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Nakao M, Ross MG, Magawa S, Toyokawa S, Ichizuka K, Kanayama N, Satoh S, Tamiya N, Nakai A, Fujimori K, Maeda T, Oka A, Suzuki H, Iwashita M, Ikeda T. Prevention of fetal brain injury in category II tracings. Acta Obstet Gynecol Scand 2023; 102:1730-1740. [PMID: 37697658 PMCID: PMC10619613 DOI: 10.1111/aogs.14675] [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: 06/10/2023] [Revised: 08/15/2023] [Accepted: 08/22/2023] [Indexed: 09/13/2023]
Abstract
INTRODUCTION With category II fetal heart rate tracings, the preferred timing of interventions to prevent fetal hypoxic brain damage while limiting operative interventions remains unclear. We aimed to estimate fetal extracellular base deficit (BDecf ) during labor with category II tracings to quantify the timing of potential interventions to prevent severe fetal metabolic acidemia. MATERIAL AND METHODS A longitudinal study was conducted using the database of the Recurrence Prevention Committee, Japan Obstetric Compensation System for Cerebral Palsy, including infants with severe cerebral palsy born at ≥34 weeks' gestation between 2009 and 2014. Cases included those presumed to have an intrapartum onset of hypoxic-ischemic insult based on the fetal heart rate pattern evolution from reassuring to an abnormal pattern during delivery, in association with category II tracings marked by recurrent decelerations and an umbilical arterial BDecf ≥ 12 mEq/L. BDecf changes during labor were estimated based on stages of labor and the frequency/severity of fetal heart rate decelerations using the algorithm of Ross and Gala. The times from the onset of recurrent decelerations to BDecf 8 and 12 mEq/L (Decels-to-BD8, Decels-to-BD12) and to delivery were determined. Cases were divided into two groups (rapid and slow progression) based upon the rate of progression of acidosis from onset of decelerations to BDecf 12 mEq/L, determined by a finite-mixture model. RESULTS The median Decels-to-BD8 (28 vs. 144 min, p < 0.01) and Decels-to-BD12 (46 vs. 177 min, p < 0.01) times were significantly shorter in the rapid vs slow progression. In rapid progression cases, physicians' decisions to deliver the fetus occurred at ~BDecf 8 mEq/L, whereas the "decisions" did not occur until BDecf reached 12 mEq/L in slow progression cases. CONCLUSIONS Fetal BDecf reached 12 mEq/L within 1 h of recurrent fetal heart rate decelerations in the rapid progression group and within 3 h in the slow progression group. These findings suggest that cases with category II tracings marked by recurrent decelerations (i.e., slow progression) may benefit from operative intervention if persisting for longer than 2 h. In contrast, cases with sudden bradycardia (i.e., rapid progression) represent a challenge to prevent severe acidosis and hypoxic brain injury due to the limited time opportunity for emergent delivery.
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Affiliation(s)
- Masahiro Nakao
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral PalsyJapan Council for Quality Health CareTokyoJapan
- Department of Obstetrics and GynecologyMie University Graduate School of MedicineTsuMieJapan
- Department of Obstetrics and GynecologySakakibara Heart InstituteTokyoJapan
| | - Michael G. Ross
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral PalsyJapan Council for Quality Health CareTokyoJapan
- Department of Obstetrics and GynecologyGeffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Shoichi Magawa
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral PalsyJapan Council for Quality Health CareTokyoJapan
- Department of Obstetrics and GynecologyMie University Graduate School of MedicineTsuMieJapan
| | - Satoshi Toyokawa
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral PalsyJapan Council for Quality Health CareTokyoJapan
- Faculty of NursingWayo Women's UniversityChibaJapan
| | - Kiyotake Ichizuka
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral PalsyJapan Council for Quality Health CareTokyoJapan
- Department of Obstetrics and GynecologyShowa University Northern Yokohama HospitalYokohamaKanagawaJapan
| | - Naohiro Kanayama
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral PalsyJapan Council for Quality Health CareTokyoJapan
- Department of Obstetrics and GynecologyHamamatsu University School of MedicineShizuokaJapan
| | - Shoji Satoh
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral PalsyJapan Council for Quality Health CareTokyoJapan
- Maternal and Perinatal Care CenterOita Prefectural HospitalOitaJapan
| | - Nanako Tamiya
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral PalsyJapan Council for Quality Health CareTokyoJapan
- Department of Health Services Research, Faculty of MedicineUniversity of TsukubaIbarakiJapan
| | - Akihito Nakai
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral PalsyJapan Council for Quality Health CareTokyoJapan
- Department of Obstetrics and GynecologyNippon Medical SchoolTokyoJapan
| | - Keiya Fujimori
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral PalsyJapan Council for Quality Health CareTokyoJapan
- Department of Obstetrics and GynecologyFukushima Medical UniversityFukushimaJapan
| | - Tsugio Maeda
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral PalsyJapan Council for Quality Health CareTokyoJapan
- Maeda ClinicIncorporated Association Anzu‐kaiShizuokaJapan
| | - Akira Oka
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral PalsyJapan Council for Quality Health CareTokyoJapan
- Department of PediatricsSaitama Children's Medical CenterSaitamaJapan
| | - Hideaki Suzuki
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral PalsyJapan Council for Quality Health CareTokyoJapan
| | - Mitsutoshi Iwashita
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral PalsyJapan Council for Quality Health CareTokyoJapan
- Kugayama HospitalTokyoJapan
| | - Tomoaki Ikeda
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral PalsyJapan Council for Quality Health CareTokyoJapan
- Department of Obstetrics and GynecologyMie University Graduate School of MedicineTsuMieJapan
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Terada S, Fujiwara T, Sugawara J, Maeda K, Satoh S, Mitsuda N. Association of severe maternal morbidity with bonding impairment and self-harm ideation: A multicenter prospective cohort study. J Affect Disord 2023; 338:561-568. [PMID: 37385386 DOI: 10.1016/j.jad.2023.06.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Evidence on the association between severe maternal morbidity (SMM) and mother-infant bonding and self-harm ideation is limited. We aimed to examine these associations and the mediating effect of Neonatal Intensive Care Unit (NICU) admission at one-month postpartum. METHODS This multicenter, prospective cohort study was conducted in Japan (n = 5398). SMM included preeclampsia, eclampsia, severe postpartum hemorrhage, placental abruption, and a ruptured uterus. Lack of affection (LA) and Anger and Rejection (AR) were assessed using the Mother-Infant Bonding Scale (MIBS), and self-harm ideation was assessed using the 10th item of the Edinburgh Postnatal Depression Scale (EPDS). Linear and logistic regression models were used to examine the association between SMM and MIBS score and self-harm ideation. A structural equation model (SEM) was employed to examine the mediating effect of NICU admission on the association between SMM and mother-infant bonding and postpartum depressive symptoms. RESULTS Women with SMM had a 0.21 (95 % confidence interval [CI]: 0.03-0.40) point higher MIBS score and a decreasing trend in the risk of self-harm ideation (odds ratio 0.28, 95 % CI: 0.07-1.14) compared to those without SMM. SEM analysis revealed that SMM was associated with MIBS partially through NICU admission. LIMITATIONS EPDS scores during pregnancy could be an unmeasured confounder. CONCLUSIONS Women with SMM had higher MIBS scores, particularly on the LA subscale, which was partially mediated by NICU admission. Psychotherapy to support parent-infant relationships is necessary for women with SMM.
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Affiliation(s)
- Shuhei Terada
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Junichi Sugawara
- Graduate School of Medicine, Tohoku University, Miyagi, Japan; Suzuki Memorial Hospital, Miyagi, Japan
| | - Kazuhisa Maeda
- Department of Obstetrics and Gynecology, National Hospital Organizations: Shikoku Medical Center for Children and Adults, Kagawa, Japan
| | - Shoji Satoh
- Maternal and Perinatal Care Center, Oita Prefectural Hospital, Oita, Japan
| | - Nobuaki Mitsuda
- Department of Maternal Fetal Medicine, Osaka Women's and Children's Hospital, Osaka, Japan
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Maeda Y, Doi S, Isumi A, Terada S, Sugawara J, Maeda K, Satoh S, Mitsuda N, Fujiwara T. Association between poor parent-daughter relationships and the risk of hyperglycemia in pregnancy: a hospital-based prospective cohort study in Japan. BMC Pregnancy Childbirth 2023; 23:227. [PMID: 37016315 PMCID: PMC10071734 DOI: 10.1186/s12884-023-05535-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/21/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Adverse child experiences (ACEs), childhood maltreatment and household dysfunction, are risk factors of hyperglycemia in pregnancy (HIP), including diabetes before pregnancy, gestational diabetes (GDM), and overt diabetes in pregnancy, through increased risk of unhealthy behaviors, obesity, and stress response system dysfunction. While ACEs are often difficult to be assessed in hospital settings, parent-daughter relationship, that is, pregnant women's relationship with their parents can be considered as a measurable maker for ACEs that may be associated with HIP. The purpose of this study is to examine the association between poor parent-daughter relationship and HIP. METHODS Hospital-based prospective cohort study was conducted in Japan (N = 6,264). Women visiting participating 58 facilities for delivery between April 2019 and March 2020 were included. Parent-daughter relationship was assessed by a questionnaire asking whether participants were satisfied with their relationship with their parents. HIP was diagnosed based on the criteria used in Japan. A multiple logistic regression model was applied to adjust for covariates. RESULTS Pregnant women who were not very satisfied and not satisfied at all with the relationship with their parents, and HIP were 343 (5.5%), 74 (1.2%), and 274 (4.4%), respectively. Pregnant women who were not very satisfied with their parent-daughter relationship showed a significant positive association with HIP in the crude model (odds ratio (OR): 1.71, 95% confidence interval (CI): 1.11-2.63). When stratified by psychiatric disease history, we found a significant positive association among those without psychiatric disease history (OR: 1.77, 95% CI: 1.11-2.84), but not among those with psychiatric disease history (OR: 0.61, 95% CI: 0.16-2.28). CONCLUSIONS Poor parent-daughter relationship was associated with the risk of HIP among pregnant women without psychiatric disease history, suggesting that this simple question could be used to estimate the risk of HIP when it was challenging to inquire directly about ACEs. Further research is needed to elucidate the mechanism of the association.
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Affiliation(s)
- Yuto Maeda
- Department of Global Health Promotion, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Aya Isumi
- Department of Global Health Promotion, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Shuhei Terada
- Department of Global Health Promotion, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Junichi Sugawara
- Division of Feto-Maternal Medical Science, Department of Community Medical Support, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Kazuhisa Maeda
- Department of Obstetrics and Gynecology, Shikoku Medical Centre for Children and Adults, Kagawa, Japan
| | - Shoji Satoh
- Perinatal Center, Oita Prefectural Hospital, Oita, Japan
| | - Nobuaki Mitsuda
- Department of Maternal Fetal Medicine, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
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Okamoto Y, Doi S, Isumi A, Sugawara J, Maeda K, Satoh S, Fujiwara T, Mitsuda N. Development of Social Life Impact for Mother (SLIM) scale at first trimester to identify mothers who need social support postpartum: a hospital-based prospective study in Japan. Int J Gynaecol Obstet 2022; 159:882-890. [PMID: 35575125 PMCID: PMC9796442 DOI: 10.1002/ijgo.14263] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 03/17/2022] [Accepted: 05/09/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To develop and validate the Social Life Impact for Mother (SLIM) scale to identify mothers in Japan who need social support postpartum. METHODS Hospital-based prospective study was implemented nationwide in Japan. A total of 7462 pregnant women completed the SLIM scale in their first trimester, and postpartum social problems (postpartum depression and bonding disorders) were assessed at 1 month after delivery (N = 5768, follow-up rate 77.3%). Multivariate logistic regression was applied to investigate the association between SLIM scale and postpartum social problems. RESULTS The SLIM scale is made up of nine risk factors for postpartum social problems, including relationship problems, lower financial status, and lack of social support. The SLIM scale predicted postpartum social problems with moderate accuracy (area under the curve 0.63, 95% confidence interval 0.60-0.65). Further stratification by local clinic and tertiary hospital did not affect the estimates. CONCLUSION The SLIM scale at prenatal check-up may be useful for obstetricians to detect mothers with postpartum social problems. Further intervention studies using the SLIM score are warranted.
