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Last Updated :2024/10/18

研究者情報

マスター

アカウント（マスター）

  • 氏名

    蝦名　康彦(エビナ　ヤスヒコ), エビナ　ヤスヒコ

所属（マスター）

  • 保健科学研究院　保健科学部門　創成看護学分野

所属（マスター）

  • 保健科学研究院　保健科学部門　創成看護学分野

独自項目

syllabus

  • 2021, ウイメンズヘルス特論, Advanced Women's Health, 修士課程, 保健科学院, ライフサイクル、性ホルモン、月経、妊娠、不妊症、性分化疾患、性感染症、排尿障害、骨盤臓器脱、子宮がん、卵巣がん、HPV、更年期障害、血栓性素因、遺伝性腫瘍、家族計画、プレコンセプションケア
  • 2021, 助産診断・技術学特論, Advanced Diagnostic Methodology and Applied Technology in Midwifery, 修士課程, 保健科学院, 異常妊娠、異常分娩、産褥、診断・治療、周産期ケア
  • 2021, 助産学実践演習, Seminar on Clinical practice in Midwifery, 修士課程, 保健科学院, 科学的根拠に基づいた助産ケア
  • 2021, 地域・国際母子保健学, Advanced Midwifery on Maternal and Child for global health, 修士課程, 保健科学院, 地域母子保健　健康教育　母子保健政策　コミュニティヘルス プライマリーケア　　　　
  • 2021, 助産学実習Ⅱ, Clinical Midwifery PracticeⅡ, 修士課程, 保健科学院, 助産管理、周産期医療システム、助産師主導ケア、院内助産システム、助産所運営管理
  • 2021, 助産学実習Ⅲ, Clinical Midwifery PracticeⅢ, 修士課程, 保健科学院, ハイリスク妊娠、ハイリスク新生児、NICU／GCU
  • 2021, がん・再生医療特論, Oncology and Regenerative Medicine, 修士課程, 保健科学院, １）細胞・臓器へのストレス・ストレス応答（再生を含む）とそのメカニズム ２）がん発生および生物学・病態・進展、治療による影響 ３）遺伝医学とがん
  • 2021, 事例研究方法特論, Case study methods in Health Sciences, 修士課程, 保健科学院, 事例研究認識論、医学事例研究、看護学事例研究、リハビリテーション学事例研究
  • 2021, 母子看護学演習, Seminar on Maternal and Child Nursing Science, 修士課程, 保健科学院, 母子看護、成育医療、ウィミンズ・ヘルス、子どもの権利、看護倫理
  • 2021, 母子看護学特論, Maternal and Child Nursing Science, 修士課程, 保健科学院, 母子看護、成育医療、ウィメンズ・ヘルス、子どもの権利、看護理論
  • 2021, 大学院共通授業科目（一般科目）：複合領域, Inter-Graduate School Classes(General Subject):Inter-Disciplinary Sciences, 修士課程, 大学院共通科目, セックス、ジェンダー、セクシュアリティ, SOGIESC、人文科学、社会科学、自然科学
  • 2021, 社会看護科学特講, Advanced Study of Social Health and Nursing Science, 博士後期課程, 保健科学院, 保健医療福祉制度と健康、ストレス、地域社会、プロダクティブヘルス、高齢者支援システム、未来社会
  • 2021, 社会看護科学特講演習, Seminar on Social Health and Nursing Science, 博士後期課程, 保健科学院, 保健医療制度、地域保健、母子保健、高齢社会、国際保健、論文クリティーク
  • 2021, 細胞診断学講義演習, Lecture and Seminar on Diagnostic Cytology, 学士課程, 医学部, 細胞診、細胞検査士（サイトスクリーナー）
  • 2021, 一般教育演習(ﾌﾚｯｼｭﾏﾝｾﾐﾅｰ), Freshman Seminar, 学士課程, 全学教育, 女性ホルモン、エストロゲン、ライフサイクル、健康障害、メンタルヘルス、リプロダクティブ・ヘルス／ライツ
  • 2021, 健康と社会, Health and Society, 学士課程, 全学教育, 女性ホルモン、エストロゲン、ライフサイクル、健康障害、メンタルヘルス、リプロダクティブ・ヘルス／ライツ
  • 2021, 母性健康障害論, Maternal Health Disorder, 学士課程, 医学部, リプロダクティブヘルス、生殖、ライフステージ、思春期、更年期、不妊症、婦人科がん、HPV、異常妊娠、異常分娩、倫理的課題
  • 2021, 保健薬理学, Pharmacology, 学士課程, 医学部, 疾病、病態生理、薬物療法、薬理作用
  • 2021, ヘルスプロモーション看護, Health Promotion Nursing, 学士課程, 医学部, 健康教育　ウィメンズヘルス　集団指導　
  • 2021, 人間と文化, People and Culture, 学士課程, 全学教育, ジェンダー，セックス，セクシュアリティ、人文科学、社会科学、自然科学
  • 2021, 母性看護学援助論Ⅰ, Maternal Nursing Ⅰ, 学士課程, 医学部, 女性のライフステージ、妊娠、周産期ケア、リプロダクティブヘルス、ウィメンズヘルス

researchmap

プロフィール情報

所属

  • 北海道大学, 環境健康科学研究教育センター
  • 北海道大学, 高等教育推進機構

学位

  • 医学博士（北海道大学）

プロフィール情報

  • プロフィール

    わたくしは、産婦人科学における幅広い領域（産科学、婦人科腫瘍学、生殖免疫学など）の研究を行ってまいりました。研究紹介はこちらからごらんください。

    現在は、既存領域の枠組みを超え、女性の生涯にわたる健康を支援するケアやサポートを探求しています。妊娠、出産、育児に関連するテーマを中心に、幅広い年代の女性の健康問題に取り組み、更年期や思春期の健康管理、女性特有のメンタルヘルスケアの研究も行っています。女性が生涯にわたって健康で充実した生活を送るための支援を提供することを目指しています。


    その取り組みでは、アカデミアの狭い枠にとどまらず、刻々と変化する社会のニーズに応えるための教育、予防、管理の視点を重視しています。私たちの研究や活動は、臨床現場での実践に直結するだけでなく、広く社会全体に貢献することを目指しています。

    略歴：1965年、青森県生まれ。1990年北海道大学医学部医学科卒業、1997年北海道大学大学院医学研究科単位取得退学。2000年北海道大学附属病院助手、2010年神戸大学大学院医学研究科外科系講座産婦人科学分野 講師、2012年同准教授を経て、2020年より北海道大大学大学院保健科学研究院教授（助産学/母性看護学/女性医学教室、創成看護学分野）。博士（医学）（北海道大学）

  • 姓

    蝦名, エビナ

  • 名

    康彦, ヤスヒコ

  • ID各種

    201001054175181964

対象リソース

所属

  • 北海道大学, 環境健康科学研究教育センター
  • 北海道大学, 高等教育推進機構

業績リスト

研究キーワード

  • ネットワーク分析   network psychometrics   女性のメンタルヘルス   月経前症候群   産後うつ病   更年期障害   心身症   ウイメンズヘルス   HPVワクチン   がん予防   思春期   性教育   月経随伴症   周産期医学   特定妊婦   社会的ハイリスク妊婦   母乳育児   婦人科腫瘍学   臨床遺伝学   生殖免疫学   細胞診断学   

研究分野

  • ライフサイエンス / 産婦人科学
  • ライフサイエンス / 生涯発達看護学
  • 人文・社会 / 臨床心理学
  • 自然科学一般 / 応用数学、統計数学
  • ライフサイエンス / 人体病理学

経歴

  • 2020年05月 - 現在 北海道大学大学院保健科学研究院 保健科学部門（創成看護学分野） 教授
  • 2019年07月 - 2020年04月 市立札幌病院 産婦人科 医長
  • 2012年04月 - 2019年06月 神戸大学大学院医学研究科 外科系講座 産科婦人科学分野 准教授
  • 2010年08月 - 2012年03月 神戸大学大学院医学研究科 外科系講座 産科婦人科学分野 講師
  • 2009年07月 - 2010年07月 JA北海道厚生連 旭川厚生病院主任部長（産婦人科）
  • 2007年04月 - 2009年06月 北海道大学病院助教（産婦人科）
  • 2007年05月 Memorial Sloan-Kettering Cancer Center, Department of Surgery, Gynecology Service
  • 2003年02月 - 2007年03月 北海道大学医学部付属病院助手（産婦人科）
  • 2000年11月 - 2003年01月 北海道対がん協会細胞診センター所長
  • 2000年01月 - 2000年10月 北海道大学医学部付属病院助手（産婦人科）

学歴

  •         - 1997年   北海道大学   大学院医学研究科   外科系
  •         - 1990年   北海道大学   医学部医学科

委員歴

  • 2021年04月 - 現在   北海道産科婦人科学会   理事
  • 2021年04月 - 現在   日本産科婦人科学会   代議員
  • 2021年01月 - 現在   北海道産婦人科医会   理事
  • 2020年10月 - 現在   北海道母性衛生学会   理事
  • 2014年12月 - 現在   日本生殖免疫学会   評議員

受賞

  • 2015年06月 平成27年度 兵庫県産科婦人科学会賞
     The IgG avidity value for the prediction of congenital cytomegalovirus infection in a prospective cohort study 
    受賞者: 蝦名 康彦

論文

  • Maya Nakamura, Yunjie Luo, Yasuhiko Ebina
    BMJ open 14 9 e083389  2024年09月13日 [査読有り][通常論文]
     
    INTRODUCTION: Breastfeeding is crucial in infant nutrition and bonding, recommended for at least 6 months and up to 2 years postpartum, providing health benefits for both infants and mothers. However, nipple trauma is common among lactating mothers. Moisturising therapies, such as hydrogel application, aim to promote the healing of nipple wounds. Despite various interventions proposed, comprehensive reviews evaluating the efficacy of moisturising therapies for nipple trauma are lacking. This review aims to appraise the effectiveness of moisturising therapy, particularly tailored for nipple trauma in lactating women. METHODS AND ANALYSIS: This systematic review protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines and is registered in the International Prospective Register of Systematic Reviews. The focus will be on both randomised and non-randomised controlled trials addressing the treatment of nipple trauma in lactating women. In this context, 'moisturising therapy' is categorised as a non-pharmacological intervention applied directly to the nipple, excluding treatments for bacterial or fungal infections. The primary outcomes will include measures of the healing efficiency of nipple trauma and reduction in nipple pain. Searches will be conducted without date restrictions across multiple databases, including PubMed, CINAHL, the Cochrane Library, Web of Science, CiNii Research and Ichushi-Web, in addition to exploration of grey literature. Two independent reviewers will manage all stages of the review process, under the supervision of a third reviewer. Data extraction will encompass participant demographics, study methodologies, sample specifics and measured outcomes. Quality assessment will be conducted using the Joanna Briggs Institute Appraisal Checklist Tools. ETHICS AND DISSEMINATION: Ethics approval is not required for this study. The findings of this review will be disseminated through academic publications, detailed reports and presentations at relevant conferences. PROSPERO REGISTRATION NUMBER: CRD42023481761.
  • Yunjie Luo, Yasuhiko Ebina, Yoko Sato
    SSM - Population Health 26 101686 - 101686 2024年06月 [査読有り][通常論文]
  • 金内 里美, 蝦名 康彦
    母性衛生 64 4 756 - 762 (公社)日本母性衛生学会 2024年01月 [査読有り][通常論文]
     
    統合失調症を合併する妊産褥婦に対する支援方法について文献検討を行った。医中誌,CiNii,PubMedを使用し,2006年4月から2022年6月までの文献について,キーワードを「統合失調症」「妊娠」「分娩」「出産」「産褥」「移行期のケア」「退院」「育児支援」として検索した。会議録を除いた45件のうち,最終的に17件を分析対象とした。支援としては,妊娠継続管理,精神状態の管理,児への対応,妊娠中・出産後の生活,育児という視点が共通していた。そして連携先は,産科,精神科,小児科,地域,子どもの行先となる施設であった。連携職種が多岐にわたるため,それぞれが情報を共有し共通の視点を持つことが重要であり,多職種カンファレンスが円滑な連携の一助であることが推察された。(著者抄録)
  • 自己採取HPV検査の導入が女子大学生の子宮頸がん検診における受診意識に及ぼす影響
    藤澤 玲花, 竹内 瑞季, 蝦名 康彦
    看護総合科学研究会誌 21 1 3 - 10 看護総合科学研究会 2023年12月 [査読有り][通常論文]
  • Yasuhiko Ebina
    Clinical and Experimental Obstetrics & Gynecology 50 9 186 - 186 2023年09月19日 [査読有り][通常論文]
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  • 小林 后, 蝦名 康彦
    母性衛生 64 1 196 - 203 (公社)日本母性衛生学会 2023年04月 [査読有り][通常論文]
     
    本研究は,妊産婦のメンタルヘルス支援における多職種連携について,わが国の研究動向,そして実態と問題点を明らかにすることを目的とした。2012年1月から2022年9月までの文献について,医中誌,CiNii,Jdream IIIを用いて,「妊産婦」「メンタルヘルス」「多部門連携or連携or協働」をキーワードにAND検索を行った。第1段階では,61件の文献を対象に研究動向について検討した。第2段階では研究の趣旨に合致した13件(原著論文8件,逐次刊行物4件,紀要1件)について,多職種連携の実態と問題点について精査した。発表論文数は増加傾向を認め,研究の広がりがみえるが,原著論文が少なく学術研究としての深まりが少ないと考えられた。多職種連携の実態について,産科施設内では,助産師と精神科医との連携体制が整っていないなど,相談できる体制が不十分であった。一方施設外では,産科施設と精神科施設との連携が少ないこと,産科施設と行政機関との情報共有や協働が不足していること,地域での多職種連携体制の構築が不十分であることが明らかになった。(著者抄録)
  • 竹内 瑞季, 蝦名 康彦
    母性衛生 63 4 747 - 757 (公社)日本母性衛生学会 2023年01月 [査読有り][通常論文]
     
    【目的】産後うつ病に対する妊娠期の予防的介入の実施状況と,実施に影響を与える因子について明らかにする。【方法】全国の分娩を取り扱う病院および診療所(計2,161施設)の産婦人科病棟に勤務する臨床経験6年目以上の助産師(各施設1名)を対象として,オンライン調査を実施した。【結果】回収数は390部(回収率18.0%)であり,有効回答374部について分析した。予防的介入を実施している施設は241件(64.4%)であった。予防的介入実施に影響を与える因子は,施設の特徴としての「精神的支援のためのカンファレンス実施状況」「妊娠期のメンタルヘルスのスクリーニング実施状況」,そして助産師の認識としての「介入の必要性」「マンパワーを割くのが難しい」「病院の収益につながらない」「院内の意思統一が図れない」であった。【結論】全国の分娩取り扱い施設の6割以上で,妊娠期の予防的介入が実施されていた。そして,その実施に影響を与える6つの因子が明らかになった。予防的介入を拡大していくために,これらの事項について重点的に取り組んでいく必要性が示唆された。(著者抄録)
  • Yunjie Luo, Yoko Sato, Tianyue Zhai, Hiromi Kagamiyama, Yasuhiko Ebina
    International journal of environmental research and public health 19 20 2022年10月19日 [査読有り][通常論文]
     
    Chinese women raising children in Japan tend to experience high parenting stress and poor mental well-being. However, their specific parenting and mental health promotion needs remain unknown. This study aimed to explore the parenting and mental health promotion needs of Chinese women living in Japan and provide recommendations to guide interventions. Semi-structured in-depth interviews were conducted. Participants included 15 women aged 28-39 years who were pregnant or rearing a child younger than six years old. Thematic analysis was performed for data analysis. More than half of the participants experienced mental health problems, such as depressive symptoms and child-rearing stress. Four themes relating to their needs were identified: concrete support, information provision, caring and understanding, and social network building. Information provision and social network building should be emphasized as practical social support mechanisms to improve these women's mental health. Furthermore, a mental health promotion intervention should be developed to address this vulnerable population's needs. Healthcare providers and public health workers should help improve the social support systems of Chinese women in Japan to prevent mental health problems. Potential transcultural education can, arguably, help healthcare providers better understand transcultural care.
  • Manabu Seino, Satoru Nagase, Tsuyoshi Ohta, Wataru Yamagami, Yasuhiko Ebina, Yoichi Kobayashi, Tsutomu Tabata, Masanori Kaneuchi, Takayuki Enomoto, Mikio Mikami
    Journal of gynecologic oncology 34 1 e4  2022年09月29日 [査読有り][通常論文]
     
    OBJECTIVE: The aim of this study was to review the clinicopathological characteristics of small cell neuroendocrine cervical cancer (SCNEC) and to identify the optimal treatment. METHODS: The Japanese Society of Gynecologic Oncology conducted a retrospective cohort study of SCNECs enrolled in the Gynecological Tumor Registry of the Japan Society of Obstetrics and Gynecology between 2004 and 2015. All cases were modified and unified by International Federation of Gynecology and Obstetrics 2008 (Union for International Cancer Control 7th edition). RESULTS: There were 822 registered patients diagnosed with SCNEC from 2004 to 2015 which comprised 1.1% (822/73,698) of all uterine cervical cancer cases. Rates of lymph-node and distant metastasis were significantly higher in T1b2 (38.9% and 13.7%, respectively) than T1b1 (14.2% and 4.4%, respectively) (p<0.01). In IB2 and T1bN1M0 SCNEC, the 5-year survival rate with surgery followed by chemotherapy was significantly higher than that with surgery followed by radiation therapy/concurrent chemoradiation therapy (p<0.01). CONCLUSION: SNCEC tumors >4 cm in size had greater rates of lymph-node and distant metastasis when compared with tumors ≤4 cm. Adjuvant chemotherapy, rather than radiotherapy, may improve prognosis after surgery in T1bN1M0 SCNEC.
  • 大川 加奈, 蝦名 康彦
    母性衛生 63 2 474 - 482 (公社)日本母性衛生学会 2022年07月 [査読有り][通常論文]
     
    本研究の目的は、夜間電話相談を利用した特定妊婦について、その要因(カテゴリー)の頻度と各カテゴリー間の共起関係、各カテゴリーにおける特徴語を明らかにすることである。特定妊婦からよせられた432件を対象とし、量的記述研究を用いて、テキストマイニング、カテゴリー間の共起性の検討、特徴語の分析を行った。その結果、特定妊婦15カテゴリーのうち、件数の多い3カテゴリーは若年妊娠、精神疾患、未受診であった。105件(24.3%)は複数のカテゴリーに該当した。支援者不足、音信不通、未婚、金銭問題、未受診、未交付の間で強い共起関係がみられた。特徴語の分析により、例えば「未受診」の<未受診><救急><胎動><破水><最終月経><分娩>のように、相談者が置かれている状況が明らかになった。電話相談においては、共起関係の強いカテゴリーを認識し、各カテゴリーに特徴的な語に留意することにより、個々の特定妊婦が直面している困難を把握しやすくなる可能性がある。(著者抄録)
  • Yunjie Luo, Yasuhiko Ebina, Hiromi Kagamiyama, Yoko Sato
    Journal of Clinical Nursing 2022年06月02日 [査読有り][通常論文]
  • 吉田 ひかる, 蝦名 康彦
    母性衛生 63 1 43 - 52 (公社)日本母性衛生学会 2022年04月 [査読有り]
     
    【目的】高校生の妊娠についての知識や受け止め、支援者の有無や親子関係が、妊娠成立後の受診行動にどのように関連するかを明らかにする。【方法】高等学校4校(共学)に通う1～3年生の男女を対象として、無記名自記式質問紙を用いて調査した。質問紙は個人属性と<妊娠に関わる知識><妊娠に対する受け止め><妊娠時の支援者><親子関係>を構成要素とした。【結果】199人から有効回答が得られた。<妊娠の受け止め>と<支援者>の存在が受診行動に関連していた。<親子関係>が良好であれば<妊娠の受け止め>も良好であり、母子関係が良好であれば(支援者>がいると考えていた。【結論】高校生の妊娠成立後の受診行動に関連する因子が明らかになった。親子関係は、間接的に受診行動に関連している可能性が示唆された。(著者抄録)
  • 水口 実咲, 蝦名 康彦
    母性衛生 63 1 53 - 62 (公社)日本母性衛生学会 2022年04月 [査読有り][通常論文]
     
    【目的】妊娠中のやせ願望、体重増加への受容性に関連する因子を明らかにする。そして、やせ願望および受容性と体重増加量・児の出生体重との関連を明らかにする。【方法】産後1ヵ月の女性を対象とし、無記名自記式質問票(Googleフォーム)を用いた横断調査を実施した。統計解析にはカイ2乗検定、Mann-WhiteneyのU検定、Kruskal-Wallisの検定、Pearsonの相関検定を用いた。【結果】有効回答数は178件であった。妊娠中のやせ願望に関連する個人の因子としては、非協調性を示すパーソナリティ、高い非妊時Body Mass Indexが抽出された。環境の因子は、パートナーから妊娠中の体調管理について助言がないこと、痩せる方法に関するメディアの視聴や実践、体型へのプレッシャーやスタイルの願望であった。さらに、メディアの項目は、体重増加への受容性とも関連していた。また、妊娠中のやせ願望が強いことと体重増加への受容性が弱いことが、妊娠中の推奨より過多な体重増加と関連していた。妊娠中の体重増加への受容性が弱い群では、児の出生体重が多かった。【結論】妊娠中には過度なやせ願望を抱かないように、個人の特性に合わせた指導を行うこと、体重増加の心理的葛藤を理解して寄り添って関わることが重要である。(著者抄録)
  • 竹内 瑞季, 蝦名 康彦
    母性衛生 63 1 165 - 179 (公社)日本母性衛生学会 2022年04月 [査読有り][通常論文]
     
    産後うつ病に対する妊娠期からの予防的介入について文献検討を行い、介入方法とその効果について分析した。医中誌、CiNii、PubMedを使用し、2001年1月から2021年4月までの文献について、キーワードを「産後うつ」「妊娠期」「介入or支援」とし、わが国における研究による原著論文、研究報告、資料で検索した。最終的に14件が分析対象となった。介入方法は保健指導・面談を中心としたもの6件、グループセッションを中心としたもの5件、心理教育とサポート要請トレーニング1件、胎児愛着促進プログラム2件であった。実施時期は妊娠28週以降が6件、妊娠中期以降が4件であった。評価は10件でEPDSを使用しており、そのほか不安や愛着の尺度を使用していた。介入により産後1ヵ月(6件)および3ヵ月(2件)の抑うつ、産後1ヵ月の不安(1件)および児への愛着(4件)に良好な効果を認めていた。以上より、産後うつ病に対する妊娠期からの予防的介入は有効であると考えるが、介入方法の最適化に関してはさらなる研究が必要である。(著者抄録)
  • Hiroko Machida, Koji Matsuo, Yoichi Kobayashi, Mai Momomura, Fumiaki Takahashi, Tsutomu Tabata, Eiji Kondo, Wataru Yamagami, Yasuhiko Ebina, Masanori Kaneuchi, Satoru Nagase, Mikio Mikami
    Journal of gynecologic oncology 33 3 e26  2022年02月03日 [査読有り][通常論文]
     
    OBJECTIVE: To assess the efficacy of the FIGO 2018 classification system for nodal-specific classifications for early-stage cervical cancer; specifically, to examine the impact of nodal metastasis on survival and the effect of postoperative treatments, according to histological subtypes. METHODS: This society-based retrospective observational study in Japan examined 16,539 women with the 2009 FIGO stage IB1 cervical cancer who underwent primary surgical treatment from 2004 to 2015. Associations of cause-specific survival (CSS) with nodal metastasis and postoperative adjuvant therapy were examined according to histology type (squamous cell carcinoma [SCC], n=10,315; and non-SCC, n=6,224). RESULTS: The nodal metastasis rate for SCC was higher than that for non-SCC (10.7% vs. 8.3%, p<0.001). In multivariable analysis, the impact of nodal metastasis on CSS was greater for non-SCC tumors (adjusted-hazard ratio [HR], 3.11; 95% confidence interval [CI], 2.40-4.02) than for SCC tumors (adjusted-HR, 2.20; 95% CI, 1.70-2.84; p<0.001). Propensity score matching analysis showed significantly lower CSS rates for women with pelvic nodal metastasis from non-SCC tumors than from SCC tumors (5-year CSS rate, 75.4% vs. 90.3%, p<0.001). The CSS rates for women with nodal metastasis in SCC histology were similar between the postoperative concurrent chemoradiotherapy/radiotherapy and chemotherapy groups (89.2% vs. 86.1%, p=0.42), whereas those in non-SCC histology who received postoperative chemotherapy improved the CSS (74.1% vs. 67.7%, p=0.043). CONCLUSION: The node-specific staging system in the 2018 FIGO cervical cancer classification is applicable to both non-SCC tumors and SCC tumors; however, the prognostic significance of nodal metastases and efficacy of postoperative therapies vary according to histology.
  • Yasuhiko Ebina, Mizuki Takeuchi, Maya Nakamura
    Clinical and Experimental Obstetrics & Gynecology 49 1 1 - 1 2022年01月10日 [査読有り][通常論文]
  • Eiji Kondo, Kenta Yoshida, Tsutomu Tabata, Yoichi Kobayashi, Wataru Yamagami, Yasuhiko Ebina, Masanori Kaneuchi, Satoru Nagase, Hiroko Machida, Mikio Mikami
    Journal of gynecologic oncology 33 2 e14  2021年12月06日 [査読有り][通常論文]
     
    OBJECTIVE: The study compared the treatment outcomes of surgery versus radiotherapy, including concurrent chemoradiotherapy, in stage Ib2-IIb cervical adenocarcinoma patients in Japan. METHODS: Of 57,470 patients diagnosed with stage I-IV cervical cancer from January 2001-December 2011, 1,932 patients with stage Ib2-IIb cervical adenocarcinoma were initially treated by surgery or radiotherapy. The primary endpoint was 5-year overall survival (OS) in all and 614 propensity score-matched (PSM) patients (307 per group). We compared OS and prognosis factors based on age, primary stage, and treatment arm. RESULTS: In Japan, >80% (n=1,573) of stage Ib2-IIb cervical adenocarcinoma patients underwent surgery. The 5-year OS of surgery vs. radiotherapy groups were 82.1% (n=704) vs. 79.7% (n=59) (hazard ratio [HR]=1.494; 95% confidence interval [CI]=0.826-2.702; p=0.181) for stage Ib2, 76.6% (n=239) vs. 66.7% (n=54) (HR=1.679; 95% CI=0.986-2.858; p=0.053) for stage IIa, and 71.1% (n=630) vs. 58.9% (n=246) (HR=1.711; 95% CI=1.341-2.184; p<0.001) for stage IIb. In 614 PSM patients balanced for age and carcinoma stage Ib2-IIb, the 5-year OS of surgery vs. radiation groups was 73.0% (n=307) vs. 65.5% (n=307) (HR=1.394; 95% CI=1.044-1.860; p=0.023). In multivariable analysis, age (HR=1.293; 95% CI=1.045-1.601; p=0.018), treatment arm, radiotherapy (HR=1.556; 95% CI=1.253-1.933; p<0.001), and stage IIb (HR=1.783; 95% CI=1.443-2.203; p=0.018) were independent prognosis factors for 5-year OS in stage Ib2-IIb adenocarcinoma patients. CONCLUSION: Age (>65 years), treatment arm (radiotherapy), and stage IIb significantly affect OS in cervical adenocarcinoma patients. Surgery may be considered for <65-year-old patients with stage IIb adenocarcinoma.
  • Yasuhiko Ebina, Wataru Yamagami, Yoichi Kobayashi, Tsutomu Tabata, Masanori Kaneuchi, Satoru Nagase, Takayuki Enomoto, Mikio Mikami
    Gynecologic oncology 2021年08月25日 [査読有り][通常論文]
     
    OBJECTIVES: The aim of this study was to elucidate the clinicopathological features of ovarian granulosa cell tumors (GCTs) and to identify the prognostic factors. METHODS: The Japanese Society of Gynecologic Oncology (JSGO) conducted an observational retrospective cohort study of women with GCTs enrolled in the Gynecological Tumor Registry of the Japan Society of Obstetrics and Gynecology (JSOG) between 2002 and 2015. Clinicopathological features, including lymph node metastasis, were evaluated. In addition, we performed a prognostic analysis of patients between 2002 and 2011 for whom survival data were available. Kaplan-Meier and multivariate Cox proportional hazards analyses were performed. RESULTS: We identified 1426 patients with GCTs. Of the 222 patients who underwent lymph node dissection, 10 (4.5%) had lymph node metastasis. The incidence of lymph node metastasis in patients with pT1, pT2, and pT3 was 2.1%, 13.3%, and 26.7%, respectively (p < 0.001). Prognostic analysis was performed on 674 patients. In the multivariate Cox regression analysis, residual disease after initial surgery (hazard ratio (HR) = 10.39, 95% confidence interval (CI) = 3.15-34.29) and lymph node metastasis (HR = 5.58, 95% CI = 1.62-19.19) were independent risk factors for cancer-specific survival. CONCLUSIONS: In the initial surgery for GCTs, lymph node dissection can be omitted if the operative finding is pT1. In cases of pT2 or higher, lymph node dissection should be considered. Debulking is critical for achieving no gross residual tumor at the end of the surgery.
  • Kensuke Sakai, Wataru Yamagami, Hiroko Machida, Yasuhiko Ebina, Yoichi Kobayashi, Tsutomu Tabata, Masanori Kaneuchi, Satoru Nagase, Takayuki Enomoto, Daisuke Aoki, Mikio Mikami
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 156 2 262 - 269 2021年04月29日 [査読有り][通常論文]
     
    OBJECTIVE: To clarify the role of radiotherapy for endometrial cancer. METHODS: Data were analyzed for 39 247 patients with endometrial cancer registered with the Gynecologic Cancer Registry of the Japan Society of Obstetrics and Gynecology from 2004 to 2011. RESULTS: The rates of 5-year overall survival (5y-OS) in the radiotherapy and surgery groups were 53.6% and 94.5% in stage I or II, and 15.5% and 67.5% in stage III or IV, respectively. The prognosis in the radiotherapy group was significantly poorer than that in the surgery group. In multivariate analysis, age, advanced stage, histological type, risk of recurrence, and initial radiotherapy were independent prognostic factors. The rates of 5y-OS with no adjuvant therapy, adjuvant chemotherapy, and adjuvant radiotherapy were 95.3%, 92.9%, and 87.1% for stage I or II, respectively, with significant differences among all groups (P < 0.001), and 60.0%, 70.4%, and 55.5% for stage III or IV, respectively, with significant differences of adjuvant chemotherapy with no adjuvant therapy (P < 0.001) and with adjuvant radiotherapy (P < 0.001). In multivariate analysis, age, advanced stage, histological type, lymphadenectomy, and adjuvant radiotherapy were independent prognostic factors. CONCLUSION: Patients treated with radiotherapy had a significantly poorer prognosis and the appropriate indication of radiotherapy for endometrial cancer requires further study.
  • Emi Hirayama, Yasuhiko Ebina, Kei Kato, Kinuko Akabane-Nakagawa, Kazuhiko Okuyama
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2021年01月20日 [査読有り][通常論文]
     
    OBJECTIVE: To determine the association between cervical polyps in early pregnancy and late abortion and spontaneous preterm birth (SPTB). We also aimed to explore the relationship between cervical polyps and cervical insufficiency in the second trimester. METHODS: We conducted a retrospective cohort study of 2941 singleton pregnant women between January 2010 and December 2015. The frequency of late abortion and SPTB (before 28, 34, or 37 weeks of pregnancy) was compared between the two groups of 142 (4.8%) patients who had cervical polyps early in the pregnancy (P group) and 2799 who did not (non-P group). Multivariate analysis was performed to identify risk factors for late abortion and SPTB. RESULTS: The incidence of late abortion and SPTB was significantly higher in the P group than in the non-P group. Cervical polyps in early pregnancy were selected as independent risk factors for late abortion and SPTB before 28, 34, or 37 weeks of pregnancy. The P group had a significantly higher rate of cases requiring therapeutic cervical cerclage than the non-P group. CONCLUSION: Cervical polyps in early pregnancy are risk factors for late abortion and SPTB. They are also associated with the occurrence of cervical insufficiency.
  • Keiko Saotome, Wataru Yamagami, Hiroko Machida, Yasuhiko Ebina, Yoichi Kobayashi, Tsutomu Tabata, Masanori Kaneuchi, Satoru Nagase, Takayuki Enomoto, Daisuke Aoki, Mikio Mikami
    Obstetrics & gynecology science 64 1 80 - 89 2021年01月 [査読有り]
     
    OBJECTIVE: Regional lymph node (LN) dissection is a standard surgical procedure for endometrial cancer, but there is currently no clear consensus on its therapeutic significance. We aimed to determine the impact of regional LN dissection on the outcome of endometrial cancer. METHODS: Study subjects comprised 36,813 patients who were registered in the gynecological tumor registry of the Japan Society of Obstetrics and Gynecology, had undergone initial surgery for endometrial cancer between 2004 and 2011, and whose clinicopathological factors and prognosis were appropriate for our investigation. The following clinicopathological factors were obtained from the registry: age, surgical stage classification, Union for International Cancer Control tumor, node, metastasis classification, histological type, histological differentiation, presence or absence of LN dissection, and postoperative treatment. We retrospectively analyzed the clinicopathological factors and therapeutic outcomes for patients with endometrial cancer. RESULTS: Analysis of all subjects showed that the group that underwent LN dissection had a significantly better overall survival than the group that did not undergo dissection. Analysis based on stage showed similar results across groups, except for stage Ia. Analysis based on stage and histological type showed similar results across groups, except for stage Ia endometrial carcinoma G1 or Ia G2. Multivariate analysis of prognostic factors indicated that LN dissection is an independent prognostic factor and that it has a greater impact on prognosis than adjuvant chemotherapy. CONCLUSION: Despite the limitations of a retrospective study with some biases, the results suggest that LN dissection in endometrial cancer has a prognostic effect.
  • Hiroko Machida, Koji Matsuo, Shinya Matsuzaki, Wataru Yamagami, Yasuhiko Ebina, Yoichi Kobayashi, Tsutomu Tabata, Masanori Kaneuchi, Satoru Nagase, Takayuki Enomoto, Mikio Mikami
    Cancers 12 5 2020年05月15日 [査読有り]
     
    (1) Background: This study examined the use of a two-tier system in grouping cervical adenocarcinoma for survival discrimination. (2) Methods: A nationwide retrospective observational cohort study was conducted using the Japan Society of Gynecologic Oncology tumor registry database from 2001 to 2015 (n = 86,754). Adenocarcinoma subtypes were grouped as type 1 (endocervical usual type and endometrioid) or type 2 (serous, clear, mucinous, and not otherwise specified), based on their relative survival compared with that of squamous tumors. (3) Results: The majority of the adenocarcinoma cases were type 1 (n = 10,121) versus type 2 tumors (n = 5157). Type 2 tumors were more likely to be old and have stage IV disease than those with squamous tumors. The number of type 2 tumors increased from 2001 to 2014 (106.1% relative increase, p < 0.001). Type 2 tumors had disproportionally poorer survival compared to other types (5-year survival rates: 68.9% for type 2, 75.4% for type 1, and 78.0% for squamous; p < 0.001). On multivariate analysis, type 2 tumors remained an independent prognostic factor associated with decreased survival compared with squamous (adjusted hazard ratio 2.00, 95% CI 1.84-2.15, p < 0.001). (4) Conclusion: The survival of cervical adenocarcinoma varies largely across the histological subtypes, and the proposed two-tier grouping may be useful for survival discrimination.
  • Koji Matsuo, Hiroko Machida, Wataru Yamagami, Yasuhiko Ebina, Yoichi Kobayashi, Tsutomu Tabata, Masanori Kaneuchi, Satoru Nagase, Takayuki Enomoto, Mikio Mikami
    Obstetrics and gynecology 134 5 1017 - 1026 2019年11月 [査読有り][通常論文]
     
    OBJECTIVE: To examine the incidence and prognostic effects of intraoperative capsule rupture and to assess the effectiveness of postoperative chemotherapy for intraoperative tumor rupture in apparent stage I epithelial ovarian cancer. METHODS: This is a society-based retrospective observational study in Japan that examined 15,163 women with stage IA-IC1 epithelial ovarian cancer who underwent primary surgical treatment between 2002 and 2015. Associations between intraoperative capsule rupture and cause-specific survival, and between postoperative chemotherapy and cause-specific survival among intraoperatively ruptured cases were examined by histology type (clear cell n=6,107, endometrioid n=3,910, mucinous n=3,382, and serous n=1,764). RESULTS: Clear cell histology had the highest risk of intraoperative capsule rupture (57.3%), followed by endometrioid (48.8%), serous (41.8%), and mucinous (32.0%) histologies (P<.001). On multivariable analysis, clear cell type exhibited the largest effect of intraoperative capsule rupture on cause-specific survival (adjusted hazard ratio [HR] 1.99, 95% CI 1.45-2.75), followed by serous (adjusted HR, 1.61, 95% CI 0.84-3.11), mucinous (adjusted HR 1.28, 95% CI 0.79-2.09), and endometrioid (adjusted HR, 1.14, 95% CI 0.64-2.01) tumors. Postoperative chemotherapy for intraoperatively ruptured cases did not improve cause-specific survival in any histologic types in multivariable analysis: clear cell, adjusted HR 0.86, 95% CI 0.56-1.31; serous, adjusted HR 1.08, 95% CI 0.42-2.74; mucinous, adjusted HR 1.11, 95% CI 0.55-2.27; and endometrioid, adjusted HR 2.81, 95% CI 0.85-9.30 (all, P>.05). In the cohort-level analysis of ruptured cases (n=7,227), postoperative chemotherapy use has significantly decreased in mucinous (16.3% relative decrease), endometrioid (13.1% relative decrease), and clear cell (9.3% relative decrease) (all, P<.05); but, the cohort-level 5-year cause-specific survival rate did not change over time (all, P>.05). CONCLUSION: Among apparent stage I epithelial ovarian cancer, the clear cell type possesses a disproportionally high risk of capsule rupture during adnexectomy and is associated with the most adverse effect on survival. A decrease in the use of postoperative chemotherapy for intraoperatively ruptured cases in Japan is likely the result of increasing awareness of the absence of survival benefits.
  • Maho Miyaji, Masashi Deguchi, Kenji Tanimura, Yuki Sasagawa, Mayumi Morizane, Yasuhiko Ebina, Hideto Yamada
    Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology 35 10 913 - 918 2019年10月 [査読有り][通常論文]
     
    The aim of this prospective cohort study was to evaluate clinical factors associated with pregnancy outcomes in women with recurrent pregnancy loss (RPL). Women with a history of two or more pregnancy losses underwent workups for clinical factors of RPL and their pregnancies were followed-up with informed consent. Two hundred eleven (81.5%) of 259 women with RPL became pregnant. The multivariable analyses demonstrated that age (p < .01, OR 0.9, 95%CI 0.97-0.83), uterine abnormality (p < .05, OR 0.3, 95%CI 0.11-0.8), and protein C (PC) deficiency (p < .01, OR 0.14, 95%CI 0.03-0.6) were independent factors for becoming pregnancy in women with RPL. The number of previous pregnancy loss (p < .01, OR 0.57, 95%CI 0.43-0.75) and natural killer (NK) cell activity ≥33% (p < .01, OR 0.31, 95%CI 0.13-0.73) were independent factors for live birth in the subsequent pregnancy. Advanced age, the presence of uterine abnormality, and PC deficiency were risk factors for reduced pregnancy rate in women with RPL. Increased number of previous pregnancy loss and high NK cell activity were risk factors for miscarriage in the subsequent pregnancy. These results involve important information and are helpful for clinical practitioners.
  • 今福 仁美, 蝦名 康彦
    日本臨床細胞学会雑誌 58 4 162 - 166 (公社)日本臨床細胞学会 2019年07月 [査読有り][通常論文]
     
    目的:子宮頸部細胞診atypical squamous cells、cannot excluded high-grade squamous intraepithelial lesion(ASC-H)判定例の臨床的取り扱いにおける留意点を明らかにする。方法:2010年1月から2016年12月までの期間に、ASC-Hと判定して子宮頸部組織診を施行した80人を対象とした。初回組織診検査結果、経過観察例における臨床的転帰について検討した。成績:初回の組織診結果は、cervical intraepithelial neoplasia(CIN)3が30人(37.5%)と最も多く、次いでCIN1 10人(12.5%)、CIN2 9人(11.3%)、子宮頸癌IA1期4人(5.0%)、子宮体部癌肉腫1人(1.2%)であった。CIN2以上の診断となったものは、44人(55.0%)であった。初回の組織診結果が良性で経過観察を行った22例のうち、6例(27.3%)が中央値16ヵ月(範囲10〜32ヵ月)で、CIN2〜3の組織診断となった。結論:ASC-H判定例においては、CIN2以上の組織診断となる頻度が高く、すみやかなコルポスコピー下生検が必須である。また、初回の組織診結果が良性であっても、経過観察中にhigh-grade CINと診断される頻度が高く、厳重なフォローアップが必要である。(著者抄録)
  • Hideto Yamada, Kenji Tanimura, Masashi Deguchi, Shinya Tairaku, Mayumi Morizane, Akiko Uchida, Yasuhiko Ebina, Akira Nishikawa
    Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 25 6 427 - 430 2019年06月 [査読有り][通常論文]
     
