Faculty Profiles - MASUYAMA Hisashi

生殖補助医療により妊娠・出産に至った汎下垂体機能低下症の一例—A case of panhypopituitarism leading to pregnancy and childbirth with assisted reproductive technology

澤井雄大, 光井崇, 岡本遼太, 樫野千明, 久保光太郎, 鎌田泰彦, 中塚幹也, 増山寿

現代産婦人科 72 ( 1 ) 83 - 86 2023

Language：Japanese Publisher：[広島] : 日本産科婦人科学会中国四国合同地方部会

汎下垂体機能低下症は様々な誘因により発症しうる。今回,汎下垂体機能低下症による性腺機能低下症の患者に生殖補助医療を行い,妊娠・出産に至った一例を報告する。症例は30代女性。頭蓋咽頭腫で,2歳時,12歳時に開頭腫瘍摘出手術を施行された。術後に汎下垂体機能低下症となり,低ゴナドトロピン性性腺機能低下症に伴う2次性徴遅延に対して14歳よりカウフマン療法が施行されていた。結婚され,挙児希望のため当科外来を受診。受診時の血清follicle stimulating hormone(FSH)<0.1mIU/ml,luteinizing hormone0.1mIU/ml,エストラジオール<0.5pg/ml,テストステロン<0.7ng/dlといずれも低値であり,抗ミュラー管ホルモン2.73ng/mlであった。まず一般不妊治療として,リコンビナントFSH37.5IU/日によるFSH低用量漸増療法を開始し,100IU/日まで漸増したところで複数の卵胞発育を認めたため,多胎リスクを考慮し治療中止とした。患者と相談の上で生殖補助医療の方針とし,Progestin-primed Ovarian Stimulation法にて卵巣刺激を行った。6個の卵胞から4個の卵子が得られ,1個の胚盤胞(day 5,4AA)を凍結保存した。ホルモン補充周期での凍結融解胚盤胞移植にて妊娠成立し,女性ホルモンに関しては妊娠14週まで補充を継続し,内科的管理も施行しながら妊娠経過は順調であった。妊娠41週1日に予定日超過のため陣痛誘発を開始し,妊娠41週3日に経腟分娩に至った。出生児は女性,出生体重3216g,身長52.5cm,Apgar score 8/9であった。産褥経過は良好で,母乳の分泌を認めたが直母のみでは不十分で人工乳混合となった。カウフマン療法は分娩後6ヵ月から再開した。(著者抄録)

CiNii Books

【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

Other Link： https://search.jamas.or.jp/link/ui/2024074672

Biological and clinical value of OCT4A/SPP1C axis in endometrial and lung adenocarcinoma Reviewed

Kyohei Irie, Nobuhiko Mizuno, Tomoyuki Miyamoto, Aiji Ohtsuka, Hiromasa Yamamoto, Shinichi Toyooka, Hisashi Masuyama, Mitsuko Kosaka

Cancer Research 82 ( 12_Supplement ) 5125 2022.6

当院におけるオンライン分娩シミュレーション教育の取り組み

大平安希子, 三苫智裕, 横畑理美, 三島桜子, 谷和佑, 牧尉太, 桐野智江, 衛藤英理子, 早田桂, 増山寿

日本周産期・新生児医学会雑誌(Web) 58 ( Suppl.1 ) 2022

産婦人科診療に必要な遺伝カウンセリングの基本知識と実際がんゲノム医療:検査前遺伝カウンセリング

小川千加子, 依田尚之, 増山寿, 平沢晃

産婦人科の実際 71 ( 2 ) 2022

産婦人科医が知っておきたい臨床遺伝学のすべて腫瘍がんゲノム医療とgermline findingsの取り扱い

小川千加子, 増山寿, 平沢晃

臨床婦人科産科 76 ( 1 ) 2022

Plus One Seminar2021~ICTを駆使した産婦人科領域ハイフレックス型教育システムの構築~

衛藤英理子, 三苫智裕, 横畑理美, 三島桜子, 大平安希子, 桐野智江, 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(Web) 58 ( Suppl.1 ) 2022

帝王切開術後の重症手術部位感染(SSI)に対して異なる治療法を選択した3症例

桐野智江, 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, 早田桂, 増山寿

日本周産期・新生児医学会雑誌(Web) 58 ( Suppl.1 ) 2022

A Study of differences between venders of strain Values in Fetal Echocardiography

大平安希子, 早田桂, 三苫智裕, 横畑理美, 三島桜子, 谷和祐, 牧尉太, 桐野智江, 衛藤英理子, 増山寿

超音波医学 Supplement 49 2022

A case report of fetal ovarian cyst pedicle torsion

谷和祐, 三苫智裕, 横畑理美, 三島桜子, 大平安希子, 桐野智江, 牧尉太, 衛藤英理子, 早田桂, 増山寿

超音波医学 Supplement 49 2022

当院で経験した死戦期帝王切開と多職種連携の重要性について

三苫智裕, 横畑理美, 三島桜子, 大平安希子, 桐野智江, 谷和祐, 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(Web) 58 ( Suppl.1 ) 2022

The relationship of maternal body composition and resting energy expenditure to newborn birthweight in pregnant women with or without diabetes

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

日本女性栄養・代謝学会誌 27 ( 2 ) 2022

妊産婦緊急搬送補助システム“iPicss”を用いた救急隊との搬送連携/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(Web) 57 ( 4 ) 2022

A case of coarctation of the aorta and persistent left superior vena cava: HDlive Flow features at 14 weeks of gestation

小柳彩, 秦利之, 高吉理子, 中井祐一郎, 三宅貴仁, 谷和祐, 早田桂, 増山寿

超音波医学 Supplement 49 2022

不妊症・不育症女性における体組成の日内変動について

桐野智江, 大羽輝, 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, 早田桂, 中塚幹也, 増山寿

日本女性栄養・代謝学会誌 28 ( 1 ) 2022

予期せぬ常位癒着胎盤に対しLigaSureと子宮圧迫縫合が有用であった3症例

谷和祐, 大羽輝, 横畑理美, 三苫智裕, 三島桜子, 大平安希子, 桐野智江, 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(Web) 58 ( Suppl.1 ) 2022

sFlt-1投与マウスの胎盤におけるプロレニン受容体を介したエンドセリン1の産生

三島桜子, 光井崇, 三苫智裕, 大平安希子, 谷和祐, 牧尉太, 桐野智江, 衛藤英理子, 早田桂, 増山寿

日本周産期・新生児医学会雑誌(Web) 58 ( Suppl.1 ) 2022

妊娠高血圧症候群の母体から出生した児における3歳時のbody mass indexへの影響因子の検討

光井崇, 三島桜子, 谷和祐, 増山寿

日本周産期・新生児医学会雑誌(Web) 58 ( Suppl.1 ) 2022

生児を得た帝王切開瘢痕部妊娠例の一例と術中経腟エコーの有用性

早田桂, 三苫智裕, 横畑理美, 三島桜子, 大平安希子, 桐野智江, 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(Web) 58 ( Suppl.1 ) 2022

妊娠初期より分娩まで経静脈栄養を要し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, 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

日本女性栄養・代謝学会誌 27 ( 2 ) 2022

腹腔鏡手術後に腸閉塞を発症した小腸子宮内膜症の1例

久保光太郎, 楠元理恵, 樫野千明, 光井崇, 鎌田泰彦, 増山寿

日本エンドメトリオーシス学会プログラム・抄録集 43rd 2022

増山寿, 衛藤英理子, 谷村吏香

産科と婦人科 88 ( 10 ) 1191 - 1196 2021.10

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)

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

妊娠高血圧症候群up to date

増山寿

母性衛生 62 ( 3 ) 61 - 61 2021.9

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

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

【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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

BRCA1/2遺伝学的検査陰性でがん遺伝子プロファイル検査からBRCA1病的バリアントを認めた卵巣癌の1例

二川摩周, 松岡敬典, 加藤芙美乃, 十川麗美, 浦川優作, 山本英喜, 山本英喜, 河内麻里子, 依田尚之, 小川千加子, 中村圭一郎, 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 27th 2021

遺伝性腫瘍教育により防ぎえた症例から学ぶ親世代のHBOC

小川千加子, 十川麗美, 二川摩周, 加藤芙美乃, 河内麻里子, 依田尚之, 松岡敬典, 岡本和浩, 中村圭一郎, 平沢晃, 平沢晃, 増山寿

日本遺伝性腫瘍学会学術集会プログラム・抄録集 27th 2021

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(Web) 57 ( Suppl ) 2021

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(Web) 57 ( Suppl ) 2021

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(Web) 57 ( Suppl ) 2021

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(Web) 57 ( Suppl ) 2021

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(Web) 57 ( Suppl ) 2021

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(Web) 57 ( Suppl ) 2021

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(Web) 57 ( Suppl ) 2021

A Case of Pentalogy of Cantrell

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 Supplement 48 2021

A survey on physical development up to the third year of life in offspring born to mothers with hypertensive disorders of pregnancy: prevalence of obesity and associated risk factors in three years old offspring born to mothers with hypertensive disorders of pregnancy

MITSUI Takashi, MISHIMA Sakurako, TANI Kazumasa, KUSUMOTO Rie, KASHINO Chiaki, KUBO Kotaro, KAMADA Yasuhiko, NARAI Yoko, HONDA Tetsurou, KAI Kenji, TADA Katsuhiko, HARADA Takashi, MAEDA Kazuhisa, NAGAI Ryuhei, SHIMOYA Koichiro, ABE Emiko, MATSUBARA Yuko, MURATA Susumu, MIYOSHI Hiroshi, MASUYAMA Hisashi

日本産科婦人科学会雑誌 73 2021

Laparoscopic evaluation is useful for treatment of imperforate hymen

KAMADA Yasuhiko, KUSUMOTO Rie, KASHINO Chiaki, KUBO Kotaro, MITSUI Takashi, MASUYAMA Hisashi

日本産科婦人科学会雑誌 73 2021

糖尿病マウスにおけるProtein kinase Cの活性化を介した血管新生因子及び抗血管新生因子の産生

光井崇, 三島桜子, 谷和祐, 増山寿

日本絨毛性疾患研究会・日本胎盤学会学術集会プログラム・抄録集 39th-29th 2021

妊娠高血圧腎症モデルマウスの胎盤プロレニン受容体を介したエンドセリン1の産生

三島桜子, 光井崇, 谷和祐, 三苫智裕, 横畑理美, 大平安希子, 牧尉太, 桐野智江, 衛藤英理子, 早田桂, 増山寿

日本絨毛性疾患研究会・日本胎盤学会学術集会プログラム・抄録集 39th-29th 2021

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(Web) 57 ( Suppl ) 2021

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(Web) 57 ( Suppl ) 2021

Clinical value of OCT4A/SPP1C axis in endometrial and lung adenocarcinoma

入江恭平, 入江恭平, 水野伸彦, 越宗靖二郎, 越宗靖二郎, 宮本朋幸, 宮本朋幸, 大塚愛二, 山本寛斉, 豊岡伸一, 増山寿, 小阪美津子

日本がん転移学会学術集会・総会プログラム抄録集 30th ( 12 ) 2021

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

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

EG-VEGFはPROKR2を介して絨毛外トロホブラスト浸潤を促進する

谷和祐, 三島桜子, 大平安希子, 牧尉太, 光井崇, 衛藤英理子, 早田桂, 増山寿

日本絨毛性疾患研究会・日本胎盤学会学術集会プログラム・抄録集 38th-28th 2020

The standard value for strain using fetal echocardiography and the need for frame rate

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 Supplement 47 2020

The ethical considerations of obstetrician and pediatric cardiologist for fetal congenital heart disease

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 Supplement 47 2020

治療前サルコペニアは子宮頸癌における放射線治療の予後を反映しない

松岡敬典, 中村圭一郎, 岡本和浩, 依田尚之, 春間朋子, 衛藤英理子, 小川千加子, 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 44th 2020

健常妊婦の妊娠中体重変化と安静時代謝量および体組成量の関連

衛藤英理子, 三島桜子, 大平安希子, 谷和祐, 牧尉太, 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 44th 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

高血糖条件下の胎盤におけるProtein kinase Cの活性化を介した血管新生因子及び抗血管新生因子の産生

光井崇, 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

日本絨毛性疾患研究会・日本胎盤学会学術集会プログラム・抄録集 37th-27th 2019

EG-VEGFはPROKR2を介してMMP-2,-9を産生し,トロホブラスト浸潤を促進する.

谷和祐, 三島桜子, 大平安希子, 牧尉太, 玉田祥子, 光井崇, 衛藤英理子, 早田桂, 増山寿

日本絨毛性疾患研究会・日本胎盤学会学術集会プログラム・抄録集 37th-27th 2019

The utility of aromatherapy in labor and delivery

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(Web) 20 ( 2 ) 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

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

【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

Language：Japanese Publisher：金原出版(株)

＜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

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

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

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

Language：Japanese Publisher：金原出版(株)

＜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

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

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

高血糖条件下の絨毛細胞におけるPKCを介した血管新生因子及び抗血管新生因子の産生

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

日本産科婦人科栄養・代謝研究会誌 24 ( 1 ) 2018

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(Web) 61 ( 5 ) 2018

妊娠とがんを抱えた患者の心理的支援

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

日本周産期メンタルヘルス学会学術集会プログラム・抄録集 15th 2018

胎児先天性心疾患を指摘された2家族それぞれの選択とメンタルヘルスケア

吉田由理, 衛藤英理子, 三村麻里, 藤岡まゆみ, 増山寿

日本周産期メンタルヘルス学会学術集会プログラム・抄録集 15th 2018

中心静脈栄養を要する重症妊娠悪阻に対してオランザピンが奏功した一例

兼森美帆, 関典子, 衛藤英理子, 増山寿

日本周産期・新生児医学会雑誌 54 ( 2 ) 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

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

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.

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.

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

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

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

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

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

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

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.

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

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)

Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J05038&link_issn=&doc_id=20170612460016&doc_link_id=%2Fcv0mtrob%2F2016%2F006502%2F016%2F0217-0221%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcv0mtrob%2F2016%2F006502%2F016%2F0217-0221%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J05038&link_issn=&doc_id=20170612460017&doc_link_id=%2Fcv0mtrob%2F2016%2F006502%2F017%2F0223-0227%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcv0mtrob%2F2016%2F006502%2F017%2F0223-0227%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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

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)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J05038&link_issn=&doc_id=20171221410019&doc_link_id=%2Fcv0mtrob%2F2017%2F006601%2F019%2F0109-0115%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcv0mtrob%2F2017%2F006601%2F019%2F0109-0115%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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

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

【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

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

Medical nutrition therapy for diabetic pregnant women evaluated from resting energy expenditure

17 ( 2 ) S - 54-56 2017

高血糖条件下の絨毛細胞におけるPKCを介した血管新生因子及び抗血管新生因子の産生

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

日本産科婦人科栄養・代謝研究会プログラム・抄録集 41st 2017

「FGRを伴う妊娠糖尿病・糖尿病合併妊婦へのインスリン療法の是非」「積極派」

光井崇, 増山寿, 岡本和浩, 柏原麻子, 牧尉太, 江口武志, 玉田祥子, 衛藤英理子, 早田桂, 平松祐司

日本産科婦人科栄養・代謝研究会誌 23 ( 1 ) 2017

当院における精神疾患合併妊婦の現状と今後の取り組み

衛藤英理子, 谷和祐, 牧尉太, 江口武志, 玉田祥子, 光井崇, 早田桂, 増山寿

日本周産期メンタルヘルス学会学術集会プログラム・抄録集 14th 2017

帝王切開瘢痕部妊娠の診断と管理

増山寿, 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

日本絨毛性疾患研究会・日本胎盤学会学術集会プログラム・抄録集 35th-25th 2017

糖代謝異常妊婦の安静時代謝量と体組成

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

日本産科婦人科栄養・代謝研究会誌 23 ( 1 ) 2017

婦人科悪性腫瘍根治手術患者における大建中湯の有用性について

関典子, 藤田志保, 西條昌之, 依田尚之, 大道千晶, 西田傑, 原賀順子, 楠本知行, 中村圭一郎, 増山寿, 奥田博之, 平松祐司

日本婦人科腫瘍学会雑誌 35 ( 3 ) 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

Language：English Publisher：NATURE PUBLISHING GROUP

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

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

Language：English Publisher：OKAYAMA UNIV MED SCHOOL

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

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

Language：English Publisher：ELSEVIER SCI LTD

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

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

Language：English Publisher：SPRINGER JAPAN KK

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

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

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

Language：English Publisher：SPANDIDOS PUBL LTD

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

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

Language：English Publisher：SPRINGER

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

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

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

[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

Language：English Publisher：BIOMED CENTRAL LTD

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 (>= 1 year after treatment and age of <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.

