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Ito M, Yoshino O, Hiraoka T, Ono Y, Tanaka K, Iwahata S, Honda M, Furue A, Nishijima J, Shimoda T, Iwase H, Miki A, Tagaya H, Hirata S, Unno N. Oral Gonadotropin-Releasing Hormone Antagonist Relugolix Has the Same Effect as Gonadotropin-Releasing Hormone Agonist Injections in Terms of Preparation for Transcervical Resection Myomectomy. Gynecol Minim Invasive Ther 2022; 11:238-241. [PMID: 36660323 PMCID: PMC9844050 DOI: 10.4103/gmit.gmit_9_22] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 11/09/2022] Open
Abstract
For preparing the optimal condition in transcervical resection (TCR) surgery, gonadotropin-releasing hormone (GnRH) agonist has been utilized. Recently, an oral GnRH antagonist (relugolix) is available and acts directly on GnRH receptor, avoiding flare up and reducing blood E2 levels rapidly. We retrospectively compared the oral GnRH antagonist (n = 14) effect to that of subcutaneous GnRH agonist (n = 19) for the pretreatment of endometrium in TCR myomectomy. Endometrial thickening was determined by intraoperative videos. The color tone of the endometrium in the normal part was assessed by digital image processing. The median duration of the first GnRH agonist injection and the surgery was 67 days (21-136 days), which is significantly longer than that of the oral GnRH antagonist group, 18.5 days (7-157 days P < 0.01). Both the GnRH agonist and antagonist groups did not exhibit prominence in the endometrium. The GnRH antagonist group showed the same degree of whiteness in the normal endometrium as the GnRH agonist group. The oral GnRH antagonist administration could rapidly atrophy the endometrium and create an optimal surgical field for TCR in a short period.
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Affiliation(s)
- Mika Ito
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan,Department of Obstetrics and Gynecology, Kitasato University Medical Center, School of Medicine, Kitamoto, Japan
| | - Osamu Yoshino
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan,Department of Obstetrics and Gynecology, University of Yamanashi, Kofu, Japan,Address for correspondence: Dr. Osamu Yoshino, Department of Obstetrics and Gynecology, University of Yamanashi, 1110 Shimokato, Chuo-Shi, Zip: 409-3898, Yamanashi, Japan. E-mail:
| | - Takehiro Hiraoka
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yosuke Ono
- Department of Obstetrics and Gynecology, University of Yamanashi, Kofu, Japan
| | - Kouta Tanaka
- Department of Obstetrics and Gynecology, University of Yamanashi, Kofu, Japan
| | - Shunsuke Iwahata
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Masako Honda
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Akiko Furue
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Junichi Nishijima
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Takahito Shimoda
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Haruko Iwase
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Akinori Miki
- Department of Obstetrics and Gynecology, Kitasato University Medical Center, School of Medicine, Kitamoto, Japan
| | - Hikaru Tagaya
- Department of Obstetrics and Gynecology, University of Yamanashi, Kofu, Japan
| | - Shuji Hirata
- Department of Obstetrics and Gynecology, University of Yamanashi, Kofu, Japan
| | - Nobuya Unno
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
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Yoshino O, Ono Y, Honda M, Hattori K, Sato E, Hiraoka T, Ito M, Kobayashi M, Arai K, Katayama H, Tsuchida H, Yamada-Nomoto K, Iwahata S, Fukushi Y, Wada S, Iwase H, Koga K, Osuga Y, Iwaoka M, Unno N. Relaxin-2 May Suppress Endometriosis by Reducing Fibrosis, Scar Formation, and Inflammation. Biomedicines 2020; 8:biomedicines8110467. [PMID: 33142814 PMCID: PMC7693148 DOI: 10.3390/biomedicines8110467] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 09/28/2020] [Revised: 10/21/2020] [Accepted: 10/28/2020] [Indexed: 12/26/2022] Open
Abstract
Background: Relaxin (RLX)-2, produced by the corpus luteum and placenta, is known to be potentially effective in fibrotic diseases of the heart, lungs, kidneys, and bladder; however, its effectiveness in endometriosis has not yet been investigated. In the present study, we conducted a comprehensive study on the effect of RLX-2 on endometriosis. We checked the expressions of LGR-7, a primary receptor of RLX-2, in endometriomas using immunohistochemistry. Endometriotic stromal cells (ESCs) purified from surgical specimens were used in in vitro experiments. The effects of RLX-2 on ESCs were evaluated by quantitative-PCR, ELISA, and Western blotting. Gel contraction assay was used to assess the contraction suppressive effect of RLX-2. The effect of RLX-2 was also examined in the endometriosis mouse model. LGR-7 was expressed in endometriotic lesions. In ESCs, RLX-2 increased the production of cAMP and suppressed the secretion of interleukin-8, an inflammatory cytokine, by 15% and mRNA expression of fibrosis-related molecules, plasminogen activator inhibitor-1 (PAI-1), and collagen-I by approximately 50% (p < 0.05). In the gel contraction assay, RLX-2 significantly suppressed the contraction of ESCs, which was cancelled by removing RLX-2 from the medium or by adding H89, a Protein Kinase A (PKA) inhibitor. In ESCs stimulated with RLX-2, p38 MAPK phosphorylation was significantly suppressed. In the endometriosis mouse model, administration of RLX-2 significantly decreased the area of the endometriotic-like lesion with decreasing fibrotic component compared to non-treated control (p = 0.01). RLX-2 may contribute to the control of endometriotic lesion by suppressing fibrosis, scar formation, and inflammation.
