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Kotaka S, Kondo E, Kawai Y, Okamoto K, Kishigami Y, Yamawaki T, Nagao K, Toru H, Suzuki S. Paclitaxel-carboplatin plus bevacizumab therapy for advanced neuroendocrine carcinoma of the uterine cervix: A retrospective case series. J Obstet Gynaecol Res 2023; 49:2868-2874. [PMID: 37658751 DOI: 10.1111/jog.15783] [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: 05/24/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023]
Abstract
AIM There is no conclusive data on the prognosis of patients who receive paclitaxel-carboplatin (TC) plus bevacizumab therapy for advanced neuroendocrine carcinoma (NEC) of the uterine cervix, a rare histological subtype of cervical cancer. Thus, the aim of this study was to determine the efficacy of TC chemotherapy plus bevacizumab and bevacizumab single maintenance therapy for advanced NEC of the cervix. METHODS This was a retrospective review of patients who received TC plus bevacizumab therapy for metastatic, recurrent, or persistent NEC of the cervix at seven institutions between 2015 and 2020. Relevant data were extracted from the patients' medical records and analyzed. RESULTS Seven patients, including six with small-cell NEC and one with large-cell NEC, were included for analysis. Three patients received bevacizumab single maintenance therapy following TC plus bevacizumab therapy, whereas four patients did not receive bevacizumab single maintenance therapy. The median overall survival and progression-free survival of the patients who received bevacizumab single maintenance therapy were longer than those of the patients who did not receive the therapy (34 months vs. 10.5 months and 19 months vs. 5 months, respectively). However, the patients who received bevacizumab single maintenance therapy had received cisplatin-based chemotherapy previously. CONCLUSIONS On the premise that cisplatin-based chemotherapy is administered as the first-line treatment for advanced NEC of the cervix, bevacizumab single maintenance therapy following TC plus bevacizumab may be considered the second- or third-line treatment. However, the risk of adverse events, such as intestinal perforation, should be discussed with patients.
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Affiliation(s)
- Saki Kotaka
- Department of Gynecologic Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Mie, Japan
- Department of Obstetrics and Gynecology, Kuwana City Medical Center, Kuwana, Mie, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Mie, Japan
| | - Yosuke Kawai
- Department of Obstetrics and Gynecology, Toyohashi Municipal Hospital, Toyohashi, Aichi, Japan
| | - Kota Okamoto
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Mie, Japan
| | - Yasuyuki Kishigami
- Department of Obstetrics and Gynecology, Toyota Memorial Hospital, Toyota, Aichi, Japan
| | - Takaharu Yamawaki
- Department of Obstetrics and Gynecology, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Kenji Nagao
- Department of Obstetrics and Gynecology, Yokkaichi Municipal Hospital, Yokkaichi, Mie, Japan
| | - Hirata Toru
- Department of Obstetrics and Gynecology, Kuwana City Medical Center, Kuwana, Mie, Japan
| | - Shiro Suzuki
- Department of Gynecologic Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
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Kotaka S, Kondo E, Kawai Y, Okamoto K, Kishigami Y, Yamawaki T, Nagao K, Hirata T, Suzuki S. Real-world efficacy and safety of bevacizumab single-maintenance therapy following platinum-paclitaxel chemotherapy plus bevacizumab in patients with advanced cervical cancer. J Gynecol Oncol 2023; 34:e60. [PMID: 37170726 PMCID: PMC10482586 DOI: 10.3802/jgo.2023.34.e60] [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: 12/28/2022] [Revised: 02/27/2023] [Accepted: 03/22/2023] [Indexed: 05/13/2023] Open
Abstract
OBJECTIVE Bevacizumab maintenance therapy following platinum-based combination chemotherapy for metastatic, recurrent, or persistent cervical cancer is not recommended as standard therapy. This pilot study aimed to evaluate the efficacy and safety of bevacizumab maintenance therapy and the contribution of the platinum-free interval to the efficacy of subsequent chemotherapy for advanced cervical cancer. METHODS We retrospectively identified 115 patients with metastatic, recurrent, or persistent cervical cancer treated with platinum-paclitaxel chemotherapy plus bevacizumab at 7 institutions between 2015 and 2020. The primary endpoints were overall survival (OS) and progression-free survival (PFS) in patients who received bevacizumab maintenance therapy and those who did not. We also analyzed the adverse events associated with bevacizumab and survival time from the start of subsequent chemotherapy in both groups. RESULTS Following platinum-paclitaxel plus bevacizumab chemotherapy, 34 patients received bevacizumab maintenance therapy and 81 patients did not. Of the 115 patients, 56 received chemotherapy for subsequent relapse. Although bevacizumab maintenance therapy prolonged PFS (median of 16.0 months vs. 9.0 months, p=0.041), significant differences were not observed in OS (p=0.374). Furthermore, bevacizumab maintenance therapy did not prolong OS and PFS after the start of subsequent chemotherapy (p=0.663 and p=0.136, respectively). Bevacizumab maintenance therapy significantly increased hypertension (p=0.035) and proteinuria (p=0.005) but did not cause complications leading to death. CONCLUSION Bevacizumab single-maintenance therapy for advanced cervical cancer can be considered in selected cases, such as those with acceptable bevacizumab-related side effects. The outcomes of our study will likely contribute to decision-making regarding practical treatment strategies.
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Affiliation(s)
- Saki Kotaka
- Department of Gynecologic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Japan
| | - Yosuke Kawai
- Department of Obstetrics and Gynecology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Kota Okamoto
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Japan
| | - Yasuyuki Kishigami
- Department of Obstetrics and Gynecology, Toyota Memorial Hospital, Toyota, Japan
| | - Takaharu Yamawaki
- Department of Obstetrics and Gynecology, Ise Red Cross Hospital, Ise, Japan
| | - Kenji Nagao
- Department of Obstetrics and Gynecology, Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - Toru Hirata
- Department of Obstetrics and Gynecology, Kuwana City Medical Center, Kuwana, Japan
| | - Shiro Suzuki
- Department of Gynecologic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan.
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Tano S, Kotani T, Ushida T, Yoshihara M, Imai K, Nakamura N, Iitani Y, Moriyama Y, Emoto R, Kato S, Yoshida S, Yamashita M, Kishigami Y, Oguchi H, Matsui S, Kajiyama H. Evaluating glucose variability through OGTT in early pregnancy and its association with hypertensive disorders of pregnancy in non-diabetic pregnancies: a large-scale multi-center retrospective study. Diabetol Metab Syndr 2023; 15:123. [PMID: 37296464 DOI: 10.1186/s13098-023-01103-z] [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: 12/16/2022] [Accepted: 05/31/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Recent evidence suggests increased glucose variability (GV) causes endothelial dysfunction, a central pathology of hypertensive disorders of pregnancy (HDP). We aimed to investigate the association between GV in early pregnancy and subsequent HDP development among non-diabetes mellitus (DM) pregnancies. METHODS This multicenter retrospective study used data from singleton pregnancies between 2009 and 2019. Among individuals who had 75 g-OGTT before 20 weeks of gestation, we evaluated GV by 75 g-OGTT parameters and examined its relationship with HDP development, defining an initial-increase from fasting-plasma glucose (PG) to 1-h-PG and subsequent-decrease from 1-h-PG to 2-h-PG. RESULTS Approximately 3.0% pregnancies (802/26,995) had 75 g-OGTT before 20 weeks of gestation, and they had a higher prevalence of HDP (14.3% vs. 7.5%). The initial-increase was significantly associated with overall HDP (aOR 1.20, 95% CI 1.02-1.42), and the subsequent-decrease was associated with decreased and increased development of early-onset (EoHDP: aOR 0.56, 95% CI 0.38-0.82) and late-onset HDP (LoHDP: aOR 1.38, 95% CI 1.11-1.73), respectively. CONCLUSIONS A pattern of marked initial-increase and minor subsequent-decrease (i.e., sustained hyperglycemia) was associated with EoHDP. Contrarily, the pattern of marked initial-increase and subsequent-decrease (i.e., increased GV) was associated with LoHDP. This provides a new perspective for future study strategies.