DOI： 10.1186/s12885-016-2627-0

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

Language：English Publisher：BIOMED CENTRAL LTD

DOI： 10.1186/s12885-016-2627-0

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

Language：English Publisher：NATURE PUBLISHING GROUP

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<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

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

Language：English Publisher：AMER PHYSIOLOGICAL SOC

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

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

Language：English Publisher：WILEY

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 < 0.001 for early-, advanced- and all-stages; OS; P < 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

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

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

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

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

【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

Language：Japanese Publisher：(公社)日本超音波医学会

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

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J00833&link_issn=&doc_id=20160323480009&doc_link_id=%2Fed5choon%2F2016%2F004302%2F011%2F0311-0315%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fed5choon%2F2016%2F004302%2F011%2F0311-0315%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

P3-52-4 不育症に対する妊娠早期の低用量アスピリン投与(ASA)の妊娠高血圧症候群の予防効果について(Group 117 妊娠高血圧症候群3,一般演題,公益社団法人日本産科婦人科学会第68回学術講演会)

平野友美加, 増山寿, 江口武志, 玉田祥子, 光井崇, 衛藤英理子, 延本悦子, 早田桂, 酒本あい, 小谷早葉子, 鎌田泰彦, 平松祐司

日本産科婦人科學會雜誌 68 ( 2 ) 985 - 985 2016

P3-16-2 Glasgow prognostic score(GPS)は卵巣癌患者の予後不良因子となりうる(Group 81 卵巣腫瘍・バイオマーカー,一般演題,公益社団法人日本産科婦人科学会第68回学術講演会)

大道千晶, 中村圭一郎, 原賀順子, 西田傑, 春間朋子, 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 68 ( 2 ) 865 - 865 2016

P3-23-11 婦人科悪性腫瘍手術における自己血貯血の適応について(Group88 悪性腫瘍全般・その他治療,一般演題,公益社団法人日本産科婦人科学会第68回学術講演会)

関典子, 原賀順子, 大道千晶, 西田傑, 春間朋子, 小川千加子, 楠本知行, 中村圭一郎, 増山寿, 平松祐司

日本産科婦人科學會雜誌 68 ( 2 ) 886 - 886 2016

P2-65-6 フィブリノゲン補充療法と抗凝固療法により妊娠管理を行った先天性低フィブリノゲン血症双胎妊娠の一例(Group65 性分化異常・その他,一般演題,公益社団法人日本産科婦人科学会第68回学術講演会)

小谷早葉子, 鎌田泰彦, 藤田志保, 長谷川徹, 酒本あい, 平野友美加, 早田桂, 増山寿, 中塚幹也, 平松祐司

日本産科婦人科學會雜誌 68 ( 2 ) 815 - 815 2016

P2-33-3 子宮頸癌放射線治療前のprognostic nutritional indexは予後と相関する(Group33 子宮頸癌・治療4・放射線療法,一般演題,公益社団法人日本産科婦人科学会第68回学術講演会)

原賀順子, 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 68 ( 2 ) 702 - 702 2016

P3-33-1 妊娠初期の腟分泌物培養検査は流早産予防に関与するか(Group98 早産2,一般演題,公益社団法人日本産科婦人科学会第68回学術講演会)

鈴井泉, 早田桂, 松原侑子, 牧尉太, 江口武志, 玉田祥子, 光井崇, 平野友美加, 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 68 ( 2 ) 913 - 913 2016

P2-56-9 妊娠高血圧症候群の発症時期による新生児,乳幼児期の発育への影響(Group56 妊娠高血圧症候群1,一般演題,公益社団法人日本産科婦人科学会第68回学術講演会)

光井崇, 増山寿, 牧尉太, 江口武志, 玉田祥子, 平野友美加, 衛藤英理子, 延本悦子, 早田桂, 平松祐司

日本産科婦人科學會雜誌 68 ( 2 ) 787 - 787 2016

P2-46-6 当院で経験した心疾患合併妊娠の検討(Group46 合併症妊婦1,一般演題,公益社団法人日本産科婦人科学会第68回学術講演会)

松原侑子, 延本悦子, 鈴井泉, 光井崇, 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 68 ( 2 ) 750 - 750 2016

MW5-1 "Diabetes begets diabetes" : メカニズムの解明に向けて(ミニワークショップ5 妊娠の栄養代謝,一般演題,公益社団法人日本産科婦人科学会第68回学術講演会)

増山寿, 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, 早田桂, 瀬川友功, 平松祐司

日本産科婦人科學會雜誌 68 ( 2 ) 600 - 600 2016

P3-15-12 婦人科癌患者の治療後における就労生活の現状(Group 80 悪性腫瘍全般・合併症・緩和治療,一般演題,公益社団法人日本産科婦人科学会第68回学術講演会)

中村圭一郎, 西田傑, 原賀順子, 大道千晶, 春間朋子, 小川千加子, 楠本和行, 関典子, 増山寿, 平松祐司

日本産科婦人科學會雜誌 68 ( 2 ) 864 - 864 2016

P3-41-2 抗NMDA受容体抗体脳炎による心肺停止から回復後,自然妊娠し生児を得た一例(Group106 合併症妊娠8,一般演題,公益社団法人日本産科婦人科学会第68回学術講演会)

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, 瀬川友功, 増山寿, 平松祐司

日本産科婦人科學會雜誌 68 ( 2 ) 943 - 943 2016

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

Low incidence of pregnancy-induced hypertension in patients with habitual abortion administered with low-dose aspirin prophylaxis from the first trimester

65 ( 1 ) 21 - 27 2016

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

Pretreatment prognostic nutritional index is a significant predictor of prognosis in patients with cervical cancer treated with concurrent chemoradiotherapy. International journal

Junko Haraga, Keiichiro Nakamura, Chiaki Omichi, Takeshi Nishida, Tomoko Haruma, Tomoyuki Kusumoto, Noriko Seki, Hisashi Masuyama, Norihisa Katayama, Susumu Kanazawa, Yuji Hiramatsu

Molecular and clinical oncology 5 ( 5 ) 567 - 574 2016

Language：English Publisher：SPANDIDOS PUBL LTD

This study investigated whether pretreatment neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and prognostic nutritional index (PNI) are prognostic factors in patients with cervical cancer who undergo concurrent chemoradiotherapy (CCRT) and radiotherapy (RT). A total of 131 patients who underwent CCRT and RT for cervical cancer were retrospectively investigated and the correlations of NLR, PLR and PNI with clinical parameters and prognosis were assessed in CCRT and RT. The CCRT and RT groups had a median progression-free survival (PFS) of 41.82 and 24.72 months, respectively, and an overall survival of 49.70 and 29.56 months, respectively. At a cut-off value of NLR≥2.85, the PFS and OS in patients with higher NLR undergoing RT were significantly shorter compared with those in patients with lower NLR (P=0.029 and P=0.017, respectively). At a cut-off value for PNI of ≤48.55 in patients undergoing CCRT and ≤45.80 in patients undergoing RT, the PFS and OS in patients with lower PNI were significantly shorter compared with those in patients with higher PNI (PFS and OS with CCRT, P<0.001 and P<0.001, respectively; PFS and OS with RT, P=0.002 and P=0.008, respectively). Multivariate analyses also identified low PNI as an independent prognostic factor for PFS and OS in patients receiving CCRT. Therefore, low PNI was shown to predict poor prognosis in patients with cervical cancer.

DOI： 10.3892/mco.2016.1028

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

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

【目的】先天性心疾患は新生児の約1%にみられる最も頻度の高い先天奇形の一つであるため、出生後に適切な治療を行う上で胎児診断が重要となっている。当院における胎児心疾患症例の現状と課題を把握することを目的とした。【研究方法】2011年4月から2014年3月までに当院で先天性心疾患疑いのため当院産科胎児超音波精査外来を受診した109例を対象に、診療録より母体背景、胎児診断名および診断週数、新生児診断名、染色体検査の有無、分娩方法、児の予後を抽出し、後方視的に検討した。また1997年から2013年までの胎児心疾患症例数を診療録より集計した。【研究成績】胎児心疾患症例は年々増加し、2000年と比較すると2013年は約9倍となっていた。109例のうち紹介例は102例(県外51例)、当院での胎児診断週数は32.9±3.8週であった。新生児診断では左心低形成症候群が23例と最も多く、心室中隔欠損症18例、両大血管右室起始症13例、肺動脈閉鎖症11例などであった。胎児診断と新生児診断を比較すると、特に完全大血管転位症、両大血管右室起始症、ファロー四徴症、総肺静脈還流異常症の胎児診断に苦慮する傾向がみられた。児の予後不良例は10例(子宮内胎児死亡1例、新生児死亡9例)あり、左心低形成症候群の重症型や18トリソミーの症例が多かった。胎児超音波検査で染色体異常が疑われて出生前に羊水染色体検査が行われた症例と、出生後に児の染色体検査が行われた症例とを合わせると、18トリソミー7例、21トリソミー5例、22q11.2欠失症候群1例という結果であった。【結語】当院は先天性心疾患の紹介例が多く、中でも左心低形成症候群が多いのが特徴であった。羊水染色体検査は適切な症例に施行すれば有用な情報が得られる。円錐動脈幹奇形や総肺静脈還流異常症の胎児診断率の向上が今後の課題である。(著者抄録)

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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

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

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

胃癌合併妊娠は稀であるが、欧米と比較して日本では比較的高率である。妊娠に合併する胃癌は、症状としては悪心嘔吐、上腹部痛等があるがそれらは正常な妊娠経過でも経験し、特異的でないこと、また妊娠中は放射線検査が躊躇されることもあり発見が遅れることも多く、診断時に進行している症例が多く、予後は不良である。今回我々は急性膵炎を契機に発見された胃癌合併妊娠の一例を経験したので文献的考察を踏まえて報告する。症例は29歳、0経妊0経産。妊娠33週5日に背部痛を認め、翌日に前医救急外来を受診。血液検査で著明なアミラーゼ高値を認め、急性膵炎の診断となった。第3病日に今後の加療目的に当科紹介転院となった。第4病日に施行したMRI検査にて悪性腫瘍合併が疑われ、その他の画像検査と併せて胃癌合併が強く疑われた。既に妊娠34週に入っており、児の娩出は問題ないと判断し、第6病日・妊娠34週4日に帝王切開を行い、妊娠を終了した。帝王切開時、腹腔内に多発する転移巣を認め、胃幽門部に腫瘤性病変を認め、周囲のリンパ節腫大、胃から膵への直接浸潤を認めた。第10病日・帝王切開術後4日目に上部消化管内視鏡を行い、胃体下部に3型・潰瘍浸潤型の胃癌を認めた。第19病日・術後13日目より化学療法(5-FU+PTX)を開始した。第51病日に癌性髄膜症による急性水頭症を認め、V-P shunt術を施行した。その際の脳脊髄液細胞診はclassVであり、癌細胞は既知の胃癌として矛盾しない所見であった。第65病日早朝より除脳硬直が出現し、約1時間後に永眠された。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J05038&link_issn=&doc_id=20160624350054&doc_link_id=%2Fcv0mtrob%2F2015%2F006402%2F054%2F0431-0434%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcv0mtrob%2F2015%2F006402%2F054%2F0431-0434%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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

Three histologically distinct cancers of the uterine corpus: A case report and review of the literature. International journal

Hisashi Masuyama, Junko Haraga, Takashi Nishida, Chikako Ogawa, Tomoyuki Kusumoto, Keiichiro Nakamura, Noriko Seki, Hiroyuki Yanai, Yuji Hiramatsu

Molecular and clinical oncology 4 ( 4 ) 563 - 566 2016

Language：English Publishing type：Book review, literature introduction, etc. Publisher：SPANDIDOS PUBL LTD

Collision tumors, which are characterized by the coexistence of two or more completely distinct and independent tumors in the uterine corpus, are very rare. A collision tumor is mainly composed of two distinct tumor types, epithelial and mesenchymal. To the best of our knowledge, there has only been a single case in which a choriocarcinoma with an endometrial carcinoma were coexistent but histologically distinct. We herein report the first case of a collision tumor in a 52-year-old woman, with a history of two pregnancies and two deliveries. The collision tumor was composed of three histologically distinct neoplasms in the uterine corpus, namely an endometrioid carcinoma, an undifferentiated carcinoma and a choriocarcinoma. The patient underwent hysterectomy, bilateral adnexectomy and pelvic lymph node dissection, followed by six cycles of adjuvant chemotherapy with paclitaxel/carboplatin due to the high risk of endometrial cancer, and an additional five cycles of chemotherapy with methotrexate, as the β-human chorionic gonadotropin level was beyond the normal range. Following adjuvant chemotherapy, the tumor markers were within normal limits and no relapses of the cancer have been observed during 1 year of follow-up. Diagnosing a collision tumor prior to surgery is difficult if the neoplasms are in close proximity, or if one of the tumors predominates. Careful pathological examination is crucial for accurately diagnosing the neoplasms in a collision tumor and ensuring appropriate management and a favorable prognosis.

DOI： 10.3892/mco.2016.770

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

Language：English

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.

A case of ovarian endometrioid adenocarcinoma resembling sex-cord stromal tumor with hyperandrogenism, hyperestrogenism and pseudo-Meigs syndrome

34 ( 2 ) 112 - 118 2016

妊娠高血圧症候群を合併した母体の出生児の3歳までの身体発育の性差

光井崇, 増山寿, 江口武志, 玉田祥子, 衛藤英理子, 早田桂, 平松祐司

日本産科婦人科栄養・代謝研究会プログラム・抄録集 40th 2016

糖代謝異常妊婦の安静時代謝量と体組成

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

日本産科婦人科栄養・代謝研究会プログラム・抄録集 40th 2016

“Diabetes begets diabetes”-メカニズムの解明に向けて-

増山寿, 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, 早田桂, 瀬川友功, 平松祐司

日本産科婦人科学会雑誌 68 ( 2 ) 2016

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

Language：English Publisher：WILEY-BLACKWELL

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 <22weeks of gestation, the TCD reference standard was calculated as follows: TCD=(1.027xGA)-0.674 (R-2=0.97, P<0.001). The reference standard of the APCD was calculated as follows: APCD=(0.682xGA)-3.925 (R-2=0.73, P<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 >22 weeks of gestation, the reference standard of the TCD was calculated as follows: TCD=(1.603xGA) - 13.216 (R-2=0.92, P<0.001). The reference standard of the APCD was calculated as follows: APCD=(0.859xGA) - 7.30 (R-2=0.84, P<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

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

Language：English Publisher：JAPAN ENDOCRINE SOC

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

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

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

Language：English Publisher：Springer-Verlag Tokyo

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
sup&gt
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

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

Language：English Publisher：LIPPINCOTT WILLIAMS & WILKINS

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 < 0.001; OS, P < 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

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

Language：English Publisher：ENDOCRINE SOC

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

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

Language：English Publisher：John Wiley and Sons Ltd

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

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

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

先天性第V因子欠乏症は、発症頻度100万人に1人といわれる稀な疾患である。今回、術前検査の凝固能異常から本疾患が判明した症例を経験したので報告する。38歳女性、1経妊1経産。出血傾向の既往や家族歴はなかった。自然妊娠後、経過順調であったが、骨盤位のため選択的帝王切開術とした。術前検査で凝固能異常を認め、妊娠36週、精査加療目的で血液内科に紹介となった。初診時、プロトロンビン時間(PT)48%(正常値:80〜120%)、活性化部分トロンボプラスチン時間(APTT)47秒(正常値:25〜36秒)と延長していた。凝固因子検査で第V因子活性が3%未満と低値で、先天性第V因子欠乏症と診断された。妊娠39週2日、入院管理のもと新鮮凍結血漿(FFP)15単位を輸血した。妊娠39週3日、手術開始前にFFP5単位投与を追加した。術直前の血液検査でPT77%、APTT31.9秒に改善していることを確認し、全身麻酔下での予定帝王切開術を施行した。術中出血量は、羊水込みで約2020mlと多かったが、子宮収縮不良による弛緩出血が主な原因であり、創部の止血や悪露の排出量に異常はなかった。FFPは、術終了後から術後3日目までは5単位、術後4日目から術後5日目までは2単位を12時間毎に輸血をした。期間中に出血傾向を認めず、術後6日目以降はFFPの追加補充を行うことはなかった。経過良好で術後7日目に退院となった。先天性第V因子欠乏症は、臨床症状が軽微なことから未診断の症例があるとされており、術前スクリーニングで凝固機能異常を認めた場合には本疾患を念頭において精査する必要があると考える。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J05038&link_issn=&doc_id=20151215460025&doc_link_id=%2Fcv0mtrob%2F2015%2F006401%2F025%2F0131-0134%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcv0mtrob%2F2015%2F006401%2F025%2F0131-0134%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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

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

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

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

DOHaD説.

