岡山医学会 Acta Medica Okayama 0030-1558 137 3 2025 流死産をあきらめない：不育症の治療とケア―第７回日本不育症学会学術集会を岡山で開催― 147 148 EN Mikiya Nakatsuka Faculty of Health Sciences, Okayama University, The Reproduction Center, Okayama University Hospital, OKAYAMA Infertility Consultation Center No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 79 2 2025 Relationship between Personality Traits and Postpartum Depressive Symptoms in Women who Became Pregnant via Infertility Treatment 109 116 EN Kyoko Awai Graduate School of Health Sciences, Okayama University Mikiya Nakatsuka Faculty of Health Sciences, Okayama University Original Article 10.18926/AMO/68649 The status of postpartum depression was elucidated herein with the use of the Edinburgh Postnatal Depression Scale (EPDS) in women in Shikoku, Japan who became pregnant and gave birth after undergoing infertility treatment, including assisted reproductive technology (ART). The assessment was performed during their children’s 4-month health examination. The relationships between postpartum depression and the mothers’ background factors and scores on the Big Five personality traits scale were also examined. Of the Big Five personality traits, the scores for neuroticism were significantly higher in the ART group (n=71) than in the general infertility treatment (n=118) and natural pregnancy (n=872) groups. No significant differences in EPDS scores were seen among these three groups. A logistic regression analysis showed that neuroticism was associated with an EPDS score ≧9 points, (which is suggestive of postpartum depression, ) in all groups. Moreover, although a long-standing marriage had an inhibitory effect on postpartum depression in the natural pregnancy group, no such trend was seen in the ART group, which included many women with long-standing marriages. Particularly for women who become pregnant by ART, an individualized response that pays close attention to the woman’s personality traits is needed. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 135 3 2023 メンタルヘルスと社会：多層的で持続可能な支援に向けて― 第51回日本女性心身医学会学術集会／第36回日本女性心身医学会研修会を終えて― 183 185 EN Mikiya Nakatsuka Faculty of Health Sciences, Okayama University, The Reproduction Center, Okayama University Hospital, Okayama University Gender Clinic No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 77 6 2023 Japanese Nursing Staff’s Knowledge and Attitude toward Bereavement Care for Couples with Miscarriage/Stillbirth and Its Associated Factors 577 587 EN Siyu Liu Graduate School of Health Sciences, Okayama University Rukmali Athurupana Graduate School of Health Sciences, Okayama University Hongmei Han Graduate School of Health Sciences, Okayama University Titi Yang Graduate School of Medicine, Density and Pharmaceutical Sciences, Okayama University Mikiya Nakatsuka Graduate School of Health Sciences, Okayama University Original Article 10.18926/AMO/66149 Bereavement care is conducted to meet the emotional needs of grieving couples who are devastated by the experience of a miscarriage or stillbirth. From January to April 2022, we distributed a questionnaire that assessed the knowledge and attitudes of Japanese nursing staff (nurses and midwives) in Japan’s Chugoku-Shikoku region toward bereavement care for couples with miscarriage/stillbirth. The 370 survey respondents’ answers revealed that the nursing staff’s knowledge regarding recurrent pregnancy loss and subsequent bereavement care was insufficient. About 41.1% and 64.1% of the respondents had received school and on-the-job education in bereavement care, respectively, and 79.2% expressed willingness to provide such care. Our analyses revealed that the following factors were associated with the nursing staff’s knowledge level: parent status, age, reproductive history, midwifery license, work experience and environment, and on-the-job education. The following were correlated with the staff’s willingness to provide bereavement care: work environment, midwifery license, bereavement care knowledge, and on-the-job education. Together our findings indicate that education plays a significant role in equipping caregivers to provide effective bereavement care for couples who have experienced a miscarriage or stillbirth. No potential conflict of interest relevant to this article was reported.