    Primary infection with Toxoplasma gondii (T. gondii) during pregnancy may cause congenital infection of the infant. This study evaluated whether screening using IgG avidity and multiplex-nested polymerase chain reaction (PCR) methods was effective for detecting a high-risk pregnancy for congenital T. gondii infection. In a prospective cohort study serum T. gondii IgG avidity was measured in 469 pregnant women who had a positive test for T. gondii antibody plus a positive or equivocal test for IgM. Multiplex-nested PCR for T. gondii DNA on amniotic fluid, maternal blood, and neonatal blood was performed with informed consent. Low (<30%), borderline (30-35%), and high (>35%) IgG avidity indices were found in 104 (22.2%), 30 (6.4%), and 305 (71.4%), respectively. A total of 12 cases had a positive PCR test for amniotic fluids of the prenatal amniocentesis or at birth, or neonatal blood. Seven of the 12 cases were diagnosed as having congenital T. gondii infection, and they had low IgG avidity indices. Congenital T. gondii infection screening using of IgG avidity and multiplex-nested PCR methods for pregnant women with a positive test for T. gondii antibody plus a positive or equivocal test for T. gondii IgM was useful for detecting a high-risk pregnancy and diagnosing congenital T. gondii infection.
  • Hiroko Machida, Koji Matsuo, Wataru Yamagami, Yasuhiko Ebina, Yoichi Kobayashi, Tsutomu Tabata, Masanori Kanauchi, Satoru Nagase, Takayuki Enomoto, Mikio Mikami
    Gynecologic oncology 153 3 589 - 596 2019年06月 [査読有り][通常論文]
     
    OBJECTIVE: To examine the trends of epithelial ovarian cancer histologic subtypes in Japan. METHODS: A nationwide retrospective registry study was performed between 2002 and 2015 (Japan cohort, n = 48,640). Trends were also examined in The Surveillance, Epidemiology, and End Results Program (US cohort, n = 49,936). Time-specific proportional changes of four major histological subtypes (serous, clear cell, endometrioid, and mucinous) were examined. RESULTS: The Japan cohort had more stage I disease (44.1% versus 24.9%) and less stage IV disease (10.0% versus 23.1%) than the US cohort (P < 0.001). The Japan cohort had more non-serous histology, particularly clear cell carcinoma (26.9% versus 8.4%), than the US cohort (P < 0.001). In the Japan cohort, proportion of clear cell carcinoma increased significantly from 23.4% to 29.1% between 2002 and 2010 (P < 0.001). Among stage I disease, clear cell carcinoma increased significantly in the Japan cohort from 32.9% to 40.3% between 2002 and 2015 (P < 0.001), whereas mucinous carcinoma increased significantly in the US cohort from 15.0% to 24.8% (P = 0.01). In 2015, clear cell carcinoma was most common among women aged <50 years from the Japan cohort (30.2%) versus serous carcinoma in the US cohort (50.8%). In the Japan cohort, the peak age was 75 years for serous, 57 for clear cell, and 45 for endometrioid carcinoma (P < 0.001). Mucinous carcinoma decreased until 43 years and increased again after age 73 years (P < 0.001). CONCLUSION: Characteristics of epithelial ovarian cancer in Japan are largely different compared to the US. In Japan, clear cell carcinoma has increased significantly in recent years to account for nearly 30% of epithelial ovarian cancer.
  • Mizuki Uenaka, Mayumi Morizane, Kenji Tanimura, Masashi Deguchi, Yasuhiko Ebina, Makoto Hashimoto, Ichiro Morioka, Hideto Yamada
    The Kobe journal of medical sciences 64 6 E197-E199 - E199 2019年03月05日 [査読有り][通常論文]
     
    Antibodies against fetal platelet alloantigens in maternal blood cause neonatal alloimmune thrombocytopenia (NAIT). We encountered four newborns with NAIT from three women. A woman carried anti-human platelet antigen (HPA)-1a antibody, and vaginally delivered a newborn who had subarachnoid hemorrhage and platelet transfusions. She delivered the second newborn by a cesarean section who had no symptom. The second woman carried anti-human leukocyte antigen-A2 antibody and vaginally delivered a newborn who had no symptom. The third woman with a history of recurrent pregnancy losses carried anti-HPA-4b antibody, and delivered a newborn by a cesarean section who received platelet transfusions and immunoglobulin infusions. Antiplatelet antibody screening may be helpful in women who have a history of blood transfusion, or previous neonates with thrombocytopenia or intracranial hemorrhage.
  • Yasuhiko Ebina, Mikio Mikami, Satoru Nagase, Tsutomu Tabata, Masanori Kaneuchi, Hironori Tashiro, Masaki Mandai, Takayuki Enomoto, Yoichi Kobayashi, Hidetaka Katabuchi, Nobuo Yaegashi, Yasuhiro Udagawa, Daisuke Aoki
    International journal of clinical oncology 24 1 1 - 19 2019年01月 [査読有り][通常論文]
     
    The Japan Society of Gynecologic Oncology (JSGO) Guidelines 2017 for the Treatment of Uterine Cervical Cancer are for the purpose of providing standard treatment strategies for cervical cancer, indicating treatment methods currently considered appropriate for cervical cancer, minimizing variances in treatment methods among institutions, improving the safety of treatment and prognosis of diseases, reducing the economic and psychosomatic burden of patients by promoting performance of appropriate treatment, and enhancing mutual understanding between patients and healthcare professionals. The guidelines were prepared through consensus of the JSGO Guideline Committee, based on careful review of evidence gathered through the literature searches and in view of the medical health insurance system and actual clinical practice situations in Japan. The guidelines comprise eight chapters and five algorithms. The main features of the 2017 revision are as follows: (1) evidence was collected using a search formula and with cooperation of the Japan Library Association. The bibliographical search formula was placed at the end of the book; (2) regarding clinical questions (CQs) where evidence or clinical inspection in Japan was lacking, opinions of the Guidelines Committee were described as "proposals for future directions"; (3) cervical intraepithelial neoplasia (CIN) 3 and adenocarcinoma in situ (AIS) were treated as a cervical precancerous lesion; (4) the CQs of endoscopic surgery, radical trachelectomy, and sentinel node biopsy were newly added in Chapter 3, "primary treatment for stage IB-II cervical cancer"; and (5) the CQ about hormone replacement therapy after cancer treatment was newly established. Each recommendation is accompanied by a classification of recommendation categories based on the consensus reached by the Guideline Committee members. Here, we present the English version of the JSGO Guidelines 2017 for the Treatment of Uterine Cervical Cancer.
  • Yoshiya Miyahara, Hitomi Imafuku, Yuka Murata, Yasuhiko Ebina, Hideto Yamada
    European Journal of Gynaecological Oncology 40 4 563 - 566 2019年 
    Objectives: The aim of this study was to evaluate the relation between pathology, operative complications, and giant ovarian tumor weighing more than 5,000 grams. Materials and Methods: The authors assessed 11 factors of 18 patients with giant ovarian tumors after surgery, including age, performance status (PS), total weight of the tumor, fluid weight of the tumor, pathology, side, preoperative serum D-dimer, rate of deep venous thrombosis (DVT), intraoperative complications, and rate of postoperative ICU management. The subjects were divided into two groups: tumor weight ≥ 10,000 grams (group ≥ 10,000 grmas) and tumor weight < 10,000 grams (group < 10,000 grams), and the same factors were compared between two groups. Results: The most frequent pathology of giant ovarian tumors weighing more than 5,000 grmas was found to be adenocarcinoma. Compared to 11 patients of group < 10,000 grmas, seven patients out of group ≥ 10,000 grmas had a significantly higher rate of intra-abdominal adhesion (85.7% vs. 9.0%, p < 0.05), blood loss weight (890 grams vs. 130 grams, p < 0.05), and rate of postoperative ICU management (85.7% vs. 18.2%, p < 0.05), respectively. Conclusions: Much attention should be paid to patients with giant ovarian tumors, and aggressive surgery is recommended due to a frequent incidence of cancer.
  • Hideto Yamada, Kenji Tanimura, Shinya Tairaku, Ichiro Morioka, Masashi Deguchi, Mayumi Morizane, Satoshi Nagamata, Kana Ozaki, Yasuhiko Ebina, Toshio Minematsu
    Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 24 9 702 - 706 2018年09月 [査読有り][通常論文]
     
    The aim of this nested case-control study was to evaluate clinical factors associated with the occurrence of congenital cytomegalovirus (CMV) infection in pregnant women with non-primary CMV infection. In a cohort study of CMV screening for 2193 pregnant women and their newborns, seven newborns with congenital CMV infection were identified among 1287 pregnant women with non-primary CMV infection that was defined as negative IgM and positive IgG with IgG avidity index >45%. In the 1287 women with non-primary CMV infection, clinical findings and complications were compared between pregnancies with and without congenital CMV infection. Clinical factors associated with the occurrence of congenital CMV infection were evaluated. The birth weight of newborns with congenital CMV infection was less than that of newborns without congenital infection (p < 0.05). Univariate logistic regression analyses demonstrated that threatened premature delivery (OR 10.6, 95%CI 2.0-55.0; p < 0.01) and multiple pregnancy (OR 7.1, 95%CI 1.4-37.4; p < 0.05) were associated with congenital infection. Multivariable logistic regression analyses demonstrated that threatened premature delivery (OR 8.4, 95%CI 1.5-48.1; p < 0.05) was a single risk factor for congenital CMV infection in pregnant women with non-primary CMV infection. This study revealed for the first time that threatened premature delivery was associated with the occurrence of congenital CMV infection in pregnant women with non-primary CMV infection, the pathophysiology of which may be closely associated with CMV reactivation during pregnancy.
  • Yasuhiko Ebina, Mihoko Uchiyama, Hitomi Imafuku, Kaho Suzuki, Yoshiya Miyahara, Hideto Yamada
    Medicine 97 23 e11009  2018年06月 [査読有り][通常論文]
     
    We aim to clarify the incidence of deep venous thrombosis (DVT) before treatment in women with ovarian cancer and identify risk factors for DVT.In this prospective study, 110 women underwent venous ultrasonography before cancer treatment and D-dimer levels were measured. We investigated factors predicting DVT by logistic regression.DVT was detected in 25 of 110 women (22.7%) and pulmonary thromboembolism was coexisted in 2 women (1.8%). A total of 21 women (84.4%) with DVT were asymptomatic. D-dimer levels in women with DVT (median, 10.9; range, <0.5-98.2 μg/mL) were significantly higher than those in women without DVT (2.0; <0.5-60.8 μg/mL; P < .01). When 10.9 μg/mL was used as a cutoff value for D-dimer levels to predict DVT, specificity, sensitivity, and positive and negative predictive values were 92.9%, 52.0%, 68.4%, and 86.8%, respectively. The multivariate analysis demonstrated that D-dimer level (odds ratio [OR], 19.7; 95% confidence interval [CI], 5.89-76.76) and clear cell histology (OR, 7.1; 95% CI, 2.12-25.67) were independent factors predicting DVT.Asymptomatic DVT occurred with great frequency before treatment in patients with ovarian cancer. High D-dimer level and clear cell pathology is associated with a higher DVT risk.
  • Hitomi Imafuku, Yoshiya Miyahara, Yasuhiko Ebina, Hideto Yamada
    The Kobe journal of medical sciences 64 1 E1-E5 - E5 2018年05月28日 [査読有り][通常論文]
     
    BACKGROUND: Both twin pregnancies with complete hydatidiform mole and coexisting normal fetus (CHMCF) and partial hydatidiform mole can be found in association with a live fetus and a placenta displaying a molar degeneration. Two cases of CHMCF using magnetic resonance imaging (MRI) for a diagnosis are reported. CASE: In the first, CHMCF was suspected at 12 weeks of gestation. At 18 weeks of gestation, the existence of molar placenta and a sac separating from fetus and normal placenta was clearly depicted on MRI. At 19 weeks of gestations, she had termination of pregnancy because of a development of gestational trophoblastic neoplasia (GTN) and started chemotherapy. In the second case, CHMCF was suspected at 14 weeks of gestation. MRI demonstrated the existence of molar placenta and a sac separating from fetus and normal placenta. She chose induced abortion and there was no evidence of GTN during the 1 year-follow up period. Pathological examination in both cases was consistent with a complete hydration mole and a coexisting normal female fetus. CONCLUSION: MRI was useful for an accurate diagnosis for CHMCF.
  • Ryo Nishikawa, Kenji Yoshida, Yasuhiko Ebina, Mayumi Omoteda, Daisuke Miyawaki, Takeaki Ishihara, Yasuo Ejima, Hiroaki Akasaka, Hitoaki Satoh, Katsusuke Kyotani, Satoru Takahashi, Ryohei Sasaki
    Journal of radiation research 59 3 316 - 326 2018年05月01日 [査読有り][通常論文]
     
    This study aimed to compare dosimetric parameters between non-optimized and optimized treatment planning (NOP and OP, respectively) of magnetic resonance imaging (MRI) -based intracavitary (IC) image-guided adaptive brachytherapy (IGABT) using the central shielding (CS) technique for cervical cancer. Fifty-three patients treated with external beam radiotherapy using CS and MRI-based IGABT with the IC approach alone were evaluated. The total high-risk clinical target volume (HR-CTV) D90 was aimed at >70 Gy equivalent dose in 2 Gy fractions (EQD2). In the small HR-CTV group (≤30 cm3), the mean D90s for NOP/OP were 98.6/80.7 Gy. In the large (30.1-40 cm3) and extensive (>40 cm3) HR-CTV groups, the mean D90s were 81.9/77.5 and 71.1/73.6 Gy, respectively. The mean D2cc values for organs at risks (OARs) in OP were acceptable in all groups, despite the high bladder D2cc in the NOP. The correlation between HR-CTV at first brachytherapy (BT) and NOP D90 was stronger than that between HR-CTV at first BT and OP D90. The targeted HR-CTV D90 and dose constraints of D2cc for OARs were both achieved in 16 NOP/47 OP patients for the bladder, 39/50 for the rectum, and 47/50 for the sigmoid colon (P < 0.001, P = 0.007, and P = 0.34, respectively). For small tumors, the role of optimization was to reduce the D2cc for OARs while maintaining the targeted D90. However, optimization was of limited value for extensive tumors. Methods of optimization in IGABT with CS for cervical cancer should be standardized while considering its effectiveness and limitations.
  • 鈴木 嘉穂, 蝦名 康彦, 長又 哲史, 白川 得朗, 今福 仁美, 若橋 宣, 宮原 義也
    日本産科婦人科内視鏡学会雑誌 34 1 174 - 178 (一社)日本産科婦人科内視鏡学会 2018年04月 
    36歳(0経妊)。前医にて不妊治療中であったが、周期20日目に気分不良、腹痛、腹部膨満、ふらつきを自覚し、当院へ救急搬送された。臨床経過および経腟超音波断層検査、腹部単純CT所見よりOHSS(卵巣過剰刺激症候群)と診断され、保存的加療を行ったが症状は改善せず、腫大卵巣の縮小を認めなかった。周期40日目に血中hCGを測定したところ上昇がみられ、経腟超音波断層検査および腹部単純MRIにて異所性妊娠が疑われ、全身麻酔下で審査腹腔鏡下手術を行ったところ、腹膜妊娠が判明した。術後は血中hCGの低下を認め、術後7日目に退院となった。
  • Kenji Tanimura, Mayumi Morizane, Masashi Deguchi, Yasuhiko Ebina, Utaru Tanaka, Yoshiko Ueno, Kazuhiro Kitajima, Tetsuo Maeda, Kazuro Sugimura, Hideto Yamada
    Placenta 64 27 - 33 2018年04月 [査読有り][通常論文]
     
    INTRODUCTION: Placenta previa (PP) is one of the most significant risk factors for adherent placenta (AP). The aim of this study was to evaluate the diagnostic efficacy of a novel scoring system for predicting AP in pregnant women with PP. METHODS: This prospective cohort study enrolled 175 women with PP. The placenta previa with adherent placenta score (PPAP score) is composed of 2 categories: (1) past history of cesarean section (CS), surgical abortion, and/or uterine surgery; and (2) ultrasonography and magnetic resonance imaging findings. Each category is graded as 0, 1, 2, or 4 points, yielding a total score between 0 and 24. When women with PP had PPAP score ≥8, they were considered to be at a high risk for AP and received placement of preoperative internal iliac artery occlusion balloon catheters. If they were found to have AP during CS, they underwent hysterectomy or placenta removal using advanced bipolar with balloon catheter occlusion. The predictive accuracy of PPAP score was evaluated. RESULTS: In total, 23 of the 175 women with PP were diagnosed as having AP, histopathologically or clinically. Twenty-one of 24 women with PPAP score ≥8 had AP, whereas two of 151 women with PPAP score <8 had AP. The scoring system yielded 91.3% sensitivity, 98.0% specificity, 87.5% positive predictive value, and 98.7% negative predictive value for predicting AP in women with PP. DISCUSSION: This prospective study demonstrated that PPAP scoring system may be useful for predicting AP in women with PP.
  • Yoko Maesawa, Masashi Deguchi, Kenji Tanimura, Mayumi Morizane, Yasuhiko Ebina, Hideto Yamada
    Reproductive medicine and biology 17 2 149 - 154 2018年04月 [査読有り][通常論文]
     
    Purpose: This study aimed to assess the efficacy of high-dose i.v. immunoglobulin (HIVIg) therapy in pregnant women with antiphospholipid syndrome (APS) secondary to systemic lupus erythematosus with a history of pregnancy failure, despite receiving low-dose aspirin plus unfractionated heparin therapy, of which condition being designated as "aspirin-heparin-resistant APS" (AHRAPS). Methods: The HIVIg therapy (20 g/d, 5 days) was performed for the pregnancies of five women with AHRAPS. Results: Five of the eight pregnancies ended in live births. The gestational ages of delivery in four of the five pregnancies were extended, compared with previous pregnancies. The HIVIg therapy was considered to be successful for these four pregnancies. Excluding one pregnancy that ended in miscarriage with an abnormal chromosome karyotype of the villi, the HIVIg therapy was considered to be successful in four (57.1%) of the seven pregnancies of the women with AHRAPS. Although all the live newborns were prematurely delivered, no adverse effect of the HIVIg therapy was observed. Conclusions: The HIVIg therapy might be beneficial as an immune modifier for pregnant women with AHRAPS. However, the precise indication of which women with AHRAPS who should receive HIVIg therapy remains unknown.
  • Shigeki Shimada, Yasuhiko Ebina, Norifumi Iijima, Masashi Deguchi, Hideto Yamada
    American journal of reproductive immunology (New York, N.Y. : 1989) 79 2 2018年02月 [査読有り][通常論文]
     
    PROBLEM: Is an abnormal increase or decrease of M1/M2 macrophages observed in the deciduae of miscarriages with normal fetal chromosome (MN)? METHODS OF STUDY: Deciduae of 18 MN and 26 miscarriages with abnormal fetal chromosome (MA) were obtained. Additionally, deciduae from 15 women whose pregnancies ended in induced abortions (IA) and endometriums at the mid-luteal phase from 19 non-pregnant women endomeriums of mid-luteal phases (EM) were obtained. Macrophages were analyzed by flow cytometry using monoclonal antibodies for CD68, HLA-DR, and CD163. RESULTS: M1 macrophages, defined as CD68+ HLA-DR+ CD163- cells, increased in MN compared with MA or IA. M2 macrophages, defined as CD68+ HLA-DR- CD163+ cells, increased in the deciduae of MA and IA compared with EM. However, this increase was not observed in the deciduae of MN. CONCLUSION: Our findings of phenotypic characters of decidual macrophages in MN provide additional evidence that M2 polarization is favorable for the maintenance of early stages of pregnancy.
  • Masashi Deguchi, Yoko Maesawa, Shino Kubota, Mayumi Morizane, Kenji Tanimura, Yasuhiko Ebina, Hideto Yamada
    Journal of reproductive immunology 125 39 - 44 2018年02月 [査読有り][通常論文]
     
    The aim of this prospective study was to determine clinical factors associated with adverse pregnancy outcomes in women with systematic lupus erythematosus (SLE). Fifty-six pregnancies from 46 women with SLE were enrolled. Risk factors for pregnancy loss, premature delivery, hypertensive disorders of pregnancy (HDP), and light-for-date neonate (LFD), were evaluated. Univariate and multivariate logistic regression analyses revealed a history of two or more pregnancy losses before 10 gestational weeks (GW) (OR 11.5, 95%CI 1.72-76.8) as a risk factor for pregnancy loss; low levels of blood complements (OR 7.55, 95%CI 1.10-51.9) and antiphospholipid syndrome (OR 26.5, 95%CI 3.17-219) as risk factors for premature delivery before 37 GW; SLEDAI score at conception (OR 1.68, 95%CI 1.05-2.68) and positive tests for two or more antiphospholipid antibodies (OR 6.89, 95%CI 1.13-41.9) as risk factors for premature delivery before 34 GW; prednisolone therapy >14mg/day (OR 7.55, 95%CI 1.10-51.9) as a risk factor for HDP; and low dose aspirin therapy (OR 0.21, 95%CI 0.05-0.97) decreased the risk for LFD neonate. These results have important implications for clinicians managing SLE complicated pregnancy.
  • Kenji Tanimura, Shinya Tairaku, Ichiro Morioka, Kana Ozaki, Satoshi Nagamata, Mayumi Morizane, Masashi Deguchi, Yasuhiko Ebina, Toshio Minematsu, Hideto Yamada
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 65 10 1652 - 1658 2017年10月30日 [査読有り][通常論文]
     
    Background: The aim of this prospective cohort study was to evaluate the efficacy of maternal screening for congenital cytomegalovirus infection (CCI) using cytomegalovirus (CMV) immunoglobulin G (IgG) and the IgG avidity index (AI). Methods: Pregnant women underwent screening of CMV IgG and AI measurements. IgG-negative women underwent remeasurement of IgG after educational intervention. Women with an AI ≤45% received further examinations, including measurement of CMV IgM. All newborns received polymerase chain reaction analyses of the urine, and CCI was diagnosed by the detection of CMV-DNA in the urine. Primary infection was defined as an AI <35% and/or positive IgM (>1.20 index). Serum samples from women with an AI >45% were stored, and the IgM levels were measured after delivery. The efficacy of AI and IgM for CCI screening was compared. Results: A total of 1562 (71.2%) women tested positive for IgG. In this study, 10 newborns with CCI were detected. The presence of infection in 3 newborns from mothers with primary infection was predicted by screening of IgG and AI <35%. However, infection in 7 newborns from women with nonprimary infection could not be predicted by screening of CMV IgG, AI <35%, or IgM. The application of an AI <35% for CCI screening yielded 22.2% sensitivity, 95.0% specificity, 2.5% positive predictive value, and 99.5% negative predictive value and was similar to that of IgM (11.1% sensitivity, 93.2% specificity, 0.9% positive predictive value, and 92.7% negative predictive value). Conclusions: Maternal screening using CMV IgG and AI can identify pregnancies with CCI from primary infection, but overlooks a number of those from nonprimary infection.
  • Kenji Tanimura, Yasuhiko Ebina, Hideto Yamada
    Expert review of molecular diagnostics 17 6 535 - 537 2017年06月 [査読有り][招待有り]
  • Yasuhiko Ebina, Yukari Nishino, Masashi Deguchi, Yoko Maesawa, Yuki Nakashima, Hideto Yamada
    Journal of reproductive immunology 120 42 - 47 2017年04月 [査読有り][通常論文]
     
    This study aimed to evaluate whether natural killer (NK) cell activity was associated with the etiology of recurrent miscarriage (RM), and to evaluate the predictive value of NK cell activity for outcomes of following pregnancies in women with RM. Peripheral NK cell activity was measured in 160 non-pregnant women with a history of two or more miscarriages. This activity was compared according to the etiology of RM and to pregnancy outcomes in women who became pregnant. NK cell activity in women with unexplained RM was significantly higher than that in those with known etiologies of RM. NK cell activity in women whose next pregnancies ended in miscarriage of fetuses with a normal chromosome karyotype (MN) was higher than that in those with live births (p<0.05). Women with NK cell activity ≥33% had a higher risk for MN (relative risk 3.4, 95% confidence interval 1.3-8.7). An increase in peripheral NK cell activity was associated with MN. This increase might be involved in the pathophysiology underlying RM.
  • Kana Ozaki, Kenji Tanimura, Yasuhiko Ebina, Kiyonori Kanemitsu, Hideto Yamada
    Journal of Medical Case Reports 11 1 66  2017年03月11日 [査読有り][通常論文]
     
    Background: Surgical meshes are widely used in incisional hernia repair. However, there are no reports of pregnancies complicated by infection of surgical meshes used for hernia repair. This is the first case report of a pregnant woman who experienced surgical site infection associated with surgical mesh used for repair of an abdominal wall incisional hernia. Case presentation: We report a case of a 41-year-old pregnant Japanese woman with surgical site infection after mesh repair of an abdominal wall incisional hernia. She was diagnosed with an abdominal wall incisional hernia at 3 months after her third cesarean section, and she underwent an operation of hernia repair with use of monofilament polypropylene mesh 7 months after the third cesarean section. However, a surgical site infection associated with surgical mesh occurred. During antibiotic treatment, she was found to be pregnant. She was referred to our hospital at 13 weeks and 2 days of gestation. The surgeons removed the infected mesh at 16 weeks and 3 days of gestation. Neither the hernia nor infection at the surgical site recurred throughout pregnancy. We planned a cesarean section using a transverse uterine fundal incision method with an upper abdominal incision. The patient delivered a 2478-g healthy female infant. Conclusions: The present report shows that removal of mesh can safely control surgical site infection during pregnancy.
  • H. Morita, Y. Miyahara, Y. Ueno, K. Otani, F. Kawakami, Y. Ebina, H. Yamada
    EUROPEAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY 38 5 815 - 817 2017年 [査読有り][通常論文]
     
    Lymphangioleiomyomatosis (LAM) is a rare disease that afflicts mostly young women. It is characterized pathologically by the appearance of interstitial collections of atypical smooth muscle cells and cyst formation in the lungs, lymph node, kidney, and so on. A case was presented that underwent radical operation with the diagnosis of endometrial cancer, in which were found LAM cells in dissected lymph node and myometrium. Case: A 40-year-old woman underwent radical operation with the diagnosis of endometrial cancer. Although the dissected pelvic and para-aortic lymph nodes did not show the metastases of cancer, immunohistochemical study revealed the LAM cells among the dissected lymph nodes. Further histological study showed the LAM cells were in the uterine myometrium as well. Physical examination excluded the diagnosis of tuberous sclerosis. Since pulmonary LAM were observed as well, the physician followed the patient. Discussion: Sporadic LAM, without a complication of tuberous sclerosis, rarely shows LAM cells systemically as in this case. Conclusions: When LAM is observed coincidentally in operated dissected lymph node, it is important to examine for tuberous sclerosis and also to follow up the fmdings in the lung.
  • Kenji Tanimura, Shinya Tairaku, Yasuhiko Ebina, Ichiro Morioka, Satoshi Nagamata, Kana Deguchi, Mayumi Morizane, Masashi Deguchi, Toshio Minematsu, Hideto Yamada
    CLINICAL INFECTIOUS DISEASES 64 2 159 - 165 2017年01月 [査読有り][通常論文]
     
    Background. This prospective study aimed to determine maternal clinical, laboratory, and ultrasound findings that effectively predict the occurrence of congenital cytomegalovirus (CMV) infection (CCI) in high-risk pregnant women. Methods. Three hundred CMV immunoglobulin (Ig) M-positive pregnant women were enrolled. The maternal clinical and laboratory findings, including serum CMV IgM and IgG; IgG avidity index (AI); antigenemia assay (C7-HRP); polymerase chain reaction (PCR) for the detection of CMV-DNA in the maternal serum, urine, and uterine cervical secretion; and prenatal ultrasound findings, were evaluated. To determine predictive factors for the occurrence of CCI, logistic regression analyses were performed. Results. In 22 of the 300 women, CCI was confirmed using PCR for CMV-DNA in newborn urine. Univariate analyses demonstrated that the presence of maternal flu-like symptoms, presence of ultrasound fetal abnormalities, serum titers of CMV IgM, positive results for C7-HRP, CMV IgG AI <40%, and positive PCR results in the uterine cervical secretion were statistically associated with the occurrence of CCI. Multivariable analysis revealed that the presence of ultrasound fetal abnormalities (odds ratio [OR], 31.9; 95% confidence interval [CI], 8.5-120.3; P<.001) and positive PCR results in the uterine cervical secretion (OR, 16.4; 95% CI, 5.0-54.1; P<.001) were independent predictive factors of CCI in CMV IgM-positive women. Conclusions. This is the first prospective cohort study to suggest that the presence of CMV-DNA in the maternal uterine cervical secretion and ultrasound fetal abnormalities are predictive of the occurrence of congenital CMV infection in high-risk pregnant women.
  • 山田秀人, 出口雅士, 森岡一朗, 谷村憲司, 蝦名康彦
    産婦人科の実際 65 13号 1719 - 1724 金原出版 2016年12月 [査読無し][招待有り]
  • Yasuhiko Ebina, Shigeki Shimada, Masashi Deguchi, Yoko Maesawa, Norifumi Iijima, Hideto Yamada
    AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY 76 3 199 - 204 2016年09月 [査読有り][通常論文]
     
    ProblemThe aim of this prospective study was to evaluate phenotypic differences of helper T (Th), cytotoxic T (Tc), and regulatory T (Treg) cells in the deciduae of missed miscarriage with a normal chromosome karyotype of a fetus (MN) and missed miscarriage with an abnormal chromosome karyotype of a fetus (MA). Methods of studyThe decidua of 19 MN and 28 MA was obtained. Additionally, the decidua of 15 induced abortion (IA) and the endometrium of 19 non-pregnant women (EM) were obtained. IFN-(+), IL-17(+), CD25(high)Foxp3(+) cells in CD4(+) (Th) cells, and IFN-(+) cells in CD8(+) (Tc) cells were evaluated by flow cytometry. ResultsThe percentages of IFN-(+) Tc and CD4(+)CD25(high)Foxp3(+) (Treg) cells in MN were significantly increased as compared with MA and IA. The percentage of IFN-(+) Th in MN was increased as compared with IA. ConclusionActivation of IFN-(+) Tc and Treg cells in the decidua might be associated with the pathophysiology underlying MN.
  • Yasuhiko Ebina, Hidetaka Katabuchi, Mikio Mikami, Satoru Nagase, Nobuo Yaegashi, Yasuhiro Udagawa, Hidenori Kato, Kaneyuki Kubushiro, Kiyoshi Takamatsu, Kazuhiko Ino, Hiroyuki Yoshikawa
    INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY 21 3 419 - 434 2016年06月 [査読有り][通常論文]
     
    The third version of the Japan Society of Gynecologic Oncology guidelines for the treatment of uterine body neoplasms was published in 2013. The guidelines comprise nine chapters and nine algorithms. Each chapter includes a clinical question, recommendations, background, objectives, explanations, and references. This revision was intended to collect up-to-date international evidence. The highlights of this revision are to (1) newly specify costs and conflicts of interest; (2) describe the clinical significance of pelvic lymph node dissection and para-aortic lymphadenectomy, including variant histologic types; (3) describe more clearly the indications for laparoscopic surgery as the standard treatment; (4) provide guidelines for post-treatment hormone replacement therapy; (5) clearly differentiate treatment of advanced or recurrent cancer between the initial treatment and the treatment carried out after the primary operation; (6) collectively describe fertility-sparing therapy for both atypical endometrial hyperplasia and endometrioid adenocarcinoma (corresponding to G1) and newly describe relapse therapy after fertility-preserving treatment; and (7) newly describe the treatment of trophoblastic disease. Overall, the objective of these guidelines is to clearly delineate the standard of care for uterine body neoplasms in Japan with the goal of ensuring a high standard of care for all Japanese women diagnosed with uterine body neoplasms.
  • Satoshi Nagamata, Yasuhiko Ebina, Yumika Yamano, Takeo Miyamoto, Mitsuhiro Nishijima, Hideto Yamada
    Kobe Journal of Medical Sciences 62 2 E45 - E48 2016年 [査読有り][通常論文]
     
    Uterine leiomyosarcoma (ULMS) is an aggressive tumor associated with high rates of progression, recurrence, and mortality. Pazopanib is the only approved molecular targeted drug for advanced soft tissue sarcoma, and it has been proven to prolong progression-free survival relative to placebo. We herein report a case of ULMS with multiple lung metastases treated with pazopanib, which led to sustained disease control for 44 weeks. A 53-year-old woman was referred to our hospital due to massive uterine bleeding from a uterine corpus tumor mass. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed as emergency surgery. The final histopathological diagnosis was uterine leiomyosarcoma, and computed tomography revealed multiple lung metastases. After chemotherapy with 17 cycles of gemcitabine and docetaxel and two cycles of doxorubicin, the lung metastases had increased in size and new lesions had appeared. Pazopanib administration at 800 mg/day was started as third-line therapy. Ten weeks later, the dose of pazopanib was reduced to 600 mg/day because of hepatic impairment and hypertension. However, lung metastases of ULMS were stabilized by pazopanib administration for about 44 weeks without a decline in the patient’s quality of life. After 44 weeks of therapy, pazopanib administration was discontinued because of progressive disease and worsening of the patient’s respiratory status. Pazopanib is an oral multityrosine kinase inhibitor of vascular endothelial growth factor receptor-1,-2, and-3 platelet-derived growth factor-α and-β and c-Kit receptor. The role of pazopanib may be clinically significant in the treatment of advanced ULMS.
  • Nanae Shinozaki, Yasuhiko Ebina, Masashi Deguchi, Kenji Tanimura, Mayumi Morizane, Hideto Yamada
    GYNECOLOGICAL ENDOCRINOLOGY 32 8 672 - 674 2016年 [査読有り][通常論文]
     
    This prospective study aimed to evaluate pregnancy outcome and complications in women with recurrent pregnancy loss (RPL) and protein S (PS) deficiency, who received low dose aspirin (LDA) or LDA plus heparin (LDA/H) therapies. Clinical characteristics, pregnancy outcome and complications of 38 women with two or more RPL and <60% of plasma free PS antigen were compared among three groups: antiphospholipid antibody (aPL)-negative women who received LDA (group A), aPL-negative women who received LDA/H (group B) and aPL-positive women who received LDA/H (group C). Gestational weeks (GW) at delivery in group C (median 32 GW) were earlier than 40 GW in group A and 38.5 GW in group B (p < 0.05). The birth weight in group C (median 1794 g) was less than 2855 g in group B (p < 0.05). The incidences of fetal growth restriction (37.5%), pregnancy-induced hypertension (37.5%), and preterm delivery (62.5%) in group C were higher than those (4.5%, 0%, and 4.5%, respectively) in group B (p<0.05). Women with RPL, PS deficiency, and positive aPL had high risks for adverse pregnancy outcome and complications, even when they received LDA/H therapy. Among women with RPL, PS, and negative aPL, there was no difference in these risks between LDA alone and LDA/H therapies.
  • Kenji Tanimura, Akira Nishikawa, Shinya Tairaku, Nanae Shinozaki, Masashi Deguchi, Mayumi Morizane, Yasuhiko Ebina, Ichiro Morioka, Hideto Yamada
    JOURNAL OF INFECTION AND CHEMOTHERAPY 21 9 668 - 671 2015年09月 [査読有り][通常論文]
     
    Primary Toxoplasma gondii (T. gondii) infection during pregnancy may lead to congenital toxoplasmosis. Maternal screening using T. gondii IgG avidity measurement and multiplex nested PCR was performed. The aim of this prospective cohort study was to determine a cut-off value of IgG avidity index (AI) for the prediction of the presence of T. gondii DNA in the amniotic fluid. One hundred thirty-nine women with positive or equivocal tests for IgM underwent both serum IgG avidity measurement and PCR analysis for the amniotic fluid. Nine had positive PCR results, and three of them were diagnosed as having congenital infection. A cut-off value of IgG AI was determined using receiver operating characteristic analysis. IgG AI (mean 13%) in women with positive PCR results was significantly lower than that (39%) in women with negative results. A cut-off value of <25% IgG AI yields the best results with 77.8% sensitivity and 81.5% specificity for the presence of T. gondii DNA in the amniotic fluid. None of women with IgG AI of >= 30% had a positive PCR result or congenital infection. This study firstly demonstrated that a cut-off value of 25 -30% IgG AI might be useful for the prediction of the presence of T. gondii DNA in the amniotic fluid and congenital infection. (C) 2015, Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
  • Yasuhiko Ebina, Masahiro Ieko, Sumiyoshi Naito, Gen Kobashi, Masashi Deguchi, Hisanori Minakami, Tatsuya Atsumi, Hideto Yamada
    THROMBOSIS AND HAEMOSTASIS 114 1 65 - 69 2015年07月 [査読有り][通常論文]
     
    It was the study objective to evaluate whether low levels of plasma protein S (PS) activity, free PS, protein C (PC) activity and coagulation factor XII (FXII) during early pregnancy are related to adverse pregnancy outcomes. Peripheral blood samples were obtained at 8-14 gestational weeks (GW) from a consecutive series of 1,220 women. The levels of plasma PS activity, free PS, PC activity, and FXII were measured. Cut-off values were defined as <1st, <5th, and <10th percentiles of values obtained from 933 women whose pregnancies ended in normal deliveries without complications. PS activity of <10th percentile yielded risks of pregnancy-induced hypertension (PIN) and severe PIH, while free PS level of <5th percentile yielded a risk of pre-eclampsia. FXII level of <1st percentile yielded a risk of premature delivery (PD) at <34 GW. None was associated with PD at <37 GW, fetal growth restriction or fetal loss. A multivariate analysis demonstrated that PS activity of <10th percentile (odds ratio 5.9, 95% confidence interval 1.7-18.1) and body mass index (BMI) >= 25 kg/m(2) (4.3, 1 1.1-13.3) were independent risk factors for severe PIN. Similarly, free PS level of <5th percentile (4.4, 1.0-14.3) and BMI >= 25 kg/m(2) (4.0, 1.3-10.9) were independent risk factors for pre-eclampsia. In conclusion, women with low levels of plasma PS activity and free PS during early pregnancy might have increased risks of PIN, severe PIN or pre-eclampsia. Women with low FXII level might have an increased risk of PD at <34 GW.
  • Kazuhiro Kitajima, Yuko Suenaga, Yoshiko Ueno, Tetsuo Maeda, Yasuhiko Ebina, Hideto Yamada, Takashi Okunaga, Kazuhiro Kubo, Keitarou Sofue, Tomonori Kanda, Yukihisa Tamaki, Kazuro Sugimura
    EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 42 8 1268 - 1275 2015年07月 [査読有り][通常論文]
     
    Purpose To evaluate the usefulness of metabolic parameters obtained by F-18-FDG PET/CT for preoperative stratification of high-risk and low-risk endometrial carcinomas. Methods Preoperative F-18-FDG PET/CT was performed in 56 women with endometrial cancer. Maximum standardized uptake values (SUVmax), metabolic tumour volume (MTV) and total lesion glycolysis (TLG) of primary tumours were compared with clinicopathological features of surgical specimens. Diagnostic performance in terms of differentiation of low-risk disease (endometrioid histology, histological grade 1 or 2, invasion of less than half of the myometrium, and FIGO stage I) from high-risk disease was assessed. Results MTV and TLG were significantly higher in patients with higher histological grade (p = 0.0026 and p = 0.034), larger tumour size (p = 0.002 and p = 0.0017), lymphovascular space involvement (LVSI; p = 0.012 and p = 0.0051), myometrial invasion (p = 0.027 and p = 0.031), cervical stromal invasion (p = 0.023 and p = 0.014), ovarian metastasis (p = 0.00022 and p = 0.00034), lymph node metastasis (p < 0.0001 and p < 0.0001), and higher FIGO stage (p = 0.0011 and p = 0.00048). SUVmax was significantly higher in patients with larger tumour size (p = 0.0025), LVSI (p = 0.00023) and myometrial invasion (p < 0.0001). The areas under the ROC curves (AUCs) for distinguishing high-risk from low-risk carcinoma were 0.625, 0.829 and 0.797 for SUVmax, MTV and TLG, respectively. AUCs for both MTV and TLG were significantly larger than that for SUVmax (p = 0.0049 and p = 0.021). The optimal TLG cut-off value of 70.2, determined by ROC analysis, was found to have 72.0 % sensitivity and 74.2 % specificity for risk stratification. Conclusion MTV and TLG of primary endometrial cancer show better correlations with clinicopathological features and are more useful for differentiating high-risk from low-risk carcinoma than SUVmax.
  • Hideto Yamada, Masashi Deguchi, Yoko Maesawa, Yuki Nakajima, Yukari Nishino, Kenji Tanimura, Yasuhiko Ebina
    JOURNAL OF REPRODUCTIVE IMMUNOLOGY 109 48 - 51 2015年06月 [査読有り][通常論文]
     