増山寿, 平松祐司

週刊日本医事新報 ( 4735 ) 51 - 51 2015

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

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

Pretreatment platelet-lymphocyte ratio is an independent predictor of cervical cancer recurrence following concurrent chemoradiation therapy. International journal

Keiichiro Nakamura, Takeshi Nishida, Tomoko Haruma, Junko Haraga, Chiaki Omichi, Chikako Ogawa, Tomoyuki Kusumoto, Noriko Seki, Hisashi Masuyama, Yuji Hiramatsu

Molecular and clinical oncology 3 ( 5 ) 1001 - 1006 2015

Language：English Publisher：SPANDIDOS PUBL LTD

The aim of the present study was to identify the correlations between inflammation markers such as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and C-reactive protein (CRP) and the prognosis in patients with recurrent cervical cancer. The associations among NLR, PLR and CRP and clinical characteristics and prognosis were examined in 32 patients receiving chemotherapy with recurrent cervical cancer following concurrent chemoradiation therapy (CCRT). The patient median survival time was 198 days (range, 42-1,022 days). Pretreatment NLR and PLR were significantly correlated with the recurrence of cervical cancer following CCRT (R=-0.538, P=0.002; and R=-0.542, P=0.001, respectively). Pretreatment PLR >322.0 was significantly associated with a poor prognosis for recurrent cervical cancer following CCRT by univariate and multivariate analyses (P=0.015 and P=0.029). These findings indicate that pretreatment PLR is an important predictor of prognosis in patients with recurrent cervical cancer following CCRT.

DOI： 10.3892/mco.2015.595

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

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

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

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

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

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

先天性サイトメガロウイルス感染症の2例

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

日本絨毛性疾患研究会・日本胎盤学会学術集会プログラム・抄録集 33rd-23rd 2015

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

Language：English Publisher：WILEY-BLACKWELL

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.

DOI： 10.1111/ajo.12228

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

Language：English Publisher：PERGAMON-ELSEVIER SCIENCE LTD

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

Additive Effects of Maternal High Fat Diet during Lactation on Mouse Offspring

Hisashi Masuyama, Yuji Hiramatsu

PLOS ONE 9 ( 3 ) e92805-e92805 2014.3

Language：English Publisher：PUBLIC LIBRARY SCIENCE

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.

DOI： 10.1371/journal.pone.0092805

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

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

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

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

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

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

A case of chronic abruption placentae diagnosed incidentally upon blood examination by the detection of progressive anemia over a short period of time

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

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

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

妊娠時の急性腹症は早期診断されないと母児に多大な影響を与えるが、CT、MRI検査が制限されること、血液データに妊娠性変化があるため診断に苦慮する。本研究の目的は文献的考察をふまえ、我々の経験症例から妊娠時の急性腹症の早期診断において重要な点、それらをいかに治療するかについて検討することである。症例は岡山大学病院産婦人科において2008年4月から2013年3月までに妊娠中に急性腹症を呈した12症例。疾患の内訳は変性筋腫3例、卵巣嚢腫茎捻転3例、尿管結石3例、虫垂炎1例、穿通胎盤1例、胃癌末期1例の計12例。正診率は75%(9/12)、卵巣嚢腫茎捻転の1例は尿管結石、穿通胎盤は腸閉塞、胃癌末期は急性膵炎と初診時に診断されていた。初診時の診断では症状、身体診察、既往歴、エコー検査によってなされており、中でも既往歴は特に重要と思われ、変性筋腫の3/3例、卵巣嚢腫茎捻転の2/3例、尿管結石の2/3例は妊娠初期より筋腫、卵巣嚢腫、尿管結石を指摘されており、初診時に正診されている。血液検査は全例施行しており、WBC、CRPは妊娠を考慮すると明らかな異常値はなく、D-dimerは穿通胎盤、胃癌末期の症例において明らかな異常値であった。CTを施行した症例はなく、MRIは穿通胎盤、胃癌末期の症例で施行されており、正診されている。治療は卵巣嚢腫茎捻転の3例、穿通胎盤、胃癌末期の計5例が手術加療、その他の7例は保存的加療、なお尿管結石の1例は尿管ステント留置を施行されている。予後は胃癌末期の症例がその後癌性髄膜炎を発症して死亡、その他の11例は予後良好であった。妊娠時の急性腹症の診断では筋腫、卵巣嚢腫、尿管結石などの合併症を妊娠初期より診断し、上記妊娠合併症がある場合には後に急性腹症の原因となる可能性を念頭におく必要がある。血液検査ではWBC、CRPのみでは診断に結びつかない可能性が高い。妊娠を考慮しても明らかな異常値を呈する場合にはMRIを施行する必要があると思われた。(著者抄録)

Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J05038&link_issn=&doc_id=20141216480015&doc_link_id=%2Fcv0mtrob%2F2014%2F006301%2F015%2F0067-0071%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcv0mtrob%2F2014%2F006301%2F015%2F0067-0071%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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

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

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

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

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

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

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

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

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

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

当院における体重増加量が少ない妊婦の周産期予後の比較

延本悦子, 衛藤英理子, 早田桂, 瀬川友功, 増山寿, 平松祐司

日本産科婦人科栄養・代謝研究会誌 20 ( 1 ) 2014

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

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

Language：English Publisher：WILEY-BLACKWELL

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

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

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

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

2009年1月〜2012年6月までに分娩した1121名を対象に、やせ妊婦について児の出生体重や周産期合併症について検討した。対象は、非妊時BMIによりやせ群(BMI18.5未満)216名19%、普通体重群(BMI18.5以上25未満)771名69%、肥満群(BMI25以上)134名12%であった。やせ群は10代20代の妊婦が肥満群より有意に多く、有意に低出生体重児が多かった。また、やせ群の体重増加量は平均9.3kgで約50%は9kg未満であったが、適正体重増加量を満たさない場合は早産や低出生体重児が有意に多かった。以上より、やせ妊婦に対しては栄養管理による適正な体重増加の指導が必要であると考えられた。

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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

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

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

産褥期の緊急搬送は、妊娠中の母体搬送と比較し頻度は低いものの、とくに出産直後に生じる急性疾患は迅速な診断と治療が要求され、対応が遅れると母体死亡にいたる危険をはらんでいるが、逆に適切な処置により早期の回復が期待できる。今回われわれは、当科における緊急産褥搬送の現状について調査・検討を行った。2007年1月〜2012年6月において、当科に産褥期に緊急搬送された52症例を対象とし、その病態・入院時所見・治療内容について後方視的検討を行った。産褥搬送症例の内訳は、出血性疾患42例(弛緩出血13例、外陰腟壁血腫10例、癒着胎盤・胎盤遺残8例、頸管・腟壁裂傷4例、子宮破裂3例、子宮内反症2例、その他2例)および非出血性疾患10例であった。出血性疾患において入院時平均ヘモグロビン値は8.7g/dl(1.4-13.6)、推定総出血量2,657ml(130-15,000)、shock index 1.0以上であったのは13例(32%)であった。そのうち輸血は24例(57.1%)、外科的処置は22例(52.4%)、子宮動脈塞栓術は9例(21.4%)に施行された。緊急産褥搬送された症例は、高率に輸血や外科的介入を要するため、個々の症例の病態や重症度に応じて、迅速に評価・判断を行い適切な治療を行う必要がある。母体救命のためには、前医および関連各科との円滑な連携体制、迅速な血液製剤輸血の準備、手術室の整備が必須であると考えられた。(著者抄録)

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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

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

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

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

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

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

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

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

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

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

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

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

Language：English Publisher：AMER PHYSIOLOGICAL SOC

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.

DOI： 10.1152/ajpendo.00167.2012

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

Language：English Publisher：ENDOCRINE SOC

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

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

Language：English Publisher：OKAYAMA UNIV MED SCHOOL

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.

A case of a pregnant woman expected to be infected with syphilis during pregnancy

MURAKAMI Yuko, INOUE Seiji, SAITO Masako, NOBUMOTO Etsuko, OKIMOTO Naoki, SEGAWA Tomonori, MASUYAMA Hisashi, HIRAMATSU Yuji, FUJIWARA Michihisa

60 ( 2 ) 341 - 344 2012.3

A case of twin pregnancy complicated with intrauterine fetal death caused by colon cancer

SAITO Masako, INOUE Seiji, KUBO Kotaro, KUROKAWA Haruna, NISHIDA Takeshi, HASEGAWA Toru, MITSUI Takashi, NOBUMOTO Etsuko, OKIMOTO Naoki, SEGAWA Tomonori, MASUYAMA Hisashi, HIRAMATSU Yuji

60 ( 2 ) 219 - 224 2012.3

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

Language：English Publisher：AMER PHYSIOLOGICAL SOC

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.

DOI： 10.1152/ajpendo.00548.2011

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

Language：English Publisher：ELSEVIER IRELAND LTD

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

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)

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

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

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)

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

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

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

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)

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

早田裕, 増山寿, 平松祐司

臨床婦人科産科 65 ( 2 ) 118 - 121 2011.2

Retinol-binding protein 4 and insulin resistance in preeclampsia

Hisashi Masuyama, Seiji Inoue, Yuji Hiramatsu

ENDOCRINE JOURNAL 58 ( 1 ) 47 - 53 2011.1

Language：English Publisher：JAPAN ENDOCRINE SOC

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.

DOI： 10.1507/endocrj.K10E-288

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.

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

－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

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

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

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

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

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

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

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

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

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

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

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

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

P1-15-7 当科で開発した周産期電子カルテシステムの現状(Group27 妊娠・分娩・産褥と社会2・胎児・新生児の病理,一般演題,第63回日本産婦人科学会学術講演会)

瀬川友功, 赤堀洋一郎, 岸本佳子, 沖本直輝, 井上誠司, 増山寿, 平松祐司

日本産科婦人科學會雜誌 63 ( 2 ) 547 - 547 2011

P1-16-11 妊娠中のインスリン抵抗性亢進への核内受容体Constitutive androstane receptorの関与(Group31 合併症妊娠2,一般演題,第63回日本産婦人科学会学術講演会)

増山寿, 平松祐司

日本産科婦人科學會雜誌 63 ( 2 ) 557 - 557 2011

P1-13-30 妊娠における血圧変動評価についての検討(Group23 妊娠・分娩・産褥の生理・病理6 PIH・他,一般演題,第63回日本産科婦人科学会学術講演会)

岸本佳子, 赤堀洋一郎, 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 ) 534 - 534 2011

P1-12-2 早産IUGRのEUGR(Extrauterine Growth Restriction)発症に対する子宮内環境の影響(Group18 妊娠・分娩・産褥の生理・病理1 早産,一般演題,第63回日本産科婦人科学会学術講演会)

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

日本産科婦人科學會雜誌 63 ( 2 ) 515 - 515 2011

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

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

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.

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

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

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.

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

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)

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)

A case of a pregnant woman with status epilepticus

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

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。

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

P2-73 子宮内胎児死亡(IUFD)を伴った常位胎盤早期剥離(早剥)の分娩方法に関する多施設共同研究(Group52 妊娠分娩産褥6,一般演題,第62回日本産科婦人科学会学術講演会)

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

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

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

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

瀬川友功, 増山寿, 平松祐司, 片山富博, 三好博史, 池上信夫, 住江正大, 岩部富夫, 青木昭和, 前田和寿, 牛越賢治郎, 堀玲子, 立石洋子, 三田尾賢, 水田正能, 伊庭敬子, 小國信嗣, 漆川敬治, 上田克憲, 佐村修, 早田桂, 洲脇尚子, 寺本秀樹, 野々垣多加史, 林和俊, 福家義雄, 竹内裕一郎, 高崎彰久, 佐世正勝, 中橋徳文, 赤木武文, 山中研二, 入江隆, 真鍋敦, 横山幹文, 藤原道久, 後賢, 澤崎隆, 竹中泰子, 池野慎治, 伊原直美, 河原義文, 上田敏子, 別宮史朗, 松島幸生, 江川美砂, 矢野秀明, 早田裕, 山本暖

日本産科婦人科學會雜誌 62 ( 2 ) 489 - 489 2010

P1-130 当科で経験した稀な遺伝性出血性末梢血管拡張症合併妊娠の3症例(Group16 合併症妊娠2,一般演題,第62回日本産科婦人科学会学術講演会)

早田裕, 岸本佳子, 赤堀洋一郎, 井上誠司, 増本由美, 瀬川友功, 増山寿, 平松祐司

日本産科婦人科學會雜誌 62 ( 2 ) 392 - 392 2010

P3-109 Oncostatin Mの核内受容体Constitutive androstane receptorを介した新生児黄疸への関与(Group111 胎児・新生児8,一般演題,第62回日本産科婦人科学会学術講演会)

増山寿, 中務日出輝, 平松祐司

日本産科婦人科學會雜誌 62 ( 2 ) 660 - 660 2010

P2-380 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(Group90 胎児・新生児6,一般演題,第62回日本産科婦人科学会学術講演会)

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

日本産科婦人科學會雜誌 62 ( 2 ) 591 - 591 2010

P1-312 早期新生児期に子宮は劇的に縮小する(Group38 胎児・新生児1,一般演題,第62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, 増本由美, 瀬川友功, 増山寿, 平松祐司

日本産科婦人科學會雜誌 62 ( 2 ) 452 - 452 2010

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

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

Language：English Publisher：ELSEVIER SCIENCE INC

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

Elevated level of serum retinol-binding protein 4 in pregnancy-induced hypertension

61 ( 6 ) 1251 - 1251 2009.6

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

Language：English Publisher：WILEY

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 < 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 < 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

P3-115 当科で経験した双胎妊娠の分娩方法に関する検討(Group91 多胎妊娠2,一般演題,第61回日本産科婦人科学会学術講演会)

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

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

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

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

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

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

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

瀬川友功, 丹羽家泰, 赤堀洋一郎, 中務日出輝, 井上誠司, 舛本明生, 住田由美, 増山寿, 平松祐司

日本産科婦人科學會雜誌 61 ( 2 ) 706 - 706 2009

P1-168 妊娠高血圧症候群の発症時期による血管新生関連因子の動態の相違とadipocytokineの関与(Group23 妊娠高血圧2,一般演題,第61回日本産科婦人科学会学術講演会)

増山寿, 中務日出輝, 赤堀洋一郎, 井上誠司, 舛本明生, 住田由美, 瀬川友功, 平松祐司

日本産科婦人科學會雜誌 61 ( 2 ) 502 - 502 2009

P1-161 妊娠高血圧症候群における胎盤でのプロラクチン発現について(Group22 妊娠高血圧1,一般演題,第61回日本産科婦人科学会学術講演会)

舛本明生, 赤堀洋一郎, 井上誠司, 住田由美, 瀬川友功, 増山寿, 平松祐司

日本産科婦人科學會雜誌 61 ( 2 ) 499 - 499 2009

P1-137 出生直後に外科的介入が必要と予想され,計画的分娩を行った先天性心疾患(CHD)の4例 : 心房間交通確認の重要性(Group18 胎児新生児1,一般演題,第61回日本産科婦人科学会学術講演会)

