Faculty Profiles - MASUYAMA Hisashi

MISC - MASUYAMA Hisashi

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P1-12-14 胎児発育からみた尿酸の意義(Group19 妊娠・分娩・産褥の生理・病理2 早産・IUGR,一般演題,第63回日本産科婦人科学会学術講演会)

赤堀洋一郎, 岸本佳子, 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 63 ( 2 ) 519 - 519 2011

Conservative Management for Infertile Women with Subserosal Myoma

MASUYAMA Hisashi

63 ( 12 ) "N - 173"-"N-179" 2011

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

Language：English Publishing type：Book review, literature introduction, etc.

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

Language：English Publisher：OKAYAMA UNIV MED SCHOOL

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 < 0.05). The expression of cathepsin D in PIH placentas was significantly lower than that in those without PIH < 0.05), while the placental expression of procathepsin D was significantly greater in PIH cases than in the normal pregnancies (p < 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.

DOI： 10.18926/AMO/40133

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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

Language：English Publisher：OKAYAMA UNIV MED SCHOOL

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

Language：English Publishing type：Book review, literature introduction, etc. Publisher：SPRINGER HEIDELBERG

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' 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' 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.

DOI： 10.1007/s00404-009-1181-2

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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

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

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 < body mass index < 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

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

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

Language：Japanese Publisher：中国四国産科婦人科学会

肺高血圧症合併妊娠は母児ともに様々なリスクを伴い、循環器科や麻酔科と協力した厳重な妊娠・分娩管理が必要となる。今回われわれは原発性肺高血圧症合併妊娠の一症例及び続発性合併妊娠の一症例を経験したため報告する。【症例1】39歳、1経妊0経産。二年前に原発性肺高血圧症と診断され、在宅酸素療法を行っていた。妊娠初期に近医より当科紹介となった。妊娠18週、呼吸困難感の増悪と下腿浮腫にて入院となるも、安静・酸素投与で状態は安定していた。二週間毎の心機能評価でも肺高血圧の急性増悪を認めなかった。麻酔科、循環器科とのカンファレンスの結果、硬膜外麻酔下の経腟分娩を予定した。妊娠38週0日前期破水となり、スワンガンツカテーテル・中心静脈カテーテル・末梢動脈ラインにてモニタリングしながら硬膜外麻酔併用での陣痛促進を行ったが、翌日分娩停止及び子宮内感染の疑いにて緊急帝王切開術を施行した。2628gの女児(Apgar score 8/9)であった。術後肺動脈圧が上昇したためCICUでの治療を受け、術後14日目に退院となった。【症例2】26歳、0経妊0経産。5歳時に多発性肺動静脈瘻と診断され摘出術を受けたが肺高血圧症が残存し、抗凝固薬内服で管理されていた。妊娠初期に当科初診。妊娠33週、特に症状はなかったがBNP上昇のため入院となった。安静・酸素投与・ヘパリン持続静注にて管理するも次第に心機能が悪化したため、陣痛誘発による計画分娩を予定した。妊娠37週6日頸管拡張後、陣痛発来し、スワンガンツカテーテル・中心静脈カテーテル・末梢動脈ラインを挿入。フェンタネスト静注による和痛分娩を併用した吸引分娩にて2300gの女児(Apgar score 9/10)を分娩した。産褥期はCICUで管理されていたが、右心不全症状が出現した。産褥19日目に近医転院の上、利尿剤投与により軽快した。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2010&ichushi_jid=J05038&link_issn=&doc_id=20100428480005&doc_link_id=%2Fcv0mtrob%2F2009%2F005802%2F005%2F0131-0135%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcv0mtrob%2F2009%2F005802%2F005%2F0131-0135%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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

