記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1093/ibd/izab222

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Cancer therapy has priority over fertility preservation. The time available for fertility preservation in patients with cancer is often very limited and depends on the condition of the underlying disease. This case report presents the results of two rounds of controlled ovarian stimulations (COSs) performed after an induced abortion. The patient had mixed phenotype acute leukemia diagnosed during early pregnancy and underwent a surgical abortion, followed by ovarian stimulation using urinary follicle-stimulating hormone (uFSH) and gonadotropin-releasing hormone (GnRH) agonists. Oocyte retrieval was subsequently performed for oocyte cryopreservation. Despite good hormonal and ultrasonic follicular growth, no oocytes were obtained. During a second COS performed at a low human chorionic gonadotropin (hCG) level (less than 100 IU/L), several mature oocytes were obtained, suggesting that higher hCG levels during COS induce the absence of mature oocytes during normal follicular growth. It is recommended to start COS post-abortion after confirming a low hCG level while considering the timing of cancer treatment.

DOI： 10.1080/09513590.2021.1950135

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本思春期学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：神奈川産科婦人科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIM: In Japan, most of the patients with primary amenorrhea or related conditions, such as delayed menarche, are diagnosed by pediatricians or gynecologists; accordingly, the number of the patients and the ratio of the causes were unclear. To clarify them, we conducted a nationwide survey in both the departments for the first time. METHODS: We sent a questionnaire about the patients with chief complaint of no menarche whose first visit was from January 2015 to December 2017, to 596 training institutions for specialist physicians of the Japan Society of Obstetrics and Gynecology and 152 facilities to which councilors of the Japanese Society for Pediatric Endocrinology belong. RESULTS: We received replies from 283 (37.8%) institutions. During the 3 years, 1043 patients first visited pediatrics or gynecology for no menarche. In 303 patients under 16 years old at the first visit, 177 (58.4%) patients had menarche by the age of 16. Of them, 41 (13.5%) patients had menarche spontaneously. Among 308 patients aged 16 to 17 at the first visit, 216 patients were 18 years or older at the survey. Of them, 124 (57.4%) patients had menarche by the age of 18, and 21 (9.7%) of them had menarche spontaneously. The causes of amenorrhea were detected in 462 patients. Abnormal karyotype including Turner syndrome was the most common at 122 (26.4%), followed by Mullerian agenesis at 73 (15.8%). CONCLUSIONS: The first national survey revealed the number and causes of primary amenorrhea and related conditions. This report will provide better information for clinicians.

DOI： 10.1111/jog.14606

PubMed

researchmap

記述言語：日本語   出版者・発行元：(公社)日本婦人科腫瘍学会  

researchmap

記述言語：日本語   出版者・発行元：神奈川県医師会  

researchmap

掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

DOI： 10.1002/ijgo.13470

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

The effects of the age at estrogen replacement therapy (ERT) initiation on bone quality in Turner syndrome were evaluated using trabecular bone score. Early puberty ERT positively correlated with increase in bone quality. Early initiation of ERT is necessary for the acquisition of bone quality as well as bone density. INTRODUCTION: Studies have reported associations between bone mineral density and estrogen replacement therapy (ERT) in Turner syndrome (TS) patients; however, few studies exist on the effect on bone quality. The aim of this study was to evaluate the effects of the age at ERT initiation on bone quality of Japanese TS patients, cross-sectionally and longitudinally. METHODS: Cross-sectionally, 95 TS patients were divided into three groups based on their age at initiation of ERT: A (12-14 years, 11 patients), B (15-17 years, 47 patients), and C (over 18 years, 37 patients). To assess bone quality, trabecular bone score (TBS) was used. The effects of age at initiation and duration of ERT on TBS were examined using multiple regression analysis. In the longitudinal study, 48 patients who underwent dual-energy X-ray absorptiometry multiple times were divided into three groups: D (12-14 years, 8 patients), E (15-17 years, 18 patients), and F (over 18 years, 22 patients). Each group was analyzed for the rate of change in TBS per year. RESULTS: Cross-sectionally, the TBS showed significant differences among the three groups (TBS A, 1.302; B, 1.299; C, 1.245) (p = 0.013); group C was significantly lower than B (p = 0.014); bone quality was degraded. Multiple regression analysis revealed that age at ERT initiation significantly affected the increase in TBS (p = 0.002). Longitudinally, the rate of change of TBS was not significantly different in the three groups (p = 0.73). CONCLUSION: Early initiation of ERT may have positive effects on bone quality in TS. Large prospective studies will be needed.

DOI： 10.1007/s00198-020-05652-1

PubMed

researchmap

記述言語：日本語   出版者・発行元：神奈川産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：神奈川産科婦人科学会  

単角子宮では不妊症を14%に認めるが単角子宮そのものが不妊症の原因となるかは議論が残る。非交通性副角子宮を伴う単角子宮を有し体外受精を反復するも妊娠に至らず、合併する内膜症性嚢胞と月経困難症悪化に伴い副角子宮切除後、初回の採卵で妊娠に至った症例を経験したため、当院での副角子宮手術6例の転帰と文献的考察を加えて報告する。症例は37歳女性、0妊0産。8年間の不妊、右内膜症性嚢胞3cm、右副角子宮の診断で当科を受診した。精査の結果、左卵管に疎通性なく右副角子宮には交通性を認められず、体外受精の方針となった。解剖学的位置より右卵巣は穿刺できず左からのみ3回採卵、胚移植を4回行うも妊娠に至らず。この間に内膜症性嚢胞の増大と月経困難症を認めるようになったため、当科初診1年9ヵ月後、腹腔鏡下右副角子宮切除、右卵巣嚢腫摘出、左卵管切除を施行した。術後は左右卵巣から採卵できるようになり、初回の採卵・胚移植後に妊娠が成立し、妊娠37週で妊娠高血圧症候群による緊急帝王切開で生児を得た。本症例以外にも当院では不妊を主訴とした副角子宮の切除後妊娠例を経験しており、副角子宮が不妊の原因となるかどうかは結論が未だ出ないが、挙児希望のある副角子宮患者においては手術を積極的に考えていくことが考慮される。(著者抄録)

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIM: Reports on pregnancy and delivery in women with Turner syndrome (TS) in Japan are limited to case reports, and the current situation remains unclear. Therefore, this study aimed to clarify the current situation of pregnancy and delivery in women with TS in Japan. METHODS: Our study comprised primary and secondary surveys and we included perinatal centers approved by the Ministry of Health, Labor and Welfare. RESULTS: A total of 24 cases from 19 facilities were reported, and we obtained individual information for 20 cases from 16 facilities. Of these 20 patients, 13 (65%) had become pregnant via oocyte donation. Three of these patients had received oocyte donation in Japan, while the other 10 had received donations in foreign countries. The other seven patients became pregnant with their own oocyte, with spontaneous menarche. Live babies were delivered by 18 patients, while an induced abortion was required at 18 weeks of gestation in one patient and an intrauterine fetal death from an unknown cause was detected at 38 weeks of gestation in another patient. Cesarean section was performed in 14 patients, with the most frequent indication being cephalopelvic disproportion. The rate of implementation of screening for complications related to TS was low, suggesting insufficient cooperation between facilities responsible for TS treatment, infertility and pregnancy and delivery management. CONCLUSION: To improve pregnancy outcomes in women with TS, improved cooperation between facilities and laws regarding oocyte donation in Japan are needed.