岸本佳子, 赤堀洋一郎, 松田美和, 井上誠司, 舛本明生, 住田由美, 瀬川友功, 増山寿, 平松祐司

日本産科婦人科學會雜誌 61 ( 2 ) 491 - 491 2009

微弱陣痛 (特集緊急対応の流れがわかる異常分娩の介助と助産師の役割)

増山寿, 平松祐司, 難波道子

ペリネイタル・ケア 27 ( 12 ) 1174 - 1178 2008.12

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, 中務日出輝, 井上誠司, 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 = Journal of Japan Society of Perinatal and Neonatal Medicine 44 ( 2 ) 301 - 301 2008.6

Circulating leptin and angiogenic factors in preeclampsia patients

Hideki Nakatsukasa, Hisashi Masuyama, Norio Takamoto, Yuji Hiramatsu

ENDOCRINE JOURNAL 55 ( 3 ) 565 - 573 2008.6

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

A case of fetal chyrothorax treated with thoracocentesis before delivery

75 ( 4 ) 493 - 497 2008

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

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

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

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

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

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

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

糖尿病と妊娠 8 43 - 48 2008

Relation between neonatal jaundice and oncostatin M, hepatocyte growth factor and soluble gp130 levels in umbilical cord

Hideki Nakatsukasa, Hisashi Masuyama, Yoichiro Akahori, Seiji Inoue, Akio Masumoto, Yuji Hiramatsu

ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA 87 ( 12 ) 1322 - 1328 2008

Language：English Publisher：TAYLOR & FRANCIS AS

Objectives. Oncostatin M (OSM), hepatocyte growth factor (HGF) and soluble glycoprotein 130 (sgp130) have been demonstrated to be involved in fetal liver development. In this study, we examined the relation between neonatal jaundice and OSM, gp130 or HGF levels in umbilical cord blood. Design. A cross-sectional study of 160 neonates born at Okayama University Hospital. Setting. Tertiary referral center serving a population of three million. Methods. The serum concentrations of OSM, HGF and sgp130 in umbilical venous cord blood were measured and compared with the clinical records of these neonates. Results. The HGF level was correlated to both gestational week (p=0.007) and birthweight (p=0.015), as well as to total bilirubin on Day 1 (p=0.032). In preterm neonates, the HGF levels were lower in neonates who received phototherapy (photo group) than in those who did not receive phototherapy (non-photo group) (p=0.002). In contrast, in term neonates, OSM levels were lower in the photo group than in the non-photo group (p=0.0003). Conclusions. These findings suggest that the phototherapy requirement for neonatal jaundice may be associated with lower umbilical HGF concentration in preterm neonates and with lower umbilical OSM concentration in term neonates.

DOI： 10.1080/00016340802468332

K2-2 新規インスリン感受性調節因子CNTF (ciliary neurotroohic factor)と妊娠中のインスリン抵抗性,特に妊娠高血圧症候群との関連(優秀演題賞候補演題1,高得点プログラム,第60回日本産科婦人科学会学術講演会)

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

赤堀洋一郎, 高本憲男, 中務日出揮, 井上誠司, 舛本明生, 増山寿, 平松祐司

日本産科婦人科學會雜誌 60 ( 2 ) 599 - 599 2008

P2-119 妊娠中におけるRetinol binding protein 4(RBP4)とインスリン抵抗性との関連性についての検討(Group48 合併症妊娠2,一般講演,第60回日本産科婦人科学会学術講演会)

井上誠司, 高本憲男, 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

日本産科婦人科學會雜誌 60 ( 2 ) 653 - 653 2008

P2-64 肥満妊婦のpreeclampsia発症へのadipocytokineの関与(Group 42 妊娠・分娩・産褥の生理5,一般講演,第60回産科婦人科学会学術講演会)

増山寿, 中務日出輝, 高木憲男, 平松祐司

日本産科婦人科學會雜誌 60 ( 2 ) 635 - 635 2008

P1-102 当科で経験したUAE後に妊娠に至った5症例についての検討(Group12 妊娠高血圧症候群1,一般演題,第60回日本産科婦人科学会学術講演会)

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, 野口聡一, 高本憲男, 増山寿, 平松祐司

日本産科婦人科學會雜誌 60 ( 2 ) 530 - 530 2008

P1-149 糖変動パターンによる絨毛細胞障害に関する研究(Group17 胎盤2,一般演題,第60回日本産科婦人科学会学術講演会)

舛本明生, 高本憲男, 赤堀洋一郎, 井上誠司, 中務日出輝, 住田由美, 瀬川友功, 増山寿, 平松祐司

日本産科婦人科學會雜誌 60 ( 2 ) 546 - 546 2008

P4-66 Oncostatin MとHGF(hepatic growth factor)の新生児黄疸への関与(Group101 合併症妊娠5,一般演題,第60回日本産科婦人科学会学術講演会)

中務日出輝, 増山寿, 赤堀洋一郎, 井上誠司, 舛本明生, 住田由美, 瀬川友功, 高本憲男, 平松祐司

日本産科婦人科學會雜誌 60 ( 2 ) 806 - 806 2008

Down-regulation of pregnane X receptor contributes to cell growth inhibition and apoptosis by anticancer agents in endometrial cancer cells

Hisashi Masuyama, Hideki Nakatsukasa, Norio Takamoto, Yuji Hiramatsu

MOLECULAR PHARMACOLOGY 72 ( 4 ) 1045 - 1053 2007.10

Language：English Publisher：AMER SOC PHARMACOLOGY EXPERIMENTAL THERAPEUTICS

Recent studies have revealed that pregnane X receptor (PXR) can function as a master regulator to control the expression of drug-metabolizing enzymes, cytochrome P450 3A (CYP3A) family, and members of the drug transporter family, including multiple drug resistance 1 (MDR1). We demonstrated previously that steroid/xenobiotic metabolism by tumor tissue through the PXR-CYP3A pathway might play an important role in endometrial cancer and that PXR ligands enhance PXR-mediated transcription in a ligand- and promoter-dependent fashion, leading to differential regulation of individual PXR targets, especially CYP3A4 and MDR1. In this study, we investigated the potential contribution of PXR down-regulation by RNA interference toward the augmentation of drug sensitivity and the overcoming of drug resistance. We observed the protein levels of both CYP3A4 and MDR1 in PXR small interfering RNA (siRNA)-transfected cells were not increased in the presence of PXR ligands, paclitaxel, cisplatin, estradiol, or medroxyprogesterone acetate (MPA) compared with control siRNA-transfected cells. There was no PXR-mediated transactivation or augmentation of transcription by coactivators in the presence of these ligands. We then found that PXR down-regulation caused a significant increase in cell growth inhibition and enhancement of apoptosis in the presence of the anticancer agents, paclitaxel, cisplatin, and MPA. Finally, we demonstrated that PXR overexpression caused a significant decrease in cell growth inhibition and inhibited apoptosis in the presence of paclitaxel or cisplatin. These data suggest that PXR down-regulation could be a novel therapeutic approach for the augmentation of sensitivity to anticancer agents, or to overcome resistance to them, in the treatment of endometrial cancer.

DOI： 10.1124/mol.107.037937

Correlation between soluble endoglin, vascular endothelial growth factor receptor-1, and adipocytokines in preeclampsia

Hisashi Masuyama, Hideki Nakatsukasa, Norio Takamoto, Yuji Hiramatsu

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM 92 ( 7 ) 2672 - 2679 2007.7

Language：English Publisher：ENDOCRINE SOC

Context: Recent reports have demonstrated that soluble endoglin (sEng), an antiangiogenic protein thought to impair TGF-beta binding to receptors, and soluble vascular endothelial growth factor receptor (sVEGFR)-1 play important roles in the pathophysiology of pre-eclampsia ( PE). Moreover, insulin resistance, which is greatly influenced by adipocytokines, characterizes PE.
Objectives: We examined possible links between sEng, VEGF, sVEGFR, and adipocytokines in the pathophysiology of PE.
Study Design: We performed a cross-sectional study in 30 PE patients and controls matched for gestational age and body mass index. Blood samples were collected soon after disease onset. We measured serum concentrations of leptin, adiponectin, sEng, VEGF, placental growth factor (PlGF), and sVEGFR [soluble fms-like tyrosine kinase 1 (sFlt-1) and soluble fetal liver kinase 1 (sFlk-1)], and examined the placental protein content of sEng and sFlt-1.
Results: sEng concentrations in PE patients (60.9 +/- 28.8 ng/ml) were significantly higher than those in controls (11.2 +/- 4.4 ng/ml). There was a significant correlation between sEng and sFlt-1 or PlGF. Moreover, there were significant differences in mean blood pressure between the high and low sEng groups, and in proteinuria between the high and low sFlt- 1 groups, and significant differences in placental sEng and sFlt- 1 contents between patients with and without severe hypertension or proteinuria. sEng was also correlated positively with adiponectin levels and negatively with the leptin to adiponectin ratio.
Conclusions: Along with sFlt-1 and PlGF, sEng might play a role in the pathophysiology of PE, especially in elevating blood pressure, while the association with hypoadiponectinemia and the high leptin to adiponectin ratio in pregnancy seem to be risk factors for PE.

DOI： 10.1210/jc.2006-2349

Expression and potential role of peroxisome proliferator-activated receptor gamma in the placenta of diabetic pregnancy

N. Suwaki, H. Masuyama, A. Masumoto, N. Takamoto, Y. Hiramatsu

PLACENTA 28 ( 4 ) 315 - 323 2007.4

Language：English Publisher：W B SAUNDERS CO LTD

Peroxisome proliferator-activated receptor gamma (PPAR gamma) is expressed predominantly in adipose tissue and is known to be involved in adipocyte differentiation and insulin sensitivity. Recent reports indicated that PPAR gamma-deficient mice were embryonic lethal due to abnormal placental development, suggesting that PPAR gamma plays an important role in normal development of placenta. On the other hand, expression of vascular endothelial growth factor (VEGF), the other important factor in placental development, has been demonstrated to be regulated by PPAR gamma in vascular smooth muscle cells. Also, diabetic pregnancy is often associated with defective placental functions. In order to investigate physiological roles of PPAR gamma and VEGF in placental development during diabetic pregnancy, we examined the expressions of PPAR gamma and VEGF in placentas, which were obtained from normal and streptozotocin-induced diabetic pregnant mouse, and studied in vitro effects of hyperglycemic condition and PPAR gamma ligands (rosiglitazone and 15-deoxy-delta(12,14)prostaglandin J(2)) on trophoblasts using human choriocarcinoma cell lines. In diabetic mouse placentas (n = 5), expressions of PPAR gimel and VEGF proteins significantly increased as compared with these in normal placenta (n = 3 or 4). In vitro studies indicated that hyperglycemic condition (42 mM) significantly enhanced the PPAR gamma expression and hCG production, and significantly suppressed cell proliferation, however these effects were attenuated by PPAR gamma ligands that accompanied with increased VEGF production. These data suggest that the PPAR gamma pathway might be involved in the impairment of placental development induced by high glucose conditions, and that VEGF might play some roles in this pathway. (c) 2006 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.placenta.2006.04.002

妊娠高血圧症候群と代謝異常

平松祐司, 増山寿, 洲脇尚子

周産期医学 37 ( 9 ) 1115 - 1120 2007

Elevated serum sFlt-1/Ang-2 ratio in women with preeclampsia

Kumiko Hirokoshi, Yohei Maeshima, Kazuko Kobayashi, Eiji Matsuura, Hitoshi Sugiyama, Yasushi Yamasaki, Hisashi Masuyama, Yuji Hiramatsu, Hirofumi Makino

NEPHRON CLINICAL PRACTICE 106 ( 1 ) C43 - C50 2007

Language：English Publisher：KARGER

Background: An imbalance of angiogenesis-associated factors may predispose to preeclampsia. Here, we determined the ratio of serum concentration of soluble fms-like tyrosine kinase 1 (sFlt-1), a natural inhibitor of pro-angiogenic vascular endothelial growth factor (VEGF) relative to angiopoietin-2 (Ang-2), a natural antagonist of angiopoietin-1 (Ang-1) involved in promoting angiogenesis in the presence of VEGF, in women with preeclampsia. Methods: The levels of serum sFlt-1 and Ang-2 were measured by enzyme-linked immunosorbent assay. Results: Significant decrease of serum Ang-2 and the increase of sFlt-1 were observed in women with preeclampsia as compared to healthy pregnant women. The serum sFlt-1/Ang-2 ratio was strikingly increased in preeclamptic women in contrast to healthy pregnant women exhibiting lower value similar to non-pregnant women. The serum sFlt1 concentrations tended to positively correlate with mean blood pressure (BP) in preeclamptic women, but not in healthy pregnant women. A cut-off value > 0.25 in the serum sFlt-1/Ang-2 ratio showed 87.1% sensitivity and 82.8% specificity in differentiating preeclamptic women from healthy pregnant women. Conclusion: The serum sFlt-1/Ang-2 ratio is significantly elevated in preeclamptic women as compared to healthy pregnant women. Remarkable difference of sFlt-1/Ang-2 ratio between these two groups with excellent specificity and sensitivity suggests the clinical usefulness of the serum sFlt-1/Ang-2 ratio in diagnosing and potentially predicting the onset of preeclampsia. Copyright (c) 2007 S. Karger AG, Basel.

DOI： 10.1159/000101483

P1-541 肥満妊娠高血圧症候群患者における血管増殖因子とadipocytokineの関与(Group67 妊娠高血圧症候群1,一般演題,第59回日本産科婦人科学会学術講演会)

わが国の周産期医療の現況と周産期オープンシステム

平松祐司, 増山寿, 野口聡一

岡山県母性衛生 23 25 - 26 2007

Gestational transient hyperthyroidismを伴ったMirror症候群の一例

井上誠司, 妹尾絵美, 住田由美, 瀬川友功, 高本憲男, 野口聡一, 増山寿, 平松祐司

日本周産期・新生児医学会雑誌 43 ( 4 ) 1079 - 1082 2007

産婦人科領域における止血のための動脈塞栓術

田村正明, 前林俊也, 正岡直樹, 山本樹生, 平松祐司, 三橋直樹, 福地剛, 増山寿, 寺尾泰久

産婦人科手術 ( 18 ) 171 - 174 2007

前回帝王切開後の前置胎盤と癒着胎盤に対する対処法

寺尾泰久, 竹田省, 木下勝之, 平松祐司, 三橋直樹, 福地剛, 正岡直樹, 増山寿

産婦人科手術 ( 18 ) 175 - 181 2007

糖尿病と胎盤

平松祐司, 洲脇尚子, 増山寿

産科と婦人科 74 ( 7 ) 829 - 834 2007

洲脇尚子, 増山寿, 赤堀洋一郎, 中務日出輝, 井上誠司, 舛本明生, 住田由美, 瀬川友功, 高本憲男, 平松祐司

日本産科婦人科學會雜誌 59 ( 2 ) 529 - 529 2007

P2-494 当科における産道GBS陽性妊婦の児の感染状況について(Group169 周産期感染症2,一般演題,第59回日本産婦人科学会学術講演会)

住田由美, 赤堀洋一郎, 井上誠司, 舛本明生, 洲脇尚子, 瀬川友功, 高本憲男, 野口聡一, 増山寿, 平松祐司

日本産科婦人科學會雜誌 59 ( 2 ) 728 - 728 2007

P1-95 子宮体癌におけるCOUP-TFIIの発現について(Group8 子宮体部腫瘍1,一般演題,第59回日本産科婦人科学会学術講演会)

赤堀洋一郎, 高本憲男, 中村圭一郎, 中務日出輝, 井上誠司, 舛本明生, 洲脇尚子, 住田由美, 瀬川友功, 増山寿, 平松祐司

日本産科婦人科學會雜誌 59 ( 2 ) 380 - 380 2007

Hypoadiponectinemia and circulating angiogenic factors in overweight patients complicated with pre-eclampsia

Naoko Suwaki, Hisashi Masuyama, Hideki Nakatsukasa, Akio Masumoto, Yumi Sumida, Norio Takamoto, Yuji Hiramatrsu

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 195 ( 6 ) 1687 - 1692 2006.12

Language：English Publisher：MOSBY-ELSEVIER

Objective: Obesity is a risk factor for pre-eclampsia, and adiponectin is an important adipocyte-derived hormone that might protect the endothelium. Recent reports have underlined importance of circulating angiogenic factors for pathophysiology of pre-eclampsia. Here we examined whether adiponectin in conjunction with angiogenic factors plays some roles in the pathophysiology of pre-eclampsia.
Study design: We measured serum concentrations of adiponectin and angiogenic factors, vascular endothelial growth factor, placental growth factor, and the soluble vascular endothelial growth factor receptors, soluble fins-like tyrosine Kinase 1 (sFlt-1) and soluble fetal liver kinase 1 (sFik-1), in women with pre-eclampsia and healthy pregnant women. We also investigated the differences of these factors in overweight and normal-weight patients with pre-eclampsia.
Results: Significant correlations were found among the circulating adiponectin and angiogenic factors placental growth factor (R = 0.772, P = .0012) and sFlt-1 (R = 0.787, P = .0005); while, no correlation was found between adiponectin and sFlk-1 (R = 0.3, P = .3434) in patients with pre-eclampsia. Overweight patients with pre-eclampsia showed significantly lower adiponectin levels and a mild imbalance of circulating angiogenic factors, compared with normal-weight patients with pre-eclampsia.
Conclusion: Overweight women with pre-eclampsia appeared to have lower levels of adiponectin and sFlt1 and higher levels of placental growth factor than women with pre-eclampsia who were of normal weight. These results suggest that hypoadiponectinemia might be involved in the pathophysiology of overweight patients with pre-eclampsia. (c) 2006 Mosby, Inc. All rights reserved.