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Affiliation(s)
- Sho Tano
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Nagoya, Aichi, Japan
| | - Tomomi Kotani
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
- Division of Perinatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Achi, Japan.
| | - Takafumi Ushida
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Masato Yoshihara
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Kenji Imai
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Noriyuki Nakamura
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yukako Iitani
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yoshinori Moriyama
- Department of Obstetrics and Gynecology, Fujita Health University School of Medicine, Nagoya, Aichi, Japan
| | - Ryo Emoto
- Department of Biostatistics, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Sawako Kato
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | | | | | - Yasuyuki Kishigami
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Nagoya, Aichi, Japan
| | - Hidenori Oguchi
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Nagoya, Aichi, Japan
| | - Shigeyuki Matsui
- Department of Biostatistics, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Uno K, Yoshihara M, Tano S, Takeda T, Kishigami Y, Oguchi H. Proton beam therapy for the isolated recurrence of endometrial cancer in para-aortic lymph nodes: a case report. BMC Womens Health 2022; 22:375. [PMID: 36104694 PMCID: PMC9476307 DOI: 10.1186/s12905-022-01961-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 09/02/2022] [Indexed: 12/02/2022] Open
Abstract
Background Proton beam therapy penetrates tumor tissues with a highly concentrated dose. It is useful when normal structures are too proximate to the treatment target and, thus, may be damaged by surgery or conventional photon beam therapy. However, proton beam therapy has only been used to treat recurrent endometrial cancer in a few cases; therefore, its effectiveness remains unclear. Case presentation We herein report a case of the isolated recurrence of endometrial cancer in the para-aortic lymph nodes in a 59-year-old postmenopausal woman that was completely eradicated by proton beam therapy. The patient was diagnosed with stage IIIC2 endometrial cancer and treated with 6 courses of doxorubicin (45 mg/m2) and cisplatin (50 mg/m2) in adjuvant chemotherapy. Fifteen months after the initial therapy, the isolated recurrence of endometrial cancer was detected in the para-aortic lymph nodes. The site of recurrence was just under the left renal artery. Due to the potential risks associated with left kidney resection due to the limited surgical space between the tumor and left renal artery, proton beam therapy was administered instead of surgery or conventional photon beam therapy. Following proton beam therapy, the complete resolution of the recurrent lesion was confirmed. No serious complications occurred during or after treatment. There have been no signs of recurrence more than 7 years after treatment. Conclusions Proton beam therapy is a potentially effective modality for the treatment of recurrent endometrial cancer where the tumor site limits surgical interventions and the use of conventional photon beam therapy.
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Yoshihara M, Kitamura K, Tsuru S, Shimono R, Sakuda H, Mayama M, Tano S, Uno K, Ukai MO, Kishigami Y, Oguchi H, Hirota A. Factors associated with response to compression-based physical therapy for secondary lower limb lymphedema after gynecologic cancer treatment: a multicenter retrospective study. BMC Cancer 2022; 22:25. [PMID: 34980013 PMCID: PMC8722292 DOI: 10.1186/s12885-021-09163-y] [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: 02/27/2021] [Accepted: 11/30/2021] [Indexed: 11/30/2022] Open
Abstract
Background Lower limb lymphedema (LLL) is one of the most refractory and debilitating complications related to gynecological cancer treatment. We investigated factors associated with response to compression-based physical therapy (CPT) for secondary LLL after gynecologic cancer treatment. Methods We performed a multicenter retrospective study using the records of seven medical institutions from 2002 and 2014. Patients who developed LLL after gynecological cancer treatment were included. Limb volumes were calculated from the lengths of the limb circumferences at four points. All participants underwent compression-based physical therapy for LLL. Factors, including MLD, indicative of circumference reductions in LLL were determined. Results In total, 1,034 LLL met the required criteria of for the study. A multivariate linear regression analysis identified age; body mass index (BMI); endometrial cancer; radiotherapy; and initial limb circumference as significant independent prognostic factors related to improvement in LLL. In analysis of covariance for improvement in LLL adjusted by the initial limb circumference and stratified by BMI and radiotherapy, patients with BMI 28 kg/m2 or higher and receiving radiation rarely responded to CPT. Conclusions Improvements in the lower limb circumference correlated with clinical histories and physical characteristics, which may be used as independent prognostic factors for successful CPT for LLL after gynecological cancer treatment.
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Affiliation(s)
- Masato Yoshihara
- Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.,Obstetrics and Gynecology, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Kaoru Kitamura
- Department of Breast Surgery, Kaizuka Hospital, 7-7-27 Hakozaki, Higashi-ku, Fukuoka, Fukuoka, 812-0053, Japan
| | - Satoko Tsuru
- School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan.
| | - Ryoko Shimono
- Organization for Interdisciplinary Research Project, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan
| | - Hiromi Sakuda
- Graduate School of Nursing, Osaka City University, 3-3-138, Sugimoto, Sumiyoshi-ku, Osaka-shi, 558-8585, Japan
| | - Michinori Mayama
- Obstetrics and Gynecology, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan.,Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita 8, Nishi 5, Kita-ku, Sapporo, Hokkaido, 060-0808, Japan
| | - Sho Tano
- Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.,Obstetrics and Gynecology, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Kaname Uno
- Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.,Obstetrics and Gynecology, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Mayu Ohno Ukai
- Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.,Obstetrics and Gynecology, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Yasuyuki Kishigami
- Obstetrics and Gynecology, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Hidenori Oguchi
- Obstetrics and Gynecology, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Akio Hirota
- Hirota Internal Medicine Clinic, 5-19-10 Minami-karasuyama, Setagaya-ku, Tokyo, 157-0062, Japan
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Tano S, Kotani T, Ushida T, Yoshihara M, Imai K, Nakano-Kobayashi T, Moriyama Y, Iitani Y, Kinoshita F, Yoshida S, Yamashita M, Kishigami Y, Oguchi H, Kajiyama H. Annual Body Mass Index Gain and Risk of Gestational Diabetes Mellitus in a Subsequent Pregnancy. Front Endocrinol (Lausanne) 2022; 13:815390. [PMID: 35399932 PMCID: PMC8990746 DOI: 10.3389/fendo.2022.815390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/16/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Weight change during the interpregnancy is related to gestational diabetes mellitus (GDM) in the subsequent pregnancy. In interpregnancy care/counseling, the timeframe for goal setting is important, while the timing of the next conception is unpredictable and preventing age-related body weight gain is difficult. This study aimed to investigate the association between annual weight gain during the interpregnancy, which provide clearer timeframe, and GDM in subsequent pregnancies. METHODS This multicenter retrospective study was conducted by collecting data on two pregnancies of the same women in 2009-2019. The association between annual BMI gain and GDM during the subsequent pregnancy was examined. RESULTS This study included 1,640 pregnant women. A history of GDM [adjusted odds ratio (aOR), 26.22; 95% confidence interval (CI), 14.93-46.07] and annual BMI gain (aOR, 1.48; 95% CI, 1.22-1.81) were related to GDM during the subsequent pregnancy. In the women with a pre-pregnant BMI of <25.0 kg/m2 and without GDM during the index pregnancy, an annual BMI gain of ≥0.6 kg/m2/year during the interpregnancy were associated with GDM in subsequent pregnancies; however, in the other subgroups, it was not associated with GDM in subsequent pregnancies. CONCLUSIONS For women with a pre-pregnant BMI of <25.0 kg/m2 and without GDM during the index pregnancy, maintaining an annual BMI gain of <0.6 kg/m2/year may prevent GDM during the subsequent pregnancy.