DOI： 10.1111/jog.14352

PubMed

researchmap

記述言語：日本語   出版者・発行元：神奈川県医師会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本思春期学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本思春期学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：神奈川産科婦人科学会  

ターナー症候群の患者は、卵巣機能低下が背景にあるため自然妊娠率は低い。今回卵子提供から妊娠、分娩に至ったターナー症候群合併妊娠の一例を経験したので報告する。症例は36歳、13歳で低身長を契機にターナー症候群と診断され、成長ホルモン、エストロゲンの補充を開始し、以後Kauffman療法を継続していた。結婚後、不妊治療を行うも妊娠せず、卵子提供の方針とした。卵子提供で2度妊娠するも、初期自然流産及び妊娠38週時原因不明の子宮内胎児死亡という転帰であった。今回新たに3度目の卵子提供で妊娠し、妊娠12週までホルモン補充を行った。自宅血圧は異常なく、妊娠初期に妊娠糖尿病の診断に至るが、食事療法で血糖コントロールは良好であった。妊娠20週、30週の母体心エコーで異常はなかった。原因不明の子宮内胎児死亡の既往のため、妊娠34週より管理入院とした。妊娠36週6日に頸管拡張を行い、同日陣痛発来し、翌日妊娠37週0日に自然経腟分娩となった。児は2882g、女児、Apgar scoreは8点(1分後)/9点(5分後)だった。ターナー症候群合併妊娠は耐糖能異常や甲状腺機能低下症いった内科的合併症や妊娠中の妊娠高血圧症候群や妊娠糖尿病などの合併症の発生頻度が高いハイリスク妊娠であり、高い帝王切開率の報告がある。そのため、ターナー症候群合併妊娠では、妊娠前から分娩に至るまで適切な評価・診療が重要である。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：神奈川県医師会  

researchmap

記述言語：日本語   出版者・発行元：神奈川産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：神奈川産科婦人科学会  

悪性腫瘍においては、時に凝固異常が認められるが、良性腫瘍においては稀である。今回我々は、腫瘍内血栓形成によりFDPの上昇及びフィブリノーゲンの低下といった凝固異常を呈した子宮筋腫の一例を経験したので報告する。症例は50歳、1妊1産、数ヵ月に1回の過多月経及び腹部膨満感を主訴に近医受診。腹部に巨大な腫瘍を指摘され、当院紹介受診した。血液検査にてHb5.8g/dL、フィブリノーゲン86mg/dL、D-dimer 104.4μg/mL、FDP241.8μg/mLと重症貧血及び凝固異常を認めた。骨盤部MRIでは、子宮前壁筋層内に18×13×20cm大の腫瘤を認めた。造影効果を伴う嚢胞様構造が集簇しており、典型的な子宮筋腫の所見ではなかった。腹式単純子宮全摘術を施行した。摘出子宮は3350gで、割面には大小多数の血管腔がみられた。病理組織学的には、紡錘形細胞と大小多数の血管の増生を認めた。血管内腔には血栓の形成とその周囲に梗塞とみられる壊死巣を認め、多数の腫瘍内血栓形成の存在が示唆された。病理組織学的診断は、平滑筋腫であった。凝固異常は、術後改善した。良性疾患である子宮筋腫でも、腫瘍内血栓形成から凝固異常を呈することがある。画像検査等で子宮筋腫として典型的でない子宮腫瘍を認めた場合には、貧血だけでなく凝固機能の評価を行い、治療介入の適切な時期を判断する必要があると考えられた。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)関東連合産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本骨粗鬆症学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：神奈川県医師会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本周産期・新生児医学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/jog.13913

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

A 35-year-old primiparous woman was diagnosed with Turner syndrome at the age of 12 yr due to short stature. Her karyotype showed a mosaic pattern [45, X(19)/46, XX(11)]. She had been followed up by the pediatric service. GH was not prescribed because, although she was of relatively short stature, her growth trajectory was reasonable. She was started on estrogen replacement therapy at 15 yr of age and switched to Kaufmann therapy after 1 yr. After transitioning her care to the gynecology service at 20 yr of age, she was screened for complications and Kaufmann therapy was continued. No abnormalities were detected in the pre-pregnancy screening. She conceived by in vitro fertilization and embryo transplantation with oocyte donation. No severe complications occurred during gestation, and she gave birth to a female neonate vaginally at 41 wk and 6 d of gestation. The neonate's birthweight was 3166 g, and her Apgar scores were 8 and 9 at 1 and 5 min, respectively. No severe complications occurred during the postpartum period. Comprehensive medical treatment and appropriate transition from pediatric to adult services may improve the pregnancy outcomes of women with Turner syndrome.

DOI： 10.1297/cpe.28.37

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)関東連合産科婦人科学会  

絨毛癌は,先行妊娠終了から発症までの潜伏期間が比較的短期間であることが多いとされている.今回,存続絨毛症の治療後9年を経てから不正性器出血を契機に受診され,絨毛癌と診断した1例を経験したので報告する.症例は50歳,3妊1産,閉経は47歳.40歳の時に自然妊娠したが,超音波画像から胞状奇胎が疑われ,子宮内容除去術施行後に部分胞状奇胎の診断となった.その後hCG値の減少が非順調型で,臨床的に病巣が確認できず,奇胎後hCG存続症の診断でメトトレキサート単剤による化学療法を施行したところ,hCG値は漸減し,半年後に寛解した.その後,4年間経過観察を行ったが,hCG値の再上昇なくフォロー終了し,終診となった.その5年後,不正性器出血を主訴に近医を受診され,超音波検査で子宮体部腫瘤を疑われて精査加療目的に当院へ紹介となった.超音波・造影MRI検査上,子宮体部左側筋層内に54mm大の腫瘤形成を認め,また血液検査でhCG 2,085mIU/mlと高値であった.全身検索を行ったが,病巣が確認されたのは子宮のみであり,絨毛癌の診断で組織学的診断・治療目的に腹式単純子宮全摘術,両側付属器摘出術を施行した.病理診断は絨毛癌であった.術後にMEA療法を5コース施行し,寛解した.先行妊娠終了から長期の潜伏期間を経てから絨毛癌が発症する可能性があることを認識する必要がある.(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本骨粗鬆症学会  

researchmap

記述言語：日本語   出版者・発行元：神奈川産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：神奈川県医師会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1507/endocrj.EJ17-0498

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Frontiers Media S.A.  

