著者 増山 寿|
発行日 1995-03-31
出版物タイトル
資料タイプ 学位論文
JaLCDOI 10.18926/AMO/32843
フルテキストURL fulltext.pdf
著者 Kumazawa, Kazumasa| Hiramatsu, Yuji| Masuyama, Hisashi| Mizutani, Yasushi| Nakata, Takakimi| Kudo, Takafumi|
抄録 <p>Surfactant treatment in infants with respiratory distress syndrome (RDS) has decreased neonatal mortality. With the advent of this therapy, it has become important to predict accurately the fetal lung maturity of a fetus before delivery. We evaluated the stable microbubble test (SMT), surfactant protein-A (SP-A) and hepatocyte growth factor (HGF) in amniotic fluid as predicting markers for RDS. Of 55 amniotic fluid samples obtained by amniocentesis from women less than 37 weeks pregnant, the SMT values were as follows: sensitivity 76.5%, specificity 84.2%, positive predictive value 68.4%, negative predictive value 88.9% and overall accuracy 81.8%. For SP-A, the values were 88.2%, 65.8%, 53.6%, 92.6% and 72.7%, respectively. If we used both SMT and SP-A, we could diagnose with 100% accuracy that a case with measurements of SMT &#62; or = 2 and SP-A &#62; or = 420 ng/ml would not complicate with RDS (24/24). However, the RDS diagnostic accuracy of HGF does not equal to those of SMT and SP-A levels. We concluded that the rapidity, simplicity and reliability of SMT was very useful during 24-36 weeks of gestation as a bedside procedure to predict fetuses likely to develop RDS. We also noted the additive effect of SP-A in improving the accuracy of lung maturity diagnosis.</p>
キーワード respiratpry distress syndrome stable microbubble test surfactant protein-A hepatocyte growth factor
Amo Type Article
発行日 2003-02
出版物タイトル Acta Medica Okayama
57巻
1号
出版者 Okayama University Medical School
開始ページ 25
終了ページ 32
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
OAI-PMH Set 岡山大学
論文のバージョン publisher
査読 有り
Submission Path amo/vol57/iss1/4
PubMed ID 12765221
Web of Sience KeyUT 000181198200004
著者 増山 寿|
発行日 2005-01-31
出版物タイトル 岡山医学会雑誌
116巻
3号
資料タイプ 学術雑誌論文
JaLCDOI 10.18926/AMO/31972
フルテキストURL fulltext.pdf
著者 Hiramatsu, Yuji| Masuyama, Hisashi| Ishida, Makoto| Murakami, Kazuharu| Sakurai, Masaru|
抄録 <p>It is well known that antecedent term delivery and metastasis to sites other than the lungs and vagina are high risk factors for patients with gestational trophoblastic neoplasia. Here we report on a patient with choriocarcinoma who presented with brain and lung metastases after term delivery and was treated by EMA-CO chemotherapy. A 31-year-old woman delivered a healthy infant at term. Frequent episodes of hemoptysis occurred beginning 3 weeks after the delivery. On admission to our hospital, she had lesions in the uterus, lungs and brain as well as motor aphasia and hemiplagia. The pretreatment beta-hCG level was 21,000 ng/ml and the WHO score was 16 (high-risk group). The EMA-CO regimen was administrated as first-line chemotherapy and the patient achieved complete remission after 7 courses. Treatment was terminated after 11 courses and maintained with etoposide (25 mg/day) for 6 months. The patient has remained in complete remission for more than 16 years without other adjuvant therapies. We believe that EMA-CO can currently be considered the regimen of first choice for most high-risk patients with gestational trophoblastic neoplasia in view of its effectiveness and excellent tolerability.</p>
キーワード choriocarcinoma term delivery EMA-CO chemotherapy metastasis