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

5th The International Association of the Diabetes and Pregnancy Study Groups(International Association of Diabetes and Pregnancy Study Groups(以下IADPSGと略す)会議でHyperglycemia and Adverse Pregnancy Outcome(以下HAPOと略す)Studyのデータを基に、世界統一の妊娠糖尿病gestational diabetes mellitus(GDM)診断基準が提唱された。その内容は、75gOGTTで空腹時(F値):92mg/dl、1時間値(1h値):180mg/dl、2時間値(2h値):153mg/dlの1ポイント以上陽性のときにGDMと診断するというものである。今回、この新GDM診断基準をわが国で用いた場合、GDM頻度、周産期予後にどのような変化、問題が起こるか検討した。対象として、わが国での「妊娠糖尿病のスクリーニングに関する多施設共同研究」(Japan Assessment of Gestational Diabetes Mellitus Screening,以下JAGS trialと略す)での登録症例3020例のうち、妊娠中期に75gOGTTを施行した2436例を使用した。(1)1ポイント以上基準を満たした場合をGDMとする場合(IADPSG原案)と、(2)2ポイント以上の基準を満たした場合をGDMとする場合について、現行基準と比較しGDM頻度の変化と周産期予後の検討を行った。(1)の場合、GDMの頻度の変化50例/2436例(2.1%)から208例/2436例(8.5%)となり、4倍に増加する。周産期予後は増加例の中に耐糖能異常に関係する異常を認めていた。(2)の場合GDMの頻度の変化は50例/2436例(2.1%)から56例/2436例(2.3%)とほとんど変化しなかった。周産期予後においても大きな変化は認めなかった。IADPSGの提唱する新診断基準を採用した場合、頻度は増加するが、周産期合併症の減少、将来の糖尿病予防のためには有用と考えられる。しかし、新しく増加するGDMに対する適切な管理法については、今後の検討が必要である。(著者抄録)

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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

A case of a pregnant woman with status epilepticus

Modern trends in obstetrics & gynecology 59 ( 1 ) 43 - 46 2010

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

Language：Japanese Publisher：(株)東京医学社

2008年1月～12月に妊娠初期より管理した妊娠症例200例を対象に、妊娠中の尿糖出現率の推移を検討した。また、妊娠糖尿病(GDM)スクリーニング共同研究会のJAGSトライアルのデータを用い、妊娠初期・中期における尿糖出現率、尿糖の出現の有無による75gOGTT検査結果の比較、尿糖のGDM・ワンポイント異常に対する陽性的中率、尿糖の有無による周産期予後の比較、他のGDMのリスク因子との比較について検討した。妊娠初期から後期にかけての尿糖出現率は緩やかに漸増する傾向にあり、妊娠30～31週では最も高率(8.8%)であった。JAGSトライアルのデータを用いた検討では、妊娠中の尿糖出現率はGDM群が正常群より高率であった(妊娠初期10.3%・3.1%、妊娠中期13.3%、5.5%)。妊娠初期の75gOGTT検査において負荷前値は両群で有意差を認めなかったが1時間値、2時間値は共に尿糖陽性例の方が有意に高値であった。妊娠中期も同様の結果であった。妊娠初期・中期共に尿糖陰性群に比べ尿糖陽性群はGDM・ワンポイント異常共に発症率は高率であった。尿糖陽性の場合、GDM・ワンポイント異常に対する陽性的中率は初期で20.8%、中期で11.4%であった。患者背景(年齢・糖尿病家族歴・分娩歴・妊娠前体重・BMI・妊娠中の体重増加)はいずれの項目においても有意差を認めなかった。妊娠合併症(切迫早産・妊娠高血圧症候群(PIH)・羊水過多・緊急帝王切開)はいずれの項目も有意差を認めなかった。新生児予後(分娩週数、出生体重、Apgarスコア、血糖値、奇形発生率、呼吸障害)はいずれの項目も有意差を認めなかった。妊娠初期に尿糖陽性の場合、GDMは12%、妊娠中期に尿糖陽性の場合はGDM9%であった。尿糖と他のGDMのリスク因子を比べると糖尿病家族歴や高齢といった項目が比較的感度が高く、尿糖はこれらの因子より感度は劣ったが特異度は他の因子よりも高率であった。

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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

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

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

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

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' 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' 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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