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Affiliation(s)
- Yoko Okamoto
- Department of Maternal Fetal MedicineOsaka Women's and Children's HospitalOsakaJapan
| | - Satomi Doi
- Department of Global Health PromotionTokyo Medical and Dental UniversityTokyoJapan,Japan Society for the Promotion of ScienceTokyoJapan
| | - Aya Isumi
- Department of Global Health PromotionTokyo Medical and Dental UniversityTokyoJapan,Japan Society for the Promotion of ScienceTokyoJapan
| | - Junichi Sugawara
- Division of Feto‐Maternal Medical Science, Department of Community Medical Support, Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Kazuhisa Maeda
- Department of Obstetrics and GynecologyShikoku Medical Center for Children and AdultsKagawaJapan
| | - Shoji Satoh
- Maternal and Perinatal Care CenterOita Prefectural HospitalOitaJapan
| | - Takeo Fujiwara
- Department of Global Health PromotionTokyo Medical and Dental UniversityTokyoJapan
| | - Nobuaki Mitsuda
- Department of Maternal Fetal MedicineOsaka Women's and Children's HospitalOsakaJapan
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Nakao M, Nanba Y, Okumura A, Hasegawa J, Toyokawa S, Ichizuka K, Kanayama N, Satoh S, Tamiya N, Nakai A, Fujimori K, Maeda T, Suzuki H, Iwashita M, Oka A, Ikeda T. Fetal heart rate evolution and brain imaging findings in preterm infants with severe cerebral palsy. Am J Obstet Gynecol 2022; 228:583.e1-583.e14. [PMID: 36370872 DOI: 10.1016/j.ajog.2022.11.1277] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Cerebral palsy is more common among preterm infants than among full-term infants. Although there is still no clear evidence that fetal heart rate monitoring effectively reduces cerebral palsy incidence, it is helpful to estimate the timing of brain injury leading to cerebral palsy and the causal relationship with delivery based on the fetal heart rate evolution patterns. Understanding the relationship between the timing and the type of brain injury can help to identify preventive measures in obstetrical care. OBJECTIVE This study aimed to examine the relationship between the timing of insults and the type of brain injury in preterm infants with severe cerebral palsy. STUDY DESIGN This longitudinal study was based on a nationwide database for cerebral palsy. The data of infants with severe cerebral palsy (equivalent to levels 3-5 of the Gross Motor Function Classification System-Expanded and Revised), born between 2009 and 2014 at 28 to 33 weeks of gestation, were included. The intrapartum fetal heart rate evolution patterns were evaluated by 3 obstetricians blinded to clinical information other than gestational age at birth, and these were categorized after agreement by at least 2 of the 3 reviewers into (1) continuous bradycardia, (2) persistently nonreassuring (prenatal onset), (3) reassuring-prolonged deceleration, (4) Hon's pattern (intrapartum onset), (5) persistently reassuring (pre- or postnatal onset), and (6) unclassified. Infant brain magnetic resonance imaging findings at term-equivalent age were assessed by a pediatric neurologist blinded to the background details, except for gestational age at birth and corrected age at image acquisition, and these were categorized as (1) basal ganglia-thalamus, (2) white matter, (3) watershed cortex or subcortex, (4) stroke, (5) normal, and (6) unclassified based on the predominant site involved. The risk factors for the basal ganglia-thalamus group were compared with those of the combined white matter and watershed injuries group. RESULTS Among 1593 infants with severe cerebral palsy, 231 were born at 28 to 33 weeks of gestation, and 140 met the eligibility criteria. Fetal heart rate evolution patterns were categorized as bradycardia (17% [24]); persistently nonreassuring (40% [56]); reassuring-prolonged deceleration (7% [10]); reassuring-Hon (6% [8]); persistently reassuring (7% [10]); and unclassified (23% [32]). Cerebral palsy was presumed to have an antenatal onset in 57% of infants and to have been caused by intrapartum insult in 13% of infants. Magnetic resonance imaging showed that 34% (n=48) of infants developed basal ganglia-thalamus-dominant brain injury. Of the remaining 92 infants, 43% (60) showed white matter injuries, 1% (1) showed watershed injuries, 4% (5) showed stroke, 1% (1) had normal findings, and 18% (25) had unclassified findings. Infants with continuous bradycardia (adjusted odds ratio, 1033.06; 95% confidence interval, 15.49-68,879.92) and persistently nonreassuring fetal heart rate patterns (61.20; 2.09-1793.12) had a significantly increased risk for basal ganglia-thalamus injury. CONCLUSION Severe cerebral palsy was presumed to have an antenatal onset in 57% of infants and to have been caused by intrapartum insult in only 13% of infants born at 28 to 33 weeks of gestation. Although the white matter-watershed injury was predominant in the study populations, severe acute hypoxia-ischemia may be an important prenatal etiology of severe cerebral palsy in preterm infants.
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Hasegawa J, Nakao M, Ikeda T, Toyokawa S, Jojima E, Satoh S, Ichizuka K, Tamiya N, Nakai A, Fujimori K, Maeda T, Takeda S, Suzuki H, Ueda S, Iwashita M, Ikenoue T. Fetal heart rate evolution patterns in cerebral palsy associated with umbilical cord complications: a nationwide study. BMC Pregnancy Childbirth 2022; 22:177. [PMID: 35241026 PMCID: PMC8896380 DOI: 10.1186/s12884-022-04508-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 02/21/2022] [Indexed: 11/22/2022] Open
Abstract
Background The aim of the present study was to clarify fetal heart rate (FHR) evolution patterns in infants with cerebral palsy (CP) according to different types of umbilical cord complications. Methods This case–control study included children born: with a birth weight ≥2000 g, at gestational age ≥33 weeks, with disability due to CP, and between 2009 and 2014. Obstetric characteristics and FHR patterns were compared among patients with CP associated with (126 cases) and without (594 controls) umbilical cord complications. Results There were 32 umbilical cord prolapse cases and 94 cases with coexistent antenatal umbilical cord complications. Compared with the control group, the persistent non-reassuring pattern was more frequent in cases with coexistent antenatal umbilical cord complications (p = 0.012). A reassuring FHR pattern was observed on admission, but resulted in prolonged deceleration, especially during the first stage of labor, and was significantly identified in 69% of cases with umbilical cord prolapse and 35% of cases with antenatal cord complications, compared to 17% of control cases (p < 0.001). Conclusion Hypercoiled cord and abnormal placental umbilical cord insertion, may be associated with CP due to acute hypoxic-ischemic injury as well as sub-acute or chronic adverse events during pregnancy, while umbilical cord prolapse may be characterized by acute hypoxic-ischemic injury during delivery. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04508-2.
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Affiliation(s)
- Junichi Hasegawa
- Visiting Researcher, Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan. .,Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.
| | - Masahiro Nakao
- Visiting Researcher, Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Mie, Japan.,Department of Obstetrics and Gynecology, Sakakibara Heart Institute, Tokyo, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Mie, Japan.,The Prevention Recurrence Committee, Japan Obstetric Compensation System for Cerebral Palsy, Tokyo, Japan
| | - Satoshi Toyokawa
- Visiting Researcher, Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Public Health, The University of Tokyo, Tokyo, Japan
| | - Emi Jojima
- Department of the Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan
| | - Shoji Satoh
- The Prevention Recurrence Committee, Japan Obstetric Compensation System for Cerebral Palsy, Tokyo, Japan.,Maternal and Perinatal Care Center, Oita Prefectural Hospital, Oita, Japan
| | - Kiyotake Ichizuka
- The Prevention Recurrence Committee, Japan Obstetric Compensation System for Cerebral Palsy, Tokyo, Japan.,Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Kanagawa, Japan
| | - Nanako Tamiya
- The Prevention Recurrence Committee, Japan Obstetric Compensation System for Cerebral Palsy, Tokyo, Japan.,Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Akihito Nakai
- The Prevention Recurrence Committee, Japan Obstetric Compensation System for Cerebral Palsy, Tokyo, Japan.,Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan
| | - Keiya Fujimori
- The Prevention Recurrence Committee, Japan Obstetric Compensation System for Cerebral Palsy, Tokyo, Japan.,Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Japan
| | - Tsugio Maeda
- The Prevention Recurrence Committee, Japan Obstetric Compensation System for Cerebral Palsy, Tokyo, Japan.,Maeda Clinic, Incorporated Association Anzu-kai, Shizuoka, Japan
| | - Satoru Takeda
- The Prevention Recurrence Committee, Japan Obstetric Compensation System for Cerebral Palsy, Tokyo, Japan.,Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Hideaki Suzuki
- Department of the Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan
| | - Shigeru Ueda
- Department of the Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan
| | - Mitsutoshi Iwashita
- The Prevention Recurrence Committee, Japan Obstetric Compensation System for Cerebral Palsy, Tokyo, Japan.,Kugayama Hospital, Tokyo, Japan
| | - Tsuyomu Ikenoue
- The Prevention Recurrence Committee, Japan Obstetric Compensation System for Cerebral Palsy, Tokyo, Japan.,Miyazaki University, Miyazaki, Japan
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Yamamoto R, Saito M, Aoyama Y, Sagehashi R, Saito T, Kashima S, Koizumi A, Nara T, Numakura K, Narita S, Satoh S, Habuchi T. Protective effects of regulatory T cells in renal ischemia/reperfusion injury in mice. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01165-4] [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: 11/04/2022]
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Nakao M, Nanba Y, Okumura A, Hasegawa J, Toyokawa S, Ichizuka K, Kanayama N, Satoh S, Tamiya N, Nakai A, Fujimori K, Maeda T, Suzuki H, Iwashita M, Oka A, Ikeda T. Correlation between fetal heart rate evolution patterns and magnetic resonance imaging findings in severe cerebral palsy: A longitudinal study. BJOG 2022; 129:1574-1582. [PMID: 35007405 PMCID: PMC9545186 DOI: 10.1111/1471-0528.17089] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To investigate the association between hypoxic-ischaemic insult timing and brain injury type in infants with severe cerebral palsy (CP). DESIGN Longitudinal study. SETTING Database of the Recurrence Prevention Committee, Japan Obstetric Compensation System for Cerebral Palsy. SAMPLE Infants with severe CP born at ≥34 weeks of gestation. METHODS The intrapartum fetal heart rate (FHR) strips were categorised as continuous bradycardia; persistently non-reassuring (NR-NR); reassuring-prolonged deceleration (R-PD); Hon's pattern (R-Hon); persistently reassuring (R-R); and unclassified. The brain magnetic resonance imaging (MRI) scans were categorised based on the predominant site involved: basal ganglia-thalamus (BGT); white matter (WM); watershed (WS); stroke; normal; and unclassified. MAIN OUTCOME MEASURES Manifestations of the brain MRI types and the association between FHR evolution pattern and MRI type were analysed. RESULTS Among 672 eligible infants, 76% had BGT-dominant injury, 5.4% WM, 1.2% WS, 1.6% stroke, 1.9% normal, and 14% unclassified. Placental abruption and small-for-gestational age were associated with an increased (adjusted odds ratio [aOR] 8.02) and decreased (aOR 0.38) risk of BGT injury, respectively. The majority of infants had BGT injury in most FHR groups (bradycardia, 97%; NR-NR, 75%; R-PD, 90%; R-Hon, 76%; and R-R, 45%). The risk profiles in case of BGT in the NR-NR group were similar to those in the R-PD and R-Hon groups. CONCLUSION BGT-dominant brain damage accounted for three-fourths of the cases of CP in term or near-term infants, even in prenatal onset cases. Hypoxic-ischaemic insult has a major impact on CP development during the antenatal period.
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Affiliation(s)
- Masahiro Nakao
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynaecology, Mie University Graduate School of Medicine, Tsu, Japan.,Department of Obstetrics and Gynecology, Sakakibara Heart Institute, Tokyo, Japan
| | - Yukiko Nanba
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Paediatrics, National Rehabilitation Center for Children with Disabilities, Tokyo, Japan
| | - Asumi Okumura
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynaecology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Junichi Hasegawa
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynaecology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Satoshi Toyokawa
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Public Health, The University of Tokyo, Tokyo, Japan
| | - Kiyotake Ichizuka
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynaecology, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Naohiro Kanayama
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynaecology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Shoji Satoh
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan.,Maternal and Perinatal Care Centre, Oita Prefectural Hospital, Oita, Japan
| | - Nanako Tamiya
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Akihito Nakai
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynaecology, Nippon Medical School, Tokyo, Japan
| | - Keiya Fujimori
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynaecology, Fukushima Medical University, Fukushima, Japan
| | - Tsugio Maeda
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan.,Maeda Clinic, Incorporated Association Anzu-kai, Shizuoka, Japan
| | - Hideaki Suzuki
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan.,The Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan
| | - Mitsutoshi Iwashita
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan.,Kugayama Hospital, Tokyo, Japan
| | - Akira Oka
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Paediatrics, Saitama Children's Medical Centre, Saitama, Japan
| | - Tomoaki Ikeda
- The Recurrence Prevention Committee, The Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynaecology, Mie University Graduate School of Medicine, Tsu, Japan
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9
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Terada S, Doi S, Tani Y, Maeda Y, Isumi A, Sugawara J, Maeda K, Satoh S, Mitsuda N, Fujiwara T. Relationship trajectories of pregnant women with their parents and postpartum depression: A hospital-based prospective cohort study in Japan. Front Psychiatry 2022; 13:961707. [PMID: 36405917 PMCID: PMC9668856 DOI: 10.3389/fpsyt.2022.961707] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 10/17/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUNDS A history of childhood abuse and subsequent poor relationship with parents in adulthood among pregnant women is a known risk factor for postpartum depression (PPD). Although parent-daughter relationship can change during pregnancy, little is known whether the trajectories have an impact on PPD. The aim of this study is to examine whether trajectories of parent-daughter relationship during pregnancy are associated with PPD in Japanese mothers. METHODS In a hospital-based prospective cohort study conducted in Japan, 4,772 women were followed from their first visit to their 1-month postpartum check-up (follow-up rate: 77.4%). Parent-daughter relationship was assessed whether participants were satisfied with their parents at first visit and after delivery. We defined four parent-daughter relationship trajectory categories: consistently satisfied, improving, deteriorating, and consistently unsatisfied. PPD was assessed by the Edinburgh Postnatal Depression Scale. Logistic regression model was applied to adjust covariates. RESULTS There were 129 (2.7%), 122 (2.6%), and 181 (3.8%) cases of improving, deteriorating, and consistently unsatisfied relationship, respectively. Compared to the group that was consistently satisfied, pregnant women of the deteriorating and consistently unsatisfied group showed 2.81 (95% CI: 1.73-4.55) and 2.39 (95% CI: 1.58-3.62) times, respectively, more likely to show PPD after adjustment for confounders. CONCLUSION Women who felt that their relationship with parents "deteriorated" or was "consistently unsatisfactory" during pregnancy showed significant risk of PPD. Paying attention to the pregnant women's feelings about the relationship with their parents and promoting positive change may help predict and prevent PPD.
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Affiliation(s)
- Shuhei Terada
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo, Japan
| | - Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo, Japan.,Japan Society for the Promotion of Science (JSPS), Tokyo, Japan
| | - Yukako Tani
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo, Japan
| | - Yuto Maeda
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo, Japan
| | - Aya Isumi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo, Japan.,Japan Society for the Promotion of Science (JSPS), Tokyo, Japan
| | - Junichi Sugawara
- Division of Feto-Maternal Medical Science, Department of Community Medical Support, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Kazuhisa Maeda
- Department of Obstetrics and Gynecology, Shikoku Medical Center for Children and Adults, Zentsuji, Japan
| | - Shoji Satoh
- Maternal and Perinatal Care Center, Oita Prefectural Hospital, Oita, Japan
| | - Nobuaki Mitsuda
- Department of Maternal Fetal Medicine, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo, Japan
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10
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Shimoya K, Kotani T, Satoh S, Suzuki S, Kashima H, Ogasawara K, Ozaki N, Suzuki E, Tachibana Y, Suzuki T. Clinical guide for women with mental health problems during the perinatal period. J Obstet Gynaecol Res 2021; 48:20-33. [PMID: 34713531 DOI: 10.1111/jog.15068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/02/2021] [Accepted: 10/04/2021] [Indexed: 11/27/2022]
Abstract
Pregnancy and childbirth have various effects on the physical as well as mental aspects of women. Therefore, appropriate considerations must be given to the mental health of pregnant women. The Guideline Review Committee of the Japanese Society of Psychiatry and Neurology launched a liaison meeting for the Japanese Society of Psychiatry and Neurology and the Japan Society of Obstetrics and Gynecology, with a view to creating a "Clinical guide for women with mental health problems during the perinatal period" by cooperation of these two fields. After repeated discussions with input from both academic societies, they jointly formulated the "Clinical guide for women with mental health problems during the perinatal period: Overview" in May 2020, and reported its "Detailed Contents" in April 2021. We hope that this guide, which is the English overview of the detailed guide, will contribute to the mental health of pregnant women, facilitating healthy pregnancies and childbirth.
