研究者詳細 - 平沢　晃

論文 - 平沢　晃

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遺伝性腫瘍領域の新たな潮流

平沢晃, 青木大輔

実験医学 34 ( 16 ) 2671 - 2674 2016年10月

婦人科悪性腫瘍に脳梗塞を合併したTrousseau症候群5例の検討

沖山愛, 山上亘, 坂井健良, 真壁健, 二宮委美, 野村弘行, 片岡史夫, 平沢晃, 阪埜浩司, 進伸幸, 青木大輔

日本婦人科腫瘍学会雑誌 34 ( 4 ) 620 - 625 2016年10月

記述言語：日本語出版者・発行元：(公社)日本婦人科腫瘍学会

Trousseau症候群は悪性腫瘍に伴う血液凝固線溶異常により血栓塞栓症を生じる病態であり、進行例が多く予後不良である。当科でも2006〜2014年に5例の脳梗塞を発症したTrousseau症候群を経験した。年齢の中央値は63歳(54〜69歳)で、合併悪性腫瘍は子宮体癌2例、卵巣癌2例、子宮頸癌1例であり、組織型は類内膜腺癌2例、漿液性腺癌2例、扁平上皮癌1例であった。4例は進行再発癌、1例は早期癌であった。病態はいずれも多発脳梗塞によるものであり、脳出血の症例はなかった。感染性心内膜炎との鑑別に難渋した進行再発例の1例を除く全症例でヘパリンナトリウムによる抗凝固療法を開始したが、手術不能な進行再発癌の4例は原疾患の治療が奏効せず、発症後約2ヵ月以内に死亡した。手術で腫瘍を完全摘出できた早期の卵巣癌の1例は予後良好であり、手術可能な症例では原疾患の摘除により予後改善の可能性があることが示唆された。(著者抄録)

J-GLOBAL

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Symptoms and effects of physical factors in Japanese middle-aged women. 国際誌

Megumi Yokota, Kazuya Makita, Akira Hirasawa, Takashi Iwata, Daisuke Aoki

Menopause (New York, N.Y.) 23 ( 9 ) 974 - 83 2016年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Lippincott Williams and Wilkins

OBJECTIVE: The aim of the study was to clarify the prevalence and severity rates of symptoms and investigate whether symptoms varied in relation to body mass index (BMI). METHODS: The study group composed of 1,969 women, aged 40 to 60 years, who presented at our department from 1993 through 2014. The participation rate was 98%. The presence or absence of symptoms was evaluated by having the participants complete the Keio Questionnaire, a self-administered questionnaire. To allow the results to be compared according to ovarian function, serum levels of follicle-stimulating hormone and estradiol were measured. Participants were classified into three groups according to BMI: underweight, normal weight, and overweight. Symptoms were also compared among these subgroups. RESULTS: The most common symptom was general fatigue. Vasomotor symptoms differed significantly between pre- and postmenopause status. When symptoms were analyzed according to BMI, the severity rates of the following symptoms were significantly higher in the overweight group than in the normal weight and underweight groups: hot flushes, sweats, joint pain, numbness, and incontinence. On the contrary, the underweight group had significantly higher severities of cold constitution, nervousness, and wrinkled skin than did the other groups. In addition, an increase in BMI was associated with an increased severity of vasomotor symptoms. CONCLUSIONS: The prevalence and severities of shoulder stiffness, considered a characteristic symptom in Japanese women, were high. Increased BMI was shown to be associated with a higher severity of vasomotor symptoms, joint pain, nervousness, and urinary symptoms.

DOI： 10.1097/GME.0000000000000660

Scopus

PubMed

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Symptoms and effects of physical factors in Japanese middle-aged women 査読

Megumi Yokota, Kazuya Makita, Akira Hirasawa, Takashi Iwata, Daisuke Aoki

MENOPAUSE-THE JOURNAL OF THE NORTH AMERICAN MENOPAUSE SOCIETY 23 ( 9 ) 974 - 983 2016年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS

Objective:The aim of the study was to clarify the prevalence and severity rates of symptoms and investigate whether symptoms varied in relation to body mass index (BMI).Methods:The study group composed of 1,969 women, aged 40 to 60 years, who presented at our department from 1993 through 2014. The participation rate was 98%. The presence or absence of symptoms was evaluated by having the participants complete the Keio Questionnaire, a self-administered questionnaire. To allow the results to be compared according to ovarian function, serum levels of follicle-stimulating hormone and estradiol were measured. Participants were classified into three groups according to BMI: underweight, normal weight, and overweight. Symptoms were also compared among these subgroups.Results:The most common symptom was general fatigue. Vasomotor symptoms differed significantly between pre- and postmenopause status. When symptoms were analyzed according to BMI, the severity rates of the following symptoms were significantly higher in the overweight group than in the normal weight and underweight groups: hot flushes, sweats, joint pain, numbness, and incontinence. On the contrary, the underweight group had significantly higher severities of cold constitution, nervousness, and wrinkled skin than did the other groups. In addition, an increase in BMI was associated with an increased severity of vasomotor symptoms.Conclusions:The prevalence and severities of shoulder stiffness, considered a characteristic symptom in Japanese women, were high. Increased BMI was shown to be associated with a higher severity of vasomotor symptoms, joint pain, nervousness, and urinary symptoms.

DOI： 10.1097/GME.0000000000000660

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Retrospective Analysis on the Feasibility and Efficacy of Docetaxel-Cisplatin Therapy for Recurrent Endometrial Cancer. 国際誌

Tomomi Ninomiya, Wataru Yamagami, Nobuyuki Susumu, Takeshi Makabe, Kensuke Sakai, Michiko Wada, Aya Takigawa, Tatsuyuki Chiyoda, Hiroyuki Nomura, Fumio Kataoka, Akira Hirasawa, Kouji Banno, Daisuke Aoki

Anticancer research 36 ( 4 ) 1751 - 8 2016年4月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：INT INST ANTICANCER RESEARCH

AIM: There is poor evidence regarding effective treatment for recurrent endometrial cancer. We treated patients with recurrent endometrial cancer with docetaxel-cisplatin (DP) therapy as second-line or third-line chemotherapy. We aimed to evaluate the feasibility and efficacy of DP therapy for patients with recurrent endometrial cancer. PATIENT AND METHODS: We included 26 patients diagnosed with recurrent endometrial cancer, who underwent DP chemotherapy at our Institution. Docetaxel at 70 mg/m(2)and cisplatin at 60 mg/m(2)were administered by intravenous injection every 3 weeks. We retrospectively analyzed the clinicopathological factors associated with the response rate (RR) and prognosis. We also analyzed the adverse effects of DP therapy. RESULTS: Median follow-up was 33.8 months and the median number of therapy cycles was six. Grade 3 or 4 adverse effects included leukopenia (66%), neutropenia (81%), anemia (9%), diarrhea (12%), general fatigue (12%), liver dysfunction (4%), peripheral neuropathy (4%), and hyponatremia (4%). RR was 58% and the median progression-free survival (PFS) was 7.5 months. The group with a treatment-free interval of 6 months or more tended to have better PFS than that with less than 6 months (p=0.01). The group with a platinum-free interval of 6 months or more had significantly better PFS than that with less than 6 months (p=0.09). Although the history of taxane usage was not relevant to prognosis, a taxane-free interval of 12 months or more was associated with a tendency for better PFS (p=0.06). CONCLUSION: DP therapy was fully feasible and demonstrated efficacy for patients with recurrent endometrial cancer.

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PubMed

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婦人科疾患における自覚症状としての「冷え」,疾患単位としての「冷え症」の合併頻度についての検討

渡辺賢治, 堀場裕子, 吉野鉄大, 平沢晃, 牧田和也, 横田めぐみ, 岩田卓, 青木大輔

日本産科婦人科学会雑誌 68 ( 2 ) 677 - 677 2016年2月

遺伝性乳がん卵巣がんに対するリスク低減卵管卵巣摘出術と術後ヘルスケア

横田めぐみ, 平沢晃, 堀場裕子, 岩田卓, 牧田和也, 青木大輔

更年期と加齢のヘルスケア 14 ( 2 ) 316 - 318 2016年2月

Factors affecting pregnancy outcomes in young women treated with fertility-preserving therapy for well-differentiated endometrial cancer or atypical endometrial hyperplasia. 査読国際誌

Osamu Inoue, Toshio Hamatani, Nobuyuki Susumu, Wataru Yamagami, Seiji Ogawa, Takashi Takemoto, Akira Hirasawa, Kouji Banno, Naoaki Kuji, Mamoru Tanaka, Daisuke Aoki

