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Maki S, Takakura S, Tsuji M, Magawa S, Tamaishi Y, Nii M, Kaneda M, Yoshida K, Toriyabe K, Kondo E, Ikeda T. Tadalafil for Treatment of Fetal Growth Restriction: A Review of Experimental and Clinical Studies. Biomedicines 2024; 12:804. [PMID: 38672159 PMCID: PMC11047858 DOI: 10.3390/biomedicines12040804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 03/30/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
Fetal growth restriction (FGR) is a major concern in perinatal care. Various medications have been proposed as potential treatments for this serious condition. Nonetheless, there is still no definitive treatment. We studied tadalafil, a phosphodiesterase-5 inhibitor, as a therapeutic agent for FGR in clinical studies and animal experiments. In this review, we summarize our preclinical and clinical data on the use of tadalafil for FGR. Our studies in mouse models indicated that tadalafil improved FGR and hypertensive disorders of pregnancy. A phase II trial we conducted provided evidence supporting the efficacy of tadalafil in prolonging pregnancy (52.4 vs. 36.8 days; p = 0.03) and indicated a good safety profile for fetuses and neonates. Fetal, neonatal, and infant mortality was significantly lower in mothers receiving tadalafil treatment than that in controls (total number: 1 vs. 7, respectively; p = 0.03), and no severe adverse maternal events associated with tadalafil were observed. Although further studies are needed to establish the usefulness of tadalafil in FGR treatment, our research indicates that the use of tadalafil in FGR treatment may be a paradigm shift in perinatal care.
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Affiliation(s)
- Shintaro Maki
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu 514-8507, Mie, Japan; (S.T.); (M.T.); (S.M.); (Y.T.); (M.N.); (M.K.); (K.Y.); (K.T.); (E.K.); (T.I.)
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Sato T, Ogihara Y, Nakaya H, Sugiura E, Okamoto R, Furuhashi F, Nii M, Toriyabe K, Ikeda T, Dohi K. Management of pulmonary hemodynamics prior to delivery in a pregnant woman with development of decompensated pulmonary arterial hypertension. J Cardiol Cases 2024; 29:55-58. [PMID: 38362581 PMCID: PMC10865132 DOI: 10.1016/j.jccase.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 09/06/2023] [Accepted: 10/05/2023] [Indexed: 02/17/2024] Open
Abstract
Prompt termination of pregnancy in patients with decompensated pulmonary arterial hypertension (PAH) is imperative for improvement of maternal hemodynamics, but such termination may also result in maternal death due to further deterioration of PAH immediately after delivery. However, there have been limited reports on whether implementation of PAH therapy with continuation of pregnancy improves the maternal outcome, especially in treatment-naïve patients with PAH. A 24-year-old woman was admitted to our hospital with a chief complaint of dyspnea (WHO functional class IV) at 22 weeks and 3 days of gestation. She was diagnosed with PAH accompanied by right heart failure and low cardiac output. Intensive treatment was initiated with inotropic agents, oxygen therapy, and PAH therapy, resulting in improvement of her hemodynamics. A caesarean section was performed at 23 weeks and 3 days. Although her pulmonary arterial pressure transiently increased with oxygenation deteriorating immediately after delivery, worsening PAH improved without mechanical circulatory support. She continued receiving pulmonary vasodilators without relapse of pulmonary hypertension for three years. The improvement of pulmonary hemodynamics prior to delivery with PAH therapy led to a favorable outcome after delivery. Learning objective Pulmonary hemodynamics in pregnant patients with pulmonary arterial hypertension (PAH) can deteriorate with the continuation of pregnancy, while termination can also cause PAH surge immediately after delivery. In treatment-naïve patients with PAH, who are most likely to benefit from PAH therapy, implementation of PAH therapy with continuation, even with a decompensated status, may improve the hemodynamics prior to delivery, resulting in a favorable outcome after delivery.
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Affiliation(s)
- Toru Sato
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yoshito Ogihara
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hitoshi Nakaya
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Emiyo Sugiura
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Ryuji Okamoto
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Fumi Furuhashi
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Masafumi Nii
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kuniaki Toriyabe
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
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Nii M, Enomoto N, Ishida M, Magawa S, Takakura S, Maki S, Tanaka K, Toriyabe K, Tanaka H, Kondo E, Sakuma H, Ikeda T. Two-dimensional phase-contrast MRI reveals changes in uterine arterial blood flow in pregnant women administered tadalafil for fetal growth restriction. Placenta 2024; 146:1-8. [PMID: 38157651 DOI: 10.1016/j.placenta.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 11/15/2023] [Accepted: 12/10/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION We aimed to examine the effect of uterine arterial (UtA) blood flow changes after tadalafil treatment for fetal growth restriction (FGR) using two-dimensional (2D) phase-contrast magnetic resonance imaging (PC-MRI). METHODS We recruited 14 pregnant women with FGR aged 20-44 years, at ≥20 weeks' gestation, between May 2019 and July 2020. They underwent 2D PC-MRI for UtA blood flow measurement 3 days (interquartile range: 2-4) after diagnosis. This group (FGR group) was compared with 14 gestational age (GA)-matched healthy pregnant women (control group). Six patients in the FGR group received treatment with tadalafil administered at 20 mg twice daily after the first MRI until delivery. They underwent a second MRI a week later. RESULTS The median total UtA blood/body surface area was 420 mL/min/m2 (290-494) in the FGR group and 547 mL/min/m2 (433-681) in the control group (p = 0.01). Percent increase in blood flow were significantly different between the FGR cases treated with tadalafil and control at 15.8 % (14.3-21.3) and 4.2 % (3.6-8.7), respectively (p = 0.03). DISCUSSION UtA blood flow in pregnant women with FGR was significantly lower than that in healthy pregnant women. Tadalafil is expected to improve UtA blood flow, thereby improving placental function in pregnant patients with FGR.
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Affiliation(s)
- Masafumi Nii
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Edobashi, Tsu, Mie, Japan.
