129 results on '"Shuji Hirata"'
Search Results
2. Effectiveness of laparoscopic adenomyomectomy on perinatal outcomes
- Author
-
Yosuke Ono, Hajime Ota, Yoshiyuki Fukushi, Hikaru Tagaya, Yasuhiko Okuda, Osamu Yoshino, Hideto Yamada, Shuji Hirata, and Shinichiro Wada
- Subjects
adenomyosis ,fetal growth restriction ,laparoscopic adenomyomectomy ,perinatal outcome ,pregnancy ,Gynecology and obstetrics ,RG1-991 - Abstract
Objectives: The objective of this study was to observe the influence of laparoscopic adenomyomectomy on perinatal outcomes. Materials and Methods: The retrospective cohort study included 43 pregnant cases with adenomyosis who did not undergo laparoscopic surgery before pregnancy (nonsurgery group; 26 cases) and did (surgery group; 17 cases). To evaluate the impact of surgery on perinatal outcomes, nine obstetric complications including preterm delivery, hypertensive disorder of pregnancy, placental malposition, oligohydramnios, gestational diabetes mellitus, uterine rupture, abruptio placentae, and postpartum hemorrhage were selected. One obstetric complication was counted as one point (Maximum 9 points for one person). The obstetrical morbidity was compared by adding up the number of relevant events (0–9) between the two groups. Apgar score, umbilical artery pH (UApH), neonatal intensive care unit (NICU) admission, and neonatal death were also examined. Results: The surgery group had a significantly lower prevalence of fetal growth restriction compared to the nonsurgery group (nonsurgery vs. surgery; 26.9%, 7/26 vs. 0%, 0/17: P = 0.031). No differences were found in the morbidity of the nine obstetric complications (19.2%, 45/234 vs. 13.7%, 21/153), gestational weeks (mean ± standard deviation, 37.2 ± 2.4 vs. 36.4 ± 3.2), birth weight (2573.6 ± 557.9 vs. 2555.4 ± 680.8 g), Apgar score (1, 5 min; 8.0 ± 0.7 vs. 7.7 ± 1.2, 8.9 ± 0.6 vs. 8.5 ± 1.8), UApH (7.28 ± 0.08 vs. 7.28 ± 0.06), NICU admission (26.9%, 7/26 vs. 41.2%, 7/17), and neonatal death (0%, 0%) between both groups. Conclusion: Laparoscopic adenomyomectomy may not increase obstetric complications, although attention must be paid to uterine rupture during pregnancy.
- Published
- 2023
- Full Text
- View/download PDF
3. Association of glycated hemoglobin at an early stage of pregnancy with the risk of gestational diabetes mellitus among non‐diabetic women in Japan: The Japan Environment and Children’s Study
- Author
-
Tetsuo Sekine, Kyoichiro Tsuchiya, Hiroyuki Uchinuma, Sayaka Horiuchi, Megumi Kushima, Sanae Otawa, Hiroshi Yokomichi, Kunio Miyake, Yuka Akiyama, Tadao Ooka, Reiji Kojima, Ryoji Shinohara, Shuji Hirata, Zentaro Yamagata, and The Japan Environment and Children’s Study Group
- Subjects
Cohort studies ,Hyperglycemia ,Pregnancy outcome ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Abstract Aims/Introduction Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and is associated with adverse pregnancy outcomes. This study aimed to explore the associations between glycated hemoglobin (HbA1c) levels at the early stage of pregnancy and the GDM risk among non‐diabetic women in a nationwide study in Japan. In addition, the relationship between GDM and adverse pregnancy outcomes was also analyzed. Materials and Methods This cohort study (n = 89,799) used data from the Japan Environment and Children’s Study. We stratified the participants into four groups according to HbA1c levels at an early stage of pregnancy. We investigated the association of HbA1c at an early stage of pregnancy with the risk of GDM, and of GDM with the risk of some representative adverse pregnancy outcomes, using the multiple logistic regression model with adjustment for potential confounders. Results The adjusted odds ratio for GDM per 0.1 percentage point increase in HbA1c (%) was 1.20. The adjusted odds ratio for developing GDM was significantly increased in women from the HbA1c 5.0–5.4% category. GDM significantly increased the adjusted odds ratio for adverse pregnancy outcomes, such as hypertensive disorders of pregnancy, polyhydramnios and premature birth. Conclusions High‐normal HbA1c levels at the early stage of pregnancy are significantly associated with GDM risk in women in Japan. GDM was significantly associated with adverse pregnancy outcomes.
- Published
- 2022
- Full Text
- View/download PDF
4. Effect of transdermal estrogen dose regimen for endometrial preparation of frozen‐thawed embryo transfer on reproductive and obstetric outcomes
- Author
-
Tatsuyuki Ogawa, Tsuyoshi Kasai, Maki Ogi, Jiro Fukushima, and Shuji Hirata
- Subjects
constant dose ,endometrial preparation ,frozen‐thawed embryo transfer ,hormone replacement cycle ,transdermal estrogen patches ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 ,Reproduction ,QH471-489 - Abstract
Abstract Purpose Previous studies have reported different methods of estrogen administration during endometrial preparation for frozen‐thawed embryo transfer (FET). This study aimed to investigate a beneficial regimen of transdermal estrogen administration for FET. Methods We investigated the reproductive and obstetric outcomes of FET by comparing the increasing dose (ID) group that mimics changes in serum estradiol during the menstrual cycle and the constant dose (CD) group. Transdermal patches were used for estrogen administration in both groups. In our hospital, we targeted 315 cycles of the ID group in which FET was performed in 2017 and 324 cycles of the CD group in which FET was performed in 2018. In all cases, single embryo transfer was performed. Results All were singleton pregnancies. There was no difference in clinical pregnancy rate (28.9% vs 28.2%, P =.837) and live birth rate (17.3% vs 21.4%, P =.201) between the ID and CD groups. Spontaneous abortion rate was significantly lower in the CD group than in the ID group (37.2% vs 23.0%, P =.041). There was no difference in obstetrical outcomes. Conclusions It was considered that the simple CD regimen may be more beneficial than the complicated ID regimen.
- Published
- 2021
- Full Text
- View/download PDF
5. Improvement of early developmental competence of postovulatory‐aged oocytes using metaphase II spindle injection in mice
- Author
-
Tatsuyuki Ogawa, Hiroko Fukasawa, and Shuji Hirata
- Subjects
assisted reproductive technology ,infertility treatment ,intracytoplasmic sperm injection ,metaphase II spindle transfer ,oocyte ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 ,Reproduction ,QH471-489 - Abstract
Abstract Purpose Assisted reproductive technology (ART) is a widely applied fertility treatment. However, the developmental competence of aged oocytes from women of a late reproductive age is seriously reduced and the aged oocytes often fail in fertilization even when ART is used. To resolve this problem, we examined usefulness of a new method “the metaphase II spindle transfer (MESI)” as ART using mouse oocytes. Methods This work was composed of two experiments. First, 24 hours after collection, embryos from oocytes (1‐day‐old oocytes, called postovulatory‐aged oocytes), were observed, after intracytoplasmic sperm injection (ICSI), and it was found that they were not able to reach the blastocyst stage. Next, the metaphase II chromosome‐spindle complexes from 1‐day‐old oocytes were injected into cytoplasts from oocytes just collected, using piezo pulses to generate reconstructed oocytes. This procedure was named metaphase II spindle injection (MESI). Results After ICSI, embryos from the reconstructed oocytes (32/105), which contained the genes of 1‐day‐old oocytes, were able to develop into the blastocyst stage. The fragmentation rate after ICSI was 28.6%. Thus, the developmental competence of 1‐day‐old oocytes was improved by MESI. Conclusions The MESI method has the potential to improve the success rate of infertility treatments for women of a late reproductive age.
- Published
- 2020
- Full Text
- View/download PDF
6. Influence of laparoscopic surgery for endometriosis and its recurrence on perinatal outcomes
- Author
-
Yosuke Ono, Kyoko Furumura, Osamu Yoshino, Hajime Ota, Yasushi Sasaki, Takao Hidaka, Yoshiyuki Fukushi, Shuji Hirata, Hideto Yamada, and Shinichiro Wada
- Subjects
endometriosis ,laparoscopic surgery ,perinatal outcome ,placenta previa ,pregnancy ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 ,Reproduction ,QH471-489 - Abstract
Abstract Purpose It is unknown whether surgery for endometriosis or recurrence of endometriosis affects obstetric outcomes. Methods A total of 208 pregnant women with a history of endometriosis were analyzed. Patients who had endometriomas >3 cm and no history of laparoscopic surgery for endometriosis were defined as non‐surgery group (n = 60), while those who had a history of surgery for endometriosis (n = 148) were defined as surgery group. We investigated the obstetric outcomes in 208 patients according to with or without postoperative recurrence of endometriosis and the time from surgery to pregnancy. Results Among 177 cases of on‐going pregnancy, in surgery group, there were lower prevalence of placenta previa compared with non‐surgery group (8.5% vs. 23.4%; p = 0.020). Subgroup analysis revealed a decreased prevalence of placenta previa in postoperative non‐recurrence group (6.0%: p = 0.007) compared with non‐surgery (23.4%) and postoperative recurrence group (28.6%). Placenta previa was more prevalent in the patients who got pregnant more than 2 years after surgery (20.0%) than the patients who got pregnant within 2 years (2.4%: p = 0.002). Multivariate analysis revealed that the surgery was associated with a reduction in placenta previa (OR: 0.32, 95% CI [0.11–0.90]; p = 0.032). Conclusions Pregnancy within two years after laparoscopic surgery for endometriosis may reduce placenta previa.
- Published
- 2022
- Full Text
- View/download PDF
7. Predictive possibility of the transverse cerebellar diameter to abdominal circumference ratio for small-for-gestational-age fetus suspected as a cause of maternal placental syndromes: a retrospective cohort study
- Author
-
Satoshi Shinohara, Yasuhiko Okuda, Shuji Hirata, and Kohta Suzuki
- Subjects
transverse cerebellar diameter ,abdominal circumference ,small for gestational age ,maternal placental syndromes ,ultrasound examination ,Gynecology and obstetrics ,RG1-991 - Abstract
Objective To examine whether fetal transverse cerebellar diameter (TCD) to abdominal circumference (AC) ratio can predict small-for-gestational age suspected as a cause of maternal placental syndromes (SGA-MPS). Methods We evaluated 473 women who underwent ultrasound examinations at 24–28 weeks of gestation. A receiver operating characteristic curve was used to determine the TCD/AC ratio thresholds to predict SGA-MPS. We used multivariable logistic regression analysis to examine the association. Results TCD/AC ratio>14.37 was associated with SGA-MPS. Conclusions Accurate risk stratification using the TCD/AC ratio could assist in managing patients with small-for-gestational-age fetuses at risk of developing MPS-associated adverse outcomes.