Reproductive biology and endocrinology : RB&E 14 ( 1 ) 2 - 2 2016年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：BIOMED CENTRAL LTD

BACKGROUND: Patients hoping to preserve their fertility receive conservative treatment with high-dose medroxyprogesterone acetate (MPA) for well-differentiated endometrioid adenocarcinoma (EC) or atypical endometrial hyperplasia (AEH) . Such treatment generally involves frequent intrauterine operations, including dilation and curettage (D&C) and endometrial biopsy (EMB), which could result in endometritis, endometrial thinning, or intrauterine adhesion. In turn, any of these outcomes could adversely affect implantation and pregnancy development. The current study thus aimed to identify factors that might affect pregnancy following conservative treatment by MPA. METHODS: We compared a pregnancy group (45 patients) with a non-pregnancy group (53 patients) of MPA-treated patients to evaluate the factors affecting clinical pregnancy establishment. We undertook a multivariate logistic regression analysis based on factors shown by univariate analysis to be significantly different between the groups. Univariate analysis identified number of D&C, endometrial thickness, duration of MPA administration, age of pregnancy permission (the age at which a patient was first allowed to attempt pregnancy after disappearance of the lesion), period of disappearance of lesions, and recurrence as independent variables. RESULTS: The odds ratios (95 % confidence interval) of multivariate analysis for disease recurrence, endometrial thickness during ovulation, and age of pregnancy permission were 0.283 (0.102-0.785), 1.677 (1.251-2.248), and 0.889 (0.792-0.998), respectively. There was no significant difference in the other independent variables between groups. CONCLUSIONS: We identified three factors considered to affect pregnancy establishment following conservative treatment with MPA: recurrence, endometrial thickness during ovulation, and the age of the pregnancy permission. Introduction of infertility treatment including assisted reproductive technology (ART) soon after achieving tumor disappearance by MPA would therefore be beneficial for patients with disease recurrence, thin endometrium, or a higher age of pregnancy permission.

DOI： 10.1186/s12958-015-0136-7

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PubMed

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バイオリソースを用いた研究基盤整備に関する国内外の動き招待査読

平沢晃, 青木大輔

産科と婦人科 83 ( 1 ) 13 - 19 2016年

記述言語：日本語出版者・発行元：(株)診断と治療社

基礎研究、トランスレーショナルリサーチ、臨床研究の連携と推進にはバイオリソース、すなわち研究に用いる生物資源が必要であり、バイオバンクがその橋渡し機能を担う。バイオバンクの役割は、単に試料を採取・保管するのみならず、臨床情報、ゲノム解析情報、画像情報をはじめとした重層オミクスのビックデータを扱うことにより、医歯学、保健、基礎生命科学の発展や創薬開発研究のハブ機能にある。がんをはじめとした難治性疾患の個別化治療の実現ためにバイオバンクは不可欠であり、各国とも国をあげてその整備に取り組んでいる。ヒト試料のバンキングは人類が希求する難治性疾患の画期的な診断法・治療法・予防法の開発、さらには知財形成や創薬研究における研究基盤となるため、率先して取り組むべき課題である。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J00525&link_issn=&doc_id=20160108220002&doc_link_id=%2Fae4sanke%2F2016%2F008301%2F003%2F0013-0019%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fae4sanke%2F2016%2F008301%2F003%2F0013-0019%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