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Affiliation(s)
- Koichiro Shimoya
- Department of Obstetrics and Gynecology, Kawasaki Medical School, Kurashiki, Japan
| | - Tomomi Kotani
- Department of Obstetrics and Gynecology, Nagoya University Hospital, Nagoya, Japan
| | - Shoji Satoh
- Department of Obstetrics and Gynecology, Oita Prefectural Hospital, Oita, Japan
| | - Shunji Suzuki
- Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan
| | - Haruo Kashima
- Department of Neuropsychiatry, Keio University, Tokyo, Japan
| | | | - Norio Ozaki
- Department of psychiatry, Nagoya University, Nagoya, Japan
| | - Eiji Suzuki
- Department of psychiatry, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Yoshiyuki Tachibana
- Department of Psychosocial Medicine, National Center for Child Health and Development, Tokyo, Japan
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11
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Saito M, Lee Y, Sato Y, Fujiyama N, Narita S, Satoh S, Yanagita M, Habuchi T. Clinical implication of tertially lymphoid tissue in the renal graft. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00715-6] [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: 11/27/2022]
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12
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Nakao M, Okumura A, Hasegawa J, Toyokawa S, Ichizuka K, Kanayama N, Satoh S, Tamiya N, Nakai A, Fujimori K, Maeda T, Suzuki H, Iwashita M, Ikeda T. Fetal heart rate pattern in term or near-term cerebral palsy: a nationwide cohort study. Am J Obstet Gynecol 2020; 223:907.e1-907.e13. [PMID: 32497609 DOI: 10.1016/j.ajog.2020.05.059] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 02/22/2020] [Revised: 05/20/2020] [Accepted: 05/29/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND It is crucial to interpret fetal heart rate patterns with a focus on the pattern evolution during labor to estimate the relationship between cerebral palsy and delivery. However, nationwide data are not available. OBJECTIVE The aim of our study was to demonstrate the features of fetal heart rate pattern evolution and estimate the timing of fetal brain injury during labor in cerebral palsy cases. STUDY DESIGN In this longitudinal study, 1069 consecutive intrapartum fetal heart rate strips from infants with severe cerebral palsy at or beyond 34 weeks of gestation, were analyzed. They were categorized as follows: (1) continuous bradycardia (Bradycardia), (2) persistently nonreassuring, (3) reassuring-prolonged deceleration, (4) Hon's pattern, and (5) persistently reassuring. The clinical factors underlying cerebral palsy in each group were assessed. RESULTS Hypoxic brain injury during labor (those in the reassuring-prolonged deceleration and Hon's pattern groups) accounted for 31.5% of severe cerebral palsy cases and at least 30% of those developed during the antenatal period. Of the 1069 cases, 7.86% were classified as continuous bradycardia (n=84), 21.7% as persistently nonreassuring (n=232), 15.6% as reassuring-prolonged deceleration (n=167), 15.9% as Hon's pattern (n=170), 19.8% as persistently reassuring (n=212), and 19.1% were unclassified (n=204). The overall interobserver agreement was moderate (kappa 0.59). Placental abruption was the most common cause (31.9%) of cerebral palsy, accounting for almost 90% of cases in the continuous bradycardia group (64 of 73). Among the cases in the Hon's pattern group (n=67), umbilical cord abnormalities were the most common clinical factor for cerebral palsy development (29.9%), followed by placental abruption (20.9%), and inappropriate operative vaginal delivery (13.4%). CONCLUSION Intrapartum hypoxic brain injury accounted for approximately 30% of severe cerebral palsy cases, whereas a substantial proportion of the cases were suspected to have either a prenatal or postnatal onset. Up to 16% of cerebral palsy cases may be preventable by placing a greater focus on the earlier changes seen in the Hon's fetal heart rate progression.
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Affiliation(s)
- Masahiro Nakao
- Department of Obstetrics and Gynecology, Sakakibara Heart Institute, Tokyo, Japan; Recurrence Prevention Committee, the Japan Obstetric Compensation System for Cerebral Palsy, Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan; Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Mie, Japan.
| | - Asumi Okumura
- Department of Obstetrics and Gynecology, Sakakibara Heart Institute, Tokyo, Japan; Recurrence Prevention Committee, the Japan Obstetric Compensation System for Cerebral Palsy, Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan
| | - Junichi Hasegawa
- Recurrence Prevention Committee, the Japan Obstetric Compensation System for Cerebral Palsy, Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan; Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Satoshi Toyokawa
- Recurrence Prevention Committee, the Japan Obstetric Compensation System for Cerebral Palsy, Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan; Department of Public Health, the University of Tokyo, Tokyo, Japan
| | - Kiyotake Ichizuka
- Recurrence Prevention Committee, the Japan Obstetric Compensation System for Cerebral Palsy, Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan; Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Naohiro Kanayama
- Recurrence Prevention Committee, the Japan Obstetric Compensation System for Cerebral Palsy, Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan; Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Shoji Satoh
- Recurrence Prevention Committee, the Japan Obstetric Compensation System for Cerebral Palsy, Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan; Maternal and Perinatal Care Center, Oita Prefectural Hospital, Oita, Japan
| | - Nanako Tamiya
- Recurrence Prevention Committee, the Japan Obstetric Compensation System for Cerebral Palsy, Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan; Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Akihito Nakai
- Recurrence Prevention Committee, the Japan Obstetric Compensation System for Cerebral Palsy, Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan; Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan
| | - Keiya Fujimori
- Recurrence Prevention Committee, the Japan Obstetric Compensation System for Cerebral Palsy, Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan; Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Japan
| | - Tsugio Maeda
- Recurrence Prevention Committee, the Japan Obstetric Compensation System for Cerebral Palsy, Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan; Maeda Clinic, Incorporated Association Anzu-kai, Shizuoka, Japan
| | - Hideaki Suzuki
- Recurrence Prevention Committee, the Japan Obstetric Compensation System for Cerebral Palsy, Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan; Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan
| | - Mitsutoshi Iwashita
- Recurrence Prevention Committee, the Japan Obstetric Compensation System for Cerebral Palsy, Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan; Department of Obstetrics and Gynecology, Kyorin University School of Medicine, Tokyo, Japan
| | - Tomoaki Ikeda
- Recurrence Prevention Committee, the Japan Obstetric Compensation System for Cerebral Palsy, Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan; Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Mie, Japan
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13
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Toyokawa S, Hasegawa J, Ikenoue T, Asano Y, Jojima E, Satoh S, Ikeda T, Ichizuka K, Takeda S, Tamiya N, Nakai A, Fujimori K, Maeda T, Masuzaki H, Suzuki H, Ueda S. Weekend and off-hour effects on the incidence of cerebral palsy: contribution of consolidated perinatal care. Environ Health Prev Med 2020; 25:52. [PMID: 32912144 PMCID: PMC7488476 DOI: 10.1186/s12199-020-00889-y] [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: 07/22/2020] [Accepted: 08/27/2020] [Indexed: 11/25/2022] Open
Abstract
Objective This study estimated the effects of weekend and off-hour childbirth and the size of perinatal medical care center on the incidence of cerebral palsy. Methods The cases were all children with severe cerebral palsy born in Japan from 2009 to 2012 whose data were stored at the Japan Obstetric Compensation System for Cerebral Palsy database, a nationally representative database. The inclusion criteria were the following: neonates born between January 2009 and December 2012 who had a birth weight of at least 2000 g and gestational age of at least 33 weeks and who had severe disability resulting from cerebral palsy independent of congenital causes or factors during the neonatal period or thereafter. Study participants were restricted to singletons and controls without report of death, scheduled cesarean section, or ambulance transportation. The controls were newborns, randomly selected by year and type of delivery (normal spontaneous delivery without cesarean section and emergency cesarean section) using a 1:10 case to control ratio sampled from the nationwide Japan Society of Obstetrics and Gynecology database. Results A total of 90 cerebral palsy cases and 900 controls having normal spontaneous delivery without cesarean section were selected, as were 92 cerebral palsy cases and 920 controls with emergent cesarean section. A significantly higher risk for cerebral palsy was found among cases that underwent emergent cesarean section on weekends (odds ratio [OR] 1.72, 95% confidence interval [CI] 1.06–2.81) and during the night shift (OR 2.29, 95% CI 1.30–4.02). No significant risk was found among normal spontaneous deliveries on weekends (OR 1.63, 95% CI 0.97–2.73) or during the quasi-night shift (OR 1.26, 95% CI 0.70–2.27). Regional perinatal care centers showed significantly higher risk for cerebral palsy in both emergent cesarean section (OR 2.35, 95% CI 1.47–3.77) and normal spontaneous delivery (OR 2.92, 95% CI 1.76–4.84). Conclusion Labor on weekends, during the night shift, and at regional perinatal medical care centers was associated with significantly elevated risk for cerebral palsy in emergency cesarean section.
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Affiliation(s)
- Satoshi Toyokawa
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. .,Department of the Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan.
| | - Junichi Hasegawa
- Department of the Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan
| | | | - Yuri Asano
- Department of the Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan
| | - Emi Jojima
- Department of the Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan
| | - Shoji Satoh
- Maternal and Perinatal Care Center, Oita Prefectural Hospital, Oita, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Mie, Japan
| | - Kiyotake Ichizuka
- Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Kanagawa, Japan
| | - Satoru Takeda
- Department of Obstetrics and Gynecology, Juntendo University, Tokyo, Japan
| | - Nanako Tamiya
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Akihito Nakai
- Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan
| | - Keiya Fujimori
- Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Japan
| | | | - Hideaki Masuzaki
- Department of Obstetrics and Gynecology, University of Nagasaki, Nagasaki, Japan
| | - Hideaki Suzuki
- Department of the Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan
| | - Shigeru Ueda
- Department of the Japan Obstetric Compensation System for Cerebral Palsy, Japan Council for Quality Health Care, Tokyo, Japan
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14
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Ichizuka K, Toyokawa S, Ikenoue T, Satoh S, Hasegawa J, Ikeda T, Tamiya N, Nakai A, Fujimori K, Maeda T, Kanayama N, Masuzaki H, Iwashita M, Suzuki H, Takeda S. Risk factors for cerebral palsy in neonates due to placental abruption. J Obstet Gynaecol Res 2020; 47:159-166. [PMID: 32885550 PMCID: PMC7818445 DOI: 10.1111/jog.14447] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 02/24/2020] [Revised: 07/14/2020] [Accepted: 08/02/2020] [Indexed: 11/28/2022]
Abstract
Aim This study aimed to identify risk factors for the onset of cerebral palsy (CP) in neonates due to placental abruption and investigate their characteristics. Methods A retrospective case–control study was conducted using a nationwide registry from Japan. The study population included pregnant women (n = 122) who delivered an infant with CP between 2009 and 2015, where placental abruption was identified as the single cause of CP. The control group consisted of pregnant women with placental abruption, who delivered an infant without CP and were managed from 2013 to 2014. They were randomly identified from the prenatal database of the Japan Society of Obstetrics and Gynecology (JSOG‐DB; n = 1214). Risk factors were investigated using multivariate analysis. Results Alcohol consumption (3.38, 2.01–5.68) (odds ratio, 95% confidence interval), smoking during pregnancy (3.50, 1.32–9.25), number of deliveries (1.28, 1.05–1.56), polyhydramnios (5.60, 1.37–22.6), oral administration of ritodrine hydrochloride (2.09, 1.22–3.57) and hypertensive disorders in pregnancy (2.25, 1.27–4.07) were significant risk factors. In contrast, intravenous administration of oxytocin (odds ratio, 95% confidence interval: 0.22, 0.09–0.58) and magnesium sulfate (0.122, 0.02–0.89) attenuated risk. Conclusion Alcohol consumption, smoking during pregnancy, number of deliveries, polyhydramnios, oral administration of ritodrine hydrochloride and hypertensive disorders in pregnancy were identified as risk factors for CP following placental abruption. Regarding alcohol consumption and smoking during pregnancy, the results suggest the importance of educational activities targeting pregnant women to increase their awareness of placental abruption.