- Published
- 2020
- Full Text
- View/download PDF
8. Risk assessment of shoulder dystocia via the difference between transverse abdominal and biparietal diameters: A retrospective observational cohort study.
- Author
-
Satoshi Shinohara, Yasuhiko Okuda, and Shuji Hirata
- Subjects
Medicine ,Science - Abstract
Shoulder dystocia is defined as vaginal cephalic delivery that requires additional obstetric maneuvers to deliver the fetus after the head has been delivered and gentle traction has failed. A bigger difference between the transverse abdominal diameter (TAD) (abdominal circumference [AC]/π) and biparietal diameter (BPD) (TAD-BPD) has been reported as a risk factor for shoulder dystocia in different countries; however, it remains unclear if this relationship is relevant in Japan. This study aimed to clarify the association between TAD-BPD and shoulder dystocia after adjusting for potential confounding factors in a Japanese cohort. We retrospectively examined 1,866 Japanese women who delivered vaginally between 37+0 and 41+6 weeks of gestation at the University of Yamanashi Hospital between June 2012 and November 2018. The cutoff value of TAD-BPD associated with shoulder dystocia and the association between TAD-BPD and shoulder dystocia were evaluated. The mean maternal age was 32.5±5.3 years; the patients included 1,053 nulliparous women (57.5%), 915 male infants (49.0%), 154 women with gestational diabetes mellitus (GDM) (8.3%), and 5 infants with macrosomia (0.3%). The mean TAD-BPD was 9.03±4.7 mm. The overall incidence of shoulder dystocia was 2.4% (44/1866). The cutoff value to predict shoulder dystocia was 12.0 mm (sensitivity, 61.4%; specificity, 73.8%; likelihood ratio, 2.34; positive predictive value, 5.4%; negative predictive value, 98.8%). We then used a multivariable logistic regression analysis to examine the association between TAD-BPD and shoulder dystocia while controlling for the potential confounding factors. In multivariate analyses, TAD-BPD ≥12.0 mm (adjusted odds ratio [OR], 4.39; 95% confidence interval [CI], 2.35-8.18) and GDM (adjusted OR, 3.59; 95% CI, 1.71-7.52) were associated with shoulder dystocia. Although TAD-BPD appears to be a relevant risk factor for shoulder dystocia, sonographic fetal anthropometric measures do not appear to be useful in screening for shoulder dystocia due to a low positive predictive value.
- Published
- 2021
- Full Text
- View/download PDF
9. Sphingosine 1-Phosphate (S1P) in the Peritoneal Fluid Skews M2 Macrophage and Contributes to the Development of Endometriosis
- Author
-
Yosuke Ono, Takako Kawakita, Osamu Yoshino, Erina Sato, Kuniyuki Kano, Mai Ohba, Toshiaki Okuno, Masami Ito, Kaori Koga, Masako Honda, Akiko Furue, Takehiro Hiraoka, Shinichiro Wada, Takeshi Iwasa, Takehiko Yokomizo, Junken Aoki, Nagamasa Maeda, Nobuya Unno, Yutaka Osuga, and Shuji Hirata
- Subjects
endometriosis ,lipid ,S1P ,macrophage ,Biology (General) ,QH301-705.5 - Abstract
Sphingosine 1-phosphate (S1P), an inflammatory mediator, is abundantly contained in red blood cells and platelets. We hypothesized that the S1P concentration in the peritoneal cavity would increase especially during the menstrual phase due to the reflux of menstrual blood, and investigated the S1P concentration in the human peritoneal fluid (PF) from 14 non-endometriosis and 19 endometriosis patients. Although the relatively small number of samples requires caution in interpreting the results, S1P concentration in the PF during the menstrual phase was predominantly increased compared to the non-menstrual phase, regardless of the presence or absence of endometriosis. During the non-menstrual phase, patients with endometriosis showed a significant increase in S1P concentration compared to controls. In vitro experiments using human intra-peritoneal macrophages (MΦ) showed that S1P stimulation biased them toward an M2MΦ-dominant condition and increased the expression of IL-6 and COX-2. An in vivo study showed that administration of S1P increased the size of the endometriotic-like lesion in a mouse model of endometriosis.
- Published
- 2021
- Full Text
- View/download PDF
10. Utility of imaging modalities for predicting carcinogenesis in lobular endocervical glandular hyperplasia.
- Author
-
Makiko Omori, Tetsuo Kondo, Hikaru Tagaya, Yumika Watanabe, Hiroko Fukasawa, Masataka Kawai, Kumiko Nakazawa, Akihiko Hashi, and Shuji Hirata
- Subjects
Medicine ,Science - Abstract
ObjectivesTo investigate the use of imaging methods for predicting carcinogenesis in lobular endocervical glandular hyperplasia (LEGH).MethodsWe retrospectively analyzed preoperative images on transvaginal sonography and magnetic resonance imaging (MRI) in 23 cases with histologically diagnosed LEGH.ResultsShape of cervical multicystic lesions on MR images could be divided into two types the flower-type with many small cysts surrounded by larger cysts, and the raspberry-type with many tiny, closely aggregated cysts. Six (46%) of 13 cases had raspberry-type lesions that were not detected on transvaginal sonography but were seen on MRI. Adenocarcinoma in situ (AIS) was identified in 4 postmenopausal women with raspberry-type lesions during the follow-up periods. In these cases, cytologic examination by targeted endocervical sampling using sonography enabled early detection of AIS.ConclusionsMRI and cytologic examination by targeted endocervical sampling may be very useful for predicting carcinogenesis in LEGH.
- Published
- 2019
- Full Text
- View/download PDF
11. Delayed detection of ureteral thermal injury in laparoscopic surgery
- Author
-
Satoshi Shinohara, Tsuyoshi Kasai, Mayuko Kasai, and Shuji Hirata
- Subjects
Gynecology and obstetrics ,RG1-991 - Published
- 2017
- Full Text
- View/download PDF
12. Cytoplasmic streaming induced by intracytoplasmic spindle translocation contributes to developmental competence through mitochondrial distribution in mouse oocytes
- Author
-
Shoko Ikeda, Hiroko Fukasawa, Tadashi Mabuchi, and Shuji Hirata
- Subjects
Mice ,Embryology ,Reproductive Medicine ,Cytochalasin B ,Parthenogenesis ,Oocytes ,Animals ,Cytoplasmic Streaming ,Humans ,Female ,Mitochondria - Abstract
To evaluate the developmental competency of mouse metaphase II oocytes and the pattern of mitochondrial positioning through cytoplasmic streaming in mouse metaphase II oocytes.We observed cytoplasmic streaming as movement indicated by fluorescently stained mitochondria using a newly developed method in which the spindle is translocated to the opposite site of the oocyte. This method is termed as intracytoplasmic spindle translocation (ICST).University research laboratory.Female B6D2F1 mice.None.Fresh oocytes, postovulatory-aged oocytes, and oocytes treated with cytochalasin B were classified based on the presence of cytoplasmic streaming induced by ICST. The pattern of redistributed mitochondria and developmental competence caused by parthenogenetic activation were evaluated in oocytes with or without cytoplasmic streaming.Induced cytoplasmic streaming occurred in 84% of the fresh oocytes but not in the postovulatory-aged oocytes and the oocytes treated with cytochalasin B. Abnormal mitochondrial aggregation was observed in oocytes in which cytoplasmic streaming was not induced. Furthermore, the developmental competence was significantly lower in oocytes without cytoplasmic streaming.Cytoplasmic streaming induced by ICST contributes to developmental competence through the redistribution of mitochondria and may be a valuable criterion for predicting early developmental competence in mouse oocytes.
- Published
- 2022
13. Recurrent embolic stroke associated with adenomyosis: A single case report and literature review
- Author
-
Yuto Morishima, Yuji Ueno, Akane Satake, Toko Fukao, Mai Tsuchiya, Takanori Hata, Tatsuyuki Ogawa, Naoki Oishi, Sho Nakajima, Shuji Hirata, Kazumasa Shindo, and Yoshihisa Takiyama
- Subjects
Psychiatry and Mental health ,Neurology (clinical) ,Dermatology ,General Medicine - Published
- 2023
14. Effectiveness of laparoscopic adenomyomectomy on perinatal outcomes
- Author
-
Shinichiro Wada, Yosuke Ono, Hajime Ota, Yoshiyuki Fukushi, Hikaru Tagaya, Yasuhiko Okuda, Osamu Yoshino, Hideto Yamada, and Shuji Hirata
- Subjects
Obstetrics and Gynecology - Published
- 2023
15. Prognostication of Ovarian Function after Ovarian Torsion Using Intraoperative Indocyanine Green Angiography
- Author
-
Kazunori Nakamoto, Shuji Hirata, Hiroko Fukasawa, Makiko Omori, and K. Oyama
- Subjects
Indocyanine Green ,Torsion Abnormality ,medicine.medical_specialty ,Necrosis ,Ovarian Torsion ,Indocyanine green angiography ,Ischemia ,Urology ,Ovary ,In vivo ,medicine ,Animals ,Humans ,Ovarian Diseases ,Rats, Wistar ,business.industry ,Angiography ,Area under the curve ,Ovarian torsion ,Obstetrics and Gynecology ,Blood flow ,medicine.disease ,Rats ,medicine.anatomical_structure ,Reperfusion Injury ,Female ,medicine.symptom ,business - Abstract
Study Objective To quantitatively evaluate the blood flow in ovaries (ischemic ovaries) that underwent torsion using indocyanine green angiography (ICGA) and assess the use of ICGA as an indicator for functional preservation of the ovaries. Design In vivo animal study. Setting The University of Yamanashi Animal Experimentation Center. Subjects Eighteen female Wistar albino rats. Interventions As an alternative to ovarian torsion, we occluded an ovary in each rat for 24 hours, after which we performed ICGA before and after releasing ischemia and extracted the following 8 parameters: Fmax (maximum F value before releasing ischemia); Tmax (time taken from the onset of an increase in F to reaching Fmax); T½max (time taken from the onset of an increase in F to reaching half of Fmax); slope (Fmax/Tmax); time ratio (T½max/Tmax); F′max (maximum F value after releasing ischemia); reperfusion rate (F′max/Fmax); and reperfusion gap (F′max – Fmax). Four weeks later, we counted the total number of primordial and primary follicles and classified the rats into functional and nonfunctional groups. Measurements and Main Results On the basis of the total number of primordial and primary follicles, 13 rats had “functional” ovaries on the clamped side, and 5 rats had “nonfunctional” ovaries. The area under the curve values for each parameter were as follows: Fmax, 0.908; Tmax, 0.569; T½max, 0.546; time ratio, 0.746; slope, 0.877; F′max, 0.723; reperfusion rate, 0.938; and reperfusion gap, 0.862. Conclusion ICGA can be used to quantitatively evaluate ovaries that have been subjected to ischemia, and the magnitude of fluorescence intensity can be an excellent predictor of ovarian necrosis. Quantifying the degree of reperfusion immediately after the release of ischemia can be an equally excellent predictor of necrosis.