    This study aimed to evaluate changes in natural killer (NK) cell activity and the percentage of monocytes in women with recurrent miscarriage who received medium-dose intravenous immunoglobulin (IVIg) therapy. Fourteen women with a history of six or more recurrent miscarriages of unexplained etiology received 60-g IVIg therapy (20 g daily, for three days) during early gestation. NI( cell activity in the peripheral blood decreased to 12% one week after therapy compared with before therapy (median, 22%, P<0.001) and the percentage of monocytes increased from 5.2% to 7.5% (P < 0.005). Four pregnancies ended in live births of healthy neonates, whereas the other ten pregnancies ended in miscarriages. Excluding one miscarriage with a chromosomal abnormality, the live birth rate was 30.8% (4/13). The rate of reduction of NI( cell activity in the success group (-58.8%) tended to be greater than that in the failure group (-14.8%, P = 0.057). (C) 2015 Elsevier Ireland Ltd. All rights reserved.
  • Yasuhiko Ebina, Toshio Minematsu, Ichiro Morioka, Masashi Deguchi, Shinya Tairaku, Kenji Tanimura, Ayako Sonoyama, Satoshi Nagamata, Mayumi Morizane, Hideto Yamada
    JOURNAL OF CLINICAL VIROLOGY 66 44 - 47 2015年05月 [査読有り][通常論文]
     
    Background: Human Cytomegalovirus (CMV) is the virus most frequently responsible for severe diseases of the fetus and newborn. The reported intrauterine transmission rate of CMV following primary maternal infection is approximately 40%. Invasive techniques are needed for the prenatal diagnosis of congenital CMV infection. Objectives: The aim of this study was to evaluate whether the rapidity of change in the CMV IgG avidity index (AI) is associated with the presence of congenital CMV infection among mothers with suspected primary CMV infection. Study design: The serum CMV IgG AI was repeatedly measured in 17 pregnant women with positive or borderline test results for CMV IgM together with an initial IgG AI value of <40%. Their neonates underwent polymerase chain reaction analyses for the presence of CMV DNA in the urine. The rapidity of change in the IgG AI per 4 weeks was defined as the Delta AI (%). The Delta AI of women with congenital CMV infection was compared with that of women with no infection. Results: The Delta AI of nine mothers with congenital CMV infection (median, 15.7%; range, 7.8-42.8%) was significantly higher than that of eight mothers with no infection (median, 6.5%, range, 2.0-8.8%; p < 0.001). The incidences of congenital CMV infection were 100.0%, 16.7%, and 0.0% among mothers with a Delta AI of >10, 5-10, and <5%, respectively. Conclusions: Measurement of the Delta AI in pregnant women might be useful for estimating the risk of mother-to-neonate CMV transmission. (C) 2015 Elsevier B.V. All rights reserved.
  • Yasuhiko Ebina, Nobuo Yaegashi, Hidetaka Katabuchi, Satoru Nagase, Yasuhiro Udagawa, Toru Hachisuga, Tsuyoshi Saito, Mikio Mikami, Yoichi Aoki, Hiroyuki Yoshikawa
    INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY 20 2 240 - 248 2015年04月 [査読有り][通常論文]
     
    The second edition of the Japan Society of Gynecologic Oncology guidelines for the treatment of uterine cervical cancer was published in 2011. The guidelines comprise eight chapters and five algorithms. They were prepared by consensus among the members of the Japan Society of Gynecologic Oncology Guidelines Formulation Committee and Evaluation Committee and are based on a careful review of the evidence obtained from the literature, health insurance system, and actual clinical settings in Japan. The highlights of the 2011 revision are (1) the recommended grades have been changed to five stages-A, B, C1, C2, and D; (2) the revisions are consistent with the new International Federation of Gynecology and Obstetrics staging system; (3) the roles are shared between the 'Japanese classification of cervical cancer' and the new guidelines; (4) clinical questions related to adenocarcinoma have been revised; and (5) a clinical question regarding cervical cancer in pregnant patients has been added. Each chapter includes a clinical question, recommendations, background, objectives, explanations, and references. Each recommendation is accompanied by a classification of recommendation categories. The objective of these guidelines is to update the standard treatment strategies for cervical cancer, thus eliminating unnecessary and insufficient treatment.
  • Kenji Tanimura, Yui Yamasaki, Yasuhiko Ebina, Masashi Deguchi, Yoshiko Ueno, Kazuhiro Kitajima, Hideto Yamada
    EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY 187 41 - 44 2015年04月 [査読有り][通常論文]
     
    Objective: Adherent placenta is a life-threatening condition in pregnancy, and is often complicated by placenta previa. The aim of this prospective study was to determine prenatal imaging findings that predict the presence of adherent placenta in pregnancies with placenta previa. Study design: The study included 58 consecutive pregnant women with placenta previa who underwent both ultrasonography and magnetic resonance imaging prenatally. Ultrasonographic findings of anterior placental location, grade 2 or higher placental lacunae (PL >= G2), loss of retroplacental hypoechoic clear zone (LCZ) and the presence of turbulent blood flow in the arteries were evaluated, in addition to MRI findings. Forty-three women underwent cesarean section alone; 15 women with adherent placenta underwent cesarean section followed by hysterectomy with pathological examination. To determine imaging findings that predict adherent placenta, univariate and multivariate logistic regression analyses were performed. Results: Univariate logistic regression analyses demonstrated that anterior placental location, PL >= G2, LCZ, and MRI were associated with the presence of adherent placenta. Multivariate analyses revealed that LCZ (p < 0.01, odds ratio 15.6, 95%Cl 2.1-114.6) was a single significant predictor of adherent placenta in women with placenta previa. Conclusion: This prospective study demonstrated for the first time that US findings, especially LCZ, might be useful for identifying patients at high risk for adherent placenta among pregnant women with placenta previa. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
  • Tanimura K, Jin H, Suenaga T, Morikami S, Arase N, Kishida K, Hirayasu K, Kohyama M, Ebina Y, Yasuda S, Horita T, Takasugi K, Ohmura K, Yamamoto K, Katayama I, Sasazuki T, Lanier LL, Atsumi T, Yamada H, Arase H
    Blood 125 18 2835 - 2844 2015年04月 [査読有り][通常論文]
     
    Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by thrombosis and/or pregnancy complications. beta 2-glycoprotein I (beta 2GPI) complexed with phospholipid is recognized as a major target for autoantibodies in APS; however, less than half the patients with clinical manifestations of APS possess autoantibodies against the complexes. Therefore, the range of autoantigens involved in APS remains unclear. Recently, we found that human leukocyte antigen (HLA) class II molecules transport misfolded cellular proteins to the cell surface via association with their peptide-binding grooves. Furthermore, immunoglobulin G heavy chain/HLA class II complexes were specific targets for autoantibodies in rheumatoid arthritis. Here, we demonstrate that intact beta 2GPI, not peptide, forms a complex with HLA class II molecules. Strikingly, 100 (83.3%) of the 120 APS patients analyzed, including those whose antiphospholipid antibody titers were within normal range, possessed autoantibodies that recognize beta 2GPI/HLA class II complexes in the absence of phospholipids. In situ association between beta 2GPI and HLA class II was observed in placental tissues of APS patients but not in healthy controls. Furthermore, autoantibodies against beta 2GPI/HLA class II complexes mediated complement-dependent cytotoxicity against cells expressing the complexes. These data suggest that beta 2GPI/HLA class II complexes are a target in APS that might be involved in the pathogenesis.
  • Yoko Maesawa, Hideto Yamada, Masashi Deguchi, Yasuhiko Ebina
    GYNECOLOGICAL ENDOCRINOLOGY 31 4 306 - 308 2015年04月 [査読有り][通常論文]
     
    The aim of this study was to evaluate whether the presence of history of biochemical pregnancy (BP) was associated with clinical characteristics and the subsequent pregnancy outcome among women with recurrent spontaneous abortion (RSA). One-hundred and seventy-five RSA women with two or more clinical pregnancy losses were enrolled. The clinical characteristics were compared between 164 women with history of 0-1 BP (Group A) and 11 women with two or more BP (Group B). The frequency of previous pregnancy loss and history of in vitro fertilization and embryo transfer in Group B was higher than that in Group A; while frequency of secondary RSA in Group B was lower than Group A. The subsequent pregnancy outcome was assessed prospectively; and live-birth rate in Group A (72.9%) was higher (p<0.05) than that in Group B (41.7%). The incidence of reproductive failure (58.3%, p<0.05) and spontaneous abortion with normal chromosome (25.0%, p=0.050) in Group B was higher than those (27.1 and 5.9%, respectively) in Group A. RSA women with two or more BP had higher risk of reproductive failure and spontaneous abortion with normal chromosome together with lower chance of live-birth. The results of the present study involve important information and are helpful for clinical practitioners.
  • Astuti Y, Nakabayashi K, Deguchi M, Ebina Y, Yamada H
    The Kobe journal of medical sciences 61 1 E1-8 - 8 1 2015年03月24日 [査読有り][通常論文]
     
    Relaxin is essential for trophoblast development during pregnancy. Evidence shows that relaxin increases trophoblast cell migration capacity. Here, we show the effect of relaxin on protein kinase B (AKT) activation and glycogen synthase kinase 3-beta (GSK3β) inactivation as well as on the proliferation of HTR-8/SVneo cells, a model of human extravillous trophoblast (EVT). HTR-8/SVneo cells were treated with different doses of human recombinant (rH2) relaxin in serum-deprived conditions and treated for increasing time with 1 ng/mL of rH2 relaxin. Western blot analysis was performed to detect pAKT, AKT, pGSK3β, GSK3β, and actin expression. Proliferation of HTR-8/SVneo cells was analyzed by MTS assay. rH2 relaxin treatment increased the ratio of pAKT/AKT, pGSK3β/GSK3β, and proliferation in HTR-8/SVneo cells. Furthermore, AKT and GSK3β activation by rH2 relaxin was inhibited by a phosphoinositide 3-kinase (PI3K) inhibitor. This study suggests that rH2 relaxin induces AKT and GSK3β phosphorylation as well as proliferation in HTR-8/SVneo cells.
  • Yoko Kobayashi, Ichiro Morioka, Tsubasa Koda, Yuji Nakamachi, Yoko Okazaki, Yoriko Noguchi, Miki Ogi, Masatsugu Chikahira, Kenji Tanimura, Yasuhiko Ebina, Toru Funakoshi, Masanobu Ohashi, Kazumoto Iijima, Naoki Inoue, Seiji Kawano, Hideto Yamada
    JOURNAL OF PERINATAL MEDICINE 43 2 239 - 243 2015年03月 [査読有り][通常論文]
     
    Aims: Neurological outcomes differ considerably between symptomatic and asymptomatic infants with congenital cytomegalovirus (CMV) infection. Our objective was to characterize laboratory markers in symptomatic newborns in comparison with asymptomatic newborns with congenital CMV infection. Methods: Ten newborns with symptomatic and 13 newborns with asymptomatic congenital CMV infection were included in this 3-year prospective cohort study. Total immunoglobulin M (IgM), CMV-IgM, CMV antigenemia, and CMV-DNA in blood and urine were measured and their positive rates and quantitative values compared between the symptomatic and asymptomatic groups. Results: Fifty percent of newborns in the symptomatic group were positive based on total IgM; this was significantly lower than in the asymptomatic group (100%). Quantitative total IgM values were significantly lower, and there were significantly more copies of CMV-DNA in the blood of symptomatic newborns than in -asymptomatic newborns (median values for total IgM: 14 vs. 43 mg/dL and blood CMV-DNA: 3.2 x 10(2) vs. 3.5 x 10(1) copies/10(6) white blood cells). CMV-IgM, CMV antigenemia, and urine CMV-DNA did not differ significantly between groups. Conclusion: Low total IgM values and high blood CMV loads were associated with the presence of symptoms in newborns with congenital CMV infection.
  • Hideto Yamada, Shinya Tairaku, Ichiro Morioka, Ayako Sonoyama, Kenji Tanimura, Masashi Deguchi, Satoshi Nagamata, Yasuhiko Ebina
    JOURNAL OF INFECTION AND CHEMOTHERAPY 21 3-4 161 - 164 2015年03月 [査読有り][通常論文]
     
    Objectives: The aim of this survey study was to evaluate a state of mother-to-child infections in Japan. Methods: A nationwide survey on 2714 obstetric facilities where regular maternity checkups were carried out was conducted. A primary questionnaire assessed numbers of pregnancies including induced abortion, spontaneous abortion, still-birth as well as live-birth, which were affected by congenital infections of 6 pathogens during a year of 2011. The secondary questionnaire assessed clinical information, diagnostic modality, and the outcome for each case. The clinical features and diagnostic problems were evaluated. Results: The high reply rates for the primary (73.7%) and the secondary questionnaire (100%) were achieved. The presence of congenital infections for 34 cases with cytomegalovirus (CMV), 1 with Toxoplasma gondii, 4 with rubella virus, 5 with Treponema pallidum, 8 with herpes simplex virus, and 69 with parvovirus B19 was confirmed after questionnaire assessment. The incidence of fetal demise among pregnancies with congenital parvovirus B19 infection was up to 71.0%. Eleven mothers with hydrops fetalis received prenatal fetal therapies involving fetal blood transfusion and immunoglobulin administration, whereas only three pregnancies (27.3%) ended in live-births. Conclusions: This survey study for the first time revealed the annual frequency of pregnancies with mother-to-child infections of 6 pathogens in Japan. The results involve important information and are helpful for clinical practitioners. The majority of neonates with congenital infection of CMV or T. gondii might be undiagnosed in obstetric facilities. (C) 2014, Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
  • 蝦名康彦
    小児科 56 2 191 - 198 金原出版 2015年02月 [査読有り][招待有り]
  • M. Nishimoto, Y. Miyahara, Y. Ebina, M. Deguchi, S. Matsuoka, H. Yamada
    CLINICAL AND EXPERIMENTAL OBSTETRICS & GYNECOLOGY 42 2 243 - 245 2015年 [査読有り][通常論文]
     
    Viper bites in pregnant women have rarely been reported thus far. Moreover, there is no consensus regarding the treatment of such cases. In this paper, the authors report the successful treatment of viper bite during pregnancy without using antivenom.
  • Kazuhiro Kitajima, Utaru Tanaka, Yoshiko Ueno, Tetsuo Maeda, Yuko Suenaga, Satoru Takahashi, Masashi Deguchi, Yoshiya Miyahara, Yasuhiko Ebina, Hideto Yamada, Masakatsu Tsurusaki, Yukihisa Tamaki, Kazuro Sugimura
    PLOS ONE 10 1 e0117411  2015年01月 [査読有り][通常論文]
     
    Background and Purpose To investigate the diagnostic performance of diffusion-weighted imaging (DWI) and contrast-enhanced imaging in combination with T2-weighted imaging (T2WI) for magnetic resonance imaging (MRI) evaluation of intrapelvic recurrence of gynecological malignancies. Materials and Methods Sixty-two patients with suspected intrapelvic recurrence of gynecological malignancies underwent pelvic MRI including T2WI DWI, and contrast-enhanced imaging. Diagnostic performance for detection of local recurrence, pelvic lymph node and bone metastases, and peritoneal lesions was evaluated by consensus reading of two experienced radiologists using a 5-point scoring system, and compared among T2WI with unenhanced T1-weighted imaging (T1WI) (protocol A), a combination of protocol A and DWI (protocol B), and a combination of protocol B and contrast-enhanced imaging (protocol C). Final diagnoses were obtained by histopathological examinations, radiological imaging and clinical follow-up for at least 6 months. Receiver operating characteristic (ROC) analysis and McNemar test were employed for statistical analysis. Results Locally recurrent disease, lymph node recurrence, peritoneal dissemination and bone metastases were present in 48.4%, 29.0%, 16.1%, and 6.5% of the patients, respectively. The patient-based sensitivity, specificity, accuracy, and area under the ROC curve (AUC) for detection of intrapelvic recurrence were 55.0, 81.8, 64.5% and 0.753 for protocol A, 80.0, 77.3,79.0% and 0.838 for protocol B, and 80.0, 90.9, 83.9% and 0.862 for protocol C, respectively. The sensitivity, accuracy, and AUC were significantly better for protocols B and C than for protocol A (p<0.001). There was no significant difference between protocols B and C. Conclusion MRI using a combination of DWI and T2WI gives comparatively acceptable results for assessment of intrapelvic recurrence of gynecological malignancies.
  • Fumi Kawakami, Shuho Semba, Hiroe Itami, Noriko Oka, Tamotsu Sudo, Yasuhiko Ebina, Chiho Ohbayashi, Yoshiki Mikami, Hiroshi Yokozaki, Tomoo Itoh
    The Kobe journal of medical sciences 60 3 E66-73 - 73 2014年11月06日 [査読有り][通常論文]
     
    To determine the etiology of combined high-grade squamous intraepithelial lesion (HSIL) and adenocarcinoma in situ (AIS) of the uterine cervix, we examined human papillomavirus (HPV) subtypes, methylation status of the HPV-16 L1 gene, and immunohistochemical staining pattern of Krt7 in 8 cases of combined HSIL and AIS. Overall, 6 (75%) of 8 patients with combined HSIL and AIS were infected by the same subtype of HPV in both HSIL and AIS (cases 1-5, HPV-16; and case 6, HPV-18), whereas 2 (25%) patients showed infection with different subtypes of HPV (case 7, HPV-31 and -18; and case 8, HPV-52 and -16, in HSIL and AIS, respectively). The degrees of methylation at CpG islands within the HPV-16 L1 gene were almost equivalent between HSIL and AIS in cases 1-4, whereas a great difference in CpG methylation patterns between two was seen in only 1 case (case 5). In addition, both patients infected with different subtypes of HPV between HSIL and AIS were positive for Krt7 only within the AIS component. Based on these results, we propose two distinct developmental pathways of combined HSIL and AIS of the uterine cervix, the common pathway and the individual pathway.
  • Fumi Kawakami, Shuho Semba, Hiroe Itami, Noriko Oka, Tamotsu Sudo, Yasuhiko Ebina, Chiho Ohbayashi, Yoshiki Mikami, Hiroshi Yokozaki, Tomoo Itoh
    The Kobe journal of medical sciences 60 3 E66-73 - 73 2014年11月06日 [査読有り][通常論文]
     
    To determine the etiology of combined high-grade squamous intraepithelial lesion (HSIL) and adenocarcinoma in situ (AIS) of the uterine cervix, we examined human papillomavirus (HPV) subtypes, methylation status of the HPV-16 L1 gene, and immunohistochemical staining pattern of Krt7 in 8 cases of combined HSIL and AIS. Overall, 6 (75%) of 8 patients with combined HSIL and AIS were infected by the same subtype of HPV in both HSIL and AIS (cases 1-5, HPV-16; and case 6, HPV-18), whereas 2 (25%) patients showed infection with different subtypes of HPV (case 7, HPV-31 and -18; and case 8, HPV-52 and -16, in HSIL and AIS, respectively). The degrees of methylation at CpG islands within the HPV-16 L1 gene were almost equivalent between HSIL and AIS in cases 1-4, whereas a great difference in CpG methylation patterns between two was seen in only 1 case (case 5). In addition, both patients infected with different subtypes of HPV between HSIL and AIS were positive for Krt7 only within the AIS component. Based on these results, we propose two distinct developmental pathways of combined HSIL and AIS of the uterine cervix, the common pathway and the individual pathway.
  • Yasuhiko Ebina, Toshio Minematsu, Ayako Sonoyama, Ichiro Morioka, Naoki Inoue, Shinya Tairaku, Satoshi Nagamata, Kenji Tanimura, Mayumi Morizane, Masashi Deguchi, Hideto Yamada
    JOURNAL OF PERINATAL MEDICINE 42 6 755 - 759 2014年11月 [査読有り][通常論文]
     
    Background: Cytomegalovirus (CMV) causes congenital infection with high mortality and morbidity rates in affected neonates. Objectives: To evaluate the maternal IgG avidity value for the prediction of congenital CMV infection. Study design: The serum IgG avidity in all mothers was measured, and the urine of their neonates was assessed for CMV DNA in a prospective cohort study. Results: Of 759 women with a positive test for CMV IgG, 14 had congenital CMV infection. CMV IgG avidity indices in the congenital infection group (median 35.1%) were significantly lower than those in the non-congenital infection group (70.4%). A cutoff value of <40% IgG avidity index with 96.1% specificity and 64.3% sensitivity for congenital infection was determined by receiver operating characteristic curve analyses. The highest sensitivity (88.9%), 96.2% specificity, 27.6% positive predictive value, 99.8% negative predictive value, and 96.1% accuracy were found when IgG avidity was measured in < 28 weeks of gestation. Conclusion: The IgG avidity measurement with a cutoff value of < 40% IgG avidity index might be helpful in predicting congenital CMV infection, especially in < 28 weeks of gestation.
  • 牧原 夏子, 蝦名 康彦, 山崎 友維, 生橋 義之, 松岡 正造, 前田 哲雄, 川上 史, 山田 秀人
    日本産科婦人科内視鏡学会雑誌 30 1 112 - 116 (一社)日本産科婦人科内視鏡学会 2014年11月 [査読有り][通常論文]
     
    病理診断にて卵巣成熟嚢胞性奇形腫(MCT)と診断した73例(良好群)と卵巣奇形腫の悪性転化と診断した4例(悪性群)の術前所見を後方視的に比較し、悪性転化のリスク診断に有用な因子を検討した。手術時年齢、最大腫瘍径、血清SCC抗原値、血清CEA値、骨盤MRIにおける腫瘍結節部分の造影効果の有無について解析した結果、卵巣奇形腫の悪性転化の術前診断に有用な因子として、60歳以上、腫瘍径10cm以上、血清SCC抗原2.5ng/ml以上、血清CEA 5.0ng/ml以上、骨盤MRIにて造影効果を示す充実部分を有するといった因子が選択された。術前の検査情報から得られる悪性転化のリスク、具体的な手術手技によるメリットとデメリットを十分に説明し、理解と納得を得た上で術式を選択してもらうことが重要であると考えられた。
  • Kenji Tanimura, Shinya Tairaku, Masashi Deguchi, Ayako Sonoyama, Mayumi Morizane, Yasuhiko Ebina, Ichiro Morioka, Hideto Yamada
    The Kobe journal of medical sciences 60 2 E25-9 - 9 2014年07月11日 [査読有り][通常論文]
     
    The aim of this trial study was to assess the preventive efficacy of immunoglobulin with a high titer of anti-CMV antibody for mother-to-fetus cytomegalovirus (CMV) transmission among pregnant women with primary/acute CMV infection. The primary CMV infection in mothers was diagnosed by a positive test for CMV IgM and/or low IgG avidity. Intact type immunoglobulin with a high titer of anti-CMV antibody was injected intravenously at a dosage of 2.5-5.0 g/day for consecutive 3 days to mothers with primary CMV infection. Four pregnant women were enrolled. One pregnancy ended in no congenital infection, while two pregnancies ended in congenital CMV infection. The other one pregnancy was terminated. The mother-to-fetus CMV transmission rate was found to be high as 66.7% (2/3). This preliminary result suggests that intravenous immunoglobulin injections are not effective for the prevention of mother-to-fetus CMV transmission in the present protocol.
  • Kazuhiro Kitajima, Yuko Suenaga, Yoshiko Ueno, Tomonori Kanda, Tetsuo Maeda, Masashi Deguchi, Yasuhiko Ebina, Hideto Yamada, Satoru Takahashi, Kazuro Sugimura
    CLINICAL IMAGING 38 4 464 - 469 2014年07月 [査読有り][通常論文]
     
    Purpose: To investigate the fusion of pelvic magnetic resonance imaging (MRI) and fluorodeoxyglucose positron emission tomography (PET) for assessment of locoregional extension and nodal staging of cervical cancer. Methods: PET/computed tomography (CT), MRI, and non-fused and fusion of PET and MRI for assessing the extent of the primary tumor and metastasis to nodes were evaluated. Results: Accuracy for T-status was 83.3% for fused and non-fused PET/MRI and MRI proved significantly more accurate than PET/CT (53.3%) (P=.0077). Sensitivity, specificity, and accuracy for nodal metastasis were 92.3%, 88.2%, and 90.0% for fused PET/MRI and PET/contrast-enhanced CT; 84.6%, 94.1%, and 90.0% for nonfused PET/MRI; and 69.2%, 100%, and 86.7% for MRI. Conclusion: Fused PET/MRI combines the individual advantages of MRI and PET. (C) 2014 Elsevier Inc. All rights reserved.
  • Yoshiya Miyahara, Natsuko Makihara, Yui Yamasaki, Yasuhiko Ebina, Masashi Deguchi, Hideto Yamada
    GYNECOLOGICAL ENDOCRINOLOGY 30 7 502 - 504 2014年07月 [査読有り][通常論文]
     
    Objective: The aim of this study was to determine the risk factors for hemorrhagic shock in women with placental polyp. Materials and methods: Twelve women (group A) developed hemorrhagic shock (shock index<1.5) and received uterine artery embolization (UAE). The other 25 women (group B) had shock index<1.5 and did not receive UAE. All women underwent transcervical resection (TCR). The risk factors for the development of hemorrhagic shock, including the age, conception mode, numbers of previous abortion, gestational weeks at termination of pregnancy (TOP), blood loss weights at TOP and at TCR, were analyzed. Results: When compared with group B, group A had higher in vitro fertilization-embryo transfer (IVF-ET) pregnancy rate (58.3 versus 12.0%, p<0.01), number of previous abortion (median 1.58 versus 0.68, p<0.05), gestational weeks at TOP (median 36.5 versus 17.0 weeks, p<0.05), and blood loss weight at TOP (median 2151 versus 40 g, p<0.05). A logistic regression analysis reveled that IVF-ET (OR 41, 95% CI 1.3-1264) and blood loss weight at TOP (1.0025, 1.0006-1.0044) were independent risk factors for hemorrhagic shock. Conclusions: For the first time, IVF-ET pregnancy was found to be a risk factor for the development of hemorrhagic shock in women with placental polyp.
  • Kazuhiro Kitajima, Yasuhiko Ebina, Kazuro Sugimura
    JAPANESE JOURNAL OF RADIOLOGY 32 6 313 - 323 2014年06月 [査読有り][通常論文]
     
    Integrated positron emission tomography/computed tomography (PET/CT) with 2-[18F]fluoro-2-deoxy-d-glucose (FDG) is a useful technique for acquiring both glucose metabolic and anatomic imaging data using a single device in a single diagnostic session, and has opened up a new field of clinical oncologic imaging. FDG-PET/CT has been used successfully for the staging, treatment optimization, re-staging, therapy monitoring, and prognostication of uterine and ovarian cancers as well as various malignant tumors. The present review discusses the current role of FDG-PET/CT in the management of gynecologic malignancies, focusing on its usefulness and limitations for imaging such patients.
  • Mizuki Uenaka, Kenji Tanimura, Shinya Tairaku, Ichiro Morioka, Yasuhiko Ebina, Hideto Yamada
    EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY 177 89 - 93 2014年06月 [査読有り][通常論文]
     
    Objective: To determine the factors related to adverse pregnancy outcomes and neonatal thyroid dysfunction in pregnancies complicated by Graves' disease. Study design: Thirty-five pregnancies complicated by Graves' disease were divided into two groups: adverse pregnancy outcome (n = 15) and no adverse pregnancy outcome (n = 20). Adverse pregnancy outcomes included spontaneous abortion, stillbirth, premature delivery, fetal growth restriction, and pregnancy-induced hypertension. The 31 pregnancies resulting in live births were also divided into two groups: neonatal thyroid dysfunction (n = 9) and normal neonatal thyroid function (n = 22). Serum levels of thyroid-stimulating hormone (TSH), free thyroxine (FT4), TSH-receptor antibody (TRAb), the duration of hyperthyroidism in pregnancy, doses of antithyroid medication, and the duration of maternal antithyroid medication throughout pregnancy were compared. Results: There were no significant differences in these factors between pregnancies with an adverse pregnancy outcome and those with no adverse pregnancy outcome. However, serum levels of FT4, TRAb, the duration of hyperthyroidism in pregnancy, the maximum daily dose of antithyroid medication, and the total dose of antithyroid medication were significantly different between pregnancies with neonatal thyroid dysfunction and those with normal neonatal thyroid function. Multivariate logistic regression analysis showed that the FT4 level in mothers was a significant factor related to the development of neonatal thyroid dysfunction (odds ratio 28.84, 95% confidence interval 1.65-503.62, p < 0.05). Conclusion: Graves' disease activity in women of childbearing age should be well controlled prior to conception. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
  • Yui Yamasaki, Hiroki Morita, Yoshiya Miyahara, Yasuhiko Ebina, Takuya Okada, Masato Yamaguchi, Hideto Yamada
    JOURNAL OF PERINATAL MEDICINE 42 3 359 - 362 2014年05月 [査読有り][通常論文]
     
    Objective: The transcatheter pelvic arterial embolization (TAE) is effective for postpartum hemorrhage (PPH). There has been a little information about the factors for ineffectiveness of TAE. The aim of this study was to determine factors associated with TAE failure for PPH. Study design: Fifty-five women who underwent TAE for intractable PPH were included. Clinical factors involving age, history of pregnancy, gestational weeks of delivery, mode of delivery, causes of PPH, complete blood count, blood loss volume, transfusion amount, shock index and disseminated intravascular coagulation (DIC) score were compared between TAE success group (n=48) and TAE failure group (n=7). Results: The uni- and multi-variate analyses revealed that advanced maternal age (OR 1.46, 95% CI 1.12-2.18) and retained placenta as a cause of PPH (15.48, 2.04-198.12) were found to be significant factors for TAE failure. Conclusion: The advanced age and retained placenta were independent factors associated with TAE failure for intractable PPH.
  • Hideto Yamada, Shinya Tairaku, Ichiro Morioka, Yasuhiko Ebina, Ayako Sonoyama, Kenji Tanimura, Masashi Deguchi, Satoshi Nagamata
    CONGENITAL ANOMALIES 54 2 100 - 103 2014年05月 [査読有り][通常論文]
     
    Mother-to-child infections cause congenital infection with disease and sequelae. To evaluate a state of maternal blood screening for mother-to-child infections in Japan, we for the first time conducted a nationwide survey on obstetric facilities where regular maternity checkups were carried out. A questionnaire assessment involved an annual number of deliveries, scale of facilities and a state of maternal blood screening for eight pathogens. A high rate (73.7%) of reply to the questionnaire was achieved from 1990 facilities, covering 75.1% of annual number of delivery in 2011. The performance rates of blood screening were more than 99% for rubella virus, Treponema pallidum, human immunodeficiency virus (HIV), human T cell leukemia virus type 1 (HTLV-1), hepatitis B virus, and hepatitis C virus, while the rate was found to be only 4.5% for cytomegalovirus (CMV), and 48.5% for Toxoplasma gondii with large differences in regions. Most of the facilities performed blood tests for rubella virus, Treponema pallidum, HIV, hepatitis B virus and hepatitis C virus once in early pregnancy, while approximately 28% of the facilities performed blood tests for HTLV-1 once during the 2nd or 3rd trimester. Most of the facilities used HA tests for Toxoplasma gondii, whereas there was a wide variation in antibody measurement methods for CMV. Generally, the obstetric facilities in Japan have performed maternal blood screening properly according to the current recommendations. The results of this survey involve important information and are helpful for clinical practitioners.
  • Management of Thromboembolism in Pregnant Women with Inherited Antithrombin
    Ebina Y, Nakamachi Y, Tanimura K, Morizane M, Morikami D, Deguchi M, Kawano S, Yamada H
    Exprimental & Clinical Cardiology 20 6 145 - 159 2014年04月 [査読有り][通常論文]
  • Yasuhiko Ebina, Hidemichi Watari, Masanori Kaneuchi, Mahito Takeda, Masayoshi Hosaka, Masataka Kudo, Hideto Yamada, Noriaki Sakuragi
    EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 41 3 446 - 451 2014年03月 [査読有り][通常論文]
     
    Purpose To investigate the impact of PET and PET/CT scanning on decision-making in management planning and to identify the optimal setting for selecting candidates for surgery in suspicious recurrent ovarian cancer. Methods A retrospective chart review was performed in patients with possible recurrent ovarian cancer after primary optimal cytoreduction and taxane/carboplatin chemotherapy who had undergone FDG PET or FDG PET/CT scans from July 2002 to August 2008 to help make treatment decisions. The analysis included 44 patients who had undergone a total of 89 PET scans. The positive PET scans were classified as follows. (1) localized (one or two localized sites of FDG uptake), (2) multiple (three or more sites of FDG uptake), (3) diffuse (extensive low-grade activity outlining serosal and peritoneal surfaces). Results Of the 89 PET scans, 52 (58.4 %) led to a change in management plan. The total number of patients in whom cytoreductive surgery was selected as the treatment of choice increased from 12 to 35. Miliary disseminated disease, which was not detected by PET scan, was found in 22.2 % of those receiving surgery. Miliary disseminated disease was detected in 6 of the 12 patients with recurrent disease whose treatment-free interval (TFI) was <12 months, whereas none of those with a TFI of >= 12 months had such disease (P = 0.0031). Conclusion PET or PET/CT is useful for selecting candidates for cytoreductive surgery among patients with recurrent ovarian cancer. To avoid surgical attempts in those with miliary dissemination, patients with a TFI of >= 12 months are the best candidates for cytoreductive surgery.
  • Ichiro Morioka, Ayako Sonoyama, Shinya Tairaku, Yasuhiko Ebina, Satoshi Nagamata, Mayumi Morizane, Kenji Tanimura, Kazumoto Iijima, Hideto Yamada
    CONGENITAL ANOMALIES 54 1 35 - 40 2014年02月 [査読有り][通常論文]
     
    To reduce the incidence of infants with congenital infections, women should be aware of and know prevention measures against maternal infection with mother-to-child infections during pregnancy. Our objective was to assess the awareness of and knowledge about mother-to-child infections in Japanese pregnant women. A survey of 343 Japanese pregnant women was completed. Awareness of 13 pathogens capable of mother-to-child transmission was surveyed. Knowledge about the transmission route, the most susceptible time of infection that may cause severe fetal disease during pregnancy, and methods to prevent maternal infection were investigated for four major pathogens (cytomegalovirus, rubella virus, Toxoplasma gondii, and parvovirus B19) and results were compared between these pathogens. The proportion of women aware of pathogens concerning TORCH syndrome was the following: rubella virus 76%, Treponema pallidum 69%, Toxoplasma gondii 58%, parvovirus B19 28%, herpes simplex virus 27%, and cytomegalovirus 18%. Only 8% knew how cytomegalovirus is transmitted, and only 12% knew how parvovirus B19 is transmitted; both were significantly lower than those who knew transmission routes for rubella virus or Toxoplasma gondii. The proportion of women who knew the most susceptible time for severe fetal infection by maternal acquisition of cytomegalovirus, Toxoplasma gondii, or parvovirus B19 was significantly lower than that for rubella virus. The vast majority of surveyed women were not aware of methods to prevent maternal infection with cytomegalovirus or parvovirus B19. In conclusion, current awareness of and knowledge about cytomegalovirus and parvovirus B19 infection are low in Japanese pregnant women.
  • N. Makihara, T. Maeda, Y. Ebina, K. Kitajima, F. Kawakami, S. Hara, H. Yamada
    EUROPEAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY 35 2 174 - 177 2014年 [査読有り][通常論文]
     
    Primary leiomyosarcoma of the broad ligament is a very rare and highly malignant gynecological tumor. The authors report a 61-year-old postmenopausal woman with signs and symptoms of malignant ovarian tumor. Preoperative magnetic resonance imaging (MRI) was interpreted as being suspicious for malignant tumors, such as an ovarian cancer or a leiomyosarcoma of the broad ligament, so laparotomy was performed. Macroscopically, the tumor was revealed with a 18x13.7x9.5 cm degenerated, multiple cystic part and solid whitish part arising from broad ligament which on histopathology proved to be leiomyosarcoma. To the best of the authors' knowledge, primary leiomyosarcoma of the broad ligament has been documented in 21 reports or so, and no imaging findings are available. Here the authors present the Mill findings of primary leiomyosarcoma of the broad ligament.
  • Kazuhiro Kitajima, Yuko Suenaga, Yoshiko Ueno, Tomonori Kanda, Tetsuo Maeda, Natsuko Makihara, Yasuhiko Ebina, Hideto Yamada, Satoru Takahashi, Kazuro Sugimura
    ANNALS OF NUCLEAR MEDICINE 28 1 25 - 32 2014年01月 [査読有り][通常論文]
     
    To evaluate the diagnostic value of retrospective image fusion from pelvic magnetic resonance imaging (MRI) and F-18-fluorodeoxyglucose positron emission tomography (PET) in detecting intra-pelvic recurrence of gynecological tumor. Thirty patients with a suspicion of recurrence of gynecological malignancy underwent inline contrast-enhanced PET/computed tomography (CT) and pelvic contrast-enhanced MRI for restaging. Diagnostic performance about the local recurrence, pelvic lymph node and bone metastasis and peritoneal lesion of PET/low-dose non-enhanced CT (PET/ldCT), PET/full-dose contrast-enhanced CT (PET/ceCT), contrast-enhanced MRI, and retrospective image fusion from PET and MRI (fused PET/MRI) were evaluated by two experienced readers. Final diagnoses were obtained by histopathological examinations, radiological imaging and clinical follow-up for at least 6 months. McNemar test was employed for statistical analysis. Documented positive locally recurrent disease, pelvic lymph node and bone metastases, and peritoneal dissemination were present in 53.3, 26.7, 10.0, and 16.7 %, respectively. Patient-based sensitivity for detecting local recurrence, pelvic lymph node and bone metastasis and peritoneal lesion were 87.5, 87.5, 100 and 80.0 %, respectively, for fused PET/MRI, 87.5, 62.5, 66.7 and 60.0 %, respectively, for contrast-enhanced MRI, 62.5, 87.5, 66.7 and 80.0 %, respectively, for PET/ceCT, and 50.0, 87.5, 66.7 and 60.0 %, respectively, for PET/ldCT. The sensitivity of diagnosing local recurrence by fused PET/MRI was significantly better than that of PET/ldCT (p = 0.041). The patient-based sensitivity, specificity and accuracy for the detection of intra-pelvic recurrence/metastasis were 91.3, 100 and 93.3 % for fused PET/MRI, 82.6, 100 and 86.7 % for contrast-enhanced MRI, 82.6, 100 and 86.7 % for PET/ceCT and 78.3, 85.7 and 80.0 % for PET/ldCT. Fused PET/MRI combines the individual advantages of MRI and PET, and is a valuable technique for assessment of intra-pelvic recurrence of gynecological cancers.
  • Romana S. Z. Lodhi, Koji Nakabayashi, Kaho Suzuki, Ai Y. Yamada, Rhoichi Hazama, Yasuhiko Ebina, Hideto Yamada
    GYNECOLOGICAL ENDOCRINOLOGY 29 12 1051 - 1054 2013年12月 [査読有り][通常論文]
     