Anatomical studies have suggested that one of the brain structures involved in gender identity is the bed nucleus of the stria terminalis, though this brain structure is probably not the only one to control gender identity. We hypothesized that, if this brain area also affected gonadotropin secretion in humans, transsexual individuals might produce different gonadotropin levels in response to exogenous stimulation. In the present study, we examined whether estrogen combined with progesterone might lead to a change in luteinizing hormone (LH) secretion in female-to-male (FTM) transsexual individuals. We studied female control subjects (n = 9), FTM transsexual subjects (n = 12), and male-to-female (MTF) transsexual subjects (n = 8). Ethinyl estradiol (50 μg/tablet) was administered orally, twice a day, for five consecutive days. After the first blood sampling, progesterone (12.5 mg) was injected intramuscularly. Plasma LH was measured with an immunoradiometric assay. The combination of estrogen and progesterone resulted in increased LH secretion in female control subjects and in MTF subjects, but this increase appeared to be attenuated in FTM transsexual subjects. In fact, the %LH response was significantly reduced in FTM subjects (P &lt
0.05), but not in MTF subjects (P &gt
0.5), compared to female control subjects. In addition, the peak time after progesterone injection was significantly delayed in FTM subjects (P &lt
0.05), but not in MTF subjects (P &gt
0.5), compared to female control subjects. We then compared subjects according to whether the combination of estrogen and progesterone had a positive (more than 200% increase) or negative (less than 200% increase) effect on LH secretion. A χ2 analysis revealed significantly different (P &lt
0.05) effects on LH secretion between female controls (positive n = 7, negative n = 2) and FTM transsexual subjects (positive n = 4, negative n = 8), but not between female controls and MTF transsexual subjects (positive n = 7, negative n = 1). Thus, LH secretion in response to estrogen- and progesterone priming was attenuated in FTM subjects, but not in MTF subjects, compared to control females. This finding suggested that the brain area related to gender identity in morphological studies might also be involved in the LH secretory response in humans. Thus, altered brain morphology might be correlated to altered function in FTM transsexuals.

DOI： 10.3389/fendo.2018.00212

Scopus

researchmap

記述言語：日本語   出版者・発行元：(一社)日本思春期学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本思春期学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本骨粗鬆症学会  

目的:妊娠授乳関連骨粗鬆症(pregnancy and lactation-associated osteoporosis:PLO)は比較的まれな疾患であるとされるが、その多くが症例報告にとどまり、病態は不明な点が多く、治療法にも定見がないのが現状である。しかし実際の臨床では少なからず経験し、特に多発脊椎圧迫骨折をきたす症例は重篤で治療に難渋する。今回われわれはPLOに伴う脊椎圧迫骨折の発症数を推測し、認知度、治療法の現状を把握する目的で横浜市内の整形外科を標榜する施設へアンケート調査を行った。方法:横浜市内で整形外科を標榜する337施設を対象とした。調査方法は郵送による質問紙法を用いた(調査期間2016年1月〜5月)。質問内容は疾患概念の認知の有無、PLOに伴う脊椎骨折症例の経験の有無、経験がある場合には施行した検査や治療法とした。結果:回収されたアンケート数は297施設(88%)であった。疾患についての認知度は108施設(36%)にとどまった。症例経験があると回答したのは26施設(9%)で計52症例であった。そのうち1年以内に経験したと回答したのは7施設で計8症例であった。骨密度測定は15施設(58%)で施行されていた。治療内容は、コルセット装着や安静指示が17施設(68%)、薬物療法(骨粗鬆症治療薬)が8施設(32%)であった。治療目的に断乳指示をした施設が4施設(16%)、骨粗鬆症治療薬投与のために断乳指示をした施設は3施設(12%)であった。結論:横浜市において過去1年以内に、PLOに伴う脊椎圧迫骨折は少なくとも8症例発症していることが判明したが、年間約26,000件の分娩数に対し、決して少なくないと思われる。症例に対する検査や治療法は施設間で差があり、適切な治療介入をするために、PLOについてのさらなる病態解明と調査が望まれる。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本がん・生殖医療学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本がん・生殖医療学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：神奈川県医師会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER TAIWAN  

Objective: Pregnancy and lactation-associated osteoporosis (PLO) is a rare disease, which can lead to vertebral fractures in women of reproductive age. No treatment strategy for PLO has been established. Here we report a case of PLO treated with teriparatide followed by denosumab, in which remarkable improvement in bone mineral density (BMD) was achieved.
Case report: A 27-year-old woman experienced severe back pain two weeks after her first delivery. PLO was diagnosed from her low BMD and multiple vertebral compression fractures. She was treated with teriparatide for 6 months, followed by denosumab. After 1 year, her BMD increase from baseline was 16.5% in L2-4 and her pain had been relieved.
Conclusion: In addition to weaning, administration of teriparatide followed by denosumab led to remarkable improvement in the patient's symptoms and BMD. Therefore, we regard this method as a promising choice for the treatment of PLO. (C) 2017 Taiwan Association of Obstetrics & Gynecology. Publishing services by Elsevier B.V.

DOI： 10.1016/j.tjog.2017.10.028

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY  

AimThe aim of this study was to provide medical terms to describe the condition of a girl who should be evaluated for primary amenorrhea in order to facilitate intervention at an appropriate time.
MethodsWe performed a literature and clinical guidelines search for recent practices with regard to menarche and discussed relevant cases that had been experienced by committee members. Additionally, we theoretically reviewed medical terms defined in the Glossary Book of Obstetrics and Gynecology in Japan (Japan Society of Obstetrics and Gynecology, 3rd edition).
ResultsThe committee for the redefinition of primary amenorrhea proposed the introduction of two terms and the deletion of one term that had been defined by the Japan Society of Obstetrics and Gynecology, instead of changing the age definition of primary amenorrhea. Delayed menarche' was introduced to describe a condition in which a girl has never experienced cyclic menstruation (menarche) by 15-17 years of age. Late menarche' was also introduced to describe a condition in which a girl has experienced menarche at 15 years of age or older. Delayed menstruation,' which was defined as a condition in which a girl experiences menarche at 15-18 years of age, was deleted.
ConclusionThe new terms delayed menarche' and late menarche' were introduced, and the term delayed menstruation' was deleted. The new system might help in the early detection and appropriate treatment of primary amenorrhea.

DOI： 10.1111/jog.13442

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一社)関東連合産科婦人科学会  

精索静脈瘤は男性不妊症の原因の30%を占め外科的治療が可能であるが,手術により妊孕性が改善するかどうかについては未だ一定の見解は得られていない.今回我々は手術群と待機群の妊娠転帰と術後精液所見の改善率について後方視的に検討した.不妊を主訴に当院を受診され,男性因子を有し(精子運動率40%以下もしくは精子濃度1,500万/ml以下),診察時に精索静脈瘤を有する全56例を対象とした.初診時の精液所見,静脈瘤のgrade,夫婦の年齢,夫のFSH値,テストステロン値,術後3ヵ月後,6ヵ月後の精液所見,妻の治療内容,妊娠の有無について検討した.全56例中,待機群は33例,手術群は23例だった.総運動精子数は,待機群5.02×10^6に対して手術群1.85×10^6と手術群で有意に低く(P<0.05),より精液所見が不良の症例に手術を施行していた.手術群における総運動精子数は,術後3ヵ月,術後6ヵ月共に術前に比して有意に改善していた(それぞれp=0.033,p=0.023).妊娠率は待機群で36.4%(12/33例),手術群で65.2%(15/23例)であり手術群で高い傾向だった(P=0.056).さらに手術群の妊娠症例15例のうち3例は,術後に治療法のstep-downが可能となっていた.精索静脈瘤手術により精液所見の改善を期待でき,妊娠率の改善に寄与する可能性があることがわかった.(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)関東連合産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER JAPAN KK  

