基本情報
- 所属
- 自治医科大学 医学部産科婦人科学講座 教授
- 学位
- 医学博士(自治医科大学)
- 研究者番号
- 80544303
- ORCID ID
- https://orcid.org/0000-0003-1652-9438
- J-GLOBAL ID
- 201401003507762210
- researchmap会員ID
- B000237574
研究分野
1学歴
2-
2010年4月 - 2014年3月
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1994年4月 - 2000年3月
受賞
6-
2013年4月
論文
268-
ARCHIVES OF GYNECOLOGY AND OBSTETRICS 296(5) 1039-1040 2017年11月 査読有り
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BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY 124(11) 1792-1793 2017年10月 査読有り
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JOURNAL OF OBSTETRICS AND GYNAECOLOGY 37(7) 973-973 2017年10月 査読有り
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JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 43(10) 1660-1661 2017年10月 査読有り
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BJOG : an international journal of obstetrics and gynaecology 124(10) 1621-1622 2017年9月 査読有り
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EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY 215 259-260 2017年8月 査読有り筆頭著者責任著者
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JOURNAL OF ZHEJIANG UNIVERSITY-SCIENCE B 18(8) 723-724 2017年8月 査読有り
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ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA 96(8) 1029-1029 2017年8月 査読有り
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AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 217(1) 101-102 2017年7月 査読有り
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JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE 30(9) 1087-1088 2017年5月 査読有り筆頭著者責任著者
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TAIWANESE JOURNAL OF OBSTETRICS & GYNECOLOGY 56(2) 270-270 2017年4月 査読有り
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JOURNAL OF OBSTETRICS AND GYNAECOLOGY 37(3) 403-403 2017年4月 査読有り
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INTERNATIONAL JOURNAL OF SURGERY 39 148-149 2017年3月 査読有り
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EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY 210 281-285 2017年3月 査読有りObjective: The intrauterine balloon (Balloon) has recently been widely used to achieve hemostasis for postpartum hemorrhage (PPH). We concomitantly used a novel method, "holding the cervix", with the Balloon to prevent Balloon prolapse and achieve hemostasis. We aimed to clarify the following three factors: 1) hemostatic success rate of Balloon use for PPH, 2) effect of holding the cervix on Balloon prolapse, and, 3) the rate of bleeding after Balloon insertion, possibly predictive of Balloon failure. Study design: We retrospectively examined 80 patients undergoing Balloon application for PPH in our institution. We defined "success" as achieving hemostasis with no requirement of additional invasive procedures, and "failure" as their requirement. Between success vs. failure, several parameters were compared. For statistical analyses, Fisher's exact test and Wilcoxon rank sum test were applied. Results: Excluding "unable to insert" patients, "holding the cervix" was performed in 56 (75%). Prolapse was less likely to occur in patients with than in those without "holding the cervix" (4 vs. 11%, respectively). The success rate in patients with "Balloon + holding the cervix" was 94%. Treatment for atonic bleeding and placenta previa (PP) showed similarly high success rates (97 and 94%, respectively). The rate of bleeding following Balloon insertion was significantly higher in failure than success cases (P =0.03) and all failure cases showed bleeding >250 mL/h. Conclusions: The "Balloon + holding the cervix" strategy achieved hemostasis in over 90% of primary PPH. Treatment: for not only atonic bleeding but also PP showed a high success rate. Bleeding >250 mL/h after Balloon insertion may indicate the requirement of additional invasive procedures. (C) 2017 Elsevier B.V. All rights reserved.
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JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 43(3) 592-594 2017年3月 査読有り筆頭著者責任著者Posterior reversible encephalopathy syndrome (PRES) is associated with several symptoms; of those, visual acuity loss, light oversensitivity (photophobia), and light flashes (photopsia) are known as PRES-related eye symptoms. We report a post-partum woman with PRES associated with hemolysis, elevated liver enzymes, and low platelets syndrome (HELLP), in whom color vision abnormality (achromatopsia) was the sole manifestation. Cesarean section was performed at 28 weeks due to headache, epigastralgia, and severe hypertension. HELLP became evident after delivery. On post-partum day 1, she complained of achromatopsia, stating: all things look brownish-gray. Ophthalmologic examination was normal, but brain magnetic resonance imaging showed occipital lobe lesions, indicative of PRES, and, interestingly, also color vision center (area V4) lesions, suggesting that the achromatopsia had been caused by brain damage. It may be prudent to question HELLP patients concerning achromatopsia.