Amo Type Article
発行日 2005-10
出版物タイトル Acta Medica Okayama
59巻
5号
出版者 Okayama University Medical School
開始ページ 253
終了ページ 258
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
OAI-PMH Set 岡山大学
論文のバージョン publisher
査読 有り
Submission Path amo/vol59/iss5/9
PubMed ID 16286962
Web of Sience KeyUT 000232835600009
著者 増山 寿|
発行日 2006-01-04
出版物タイトル 岡山医学会雑誌
117巻
3号
資料タイプ 学術雑誌論文
JaLCDOI 10.18926/AMO/32847
フルテキストURL fulltext.pdf
著者 Akahori, Yoichiro| Takamoto, Norio| Masumoto, Akio| Inoue, Seiji| Nakatsukasa, Hideki| Masuyama, Hisashi| Hiramatsu, Yuji|
抄録 <p>Ciliary neurotrophic factor (CNTF) has been shown to decrease food intake in mouse models of obesity and to improve insulin sensitivity. It is well known that tight regulation of glucose metabolism is essential for successful gestational outcomes (e.g. fetal growth), and that abnormal insulin resistance is associated with preeclampsia (PE). To investigate the possibility that CNTF might be involved in the regulation of insulin resistance during pregnancy, circulating levels of CNTF were assessed in non-pregnant, normal pregnant, postpartum, and pregnant women with PE. Sera from healthy non-pregnant women (n10), pregnant women (n30:1st trimester;n10, 2nd trimester n10;3rd trimester;n10), postpartum women (n10), and patients with PE (n11) were studied with Western blotting. Circulating CNTF was detected by Western blotting, and the levels of CNTF in pregnant women were decreased as compared with those in non-pregnant women, and tended to decrease as pregnancy progressed. A significant decrease was found in PE as compared with normal pregnancy. Circulating CNTF might be associated with physiological and abnormal insulin resistance during pregnancy.</p>
キーワード ciliary neurotrophic factor insulin sensitivity pregnancy preeclampsia placenta
Amo Type Original Article
発行日 2010-04
出版物タイトル Acta Medica Okayama
64巻
2号
出版者 Okayama University Medical School
開始ページ 129
終了ページ 136
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
OAI-PMH Set 岡山大学
論文のバージョン publisher
査読 有り
Submission Path amo/vol64/iss2/7
PubMed ID 20424668
Web of Sience KeyUT 000276996900007
JaLCDOI 10.18926/AMO/40133
フルテキストURL 64_4_249.pdf
著者 Masumoto, Akio| Masuyama, Hisashi| Takamoto, Norio| Akahori, Yoichiro| Hiramatsu, Yuji|
抄録 It has been reported that prolactin (PRL) is cleaved to 14 or 16 kDa fragments by cathepsin D in vitro and in vivo, and that such fragments exhibit antiangiogenic and proapoptotic properties. The aim of this study was to investigate the relationship between pregnancy induced hypertension (PIH) and the placental expression of antiangiogenic PRL fragments and cathepsin D. Placental expression of PRL fragments and cathepsin D was evaluated by Western blot analysis in a group of 9 pregnant women consisting of 5 normal pregnancies and 4 severe PIH cases. Antiangiogenic PRL fragments were detected in 4 placental samples from all PIH cases but not detected in those from normal pregnancies (p0.05). The expression of cathepsin D in PIH placentas was significantly lower than that in those without PIH (p0.05), while the placental expression of procathepsin D was significantly greater in PIH cases than in the normal pregnancies (p0.05). These data suggest that antiangiogenic PRL fragments in the placenta may be present only in PIH cases, and that PRL fragments in the placenta might be implicated in the pathophysiology of PIH.