DOI： 10.1016/j.ajog.2006.04.003

Parathyroid hormone-related protein as a potential tumor marker: A case report of ovarian clear cell carcinoma

N Suwaki, H Masuyama, Y Mizutani, J Kodama, Y Hiramatsu

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 32 ( 1 ) 94 - 98 2006.2

Language：English Publisher：BLACKWELL PUBLISHING

Hypercalcemia is one of the important paraneoplastic syndromes, mostly occurring in patients with advanced cancer. Clear cell carcinoma is known to be one of the most common histological subtypes of ovarian tumor associated with hypercalcemia. We present a case of ovarian clear cell carcinoma with hypercalcemia caused by elevated serum parathyroid hormone-related protein (PTHrP). PTHrP mRNA and protein were detected by reverse transcription-polymerase chain reaction and immunohistochemical analysis in the primary and metastasis lesions. Serum calcium and PTHrP levels returned to normal after antihypercalcemic treatment and a radical operation, but they elevated along with the recurrence. Because tumor markers such as carcinoembryonic antigen, carbohydrate antigen (CA)125 and CA19-9 were unstable owing to the patient's liver cirrhosis and were not reliable data for management, serum calcium and PTHrP levels are shown to have been a potential indicator of the recurrence in this case.

DOI： 10.1111/j.1447-0756.2006.00358.x

Circulating angiogenic factors in preeclampsia, gestational proteinuria, and preeclampsia superimposed on chronic glomerulonephritis

H Masuyama, N Suwaki, H Nakatsukasa, A Masumoto, Y Tateishi, Y Hiramatrsu

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 194 ( 2 ) 551 - 556 2006.2

Language：English Publisher：MOSBY, INC

Objective: Recently, reports have indicated that the imbalance of circulating angiogenic factors is important in the onset of preeclampsia. In this study we investigated angiogenic factor levels in women with preeclampsia, preeclampsia superimposed on chronic glomerulonephritis, gestational proteinuria, and normal pregnancies.
Study design: We measured several circulating angiogenic factors, placental growth factor, vascular endothelial growth factor, soluble fins-like tyrosine kinase-1, and soluble fetal liver kinase-1.
Results: Compared with women with normal pregnancies, placental growth factor concentrations were lower, and soluble fins-like tyrosine kinase 1 concentrations were higher in women with preeclampsia and gestational proteinuria; soluble fms-like tyrosine kinase I concentrations were also higher in women with preeclampsia superimposed on chronic glomerulonephritis.
Conclusion: There were obvious differences in the levels of circulating angiogenic factors placental growth factor and soluble fms-like tyrosine kinase I among preeclampsia, gestational proteinuria, and controls. The imbalance of angiogenic factors is important in the onset of preeclampsia superimposed on chronic glomerulonephritis. (c) 2006 Mosby, Inc. All rights reserved.

DOI： 10.1016/j.ajog.2005.08.034

Ubiquitin/Proteasome経路を介した核内受容体turnoverにおけるSuppressor for Gal-1の役割

増山寿

岡山医誌 117 ( 3 ) 205 - 209 2006

核内受容体Constitutive Androstane Receptor (CAR) の新生児黄疸発症機序への関与 .

中務日出輝, 増山寿, 舛本明生, 洲脇尚子, 瀬川友功, 住田由美, 立石洋子, 井下秀司, 高本憲男, 平松祐司

日本産科婦人科栄養・代謝研究会誌 2006

当科における羊水染色体検査とnuchal translucencyとの関連についての検討.

石濱陽子, 住田由美, 洲脇尚子, 井上誠司, 立石洋子, 瀬川友功, 井下秀司, 高本憲男, 野口聡一, 増山寿, 平松祐司

日本産科婦人科学会中国四国合同地方部会雑誌 2006

特集症例に学ぶ：糖尿病合併妊娠のpitfall 巨大児分娩反復例に合併した肩甲難産の1例.

住田由美, 舛本明生, 洲脇尚子, 井上誠司, 高本憲男, 増山寿, 平松祐司

産婦人科の実際 55 ( 8 ) 1219 - 1222 2006

巨大児分娩反復例に合併した肩甲難産の1例.

住田由美, 舛本明生, 洲脇尚子, 井上誠司, 高本憲男, 増山寿, 平松祐司

糖尿病と妊娠 55 ( 8 ) 1215 - 1218 2006

巨大児分娩反復例に合併した肩甲難産の１例

住田由美, 舛本明生, 洲脇尚子, 井上誠司, 高本憲男, 増山寿, 平松祐司

産婦実際 2006

妊娠時のインスリン抵抗性の評価

洲脇尚子, 舛本明生, 住田由美, 井上誠司, 高本憲男, 増山寿, 平松祐司

糖尿病と妊娠 2006

新しい核内受容体Pregnane X Receptorの生殖生理における役割と子宮体癌への関与

増山寿

第４回子宮内膜疾患研究会記録集 2006

IUGRにおける羊水量および胎児血流速度波形の計測の意義.

井上誠司, 増山寿, 舛本明生, 洲脇尚子, 住田由美, 立石洋子, 井下秀司, 高本憲男, 平松祐司

産婦人科の実際 55 ( 9 ) 1461 - 1466 2006

新しい核内受容体Pregnane X Receptorの生殖生理における役割

増山寿

産婦中四会誌 2006

潰瘍性大腸炎合併妊娠の検討

松尾環, 中村圭一郎, 舛本明生, 住田由美, 立石洋子, 井下秀司, 高本憲男, 増山寿, 平松祐司

産婦実際 2006

ワークショップ2：妊娠時のインスリン抵抗性の評価妊娠時のインスリン抵抗性の評価.

洲脇尚子, 舛本明生, 住田由美, 井上誠司, 高本憲男, 増山寿, 平松祐司

糖尿病と妊娠 6,1,76-79 2006

当科における羊水染色体検査とNuchal Translucencyとの関連性についての検討

石濱陽子, 住田由美, 洲脇尚子, 井上誠司, 立石洋子, 瀬川友功, 井下秀司, 高本憲男, 野口聡一, 増山寿, 平松祐司

産婦中四会誌 2006

第21回日本糖尿病・妊娠学会年次学術集会「医師、コメディカルから学生まで幅広い参加者」.

増山寿

プラクティス 23,2,226-227 2006

自己血輸血の適応，方法.

落合和彦, 星合昊, 平松祐司, 三橋直樹, 長田尚夫, 塩田充, 福地剛, 増山寿

産婦人科手術 ,17,149-152 2006

P1-545 肥満が妊娠高血圧症候群発症リスク因子となる磯序 : adiponectinの関与(Group 72 妊娠高血圧症候群II,一般演題,講演要旨,第58回日本産科婦人科学会学術講演会)

洲脇尚子, 増山寿, 舛本明生, 中務日出輝, 住田由美, 立石洋子, 井下秀司, 高本憲男, 平松祐司

日本産科婦人科學會雜誌 58 ( 2 ) 552 - 552 2006

P1-544 Preeclampsia, gestational proteinuria及び正常妊婦における母体血中の血管新生因子の検討(Group 72 妊娠高血圧症候群II,一般演題,講演要旨,第58回日本産科婦人科学会学術講演会)

増山寿, 中務日出輝, 舛本明生, 洲脇尚子, 住田由美, 立石洋子, 井下秀司, 高本憲男, 平松祐司

日本産科婦人科學會雜誌 58 ( 2 ) 552 - 552 2006

P2-440 当科における新生児神経学的予後の検討(Group 170 胎児・新生児XI,一般演題,講演要旨,第58回日本産科婦人科学会学術講演会)

立石洋子, 安達美和, 井上誠司, 松尾環, 住田由美, 井下秀司, 増山寿, 平松祐司, 宮木康成

日本産科婦人科學會雜誌 58 ( 2 ) 738 - 738 2006

P1-488 糖尿病マウスモデル胎盤におけるreceptor for advanced glycation endproduct (RAGE)の関与と胎仔発育(Group 64 合併症妊娠III,一般演題,講演要旨,第58回日本産科婦人科学会学術講演会)

舛本明生, 中務日出輝, 洲脇尚子, 瀬川友功, 住田由美, 立石洋子, 井下秀司, 高本憲男, 増山寿, 平松祐司

日本産科婦人科學會雜誌 58 ( 2 ) 533 - 533 2006

P1-600 出生前から房室弁逆流を認めた先天性心疾患の検討(Group 79 胎児・新生児VII,一般演題,講演要旨,第58回日本産科婦人科学会学術講演会)

井下秀司, 舛本明生, 松尾環, 洲脇尚子, 住田由美, 立石洋子, 増山寿, 平松祐司, 多田克彦

日本産科婦人科學會雜誌 58 ( 2 ) 570 - 570 2006

P2-442 核内受容体CARの新生児黄疸発症機序への関与(Group 170 胎児・新生児XI,一般演題,講演要旨,第58回日本産科婦人科学会学術講演会)

中務日出輝, 増山寿, 井上誠司, 舛本明生, 洲脇尚子, 住田由美, 瀬川友功, 立石洋子, 井下秀司, 高本憲男, 平松祐司

日本産科婦人科學會雜誌 58 ( 2 ) 739 - 739 2006

P1-345 Nuclear Orphan Receptor COUP-TFIIの雌生殖器系における機能(Group 46 生殖生理・病理IX,一般演題,講演要旨,第58回日本産科婦人科学会学術講演会)

高本憲男, 井上誠司, 舛本明生, 中務日出輝, 洲脇尚子, 増山寿, 平松祐司

日本産科婦人科學會雜誌 58 ( 2 ) 485 - 485 2006

Term delivery choriocarcinoma patient with brain and lung metastases successfully treated by etoposide, methotrexate, actomycin D, cyclophosphamide and vincristine (EMA-CO) chemotherapy

Y Hiramatsu, H Masuyama, M Ishida, K Murakami, M Sakurai

ACTA MEDICA OKAYAMA 59 ( 5 ) 235 - 238 2005.10

Language：English Publisher：OKAYAMA UNIV MED SCHOOL

It is well known that antecedent term delivery and metastasis to sites other than the lungs and vagina are high risk factors for patients with gestational trophoblastic neoplasia. Here we report on a patient with choriocarcinoma who presented with brain and lung metastases after term delivery and was treated by EMA-CO chemotherapy. A 31-year-old woman delivered a healthy infant at term. Frequent episodes of hemoptysis occurred beginning 3 weeks after the delivery. On admission to our hospital, she had lesions in the uterus, lungs and brain as well as motor aphasia and hemiplagia. The pretreatment beta-hCG level was 21,000 ng/ml and the WHO score was 16 (high-risk group). The EMA-CO regimen was administrated as first-line chemotherapy and the patient achieved complete remission after 7 courses. Treatment was terminated after 11 courses and maintained with etoposide (25 mg/day) for 6 months. The patient has remained in complete remission for more than 16 years without other adjuvant therapies. We believe that EMA-CO can currently be considered the regimen of first choice for most high-risk patients with gestational trophoblastic neoplasia in view of its effectiveness and excellent tolerability.

Increase of serum angiopoietin-2 during pregnancy is suppressed in women with preeclampsia

K Hirokoshi, Y Maeshima, K Kobayashi, E Matsuura, H Sugiyama, Y Yamasaki, H Masuyama, Y Hiramatsu, H Makino

AMERICAN JOURNAL OF HYPERTENSION 18 ( 9 ) 1181 - 1188 2005.9

Language：English Publisher：ELSEVIER SCIENCE INC

Background: Numerous recent reports demonstrated that changes in serum levels of angiogenesis-related factors were associated with preeclampsia. Here, we determined the serum concentration of angiopoietin-2 (Ang-2), a natural antagonist of angiopoietin-1 (Ang-1) involved in promoting angiogenesis in the presence of angiogenic stimuli such as vascular endothelial growth factor (VEGF), in women with preeclampsia.
Methods: The levels of serum Ang-2 and Tie-2, a receptor for Ang-1 expressed on endothelial cells, were determined by enzyme-linked immunosorbent assay.
Results: The concentrations of serum Ang-2 were significantly elevated in healthy pregnant women (18.9 ng/ mL) as compared to nonpregnant women or women in postpartum period. Increase in the levels of serum Ang-2 was significantly suppressed in preeclamptic women (4.5 ng/mL). The serum Ang-2 concentrations inversely correlated with gestational age in healthy pregnant women, but not in preeclamptic women. The serum Ang-2 concentrations positively correlated with placental weight or mean blood pressure (BP) in healthy pregnant women,but not in preeclamptic women. The serum Ang-2 concentrations inversely correlated with proteinuria in preeclamptic women. The serum concentrations of Tie-2 were riot significantly different between preeclamptic and nonpreeclamptic women.
Conclusions: These results suggest the potential requirement of circulating Ang-2 in proper formation of placental vasculatures during pregnancy. Although we cannot exclude the possibility that suppression in the increase of serum Ang-2 levels during pregnancy in preeclampsia as a consequence rather than a cause, measurement of serum Ang-2 concentration in pregnant women may serve as a useful marker in the diagnosis and potentially in predicting subsequent development of preeclampsia.

DOI： 10.1016/j.amjhyper.2005.03.745

INCREASE OF SERUM ANGIOPOIETIN-2 DURING PREGNANCY IS AMELIORATED IN WOMEN WITH PREECLAMPSIA

Kumiko Hirokoshi, Yohei Maeshima, Hitoshi Sugiyama, Yasushi Yamasaki, Hirofumi Makino, Kazuko Kobayashi, Eiji Matsuura, Hisashi Masuyama, Yuji Hiramatsu

NEPHROLOGY 10 A103 - A103 2005.6

The pregnane X receptor regulates gene expression in a ligand- and promoter-selective fashion

H Masuyama, N Suwaki, Y Tateishi, H Nakatsukasa, T Segawa, Y Hiramatsu

MOLECULAR ENDOCRINOLOGY 19 ( 5 ) 1170 - 1180 2005.5

Language：English Publisher：ENDOCRINE SOC

Recent studies have revealed that pregnane X receptor (PXR) can function as a master regulator to control the expression of phase I and phase II drug-metabolizing enzymes, as well as members of the drug transporter family, including multiple drug resistance (MDR) 1, which has a major role in multidrug resistance. Previously, we have demonstrated that steroid/xenobiotics metabolism by tumor tissue through the PXR-cytochrome P-450 3A (CYP3A) pathway might play an important role in endometrial cancer. In this study, we examined which endocrine-disrupting chemicals (EDCs) and anticancer agents might be ligands for PXR and whether these chemicals enhanced PXR-mediated transcription through two different PXR-responsive elements (PXREs), CYP3A4 and MDR1, in endometrial cancer cell lines. Some steroids/EDCs strongly activated PXR-mediated transcription through the CYP3A4-responsive element compared with the MDR1-responsive element, whereas these steroids/EDCs also enhanced the CYP3A4 expression compared with the MDR1 expression. In contrast, the anticancer agents, cisplatin and paclitaxel, strongly activated PXR-mediated transcription through the MDR1-responsive element compared with the CYP3A4-responsive element, whereas these drugs also enhanced the MDR1 expression compared with the CYP3A4 expression. We also analyzed how these ligands regulated PXR-mediated transcription through two different PXREs. In the presence of PXR ligands, there was no difference in the DNA binding affinity of the PXR/retinoid X recptor heterodimer to each PXRE, but there were different interactions of the coactivator to each PXR/PXRE complex. These data suggested that PXR ligands enhanced PXR-mediated transcription in a ligand- and promoter-dependent fashion, which in turn differentially regulated the expression of individual PXR targets, especially CYP3A4 and MDR1.