    The study was conducted to evaluate the effects of human relaxin on apoptosis in the human trophoblast derived HTR-8/SV neo cell line, which is a possible model of human extravillous trophoblasts (EVTs). HTR-8/SV neo cells, cultured in phenol red free RPMI1640 medium, were treated with different doses of human recombinant (rH2) relaxin in serum-deprived conditions. RT-PCR was used for evaluating relaxin receptor: RXFP1 and RXFP2 expression in HTR-8/SV neo cells. The cell death was examined by TUNEL assay. Furthermore, we investigated caspase-3, cleaved PARP and Bcl-2 expressions by Western blot analysis to recognize the translational effects of anti-apoptotic and pro-apoptotic proteins. RXFP1 and RXFP2 mRNA expression was observed in HTR-8/SV neo cells. Compared with untreated control cultures, treatment with rH2 relaxin, decreased TUNEL-positive rate in HTR-8/SV neo cells was observed. Western blot analysis revealed that treatment with rH2 relaxin decreased the expression of caspase-3 and cleaved PARP, but in contrast increased Bcl-2 expression in those cells. These results suggest that rH2 relaxin has anti-apoptotic effects on HTR8/SV neo cells by decreasing pro-apoptotic caspase-3 and cleaved PARP expression and up-regulating anti-apoptotic Bcl-2 expression.
  • Kitajima K, Suenaga Y, Ueno Y, Kanda T, Maeda T, Takahashi S, Ebina Y, Miyahara Y, Yamada H, Sugimura K
    European journal of radiology 82 10 1672 - 1676 10 2013年10月 [査読有り][通常論文]
     
    Purpose: To investigate the diagnostic value of retrospective fusion of pelvic MRI and F-18-fluorodeoxyglucose (F-18-FDG) PET images for assessment of locoregional extension and nodal staging of endometrial cancer. Materials and methods: Thirty patients with biopsy-proven endometrial cancer underwent preoperative contrast-enhanced PET/CT (PET/ceCT) and pelvic dynamic contrast-enhanced MRI for initial staging. Diagnostic performance of PET/ceCT, contrast-enhanced MRI, and retrospective image fusion from PET and MRI (fused PET/MRI) for assessing the extent of the primary tumor (T stage) and metastasis to regional LNs (N stage) was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. The McNemar test was employed for statistical analysis. Results: Fused PET/MRI and MRI detected 96.7% of the primary tumors, whereas PET/ceCT detected 93.3%. Accuracy for T status was 80.0% for fused PET/MRI, and MRI proved significantly more accurate than PET/ceCT, which had an accuracy of 60.0% (p = 0.041). Patient-based sensitivity, specificity and accuracy for detecting pelvic nodal metastasis were 100%, 96.3% and 96.7% for both fused PET/MRI and PET/ceCT, and 66.7%, 100% and 96.7% for MRI, respectively. These three parameters were not statistically significant (p = 1). Conclusion: Fused PET/MRI, which complements the individual advantages of MRI and PET, is a valuable technique for assessment of the primary tumor and nodal staging in patients with endometrial cancer. Crown Copyright (C) 2013 Published by Elsevier Ireland Ltd. All rights reserved.
  • Ayako Sonoyama, Yasuhiko Ebina, Ichiro Morioka, Kenji Tanimura, Mayumi Morizane, Shinya Tairaku, Toshio Minematsu, Naoki Inoue, Hideto Yamada
    JOURNAL OF MEDICAL VIROLOGY 84 12 1928 - 1933 2012年12月 [査読有り][通常論文]
     
    Cytomegalovirus (CMV) causes congenital infection with high mortality and morbidity rates in affected neonates. The aim of this study was to assess whether prenatal clinical or laboratory findings in pregnant women who had high risks for primary CMV infection predicted the presence of congenital infection. Fifty pregnant women who had serum CMV IgG and positive or borderline tests for serum CMV IgM were included in this prospective study. Serum IgG avidity was measured, and PCR was conducted for CMV DNA in maternal serum, urine, and uterine cervical secretion. All neonates underwent PCR testing for CMV DNA in the urine for the presence of congenital infection. Risk factors were compared between congenital infection group and group without congenital infection. As a result, nine neonates (18%) were diagnosed as having congenital infection. The frequencies of ultrasound fetal abnormality and positive test for CMV DNA in cervical secretion, CMV IgM titer and IgM/IgG ratio in the congenital infection group were significantly higher than those in the group without congenital infection. Conversely, IgG avidity index in the congenital infection group was significantly lower than that in the group without congenital infection. By multivariate logistic regression analyses, IgG avidity index (Odds ratio 0.91, 95% CI: 0.830.99) and ultrasound fetal abnormality (291.22, 2.7231125.05), were selected independently as significant signs predictive of congenital CMV infection. Among pregnant women with positive or borderline tests for CMV IgM, when they have findings of low serum CMV IgG avidity or ultrasound fetal abnormality, the probability of congenital CMV infection may increase. J. Med. Virol. 84:19281933, 2012. (c) 2012 Wiley Periodicals, Inc.
  • Kazuhiro Kitajima, Yoshiko Ueno, Kayo Suzuki, Masato Kita, Yasuhiko Ebina, Hideto Yamada, Michio Senda, Tetsuo Maeda, Kazuro Sugimura
    EUROPEAN JOURNAL OF RADIOLOGY 81 11 3557 - 3562 2012年11月 [査読有り][通常論文]
     
    Objective: To evaluate low-dose non-enhanced CT (ldCT) and full-dose contrast-enhanced CT (ceCT) in integrated F-18-fluorodeoxyglucose (FDG)-PET/CT studies for restaging of ovarian cancer. Materials and methods: One hundred and twenty women who had undergone treatment for ovarian cancer underwent a conventional PET/CT scans with ldCT, and then ceCT. Two observers interpreted and decided in consensus on the PET/ldCT and PET/ceCT images by a 3-point scale (N: negative, E: equivocal, P: positive) per patient and lesion site. Final diagnoses were obtained by histopathological examinations, or clinical follow-up for at least 6 months. Results: Patient-based analysis showed that the sensitivity, specificity, and accuracy of PET/ceCT was 86.9% (40/46), 95.9% (71/74), and 92.5% (111/120), respectively, whereas those of PET/ldCT were 78.3% (36/46), 95.0% (70/74), and 88.3% (106/120), respectively. All sensitivity, specificity, and accuracy significantly differed between two methods (McNemar test, p < 0.0005, p = 0.023, and p < 0.0001, respectively). The scales of detecting 104 recurrent lesion sites were N: 14, E: 6, P: 84 for PET/ceCT, and N: 15, E: 17, P: 72 for PET/ldCT, respectively. Eleven equivocal and one negative regions by PET/ldCT were correctly interpreted as positive by PET/ceCT. Conclusion: PET/ceCT is a more accurate imaging modality with higher confidence for assessing ovarian cancer recurrence than PET/ldCT. Crown Copyright (C) 2012 Published by Elsevier Ireland Ltd. All rights reserved.
  • Hideto Yamada, Mayumi Morizane, Kenji Tanimura, Ichiro Morioka, Yasuhiko Ebina, Hideo Matsuda, Masashi Yoshida, Hajime Wakamatsu, Kenichi Furuya, Jun Murotsuki, Shigeru Saito, Ichiro Kawabata, Yuichiro Takahashi, Toshiko Ueda, Yukiyasu Sato, Masato Kamitomo, Yuko Maruyama, Hideto Hirano, Takashi Yamada, Hisanori Minakami, Nobuo Yaegashi, Toshio Minematsu, Ryu Matsuoka, Michio Banzai, Tsuyomu Ikenoue
    JOURNAL OF REPRODUCTIVE IMMUNOLOGY 95 1-2 73 - 79 2012年09月 [査読有り][通常論文]
     
    No medical intervention guideline for prenatally diagnosed symptomatic congenital cytomegalovirus infection (CCMVI) is currently available. The aim of the study was to assess the efficacy of immunoglobulin fetal therapy for symptomatic CCMVI. With informed consent, hyper-immunoglobulin was injected into the peritoneal cavity of affected fetuses or into the maternal blood in 12 women who had symptomatic CCMVI. After immunoglobulin therapy, ultrasound examinations demonstrated the following changes: Ascites disappearance 57.1% (4/7) and a decrease in ascites volume 14.3% (1/7); improvement in intrauterine growth restriction 54.5% (6/11); disappearance of mild ventriculomegaly 40% (2/5); and in one case hepatomegaly and hydronephrosis disappeared. The survival rate of affected infants was found to be 83.3% (10/12). Concerning morbidity, 25.0% (3/12) of the infants developed normally. An additional two cases had only unilateral hearing difficulty without other sequelae. Therefore, 41.7% (5/12) of symptomatic CCMVI infants whose mothers received prenatal immunoglobulin therapies had no or only minimal sequelae (unilateral hearing difficulty). No direct adverse effects were observed. Immunoglobulin therapy may be effective for symptomatic CCMVI, reducing the incidence and severity of sequelae. To confirm the efficacy, a randomized study should be further performed. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
  • Kenji Tanimura, Yashuhiko Ebina, Ayako Sonoyama, Hiroki Morita, Shigeki Miyata, Hideto Yamada
    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 38 4 749 - 752 2012年04月 [査読有り][通常論文]
     
    A 33-year-old woman developed deep venous thrombosis at 7 gestational weeks (GW). Heparin-induced thrombocytopenia was evident at 9 GW during unfractionated heparin infusion. Immediately, anticoagulation therapies together with antithrombin (AT) infusion were commenced with the use of argatroban from 9 GW, and fondaparinux was substituted for argatroban after 24 GW. The patient had hereditary AT deficiency type I determined by laboratory findings and results of genomic DNA analysis. The pregnancy ended in full-term vaginal delivery of a healthy male without adverse effects of the anticoagulation therapies. This was the first report of a pregnant woman who developed heparin-induced thrombocytopenia caused by heparin therapy for deep venous thrombosis due to AT deficiency.
  • Kaho Suzuki, Koji Nakabayashi, Ai Y. Yamada, Romana S. Z. Lodhi, Rhoichi Hazama, Yasuhiko Ebina, Hideto Yamada
    FERTILITY AND STERILITY 97 3 734 - 741 2012年03月 [査読有り][通常論文]
     
    Objective: To evaluate the effects of human relaxin on proliferation and apoptosis in cultured human uterine leiomyoma cells and normal myometrial cells. Design: In vitro experiment. Setting: Research laboratory at Kobe University Graduate School of Medicine. Patient(s): Nine patients undergoing hysterectomy for uterine leiomyoma. Intervention(s): Cultured leiomyoma cells and normal myometrial cells were treated with human recombinant (rH2) relaxin. Main Outcome Measure(s): Human relaxin receptor LGR7 expressions in cultured leiomyoma cells and myometrial cells were evaluated by immunocytochemical staining. Cell proliferation, proliferating cell nuclear antigen-positive rate, and TUNEL-positive rate were assessed by MTS assay, immunocytochemistry, and TUNEL assay, respectively. Caspase-3 expression was evaluated by Western blot analysis. Result(s): LGR7 expression was observed both in cultured human leiomyoma cells and myometrial cells. Compared with untreated control cultures, treatment with rH2 relaxin increased the number of viable cultured leiomyoma cells and the proliferating cell nuclear antigen-positive rate in those cells but not in myometrial cells. Moreover, treatment with rH2 relaxin decreased the TUNEL-positive rate in cultured leiomyoma cells but not in myometrial cells. Similarly, Western blot analysis revealed that treatment with rH2 relaxin decreased the expression of caspase-3 in cultured leiomyoma cells but not in myometrial cells. Conclusion(s): These results suggest that rH2 relaxin selectively inhibits apoptosis by down-regulating caspse-3 expression and induces proliferation in cultured human leiomyoma cells without affecting apoptosis or proliferation in normal myometrial cells. (Fertil Steril (R) 2012; 97: 734-41. (C) 2012 by American Society for Reproductive Medicine.)
  • Yamada H, Takeda M, Maezawa Y, Ebina Y, Hazama R, Tanimura K, Wakui Y, Shimada S
    ISRN obstetrics and gynecology 2012 512732  2012年 [査読有り][通常論文]
  • Yoshiya Miyahara, Shigeki Yoshida, Tokuro Shirakawa, Natsuko Makihara, Kiyoshi Niiya, Yasuhiko Ebina, Hideto Yamada
    Kobe Journal of Medical Sciences 58 5 E138 - E144 2012年 [査読有り][通常論文]
     
    OBJECTIVE: The purpose of this study was to validate the therapeutic efficacy of the innovative surgical approach using laparoscopy, atelocollagen sponge, and hand-made mould on the achievement of a satisfactory neovagina in patients with vaginal agenesis. STUDY DESIGN: The current study involved four patients diagnosed as having Mayer-Rokitansky-Küster-Hauser syndrome. After creating a vaginal tunnel, the mould wrapped with atelocollagen sponge was placed within the neovagina. The hand-made mould made of expanded polystyrene was started to insert into the neovagina at 7 days after operation. Since this mould is lighter and easier to adjust compared with the previous commercialized ones, it was less stressful for the patients to master the procedure than previous methods. RESULTS: Average operation time was 124 minutes with average blood loss being 45 ml. Average hospital stay was 23 days. The mean length of the neovagina one week postoperation was 8 cm with two fingers in width in all patients. No remarkable postoperative complications were noted. At two months after surgery, the neovagina was confirmed to be completely epithelialized in all patients, assessed by Schiller's test. CONCLUSIONS: This innovative surgical procedure using a mould wrapped with atelocollagen sponge may be a more useful approach for the treatment of vaginal agenesis.
  • Ebina Y, Hazama R, Nishimoto M, Tanimura K, Miyahara Y, Morizane M, Nakabayashi K, Fukumoto T, Ku Y, Yamada H
    Journal of prenatal medicine 5 93 - 96 4 2011年10月 [査読有り][通常論文]
  • 宮原 義也, 吉田 茂樹, 武居 智信, 牧原 夏子, 陌間 亮一, 蝦名 康彦, 山田 秀人
    産婦人科の進歩 63 3 336 - 338 近畿産科婦人科学会 2011年 [査読有り][通常論文]
  • Tomoko Mitsuhashi, Katsuhiko Warita, Teruo Sugawara, Yoshiaki Tabuchi, Ichiro Takasaki, Takashi Kondo, Fumio Hayashi, Zhi-Yu Wang, Yoshiki Matsumoto, Takanori Miki, Yoshiki Takeuchi, Yasuhiko Ebina, Hideto Yamada, Noriaki Sakuragi, Toshifumi Yokoyama, Takashi Nanmori, Hiroshi Kitagawa, Jeffrey A. Kant, Nobuhiko Hoshi
    CONGENITAL ANOMALIES 50 2 85 - 94 2010年06月 [査読有り][通常論文]
     
    In normal ontogenetic development, the expression of the sex-determining region of the Y chromosome (SRY) gene, involved in the first step of male sex differentiation, is spatiotemporally regulated in an elaborate fashion. SRY is expressed in germ cells and Sertoli cells in adult testes. However, only few reports have focused on the expressions of SRY and the other sex-determining genes in both the classical organ developing through these genes (gonad) and the peripheral tissue (skin) of adult XY females. In this study, we examined the gonadal tissue and fibroblasts of a 17-year-old woman suspected of having disorders of sexual differentiation by cytogenetic, histological, and molecular analyses. The patient was found to have the 46,X,inv(Y)(p11.2q11.2) karyotype and streak gonads with abnormally prolonged SRY expression. The sex-determining gene expressions in the patient-derived fibroblasts were significantly changed relative to those from a normal male. Further, the acetylated histone H3 levels in the SRY region were significantly high relative to those of the normal male. As SRY is epistatic in the sex-determination pathway, the prolonged SRY expression possibly induced a destabilizing effect on the expressions of the downstream sex-determining genes. Collectively, alterations in the sex-determining gene expressions persisted in association with disorders of sexual differentiation not only in the streak gonads but also in the skin of the patient. The findings suggest that correct regulation of SRY expression is crucial for normal male sex differentiation, even if SRY is translated normally.
  • Tomoko Mitsuhashi, Katsuhiko Warita, Yoshiaki Tabuchi, Ichiro Takasaki, Takashi Kondo, Teruo Sugawara, Fumio Hayashi, Zhi-Yu Wang, Yoshiki Matsumoto, Takanori Miki, Yoshiki Takeuchi, Yasuhiko Ebina, Hideto Yamada, Noriaki Sakuragi, Toshifumi Yokoyama, Takashi Nanmori, Hiroshi Kitagawa, Jeffrey A. Kant, Nobuhiko Hoshi
    CONGENITAL ANOMALIES 50 1 40 - 51 2010年03月 [査読有り][通常論文]
     
    XY females are rare individuals who carry a Y chromosome but are phenotypically female. In approximately 80-90% of these cases, there are no mutations in the SRY gene, a testis-determining gene on the short arm of the Y chromosome, and the pathophysiology of XY females without SRY mutation remains unclear. In the present study, we used a molecular data mining technique to analyze the pathophysiology of an XY female with functional SRY and pericentric inversion of the Y chromosome, and compared the results with those of a normal male. Interestingly, upregulations of numerous genes included in the development category of the Biological Process ontology, including genes associated with sex determination and organ morphogenesis, were seen in the patient. Additionally, the transforming growth factor-beta (TGF-beta) signaling pathway and Wnt signaling pathway, in which most cell-cell interactions during embryonic development are involved, were altered. Alterations in the expression of numerous genes at the developmental stage, including alterations at both the gene and pathway levels, may persist as a vestige of anomalies of sex differentiation that presumably began in the fetal period. The present study indicates that a data mining technique using bioinformatics contributes to identification of not only genes responsible for birth defects, but also disorders of sex development (DSD)-specific pathways, and that this kind of analysis is an important tool for clarifying the pathophysiology of human idiopathic XY gonadal dysgenesis. Our findings could serve as one of the basic datasets which will be used for future follow-up investigations.
  • Hee Chul Park, Shinichi Shimizu, Akio Yonesaka, Kazuhiko Tsuchiya, Yasuhiko Ebina, Hiroshi Taguchi, Norio Katoh, Rumiko Kinoshita, Masayori Ishikawa, Noriaki Sakuragi, Hiroki Shirato
    YONSEI MEDICAL JOURNAL 51 1 93 - 99 2010年01月 [査読有り][通常論文]
     
    Purpose: The purpose of this study is to evaluate the clinical results of treatment with a high dose of 3-dimensional conformal boost (3DCB) using a real-time tracking radiation therapy (RTRT) system in cervical cancer patients. Materials and Methods: Between January 2001 and December 2004, 10 patients with cervical cancer were treated with a high dose 3DCB using RTRT system. Nine patients received whole pelvis radiation therapy (RT) with a median dose of 50 Gy (range, 40-50 Gy) before the 3DCB. The median dose of the 3DCB was 30 Gy (range, 25-30 Gy). Eight patients received the 3DCB twice a week with a daily fraction of 5 Gy. The determined endpoints were tumor response, overall survival, local failure free survival, and distant metastasis free survival. The duration of survival was calculated from the time of the start of radiotherapy. Results: All patients were alive at the time of analysis and the median follow-up was 17.6 months (range, 4.9-27.3 months). Complete response was achieved in nine patients and one patient had a partial response. The 1- and 2-year local failure free survival was 78.8% and 54%, respectively. The 1- and 2-year distant metastasis free survival was 90% and 72%, respectively. Late toxicity of a grade 2 rectal hemorrhage was seen in one patient. A subcutaneous abscess was encountered in one patient. Conclusion: the use of the high dose 3DCB in the treatment of cervical cancer is safe and feasible where intracavitary brachytherapy (ICBT) is unable to be performed. The escalation of the 3DCB dose is currently under evaluation.
  • Hidemichi Watari, Takashi Mitamura, Masashi Moriwaki, Masayoshi Hosaka, Yoko Ohba, Satoko Sudo, Yukiharu Todo, Mahito Takeda, Yasuhiko Ebina, Noriaki Sakuragi
    INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER 19 9 1585 - 1590 2009年12月 [査読有り][通常論文]
     
    We investigated the survival and the failure pattern of 288 patients with endometrial cancer treated with extensive surgery including systematic pelvic and para-aortic lymphadenectomy followed by cisplatin-based chemotherapy from 1982 to 2002. We correlated the failure pattern with various clinicopathologic factors to find the predictors of recurrence sites. The 5-year overall survival rates were 97.5% for stage I, 87.5% for stage II, 85.2% for stage III, and 12.5% for stage IV Notably, the 5-year survival rate was 76.5% for patients with stage IIIC disease. Among patients with a low risk (n = 92) for recurrence who received no adjuvant chemotherapy, 2 (2.2%) showed recurrent disease. Among those with intermediate (n 98) and high (n = 98) risks for recurrence who received adjuvant chemotherapy, 9 (9.2%) and 20 (20.4%) showed recurrent disease, respectively. The recurrence sites were described as follows: distant (n = 12), vaginal (n = 8), peritoneal (n = 7), pelvic (n = 2), and lymphatic (n = 2). Lymphatic failure was found beyond the area of lymphadenectomy. Architectural and nuclear grades; myometrial, lymph-vascular space, and cervical invasions; and lymph node metastasis were predictors of distant failure. Cervical invasion and lymph node metastasis were predictors of vaginal failure. For patients with stage I/II cancer, the architectural and nuclear grades were related to distant failure. Seven (63.6%) of 11 patients with a low or intermediate risk survived after relapse, whereas only 1 (4.8%) of 21 patients with a high risk survived after a recurrence. We conclude that we need to further test the efficacy of systemic adjuvant therapy using new chemotherapeutic regimens to prevent distant failure and to improve the survival of patients with endometrial cancer.
  • Masayoshi Hosaka, Hidemichi Watari, Mahito Takeda, Masashi Moriwaki, Yoko Hara, Yukiharu Todo, Yasuhiko Ebina, Noriaki Sakuragi
    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 34 4 552 - 556 2008年08月 [査読有り][通常論文]
     
    Aim: To compare the clinical efficacy focused on post-treatment morbidity between adjuvant chemotherapy (CT) and pelvic radiotherapy (RT) after radical hysterectomy for patients with cervical cancer. Methods: A total of 125 patients with cervical squamous cell carcinoma who underwent radical hysterectomy and pelvic lymphadenectomy at Hokkaido University Hospital between 1991 and 2002 were enrolled in the study for retrospective analysis. Seventy patients with recurrent risk factors, including deep stromal invasion, lymph vascular space invasion, parametrial invasion, lymph node metastasis (LNM), and bulky tumor (>= 4 cm), received adjuvant therapy; 42 were treated with RT, and 28 were treated with CT. Almost all patients with multiple LNM received RT. Analyses were also performed on a subgroup of 50 patients without multiple LNM (23 RT, 27 CT). Clinical efficacy of post-treatment morbidity and survival was evaluated. Results: Because there were more patients with multiple LNM in the RT group, we analyzed disease-free survival in 50 patients without multiple LNM. The 3-year disease-free survival rate was 82.6% with RT and 96.3% with CT (P = 0.16). Postoperative bowel obstruction was significantly more frequent in the RT group versus the CT (P = 0.007) and no-therapy (P = 0.0026) groups. Urinary disturbance was also more frequent in the RT group than in the CT (P = 0.0016) and no-therapy (P = 0.089) groups. Conclusion: CT has the equivalent therapeutic effect as RT with fewer postoperative complications for patients with intermediate risks. A prospective randomized trial is needed to compare CT combined with radical hysterectomy and pelvic lymphadenectomy to RT or chemoradiotherapy.
  • Takahiro Yamada, Takao Matsuda, Masataka Kudo, Takashi Yamada, Masashi Moriwaki, Shinya Nishi, Yasuhiko Ebina, Hideto Yamada, Hidenori Kato, Tomoo Ito, Norio Wake, Noriaki Sakuragi, Hisanori Minakami
    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 34 1 121 - 124 2008年02月 [査読有り][通常論文]
     
    We present the first report of complete hydatidiform mole (HM) with coexisting dichorionic diamniotic twins. This pregnancy was achieved after testicular sperm extraction and intracytoplasmic sperm injection (ICSI) for azoospermia in the woman's husband. Standard in vitro fertilization may cause multisperm fertilization and increase triploid partial HM and complete HM, which arise from dispermic fertilization. In contrast, ICSI can avoid multisperm fertilization. In our case, paternal isodisomy in the molar tissue was confirmed by microsatellite analysis suggesting that it resulted from duplication of a haploid paternal genome following monospermic fertilization of an inactivated oocyte or from monospermic fertilization of an inactivated oocyte with a diploid sperm. Although the patient was eager to continue the pregnancy, the size of the HM component increased rapidly and termination of the pregnancy was required for pre-eclampsia-like symptoms at 15 weeks of gestation. After the operation, chemotherapy was initiated for persistent trophoblastic disease.
  • H. Watari, M. Hosaka, T. Mitamura, M. Moriwaki, Y. Ohba, Y. Todo, M. Takeda, Y. Ebina, N. Sakuragi
    EUROPEAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY 29 6 573 - 577 2008年 [査読有り][通常論文]
     
    Purpose: Since the prognosis of recurrent ovarian cancer patients is still poor, we need to establish a useful treatment strategy to achieve their long-term survival. We treated recurrent ovarian cancer patients with weekly paclitaxel (PTX)/5-fluorouracil (5-FU) followed by platinum retreatment to investigate its clinical efficacy in a preliminary manner. Methods: Sixteen patients with recurrent ovarian cancer. pretreated with taxane and platinum, were treated with weekly paclitaxel (PTX)/5-fluorouracil (FU). PTX (80 mg/m(2)) on day 1, 8, and 15 was combined with a bolus injection of 5-FU (500 mg/m(2)) on day 2, 9, and 16. Chemotherapy was given every four weeks. Patients with stable disease or progressive disease Were subsequently retreated with a platinum-containing regimen, Response was evaluated by RECIST criteria or CA 1225 criteria. Toxicities were evaluated according to the National Cancer Institute-common toxicity Criteria (NCI-CTC) version 3. Results: Among live patients with sensitive disease, one Of four patients with measurable turner and one without measurable tumor responded to weekly PTX/5-FU. Among 11 patients with resistant disease. none of five patients with measurable tumor and three of six patients without measurable tumor responded to weekly PTX/5-FU, Overall objective response rate by weekly PTX/5-FU was 31.3% (5/16). Among 16 patients, 13 patients who showed no response or progressive disease (three with sensitive disease, ten with resistant disease) received platinum retreatment after weekly PTX/5FU. All three patients with sensitive disease and three of ten patients with resistant disease revealed response to platinum retreatment. Overall objective response rate by platinum retreatment after weekly PTX/5-FU was 46.2% (6/13). Conclusions: Weekly PTX/5FU followed by platinum retreatment Could be a useful treatment strategy for recurrent ovarian cancer patients. We need to establish the standard treatment strategy for recurrent ovarian cancer patients with a poor prognosis.
  • Yukiharu Todo, Kazuhira Okamoto, Masaru Hayashi, Shinichiro Minobe, Eiji Nomura, Hitoshi Hareyama, Mahito Takeda, Yasuhiko Ebina, Hidemichi Watari, Noriaki Sakuragi
    GYNECOLOGIC ONCOLOGY 104 3 623 - 628 2007年03月 [査読有り][通常論文]
     
    Objetive. The aim of this study was to verify whether a preoperative scoring system to estimate the risk of lymph node metastasis (LNM) in endometrial carcinoma is clinically useful for tailoring the indication of lymphadenectomy. Study design. LNM score was set up using volume index, serum CA125 level, and tumor grade/histology, which were found to be independent risk factors for LNM in a pilot study. Based on the LNM score before a validation study was started, the estimated rates of LNM (para-aortic LNM) were 3.4% (0.0%) in a low risk group, 7.7% (5.8%) in an intermediate group, 44.4% (30.6%) in a high risk group and 70.0% (50.0%) in an extremely high risk group. The validation study was carried out using data for 211 patients with endometrial carcinoma for whom three risk factors were preoperatively confirmed. Logistic regression analysis was used to determine whether these factors remain valid. The actual rate of LNM was investigated according to the LNM score. Results. Volume index, serum CA125 level, and tumor grade/histology were found to be independent risk factors for LNM in the cohort of this study. The actual rates of LNM (para-aortic LNM) were 3.2% (1.0%) in the low risk group, 15.3% (11.9%) in the intermediate group, 30.2% (23.8%) in the high risk group and 78.6% (57.1%) in the extremely high risk group. Conclusion. The actual rate of LNM for each score was fairly consistent with the estimated rate of LNM. Para-aortic lymphadenectomy may not be necessary in cases of a low risk group. A large prospective multicenter clinical trial needs to be conducted to establish the clinical usefulness of our preoperative scoring system. (c) 2006 Elsevier Inc. All rights reserved.
  • Y Todo, M Kuwabara, H Watari, Y Ebina, M Takeda, M Kudo, R Yamamoto, N Sakuragi
    INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER 16 1 369 - 375 2006年01月 [査読有り][通常論文]
     
    The objective of this study was to assess the postsurgical bladder function by urodynamic study in patients with cervical cancer treated with nerve-sparing radical hysterectomy. A total of 27 consecutive patients were included in the study. Of the 27 patients, autonomic nerves had been completely preserved at least on one side in 22 patients (group A), and autonomic nerves could not be successfully preserved in five patients (group B). In group A, there was no significant difference in compliance at the moment of strong desire to void, maximum flow rate, and residual urine volume between before the operation and at 12 months after the operation. However, abdominal pressure at maximum flow had significantly increased in patients of group B than of group A. Detrusor contraction pressure at maximum flow had significantly decreased in patients of group B than of group A. Bladder sensation was diminished in three cases (60%) of group B but preserved in all the patients of group A. Although it is still preliminary, our surgical technique described in this report is thought to be effective for preservation of bladder function. For further evaluation of the efficacy of nerve-sparing radical hysterectomy in terms of quality of life and survival of patients, a prospective randomized trial needs to be performed.
  • R Yamamoto, T Ohkouchi, K Tabata, Y Ebina, H Watari, M Kudo, K Shimizu, S Satomura, H Minakami, N Sakuragi
    ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA 84 12 1145 - 1149 2005年12月 [査読有り][通常論文]
     
    Background. The mechanisms of the increase in the percentage of alpha-fetoproteins (AFPs) that strongly binds to Lens culinaris agglutinin (AFP-L3) in pregnancies with a trisomy 21 fetus have not been analyzed. To investigate the oligosaccharide variants of AFP produced by normal fetuses and fetuses with trisomy 21, the lectin reactivity of AFP was analyzed. Methods. Fetal liver tissue, amniotic fluid, and maternal serum were obtained from five normal pregnancies and five pregnancies with a trisomy 21 fetus. The percentages of AFP reactive to lectins were determined by lectin-affinity electrophoresis coupled with antibody-affinity blotting. Results. The percentages of AFP-L3 in the fetal liver and the maternal serum were 23.9 and 27.0%, respectively, in normal pregnancies, and 28.7 and 38.5%, respectively, in pregnancies with a trisomy 21 fetus. There was no statistically significant difference between the percentage in the fetal liver and the percentage in the maternal serum in normal pregnancies; however, a significant difference (P < 0.01) was found in pregnancies with a trisomy 21 fetus. In regard to the percentage of AFP-L3 in the fetal liver, there was no significant difference; however, a significant difference (P < 0.05) was found in the maternal serum between normal pregnancies and pregnancies with a trisomy 21 fetus. Conclusions. The transference of the AFP-L3 fraction might be relatively high in the placentas of women carrying a trisomy 21 fetus, and this could be the one of the reasons for the increase in the percentage of AFP-L3 in the maternal serum in pregnancies with a trisomy 21 fetus.
  • N Sakuragi, H Watari, Y Ebina, R Yamamoto, E Steiner, H Koelbl, M Yano, M Tada, T Moriuchi
    INTERNATIONAL JOURNAL OF CANCER 116 4 514 - 519 2005年09月 [査読有り][通常論文]
     
    In addition to the loss of function, mutant p53 can possess a dominant-negative effect on wild-type p53 and may also exert gain-of-function activity. It is not clear whether the functional status of p53 mutation contributes to differences in outcome in endometrial cancer. We collected a total of 92 RNA samples of high quality from endometrial cancer tissues, and the samples were subjected to yeast functional assay and sequencing for p53 mutations. The detected mutant p53 genes were further investigated for their dominant-negative activity using a yeast-based transdominance assay. p53 mutation was found in 24 out of 92 (26.1%) tumors, of which 10 exhibited no dominant-negative activity (recessive mutation) and 14 showed dominant-negative activity. Dominant-negative p53 mutation was related to advanced stages (p = 0.01), non-endometrioid type tumors (p = 0.01) and grade 3 tumors (p = 0.04). The patients with dominant-negative mutation had significantly shorter survival than patients with no mutation (p < 0.0001) and those with a recessive mutation (p = 0.01) in the p53 gene. No difference in survival was found between the patients with tumors harboring a recessive p53 mutation and those with tumors harboring a wild-type p53. Multivariate analysis revealed that dominant-negative p53 mutation (p = 0.019), FIGO stage (p = 0.0037) and histologic subtype (p = 0.014) were independently related to patient survival. Dominant-negative p53 mutation was the most important prognostic factor for stage III/IV endometrial cancer (P = 0.0023). In conclusion, dominant-negative p53 mutation is often found in advanced stages and aggressive histologic subtypes of endometrial cancer and it is a strong predictor of survival of patients with advanced endometrial cancer. To elucidate further the role of p53 mutation in endometrial cancer, it is necessary to investigate gain-of-function activity involving dominant-negative p53 mutant proteins. (c) 2005 Wiley-Liss, Inc.
  • H Watari, Y Todo, M Takeda, Y Ebina, R Yamamoto, N Sakuragi
    GYNECOLOGIC ONCOLOGY 96 3 651 - 657 2005年03月 [査読有り][通常論文]
     
    Objective. The aim of this Study was to determine pathologic variables associated with disease-specific survival of node-positive patients with endometrial carcinoma treated with combination of surgery including pelvic and para-aortic lymphadenectomy and adjuvant chemotherapy. Methods. Survival of 55 node-positive endometrial carcinoma patients prospectively treated with Surgery and adjuvant chemotherapy between 1982 and 2002 at Hokkaido University Hospital was compared to various histopathologic variables. All patients underwent primary surgical treatment including pelvic and para-aortic lymphadenectomy followed by adjuvant chemotherapy consisting of intravenous cisplatin, doxorubicin, and cyclophosphamide. Survival analyses were performed by the Kaplan-Meier curves and the log-rank test. Independent prognostic factors were determined by multivariate Cox regression analysis using a forward stepwise selection. Results. Among 303 consecutive endometrial cancer patients treated during the period of this study, 55 patients (18.2%), including 44 without peritoneal rnetastasis (FIGO stage IIIc) and II with peritoneal metastasis (FIGO stage IV), were found to have retroperitoneal lymph node metastasis. Multivariate Cox regression analysis revealed that peritoneal metastasis and lymph-vascular space invasion (LVSI) were independently related to poor Survival in node-positive endometrial carcinoma. The estimated 5-year survival rate of stage IIIc patients with or without moderate/prominent LVSI was 50.9% and 93.3%, respectively with statistically significant difference (P = 0.0024). The estimated 5-year survival rate of stage IV patients was 20.0%. Prognosis of stage IIIc patients could be stratified into three groups by the number of positive para-aortic node (PAN) with an estimated 5-year survival rate of 86.4% for no positive PAN (n = 23), 60.4% for one positive PAN (n = 13), and 20.0% for >= 2 positive PAN (n = 8). The difference of survival rate between no or one positive PAN and >= 2 positive PAN was statistically significant (P = 0.0007 for no positive PAN vs. >= 2 positive PAN, P = 0.0319 for one positive PAN vs. >= 2 positive PAN). Multivariate analysis including number of positive PAN groups showed that LVSI, number of positive PAN groups were independent prognostic factors for survival. Survival of patients with stage IIIc disease could be stratified into three groups by combination of LVSI and number of positive PAN groups with an estimated 5-year Survival rate of 93.3% for no or one positive PAN group with nil or minimal LVSI, 62.6% for no or one positive PAN group with intermediate or prominent LVSI, and 20.0% for 2 positive PAN groups irrespective of LVSI (P = 0.0002 for no or one positive PAN group with nil or minimal LVSI vs. 2 positive PAN groups, P = 0.0223 for no or one positive PAN group with nil or minimal LVSI vs. no or one positive PAN group with intermediate or prominent LVSI, P = 0.0388 for no or one positive PAN group with intermediate or prominent LVSI vs. >= 2 positive PAN groups). Conclusions. LVSI and number of positive PAN groups were independent prognostic factors for stage IIIc endometrial cancer patients. Postoperative therapy and follow-up modality need to be individualized according to LVSI and the number of positive PAN for stage life patients. New molecular markers to predict the Prognosis of endometrial cancer patients preoperatively should be found for individualization of treatment. New chemotherapy regimen including taxane needs to be considered as an adjuvant therapy for patients with node-positive endometrial cancer. (c) 2004 Elsevier Inc. All rights reserved.
  • H Negishi, M Takeda, T Fujimoto, Y Todo, Y Ebina, H Watari, R Yamamoto, H Minakami, N Sakuragi
    GYNECOLOGIC ONCOLOGY 94 1 161 - 166 2004年07月 [査読有り][通常論文]
     
    Objective. We evaluated the primary sites of lymph node (LN) metastasis in patients during the early stage of ovarian cancer. Methods. Study 1: patients with clinical stage I and II common epithelial ovarian carcinoma (n=150) underwent systematic retroperitoneal LN dissection of the pelvic and paraaortic areas. The relationship between the incidence and location of LN metastasis and clinical and histological characteristics was examined. Study 2: we studied I I women with endometrial or fallopian tube tumors. At laparotomy, activated charcoal solution was injected into the unilateral cortex of the ovary. Ten minutes later, the retroperitoneal spaces were opened and charcoal uptake within the pelvic lymph node (PLN) and paraaortic node (PAN) as far as the level of renal vein was examined. Results. Study 1: The incidence of LN metastasis by stage was 6.5% (8/123) in stage I and 40.7% (11/27) in stage II. Among 19 patients with LN metastasis, 14 had only PAN, 2 had only pelvic LN, and 3 had both PAN and PLN metastases. Metastasis was limited to the ipsilateral side in 12 (63%) patients, but was bilateral in 5 (26%) and contralateral to the neoplastic ovary in 2 (11%). Positive peritoneal cytology was significantly (P<0.05) correlated with lymph node metastasis. Study 2: Lymphatic channels along the ovarian vessels were identified in all injected ovaries. Charcoal was deposited in the LN of all patients. The locations of these nodes included PAN in all patients, common iliac node in three, and external iliac node in one. Conclusion. PAN is the primary site of LN metastasis in ovarian cancer. Bilateral PAN dissections are necessary to determine the extent of tumors even in stage I ovarian carcinoma. (C) 2004 Elsevier Inc. All rights reserved.
  • Yamamoto R, Minobe S, Ebina Y, Watari H, Kudo M, Henmi F, Satomura S, Fujimoto S, Minakami H, Sakuragi N
    Congenital anomalies 44 2 87 - 92 2 2004年06月 [査読有り][通常論文]
  • M Kaneuchi, M Sasaki, Y Tanaka, H Shiina, M Verma, Y Ebina, E Nomura, R Yamamoto, N Sakuragi, R Dahiya
    BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS 316 4 1156 - 1162 2004年04月 [査読有り][通常論文]
     
    We hypothesize that 14-3-3 sigma gene expression and its regulation by methylation can characterize histological types of primary human epithelial ovarian cancer. To test this hypothesis, ovarian cancer cell lines and 54 ovarian cancer tissue samples were analyzed for expression and methylation of 14-3-3 sigma gene using methylation specific PCR. The results of our experiments demonstrate that 14-3-3 sigma gene was methylated and inactivated in ES-2 ovarian cell line, which was derived from clear cell adenocarcinoma. Treatment of this cell line with demethylating agent 5-aza-2'-deoxycytidine restored the expression of 14-3-3 sigma gene. In human ovarian cancer tissues, the expression of 14-3-3 sigma protein was inactivated in most of the ovarian clear cell carcinoma tissues. Interestingly, 14-3-3 sigma protein expression was positive in significantly higher percentages of serous (89.5%), endometrioid (90%), and mucinous (81.8%) ovarian adenocarcinoma tissues. The ovarian clear cell carcinoma samples with inactivated 14-3-3 sigma protein were highly methylated, suggesting that inactivation of 14-3-3 sigma gene is through DNA methylation. Using direct DNA sequencing, 14-3-3 sigma gene methylation on all the 17 CpG sites was significantly higher in ovarian clear cell carcinoma as compared to other histological types of ovarian cancer (serous, endometrioid, and mucinous). This is the first report suggesting that 14-3-3 sigma gene expression and methylation status can characterize histological features of different types of ovarian cancer. (C) 2004 Elsevier Inc. All rights reserved.
  • Y Ebina, D Akashi, M Takeda, H Watari, R Yamamoto, H Minakami, N Sakuragi
    PET AND MOLECULAR IMAGING: STATE OF THE ART AND FUTURE PERSPECTIVES 1264 222 - 226 2004年 [査読有り][通常論文]
     