キーワード pregnancy induced hypertension preeclampsia prolactin prolactin fragment cathepsin-D
Amo Type Original Article
発行日 2010-08
出版物タイトル Acta Medica Okayama
64巻
4号
出版者 Okayama University Medical School
開始ページ 249
終了ページ 255
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
OAI-PMH Set 岡山大学
著作権者 Okayama University Medical School
論文のバージョン publisher
査読 有り
Submission Path amo/vol64/iss4/6
PubMed ID 20802542
Web of Sience KeyUT 000281384400006
JaLCDOI 10.18926/AMO/48267
フルテキストURL 66_2_171.pdf.pdf
著者 Masuyama, Hisashi| Nobumoto, Etsuko| Segawa, Tomonori| Hiramatsu, Yuji|
抄録 Preeclampsia may be due to an excess of circulating anti-angiogenic growth factors derived from the placenta, but metabolic syndrome-like disorders may also set off a cascade of placental and systemic inflammation and oxidative stress. We present a case of severe superimposed preeclampsia with obesity, diabetes and a mild imbalance of angiogenic factors, in which diet therapy ameliorated the preeclamptic signs while improving the adiponectin level. A 41-year-old pregnant woman with obesity and diabetes was referred to our hospital because of severe proteinuria and hypertension at 22 weeks of gestation. After administration of insulin and hydralazine with diet therapy, her hypertension and proteinuria were ameliorated with a 15-kg weight loss. Her adiponectin level was low and her leptin level was high, but her angiogenic factor levels were within the normal ranges for pregnant women at admission. The diet therapy ameliorated her hypertension and proteinuria while improving her adiponectin level as she achieved weight loss. This case suggests that diet therapy for obese preeclampsia patients with a mild imbalance of anti-and pro-angiogenic factors may play an important role in managing preeclampsia. Measurements of maternal adipocytokines and angiogenic factors may be important to distinguish the main cause of preeclampsia, i.e., poor placentation or maternal constitutional factors, for managing preeclampsia in patients with obesity.
キーワード adipocytokine angiogenic factor diet therapy obesity preeclampsia
Amo Type Case Report
発行日 2012-04
出版物タイトル Acta Medica Okayama
66巻
2号
出版者 Okayama University Medical School
開始ページ 171
終了ページ 175
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
OAI-PMH Set 岡山大学
著作権者 CopyrightⒸ 2012 by Okayama University Medical School
論文のバージョン publisher
査読 有り
Submission Path amo/vol66/iss2/10
PubMed ID 22525475
Web of Sience KeyUT 000303175300010
フルテキストURL K0005453_other1.pdf
著者 Nobumoto, Etsuko| Masuyama, Hisashi| Hiramatsu, Yuji| Sugiyama, Takashi| Kusaka, Hideto| Toyoda, Nagayasu|
抄録 Background  The new diagnostic criteria for gestational diabetes mellitus (GDM), proposed by the International Association of Diabetes and Pregnancy Study Groups in 2010, were recently accepted in Japan. Therefore, the frequency of GDM is four times higher than previously recorded. This means that GDM has become a more clinically important disease. This study aimed to assess how the number of patients with GDM as well as its complications have changed after adoption of the new criteria. Methods  A total of 3,610 pregnant women in the Japan Assessment of GDM Screening Trial and Okayama University Hospital were included. We analyzed the prevalence of GDM and its complications using the old and new criteria. Results  The prevalence of perinatal outcomes was increased by adopting the new criteria. There were many important perinatal complications in the additional new GDM criteria; therefore, patients with mild GDM, such as one-point disorder patients, should have careful interventions. Admission to the neonatal intensive care unit was significantly increased (p = 0.01) according to the new GDM criteria because the old criteria were stricter than the new ones. GDM patients with obesity (BMI ≥ 25 kg/m2) had a high frequency of perinatal complications that could require active intervention and strict follow-up. Conclusions  Because the new GDM criteria greatly affect perinatal complications, intervention for GDM starting at an early stage and strict follow-up (especially GDM with obesity) are important for reducing complications as well as the incidence of diabetes and metabolic syndrome in the mother and child.