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CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY 40(3) 474-475 2017年3月 査読有り
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CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY 40(3) 478-479 2017年3月 査読有り
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日本産科婦人科学会雑誌 69(2) 655-655 2017年2月
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PLACENTA 50 25-31 2017年2月 査読有り筆頭著者Introduction: Adequate extravillous trophoblast (EVT) invasion is essential for successful placentation. Although miR-520c-3p plays an important role in CD44-mediated invasion in cancer cells, there is little information on whether miR-520c-3p is involved in the regulatory mechanisms of CD44-mediated EVT invasion. Methods: We screened first trimester trophoblast cells and trophoblast cell lines for expression of miR-520c-3p using real-time polymerase chain reaction. The cell invasion assay was performed using EVT cell lines, HTR8/SVneo and HChEpC1b, to investigate the capability of suppressing EVT invasion by miR-520c-3p. Laser microdissection analysis was then used to determine whether miR-520c-3p was present in the first trimester decidua. Finally, the possibility of chorionic villous trophoblast (CVT)-EVT communication via exosomal miR-520c-3p was determined using an in vitro model based on BeWo exosomes and the EVT cell lines as recipient cells. Results: The miR-520c-3p level was significantly downregulated in EVT cell lines and EVTs. Cell invasion was significantly inhibited in miR-520c-3p-overexpressing cell lines, involving a significant reduction of CD44. Laser microdissection analysis showed that miR-520c-3p in the periarterial area of the decidua was significantly higher than that in the non-periarterial area. Using an in vitro model system, BeWo exosomal miR-520c-3p was internalized into the EVT cells with subsequently reduced cell invasion via CD44 repression. Conclusions: EVT invasion is synergistically enhanced by the reciprocal expression of endogenous miR-520c-3p and CD44. The present study supports a novel model involving a placenta-associated miRNA function in cell-cell communication in which CVT exosomal miR-520c-3p regulates cell invasion by targeting CD44 in EVTs. (C) 2016 Elsevier Ltd. All rights reserved.
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JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 43(2) 403-407 2017年2月 査読有り責任著者A primiparous pregnant woman in remission of myositis suffered very acute-onset ritodrine-induced rhabdomyolysis. At 29 gestational weeks, ritodrine was administered for threatened preterm labor. Just 3 h later, she complained of severe limb muscle pain, with serum creatinine phosphokinase elevated to 32019 U/L and myoglobinuria. The muscle pain disappeared immediately after ceasing administration of ritodrine. At 31 weeks, premature rupture of the membranes occurred, necessitating cesarean section, yielding a baby with weak tonus, and the presence of infantile muscle diseases was suspected. Genetic analysis of the infant confirmed myotonic dystrophy (dystrophia myotonica, DM), which prompted us to perform maternal genetic analysis, confirming maternal DM. Ritodrine can induce rhabdomyolysis even in the prodromal phase with a mild phenotype of DM. A literature review suggested that ritodrine-induced rhabdomyolysis may be likely to occur more acutely after ritodrine administration in DM compared with non-DM mothers.