Public Library of Science Acta Medica Okayama 1932-6203 18 3 2023 Collaborative support for child abuse prevention: Perspectives of public health nurses and midwives regarding pregnant and postpartum women of concern EN Akemi Yokomizo Graduate School of Health Sciences, Okayama University Hiroko Nagae Kameda University of Health Science, Kamogawa City Rukmali Athurupana Graduate School of Health Sciences, Okayama University Mikiya Nakatsuka Graduate School of Health Sciences, Okayama University Child abuse is a globally prevalent problem, and its numbers have continuously increased in Japan over the past 30 years. Prevention of child abuse depends on the support available to pregnant and postpartum women from the time of pregnancy. Public health nurses and midwives are expected to provide preventive support in cooperation, as they can support pregnant and postpartum women from close proximity and recognize their health problems and potential signs of child abuse. This study aimed to deduce the characteristics of pregnant and postpartum women of concern, as observed by public health nurses and midwives, from the perspective of child abuse prevention. The participants comprised ten public health nurses and ten midwives with five or more years of experience working at the Okayama Prefecture municipal health centers and obstetric medical institutions. Data were collected through a semi-structured interview survey and analyzed qualitatively and descriptively using an inductive approach. The characteristics of pregnant and postpartum women, as confirmed by public health nurses, included four main categories: having "difficulties in daily life;" "a sense of discomfort of not feeling like a normal pregnant woman;" "difficulty in child-rearing behavior;" and "multiple risk factors checked by objective indicators using an assessment tool." The characteristics observed by midwives were grouped into four main categories: "mental and physical safety of the mother is in jeopardy;" have "difficulty in child-rearing behavior;" "difficulties in maintaining relationships with the surrounding people;" and "multiple risk factors recognized by an assessment tool." Public health nurses evaluated pregnant and postpartum women's daily life factors, while midwives evaluated the mothers' health conditions, their feelings toward the fetus, and stable child-rearing skills. To prevent child abuse, they utilized their respective specialties to observe those pregnant and postpartum women of concern with multiple risk factors. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 76 5 2022 Gestational Outcomes and Birth Weight in Japanese Women at the Upper and Lower limits of the Normal BMI range 519 526 EN Yoko Ishioka Graduate School of Health Sciences, Okayama University Hiroyuki Yamashita Yamaguchi Rosai Hospital Kinya Hamaguchi Hamaguchi Women's Clinic Yoshitaka Kuwahara Kuwahara Obstetrics and Gynecology Clinic Kaoru Nakamura Okinawa Kyoudou Hospital Mikiya Nakatsuka Graduate School of Health Sciences, Okayama University Original Article 10.18926/AMO/64032 To examine the outcome of gestational blood pressure and birth weight in women with normal pre-pregnancy BMI (18.5-25 kg/m2) who are at the lower and upper limits of this range, i.e., slightly underweight or slightly overweight. Overall, 2,038 Japanese women with low -risk who had delivered during January 2014–December 2016 were classified according to their pre-pregnancy BMI: underweight (< 18.5 kg/m2), slightly underweight (18.5≤BMI<21 kg/m2), normal (21≤BMI<23 kg/m2), slightly overweight (23≤BMI<25 kg/m2) and overweight (≤ 25 kg/m2). Their blood pressure during each trimester and birth weight was evaluated. The slightly overweight group showed a significantly higher blood pressure than the underweight and slightly underweight groups. Birth weight was lower in the slightly underweight than in the slightly overweight group (p<0.01). The incidence rate of “heavy for dates” (HFD) infants was significantly higher in the slightly overweight and overweight groups than in the other groups (p<0.05 and p<0.01, respectively). Weight gain of < 7 kg significantly increased the rate of “light for dates” (LFD) infants, while a weight gain of ≥13 kg significantly increased the rate of HFD infants (p<0.05 and p<0.01, respectively). Blood pressure during pregnancy was ssociated with pre-pregnancy BMI. The birth weight of infants of low-risk pregnant women is affected by both pre-pregnancy BMI and gestational weight gain. No potential conflict of interest relevant to this article was reported.