DOI： 10.1210/me.2004-0434

脳出血を伴ったRPLS(reversible posterior leukoencephalopathy syndrome)を呈した分娩子癇の一症例.

IV.異常分娩２．難産２）胎勢異常・回旋異常・肩甲難産.

平松祐司, 舛本明生, 高本憲男, 増山寿

産科と婦人科 72,11,1573-1579 2005

糖尿病合併妊娠の胎盤形成におけるperoxisome proliferator activated receptor γの役割 .

洲脇尚子, 増山寿, 舛本明生, 平松祐司

糖尿病と妊娠 2005

25歳未満の妊婦に対するGDMスクリーニングの必要性についての検討.

住田由美, 洲脇尚子, 清水恵子, 増山寿, 平松祐司, 丹羽国泰, 小国信嗣

日本産科婦人科学会中国四国合同地方部会雑誌 2005

井上誠司, 清水恵子, 舛本明生, 洲脇尚子, 住田由美, 立石洋子, 井下秀司, 増山寿, 平松祐司

産婦人科の実際 54 ( 6 ) 995 - 999 2005

糖尿病合併妊娠における胎盤発育不全とPeroxisome Proliferator-Activated Receptor(PPAR)γ.

洲脇尚子, 増山寿, 舛本明生, 立石洋子, 水谷靖司, 平松祐司

日本産科婦人科栄養・代謝研究会誌 2005

新しい核内受容体PXRを介したステロイドホルモン・Xenobiotics代謝調節機構 .

増山寿, 中務日出輝, 舛本明生, 洲脇尚子, 瀬川友巧, 立石洋子, 井下秀司, 水谷靖司, 平松祐司

日本産科婦人科栄養・代謝研究会誌 2005

精神病合併妊娠における周産期管理.

立石洋子, 増山寿, 平松祐司

産婦人科の実際 54 ( 1 ) 145 - 149 2005

妊娠31週に急性腹症にて発症した既往帝王切開妊婦の子宮破裂の一症例.

舛本明生, 中務日出輝, 洲脇尚子, 瀬川友功, 住田由美, 立石洋子, 井下秀司, 増山寿, 水谷靖司, 平松祐司

日本産科婦人科学会中国四国合同地方部会雑誌 2005

尿路合併症の予防と対応.

平松祐司, 増山寿, 水谷靖司

産婦人科手術 16,13-20 2005

絨毛膜羊膜炎とその対策.

増山寿, 立石洋子, 平松祐司

産婦人科治療 90,増,673-677 ( 1 ) 11 - 16 2005

海外文献から－血清中の血管新生因子と妊娠高血圧腎症のリスク－.

増山寿

産婦人科の実際 54,3,440 2005

血液製剤の種類と使用上の注意点.

増山寿, 平松祐司, 福地剛, 塩田充, 落合和彦, 長田尚夫, 三橋直樹, 星合昊

産婦人科手術 16,120-124 2005

新しい核内受容体Pregnane X Receptorの生殖生理における役割－岡山大学医学賞（林原賞）を受賞して－.

増山寿

岡山医学会雑誌 116,,215-220 2005

透析妊婦、既往腎移植妊婦の管理.

平松祐司, 舛本明生, 高本憲男, 増山寿

産婦人科の実際 54,8,1191-1196 2005

Heavy-for-date (HFD) 児出生と耐糖能異常の関連についての検討(合併症妊娠III, 第57回日本産科婦人科学会学術講演会)

住田由美, 舛本明生, 洲脇尚子, 清水恵子, 立石洋子, 井下秀司, 増山寿, 水谷靖司, 平松祐司, 小国信嗣, 丹羽国泰

日本産科婦人科學會雜誌 57 ( 2 ) 737 - 737 2005

子宮体癌における新しい薬物耐性機構の解明(子宮体部悪性腫瘍IX, 第57回日本産科婦人科学会学術講演会)

増山寿, 中務日出輝, 洲脇尚子, 立石洋子, 瀬川友功, 井下秀司, 水谷靖司, 平松祐司

日本産科婦人科學會雜誌 57 ( 2 ) 607 - 607 2005

潰瘍性大腸炎合併妊娠の検討(合併症妊娠V, 第57回日本産科婦人科学会学術講演会)

松尾環, 井上誠司, 舛本明生, 住田由美, 立石洋子, 井下秀司, 増山寿, 水谷靖司, 平松祐司

日本産科婦人科學會雜誌 57 ( 2 ) 742 - 742 2005

Peroxisome proliferator-activated receptorγ ligand は糖尿病合併妊娠における胎盤機能不全を改善する(合併症妊娠III, 第57回日本産科婦人科学会学術講演会)

洲脇尚子, 増山寿, 舛本明生, 立石洋子, 井下秀司, 水谷靖司, 平松祐司

日本産科婦人科學會雜誌 57 ( 2 ) 737 - 737 2005

糖尿病マウス胎仔での奇形の発生における終末糖化産物 (AGE) の関与(胎児・新生児VIII, 第57回日本産科婦人科学会)

舛本明生, 洲脇尚子, 立石洋子, 井下秀司, 増山寿, 水谷靖司, 平松祐司

日本産科婦人科學會雜誌 57 ( 2 ) 705 - 705 2005

099 低出生体重児を出産した母親への分娩直後の援助(妊娠、分娩、産褥20)(第45回日本母性衛生学会総会学術集会)

大井伸子, 増山寿, 新田明子, 松井たみこ

母性衛生 45 ( 3 ) 127 - 127 2004.9

Involvement of suppressor for Gal 1 in the ubiquitin/proteasome-mediated degradation of estrogen receptors

H Masuyama, Y Hiramatsu

JOURNAL OF BIOLOGICAL CHEMISTRY 279 ( 13 ) 12020 - 12026 2004.3

Language：English Publisher：AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC

The proteasome-mediated pathway involves the degradation of several nuclear receptors. Previously we demonstrated that the interaction between the suppressor for Gal 1 (SUG1) and nuclear receptors, the vitamin D receptor, or the pregnane X receptor was involved in proteasome-mediated degradation. In our recent experiments, we examined the potential role of SUG1 in the proteasome-mediated degradation of estrogen receptors (ER)alpha and - beta. Both ERs interacted with SUG1 in a ligand-dependent manner. Functionally, the overexpression of SUG1 inhibited both ERalpha- and ERbeta-mediated transcription in the presence of ligands. Transient expression studies demonstrated that the overexpression of wildtype SUG1 generated proteolytic fragments of both ERs and that these products were blocked by a proteasome inhibitor. The overexpression of SUG1 also enhanced the formation of ubiquitinated proteins of both ERs in the presence of ligand. On the other hand, bisphenol A (BSA), which activated ER-mediated transcription, did not enhance the interaction between ERbeta and SUG1. Furthermore, the degradation of ERbeta was much slower in the presence of BSA than in the presence of estradiol or phthalate, which is another endocrine-disrupting chemical. Also, BSA had no effect on the formation of proteolytic fragments of ERbeta, and neither did it have any effect on the ubiquitination of ERbeta. These findings indicate that the ubiquitin/proteasome-mediated degradation of both ER proteins may involve the interaction of SUG1 with both ERs. Moreover, BSA strongly blocked the ubiquitination and degradation of ERbeta compared with estradiol, suggesting that BSA may affect the ERbeta-mediated transcription of target genes by inhibiting ERbeta degradation.

DOI： 10.1074/jbc.M312762200

正常及び糖尿病マウス胎盤におけるPeroxisome Proliferator Activated Receptor(PPAR)γとVascular endotherial growth factor(VEGF)の発現に関する検討.

Proteasomeを介した核内受容体turnoverとsuppressor for gal-1(SUG1).

増山寿, 井下秀司, 瀬川友功, 洲脇尚子, 水谷靖司, 平松祐司

日本産科婦人科栄養・代謝研究会誌 2004

特発性血小板減少性紫斑病（ITP）合併妊娠

平松祐司, 洲脇尚子, 増山寿

産婦人科の実際 53,9,1349-1358 2004

＜林原賞受賞講演＞Expression and Potential Roles of Pregnane X Receptor in Endometrial Cancer.

増山寿

岡山医学会雑誌 116,,191 2004

術中体位と術後血栓予防について－アンケート調査報告－

長田尚夫, 落合和彦, 塩田充, 滝澤憲, 平松祐司, 福地剛, 増山寿, 三橋直樹, 星合昊

産婦人科手術 15,129-134 2004

人工真皮の種類と人工造膣術への応用

平松祐司, 三橋直樹, 長田尚夫, 落合和彦, 滝澤憲, 福地剛, 塩田充, 増山寿, 星合昊

産婦人科手術 15,123-128 2004

妊娠29週に急性発症したI 型糖尿病の一症例.

舛本明生, 洲脇尚子, 井下秀司, 増山寿, 水谷靖司, 平松祐司, 野田清史, 森巍

日本産科婦人科栄養・代謝研究会誌 2004

超音波検査にて診断し得た副胎盤を伴う前置血管の1症例.

清水恵子, 住田由美, 増山寿, 平松祐司, 小国信嗣

日本産科婦人科学会中国四国合同地方部会雑誌 2004

当科における胎児腔水症・胎児水腫症例の検討.

増山寿, 赤堀洋一郎, 井下秀司, 舛本明生, 洲脇尚子, 石井恵子, 住田由美, 立石洋子, 水谷靖司, 平松祐司

産婦人科の実際 53 ( 12 ) 1939 - 1944 2004

腎疾患合併妊娠におけるsuperimposed preeclampsia症例の検討.

増山寿, 舛本明生, 中務日出輝, 水谷靖司, 澤井倫子, 岸本廉夫, 守屋聡子, 江尻孝平, 平松祐司

日本妊娠高血圧学会雑誌 2004

洲脇尚子, 増山寿, 舛本明生, 井下秀司, 水谷靖司, 平松祐司

日本産科婦人科栄養・代謝研究会誌 55 ( 2 ) 456 - 456 2004

26-26.子宮におけるBisphenol Aの新たなエストロゲン様作用機序の検討(第128群生殖生理・病理16)(一般演題)

井下秀司, 増山寿, 洲脇尚子, 舛本明生, 立石洋子, 瀬川友功, 水谷靖司, 平松祐司

日本産科婦人科學會雜誌 56 ( 2 ) 636 - 636 2004

住田由美, 舛本明生, 洲脇尚子, 石井恵子, 立石洋子, 井下秀司, 増山寿, 水谷靖司, 平松祐司, 丹羽国泰, 小国信嗣

日本産科婦人科學會雜誌 56 ( 2 ) 484 - 484 2004

23-14.治療前に深部静脈血栓,肺塞栓を合併した婦人科腫瘍症例の臨床的検討(第111群その他の良性・悪性腫瘍3)(一般演題)

水谷清司, 藤原美佐保, 舛本明生, 洲脇尚子, 井下秀司, 倉本博行, 中村圭一郎, 本郷淳司, 増山寿, 児玉順一, 平松祐司

日本産科婦人科學會雜誌 56 ( 2 ) 601 - 601 2004

29-28.脳出血を伴ったReversible posterior leukoencephalopathy syndromeを呈した分娩子癇の一例(第144群妊娠・分娩・産褥期27)(一般演題)

井上誠司, 増山寿, 井下秀司, 舛本明生, 洲脇尚子, 石井恵子, 住田由美, 立石洋子, 藤原美佐保, 水谷靖司, 平松祐司

日本産科婦人科學會雜誌 56 ( 2 ) 670 - 670 2004

31-26.正常及び糖尿病合併妊娠におけるPeroxisome Proliferator Activated Receptor(PPAR)γとVascular Endotherial Growth Factor(VEGF)の胎盤形成及び分化への影響(第155群妊娠・分娩・産褥期38)(一般演題)

洲脇尚子, 増山寿, 舛本明生, 立石洋子, 井下秀司, 水谷靖司, 平松祐司

日本産科婦人科學會雜誌 56 ( 2 ) 694 - 694 2004

3-22.Pregnane X Receptorの子宮体癌における発現とその役割(第10群子宮体部悪性腫瘍3)(一般演題)

増山寿, 児玉順一, 水谷靖司, 平松祐司

日本産科婦人科學會雜誌 56 ( 2 ) 364 - 364 2004

The different effects of endocrine-disrupting chemicals on estrogen receptor-mediated transcription through interaction with coactivator TRAP220 in uterine tissue

H Inoshita, H Masuyama, Y Hiramatsu

JOURNAL OF MOLECULAR ENDOCRINOLOGY 31 ( 3 ) 551 - 561 2003.12

Language：English Publisher：SOC ENDOCRINOLOGY

An endocrine-disrupting chemical (EDC) can alter endocrine functions through a variety of mechanisms, including nuclear receptor-mediated changes in protein synthesis, interference with membrane receptor binding, steroidogenesis or synthesis of other hormones. Although major chemicals have been shown to disrupt estrogenic actions mainly through their binding to estrogen receptor (ER) or androgen receptor, it is not clear how EDCs affect endocrine functions in vivo. We present evidence that the EDCs bisphenol A and phthalate activate ER-mediated transcription through interaction with TRAP220. Moreover, bisphenol A had positive effects on the interaction between ER-beta and TRAP220 and on the expression of ER-beta and TRAP220 compared with phthalate and estradiol in uterine tissue. These data suggested that some EDCs might alter endocrine function through the change of the receptor and coactivator levels in uterine tissue and through the different effect on the interaction between ERs and coactivator TRAP220.

DOI： 10.1677/jme.0.0310551

Expression and potential roles of pregnane X receptor in endometrial cancer

H Masuyama, Y Hiramatsu, JI Kodama, T Kudo

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM 88 ( 9 ) 4446 - 4454 2003.9

Language：English Publisher：ENDOCRINE SOC

Estrogen has been shown to contribute greatly to growth and development in endometrial cancer. And recent research has suggested that intratumoral production of estrogen may play important roles in this cancer tissue. On the other hand, pregnane X receptor (PXR), a new member of nuclear receptors, has been shown to mediate the genomic effects of steroid hormones, including estrogen and xenobiotics. And this receptor is thought to regulate the expression of the cytochrome P-450 3A (CYP3A) gene family, which plays important roles in the metabolism of endogenous steroids and xenobiotics. Various levels of PXR expression were found in endometrial cancer tissues but not normal tissues. Tissues showing high PXR expression showed significantly high expression of CYP3A4/7 and low expression of estrogen receptor (ER) compared with levels in tissues showing low PXR expression. In endometrial cancer cell lines, HEC-1 cells, which express high PXR and low ER and progesterone receptor, show a stronger transcriptional response of the PXR-CYP3A pathway to the PXR ligands, especially endocrine-disrupting chemical, than do Ishikawa cells. These data suggest that the steroid/xenobiotics metabolism in the tumor tissue through PXR-CYP3A pathway might play an important role, especially in alternative pathway for gonadal hormone and endocrine-disrupting chemical effects on endometrial cancer expressing low ERalpha.