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Affiliation(s)
- Sho Tano
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Japan
| | - Tomomi Kotani
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Division of Perinatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan
- *Correspondence: Tomomi Kotani,
| | - Takafumi Ushida
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masato Yoshihara
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenji Imai
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomoko Nakano-Kobayashi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshinori Moriyama
- Department of Obstetrics and Gynecology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yukako Iitani
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Fumie Kinoshita
- Data Science Division, Data Coordinating Center, Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan
| | | | | | - Yasuyuki Kishigami
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Japan
| | - Hidenori Oguchi
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Japan
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Tano S, Ueno T, Mayama M, Yamada T, Takeda T, Uno K, Yoshihara M, Ukai M, Suzuki T, Kishigami Y, Oguchi H. Relationship between vaginal group B streptococcus colonization in the early stage of pregnancy and preterm birth: a retrospective cohort study. BMC Pregnancy Childbirth 2021; 21:141. [PMID: 33593322 PMCID: PMC7888155 DOI: 10.1186/s12884-021-03624-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 02/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although infection and inflammation within the genital tract during pregnancy is considered a major risk factor for spontaneous preterm birth (PTB), there are few studies on association between vaginal microorganisms in the early stage of pregnancy and PTB. The aim of this study was to investigate relationship between vaginal Group B streptococcus (GBS) colonization, a leading cause of infection during pregnancy, in the early stage of pregnancy and PTB. METHODS This single-center, retrospective cohort study utilized data from 2009 to 2017 obtained at TOYOTA Memorial Hospital. Women with singleton pregnancies who underwent vaginal culture around 14 weeks of gestation during their routine prenatal check-up were included. Vaginal sampling for Gram staining and culture was performed regardless of symptoms. GBS colonization was defined as positive for GBS latex agglutination assay. Statistical analysis was performed to determine the factors associated with PTB. RESULTS Overall 1079 singleton pregnancies were included. GBS (5.7%) and Candida albicans (5.5%) were the most frequently observed microorganisms. The incidence of PTB (before 34 and before 37 weeks of gestation) were significantly higher in the GBS-positive group than in the GBS-negative group (6.6% vs 0.5%, p = 0.001 and 9.8% vs 4.3%, p = 0.047). Our multivariable logistic regression analysis revealed that GBS colonization was a factor associated with PTB before 34 and before 37 weeks of gestation (Odds ratio [OR] 15.17; 95% confidence interval [CI] 3.73-61.74), and OR 2.42; 95%CI 1.01-5.91, respectively). CONCLUSIONS The present study found that vaginal GBS colonization in the early stage of pregnancy was associated with PTB. Our study indicates that patients at a high risk for PTB can be extracted by a simple method using conventional culture method.
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Affiliation(s)
- Sho Tano
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan.
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
| | - Takuji Ueno
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Michinori Mayama
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Takuma Yamada
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Takehiko Takeda
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Kaname Uno
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Masato Yoshihara
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Mayu Ukai
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Teppei Suzuki
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Yasuyuki Kishigami
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
| | - Hidenori Oguchi
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, 471-8513, Japan
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Uno K, Mayama M, Yoshihara M, Takeda T, Tano S, Suzuki T, Kishigami Y, Oguchi H. Reasons for previous Cesarean deliveries impact a woman's independent decision of delivery mode and the success of trial of labor after Cesarean. BMC Pregnancy Childbirth 2020; 20:170. [PMID: 32204702 PMCID: PMC7092517 DOI: 10.1186/s12884-020-2833-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 05/05/2019] [Accepted: 02/24/2020] [Indexed: 11/24/2022] Open
Abstract
Background Cesarean delivery rates are increasing globally with almost half of them occurring due to a previous Cesarean delivery. A trial of labor after Cesarean (TOLAC) is considered a safe procedure, but most eligible women instead undergo Cesarean before 39 weeks of gestation. Lack of education about TOLAC is often associated with increased repeat Cesarean. To reveal the safety and feasibility of TOLAC, we conducted this observational, prospective study with women’s independent decisions. We aimed to clarify the relationship between their chosen mode of delivery and the reason for their previous Cesarean. Additionally, we have tried to identify maternal and obstetric factors associated with failed TOLAC to improve its success rate. Methods This was a prospective, observational study of 1086 pregnant women with at least one previous Cesarean delivery. Of these, 735 women met our TOLAC criteria (Table 1), and then, could choose TOLAC or repeat Cesarean after receiving detailed explanations regarding the risks and benefits of both procedures. The primary outcomes were the number of successful TOLAC procedures and 5-min Apgar scores < 7 for the trial of labor after Cesarean group and elective Cesarean group. We collected the maternal and neonatal data including the reasons of previous Cesarean. Results In total, 64.1% of women chose TOLAC. The success rate was 91.3%. The uterine rupture rate was 0.6%. There were no significant differences in the rate of Apgar scores at 5 min < 7 between both groups. Histories of experience of labor in previous Cesarean delivery were observed in 30 and 50% of women who chose TOLAC and repeat Cesarean, respectively (p < 0.05). Factors related to failed TOLAC included ≥40 weeks of gestation (odds: 5.47, 95% CI: 2.55–11.70) and prelabor rupture of membranes (PROM) (odds: 4.47, 95% CI: 2.07–9.63). Conclusions TOLAC is a favorable delivery option for both mothers and neonates when women meet criteria and choose after receiving detailed explanations. Women who experience PROM or ≥ 40 weeks of gestation, their modes of delivery should be reconsulted.