キーワード New GDM criteria Perinatal complications Obesity 75-g oral glucose tolerance test
備考 The final publication is available at Springer 学位審査副論文
発行日 2015-09
出版物タイトル Diabetology International
6巻
3号
出版者 Springer Japan
開始ページ 226
終了ページ 231
ISSN 21901678
NCID AA12503387
資料タイプ 学術雑誌論文
言語 English
OAI-PMH Set 岡山大学
著作権者 https://creativecommons.org/licenses/by-nc-nd/4.0/deed.ja
論文のバージョン author
Web of Sience KeyUT 000366631000009
関連URL http://doi.org/10.1007/s13340-014-0193-8 http://ousar.lib.okayama-u.ac.jp/55005
JaLCDOI 10.18926/AMO/54985
フルテキストURL 71_2_161.pdf
著者 Nobumoto, Etsuko| Masuyama, Hisashi| Maki, Jota| Eguchi, Takeshi| Tamada, Shoko| Mitsui, Takashi| Eto, Eriko| Hayata, Kei| Hiramatsu, Yuji|
抄録 Although gestational hypertension (GH) is thought to be different from preeclampsia (PE), in Japan GH and PE are usually treated as the same disease (i.e., pregnancy-induced hypertension). Here we sought to determine whether there are any differences in fetal growth and maternal kidney function between pregnancies with PE and those with GH. We retrospectively analyzed 61 GH patients and 60 PE patients with singleton pregnancies who delivered at Okayama University Hospital (2008-2015). We compared maternal and perinatal outcomes and maternal kidney function parameters between the GH and PE pregnancies. The mean values of maternal age (p=0.01), gestational age at delivery (p<0.0001), placental weight (p=0.002), birth weight and height (p<0.0001, p=0.0001), and head circumference standard deviation score (p=0.007) of newborns of the GH group were significantly higher than those of the PE group. The duration until termination of PE or GH was not significantly correlated with kidney function. The birth weight percentile was significantly correlated with kidney function in PE but not GH. However, GH patients with poor kidney function and small-for-gestational age infants showed perinatal outcomes similar to those of the PE group. Monitoring kidney function is thus important for determining the severity of PE and GH.
キーワード preeclampsia gestational hypertension perinatal outcome kidney function fetal growth
Amo Type Original Article
発行日 2017-04
出版物タイトル Acta Medica Okayama
71巻
2号
出版者 Okayama University Medical School
開始ページ 161
終了ページ 169
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
OAI-PMH Set 岡山大学
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
Submission Path amo/vol71/iss2/10
PubMed ID 28420898
JaLCDOI 10.18926/AMO/54988
フルテキストURL 71_2_181.pdf
著者 Hayata, Kei| Hiramatsu, Yuji| Masuyama, Hisashi| Eto, Eriko| Mitsui, Takashi| Tamada, Shoko|
抄録 We experienced a case of advanced maternal age in which a fetus was found to be positive for trisomy 18 at re-examination following indeterminate non-invasive prenatal genetic testing (NIPT), the amniotic fluid chromosomal test revealed a normal karyotype, and confined placental mosaicism (CPM) was observed in an SNP microarray analysis of the placenta. The child was born with no defects or complications. In the present case, the result of the original NIPT at week 15 of pregnancy was indeterminate and the subsequent re-examination result was positive; since the definitive normal diagnosis was not reported until the latter half of week 21, the pregnant patient was subjected to psychological stress for a long period of time. The problem with NIPT is that most of the fetus-derived cell-free DNA in the maternal blood is not derived directly from the fetus but from the villus cells of the placenta, leading to indefinite diagnoses; for that reason, the pregnant patient was subjected to psychological stress for a long period of time. Of the 18,251 cases undergoing NIPT in the past 2 years in Japan, 51 had indeterminate results; this was the second case in which a subsequent re-examination gave a positive result for trisomy 18.
キーワード non-invasive prenatal genetic testing massively parallel sequencing confined placental mosaicism genetic counseling trisomy 18
Amo Type Case Report
発行日 2017-04
出版物タイトル Acta Medica Okayama
71巻
2号
出版者 Okayama University Medical School
開始ページ 181
終了ページ 185
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
OAI-PMH Set 岡山大学
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
Submission Path amo/vol71/iss2/13
PubMed ID 28420901