- Published
- 2022
16. Gestational body weight gain and risk of low birth weight or macrosomia in women of Japan: a nationwide cohort study
- Author
-
Kunio Miyake, Tetsuo Sekine, Kyoichiro Tsuchiya, Shuichi Ito, Hiroyuki Uchinuma, Hiroshi Yokomichi, Shuji Hirata, Nobuo Yaegashi, Narufumi Suganuma, Chisato Mori, Sanae Otawa, Michihiro Kamijima, Ryoji Shinohara, Yuka Akiyama, Koichi Kusuhara, Shin Yamazaki, Reiko Kishi, Takahiko Katoh, Yukihiro Ohya, Megumi Kushima, Youichi Kurozawa, Sayaka Horiuchi, Hidekuni Inadera, Masayuki Shima, Reiji Kojima, Takeo Nsakayama, Hiroyasu Iso, Tadao Ooka, Koichi Hashimoto, and Zentaro Yamagata
- Subjects
Adult ,medicine.medical_specialty ,Percentile ,endocrine system diseases ,Epidemiology ,Endocrinology, Diabetes and Metabolism ,Medicine (miscellaneous) ,Body weight ,Article ,Fetal Macrosomia ,Cohort Studies ,Japan ,Pregnancy ,Second trimester ,Prenatal Diagnosis ,medicine ,Humans ,Correlation of Data ,reproductive and urinary physiology ,Nutrition and Dietetics ,Obstetrics ,business.industry ,Infant, Low Birth Weight ,Gestational Weight Gain ,female genital diseases and pregnancy complications ,Low birth weight ,Risk factors ,Gestation ,Female ,medicine.symptom ,business ,Weight gain ,Body mass index ,Cohort study - Abstract
Objective Both maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) influence maternal and pediatric outcomes. We sought to clarify the impact of prepregnancy BMI-specific GWG and its patterns on the risk of low birth weight (LBW) or macrosomia using data from a large nationwide study in Japan. Methods This cohort study (n = 98,052) used data from the Japan Environment and Children’s Study (JECS). The outcome variables in this study were LBW and macrosomia. We stratified the subjects into groups according to prepregnancy BMI. Results GWG from pre-pregnancy to the first trimester had a small effect on the risk of LBW and macrosomia. From the first to second trimesters, insufficient GWG was associated with the risk of LBW, and from the second trimester to delivery, a GWG of less than 2 kg was associated with the risk of LBW. These associations were commonly observed in all prepregnancy BMI categories. Irrespective of the GWG from pre-pregnancy to the first trimester, GWG from the first to second trimesters affects LBW and/or macrosomia. Irrespective of the GWG from the first to second trimesters, GWG from the second trimester to delivery affects LBW and/or macrosomia. LBW or macrosomia was associated with the prevalence of a sustained low or high BMI percentile until three years of age, respectively. Conclusions The present large national cohort study indicates that the risk of LBW or macrosomia is associated with GWG in women in Japan; the significance of this risk depends on the GWG patterns.
- Published
- 2021
17. Leptomeningeal metastasis from cervical cancer: Report of two cases and a review of the literature
- Author
-
Shuji Hirata, Makiko Omori, Tatsuyuki Ogawa, Hikaru Tagaya, K. Oyama, and Hiroko Fukasawa
- Subjects
Cervical cancer ,Diplopia ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,biology ,business.industry ,Fulminant ,Obstetrics and Gynecology ,medicine.disease ,biology.organism_classification ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Vertigo ,medicine ,Vomiting ,Radiology ,medicine.symptom ,Stage (cooking) ,business ,Complication ,Lymph node - Abstract
Leptomeningeal metastases from cervical cancer are extremely rare, with only 24 cases reported in the English-language literature. Leptomeningeal metastasis (LM) is usually a late event, but it can develop at any stage. A 44-year-old woman presented with vertigo, tinnitus, diminution of hearing, and a cervical tumor at the initial visit. She underwent whole brain radiotherapy and systemic chemotherapy. Five months after the initial visit, her condition deteriorated rapidly and she died. A 49-year-old woman underwent surgery and pelvic radiotherapy for cervical cancer. She underwent resection of lung metastases 2 years later and received systemic chemotherapy for lymph node metastases 4 years later. Five years after the initial visit, the patient suddenly presented with diplopia, headache, and vomiting; her clinical course was fulminant and she died. Most patients with LM present with diverse clinical manifestations and deteriorate rapidly despite multiple treatment modalities. Gynecologic oncologists should be aware of this rare complication.
- Published
- 2021
18. A case of ovarian stimulation for fertility preservation in a patient with Philadelphia chromosome‐positive acute lymphoblastic leukemia after treatment with dasatinib
- Author
-
Maki Ogi, Tatsuyuki Ogawa, and Shuji Hirata
- Subjects
Oncology ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,Philadelphia Chromosome Positive ,medicine.drug_class ,business.industry ,Obstetrics and Gynecology ,Hematopoietic stem cell ,Stimulation ,Tyrosine-kinase inhibitor ,Dasatinib ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,hemic and lymphatic diseases ,030220 oncology & carcinogenesis ,Internal medicine ,Remission Induction Therapy ,medicine ,Fertility preservation ,business ,Tyrosine kinase ,medicine.drug - Abstract
Tyrosine kinase inhibitors (TKIs) are effective for treating Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL). However, the use of TKIs may decrease the number of collected oocytes during fertility preservation procedures. We report the case of a 19-year-old patient with Ph+ALL for whom 21 oocytes were frozen after controlled ovarian stimulation was initiated 2 days after the completion of 28 days of remission induction therapy with dasatinib. After collecting the oocytes, consolidation therapy was initiated immediately, and a hematopoietic stem cell transplant from her younger brother was scheduled. It is believed that a 2-day withdrawal period is sufficient for fertility preservation or that the effect of dasatinib on the number of oocytes obtained is minimal.
- Published
- 2021
19. High‐grade uterine sarcoma with osteosarcomatous differentiation arising from a MED12‐ mutated leiomyoma, a case report
- Author
-
Makiko Omori, Tetsuo Kondo, Minh-Khang Le, Shuji Hirata, Naoki Oishi, Hiroko Fukasawa, and Megumi Oi
- Subjects
0301 basic medicine ,Pathology ,medicine.medical_specialty ,Abdominal pain ,Hysterectomy ,Uterine leiomyoma ,Uterine sarcoma ,business.industry ,medicine.medical_treatment ,General Medicine ,medicine.disease ,Pathology and Forensic Medicine ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Leiomyoma ,Paraaortic lymph nodes ,030220 oncology & carcinogenesis ,medicine ,Osteosarcoma ,Sarcoma ,medicine.symptom ,business - Abstract
Uterine osteosarcoma has been reported, but it is an extremely rare tumor with highly aggressive behavior and poor prognosis. The pathogenesis of uterine osteosarcoma is not fully understood. Herein, we report on a high-grade uterine sarcoma with focal osteosarcomatous differentiation that developed from a long-standing MED12-mutated leiomyoma. A 47-year-old nulligravida woman, with known uterine leiomyoma presented with abdominal pain and distention. Imaging analyses revealed a tumor with a large cystic area in the uterine corpus and multiple metastases in intrapelvic and paraaortic lymph nodes, left ovary and left lung. With a clinical diagnosis of uterine sarcoma the patient underwent abdominal total hysterectomy, bilateral salpingo-oophorectomy, partial omentectomy and removal of the left obturator lymph node. Despite postoperative chemotherapy and radiation therapy, the tumor progressed rapidly. She died 18 weeks after the surgery. Histopathologic examination identified a high-grade pleomorphic sarcoma in which focal osteoid production was observed. This high-grade sarcoma with focal osteosarcomatous differentiation was located within the uterine leiomyoma, and Sanger sequencing showed the identical MED12 L36R mutation in both the osteosarcomatous and leiomyomatous components supporting the shared origin of these two components. We, therefore, concluded that the high-grade sarcoma with osteosarcomatous differentiation arose from the transformation of the precedent leiomyoma.
- Published
- 2021
20. Predictive factors for secondary postpartum hemorrhage: a case-control study in Japan
- Author
-
Kohta Suzuki, Yasuhiko Okuda, Shuji Hirata, and Satoshi Shinohara
- Subjects
Adult ,Male ,medicine.medical_specialty ,Maternal morbidity ,Secondary postpartum hemorrhage ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Pregnancy ,Risk Factors ,medicine ,Humans ,030212 general & internal medicine ,030219 obstetrics & reproductive medicine ,Obstetrics ,business.industry ,Incidence (epidemiology) ,Postpartum Hemorrhage ,Case-control study ,Obstetrics and Gynecology ,Parity ,Case-Control Studies ,Pediatrics, Perinatology and Child Health ,Female ,business ,Vaginal blood loss - Abstract
Secondary postpartum hemorrhage (PPH) is defined as excessive vaginal blood loss occurring between 24 h and 6-12 weeks after birth. The incidence of secondary PPH varies from 0.2% to 3.0%, and the peak incidence ranges from 1 to 2 weeks postpartum. There is no clinical evidence regarding the cause of secondary PPH. Therefore, this study aimed to determine the predictive factors for secondary PPH in an Asian population.A case-control study was performed. The clinical data of 25 secondary PPH patients who had been admitted to our hospital between June 2012 and January 2019 were obtained for this study. Control patients (The median maternal age was 34 years (range, 24-42 years); 85 (68.0%) women were nulliparous, 31 (24.8%) used ART, and 116 (92.8%) had term deliveries. Immediate PPH (adjusted odds ratio [OR], 2.84; 95% confidence interval [CI], 1.04-7.75) and manual removal of the placenta (adjusted OR, 6.14; 95% CI, 1.21-31.1) were associated with secondary PPH.Increasing the awareness of the predictive factors for secondary PPH could play an important role in the recognition and treatment of postpartum morbidity.