    We evaluated the clinical significance of FDG-PET to detect recurrent tumors in ovarian cancer patients. Retrospective chart review of four patients with recurrent ovarian cancer was performed. All patients underwent initial cytoreductive surgery and chemotherapy. Recurrence was suspected at 3-14 years after initial treatment. Three patients had a suspected recurrence based on elevated serum CA 125 level. All patients had increased FDG uptakes in abdominal wall, ascending colon, paraaortic node, and pararectal lesion. They underwent laparotomy to resect the tumors and histology confirmed recurrence. After completion of the operation, CA 125 level was normalized. Accurate identification of recurrent tumor nodules may have a significant impact on clinical management and the selection of patients for tumor resection. (C) 2004 Elsevier B.V. All rights reserved.
  • H Yamada, EH Kato, M Morikawa, S Shimada, Y Ebina, N Sakuragi, S Suzuki, H Minakami
    SEMINARS IN THROMBOSIS AND HEMOSTASIS 29 6 639 - 643 2003年12月 [査読有り][通常論文]
     
    We present the clinical characteristics of pregnancy histories and subsequent pregnancy outcomes of 13 women who tested positive for anticardiolipin beta(2)-glycoprotein I antibody (aCLbeta2GPI). Six of the 13 women had a history of recurrent spontaneous abortion (RSA). The prevalence of aCLbeta2GPI syndrome among women with RSA was very low (2.1%). Other women with aCLbeta2GPI were identified by the presence of a biological falsepositive serological test for syphilis, intrauterine growth restriction (IUGR), and a history of thrombosis. However, serum aCLbeta2GPI titers in the 13 women varied, with a wide range from 3.6 to 1468 U/mL. Their pregnancy histories, subsequent pregnancy outcomes, and complications were compared according to the classification of serum aCLbeta2GPI titers as low, moderate, or high. The history of second trimester fetal death was found only in women with high serum aCLbeta2GPI titers. All women with high serum aCLbeta2GPI titers experienced severe maternal-fetal complications such as IUGR, fetal distress, systemic thromboembolism, and neonatal sequelae in subsequent pregnancies.
  • Y Todo, S Minobe, K Okamoto, M Takeda, Y Ebina, H Watari, M Terashima, M Kaneuchi, R Yamamoto, N Sakuragi
    JAPANESE JOURNAL OF CLINICAL ONCOLOGY 33 12 636 - 641 2003年12月 [査読有り][通常論文]
     
    Objective: Serous adenocarcinoma (SAC) of the endometrium has a poor prognosis compared with that of typical endometrioid adenocarcinoma (EAC). The objective of this study was to determine whether SAC can be distinguished from EAC preoperatively by cervical or endometrial cytology. Study design: Cervical smears and endometrial smears obtained from 128 patients with endometrial carcinoma were reviewed. Histological types included 117 cases of EAC and 11 cases of SAC. The positive rates of cervical smears and those of endometrial smears in SAC and EAC cases were compared. Papillary clusters and bare nuclei of malignant cells in positive cervical smears were also investigated for their diagnostic significance in discriminating between EAC and SAC. Results: The positive rate of cervical smears in SAC was significantly higher than that in EAC (72.7 vs 27.4%, P < 0.05). Among cases with positive cervical smears, there were significantly more cases with papillary clusters and/or bare nuclei in cases of SAC than in cases of EAC. Conclusion: When endometrial carcinoma is clinically suspected and a cervical smear is positive, the predominance of either papillary clusters or features of bare nuclei of malignant cells in the smear may indicate the presence of SAC.
  • Y Todo, N Sakuragi, R Nishida, T Yamada, Y Ebina, R Yamamoto, S Fujimoto
    AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 188 5 1265 - 1272 2003年05月 [査読有り][通常論文]
     
    OBJECTIVE: The aim of this study was to predict retroperitoneal lymph node metastasis during the preoperative examination of patients with endometrial carcinoma and to determine whether lymphadenectomy must be performed. STUDY DESIGN: This study was carried out on 214 patients with endometrial carcinoma. Preoperative evaluators were volume index, depth of myometrial invasion (as assessed by magnetic resonance imaging), serum CA 125 level, histologic type, and histologic grade. With the use of receiver operating characteristic curves, cutoff values of volume index and serum CA 125 levels were determined. The relationships of these evaluators with pelvic lymph node metastasis were investigated by multivariate analysis with a logistic regression model. The relationships of these evaluators with para-aortic lymph node metastasis were investigated in the same way. RESULTS: Histologic type, volume index, histologic grade, and serum CA 125 level were found to be independent risk factors for pelvic lymph node metastasis; serum CA 125 level and volume index were found to be independent risk factors for para-aortic lymph node metastasis. Among 110 cases with no risk factors for pelvic lymph node metastasis, pelvic lymph node metastasis was observed in 4 cases (3.6%). On the other hand, only 1 case of 128 cases (0.7%) with no risk factors for para-aortic lymph node metastasis actually had metastasis. CONCLUSION: Careful consideration of the possibility of the elimination of the requirement of retroperitoneal lymphadenectomy is needed in cases with no risk factors for lymph node metastasis. However, our results suggest that para-aortic lymphadenectomy may not be necessary in cases with no risk factors for para-aortic lymph node metastasis.
  • T Kishida, H Yamada, Furuta, I, N Kobayashi, EK Hirayama, Y Ebina, N Sakuragi, S Fujimoto
    FETAL DIAGNOSIS AND THERAPY 18 2 98 - 104 2003年03月 [査読有り][通常論文]
     
    Objective: The objective of this study was to investigate the predictive factors of premature rupture of the membranes (preterm PROM). Methods:The study was undertaken with cervical secretions collected from 72 consenting singleton pregnant women between 20 and 33 weeks of gestation. The levels of interleukin (IL) 1alpha, IL-1beta, IL-6, IL-8, matrix metalloproteinase (MMP) 1, MMP-2, MMP-9, tissue inhibitors of matrix metalloproteinase (TIMP) 1, TIMP-2, granulocyte elastase, and fetal fibronectin in cervical diluted specimens were measured by immunoassay, and the uterine cervix was assessed by transvaginal ultrasonography. Demographic, obstetric, clinical, neonatal, and laboratory data were analyzed by univariate analysis, multiple logistic regression, and receiver operator characteristic curve analysis. Results: Preterm PROM occurred in 6 women, and 63 women delivered at term. Multiple logistic regression analysis indicated a significant independent association with preterm PROM for the cervical IL-6 levels and cervical length. The receiver operator characteristic curve analysis revealed that an IL-6 level of greater than or equal to240 pg/ml in cervical secretions and a cervical length of less than or equal to28 mm had higher diagnostic performance in predicting preterm PROM. Conclusion: It is suggested that preterm PROM is associated with increased cervical IL-6 levels and a short cervix. Copyright (C) 2003 S. Karger AG, Basel.
  • Y Ebina, H Yamada, EH Kato, R Yamamoto, N Sakuragi, S Fujimoto
    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 28 5 251 - 257 2002年10月 [査読有り][通常論文]
     
    We treated three thrombophilia-complicated pregnant women (two antiphospholipid antibody syndrome, one protein C deficiency) with low molecular weight heparin (dalteparin). All three pregnancies including one twin pregnancy ended in live births without a decrease in bone mineral density This treatment modality was effective and safe preventing thrombosis during their pregnancies.
  • Y Ebina, N Sakuragi, H Hareyama, Y Todd, E Nomura, M Takeda, K Okamoto, H Yamada, R Yamamoto, S Fujimoto
    ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA 81 5 458 - 465 2002年05月 [査読有り][通常論文]
     
    Background. To investigate the relationship between preoperative serum CA 125 levels and para-aortic lymph node (PAN) metastasis as determined by systematic pelvic and para-aortic lymph node dissection in endometrial carcinoma. Methods. This study included 180 patients (n = 55, premenopausal; n = 125, postmenopausal) with endometrial carcinoma treated by complete surgical staging. Cut-off values of preoperative serum CA 125 levels for PAN metastasis were determined by receiver characteristic curve (ROC) analysis. Logistic regression analysis was used to determine independent predictors for PAN metastasis. Results. The median serum CA 125 levels of patients with PAN metastasis were significantly higher than the levels of those with no metastasis in both premenopausal and postmenopausal groups. Based on ROC analysis, we could determine four cut-off values (70 and 210 U/mL for premenopausal patients, 20 and 60 U/mL for postmenopausal patients) and categorize the serum CA 125 levels into low, moderate and high groups. By logistic regression analysis, the CA 125 level and nuclear grade were found to be significant predictors of PAN metastasis, respectively. Using this model, the patients were stratified into three risk groups. The probabilities of PAN metastasis for patients in the low-risk, intermediate-risk and high-risk groups were less than 2%, 2-25% and more than 50%, respectively. Conclusions. Serum CA 125 levels and nuclear grade are important risk factors for PAN metastasis in endometrial carcinoma.
  • A Yamaguchi, N Hashimoto, W Tsutae, K Seino, Y Ebina, T Tokino, N Sato, K Kikuchi
    CLINICA CHIMICA ACTA 318 1-2 41 - 49 2002年04月 [査読有り][通常論文]
     
    Background: Cervical cancer screening is conducted by a cytological Papanicolaou (Pap) test. For screening, it is becoming increasingly important to introduce a more objective result, based on human papillomavirus (HPV) DNA test. We describe here a practical method allowing the mass detection of HPV-DNA by PCR followed by fluorogenic DNA intercalation. Methods: Samples used were cervical scrapes or biopsy specimens obtained from women who had undergone cytological testing for cervical cancer, Crude DNAs were extracted by a simplified proteinase K-boil method. Common and type-specific primers were newly designed for major types of high-risk HPVs. A fluorogenic DNA intercalator, SYBR(R) Green I was directly added to the specific PCR products. The resultant fluorescence was measured by a conventional fluorometric microplate reader. Results: The proposed PCR/microfluorometry (MFL) allowed a simple, rapid and economical detection of HPV-DNA without any use of labeling primers or probes. HPV-DNAs were found in 48.2% (123/255) of the cervical scrapes. The detection rate of HPV in cervical cancer biopsy specimen was 92.4% (61/66). Conclusions: PCR/MFL detection of HPV-DNA, followed by combined type-specific PCR, is expected to be an extremely useful tool in cervical cancer screening. (C) 2002 Elsevier Science B.V. All rights reserved.
  • S Kataoka, Furuta, I, H Yamada, EH Kato, Y Ebina, T Kishida, N Kobayashi, S Fujimoto
    PLACENTA 23 2-3 224 - 231 2002年02月 [査読有り][通常論文]
     
    Apoptosis is thought to participate pathophysiologically in the rupture of human fetal membranes (ROM). The aim of this study was to assess apoptosis of the amnion and the chorion in relation to ROM and chorioamnionitis (CAM). The amnion and chorian at the position of the cervical os and fundus of the uterus were obtained from 44 patients. Apoptotic DNA fragmentation was densitometrically determined, and the relative ratio was used for the quantitative evaluation. Among patients without CAM, the relative ratios of apoptosis in the amnion from patients with ROM were higher than those in patients without ROM (P<0.05). Among patients without ROM, the apoptotic levels in the amnion from patients with CAM were higher than those in patients without CAM (P<0.05). These were the cases with die amnion at the position of cervical os and fundus, but not with the chorion, The highest ratio of apoptosis was seen in the amnion from patients with CAM and ROM. Among patients with ROM and no CAM, the apoptotic levels at the cervical os in the amnion (P=0.059) and chorion (P<0.05) was higher than those at the fundus. The increased apoptosis of human fetal membranes was related to ROM and CAM. Apoptosis plays a role in the pathophysiology of ROM. (C) 2002 Esevier Science Ltd.
  • Y Ebina, Y Shirakawa, J Hino, T Sasaki, K Seino, K Kikuchi
    9TH BIENNIAL MEETING OF THE INTERNATIONL GYNECOLOGIC CANCER SOCIETY 25 - 27 2002年 [査読有り][通常論文]
     
    We investigated the possible correlation between the presence of high-risk HPV DNA and the prognosis of patients with cervical dysplasia. A total of 122 patients were followed carefully by using repeated cytology, colposcopy and punch biopsy. HPV testing was performed using cytological specimens by PCR techniques. The regression rate in patients with negative HPV DNA was 51.4%, which was significantly higher than that of those with positive HPV DNA (14.1%, p<0.01). Nine cases positive for HPV DNA were progressed to CIS. In contrast, no progression was seen in negative HPV DNA group. The results show that the presence of high-risk HPV DNA in patients with cervical dysplasia is a promising marker for progressive disease.
  • G Kobashi, H Yamada, K Ohta, EH Kato, Y Ebina, S Fujimoto
    AMERICAN JOURNAL OF MEDICAL GENETICS 103 3 241 - 244 2001年10月 [査読有り][通常論文]
     
    Hypertension in pregnancy (HP), including preeclampsia, is known to be a multifactorial disease. Recently, a Glu298Asp variant of the endothelial nitric oxide synthase gene (NOS3) was identified as being associated with coronary spasm and myocardial infarction, whereas it has been reported that endothelial nitric oxide synthase plays a role in HP. We therefore performed an association study of the Glu298Asp variant with HP among 152 H-P patients and 335 normal pregnant control individuals, in the context of other risk factors before pregnancy. The frequency of the variant GA+AA NOS3 genotypes was significantly higher in the patients (0.23) than in the controls (0.12) (P <0.01). Multivariate analysis revealed that family history of hypertension, TT genotype of the angiotensinogen gene (AGT), GA+AA NOS3 genotype, and prepregnancy body mass index greater than or equal to 24 were independent potent risk factors, after adjustment for maternal age and parity. The odds ratios of the factors were 2.7, 2.3, 2.2, and 2.1, respectively. Our results suggested that the Asp298 of NOS3 is a potent, independent risk factor for HP. (C) 2001 Wiley-Liss, Inc.
  • T Kishida, H Yamada, Furuta, I, N Kobayashi, EK Hirayama, Y Ebina, K Cho, K Okuyama, S Fujimoto
    FETAL DIAGNOSIS AND THERAPY 16 5 259 - 264 2001年09月 [査読有り][通常論文]
     
    Objectives: The objectives of this study were to cl in ica I ly characterize and seek risk factors for the patients with persistently detected alfa-fetoprotein (AFP) in the vagina without showing overt preterm premature rupture of the membranes (PROM). Study Design: The cohort study was undertaken using vaginal-cervical specimens collected consecutively between 21 and 40 weeks of gestation from 25 consenting women. Demographic, obstetric, neonatal, and laboratory data from patients with persistent positive results of AFP kit tests without showing overt leakage of amniotic fluid were compared to those from controls. Cervical levels of interleukin-1 alpha, interleukin-1 beta, interieukin-6, interleukin-8, and granulocyte elastase were measured by immunoassay, and the uterine cervix was assessed by transvaginal ultrasonography. Statistical analysis involved Fisher's exact test and Mann-Whitney U test. Results: The incidence of overt preterm PROM was significantly higher in the patients with persistently detected AFP in preterm (3 in 4 cases) than in controls (3 in 21 controls). At sampling before determination of persistently detected AFP, patients with persistently detected AFP had significantly higher cervical levels of interleukin-6 and significantly shorter cervical length than controls. Conclusions: Patients with persistently detected AFP in the vagina without showing overt preterm PROM have the risk of overt preterm PROM. Increased levels of interleukin-6 in cervical specimens and short cervical length may be risk factors for the occurrence of persistent detection of AFP in the preterm. Copyright (C) 2001 S. Karger AG, Basel.
  • Yamada H, Kato EH, Kobashi G, Ebina Y, Shimada S, Morikawa M, Sakuragi N, Fujimoto S
    American journal of reproductive immunology (New York, N.Y. : 1989) 46 132 - 136 2 2001年08月 [査読有り][通常論文]
  • H Yamada, EH Kato, G Kobashi, Y Ebina, S Shimada, M Morikawa, N Sakuragi, S Fujimoto
    AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY 46 2 132 - 136 2001年08月 [査読有り][通常論文]
     
    PROBLEM: The aim of this study was to assess the role of natural killer (NK) cells in pregnant women with a history of recurrent spontaneous abortion (RSA). METHOD OF STUDY: Consecutive 66 pregnant women with a history of RSA were prospectively assessed for peripheral NK cell activity, percentage of the NK cell subsets, and subsequent pregnancy outcome. RESULTS: NK cell activity in women with subsequent live birth (group I) at 4-5 gestational weeks (GW) (mean +/- SD, 32.5 +/- 12.3%) significantly decreased at 6-7 GW (28.1 +/- 12.1%) and at 8-9 GW (28.0 +/- 11.8%). NK cell activity in women with subsequent abortion with normal chromosomes (group II) at 6-7 GW (41.2 +/- 19.0%) was significantly higher than that in group I women, while NK cell activity at 6-7 GW in women with subsequent abortion with abnormal chromosomes (group III) was the same as the level in group I women. CONCLUSIONS: High NK cell activity at 6-7 GW correlates with subsequent abortion with normal chromosomes.
  • Yamada H, Noro N, Kato EH, Ebina Y, Cho K, Fujimoto S
    European journal of obstetrics, gynecology, and reproductive biology 97 1 101 - 104 1 2001年07月 [査読有り][通常論文]
     
    A pregnant woman developed acute demyelinating poly-neuropathy (Guillain-Barre syndrome (GBS)) in the 28th week of gestation (GW) after flu-like infection. Hypertension, liver dysfunction, and a decrease in consciousness level developed at 29 GW. Blood chemical analysis revealed increased levels of liver enzymes GOT 247 IU/I and GPT 624 IU/I. Viral serological study showed a positive test for Epstein-Barr virus IgM. Weakness of bilateral facial muscles and limbs, a loss of tendon reflexes, and generalized paresthesia were detected by neurologic examinations. Over the course of 5 days, a massive dose (100 g) of intravenous immunoglobulin (MIVIg) was infused in 30 GW. An average manual muscle testing score by the Medical Research Council method and peak flow value began to be significantly restored during and after MIVIg infusions. Values of the liver enzymes gradually decreased, and improvement of the muscle weakness and dysbasia was observed. Her pregnancy normally ended in spontaneous vaginal delivery of a healthy infant in 37 GW. This is the first report confirming the efficacy of MIVIg, without plasmapheresis, in GBS-complicated pregnancy. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.
  • ML Luo, N Sakuragi, M Shimizu, K Seino, K Okamoto, M Kaneuchi, Y Ebina, K Okuyama, T Fujino, T Sagawa, S Fujimoto
    CANCER CYTOPATHOLOGY 93 2 115 - 123 2001年04月 [査読有り][通常論文]
     
    BACKGROUND. Noncancerous cells simulating adenocarcinoma cells may interfere with the analysis of peritoneal cytology (PC) in patients with endometrial carcinoma. Immunocytochemistry (ICC) may improve the diagnosis of PC. METHODS, PC slides from 115 patients with endometrial carcinoma were reviewed. Suspicious or positive cell clusters were recovered with a cell transfer method and were subjected to ICC for MOC-31, cytokeratin 5/6, and p53. Conventional Papanicolaou staining and ICC results were compared directly on the same cells. RESULTS. By combined conventional and immunocytochemical PC (CONV-ICC-PC), cytodiagnosis was positive in 18 of 115 patients (15.7%) and suspicious in 3 of 115 patients (2.6%). According to a multivariate Cox regression analysis of patients with tumors confined to the uterus that included grade, myometrial invasion, cervical involvement, and CONV-ICC-PC, only CONV-ICC-PC was an independent prognostic factor (P < 0.05). A multivariate analysis for all of the patients studied that compared CONV-ICC-PC with staging variables revealed that only peritoneal metastasis (P < 0.0001) and lymph node metastasis (P < 0.01) were independent prognostic factors. When peritoneal metastases were excluded, CONV-ICC-PC (P < 0.01) and lymph node metastasis (P < 0.0025) were the independent prognostic factors. By cell transfer and p53 immunostaining in samples from 14 patients with malignant cells in their peritoneal washings, no deaths occurred among 5 patients with negative p53, whereas 5 of 9 patients with positive p53 died of disease at the time of data analysis. CONCLUSIONS, MOC-31 immunostaining improves the diagnosis of PC in endometrial carcinoma. Positive PC is an important prognostic factor for patients with endometrial carcinoma confined to the uterus. The p53 positive cells in PC have possible prognostic significance. Cancer (Cancer Cytopathol) 2001;93:115-123, (C) 2001 American Cancer Society.
  • Y Ebina, H Yamada, EH Kato, F Tanuma, S Shimada, K Cho, S Fujimoto
    PRENATAL DIAGNOSIS 21 1 68 - 71 2001年01月 [査読有り][通常論文]
     
    We report a case of agnathia-holoprosencephaly which was prenatally diagnosed based on helical computed tomography (CT) images obtained at 23 weeks of gestation. Ultrasound examination first showed the presence of alobar holoprosencephaly, but the facial structures were not clearly detailed. However, three-dimensional imaging by helical CT precisely demonstrated the most striking feature of agnathia: absence of the mandible. This technique provided us valuable information that contributed to the in utero diagnosis. In utero helical CT is a useful examination tool for the diagnosis of osteogenic abnormalities. Copyright (C) 2001 John Wiley & Sons, Ltd.
  • H Yamada, EH Kato, R Tsuruga, Y Ebina, G Kobashi, T Sagawa, Z Makita, T Koike, S Fujimoto
    GYNECOLOGIC AND OBSTETRIC INVESTIGATION 51 2 103 - 109 2001年 [査読有り][通常論文]
     
    The aim of this study was to evaluate the insulin dynamics of patients with gestational diabetes mellitus (GDM) and to compare perinatal outcomes according to the insulin response patterns. Twenty-two out of 925 consecutive women examined were diagnosed as having GDM. One hundred and ten women who experienced a normal pregnancy were used as controls. Plasma glucose levels and insulin responses were evaluated by a 2-hour 75-gram oral glucose tolerance test (OGTT). Immunoreactive insulin (IRI), the area under the curve (AUC) of glucose (AUCg) and insulin (AUCi), and the insulinogenic index (II = Delta IRI 30 min/Delta BS 30 min) were measured. The GDM patients were divided into three subgroups, consisting of hyper-, normo- and hypoinsulinemic groups, according to the mean +/- 2 SD of the AUCi obtained from the controls. Clinical and laboratory findings were compared among the GDM subgroups and controls. The GDM patients showed impaired insulin secretion to glucose stimuli, with low plasma insulin levels (at 30 min) and reduced insulin/glucose ratios (at 30 and 60 min) early in the 75-gram OGTT. The II and AUCi/AUCg values of GDM patients were reduced as compared with those of controls. These reduced insulin responses were remarkable in hypo- and normoinsulinemic GDM patients, but were not detected in hyperinsulinemic GDM patients. The number of babies large for their gestational age in normo- and hypoinsulinemic GDM patients was significantly higher than that in hyperinsulinemic GDM patients or controls. Hyperinsulinemic GDM patients had a high frequency of pregnancy-induced hypertension (40%). The body mass index prior to pregnancy of hyperinsulinemic GDM patients was significantly higher than that of normoinsulinemic GDM patients or controls. It was demonstrated that not only insulin secretion, but also perinatal clinical characteristics, differed among the GDM subgroups. The heterogeneity of the disease was thus confirmed. Copyright (C) 2001 S. Karger AG. Basel.
  • H Yamada, EH Kato, G Kobashi, Y Ebina, S Shimada, M Morikawa, T Yamada, N Sakuragi, S Fujimoto
    SEMINARS IN THROMBOSIS AND HEMOSTASIS 27 2 121 - 129 2001年 [査読有り][通常論文]
     
    Congenital and acquired thrombophilia are associated with an increased risk of pregnancy-associated venous thrombosis and fetal loss. Two hundred eighty-nine patients with a history of recurrent spontaneous abortion were subjected to screening examinations for the etiology of these abortions. Endocrine abnormality (28.0%), uterine abnormality (10.4%), autoimmune diseases (1.4%), antiphospholipid antibody syndrome (4.5%), and balanced type chromosome translocation (4.2%) were found as underlying causes of recurrent abortions, and the remaining 55.0% of the 289 patients were classified as having an unexplained etiology. Congenital thrombophilia such as protein C (PC) deficiency, protein S (PS) deficiency, antithrombin deficiency, and factor V Leiden mutation was not frequently detected; only one patient had PS deficiency. A reduced factor XII activity was found at a frequency of 4.2%. The frequency of methylene tetrahydrofolate reductase gene C677T mutation in recurrent aborters (0.38) was the same as that found in a fertile control group. Although the prevalence of anti-beta2-glycoprotein I antibody (a beta2-GPI) syndrome was very low (1.7%), patients with a high titer of immunoglobulin G (IgG) class a beta2-GPI, despite anticoagulation therapy, experienced severe fetomaternal complications in subsequent pregnancies. The rate (13.8%) of positive tests for serum IgA class a beta2-GPI in patients with unexplained etiology was higher than that in the controls (0%) (P < .05). We conclude that congenital thrombophilia is rare in Japanese patients who had experienced consecutive spontaneous abortions.
  • M Morikawa, H Yamada, EH Kato, S Shimada, Y Ebina, T Yamada, T Sagawa, G Kobashi, S Fujimoto
    GYNECOLOGIC AND OBSTETRIC INVESTIGATION 52 3 163 - 167 2001年 [査読有り][通常論文]
     
    Objective: The aim of this study was to assess the role of NK cells in nonpregnant women with a history of spontaneous abortion. Study Design: 113 nonpregnant women with a history of spontaneous abortion were assessed for peripheral NK cell activity and percentage of NK cell subsets, in relation to the cause of abortions, the number of spontaneous abortions, and subsequent pregnancy outcome (n = 56). Results: Neither NK cell activity nor subsets showed a significant difference in relation to the cause or number of spontaneous abortions. NK cell activity in nonpregnant women who later experienced subsequent abortion with normal chromosomes (n = 10) (mean SD: 42.8 +/- 15.8%) was relatively higher than that in women with subsequent live birth (control, n = 39) (32.1 +/- 13.7%) (p = 0.099). NK cell activity in women who later experienced subsequent abortion with abnormal chromosomes (n = 7) (28.7 +/- 21.4%) was the same as the level in the control. Conclusion: Peripheral NK cell activity or subsets during nonpregnant status were not related to the cause or number of previous spontaneous abortions. A relation between preconceptional NK cell activity and later experiencing abortion with normal chromosomes should be further studied. Copyright (C) 2001 S. Karger AG, Basel.
  • ML Luo, N Sakuragi, M Shimizu, K Seino, K Okamoto, M Kaneuchi, Y Ebina, K Okuyama, T Fujino, T Sagawa, S Fujimoto
    FRONTIERS IN OBSTETRICS AND GYNECOLOGY, PROCEEDINGS 49 - 53 2001年 [査読有り][通常論文]
     
    We examined peritoneal cytology (PC) for 115 cases of endometrial carcinoma using immunocytochemistry (ICC) for MOC-31, which reacts with glandular epithelial cells. PC was positive in 18 of 115 (15.7%) cases and suspicious in 3 of 115 (2.6%) cases. By a multivariate Cox regression analysis including grade, myometrial invasion, cervical involvement, and PC, only PC was found to be the independent prognostic factor for tumors confined to the uterus (p <0.05). A multivariate analysis for all the patients studied, which compared PC with staging variables, revealed that only peritoneal metastasis (p <0.0001) and lymph node metastasis (p <0.01) were independent prognostic factors. These results suggest that positive PC is an important prognostic factor for patients with endometrial carcinoma confined to the uterus.
  • M Sakaihara, H Yamada, EH Kato, Y Ebina, S Shimada, G Kobashi, M Fukushi, S Fujimoto
    CLINICAL ENDOCRINOLOGY 53 4 487 - 492 2000年10月 [査読有り][通常論文]
     
    OBJECTIVE The aim of this study was to establish the risk of postpartum thyroid dysfunction (PPTD) in women who had normal thyroid function during pregnancy and no history of thyroid disease. DESIGN Four thousand and twenty-two consecutive pregnant women were screened for thyroid function and antithyroid antibody. Among women with normal thyroid function during pregnancy and no history of thyroid disease, thyroid function were assessed in 131 of 388 antithyroid antibody positive (Group I) and 1030 of 3503 antibody negative (Group II) women at 1 and 3 months postpartum. In Group I women who experienced PPTD, the frequency of later manifestation of Hashimoto's disease was compared according to titres of antithyroid antibodies. MEASUREMENTS Blood samples in early pregnancy, and at 1 month and 3 months postpartum were obtained using the dried blood spot method. Levels of fT4 were measured by RIA, TSH by fluoroimmunoassay or ELISA, antimicrosome antibody (AMC) and antithyroglobulin antibody (ATG) by indirect agglutination reactions. RESULTS The prevalence of PPTD at 1 month and 3 months postpartum were found to be 6.9% and 21.3% in Group I, and 5.3% and 4.7% in Group II, respectively. The prevalence of PPTD was significantly higher at 3 months postpartum in Group I (P < 0.05). 27.3% of women with PPTD in Group I were later found to have Hashimoto's disease and 9.1% manifested hypothyroidism without goitre. A high AMC titre (greater than or equal to 25 600) at 3 months postpartum in women with PPTD was related to the manifestation of Hashimoto's disease. AMC titres of PPTD women and women who developed Hashimoto's disease were significantly higher than those of control women who did not experience PPTD. CONCLUSION A high prevalence of PPTD was found in women with antithyroid antibodies who were euthyroid during pregnancy. Prolonged follow-up of the subsequent thyroid function may be needed in women who experience PPTD and/or show a high titre of antithyroid antibody.
  • R Yamamoto, T Saitoh, T Kusaka, Y Todo, M Takeda, K Okamoto, E Nomura, Y Ebina, M Kaneuchi, N Sakuragi, S Fujimoto
    JAPANESE JOURNAL OF CLINICAL ONCOLOGY 30 9 397 - 400 2000年09月 [査読有り][通常論文]
     
    Background: The occurrence of pelvic lymphocysts is an important complication following systematic lymphadenectomy for gynecological malignancies. We employed a procedure to prevent vaginal shortening following radical hysterectomy and we examined whether this procedure could be effective in preventing pelvic lymphocyst formation. Methods: We studied the incidence of lymphocysts in 190 patients with 84 cervical cancers, 74 endometrial cancers and 32 ovarian cancers, using computed tomographic examination at 3 and 6 months subsequent to the surgery. The surgery included radical hysterectomy and a procedure to prevent vaginal shortening (101), modified radical hysterectomy (79) and simple hysterectomy (7), with systematic lymphadenectomy. Results: There was a significant difference in the incidence of pelvic lymphocysts between cervical cancer (4.8%) and ovarian cancer (18.8%). The postoperative incidence of lymphocyst formation in patients undergoing radical hysterectomy with the procedure to prevent vaginal shortening (5.9%) was significantly lower than in those who underwent modified radical hysterectomy (15.2%). Conclusion: Our procedure to prevent vaginal shortening could be effective in preventing not only the shortening of the vagina but also the occurrence of pelvic lymphocysts in patients undergoing radical hysterectomy with systematic lymphadenectomy for gynecological malignancies.
  • R Yamamoto, K Okamoto, Y Ebina, H Shirato, N Sakuragi, S Fujimoto
    BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY 107 7 841 - 845 2000年07月 [査読有り][通常論文]
     
    We describe a surgical procedure and post-operative management for the prevention of vaginal shortening following radical hysterectomy. A total of 452 patients who underwent hysterectomies were examined prospectively depending on the operation method. This study showed that our procedure was effective in the prevention of vaginal shortening following radical hysterectomy. Preservation of the ovaries appeared to be important in preventing vaginal shortening, and post-operative hormone replacement therapy was not as effective as the preservation of the ovaries. The effect of external irradiation on vaginal shortening was not conspicuous in the case that the ovaries were preserved.
  • H Yamada, N Hoshi, EH Kato, Y Ebina, T Kishida, T Sagawa, K Matsuno, S Fujimoto
    AMERICAN JOURNAL OF MEDICAL GENETICS 91 5 348 - 350 2000年04月 [査読有り][通常論文]
     
    A 35-year-old Japanese woman with a low level (42-54%) of blood antithrombin (AT) III, experienced two induced abortions due to deep venous thrombosis at 8 weeks of gestation (GW) and cerebral thrombosis at 10 GW, The present pregnancy was successfully managed with intravenous administration of AT III (6,000-8,000 U/wk), Analysis of polymerase chain reaction (PCR)-single strand conformation polymorphism (SSCP) for exons 3A and 4 of the AT III gene (AT3) using her DNA revealed extra expansion bands with altered migration. The DNA sequencing demonstrated novel mutations in exon 3A of AT3: a G to T substitution at nucleotide position 5333 in codon GAG for Glu 113, causing a stop codon (E113X), and an A to T substitution at position 5338 in codon AAA for Lys 114, forming Asn (K114N). These novel mutations, especially E113X, in AT3 may be related to recurrent thrombosis in the pregnancy. (C) 2000 Wiley-Liss, Inc.
  • H Yamada, EH Kato, Y Ebina, T Kishida, N Hoshi, G Kobashi, N Sakuragi, S Fujimoto
    GYNECOLOGIC AND OBSTETRIC INVESTIGATION 49 2 80 - 83 2000年 [査読有り][通常論文]
     
    Congenital thrombophilia is known to cause significant maternal complications, and possibly has an adverse effect on normal feta I development, The aim of this study was to assess the prevalence of factor XII (FXII) deficiency in women with a history of recurrent miscarriage. Two hundred and forty-one consecutive Japanese women with a history of two or more recurrent miscarriages were prospectively assessed for their etiology by conventional screening methods. Seven women were found to have reduced FXII activity (19.2-46.1%) and prolonged activated partial thromboplastin time (33.3-51.3 s). Of these 7 women, 6 had experienced early pregnancy losses, while 1 woman had experienced repeated midtrimester fetal losses with coincidental gestational thrombocytopenia, In 241 women with a history of recurrent miscarriage, the prevalence of FXII deficiency was 2.9%. Copyright (C) 2000 S. Karger AG, Basel.
  • Ritsu Yamamoto, Kazuhira Okamoto, Yasuhiko Ebina, Hiroki Shirato, Noriaki Sakuragi, Seiichiro Fujimoto
    BJOG: An International Journal of Obstetrics and Gynaecology 107 7 841 - 845 2000年 [査読有り][通常論文]
     
    We describe a surgical procedure and post-operative management for the prevention of vaginal shortening following radical hysterectomy. A total of 452 patients who underwent hysterectomies were examined prospectively depending on the operation method. This study showed that our procedure was effective in the prevention of vaginal shortening following radical hysterectomy. Preservation of the ovaries appeared to be important in preventing vaginal shortening, and post-operative hormone replacement therapy was not as effective as the preservation of the ovaries. The effect of external irradiation on vaginal shortening was not conspicuous in the case that the ovaries were preserved. © 2017 Wiley. All rights reserved.
  • Y Ebina, H Yamada, T Fujino, Furuta, I, N Sakuragi, R Yamamoto, M Katoh, M Oshimura, S Fujimoto
    INTERNATIONAL JOURNAL OF CANCER 84 5 529 - 532 1999年10月 [査読有り][通常論文]
     
    Telomerase activity has been implicated in the progression of various human tumors. Our aim was to evaluate telomerase activity and to compare it with histo-pathological factors in uterine endometrial carcinoma, to look for possible correlations. Telomerase activity was measured by dilution analysis using a PCR-based telomeric repeat amplification method and detected in 31 of 35 primary endometrial carcinoma tumor specimens. High telomerase activity, detected after 100-fold dilution of extracts, was identified in 15 specimens. There was no significant correlation between the positive telomerase activity and tumor surgical stage or histopathological factors. However, high telomerase activity was significantly correlated with advanced surgical stage and with pelvic lymph node metastasis. Our findings suggest that an increase in telomerase activity may be associated with tumor progression and that its level may have a prognostic value in endometrial carcinoma. Int. J. Cancer (Pred. Oncol.) 84:529-532, 1999. (C) 1999 Wiley-Liss, Inc.
  • H Yamada, EH Kato, Y Ebina, M Moriwaki, R Yamamoto, Furuta, I, S Fujimoto
    AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY 42 4 226 - 232 1999年10月 [査読有り][通常論文]
     
    PROBLEM: Maternal anti-SSA(B) antibody crosses the placenta and causes fetal myocarditis, congenital heart block (CHB), hydrops fetalis, and intrauterine fetal death. The aim of this study was to evaluate corticosteroids' efficacy as a treatment for CHB. METHOD OF STUDY: One fetus with complete CHB and one fetus with incomplete CHB due to anti-SSA(B) antibody received maternal prednisolone (PSL) and dexamethasone (DEXA) treatments. Heart rate, cardiothoracic ratio (CTR), left ventricular fractional shortening (FS), and preload index (PLI) were longitudinally measured by serial fetal echocardiograms. RESULTS: In the former case, after maternal PSL/DEXA administration,improvement of cardiohemodynamics, i.e., the reduction of PLI from 1.7 to 0.4, CTR from 70 to 52%, and FS from 63 to 54% were observed. In the latter case, second degree 2:1 block was converted to 3:2 block/sinus rhythm, resulting in the increase of the fetal heart rate from 65 to 116 beats per minute (bpm). CONCLUSIONS: We disclosed for the first time the beneficial effects of corticosteroids in the fetal cardiohemodynamics and conduction system of affected fetuses with the presence of maternal anti-SSA(B) antibodies.
  • Ritsu Yamamoto, Yukio Wakui, Kazuhisa Taketa, Hiroshi Ishikura, Noriaki Sakuragi, Rifumi Hattori, Hirofumi Sato, Yasuhiko Ebina, Shinzo Nishi, Seiichiro Fujimoto
    Tumor Biology 20 4 212 - 217 1999年07月 [査読有り][通常論文]
     
    The carbohydrate structure of glycoproteins is considered to be tissue- specific or cell type-specific, but there have been no reports on the differences of the carbohydrate structure of alpha-fetoproteins (AFPs) produced by histologically identical tumors in different tissues. The lectin affinity electrophoresis of hepatoid adenocarcinomas and yolk sac tumors from different organs suggested that either the tumor heterogeneity or the tissue specificity is possibly involved, the lectin reactivity of the AFP sugar chain structure produced by the tumors in different tissues.
  • R Yamamoto, M Fujita, M Kuwabara, M Sogame, Y Ebina, N Sakuragi, H Kato, S Fujimoto
    JAPANESE JOURNAL OF CLINICAL ONCOLOGY 29 6 308 - 313 1999年06月 [査読有り][通常論文]
     
    We investigated the tumor marker for malignant Brenner tumors, which had not been established because of the rarity and variable histological criteria. Representative areas of two cases of malignant Brenner tumor were investigated by means of the peroxidase-antiperoxidase method using monoclonal antibody to CA125 and CA72-4 antigen and the streptavidin-biotin immunoperoxidase complex method using monoclonal antibody to SCC antigen. Based on clinical course and immunohistochemical studies, serum CA125 and CA72-4 for Case 1 and SCC and CA72-4 for Case 2 were appropriate tumor markers for the establishment of the extent of tumor burden before treatment and to monitor the response to therapy. The discrepancy of the tumor markers of the two present cases is considered to be a reflection of the difference in the malignant component of these cases. However, serum CA72-4 was an appropriate tumor marker for both malignant Brenner tumors.
  • Noriko Kobayashi, Hideto Yamada, Tatsuro Kishida, Emi-Hirayama Kato, Yasuhiko Ebina, Noriaki Sakuragi, Gen Kobashi, Akito Tsutsumi, Seiichiro Fujimoto
    American Journal of Reproductive Immunology 42 3 153 - 159 1999年 [査読有り][通常論文]
     
    PROBLEM: The aim of this study was to elucidate fetomaternal risks in systemic lupus erythematosus (SLE)-complicated pregnancy. METHOD OF STUDY: Pregnancy course, complications, and fetal outcome in 82 pregnancies of 55 patients with SLE were investigated. RESULTS: These 82 pregnancies resulted in 14 fetal losses and 66 live births. Without clinical manifestation of SLE-flare, 4 of 8 patients who had low serum complement activity during the pregnancies delivered small-for-date neonates. The rate of the intrauterine growth retardation was significantly higher than that observed in pregnancies with normal complement activity. The frequency of premature deliveries (60%) in patients who received more than 15 mg/day of prednisolone was significantly high when compared with pregnancies maintained by 0-15 mg/day (13.1%) CONCLUSIONS: These data demonstrate the preconceptional and perinatal management necessary in SLE and suggest that the pregnancy with hypocomplementemia, the disease activity, and/or a relatively high maintenance dose of corticosteroid should be carefully managed and monitored.
  • Hideto Yamada, Emi H. Kato, Yasuhiko Ebina, Masashi Moriwaki, Ritsu Yamamoto, Itsuko Furuta, Seiichiro Fujimoto
    American Journal of Reproductive Immunology 42 4 226 - 232 1999年 [査読有り][通常論文]
     