| | - Naosuke Enomoto
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Edobashi, Tsu, Mie, Japan
| | - Masaki Ishida
- Department of Radiology, Mie University School of Medicine, Edobashi, Tsu, Mie, Japan
| | - Shoichi Magawa
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Edobashi, Tsu, Mie, Japan
| | - Sho Takakura
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Edobashi, Tsu, Mie, Japan
| | - Shintaro Maki
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Edobashi, Tsu, Mie, Japan
| | - Kayo Tanaka
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Edobashi, Tsu, Mie, Japan
| | - Kuniaki Toriyabe
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Edobashi, Tsu, Mie, Japan
| | - Hiroaki Tanaka
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Edobashi, Tsu, Mie, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Edobashi, Tsu, Mie, Japan
| | - Hajime Sakuma
- Department of Radiology, Mie University School of Medicine, Edobashi, Tsu, Mie, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Edobashi, Tsu, Mie, Japan
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Kondo E, Kubo-Kaneda M, Mori K, Yoshida K, Nii M, Toriyabe K, Maki S, Magawa S, Okamoto K, Ikeda T. Efficacy of a portable interface pressure sensor for robotic surgery in preventing compartment syndrome. Asian J Surg 2023; 46:3575-3580. [PMID: 37142500 DOI: 10.1016/j.asjsur.2023.04.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/27/2023] [Accepted: 04/14/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND/OBJECTIVE This study determines whether the use of a portable interface pressure sensor (Palm Q) for robotic surgery could prevent compartment syndrome. METHODS In the present single center, non-trial observational study, patients diagnosed with gynecological diseases between April 2015 and August 2020 treated with laparoscopic or robotic surgery were enrolled. We assessed 256 cases involving surgery performed in the lithotomy position with an operative time >4 h. The Palm Q device was placed preoperatively on both sides of the patients' lower legs. The pressure was measured every 30 min preoperatively and intraoperatively and adjusted to ≤30 mmHg. If the pressure reached ≥30 mmHg, the operation was stopped, the patient was repositioned, the leg position was released, the pressure was reduced to ≤30 mmHg, and the procedure was resumed. We compared the maximum creatine kinase levels of the Palm Q and non-Palm Q groups. We also analyzed the correlation between the patients' symptoms postoperatively (shoulder and leg pain) and compartment syndrome. RESULTS Our data showed that immediate postoperative creatine kinase levels predict compartment syndrome. Propensity score matching of the 256 enrolled patients resulted in 92 cases (46 per group), balanced for age, body mass index, and lifestyle disease. Creatine kinase levels differed significantly between the Palm Q and non-Palm Q groups (p = 0.041). None of the patients in the Palm Q group experienced well-leg compartment syndrome complications. CONCLUSION Palm Q can potentially help to prevent perioperative compartment syndrome.
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Affiliation(s)
- Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan; 2-174 Edobashi, Tsu city, Mie, 514-8507, Japan.
| | - Michiko Kubo-Kaneda
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan; 2-174 Edobashi, Tsu city, Mie, 514-8507, Japan
| | - Kotoko Mori
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan; 2-174 Edobashi, Tsu city, Mie, 514-8507, Japan
| | - Kenta Yoshida
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan; 2-174 Edobashi, Tsu city, Mie, 514-8507, Japan
| | - Masafumi Nii
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan; 2-174 Edobashi, Tsu city, Mie, 514-8507, Japan
| | - Kuniaki Toriyabe
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan; 2-174 Edobashi, Tsu city, Mie, 514-8507, Japan
| | - Shintaro Maki
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan; 2-174 Edobashi, Tsu city, Mie, 514-8507, Japan
| | - Shoichi Magawa
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan; 2-174 Edobashi, Tsu city, Mie, 514-8507, Japan
| | - Kota Okamoto
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan; 2-174 Edobashi, Tsu city, Mie, 514-8507, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan; 2-174 Edobashi, Tsu city, Mie, 514-8507, Japan
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Magawa S, Maki S, Nii M, Yamaguchi M, Tamaishi Y, Enomoto N, Takakura S, Toriyabe K, Kondo E, Ikeda T. Evaluation of fetal acidemia during delivery using the conventional 5-tier classification and Rainbow systems. PLoS One 2023; 18:e0287535. [PMID: 37352197 PMCID: PMC10289380 DOI: 10.1371/journal.pone.0287535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 06/07/2023] [Indexed: 06/25/2023] Open
Abstract
The association between prepartum time-series fetal heart rate pattern changes and cord blood gas data at delivery was examined using the conventional 5-tier classification and the Rainbow system for 229 female patients who delivered vaginally. They were classified into three groups based on the results of umbilical cord blood gas analysis at delivery. The fetal heart rate pattern classifications were based on analysis of measurement taken at 10-min intervals, beginning at 120 min pre-delivery. The relationship between fetal heart rate pattern classification and cord blood pH at delivery changed over time. The 5-tier classification at each interval increased before delivery in the Mild and Severe groups compared with the Normal group. No significant differences were observed between acidemia groups. The Rainbow classification showed a significant differences between the acidemia groups at each interval, particularly during the prepartum period. A relationship between classification and outcome was evident before delivery for both the 5-tier classification and Rainbow system.
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Affiliation(s)
- Shoichi Magawa
- Department of Obstetrics and Gynecology, Mie University Faculty of Medicine, Mie, Japan
| | - Shintaro Maki
- Department of Obstetrics and Gynecology, Mie University Faculty of Medicine, Mie, Japan
| | - Masafumi Nii
- Department of Obstetrics and Gynecology, Mie University Faculty of Medicine, Mie, Japan
| | - Mizuki Yamaguchi
- Department of Obstetrics and Gynecology, Mie University Faculty of Medicine, Mie, Japan
| | - Yuya Tamaishi
- Department of Obstetrics and Gynecology, Mie University Faculty of Medicine, Mie, Japan
| | - Naosuke Enomoto
- Department of Obstetrics and Gynecology, Mie University Faculty of Medicine, Mie, Japan
| | - Sho Takakura
- Department of Obstetrics and Gynecology, Mie University Faculty of Medicine, Mie, Japan
| | - Kuniaki Toriyabe
- Department of Obstetrics and Gynecology, Mie University Faculty of Medicine, Mie, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University Faculty of Medicine, Mie, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University Faculty of Medicine, Mie, Japan
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Kasai R, Toriyabe K, Goto T, Hatano M, Kondo Y, Ohta T, Suyama M, Goto T, Koide W, Maki K, Ushijima K, Ban K. A case of breast milk-acquired cytomegalovirus infection in an extremely low birth weight infant. J Neonatal Perinatal Med 2023:NPM221130. [PMID: 37182845 DOI: 10.3233/npm-221130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
INTRODUCTION Although breast milk is considered the optimal nutrition for infants, it is also the primary cause of postnatal cytomegalovirus (CMV) infection. Preterm infants with postnatal CMV infections are susceptible to a variety of life-threatening conditions. CASE SUMMARY Twin male infants were delivered via emergency caesarian section at 27 weeks' gestation secondary to maternal complete uterine rupture. The Apgar scores at 1 and 5 min were 1 and 1 for the older twin (Twin A) and 0 and 3 for the younger twin (Twin B). Their birth weights were 1203 g (+ 0.65SD) and 495 g (- 3.79SD) respectively. On day 41, laboratory blood test results for Twin B showed a moderate elevation in C-reactive protein (CRP), thrombocytopenia. CMV quantitative polymerase chain reaction (qPCR) tests in Twin B's urine and blood as well as in the mother's breast milk were positive, but stored, dried umbilical cord CMV qPCR tests were negative. Twin B was diagnosed with a postnatal CMV infection secondary to infected breast milk and ganciclovir was commenced on day 52. Treatment was switched to valganciclovir at 74 days of age, but a negative CMV-DNA level in the blood was not achieved. Postnatal CMV infection in this infant led to an exacerbation of pre-existing bronchopulmonary dysplasia (BPD) and he demised at 182 days of age. CONCLUSION Postnatal cytomegalovirus infections may lead to exacerbations of BPD. Early use of raw breast milk in preterm infants should be done with careful consideration of this potential complication.