- Published
- 2020
21. Improvement of early developmental competence of postovulatory‐aged oocytes using metaphase II spindle injection in mice
- Author
-
Shuji Hirata, Tatsuyuki Ogawa, and Hiroko Fukasawa
- Subjects
0301 basic medicine ,metaphase II spindle transfer ,lcsh:QH471-489 ,medicine.medical_treatment ,intracytoplasmic sperm injection ,Biology ,Cytoplast ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,Intracytoplasmic sperm injection ,Andrology ,03 medical and health sciences ,0302 clinical medicine ,Human fertilization ,infertility treatment ,assisted reproductive technology ,medicine ,Spindle transfer ,lcsh:Reproduction ,Blastocyst ,oocyte ,030219 obstetrics & reproductive medicine ,Assisted reproductive technology ,lcsh:RC648-665 ,Embryo ,Original Articles ,Cell Biology ,Oocyte ,030104 developmental biology ,medicine.anatomical_structure ,Reproductive Medicine ,Original Article - Abstract
Purpose Assisted reproductive technology (ART) is a widely applied fertility treatment. However, the developmental competence of aged oocytes from women of a late reproductive age is seriously reduced and the aged oocytes often fail in fertilization even when ART is used. To resolve this problem, we examined usefulness of a new method “the metaphase II spindle transfer (MESI)” as ART using mouse oocytes. Methods This work was composed of two experiments. First, 24 hours after collection, embryos from oocytes (1‐day‐old oocytes, called postovulatory‐aged oocytes), were observed, after intracytoplasmic sperm injection (ICSI), and it was found that they were not able to reach the blastocyst stage. Next, the metaphase II chromosome‐spindle complexes from 1‐day‐old oocytes were injected into cytoplasts from oocytes just collected, using piezo pulses to generate reconstructed oocytes. This procedure was named metaphase II spindle injection (MESI). Results After ICSI, embryos from the reconstructed oocytes (32/105), which contained the genes of 1‐day‐old oocytes, were able to develop into the blastocyst stage. The fragmentation rate after ICSI was 28.6%. Thus, the developmental competence of 1‐day‐old oocytes was improved by MESI. Conclusions The MESI method has the potential to improve the success rate of infertility treatments for women of a late reproductive age., The metaphase II chromosome‐spindle complexes from 1‐day‐old oocytes (postovulatory‐aged oocytes 24 hours after collection) were injected into cytoplasts from freshly collected oocytes using piezo pulses to generate reconstructed oocytes (MESI). After ICSI, the embryos from reconstructed oocytes (32/105) could develop into the blastocyst stage. However, the developmental competence of 1‐day‐old oocytes was improved by MESI.
- Published
- 2020
22. Predictive possibility of the transverse cerebellar diameter to abdominal circumference ratio for small-for-gestational-age fetus suspected as a cause of maternal placental syndromes: a retrospective cohort study
- Author
-
Kohta Suzuki, Shuji Hirata, Yasuhiko Okuda, and Satoshi Shinohara
- Subjects
Adult ,medicine.medical_specialty ,Placenta Diseases ,030204 cardiovascular system & hematology ,Ultrasonography, Prenatal ,Fetal Development ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Cerebellum ,Abdomen ,Internal Medicine ,Humans ,Medicine ,Retrospective Studies ,Fetus ,Small for gestational age fetus ,030219 obstetrics & reproductive medicine ,Anthropometry ,business.industry ,Obstetrics ,Abdominal circumference ,food and beverages ,Obstetrics and Gynecology ,Retrospective cohort study ,medicine.disease ,Infant, Small for Gestational Age ,cardiovascular system ,Small for gestational age ,Female ,business - Abstract
Objective: To examine whether fetal transverse cerebellar diameter (TCD) to abdominal circumference (AC) ratio can predict small-for-gestational age suspected as a cause of maternal placental syndr...
- Published
- 2020
23. Association of glycated hemoglobin at an early stage of pregnancy with the risk of gestational diabetes mellitus among non-diabetic women in Japan: The Japan Environment and Children's Study
- Author
-
Tetsuo, Sekine, Kyoichiro, Tsuchiya, Hiroyuki, Uchinuma, Sayaka, Horiuchi, Megumi, Kushima, Sanae, Otawa, Hiroshi, Yokomichi, Kunio, Miyake, Yuka, Akiyama, Tadao, Ooka, Reiji, Kojima, Ryoji, Shinohara, Shuji, Hirata, Zentaro, Yamagata, and Takahiko, Katoh
- Subjects
medicine.medical_specialty ,Complications of pregnancy ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,Cohort Studies ,chemistry.chemical_compound ,Japan ,Pregnancy ,Diabetes mellitus ,Internal Medicine ,Medicine ,Humans ,Child ,Glycated Hemoglobin ,business.industry ,Obstetrics ,Pregnancy Outcome ,nutritional and metabolic diseases ,General Medicine ,Odds ratio ,medicine.disease ,female genital diseases and pregnancy complications ,Gestational diabetes ,Diabetes, Gestational ,chemistry ,Premature birth ,Female ,Glycated hemoglobin ,business ,Cohort study - Abstract
AIMS/INTRODUCTION Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and is associated with adverse pregnancy outcomes. This study aimed to explore the associations between glycated hemoglobin (HbA1c) levels at the early stage of pregnancy and the GDM risk among non-diabetic women in a nationwide study in Japan. In addition, the relationship between GDM and adverse pregnancy outcomes was also analyzed. MATERIALS AND METHODS This cohort study (n = 89,799) used data from the Japan Environment and Children's Study. We stratified the participants into four groups according to HbA1c levels at an early stage of pregnancy. We investigated the association of HbA1c at an early stage of pregnancy with the risk of GDM, and of GDM with the risk of some representative adverse pregnancy outcomes, using the multiple logistic regression model with adjustment for potential confounders. RESULTS The adjusted odds ratio for GDM per 0.1 percentage point increase in HbA1c (%) was 1.20. The adjusted odds ratio for developing GDM was significantly increased in women from the HbA1c 5.0-5.4% category. GDM significantly increased the adjusted odds ratio for adverse pregnancy outcomes, such as hypertensive disorders of pregnancy, polyhydramnios and premature birth. CONCLUSIONS High-normal HbA1c levels at the early stage of pregnancy are significantly associated with GDM risk in women in Japan. GDM was significantly associated with adverse pregnancy outcomes.
- Published
- 2021
24. Sphingosine 1-Phosphate (S1P) in the Peritoneal Fluid Skews M2 Macrophage and Contributes to the Development of Endometriosis
- Author
-
Takehiro Hiraoka, Nagamasa Maeda, Masako Honda, Kaori Koga, Takehiko Yokomizo, Nobuya Unno, Takako Kawakita, Toshiaki Okuno, Erina Sato, Yutaka Osuga, Shuji Hirata, Yosuke Ono, Masami Ito, Mai Ohba, Junken Aoki, Kuniyuki Kano, Shinichiro Wada, Takeshi Iwasa, Osamu Yoshino, and Akiko Furue
- Subjects
endometriosis ,medicine.medical_specialty ,QH301-705.5 ,Endometriosis ,Medicine (miscellaneous) ,macrophage ,S1P ,General Biochemistry, Genetics and Molecular Biology ,Article ,Lesion ,chemistry.chemical_compound ,Peritoneal cavity ,In vivo ,lipid ,Internal medicine ,medicine ,Sphingosine-1-phosphate ,Biology (General) ,Sphingosine ,Chemistry ,Peritoneal fluid ,medicine.disease ,M2 Macrophage ,Endocrinology ,medicine.anatomical_structure ,lipids (amino acids, peptides, and proteins) ,medicine.symptom - Abstract
Sphingosine 1-phosphate (S1P), an inflammatory mediator, is abundantly contained in red blood cells and platelets. We hypothesized that the S1P concentration in the peritoneal cavity would increase especially during the menstrual phase due to the reflux of menstrual blood, and investigated the S1P concentration in the human peritoneal fluid (PF) from 14 non-endometriosis and 19 endometriosis patients. Although the relatively small number of samples requires caution in interpreting the results, S1P concentration in the PF during the menstrual phase was predominantly increased compared to the non-menstrual phase, regardless of the presence or absence of endometriosis. During the non-menstrual phase, patients with endometriosis showed a significant increase in S1P concentration compared to controls. In vitro experiments using human intra-peritoneal macrophages (MΦ) showed that S1P stimulation biased them toward an M2MΦ-dominant condition and increased the expression of IL-6 and COX-2. An in vivo study showed that administration of S1P increased the size of the endometriotic-like lesion in a mouse model of endometriosis.
- Published
- 2021
25. The involvement of anti-β2GPI/HLA-DR antibodies (neoself antibodies) in infertility
- Author
-
Yousuke Ono, Hajime Ota, Tatsuyuki Ogawa, Maki Ohgi, Kenji Tanimura, Osamu Yoshino, Shuji Hirata, Shinichiro Wada, and Hideto Yamada
- Subjects
Reproductive Medicine ,Immunology ,Obstetrics and Gynecology ,Immunology and Allergy - Published
- 2022
26. Oral Gonadotropin‑Releasing Hormone Antagonist Relugolix Has the Same Effect as Gonadotropin‑Releasing Hormone Agonist Injections in Terms of Preparation for Transcervical Resection Myomectomy.
- Author
-
Mika Ito, Osamu Yoshino, Takehiro Hiraoka, Yosuke Ono, Kouta Tanaka, Shunsuke Iwahata, Masako Honda, Akiko Furue, Junichi Nishijima, Takahito Shimoda, Haruko Iwase, Akinori Miki, Hikaru Tagaya, Shuji Hirata, and Nobuya Unno
- Abstract
For preparing the optimal condition in transcervical resection (TCR) surgery, gonadotropin‑releasing hormone (GnRH) agonist has been utilized. Recently, an oral GnRH antagonist (relugolix) is available and acts directly on GnRH receptor, avoiding flare up and reducing blood E2 levels rapidly. We retrospectively compared the oral GnRH antagonist (n = 14) effect to that of subcutaneous GnRH agonist (n = 19) for the pretreatment of endometrium in TCR myomectomy. Endometrial thickening was determined by intraoperative videos. The color tone of the endometrium in the normal part was assessed by digital image processing. The median duration of the first GnRH agonist injection and the surgery was 67 days(21–136 days), which is significantly longer than that of the oral GnRH antagonist group, 18.5 days (7–157 days P < 0.01). Both the GnRH agonist and antagonist groups did not exhibit prominence in the endometrium. The GnRH antagonist group showed the same degree of whiteness in the normal endometrium as the GnRH agonist group. The oral GnRH antagonist administration could rapidly atrophy the endometrium and create an optimal surgical field for TCR in a short period. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
27. Bone Marrow Invasion of Small Cell Neuroendocrine Carcinoma of the Endometrium: A Diagnostic Pitfall Mimicking a Haematological Malignancy
- Author
-
Kei Nakajima, Tetsuo Kondo, Ichiro Kawashima, Takuma Kumagai, Megumi Koshiishi, Hiroko Fukasawa, Kazunari Kasai, Akihiko Hashi, Shuji Hirata, and Keita Kirito
- Subjects
Pathology ,medicine.medical_specialty ,Biopsy ,Case Report ,myelofibrosis ,Endometrium ,small cell neuroendocrine carcinoma ,Metastasis ,Diagnosis, Differential ,Bone Marrow ,Internal Medicine ,medicine ,Humans ,Neoplasm Invasiveness ,Carcinoma, Small Cell ,Myelofibrosis ,medicine.diagnostic_test ,business.industry ,bone marrow metastasis ,General Medicine ,therapy-related myelodysplastic syndrome ,Middle Aged ,medicine.disease ,Carcinoma, Neuroendocrine ,Endometrial Neoplasms ,Bone marrow examination ,Haematopoiesis ,medicine.anatomical_structure ,Hematologic Neoplasms ,Cancer cell ,Female ,Bone marrow ,business - Abstract
Metastasis of cancer cells to the bone marrow is relatively rare, despite being one of the most important causes of myelosuppression in patients with solid tumours. A bone marrow examination via a biopsy is the standard method of diagnosing cancer cell invasion into the bone marrow. However, it is sometimes challenging to distinguish neuroendocrine carcinoma cells from haematopoietic cells due to their small, round shape and chromosomal abnormalities resembling haematological malignancies. We herein report a case of bone marrow invasion of small cell neuroendocrine carcinoma of the endometrium mimicking therapy-related myeloid malignancy.
