 0.05) in cases of severe SGA (<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

DOI： 10.1159/000332391

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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

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

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

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

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

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

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

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

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

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

Language：English Publisher：WILEY-BLACKWELL

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.

DOI： 10.1111/j.1447-0756.2011.01539.x

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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

Language：English Publisher：BIOSCIENTIFICA LTD

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

DOI： 10.1530/JME-11-0046

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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

産科領域での静脈血栓塞栓症の予防策 (今月の臨床静脈血栓塞栓症--予防・診断・治療)

早田裕, 増山寿, 平松祐司

臨床婦人科産科 65 ( 2 ) 118 - 121 2011.2

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