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Affiliation(s)
- R Kasai
- Department of Pediatrics, Yokkaichi Municipal Hospital, Shibata, Yokkaichi, Japan
| | - K Toriyabe
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Japan
| | - T Goto
- Department of Pediatrics, Yokkaichi Municipal Hospital, Shibata, Yokkaichi, Japan
| | - M Hatano
- Department of Pediatrics, Yokkaichi Municipal Hospital, Shibata, Yokkaichi, Japan
| | - Y Kondo
- Department of Pediatrics, Yokkaichi Municipal Hospital, Shibata, Yokkaichi, Japan
| | - T Ohta
- Department of Pediatrics, Yokkaichi Municipal Hospital, Shibata, Yokkaichi, Japan
| | - M Suyama
- Department of Pediatrics, Yokkaichi Municipal Hospital, Shibata, Yokkaichi, Japan
| | - T Goto
- Department of Pediatrics, Yokkaichi Municipal Hospital, Shibata, Yokkaichi, Japan
| | - W Koide
- Department of Pediatrics, Yokkaichi Municipal Hospital, Shibata, Yokkaichi, Japan
| | - K Maki
- Department of Pediatrics, Yokkaichi Municipal Hospital, Shibata, Yokkaichi, Japan
| | - K Ushijima
- Department of Pediatrics, Yokkaichi Municipal Hospital, Shibata, Yokkaichi, Japan
| | - K Ban
- Department of Pediatrics, Yokkaichi Municipal Hospital, Shibata, Yokkaichi, Japan
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Toriyabe K, Kitamura A, Hagimoto-Akasaka M, Ikejiri M, Suga S, Kondo E, Kihira M, Morikawa F, Ikeda T. Transient Decrease in Incidence Rate of Maternal Primary Cytomegalovirus Infection during the COVID-19 Pandemic in Japan. Viruses 2023; 15:v15051096. [PMID: 37243182 DOI: 10.3390/v15051096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/22/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
This study evaluated the impact of the coronavirus disease 2019 (COVID-19) pandemic on the occurrence of maternal primary cytomegalovirus (CMV) infection in Japan. We performed a nested case-control study using data from maternal CMV antibody screening under the Cytomegalovirus in Mother and infant-engaged Virus serology (CMieV) program in Mie, Japan. Pregnant women with negative IgG antibodies at ≤20 weeks of gestation who were retested at ≥28 weeks were enrolled. The study period was divided into 2015-2019 as the pre-pandemic and 2020-2022 as the pandemic period, and the study site included 26 institutions conducting the CMieV program. The incidence rate of maternal IgG seroconversion was compared between the pre-pandemic (7008 women enrolled) and pandemic (2020, 1283 women enrolled; 2021, 1100 women; and 2022, 398 women) periods. Sixty-one women in the pre-pandemic period and five, four, and five women during 2020, 2021, and 2022, respectively, showed IgG seroconversion. The incidence rates in 2020 and 2021 were lower (p < 0.05) than that in the pre-pandemic period. Our data suggest a transient decrease in the incidence of maternal primary CMV infection in Japan during the COVID-19 pandemic, which could be due to prevention and hygiene measures taken at the population level.
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Affiliation(s)
- Kuniaki Toriyabe
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
| | - Asa Kitamura
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
- Department of Obstetrics and Gynecology, National Hospital Organization Mie Chuo Medical Center, Tsu 514-1101, Japan
| | - Miki Hagimoto-Akasaka
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
| | - Makoto Ikejiri
- Department of Clinical Laboratory, Mie University Hospital, Tsu 514-8507, Japan
| | - Shigeru Suga
- Institute for Clinical Research, National Hospital Organization Mie National Hospital, Tsu 514-0125, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
| | - Masamichi Kihira
- Mie Association of Obstetricians and Gynecologists, Tsu 514-0003, Japan
| | - Fumihiro Morikawa
- Mie Association of Obstetricians and Gynecologists, Tsu 514-0003, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
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Kitamura A, Toriyabe K, Hagimoto-Akasaka M, Hamasaki-Shimada K, Ikejiri M, Minematsu T, Suga S, Kondo E, Kihira M, Morikawa F, Ikeda T. Revision of Cytomegalovirus Immunoglobulin M Antibody Titer Cutoff in a Maternal Antibody Screening Program in Japan: A Cohort Comparison Involving a Total of 32,000 Pregnant Women. Viruses 2023; 15:v15040962. [PMID: 37112942 PMCID: PMC10143041 DOI: 10.3390/v15040962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/07/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Cytomegalovirus (CMV) is associated with congenital infections. We aimed to validate the revised CMV immunoglobulin (Ig) M titer cutoff for IgG avidity measurements as a reflex test in maternal screening to identify women with primary CMV infection and newborn congenital cytomegalovirus (cCMV). We screened maternal CMV antibodies (the Denka assay) in Japan, from 2017 to 2019, using a revised IgM cutoff (≥4.00 index). Participants were tested for IgG and IgM antibodies, and for IgG avidity if IgM levels exceeded the cutoff. We compared these with corresponding results from 2013 to 2017 based on the original cutoff (≥1.21) and recalculated using the revised cutoff. Newborn urine CMV DNA tests were performed for women with low avidity (≤35.0%). Among 12,832 women screened in 2017-2019, 127 (1.0%) had IgM above the revised cutoff. Thirty-five exhibited low avidity, and seven infants developed cCMV. Of 19,435 women screened in 2013-2017, 184 (1.0%) had IgM above the revised cutoff, 67 had low avidity, and 1 had cCMV. The 2017-2019 results were not significantly different from the 2013-2017 results. The revised IgM cutoff improves maternal screening in identifying primary infection and newborn cCMV; however, further study related to other assays than Denka is required.
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Affiliation(s)
- Asa Kitamura
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
- Department of Obstetrics and Gynecology, National Hospital Organization Mie Chuo Medical Center, Tsu 514-8507, Japan
| | - Kuniaki Toriyabe
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
| | - Miki Hagimoto-Akasaka
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
| | - Kyoko Hamasaki-Shimada
- Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama 710-8522, Japan
| | - Makoto Ikejiri
- Clinical Laboratory, Mie University Hospital, Tsu 514-8507, Japan
| | - Toshio Minematsu
- Research Center for Disease Control, Aisenkai Nichinan Hospital, Miyazaki 887-0034, Japan
| | - Shigeru Suga
- Institute for Clinical Research, National Hospital Organization Mie National Hospital, Tsu 514-8507, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
| | - Masamichi Kihira
- Mie Association of Obstetricians and Gynecologists, Tsu 514-8507, Japan
| | - Fumihiro Morikawa
- Mie Association of Obstetricians and Gynecologists, Tsu 514-8507, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
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Toriyabe K, Kitamura A, Hagimoto-Akasaka M, Minematsu T, Takeuchi H, Kondo E, Kihira M, Morikawa F, Ikeda T. Maternal Cytomegalovirus Antibodies during Early and Late (Persistent) Phases after Primary Cytomegalovirus Infection during Pregnancy: An Observational Study. CLIN EXP OBSTET GYN 2022. [DOI: 10.31083/j.ceog4912269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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10
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Kitamura A, Toriyabe K, Hagimoto-Akasaka M, Ikejiri M, Minematsu T, Suga S, Kitano M, Takeuchi K, Usui S, Masuda S, Kondo E, Kihira M, Morikawa F, Ikeda T. Congenital Cytomegalovirus Infection and Maternal Primary Cytomegalovirus Infection in Universal Newborn Hearing Screening Referral Patients: A Prospective Cohort Study. CLIN EXP OBSTET GYN 2022. [DOI: 10.31083/j.ceog4912259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kitajima T, Schüz J, Morita A, Ikeda W, Tanaka H, Togawa K, Gabazza EC, Taki M, Toriyabe K, Ikeda T, Sokejima S. Measurement of Intermediate Frequency Magnetic Fields Generated by Household Induction Cookers for Epidemiological Studies and Development of an Exposure Estimation Model. Int J Environ Res Public Health 2022; 19:11912. [PMID: 36231220 PMCID: PMC9565691 DOI: 10.3390/ijerph191911912] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/10/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Exposure assessment of intermediate frequency (IF) electromagnetic fields (EMFs) is difficult and epidemiological studies are limited. In the present study, we aimed to estimate the exposure of pregnant women to IF-EMFs generated by induction cookers in the household using a questionnaire and discussed its applicability to epidemiological studies. METHOD Two main home-visit surveys were conducted: a Phase 1 survey to develop an estimation model and a Phase 2 survey to validate the model. The estimation model included the following variables: wattage, cookware diameter, and distance from the hob center (center of the stove). Four models were constructed to determine the importance of each variable and the general applicability for epidemiological studies. In addition, estimated exposure values were calculated based on the Phase 2 survey questionnaire responses and compared with the actual measured values using the Spearman rank correlation coefficient. RESULT The average value of the magnetic field measured in the Phase 1 survey was 0.23 μT (variance: 0.13) at a horizontal distance of 30 cm at the height of the cooking table. The highest validity model was inputted distance from the hob center to the body surface that is variable (correlation coefficient = 0.54, 95% confidence interval: 0.22-0.75). No clear differences were identified in the correlation coefficients for each model (z-value: 0.09-0.18, p-value: 0.86-0.93). DISCUSSION AND CONCLUSIONS No differences were found in the validity of the four models. This could be due to the biased wattage of the validation population, and for versatility it would be preferable to use three variables (distance, wattage, and estimation using the diameter of the cookware) whenever possible. To our knowledge, this is the first systematic measurement of magnetic fields generated by more than 70 induction cookers in a real household environment. This study will contribute to finding dose-response relationships in epidemiological studies of intermediate-frequency exposure without the use of instrumentation. One of the limitations of this study is it estimates instantaneous exposure in place during cooking only.
