Faculty Profiles - MASUYAMA Hisashi

MISC - MASUYAMA Hisashi

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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

Language：English Publisher：WILEY

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

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

Language：English Publisher：OKAYAMA UNIV MED SCHOOL

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<0.0001), placental weight (p=0.002), birth weight and height (p<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

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

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

Language：English

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

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

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

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

Language：English Publisher：ELSEVIER SCIENCE BV

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 < 0.001; OS; P < 0.001). On multivariate analysis, GPS (GPS 2) was an independent predictor of both recurrence (P < 0.001) and survival (P < 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

Language：English Publisher：TAYLOR & FRANCIS LTD

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

Language：English Publisher：LIPPINCOTT WILLIAMS & WILKINS

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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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

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

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

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

近年40歳以下の若年子宮内膜癌患者は増加しており、その妊孕性温存が注目されている。我々は子宮内膜癌IA期発症後にmedroxyprogesterone acetate(MPA)による高用量黄体ホルモン療法後の再発に対し再度MPA療法を行い、生殖補助医療により生児を得た症例を経験したので報告する。症例は32歳女性既婚、未経妊。不正性器出血を主訴に前医を受診した。子宮内膜組織診でendometrioid adenocarcinoma、Grade 1と診断され、当科紹介となった。当院での精査で、子宮内膜癌IA期相当と診断、妊孕性温存希望のため、MPA療法を6ヵ月間行った。子宮内膜組織診で悪性所見の消失を確認後、妊娠を試みるも妊娠成立せず、初回治療から3年2ヵ月後に組織診断でendometrioid adenocarcinomaの再発が指摘された。依然挙児希望は強く、リスクを十分に説明した上で再度MPA療法を6ヵ月間行った。子宮内膜組織診で悪性所見の消失を確認し、不妊治療を再開した。生殖補助医療を選択し、GnRHアンタゴニスト法で14個の卵子を採取し体外受精した。受精後6日目に胚盤胞まで達した3AA胚1個を凍結した。子宮内膜組織診で陰性を確認後、ホルモン補充周期で凍結融解胚移植を行い、妊娠成立した。妊娠経過は順調で、妊娠40週4日に胎児機能不全の適応で帝王切開術を施行した。MPA療法は治療後1〜3年以内に再発する症例が多く、寛解後早期の不妊治療開始が推奨され、体外受精により妊娠する症例が多い。本症例のように子宮内膜癌再発後にMPA療法と生殖補助医療を行い、生児を得た症例の報告は散見されるが、本邦のガイドラインでは推奨されていないため、十分な説明と同意のもとに慎重に行われるべきである。(著者抄録)

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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

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

抗SS-A抗体陽性母体児に房室ブロックが生じる確率は1〜7.5%と報告されており、適切な治療がなされなければ胎児死亡となってしまう症例も少なくない。今回我々は、胎児完全房室ブロックに対し、塩酸リトドリン点滴とデキサメタゾン内服にて胎児の心不全予防を行った一例を経験したので報告する。症例は27歳、0経妊0経産。妊娠24週の健診時、胎児徐脈および心嚢液貯留を認め、精査目的に前医を紹介受診した。心室拍数60bpm、心房拍数120-130bpmの完全房室ブロックを認めたため、入院し胎児心拍数改善目的に塩酸リトドリン持続点滴を開始した。また母体の抗SS-A/SS-B抗体陽性が判明し、デキサメタゾン4mg/日内服も開始した。妊娠30週より新生児治療を含めた周産期管理のため当院転院となった。入院時超音波検査では、胎児推定体重1839g(+1.7SD)、心室拍数65bpm、心房拍数120bpm、心胸郭比34%、左室収縮率60%で、心嚢液はごくわずかに貯留していたが、胎児水腫は認めなかった。デキサメタゾン内服と塩酸リトドリン点滴を継続し、心室拍数70bpmとわずかに改善し心嚢液貯留はほぼ消失した。しかし母体に塩酸リトドリンに対する薬疹が出現し投与を中止したところ、胎児心室拍数は次第に減少し55bpmを下回るようになり、心嚢液も増悪した。イソクスプリン持続点滴を開始し再び55bpm以上まで改善したが、早期娩出が望ましいと判断し35週6日に選択的帝王切開にて分娩に至った。出生児は男児、2413g、Apgar score 7/8(1分値/5分値)、臍帯動脈血pH7.384であった。出生時心拍60-70bpmの徐脈であり、イソプロテレノール点滴による加療を行ったが改善を認めず、日齢68に恒久的ペーシング埋め込み術を施行され、日齢91に退院となった。胎児完全房室ブロックを発症した場合、徐脈性心不全への進行を予防することが重要であり、胎児心拍数が55bpmを下回った場合胎児死亡となる可能性がある。本症例では、ステロイド内服とβ刺激剤点滴にて胎児徐脈の改善および心不全への進行を予防し、妊娠期間を延長することができた。(著者抄録)