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Affiliation(s)
- Osamu Yoshino
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Kanagawa 252-0375, Japan; (M.H.); (K.H.); (E.S.); (T.H.); (S.I.); (H.I.); (N.U.)
- Correspondence:
| | - Yosuke Ono
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Hokkaido 006-0811, Japan; (Y.O.); (Y.F.); (S.W.)
| | - Masako Honda
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Kanagawa 252-0375, Japan; (M.H.); (K.H.); (E.S.); (T.H.); (S.I.); (H.I.); (N.U.)
| | - Kyoko Hattori
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Kanagawa 252-0375, Japan; (M.H.); (K.H.); (E.S.); (T.H.); (S.I.); (H.I.); (N.U.)
| | - Erina Sato
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Kanagawa 252-0375, Japan; (M.H.); (K.H.); (E.S.); (T.H.); (S.I.); (H.I.); (N.U.)
| | - Takehiro Hiraoka
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Kanagawa 252-0375, Japan; (M.H.); (K.H.); (E.S.); (T.H.); (S.I.); (H.I.); (N.U.)
| | - Masami Ito
- Department of Obstetrics and Gynecology, University of Toyama, Toyama 930-0194, Japan; (M.I.); (M.K.); (H.T.); (K.Y.-N.)
| | - Mutsumi Kobayashi
- Department of Obstetrics and Gynecology, University of Toyama, Toyama 930-0194, Japan; (M.I.); (M.K.); (H.T.); (K.Y.-N.)
| | - Kenta Arai
- Department of Chemistry, School of Science, Tokai University, Tokyo 259-1292, Japan; (K.A.); (M.I.)
| | - Hidekazu Katayama
- Department of Applied Biochemistry, Tokai University, Tokyo 259-1292, Japan;
| | - Hiroyoshi Tsuchida
- Department of Obstetrics and Gynecology, University of Toyama, Toyama 930-0194, Japan; (M.I.); (M.K.); (H.T.); (K.Y.-N.)
| | - Kaori Yamada-Nomoto
- Department of Obstetrics and Gynecology, University of Toyama, Toyama 930-0194, Japan; (M.I.); (M.K.); (H.T.); (K.Y.-N.)
| | - Shunsuke Iwahata
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Kanagawa 252-0375, Japan; (M.H.); (K.H.); (E.S.); (T.H.); (S.I.); (H.I.); (N.U.)
| | - Yoshiyuki Fukushi
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Hokkaido 006-0811, Japan; (Y.O.); (Y.F.); (S.W.)
| | - Shinichiro Wada
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Hokkaido 006-0811, Japan; (Y.O.); (Y.F.); (S.W.)
| | - Haruko Iwase
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Kanagawa 252-0375, Japan; (M.H.); (K.H.); (E.S.); (T.H.); (S.I.); (H.I.); (N.U.)
| | - Kaori Koga
- Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo 113-8655, Japan; (K.K.); (Y.O.)
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo 113-8655, Japan; (K.K.); (Y.O.)
| | - Michio Iwaoka
- Department of Chemistry, School of Science, Tokai University, Tokyo 259-1292, Japan; (K.A.); (M.I.)
| | - Nobuya Unno
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Kanagawa 252-0375, Japan; (M.H.); (K.H.); (E.S.); (T.H.); (S.I.); (H.I.); (N.U.)