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Affiliation(s)
- Takumi Kitajima
- Department of Public Health and Occupational Medicine, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC), WHO, 69372 Lyon, France
| | - Akemi Morita
- Department of Public Health and Occupational Medicine, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
| | - Wakaha Ikeda
- Epidemiology Centre for Disease Control and Prevention, Mie University Hospital, Tsu 514-8507, Japan
| | - Hirokazu Tanaka
- Division of Surveillance and Policy Evaluation, National Cancer Center Japan Institute for Cancer Control, Chuo-ku, Tokyo 104-0045, Japan
| | - Kayo Togawa
- International Agency for Research on Cancer (IARC), WHO, 69372 Lyon, France
- Division of Surveillance and Policy Evaluation, National Cancer Center Japan Institute for Cancer Control, Chuo-ku, Tokyo 104-0045, Japan
| | - Esteban C. Gabazza
- Department of Immunology, Division of Molecular and Experimental Medicine, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
| | - Masao Taki
- Department of Systems Design, Tokyo Metropolitan University, Hachioji 192-0397, Japan
- Electromagnetic Compatibility Laboratory, National Institute of Information and Communications Technology, Koganei 184-0015, Japan
| | - Kuniaki Toriyabe
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
| | - Shigeru Sokejima
- Department of Public Health and Occupational Medicine, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
- Epidemiology Centre for Disease Control and Prevention, Mie University Hospital, Tsu 514-8507, Japan
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Yokoyama Y, Kubo-Kaneda M, Sunada K, Teishikata Y, Kitamura A, Okamoto K, Toriyabe K, Nii M, Yoshida K, Kondo E, Ikeda T. Adverse Events Associated With Long-term Treatment of Epithelial Ovarian Cancer With Bevacizumab and Chemotherapy. Anticancer Res 2022; 42:4165-4171. [PMID: 35896225 DOI: 10.21873/anticanres.15916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/20/2022] [Accepted: 07/05/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Adverse events associated with long-term bevacizumab administration for ovarian cancer have been poorly documented in Japan. This study aimed to evaluate the adverse events of bevacizumab combined with chemotherapy for treating primary and recurrent epithelial ovarian cancer in Japan. PATIENTS AND METHODS In this single-center retrospective study, we analyzed data of patients with advanced and recurrent epithelial ovarian cancer treated with bevacizumab and chemotherapy between January 2013 and November 2019. Statistical analyses were performed using the Fisher's exact test and Kaplan-Meier method. RESULTS A total of 46 patients were included and the follow-up time was 30 months. The median duration of bevacizumab treatment was 14 months, and the median total dose of bevacizumab was 247.5 mg/kg. The most common adverse events were hypertension (n=30; 65.2%) and proteinuria (n=24; 49%) in all grades. The onset of hypertension and proteinuria occurred at a median of 2 months and 14 months after treatment initiation in all grades, respectively. Gastrointestinal perforation occurred significantly more frequently in patients with a history of radiation therapy. CONCLUSION This study included cases of primary advanced and recurrent epithelial ovarian cancer, and had a longer observation period and reported more adverse events of bevacizumab with chemotherapy than previous reports. The administration of bevacizumab therapy in patients with a history of radiation should be carefully considered due to increased chances of gastrointestinal perforation.
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Affiliation(s)
- Yuka Yokoyama
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Michiko Kubo-Kaneda
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Kimi Sunada
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Yasuhiro Teishikata
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Asa Kitamura
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Kota Okamoto
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Kuniaki Toriyabe
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Masafumi Nii
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Kenta Yoshida
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
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Shimada K, Toriyabe K, Kitamura A, Morikawa F, Ikejiri M, Minematsu T, Nakamura H, Suga S, Ikeda T. Characteristics and serology of pregnant women with cytomegalovirus immunoglobulin G seroconversion during pregnancy in Japan. Taiwan J Obstet Gynecol 2021; 60:621-627. [PMID: 34247798 DOI: 10.1016/j.tjog.2021.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Investigate the characteristics and serology of pregnant women with cytomegalovirus (CMV) immunoglobulin (Ig)G seroconversion during pregnancy to understand the risk factors associated with primary CMV infection and the occurrence of fetal congenital CMV infection. MATERIALS AND METHODS We retrospectively studied 3202 pregnant women who were CMV IgG-negative in early pregnancy and were retested for IgG in late pregnancy. Characteristics were compared between participants with and without IgG seroconversion, and serological parameters were compared between participants with and without fetal congenital CMV infection. RESULTS Twenty-six participants showed CMV IgG seroconversion and fifteen showed fetal congenital CMV infection. Seroconversion rates were significantly higher in teens (5.0%) than in older women (20s: 0.8%; 30s and over: 0.6%) (p < 0.001). Titers of CMV IgM at IgG seroconversion were higher in women without (median 8.66) than with (median 6.54) congenital infection (p = 0.045). The congenital infection rate was high when IgM titers at IgG seroconversion were low (47.1% with 4.00-12.00 titers and 100% with 1.21-3.99 IgM titers) (p = 0.048). CONCLUSIONS Nulliparous pregnant teenagers have a high risk of CMV IgG seroconversion and the CMV IgM titer at IgG seroconversion may help predict the occurrence of fetal congenital CMV infection.