Background Female childhood cancer survivors who develop gonadal dysfunction require female hormone replacement therapy (HRT) from puberty until menopause. However, the support provided in such cases has not been studied. We investigated the physical and social characteristics and support needs of adult female childhood cancer survivors who underwent HRT.
Method Forty-nine adult female childhood cancer survivors completed self-administered questionnaires. We compared the clinical characteristics, health status, and social conditions between a group that underwent HRT and a group that did not, and we surveyed support needs of the group that underwent HRT.
Results The median age of the subjects was 25.0 years (range 20-41). Twenty subjects (40.8%) underwent HRT. A significantly high number of those who underwent HRT also underwent radiation therapy (p &lt; 0.01) and hematopoietic stem cell transplantation (p &lt; 0.001), and none of them had a history of pregnancy or childbirth (p &lt; 0.05). There were no significant differences in physical symptoms and social characteristics between the groups. Those who experienced anxiety regarding fertility required information about HRT, a platform to share their concerns, and psychological support and cooperation among healthcare providers.
Conclusions Although the subjects of this survey exhibited good social adjustment regardless of whether or not they underwent HRT, they were anxious about fertility. It is important to understand the concerns and anxieties unique to female childhood cancer survivors and to enhance psychological support in addition to providing educational support so that HRT can be administered.

DOI： 10.1007/s10147-017-1120-3

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jpag.2015.12.001

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier B.V.  

Study objective In order to reduce the risk of vaginal recurrence, we have chosen total laparoscopic modified radical hysterectomy instead of extrafascial hysterectomy in the treatment of endometrial cancer. The aim of this study was to assess the safety of this method. Design Retrospective study of gynecological patients. Setting Yokohama City University Medical Center, Yokohama, Japan. Patients Forty-nine patients who underwent total laparoscopic modified radical hysterectomy for the treatment of endometrial cancer at our hospital between December 2011 and September 2015. Interventions Total laparoscopic modified radical hysterectomy + bilateral salpingo-oophorectomy (n = 20), total laparoscopic modified radical hysterectomy + bilateral salpingo-oophorectomy + pelvic lymphadenectomy (n = 18), or total laparoscopic modified radical hysterectomy + bilateral salpingo-oophorectomy + pelvic and para-aortic lymphadenectomy (n = 11). Measurements and Main Results The surgical outcomes were analyzed and compared to previous reports. The median operative time was 204 minutes (range, 99–504 minutes) and the median intraoperative blood loss was 150 mL (range, 0–680 mL). No patients needed a blood transfusion, conversion to laparotomy, or reoperation. Intra- and postoperative complications were observed in three patients and nine patients, respectively. The amount of blood loss and the incidence of complications in our study were almost identical to previous reports of laparoscopic hysterectomy. The operative time in our study was equivalent to previous reports of total laparoscopic modified radical hysterectomy. Conclusion Total laparoscopic modified radical hysterectomy is safe and feasible for the treatment of early stage endometrial cancer. This procedure can be an alternative to total laparoscopic hysterectomy, especially when the uterus must be removed completely.

DOI： 10.1016/j.gmit.2016.04.001

Scopus

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：FRONTIERS MEDIA SA  

DOI： 10.3389/fped.2017.00028

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一社)関東連合産科婦人科学会  

Well-leg compartment syndrome(WLCS)は術中の体位によって健常な足に生じたコンパートメント症候群と定義される.腹腔鏡手術は低侵襲で有効な術式である一方,載石位に加えてTrendelenburg体位での手術であること及び手術時間延長傾向から,それに伴う合併症に遭遇する事がある.我々は腹腔鏡手術後にWLCSを発症した3例を経験した.症例は45〜52歳で,BMIは24.8〜27.3kg/m2,2例は子宮体癌で1例は子宮筋腫であった.初めての症例では症状の把握や検査,診断に遅れが生じたが,2例目以降はCTなどの早期画像検査及び整形外科への併診などが円滑に進められた.3例とも筋膜切開は行わず,対症療法のみで軽快し,後遺症は残らなかった.WLCSは早急な診断と適切な治療が求められ,時期を逸すると運動障害や神経障害の後遺症を残す可能性や横紋筋融解による急性腎不全を併発し,生命に危険が及ぶこともある.組織内の虚血度合を推測し,疼痛や知覚異常といった症状や臨床検査データの変化に注意し,症例毎に適宜内圧測定を行うなど対応する必要がある.我々は3症例の経験をもとに,産婦人科に限らず施設に属する医師やスタッフがWLCSの病態や診断,治療法,発症リスクを理解し,その発症リスクを下げることに努めなければならない.(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

researchmap

記述言語：日本語   出版者・発行元：神奈川産科婦人科学会  

経腟分娩後に骨盤内膿瘍をきたすことは稀にあり、緊急腹腔鏡下ドレナージにより治療し得た一例を経験したので報告する。31歳女性、2回経妊2回経産。自然妊娠し、妊娠27週1日性器出血を主訴に前医を受診、38℃台の発熱及び血液検査上の炎症所見があり緊急入院ののち、翌日切迫早産及び子宮内感染の診断で、当院へ母体搬送となった。来院時羊水流出あり、前期破水と診断した。体温は36℃台であり、経母体ステロイド投与施行の上、前医からの抗菌薬及び塩酸リトドリン点滴を継続した。妊娠27週4日炎症所見が持続していたためtocolysisを中止、陣痛発来し経腟分娩に至った。分娩後抗菌薬点滴を継続し、炎症所見軽快後、産褥5日目に退院とした。同日夕より腹痛及び下痢が出現し、骨盤腹膜炎の診断で産褥7日目再入院した。抗菌薬点滴を開始し、炎症所見は軽快、産褥9日目退院とするも、その2日後に再度発熱し、ダグラス窩に圧痛を伴う6cm大の多房性腫瘤を認めた。骨盤内膿瘍と診断し、緊急腹腔鏡下骨盤内膿瘍ドレナージ術を施行した。子宮後壁底部と腸管の癒着によりダグラス窩は閉鎖し、膿瘍腔が形成されていた。病理組織学的検査結果は、胎盤は絨毛膜羊膜炎Blanc stage II相当、摘出腫瘤は膿瘍に加え子宮内膜症であり、感染の増悪因子と考えられた。周術期から早期の回復が得られ、腹腔鏡下手術は有用であった。(著者抄録)

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japan Endocrine Society  

Estrogen replacement therapy (ERT) is necessary for uterine development and bone mass acquisition in women with Turner syndrome (TS) suffering from ovarian insufficiency. However, adequate ERT regimens have not yet been established. The aim of this study was to evaluate the efficacy of ERT for both uterine development and bone mass acquisition. One hundred TS patients from Yokohama City University Hospital (88 with primary amenorrhea (PA) and 12 patients with spontaneous menstrual cycles (MC)) were enrolled after obtaining consent. Clinical profiles, uterine length (UL) measured by ultrasonic examination, and bone mineral density (BMD) of the lumbar vertebrae (L2–4) assessed by DEXA were evaluated. At the time of the first visit, the ULs of patients in the PA group were significantly shorter than those in the MC group. After receiving ERT, there were no significant differences in UL between patients with PA and MC. Forty-seven patients for whom the ERT initiation age was known were investigated to clarify the influence on BMD. The results showed that the BMD in the late initiation (18 years or older) group at the latest visit (0.770 ± 0.107 g/cm2: n = 16) was significantly lower than that in the early initiation (under 18 years) group (0.858 ± 0.119 g/cm2: n = 21) or the MC group (0.941 ± 0.118 g/cm2: n = 10). No significant differences were seen between the early initiation and MC group. ERT was effective in increasing UL and BMD. However, early initiation of ERT is necessary to increase BMD.