おかやま妊娠・出産サポートセンター(岡山県) ; 岡山大学保健学研究科 Acta Medica Okayama 2021 全国の「都道府県等における妊婦の方々への新型コロナウイルスに関する相談窓口」への調査報告書 : 新型コロナウィルス感染拡大に伴う妊産婦や母親の不安と支援の実態 1 50 EN Mikiya Nakatsuka Graduate School of Health Sciences, Okayama University No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 74 2 2020 Increased Plasma Levels of Platelet Factor 4 and β-thromboglobulin in Women with Recurrent Pregnancy Loss 115 122 EN Sayoko Kotani Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yasuhiko Kamada Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Keiko Shimizu Okayama Rosai Hospital Ai Sakamoto Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Mikiya Nakatsuka Graduate School of Health Sciences, Okayama University Yuji Hiramatsu Okayama City Hospital Hisashi Masuyama Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Original Article 10.18926/AMO/58269 Thrombosis in decidual vessels is one of the mechanisms of pregnancy loss. However, few studies have assessed the relation between platelet activation, which is known to cause of thrombosis, and recurrent pregnancy loss (RPL). We investigated platelet activation in women with RPL compared to controls by measuring plasma levels of platelet factor 4 (PF4) and β-thromboglobulin (βTG), and assessed correlations between PF4/βTG and coagulative risk factors associated with RPL. The study group included 135 women who had experienced two or more consecutive pregnancy losses. The control group included 28 age-matched healthy women who had never experienced pregnancy loss. PF4 and βTG plasma levels were significantly higher in the women with RPL than controls (PF4: 14.0 [8.0-20.0] vs. 9.0 [6.0-12.0] ng/ml, p=0.043; βTG: 42.0 [24.3-59.8] vs. 31.5 [26.6-36.4] ng/ml, p=0.002). There was a significant association between βTG and anti-phosphatidylethanolamine antibody immunoglobulin M (aPE IgM) (p=0.048). Among the women with RPL, 18 of those who were positive for PF4 (45%) and 18 of those who were positive for βTG (37%) were negative for all known coagulative risk factors associated with RPL. Measurements of PF4 and βTG may be important because they help identify women who are at risk of RPL. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 71 3 2017 Increased Anti-HSP60 and Anti-HSP70 Antibodies in Women with Unexplained Recurrent Pregnancy Loss 201 208 EN Miwa Matsuda Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Aiko Sasaki Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Keiko Shimizu Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yasuhiko Kamada Department of Obstetrics and Gynecology, Okayama University Hospital Soichi Noguchi Department of Obstetrics and Gynecology, Okayama University Hospital Yuji Hiramatsu Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Mikiya Nakatsuka Graduate School of Health Sciences, Okayama University Original Article 10.18926/AMO/55202 　Vascular dysfunction has been reported in women with recurrent pregnancy loss (RPL). We investigated the severity of vascular dysfunction in non-pregnant women with RPL and its correlation with anti-heat shock protein (HSP) antibodies that are known to induce arteriosclerosis. We measured the serum anti-HSP60 antibodies, anti-HSP70 antibodies, and anti-phospholipid antibodies (APA) in 68 women with RPL and 29 healthy controls. Among the women with RPL, 14 had a diagnosis of antiphospholipid syndrome (APS), and in the remaining 54, the causes for RPL were unexplained. Compared to the controls, the brachial-ankle pulse wave velocity (baPWV), carotid augmentation index (cAI), and uterine artery pulsatility index (PI) were all significantly higher in the women with both APS and unexplained RPL. Compared to the controls, the anti-HSP60 antibody levels were significantly higher in the APA-positive group of women with unexplained RPL, and the anti-HSP70 antibody levels were significantly higher in APS and APA-positive group of women with unexplained RPL. However, the anti-HSP60 and anti-HSP70 antibody levels did not correlate with the values of baPWV or cAI. Our results demonstrated anti-HSP60 and anti-HSP70 antibodies are increased in women with unexplained RPL. Further studies are needed to elucidate the roles of anti-HSP antibodies and their pathophysiology in unexplained RPL. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 70 1 2016 Erratum for Vol. 69, No. 6, pp339-348, Anxiety and Feelings toward Their Baby among Pregnant Women with Uterine Leiomyomas 67 68 EN Miki Senoo Mikiya Nakatsuka Erratum 10.18926/AMO/54008 Pregnant women with uterine leiomyomas may experience anxiety toward their pregnancies and unfavorable feelings toward their infants. From March to July 2010, we distributed anonymous self-recorded questionnaires to 200 pregnant women who visited Okayama Central Hospital for an antenatal check-up after informed consent was provided, and 132 women (23 pregnant women with uterine leiomyomas) were included in our study. Among the multiparous women in their first trimester, the women with uterine leiomyomas had a higher rate of anxiety than those without uterine leiomyomas. ʻAvoidanceʼ scores on the Feeling Toward the Baby Scale were significantly higher in the leiomyoma