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Affiliation(s)
- Kyoko Shimada
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Japan; Mie Association of Obstetricians and Gynecologists, Tsu, Japan
| | - Kuniaki Toriyabe
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Japan; Mie Association of Obstetricians and Gynecologists, Tsu, Japan.
| | - Asa Kitamura
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Japan; Mie Association of Obstetricians and Gynecologists, Tsu, Japan
| | | | | | - Toshio Minematsu
- Center for Disease Control, Aisenkai Nichinan Hospital, Nichinan, Japan
| | - Haruna Nakamura
- Institute for Clinical Research, National Mie Hospital, Tsu, Japan
| | - Shigeru Suga
- Institute for Clinical Research, National Mie Hospital, Tsu, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Japan; Mie Association of Obstetricians and Gynecologists, Tsu, Japan
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14
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Tanaka H, Tanaka K, Enomoto N, Takakura S, Magawa S, Maki S, Nii M, Toriyabe K, Katsuragi S, Ikeda T. Reference range for C1-esterase inhibitor (C1 INH) in the third trimester of pregnancy. J Perinat Med 2021; 49:166-169. [PMID: 32887189 DOI: 10.1515/jpm-2020-0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 08/21/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The objectives of this study were to (i) establish the reference range and mean value for normal levels of C1-esterase inhibitor (C1 INH) during pregnancy, and (ii) investigate the association between C1 INH and uterine atony, as measured by blood loss at delivery. METHODS We prospectively studied 200 healthy pregnant women who were registered. We studied C1 INH levels in 188 women at 34 and 35 gestational weeks of pregnancy. The reference range for C1 INH during the third trimester of pregnancy was calculated using the value of C1 INH that was determined at registration. RESULTS The mean value of C1 INH was determined to be 70.3% (95% confidence interval, 68.7-71.9). While the C1 INH levels in four women were determined to be 40% lower than the calculated mean value, amniotic fluid embolism (AFE) did not occur in any of the women studied. CONCLUSIONS This study successfully demonstrated that a reference value for C1 INH activity can be established using the methods described herein. Further research is needed to determine whether C1 INH is involved in obstetric coagulopathy syndrome such as amniotic fluid embolism.
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Affiliation(s)
- Hiroaki Tanaka
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Tsu, Japan
| | - Kayo Tanaka
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Tsu, Japan
| | - Naosuke Enomoto
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Tsu, Japan
| | - Sho Takakura
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Tsu, Japan
| | - Shoichi Magawa
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Tsu, Japan
| | - Shintaro Maki
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Tsu, Japan
| | - Masafumi Nii
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Tsu, Japan
| | - Kuniaki Toriyabe
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Tsu, Japan
| | - Shinji Katsuragi
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Tsu, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Tsu, Japan
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Kawamura T, Tanaka H, Tachibana R, Yoshikawa K, Maki S, Toriyabe K, Takeuchi H, Katsuragi S, Tanaka K, Ikeda T. Maternal tadalafil therapy for fetal growth restriction prevents non-alcoholic fatty liver disease and adipocyte hypertrophy in the offspring. Sci Rep 2021; 11:1186. [PMID: 33441894 PMCID: PMC7806616 DOI: 10.1038/s41598-020-80643-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 12/17/2020] [Indexed: 11/18/2022] Open
Abstract
We aimed to investigate the effects of maternal tadalafil therapy on fetal programming of metabolic function in a mouse model of fetal growth restriction (FGR). Pregnant C57BL6 mice were divided into the control, L-NG-nitroarginine methyl ester (L-NAME), and tadalafil + L-NAME groups. Six weeks after birth, the male pups in each group were given a high-fat diet. A glucose tolerance test (GTT) was performed at 15 weeks and the pups were euthanized at 20 weeks. We then assessed the histological changes in the liver and adipose tissue, and the adipocytokine production. We found that the non-alcoholic fatty liver disease activity score was higher in the L-NAME group than in the control group (p < 0.05). Although the M1 macrophage numbers were significantly higher in the L-NAME/high-fat diet group (p < 0.001), maternal tadalafil administration prevented this change. Moreover, the epididymal adipocyte size was significantly larger in the L-NAME group than in the control group. This was also improved by maternal tadalafil administration (p < 0.05). Further, we found that resistin levels were significantly lower in the L-NAME group compared to the control group (p < 0.05). The combination of exposure to maternal L-NAME and a high-fat diet induced glucose impairment and non-alcoholic fatty liver disease. However, maternal tadalafil administration prevented these complications. Thus, deleterious fetal programming caused by FGR might be modified by in utero intervention with tadalafil.
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Affiliation(s)
- Takuya Kawamura
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Hiroaki Tanaka
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Ryota Tachibana
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Kento Yoshikawa
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Shintaro Maki
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Kuniaki Toriyabe
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Hiroki Takeuchi
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Shinji Katsuragi
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Kayo Tanaka
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
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Tanaka H, Nagahashi Y, Toriyabe K, Maki S, Takakura S, Enomoto N, Tanaka K, Shinji K, Ikeda T. sFlt-1 value predicts pregnancy prolongation periods from diagnosis in pregnant women diagnosed with early-onset preeclampsia. J Matern Fetal Neonatal Med 2020; 35:4196-4198. [PMID: 33207964 DOI: 10.1080/14767058.2020.1849093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of this study is to analyze whether soluble fms-like tyrosine kinase-1 (sFlt-1) can be correlated with the severity of PE. MATERIALS AND METHODS This study was conducted in a single hospital and is a prospective, observational study. sFlt-1 was measured at the diagnosis of preeclampsia. The period from diagnosis to pregnancy termination (pregnancy prolongation periods) was defined as the barometer for the severity of PE. The correlations between sFlt-1 level with pregnancy prolongation periods were then analyzed. RESULTS Eighteen pregnant women diagnosed with early-onset preeclampsia were recruited. sFlit-1 value significantly negatively correlated with the pregnancy prolongation period from diagnosis (p = .003, R = 0.647). CONCLUSION sFlt-1 was correlated with the pregnancy prolongation periods after onset of PE. sFlt-1 in early-onset PE may reflect the severity of PE in pregnant women.
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Affiliation(s)
- Hiroaki Tanaka
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Yuko Nagahashi
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Kuniaki Toriyabe
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Shintaro Maki
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Sho Takakura
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Naosuke Enomoto
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Kayo Tanaka
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Katsuragi Shinji
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
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Kawaguchi K, Akeda K, Takegami N, Kurata T, Toriyabe K, Ikeda T, Sudo A. Cervical schwannoma in the early stage of pregnancy: a case report. BMC Surg 2020; 20:245. [PMID: 33081764 PMCID: PMC7576856 DOI: 10.1186/s12893-020-00903-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/08/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Although spinal schwannomas generally grow very slowly, it has been reported that these clinical growths and their associated neurological symptoms accelerate during pregnancy. Because these cases are rare, surgical intervention for this tumor during pregnancy poses a significant challenge. The change of pregnancy-related hormones, such as estrogen and progesterone, is considered to have an effect on the clinical symptoms of spinal tumors. Expressions of the receptors for estrogen and progesterone in orbital and vestibular schwannomas have been reported; however, those expressions in spinal schwannomas have not been examined. CASE PRESENTATION A 36-year-old woman at 8 weeks' gestation suffered from developing neck pain and neurological symptoms in the right upper extremity. Magnetic resonance imaging (MRI) confirmed the presence of a cervical intradural extramedullary tumor. Under general anesthesia, using intraoperative neurophysiological monitoring of motor-evoked potentials (MEPs), spinal tumor resection following a hemi-laminoplasty was performed in a prone position at 12 weeks gestation. The pathological diagnosis following surgery was spinal schwannoma. Her neurological symptoms were significantly improved after surgery and she delivered a healthy baby in her 40th week of pregnancy. At a 12-month follow-up, no abnormalities were observed during medical examinations of both mother and child. An immunohistochemical study identified the expression of estrogen receptors, but not progesterone receptors, in the spinal schwannoma. CONCLUSIONS A cervical spinal schwannoma was successfully removed under general anesthesia at 12 weeks gestation by coordination between orthopaedic, obstetric and anesthesia teams. For the first time, an immunohistochemical analysis showed that the expression of estrogen receptors was identified in spinal schwannoma cells, suggesting the possibility that these hormone receptors in spinal schwannoma might contribute to the worsening of neurological symptoms during pregnancy.