DOI： 10.1507/endocrj.EJ15-0172

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MOSBY-ELSEVIER  

OBJECTIVE: Myomatous erythrocytosis syndrome is a rare complication of uterine leiomyoma caused by erythropoietin (EPO) that is produced by tumor cells. We assessed the EPO expression in leiomyomas and investigated the effects of EPO on the tumor growth.
STUDY DESIGN: Tissue samples were collected from 114 patients with uterine leiomyomas who underwent myomectomy or hysterectomy in Yokohama City University Hospital. From 17 patients, the corresponding normal myometrium was also collected. All samples were analyzed for EPO messenger RNA (mRNA) expression by real-time reverse transcription-polymerase chain reaction. EPO protein expression was determined by an enzyme-linked immunosorbent assay. The relationships between EPO expression and clinicopathological features were retrospectively analyzed using the patients' charts. Blood vessel density and maturity were assessed using hematoxylin-eosin staining and CD34 immunohistochemistry.
RESULTS: EPO mRNA expression was detected in 108 of 114, or 95%, of the leiomyomas. The mean EPO mRNA expression in the leiomyoma was higher than the corresponding normal myometrium (3836 +/- 4122 vs 1455 +/- 2141; P = .025 by Wilcoxon rank test). The EPO mRNA expression in the leiomyomas varied extensively among samples, ranging from undetectable levels to 18-fold above the mean EPO mRNA of normal myometrium. EPO protein production was observed concomitant with mRNA expression. A positive correlation of leiomyoma size and EPO mRNA expression was shown by Spearman rank correlation coefficient (rho = 0.294; P = .001), suggesting the involvement of EPO in leiomyoma growth. The blood vessel maturity was also significantly increased in EPO-producing leiomyomas (high vessel maturity in high vs low EPO group: 67% vs 20%; P = .013 by Fisher exact test).
CONCLUSION: This report demonstrates that EPO is produced in most of conventional leiomyomas and supports a model in which EPO accelerates tumor growth, possibly by inducing vessel maturity. Our study suggests one possible mechanism by which some uterine leiomyomas reach a large size, and the understanding of EPO expression patterns in these tumors may be useful for management of the patients with leiomyomas.

DOI： 10.1016/j.ajog.2015.02.016

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

Transverse vaginal septum is a residual vaginal plate composed of the Mullerian duct and urogenital sinus. Imperforate hymen results from failure of perforation of the membrane between the urogenital sinus and vaginal cavity. We report a rare case of concurrence of these two conditions. A 16-year-old girl had been treated with puncture several times for hematometra and hematocolpos from 13 years of age because of monthly occurrence of lower abdominal pain without menstrual bleeding and was referred to our hospital. Magnetic resonance imaging demonstrated hematometra, hematocolpos and expansion of the vaginal fornix. The imperforate hymen was incised and a slight adhesion at the lower vaginal cavity was detached. After that, a complete transverse vaginal septum, which was 5mm thick, was identified. It was excised after ultrasonography-guided puncture. Although two cycles of menstrual bleeding took place, molimina recurred. Re-operation was performed 6 months after the first operation, and recurrence of adhesion in the lower vaginal cavity was identified. A silicon dilator was inserted, but she could not use it at home and instead used a tampon. Cyclic menstrual bleeding is observed 4 months after the second operation.

DOI： 10.1111/jog.12669

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.3109/01443615.2015.1022141

researchmap

記述言語：日本語   出版者・発行元：(一社)関東連合産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：日本医学教育学会  

<p> 慢性的な人手不足により逼迫していた産婦人科を取り巻く環境下で, 平成19年に横浜市立大学の医学部生へのアンケートが行われ, 過酷な労働環境を理由に産婦人科を志望しないことがわかった.</p><p> そこで, 労働環境を整える取り組みを始めた. まず, 平成18年度に文部科学省の補助金で「長期専門医コース」を設立し, 育児中のシニアレジデントを補助金で雇用し, 週1〜2回の外来勤務から緩やかにフルタイムへ移行させた. さらに, 平成21年度に文科省の「周産期医療環境整備事業」を得て, 育児支援プログラムを継続した. その結果, 当科の入局者は平成20年度から増加した.</p><p> 育児支援を支えるフルタイム勤務の医師のインセンティブの確保などが今後の課題である.</p>

DOI： 10.11307/mededjapan.46.3_242

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2015290558

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Hemorrhagic ascites caused by endometriosis is extremely rare, and its treatment is under discussion. We report a case of recurrent endometriosis-related ascites treated with dienogest (DNG). A 35-year-old nulliparous Japanese woman with a history of infertility presented with worsening dysmenorrhea and abdominal distention caused by massive ascites. The patient underwent exploratory laparotomy, and hemorrhagic ascites (5500 mL) was drained. She had a normal-sized uterus, and the bilateral ovaries could not be observed because of extensive adhesion in the abdominal cavity. Endometriosis was diagnosed by histopathological evaluation of the omental biopsy, and this was considered to be the cause of ascites. After laparotomy, she had recurrence of ascites. For the next 8 years, the patient was treated conservatively with gonadotropin-releasing hormone agonist therapy and drainage during the intermittent periods followed by DNG administration. She has been treated continuously with DNG for 1 year with no recurrence of ascites. DNG could be an effective treatment for recurrent ascites associated with endometriosis, especially when surgical therapy is undesirable. (C) 2014 AAGL. All rights reserved.

DOI： 10.1016/j.jmig.2014.04.014

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Korean Society of Spine Surgery  

Study Design: Retrospective case series. Purpose: To calculate the prevalence of L5-S1 intervertebral disc degeneration (IDD) by evaluating gynecological disease findings, obtained by pelvic magnetic resonance imaging (MRI), and reveal the risk factors for IDD by analyzing its relationship with age, sacral structure, body mass index (BMI), number of deliveries, and intrapelvic space-occupying lesions. Overview of Literature: Age, obesity, height, smoking history, occupation, and lumbosacral structure are reportedly the main factors of lumbar IDD. However, in women, the relationship of IDD with obstetric and gynecological history is unclear. Methods: The presence of L5-S1 IDD was evaluated on sagittal T2-weighted pelvic MRI during gynecological evaluations in 660 Japanese women. We measured the sacral table angle (STA), sacral kyphosis angle (SKA), and intrapelvic space-occupying lesion size. Age, height, weight, BMI, number of deliveries, lumbosacral structure, size of space-occupying lesions, and presence of uterine leiomyoma based on medical records were compared between the IDD-positive and IDD-negative groups. Results: Lumbosacral IDD was observed in 405 cases (61.4%), and its prevalence increased with age. Differences in age, height, weight, BMI, and number of deliveries between the IDD-positive and -negative groups were significant, but differences in STA, SKA, and presence of uterine leiomyoma and space-occupying lesion size were not. Logistic regression analysis indicated that age, BMI, and STA were risk factors for lumbosacral IDD. Conclusions: Age is the biggest risk factor for lumbosacral IDD in Japanese women, with BMI and STA also contributing to its development. However, SKA and obstetric and gynecological history were not significantly involved.