DOI： 10.1210/jc.2003-030203

Prediction markers for respiratory distress syndrome: Evaluation of the stable microbubble test, surfactant protein-A and hepatocyte growth factor levels in amniotic fluid

K Kumazawa, Y Hiramatsu, H Masuyama, Y Mizutani, T Nakata, T Kudo

ACTA MEDICA OKAYAMA 57 ( 1 ) 25 - 32 2003.2

Language：English Publisher：OKAYAMA UNIV MED SCHOOL

Surfactant treatment in infants with respiratory distress syndrome (RDS) has decreased neonatal mortality. With the advent of this therapy, it has become important to predict accurately the fetal lung maturity of a fetus before delivery. We evaluated the stable microbubble test (SMT), surfactant protein-A (SP-A) and hepatocyte growth factor (HGF) in amniotic fluid as predicting markers for RDS. Of 55 amniotic fluid samples obtained by amniocentesis from women less than 37 weeks pregnant, the SMT values were as follows: sensitivity 76.5%, specificity 84.2%, positive predictive value 68.4%, negative predictive value 88.9% and overall accuracy 81.8%. For SP-A, the values were 88.2%, 65.8%, 53.6%, 92.6% and 72.7%, respectively. If we used both SMT and SP-A, we could diagnose with 100% accuracy that a case with measurements of SMT greater than or equal to2 and SP-A greater than or equal to420 ng/ml would not complicate with RDS (24/24). However, the RDS diagnostic accuracy of HGF does not equal to those of SMT and SP-A levels. We concluded that the rapidity, simplicity and reliability of SMT was very useful during 24-36 weeks of gestation as a bedside procedure to predict fetuses likely to develop RDS. We also noted the additive effect of SP-A in improving the accuracy of lung maturity diagnosis.

DOI： 10.18926/AMO/32843

全血流動性の測定は術後血栓症の早期診断に有用か(第118群悪性腫瘍全般6)

進行子宮腫瘍手術における逆行性子宮全摘術および内腸骨動脈結紮術の応用

平松祐司, 水谷靖司, 増山寿, 舛本明生, 洲脇尚子, 藤原美佐保, 井下秀司, 工藤尚文

産婦人科手術 2003

当科における血小板減少症23症例の検討

洲脇尚子, 平松祐司, 増山寿, 工藤尚文

産婦人科の実際 2003

環境ホルモン作用の分子機構

増山寿, 平松祐司

産婦人科の実際 52,13,2343-2351 2003

子宮内胎児発育遅延（IUGR)の治療

増山寿, 工藤尚文

産婦人科治療 86,増,485-489 2003

プレグナンXレセプター ━新しいステロイド・Xenobiotics代謝調節機構━

増山寿

医学のあゆみ 204,13,964-968 2003

異常妊娠・合併症妊娠の管理 preterm PROM ー治療法の選択ー

増山寿, 井下秀司, 平松祐司

産婦人科の実際 52,12,1841-1848 2003

環境ホルモンと核内受容体

増山寿, 平松祐司

岡山医学会雑誌 115,,161-164 2003

水谷靖司, 藤原美佐保, 増山寿, 井下秀司, 洲脇尚子, 児玉順一, 平松祐司, 工藤尚文

日本産科婦人科學會雜誌 55 ( 2 ) 400 - 400 2003

Proteasomeを介した核内受容体turnoverとsuppressor for gal-1(第96群生殖生理・病理12)

増山寿, 平松祐司, 井下秀司, 瀬川友功, 洲脇尚子, 水谷靖司, 工藤尚文

日本産科婦人科學會雜誌 55 ( 2 ) 357 - 357 2003

Inhibition of placental ornithine decarboxylase by DL-alpha-difluoro-methyl ornithine causes fetal growth restriction in rat

M Ishida, Y Hiramatsu, H Masuyama, Y Mizutani, T Kudo

LIFE SCIENCES 70 ( 12 ) 1395 - 1405 2002.2

Language：English Publisher：PERGAMON-ELSEVIER SCIENCE LTD

The roles of polyamines in intrauterine growth restriction (IUGR) is studied. The DL-alpha-difluoromethyl ornithine (DFMO), an irreversible inhibitor of ornithine decarboxylase (ODC) which is a rate limiting enzyme of polyamine synthesis was administrated to pregnant rats so that we obtained rat fetuses with IUGR. The changes of maternal nutrition, damage of the placenta, and the direct effect of DFMO on the fetus were examined in this IUGR model. Administration of DFMO did not induced changes of maternal nutrition except for triglyceride and the fetal metabolic state. But the placental weight, ODC activity, and DNA in the placenta were decreased significantly. The ODC activity in the total placenta decreased to less than 10 % of that of the control. Depression of ODC activity in the placenta may be the major cause of IUGR induced by DFMO administration, and polyamines play important roles to carry pregnancy. (C) 2002 Elsevier Science Inc. All rights reserved.

DOI： 10.1016/S0024-3205(01)01510-7

Inhibition of placental ornithine decarboxylase by DL-alpha-difluoro-methyl ornithine causes fetal growth restriction in rat

M Ishida, Y Hiramatsu, H Masuyama, Y Mizutani, T Kudo

LIFE SCIENCES 70 ( 12 ) 1395 - 1405 2002.2

Language：English Publisher：PERGAMON-ELSEVIER SCIENCE LTD

DOI： 10.1016/S0024-3205(01)01510-7

Ligands have various potential effects on the degradation of pregnane X receptor by proteasome

H Masuyama, H Inoshita, Y Hiramatsu, T Kudo

ENDOCRINOLOGY 143 ( 1 ) 55 - 61 2002.1

Language：English Publisher：ENDOCRINE SOC

The degradations of several nuclear receptors are involved in the proteasome-mediated pathway. In our recent experiments, we found that mouse pregnane X receptor (PXR) interacted with suppressor for gall (SUG1), a component of the proteasome, in a progesterone-dependent manner, but that endocrine-disrupting chemicals (EDCs), phthalic acid and nonylphenol, which activated PXR-mediated transcription, did not enhance this interaction. PXR protein levels were markedly increased in the presence of proteasome inhibitors, suggesting that PXR may be degraded by proteasome. Furthermore, in the absence of ongoing protein synthesis, there is much slower degradation of PXR in the presence of phthalic acid compared with that in the presence of progesterone. The sion of wild-type SUG1 generated proteolytic PXR fragments, and these productions were blocked by a proteasome inhibitor. Functionally, expression of SUG1 inhibited PXR- and progesterone-mediated transcription. Moreover, in the presence of EDCs, SUG1 had no effect on the transcription. These findings indicate that the interaction between PXR and SUG1 may be involved in the proteasome-mediated degradation. Moreover, an EDC strongly blocks the degradation of PXR compared with progesterone, suggesting that EDCs may affect PXR-mediated transcription of target genes through up-regulation of the PXR protein level.

DOI： 10.1210/en.143.1.55

高度蛋白尿をともない急性発症した遅発型重症妊娠中毒症の１症例

産科大出血とその処置

増山寿, 熊澤一真, 工藤尚文

産婦人科治療 84,,695-700 2002

産科医・助産婦の初期・生涯研修環境―山陽・山陰圏の周産期医療の課題―

増山寿, 工藤尚文

産婦人科の世界 2002

平松祐司, 早田桂, 藤原美佐保, 石井恵子, 井下秀司, 熊澤一真, 増山寿, 工藤尚文, 杉山斉, 槇野博史, 佐藤靖

産婦人科の実際 51 ( 10 ) 1461 - 1464 2002

Paclitaxel投与時の筋肉痛・関節痛に対する芍薬甘草湯，L-Glutamineの効果

長谷川幸清, 水谷靖司, 倉本博行, 長尾昌二, 増山寿, 本郷淳司, 児玉順一, 吉野内光夫, 平松祐司, 工藤尚文, 奥田博之

癌と化学療法 29 569 - 574 2002

妊娠時、および帝王切開時の子宮筋腫核出術

平松祐司, 増山寿, 水谷靖司, 洲脇尚子, 工藤尚文

日本生殖外科学会雑誌 2002

妊娠糖尿病管理上の問題点

藤原美佐保, 平松祐司, 水谷靖司, 増山寿, 工藤尚文

日本産科婦人科学会中国四国合同地方部会雑誌 2002

116 Diacylglycerol(DAG)-Protein Kinase C(PKC)cascade異常とdiabetic embryopathy

平松祐司, 増山寿, 水谷靖司, 工藤尚文

日本産科婦人科學會雜誌 54 ( 2 ) 281 - 281 2002

P-523 Parathyroid Hormone-related Protein(PTHrP)が腫瘍マーカーとして有用であった卵巣明細胞癌の一例

洲脇尚子, 増山寿, 水谷靖司, 児玉順一, 平松祐司, 工藤尚文

日本産科婦人科學會雜誌 54 ( 2 ) 561 - 561 2002

Coexistence of Graves' disease and struma ovarii: Case report and literature review

Y Mimura, M Kishida, H Masuyama, N Suwaki, J Kodama, F Otsuka, H Kataoka, T Yamauchi, T Ogura, T Kudo, H Makino

ENDOCRINE JOURNAL 48 ( 2 ) 255 - 260 2001.4

Language：English Publishing type：Book review, literature introduction, etc. Publisher：JAPAN ENDOCRINE SOCIETY

We report a rare case of Graves' disease associated with struma ovarii. A 26-year-old Japanese woman had preexisting Graves' disease and was positive for TSH receptor antibody. She had been on antithyroid medication at presentation. She noted a mass in the lower left abdomen, which was diagnosed as a left struma ovarii by radiological work-up including computed tomography, magnetic resonance imaging and scintigraphy. The surgically excised teratomatous tumor, containing cystic spaces with thyroid tissue, was histologically proved to be struma ovarii. Since thyroid function tests and TSH receptor antibody did not change after surgery, her hyperthyroidism was considered to be due to Graves' disease. Our case was diagnosed as struma ovarii before surgery using various imaging studies.

DOI： 10.1507/endocrj.48.255

The expression of pregnane X receptor and its target gene, cytochrome P450 3A1, in perinatal mouse

H Masuyama, Y Hiramatsu, Y Mizutani, H Inoshita, T Kudo

MOLECULAR AND CELLULAR ENDOCRINOLOGY 172 ( 1-2 ) 47 - 56 2001.2

Language：English Publisher：ELSEVIER SCI IRELAND LTD

Recently, pregnane X receptor (PXR) has been described to mediate the genomic effects of several steroid hormones, such as progesterone (P), glucocorticoid (Dex), pregnenolone (Preg), and xenobiotics through the cytochrome P-450 3A gene family (CYP3A), which are monooxygenases, responsible for the oxidative metabolism of some endogenous substrates and xenobiotics. In the present study, we used a transient transfection reporter gene expression assay of COS-7 cells to demonstrate that P, Dex and Preg significantly stimulate PXR-mediated transcription at relatively high concentration comparable with that of progesterone near term pregnancy. In yeast two-hybrid protein interaction assay, PXR interacted with nuclear receptor coactivator proteins, SRC1, RIP140, and SUGI in a ligand-dependent manner. The expression of PXR mRNA was observed in the liver, intestine, uterus, ovary and placenta. The expressions of PXR mRNA in the liver and ovary increased towards term about fifty-fold compared with that of non-pregnancy and decreased postpartum. Its expression in the placenta was not drastically changed towards term. CYP3A, a target gene of PXR, was also expressed in the liver, ovary, and placenta. The expressions of CYP3A mRNA as well as PXR in the liver and ovary increased about 20-fold during prenatal period. These data suggest: that PXR may play certain roles in perinatal period, possibly in the protection of the feto-maternal system from the toxic effect of endogenous steroids and foreign substrates. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.

DOI： 10.1016/S0303-7207(00)00395-6

新しい核内受容体であるPregnane X Receptorの妊娠中及び内分泌撹乱作用における役割

子宮破裂

熊澤一真, 増山寿, 工藤尚文

周産期医学 31,増,249-250 2001

妊婦の栄養・食事指導の実際：貧血妊婦

工藤尚文, 増山寿

周産期医学 31,2,243-247 2001

新しいステロイド・Xenobitotics代謝調節機構の解明

増山寿, 井下秀司, 国富衛, 水谷靖司, 平松祐司, 工藤尚文

産婦人科治療 82,1,103 2001

新しい核内受容体 pregnane X receptor(PXR)

増山寿, 平松祐司, 工藤尚文

HORMONE FRONTIER IN GYNECOLOGY 8,4,365-372 2001

増山寿, 工藤尚文

生活と環境 46,5,43-48 ( 5 ) 43 - 48 2001

Effect of Retinoids on Fetal Lung Development in the Rat,

H.Masuyama, Y.Hiramatsu, T.Kudo

Biol Neonate 2001

子宮内反症

熊澤一真, 増山寿, 工藤尚文

周産期医学 31,増,247-248 2001

397 内分泌撹乱物質のProteasomeを介したPregnane X Receptor turnoverに及ぼす影響

増山寿, 井下秀司, 国富衛, 中田高公, 水谷靖司, 平松祐司, 工藤尚文

日本産科婦人科學會雜誌 53 ( 2 ) 357 - 357 2001

妊娠中の新しいステロイドホルモン代謝調節機構の解明

増山寿, 井下秀司, 国富衛, 中田高公, 水谷靖司, 平松祐司, 工藤尚文

日本産科婦人科栄養・代謝研究会誌 2001

妊娠糖尿病スクリーニングにおける肥満妊婦の特性と診断効率改善に関する検討

深井佳恵, 平松祐司, 水谷靖司, 大橋美佐保, 増山寿, 工藤尚文, 小国信嗣, 小国美種, 大本裕之, 吉田信隆

日本産科婦人科栄養・代謝研究会誌 2001

Streptozotocin-induced diabetic pregnant rats exhibit signs and symptoms mimicking preeclampsia

G Ishihara, Y Hiramatsu, H Masuyama, T Kudo

METABOLISM-CLINICAL AND EXPERIMENTAL 49 ( 7 ) 853 - 857 2000.7

Language：English Publisher：W B SAUNDERS CO-ELSEVIER INC

The number of patients with hypertension, obesity, diabetes, and hyperlipidemia is increasing. This tendency is observed in pregnant women, in whom many obstetrical and perinatal complications occur. The prevention of these abnormalities is important in reducing perinatal mortality and the risk of coronary disease. We established a pregnant rat model with diabetes and signs and symptoms mimicking preeclampsia. On day 6 of pregnancy, streptozotocin (STZ) or citrate buffer was injected into the tail vein, After STZ administration, plasma glucose was increased within 48 hours and sustained at a high level until day 20 of pregnancy, and plasma insulin was decreased. Fetuses from STZ-treated mothers were growth-restricted, and plasma glucose was 6-fold higher in fetuses of STZ-treated versus control rats. The systolic blood pressure, urinary protein, and hematocrit were increased significantly in STZ-treated rats. Total cholesterol and triglycerides were also elevated in STZ-treated rats, but plasma leptin levels were decreased. The STZ-induced diabetic pregnant rat model exhibited preeclampsia, hemoconcentration, hyperlipidemia, hypoleptinemia, and intrauterine growth restriction. This model closely mimics the features of human pregnancy complicated by diabetes and is useful for the basic study of the pathophysiology of pregnancy with diabetes. Copyright (C) 2000 by W.B. Saunders Company.

DOI： 10.1053/meta.2000.6750

Endocrine disrupting chemicals, phthalic acid and nonylphenol, activate Pregnane X receptor-mediated transcription

H Masuyama, Y Hiramatsu, M Kunitomi, T Kudo, PN MacDonald

MOLECULAR ENDOCRINOLOGY 14 ( 3 ) 421 - 428 2000.3

Language：English Publisher：ENDOCRINE SOC

Recently, Pregnane X receptor (PXR), a new member of the nuclear receptor superfamily, was shown to mediate the effects of several steroid hormones, such as progesterone, glucocorticoid, pregnenolone, and xenobiotics on cytochrome P450 3A genes (CYP3A) through the specific DNA sequence for CYP3A, suggesting that PXR may play a role in steroid hormone metabolism. In this paper, we demonstrated that phthalic acid and nonylphenol, endocrine-disrupting chemicals (EDCs), stimulated PXR-mediated transcription at concentrations comparable to those at which they activate estrogen receptor-mediated transcription using a transient reporter gene expression assay in COS-7 cells. However, bisphenol A, another EDC, had no effect on PXR-mediated transcription, although this chemical significantly enhanced ER-mediated transcription. In the yeast two-hybrid protein interaction assay, PXR interacted with two nuclear receptor coactivator proteins, steroid hormone receptor coactivator-1 and receptor interacting protein 140, in the presence of phthalic acid or nonylphenol. Thus, EDC-occupied PXR may regulate its specific gene expression through the receptor-coactivator interaction. In contrast, these EDCs had no effect on the interaction between PXR and suppressor for gal 1, a component of proteasome. Finally, the expression of CYP3A1 mRNA in the liver of rats exposed to phthalic acid or nonylphenol markedly increased compared with that in rats treated with estradiol, bisphenol A, or ethanol as assessed by competitive RT-PCR. These data suggest that EDCs may affect endocrine functions by altering steroid hormone metabolism through PXR.