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Affiliation(s)
- Koki Kawaguchi
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Koji Akeda
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
| | - Norihiko Takegami
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Tatsuya Kurata
- Department of Orthopaedic Surgery, Sakakibara Onsen Hospital, 1033-4 Sakakibara town, Tsu, Mie, 514-1293, Japan
| | - Kuniaki Toriyabe
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Mie, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Mie, Japan
| | - Akihiro Sudo
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
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Morimoto M, Sawada H, Yodoya N, Ohashi H, Toriyabe K, Hanaki R, Sugiura K, Toyoda H, Matsushita K, Koike Y, Otake K, Inoue M, Uchida K, Imai H, Mitani Y, Maruyama K, Komada Y, Ikeda T, Hirayama M. Refractory Ileal Perforations in a Cytomegalovirus-Infected Premature Neonate Resolved After Ganciclovir Therapy. Front Pediatr 2020; 8:352. [PMID: 32760683 PMCID: PMC7372912 DOI: 10.3389/fped.2020.00352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 05/27/2020] [Indexed: 11/13/2022] Open
Abstract
Severe neonatal gastrointestinal diseases such as necrotizing enterocolitis or spontaneous intestinal perforation are potentially lethal conditions which predominantly occur in preterm infants. Cytomegalovirus (CMV), which is known to cause congenital and acquired infections in the newborns, has also been implicated in such severe gastrointestinal diseases in premature infants. However, the pathogenic role of CMV and effect of antiviral therapy in severe gastrointestinal disease in premature neonates is currently unclear. We present an infant, born at 26-weeks' gestation, presented with progressive dyspepsia and abdominal distention after the closure of the symptomatic patent ductus arteriosus at the day of life (DOL) 4, requiring the emergent surgery for ileal perforation at the DOL8. After the surgery, abdominal symptoms persisted and the second emergent surgery was performed for the recurrent ileal perforation at DOL17. Even then the abdominal symptoms prolonged and pathological examination in the affected intestine at the second surgery showed CMV inclusion body. Immunoreactivity for CMV antigen was detected in the specimen at the first surgery on DOL8. Blood and urinary CMV-DNA were detected at DOL28. CMV-DNA was also detected in the dried umbilical cord which was obtained within a week from birth. A 6-week course of intravenous ganciclovir (12 mg/kg/day) was started at DOL34 and then symptoms resolved along with decreasing blood CMV-DNA. Pathological findings characteristic of CMV were not detected in the resection specimen at the ileostomy closure at DOL94. These observations indicate that anti-CMV therapy may be beneficial for some premature infants with severe CMV-associated gastrointestinal diseases and warrants further studies focusing on pathogenic role, diagnosis, treatment and prevention of this underrecognized etiology of severe gastrointestinal diseases particularly in premature neonates.
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Affiliation(s)
- Mari Morimoto
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hirofumi Sawada
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan.,Anesthesiology and Critical Care Medicine, Mie University Graduate School of Medicine, Tsu, Japan
| | - Noriko Yodoya
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hiroyuki Ohashi
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kuniaki Toriyabe
- Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Ryo Hanaki
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan
| | - Katsumi Sugiura
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hidemi Toyoda
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kohei Matsushita
- Department of Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yuhki Koike
- Department of Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kohei Otake
- Department of Pediatric Surgery, Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - Mikihiro Inoue
- Department of Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Keiichi Uchida
- Department of Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hiroshi Imai
- Pathology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yoshihide Mitani
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kazuo Maruyama
- Anesthesiology and Critical Care Medicine, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yoshihiro Komada
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan
| | - Tomoaki Ikeda
- Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Masahiro Hirayama
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan
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19
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Magawa S, Tanaka H, Furuhashi F, Maki S, Nii M, Toriyabe K, Kondo E, Ikeda T. RETRACTED ARTICLE: Intrapartum cardiotocogram monitoring between obstetricians and computer analysis. J Matern Fetal Neonatal Med 2019; 34:3408-3414. [PMID: 31056986 DOI: 10.1080/14767058.2019.1615876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We, the Editors and Publisher of The Journal of Maternal-Fetal & Neonatal Medicine, have retracted the following article:Shoichi Magawa, Hiroaki Tanaka, Fumi Furuhashi, Shintaro Maki, Masafumi Nii, Kuniaki Toriyabe, Eiji Kondo & Tomoaki Ikeda; Intrapartum cardiotocogram monitoring between obstetricians and computer analysis, The Journal of Maternal-Fetal & Neonatal Medicine (Author Accepted Version), 10.1080/14767058.2019.1615876.The incorrect manuscript was provided by the authors resulting in a duplicate publication.We have been informed in our decision-making by our policy on publishing ethics and integrity and the COPE guidelines on retractions.The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as "Retracted".
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Affiliation(s)
- Shoichi Magawa
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine , Mie, Japan
| | - Hiroaki Tanaka
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine , Mie, Japan
| | - Fumi Furuhashi
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine , Mie, Japan
| | - Shintaro Maki
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine , Mie, Japan
| | - Masafumi Nii
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine , Mie, Japan
| | - Kuniaki Toriyabe
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine , Mie, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine , Mie, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine , Mie, Japan
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Magawa S, Tanaka H, Furuhashi F, Maki S, Nii M, Toriyabe K, Kondo E, Ikeda T. Intrapartum cardiotocogram monitoring between obstetricians and computer analysis. J Matern Fetal Neonatal Med 2019; 34:787-793. [PMID: 31072186 DOI: 10.1080/14767058.2019.1617688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To investigate the accuracy of computer analysis and its features to be used as a fu fetal heart rate (FHR) interpretation method in clinical settings.Methods: The Trium CTG Online® was used as the computer analysis software. Twenty-six cases of intrapartum FHR tracings (total time, 6900 min) were randomly selected from third-trimester pregnancies. Three obstetricians blinded to the patients' clinical information traced the decelerations, variability, and baseline cardiotocogram (CTG) data. Three obstetrician observer individually interpreted the data and only the waveforms they interpreted were adopted. The agreement between the deceleration and baseline, variability, and level of five-tier system was estimated. Weighted kappa (κ) statistics were used to assess reliability.Results: Based on the observers and Trium's classification, κ was 0.78 and the strength of agreement level was substantial. The obstetricians and Trium mostly agreed on the variability and baseline data. However, κ of each deceleration was approximately 0.65 (0.63-0.66), with substantial strength of agreement.Conclusion: Based on the obstetricians and Trium's interpretation, the latter was found to be excellent for FHR interpretation. However, it was difficult for Trium to interpret specific waveform patterns. Therefore, clinical staff should understand these characteristics to more sensitively evaluate the fetal well-being.