- Published
- 2019
28. MR-guided Focused Ultrasound for Uterine Fibroids: A Preliminary Study of Relationship between the Treatment Outcomes and Factors of MR Images Including Elastography
- Author
-
Shuji Hirata, Makiko Omori, Katsuhiro Sano, Shintaro Ichikawa, Hiroshi Onishi, Utaroh Motosugi, and Yoshie Omiya
- Subjects
Adult ,medicine.medical_specialty ,Uterine fibroids ,Treatment outcome ,Focused ultrasound ,030218 nuclear medicine & medical imaging ,Symptoms Severity Score ,stiffness ,03 medical and health sciences ,0302 clinical medicine ,Technical Note ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,Leiomyoma ,medicine.diagnostic_test ,magnetic resonance-guided focused ultrasound ,business.industry ,uterine fibroid ,Middle Aged ,equipment and supplies ,medicine.disease ,magnetic resonance elastography ,Magnetic Resonance Imaging ,Magnetic resonance elastography ,SSS ,Uterine Neoplasms ,Elasticity Imaging Techniques ,High-Intensity Focused Ultrasound Ablation ,Female ,Radiology ,Elastography ,Mr images ,business ,Mri guided - Abstract
We evaluated the value of magnetic resonance elastography (MRE) for the prediction of response to magnetic resonance-guided focused ultrasound (MRgFUS) for uterine fibroids. Eleven patients were enrolled. A fractional change of >30% in Symptoms Severity Score (SSS) was defined as a ‘substantial symptomatic improvement’ at 12 months after treatment. The fractional stiffness value reduction in the patients with a substantial improvement in SSS was significantly higher than that in those without (P = 0.0446).
- Published
- 2019
29. Risk assessment of shoulder dystocia via the difference between transverse abdominal and biparietal diameters: A retrospective observational cohort study
- Author
-
Yasuhiko Okuda, Shuji Hirata, and Satoshi Shinohara
- Subjects
Male ,Epidemiology ,Physiology ,Maternal Health ,Biochemistry ,Labor and Delivery ,Endocrinology ,Postoperative Complications ,Japan ,Pregnancy ,Medicine and Health Sciences ,Insulin ,Musculoskeletal System ,Multidisciplinary ,Obstetrics ,Organic Compounds ,Monosaccharides ,Obstetrics and Gynecology ,female genital diseases and pregnancy complications ,Gestational diabetes ,Chemistry ,Physiological Parameters ,Cohort ,Physical Sciences ,Medicine ,Female ,Anatomy ,Cohort study ,Research Article ,Adult ,medicine.medical_specialty ,Science ,Carbohydrates ,Ultrasonography, Prenatal ,Shoulder dystocia ,Fetus ,Sex Factors ,mental disorders ,medicine ,Humans ,Obesity ,Risk factor ,Shoulder Dystocia ,Diabetic Endocrinology ,business.industry ,Organic Chemistry ,Body Weight ,Chemical Compounds ,Infant, Newborn ,Biology and Life Sciences ,Odds ratio ,medicine.disease ,Delivery, Obstetric ,Confidence interval ,Hormones ,Glucose ,Shoulders ,Medical Risk Factors ,Birth ,Women's Health ,business - Abstract
Shoulder dystocia is defined as vaginal cephalic delivery that requires additional obstetric maneuvers to deliver the fetus after the head has been delivered and gentle traction has failed. A bigger difference between the transverse abdominal diameter (TAD) (abdominal circumference [AC]/π) and biparietal diameter (BPD) (TAD-BPD) has been reported as a risk factor for shoulder dystocia in different countries; however, it remains unclear if this relationship is relevant in Japan. This study aimed to clarify the association between TAD-BPD and shoulder dystocia after adjusting for potential confounding factors in a Japanese cohort. We retrospectively examined 1,866 Japanese women who delivered vaginally between 37+0 and 41+6 weeks of gestation at the University of Yamanashi Hospital between June 2012 and November 2018. The cutoff value of TAD-BPD associated with shoulder dystocia and the association between TAD-BPD and shoulder dystocia were evaluated. The mean maternal age was 32.5±5.3 years; the patients included 1,053 nulliparous women (57.5%), 915 male infants (49.0%), 154 women with gestational diabetes mellitus (GDM) (8.3%), and 5 infants with macrosomia (0.3%). The mean TAD-BPD was 9.03±4.7 mm. The overall incidence of shoulder dystocia was 2.4% (44/1866). The cutoff value to predict shoulder dystocia was 12.0 mm (sensitivity, 61.4%; specificity, 73.8%; likelihood ratio, 2.34; positive predictive value, 5.4%; negative predictive value, 98.8%). We then used a multivariable logistic regression analysis to examine the association between TAD-BPD and shoulder dystocia while controlling for the potential confounding factors. In multivariate analyses, TAD-BPD ≥12.0 mm (adjusted odds ratio [OR], 4.39; 95% confidence interval [CI], 2.35–8.18) and GDM (adjusted OR, 3.59; 95% CI, 1.71–7.52) were associated with shoulder dystocia. Although TAD-BPD appears to be a relevant risk factor for shoulder dystocia, sonographic fetal anthropometric measures do not appear to be useful in screening for shoulder dystocia due to a low positive predictive value.
- Published
- 2021
30. Effect of transdermal estrogen dose regimen for endometrial preparation of frozen-thawed embryo transfer on reproductive and obstetric outcomes
- Author
-
Jiro Fukushima, Tsuyoshi Kasai, Shuji Hirata, Tatsuyuki Ogawa, and Maki Ogi
- Subjects
0301 basic medicine ,medicine.medical_specialty ,lcsh:QH471-489 ,medicine.drug_class ,media_common.quotation_subject ,Single Embryo Transfer ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,03 medical and health sciences ,0302 clinical medicine ,Transdermal estrogen ,lcsh:Reproduction ,Medicine ,Menstrual cycle ,media_common ,Transdermal ,transdermal estrogen patches ,Gynecology ,lcsh:RC648-665 ,030219 obstetrics & reproductive medicine ,endometrial preparation ,business.industry ,constant dose ,hormone replacement cycle ,Cell Biology ,Original Articles ,Embryo transfer ,frozen‐thawed embryo transfer ,Regimen ,030104 developmental biology ,Reproductive Medicine ,Estrogen ,Original Article ,business ,Live birth - Abstract
Purpose Previous studies have reported different methods of estrogen administration during endometrial preparation for frozen‐thawed embryo transfer (FET). This study aimed to investigate a beneficial regimen of transdermal estrogen administration for FET. Methods We investigated the reproductive and obstetric outcomes of FET by comparing the increasing dose (ID) group that mimics changes in serum estradiol during the menstrual cycle and the constant dose (CD) group. Transdermal patches were used for estrogen administration in both groups. In our hospital, we targeted 315 cycles of the ID group in which FET was performed in 2017 and 324 cycles of the CD group in which FET was performed in 2018. In all cases, single embryo transfer was performed. Results All were singleton pregnancies. There was no difference in clinical pregnancy rate (28.9% vs 28.2%, P =.837) and live birth rate (17.3% vs 21.4%, P =.201) between the ID and CD groups. Spontaneous abortion rate was significantly lower in the CD group than in the ID group (37.2% vs 23.0%, P =.041). There was no difference in obstetrical outcomes. Conclusions It was considered that the simple CD regimen may be more beneficial than the complicated ID regimen.
- Published
- 2020
31. Association between infertility treatment and intrauterine growth: a multilevel analysis in a retrospective cohort study
- Author
-
Kohta Suzuki, Shuji Hirata, and Satoshi Shinohara
- Subjects
Infertility ,Adult ,Male ,medicine.medical_specialty ,Birth weight ,medicine.medical_treatment ,Pregnancy Complications, Cardiovascular ,Placenta Previa ,Gestation period ,Fetal Development ,Young Adult ,Sex Factors ,infertility treatment ,Hypothyroidism ,Japan ,Pregnancy ,Spontaneous conception ,Obstetrics and Gynaecology ,medicine ,Single Embryo Transfer ,Birth Weight ,Humans ,Retrospective Studies ,Assisted reproductive technology ,business.industry ,Obstetrics ,Smoking ,Retrospective cohort study ,Prenatal Care ,General Medicine ,medicine.disease ,Embryo Transfer ,Gestational diabetes ,Diabetes, Gestational ,Parity ,Fertilization ,Hypertension ,intrauterine growth trajectory ,Multilevel Analysis ,Female ,business ,fetal growth ,Maternal Age - Abstract
ObjectivesThis study aimed to identify intrauterine growth differences according to infertility treatment compared with spontaneous conception and to describe intrauterine growth trajectories.DesignRetrospective cohort study.SettingA single primary and tertiary medical centre in Japan.ParticipantsThis study included singleton pregnant women with prenatal check-ups and delivery at the University of Yamanashi Hospital between 1 July 2012 and 30 September 2017. Patients were divided into four groups: spontaneous conception, infertility treatment without assisted reproductive technology (ART), fresh-embryo transfer and frozen embryo transfer (FET).InterventionsDifferences in intrauterine growth according to the infertility treatment, including ART, and birth weight were evaluated. Multilevel analysis was employed to evaluate intrauterine growth trajectories stratified by the sex of the offspring.Primary outcome measureEstimated fetal weight (EFW) assessed by ultrasound examination.ResultsWe assessed data from 37 239 prenatal examination results from 2377 pregnant women (spontaneous conception, n=1764; infertility treatment without ART, n=171; fresh-embryo transfer, n=112; and FET, n=330) in the final analysis. Multilevel analysis was adjusted for gestation duration, gestation period, parity, hypertensive disorders of pregnancy, type of infertility treatment, maternal age, smoking status, placenta previa, thyroid disease, gestational diabetes mellitus and the interaction between each potential confounding factor and gestation duration. In male fetuses, the interaction between FET and gestational duration (estimate: 0.36; 95% CI: 0.06 to 0.67) significantly affected the EFW. Similarly, in female fetuses, FET (estimate: −69.85; 95% CI: −112.09 to −27.61) and the interaction between FET and gestation duration (estimate: 0.57; 95% CI: 0.28 to 0.87) significantly affected the EFW.ConclusionsThis study shows that FET affects intrauterine growth trajectory from the second trimester to term, particularly in female fetuses. Our findings require further prospective research to examine the effect of infertility treatment on fetal growth.