    PROBLEM: Maternal anti-SSA(B) antibody crosses the placenta and causes fetal myocarditis, congenital heart block (CHB), hydrops fetalis, and intrauterine fetal death. The aim of this study was to evaluate corticosteroids' efficacy as a treatment for CHB. METHOD OF STUDY: One fetus with complete CHB and one fetus with incomplete CHB due to anti-SSA(B) antibody received maternal prednisolone (PSL) and dexamethasone (DEXA) treatments. Heart rate, cardiothoracic ratio (CTR), left ventricular fractional shortening (FS), and preload index (PLI) were longitudinally measured by serial fetal echocardiograms. RESULTS: In the former case, after maternal PSL/DEXA administration, improvement of cardiohemodynamics, i.e., the reduction of PLI from 1.7 to 0.4, CTR from 70 to 52%, and FS from 63 to 54% were observed. In the latter case, second degree 2:1 block was converted to 3:2 block/sinus rhythm, resulting in the increase of the fetal heart rate from 65 to 116 beats per minute (bpm). CONCLUSIONS: We disclosed for the first time the beneficial effects of corticosteroids in the fetal cardiohemodynamics and conduction system of affected fetuses with the presence of maternal anti-SSA(B) antibodies.
  • H Yamada, EH Kato, G Kobashi, T Kishida, Y Ebina, M Kaneuchi, S Suzuki, S Fujimoto
    SEMINARS IN THROMBOSIS AND HEMOSTASIS 25 5 491 - 496 1999年 [査読有り][通常論文]
     
    The aim of this study was to evaluate risk factors for occurrence of neonatal passive immune thrombocytopenia (PIT) in pregnancy complicated by idiopathic thrombocytopenic purpura (ITP). We studied 63 pregnant women with ITP and the 66 neonates retrospectively. Neonatal platelet counts were compared with maternal platelet counts, platelet-associated gamma G immunoglobulin (PAIgG) values, and the presence of antiplatelet antibody in the maternal circulation, history of previous PIT, maternal treatments for ITP, and other maternal or neonatal factors. PIT (platelet counts <100 x 10(3)/mu L) was observed in 9 (14.3 %) of 63 pregnancies. Presence of circulating antiplatelet antibody in maternal blood, splenectomy prior to pregnancy, and history of previous PIT were observed more frequently with statistical significance in patients giving birth to neonates who developed PIT. No effect on occurrence of PIT was found by the administration of corticosteroids or immunoglobulin. Splenectomy prior to pregnancy was found by logistic regression analysis to be a single significant variable (p = 0.021, odds ratio 7.20, confidence intervals: 1.35 to 38.3) among the risk factors for PIT.
  • Prenatal diagnosis and fetal therapy for congenital cytomegalovirus infection: a trial of intraperitoneal hyperimmunoglobulin injection.
    Yamada H, Negishi H, Ebina Y, Kato EH, Kobashi G, Sagawa T, Sakuragi N, Fujimoto S
    Virus Infection Seminar 1 27 - 34 1999年 [査読有り][通常論文]
  • M Nishiya, N Sakuragi, H Hareyama, Y Ebina, M Furuya, M Oikawa, R Yamamoto, T Fujino, S Fujimoto
    INTERNATIONAL JOURNAL OF CANCER 79 5 521 - 525 1998年10月 [査読有り][通常論文]
     
    The International Federation of Gynecology and Obstetrics (FIGO) adopted surgical staging criteria in 1988. Many studies have shown that histologic grade, nuclear grade, lymphvascular space invasion and cell type are also important predictors of survival. It has not been clarified, however, how to integrate these histopathologic variables into the process of estimating individual prognosis. We performed Cox multivariate regression analysis to create models that incorporate various histopathologic factors for estimating the prognoses of patients with endometrioid adenocarcinoma of the uterine corpus. Our study was based on data from 206 patients who underwent complete surgical staging, including systematic pelvic and para-aortic lymph node dissection. Two models resulted: one included depth of myometrial invasion, paraaortic node metastasis and the number of sites involved by the tumor among the cervix, ovary and pelvic lymph nodes (which we designated as extracorporeal spread score, ECS) and the other incorporated nuclear grade and lymph-vascular space invasion as variables. These 2 models enabled the prognosis for patients with endometrioid adenocarcinoma to be stratified into several levels according to hazard ratio. Comprehensive integration of the histopathologic prognostic factors, categorized into those relating to tumor extent and those relating to tumor virulence, should facilitate the estimation of individual prognosis more accurately than FIGO staging alone. Int. J. Cancer (Pred. Oncol.) 79:521-525, 1998. (C) 1998 Wiley-Liss, Inc.
  • R Yamamoto, K Taketa, Y Ebina, Y Cho, H Hareyama, N Sakuragi, S Makinoda, K Kobayashi, S Nishi, S Fujimoto
    JOURNAL OF CLINICAL PATHOLOGY 50 10 856 - 858 1997年10月 [査読有り][通常論文]
     
    Aims-To investigate a potential diagnostic use of alpha fetoprotein (alpha FP) isoform analysis by lectin affinity electrophoresis to distinguish between endodermal sinus tumours arising in the vagina in infants from those at other sites. Methods-alpha FP in the serum of a patient with a vaginal endodermal sinus tumour was analysed for its isoforms by lectin affinity electrophoresis. The isoforms were compared with that of cord serum, sera of hepatoid adenocarcinoma of the uterus, and endodermal sinus tumour of the ovary. Results-The isoforms of alpha FP obtained by lectin affinity electrophoresis in the serum of the patient with vaginal endodermal sinus tumour differed from the isoforms of alpha FP in the cord serum of normal neonates, and sera of patients with hepatoid adenocarcinoma of the uterus or endodermal sinus tumour of the ovary. Conclusions-Endodermal sinus tumour arising in the vagina could be distinguished from that in the ovary by the lectin affinity electrophoresis, and a potential diagnostic use of alpha FP isoform analysis by the lectin affinity electrophoresis for the detection of the endodermal sinus tumour in infants was demonstrated.
  • Y Ebina, H Hareyama, N Sakuragh, R Yamamoto, M Furuya, M Sogame, T Fujino, S Makinoda, S Fujimoto
    INTERNATIONAL SURGERY 82 3 244 - 248 1997年07月 [査読有り][通常論文]
     
    Background. There has been a controversy about the prognostic significance of positive peritoneal cytology in endometrial carcinoma. Materials and methods. Peritoneal cytology was obtained at the time of surgery, including systematic retroperitoneal lymph node dissection, in 114 patients. Results. The incidence of positive peritoneal cytology was 35.1%, The 5-year survival rates of the stage IIIA and IIIC (FIGO, 1988) cases were 82.8% and 58.3%, respectively, In pathological stage I (the disease was histologically confined to the uterine corpus), there was no significant difference in 5-year survival rates between patients with and without positive peritoneal cytology, Though the patients in stage IIIA who had only positive peritoneal cytology were given no postoperative therapy unless they had extrauterine disease, no patients developed recurrence, In stages IIIC and IV, the prognosis was significantly poorer for patients with positive peritoneal cytology than for those with negative cytology. Conclusion. Positive peritoneal cytology is not an adverse prognostic factor of endometrial carcinoma if disease is limited to the uterus.

MISC

  • 出口 雅士, 谷村 憲司, 蝦名 康彦, 山田 秀人 産婦人科の実際 69 (13) 1605 -1614 2020年12月 
    ＜文献概要＞血栓性素因のうち抗リン脂質抗体症候群のみ,不育症の明らかな原因といえる。そのほかの血栓性素因としては,わが国ではプロテインS低下,凝固第XII因子低下が代表的である。これらの(抗)凝固因子低下と不育症には弱い関連があるものの,治療が妊娠予後を改善するエビデンスは乏しい。不妊症と血栓性素因との関連についてはさらにエビデンスに乏しく,血栓性素因のある不妊・不育症患者の全例に抗凝固療法を行うべきではない。抗リン脂質抗体症候群については確立された治療法(低用量アスピリンとヘパリンの併用)があり,不育症(生化学的妊娠の反復を含む)や妊娠34週未満早産,胎児発育不全,妊娠高血圧症候群,常位胎盤早期剥離,HELLP症候群などの妊娠合併症があれば,不妊治療施設でもプレコンセプションケアとして積極的に診断検査基準に含まれる抗リン脂質抗体(aPL)を測定する。一方,血栓症の既往からみつかった血栓性素因についてはまったく対応が異なり,不妊治療に伴う卵巣過剰刺激症候群(OHSS)の徴候がみられた場合や妊娠が明らかとなった場合は,積極的にヘパリンを含む抗凝固療法を行う必用がある。また,凝固検査の評価においては,本検査が非常に繊細な検査であり,採血・検体処理手技により検査値が大きく変動する可能性があることに留意し,より正確な凝固検査を実施する体制を整備していくことが重要である。
  • 安積 麻帆, 鈴木 嘉穂, 出口 雅士, 松本 培世, 長又 哲史, 高橋 良輔, 蝦名 康彦, 寺井 義人 日本婦人科腫瘍学会雑誌 38 (2) 193 -199 2020年04月 
    子宮頸部小細胞癌は子宮頸部に発生する高異型度神経内分泌腫瘍であり、子宮頸癌の1〜3%を占めるに過ぎないが、早期に再発・転移をきたすことが多く予後不良な疾患として知られている。統一した治療方針は確立されていない。一方で子宮頸癌の治療において、腫瘍径が大きく、摘出が困難な進行症例では、術前化学療法が考慮される。今回我々は、局所進行子宮頸部小細胞癌に術前後の化学療法を施行し、良好な経過を得られたので報告する。症例は76歳。多量の不正出血を主訴に来院した。子宮傍組織に至る86mm大の腫瘤を認め、IIB期と診断した。組織診はsmall cell carcinomaであった。術前化学療法としてイリノテカン+シスプラチン(CPT-P)療法を1コース施行したところ、著明な縮小を認めたため、直ちに広汎子宮全摘術、両側付属器摘出術、骨盤リンパ節郭清、傍大動脈リンパ節郭清を行った。術後に2コースを追加し、術後7ヵ月で再発なく外来経過観察中である。転移のない局所進行子宮頸部小細胞癌では、術前後の化学療法が奏功し、予後を改善する可能性がある。(著者抄録)
  • 蝦名 康彦 産婦人科の進歩 71 (3) 287 -292 2019年08月 [査読有り][招待有り]
  • 卵巣癌初回治療におけるdose-dense TC療法とTC+bevacizumab併用療法の比較
    鈴木 嘉穂, 中筋 由紀子, 安積 麻帆, 高橋 良輔, 長又 哲史, 松本 培世, 出口 雅士, 蝦名 康彦, 寺井 義人 日本婦人科腫瘍学会雑誌 37 (3) 451 -451 2019年06月 [査読無し][通常論文]
  • 卵巣癌・腹膜癌の術前化学療法時の診断において、腹腔鏡下生検と体腔液Cell block法の比較検討
    高橋 良輔, 鈴木 嘉穂, 中筋 由紀子, 安積 麻帆, 長又 哲史, 松本 培世, 出口 雅士, 蝦名 康彦, 寺井 義人 日本婦人科腫瘍学会雑誌 37 (3) 457 -457 2019年06月 [査読無し][通常論文]
  • 子宮頸がんに対する放射線治療後不全骨折発症のリスクについての検討
    松本 培世, 鈴木 嘉穂, 安積 麻帆, 中筋 由紀子, 清水 真帆, 高橋 良輔, 長又 哲史, 蝦名 康彦, 出口 雅士, 寺井 義人 日本婦人科腫瘍学会雑誌 37 (3) 476 -476 2019年06月 [査読無し][通常論文]
  • トラベクテジンの長期投与が可能であった平滑筋肉腫の二例
    長又 哲史, 蝦名 康彦, 安積 麻帆, 高橋 良輔, 松本 培世, 鈴木 嘉穂, 出口 雅士, 寺井 義人 日本婦人科腫瘍学会雑誌 37 (3) 525 -525 2019年06月 [査読無し][通常論文]
  • 蝦名 康彦, 長又 哲史, 鈴木 嘉穂, 若橋 宣, 宮原 義也, 出口 雅士, 山田 秀人 日本女性栄養・代謝学会誌 25 (1) 49 -50 2019年06月
  • 当院で経験した腹膜原発癌肉腫の2例
    中筋 由紀子, 鈴木 嘉穂, 長又 哲史, 安積 麻帆, 高橋 良輔, 松本 培世, 蝦名 康彦, 出口 雅士, 寺井 義人, 山田 秀人 産婦人科の進歩 71 (2) 230 -230 2019年05月 [査読無し][通常論文]
  • 【産婦人科感染症の最前線】風疹,サイトメガロウイルス,パルボウイルスB19
    谷村 憲司, 蝦名 康彦, 山田 秀人 日本産科婦人科学会雑誌 71 (5) 643 -651 2019年05月
  • 蝦名 康彦 臨床婦人科産科 73 (4) 26 -31 2019年04月
  • 吉澤 ひかり, 蝦名 康彦, 今福 仁美, 鈴木 嘉穂, 若橋 宣, 宮原 義也, 出口 雅士, 山田 秀人 産婦人科の進歩 71 (1) 9 -16 2019年02月 [査読無し][通常論文]
     
    過去10年間に当科で経験した正常胎児と全奇胎の双胎(CHMCF)3例について報告した。CHMCFの診断週数は12〜14週で、2例は排卵誘発による妊娠であった。母体合併症は妊娠悪阻が1例、性器出血が3例であった。診断後、妊娠継続に関するリスクについて十分な説明を行ったところ、2例は妊娠中絶を希望したが、残りの1例は希望により妊娠継続をしていた。だが、臨床的侵入奇胎のため妊娠21週1日目で人工妊娠中絶となった。3例中2例では続発性疾患(奇胎後hCG存続症1例、臨床的侵入奇胎1例)を認め、化学療法にて寛解が得られた。
  • 不育症のトピックス 不育症とネオ・セルフ
    谷村 憲司, 笹川 勇樹, 今福 仁美, 森實 真由美, 出口 雅士, 蝦名 康彦, 荒瀬 規子, 荒瀬 尚, 齋藤 滋, 山田 秀人 日本生殖医学会雑誌 63 (3) 230 -230 2018年08月 [査読無し][通常論文]
  • 婦人科がん 最新の研究動向 子宮頸癌治療ガイドライン
    蝦名康彦, 三上幹男 日本臨床 76 (増2) 259 -261 2018年03月 [査読無し][招待有り]
  • サイトメガロウイルス母子感染の対策
    山田秀人, 森岡一朗, 出口雅士, 谷村憲司, 平久進也, 森實真由美, 蝦名康彦, 峰松俊夫 日本産婦人科感染症学会誌 2 (1) 2 -12 2018年 [査読無し][通常論文]
  • 山田 秀人, 蝦名 康彦 日本医事新報 (4872) 26 -32 2017年09月09日
  • 施 裕徳, 蝦名康彦, 宮原義也, 山田秀人 産婦人科の進歩 69 (2) 126 -130 2017年05月 [査読無し][通常論文]
     

    非産褥期子宮内反症は非常にまれな疾患である．われわれは粘膜下筋腫に続発した非産褥期不全子宮内反症と診断し，子宮全摘出術を施行した症例を経験したので報告する．患者は52歳，2経産婦．47歳時より粘膜下子宮筋腫を指摘されていた．50歳時から性腺刺激ホルモン放出ホルモンアゴニスト（Gonadotropin releasing hormone agonist；GnRHa）療法による保存療法が繰り返されていた．しかし，子宮筋腫の縮小を認めず，大量の帯下を主訴として紹介された．腟内に膨隆する粘膜下筋腫を認め，骨盤MRIでは子宮底部が陥凹しており，非産褥期不全子宮内反症と診断した．腹式単純子宮全摘出術および両側卵管切除術を実施した．病理組織検査結果は平滑筋腫であった．長期間にわたる保存療法中に，粘膜下筋腫の増大に伴い内反状態が増悪したと推測された．〔産婦の進歩69（2）：126-130，2017（平成29年5月）〕

  • 浦瀬 靖代, 北島 一宏, 上野 嘉子, 前田 哲雄, 高橋 哲, 蝦名 康彦, 原 重雄, 杉村 和朗 臨床放射線 62 (5) 719 -723 2017年05月
  • 出口 雅士, 森實 真由美, 蝦名 康彦, 山田 秀人 チャイルドヘルス 20 (5) 346 -351 2017年05月
  • Kazuhiro Kitajima, Munenobu Nogami, Satoru Takahashi, Yoshiko Ueno, Yasuhiko Ebina, Kazuhiro Kubo, Utaru Tanaka, Keitaro Sofue, Takeaki Ishihara, Yuichi Wakabayashi, Kazunari Ishii, Kazuro Sugimura JOURNAL OF NUCLEAR MEDICINE 58 2017年05月 [査読無し][通常論文]
  • 卵管癌との鑑別に苦慮した活動性卵管炎の1例
    末永 裕子, 前田 哲雄, 上野 嘉子, 高橋 哲, 杉本 幸司, 杉村 和朗, 蝦名 康彦, 山田 秀人, 糸口 直江, 原 重雄 Japanese Journal of Radiology 35 (Suppl.) 45 -45 2017年02月 [査読無し][通常論文]
  • 山田 秀人, 谷村 憲司, 出口 雅士, 蝦名 康彦, 森岡 一朗, 峰松 俊夫 周産期医学 47 (2) 213 -218 2017年02月
  • 【多彩なヘルペスウイルス感染症-その診断と治療up to dateとして-】 ヘルペスウイルス感染症の診断と治療 産婦人科領域のヘルペスウイルス感染症 性器ヘルペス
    蝦名康彦, 山田秀人 Modern Physician 36 (12) 1289 -1293 2016年12月 [査読無し][招待有り]
     
    ＜ポイント＞性器ヘルペスは単純ヘルペスウイルス(HSV)による性行為感染症である。臨床的に、初発と再発に分類され、さらに初発は初感染初発と非初感染初発にわけられる。病変からの検体を用いた病原診断、または、病歴、臨床症状、局所所見に基づいた臨床診断を行う。HSVの増殖を抑制する抗ウイルス薬が有効であり、アシクロビルもしくはバラシクロビルを使用する。妊婦が性器ヘルペスに罹患すると、産道感染をきたし新生児ヘルペスの原因となる。分娩時にヘルペス病変が外陰部にある場合には帝王切開が強く勧められる。初感染初発から1ヵ月以内か、再発または非初感染初発発症から1週間以内に分娩となる場合には予定帝王切開を考慮する。(著者抄録)
  • 白川得朗, 蝦名康彦, 豊永絢香, 小嶋伸恵, 鈴木嘉穂, 若橋 宣, 市田耕太郎, 宮原義也, 森田宏紀, 山田秀人 日本産科婦人科内視鏡学会雑誌 32 (1) 255 -259 2016年11月 [査読有り][通常論文]
     

      We present a case of complete androgen insensitivity syndrome (CAIS) treated by laparoscopic gonadectomy. Case: A 19-year-old phenotypical female, who complained of primary amenorrhea, was referred to our hospital. Physical examination revealed the absence of the proximal vagina and female external genitalia. Pelvic magnetic resonance imaging revealed bilateral pelvic masses, and the absence of both the uterus and the vagina. Hormonal examination revealed elevated serum testosterone level at 8.3 ng/mL (normal values in female adults, 0.06-0.86 ng/mL). Her karyotype was 46,XY. Therefore, we diagnosed complete CAIS. She underwent laparoscopic gonadectomy. Histopathological examination showed immature seminiferous tubules and Leydig cells in both gonads. Her postoperative course was uneventful and she was discharged on postoperative day 5. She is being treated with and will continue to receive hormone replacement. Care for patients with CAIS needs to be individualized, flexible, and holistic because they are often raised socially as women. Laparoscopic gonadectomy in patients with CAIS is useful, because it is less invasive and has improved cosmetic results compared with open surgery.

  • 山田 秀人, 出口 雅士, 蝦名 康彦 産科と婦人科 83 (5) 535 -539 2016年05月
  • 特集 伝染性紅斑を見直す ４ 母子感染の実態～全国産科施設を対象とした実態調査
    蝦名康彦, 平久進也, 森岡一朗, 出口雅士, 森實真由美, 山田秀人 小児科 56 1867 -1873 2015年11月 [査読有り][招待有り]
  • 伝染性紅斑流行時の妊婦健診における留意点について
    蝦名康彦 産婦の進歩 67 419 -420 2015年11月 [査読有り][招待有り]
  • 母子感染アップデート わが国におけるパルボウイルスB19母子感染の実態調査
    蝦名康彦 医学のあゆみ 253 1245 -1249 2015年06月 [査読無し][招待有り]
  • 新生児尿スクリーニングと抗ウイルス薬治療導入後の症候性先天性サイトメガロウイルス感染児の後遺症発生率
    森岡 一朗, 西田 浩輔, 香田 翼, 岩谷 壮太, 出口 雅士, 谷村 憲司, 平久 進也, 蝦名 康彦, 船越 徹, 大橋 正伸, 飯島 一誠, 山田 秀人 日本産婦人科感染症学会学術講演会プログラム・抄録集 32回 37 -37 2015年05月 [査読無し][通常論文]
  • 症候性先天性サイトメガロウイルス感染児の聴性脳幹反応に対する抗ウイルス薬治療の効果と問題点
    森岡 一朗, 西田 浩輔, 香田 翼, 岩谷 壮太, 出口 雅士, 谷村 憲司, 平久 進也, 蝦名 康彦, 飯島 一誠, 山田 秀人 日本産婦人科感染症学会学術講演会プログラム・抄録集 32回 38 -38 2015年05月 [査読無し][通常論文]
  • 周産期の炎症・感染への挑戦 先天性サイトメガロウイルス感染の効果的な周産期管理法の確立を目指して
    森岡 一朗, 平久 進也, 蝦名 康彦, 谷村 憲司, 出口 雅士, 園山 綾子, 峰松 俊夫, 井上 直樹, 飯島 一誠, 山田 秀人 日本周産期・新生児医学会雑誌 50 (別冊) 22 -23 2015年01月 [査読無し][通常論文]
  • 長又 哲史, 蝦名 康彦, 宮原 義也, 新谷 潔, 上野 嘉子, 北島 一宏, 川上 史, 山田 秀人 産婦人科の進歩 66 (4) 361 -366 2014年10月 [査読無し][通常論文]
     
    47歳女。39歳時に腹腔鏡下子宮筋腫核出術、40歳時に甲状腺乳頭癌に対して甲状腺摘出術の既往があった。無月経、不正性器出血で受診した際に、骨盤内から後腹膜腔へ発達する巨大な腫瘍を指摘された。PET-CTでは腫瘍部位にFDGの有意な集積を認めず、有茎性漿膜下筋腫を疑った。原発不明腫瘍の診断で手術を施行した。病理組織では、腹腔鏡下子宮筋腫核出術の既往があることから、腹腔鏡下筋腫核出術後に発生した医原性parasitic myomaと推察した。当時の手術記録を取り寄せたところ、子宮後壁頸部近くの97mm大の筋腫を核出後、モルセレーターを使用し体外に摘出していた。その際の残存筋腫が栄養血管を獲得しながら発育し、後腹膜腔にまで達する巨大なparasitic myomaとなったと推測された。腫瘍および子宮頸部・体部細胞診において悪性所見は認めず、不正性器出血に関しては閉経周辺期の機能性子宮出血と考えられた。
  • 蝦名康彦, 山崎友維, 白川得朗, 牧原夏子, 宮原義也, 新谷潔, 中林幸士, 松岡正造, 上中建, 横田一郎, 苅田典生, 田中惠子, 山田秀人 日本産科婦人科内視鏡学会雑誌 29 (2) 469 -474 2014年03月 [査読有り][通常論文]
     
    症例は35歳女で、職場で気分高揚・多弁となり、躁状態は悪化して奇異で滅裂な言動が増加し、さらに傾眠傾向、独語、手足の振戦、流涎が出現し、無呼吸発作も頻発した。骨盤MRIで右卵巣の一部に長径17mmの脂肪抑制を受けるT1 highの部分を認め、頭部MRIでは両側側頭内側皮質に淡い高信号域を認めた。右成熟嚢胞性奇形腫を伴う抗N-methyl-D-aspartate受容体(NMDAR)抗体関連脳炎を疑い、腹腔鏡下右付属器摘出術を施行した。摘出卵巣は5×3×2.5cmで、神経成分や皮膚、軟骨の成分を認めたが未熟成分や悪性所見はなく、成熟嚢胞性奇形腫と診断した。髄液検査では抗NMDAR抗体陽性が確認された。術後は自律神経系の障害がみられ、ステロイドパルス療法、中枢性低換気に対する気管切開、血漿交換、大量免疫グロブリン療法を施行し、徐々に意思疎通が可能となり、第97病日にリハビリのため転院した。発症から8ヵ月で職場復帰を果たした。
  • 森岡一朗, 山田秀人, 平久進也, 蝦名康彦, 出口雅士, 香田翼, 飯島一誠 小児科診療 77 (3) 347 -350 2014年03月01日 [査読無し][通常論文]
  • 牧原夏子, 蝦名康彦, 山崎友維, 今福仁美, 生橋義之, 松岡正造, 宮原義也, 新谷潔, 森田宏紀, 山田秀人 日本産科婦人科学会雑誌 66 (2) 627 2014年02月01日 [査読無し][通常論文]
  • 青木茂, 秋野亮介, 新垣達也, 池田智明, 市塚清健, 伊東宏晃, 蝦名康彦, 太田創, 大槻克文, 大野泰正, 大場智洋, 大原玲奈, 奥田美加, 奥山亜由美, 小畠真奈, 折坂勝, 葛西路, 倉澤健太郎, 佐藤昌司, 佐村修, 下平和久, 関沢明彦, 平久進也, 高橋恒男, 瀧田寛子, 塚原優己, 出口雅士, 徳中真由美, 中田雅彦, 中田雅彦, 仲村将光, 西田浩子, 長谷川潤一, 長谷川良実, 花岡正智, 濱田尚子, 濱田洋実, 松岡隆, 松本美奈子, 三科美幸 ペリネイタルケア 290P 2014年01月10日 [査読無し][通常論文]
  • 山田秀人, 森岡一朗, 平久進也, 谷村憲司, 出口雅士, 蝦名康彦 周産期医学 43 (10) 1295 -1299 2013年10月10日 [査読無し][通常論文]
  • 牧原 夏子, 蝦名 康彦, 出口 可奈, 白川 得朗, 宮原 義也, 上野 嘉子, 前田 哲雄, 川上 史, 原 重雄, 山田 秀人 日本婦人科腫瘍学会雑誌 31 (4) 1062 -1067 2013年10月 [査読無し][通常論文]
     
    子宮体部扁平上皮癌(primary endometrial squamous cell carcinoma:PESCC)は非常に稀な症例である。今回われわれは子宮留膿腫に伴う発熱・腹痛を初発症状として発見され、治療を行った子宮体部扁平上皮癌の1症例を経験したので報告する。患者は79歳、4経妊2経産、50歳で閉続。内分泌疾患精査のため。当院内科入院中に下腹部痛と発熱の症状が出現し、腹部CTにて子宮腫大と子宮内腔の液体貯留を認めたため、当科へ紹介となった。経腟超音波・骨盤MRIでは子宮底部に充実性腫瘤を認め、子宮体癌が疑われたが、子宮内膜組織診では異型を認めなかった。しかし、初診時の腫瘍マーカー検査にてSCC抗原が97.9ng/mlと異常高値であったため、全身検索目的にてFDG-PETを施行したところ、子宮体部腫瘍に一致して強い集積を認めた。そのため子宮体部悪性腫瘍を疑い、初診の2ヵ月後に腹式単純子宮全摘術+両側付属器切除術を施行した。術後病理組織診断で、子宮体部原発扁平上皮癌Ic期と診断された。年齢を考慮し後療法は施行せずに外来にて経過観寮中であるが、術後15ヵ月で再発兆候を認めていない。(著者抄録)
  • 子宮頸癌放射線治療の新展開 高齢子宮頸癌患者に対する根治的放射線治療の経験
    吉田 賢史, 宮脇 大輔, 江島 泰生, 西村 英輝, 岡本 欣晃, 蝦名 康彦, 佐々木 良平 日本婦人科腫瘍学会雑誌 31 (3号) 412 -412 2013年06月 [査読無し][通常論文]
  • 蝦名康彦, 山田秀人 内科 111 (6) 1546 2013年06月01日 [査読無し][通常論文]
  • 森岡一朗, 柴田暁男, 三輪明弘, 横山直樹, 園山綾子, 平久進也, 谷村憲司, 蝦名康彦, 峰松俊夫, 井上直樹, 飯島一誠, 山田秀人 先天性サイトメガロウイルス感染症対策のための妊婦教育の効果の検討、妊婦・新生児スクリーニング体制の構築及び感染新生児の発症リスク同定に関する研究 平成23-24年度 総合研究報告書 109 2013年 [査読無し][通常論文]
  • 山田秀人, 古谷野伸, 岡明, 井上直樹, 森岡一朗, 森内浩幸, 吉川哲史, 伊藤裕司, 浅野仁覚, 五石圭司, 三牧正和, 蝦名康彦, 谷村憲司, 平久進也, 園山綾子, 出口雅士 先天性サイトメガロウイルス感染症対策のための妊婦教育の効果の検討、妊婦・新生児スクリーニング体制の構築及び感染新生児の発症リスク同定に関する研究 平成23-24年度 総合研究報告書 31 -53 2013年 [査読無し][通常論文]
  • 平久進也, 谷村憲司, 園山綾子, 蝦名康彦, 森岡一朗, 山田秀人 先天性サイトメガロウイルス感染症対策のための妊婦教育の効果の検討、妊婦・新生児スクリーニング体制の構築及び感染新生児の発症リスク同定に関する研究 平成24年度 総括・分担研究報告書 86 2013年 [査読無し][通常論文]
  • 園山綾子, 蝦名康彦, 谷村憲司, 森岡一朗, 森實真由美, 平久進也, 峰松俊夫, 山田秀人 先天性サイトメガロウイルス感染症対策のための妊婦教育の効果の検討、妊婦・新生児スクリーニング体制の構築及び感染新生児の発症リスク同定に関する研究 平成23-24年度 総合研究報告書 113 2013年 [査読無し][通常論文]
  • 山田秀人, 古谷野伸, 岡明, 井上直樹, 森岡一朗, 森内浩幸, 吉川哲史, 伊藤裕司, 浅野仁覚, 三牧正和, 蝦名康彦, 平久進也, 出口雅士 先天性サイトメガロウイルス感染症対策のための妊婦教育の効果の検討、妊婦・新生児スクリーニング体制の構築及び感染新生児の発症リスク同定に関する研究 平成24年度 総括・分担研究報告書 29 -47 2013年 [査読無し][通常論文]
  • 蝦名康彦, 森上聡子, 平久進也, 谷村憲司, 森岡一朗, 園山綾子, 峰松俊夫, 山田秀人 先天性サイトメガロウイルス感染症対策のための妊婦教育の効果の検討、妊婦・新生児スクリーニング体制の構築及び感染新生児の発症リスク同定に関する研究 平成24年度 総括・分担研究報告書 87 2013年 [査読無し][通常論文]
  • 森岡一朗, 園山綾子, 平久進也, 谷村憲司, 蝦名康彦, 山田秀人 先天性サイトメガロウイルス感染症対策のための妊婦教育の効果の検討、妊婦・新生児スクリーニング体制の構築及び感染新生児の発症リスク同定に関する研究 平成23-24年度 総合研究報告書 114 2013年 [査読無し][通常論文]
  • 山田秀人, 平久進也, 谷村憲司, 蝦名康彦, 森岡一朗 先天性サイトメガロウイルス感染症対策のための妊婦教育の効果の検討、妊婦・新生児スクリーニング体制の構築及び感染新生児の発症リスク同定に関する研究 平成24年度 総括・分担研究報告書 88 2013年 [査読無し][通常論文]
  • 森岡一朗, 園山綾子, 平久進也, 足立陽子, 谷村憲司, 蝦名康彦, 山田秀人 先天性サイトメガロウイルス感染症対策のための妊婦教育の効果の検討、妊婦・新生児スクリーニング体制の構築及び感染新生児の発症リスク同定に関する研究 平成24年度 総括・分担研究報告書 85 2013年 [査読無し][通常論文]
  • 上中美月, 平久進也, 園山綾子, 陌間亮一, 谷村憲司, 蝦名康彦, 森田宏紀, 山崎峰夫, 山田秀人 日本周産期・新生児医学会雑誌 48 (4) 976 -980 2012年12月15日 [査読無し][通常論文]
  • 山崎友維, 蝦名康彦, 米 温子, 富山陽子, 岡田朋子, 藤田一郎, 左右田裕生, 山田秀人 日本産科婦人科内視鏡學會雜誌 = The journal of the Japan Endoscopy Society of Obstetrics and Gynecology 28 (1) 378 -381 2012年08月 [査読無し][通常論文]
     
    An ectopic ovary is a very rare condition. A 27-year-old woman underwent laparoscopy because of a dermoid cyst on the right ovary and was found to have a cystic mass in the mesentery of the sigmoid colon. Despite thorough inspection, her left ovary was not found in the usual place. The left infundibulopelvic ligament was also nonexistent. Pathological examination revealed ovarian stromata in the cystic mass in the mesentery of the sigmoid colon.
  • 山田秀人, 谷村憲司, 前澤陽子, 蝦名康彦 産婦人科の実際 61 (7) 1043 -1049 2012年07月01日 [査読無し][通常論文]
  • 山田秀人, 谷村憲司, 蝦名康彦 臨床婦人科産科 66 (5) 166 -174 2012年04月20日 [査読無し][通常論文]
  • 蝦名康彦 産婦人科の進歩 64 (2) 215 -220 2012年 [査読有り][招待有り]
  • 山田秀人, 前澤陽子, 武田真光, 谷村憲司, 陌間亮一, 蝦名康彦 産婦人科の実際 60 (10) 1473 -1480 2011年10月01日 [査読無し][通常論文]
  • 山田秀人, 谷村憲司, 森岡一朗, 森實真由美, 園山綾子, 平久進也, 蝦名康彦, 井上直樹, 古谷野伸, 峰松俊夫 産婦人科の実際 60 (9) 1309 -1321 2011年09月01日 [査読無し][通常論文]
  • 武居智信, 中林幸士, 竹村直也, 牧原夏子, 鈴木嘉穂, 陌間亮一, 森實真由美, 出口雅士, 宮原義也, 蝦名康彦, 吉田茂樹, 山田秀人 産婦人科の進歩 63 (3) 271 -276 2011年08月01日 [査読無し][通常論文]
     
    卵巣腫瘍症例におけるDVTの術前診断の指針について検討した．2006年1月～2010年6月の間に，当科で術前に血漿D-dimer値を測定した卵巣腫瘍193例（良性115例，境界悪性15例，悪性63例）を対象とした．主治医の判断で術前に下肢静脈ドップラー超音波検査を施行したのは32例（良性9例，境界悪性6例，悪性17例）で，DVTと診断された症例は18例（良性5例，境界悪性2例，悪性11例）であった．DVTの有無と良・悪性別，年齢別，症状の有無，最大腫瘍径，血漿D-dimer値などの項目との関係について解析したところ，DVTと診断された症例の割合は，良性腫瘍に比し悪性腫瘍で有意に高く，下肢の腫脹・浮腫・疼痛・熱感などの症状を有する症例は，症状がない症例に比し有意にDVTと診断された症例が多いことが明らかになった．またDVTの有無と，最大腫瘍径値，BMIの多寡等との間には有意な関連を認めなかったが，血漿D-dimer値が高い症例でDVTと診断されることが多かった．DVTと診断した18例は，すべて血漿D-dimer値が3.0μg/ml以上であったが，一方でDVTに関連した臨床症状のなかった症例が6例あった．本検討により，DVTに関連した臨床症状のある症例や，術前の血漿D-dimer値が少なくとも3.0μg/ml以上の症例であれば，全例術前に下肢静脈ドップラー超音波検査を施行しDVTをスクリーニングすることが重要であると考えられた．〔産婦の進歩63（3）：271-276，2011（平成23年8月）〕
  • 蝦名康彦, 谷村憲司, 山田秀人 周産期医学 41 (8) 1081 -1085 2011年08月 [査読有り][招待有り]
  • 周産期におけるサイトメガロウイルス対策
    山田秀人, 谷村憲司, 森岡一朗, 森實真由美, 平久進也, 蝦名康彦 日本産婦人科感染症研究会学術講演会記録集 (29号) 28 -36 2011年06月 [査読無し][通常論文]
  • 円錐切除後子宮頸管狭窄に対するナイチノールステント留置の試み
    前田 悟郎, 首藤 聡子, 木川 聖美, 三田村 卓, 保坂 昌芳, 武田 真人, 蝦名 康彦, 渡利 英道, 金内 優典, 工藤 正尊, 水上 尚典, 櫻木 範明 北海道産科婦人科学会会誌 55 (1) 154 -155 2011年03月 [査読無し][通常論文]
  • 細胞診陽性者におけるヒト・パピローマ・ウイルス(HPV)型分析の有用性および新しい経過観察指針作成について
    藤田 博正, 佐々木 隆之, 保坂 昌芳, 蝦名 康彦, 渡利 英道, 櫻木 範明 北海道産科婦人科学会会誌 55 (1) 153 -154 2011年03月 [査読無し][通常論文]
  • 当科で子宮頸癌に対して施行した腹腔鏡下広汎子宮全摘(LRH)および骨盤リンパ節郭清の安全性や広汎性についての検討
    保坂 昌芳, 工藤 正尊, 森脇 征史, 三田村 卓, 加藤 達矢, 首藤 聡子, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 櫻木 範明 日本産科婦人科内視鏡学会雑誌 26 (1) 65 -65 2010年07月 [査読無し][通常論文]
  • 保坂昌芳, 工藤正尊, 明石大輔, 三田村卓, 加藤達矢, 森脇征史, 首藤聡子, 武田真人, 蝦名康彦, 渡利英道, 金内優典, 櫻木範明 日本産科婦人科内視鏡學會雜誌 = The journal of the Japan Endoscopy Society of Obstetrics and Gynecology 25 (2) 432 -437 2009年12月 [査読無し][通常論文]
     
    <B>Objectives:</B> The purpose of this study was to determine the feasibility and radicality of endoscopic radical hysterectomy (ERH) and endoscopic modified radical hysterectomy (EmRH) combined with pelvic lymphadenectomy (ELND) in invasive cervical cancer patients.<BR><B>Methods:</B> Five patients with invasive cervical cancer underwent ERH or EmRH between May 2003 and March 2007 at Hokkaido University Hospital. Two patients with stage I a adenocarcinoma underwent an EmRH, and two patients with stage I b1 and one patient with stage II a underwent an ERH. All patients gave their informed consent to this experimental procedure before surgery.<BR><B>Results:</B> The median age of patients was 39 years (range, 33-45 years), and the median body mass index was 20.2 kg/m<SUP>2</SUP> (range, 18.5-23.7 kg/m<SUP>2</SUP>). The maximum tumor diameter was 20mm in 1 patient, and ≤10mm in 4 patients. The pathologic subtype was squamous cell carcinoma in 2 patients, and adenocarcinoma in 3 patients. The median operative time was 734 min (range, 583-974 min), the median blood loss was 890 ml(range, 280-2650 ml), the median number of lymph nodes removed was 77 (range, 47-103), and the median length of vaginal cuff removed was 20mm(range, 10-25mm). The median duration of hospitalization post-operatively was 16 days (range, 13-23 days). A post-surgical infection occurred in one patient, but no severe complications were noted. There were no relapses after a mean follow-up period of 31.8 months (range, 15-71 months).<BR><B>Conclusions:</B> An ERH or EmRH with ELND is feasible and might be beneficial for early invasive cervical cancer.
  • 婦人科系
    保坂 昌芳, 蝦名 康彦, 木川 聖美, 三田村 卓, 加藤 達矢, 首藤 聡子, 武田 真人, 渡利 英道, 金内 優典, 櫻木 範明 日本臨床細胞学会北海道支部会報 18 58 -60 2009年09月 [査読無し][通常論文]
  • 蝦名康彦, 櫻木範明 臨床婦人科産科 63 (9) 1204 -1211 2009年09月 [査読無し][通常論文]
  • 上皮性卵巣癌におけるp53変異とその予後に与える影響(Mutations of p53 in epithelial ovarian cancers and its effect on prognosis)
    鈴木 友希子, 多田 光宏, 金内 優典, 蝦名 康彦, 渡利 英道, 半田 康, 加藤 秀則, 櫻木 範明, 浜田 淳一, 守内 哲也 日本癌学会総会記事 68回 329 -329 2009年08月 [査読無し][通常論文]
  • 【子宮疾患・子宮内膜症の臨床 基礎・臨床研究のアップデート】 感染症・炎症性疾患 子宮腟部びらん
    金内 優典, 武田 真人, 蝦名 康彦, 渡利 英道, 櫻木 範明 日本臨床 67 (増刊5 子宮疾患・子宮内膜症の臨床) 335 -338 2009年08月 [査読無し][通常論文]
  • 保坂 昌芳, 藤堂 幸治, 小田 泰也, 三田村 卓, 加藤 達矢, 首藤 聡子, 武田 真人, 蝦名 康彦, 渡利 英道, 金内 優典, 櫻木 範明 産婦人科の実際 58 (8) 1227 -1232 2009年08月 [査読無し][通常論文]
     