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Affiliation(s)
- Kaname Uno
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi, Japan.
| | - Michinori Mayama
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi, Japan
| | - Masato Yoshihara
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi, Japan
| | - Takehiko Takeda
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi, Japan
| | - Sho Tano
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi, Japan
| | - Teppei Suzuki
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi, Japan
| | - Yasuyuki Kishigami
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi, Japan
| | - Hidenori Oguchi
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi, Japan
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Uno K, Yoshida E, Ueno T, Yamada T, Takeda T, Tano S, Ukai M, Suzuki T, Kishigami Y, Oguchi H. The safety and feasibility of trial labor after cesarean in preterm delivery and neonates respiratory outcomes. Eur J Obstet Gynecol Reprod Biol 2019. [DOI: 10.1016/j.ejogrb.2018.08.461] [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: 11/28/2022]
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Uno K, Yoshida E, Yamada T, Takeda T, Tano S, Ukai M, Suzuki T, Ueno T, Kishigami Y, Oguchi H. For 12 years prospective study; Trial of labor after cesarean versus elective repetitive cesarean delivery based on informed choice of desirable delivery way in a single perinatal medical center. Eur J Obstet Gynecol Reprod Biol 2019. [DOI: 10.1016/j.ejogrb.2018.08.302] [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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Fukuta T, Yoshimoto R, Ueno T, Yamada T, Takeda T, Uno K, Tano S, Ukai M, Suzuki T, Harata T, Kishigami Y, Oguchi H. 112. Reversible cerebral vasoconstriction syndrome associated with pregnancy in peripartum period. Pregnancy Hypertens 2018. [DOI: 10.1016/j.preghy.2018.08.229] [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: 10/28/2022]
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12
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Takeda T, Fukuta T, Yoshimoto R, Yamada T, Tano S, Uno K, Ukai M, Kishigami Y, Oguchi H. 157. The efficacy of recombinant human soluble thrombomodulin in preeclampsia. Pregnancy Hypertens 2018. [DOI: 10.1016/j.preghy.2018.08.261] [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: 10/28/2022]
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13
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Mayama M, Yoshihara M, Uno K, Tano S, Takeda T, Ukai M, Kishigami Y, Oguchi H. Factors influencing brain natriuretic peptide levels in healthy pregnant women. Int J Cardiol 2016; 228:749-753. [PMID: 27888752 DOI: 10.1016/j.ijcard.2016.11.111] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [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: 08/14/2016] [Revised: 09/23/2016] [Accepted: 11/06/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND The normal range of plasma brain natriuretic peptide (BNP) in pregnant women is still unclear. Moreover, pregnant women experience dynamic body weight changes and suffer from anemia, but effects on maternal BNP have not been investigated. This study aimed to reveal the normal plasma BNP range and examine the effects of physiological changes on BNP among pregnant women. METHODS AND RESULTS Plasma BNP, hemoglobin, plasma creatinine and BMI were measured in 58 non-pregnant control women and in 773 normal pregnant women at late pregnancy, early postpartum and 1-month postpartum. Mean plasma BNP (in pg/mL) was 11.8 (95% confidence interval: 0-27.5) in non-pregnant women, 17.9 (0-44.7, p<0.001) at late pregnancy, 42.5 (0-112.6, p<0.001) early postpartum and 16.1 (0-43.9, p=0.001) 1-month postpartum. Multiple regression analysis revealed that pre-delivery BNP levels were negatively correlated with BMI (p<0.001) and hemoglobin (p=0.002) and positively correlated with creatinine (p<0.001). Post-delivery BNP was positively associated with body weight change during pregnancy (p=0.001) and post-delivery creatinine (p=0.010) but negatively associated with body weight loss at delivery (p<0.001) and post-delivery hemoglobin (p=0.004). CONCLUSION Even normal pregnancy affects plasma BNP, particularly in the early postpartum period, indicative of cardiac stress. Plasma BNP levels are affected by BMI, body weight changes, creatinine and hemoglobin levels; therefore, these factors should be considered when analysing cardiac function and the physiological implications of BNP levels in pregnant women.
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Affiliation(s)
- Michinori Mayama
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Aichi, Japan.
| | - Masato Yoshihara
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
| | - Kaname Uno
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
| | - Sho Tano
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
| | - Takehiko Takeda
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
| | - Mayu Ukai
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
| | - Yasuyuki Kishigami
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
| | - Hidenori Oguchi
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
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Yamauchi Y, Uno K, Takeda T, Tano S, Yoshihara M, Mayama M, Ukai M, Harata T, Kishigami Y, Oguchi H. Reversible cerebral vasoconstriction syndrome associated with pregnancy. Eur J Obstet Gynecol Reprod Biol 2016. [DOI: 10.1016/j.ejogrb.2016.07.468] [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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Tano S, Takeda T, Uno K, Yoshihara M, Mayama M, Ukai M, Harata T, Kishigami Y, Oguchi H. Risk factors for cellulitis in patients with secondary lower limb lymphedema associated with gynecological cancer treatment. Eur J Obstet Gynecol Reprod Biol 2016. [DOI: 10.1016/j.ejogrb.2016.07.294] [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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Mayama M, Yamauchi Y, Tano S, Uno K, Yoshihara M, Ukai M, Kishigami Y, Oguchi H. Brain natriuretic peptide levels of normal pregnant women. Eur J Obstet Gynecol Reprod Biol 2016. [DOI: 10.1016/j.ejogrb.2016.07.412] [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: 11/28/2022]
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17
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Mayama M, Uno K, Tano S, Yoshihara M, Ukai M, Kishigami Y, Ito Y, Oguchi H. Incidence of posterior reversible encephalopathy syndrome in eclamptic and patients with preeclampsia with neurologic symptoms. Am J Obstet Gynecol 2016; 215:239.e1-5. [PMID: 26902987 DOI: 10.1016/j.ajog.2016.02.039] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [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: 12/01/2015] [Revised: 01/28/2016] [Accepted: 02/16/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Posterior reversible encephalopathy syndrome is observed frequently in patients with eclampsia; however, it has also been reported in some patients with preeclampsia. OBJECTIVES The aim of this study was to determine the incidence of posterior reversible encephalopathy syndrome in patients with preeclampsia and eclampsia and to assess whether these 2 patient groups share similar pathophysiologic backgrounds by comparing clinical and radiologic characteristics. STUDY DESIGN This was a retrospective cohort study of 4849 pregnant patients. A total of 49 patients with eclampsia and preeclampsia and with neurologic symptoms underwent magnetic resonance imaging and magnetic resonance angiography; 10 patients were excluded from further analysis because of a history of epilepsy or dissociative disorder. The age, parity, blood pressure, and routine laboratory data at the onset of symptoms were also recorded. RESULTS Among 39 patients with neurologic symptoms, 12 of 13 patients with eclampsia (92.3%) and 5 of 26 patients with preeclampsia (19.2%) experienced the development of posterior reversible encephalopathy syndrome. Whereas age and blood pressure at onset were not significantly different between patients with and without encephalopathy, hematocrit, serum creatinine, aspartate transaminase, alanine transaminase, and lactate dehydrogenase values were significantly higher in patients with posterior reversible encephalopathy syndrome than in those without magnetic resonance imaging abnormalities. In contrast, patients with eclampsia with posterior reversible encephalopathy syndrome did not show any significant differences in clinical and laboratory data compared with patients with preeclampsia with posterior reversible encephalopathy syndrome. In addition to the parietooccipital regions, atypical regions (such as the frontal and temporal lobes), and basal ganglia were also involved in patients with eclampsia and patients with preeclampsia with posterior reversible encephalopathy syndrome. Finally, intraparenchymal hemorrhage was detected in 1 patient with eclampsia, and subarachnoid hemorrhage was observed in 1 patient with preeclampsia. CONCLUSIONS Although the incidence of posterior reversible encephalopathy syndrome was high in patients with eclampsia, nearly 20% of the patients with preeclampsia with neurologic symptoms also experienced posterior reversible encephalopathy syndrome. The similarities in clinical and radiologic findings of posterior reversible encephalopathy syndrome between the 2 groups support the hypothesis that these 2 patient groups have a shared pathophysiologic background. Thus, magnetic resonance imaging studies should be considered for patients with the recent onset of neurologic symptoms, regardless of the development of eclampsia.