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The Influence of Adverse Effects on Quality of Life of Survivors of Gynecologic Cancer. International journal

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

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society 27 ( 9 ) 2014 - 2019 2017

Language：English Publisher：LIPPINCOTT WILLIAMS & WILKINS

OBJECTIVE: The objective of this observational study was to investigate correlations between adverse effects (lower-extremity lymphedema [LEL], dysuria, and severe gastrointestinal symptoms) and quality of life (QOL) (physical well-being [PWB], social well-being, emotional well-being [EWB], and functional well-being) before treatment, at least 6 weeks after treatment (posttreatment1), and 3 or 6 months after treatment (posttreatment2) of patients with gynecologic cancer (GC). METHODS: From August 2012 to October 2016, questionnaire responses and clinical data of 75 patients with GC were collected and assessed by treatment received. The χ test was used to determine the significance of correlations. RESULTS: Participants with LEL had significantly poorer QOL than did those without it in the domains of PWB at posttreatment1 (P = 0.026) and EWB at posttreatment2 (P = 0.020). Moreover, patients with 2 adverse effects (LEL plus dysuria or severe gastrointestinal symptoms) had significantly poorer QOL than did those with no or single adverse effect in the domains of PWB at posttreatment1 and posttreatment2 (posttreatment1: P = 0.049, P = 0.001; posttreatment2: P = 0.002, P = 0.028) and poorer QOL compared with those with no adverse effect in the domain of EWB at posttreatment1 (P = 0.017). CONCLUSIONS: Poorer QOL in emotional and physical domains is associated with adverse effects of treatment in patients with GC. It is important to consider the effects of radical therapy not only on survival but also on the QOL of survivors.

DOI： 10.1097/IGC.0000000000001125

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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

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

今回比較的稀な先天奇形である骨盤腎と、全身性強皮症を合併した子宮頸癌IIB期の1例を経験した。症例は65歳3経妊3経産。前医での子宮頸部組織診で扁平上皮癌の診断で、精査加療目的に当科紹介となった。当科受診時の内診で子宮頸部に浸潤癌様腫瘤と軽度の子宮傍組織浸潤を認めた。MRI検査では子宮頸部に長径5.2cmの不整形腫瘤と両側閉鎖リンパ節の腫大を指摘され、PET/CT検査で同部位へのFDGの高集積を認めた。子宮頸癌IIB期(T2bN1M0)と診断した。同時化学放射線治療(CCRT)を行った場合、放射線照射領域内に左骨盤腎が入り、左腎臓は無機能腎となることが予想され、さらに化学療法で白金製剤を使用することから腎機能の悪化が懸念された。しかし病期、肥満を考慮し、本人と相談の上、腎機能の推移を慎重にモニタリングしながらCCRTを行う方針とした。しかしCCRT治療開始後(全骨盤18Gy照射、weekly Cisplatin 40mg/m21コース)、皮膚への色素沈着と手指硬化を認め全身性強皮症と診断された。全身性強皮症患者に対する放射線治療はGrade 3以上の晩期障害がコントロール群と比較し約2.5倍になったとの報告もあり、放射線科治療医と相談しCCRTの継続は困難と判断した。手術療法を行う方針とし、単純子宮全摘、両側付属器切除術、骨盤リンパ節郭清を施行した。術後病理検査では腫瘍の縮小を認めており、左閉鎖リンパ節に腫瘍の瘢痕があるものの、その他明らかなリンパ節転移は認めなかった。術後は化学療法を施行し治療後3ヵ月現在再発兆候なく経過観察中である。(著者抄録)

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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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