    著者らが広汎子宮全摘術を行った子宮頸癌患者で、少なくとも片側の自律神経膀胱枝を温存できた60例を温存群、両側とも温存できなかった5例を非温存群とし、術前術後の尿流動態検査(UDS)用いた膀胱機能を比較検討した。その結果、最大蓄尿時膀胱コンプライアンス、最大尿流速度、排尿時最大腹圧、排尿時最大排尿筋圧、残尿のいずれも、温存群が非温存群と比べ有意に良好であった。
  • Cyr61高発現とリンパ節転移は子宮体癌の独立予後因子である
    渡利 英道, 田中 理恵子, 三田村 卓, 加藤 達矢, 保坂 昌芳, 首藤 聡子, 武田 真人, 蝦名 康彦, 金内 優典, 工藤 正尊, 櫻木 範明 日本婦人科腫瘍学会雑誌 27 (3) 282 -282 2009年06月 [査読無し][通常論文]
  • 卵巣癌に対するパクリタキセル胸腔内投与時の薬物動態
    三田村 卓, 保坂 昌芳, 首藤 聡子, 武田 真人, 蝦名 康彦, 渡利 英道, 金内 優典, 工藤 正尊, 水上 尚典, 櫻木 範明 日本婦人科腫瘍学会雑誌 27 (3) 291 -291 2009年06月 [査読無し][通常論文]
  • 金内 優典, 保坂 昌芳, 藤堂 幸治, 三田村 卓, 加藤 達矢, 首藤 聡子, 武田 真人, 蝦名 康彦, 渡利 英道, 櫻木 範明 産婦人科治療 98 (6) 1026 -1033 2009年06月 [査読無し][通常論文]
  • 子宮頸癌におけるリンパ節転移例の予後因子についての検討
    小島 崇史, 保坂 昌芳, 三田村 卓, 森脇 征史, 原 洋子, 藤堂 幸治, 武田 真人, 蝦名 康彦, 渡利 英道, 工藤 正尊, 水上 尚典, 櫻木 範明 北海道産科婦人科学会会誌 53 (1) 51 -52 2009年01月 [査読無し][通常論文]
  • 術前化学療法を施行した子宮頸癌症例におけるアポトーシス抑制蛋白clusterinの発現と治療反応性および予後因子との関連
    渡利 英道, 鹿沼 達哉, 大田 陽子, 三田村 卓, 加藤 達矢, 保坂 昌芳, 藤堂 幸治, 首藤 聡子, 武田 真人, 蝦名 康彦, 峯岸 敬, 櫻木 範明 日本癌治療学会誌 43 (2) 814 -814 2008年10月 [査読無し][通常論文]
  • 蝦名 康彦, 三田村 卓, 加藤 達矢, 保坂 昌芳, 首藤 聡子, 武田 真人, 渡利 英道, 金内 優典, 工藤 正尊, 櫻木 範明 産婦人科の実際 57 (11) 1726 -1733 2008年10月 [査読無し][招待有り]
  • 雄性化破綻メカニズムとエピジェネティクス
    三觜 友子, 割田 克彦, 菅原 照夫, 田渕 圭章, 松本 由樹, 三木 崇範, 石原 可奈, 谷田 任司, 蝦名 康彦, 櫻木 範明, 横山 俊史, 竹内 義喜, 北川 浩, 星 信彦 日本獣医学会学術集会講演要旨集 146回 148 -148 2008年09月 [査読無し][通常論文]
  • 当科における浸潤子宮頸癌に対する鏡視下手術
    工藤 正尊, 保坂 昌芳, 森脇 征史, 藤堂 幸治, 武田 真人, 蝦名 康彦, 渡利 英道, 水上 尚典, 櫻木 範明 産婦人科手術 (19) 179 -179 2008年08月 [査読無し][通常論文]
  • 広汎子宮全摘術後の持続的な蓄尿コンプライアンス低下に影響を及ぼす因子の解析
    藤堂 幸治, 森脇 征史, 保坂 昌芳, 原 洋子, 武田 真人, 蝦名 康彦, 渡利 英道, 工藤 正尊, 櫻木 範明 日本外科系連合学会誌 33 (4) 711 -711 2008年08月 [査読無し][通常論文]
  • 櫻木範明, 森脇征史, 蝦名康彦 産婦人科治療 97 (2) 139 -143 2008年08月 [査読無し][通常論文]
  • 当科で子宮頸癌に対して施行した腹腔鏡下広汎子宮全摘(LRH)および骨盤リンパ節郭清の5例について
    保坂 昌芳, 工藤 正尊, 森脇 征史, 三田村 卓, 加藤 達矢, 首藤 聡子, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 櫻木 範明 日本産科婦人科内視鏡学会雑誌 24 (1) 123 -123 2008年07月 [査読無し][通常論文]
  • 森脇征史, 工藤正尊, 首藤聡子, 西 信也, 加藤達矢, 和田真一郎, 光部兼六郎, 保坂昌芳, 藤堂幸治, 蝦名康彦, 渡利英道, 大河内俊洋, 水上尚典, 櫻木範明 日本産科婦人科内視鏡學會雜誌 = The journal of the Japan Endoscopy Society of Obstetrics and Gynecology 24 (1) 204 -208 2008年07月 [査読無し][通常論文]
     
    Background: Submucosal myoma has been treated with hysteroscopic transcervical resection (TCR) . However, in cases of unstalked submucosal myoma over 3cm in diameter, TCR could lead to not only extended operation time but also extensive thermal damage on endometrium by electrocoagulation. In this study, we validated the feasibility and utility of total Laparoscopic approach for submucosal myoma treatment.<BR>Materials and Methods: Total laparoscopic myomectomy (TLM) was performed on 12 women with submucosal myoma. Our TLM procedure was as follows: a balloon catheter was detained in the uterine cavity to evaluate the degree of submucosal projection by sonohysterography. Culdotomy was performed to set acrylic vaginal pipe into intraperitoneal cavity as a larger access port. After intramyometrial injection of vasopressin, a transverse incision was made to extract myomas. As myomectomy progressed, endometrium filled with indigocarmine through a detained balloon catheter appeared transparent-blue bulge, which helped easy recognition of endometrial injury. Uterine wall was sutured layer by layer without tucking the endometrium into myometrium. The enucleated nodules were removed via a vaginal pipe.<BR>Results: The median size of dominant submucosal myomas was 5cm, the median blood loss was 120ml and the median operating time was 162 minutes. There was no correlation between the degree of submucosal projection and endometrial defect. Minimal endometrial damage was observed and one of 3 infertile patients was pregnant after surgery.<BR>Conclusion: TLM was feasible in the cases of submucosal myoma as well as intramural and subserosal myomas.
  • 肺動脈に進展した子宮筋腫術後のintravenous leiomyomatosisの1例
    小田 泰也, 蝦名 康彦, 原 洋子, 保坂 昌芳, 小林 範子, 藤堂 幸治, 荒木 直人, 武田 真人, 渡利 英道, 工藤 正尊, 山本 律, 水上 尚典, 櫻木 範明, 日下 剛 日本産科婦人科学会東北連合地方部会誌 (55) 62 -62 2008年06月 [査読無し][通常論文]
  • 後腹膜に発生し付属器腫瘍との鑑別を要したmalignant peripheral sheath tumorの1例
    荒木 直人, 武田 真人, 小田 泰也, 保坂 昌芳, 小林 範子, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 工藤 正尊, 山本 律, 水上 尚典, 櫻木 範明 日本産科婦人科学会東北連合地方部会誌 (55) 70 -70 2008年06月 [査読無し][通常論文]
  • Docetaxel/Gemcitabine療法が奏功した再発子宮内膜間質肉腫の1例
    中谷 真紀子, 蝦名 康彦, 森脇 征史, 保坂 昌芳, 原 洋子, 荒木 直人, 藤堂 幸治, 武田 真人, 渡利 英道, 工藤 正尊, 櫻木 範明, 小田 泰也 日本産科婦人科学会東北連合地方部会誌 (55) 182 -183 2008年06月 [査読無し][通常論文]
  • カルボプラチンの過敏症発現後にシスプラチンの脱感作療法でプラチナを投与し得た卵巣漿液性腺癌3症例
    保坂 昌芳, 渡利 英道, 森脇 征史, 原 洋子, 荒木 直人, 藤堂 幸治, 武田 真人, 蝦名 康彦, 工藤 正尊, 水上 尚典, 櫻木 範明 日本産科婦人科学会東北連合地方部会誌 (55) 191 -191 2008年06月 [査読無し][通常論文]
  • 当科におけるGemcitabineを用いた婦人科再発癌の治療経験
    蝦名 康彦, 森脇 征史, 原 洋子, 保坂 昌芳, 荒木 直人, 藤堂 幸治, 武田 真人, 渡利 英道, 工藤 正尊, 櫻木 範明 日本産科婦人科学会東北連合地方部会誌 (55) 196 -196 2008年06月 [査読無し][通常論文]
  • 当科における婦人科悪性腫瘍に対する鏡視下手術
    工藤 正尊, 保坂 昌芳, 藤堂 幸治, 森脇 征史, 原 洋子, 荒木 直人, 武田 真人, 蝦名 康彦, 渡利 英道, 山本 律, 水上 尚典, 櫻木 範明 日本産科婦人科学会東北連合地方部会誌 (55) 198 -198 2008年06月 [査読無し][通常論文]
  • Clusterinを分子標的とした上皮性卵巣癌細胞におけるパクリタキセル感受性増強効果についての検討
    渡利 英道, Mohamed Hassan, 三田村 卓, 保坂 昌芳, 首藤 聡子, 藤堂 幸治, 武田 真人, 蝦名 康彦, 工藤 正尊, 櫻木 範明 日本婦人科腫瘍学会雑誌 26 (3) 265 -265 2008年06月 [査読無し][通常論文]
  • アポトーシス抑制蛋白clusterinと子宮頸癌の術前化学療法反応性ならびに予後との関連
    保坂 昌芳, 渡利 英道, 鹿沼 達哉, 太田 陽子, 三田村 卓, 首藤 聡子, 武田 真人, 蝦名 康彦, 峰岸 敬, 櫻木 範明 日本婦人科腫瘍学会雑誌 26 (3) 276 -276 2008年06月 [査読無し][通常論文]
  • 14歳の子宮体癌症例の診断と治療
    三田村 卓, 保坂 昌芳, 藤堂 幸治, 首藤 聡子, 武田 真人, 蝦名 康彦, 渡利 英道, 櫻木 範明 日本婦人科腫瘍学会雑誌 26 (3) 284 -284 2008年06月 [査読無し][通常論文]
  • 山田崇弘, 松田貴雄, 工藤正尊, 山田 俊, 森脇征史, 西 信也, 蝦名康彦, 山田秀人, 加藤秀則, 伊藤智雄, 和氣徳夫, 櫻木範明, 水上尚典 日本産科婦人科學會雜誌 60 (3) 999 -999 2008年03月 [査読無し][通常論文]
  • 神経温存広汎子宮全摘後の膀胱機能の検討
    保坂 昌芳, 藤堂 幸治, 小島 崇史, 三田村 卓, 森脇 征史, 大場 洋子, 武田 真人, 蝦名 康彦, 渡利 英道, 工藤 正尊, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 60 (2) 614 -614 2008年02月 [査読無し][通常論文]
  • 広汎子宮全摘術後の持続的な蓄尿機能低下に影響を及ぼす因子の解析
    三田村 卓, 藤堂 幸治, 小島 崇史, 森脇 征史, 保坂 昌芳, 大場 洋子, 武田 真人, 蝦名 康彦, 渡利 英道, 工藤 正尊, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 60 (2) 623 -623 2008年02月 [査読無し][通常論文]
  • 子宮頸癌におけるリンパ節転移例の予後因子についての検討
    小島 崇史, 保坂 昌芳, 三田村 卓, 森脇 征史, 大場 洋子, 藤堂 幸治, 武田 真人, 蝦名 康彦, 渡利 英道, 工藤 正尊, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 60 (2) 623 -623 2008年02月 [査読無し][通常論文]
  • 【快適な術後経過のための工夫と対応】 リンパ節郭清術後のドレナージ
    藤堂 幸治, 森脇 征史, 保坂 昌芳, 原 洋子, 武田 真人, 蝦名 康彦, 渡利 英道, 工藤 正尊, 櫻木 範明 産科と婦人科 75 (2) 176 -181 2008年02月 [査読無し][通常論文]
  • 子宮脱手術後の腟断端脱に対して行ったlaparoscopic sacral colopexy
    藤堂 幸治, 森脇 征史, 保坂 昌芳, 原 洋子, 荒木 直人, 武田 真人, 蝦名 康彦, 渡利 英道, 工藤 正尊, 水上 尚典, 櫻木 範明 北海道産科婦人科学会会誌 52 (1) 35 -35 2008年01月 [査読無し][通常論文]
  • 小児頭大の筋腫核を経腟的に回収しえた腹腔鏡下筋腫核出術の1例
    保坂 昌芳, 工藤 正尊, 森脇 征史, 原 洋子, 荒木 直人, 藤堂 幸治, 武田 真人, 蝦名 康彦, 渡利 英道, 水上 尚典, 櫻木 範明 北海道産科婦人科学会会誌 52 (1) 34 -35 2008年01月 [査読無し][通常論文]
  • 卵巣硬化性間質性腫瘍の一例
    荒木 直人, 武田 真人, 森脇 征史, 原 洋子, 保坂 昌芳, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 工藤 正尊, 山田 秀人, 水上 尚典, 櫻木 範明 北海道産科婦人科学会会誌 52 (1) 44 -45 2008年01月 [査読無し][通常論文]
  • 蝦名康彦, 櫻木範明 産科と婦人科 74 (11) 1491 -1495 2007年11月 [査読無し][招待有り]
  • Carboplatinの急性過敏反応発症後にCisplatinを用いた脱感作療法でプラチナを再投与し得た卵巣癌3症例
    保坂 昌芳, 蝦名 康彦, 森脇 征史, 原 洋子, 荒木 直人, 藤堂 幸治, 武田 真人, 渡利 英道, 櫻木 範明 癌と化学療法 34 (9) 1505 -1508 2007年09月 [査読無し][通常論文]
     
    卵巣癌の標準化学療法はpaclitaxel/carboplatin併用療法である。このregimenは初回治療はもとより、症例によっては再発時にも用いられる。そのため、投与回数が重なった時にcarboplatinの急性過敏症反応を起こすことがある。最近、われわれはcarboplatinによる急性過敏症反応を3症例経験した。症状は頻脈、胸部苦悶感、呼吸困難などであった。そのような症例に対しcisplatinを用いた脱感作療法を行ったところ、全例にプラチナ製剤の再投与が可能であった。この方法は安全で、プラチナ感受性のある症例には有用であると考えられたので報告する。(著者抄録)
  • Hosaka M, Ebina Y, Moriwaki M, Hara Y, Araki N, Todo Y, Takeda M, Watari H, Sakuragi N Gan to kagaku ryoho. Cancer & chemotherapy 34 1505 -1508 2007年09月 [査読有り][通常論文]
  • 肺動脈に進展した子宮筋腫術後のintravenous leiomyomatosisの1例
    小田 泰也, 蝦名 康彦, 原 洋子, 保坂 昌芳, 藤堂 幸治, 荒木 直人, 武田 真人, 渡利 英道, 水上 尚典, 櫻木 範明, 日下 剛 北海道産科婦人科学会会誌 51 (1) 43 -43 2007年06月 [査読無し][通常論文]
  • 骨盤外科における機能温存を目指した手術手技の改良 広汎子宮全摘術における効果的自律神経温存法の確立と鏡視下手術導入の検討
    櫻木 範明, 藤堂 幸治, 渡利 英道, 蝦名 康彦, 武田 真人, 保坂 昌芳, 森脇 征史, 原 洋子, 工藤 正尊 日本外科系連合学会誌 32 (3) 444 -444 2007年06月 [査読無し][通常論文]
  • 婦人科悪性腫瘍における妊孕性温存手術 当科でおこなった浸潤子宮頸癌に対する子宮温存手術(円錐切除と鏡視下リンパ節郭清)
    工藤 正尊, 森脇 征史, 保坂 昌芳, 藤堂 幸治, 武田 真人, 蝦名 康彦, 渡利 英道, 水上 尚典, 櫻木 範明 日本外科系連合学会誌 32 (3) 515 -515 2007年06月 [査読無し][通常論文]
  • 子宮脱手術後の腟断端脱に対して行った腹腔鏡下腟仙骨固定術
    藤堂 幸治, 森脇 征史, 原 洋子, 保坂 昌芳, 荒木 直人, 武田 真人, 蝦名 康彦, 渡利 英道, 工藤 正尊, 水上 尚典, 櫻木 範明 産婦人科手術 (18) 203 -203 2007年06月 [査読無し][通常論文]
  • 系統的骨盤・傍大動脈リンパ節郭清を含む手術療法と術後化学療法による子宮体癌治療後の再発様式
    渡利 英道, 森脇 征史, 保坂 昌芳, 原 洋子, 荒木 直人, 藤堂 幸治, 武田 真人, 蝦名 康彦, 工藤 正尊, 櫻木 範明 日本婦人科腫瘍学会雑誌 25 (3) 256 -256 2007年06月 [査読無し][通常論文]
  • 子宮頸部adenosarcomaの1例
    保坂 昌芳, 武田 真人, 小田 泰也, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 工藤 正尊, 山本 律, 水上 尚典, 櫻木 範明 北海道産科婦人科学会会誌 51 (1) 38 -39 2007年06月 [査読無し][通常論文]
  • 骨盤の局所解剖と機能温存手術 膀胱機能温存を目指した系統的自律神経温存広汎子宮全摘術および術後管理について
    藤堂 幸治, 森脇 征史, 保坂 昌芳, 原 洋子, 武田 真人, 蝦名 康彦, 渡利 英道, 櫻木 範明 日本婦人科腫瘍学会雑誌 25 (3) 188 -189 2007年06月 [査読無し][通常論文]
  • 子宮頸部扁平上皮癌small size症例における病理組織学的予後因子と手術法の検討
    武田 真人, 森脇 征史, 保坂 昌芳, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 櫻木 範明 日本婦人科腫瘍学会雑誌 25 (3) 229 -229 2007年06月 [査読無し][通常論文]
  • 蝦名康彦, 櫻木範明 産婦人科の世界 59 (6) 551 -558 2007年06月 [査読無し][招待有り]
  • 広汎子宮全摘術における系統的自律神経温存法と術後膀胱機能の解析
    藤堂 幸治, 保坂 昌芳, 小田 泰也, 原 洋子, 武田 真人, 蝦名 康彦, 渡利 英道, 工藤 正尊, 櫻木 範明 日本女性骨盤底医学会誌 4 (1) 143 -149 2007年05月 [査読無し][通常論文]
     
    目的:我々は広汎子宮全摘術に下腹神経、骨盤内臓神経、骨盤神経叢およびその膀胱枝の系統的温存を併用してきた。骨盤神経叢子宮枝を選択的に切断し骨盤神経叢と傍腟結合織を分離させる手技が重要である。我々の行う術式の有用性を尿流動態学的検査で検証する。方法:対象は広汎子宮全摘術を行った子宮頸癌49例でA群:系統的自律神経温存を行った43例(1b1期17例、1b2期10例、2a期4例、2b期12例)、B群:系統的自律神経温存を行わなかった6例(1b1期4例、2b期2例)である。術前、術後1、3、6、12ヵ月の各時点において最大尿意時膀胱コンプライアンス(Cves)、最大尿流量率(MFR)、最大尿流量時腹腔内圧(PabdQmax)、最大尿流量時排尿筋圧(PdetQmax)、残尿量(Resid)を求めた。各パラメータの経時的推移はrepeated measure one-way ANOVAで解析し、有意差ありと判定された場合にFisher's protected least significant difference法を用いて各時点間の有意差を検討した。尿意についても評価を行った。成績:年齢、進行期分布、腫瘍径、切除腟長は両群間で差を認めなかった。A群においてCves、MFR、Residは術前と術後12ヵ月の間に差を認めなかった。PabdQmaxは手術により増加、PdetQmaxは低下したが、B群と比較してその影響は有意に小さいことが示された。A群で尿意の異常を認めた例は7%に過ぎなかったが、B群の67%で尿意が減弱した。結論:骨盤神経叢子宮枝を選択的に切断し、骨盤神経叢と傍腟結合織の分離を行う系統的自律神経温存法は切除腟長を縮小することなく膀胱機能温存を可能とするために重要な手技である。(著者抄録)
  • 粘膜下筋腫に対する全腹腔鏡下筋腫核出術
    森脇 征史, 工藤 正尊, 加藤 達矢, 保坂 昌芳, 首藤 聡子, 西 信也, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 田中 信一, 大河内 俊洋, 水上 尚典, 櫻木 範明 日本産科婦人科内視鏡学会雑誌 22 (2) 309 -309 2007年03月 [査読無し][通常論文]
  • 森脇 征史, 渡利 英道, 蝦名 康彦 産婦人科治療 94 (3) 249 -255 2007年03月 [査読無し][通常論文]
  • 子宮頸癌におけるアポトーシス関連蛋白clusterinの発現と予後因子としての有用性に関する臨床病理学的検討
    渡利 英道, 森脇 征史, 保坂 昌芳, 原 洋子, 荒木 直人, 藤堂 幸治, 武田 真人, 蝦名 康彦, 工藤 正尊, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 59 (2) 366 -366 2007年02月 [査読無し][通常論文]
  • リンパ浮腫の複合的理学療法に対する治療効果についての検討
    原 洋子, 小林 範子, 藤野 敬史, 森脇 征史, 保坂 昌芳, 荒木 直人, 藤堂 幸治, 武田 真人, 蝦名 康彦, 渡利 英道, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 59 (2) 419 -419 2007年02月 [査読無し][通常論文]
  • 子宮頸癌術後補助治療としての放射線療法と化学療法の検討
    保坂 昌芳, 武田 真人, 森脇 征史, 原 洋子, 荒木 直人, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 工藤 正尊, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 59 (2) 575 -575 2007年02月 [査読無し][通常論文]
  • 子宮頸部扁平上皮癌(3cm未満)の子宮外進展とそれに関連する病理組織学的予後因子の検討
    武田 真人, 荒木 直人, 森脇 征史, 原 洋子, 保坂 昌芳, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 工藤 正尊, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 59 (2) 581 -581 2007年02月 [査読無し][通常論文]
  • 腹腔鏡下子宮筋腫核出術における筋腫核の経腟的回収についての検討
    森脇 征史, 工藤 正尊, 加藤 達矢, 保坂 昌芳, 首藤 聡子, 西 信也, 藤堂 幸治, 武田 真人, 蝦名 康彦, 渡利 英道, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 59 (2) 643 -643 2007年02月 [査読無し][通常論文]
  • DNAアレイによる子宮頸部擦過細胞診検体および浸潤癌組織検体におけるHPVの検出
    森脇 征史, 渡利 英道, 道又 理恵, 石津 明洋, 小田 泰也, 保坂 昌芳, 藤堂 幸治, 武田 真人, 蝦名 康彦, 櫻木 範明 日本臨床細胞学会雑誌 45 (Suppl.2) 503 -503 2006年09月 [査読無し][通常論文]
  • 保坂 昌芳, 山本 律, 岡元 一平, 小田 泰也, 藤堂 幸治, 武田 真人, 蝦名 康彦, 渡利 英道, 櫻木 範明 産婦人科の実際 55 (8) 1297 -1304 2006年08月 [査読無し][通常論文]
     
    1988〜2001年に妊孕能温存治療を行った悪性卵巣腫瘍50例を対象とし,治療成績,卵巣機能への影響を検討した.初回手術は患側附属器摘出49例,両側腫瘍核出1例であり,片側附属器摘出例中46例に対側卵巣楔状切除,21例に大網切除,17例に後腹膜リンパ節摘出を施行した.33例に術後化学療法を施行し,etoposideを5回以上投与した群では排卵回復までの期間は有意に遅延していた.CAP療法を6コース施行した漿液性腺癌1例では卵巣機能が廃絶した.妊娠を希望した21例中,妊娠は8例に認めた.手術治療のみでも高い治癒率が期待できるIa期,grade 1の上皮性悪性腫瘍や境界悪性腫瘍,抗癌剤感受性の高い悪性胚細胞腫瘍例において,治療が過剰にならないことが妊娠率向上につながると考えられた
  • 子宮体癌III c期の病理組織学的予後因子についての検討
    小田 泰也, 渡利 英道, 藤堂 幸治, 保坂 昌芳, 中郷 賢二郎, 小林 範子, 武田 真人, 蝦名 康彦, 山本 律, 水上 尚典, 櫻木 範明 北海道産科婦人科学会会誌 50 (1) 113 -113 2006年06月 [査読無し][通常論文]
  • HPV感染と子宮頸癌 メンブレンアレイシステムを用いた子宮頸部細胞診検体および浸潤癌組織検体からのHPV検出
    渡利 英道, 武田 真人, 小田 泰也, 保坂 昌芳, 藤堂 幸治, 蝦名 康彦, 櫻木 範明 日本婦人科腫瘍学会雑誌 24 (3) 213 -213 2006年06月 [査読無し][通常論文]
  • 子宮頸部腺癌における血清腫瘍マーカー値・腫瘍径とリンパ節転移との関連について
    保坂 昌芳, 武田 真人, 中郷 賢二郎, 小田 泰也, 小林 範子, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 工藤 正尊, 山本 律, 水上 尚典, 櫻木 範明 北海道産科婦人科学会会誌 50 (1) 106 -107 2006年06月 [査読無し][通常論文]
  • 子宮頸癌の広汎子宮全摘術後ハイリスク症例に対する補助療法の検討
    保坂 昌芳, 武田 真人, 小田 泰也, 原 洋子, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 櫻木 範明 日本婦人科腫瘍学会雑誌 24 (3) 300 -300 2006年06月 [査読無し][通常論文]
  • 子宮体癌手術におけるリンパ節郭清の個別化 術前リンパ節転移予測スコア妥当性の研究
    藤堂 幸治, 小田 泰也, 保坂 昌芳, 武田 真人, 蝦名 康彦, 渡利 英道, 櫻木 範明 日本婦人科腫瘍学会雑誌 24 (3) 305 -305 2006年06月 [査読無し][通常論文]
  • 久保田 佳奈子, 武田 広子, 小田 泰也, 蝦名 康彦, 尾松 徳彦, 伊藤 智雄 診断病理 : Japanese journal of diagnostic pathology 23 (2) 160 -163 2006年04月30日 [査読無し][通常論文]
  • DNA array法による子宮頸部細胞診検体および子宮頸部浸潤癌組織検体中のヒトパピローマウイルス(HPV)の検出
    渡利 英道, 小田 泰也, 保坂 昌芳, 原 洋子, 荒木 直人, 藤堂 幸治, 武田 真人, 蝦名 康彦, 工藤 正尊, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 58 (2) 374 -374 2006年02月 [査読無し][通常論文]
  • Weekly paclitaxel/5-fluorouracil併用療法を用いplatinum-free intervalを考慮した再発・抵抗性卵巣漿液性腺癌に対する治療成績
    保坂 昌芳, 渡利 英道, 小田 泰也, 原 洋子, 荒木 直人, 藤堂 幸治, 武田 真人, 蝦名 康彦, 工藤 正尊, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 58 (2) 431 -431 2006年02月 [査読無し][通常論文]
  • 子宮頸癌に対するRetroperitoneal approachによる鏡視下リンパ節郭清
    工藤 正尊, 保坂 昌芳, 藤堂 幸治, 武田 真人, 蝦名 康彦, 渡利 英道, 山本 律, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 58 (2) 602 -602 2006年02月 [査読無し][通常論文]
  • 子宮体癌手術におけるリンパ節郭清術適応の個別化 術前リンパ節転移予測スコア(LNM score)のValidation Study
    藤堂 幸治, 小田 泰也, 保坂 昌芳, 原 洋子, 荒木 直人, 武田 真人, 蝦名 康彦, 渡利 英道, 工藤 正尊, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 58 (2) 606 -606 2006年02月 [査読無し][通常論文]
  • 再発卵巣癌の手術治療計画におけるFDG-PETの有用性と限界について
    小田 泰也, 蝦名 康彦, 原 洋子, 保坂 昌芳, 藤堂 幸治, 荒木 直人, 武田 真人, 渡利 英道, 工藤 正尊, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 58 (2) 627 -627 2006年02月 [査読無し][通常論文]
  • 子宮頸部扁平上皮癌における術前検査とNAC
    武田 真人, 小田 泰也, 原 洋子, 保坂 昌芳, 荒木 直人, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 工藤 正尊, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 58 (2) 592 -592 2006年02月 [査読無し][通常論文]
  • 蝦名 康彦 日本産科婦人科學會雜誌 58 (2) 429 -429 2006年02月01日 [査読無し][通常論文]
  • 蝦名 康彦, 小田 泰也, 保坂 正芳, 原 洋子, 藤堂 幸治, 荒木 直人, 武田 真人, 渡利 英道, 櫻木 範明 日本婦人科腫瘍学会雑誌 = The journal of the Japan Society of Gynecologic Oncology 24 (1) 53 -58 2006年01月25日 [査読有り][通常論文]
  • 卵巣原発扁平上皮癌の1例
    寺島 瑞恵, 藤堂 幸治, 明石 大輔, 見延 進一郎, 小林 範子, 藤本 俊郎, 蝦名 康彦, 渡利 英道, 山本 律, 櫻木 範明 北海道産科婦人科学会会誌 49 (1) 38 -38 2006年01月 [査読無し][通常論文]
  • 子宮頸部腺癌における血清腫瘍マーカー値・腫瘍径とリンパ節転移との関連について
    保坂 昌芳, 武田 真人, 中郷 賢二郎, 小田 泰也, 小林 範子, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 工藤 正尊, 山本 律, 水上 尚典, 櫻木 範明 日本産科婦人科学会東北連合地方部会誌 (53) 78 -78 2005年11月 [査読無し][通常論文]
  • 子宮体癌III c期の病理組織学的予後因子についての検討
    小田 泰也, 渡利 英道, 藤堂 幸治, 保坂 昌芳, 中郷 賢二郎, 小林 範子, 武田 真人, 蝦名 康彦, 山本 律, 水上 尚典, 櫻木 範明 日本産科婦人科学会東北連合地方部会誌 (53) 83 -83 2005年11月 [査読無し][通常論文]
  • 蝦名 康彦, 櫻木 範明 臨床婦人科産科 59 (11) 1482 -1487 2005年11月 [査読無し][招待有り]
  • 子宮体癌におけるCyr61の発現について
    渡利 英道, 熊 桜, 保坂 昌芳, 藤堂 幸治, 武田 真人, 蝦名 康彦, 山本 律, 櫻木 範明 日本婦人科腫瘍学会雑誌 23 (3) 354 -354 2005年06月 [査読無し][通常論文]
  • 広汎子宮全摘術における膀胱機能温存法
    藤堂 幸治, 武田 真人, 蝦名 康彦, 渡利 英道, 山本 律, 工藤 正尊, 水上 尚典, 櫻木 範明 産婦人科手術 (16) 138 -138 2005年06月 [査読無し][通常論文]
  • DNAarray法による子宮頸癌検体中ヒトパピローマウイルスの検出
    保坂 昌芳, 渡利 英道, 藤堂 幸治, 武田 真人, 蝦名 康彦, 山本 律, 櫻木 範明 日本婦人科腫瘍学会雑誌 23 (3) 352 -352 2005年06月 [査読無し][通常論文]
  • 当科で経験した婦人科悪性腫瘍の脳転移症例の検討
    小田 泰也, 武田 真人, 保坂 昌芳, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 山本 律, 櫻木 範明 日本婦人科腫瘍学会雑誌 23 (3) 356 -356 2005年06月 [査読無し][通常論文]
  • 再発・抵抗性卵巣癌に対するweekly paclitaxel/5-fluorouracil併用療法のfeasibility study
    中郷 賢二郎, 渡利 英道, 小田 泰也, 保坂 昌芳, 藤堂 幸治, 武田 真人, 蝦名 康彦, 山本 律, 櫻木 範明 日本婦人科腫瘍学会雑誌 23 (3) 365 -365 2005年06月 [査読無し][通常論文]
  • 当科における子宮頸部Bulky扁平上皮癌に対する広汎子宮全摘手術療法の治療成績
    武田 真人, 小田 泰也, 保坂 昌芳, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 山本 律, 櫻木 範明 日本婦人科腫瘍学会雑誌 23 (3) 374 -374 2005年06月 [査読無し][通常論文]
  • 妊娠中に子宮頸部悪性腺腫の合併を疑った症例
    藤堂 幸治, 保坂 昌芳, 武田 真人, 蝦名 康彦, 渡利 英道, 山本 律, 櫻木 範明 日本婦人科腫瘍学会雑誌 23 (3) 387 -387 2005年06月 [査読無し][通常論文]
  • 蝦名 康彦, 櫻木 範明 産婦人科治療 90 (6) 989 -995 2005年06月 [査読無し][招待有り]
  • 当科で経験した子宮体部癌肉腫の3例
    小田 泰也, 武田 真人, 保坂 昌芳, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 櫻木 範明, 太田 聡, 伊藤 智雄 日本臨床細胞学会雑誌 44 (Suppl.1) 135 -135 2005年03月 [査読無し][通常論文]
  • 当科で経験した卵管癌の4例
    石川 聡司, 武田 真人, 小田 泰也, 保坂 昌芳, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 櫻木 範明, 太田 聡, 伊藤 智雄 日本臨床細胞学会雑誌 44 (Suppl.1) 144 -144 2005年03月 [査読無し][通常論文]
  • 広汎子宮全摘術における新しい系統的自律神経温存法と術後膀胱機能の解析
    藤堂 幸治, 武田 真人, 小林 範子, 蝦名 康彦, 渡利 英道, 工藤 正尊, 山本 律, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 57 (2) 422 -422 2005年02月 [査読無し][通常論文]
  • p53癌抑制遺伝子のdominant negative変異は進行子宮体癌の予後因子である
    董 培新, 渡利 英道, 蝦名 康彦, 山本 律, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 57 (2) 448 -448 2005年02月 [査読無し][通常論文]
  • 再発・抵抗性卵巣癌に対するweekly paclitaxel/5-fluorouracil併用療法のfeasibility study
    渡利 英道, 小田 泰也, 根岸 広明, 山村 満恵, 保坂 昌芳, 小林 範子, 藤堂 幸治, 武田 真人, 蝦名 康彦, 山本 律, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 57 (2) 455 -455 2005年02月 [査読無し][通常論文]
  • 卵巣悪性腫瘍(境界悪性腫瘍を含む)に対する妊孕能温存治療の臨床的検討
    保坂 昌芳, 山本 律, 小田 泰也, 小林 範子, 藤堂 幸治, 武田 真人, 蝦名 康彦, 渡利 英道, 工藤 正尊, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 57 (2) 619 -619 2005年02月 [査読無し][通常論文]
  • 婦人科癌再発症例の治療方針決定に際してFDG-PETは有用か?
    蝦名 康彦, 小田 泰也, 保坂 昌芳, 小林 範子, 藤堂 幸治, 武田 真人, 渡利 英道, 工藤 正尊, 山本 律, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 57 (2) 633 -633 2005年02月 [査読無し][通常論文]
  • 当科におけるBulky子宮頸部扁平上皮癌に対する広汎子宮全摘手術療法の治療成績
    武田 真人, 小田 泰也, 保坂 昌芳, 小林 範子, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 工藤 正尊, 山本 律, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 57 (2) 423 -423 2005年02月 [査読無し][通常論文]
  • 蝦名 康彦 北海道醫學雜誌 = Acta medica Hokkaidonensia 80 (1) 169 -171 2005年01月01日 [査読無し][通常論文]
  • Ebina Y, Yamamoto R, Sakuragi N Nihon rinsho. Japanese journal of clinical medicine 62 Suppl 10 565 -569 2004年10月 [査読有り][通常論文]
  • 癌治療とクリニカルPET 卵巣癌再発診断におけるFDG-PETの有用性に関する検討
    蝦名 康彦, 中郷 賢二郎, 小田 泰也, 小林 範子, 藤堂 幸治, 武田 真人, 渡利 英道, 工藤 正尊, 山本 律, 水上 尚典, 櫻木 範明 日本癌治療学会誌 39 (2) 401 -401 2004年09月 [査読無し][通常論文]
  • 脈管侵襲と傍大動脈リンパ節転移部位数による子宮体癌III c期の予後層別化
    渡利 英道, 藤堂 幸治, 保坂 昌芳, 中郷 賢二郎, 小田 泰也, 小林 範子, 武田 真人, 蝦名 康彦, 山本 律, 水上 尚典, 櫻木 範明 日本癌治療学会誌 39 (2) 851 -851 2004年09月 [査読無し][通常論文]
  • 当科で経験した子宮頸部乳頭状扁平上皮癌の2例
    保坂 昌芳, 武田 真人, 小田 泰也, 見延 進一郎, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 櫻木 範明, 太田 聡, 伊藤 智雄 日本臨床細胞学会雑誌 43 (Suppl.2) 481 -481 2004年09月 [査読無し][通常論文]
  • 子宮体部小細胞癌の一例
    藤堂 幸治, 武田 真人, 蝦名 康彦, 渡利 英道, 山本 律, 櫻木 範明 日本臨床細胞学会雑誌 43 (Suppl.2) 497 -497 2004年09月 [査読無し][通常論文]
  • 系統的自律神経温存広汎子宮全摘術と術前・術後の尿流動態学的検討
    藤堂 幸治, 佐々木 瑞恵, 小林 範子, 武田 真人, 蝦名 康彦, 渡利 英道, 工藤 正尊, 山本 律, 櫻木 範明 日本外科系連合学会誌 29 (3) 593 -593 2004年06月 [査読無し][通常論文]
  • 小腸原発Gastrointestinal stromal tumor(GIST)の一例
    藤堂 幸治, 武田 真人, 蝦名 康彦, 渡利 英道, 山本 律, 櫻木 範明 日本婦人科腫瘍学会雑誌 22 (3) 246 -246 2004年06月 [査読無し][通常論文]
  • 当科で経験した子宮頸部乳頭状扁平上皮癌の4例
    武田 真人, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 山本 律, 櫻木 範明 日本婦人科腫瘍学会雑誌 22 (3) 211 -211 2004年06月 [査読無し][通常論文]
  • 脈管侵襲と傍大動脈リンパ節転移部位数は子宮体癌IIIc期の予後因子である
    渡利 英道, 藤堂 幸治, 武田 真人, 蝦名 康彦, 山本 律, 櫻木 範明 日本婦人科腫瘍学会雑誌 22 (3) 227 -227 2004年06月 [査読無し][通常論文]
  • 卵巣癌再発診断におけるFDG-PETの有用性に関する検討
    蝦名 康彦, 藤堂 幸治, 武田 真人, 渡利 英道, 山本 律, 櫻木 範明 日本婦人科腫瘍学会雑誌 22 (3) 233 -233 2004年06月 [査読無し][通常論文]
  • 蝦名 康彦, 藤堂 幸治, 武田 真人, 渡利 英道, 山本 律, 櫻木 範明 日本臨床細胞学会雑誌 43 (1) 2004年05月22日 [査読無し][通常論文]
  • 系統的自律神経温存広汎子宮全摘術と術前・術後の尿流動態学的検討
    藤堂 幸治, 寺島 瑞恵, 小林 範子, 武田 真人, 蝦名 康彦, 渡利 英道, 工藤 正尊, 山本 律, 水上 尚典, 櫻木 範明 日本ウロギネコロジー研究会誌 1 (1) 37 -37 2004年05月 [査読無し][通常論文]
  • 直腸子宮内膜症に発生した類内膜腺癌に子宮体部類内膜腺癌を同時発生した一例
    藤堂 幸治, 寺島 瑞恵, 明石 大輔, 見延 進一郎, 小林 範子, 藤本 俊郎, 武田 真人, 蝦名 康彦, 渡利 英道, 山本 律, 櫻木 範明 日本産科婦人科学会東北連合地方部会誌 (51) 113 -114 2004年03月 [査読無し][通常論文]
  • 卵巣腫瘍との鑑別が困難であった小腸Gastrointestinal stromal tumor(GIST)の二症例
    寺島 瑞恵, 藤堂 幸治, 小林 範子, 見延 進一郎, 藤本 俊郎, 武田 真人, 蝦名 康彦, 渡利 英道, 工藤 正尊, 山本 律, 水上 尚典, 櫻木 範明 日本産科婦人科学会東北連合地方部会誌 (51) 119 -119 2004年03月 [査読無し][通常論文]
  • 卵巣癌再発におけるFDG-PETの有用性
    明石 大輔, 蝦名 康彦, 小林 範子, 見延 進一郎, 藤本 俊郎, 藤堂 幸治, 武田 真人, 渡利 英道, 工藤 正尊, 山本 律, 水上 尚典, 櫻木 範明 日本産科婦人科学会東北連合地方部会誌 (51) 122 -122 2004年03月 [査読無し][通常論文]
  • 卵巣癌再発診断におけるFDG-PETの有用性に関する検討
    蝦名 康彦, 明石 大輔, 寺島 瑞恵, 小林 範子, 池田 研, 藤堂 幸治, 武田 真人, 渡利 英道, 工藤 正尊, 山本 律, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 56 (2) 312 -312 2004年02月 [査読無し][通常論文]
  • 子宮頸部腺癌における血清腫瘍マーカー値・腫瘍径とリンパ節転移との関連について
    武田 真人, 明石 大輔, 寺島 瑞恵, 小林 範子, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 工藤 正尊, 山本 律, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 56 (2) 550 -550 2004年02月 [査読無し][通常論文]
  • 初期卵巣癌におけるリンパ節転移について
    根岸 広明, 武田 真人, 藤本 俊郎, 見延 進一郎, 小林 範子, 渡利 英道, 蝦名 康彦, 山本 律, 津村 宣彦, 水上 尚典, 櫻木 範明 日本産科婦人科学会雑誌 56 (2) 581 -581 2004年02月 [査読無し][通常論文]
  • 子宮頸部小細胞癌2例の検討
    藤本 俊郎, 見延 進一郎, 武田 真人, 藤堂 幸治, 蝦名 康彦, 渡利 英道, 櫻木 範明 日本臨床細胞学会雑誌 42 (Suppl.2) 417 -417 2003年09月 [査読無し][通常論文]
  • 子宮頸部に浸潤した急性骨髄性白血病の一例
    武田 真人, 太田 聡, 伊藤 智雄, 見延 進一郎, 藤堂 幸治, 藤本 俊郎, 蝦名 康彦, 渡利 英道, 櫻木 範明 日本臨床細胞学会雑誌 42 (Suppl.2) 421 -421 2003年09月 [査読無し][通常論文]
  • 卵巣原発扁平上皮癌の一例
    藤堂 幸治, 蝦名 康彦, 寺島 瑞恵, 藤本 俊郎, 武田 真人, 渡利 英道, 櫻木 範明 日本臨床細胞学会雑誌 42 (Suppl.2) 514 -514 2003年09月 [査読無し][通常論文]
  • 卵巣腫瘍との鑑別が困難であった小腸原発gastrointestinal stromal tumor(GIST)の一例
    寺島 瑞恵, 藤堂 幸治, 藤本 俊郎, 武田 真人, 蝦名 康彦, 渡利 英道, 櫻木 範明 日本臨床細胞学会雑誌 42 (Suppl.2) 520 -520 2003年09月 [査読無し][通常論文]
  • 卵巣悪性腫瘍(境界悪性腫瘍を含む)における妊孕能温存症例の臨床的検討
    山本 律, 見延 進一郎, 小林 範子, 藤本 俊郎, 武田 真人, 蝦名 康彦, 渡利 英道, 工藤 正尊, 岡元 一平, 晴山 仁志, 水上 尚典, 櫻木 範明 日本癌治療学会誌 38 (2) 241 -241 2003年09月 [査読無し][通常論文]
  • 子宮頸部初期浸潤癌における脈管侵襲及びリンパ節転移の検討
    蝦名 康彦, 岡元 一平, 小林 範子, 藤堂 幸治, 藤本 俊郎, 見延 進一郎, 武田 真人, 渡利 英道, 山本 律, 水上 尚典, 櫻木 範明 日本癌治療学会誌 38 (2) 372 -372 2003年09月 [査読無し][通常論文]
  • 子宮体癌リンパ節転移陽性例の予後因子
    渡利 英道, 藤堂 幸治, 見延 進一郎, 小林 範子, 藤本 俊郎, 武田 真人, 蝦名 康彦, 工藤 正尊, 山本 律, 水上 尚典, 櫻木 範明 日本癌治療学会誌 38 (2) 709 -709 2003年09月 [査読無し][通常論文]
  • 藤本 俊郎, 蝦名 康彦, 山本 律 産婦人科の実際 52 (9) 1289 -1299 2003年09月
  • 腫瘍マーカーは婦人科腫瘍の診断と治療にどのくらい有益か? 子宮頸部扁平上皮癌における血清腫瘍マーカー値・腫瘍径とリンパ節転移との関連についての検討
    武田 真人, 藤本 俊郎, 蝦名 康彦, 渡利 英道, 山本 律, 櫻木 範明 日本婦人科腫瘍学会雑誌 21 (3) 169 -169 2003年06月 [査読無し][通常論文]
  • 蝦名 康彦, 山田 秀人, 平山 恵美, 山本 律, 櫻木 範明, 藤本 征一郎 日本産科婦人科學會雜誌 54 (11) 1525 -1525 2002年11月01日 [査読無し][通常論文]
  • 蝦名 康彦, 白川 洋三, 日野 順子, 佐々木 隆之, 小葉松 洋子, 清野 邦義, 菊池 浩吉 日本臨床細胞学会雑誌 41 (1) 2002年03月22日 [査読無し][通常論文]
  • T. Ishikawa, S. Kawahara, T. Saito, H. Otsuka, O. Kemmotsu, E. Hirayama, Y. Ebina, S. Fujimoto, T. Inoue, T. Koyama Japanese Journal of Anesthesiology 50 (9) 991 -997 2001年 [査読有り][通常論文]
     