遺伝性乳がん卵巣がん; 遺伝性腫瘍-実地臨床での対応を目指して招待

平沢晃, 青木大輔

日本医師会雑誌 145 ( 4 ) 705 - 709 2016年

卵巣・卵管の良性腫瘍・類腫瘍招待

日本女性医学学会編

女性医学ガイドブック思春期・性成熟期編2016年度版 151 - 154 2016年

両側卵巣摘出術を施行した婦人科がんサバイバーのQOL向上を目指した疫学因子および遺伝因子の解析. 招待査読

平沢晃

日本女性医学学会雑誌 24 ( 1 ) 48 - 52 2016年

子宮体部・卵巣同時発生重複癌40症例の臨床病理学的検討. 査読

小笠原淳, 小林佑介, 野村弘行, 山上亘, 片岡史夫, 平沢晃, 冨永英一郎, 鈴木淳, 阪埜浩司, 進伸幸, 田中守, 青木大輔

東京産科婦人科学会会誌 65 ( 3 ) 436 - 439 2016年

記述言語：日本語出版者・発行元：(一社)東京産科婦人科学会

重複癌は2つ以上の臓器または組織に異なる種類の癌腫が発生するものであり、子宮体部および卵巣に同時発生する例もしばしば経験される。臨床的には一方の癌による転移との鑑別に苦慮することも少なくないが、両者では臨床的な取扱いや経過が異なるため、その鑑別は重要である。そこで、2002年から2015年に当院において経験した子宮体部・卵巣同時発生重複癌40症例の臨床病理学的背景を検討した。臨床的には診断時の平均年齢は48.5歳と比較的若年者が多く、病理学的には高分化、早期の症例が多数を占め、組織型は子宮体部・卵巣ともに類内膜腺癌が最も多かった。類内膜腺癌重複癌の症例では85.1%で子宮内膜症の併存を認めた。(著者抄録)

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遺伝性腫瘍招待査読

平沢晃, 山上亘, 青木大輔

産婦人科の実際 65 ( 6 ) 653 - 659 2016年

Characterization of the STK11 splicing variant as a normal splicing isomer in a patient with Peutz-Jeghers syndrome harboring genomic deletion of the STK11 gene. 査読国際誌

Kenta Masuda, Yusuke Kobayashi, Tokuhiro Kimura, Kiyoko Umene, Kumiko Misu, Hiroyuki Nomura, Akira Hirasawa, Kouji Banno, Kenjiro Kosaki, Daisuke Aoki, Kokichi Sugano

Human genome variation 3 16002 - 16002 2016年

記述言語：英語掲載種別：研究論文（学術雑誌）

We report a STK11 splicing variant comprising a 131-bp insertion that is derived from intron 1, which has previously been reported to possess potent pathogenicity. The same variant was detected in a Peutz-Jeghers syndrome patient harboring a genomic deletion in the vicinity of exon 1 of the STK11 gene, which indicated that this variant was derived from the wild-type allele. We also found the same variant in other normal subjects. This variant corresponds to the predicted transcript variant of STK11 (XM_011528209), which is derived from the genomic sequence of Chr19 (NT_011295.12). Therefore, we concluded that the splicing variant was not pathogenic.

DOI： 10.1038/hgv.2016.2

PubMed

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Profiling of Epithelial Ovarian Cancer as BRCAness Status with MLPA Method. 査読

Hirasawa A, Akahane T, Masuda K, Ninomiya T, Yamagami W, Nomura H, Kataoka F, Banno K, Susumu N, Aoki D

Curr Oncol 23 ( 3 ) e305 2016年

[Free fatty acid receptors as therapeutic targets for metabolic disorders].

Akira Hirasawa, Masato Takeuchi, Ryouhei Shirai, Zao Chen, Shota Ishii, Keiko Iida

Nihon yakurigaku zasshi. Folia pharmacologica Japonica 146 ( 6 ) 296 - 301 2015年12月

EVALUATION OF PRE- OR INTRA-OPERATIVE DIAGNOSTIC METHOD FOR UTERINE CARCINOSARCOMA

T. Makabe, W. Yamagami, N. Susumu, K. Sakai, T. Yoshihama, N. Iwasa, N. Nakadaira, S. Hashimoto, T. Ninomiya, M. Wada, A. Takigawa, H. Nomura, F. Kataoka, A. Hirasawa, K. Banno, D. Aoki

INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER 25 ( 9 ) 1107 - 1107 2015年10月

子宮体がんの予防とヘルスケア

進伸幸, 平沢晃, 山上亘, 青木大輔

産婦人科の実際女性ヘルスケア集中講義！ 61 ( 10月臨時増刊号 ) 399 - 408 2015年10月

若年子宮体癌、および子宮内膜異型増殖症に対して妊孕性温存治療を施行することによる精神的影響

横田めぐみ, 山上亘, 坂井健良, 真壁健, 二宮委美, 和田美智子, 野村弘行, 片岡史夫, 平澤晃, 牧田和也, 阪埜浩司, 進伸幸, 青木大輔, 白波瀬丈一郎

日本女性医学学会雑誌 23 ( Suppl. ) 140 - 140 2015年10月

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