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Affiliation(s)
- Kiyotake Ichizuka
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Satoshi Toyokawa
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Public Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Tsuyomu Ikenoue
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynecology, Faculty of Medicine, Miyazaki University, Miyazaki, Japan
| | - Shoji Satoh
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics, Oita Prefectural Hospital, Oita, Japan
| | - Junichi Hasegawa
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynecology, Saint Marianna University School of Medicine, Kawasaki, Japan
| | - Tomoaki Ikeda
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynecology, Mie University, Tsu, Japan
| | - Nanako Tamiya
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Health Services Research, Faculty of Medicine, Tsukuba University, Tsukuba, Japan
| | - Akihito Nakai
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynecology, Nippon Medical University, Tokyo, Japan
| | - Keiya Fujimori
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Japan
| | - Tsugio Maeda
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan.,Maeda Obstetrics and Gynecology Clinic, Yaizu, Japan
| | - Naohiro Kanayama
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hideaki Masuzaki
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynecology, Nagasaki University, Nagasaki, Japan
| | - Mitsutoshi Iwashita
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan.,Kugayama Hospital, Tokyo, Japan
| | - Hideaki Suzuki
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan
| | - Satoru Takeda
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynecology, Juntendo University, Tokyo, Japan
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15
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Narita N, Nakanishi H, Matsuda Y, Huang M, Koizumi A, Kikuchi A, Sagehashi R, Nara T, Kanda S, Numakura K, Saito M, Inoue T, Satoh S, Habuchi T. The impact of phosphatidylinositol phosphate and its associated enzyme levels on clinical outcomes in patients with renal cell carcinoma who underwent surgery. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33913-6] [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: 10/23/2022] Open
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16
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Miyazawa T, Itabashi K, Tamura M, Suzuki H, Ikenoue T, Ikeda T, Ichizuka K, Satoh S, Takeda S, Tamiya N, Nakai A, Fujimori K, Maeda T. Unsupervised breastfeeding was related to sudden unexpected postnatal collapse during early skin-to-skin contact in cerebral palsy cases. Acta Paediatr 2020; 109:1154-1161. [PMID: 31385353 PMCID: PMC7318205 DOI: 10.1111/apa.14961] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 06/12/2019] [Accepted: 08/02/2019] [Indexed: 12/02/2022]
Abstract
Aim This study aimed to identify the clinical features of infants who were healthy at birth, but developed sudden unexpected collapse and were then diagnosed with cerebral palsy before 5 years of age. Methods We retrospectively analysed 1182 records from the no‐fault Japan Obstetric Compensation System for Cerebral Palsy database up to 2016. This identified 45 subjects (3.8%) who were subsequently diagnosed with severe cerebral palsy due to sudden unexpected postnatal collapse (SUPC). They were all healthy at birth, based on the criteria of five‐minute Apgar scores of seven or more, with normal umbilical cord blood gases and no need for neonatal resuscitation within five minutes of birth. Results The median birth weight of the 45 subjects (26 males) was 2770 g (range 2006‐3695 g). Of these, 10 developed SUPC during early skin‐to‐skin contact (SSC). Medical personnel were not present in all 10 cases: nine were being breastfed at the time and eight of the mothers did not notice their infant's abnormal condition until medical staff alerted them. Conclusion This national study of children with cerebral palsy who appeared healthy at birth found that unsupervised breastfeeding was a common factor in cases of SUPC during early SSC.
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Affiliation(s)
- Tokuo Miyazawa
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation Japan Council for Quality Health Care Tokyo Japan
- Department of Pediatrics Showa University School of Medicine Tokyo Japan
| | | | - Masanori Tamura
- Department of Pediatrics Saitama Medical Center Saitama Medical University Kawagoe Japan
| | - Hideaki Suzuki
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation Japan Council for Quality Health Care Tokyo Japan
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17
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Hasegawa J, Ikeda T, Toyokawa S, Jojima E, Satoh S, Ichizuka K, Tamiya N, Nakai A, Fujimori K, Maeda T, Takeda S, Suzuki H, Ueda S, Iwashita M, Ikenoue T. Obstetric factors associated with uterine rupture in mothers who deliver infants with cerebral palsy. J Matern Fetal Neonatal Med 2019; 34:663-669. [PMID: 31032674 DOI: 10.1080/14767058.2019.1611775] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: The aim of the present study was to clarify the obstetric factors associated with uterine rupture in mothers who deliver infants with cerebral palsy (CP) in Japan.Methods: This retrospective case-cohort study reviewed the obstetric characteristics and clinical courses of mothers who experienced uterine rupture and compared those who delivered an infant with CP (cases) with those who delivered an infant without CP (cohort). Data were obtained from the Japan Obstetric Compensation System for CP database (27 cases) and the perinatal database of the Japan Society of Obstetrics and Gynecology (312 cohorts). The subjects included live singleton infants delivered between 2009 and 2014 with a birth weight ≥2000 g and gestation ≥33 weeks.Results: Augmentation was performed 33% in cases and 8% in cohorts (p < .001). The amount of bleeding during surgery was 1819 g in cases and 1096 g in cohorts (p < .001). Length of gestational weeks and neonatal birth weight were significantly higher and Apgar scores and umbilical arterial pH were lower in cases compared to cohorts (p < .001). In cases with CP, 11 cases of uterine rupture involved scarred uteruses. Seven were trial of labor after a previous cesarean. On one hand, 16 cases occurred in unscarred uteruses. Five of the uterine fundal pressure maneuvers and four of tachysystole due to excessive augmentation were reported in association with uterine rupture.Conclusion: Two-third of the relevant obstetric factors for CP associated with uterine rupture were iatrogenic. At least, to reduce CP resulting from delivery-related uterine rupture, reckless delivery management should be avoided.
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Affiliation(s)
- Junichi Hasegawa
- Visiting Researcher, Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan.,Department of Obstetrics and Gynecology, St Marianna University School of Medicine, Kanagawa, Japan
| | - Tomoaki Ikeda
- The Prevention Recurrence Committee, Mie Japan Obstetric Compensation System for Cerebral Palsy, Japan.,Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Mie, Japan
| | - Satoshi Toyokawa
- The Prevention Recurrence Committee, Mie Japan Obstetric Compensation System for Cerebral Palsy, Japan.,Department of Public Health, The University of Tokyo, Tokyo, Japan
| | - Emi Jojima
- The Prevention Recurrence Committee, Mie Japan Obstetric Compensation System for Cerebral Palsy, Japan.,Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan
| | - Shoji Satoh
- The Prevention Recurrence Committee, Mie Japan Obstetric Compensation System for Cerebral Palsy, Japan.,Maternal and Perinatal Care Center, Oita Prefectural Hospital, Oita, Japan
| | - Kiyotake Ichizuka
- The Prevention Recurrence Committee, Mie Japan Obstetric Compensation System for Cerebral Palsy, Japan.,Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Kanagawa, Japan
| | - Nanako Tamiya
- The Prevention Recurrence Committee, Mie Japan Obstetric Compensation System for Cerebral Palsy, Japan.,Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Akihito Nakai
- The Prevention Recurrence Committee, Mie Japan Obstetric Compensation System for Cerebral Palsy, Japan.,Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan
| | - Keiya Fujimori
- The Prevention Recurrence Committee, Mie Japan Obstetric Compensation System for Cerebral Palsy, Japan.,Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Japan
| | - Tsugio Maeda
- The Prevention Recurrence Committee, Mie Japan Obstetric Compensation System for Cerebral Palsy, Japan.,Maeda Clinic, Incorporated Association Anzu-kai, Shizuoka, Japan
| | - Satoru Takeda
- The Prevention Recurrence Committee, Mie Japan Obstetric Compensation System for Cerebral Palsy, Japan.,Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Hideaki Suzuki
- The Prevention Recurrence Committee, Mie Japan Obstetric Compensation System for Cerebral Palsy, Japan.,Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan
| | - Shigeru Ueda
- The Prevention Recurrence Committee, Mie Japan Obstetric Compensation System for Cerebral Palsy, Japan.,Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan
| | - Mitsutoshi Iwashita
- The Prevention Recurrence Committee, Mie Japan Obstetric Compensation System for Cerebral Palsy, Japan.,Kugayama Hospital, Tokyo, Japan
| | - Tsuyomu Ikenoue
- The Prevention Recurrence Committee, Mie Japan Obstetric Compensation System for Cerebral Palsy, Japan.,Miyazaki University, Miyazaki, Japan
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18
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Akamine Y, Sato S, Kagaya H, Ohkubo T, Satoh S, Miura M. Comparison of electrochemiluminescence immunoassay and latex agglutination turbidimetric immunoassay for evaluation of everolimus blood concentrations in renal transplant patients. J Clin Pharm Ther 2018; 43:675-681. [PMID: 29679392 DOI: 10.1111/jcpt.12686] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/23/2018] [Indexed: 12/14/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE For analysis of blood concentrations of everolimus, many hospital laboratories use either latex agglutination turbidimetric immunoassay (LTIA) or electrochemiluminescence immunoassay (ECLIA). However, no studies have compared both immunoassay methods under the same conditions. Accordingly, in this study, we compared everolimus blood concentrations obtained by LTIA and ECLIA in renal transplant patients. METHODS Blood samples (n = 230) from 60 renal transplant patients (19 female and 41 male) were evaluated using both immunoassays. Subsequently, we switched the assay for detection of everolimus blood concentrations from LTIA to ECLIA as a clinical application. Three quality control (QC) samples for LTIA were analysed using ECLIA, and 3 QC samples for ECLIA were analysed using LTIA. RESULTS The Deming regression of ECLIA versus LTIA generated the following parameters: slope, 1.0067 and intercept, 1.7489 ng/mL, in the analysis of 230 samples. Bland-Altman analysis showed an average positive bias of 1.73 ng/mL between ECLIA and LTIA. When the clinical apparatus was switched from LTIA to ECLIA, the average everolimus blood concentration assayed by LTIA before switching was 3.57 ng/mL, whereas that by ECLIA after switching in the same patients taking the same daily dose (mean: 1.43 mg/day) was 5.85 ng/mL. The QCs assayed using LTIA were lower by an average of 67.3% (range: 55.8%-79.5%) for ECLIA, and in the same 230 samples from patients, the everolimus blood concentrations assayed by LTIA were lower by an average of 67.4% (range: 37.1%-114.5%) of ECLIA. WHAT IS NEW AND CONCLUSION Analysis of everolimus concentrations by immunoassays with high precision and accuracy is required to ensure long-term survival of transplant recipients. Although the concentrations of QCs and calibrators of everolimus in LTIA were previously corrected to 70% concentration because of cross-reactivity with everolimus metabolites, these adjustments may need to be reviewed.
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Affiliation(s)
- Y Akamine
- Department of Pharmacy, Akita University Hospital, Akita, Japan
| | - S Sato
- Department of Pharmacy, Akita University Hospital, Akita, Japan
| | - H Kagaya
- Department of Pharmacy, Akita University Hospital, Akita, Japan
| | - T Ohkubo
- Research Institute of Shichifuku Pharmacy, Aomori, Japan
| | - S Satoh
- Center for Kidney Disease and Transplantation, Akita University Hospital, Akita, Japan
| | - M Miura
- Department of Pharmacy, Akita University Hospital, Akita, Japan
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19
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Hasegawa J, Ikeda T, Toyokawa S, Jojima E, Satoh S, Ichizuka K, Tamiya N, Nakai A, Fujimori K, Maeda T, Masuzaki H, Takeda S, Suzuki H, Ueda S, Ikenoue T. Relevant obstetric factors associated with fetal heart rate monitoring for cerebral palsy in pregnant women with hypertensive disorder of pregnancy. J Obstet Gynaecol Res 2018; 44:647-654. [PMID: 29363232 PMCID: PMC5900742 DOI: 10.1111/jog.13555] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 10/21/2017] [Indexed: 11/30/2022]
Abstract
AIM The study identifies the relevant obstetric factors associated with fetal heart rate (FHR) monitoring for cerebral palsy (CP) in pregnant women with hypertensive disorders of pregnancy (HDP). METHODS The subjects were neonates with CP (birth weight ≥ 2000 g, gestational age ≥ 33 weeks) who were approved for compensation for CP by the Operating Organization of the Japan Obstetric Compensation System between 2009 and 2012. After selection of women with antepartum HDP, obstetric characteristics associated with FHR monitoring were analyzed. RESULTS The subjects included 33 neonates with CP whose mothers suffered from HDP during pregnancy and 450 neonates whose mothers did not develop HDP. The rates of placental abruption (48.5% vs. 20%; P < 0.001) and light-for-gestational age (12.1% vs. 2.2%; P = 0.011) were significantly higher in women with HDP than in those without HDP. Regarding FHR pattern analysis, fetal bradycardia was observed on admission to hospital in 94% of women with placental abruption. In women without placental abruption, FHR was likely to indicate a favorable pattern on admission, but became worse with the progression of labor. CONCLUSION This is first study to clinically demonstrate FHR patterns in CP cases in association with HDP. Although antepartum CP is undetectable, pregnant women with HDP should be placed under strict observation and management to minimize fetal hypoxic conditions during labor.
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Affiliation(s)
- Junichi Hasegawa
- Department of Obstetrics and GynecologySt. Marianna University School of MedicineKawasakiJapan
| | - Tomoaki Ikeda
- Department of Obstetrics and GynecologyMie University Graduate School of MedicineTsuJapan
| | | | - Emi Jojima
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated FoundationJapan Council for Quality Health CareTokyoJapan
| | - Shoji Satoh
- Maternal and Perinatal Care CenterOita Prefectural HospitalOitaJapan
| | - Kiyotake Ichizuka
- Department of Obstetrics and GynecologyShowa University Northern Yokohama HospitalYokohamaJapan
| | - Nanako Tamiya
- Department of Health Services Research, Faculty of MedicineUniversity of TsukubaTsukubaJapan
| | - Akihito Nakai
- Department of Obstetrics and GynecologyNippon Medical SchoolTokyoJapan
| | - Keiya Fujimori
- Department of Obstetrics and GynecologyFukushima Medical UniversityFukushimaJapan
| | - Tsugio Maeda
- Maeda ClinicIncorporated Association Anzu‐kaiYaizuJapan
| | - Hideaki Masuzaki
- Department of Obstetrics and GynecologyThe University of NagasakiNagasakiJapan
| | - Satoru Takeda
- Department of Obstetrics & GynecologyJuntendo UniversityTokyoJapan
| | - Hideaki Suzuki
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated FoundationJapan Council for Quality Health CareTokyoJapan
| | - Shigeru Ueda
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated FoundationJapan Council for Quality Health CareTokyoJapan
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Kakudo K, Higuchi M, Hirokawa M, Satoh S, Jung CK, Bychkov A. Thyroid FNA cytology in Asian practice-Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas. Cytopathology 2017; 28:455-466. [DOI: 10.1111/cyt.12491] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2017] [Indexed: 01/31/2023]
Affiliation(s)
- K. Kakudo
- Department of Pathology; Kindai University Faculty of Medicine; Ikoma Japan
| | - M. Higuchi
- Department of Clinical Laboratory; Kuma Hospital; Kobe Japan
| | - M. Hirokawa
- Department of Diagnostic Pathology; Kuma Hospital; Kobe Japan
| | - S. Satoh
- Endocrine Surgery; Yamashita Thyroid Hospital; Fukuoka Japan
| | - C. K. Jung
- Department of Hospital Pathology; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - A. Bychkov
- Department of Pathology; Faculty of Medicine; Chulalongkorn University; Bangkok Thailand
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21
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Matsuda Y, Sasaki K, Kakinuma K, Kakinuma T, Tagawa M, Imai K, Nonaka H, Ohwada M, Satoh S. Impact of risk factors for perinatal events in Japan: Introduction of a newly created perinatal event score. J Obstet Gynaecol Res 2017; 43:805-811. [PMID: 28168779 DOI: 10.1111/jog.13278] [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: 06/24/2016] [Revised: 10/19/2016] [Accepted: 12/03/2016] [Indexed: 11/29/2022]
Abstract
AIM A cohort study was performed to clarify the influence of risk factors on perinatal events (obstetric complications and/or perinatal deaths). METHODS This cohort study reviewed 395 785 births from 2011 to 2013. Women with singleton pregnancies delivered after 22 weeks of gestation were included. The OR were determined on multivariate analysis. The perinatal event score (PES) for risk factors, which is the product of the OR of risk factors for obstetric complications, OR of risk factors for perinatal death, and OR of obstetric complications for perinatal death, was introduced to clarify the impact of each risk combination. RESULTS There were 20 risk factors such as maternal age and medical complications relating to the 11 obstetric complications, including pregnancy-induced hypertension and preterm labor. As a result, 77 combinations of risk factors and obstetric complications were found to be significant. Six obstetric complications such as preterm labor and cervical insufficiency were found to be related to perinatal death. Two factors were found to be directly related to perinatal death: age >40 years old (OR, 1.24; 95%CI: 1.11-1.39) and essential hypertension (OR, 1.56; 95%CI: 1.19-2.05). As a result, PES ranged from 1.07 (primipara for premature rupture of membrane) to 40.1 (essential hypertension for placental abruption), and high PES (≥8) was identified in 21 combinations of risk factors and obstetric complications. CONCLUSION This newly created score for perinatal events, PES, can be used as an indicator of the impact of risk factors on perinatal events.