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Affiliation(s)
- Shoichi Magawa
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Mie, Japan
| | - Hiroaki Tanaka
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Mie, Japan
| | - Fumi Furuhashi
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Mie, Japan
| | - Shintaro Maki
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Mie, Japan
| | - Masafumi Nii
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Mie, Japan
| | - Kuniaki Toriyabe
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Mie, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Mie, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Mie, Japan
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Tanaka K, Tanaka H, Toriyabe K, Maki S, Furuhashi F, Magawa S, Ikeda T. 36: Tadalafil treatment in mice for preeclampsia with fetal growth restriction has neurobenefic effects in offspring. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2018.11.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Shimada K, Toriyabe K, Kitamura A, Takeda K, Takayama E, Maki S, Kaneda M, Nii M, Tanaka K, Tanaka H, Kamimoto Y, Ikeda T. Primary cytomegalovirus (CMV) infection in the period between late in previous pregnancy and early in current pregnancy. J Reprod Immunol 2018. [DOI: 10.1016/j.jri.2018.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Magawa S, Tanaka H, Furuhashi F, Maki S, Nii M, Toriyabe K, Ikeda T. A literature review of herpes simplex virus hepatitis in pregnancy. J Matern Fetal Neonatal Med 2018; 33:1774-1779. [PMID: 30235956 DOI: 10.1080/14767058.2018.1527311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Purpose: Hepatitis due to herpes simplex virus (HSV) during pregnancy is rare, it is often not included in the differential disease. However, hepatitis leads to maternal death; hence, early diagnosis is necessary. Hepatic enzyme elevation in late pregnancy is often associated with obstetric-related diseases, such as acute gestational fatty liver and HELLP syndrome (hemolytic anemia, elevated liver enzymes, low platelet count). These pregnancy-related diseases often improve maternal condition after completion of pregnancy, but in patients with HSV hepatitis, invasive treatment, such as cesarean section, may lead to deterioration of maternal condition after completion of pregnancy. A systematic review was conducted to extract necessary factors to avoid maternal death caused by herpetic hepatitis.Methods: In 24 cases reported since 1991, age, onset gestational weeks, initial symptoms, days from onset of symptoms to consultation, diagnosis method, treatment method, maximum liver escape enzyme value during hospitalization, bilirubin value, international normalized ratio value, and fetal/neonatal prognosis were extracted, and the relationship between maternal death group (n = 6) and maternal alive group (n = 18) was statistically analyzed.Results: Fever as an initial symptom was observed in all cases. Maternal death did not occur in patients administered with acyclovir (ACV) as empiric therapy. No difference was found between the two groups in other factors.Conclusion: Early diagnosis and treatment of herpetic hepatitis during pregnancy are important, as well as administration of empiric ACV concurrently with noninvasive diagnosis when a pregnant woman has elevated liver enzyme accompanied by fever in late pregnancy.
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Affiliation(s)
- Shoichi Magawa
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Japan
| | - Hiroaki Tanaka
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Japan
| | - Fumi Furuhashi
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Japan
| | - Shintaro Maki
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Japan
| | - Masafumi Nii
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Japan
| | - Kuniaki Toriyabe
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University Faculty Medicine, Tsu, Japan
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Tanaka H, Furuhashi FH, Toriyabe K, Matsumoto T, Magawa S, Nii M, Watanabe J, Tanaka K, Umekawa T, Kamimoto Y, Ikeda T. Management of fetal growth restriction using the contraction stress test: a case-control study. J Matern Fetal Neonatal Med 2018; 32:3221-3225. [PMID: 29614894 DOI: 10.1080/14767058.2018.1461313] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Purpose: Fetal growth restriction (FGR) is a concerning health issue. However, studies on FGR management are limited due to its rarity. We aimed to evaluate the efficacy of the contraction stress test (CST) for FGR management. Materials and methods: A case-control retrospective study design. Our institute innovated CST in FGR management in 2017. We included women in their 33rd-40th week of pregnancy with a diagnosis of FGR and retrospectively divided them into groups: the CST group (FGR management with CST) and no CST group (FGR management without CST) before and after CST development. Neonatal outcome, pH, and pO2 of umbilical artery (UA) were compared between the two groups. Results: No significant differences in the rate of birth weight, Apgar score <7 (5 minutes), neonatal death, hospitalization to newborn childhood intensive care unit (NICU), and UA pH were found between groups. Average UA pH was 7.29 ± 0.05 and 7.29 ± 0.04 in the CST and no CST groups, respectively (p = .864). Average UA pO2 values were 21.1 ± 8.6 and 15.7 ± 5.0 mmHg in the CST and no CST groups, respectively (p = .016), showing significant differences. Conclusions: Neonatal outcomes and UA pH were slightly different between the groups managed with and without CST. However, UA pO2 values significantly differed between the groups. For FGR management, the use of a CST may allow for early intervention before fetal acidemia and acidosis. For establishing the effects of a CST for FGR management, analysis including several cases and investigation of long-term outcomes of newborn infants is necessary.
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Affiliation(s)
- Hiroaki Tanaka
- a Department of Obstetrics and Gynecology , Mie University School of Medicine , Mie , Japan
| | - Fumi H Furuhashi
- a Department of Obstetrics and Gynecology , Mie University School of Medicine , Mie , Japan
| | - Kuniaki Toriyabe
- a Department of Obstetrics and Gynecology , Mie University School of Medicine , Mie , Japan
| | - Takeshi Matsumoto
- a Department of Obstetrics and Gynecology , Mie University School of Medicine , Mie , Japan
| | - Shoich Magawa
- a Department of Obstetrics and Gynecology , Mie University School of Medicine , Mie , Japan
| | - Masafumi Nii
- a Department of Obstetrics and Gynecology , Mie University School of Medicine , Mie , Japan
| | - Junko Watanabe
- a Department of Obstetrics and Gynecology , Mie University School of Medicine , Mie , Japan
| | - Kayo Tanaka
- a Department of Obstetrics and Gynecology , Mie University School of Medicine , Mie , Japan
| | - Takashi Umekawa
- a Department of Obstetrics and Gynecology , Mie University School of Medicine , Mie , Japan
| | - Yuki Kamimoto
- a Department of Obstetrics and Gynecology , Mie University School of Medicine , Mie , Japan
| | - Tomoaki Ikeda
- a Department of Obstetrics and Gynecology , Mie University School of Medicine , Mie , Japan
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Toriyabe K, Taniguchi H, Senda T, Nakano M, Kobayashi Y, Izawa M, Tanaka H, Asakura T, Tabata T, Ikeda T. Pregnancy and cesarean delivery after multimodal therapy for vulvar carcinoma: A case report. Mol Clin Oncol 2016; 5:583-586. [PMID: 27900089 DOI: 10.3892/mco.2016.1021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 09/12/2016] [Indexed: 11/06/2022] Open
Abstract
Reports of pregnancy following treatment for vulvar carcinoma are extremely uncommon, as the main problem of subsequent pregnancy is vulvar scarring following radical surgery. We herein report the case of a patient who was diagnosed with stage I squamous cell carcinoma of the vulva at the age of 17 years and was treated with multimodal therapy, including neoadjuvant chemotherapy, wide local excision with bilateral inguinal lymph node dissection and adjuvant radiotherapy. The patient became pregnant spontaneously 9 years after her initial diagnosis and the antenatal course was good, except for mild acute pyelonephritis at 25 weeks of gestation. An elective caesarean section was performed at 38 weeks of gestation due to vulvar scarring following multimodal therapy, particularly radiotherapy. The patient remains alive and well, without signs of recurrence or metastasis 12 years after her diagnosis and treatment. Radical vulvectomy as well as multimodal therapy for vulvar carcinoma, particularly radiotherapy, may cause extensive skin scarring. The presence of vulvar scarring following multimodal therapy for vulvar carcinoma may increase the incidence of caesarean delivery.