- Published
- 2020
32. Lesion-targeted cytology to improve cytological sampling for atypical polypoid adenomyomas of the uterus: A case series and review of the literature
- Author
-
Satoko Sasatsu, Tetsuo Kondo, Hiroko Fukasawa, Masataka Kawai, Makiko Omori, Shuji Hirata, Tatsuyuki Ogawa, and Kumiko Nakazawa
- Subjects
Adult ,Pathology ,medicine.medical_specialty ,Histology ,Cytodiagnosis ,education ,Uterus ,030209 endocrinology & metabolism ,Pathology and Forensic Medicine ,Specimen Handling ,Lesion ,03 medical and health sciences ,Endometrium ,0302 clinical medicine ,Cytology ,medicine ,Atypia ,Humans ,Sampling (medicine) ,Uterine Neoplasm ,Ultrasonography ,Vaginal Smears ,Leiomyoma ,business.industry ,General Medicine ,medicine.disease ,Endometrial Neoplasms ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Uterine Neoplasms ,Adenocarcinoma ,Female ,medicine.symptom ,Atypical polypoid adenomyoma ,business ,Adenomyoma - Abstract
Objective Atypical polypoid adenomyomas (APAs) are uncommon tumours consisting of atypical endometrioid glands and fibromyomatous stroma. Identifying the biphasic nature of atypical glandular components and spindle mesenchymal components without atypia is crucial for the cytological diagnosis of APA. We investigated the utility of lesion-targeted cytology (LTC) to directly collect firm spindle components. Methods We recruited seven consecutive surgical patients who underwent cytological examinations before surgery and were diagnosed with APA on postoperative histological examinations. Cytological smears were obtained by routine sampling in five cases and by targeted sampling using transvaginal ultrasonography, that is, LTC, in two cases. We retrospectively analysed the cytological findings from our cases and compared them to those of APA cases previously reported in the English literature. Results Among 5/7 cases that involved routine cytological sampling, normal cytological findings were found in 2 and atypical glandular cells were found in 3, but spindle cells from mesenchymal components were not detected. In contrast, among 2/7 cases in which sampling involved LTC, spindle cells without atypia, in addition to atypical glandular cells were found. Conclusions Lesion-targeted cytology is useful to assess mesenchymal components of APAs and may improve the cytological diagnosis of APA.
- Published
- 2020
33. Vasa praevia: cord vessels running through the foetal membranes from the uterine fundus to the internal
- Author
-
Yasuhiko Okuda, Satoshi Shinohara, and Shuji Hirata
- Subjects
Adult ,Male ,Vasa praevia ,Cord ,Placenta ,Uterine fundus ,Vasa Previa ,Umbilical cord ,Ultrasonography, Prenatal ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Internal os ,Medicine ,Humans ,Ultrasonography, Doppler, Color ,reproductive and urinary physiology ,030219 obstetrics & reproductive medicine ,Foetal membranes ,business.industry ,Cesarean Section ,Infant, Newborn ,Obstetrics and Gynecology ,Anatomy ,medicine.disease ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,Internal cervical os ,030220 oncology & carcinogenesis ,embryonic structures ,Female ,business ,Infant, Premature - Abstract
Vasa praevia, a condition where the umbilical cord runs through the foetal membranes over the internal cervical os, is rare, occurring in 1.5–4 of 10,000 pregnancies (Oyelese et al. 1999; Lee et al...
- Published
- 2019
34. Interpretation of Endocervical Cells With Gastric-Type Mucin on Pap Smears
- Author
-
Tadao Nakazawa, Kumiko Nakazawa, Tetsuo Kondo, Maki Ohgi, Shuji Hirata, Hiroko Fukasawa, Akihiko Hashi, Hikaru Tagaya, and Makiko Omori
- Subjects
0301 basic medicine ,Cervical cancer ,Pap smears ,Pathology ,medicine.medical_specialty ,business.industry ,Mucin ,General Medicine ,medicine.disease ,Gastric type ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Lobular Endocervical Glandular Hyperplasia ,030220 oncology & carcinogenesis ,Cytology ,Papanicolaou smears ,Medicine ,Adenocarcinoma ,business - Abstract
Objectives Early detection of endocervical adenocarcinoma is especially important for cancers that are human papillomavirus (HPV) negative. We investigated the clinicopathologic significance of yellow gastric-type mucin observed on Papanicolaou smears. Methods We described "atypical endocervical cells with gastric-type mucin" (AEC-GAM) when yellow mucin was observed in endocervical cells. We retrieved AEC-GAM samples from 58,752 cervical smears performed at Yamanashi University Hospital during our study period and reviewed clinical, cytologic, and pathologic features. Results We detected AEC-GAM in 172 (0.29 %) smears from 65 patients, and 41 of these 65 patients were histologically diagnosed with lobular endocervical glandular hyperplasia (LEGH) (43%) or pyloric gland metaplasia (20%). The prevalence of adenocarcinoma was 25% (7/28) in LEGH cases and 11% (7/65) in AEC-GAM smears. Conclusions Yellow mucin is a diagnostic clue for endocervical glandular lesions with gastric differentiation. We recommend describing AEC-GAM on cytologic reports to improve cytologic screening for HPV-negative cervical cancers.
- Published
- 2018
35. Association between birth weight and massive haemorrhage in pregnancy with a low-lying placenta: a 9-year single-centre retrospective cohort study in Japan
- Author
-
Yasuhiko Okuda, Shuji Hirata, and Satoshi Shinohara
- Subjects
Adult ,medicine.medical_specialty ,medicine.medical_treatment ,Birth weight ,Placenta Previa ,Massive haemorrhage ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Risk Factors ,Placenta ,medicine ,Birth Weight ,Humans ,Caesarean section ,reproductive and urinary physiology ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,Cesarean Section ,Obstetrics ,business.industry ,Postpartum Hemorrhage ,Obstetrics and Gynecology ,Retrospective cohort study ,medicine.disease ,Low-Lying Placenta ,Logistic Models ,medicine.anatomical_structure ,ROC Curve ,030220 oncology & carcinogenesis ,Female ,business ,Cohort study - Abstract
A low-lying placenta is a well-known cause of a massive intrapartum haemorrhage. We aimed to evaluate whether neonatal birth weight deviation from the nationwide average could predict a massive haemorrhage during a delivery in the women with a low-lying placenta. This study included 40 women. The main outcomes were a massive haemorrhage and a neonatal birth weight deviation. We used a receiver operating characteristic curve analysis to determine the optimal birth weight deviation cut-off for predicting a massive haemorrhage. A multiple logistic regression model was used to identify the variables significantly associated with a massive haemorrhage. The best cut-off for predicting a massive haemorrhage was a birth weight deviation of +0.51 standard deviations (SDs) from the nationwide average. A birth weight deviation of ≥ +0.51 SDs was significantly associated with an increased massive haemorrhage risk. Impact statement What is already known on this subject? A low-lying placenta is a well-known cause of a massive intrapartum haemorrhage. Therefore, when managing pregnancies with a low-lying placenta, the possibility of severe perinatal bleeding should be considered, and it is desirable to determine reliable predictors of a haemorrhage. However, few studies have reported the predictive factors of a massive haemorrhage in patients with a low-lying placenta. What do the results of this study add? We demonstrated that a birth weight deviation from the nationwide average was significantly associated with a massive intrapartum haemorrhage in patients with a low-lying placenta. To our knowledge, this is the first study to clarify the association between a neonatal birth weight and a massive intrapartum haemorrhage incidence and to determine the optimal birth weight deviation cut-off for predicting a massive haemorrhage in patients with a low-lying placenta. What are the implications of these findings for clinical practice and/or further research? An accurate risk stratification using the foetal weight as a marker for a predicting massive intrapartum haemorrhage may help in the management of patients with a low-lying placenta. Studies with a larger sample size are required to confirm our findings.
- Published
- 2018
36. A case of endocervical minimal deviation adenocarcinoma with varicolored cytopathologic features on Pap smear
- Author
-
Tetsuo Kondo, Kumiko Nakazawa, Yumika Watanabe, Satoshi Shinohara, Shuji Hirata, Tadao Nakazawa, Akihiko Hashi, Hiroko Fukasawa, and Makiko Omori
- Subjects
0301 basic medicine ,Pathology ,medicine.medical_specialty ,Histology ,Uterus ,Uterine Cervical Neoplasms ,Papanicolaou stain ,Adenocarcinoma ,Pathology and Forensic Medicine ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Parametrium ,Humans ,Medicine ,Nuclear atypia ,business.industry ,Mucin ,General Medicine ,Middle Aged ,medicine.disease ,030104 developmental biology ,medicine.anatomical_structure ,Lobular Endocervical Glandular Hyperplasia ,030220 oncology & carcinogenesis ,Female ,business ,Endocervix ,Papanicolaou Test - Abstract
We report a case of minimal deviation adenocarcinoma (MDA) of the uterine cervix showing varicolored cytopathologic features on Papanicolaou (Pap) smear, which may indicate features suggestive of lobular endocervical glandular hyperplasia (LEGH)-adenocarcinoma sequence. A 57-year-old woman presented with a profuse amount of watery vaginal discharge. Gynecological examination revealed a cervical mass with involvement of the right parametrium. Conventional Pap smear showed hypercellularity consisting of approximately 4 types of clusters as follows: (1) clusters showing a monolayered honeycomb sheet of endocervical cells with golden-yellow mucin and bland nuclei, (2) three-dimensional clusters showing varicolored mucin and irregular nuclear overlapping, (3) irregularly shaped clusters showing distorted chicken-wire-mesh appearance with noticeable protrusions of the nuclei and clear or faint varicolored cytoplasm, and (4) crowded clusters showing scarce mucin and nuclear atypia. The surgically resected uterus revealed LEGH-mimicking lesion with fused papillae and a cribriform pattern in the endocervix and many glands exhibiting gastric differentiation that invaded deeper areas of the stroma with a subtle stromal reaction. Compared with histologic findings, two types of clusters, the crowded cluster with scarce mucin and the cluster with distorted chicken-wire-mesh-type appearance, were considered as adenocarcinoma, and the latter was interpreted as a gastric-type adenocarcinoma. Three-dimensional varicolored type clusters showed atypical features, but insufficient atypical features compared with those of adenocarcinoma. Detection of clusters with varicolored mucin on conventional Pap smear may provide a clue for the early recognition of the malignant potential of LEGH on cytology. The chicken-wire-mesh type clusters may be a characteristic cytologic finding of MDA.