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Affiliation(s)
- Yoshio Matsuda
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Kemal Sasaki
- Child Health Center, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Kaoru Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Toshiyuki Kakinuma
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Miki Tagawa
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Ken Imai
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Hiroaki Nonaka
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Michitaka Ohwada
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Shoji Satoh
- Maternal and Perinatal Care Center, Oita Prefectural Hospital, Oita, Japan
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22
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Urayama T, Takahashi K, Ideno S, Yunoki M, Saito M, Numakura K, Inoue T, Satoh S, Sakai K. BK polyomavirus‐neutralizing activity of intravenous immunoglobulin products derived from donated blood in Japan. ACTA ACUST UNITED AC 2016. [DOI: 10.1111/voxs.12294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- T. Urayama
- Research and Development Division Japan Blood Products Organization Hyogo Japan
| | - K. Takahashi
- Research and Development Division Japan Blood Products Organization Hyogo Japan
| | - S. Ideno
- Research and Development Division Japan Blood Products Organization Hyogo Japan
| | - M. Yunoki
- Research and Development Division Japan Blood Products Organization Hyogo Japan
| | - M. Saito
- Department of Urology Akita University Graduate School of Medicine Akita Japan
| | - K. Numakura
- Department of Urology Akita University Graduate School of Medicine Akita Japan
| | - T. Inoue
- Department of Urology Akita University Graduate School of Medicine Akita Japan
| | - S. Satoh
- Center for Kidney Disease and Transplantation Akita University Hospital Akita Japan
| | - K. Sakai
- Research and Development Division Japan Blood Products Organization Hyogo Japan
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Ono T, Matsuda Y, Sasaki K, Satoh S, Tsuji S, Kimura F, Murakami T. Comparative analysis of cesarean section rates using Robson Ten-Group Classification System and Lorenz curve in the main institutions in Japan. J Obstet Gynaecol Res 2016; 42:1279-1285. [DOI: 10.1111/jog.13069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/04/2016] [Accepted: 05/02/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Tetsuo Ono
- Department of Obstetrics and Gynecology; Shiga University of Medical Science; Shiga Japan
| | - Yoshio Matsuda
- Department of Obstetrics and Gynecology; International University of Health and Welfare Hospital; Tochigi Japan
| | - Kemal Sasaki
- Child Health Center, Aichi Children's Health and Medical Center; Aichi Japan
| | - Shoji Satoh
- Perinatal Medical Center; Oita Prefecture Hospital; Oita Japan
| | - Shunichiro Tsuji
- Department of Obstetrics and Gynecology; Shiga University of Medical Science; Shiga Japan
| | - Fuminori Kimura
- Department of Obstetrics and Gynecology; Shiga University of Medical Science; Shiga Japan
| | - Takashi Murakami
- Department of Obstetrics and Gynecology; Shiga University of Medical Science; Shiga Japan
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Ohhashi M, Yoshitomi T, Sumiyoshi K, Kawagoe Y, Satoh S, Sameshima H, Ikenoue T. Magnesium sulphate and perinatal mortality and morbidity in very-low-birthweight infants born between 24 and 32 weeks of gestation in Japan. Eur J Obstet Gynecol Reprod Biol 2016; 201:140-5. [DOI: 10.1016/j.ejogrb.2016.03.048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 02/03/2016] [Accepted: 03/30/2016] [Indexed: 10/22/2022]
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25
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Goto M, Yoshizato T, Tatsumura M, Takashima T, Ogawa M, Nakahara H, Satoh S, Sanui A, Eguchi F, Miyamoto S. Safety and efficacy of thromboprophylaxis using enoxaparin sodium after cesarean section: A multi-center study in Japan. Taiwan J Obstet Gynecol 2016; 54:248-52. [PMID: 26166335 DOI: 10.1016/j.tjog.2014.09.008] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2013] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Pulmonary embolism (PE) is the leading cause of maternal death in developed countries, and the prevention of venous thromboembolism (VTE) is a pivotal part of current obstetric care. This study evaluated the safety and efficacy of enoxaparin sodium for thromboprophylaxis after cesarean section (C/S), and analyzed the risk factors associated with VTE. MATERIALS AND METHODS One hundred and forty-three women deemed to be at high risk of postoperative deep vein thrombosis (DVT) were enrolled between January 2011 and May 2012 in seven institutions in Japan. Subcutaneous administration of enoxaparin 4000 units/d was initiated 24-36 hours after C/S for 5 days. Adverse events, based on the Common Terminology Criteria for Adverse Events, Version 4, were recorded. The diagnoses of PE and DVT were made on clinical signs. Venous ultrasonography in the lower extremities was performed in 102 patients. The association between VTE and various risk factors was evaluated using univariate analysis. RESULTS There were 10 (7.0%) Grade 1 adverse events: elevated aspartate aminotransferase or alanine aminotransferase levels in eight patients, chest pain in one patient, and subcutaneous hematoma in one patient. No patients showed clinical signs of PE and/or DVT. Among 102 patients who underwent venous ultrasonography, thrombus was detected in unilateral soleus veins in four (3.9%) patients. A body mass index (BMI) ≥ 25 kg/m(2) before pregnancy was associated with asymptomatic DVT. CONCLUSION The current study demonstrates the safety and efficacy of enoxaparin for thromboprophylaxis after C/S. Further studies are required to determine the best method of preventing asymptomatic DVT.
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Affiliation(s)
- Maki Goto
- Department of Obstetrics and Gynecology, Iizuka Hospital, Iizuka, Japan
| | - Toshiyuki Yoshizato
- Center for Maternal, Fetal, and Neonatal Medicine, Fukuoka University Hospital, Fukuoka, Japan.
| | - Masato Tatsumura
- Department of Obstetrics and Gynecology, Yamaguchi Red Cross Hospital, Yamaguchi, Japan
| | - Takeshi Takashima
- Department of Obstetrics and Gynecology, Kitakyushu Municipal Hospital, Fukuoka, Japan
| | - Masanobu Ogawa
- Department of Obstetrics and Gynecology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Hiromasa Nakahara
- Department of Obstetrics and Gynecology, Japan Community Health Care Organization Kyushu Hospital, Fukuoka, Japan
| | - Shoji Satoh
- Department of Obstetrics and Gynecology, Oita Prefectural Hospital, Oita, Japan
| | - Ayako Sanui
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Fuyuki Eguchi
- Department of Obstetrics and Gynecology, Iizuka Hospital, Iizuka, Japan
| | - Shingo Miyamoto
- Center for Maternal, Fetal, and Neonatal Medicine, Fukuoka University Hospital, Fukuoka, Japan; Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Matsuo K, Takazawa Y, Ross MS, Elishaev E, Podzielinski I, Yunokawa M, Sheridan TB, Bush SH, Klobocista MM, Blake EA, Takano T, Matsuzaki S, Baba T, Satoh S, Shida M, Nishikawa T, Ikeda Y, Adachi S, Yokoyama T, Takekuma M, Fujiwara K, Hazama Y, Kadogami D, Moffitt MN, Takeuchi S, Nishimura M, Iwasaki K, Ushioda N, Johnson MS, Yoshida M, Hakam A, Li SW, Richmond AM, Machida H, Mhawech-Fauceglia P, Ueda Y, Yoshino K, Yamaguchi K, Oishi T, Kajiwara H, Hasegawa K, Yasuda M, Kawana K, Suda K, Miyake TM, Moriya T, Yuba Y, Morgan T, Fukagawa T, Wakatsuki A, Sugiyama T, Pejovic T, Nagano T, Shimoya K, Andoh M, Shiki Y, Enomoto T, Sasaki T, Fujiwara K, Mikami M, Shimada M, Konishi I, Kimura T, Post MD, Shahzad MM, Im DD, Yoshida H, Omatsu K, Ueland FR, Kelley JL, Karabakhtsian RG, Roman LD. Significance of histologic pattern of carcinoma and sarcoma components on survival outcomes of uterine carcinosarcoma. Ann Oncol 2016; 27:1257-66. [PMID: 27052653 DOI: 10.1093/annonc/mdw161] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [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: 12/07/2015] [Accepted: 03/29/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To examine the effect of the histology of carcinoma and sarcoma components on survival outcome of uterine carcinosarcoma. PATIENTS AND METHODS A multicenter retrospective study was conducted to examine uterine carcinosarcoma cases that underwent primary surgical staging. Archived slides were examined and histologic patterns were grouped based on carcinoma (low-grade versus high-grade) and sarcoma (homologous versus heterologous) components, correlating to clinico-pathological demographics and outcomes. RESULTS Among 1192 cases identified, 906 cases were evaluated for histologic patterns (carcinoma/sarcoma) with high-grade/homologous (40.8%) being the most common type followed by high-grade/heterologous (30.9%), low-grade/homologous (18.0%), and low-grade/heterologous (10.3%). On multivariate analysis, high-grade/heterologous (5-year rate, 34.0%, P = 0.024) and high-grade/homologous (45.8%, P = 0.017) but not low-grade/heterologous (50.6%, P = 0.089) were independently associated with decreased progression-free survival (PFS) compared with low-grade/homologous (60.3%). In addition, older age, residual disease at surgery, large tumor, sarcoma dominance, deep myometrial invasion, lymphovascular space invasion, and advanced-stage disease were independently associated with decreased PFS (all, P < 0.01). Both postoperative chemotherapy (5-year rates, 48.6% versus 39.0%, P < 0.001) and radiotherapy (50.1% versus 44.1%, P = 0.007) were significantly associated with improved PFS in univariate analysis. However, on multivariate analysis, only postoperative chemotherapy remained an independent predictor for improved PFS [hazard ratio (HR) 0.34, 95% confidence interval (CI) 0.27-0.43, P < 0.001]. On univariate analysis, significant treatment benefits for PFS were seen with ifosfamide for low-grade carcinoma (82.0% versus 49.8%, P = 0.001), platinum for high-grade carcinoma (46.9% versus 32.4%, P = 0.034) and homologous sarcoma (53.1% versus 38.2%, P = 0.017), and anthracycline for heterologous sarcoma (66.2% versus 39.3%, P = 0.005). Conversely, platinum, taxane, and anthracycline for low-grade carcinoma, and anthracycline for homologous sarcoma had no effect on PFS compared with non-chemotherapy group (all, P > 0.05). On multivariate analysis, ifosfamide for low-grade/homologous (HR 0.21, 95% CI 0.07-0.63, P = 0.005), platinum for high-grade/homologous (HR 0.36, 95% CI 0.22-0.60, P < 0.001), and anthracycline for high-grade/heterologous (HR 0.30, 95% CI 0.14-0.62, P = 0.001) remained independent predictors for improved PFS. Analyses of 1096 metastatic sites showed that carcinoma components tended to spread lymphatically, while sarcoma components tended to spread loco-regionally (P < 0.001). CONCLUSION Characterization of histologic pattern provides valuable information in the management of uterine carcinosarcoma.