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CLINICAL AND EXPERIMENTAL OBSTETRICS & GYNECOLOGY 44(1) 88-92 2017年 査読有り筆頭著者責任著者Purpose of investigation: Cesarean scar pregnancy (CSP) is a life-threatening condition that requires early pregnancy termination. Its early ultrasound diagnosis is clinically important; however, previous studies focused on the CSP site itself. The present study was conducted to investigate the authors' clinical impression that a uterine-fundal hypoechoic mass is more frequently observed in CSP. Such a finding, if confirmed, may contribute to ultrasound diagnosis of CSP. The authors also determined the relationship between the treatment strategy and outcome, with special emphasis on conditions eventually requiring uterine artery embolization (UAE). Materials and Methods: This was a case-control study of CSP, and the authors analyzed all 14 women that were treated in this single tertiary institute over a period of ten years. Control subjects consisted of all pregnant women with prior cesarean section (CS) but no CSP. Results: Patients with CSP were significantly more likely to have a hypoechoic mass than controls (42.9 vs. 15.4%, respectively; p = 0.028). On confining results to a "fundal" hypoechoic mass, only CSP(+) patients showed it (CSP vs. control: 28.6 vs. 0%, respectively; p < 0.001). Six (43%: 6/14) received UAE: four following vaginal evacuation (artificial or spontaneous), and two for bleeding after methotrexate (MTX) treatment. Conclusion: Patients with CSP more frequently had a uterine-fundal hypoechoic mass, whose detection may trigger a detailed observation of the CSP site, possibly leading to CSP diagnosis.
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SCANDINAVIAN JOURNAL OF UROLOGY 51(6) 496-497 2017年 査読有り
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The Journal of reproduction and development 63(4) 401-408 2017年 査読有り
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ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA 96(1) 128-129 2017年1月 査読有り
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American journal of obstetrics and gynecology 2016年12月 査読有り
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ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA 95(12) 1448-1448 2016年12月 査読有り
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JOURNAL OF REPRODUCTIVE IMMUNOLOGY 118 137-137 2016年11月 査読有り
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The Journal of Obstetrics and Gynaecology Research 42(11) 1502 2016年11月
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Journal of Obstetrics and Gynaecology Research 42(11) 1629-1630 2016年11月1日 査読有り
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JOURNAL OF OBSTETRICS AND GYNAECOLOGY 36(8) 999-1001 2016年11月 査読有り
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EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY 206 245-246 2016年11月 査読有り
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The Journal of Obstetrics and Gynaecology Research 42(Suppl.1) 13 2016年10月
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The Journal of Obstetrics and Gynaecology Research 42(10) 1412 2016年10月
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Journal of Medical Ultrasonics 43(4) 505-508 2016年10月
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Pediatrics International 58(10) 1059 2016年10月
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The Journal of Obstetrics and Gynaecology Research 42(Suppl.1) 13 2016年10月
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Journal of Medical Ultrasonics 43(4) 505 2016年10月
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The Journal of Obstetrics and Gynaecology Research 42(10) 1412 2016年10月
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Journal of Medical Ultrasonics 43(4) 505 2016年10月
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Pediatrics International 58(10) 1059 2016年10月
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The Journal of Obstetrics and Gynaecology Research 42(10) 1412 2016年10月
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Journal of Medical Ultrasonics 43(4) 505 2016年10月
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Pediatrics International 58(10) 1059-1061 2016年10月1日