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Affiliation(s)
- Michinori Mayama
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Aichi, Japan.
| | - Kaname Uno
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
| | - Sho Tano
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
| | - Masato Yoshihara
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
| | - Mayu Ukai
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
| | - Yasuyuki Kishigami
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
| | - Yasuhiro Ito
- Department of Neurology, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
| | - Hidenori Oguchi
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Aichi, Japan
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Uno K, Yamada T, Takeda T, Tano S, Mayama M, Ukai M, Harata T, Kishigami Y, Oguchi H. 65 Changes of maternal cardiac function in patients with mild and severe preeclampsia. Pregnancy Hypertens 2016. [DOI: 10.1016/j.preghy.2016.08.066] [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: 10/21/2022]
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Yamada T, Takeda T, Tano S, Uno K, Mayama M, Ukai M, Harata T, Kishigami Y, Oguchi H. 56 Posterior reversible encephalopathy syndrome and cerebral vasoconstriction in eclamptic and pre-eclamptic patients. Pregnancy Hypertens 2016. [DOI: 10.1016/j.preghy.2016.08.138] [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: 11/30/2022]
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Mayama M, Yamada T, Takeda T, Tano S, Uno K, Ukai M, Harata T, Kishigami Y, Oguchi H. 28 Brain natriuretic peptide monitoring in preeclampsia. Pregnancy Hypertens 2016. [DOI: 10.1016/j.preghy.2016.08.110] [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: 11/29/2022]
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21
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Yoshihara M, Mayama M, Ukai M, Tano S, Kishigami Y, Oguchi H. Fulminant liver failure resulting from massive hepatic infarction associated with hemolysis, elevated liver enzymes, and low platelets syndrome. J Obstet Gynaecol Res 2016; 42:1375-1378. [PMID: 27353746 DOI: 10.1111/jog.13042] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 10/02/2015] [Revised: 03/21/2016] [Accepted: 04/10/2016] [Indexed: 12/17/2022]
Abstract
Hepatic infarction is an extremely rare and fatal complication associated with hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome. It can develop into fulminant liver failure, which increases both maternal and neonatal mortality rates. A 34-year-old woman with no remarkable past medical history developed eclampsia after delivery at 40 weeks of gestation. Imaging indicated massive hepatic infarction and rupture followed by cardiac arrest and fulminant liver failure. Despite liver replacement therapy with plasma exchange and continuous hemodiafiltration, the patient gradually deteriorated with persistent bacterial infection until death at 98 days after delivery. The management of fulminant liver failure complicated with HELLP syndrome should be multidisciplinary. Liver transplantation, the only radical treatment for fulminant liver failure, is worth attempting, if applicable.
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Affiliation(s)
- Masato Yoshihara
- Department of Gynecology and Obstetrics, Toyota Memorial Hospital, Toyota, Aichi, Japan.
| | - Michinori Mayama
- Department of Gynecology and Obstetrics, Toyota Memorial Hospital, Toyota, Aichi, Japan
| | - Mayu Ukai
- Department of Gynecology and Obstetrics, Toyota Memorial Hospital, Toyota, Aichi, Japan
| | - Sho Tano
- Department of Gynecology and Obstetrics, Toyota Memorial Hospital, Toyota, Aichi, Japan
| | - Yasuyuki Kishigami
- Department of Gynecology and Obstetrics, Toyota Memorial Hospital, Toyota, Aichi, Japan
| | - Hidenori Oguchi
- Department of Gynecology and Obstetrics, Toyota Memorial Hospital, Toyota, Aichi, Japan
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22
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Uno K, Tano S, Yoshihara M, Mayama M, Ukai M, Kishigami Y, Nishikawa Y, Takeichi Y, Oguchi H. A Case Report and Literature Review of Spontaneous Perforation of Pyometra. J Emerg Med 2016; 50:e231-6. [PMID: 26994838 DOI: 10.1016/j.jemermed.2016.01.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 08/15/2015] [Revised: 01/04/2016] [Accepted: 01/21/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Pyometra is defined as an accumulation of purulent material in the uterine cavity. Spontaneous perforation is a very rare complication of pyometra. The clinical findings of perforated pyometra are similar to perforation of the gastrointestinal tract and other causes of acute abdomen. CASE REPORT We report a rare and difficult case of peritonitis in an elderly female that was caused by a spontaneous perforation of pyometra. A 90-year-old postmenopausal woman was referred to our hospital with complaints of vomiting, fever, and abdominal pain. Computed tomography revealed a large amount of ascites, cystic mass in the uterus, and intraperitoneal and intrauterine air. Transvaginal ultrasound demonstrated a thin area around the fundus. An emergency laparotomy was performed for the suspected gastrointestinal perforation or perforation of pyometra. At laparotomy, copious purulent fluid was present in the peritoneal cavity; however, no perforation of the gastrointestinal tract was observed. We identified a perforation site over the uterine fundus and purulent material exuding from the cavity. Subsequently, hysterectomy and bilateral salpingo-oophorectomy were performed. The patient was discharged on postoperative day 13 with no complications. Histopathologic studies revealed endometritis and myometritis with no evidence of malignancy. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: With diffuse peritonitis, ruptured pyometra should be considered, even in elderly female patients. This case illustrates the importance of clinical knowledge of acute gynecologic diseases. Here we also review the perforation of pyometra with no evidence of malignancy.