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Affiliation(s)
- K Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, USA
| | - Y Takazawa
- Department of Pathology, Cancer Institute Hospital, Tokyo, Japan
| | - M S Ross
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology
| | - E Elishaev
- Department of Pathology, MaGee-Womens Hospital, University of Pittsburgh, Pittsburgh
| | - I Podzielinski
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky, Lexington, USA
| | - M Yunokawa
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - T B Sheridan
- Department of Pathology, Mercy Medical Center, Baltimore
| | - S H Bush
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida, Tampa
| | - M M Klobocista
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Bronx
| | - E A Blake
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology; University of Colorado, Boulder, USA
| | - T Takano
- Department of Obstetrics and Gynecology, Tohoku University, Miyagi
| | - S Matsuzaki
- Department of Obstetrics and Gynecology, Osaka University, Osaka
| | - T Baba
- Department of Obstetrics and Gynecology, Kyoto University, Kyoto
| | - S Satoh
- Department of Obstetrics and Gynecology, Tottori University, Tottori
| | - M Shida
- Department of Obstetrics and Gynecology, Tokai University, Kanagawa
| | - T Nishikawa
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama
| | - Y Ikeda
- Departments of Obstetrics and Gynecology, The University of Tokyo, Tokyo
| | - S Adachi
- Department of Obstetrics and Gynecology, Niigata University, Niigata
| | - T Yokoyama
- Department of Obstetrics and Gynecology, Osaka Rosai Hospital, Osaka
| | - M Takekuma
- Department of Obstetrics and Gynecology, Shizuoka Cancer Center, Shizuoka
| | - K Fujiwara
- Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama
| | - Y Hazama
- Department of Obstetrics and Gynecology, Kawasaki Medical School, Okayama
| | - D Kadogami
- Department of Obstetrics and Gynecology; Kitano Hospital, Osaka, Japan
| | - M N Moffitt
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Portland, USA
| | - S Takeuchi
- Department of Obstetrics and Gynecology, Iwate Medical University, Morioka
| | - M Nishimura
- Department of Obstetrics and Gynecology, Tokushima University, Tokushima
| | - K Iwasaki
- Department of Obstetrics and Gynecology, Aichi Medical University, Aichi
| | - N Ushioda
- Department of Gynecology, Cancer Institute Hospital, Tokyo
| | - M S Johnson
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky, Lexington, USA
| | - M Yoshida
- Departments of Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - A Hakam
- Department of Pathology, Moffitt Cancer Center, University of South Florida, Tampa
| | - S W Li
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Bronx
| | - A M Richmond
- Department of Pathology, University of Colorado, Boulder
| | - H Machida
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, USA
| | - P Mhawech-Fauceglia
- Department of Pathology, University of Southern California, Los Angeles, USA
| | - Y Ueda
- Department of Obstetrics and Gynecology, Osaka University, Osaka
| | - K Yoshino
- Department of Obstetrics and Gynecology, Osaka University, Osaka
| | - K Yamaguchi
- Department of Obstetrics and Gynecology, Kyoto University, Kyoto
| | - T Oishi
- Department of Obstetrics and Gynecology, Tottori University, Tottori
| | - H Kajiwara
- Department of Pathology, Tokai University, Kanagawa
| | - K Hasegawa
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama
| | - M Yasuda
- Department of Pathology, Saitama Medical University International Medical Center, Saitama
| | - K Kawana
- Departments of Obstetrics and Gynecology, The University of Tokyo, Tokyo
| | - K Suda
- Department of Obstetrics and Gynecology, Niigata University, Niigata
| | - T M Miyake
- Department of Obstetrics and Gynecology, Kawasaki Medical School, Okayama
| | - T Moriya
- Department of Pathology, Kawasaki Medical School, Okayama
| | - Y Yuba
- Department of Pathology, Kitano Hospital, Osaka, Japan
| | - T Morgan
- Department of Pathology, Oregon Health & Science University, Portland, USA
| | - T Fukagawa
- Department of Pathology, Iwate Medical University, Morioka
| | - A Wakatsuki
- Department of Obstetrics and Gynecology, Aichi Medical University, Aichi
| | - T Sugiyama
- Department of Obstetrics and Gynecology, Iwate Medical University, Morioka
| | - T Pejovic
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Portland, USA
| | - T Nagano
- Department of Obstetrics and Gynecology; Kitano Hospital, Osaka, Japan
| | - K Shimoya
- Department of Obstetrics and Gynecology, Kawasaki Medical School, Okayama
| | - M Andoh
- Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama
| | - Y Shiki
- Department of Obstetrics and Gynecology, Osaka Rosai Hospital, Osaka
| | - T Enomoto
- Department of Obstetrics and Gynecology, Niigata University, Niigata
| | - T Sasaki
- Department of Pathology, The University of Tokyo, Tokyo, Japan
| | - K Fujiwara
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama
| | - M Mikami
- Department of Obstetrics and Gynecology, Tokai University, Kanagawa
| | - M Shimada
- Department of Obstetrics and Gynecology, Tottori University, Tottori
| | - I Konishi
- Department of Obstetrics and Gynecology, Kyoto University, Kyoto
| | - T Kimura
- Department of Obstetrics and Gynecology, Osaka University, Osaka
| | - M D Post
- Department of Pathology, University of Colorado, Boulder
| | - M M Shahzad
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida, Tampa
| | - D D Im
- Department of Gynecology, Mercy Medical Center, Baltimore
| | - H Yoshida
- Departments of Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - K Omatsu
- Department of Gynecology, Cancer Institute Hospital, Tokyo
| | - F R Ueland
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky, Lexington, USA
| | - J L Kelley
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology
| | - R G Karabakhtsian
- Department of Pathology, University of Kentucky, Lexington Department of Pathology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, USA
| | - L D Roman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, USA
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Hasegawa J, Toyokawa S, Ikenoue T, Asano Y, Satoh S, Ikeda T, Ichizuka K, Tamiya N, Nakai A, Fujimori K, Maeda T, Masuzaki H, Suzuki H, Ueda S. Relevant Obstetric Factors for Cerebral Palsy: From the Nationwide Obstetric Compensation System in Japan. PLoS One 2016; 11:e0148122. [PMID: 26821386 PMCID: PMC4731141 DOI: 10.1371/journal.pone.0148122] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 01/13/2016] [Indexed: 11/19/2022] Open
Abstract
Objective The aim of this study was to identify the relevant obstetric factors for cerebral palsy (CP) after 33 weeks’ gestation in Japan. Study design This retrospective case cohort study (1:100 cases and controls) used a Japanese national CP registry. Obstetric characteristics and clinical course were compared between CP cases in the Japan Obstetric Compensation System for Cerebral Palsy database and controls in the perinatal database of the Japan Society of Obstetrics and Gynecology born as live singleton infants between 2009 and 2011 with a birth weight ≥ 2,000 g and gestation ≥ 33 weeks. Results One hundred and seventy-five CP cases and 17,475 controls were assessed. Major relevant single factors for CP were placental abnormalities (31%), umbilical cord abnormalities (15%), maternal complications (10%), and neonatal complications (1%). A multivariate regression model demonstrated that obstetric variables associated with CP were acute delivery due to non-reassuring fetal status (relative risk [RR]: 37.182, 95% confidence interval [CI]: 20.028–69.032), uterine rupture (RR: 24.770, 95% CI: 6.006–102.160), placental abruption (RR: 20.891, 95% CI: 11.817–36.934), and preterm labor (RR: 3.153, 95% CI: 2.024–4.911), whereas protective factors were head presentation (RR: 0.199, 95% CI: 0.088–0.450) and elective cesarean section (RR: 0.236, 95% CI: 0.067–0.828). Conclusion CP after 33 weeks’ gestation in the recently reported cases in Japan was strongly associated with acute delivery due to non-reassuring fetal status, uterine rupture, and placental abruption.
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Affiliation(s)
- Junichi Hasegawa
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan
- * E-mail:
| | - Satoshi Toyokawa
- Department of Public Health, The University of Tokyo, Tokyo, Japan
| | | | - Yuri Asano
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan
| | - Shoji Satoh
- Maternal and Perinatal Care Center, Oita Prefectural Hospital, Oita, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Mie, Japan
| | - Kiyotake Ichizuka
- Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital, Kanagawa, Japan
| | - Nanako Tamiya
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Akihito Nakai
- Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan
| | - Keiya Fujimori
- Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Japan
| | - Tsugio Maeda
- Maeda Clinic, Incorporated association Anzu-kai, Shizuoka, Japan
| | - Hideaki Masuzaki
- Department of Obstetrics and Gynecology, The University of Nagasaki, Nagasaki, Japan
| | - Hideaki Suzuki
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan
| | - Shigeru Ueda
- Department of the Japan Obstetric Compensation System for Cerebral Palsy in Public Interest Incorporated Foundation, Japan Council for Quality Health Care, Tokyo, Japan
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Shiozaki A, Tanaka T, Ito M, Sameshima A, Inada K, Yoneda N, Yoneda S, Satoh S, Saito S. Prenatal risk assessment of gestational hypertension and preeclampsia using clinical information. Hypertens Res Pregnancy 2016. [DOI: 10.14390/jsshp.hrp2016-008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Tomoko Tanaka
- Department of Obstetrics and Gynecology, University of Toyama
| | - Mika Ito
- Department of Obstetrics and Gynecology, University of Toyama
| | - Azusa Sameshima
- Department of Obstetrics and Gynecology, University of Toyama
| | - Kumiko Inada
- Department of Obstetrics and Gynecology, University of Toyama
| | - Noriko Yoneda
- Department of Obstetrics and Gynecology, University of Toyama
| | - Satoshi Yoneda
- Department of Obstetrics and Gynecology, University of Toyama
| | - Shoji Satoh
- Maternal and Perinatal Care Center, Oita Prefectural Hospital
| | - Shigeru Saito
- Department of Obstetrics and Gynecology, University of Toyama
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Abstract
OBJECTIVE In 2007 and 2008, the Japan Society for Reproductive Medicine and the Japan Society of Obstetrics and Gynecology issued a recommendation for single embryo transfer (SET). Thereafter, SET was implemented in 73% of in vitro fertilization (IVF) cases in Japan. The purpose of this study was to evaluate the effects of compliance with the SET recommendation on perinatal outcomes. METHODS An electronic audit of the perinatal database of the Japanese Society of Obstetrics and Gynecology was conducted from 2001 through 2010. The database comprised data of 610,726 women. Totally, 20,923 women conceived through IVF. To compare perinatal outcomes, these women were categorized into two study groups depending on whether they conceived before (2004-2005, n=3,865) or after (2009-2010, n=6,842) the SET recommendation statement was issued. RESULTS The proportion of women who conceived through IVF increased from 1.3% in 2001 to 4.8% in 2010. Compliance with the SET recommendation led to a decrease in the incidence of twin pregnancies (33.9% versus 13%, p<0.01), incidence of preterm delivery (odds ratio [OR]: 0.54, 95% confidence interval [CI]: 0.50-0.59), low birth weight (OR: 0.42, 95% CI: 0.39-0.45), and neonatal intensive care unit admission (OR 0.70, 95% CI 0.65-0.76), but an increase in the incidence of monochorionic twins (1.6% versus 2.5%, p<0.01). CONCLUSION Compliance with the SET recommendation improved perinatal outcomes by reducing the incidence of twin pregnancies.
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Affiliation(s)
- Masako Hayashi
- 1. Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan
| | - Shoji Satoh
- 2. Maternal and Perinatal Care Center, Oita Prefectural Hospital, Oita, Japan
| | - Yoshio Matsuda
- 3. Department of Obstetrics and Gynecology, International University of Health and Welfare, Tochigi, Japan
| | - Akihito Nakai
- 1. Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan
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Matsuda Y, Ogawa M, Nakai A, Hayashi M, Satoh S, Matsubara S. Fetal/Placental weight ratio in term Japanese pregnancy: its difference among gender, parity, and infant growth. Int J Med Sci 2015; 12:301-5. [PMID: 25897290 PMCID: PMC4402432 DOI: 10.7150/ijms.11644] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 02/27/2015] [Indexed: 11/05/2022] Open
Abstract
PURPOSE The "inappropriately heavy placenta" has been considered to be associated with various pregnancy disorders; however, data is scarce what factors affect it. To determine whether the following three affect it; (1) infant gender and mother's parity, (2) growth restriction, and (3) preeclampsia. METHODS We employed fetal/placental weight ratio (F/P). Subjects consisted of 53,650 infants and their placentas from women who vaginally delivered singleton live term infants. First, we examined whether F/P differs among the infant's gender or mother's parity. We classified the population into 4 categories according to gender and parity: male, nulliparous (n=7,431), male, multiparous (n=7,859), female, nulliparous (n=7,559), female, multiparous (n=7,800), and, compared F/P among the four groups. Next, we determined whether F/P differs in "small" or "large" for gestational age (SGA or LGA) infants, compared with appropriate for gestational age infants. Last, we determined whether preeclampsia (representative disorder of SGA) affects F/P. RESULTS (1) F/P significantly differed according to infant gender and parity: female and nulliparity had significantly smaller F/P. F/P was significantly smaller in (2) SGA infants, and (3) infants from preeclamptic mothers. CONCLUSION We for the first time showed that in Japanese term vaginally-delivered singleton population, the following three had significantly smaller F/P than controls thus had "inappropriately heavy placenta": (1) female gender and nulliparity, (2) SGA infants, and (3) infants from preeclamptic mothers. We recommend that these factors should be taken into account in evaluating placental weight. These data may also be useful for further clarifying the fetal-placental pathophysiology in these conditions.
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Affiliation(s)
- Yoshio Matsuda
- 1. Department of Obstetrics and Gynecology, Professor, International University of Health and Welfare Hospital, Professor, 537-3 Iguchi Nasushiobara, Tochigi 329-2763, Japan
| | - Masaki Ogawa
- 2. Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Associate professor, Kawada-cho, 8-1, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Akihito Nakai
- 3. Department of Obstetrics and Gynecology, Tama-Nagayama Hospital, Nippon Medical School, Professor, 1-7-1 Nagayama, Tama-City, Tokyo 206-8512, Japan
| | - Masako Hayashi
- 3. Department of Obstetrics and Gynecology, Tama-Nagayama Hospital, Nippon Medical School, Professor, 1-7-1 Nagayama, Tama-City, Tokyo 206-8512, Japan
| | - Shoji Satoh
- 4. Maternal and Perinatal Care Center, Oita Prefectural Hospital, Director, Bunyo 476, Oita 870-8511, Japan
| | - Shigeki Matsubara
- 5. Department of Obstetrics and Gynecology, Jichi Medical University, Professor, 3311-1 Shimotsuke, Tochigi 329-0498, Japan
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Miyawaki H, Saitoh D, Hagisawa K, Noguchi M, Satoh S, Kinoshita M, Miyazaki H, Satoh Y, Sakamoto T. 0919. Effect of catecholamine immediately after blast lung injury caused by laser-induced shock wave in a mouse model. Intensive Care Med Exp 2014. [PMCID: PMC4798301 DOI: 10.1186/2197-425x-2-s1-o27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Uchida Y, Yoshida S, Kobayashi S, Koga F, Ishioka J, Satoh S, Ishii C, Tanaka H, Matsuoka Y, Numao N, Saito K, Masuda H, Fujii Y, Kihara K. Diffusion-weighted MRI as a potential imaging biomarker reflecting the metastatic potential of upper urinary tract cancer. Br J Radiol 2014; 87:20130791. [PMID: 25074719 DOI: 10.1259/bjr.20130791] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To evaluate the role of diffusion-weighted MRI (DW-MRI) as an imaging biomarker for upper urinary tract cancer (UUTC) that has already metastasized or will metastasize soon. METHODS 61 patients clinically diagnosed with UUTC were prospectively enrolled in this study. All the patients underwent MRI, including DW-MRI, prior to any interventions. Correlations between apparent diffusion coefficient (ADC) and other clinicopathological variables, including metastasis-free survival, were analysed. RESULTS Median follow-up period was 938 days. Of the 61 patients, 12 had any metastases at the initial diagnosis. 11 patients developed metastases during the follow-up period. These 23 patients were categorized as "Metastatic". Of the remaining 38 patients, 35 with a follow-up period longer than 400 days were categorized as "Localized". ADC was significantly lower in the Metastatic category than in the Localized (p = 0.0002) category. Multivariate analysis of pre-operative variables identified ADC (cut-off value, 1.08 × 10(-3) mm(2) s(-1)) and clinical T stage based on T2 weighted MRI as an independent predictive factor of metastatic UUTC. 46 patients without any metastases during the initial diagnosis were stratified into a high-risk group (16 patients with low ADC and clinical T3-4) and a low-risk group (30 patients with high ADC or clinical Ta-2). The 3-year metastasis-free survivals were 45% and 93%, respectively. CONCLUSION In the current study, UUTC with lower ADC value is more likely to have metastatic potential. Incorporating ADC with clinical T stage helps to differentiate metastatic UUTC at the initial diagnosis. ADVANCES IN KNOWLEDGE DW-MRI is a potential imaging biomarker reflecting metastatic propensity of UUTC.