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EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY 205 72-78 2016年10月 査読有りObjectives: Uterine artery pseudoaneurysm (UAP) has been considered to occur very rarely after traumatic delivery/abortion, and is usually detected after its rupture, yielding massive bleeding. Our hypothesis is: some UAP may be undetected without massive bleeding and may spontaneously resolve, and, thus, may not require transarterial embolization (TAE). We attempted: (1) to detect both ruptured and non-ruptured UAP, thereby characterizing candidates of spontaneously resolving UAP, and (2) to confirm that UAP is not rare and not always associated with traumatic events. Study design: This was a retrospective observational study of 50 women with angiographically confirmed UAP and treated by TAE. Angiograms and medical charts were retrieved to examine the associations among symptoms, ultrasound findings, and extravasation. Gray-scale ultrasound was performed for all women after delivery or abortion as our routine practice. Results: UAP occurred in 3-6/1000 deliveries and 40% occurred after non-traumatic deliveries/abortion. While 36% had active vaginal bleeding at admission, 64% did not. While 100% of patients with current active bleeding showed extravasation from the pseudoaneurysmal sac, patients without it showed a varied incidence of extravasation depending on the bleeding pattern/history and ultrasound findings. Interestingly, all patients with current bleeding (-), bleeding history (+), and ultrasound-discernable intrauterine low echoic mass (-) were devoid of extravasation, suggesting that UAP may show progression to thrombosis and, thus, resolve spontaneously. Conclusions: UAP may not be so rare and not associated with traumatic delivery/abortion. Some UAP may resolve, and, thus, may not require TAE, at least immediately. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
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European Journal of Obstetrics Gynecology and Reproductive Biology 205 72-78 2016年10月1日 査読有りObjectives Uterine artery pseudoaneurysm (UAP) has been considered to occur very rarely after traumatic delivery/abortion, and is usually detected after its rupture, yielding massive bleeding. Our hypothesis is: some UAP may be undetected without massive bleeding and may spontaneously resolve, and, thus, may not require transarterial embolization (TAE). We attempted: (1) to detect both ruptured and non-ruptured UAP, thereby characterizing candidates of spontaneously resolving UAP, and (2) to confirm that UAP is not rare and not always associated with traumatic events. Study design This was a retrospective observational study of 50 women with angiographically confirmed UAP and treated by TAE. Angiograms and medical charts were retrieved to examine the associations among symptoms, ultrasound findings, and extravasation. Gray-scale ultrasound was performed for all women after delivery or abortion as our routine practice. Results UAP occurred in 3–6/1000 deliveries and 40% occurred after non-traumatic deliveries/abortion. While 36% had active vaginal bleeding at admission, 64% did not. While 100% of patients with current active bleeding showed extravasation from the pseudoaneurysmal sac, patients without it showed a varied incidence of extravasation depending on the bleeding pattern/history and ultrasound findings. Interestingly, all patients with current bleeding (−), bleeding history (+), and ultrasound-discernable-intrauterine low echoic mass (−) were devoid of extravasation, suggesting that UAP may show progression to thrombosis and, thus, resolve spontaneously. Conclusions UAP may not be so rare and not associated with traumatic delivery/abortion. Some UAP may resolve, and, thus, may not require TAE, at least immediately.
MISC
361-
PLACENTA 128 131-132 2022年10月
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産婦人科の実際 70(4) 433-438 2021年4月<文献概要>胎児頸部嚢胞性ヒグローマ(CH)が認められると児疾患が増加する。一方,CHが認められても,それが軽快する際は予後良好であることも多い。しかし,CH軽快例が出生後長期にわたり追跡された研究はほとんどない。今回,妊娠11週0日〜13週6日に当院でCHと診断された症例の児予後を出生後も追跡調査した。CHを認めた69例中24例(34.8%)において軽快した。CH軽快例のうち追跡不能であった1例を除いた23例中,なんらかの児疾患が認められたのは12例(52.2%)であった。このなかで認められた児疾患は,ダウン症候群などの染色体異常,ヌーナン症候群,心奇形,原因不明の精神発達遅滞など多岐にわたった。CH軽快例に対する患者や家族への説明も慎重に行う必要があることが示唆された。
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栃木県産婦人科医報 47 13-15 2021年3月卵巣静脈血栓症は非常に稀で無症状に経過しその発症に気づかれないことも多い。今回、無症状であったが帝王切開術後に酸素飽和度の低下で判明した卵巣静脈血栓症、肺塞栓症を併発した双胎妊娠例を報告する。妊娠中に無症候性の卵巣静脈血栓症から、肺塞栓症を併発する場合があり、血栓リスクを考慮し、症状がなくともSpO2低下や血栓マーカー異常が認められた場合は、これらの疾患発症を念頭においた検査が必要と考える。(著者抄録)
共同研究・競争的資金等の研究課題
6-
日本学術振興会 科学研究費助成事業 2023年4月 - 2026年3月
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日本学術振興会 科学研究費助成事業 基盤研究(C) 2022年4月 - 2025年3月
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日本学術振興会 科学研究費助成事業 基盤研究(C) 2022年4月 - 2025年3月
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日本学術振興会 科学研究費助成事業 基盤研究(C) 2020年4月 - 2024年3月
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日本学術振興会 科学研究費助成事業 若手研究 2019年4月 - 2022年3月