- Published
- 2018
37. Extraovarian Fibroma With Minor Sex Cord Elements: A Case Report and Literature Review
- Author
-
Yumika Watanabe, Makiko Omori, Shuji Hirata, Megumi Oi, Akihiko Hashi, Tetsuo Kondo, Jiro Fukushima, and Tadao Nakazawa
- Subjects
Pathology ,medicine.medical_specialty ,Gonadal cord ,medicine.medical_treatment ,Broad Ligament ,Salpingo-oophorectomy ,Fibroma ,Hysterectomy ,Pathology and Forensic Medicine ,Broad ligament ,Diagnosis, Differential ,03 medical and health sciences ,Rare Diseases ,0302 clinical medicine ,Laparotomy ,Biomarkers, Tumor ,medicine ,Fallopian Tube Neoplasms ,Humans ,Sex Cord-Gonadal Stromal Tumors ,Fallopian Tubes ,Aged ,Granulosa Cell Tumor ,Ultrasonography ,030219 obstetrics & reproductive medicine ,business.industry ,Carcinoma ,Ovary ,Uterus ,medicine.disease ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Mitotic Figure ,Immunohistochemistry ,Female ,Surgery ,Anatomy ,business ,Sex Cord-Stromal Tumor ,Fallopian tube - Abstract
Extraovarian sex cord–stromal tumor is an exceedingly uncommon entity that may cause a diagnostic dilemma clinically. We report a case of extraovarian fibroma with minor sex cord elements arising in the left broad ligament. The patient was a 66-year-old woman presenting with an intra-abdominal solid mass near the left ovary on magnetic resonance imaging. The tumor was located in the left broad ligament in contact with the left ovary and fallopian tube based on laparotomy findings. Histological examination revealed that the tumor was a fibroma that contained cell nests with aggregates resembling the Call-Exner bodies of granulosa cell tumors and irregularly shaped cell nests composed of undifferentiated sex cord–type cells. Cellular atypia or mitotic figures were not identified in any of the components. It was speculated that the possible site of origin of this tumor might be a supernumerary ovary in the broad ligament that was thought to be derived from embryonic remnants.
- Published
- 2017
38. Utility of imaging modalities for predicting carcinogenesis in lobular endocervical glandular hyperplasia
- Author
-
Shuji Hirata, Tetsuo Kondo, Makiko Omori, Yumika Watanabe, Kumiko Nakazawa, Masataka Kawai, Hiroko Fukasawa, Hikaru Tagaya, and Akihiko Hashi
- Subjects
Carcinogenesis ,Uterine Cervical Neoplasms ,Cervix Uteri ,medicine.disease_cause ,Pathology and Laboratory Medicine ,Cervix ,Imaging modalities ,Diagnostic Radiology ,Adenocarcinomas ,Ultrasound Imaging ,Medicine and Health Sciences ,Medicine ,Sampling (medicine) ,Reproductive System Procedures ,Ultrasonography ,Multidisciplinary ,medicine.diagnostic_test ,Radiology and Imaging ,Hyperplasia ,Middle Aged ,Magnetic Resonance Imaging ,Oncology ,Female ,Radiology ,Anatomy ,Genital Anatomy ,Research Article ,Adult ,medicine.medical_specialty ,Histology ,Imaging Techniques ,Science ,Early detection ,Surgical and Invasive Medical Procedures ,Adenocarcinoma in Situ ,Research and Analysis Methods ,Hysterectomy ,Carcinomas ,Signs and Symptoms ,Diagnostic Medicine ,Humans ,Aged ,Postmenopausal women ,Surgical Excision ,business.industry ,Reproductive System ,Cancers and Neoplasms ,Biology and Life Sciences ,Magnetic resonance imaging ,medicine.disease ,Lobular Endocervical Glandular Hyperplasia ,Lesions ,business - Abstract
ObjectivesTo investigate the use of imaging methods for predicting carcinogenesis in lobular endocervical glandular hyperplasia (LEGH).MethodsWe retrospectively analyzed preoperative images on transvaginal sonography and magnetic resonance imaging (MRI) in 23 cases with histologically diagnosed LEGH.ResultsShape of cervical multicystic lesions on MR images could be divided into two types the flower-type with many small cysts surrounded by larger cysts, and the raspberry-type with many tiny, closely aggregated cysts. Six (46%) of 13 cases had raspberry-type lesions that were not detected on transvaginal sonography but were seen on MRI. Adenocarcinoma in situ (AIS) was identified in 4 postmenopausal women with raspberry-type lesions during the follow-up periods. In these cases, cytologic examination by targeted endocervical sampling using sonography enabled early detection of AIS.ConclusionsMRI and cytologic examination by targeted endocervical sampling may be very useful for predicting carcinogenesis in LEGH.
- Published
- 2019
39. Extranodal NK/T-cell lymphoma, nasal type of the uterine cervix: A case report
- Author
-
Shuji Hirata, Naoki Oishi, Kumiko Nakazawa, Toru Mitsumori, Makiko Omori, Tsutomu Yuminamochi, Tadao Nakazawa, and Keita Kirito
- Subjects
Pathology ,medicine.medical_specialty ,Histology ,CD30 ,Extranodal NK/T-cell lymphoma, nasal type ,Pathology and Forensic Medicine ,03 medical and health sciences ,Cytokeratin ,0302 clinical medicine ,hemic and lymphatic diseases ,Biopsy ,medicine ,Cervix ,biology ,medicine.diagnostic_test ,business.industry ,Chromogranin A ,General Medicine ,medicine.disease ,Lymphoma ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,biology.protein ,CD5 ,business ,030217 neurology & neurosurgery - Abstract
We report a rare case of extranodal NK/T-cell lymphoma, nasal type of the uterine cervix that showed cytologic features mimicking cervical cancer. A 65-year-old woman presented with vaginal bleeding. Gynecological examination revealed a bulky tumor of the cervix. A conventional Papanicolaou-stained cervical smear showed hypercellularity consisting of numerous variably sized cohesive clusters that mimicked epithelial tumors, with a necrotic and inflammatory background. A small number of individually scattered cells were also identified. These scattered cells showed pleomorphic, often cleaved, or horseshoe-shaped nuclei and pale cytoplasm. Biopsy specimens revealed a diffuse growth of atypical cells with an angiocentric pattern. Extensive necrosis and infiltration of inflammatory cells were present. There were numerous mitotic figures. The tumor cells were positive for CD45RO, CD3e, CD56, granzyme B, TIA-1, CD7, and Epstein-Barr virus (EBV)-encoded small RNA (EBER) by in situ hybridization, and negative for cytokeratin, chromogranin A, synaptophysin, CD4, CD5, CD8, CD20, and CD30. Based on these findings, this tumor was diagnosed as extranodal NK/T-cell lymphoma, nasal type of the uterine cervix.
- Published
- 2016
40. Oxidative state and zona-binding ability in mouse spermatozoa treated with reduced glutathione
- Author
-
Kaoruko, Mizuno, Shuji, Hirata, Tsuyoshi, Kasai, Seiichiro, Nagai, Shoji, Ohta, and Kazuhiko, Hoshi
- Subjects
endocrine system ,urogenital system ,Andrology ,reproductive and urinary physiology - Abstract
Background and Aims: Nuclear proteins in mature mammalian spermatozoa nuclei are oxidized to form numerous disulfide bonds. Reduced glutathione (GSH) in the oocyte has been linked to spermatozoan nuclear decondensation after fertilization. In this study, we analyzed whether GSH reduced protamines in sperm nuclei in vitro, and examined the zona‐binding ability of treated nuclei.
- Published
- 2018
41. Spermatozoon and mitochondrial DNA
- Author
-
Shuji, Hirata, Kazuhiko, Hoshi, Tomoko, Shoda, and Tadashi, Mabuchi
- Subjects
Spermatology - Abstract
In eukaryotic cells, mitochondria are the major site of ATP production, which is achieved through the electron‐transport chain and oxidative phosphorylation, according to the energy demand. Mitochondria contain their own genome (mitochondrial DNA, mtDNA) on which a limited number of genes are encoded. In the human sperm, mitochondria helically wrap the midpiece of the tail and supply the energy for the driving force of motility. While various mutations in mtDNA in somatic cells are found to be associated with a wide spectrum of diseases, it is also reported that the abnormal mtDNA causes astenozoospermia and male infertility. At fertilization, the paternal mitochondria and mtDNA are rapidly degraded early in embryogenesis, thus, only maternal mtDNA is transmitted to the descendant. We briefly review here the basic characteristics of mtDNA and its maternal transmission during fertilization, as well as male infertility. (Reprod Med Biol 2002; 1: 41–47)
- Published
- 2018
42. Relation between low 50-g glucose challenge test results and small-for-gestational-age infants
- Author
-
Kohta Suzuki, Satoshi Shinohara, Mitsuo Hirai, and Shuji Hirata
- Subjects
Pediatrics ,medicine.medical_specialty ,business.industry ,Incidence (epidemiology) ,Confounding ,Obstetrics and Gynecology ,Retrospective cohort study ,Odds ratio ,medicine.disease ,Confidence interval ,Gestational diabetes ,medicine ,Small for gestational age ,Gestation ,business - Abstract
Aim There is no consensus opinion regarding a possible relation between low 50-g glucose challenge test (GCT) results and small-for-gestational-age infants (SGA). This study aimed to clarify the relation between low 50-g GCT results and SGA, after adjusting for potential confounding factors, using a large clinical dataset. Material and Methods Our retrospective cohort study evaluated the obstetric records of women who delivered at Kofu Municipal Hospital (Japan) between January 2011 and December 2013. The exclusion criteria were gestational diabetes mellitus, diabetes in pregnancy, and GCT results of ≥140 mg/dL. Based on these criteria, we included 1603 women who had undergone a GCT between 24 and 28 weeks of gestation, and divided the subjects into a low-GCT group (≤90 mg/dL) and a non-low-GCT group (91–139 mg/dL). The χ2-test and multivariate logistic regression analysis were used to investigate the association between low GCT results and SGA. Results The mean subject age was 30.4 ± 5.4 years, with 45.1% nulliparity (n = 723) and 1538 (96.0%) term deliveries. The incidence of SGA was 10.7% (172/1603), and 17.9% (287/1603) of the women had low GCT results. Low GCT results were significantly associated with an increased risk of SGA (odds ratio, 1.66; 95% confidence interval, 1.14–2.42), after controlling for maternal age, pre-pregnancy maternal weight, maternal weight gain during pregnancy, and pregnancy-induced hypertension. Conclusion It appears that there is a significant association between low GCT results and SGA. However, further studies are needed to explore the detailed mechanisms of this association.