DOI： 10.4184/asj.2014.8.5.581

Scopus

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER JAPAN KK  

Osteoporosis prevention is an important public health goal. Bone turnover markers are clinically measured to assess bone strength. C-terminal telopeptide of type I collagen (CTX) is released when collagens degrade and serves as an indicator of bone resorption. Simple CTX immunoassays are now available. However, serum CTX (sCTX) reference ranges for Japanese women are lacking. Procollagen type I N-propeptide (intact P1NP) reflects osteoblast activity, serving as a marker of bone formation. Because sCTX and intact P1NP are clinically applied as bone turnover markers, we determined reference ranges for both sCTX and intact P1NP in healthy Japanese women. We collected 228 blood samples from healthy Japanese women aged 19-83 years, grouped by age and menopausal status. We measured sCTX and intact P1NP and examined their correlation. sCTX values differed significantly between the two consecutive decade groups encompassing 19-39 years of age, intact P1NP values between 20 and 30 s, between post-menopausal 50 and 60 s, and between pre-and post-menopausal women in their 50 s. The mean sCTX of 91 healthy pre-menopausal women was 0.255 (0.100-0.653) ng/mL, the intact P1NP in 90 women 33.2 (17.1-64.7) mu g/L. Corresponding values for post-menopausal women were 0.345 (0.115-1.030) ng/mL and 41.6 (21.9-79.1) mu g/L. sCTX correlated with intact P1NP. Bone resorption markers are measured to assess anti-resorption agents, bone formation markers to assess the effects of bone-forming agents. The sCTX and intact P1NP reference values determined herein, in healthy Japanese women, are expected to be useful for osteoporosis treatment, assessment of fracture risk, and other clinical applications.

DOI： 10.1007/s00774-013-0460-y

Web of Science

researchmap

記述言語：日本語   出版者・発行元：ライフサイエンス出版(株)  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：John Wiley and Sons Ltd  

Empty follicle syndrome (EFS) has been defined as a condition where no oocytes can be retrieved for in vitro fertilization (IVF) even though ultrasound findings and estradiol (E2) levels suggest the presence of potential follicles. The EFS is a rare condition with an incidence of 0.5-7 % of women undergoing IVF treatments. Although there are many hypotheses as to the cause of EFS, including advanced ovarian age, drug-related problems, and dysfunctional folliculogenesis, its cause remains unknown. A 37-year-old woman with endometriosis and a 5-year history of primary infertility underwent IVF treatment for 4 cycles. No oocytes were retrieved in 2 cycles and no fertilized eggs were obtained in the other 2 cycles. We assumed that endometriosis adversely affected folliculogenesis and fertilization. Aspiration of an endometrial cyst in the right ovary and subsequent administration of oral contraceptives resulted in successful folliculogenesis and fertilization. Thereafter, she conceived and delivered a 2,662 g female infant at 38 weeks of gestation. Here, we report a case of EFS who conceived in the 5th IVF cycle after aspiration of an endometrial cyst. We assumed that endometriosis might have been involved in the dysfunction of folliculogenesis and EFS. © 2013 Japan Society for Reproductive Medicine.

DOI： 10.1007/s12522-013-0146-0

Scopus

researchmap

記述言語：日本語   出版者・発行元：(一社)関東連合産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：ライフサイエンス出版(株)  

2010年11月〜2011年2月に受診した妊娠5〜12週の妊婦のうち、骨代謝に関連する疾患を有さず、ステロイド剤、ビタミン剤を服用していない160名を対象に検討した。結果、骨密度(QUS法で測定)は、stiffnessが92±14.2、BUAが115±15.5、SOSが1553±31.30m/sec、T-scoreが100±15.5%であり、全体的に良好な値を示したが、T-score 80%未満の低骨密度者が6名(4%)存在した。ライフスタイルは、1ヵ月あたりの運動回数が7±33.9回、運動時間が9±82.9時間、日光浴時間が38±49.8時間であった。栄養摂取状態(FFQ法で調査)は、ビタミンD・K摂取の平均値は推奨量を充足していたが、カルシウム摂取は94%の人が不足していた。初産婦群と経産婦群の比較、35歳以上群と未満群の比較を行ったところ、ライフスタイルと栄養摂取に有意差はなかったが、踵骨骨密度が経産婦群と35歳以上群で有意に低かった。

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2012&ichushi_jid=J03021&link_issn=&doc_id=20120815130032&doc_link_id=%2Fai6ostoe%2F2012%2F002003%2F033%2F0514-0516%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fai6ostoe%2F2012%2F002003%2F033%2F0514-0516%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

Aim: Since women with Turner Syndrome (TS) have various complications, they require comprehensive medical evaluation and multidisciplinary treatment. Although TS patients receive adequate care in childhood, many adults with TS do not. Since most TS adults attend gynecologists for hormone replacement therapy, we suggest gynecologists take primary responsibility for their management. In an attempt to provide TS patients with a comprehensive treatment regimen, we started multidisciplinary medical management in the Reproductive Health Clinic at Yokohama City University Hospital. To evaluate the efficacy of this medical care system, a retrospective analysis was conducted.
Methods: The clinical profiles of 57 TS patients were examined. The past histories, complications and clinical data of these patients were extracted from their medical records and examined clinically. Bone mineral density measurements of lumbar vertebrae (L(2-4)), anti-thyroid antibody titer measurements, hearing tests and cardiovascular MRI were also performed.
Results: Mean follow-up duration was 5.1 years (range, 1-8 years). At the time of transition, patients with complications developed in childhood, such as amenorrhea, osteopenia/osteoporosis, otitis media, thyroid dysfunction and cardiovascular disease were identified. All these complaints were successfully followed up in our adult care system. Several complications common to TS adults, such as glucose intolerance, liver dysfunction, hyperlypidemia and hypertension could be identified by our screening system. Patients were referred to specialists when necessary.
Conclusion: Multidisciplinary health management in our Reproductive Health Clinic improved the status of medical care for TS adults.