DOI： 10.1210/me.14.3.421

Heavy-for-date infants: Their backgrounds and relationship with gestational diabetes

Yuji Hiramatsu, Hisashi Masuyama, Yasushi Mizutani, Takafumi Kudo, Nobutugu Oguni, Yoshitane Oguni

Journal of Obstetrics and Gynaecology Research 26 ( 3 ) 193 - 198 2000

Language：English Publisher：University of Tokyo Press

Objective: Gestational diabetes (GDM) is closely related to birth weight. Heavy-for-date (HFD) infants, especially those with macrosomia, cause many perinatal complications. This study was performed to examine the backgrounds of HFD infants and to determine such infants' relationship with GDM. Method: Eighty cases of HFD infants who were delivered from 1996 through 1998 were analyzed, The random blood-glucose level was used for screening for GDM. Results: Maternal body weight and the body-mass index before pregnancy and at delivery and the blood glucose level at the second trimester were positively correlated with birth weight. However, only 8.8% of HFD cases were detected by this screening method in the first trimester, and 11.3% of HFD cases were detected in the second trimester and only 1 case of borderline-type was detected by subsequent 75-g OGTT. Conclusions: Maternal obesity is an independent and more important risk factor for HFD infants than glucose intolerance.

DOI： 10.1111/j.1447-0756.2000.tb01310.x

Endocrine disrupting chemicals, phthalic acid and nonylphenol, activate Pregnane X receptor-mediated transcription

Hisashi Masuyama, Yuji Hiramatsu, Mamoru Kunitomi, Takafumi Kudo, Paul N. MacDonald

Molecular Endocrinology 14 ( 3 ) 421 - 428 2000

Language：English Publisher：Endocrine Society

DOI： 10.1210/mend.14.3.0424

Endocrine disrupting chemicals, phthalic acid and nonylphenol, activate Pregnane X receptor-mediated transcription

Hisashi Masuyama, Yuji Hiramatsu, Mamoru Kunitomi, Takafumi Kudo, Paul N. MacDonald

Molecular Endocrinology 14 ( 3 ) 421 - 428 2000

Language：English Publisher：Endocrine Society

DOI： 10.1210/mend.14.3.0424

Streptozotocin-induced diabetic pregnant rats exhibit signs and symptoms mimicking preeclampsia

Go Ishihara, Yuji Hiramatsu, Hisashi Masuyama, Takafumi Kudo

Metabolism: Clinical and Experimental 49 ( 7 ) 853 - 857 2000

Language：English Publisher：W.B. Saunders

The number of patients with hypertension, obesity, diabetes, and hyperlipidemia is increasing. This tendency is observed in pregnant women, in whom many obstetrical and perinatal complications occur. The prevention of these abnormalities is important in reducing perinatal mortality and the risk of coronary disease. We established a pregnant rat model with diabetes and signs and symptoms mimicking preeclampsia. On day 6 of pregnancy, streptozotocin (STZ) or citrate buffer was injected into the tail vein. After STZ administration, plasma glucose was increased within 48 hours and sustained at a high level until day 20 of pregnancy, and plasma insulin was decreased. Fetuses from STZ-treated mothers were growth-restricted, and plasma glucose was 6-fold higher in fetuses of STZ-treated versus control rats. The systolic blood pressure, urinary protein, and hematocrit were increased significantly in STZ-treated rats. Total cholesterol and triglycerides were also elevated in STZ-treated rats, but plasma leptin levels were decreased. The STZ-induced diabetic pregnant rat model exhibited preeclampsia, hemoconcentration, hyperlipidemia, hypoleptinemia, and intrauterine growth restriction. This model closely mimics the features of human pregnancy complicated by diabetes and is useful for the basic study of the pathophysiology of pregnancy with diabetes. Copyright (C) 2000 by W.B. Saunders Company.

DOI： 10.1053/meta.2000.6750

★101 内分泌攪乱物質のPregnane X Receptorを介したステロイド代謝に及ぼす影響

増山寿, 井下秀司, 国富衛, 水谷靖司, 平松祐司, 工藤尚文

日本産科婦人科學會雜誌 52 ( 2 ) "260(S - 184)" 2000

P-495 肥満妊婦における妊娠糖尿病スクリーニングはいかに行うべきか?

深井佳恵, 平松祐司, 大橋美佐保, 熊澤一真, 中田高公, 増山寿, 水谷靖司, 工藤尚文, 小国信嗣, 小国美種, 大本裕之, 吉田信隆

日本産科婦人科學會雜誌 52 ( 2 ) "537(S - 461)" 2000

P-262 収縮能および拡張能を連合させた超音波ドプラ指標による心機能評価法であるTei indexの胎児における正常値と各種病態における有用性

多田克彦, 中田高公, 大橋美佐保, 橋本一真, 熊澤一真, 増山寿, 中塚幹也, 工藤尚文

日本産科婦人科學會雜誌 52 ( 2 ) "460(S - 384)" 2000

超低出生体重児のwell-beingの評価法一胎児心拍数図および胎児血流計測値と分娩時臍帯動脈血ガス分析値との関係一

多田克彦, 工藤尚文, 中田高公, 橋本一郎, 熊澤一真, 増山寿, 中塚幹也

産婦人科の世界 2000

本態性血小板血症合併妊娠の1症例

舛本明生, 増山寿, 橋本一郎, 熊澤一真, 高田雅代, 中田高公, 中塚幹也, 水谷靖司, 多田克彦, 平松祐司, 工藤尚文

日本産科婦人科学会中国四国合同地方部会雑誌 2000

Changes in the Aortic and Pulmonary Diameters in a Fetus with Hypoplastic Left Heart Syndrome

TADA Katsuhiko, YAMADA Satoshi, KUMAZAWA Kazumasa, TAKATA Masayo, NAKATA Takakimi, MASUYAMA Hisashi, NAKATSUKA Mikiya, KUDO Takafumi, OTSUKI Shin-ichi

26 ( 12 ) 1211 - 1216 1999.12

排卵、妊娠、産褥期におけるビタミンD代謝について

上村茂仁, 田淵和久, 伊藤裕徳, 増山寿, 水谷靖司, 中塚幹也, 平松祐司, 工藤尚文

日本骨代謝学会雑誌 = Japanese journal of bone metabolism 17 ( 2 ) 280 - 280 1999.6

産婦人科手術におけるバイポーラシザースの応用

水谷靖司, 平松祐司, 増山寿, 上村茂仁, 児玉順一, 小橋勇二, 奥田博之, 工藤尚文

産婦人科手術 10: 117-123 1999

312 新しい核内レセプター, Pregnane X receptor (PXR)の解析とその発現

増山寿, 国富衛, 上村茂仁, 水谷靖司, 平松祐司, 工藤尚文

日本産科婦人科學會雜誌 51 "S - 290" 1999

P-207 妊娠糖尿病のスクリーニング法に関する検討 : どのような妊婦に必ずスクリーニングすべきか

大橋美佐保, 平松祐司, 石原剛, 増山寿, 水谷靖司, 上村茂仁, 工藤尚文, 小国信嗣, 小国美種, 松岡巌, 関正明, 今井香里

日本産科婦人科學會雜誌 51 "S - 463" 1999

P-175 排卵,妊娠,産褥期におけるビタミンD代謝機構について.

上村茂仁, 平松祐司, 国富衛, 伊藤裕徳, 増山寿, 水谷靖司, 中塚幹也, 工藤尚文

日本産科婦人科學會雜誌 51 "S - 447" 1999

P-439 周術期の凝固線溶能からみた術後血栓症予防に対するヘパリンの至適投与法について

水谷靖司, 小橋勇二, 児玉順一, 楠本知行, 増山寿, 上村茂仁, 平松祐司, 奥田博之, 工藤尚文

日本産科婦人科學會雜誌 51 "S - 578" 1999

Proteasome-mediated degradation of the vitamin D receptor (VDR) and a putative role for SUG1 interaction with the AF-2 domain of VDR

H Masuyama, PN MacDonald

JOURNAL OF CELLULAR BIOCHEMISTRY 71 ( 3 ) 429 - 440 1998.12

Language：English Publisher：WILEY-LISS

The AF-2 helix of nuclear receptors is essential for ligand-activated transcription, and it may function to couple the receptor to transcriptional coactivator proteins. This domain also contacts components of the proteasome machinery, suggesting that nuclear receptors may be targets for proteasome-mediated proteolysis. In the present study, we demonstrate that mSUG1 (P45), a component of the 26S proteasome, interacts in a 1,25-(OH)(2)D-3-dependent manner with the AF-2 domain of the vitamin D receptor (VDR). Furthermore, treatment of ROS 17/2.8 osteosarcoma cells with the proteasome inhibitors MG132 or beta-lactone increased steady-state levels of the VDR protein. In the presence cycloheximide (10 mu g/ml), the liganded VDR protein was degraded with a half-life of approximately 8 h, and this rate of degradation was completely blocked by 0.05 mM MG132. The role of SUG1-VDR interaction in this process was investigated in transient expression studies. Overexpression of wild-type mSUG1 in ROS17/2.8 cells generated a novel proteolytic VDR fragment of approximately 50 kDa, and its production was blocked by proteasome inhibitors or by a nonhydrolyzable ATP analog. Parallel studies with SUG1 (K196H), a mutant that does not interact with the VDR, did not produce the 50 kDa VDR fragment. Functionally, expression of SUG1 in a VDR-responsive reporter gene assay resulted in a profound inhibition of 1,25-(OH)(2)D-3-activated transcription, while expression of SUG1(K196H) had no significant effect in this system. These data show that the AF-2 domain of VDR interacts with SUG1 ina 1,25-(OH)(2)D-3-dependent fashion and that this interaction may target VDR to proteasome-mediated degradation as a means to downregulate the 1,25-(OH)(2)D-3-activated transcriptional response. J. Cell. Biochem. 71 :429-440, 1998. (C) 1998 Wiley-Liss, Inc.

DOI： 10.1002/(SICI)1097-4644(19981201)71:3<429::AID-JCB11>3.0.CO;2-P

Proteasome を介した Vitamin D receptor (VDR) 分解と VDR-Suppressor for gal 1 (SUG1) 結合

増山寿, MACDONALD Paul N, 国富衛, 伊藤裕徳, 上村茂仁, 水谷靖司, 平松祐司, 工藤尚文

日本骨代謝学会雑誌 = Japanese journal of bone metabolism 16 ( 2 ) 75 - 75 1998.7

閉経女性のビタミンD1α位水酸化酵素活性について

上村茂仁, 伊藤裕徳, 国富衛, 増山寿, 水谷靖司, 平松祐司, 工藤尚文

日本骨代謝学会雑誌 = Japanese journal of bone metabolism 16 ( 2 ) 277 - 277 1998.7

原発性無月経患者の皮質骨量に関する検討

国富衛, 上村茂仁, 増山寿, 水谷靖司, 木村吉宏, 伊藤裕徳, 中塚幹也, 平松祐司, 工藤尚文

日本骨形態計測学会雑誌 = Journal of Japanese Society of Bone Morphometry 8 ( 2 ) S54 1998.6

ビタミンＤ製剤の有効性

上村茂仁, 増山寿, 平松祐司, 工藤尚文

薬の知識 49:266-267 1998

194 胎仔発育におけるポリアミンの役割に関する研究

石田理, 平松祐司, 西井英, 中田高公, 増山寿, 水谷靖司, 上村茂仁, 工藤尚文

日本産科婦人科學會雜誌 50 "S - 220" 1998

145 妊娠中毒症における末梢血単球ビタミンD代謝について

伊藤裕徳, 上村茂仁, 国富衛, 増山寿, 水谷靖司, 平松祐司, 工藤尚文

日本産科婦人科學會雜誌 50 "S - 196" 1998

Evidence for ligand-dependent intramolecular folding of the AF-2 domain in vitamin D receptor-activated transcription and coactivator interaction

H Masuyama, CM Brownfield, R StArnaud, PN MacDonald

MOLECULAR ENDOCRINOLOGY 11 ( 10 ) 1507 - 1517 1997.9

Language：English Publisher：ENDOCRINE SOC

A ligand-dependent transcriptional activation domain (AF-2) exists in region E of the nuclear receptors. This highly conserved domain may contact several coactivators that are putatively involved in nuclear receptor-mediated transcription. In this study, a panel of vitamin D receptor (VDR) AF-2 mutants was created to examine the importance of several conserved residues in VDR-activated transcription. Two AF-2 mutants (L417S and E420Q) exhibited normal ligand binding, heterodimerization with retinoid X receptor, and vitamin D-responsive element interaction, but they were transcriptionally inactive in a VDR-responsive reporter gene assay. All AF-2 mutations that abolished VDR-mediated transactivation also eliminated interactions between VDR and several putative coactivator proteins including suppressor of gall (SUG1), steroid hormone receptor coactivator-1 (SRC-1), or receptor interacting protein (RIP140), suggesting that coactivator interaction is important for AF-5-mediated transcription. In support of this concept, the minimal AF-2 domain [VDR(408- 427] fused to the gal4 DNA binding domain was sufficient to mediate transactivation as well as interaction with putative coactivators. Introducing the L417S and E420Q mutations into the minimal AF-2 domain abolished this autonomous transactivation and coactivator interactions. Finally, we demonstrate that the minimal AF-2 domain interacted with an AF-2 deletion mutant of the VDR in a 1,25-(OH)(2)D-3-dependent manner, suggesting a ligand-induced intramolecular folding of the VDR AF-2 domain. The L417S mutant of this domain disrupted the interaction with VDR ligand-binding domain, while the E420Q mutant did not affect this interaction. These studies suggest that the conserved AF-2 motif may mediate transactivation through ligand-dependent intermolecular interaction with coactivators and through ligand-induced intramolecular contacts with the VDR ligand-binding domain itself.

DOI： 10.1210/me.11.10.1507

The N-terminal domain of transcription factor IIB is required for direct interaction with the vitamin D receptor and participates in vitamin D-mediated transcription

H Masuyama, SC Jefcoat, PN MacDonald

MOLECULAR ENDOCRINOLOGY 11 ( 2 ) 218 - 228 1997.2

Language：English Publisher：ENDOCRINE SOC

The interaction of the vitamin D receptor (VDR) with transcription factor IIB (TFIIB) represents a potential physical link between the VDR-DNA complex and the transcription preinitiation complex. However, the functional relevance of the VDR-TFIIB interaction in vitamin D-mediated transcription is not well understood. In the present study, we used site-directed mutagenesis to demonstrate that the structural integrity of the amino-terminal zinc finger of TFIIB is essential for VDR-TFIIB complex formation. Altering the putative zinc-coordinating residues (C15, C34, C37, or H18) to serines abolished TFIIB interaction with the VDR as assessed in a yeast two-hybrid system and by in vitro protein interaction assays. This N-terminal, VDR-interactive domain functioned as a selective, dominant-negative inhibitor of vitamin D-mediated transcription. Expressing amino acids 1-124 of human TFIIB (N-TFIIB) in COS-7 cells or in osteoblastic ROS17/2.8 cells effectively suppressed 1,25-dihydroxyvitamin D-3 (1,25-(OH)(2)D-3)-induced transcription, but had no effect on basal or glucocorticoid-activated transcription. A mutant N-terminal domain [N-TFIIB(C34S:C37S)] that does not interact with VDR had no impact on 1,25(OH)(2)D-3-induced transcription. Interestingly, both in vitro and in vivo protein interaction assays showed that the VDR-TFIIB protein complex was disrupted by the 1,25-(OH)(2)D-3 ligand. Mechanistically, these data establish a functional role for the N terminus of TFIIB in VDR-mediated transcription, and they allude to a role for unliganded VDR in targeting TFIIB to the promoter regions of vitamin D-responsive target genes.

DOI： 10.1210/me.11.2.218