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Affiliation(s)
- Kaname Uno
- Department of Obstetrics, Perinatal Medical Center, Toyota Memorial Hospital, Toyota, Aichi, Japan
| | - Sho Tano
- Department of Obstetrics, Perinatal Medical Center, Toyota Memorial Hospital, Toyota, Aichi, Japan
| | - Masato Yoshihara
- Department of Obstetrics, Perinatal Medical Center, Toyota Memorial Hospital, Toyota, Aichi, Japan
| | - Michinori Mayama
- Department of Obstetrics, Perinatal Medical Center, Toyota Memorial Hospital, Toyota, Aichi, Japan
| | - Mayu Ukai
- Department of Obstetrics, Perinatal Medical Center, Toyota Memorial Hospital, Toyota, Aichi, Japan
| | - Yasuyuki Kishigami
- Department of Obstetrics, Perinatal Medical Center, Toyota Memorial Hospital, Toyota, Aichi, Japan
| | - Yoshitomo Nishikawa
- Department of Emergency Medicine, Toyota Memorial Hospital, Toyota, Aichi, Japan
| | - Yasushi Takeichi
- Department of Emergency Medicine, Toyota Memorial Hospital, Toyota, Aichi, Japan
| | - Hidenori Oguchi
- Department of Obstetrics, Perinatal Medical Center, Toyota Memorial Hospital, Toyota, Aichi, Japan
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Miyai Y, Tano S, Uno K, Yoshihara M, Mayama M, Ukai M, Kondo S, Kokabu T, Kishigami Y, Oguchi H. Effectiveness of detecting the primary lesion of CUP using FDG-PET/CT: a case report. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv472.30] [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: 11/14/2022] Open
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24
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Yoshihara M, Uno K, Tano S, Mayama M, Ukai M, Kondo S, Kokabu T, Kishigami Y, Oguchi H. The efficacy of recombinant human soluble thrombomodulin for obstetric disseminated intravascular coagulation: a retrospective study. Crit Care 2015; 19:369. [PMID: 26481315 PMCID: PMC4617479 DOI: 10.1186/s13054-015-1086-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 09/27/2015] [Indexed: 11/19/2022]
Abstract
Introduction Recombinant human soluble thrombomodulin (rhTM) is a novel anti-coagulant agent that regulates the imbalanced coagulation system by reducing the excessive activation of thrombin. rhTM potentially reduces the morbidity and mortality in patients with sepsis-induced disseminated intravascular coagulation (DIC). However, the efficacy of rhTM in obstetric DIC has not yet been established. We performed this study to examine whether the administration of rhTM was a potentially effective treatment for DIC induced by one or more underlying obstetric disorders. Methods This is a single-center, retrospective cohort study conducted between January 2007 and February 2015 using the records of the Department of Obstetrics at the Perinatal Medical Center of TOYOTA Memorial Hospital, Aichi, Japan. The eligibility criteria were known or suspected obstetric DIC documented on the basis of clinical and laboratory data and association with one or more major underlying obstetric disorders. Baseline imbalance between patients with and without treatment of rhTM was adjusted using an inverse probability of treatment weighting using propensity scores composed of the following independent variables: severe postpartum hemorrhage, placental abruption, and preeclampsia/eclampsia, including hemolysis, elevated liver enzymes, and low platelet syndrome, initial platelet counts, D-dimer levels, fibrinogen levels, and prothrombin time–international normalized ratio (PT–INR). We evaluated laboratory changes and clinical outcomes in the early phase of obstetric DIC. Results In total, 66 of 4627 patients admitted to our department during the study period fulfilled the required criteria; of these, 37 and 29 patients were included in the rhTM and control group, respectively. After adjustment, treatment with rhTM was associated with significant improvements in platelet counts, D-dimer levels, fibrinogen levels, and PT–INR compared with the control group. The platelet concentrate transfusion volume was significantly lower in the rhTM treatment group (3.02 vs 6.03 units, P = 0.016). None of the adjusted group differences were statistically significant for all types of organ damage and failure. Conclusion rhTM administration was associated with clinical and laboratory improvement in patients with DIC caused by underlying obstetric conditions. Further clinical research is needed to clarify the optimal application of rhTM in each of the causative obstetric disorders.
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Affiliation(s)
- Masato Yoshihara
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi, Japan.
| | - Kaname Uno
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi, Japan.
| | - Sho Tano
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi, Japan.
| | - Michinori Mayama
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi, Japan.
| | - Mayu Ukai
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi, Japan.
| | - Shinya Kondo
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi, Japan.
| | - Tetsuya Kokabu
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi, Japan.
| | - Yasuyuki Kishigami
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi, Japan.
| | - Hidenori Oguchi
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi, Japan.
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Mayama M, Yoshihara M, Ukai M, Kondo S, Kishigami Y, Oguchi H. Sarcoid-like reaction mimicking vaginal cancer recurrence. J Obstet Gynaecol Res 2015; 41:1855-8. [PMID: 26420533 DOI: 10.1111/jog.12829] [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: 04/10/2015] [Accepted: 07/10/2015] [Indexed: 11/29/2022]
Abstract
A sarcoid-like reaction is a development of non-caseating granuloma in patients with underlying malignancy and represents a false positive finding on positron emission tomography/computed tomography (PET/CT). A sarcoid-like reaction is a benign condition; therefore, differentiating a sarcoid-like reaction from cancer recurrence is necessary. Only uterine and ovarian cancer related cases have been reported in the gynecological field and to the best of our knowledge, this is the first case of a sarcoid-like reaction in vaginal cancer. A 59-year-old vaginal cancer patient received concurrent chemoradiotherapy and achieved complete remission. Recurrence of vaginal cancer was suspected because of the elevation of serum squamous cell carcinoma antigen level. PET/CT revealed abnormal uptake at the bilateral mediastinal and hilar lymph nodes. A non-caseating granuloma was detected from the biopsy of the swollen lymph nodes. No evidence of cancer recurrence was observed. A sarcoid-like reaction should be considered when evaluating PET/CT in cancer patients to prevent unnecessary treatments.
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Affiliation(s)
- Michinori Mayama
- Toyota Memorial Hospital, Department of Obstetrics and Gynecology, Toyota, Japan
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26
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Senzaki H, Miyagawa K, Kishigami Y, Sasaki N, Masutani S, Taketazu M, Kobayashi J, Kobyashi T, Asano H, Kyo S, Yokote Y. Inferior vena cava occlusion catheter for pediatric patients with heart disease: for more detailed cardiovascular assessments. Catheter Cardiovasc Interv 2001; 53:392-6. [PMID: 11458421 DOI: 10.1002/ccd.1188] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Traditional evaluation of cardiac function is too often limited by reliance on measurements with complex interdependence between cardiac properties and loading factors. Analysis by ventricular pressure-volume (P-V), -area (P-A), or -dimension (P-D) relations during inferior vena caval (IVC) occlusion independently quantifies ventricular properties and loading conditions, providing detailed information about cardiovascular dynamics. However, there has been no appropriate size of balloon catheter that can effectively occlude IVC of pediatric patients, hindering the application of P-V (P-A, or P-D) analysis to children with heart disease despite its potential benefit. To address this problem, we have developed a new balloon catheter for IVC occlusion in children. The catheter effectively occluded IVC in 92 pediatric patients with varying forms of heart disease who underwent cardiac catheterization, yielding end-systolic pressure-area relations. Thus a newly developed balloon catheter would contribute to establishing more accurate and detailed cardiovascular assessments in children with heart disease. Cathet Cardiovasc Intervent 2001;53:392-396.
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Affiliation(s)
- H Senzaki
- Department of Pediatrics, Pediatric Cardiology, Saitama Heart Institute, Saitama Medical School Hospital, 38 Morohongo, Moroyama, Saitama 350-0495, Japan.
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Abstract
In conventional radiography systems, it is apparent that only the area immediately around the central x-ray beam can be evaluated accurately. Consequently in some instances, spinal radiography for example, several exposures are needed at various points along the body to create an accurate image for diagnosis. However, if the film and body part are in a concave shape such that the radius of the curve is equal to the film focal distance, the x-ray beam will penetrate the body and strike the film at two-dimensionally right angles in all areas. Using the spine as an example we found the curved technique had three major advantages over the traditional flat technique: lack of distortion, more uniform beam intensity due to a constant focal film distance, and improved resolution at the periphery of the radiograph because of lack of a cross over effect. It was concluded that an accurate evaluation of larger body parts can be made with minimal distortion utilizing the principles of a curved table technique.