    We experienced anesthetic management for ECT in a patient with psychiatric disease during the third trimester of pregnancy. The 24 year-old patient had been on oral antipsychotics prescribed to treat schizophrenia for ten years. Her signs and symptoms deteriorated during pregnancy in spite of increased doses of antipsychotics. With tocolytic agent administered intravenously, anesthesia was induced by intravenous thiamylal immediately followed by intravenous suxamethonium for muscle relaxation. Alternative current was applied on both side of the head after the sufficient anesthesia had been obtained. The patient received intermittent mandatory ventilation by breathing mask with 100% oxygen during the procedure. Along with monitoring of maternal hemodynamic variables and arterial oxygen saturation (Spo2), fetal heart rate and uterine contraction were recorded by cardiotocogram throughout the procedure. At the first two treatments, the patient showed neither significant uterine contraction nor fetal heart rate changes. At the third treatment, continuous uterine contraction refractory to tocolysis was recorded for six minutes, resulting in fetal bradycardia. At the sixth treatment, general anesthesia was induced and maintained by sevoflurane in oxygen followed by suxamethonium for muscle relaxation. The uterine contraction was remarkably diminished and fetal heart rate remained unchanged during the procedure. In conclusion, inhalation anesthesia is beneficial for ECT in the last stage of pregnancy to reduce uterine contraction by potential uterine relaxation effect of anesthetics.
  • 蝦名 康彦, 佐川 正, 藤本 征一郎 産婦人科の実際 50 (1) 5 -12 2001年01月 [査読無し][招待有り]
  • 蝦名 康彦, 山田 秀人, 平山 恵美, 和田 真一郎, 岸田 達朗, 長 和俊, 藤本 征一郎 日本産婦人科・新生児血液学会誌 = The Japanese journal of obstetrical, gynecological & neonatal hematology 10 (1) S83 -S84 2000年05月01日 [査読無し][通常論文]
  • N Kobayashi, H Yamada, T Kishida, EH Kato, Y Ebina, N Sakuragi, G Kobashi, A Tsutsumi, S Fujimoto AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY 42 (3) 153 -159 1999年09月 [査読無し][通常論文]
     
    PROBLEM: The aim of this study was to elucidate fetomaternal risks in systemic lupus erythematosus (SLE)-complicated pregnancy. METHOD OF STUDY: Pregnancy course, complications, and fetal outcome in 82 pregnancies of 55 patients with SLE were investigated. RESULTS: These 82 pregnancies resulted in 14 fetal losses and 66 live births. Without clinical manifestation of SLE-flare, 4 of 8 patients who had low serum complement activity during the pregnancies delivered small-for-date neonates. The rate of the intrauterine growth retardation was significantly higher than that observed in pregnancies with normal complement activity. The frequency of premature deliveries (60%) in patients who received more than 15 mg/day of prednisolone was significantly high when compared with pregnancies maintained by 0-15 mg/day (13.1%). CONCLUSIONS: These data demonstrate the preconceptional and perinatal management necessary in SLE and suggest that the pregnancy with hypocomplementemia, the disease activity, and/or a relatively high maintenance dose of corticosteroid should be carefully managed and monitored.
  • 山崎 綾野, 山田 秀人, 平山 恵美, 蝦名 康彦, 岸田 達朗, 根岸 広明, 佐川 正, 藤本 征一郎 日本産科婦人科學會雜誌 51 (3) 150 -154 1999年03月01日 [査読無し][通常論文]
     
    Three cases of congenital Cytomegalovirus (CMV) infection were perinatally managed in Hokkaido University Hospital. In case 1, prenatal CT and MRI revealed dilation of ventlicles and calcification in the peliventriculararea. A male infant weighing 3,020g was born at 39 weeks of gestation (GW). He is 9 years old and has a severe hearing problem. In case 2, by prenatal ultrasound examinations, IUGR, dilation of ventricles, and hepatosplenomegaly were detected. A male infant weighing 1,800g was born at 38 GW, and died at 5 months after birth. Fetal ascites was first detected at 25 GW in case 3. Immunoglobulin (2.5g) was directly infused in to the fetal peritoneal cavity at 28 and 29 GW. At 34 GW, a male infant weighing 2,340g was born by cesarean section due to fetal distress. CMV DNA detected by PCR turned negative in neonatal ascites. He is 1 year old and has noneurological abnormality. Direct fetal infusion of immunoglobulin may be beneficial in treating congenital CMV infection.
  • 星 信彦, 晴山 仁志, 北澤 克彦, 和田 真一郎, 佐藤 修, 蝦名 康彦, 山田 秀人, 佐川 正, 山本 律, 奥山 和彦, 藤野 敬史, 櫻木 範明, 藤本 征一郎 日本産科婦人科學會雜誌 51 (0) "S -275" 1999年02月20日 [査読無し][通常論文]
  • 山田 秀人, 平山 恵美, 岸田 達朗, 蝦名 康彦, 藤本 征一郎 日本産科婦人科學會雜誌 51 (0) "S -491" 1999年02月20日 [査読無し][通常論文]
  • 蝦名康彦 産婦人科治療 79 661 -670 1999年 [査読無し][招待有り]
  • 蝦名 康彦, 櫻木 範明, 小林 範子, 桑原 道弥, 藤野 敬史, 藤本 征一郎 日本臨床細胞学会雑誌 37 (1) 1998年03月22日 [査読無し][通常論文]
  • 蝦名 康彦, 藤野 敬史, 古田 伊津子, 山田 秀人, 山本 律, 櫻木 範明, 藤本 征一郎 日本産科婦人科學會雜誌 50 (0) "S -263" 1998年02月20日 [査読無し][通常論文]
  • 櫻木 範明, 蝦名 康彦, 晴山 仁志, 藤野 敬史, 山本 律, 及川 衛, 涌井 之雄, 十亀 真志, 八重樫 稔, 桑原 道弥, 牧野 田知, 藤本 征一郎 日本臨床細胞学会雑誌 36 (1) 1997年03月 [査読無し][通常論文]
  • 山本 律, 蝦名 康彦, 保坂 昌芳, 藤野 敬史, 櫻木 範明, 牧野田 知, 藤本 征一郎 日本産科婦人科學會雜誌 49 (0) "S -306" 1997年02月20日 [査読無し][通常論文]
  • 蝦名 康彦, 藤野 敬史, 古田 伊都子, 牧野田 知, 藤本 征一郎 日本産科婦人科學會雜誌 49 (0) "S -403" 1997年02月20日 [査読無し][通常論文]
  • 蝦名康彦 産婦人科の実際 46 313 -319 1997年 [査読無し][招待有り]
  • 蝦名 康彦, 晴山 仁志, 古屋 充子, 八重樫 稔, 渡利 英道, 香城 恒麿, 十亀 真志, 牧野田 知, 藤本 征一郎, 荒川 三紀雄, 藤田 美悧, 井上 和秋 日本臨床細胞学会雑誌 35 (2) 1996年09月 [査読無し][通常論文]
  • 府中 基伸, 石倉 浩, 蝦名 康彦, 市村 英毅, 高橋 麻美, 吉木 敬 日本臨床細胞学会雑誌 35 (1) 1996年03月22日 [査読無し][通常論文]

書籍等出版物

  • 母性看護学① 概論・リプロダクティブヘルスと看護
    中込さと子編 (担当:共著範囲:性・生殖に関する生理)
    メディカ出版，大阪 2023年04月
  • 竹下, 俊行, 藤井, 知行, 山田, 秀人 (担当:共著範囲:先天性アンチトロンビン欠乏症)
    メジカルビュー社 2021年01月 (ISBN: 9784758319966) x, 237p
  • 日本産科婦人科学会 (担当:共著範囲:転移性腫瘍)
    日本産科婦人科学会事務局 2020年11月 (ISBN: 9784907890223) 1冊
  • 読める生かせる説明できる産科の臨床検査ディクショナリー
    蝦名 康彦 (担当:共著範囲:自己抗体検査、サイトメガロウイルス抗体、ヒトパルボウイルスB19)
    メディカ出版 2018年11月
  • 実践 臨床生殖免疫学
    蝦名 康彦 (担当:共著範囲:妊娠と感染症 パルボウイルスB19)
    中外医学社 2018年05月
  • 不妊・不育診療指針
    蝦名 康彦 (担当:共著範囲:不妊治療と妊娠 NIPT)
    中外医学社 2016年11月
  • 患者さんとご家族のための子宮頸がん・子宮体がん・卵巣がん治療ガイドライン 第２版
    蝦名 康彦 (担当:分担執筆範囲:卵巣がん～プラチナ抵抗性再発～)
    金原出版 2016年02月
  • 婦人科癌診療Q&A～一つ上を行く診療の実践～
    蝦名 康彦 (担当:分担執筆範囲:子宮頸癌の罹患率、死亡率の推移について教えてください。)
    中外医学社 2014年04月
  • 腫瘍減量手術に適する再発卵巣癌患者の選択におけるFDG-PETの意義
    蝦名 康彦 (担当:単著)
    メディカルレビュー社 2014年03月
  • 産科の臨床検査ディクショナリー
    蝦名 康彦 (担当:分担執筆範囲:サイトメガロウイルス抗体，ヒトパルボウイルスB19)
    メディカ出版 2014年01月
  • 内科 増大号 検査値を読む
    蝦名 康彦 (担当:分担執筆範囲:ヒト絨毛性ゴナドトロピン)
    2013年
  • EBM 婦人科疾患の治療
    蝦名 康彦 (担当:分担執筆範囲:子宮体癌：再発癌に対して推奨される化学療法とは？)
    中外医学社 2013年
  • プロメテウス婦人科がん最新医療
    蝦名 康彦 (担当:分担執筆範囲:子宮体がんにおける妊孕性温存と妊娠への影響)
    金原出版 2013年
  • The management of antiphospholipid antibodies affected pregnancy
    谷村憲司 (担当:分担執筆範囲:Antiphospholipid Syndrome)
    InTech-Open Access Publisher 2012年
  • A Smarter Path; Dhiscovery PET/CT
    蝦名 康彦 (担当:分担執筆範囲:腫瘍領域における患者のためのPET/CT活用法)
    メテオエイト（東京 2012年
  • 腹式単純子宮全摘術．「子宮筋腫の臨床」平松祐司編集
    メジカルビュー社 2008年
  • 進行・再発癌に対する化学療法．「婦人科がん標準化学療法の実際」宇田川康博，八重樫伸生編集
    金原出版 2008年
  • PET/CT 画像診断のポイント 婦人科癌
    メディカルレビュー社 2007年
  • 婦人科腫瘍におけるPET 検査．「産婦人科・専門医に聞く最新の医療」鈴木光明，吉村泰典編集
    中外医学社 2007年
  • 卵巣癌の妊孕能温存手術，「よくわかる卵巣癌のすべて」安田 允編集
    永井書店 2007年
  • 第二次腫瘍縮小手術の意義．「先端医療シリーズ39産科婦人科の最新医療」武谷雄二編集主幹
    先端医療技術研究社 2006年
  • 18F-fluoro-deoxyglucose positron emission tomography for the detection of recurrent ovarian cancer. 「PET and Molecular Imaging, State of the art and future perspectives. International Congress Series 1264」
    ELSEVIER 2004年
  • 卵巣癌と境界悪性腫瘍の最新の治療「卵巣腫瘍病理アトラス」，石倉浩編集
    文光堂 2004年
  • 超音波断層法（婦人科）「Newエッセンシャル産科学・婦人科学第３版」，池ノ上克共編
    医師薬出版株式会社 2004年
  • The presence of high-risk HPV in cervical dysplastic cells is associated with clinical course: long-term follow-up. 「9th biennial meeting of the international gynecologic cancer society」, ed by Mok JE, Quinn MA, Namkoog SE, Kim YT
    Monduzzi Editore 2002年
  • 母子感染 サイトメガロウイルス 「図説産婦人科VIEW 38，母子感染」
    メジカルビュー社 2000年
  • 常染色体転座保因者・染色体異常モザイク「周産期遺伝相談」
    医学書院 2000年
  • 産婦人科とジェネテイクス 「Modern Reproductivity Medicine 3, 生殖ジェネテイクス〜ART向上のための遺伝子学〜」
    メジカルビュー社 1999年

講演・口頭発表等

  • 人生100年時代のリプロダクティブ・ヘルス/ライツとライフプラン  [招待講演]
    蝦名康彦
    港区立男女平等参画センター「リーブラ」講演会 2023年01月
  • 【教育講演】大学生の子宮頸がん予防に対する意識と健康教育としての対応  [招待講演]
    蝦名康彦
    第41回 北海道臨床細胞学会学術集会 2021年11月 口頭発表（招待・特別）
  • 【CloCMip関連研修】母体の感染（リスクと対応）  [招待講演]
    北海道看護協会 助産師職能研修会 2021年10月 公開講演，セミナー，チュートリアル，講習，講義等
  • 【教育講演】卵巣がん治療・研究における腹水の可能性  [招待講演]
    蝦名康彦
    第59回日本臨床細胞学会秋季大会 2020年11月 口頭発表（招待・特別）
  • 産婦人科と血栓性素因  [招待講演]
    第10回神戸シンポジア 2019年03月
  • 産婦人科と血栓性素因  [招待講演]
    蝦名 康彦
    第８回神戸産婦人科臨床フォーラム 2018年01月 口頭発表（招待・特別）
  • 性分化疾患のケアと治療～ライフステージに寄り添いながら～  [招待講演]
    蝦名 康彦
    第58回 日本母性衛生学会総会 2017年10月 口頭発表（招待・特別）
  • 産婦人科と血栓性素因  [招待講演]
    蝦名 康彦
    第７回北海道産婦人科周術期合併症研究会 2017年08月 口頭発表（招待・特別）
  • 病態の理解を深めよう～婦人科がん～  [招待講演]
    蝦名 康彦
    兵庫県臨床検査技師会 新春セミナー 2017年01月 口頭発表（招待・特別）
  • シンポジウム「母子感染対策の最前線2016年」本邦におけるパルボウイルスB19母子感染の実態  [招待講演]
    蝦名 康彦
    第52回日本周産期・新生児医学会総会・学術集会 2016年07月 シンポジウム・ワークショップパネル（指名）
  • ワークショップ「母子感染予防に関する最近の話題」本邦におけるパルボウイルスB19母子感染の実態  [招待講演]
    蝦名 康彦
    第26回日本産婦人科・新生児血液学会学術集会 2016年06月 シンポジウム・ワークショップパネル（指名）
  • 婦人科再発癌手術を考える  [招待講演]
    蝦名 康彦
    第４回高知産婦人科周術期セミナー 2016年02月 口頭発表（招待・特別）
  • 再発卵巣癌化学療法のエビデンスと現状  [招待講演]
    蝦名 康彦
    中外婦人科腫瘍セミナー 2016年02月 口頭発表（招待・特別）
  • 子宮頸部無形成・双角子宮症例に対する形成術～頸部瘢痕組織を利用する工夫～  [通常講演]
    蝦名康彦, 村田友香, 田中恵里加, 森田宏紀, 山田秀人
    第38回日本産婦人科手術学会 2015年11月 シンポジウム・ワークショップパネル（公募）
  • 【教育講演】 今さら聞けない、子宮頸部の病理と臨床  [招待講演]
    蝦名 康彦
    第133回近畿産科婦人科学会 2015年10月 口頭発表（招待・特別）
  • Low levels of plasma protein S, protein C and coagulation factor XII during early pregnancy and adverse pregnancy outcome  [通常講演]
    Yasuhiko Ebina, Masahiro Ieko, Sumiyoshi Naito, Gen Kobashi, Masashi Deguchi, Hisanori Minakami, Tatsuya Atsumi, Hideto Yamada
    International Society for the Hypertension in Pregnancy (ISSHP) European Congress 2015年09月 口頭発表（一般）
  • 【Invited Lecture】 Toward optimized therapy plans using FDG PET/CT for the patients with gynecologic cancers  [招待講演]
    蝦名 康彦
    Joint Symposium of University of Liege and Kobe University 2015年05月 口頭発表（招待・特別）
  • 【特別講演】アバスチンの求められるもの ～当科の卵巣癌治療例を通して～  [招待講演]
    蝦名 康彦
    第7回神戸シンポジア 2015年02月 口頭発表（招待・特別）
  • Phenotypic differences of T cells and macrophages in the decidua obtained from spontaneous abortion  [通常講演]
    蝦名 康彦
    The 9th Conference of the Pacific Rim Society for Fertility and Sterility 2013年11月 ポスター発表
  • A trial of immunoglobulin fetal therapy for symptomatic congenital cytomegalovirus infection  [通常講演]
    蝦名 康彦
    17th International Conference on Prenatal Diagnosis and Therapy 2013年07月 ポスター発表
  • Diagnostic value of IgG avidity for prediction of congenital cytomegalovirus infection  [通常講演]
    蝦名 康彦
    17th International Conference on Prenatal Diagnosis and Therapy 2013年07月 ポスター発表
  • 【ランチョンセミナー】 FDG-PET/CTで子宮がん・卵巣がん診療はどう変わったか？  [招待講演]
    蝦名 康彦
    第65回日本産科婦人科学会学術講演会 2013年05月 公開講演，セミナー，チュートリアル，講習，講義等
  • 【ワークショップ】 自然流産における脱落膜T細胞、マクロファージの解析  [通常講演]
    蝦名 康彦
    第65回日本産科婦人科学会学術講演会 2013年05月 シンポジウム・ワークショップパネル（公募）
  • 【教育講演】先天性アンチトロンビン欠乏症合併妊娠の診断と治療  [招待講演]
    蝦名 康彦
    第２回周産期血液・免疫セミナー神戸 2012年12月 公開講演，セミナー，チュートリアル，講習，講義等
  • Low IgG Avidity and Ultrasound Fetal Abnormality Predict Congenital Cytomegalovirus Infection  [通常講演]
    蝦名 康彦
    Combined Meetings: 4th Congenital Cytomegalovirus Conference and 14th International CMV/BataHerpesvirus Workshop 2012年10月 ポスター発表
  • ssessment of treatment in patients with recurrent ovarian cancer using PET-CT：Potential change of disease free interval and chemotherapeutic regimen  [通常講演]
    蝦名 康彦
    14ｔｈ Biennial Meeting of the International Gynecologic Cancer Society 2012年10月 ポスター発表
  • 【シンポジウム】腫瘍シンポジウム「PETを用いた悪性腫瘍の治療戦略～個別化医療を視野に入れて～」 卵巣癌診療におけるPET-CTによる治療個別化の現状とその問題点について  [通常講演]
    蝦名 康彦
    第52回日本核医学会学術総会 2012年10月 シンポジウム・ワークショップパネル（指名）
  • 【ワークショップ】「早期卵巣癌を対象とした新規臨床試験」 卵巣癌の臨床試験におけるPET-CTの導入とその問題点  [通常講演]
    蝦名 康彦
    第123回 日本産科婦人科学会関東連合学術集会 2012年06月 シンポジウム・ワークショップパネル（指名）
  • 「FDG-PET/CTで子宮がん・卵巣がん診療はどう変わったか？」  [招待講演]
    蝦名 康彦
    PETサマーセミナー2012 in 松本 2012年 公開講演，セミナー，チュートリアル，講習，講義等
  • 特別講演「子宮がん・卵巣がん診療におけるPET-CTのインパクト ～婦人科医は、何を知りたいのか？～」  [招待講演]
    蝦名 康彦
    第53回兵庫県核医学研究会 2011年 口頭発表（招待・特別）
  • 特別講演「子宮がん・卵巣がん診療におけるPET-CTのインパクト ～婦人科医は、何を知りたいのか？～」  [招待講演]
    蝦名 康彦
    第二回東北FDG-PET研究会 2011年 公開講演，セミナー，チュートリアル，講習，講義等
  • 特別講演「再発卵巣癌治療 ～どのように選択する？～」  [招待講演]
    蝦名 康彦
    徳島卵巣がん化学療法講演会 2011年 公開講演，セミナー，チュートリアル，講習，講義等
  • ランチョンセミナー「子宮がん・卵巣がん診療におけるPET-CTのインパクト ～婦人科医は、何を知りたいのか？～」  [招待講演]
    蝦名 康彦
    第70回日本医学放射線学会総会 2011年 口頭発表（招待・特別）
  • ランチョンセミナー「日常臨床でのＰＥＴ/ＣＴの活用について」婦人科癌診療におけるＦＤＧ－ＰＥＴの有用性について  [招待講演]
    第10回日本核医学会春季大会（東京） 2010年 公開講演，セミナー，チュートリアル，講習，講義等
  • Impact of FDG-PET on the decision making for ovarian cancer recurrence  [通常講演]
    40th Annual Meeting of SGO（米国，サンアントニオ） 2009年 ポスター発表
  • 高得点演題「卵巣癌再発に対して，FDG-PETを用いた症例選択により行うsecondary debulking surgeryは，生存期間延長に寄与する」  [通常講演]
    第61回日本産科婦人科学会学術集会（京都） 2009年
  • シンポジウム“子宮体癌腹腔洗浄細胞診の今日的話題”「子宮体癌の腹腔細胞診にお ける，液状処理と免疫組織化学導入による診断精度向上の試み」  [招待講演]
    第50回日本臨床細胞学会総会（東京） 2009年
  • 細胞検査士要望教育シンポジウム“細胞診の将来と可能性～癌治療の選択および予後 推定における細胞診の役割～”「卵巣癌における組織型と治療戦略；細胞診が果たし 得る役割について」  [招待講演]
    第50回日本臨床細胞学会総会（東京） 2009年
  • シンポジウム“卵巣癌治療の新たな展開～10年後を見据えて～”「FDG-PETを用いた 症例選択により行う再発卵巣癌腫瘍減量手術は，生存期間延長に寄与する」  [通常講演]
    第47回日本癌治療学会総会・学術集会（横浜） 2009年
  • シンポジウム“悪性腫瘍の診療に不可欠なPET検査”「PETの臨床応用；婦人科癌 への応用」  [通常講演]
    第99回北海道癌談話会（札幌） 2009年
  • 特別講演「PET：婦人科癌診療に与えたインパクト」  [招待講演]
    蝦名 康彦
    第2回愛知PET臨床利用研究会 2008年 口頭発表（招待・特別）
  • ランチョンセミナー「PET：婦人科癌診療に与えたインパクト」  [通常講演]
    第115回日本産科婦人科学会 関東連合地方部会学術集会（東京） 2008年
  • 教育講演「最新治療の理解と看護が行う生活障害支援のベストプラクティス；婦人科がん診療アップデート」  [招待講演]
    日総研看護セミナー（札幌） 2008年
  • 教育講演「婦人科疾患の臨床と経腹超音波検査の有用性」  [通常講演]
    JSS北海道第９会地方会（帯広） 2008年
  • ンポジウム“PETのがん診療への利用”「卵巣がん診療におけるFDG-PETの有用性」  [通常講演]
    第５回北海道PET研究会（札幌） 2007年
  • ランチョンセミナー「婦人科臨床におけるPET活用のノウハウ〜PET診断のコツとピットフォール〜」  [通常講演]
    第59回日本産科婦人科学会（京都） 2007年
  • ランチョンセミナー「婦人科がん診療におけるFDG-PETの有用性と今後の展開」  [通常講演]
    第４１回日本婦人科腫瘍学会（大阪） 2006年
  • ワークショップ“婦人科悪性腫瘍の臨床におけるPETの有効性とその限界”「婦人科癌再発診断におけるFDG-PETの有用性と限界に関する検討」  [通常講演]
    第38回婦人科腫瘍学会（和歌山） 2005年
  • 高得点演題「卵巣癌再発診断におけるFDG-PETの有用性に関する検討」  [通常講演]
    第56回日本産科婦人科学会学術集会（東京） 2004年
  • シンポジウム“卵巣がんにおける細胞診の現状と問題点”「初期卵巣癌(T1/T2)症例に おける腹腔細胞診とリンパ節転移との関連」  [通常講演]
    第45回日本臨床細胞学会総会（福岡） 2004年
  • シンポジウム”腫瘍マーカーを用いた婦人科疾患の管理”「子宮体癌の診断・管理における腫瘍マーカー活用へのアプローチ」  [通常講演]
    第５回日本産婦人科腫瘍マーカー・遺伝子診断学会学術集会（東京） 2001年
  • シンポジウム”子宮頸癌検診は体癌発見を早めるか？”「北海道における集検での 子宮体癌検診〜第二次老健法後14年間の取り組み〜」  [通常講演]
    第10回日本婦人科がん検診学会学術集会（東京） 2001年

担当経験のある科目（授業）

  • 全学教育科目(一般教育演習）大学生のための金融リテラシー入門北大高等教育推進機構
  • 女性生涯看護学特講演習北大大学院保健科学院 博士後期課程
  • 女性生涯看護学特講北大大学院保健科学院 博士後期課程
  • 母性健康障害論北大医学部保健学科
  • ウイメンズヘルス特論北大大学院保健科学院 修士課程
  • 助産診断・技術学特論北大大学院保健科学院 修士課程
  • 全学教育科目(一般教育演習）女性と内分泌系北大高等教育推進機構
  • 全学教育科目(一般教育演習）生殖・遺伝と倫理北大高等教育推進機構
  • グローバルメディカルサイエンス特別講義神戸大学大学院医学研究科
  • 博士課程特別実習神戸大学大学院医学研究科
  • 全学共通原論講義神戸大学教養学部
  • 臨床統合講義神戸大学医学部
  • 臨床実習(BSL) 産婦人科神戸大学医学部
  • チュートリアル神戸大学医学部
  • 講座長期配属実習北海道大学医学部, 神戸大学医学部
  • 産科婦人科系統講義北海道大学医学部, 神戸大学医学部
  • 医学英語ゼミナール北海道大学医学部

所属学協会

  • 日本女性医学学会   日本周産期・新生児医学会   日本生殖免疫学会   International Academy of Cytology   日本婦人科がん検診学会   日本産婦人科手術学会   日本婦人科腫瘍学会   日本臨床細胞学会   日本産科婦人科学会   日本思春期学会   日本看護科学学会   日本母性衛生学会   

共同研究・競争的資金等の研究課題

  • 日本学術振興会：科学研究費助成事業 基盤研究(C)
    研究期間 : 2021年04月 -2024年03月 
    代表者 : 蝦名 康彦
     
    わが国では，周産期医療および母子保健において，産後うつ病のケアと対応が大きな課題となっている。本研究は，妊産婦の抑うつ不安症状を対象として，新手法であるネットワーク分析を行い，その病態理解の深化へつなげるものである．そして，その知見により現場の支援に関する具体的な提言をすることを目的として計画した． しかし，2021年は新型コロナウイルス感染症の影響により，全国の産婦人科臨床現場でケアの中止・縮小といった多大なる影響がでた．そこで，病院の協力が不可欠である臨床データを用いた多数例での検討に入る前に，予備的検討として既存の公的な大型データセット使用の許可を得て，産後女性の抑うつ不安症状に関するネットワーク分析を実施した．これらは産後の横断的なデータであるといえる．それにより，産褥期の女性に特有といえる抑うつ不安症状のネットワーク構造が，はじめて明らかとなった．そして，ネットワークの中で中心性の高い症状や橋渡し症状が特定された．さらに分娩後の時期（１ヶ月，６ヶ月）による相違，サブカテゴリーによる比較について，詳細な解析へ移行している．なお，解析の途中で，予測できなかったデータ取扱いや具体的な処理方法についての問題が発生したが，ひとつひとつ解決法を見出し，この点でも新たに取得するデータ解析にむけて望ましい状況であるといえる． 一方，臨床の前向きデータとして取得や解析の参考となりうる，コロナ禍の影響を含めた産後うつ病に対するケアの現状について全国調査を2022年5月に行った．その結果はすでに論文にて発表した．産科医療機関におけるコロナ禍の影響は，現在も続いているため，この情報を新データ取得等に活かしていく．
  • 日本学術振興会：科学研究費助成事業 基盤研究(C)
    研究期間 : 2017年04月 -2021年03月 
    代表者 : 山田 秀人, 出口 雅士, 谷村 憲司, 蝦名 康彦
     
    本研究では、aβ2GPI/HLA class Ⅱ測定法の不育症の原因検索や重症度診断における有用性を明らかする。また、HLA class Ⅱの新しい機能を応用し、不育症を引き起こす未知の抗原を探索する。ミスフォールド蛋白/HLA class Ⅱ複合体に対する自己抗体の新検出法が、抗リン脂質抗体症候群（APS）の診断や不育症の原因精査に有用かを調べる。この複合体抗体に起因する不育症の新たな治療法を開発し確立することを目的とする。また、検査法の標準化と汎用化のために、ELISAプレートやビーズを用いた測定法を新たに開発する。 今年度の研究実績を下に記す。 目的：不育症患者のaβ2GPI/HLA-DR7複合体（ネオ・セルフ）抗体と不育症との関係を明らかにすることを目的とした。対象と方法：2回以上の流産ないし1回以上の死産の既往がある不育症女性227人を対象とした。流死産歴無し、生産歴あり、抗リン脂質抗体（aPL）陰性、自己免疫疾患無しの女性208人をコントロールとした。コントロール女性の血清の99％ile を基準値として、対象でaβ2GPI/HLA-DR7抗体価を測定した。結果：52.6 U/mlが基準値となった。不育症女性227人中、52人（22.9%）が、aβ2GPI/HLA-DR7抗体陽性であった。不育症の原因/リスク因子が不明の121人中24人（19.8％）で、またAPS症状があるが基準aPLが陰性の114人中22人（19.3％）において、aβ2GPI/HLA-DR7抗体が陽性であることが初めて明らかになった。結論：これまで原因/リスク因子不明とされていた不育症女性の19.8%で陽性になったことから、aβ2GPI/HLA-DR7複合体抗体は、新たな不育症の原因である可能性が示された。前向きコホート研究や介入研究の臨床試験によって、因果関係の決定が今後期待される。Arthritis & Rheumatologyに投稿、リバイス中である。
  • 日本学術振興会：科学研究費助成事業 基盤研究(C)
    研究期間 : 2017年04月 -2020年03月 
    代表者 : 出口 雅士, 山田 秀人, 森實 真由美, 谷村 憲司, 蝦名 康彦
     
    末梢血ではCD94陽性NK細胞およびBreg細胞中のCD43+CD27high B細胞の割合が不育症患者で増加する傾向を認めた。また、染色体正常流産脱落膜ではマクロファージのうちM1が増加する一方、M2の増加がみられず、M2への分化が初期の妊娠維持に好ましいことが明らかとなった。また、末梢血においてはNK細胞のCD44発現には変化はないものの、CD44陽性子宮NK細胞が染色体正常流産脱落膜で増加する傾向にあった。NK細胞上のCD44発現量については、末梢血による発現よりも脱落膜での発現が流産と関連する可能性があり、非妊時の末梢血よりも脱落膜に存在するNK細胞が重要であると考えられる。
  • 日本学術振興会：科学研究費助成事業 基盤研究(C)
    研究期間 : 2013年04月 -2017年03月 
    代表者 : 蝦名 康彦
     
    子宮内膜における月経周期および発がん過程に関する、PITX1遺伝子によるテロメレース制御機構について検討した。PITX1蛋白は、子宮体がん低分化症例の腫瘍部において発現を認めるものの、90％以上の体がん組織において発現を認めず、子宮体がんにおけるテロメレース高発現に関与している可能性が示唆された。一方、正常内膜腺にPITX1発現が明らかとなった。しかし、月経周期との関連、正常内膜から増殖症をへて体がんに至る段階については、明確な関連性を見出すことはできなかった。病理組織学的因子、予後、Ki-67，ERα，PR発現との関連を含め、解析対象となるデータが多岐にわたるため、今後も解析を継続する。

社会貢献活動

  • リプロダクティブヘルスを科学する
    期間 : 2020年11月03日 - 2020年11月03日
    役割 : 講師
    主催者・発行元 : 北海道大学保健科学研究院
    イベント・番組・新聞雑誌名 : 公開講座2020「ようこそヘルスサイエンスの世界へ」
  • 「最新情報でがんにそなえる」子宮がん 最新の診断と治療
    期間 : 2017年05月06日
    役割 : 講師
    主催者・発行元 : 第１５回日本癌治療学会市民公開講座（神戸市）
  • 兵庫17事例協働調査委員会委員長
    期間 : 2012年07月 - 2014年12月
    役割 : 調査担当
    主催者・発行元 : 日本医療安全調査機構モデル事業

学術貢献活動

  • 子宮体がん治療ガイドライン（2023年版）評価委員
    期間 : 2022年10月01日 - 現在
    役割 : 企画立案・運営等
    種別 : 学会・研究会等
  • 卵巣がん・卵管癌・腹膜癌治療ガイドライン（2020年版）評価委員
    期間 : 2020年01月 - 2020年07月
    役割 : 企画立案・運営等
    種別 : 審査・学術的助言
  • 子宮頸癌治療ガイドライン（2017年版）作成委員（幹事）
    期間 : 2015年05月 - 2017年07月
    役割 : 企画立案・運営等
    種別 : 審査・学術的助言
  • 卵巣がん治療ガイドライン（2015年版）作成委員（幹事）
    期間 : 2013年06月 - 2015年03月
    役割 : 企画立案・運営等
    種別 : 審査・学術的助言
  • 子宮体がん治療ガイドライン（2013年版）作成委員（幹事）
    期間 : 2011年06月 - 2013年10月
    役割 : 企画立案・運営等
    種別 : 審査・学術的助言
  • 子宮頸癌治療ガイドライン（2011年版）作成委員（幹事）
    期間 : 2009年08月 - 2011年08月
    役割 : 企画立案・運営等
    種別 : 審査・学術的助言

その他

  • 2019年10月 - 9999年  J-MELS ベーシックコース・インストラクター 
    日本母体救命システム普及協議会(J-CIMELS)
  • 2017年04月 - 9999年  日本臨床細胞学会 教育研修指導医
  • 2016年03月 - 9999年  日本専門医機構 産婦人科専門医
  • 2015年11月 - 9999年  日本婦人科腫瘍学会 婦人科腫瘍指導医
  • 2015年08月 - 9999年  日本産科婦人科学会 産婦人科指導医
  • 2008年04月 - 9999年  日本がん治療認定医機構 認定医
  • 2007年02月 - 9999年  日本婦人科腫瘍学会 婦人科腫瘍専門医
  • 2003年09月 - 9999年  国際細胞学会 サイトパソロジスト (FIAC)
  • 1996年12月 - 9999年  日本臨床細胞学会 細胞診専門医
  • 1995年10月 - 9999年  日本産科婦人科学会 産婦人科専門医

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