DOI： 10.1111/j.1447-0756.2010.01448.x

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：NATURE PUBLISHING GROUP  

Premature ovarian failure (POF) is a disorder characterized by amenorrhea and elevated serum gonadotropins before 40 years of age. As X chromosomal abnormalities are often recognized in POF patients, defects of X-linked gene may contribute to POF. Four cases of POF with t(X;autosome) were genetically analyzed. All the translocation breakpoints were determined at the nucleotide level. Interestingly, COL4A6 at Xq22.3 encoding collagen type IV alpha 6 was disrupted by the translocation in one case, but in the remaining three cases, breakpoints did not involve any X-linked genes. According to the breakpoint sequences, two translocations had microhomology of a few nucleotides and the other two showed insertion of 3-8 nucleotides with unknown origin, suggesting that non-homologous end-joining is related to the formation of all the translocations. Journal of Human Genetics (2011) 56, 156-160; doi: 10.1038/jhg.2010.155; published online 9 December 2010

DOI： 10.1038/jhg.2010.155

Web of Science

PubMed

researchmap

記述言語：英語   出版者・発行元：JAPANESE SOCIETY OF OVA RESEARCH  

経時的胚評価法：Graduated Embryo Score（GES）は，前核期の核小体の配列，媒精から25–27時間後の早期分割の有無およびフラグメンテーションの量，Day2またはDay3における細胞数と割球の均一性およびフラグメンテーションの量を経時的に評価する方法であり，8細胞までの良好胚の選択に有用である可能性が報告されているが，胚盤胞移植における有用性についての検討はない．そこで，従来法のGardner分類で胚盤胞を評価すると同時に，GESを用いて胚評価を行いGESが胚盤胞移植の臨床成績におよぼす影響を後方視的に解析した．本検討においては発育ステージのみに着目し，媒精後118–120時間後のGardner分類4以上を良好胚盤胞，3以下を不良胚盤胞として検討を行い，内細胞塊，栄養外胚葉の評価は検討に含めなかった．Gardner分類4以上の良好胚盤胞移植群のうちGES高得点群の妊娠率47.4％（9/19）は，GES低得点群16.7％（3/18）と比較し有意に高い結果となった（P＜0.05）．GESは，胚盤胞移植における胚評価法としても有用であり，今後良好単一胚盤胞移植にも寄与することができると考えられた．<br>

DOI： 10.1274/jmor.28.83

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：日本語  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：John Wiley and Sons Ltd  

Purpose: To identify predictive factors for successful expectant management of ectopic pregnancy and to evaluate the prognosis for fertility after expectant management and laparoscopic salpingostomy. Methods: Forty-six cases of expectant management and eighty cases of laparoscopic salpingostomy for tubal ectopic pregnancy were retrospectively analyzed. Subjects were classified in three groups: those who underwent laparoscopic salpingostomy, those treated by expectant management only, and those treated by expectant management but requiring additional treatment. Results: The rates of tubal patency, intrauterine pregnancy and repeated ectopic pregnancy in the laparoscopic salpingostomy group were 75, 40, and 16%. The rates in the expectant management group were not significantly different: 72, 42 and 15%. Finally, the rates in the extra treatment group were 75, 39 and 15%. Success rate of expectant management was 54%. In 93% of cases expectant management was successfully completed when the initial levels of urinal hCG were less than 3000 mIU/ml and the levels of hCG 48 h later were less than 80% of the initial levels. However, expectant management alone was insufficient and required extra treatment in 90% of cases when the initial levels of hCG were 3000 mIU/ml and above or when the levels of hCG level 48 h later was 80% of initial levels and above. Conclusions: Expectant management in combination with salpingostomy is not only minimally invasive but also a useful way to preserve fertility. Initial urine hCG levels and their variation over time can help predict whether expectant management will succeed. © Japan Society for Reproductive Medicine 2009.

DOI： 10.1007/s12522-009-0022-0

Scopus

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MOSBY-ELSEVIER  

We report a rare case in which a cystic lesion in the cervix, caused by endometriosis, resulted in a massive vaginal hemorrhage. Cervical endometriosis is relatively common and is usually considered a mild condition. However, we report a case in which a severe vaginal bleed originated from an endometrial cyst of the cervix and in which diagnosis was confused by the presence of atypical cells.

DOI： 10.1016/j.ajog.2008.02.012

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一社)関東連合産科婦人科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：John Wiley and Sons Ltd  

To determine the best treatment for unexplained infertility. Methods: A retrospective study was used to examine Japanese women with unexplained infertility that had undergone laparoscopy. The main outcome measure of the study was the rate of pregnancy after laparoscopy. Results: One hundred and thirty-eight women diagnosed with unexplained infertility received laparoscopy and as a result 55 women had their diagnosis of unexplained infertility confirmed. There were no statistically significant differences between the women who became pregnant after laparoscopy in terms of duration of infertility, duration of treatment or age. The pregnancy rate of women with unexplained infertility was 56.4%, with 90% of these pregnancies achieved within the first 6 months. There were 64 women with minor endometriosis considered to be suffering from unexplained infertility before laparoscopy. The characteristics of the patients in the unexplained infertility group and in the minor endometriosis group were similar, but patients with minor endometriosis were found to have a lower pregnancy rate compared to those with unexplained infertility (35.9% vs 56.4%
P = 0.02). Conclusions: The effective period after laparoscopy appears to be 6 months. Assisted reproductive technology should be considered after that time. Pregnancy rates were low in women with minor endometriosis compared with unexplained infertility. It is important to clarify the cause of infertility using laparoscopy. © 2006 The AuthorsJournal compilation © 2006 Japanese Society of Fertility and Sterility.

DOI： 10.1111/j.1447-0578.2006.00124.x

Scopus

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

We report a case of fetal congenital heart block treated with maternal administration of beta-sympathomimetics. The case was diagnosed as fetal complete heart block associated with maternal anti-Ro/SS-A antibody at 22 weeks of gestation. By fetal sonography, the ventricular rate was revealed to be 60 beats/min and mild cardiomegaly was shown. We initiated maternal administration of a sympathomimetic, specifically terbutaline, to prevent fetal heart failure. An increase in the fetal ventricular rate and an improvement in cardiac function were both achieved during the treatment. A viable infant was delivered by an elective cesarean section without complications at term. Maternal administration of the beta-adrenergic agent terbutaline is suggested to be effective for improving fetal congenital heart block in order to prevent heart failure in utero. Copyright © 2001 S. Karger AG, Basel.

DOI： 10.1159/000052960

Scopus

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本思春期学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本思春期学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本思春期学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本思春期学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：神奈川産科婦人科学会  

婦人科領域における腹腔鏡下手術の合併症として気胸は稀であり、その頻度は0.24%と報告されている。その原因として横隔膜、胸膜や肺に生じた稀少部位子宮内膜症の関与も報告されている。今回我々は卵巣子宮内膜症性嚢胞に対して腹腔鏡下手術後に発症した気胸の3例を経験した。【症例1】36歳、既往歴に気胸や呼吸困難症状はなし。子宮奇形、卵管留血症、卵巣子宮内膜症性嚢胞の診断で腹腔鏡下手術を施行した。術後1日目に右気胸を認め、胸腔ドレナージを開始した。術後7日目に胸腔ドレーンを抜去し、術後8日目に退院となった。【症例2】39歳、気胸や呼吸困難症状の既往はなし。卵巣子宮内膜症性嚢胞の診断で腹腔鏡下手術を施行した。術後1日目に右気胸を認め、胸腔ドレナージを開始した。術後7日目に胸腔ドレーンを抜去し、術後9日目に退院となった。【症例3】39歳、気胸や呼吸困難症状の既往歴なし。卵巣子宮内膜症性嚢胞の診断で腹腔鏡下手術を施行した。術後2日目に右気胸を認め、胸腔ドレナージを開始した。術後7日目に胸腔ドレーンを抜去し、術後8日目に退院となった。今回の3症例はいずれも卵巣子宮内膜症性嚢胞に対する腹腔鏡下手術後に発症した右気胸であった。婦人科腹腔鏡下手術後の合併症として気胸の頻度は低いが、子宮内膜症症例に対して腹腔鏡下手術を行う際には、その他の腹腔鏡下手術より気胸のリスクが高い可能性を考慮する必要がある。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