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Affiliation(s)
- Y Kishigami
- Kishigami Veterinary Hospital, Abeno, Osaka, Japan
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Nishinarita S, Shimada H, Suzuki R, Kishigami Y, Sawada U, Horie T. [A study of the significance of serum beta 2-microglobulin levels in patients with multiple myeloma--analyzes as a marker of renal dysfunction and as a marker of tumor cell mass]. Rinsho Ketsueki 1996; 37:201-7. [PMID: 8727343] [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] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Renal involvement known as a myeloma kidney is often observed in patients with multiple myeloma (MM). This complication has been recognized as one of the most important prognostic factors in this disease. Serum beta 2-microglobulin (S beta 2-m) has been also recognized one of the prognostic factor that reflects both a glomerular infiltration rate and a volume of neoplastic cells, because beta 2-m usually can be produced by the neoplastic lymphoid cells. To clarify the significance of the S beta 2-m in MM, we compared S beta 2-m levels and the clinical stage, with another clinical parameters for renal function such as 24 hr creatinine clearance (24 hr Ccr), N-acetyl-beta-glucosaminidase (NAG) levels in urine and serum alpha 1-microglobulin (S alpha 1-m) levels. The elevated S beta 2-m levels were commonly observed not only in patients with stage IIIB, but also in stage IA, IIA and IIIA (76%) who have normal renal function judged by the serum nitrogen or creatine levels. S beta 2-m levels correlated with 24 hr Ccr the most, then correlated with S alpha 1-m levels and less correlated with NAG levels in urine. Although a single elevation of S beta 2-m levels with other normal findings of renal parameters was found only in three out of 30 MM patients, the S beta 2-m levels in these patients did not change after the chemotherapy which had led to the diminution of serum M-protein. Together with these results, it was suggested that the S beta 2-m levels mainly reflect the renal dysfunction even if it stays in the subclinical stage, and reflect less the number of neoplastic cells in MM patients.
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Affiliation(s)
- S Nishinarita
- First Department of Internal Medicine, Nihon University School of Medicine, Oyaguchi, Tokyo, Japan
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Shimada H, Nishinarita S, Kishigami Y, Hayama T, Sawada U, Horie T, Nakamura N, Kato M, Hirano M, Nakamura O. [IgD-lambda type multiple myeloma associated with IgG-kappa type benign monoclonal gammopathy]. Nihon Rinsho Meneki Gakkai Kaishi 1995; 18:235-40. [PMID: 7553059 DOI: 10.2177/jsci.18.235] [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] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A 76-year-old man was admitted to Kisen hospital because of lumbago and chest pain. Laboratory examinations revealed a chronic renal failure with marked elevation of the serum BUN (48.8 mg/dl) and creatinine levels (8.2 mg/dl). The serum electrophoresis demonstrated a hypergammaglobulinemia with M peaks. An immunoelectrophoresis demonstrated monoclonal IgD-lambda and IgG-kappa proteins in the serum, and lambda-type Bence Jones protein in the urine (0.4 g/day). Bone marrow smears revealed an abnormal proliferation of atypical plasma cells (43%). A systemic X-ray examination of the skeletal system showed systemic osteoporosis without punched out lesion. The patient was diagnosed as having IgD-lambda type multiple myeloma and IgG-kappa type benign monoclonal gammopathy by quantifying concentration of two M proteins (1,160 mg/dl in IgD, 1,179 mg/dl in IgG, respectively). A combination chemotherapy with melphalan and prednisolone was administered monthly for multiple myeloma, and hemodialysis for the renal failure was performed 3 times a week. A marked improvement of his laboratory findings including a diminution of the serum IgD-lambda M-protein was obtained. On the other hand, IgG-kappa M-protein level was unchanged. Two M-protein levels showed a different behavior after the combination chemotherapy. Although the patient died of congestive heart failure, the partial remission of multiple myeloma has been maintained for 16 months with chemotherapy.
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Affiliation(s)
- H Shimada
- First Department of Internal Medicine, Nihon University School of Medicine
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31
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Yoshimura S, Hanada K, Kishigami Y, Maehara T, Tabuchi S, Nakamura K, Iinuma T, Nakamura M, Maekawa T, Terumichi Y. Control of magnetohydrodynamic activities by electron cyclotron heating in WT-3. Fusion Engineering and Design 1995. [DOI: 10.1016/0920-3796(94)00172-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Maekawa T, Maehara T, Minami T, Kishigami Y, Kishino T, Makino K, Hanada K, Nakamura M, Terumichi Y, Tanaka S. Up-shifted frequency electron-cyclotron current drive in a lower hybrid current drive plasma. Phys Rev Lett 1993; 70:2561-2564. [PMID: 10053594 DOI: 10.1103/physrevlett.70.2561] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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33
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Nakaizumi A, Tatsuta M, Uehara H, Yamamoto R, Takenaka A, Kishigami Y, Takemura K, Kitamura T, Okuda S. Cytologic examination of pure pancreatic juice in the diagnosis of pancreatic carcinoma. The endoscopic retrograde intraductal catheter aspiration cytologic technique. Cancer 1992. [PMID: 1423189 DOI: 10.1002/1097-0142(19921201)70:11<2610::aid-cncr2820701107>3.0.co;2-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Although cytologic examination of pure pancreatic juice obtained with a duodenofiberscope has been useful for the diagnosis of pancreatic carcinoma, the rate of false-negative results is reported to be high. To eliminate these false-negative results, the authors developed a new technique, endoscopic retrograde intraductal catheter aspiration cytology, especially for an accurate cytologic diagnosis of carcinoma of the body or tail of the pancreas. METHODS The accuracy of conventional cytologic examination of pure pancreatic juice was assessed in 25 patients with pancreatic carcinoma, 29 patients with pancreatitis, and 52 control subjects. Pure pancreatic juice was collected from the pancreatic duct by endoscopic cannulation using a videoimaging duodenoscope after intravenous administration of secretin. The new endoscopic retrograde intraductal catheter aspiration technique was used in four patients with carcinoma of the body or tail of the pancreas and five patients with localized pancreatitis in whom a correct diagnosis was not made by previous cytologic examination of pure pancreatic juice. RESULTS Positive cytologic findings were obtained in 76% of the patients with pancreatic carcinoma. Positive cytologic results were more frequent in patients with carcinoma of the head of the pancreas than in those with carcinoma of the body or tail. By the new technique, positive cytologic results were obtained in all of the patients with pancreatic carcinoma. This technique caused no severe complications. CONCLUSIONS This procedure of endoscopic retrograde intraductal catheter aspiration cytology seems useful for diagnosis of pancreatic carcinoma.