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Affiliation(s)
- Y Uchida
- 1 Department of Urology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
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Fujiwara A, Fukushima K, Inoue H, Takashima T, Nakahara H, Satoh S, Ochiai M, Hara T, Shimokawa M, Kato K. Perinatal management of preterm premature ruptured membranes affects neonatal prognosis. J Perinat Med 2014; 42:499-505. [PMID: 24413214 DOI: 10.1515/jpm-2013-0192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 12/13/2013] [Indexed: 11/15/2022]
Abstract
AIM To determine the factors affecting neonatal prognosis in preterm premature rupture of membranes (PPROM). METHOD We conducted a case-control study involving 92 women between the years 2000 and 2010 diagnosed with PPROM between 25 and 31 weeks' gestation, who received antenatal steroids, and delivered between 26 and 31 weeks' gestation; a retrospective cohort study was conducted based on the results. We used data from four tertiary centers and compared the frequencies of neonatal neurologic deficits and neonatal deaths. RESULTS There was a difference between the two groups; specifically, the ND group (n=18) consisted of patients whose infants had neurologic deficits and/or neonatal deaths and the neurologically normal (NN) group (n=74) included NN neonates amongst the patients who had expectant management (94% vs. 73%, respectively). Multivariable analysis revealed that expectant management was independently associated with an increased risk for neonatal neurologic deficits and neonatal deaths (odds ratio, 16.14). All neonates with poor prognosis in the expectant-management group delivered within 14 days after PPROM. CONCLUSIONS Expectant management within 14 days after PPROM is associated with poor neonatal outcomes. Decisions regarding an expectant strategy should be made carefully. An immediate, planned delivery after steroid administration should be considered to improve neonatal prognosis in patients who have PPROM after 26 weeks' gestation.
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Minakami H, Maeda T, Fujii T, Hamada H, Iitsuka Y, Itakura A, Itoh H, Iwashita M, Kanagawa T, Kanai M, Kasuga Y, Kawabata M, Kobayashi K, Kotani T, Kudo Y, Makino Y, Matsubara S, Matsuda H, Miura K, Murakoshi T, Murotsuki J, Ohkuchi A, Ohno Y, Ohshiba Y, Satoh S, Sekizawa A, Sugiura M, Suzuki S, Takahashi T, Tsukahara Y, Unno N, Yoshikawa H. Guidelines for obstetrical practice in Japan: Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG) 2014 edition. J Obstet Gynaecol Res 2014; 40:1469-99. [DOI: 10.1111/jog.12419] [Citation(s) in RCA: 245] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 01/13/2014] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Makoto Kanai
- Shinsyu University School of Medicine; Matsumoto
| | | | | | | | | | - Yoshiki Kudo
- Hiroshima University Graduate School of Medicine; Hiroshima
| | - Yasuo Makino
- Tokyo Women's Medical University Yachiyo Medical Center
| | | | | | - Kiyonori Miura
- Nagasaki University Graduate School of Medicine; Nagasaki
| | | | | | | | | | | | | | | | | | | | | | | | - Nobuya Unno
- Kitasato University School of Medicine; Sagamihara Japan
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Matsuda Y, Umezaki H, Ogawa M, Ohwada M, Satoh S, Nakai A. Umbilical arterial pH in patients with cerebral palsy. Early Hum Dev 2014; 90:131-5. [PMID: 24485169 DOI: 10.1016/j.earlhumdev.2014.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 11/22/2013] [Revised: 12/27/2013] [Accepted: 01/03/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Umbilical arterial pH (UApH) in severe cerebral palsy (CP) is not fully understood. AIMS This work aims to determine the relationship between fetal acidemia and clinical features of severe CP. STUDY DESIGN A retrospective study design is used. SUBJECTS A review was conducted unti1 April 2013 among 218 infants with CP diagnosed to be caused by antenatal and/or intrapartum conditions determined by the Japan Council for Quality Health Care. After excluding patients in whom the causes of CP were thought to be due to events after delivery, 168 infants born at over 34weeks of gestation that both Apgar score and UApH were measured were selected. OUTCOME MEASURES Severe fetal acidemia was defined as a pH of less than 7.0. RESULTS Six major factors were found to be associated with CP: placental abruption (A, n=42), traumatic delivery with an abnormal FHR pattern (B, n=29), an abnormal FHR pattern during labor (C, n=27), chorioamnionitis with an abnormal FHR pattern (D, n=17), an abnormal FHR pattern before labor (E, n=14), and cord prolapse (F, n=10). The UApH was less than 7.0 in 114 cases (67.9%) and more than 7.20 in 20 cases (11.9%). The UApH values were lowest in group A (median 6.7, 6.43-6.99) and highest in group E (7.18, 6.92-7.45). The distribution of the UApH values was significantly different in these groups. CONCLUSION Placental abruption was a factor most associated with low pH. Even among the infants with severe CP, over 10% of patients exhibited a non-acidemic status at birth.
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Affiliation(s)
- Yoshio Matsuda
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan; Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Kawada-cho, 8-1, Shinjuku-ku, Tokyo 162-8666, Japan.
| | - Hikaru Umezaki
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Masaki Ogawa
- Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Kawada-cho, 8-1, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Michitaka Ohwada
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Shoji Satoh
- Maternal and Perinatal Care Center, Oita Prefectural Hospital, Bunyo 476, Oita 870-8511, Japan
| | - Akihito Nakai
- Tama-Nagayama Hospital, Nippon Medical School, 1-7-1 Nagayama, Tama-City, Tokyo 206-8512, Japan
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Fujita Y, Satoh S, Sugitani M, Yumoto Y, Fukushima K, Wake N. Clinical utility of augmentation index as a new parameter of peripheral circulation in human fetuses. Early Hum Dev 2013; 89:601-5. [PMID: 23561924 DOI: 10.1016/j.earlhumdev.2013.03.004] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 03/05/2013] [Accepted: 03/12/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Augmentation index (AI) is calculated from the central arterial pressure or pulse waveform and known as a parameter to evaluate arterial vascular function in adults. Patients with deterioration of peripheral circulation will demonstrate increased AI values as well as those with cardiovascular risks. It is because increased AI is caused by the early timing of the reflection wave from the periphery. On the other hand, in fetuses, although arterial pressure waveforms are not available, pulse waveforms of fetal descending aorta are recordable by using an echo-tracking system. Therefore in this study we aimed to evaluate the utility of fetal AI calculated from aortic pulse waveforms for detecting the altered peripheral circulation in human fetuses. STUDY DESIGN Fetal AI was calculated from pulse waveforms in the descending aorta using an echo-tracking system. In a cross-sectional study of 105 normal fetuses, the reference range was constructed using linear regression analysis. Retrospectively, 36 growth-restricted fetuses were divided into 2 subgroups, normal (n=21) and increased AIx (n=15), based on the 90th percentile value of normal fetuses. Clinical parameters were compared using Fisher's exact test or Mann-Whitney U test. RESULTS Fetal AI decreased linearly with advancing gestational age (r(2)=0.820). The incidences of umbilical artery absent/reversed end-diastolic flow, brain-sparing effect, and oligohydramnios were significantly higher in the increased AI group than the normal AI group. CONCLUSION Fetal AI has a possibility to detect deteriorated peripheral circulation in the fetal body as well as fetoplacental circulation.
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Affiliation(s)
- Yasuyuki Fujita
- Department of Obstetrics and Gynecology, Kyushu University, Fukuoka, Japan.
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Shiozaki A, Matsuda Y, Satoh S, Saito S. Comparison of risk factors for gestational hypertension and preeclampsia in Japanese singleton pregnancies. J Obstet Gynaecol Res 2012; 39:492-9. [DOI: 10.1111/j.1447-0756.2012.01990.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [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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Hayashi M, Nakai A, Satoh S, Matsuda Y. Adverse obstetric and perinatal outcomes of singleton pregnancies may be related to maternal factors associated with infertility rather than the type of assisted reproductive technology procedure used. Fertil Steril 2012; 98:922-8. [PMID: 22763098 DOI: 10.1016/j.fertnstert.2012.05.049] [Citation(s) in RCA: 137] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 05/22/2012] [Accepted: 05/30/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare obstetric and perinatal outcomes of singleton pregnancies conceived with different types of assisted reproductive technology (ART) procedures with those of naturally conceived pregnancies. DESIGN Retrospective cohort study. SETTING The perinatal database of the Japanese Society of Obstetrics and Gynecology. PATIENT(S) A total of 242,715 women with singleton pregnancies were examined as a base cohort. Three study groups were created according to the type of ART procedure used, namely ovulation stimulation medications (n = 4,111), IUI (n = 2,351), and IVF-ET (n = 4,570). Controls adjusted for multiple maternal characteristics were selected randomly for each study group. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Obstetric and perinatal outcomes. RESULT(S) Patients who conceived through the ART procedures were associated with an increased incidence of placenta previa, preterm delivery, and low birth weight infant and a decreased incidence of spontaneous cephalic delivery, regardless of the type of ART procedure. CONCLUSION(S) Among singleton pregnancies, patients conceived with ART procedures were at increased risk for several adverse obstetric and perinatal outcomes, regardless of the type of ART procedure used. These results suggest that maternal factors associated with infertility may contribute to the adverse outcomes rather than the ART procedures themselves.
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Affiliation(s)
- Masako Hayashi
- Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan.
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Nagasako Y, Satoh S, Isogaki J, Inaba K, Taniguchi K, Uyama I. Impact of anastomotic complications on outcome after laparoscopic gastrectomy for early gastric cancer. Br J Surg 2012; 99:849-54. [PMID: 22418853 DOI: 10.1002/bjs.8730] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2012] [Indexed: 11/07/2022]
Abstract
BACKGROUND The effects of anastomotic complications after laparoscopically assisted gastrectomy (LAG) have not been studied widely. The aims of this observational study were to identify potential factors that predict anastomotic complications and investigate the impact of anastomotic complications in patients undergoing gastrectomy for early gastric cancer. METHODS The study included consecutive patients with histologically proven T1 gastric adenocarcinoma treated by LAG with regional lymphadenectomy between August 1997 and March 2008, who had not received neoadjuvant chemotherapy. Anastomotic complications included anastomotic leakage, stricture and remnant gastric stasis of grade II or higher (modified Clavien classification) and were identified by clinical assessment and confirmatory investigation. Predictive factors for the development of anastomotic complications were identified by univariable and multivariable analyses. Long-term survival with or without anastomotic complications was examined. RESULTS Anastomotic complications occurred in 37 (9·3 per cent) of 400 patients. Multivariable analysis indicated surgeon experience as the only independent predictor of anastomotic complications (hazard ratio 4·40, 95 per cent confidence interval 2·04 to 9·53; P < 0·001). Patients with anastomotic complications had a significantly worse overall 5-year survival rate than those without (81 versus 94·2 per cent; P = 0·009). CONCLUSION Anastomotic complications after LAG lead to worse long-term survival.
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Affiliation(s)
- Y Nagasako
- Department of Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
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Anami A, Fukushima K, Fujita Y, Satoh S, Matsumoto E, Endo M, Oda Y, Wake N. Antenatally diagnosed congenital orbital teratoma in which rupture was associated with intrauterine fetal death. J Obstet Gynaecol Res 2012; 38:578-81. [PMID: 22381109 DOI: 10.1111/j.1447-0756.2011.01738.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We report a case of a fetus with a congenital orbital teratoma (COT), in which rupture of the tumor was associated with an intrauterine fetal demise. An ultrasound scan at 27 weeks' revealed a solid and cystic, complex mass in the orbital region with extensive vascularization suggestive of an orbital cystic teratoma. Magnetic resonance imaging (MRI) supported this diagnosis and clarified tumor localization. At 32 weeks', the patient presented with fetal demise and rupture of the mass was noted. Fetal COTs, like sacrococcygeal teratomas, carry the risk of rupture. MRI in utero is useful for evaluating the extent of disease.
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Affiliation(s)
- Ai Anami
- Department of Obstetrics and Gynecology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
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Minakami H, Hiramatsu Y, Koresawa M, Fujii T, Hamada H, Iitsuka Y, Ikeda T, Ishikawa H, Ishimoto H, Itoh H, Kanayama N, Kasuga Y, Kawabata M, Konishi I, Matsubara S, Matsuda H, Murakoshi T, Ohkuchi A, Okai T, Saito S, Sakai M, Satoh S, Sekizawa A, Suzuki M, Takahashi T, Tokunaga A, Tsukahara Y, Yoshikawa H. Guidelines for obstetrical practice in Japan: Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG) 2011 edition. J Obstet Gynaecol Res 2011; 37:1174-97. [PMID: 21917078 DOI: 10.1111/j.1447-0756.2011.01653.x] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Clinical guidelines for obstetrical practice were first published by the Japan Society of Obstetrics and Gynecology (JSOG) and the Japan Association of Obstetricians and Gynecologists (JAOG) in 2008, and a revised version was published in 2011. The aims of this publication include the determination of current standard care practices for pregnant women in Japan, the widespread use of standard care practices, the enhancement of safety in obstetrical practice, the reduction in burdens associated with medico-legal and medico-economical problems, and a better understanding between pregnant women and maternity-service providers. These guidelines include a total of 87 Clinical Questions followed by several Answers (CQ&A), a Discussion, a List of References, and some Tables and Figures covering common problems and questions encountered in obstetrical practice. Each answer with a recommendation level of A, B or C has been prepared based principally on 'evidence' or a consensus among Japanese obstetricians in situations where 'evidence' is weak or lacking. Answers with a recommendation level of A or B represent current standard care practices in Japan. All 87 CQ&A are presented herein to promote a better understanding of the current standard care practices for pregnant women in Japan.