- Published
- 2015
43. Cytologic features of ovarian granulosa cell tumors in pleural and ascitic fluids
- Author
-
Shuji Hirata, Makiko Omori, Hiroko Fukasawa, Kumiko Nakazawa, Yoshio Ishii, Tetsuo Kondo, Tsutomu Yuminamochi, and Akihiko Hashi
- Subjects
Pathology ,medicine.medical_specialty ,Histology ,Ovarian Granulosa Cell ,business.industry ,Pleural effusion ,Granulosa cell ,Ovary ,General Medicine ,medicine.disease ,Pathology and Forensic Medicine ,medicine.anatomical_structure ,Call-Exner bodies ,Ascites ,Medicine ,Stage (cooking) ,medicine.symptom ,Differential diagnosis ,business - Abstract
Adult granulosa cell tumor (AGCT) is an uncommon neoplasm of the ovary with potential for aggressive behavior and late recurrence. The most important prognostic factor for AGCT is tumor stage. Thus, cytological assessment of pleural or ascitic fluids is crucial for initial staging and subsequent patient management. We report herein two cases of ovarian AGCT presenting with exfoliated tumor cells in pleural and ascitic fluid. The first case involved a 61-year-old woman who presented with stage Ic (a) AGCT. Seven years after initial diagnosis, pleural effusion and pleural dissemination were identified. The second case involved a 50-year-old woman who presented with stage IV AGCT with massive ascites and right pleural effusion. Fluid cytology from both cases showed cohesive or loose clusters of small uniform neoplastic cells with round-to-oval nuclei, coffee-bean-shaped nuclear grooves, small nucleoli, and scant cytoplasm. Call-Exner bodies were also observed in these cytologic specimens. In the differential diagnosis of small monomorphic tumor cells in pleural effusion or ascites, coffee-bean-shaped nuclear grooves and cell clusters forming Call-Exner bodies are diagnostic clues of AGCT.
- Published
- 2015
44. Cardiac arrest during spinal anesthesia for cervical conization: a case report
- Author
-
Ikuko Sakamoto, Satoshi Shinohara, Masahiro Numata, Shuji Hirata, Atsushi Ikegami, and Katsuhiro Teramoto
- Subjects
medicine.medical_specialty ,spinal injections ,Spinal injections ,business.industry ,medicine.medical_treatment ,Spinal anesthesia ,Case Report ,030208 emergency & critical care medicine ,Case Reports ,General Medicine ,Cervical conization ,gynecologic surgical procedures ,Gynecologic surgical procedures ,Surgery ,conization ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,Medicine ,Complication ,business ,spinal anesthesia ,heart arrest - Abstract
Key Clinical Message Spinal anesthesia is regularly performed worldwide and is an integral part of the modern day anesthesia practice. Although unexpected cardiac arrests during this procedure are very rare, medical professionals should be aware of the potential for this complication. In making the decision to use spinal anesthesia, judicious patient selection, adequate preventive measures, and strict monitoring are important.
- Published
- 2016
45. Cytological features of transitional cell tumors of the ovary
- Author
-
Shuji Hirata, Makiko Omori, Yoshio Ishii, Hiroko Fukasawa, Kumiko Nakazawa, Tetsuo Kondo, Ryohei Katoh, and Akihiko Hashi
- Subjects
Pathology ,medicine.medical_specialty ,medicine.anatomical_structure ,medicine ,Transitional Cell ,Ovary ,Biology - Published
- 2014
46. Adenomyosis as a Potential Risk Factor for Adverse Pregnancy Outcomes: A Multicenter Case-Control Study.
- Author
-
Satoshi Shinohara, Yasuhiko Okuda, Shuji Hirata, and Kohta Suzuki
- Abstract
As the number of women who postpone their first pregnancy until their late 30s or early 40s is increasing, adenomyosis is more frequently encountered by obstetricians. Some studies have reported on the relationship between adenomyosis and pregnancy complications. We aimed to investigate the effect of adenomyosis on pregnancy complications and outcomes and associations between adenomyosis type and pregnancy outcomes. This multicenter retrospective 1:4 case-control study included 61 women with singleton pregnancies diagnosed with adenomyosis. The control group included women with singleton pregnancies without adenomyosis; these women were matched to those with adenomyosis using propensity scores. The incidence of obstetric complications, delivery, and neonatal outcomes were compared. The adenomyosis group (n = 61) had significantly higher incidence of preterm delivery (21.3% vs. 9.4%), hypertensive disorders of pregnancy (13.1% vs. 5.3%), cesarean delivery (46.0% vs. 20.9%), and postpartum hemorrhage (57.3% vs. 36.8%) than the control group (n = 244). Subgroup analysis by the adenomyosis type revealed that the diffuse adenomyosis group (n = 41) was significantly more likely to experience preterm labor (29.3% vs. 7.3%), hypertensive disorders of pregnancy (17.0% vs. 5.5%), severe hypertensive disorders of pregnancy (12.2% vs. 1.8%), preterm premature rupture of membranes (12.2% vs. 2.4%), cesarean delivery (61.3% vs. 18.9%), and postpartum hemorrhage (70.7% vs. 44.5%) than the control group (n = 164). The focal adenomyosis (n = 20) group was not statistically different from the control group (n = 80) with respect to obstetric complications. Women with diffuse adenomyosis require more careful perinatal management than previously thought. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
47. Association between infertility treatment and intrauterine growth: a multilevel analysis in a retrospective cohort study.
- Author
-
Satoshi Shinohara, Shuji Hirata, and Kohta Suzuki
- Abstract
Objectives This study aimed to identify intrauterine growth differences according to infertility treatment compared with spontaneous conception and to describe intrauterine growth trajectories. Design Retrospective cohort study. Setting A single primary and tertiary medical centre in Japan. Participants This study included singleton pregnant women with prenatal check-ups and delivery at the University of Yamanashi Hospital between 1 July 2012 and 30 September 2017. Patients were divided into four groups: spontaneous conception, infertility treatment without assisted reproductive technology (ART), fresh-embryo transfer and frozen embryo transfer (FET). Interventions Differences in intrauterine growth according to the infertility treatment, including ART, and birth weight were evaluated. Multilevel analysis was employed to evaluate intrauterine growth trajectories stratified by the sex of the offspring. Primary outcome measure Estimated fetal weight (EFW) assessed by ultrasound examination. Results We assessed data from 37 239 prenatal examination results from 2377 pregnant women (spontaneous conception, n=1764; infertility treatment without ART, n=171; fresh-embryo transfer, n=112; and FET, n=330) in the final analysis. Multilevel analysis was adjusted for gestation duration, gestation period, parity, hypertensive disorders of pregnancy, type of infertility treatment, maternal age, smoking status, placenta previa, thyroid disease, gestational diabetes mellitus and the interaction between each potential confounding factor and gestation duration. In male fetuses, the interaction between FET and gestational duration (estimate: 0.36; 95% CI: 0.06 to 0.67) significantly affected the EFW. Similarly, in female fetuses, FET (estimate: −69.85; 95% CI: −112.09 to −27.61) and the interaction between FET and gestation duration (estimate: 0.57; 95% CI: 0.28 to 0.87) significantly affected the EFW. Conclusions This study shows that FET affects intrauterine growth trajectory from the second trimester to term, particularly in female fetuses. Our findings require further prospective research to examine the effect of infertility treatment on fetal growth. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
48. Liver injury after cardiopulmonary resuscitation for cardiac arrest during cesarean delivery
- Author
-
S. Shinohara, T. Ogawa, Shuji Hirata, Y. Uchida, and M. Kasai
- Subjects
Adult ,medicine.medical_treatment ,MEDLINE ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,030202 anesthesiology ,X ray computed ,Pregnancy ,Medicine ,Humans ,Cardiopulmonary resuscitation ,Cesarean delivery ,Liver injury ,business.industry ,Cesarean Section ,Obstetrics and Gynecology ,medicine.disease ,Cardiopulmonary Resuscitation ,Heart Arrest ,Anesthesiology and Pain Medicine ,Tomography x ray computed ,Liver ,Anesthesia ,Female ,business ,Tomography, X-Ray Computed ,Clinical death - Published
- 2016
49. USEFULNESS OF CRYOPRECIPITATE IN THE TREATMENT OF MASSIVE OBSTETRICAL HEMORRHAGE
- Author
-
Shuji Hirata, Hiroji Higuchi, Kazuhiko Hoshi, Yasuhiko Okuda, Eriko Ogasahara, Mayuko Komuro, Rei Sunami, Yuko Nakajima, Hiroko Fukasawa, Mitsue Fushimi, Noriaki Iwao, and Makiko Omori
- Subjects
medicine.medical_specialty ,business.industry ,Cryoprecipitate ,medicine ,Intensive care medicine ,business - Published
- 2012
50. Fetal cell microchimerism develops through the migration of fetus-derived cells to the maternal organs early after implantation
- Author
-
Tsutomu Yuminamochi, Kazuhiko Hoshi, Rei Sunami, Mayuko Komuro, and Shuji Hirata
- Subjects
Male ,Pluripotent Stem Cells ,medicine.medical_specialty ,Immunology ,Population ,Mice, Transgenic ,Biology ,Hysterectomy ,Kidney ,Chimerism ,Streptozocin ,Mice ,Fetus ,Cell Movement ,Pregnancy ,Internal medicine ,medicine ,Animals ,Immunology and Allergy ,Placental Circulation ,Embryo Implantation ,education ,Pancreas ,education.field_of_study ,Obstetrics and Gynecology ,Cell Differentiation ,Microchimerism ,medicine.disease ,Streptozotocin ,Mice, Inbred C57BL ,Diabetes Mellitus, Type 1 ,Endocrinology ,medicine.anatomical_structure ,Liver ,Reproductive Medicine ,Female ,Bone marrow ,Stem cell ,medicine.drug - Abstract
Fetus-derived cells are present in the blood and tissues of the maternal body over a long period of time, even after delivery, resulting in fetal cell microchimerism. The exact process by which fetal cells cross the placental barrier to enter the maternal circulation is unclear. The objective of this paper was to determine the time during pregnancy that fetal cells with multilineage potential migrate to the maternal organs. Wild type female mice were crossbred with male transgenic mice, expressing enhanced green fluorescent protein (EGFP). Total hysterectomies were performed at different time points of pregnancy. On day 60 after surgery, mice were injected with either streptozotocin (STZ) to induce insulin-dependent diabetes mellitus, or vehicle. Detection and quantification of fetal cells were then undertaken in a variety of maternal organs via fluorescent microscopy and quantitative PCR amplification of the gfp transgene. In vehicle control mice, fetal cells were detected only in the maternal bone marrow. However on day 30 after STZ injection, fetal cells were detected not only in bone marrow but also in the maternal pancreas, liver and kidney. Histological analysis showed differentiated fetal cells within the pancreatic acinar cells, hepatocytes and tubular epithelial cells. Their morphological appearance was indistinguishable from their maternal counterparts, and their frequency in these organs was constant, regardless of the timing of hysterectomy. These results indicate that most fetal cells with multilineage potential in maternal tissues migrate to the maternal body early after implantation, and thereafter sustain their population over the long term after delivery.
- Published
- 2010
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.