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Affiliation(s)
- A Nakaizumi
- Department of Gastrointestinal Oncology, Center for Adult Diseases, Osaka, Japan
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Nakaizumi A, Tatsuta M, Uehara H, Yamamoto R, Takenaka A, Kishigami Y, Takemura K, Kitamura T, Okuda S. Cytologic examination of pure pancreatic juice in the diagnosis of pancreatic carcinoma. The endoscopic retrograde intraductal catheter aspiration cytologic technique. Cancer 1992; 70:2610-4. [PMID: 1423189 DOI: 10.1002/1097-0142(19921201)70:11<2610::aid-cncr2820701107>3.0.co;2-y] [Citation(s) in RCA: 85] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Although cytologic examination of pure pancreatic juice obtained with a duodenofiberscope has been useful for the diagnosis of pancreatic carcinoma, the rate of false-negative results is reported to be high. To eliminate these false-negative results, the authors developed a new technique, endoscopic retrograde intraductal catheter aspiration cytology, especially for an accurate cytologic diagnosis of carcinoma of the body or tail of the pancreas. METHODS The accuracy of conventional cytologic examination of pure pancreatic juice was assessed in 25 patients with pancreatic carcinoma, 29 patients with pancreatitis, and 52 control subjects. Pure pancreatic juice was collected from the pancreatic duct by endoscopic cannulation using a videoimaging duodenoscope after intravenous administration of secretin. The new endoscopic retrograde intraductal catheter aspiration technique was used in four patients with carcinoma of the body or tail of the pancreas and five patients with localized pancreatitis in whom a correct diagnosis was not made by previous cytologic examination of pure pancreatic juice. RESULTS Positive cytologic findings were obtained in 76% of the patients with pancreatic carcinoma. Positive cytologic results were more frequent in patients with carcinoma of the head of the pancreas than in those with carcinoma of the body or tail. By the new technique, positive cytologic results were obtained in all of the patients with pancreatic carcinoma. This technique caused no severe complications. CONCLUSIONS This procedure of endoscopic retrograde intraductal catheter aspiration cytology seems useful for diagnosis of pancreatic carcinoma.
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Affiliation(s)
- A Nakaizumi
- Department of Gastrointestinal Oncology, Center for Adult Diseases, Osaka, Japan
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Nakaizumi A, Iishi H, Yamamoto R, Kasugai H, Tatsuta M, Okuda S, Kishigami Y, Kitamura T. Diagnosis of hepatic cavernous hemangioma by fine needle aspiration biopsy under ultrasonic guidance. Gastrointest Radiol 1990; 15:39-42. [PMID: 2404823 DOI: 10.1007/bf01888731] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Percutaneous aspiration biopsy of the liver using a heparinized 22-gauge needle was performed under ultrasonic guidance in 11 patients with hepatic cavernous hemangioma. Ten (91%) of 11 biopsy specimens obtained were cytologically diagnostic for hemangioma. No indications of malignancy were found. There was no relation between the cytological diagnosis and the location, size, or ultrasonographic findings. No complications were encountered. These findings indicate that cytological examination of the liver by fine needle aspiration biopsy is useful in diagnosing hepatic cavernous hemangioma of any size and in any location, provided optimal route to the lesions is chosen.
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Affiliation(s)
- A Nakaizumi
- Department of Gastrointestinal Oncology, Center for Adult Diseases, Osaka, Japan
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Ishikawa O, Ohhigashi H, Sasaki Y, Imaoka S, Iwanaga T, Wada A, Ishiguro S, Tateishi R, Kishigami Y, Sone H. The usefulness of saline-irrigated bile for the intraoperative cytologic diagnosis of tumors and tumorlike lesions of the gallbladder. Acta Cytol 1988; 32:475-81. [PMID: 3400385] [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: 01/05/2023]
Abstract
Intraoperative cytology was performed for 48 patients with polypoid lesions (36 benign and 12 malignant) of the gallbladder. The cytologic samples consisted of pure bile from 48 patients and diluted bile collected by saline irrigation from 29 patients. Pure bile gave 32 correct diagnoses (67%) and 14 diagnoses of inadequate material (29%), which contained few nondegenerated cells and made microscopic diagnosis unreliable. Inadequate material was frequently obtained in cases of cholesterol polyp (45%), tubular or papillary adenomatous carcinoma (50%) and polypoid carcinoma (17%), but not in cases of inflammatory polyp (0%). On the other hand, cytologic study of bile samples obtained by saline irrigation showed no inadequate material and only one false negative, from a case in which the cancerous focus was mostly covered with nonneoplastic epithelium. These results imply that saline irrigation succeeded in collecting many nondegenerated cells newly exfoliated from the wall of lesions and the technique is useful in the intraoperative cytologic study of polypoid gallbladder lesions.
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Affiliation(s)
- O Ishikawa
- Department of Surgery, Center for Adult Diseases, Osaka, Japan
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37
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Okano Y, Takenaka A, Kasugai H, Morii T, Kishigami Y, Okuda S. [Cytologic changes following intratumoral high dose injection of OK-432 in advanced pancreatic cancers and gall bladder cancers with ultrasound guidance]. Gan To Kagaku Ryoho 1983; 10:1892-3. [PMID: 6882009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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38
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Kishigami Y, Noda S, Morishita T, Hashimoto Y. Improvement of the preparation method for vaginal smears for the auto-cyto-screener. Anal Quant Cytol 1981; 3:43-8. [PMID: 7015944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
An improved method of preparing vaginal smears for use in the Auto-Cyto-Screener is reported. The main alterations from the previous technique were the substitution of 2% formaldehyde phosphate buffer (pH 7.4) for 50% ethanol as the preservative fluid, the use of homogenization in place of sonication for cell aggregate dispersion and the introduction of Ficoll-gradient sedimentation, which not only removes leukocytes and other elements from the suspensions but also concentrates the cancer cells to some extent. An examination of cell deposition techniques showed that optimal results were achieved with the use of filter paper, not rubber, and with centrifugation performed immediately after loading the suspension into the chambers.
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Hashimoto Y, Kishigami Y, Noda S, Morishita T. [Cytodiagnosis and image processing]. Kango Gijutsu 1980; 26:803-9. [PMID: 6907403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Hashimoto Y, Kishigami Y. [Cytodiagnosis--autocytoscreener for mass examination in gynecology]. Nihon Ishikai Zasshi 1971; 66:634-45. [PMID: 5165803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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41
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Hashimoto Y, Kishigami Y, Noda S, Matsumoto K. [Some problems in automated cytodiagnosis of uterine cancer]. Nihon Rinsho 1971; 29:2100-5. [PMID: 4107665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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42
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Kishigami Y, Noda S, Sakuramiya M, Hattori S, Hashimoto Y. [Automated cytodiagnosis]. Nihon Rinsho 1969; 27:2944-52. [PMID: 4188618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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43
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Kishigami Y. Phase microscopic and electron microscopic studies of bacterial phagocytosis by leucocytes. I. Fate of staphylococci phagocytized by human leucocytes. Nihon Ketsueki Gakkai Zasshi 1968; 31:973-83. [PMID: 5754007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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44
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Kishigami Y. Phase microscopic and electron microscopic studies of bacterial phagocytosis by leucocytes. II. Behavior of leucocytes, expecially their granules, following phagocytosis. Nihon Ketsueki Gakkai Zasshi 1968; 31:984-1016. [PMID: 4901057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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45
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Senda N, Inui H, Tamura H, Okuda S, Kishigami Y. [Diagnosis of early stomach cancer by endoscopic irrigation cytodiagnosis]. Gan No Rinsho 1966; 12:744-9. [PMID: 6010090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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46
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Shinzen G, Iwanaga T, Kishigami Y. [Cytodiagnosis, at operation, of stomach cancer in its early stages--cell collection by a small gastric brush]. Geka Chiryo 1966; 14:641-50. [PMID: 6013431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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