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Affiliation(s)
- Hisanori Minakami
- Department of Obstetrics, Hokkaido University Graduate School of Medicine, N15 W7 Kita-ku, Sapporo, Japan.
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Fukushima K, Morokuma S, Fujita Y, Tsukimori K, Satoh S, Ochiai M, Hara T, Taguchi T, Wake N. Short-term and long-term outcomes of 214 cases of non-immune hydrops fetalis. Early Hum Dev 2011; 87:571-5. [PMID: 21592689 DOI: 10.1016/j.earlhumdev.2011.04.015] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Revised: 04/20/2011] [Accepted: 04/27/2011] [Indexed: 10/18/2022]
Abstract
Despite advances in diagnosis and management, non-immune hydrops fetalis (NIHF) has a high mortality rate. Perinatal survival depends on the underlying disorder and the gestational age at diagnosis. As prognostic information is limited, this study acquired data regarding the neurological development of perinatal survivors. We performed a retrospective chart review of 214 cases in which NIHF was diagnosed antenatally. We recorded maternal demographic characteristics and interventions and their effectiveness, as well as the short-term outcome (survival) and long-term outcome including developmental quotients. Among the affected fetuses, 91 (42.5%) survived the perinatal period. Fetuses with chylothorax, chyloascites, or meconium peritonitis, and those in whom therapy was effective, had high survival rates irrespective of the type of intrauterine intervention. The subsequent intact survival rate was 28/56 (50.0%), with intact defined as ratio of the number of infants with normal development to the number of all infants followed. In contrast to the perinatal survival rate, the intact survival rate decreased as gestational age at diagnosis advanced. These findings suggest that the long-term intact survival rate depends on the underlying cause of NIHF. Additionally, while survival was improved with intensive perinatal care during the perinatal period, aggressive perinatal intervention was not a prognostic factor for neurological outcome.
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Affiliation(s)
- Kotaro Fukushima
- Department of Obstetrics and Gynecology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan.
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Shiozaki A, Matsuda Y, Hayashi K, Satoh S, Saito S. Comparison of risk factors for major obstetric complications between Western countries and Japan: A case-cohort study. J Obstet Gynaecol Res 2011; 37:1447-54. [DOI: 10.1111/j.1447-0756.2011.01565.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Matsuda Y, Kawamichi Y, Hayashi K, Shiozaki A, Satoh S, Saito S. Impact of maternal age on the incidence of obstetrical complications in Japan. J Obstet Gynaecol Res 2011; 37:1409-14. [DOI: 10.1111/j.1447-0756.2011.01552.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [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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45
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Numakura K, Tsuchiya N, Tsuruta H, Obara T, Saito M, Inoue T, Narita S, Horikawa Y, Satoh S, Nanjyo H, Habuchi T. A Case of Intratesticular Endometrioid Papillary Cystadenocarcinoma. Jpn J Clin Oncol 2011; 41:674-6. [DOI: 10.1093/jjco/hyr038] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Matsuda Y, Hayashi K, Shiozaki A, Kawamichi Y, Satoh S, Saito S. Comparison of risk factors for placental abruption and placenta previa: Case-cohort study. J Obstet Gynaecol Res 2011; 37:538-46. [DOI: 10.1111/j.1447-0756.2010.01408.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [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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47
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Horikawa Y, Tsuchiya N, Yuasa K, Narita S, Saito M, Takayama K, Nara T, Tsuruta H, Obara T, Numakura K, Satoh S, Habuchi T, Hu X, Guo J, Lin Z, Sun L, Xu Z, Cang C, Wang G, Kanda T, Sakamoto K, Matsuki A, Ohashi R, Hirota S, Fujimori Y, Matsuda Y, Yajima K, Kosugi S, Hatakeyama K, Kitahara K, Watanabe M, Nakazono S, Wada N, Kakizaki H, Li J, Gong FJ, Sun PN, Shen L, Li Q, Li N, Qiu M, Liu J, Yi C, Luo D, Li Z, Gou H, Yang Y, Cao D, Shen Y, Wang X, Xu F, Bi F, Li Q, Zhang X, Li N, Wei W, Luo HY, Wang ZQ, Wang FH, Qiu MZ, Teng KY, Ruan DY, He YJ, Li YH, Xu RH, Matsusaka S, Mizunuma N, Suenaga M, Shinozaki E, Mishima Y, Terui Y, Hatake K, Nara E, Kodaira M, Mishima Y, Yokoyama M, Saotome T, Terui Y, Takahashi S, Hatake K, Nishimura N, Nakano K, Kodaira M, Ueda K, Yamada S, Mishima Y, Yokoyama M, Saotome T, Takahashi S, Terui Y, Hatake K, Nozawa M, Mochida Y, Nishigaki K, Nagae S, Uemura H, Oh SY, Jeong CY, Hong SC, Lee WS, Kim HG, Lee GW, Hwang IG, Jang JS, Kwon HC, Kang JH, Ozaka M, Ogura M, Matsusaka S, Shinozaki E, Suenaga M, Chin K, Mizunuma N, Hatake K, Pua PF, Ganzon D, Chan V, Sailaja K, Vishnupriya S, Raghunadharao D, Markandeya G, Reddy PRK, Reddanna P, Praveen D, Sakamoto K, Kanda T, Matsuki A, Takano T, Hanyu T, Yajima K, Kosugi S, Hirota S, Hatakeyama K, Shigekawa T, Ijichi N, Takayama S, Tsuda H, Ikeda K, Horie K, Osaki A, Saeki T, Inoue S, Subhashini J, Rajesh B, Rajesh I, Ravindran P, Takagi K, Chin K, Oba M, Kuboki Y, Ichimura T, Oto M, Kawazoe Y, Watanabe T, Ozaka M, Ogura M, Suenaga M, Shinozaki E, Matsusaka S, Mizunuma N, Hatake K, Ueda K, Saotome T, Yamada S, Nishimura N, Nara E, Nakano K, Kodaira M, Katsube A, Mishima Y, Terui Y, Yokoyama M, Takahashi S, Hatake K, Yao X, Yang Q, Li C, Diao L, Chen X, Yu Z, Zuo W, Wang Y, He Y, Zhang X, Cai S, Wang Z, Xu J, Zhan W, Zhang YF, Misumi M, Takeuchi H, Nakamiya N, Shigekawa T, Matsuura K, Fujiuchi N, Osaki A, Saeki T. CLINICAL OUTCOMES. Jpn J Clin Oncol 2011. [DOI: 10.1093/jjco/hyq254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Miura M, Niioka T, Kagaya H, Saito M, Hayakari M, Habuchi T, Satoh S. Pharmacogenetic determinants for interindividual difference of tacrolimus pharmacokinetics 1 year after renal transplantation. J Clin Pharm Ther 2011; 36:208-16. [DOI: 10.1111/j.1365-2710.2010.01163.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [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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Satoh S, Okabe H, Teramukai S, Hasegawa S, Ozaki N, Ueda S, Tsuji A, Sakabayashi S, Sakai Y. Phase II trial report of preoperative chemotherapy (CX) with S-1 plus cisplatin for stage IV gastric cancer (StIV GC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.107] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
107 Background: Prognosis of StIV GC is poor. S-1 plus cisplatin now becomes one of the Japanese standards for unresectable or recurrent GC. We conducted a multicenter phase II study of preoperative S-1 plus cisplatin for StIV GC (KYUH-UHA-GC03-01, NCT00088816 ). In ASCO 2010, we reported early outcomes, indicating that this regimen is feasible and safe. We will report here the results concerning prognosis and recurrence. Methods: Eligibility criteria included histologically proven StIV GC according to Japanese classification. Helical CT and staging laparoscopy were mandatory. Patients (pts) received oral S-1 (80-120 mg/body/day, day 1-21) and intravenous cisplatin (60 mg/m2 on day 8) every 5 weeks for 2 courses. After CX, operation was performed. S-1 (80-120 mg/body/day, day 1-14) was administered every 3 weeks for one year postoperatively. The primary endpoint was 2-year overall survival (OS), and the secondary endpoints were progression free survival (PFS), response, pathologic response, R0 resection, surgical complication, the first recurrence sites and toxicities. Sample size was set at 50. Results: 51 pts were enrolled and all pts were observed more than 2 years after registration. The median age was 63 (range 35-79). PreOp CX was accomplished in 44 cases. Response was 50% (95% CI: 27.2-72.8). 44 (86.3%) pts underwent surgery and R0 resection was done in 26 pts (51%). Adjuvant chemotherarpy was accomplished in 11 cases. Recurrences were observed 14 cases (53.8%). Most frequent recurrence site was peritoneum. 2-Y OS and PFS were 43.1% [96% CI: 29.4-56.1] and 33.3% [20.9-46.2], respectively. R0 in GC with single StIV factor (n = 24) was 79.2% and that in GC with multiple StIV factors (n = 27) was 25.9%, respectively. All pts with only Cy+ (n = 12) showed complete eradication of cancer cell by S-1/CDDP. Pts with only Cy+ showed significantly better prognosis than other pts. Conclusions: As compared to Japanese national StIV control (OS: 20.8%), this induction CX showed promising survival. Especially, pts with only Cy+ was popular and showed significantly better prognosis by S1/CDDP induction CX. No significant financial relationships to disclose.
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Affiliation(s)
- S. Satoh
- Department of Upper Gastrointestinal Surgery, Fujita Health University, Tokyoake, Japan; Kyoto University Surgical Oncology Group, Kyoto, Japan; Translational Research Center, Kyoto University Hospital, Kyoto, Japan; Translational Research Informatics Center, Kobe, Japan
| | - H. Okabe
- Department of Upper Gastrointestinal Surgery, Fujita Health University, Tokyoake, Japan; Kyoto University Surgical Oncology Group, Kyoto, Japan; Translational Research Center, Kyoto University Hospital, Kyoto, Japan; Translational Research Informatics Center, Kobe, Japan
| | - S. Teramukai
- Department of Upper Gastrointestinal Surgery, Fujita Health University, Tokyoake, Japan; Kyoto University Surgical Oncology Group, Kyoto, Japan; Translational Research Center, Kyoto University Hospital, Kyoto, Japan; Translational Research Informatics Center, Kobe, Japan
| | - S. Hasegawa
- Department of Upper Gastrointestinal Surgery, Fujita Health University, Tokyoake, Japan; Kyoto University Surgical Oncology Group, Kyoto, Japan; Translational Research Center, Kyoto University Hospital, Kyoto, Japan; Translational Research Informatics Center, Kobe, Japan
| | - N. Ozaki
- Department of Upper Gastrointestinal Surgery, Fujita Health University, Tokyoake, Japan; Kyoto University Surgical Oncology Group, Kyoto, Japan; Translational Research Center, Kyoto University Hospital, Kyoto, Japan; Translational Research Informatics Center, Kobe, Japan
| | - S. Ueda
- Department of Upper Gastrointestinal Surgery, Fujita Health University, Tokyoake, Japan; Kyoto University Surgical Oncology Group, Kyoto, Japan; Translational Research Center, Kyoto University Hospital, Kyoto, Japan; Translational Research Informatics Center, Kobe, Japan
| | - A. Tsuji
- Department of Upper Gastrointestinal Surgery, Fujita Health University, Tokyoake, Japan; Kyoto University Surgical Oncology Group, Kyoto, Japan; Translational Research Center, Kyoto University Hospital, Kyoto, Japan; Translational Research Informatics Center, Kobe, Japan
| | - S. Sakabayashi
- Department of Upper Gastrointestinal Surgery, Fujita Health University, Tokyoake, Japan; Kyoto University Surgical Oncology Group, Kyoto, Japan; Translational Research Center, Kyoto University Hospital, Kyoto, Japan; Translational Research Informatics Center, Kobe, Japan
| | - Y. Sakai
- Department of Upper Gastrointestinal Surgery, Fujita Health University, Tokyoake, Japan; Kyoto University Surgical Oncology Group, Kyoto, Japan; Translational Research Center, Kyoto University Hospital, Kyoto, Japan; Translational Research Informatics Center, Kobe, Japan
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Panigrahi A, Kiron V, Satoh S, Watanabe T. Probiotic bacteria Lactobacillus rhamnosus influences the blood profile in rainbow trout Oncorhynchus mykiss (Walbaum). Fish Physiol Biochem 2010; 36:969-977. [PMID: 20127411 DOI: 10.1007/s10695-009-9375-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Accepted: 12/20/2009] [Indexed: 05/28/2023]
Abstract
This paper reports the effect of feeding probiotic diets on blood profiles in rainbow trout. Two experiments were performed: in the first, fish of average weight 75 g were offered either a commercial feed or the same incorporated with 10(9) CFU g(-1) of lactic acid bacteria Lactobacillus rhamnosus for 30 days; in the second study performed for a similar duration, fish of average weight 126 g were offered formulated diets that either contained the same bacteria in heat-killed or freeze-dried form (nearly 10(11) CFU g(-1)), or the basal diet without the bacteria. Blood samples were collected at different times after commencement of probiotic feeding to determine the total cholesterol, triglyceride contents, the plasma alkaline phosphatase activity, plasma protein and hematocrit value. The plasma cholesterol significantly increased upon probiotic feeding in the first experiment. A significant elevation (P<0.05) of plasma cholesterol and triglyceride and alkaline phosphatase activity level was found in the freeze-dried probiotic fed groups at 20 and 30 days postfeeding. This was concomitant with the increased plasma protein and hematocrit values in FD group at 20 and 30 days. Likewise, the heat-killed probiotic fed group registered significantly high values of triglycerides, alkaline phosphatase activity, and plasma protein compared to the control diet fed groups after 20 days of feeding. Thus, alterations in the blood profiles could serve as supplementary information when examining the benefits of probiotics for fish.
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Affiliation(s)
- A Panigrahi
- Department of Marine Biosciences, Tokyo University of Marine Science and Technology, Minato, Tokyo, 108-8477, Japan.
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