group. The conflict index scores tended to be higher in the leiomyoma group. A multivariate analysis revealed no factors associated with trait-anxiety scores, whereas high state-anxiety scores were correlated with low age;however, there was no correlation between these scores and uterine leiomyomas. Although no factors were associated with State-Trait Anxiety Inventory (STAI) and approach scores toward the baby, avoidance and conflict index scores were associated with the existence of uterine leiomyomas. In pregnant women with uterine leiomyomas, efforts should be made to reduce anxiety in the first trimester, and support should be provided to help these women develop positive feelings toward their babies. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 69 6 2015 Anxiety and Feelings toward Their Baby among Pregnant Women with Uterine Leiomyomas 339 348 EN Miki Senoo Mikiya Nakatsuka Original Article 10.18926/AMO/53908 Pregnant women with uterine leiomyomas may experience anxiety toward their pregnancies and unfavorable feelings toward their infants. From March to July 2010, we distributed anonymous self-recorded questionnaires to 200 pregnant women who visited Okayama Central Hospital for an antenatal check-up after informed consent was provided, and 132 women (23 pregnant women with uterine leiomyomas) were included in our study. Among the multiparous women in their first trimester, the women with uterine leiomyomas had a higher rate of anxiety than those without uterine leiomyomas. ʻAvoidanceʼ scores on the Feeling Toward the Baby Scale were significantly higher in the leiomyoma group. The conflict index scores tended to be higher in the leiomyoma group. A multivariate analysis revealed no factors associated with trait-anxiety scores, whereas high state-anxiety scores were correlated with low age;however, there was no correlation between these scores and uterine leiomyomas. Although no factors were associated with State-Trait Anxiety Inventory (STAI) and approach scores toward the baby, avoidance and conflict index scores were associated with the existence of uterine leiomyomas. In pregnant women with uterine leiomyomas, efforts should be made to reduce anxiety in the first trimester, and support should be provided to help these women develop positive feelings toward their babies. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 69 3 2015 Knowledge and Attitudes toward Non-invasive Prenatal Testing among Pregnant Japanese Women 155 163 EN Shoko Mikamo Mikiya Nakatsuka Original Article 10.18926/AMO/53522 To assess the knowledge and attitudes of pregnant Japanese women regarding non-invasive prenatal testing (NIPT). Between March and June 2013, 557 pregnant women in the Hyogo and Hiroshima Prefectures were surveyed using an anonymous, self-completed questionnaire. A total of 91.9ｵ respondents (512/557) stated that they “agree” or “conditionally agree” with NIPT implementation in Japan. Approximately 28.5ｵ of respondents stated that they knew that the accuracy of a positive NIPT result can be affected by motherʼs age and background, while 34.5ｵ of respondents stated that it was necessary for pregnant women with a positive result to undergo fetal chromosome diagnosis using amniocentesis;both percentages were low. Additionally, 92.3ｵ of respondents would “like a detailed explanation of the test,” 65.1ｵ of them would “like psychological support if the NIPT test results came back positive,” and 5.7ｵ would terminate the pregnancy if the NIPT test results came back positive without undergoing fetal chromosome diagnosis via amniocentesis. Although a high proportion of pregnant Japanese women agreed with the introduction of NIPT into Japanese obstetrical care, there was insufficient knowledge regarding the test. It is necessary for women undergoing NIPT to be provided sufficient information and psychological support. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 1342-078X 19 2 2014 Promoting factors of physical and mental development in early infancy: a comparison of preterm delivery/low birth weight infants and term infants 160 EN Kaori Hayashida Mikiya Nakatsuka The aim of this study was to assess correlations between various factors and the physical and mental development of 4-month-old infants using a multi-faceted evaluation approach. A total of 1,402 self-administered questionnaires were distributed to consenting mothers of infants who had undergone a 4-month health checkup in Hiroshima prefecture, Japan. The questionnaires included items from the Japan Child and Family Research Institute Child Rearing Support Questionnaire and the KIDS type A test. Of the 421 completed questionnaires