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Affiliation(s)
- Kuniaki Toriyabe
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan; Department of Obstetrics and Gynecology, Mie Prefectural General Medical Center, Yokkaichi, Mie 510-8561, Japan
| | - Haruki Taniguchi
- Department of Obstetrics and Gynecology, Mie Prefectural General Medical Center, Yokkaichi, Mie 510-8561, Japan
| | - Tokihiro Senda
- Department of Obstetrics and Gynecology, Mie Prefectural General Medical Center, Yokkaichi, Mie 510-8561, Japan; Department of Obstetrics and Gynecology, Kinan Hospital, Mihama, Mie 519-5293, Japan
| | - Masako Nakano
- Department of Obstetrics and Gynecology, Mie Prefectural General Medical Center, Yokkaichi, Mie 510-8561, Japan
| | - Yoshinari Kobayashi
- Department of Obstetrics and Gynecology, Mie Prefectural General Medical Center, Yokkaichi, Mie 510-8561, Japan
| | - Miho Izawa
- Department of Obstetrics and Gynecology, Mie Prefectural General Medical Center, Yokkaichi, Mie 510-8561, Japan
| | - Hirohiko Tanaka
- Department of Obstetrics and Gynecology, Mie Prefectural General Medical Center, Yokkaichi, Mie 510-8561, Japan
| | - Tetsuo Asakura
- Department of Obstetrics and Gynecology, Mie Prefectural General Medical Center, Yokkaichi, Mie 510-8561, Japan
| | - Tsutomu Tabata
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan
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Toriyabe K, Kitamura A, Maki S, Kubo M, Nii M, Tanaka K, Nishioka M, Watanabe J, Takayama E, Maezawa T, Tanaka H, Murabayashi N, Osato K, Kamimoto Y, Ikeda T. A case of non-primary cytomegalovirus infection in a pregnant woman whose fetus developed congenital cytomegalovirus infection. J Reprod Immunol 2016. [DOI: 10.1016/j.jri.2016.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Tanaka H, Toriyabe K, Senda T, Sakakura Y, Yoshida K, Asakura T, Taniguchi H, Nagao K. Cotyledonoid dissecting leiomyoma treated by laparoscopic surgery: a case report. Asian J Endosc Surg 2013; 6:122-5. [PMID: 23601996 DOI: 10.1111/ases.12009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 10/12/2012] [Accepted: 10/26/2012] [Indexed: 11/25/2022]
Abstract
A cotyledonoid dissecting leiomyoma is categorized as a leiomyoma with an unusual growth pattern, which is characterized by remarkable extrauterine bulbous growth in continuity with a dissecting myometrial component. A 36-year-old patient was preoperatively diagnosed with a mature cystic teratoma of the left ovary, and according to MRI, the tumor protruded from the uterus into the right broad ligament and was 10 cm in diameter. She underwent laparoscopic surgery to resect ovarian teratoma and the tumor under the right broad ligament. The tumor was almost completely resected and diagnosed as a cotyledonoid dissecting leiomyoma based on intraoperative and pathological findings. Recurrence was not seen for 26 months postoperatively in our case. Gross specimens are often mistaken for malignant lesions, but this was a benign disease. Even if some remnants of the leiomyoma remained postoperatively, recurrence has never been reported. When a cotyledonoid dissecting leiomyoma is resected laparoscopically, intrapelvic structures around it, such as the ureter, uterine artery, bladder, rectum and external iliac vessels, must be given careful attention.
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Affiliation(s)
- Hirohiko Tanaka
- Department of Obstetrics and Gynecology, Mie Prefectural General Medical Center, Yokkaichi, Japan.
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Ishida T, Washizu T, Toriyabe K, Motoyoshi S, Tomoda I, Pedersen NC. Feline immunodeficiency virus infection in cats of Japan. J Am Vet Med Assoc 1989; 194:221-5. [PMID: 2537270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A seroepidemiologic survey for feline immunodeficiency virus (FIV) infection was conducted in Japan. Between June and December 1987, individual sera (n = 3,323) were submitted by veterinary practitioners from many parts of the country. Specimens were from 1,739 cats with clinical signs suggestive of FIV infection and from 1,584 healthy-appearing cats seen by the same practitioners. The overall FIV infection rate among cats in Japan was 960/3,323 cats (28.9%). The infection rate was more than 3 times higher in the clinically ill cats, compared with that in the healthy cats of the same cohort (43.9 vs 12.4%). Male cats were 1.5 times as likely to be infected as were females. Almost all FIV-infected cats were domestic cats (as opposed to purebred cats). Complete clinical history was available for 700 of 960 FIV-infected cats. Of these 700 FIV-infected cats, 626 (89.4%) were clinically ill, and the remainder did not have clinical signs of disease. The mean age at the time of FIV diagnosis for the 700 cats was 5.2 years, with younger mean age for males (4.9 years) than for females (5.8 years). Most of the infected cats (94.7%) were either allowed to run outdoors or had lived outdoors before being brought into homes. The mortality for FIV-infected cats during the 6 months after diagnosis was 14.7%, and the mean age at the time of death was 5.7 years. Concurrent FeLV infection was seen in 12.4% of the FIV-infected cats, but this was not much different from the historical incidence of FeLV infection in similar groups of cats not infected with FIV.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- T Ishida
- Department of Clinical Pathology, School of Veterinary Medicine, Nippon Veterinary and Zootechnical College, Tokyo, Japan
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Ishida T, Washizu T, Toriyabe K, Motoyoshi S. Detection of feline T-lymphotropic lentivirus (FTLV) infection in Japanese domestic cats. Nihon Juigaku Zasshi 1988; 50:39-44. [PMID: 2834600 DOI: 10.1292/jvms1939.50.39] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Ishida T, Washizu T, Fukuoka J, Toriyabe K, Uchino T, Motoyoshi S. Feline infectious peritonitis virus antibody test using enzyme-linked immunosorbent assay. Nihon Juigaku Zasshi 1987; 49:145-9. [PMID: 3573475 DOI: 10.1292/jvms1939.49.145] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Ishida T, Toriyabe K, Fukuoka J, Motoyoshi S. Serodiagnosis of feline infectious peritonitis. Adv Exp Med Biol 1987; 218:577-8. [PMID: 2829571 DOI: 10.1007/978-1-4684-1280-2_73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- T Ishida
- Department of Clinical Pathology, Nippon Veterinary and Zootechnical College, Tokyo, Japan
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