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Mochizuki J, Nakamura M, Iwahata S, Nishijima J, Ito T, Wada T, Takayama Y, Unno N. First report in Japan of a delivery of a woman with the 2019 novel coronavirus disease. J Obstet Gynaecol Res 2020; 47:407-410. [PMID: 33058362 PMCID: PMC7675692 DOI: 10.1111/jog.14393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 05/08/2020] [Revised: 06/11/2020] [Accepted: 06/20/2020] [Indexed: 02/06/2023]
Abstract
On April 2, 2020, we received a maternal transport from a local city hospital of a pregnant woman (38 weeks and 0 days of gestation) in her 20s, who had the 2019 novel coronavirus disease (COVID‐19). We performed an emergency cesarean section with spinal anesthesia because of an abnormal fetal heart rate pattern. A healthy 3106‐g male baby was delivered. All the severe acute respiratory syndrome coronavirus 2 polymerase chain reaction tests of nasal and oral discharges, anal swabs and blood samples of the neonate at 9 h, 30 h and 4 days after birth were negative. Because the mother was diagnosed as having COVID‐19 pneumonia, the neonate was given formula milk. The mother's nasal discharge samples at 20 and 21 days were negative. The mother first held her baby in her arms on the 22nd day after birth, and they were discharged on the following day. To the best of our knowledge, this is the first report in Japan of a delivery of a baby from a woman infected with COVID‐19.
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Affiliation(s)
- Junko Mochizuki
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Motohiro Nakamura
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Shunsuke Iwahata
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Junichi Nishijima
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Takashi Ito
- Department of Pediatrics, Kitasato University School of Medicine, Sagamihara, Japan
| | - Tatsuhiko Wada
- Department of Rheumatology and Infectious Disease, Kitasato University School of Medicine, Sagamihara, Japan.,Department of Infection Control and Prevention, Kitasato University Hospital, Sagamihara, Japan
| | - Yoko Takayama
- Department of Infection Control and Prevention, Kitasato University Hospital, Sagamihara, Japan.,Department of Infection Control and Infectious Diseases, Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Sagamihara, Japan
| | - Nobuya Unno
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
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Takahashi N, Yoshino O, Hayashida E, Nakamura M, Hori M, Iwahata S, Onda T, Unno N, Fujii T, Osuga Y. Quantitative analysis of ovarian cysts and tumors by using T2 star mapping. J Obstet Gynaecol Res 2019; 46:140-146. [PMID: 31742851 DOI: 10.1111/jog.14157] [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: 05/09/2019] [Accepted: 11/04/2019] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to investigate the efficacy of T2 star (T2*) mapping in diagnosing ovarian cysts/ tumors. METHODS Pelvic magnetic resonance examinations including T2*WI were performed before surgery in 35 patients. The region of interest, consisted of a 10 mm2 diameter circle, was set as much as possible inside ovarian tumors/cysts to measure T2*values, and mean T2* values were compared in ovarian cyst/tumor types, retrospectively. Diagnoses of 40 ovarian cysts/tumors were determined by pathological reports, in which 17 were endometriomas, 13 were mature cystic teratomas, 6 were mucinous cystadenomas and 4 were serous cystadenomas. RESULTS The average T2* values of endometrioma was 56.8 ± 8.7 ms (mean ± SEM), which was significantly lower than that of mucinous cystadenoma (334.2 ± 58.5 ms, mean ± SEM) or serous cystadenoma (237.0 ± 45.4 ms, mean ± SEM). There was no difference in T2* values between endometrioma and mature cystic teratoma (64.1 ± 22.6 ms, mean ± SEM). Receiver operating characteristics curve analysis revealed that optimal cut-off value for differential diagnosis of endometrioma and mucinous or serous cystadenoma was 149.2 ms as T2* value, which has an area under the curve of 0.95 (sensitivity = 92.4%, specificity = 78.6%). CONCLUSION T2* values were useful to diagnose various types of ovarian cyst/tumor.
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Affiliation(s)
- Nozomi Takahashi
- Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo, Japan
| | - Osamu Yoshino
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Kanagawa, Japan
| | | | | | - Masaaki Hori
- Department of Radiology, The University of Juntendo, Tokyo, Japan
| | - Shunsuke Iwahata
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Kanagawa, Japan
| | - Takashi Onda
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Kanagawa, Japan
| | - Nobuya Unno
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Kanagawa, Japan
| | - Tomoyuki Fujii
- Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo, Japan
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Kaneko M, Iwahata S, Asakura T. QUENCHING OF PHOTOEXCITED 4,4'-DICARBOXY-2,2'-BIPYRIDINEBIS(2,2'-BIPYRIDINE)RUTHENIUM(II) BY OXYGEN IN AQUEOUS SOLUTION AND IN SILK FIBROIN MEMBRANE. Photochem Photobiol 1992. [DOI: 10.1111/j.1751-1097.1992.tb04270.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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