on mother-child pairs that were returned, 318 met the inclusion criteria and were eligible for further analysis. Comparison between infants in a preterm delivery or low birth weight (LBW) group (preterm and/or LBW group; n = 31) and a term delivery appropriate-weight for date (AFD) infant group (term AFD group; n =287) revealed that the preterm and/or LBW group had significantly higher mother child-rearing anxiety and difficult baby scores, along with significantly lower infant development and motor skill scores. Within the term AFD group, infants of primiparous mothers had significantly higher scores for motor skill and sociability with adults than those of multiparous mothers. Language comprehension scores were significantly higher in infants that were exclusively breast-fed than those formula-fed or combined breast-fed and formula-fed. Verbalization scores of infants whose mothers worked were significantly higher than those of infants whose mothers did not work. Infants with siblings aged < 4 years exhibited significantly lower scores for motor skills, verbalization, and sociability with adults than infants without siblings or with siblings aged at least 5 years. In particular, we found that a mother's child-rearing anxiety was related to many areas of infant development. Evaluating the absence or presence of such factors and conducting preventive treatment could promote healthy infant development. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 68 3 2014 General Malaise and Physical Symptoms in Young Women with Untouched Toe 137 142 EN Megumi Akamatsu Mikiya Nakatsuka Original Article 10.18926/AMO/52653 Untouched toe is a condition in which a toe does not touch the ground while standing. It is frequently observed in women even under physiological conditions. Deformities or symptoms of the toes are not observed in these women. The clinical significance of untouched toe has not been fully elucidated. Two hundred young healthy women were recruited into the present study after informed consent. We evaluated the prevalence of untouched toe by measuring various indexes of the toe using a foot-sole-measuring equipment. We also conducted a self-administered questionnaire regarding general malaise. Untouched toe was observed in 114 of these 200 women (57.0%). The fifth toe was more frequently affected than the other toes. There were no significant differences in size of foot except the area and proportion touching the ground between women with untouched toe and those without untouched toe. The prevalence of general malaise was significantly higher in women with at least one untouched toe (57.0%) compared with those without untouched toe (43.0%) (p＜0.05). Twelve symptoms―irritability, headache, tired eyes, hazy vision, congested or runny nose, irregular menstruation or menstrual pain, shoulder stiffness, neck stiffness, low back pain, cold hands, swollen feet, and cold feet―were more frequently observed in women with at least one untouched toe compared with those without untouched toes. Untouched toe was associated with various symptoms of general malaise. However, the pathological mechanism by which untouched toe causes these symptoms has not been determined. Further analysis of gait and exercise habits in women with untouched toe is necessary. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 59 5 2005 Sex reassignment surgery for male to female transsexuals: initial experience in Okayama university hospital. 231 233 EN Atsushi Nagai Eijirou Tokuyama Yuzaburo Nanba Tetsuya Tsutsui Yoshihiro Kimata Mikiya Nakatsuka Isao Koshima Takashi Saika Yasutomo Nasu Hiromi Kumon Article 10.18926/AMO/31976 The first case of sex reassignment surgery (SRS) in our hospital was performed in January 2001; as of February, 2005, 4 cases of MTF-SRS had been performed. In the 2 most recent cases, we used penile and scrotal skin flaps to avoid complications. The depth and width of the new vagina was made to be adequate for sexual intercourse. Future attention should be focused on devising a surgical technique that will help prevent the complications of partial necrosis of the epidermal skin and wound dehiscence. Although ours is only an initial experience, we describe our surgical technique herein. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 62 5 2008 Study of Views on Posthumous Reproduction, Focusing on Its Relation with Views on Family and Religion in Modern Japan 285 296 EN Noriyuki Ueda Nobutaka Kushi Mikiya Nakatsuka Tatsuyuki Ogawa Yoshiko Nakanishi Keisuke Shishido Tsuyoshi Awaya Original Article 10.18926/AMO/30967 Posthumous reproduction has been performed in Japan several times, without sufficient civic discussion on its appropriateness or legislative regulation. There have even been several lawsuits on posthumous acknowledgment (in which a baby born to a deceased father has the same birthright as a baby born to a living father), and some judgments have proposed the need to develop societal agreement on posthumous reproduction and suggested legislative settlement. With this background, this study aims to clarify the views of the Japanese people regarding posthumous reproduction. In December 2007, we distributed a questionnaire on posthumous reproduction in relation to beliefs about family and religion to 32 universities across the country, and received 3,719 replies. It was found that about 60ｵ of respondents agreed with posthumous reproduction. Statistical analysis was applied to the relationship between this overall position on posthumous reproduction and views on assisted reproduction technologies, family, religion, and so on. The degree of support for posthumous reproduction was strongly correlated with the degree of affirmation of assisted reproduction technologies and a liberal worldview with emphasis on self-determination. On the other hand, there was also a strong correlation with having a traditional view of family, such as family succession. The degree of support for posthumous reproduction was also highly correlated with the intimacy among family members, underlying which was a strong connection to the traditional religious belief in Japan that deceased family members watch the living ones. The view on posthumous reproduction is culturally complex and cannot be explained by a simple dichotomy between traditional conservatives and liberals. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 62 2 2008 Adverse effects of advanced glycation end products on embryonal development 93 99 EN Lin Hao Soichi Noguchi Aiko Sasaki Miwa Matsuda Keiko Shimizu Yuji Hiramatsu Mikiya Nakatsuka Original Article 10.18926/AMO/30960 We studied the effects of advanced glycation end products (AGEs), which are known to accumulate in patients with diabetes, autoimmune diseases, or those who smoke, on embryonal development. Pronuclear (PN) embryos were obtained by flushing the fallopian tubes of rats after superovulation and mating. The cleavage rate and blastocyst yield were evaluated at 24, 72, 96, and 120 h of culture. Glyoxal, an AGE-forming aldehyde, suppressed embryonal development at every stage from PN to blastocyst in a concentration-dependent manner. The cleavage rate of the embryo was also signifi cantly decreased by treatment with glyoxal at concentrations of 1 mM or higher. The blastocyst yield was significantly decreased by treatment with glyoxal at concentrations of 0.5 mM or higher. N-acetyl-L-cysteine (L-NAC) at 1 mM significantly suppressed the glyoxal-induced embryonal toxicity. BSA-AGEs at 5 microg/ml or higher concentration signifi cantly reduced the cleavage rate and blastocyst yield compared to those for BSA-treated embryos. L-NAC at 1 mM significantly suppressed BSAAGE-induced embryonal toxicity. Because AGEs are embryo-toxic, AGE contamination may influence the pregnancy rate of in vitro fertilization and embryo transfer. AGEs, which are increased in women under pathological conditions, may also be involved in their infertility. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 62 6 2008 Vaginoplasty with a Pudendal-Thigh Flap in Intersexuals 415 419 EN Yuzaburo Namba Narushi Sugiyama Shuji Yamashita Kenjiro Hasegawa Yoshihiro Kimata Mikiya Nakatsuka Case Report 10.18926/AMO/30948 We treated 2 different types of intersexual patients who underwent a vaginoplasty with the pudendal-thigh flap. One was a female with testicular feminization syndrome for whom we reconstructed the total vagina with a pudendal-thigh flap, and the other was a female with an adrenogenital syndrome for whom we enlarged the introitus of the vagina with the same approach. There were no complications such as a flap necrosis. In addition, there was no stricture of the neo-vagina and no urinary problem. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 121 3 2009 「妊娠中からの母子支援」即戦力育成プログラム　なぜ，今，助産師キャリア支援なのか？ 177 181 EN Mikiya Nakatsuka No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 113 3 2001 産婦人科と性同一性障害 273 278 EN No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 00301558 119 1 2007 若年女性における血管障害 27 32 EN Mikiya Nakatsuka No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 1994 Selective inhibition of the 1'2-lipoxygenase path way of arachidonic acid metabolism by L-argi nine or sodium nitroprusside in intact human platelets EN No potential conflict of interest relevant to this article was reported.