researchmap

記述言語：日本語   出版者・発行元：神奈川産科婦人科学会  

再生不良性貧血は、造血幹細胞が減少して、骨髄の低形成と汎血球減少を呈する症候群である。発症は全年齢にみとめられ、子宮筋腫との合併により過多月経、貧血が問題となることがあるが、外科的治療の際には、貧血、出血傾向、易感染性のすべてが問題となるため、躊躇される傾向にある。今回、再生不良性貧血患者に対して、腹腔鏡下子宮全摘術を施行し、順調に経過した症例を経験したので報告する。症例は45歳、0経妊0回経産、内科にて再生不良性貧血重症と診断され、子宮筋腫による過多月経のため頻回の輸血を必要としていた。さらに輸血によるアレルギー症状も強くみられるようになったため、加療目的にて当院を受診した。子宮筋腫は、後壁に9cm大の筋層内筋腫として認め、腹腔鏡下子宮全摘術の方針とした。術前にはHb10g/dl、血小板5万/μl以上を目標に輸血を行い補正し、手術を施行したところ、貧血、出血傾向なく経過し得た。術後4日目に発熱、炎症所見の上昇を認め、骨盤内感染が疑われたが、抗生剤およびG-CSFの投与により重篤な感染症には至らず軽快し得た。腹腔鏡下子宮全摘術は、開腹術と比較し出血量、創部感染が低減できる手術方法ではあるが、本症例のように出血、感染のリスクが高い場合には、周術期管理に十分留意して行うことが必要であることが示唆された。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：神奈川産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

researchmap

その他リンク： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=456969

記述言語：英語   出版者・発行元：日本産科婦人科学会  

CiNii Books

researchmap

その他リンク： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=456294

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)関東連合産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

researchmap

その他リンク： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=455690

記述言語：日本語  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：日本思春期学会  

Disorders of sex development(DSD)は「染色体、性腺、または解剖学的性が非典型である先天的状態」と定義される病態である。解剖学的異常を是正するために手術となる場合には、症状や病態が多様なため適応や術式が標準化されておらず、個別的な対応が必要となる。そこで、その現状を把握するために当科で施行したDSD手術症例24例について後方視的に検討を行った。診断には腹部超音波と骨盤MRIが全例で施行され、必要に応じて腹腔鏡が併用されていた。手術術式は造腟術、腟中隔・処女膜切除術、予防的性腺摘出術の3つに分類され、造腟術はロキタンスキー症候群(Mayer-Rokitansky-Kuester-Hauser syndrome:MRKHS)6例、先天性副腎皮質過形成(Congenital Adrenal Hyperplasia:CAH)2例、腟中隔切除術はOHVIRA症候群(obstructed hemivagina with ipsilateral renal agenesis syndrome)8例、腟横中隔1例、処女膜閉鎖3例、予防的性腺摘出術はアンドロゲン不応症(Androgen Insensitivity Syndrome:AIS)3例、ターナー症候群1例であった。疾患により手術時期、年齢、さらに症例毎の病態も異なるので個々に応じた術前のカウンセリングが治療法の選択に重要である。また、術後も再発の有無の観察、ホルモン補充療法などのために継続的診療が必要である。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)関東連合産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)関東連合産科婦人科学会  

researchmap

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：ENDOCRINE SOC  

Web of Science

researchmap

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：ENDOCRINE SOC  

Web of Science

researchmap

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：ENDOCRINE SOC  

Web of Science

researchmap

記述言語：英語   出版者・発行元：日本産科婦人科学会  

CiNii Books

researchmap

その他リンク： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=453425

記述言語：英語   出版者・発行元：日本産科婦人科学会  

CiNii Books

researchmap

その他リンク： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=453437

記述言語：日本語  

J-GLOBAL

researchmap

記述言語：日本語  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：神奈川県医師会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：神奈川産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

researchmap

その他リンク： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=451582

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)関東連合産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：ライフサイエンス出版(株)  

10歳代から80歳代の健常女性218名を対象に骨形成マーカーと骨吸収マーカーの測定を行い、年齢層別で比較するとともに、未治療骨粗鬆症患者64名の測定値と比較検討した。その結果、標題の骨代謝状態について以下の示唆が得られた。1)閉経前であっても45歳以上で骨代謝は亢進し始め、閉経後はさらに加速する。2)骨粗鬆症患者では骨代謝回転の亢進が著明である。3)骨代謝が比較的安定している30〜44歳を基準として骨形成/骨吸収の解離を評価することで、骨代謝回転が亢進しているか否かを推定することが可能である。

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

researchmap

その他リンク： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=449545

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：ライフサイエンス出版(株)  

researchmap

記述言語：日本語   出版者・発行元：ライフサイエンス出版(株)  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

researchmap

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

researchmap

その他リンク： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=447634

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

researchmap

その他リンク： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=445936

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

researchmap

その他リンク： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=445937

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

researchmap

その他リンク： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=446685

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：JAPAN ENDOCRINE SOC  

Web of Science

researchmap

記述言語：日本語   出版者・発行元：日本思春期学会  

researchmap

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：JAPAN ENDOCRINE SOC  

Web of Science

researchmap

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：JAPAN ENDOCRINE SOC  

Web of Science

researchmap

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

researchmap

記述言語：英語   出版者・発行元：John Wiley and Sons Ltd  

Purposes: It is sometimes difficult to restore a regular ovulatory cycle in women with polycystic ovary syndrome (PCOS) using classic agents such as clomiphene citrate or gonadotropins. Saireito, a herbal medicine, is believed to have an effect similar to corticosteroids. We examined the effect of Saireito on ovulatory induction and endocrine status in women with PCOS. Methods: Twenty-four women with PCOS were treated with Saireito for 3 months. Serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), testosterone (T), estradiol (E2), adrenocorticotropic hormone (ACTH), and cortisol were measured before and after treatment, and ovulation was assessed. We compared serum LH levels between ovulation (n = 21) and anovulation (n = 3) groups, and compared ovulation rate and serum LH levels between obese (n = 6) and nonobese (n = 18) groups. Results: Ovulation was restored in 21 (87.5%) of the 24 PCOS patients following administration of Saireito for 3 months. LH levels were significantly decreased 1 month after medication in ovulatory group (P &lt
0.001), but only slightly decreased in anovulatory group. Ovulation rate in the nonobese group (94.4%) was higher than in the obese group (66.7%). Serum LH levels were significantly reduced in the nonobese group, but only slightly reduced in the obese group. Conclusions: Saireito reduced serum LH levels and increased ovulatory rate, particularly in nonobese women. © 2010 Japan Society for Reproductive Medicine.

DOI： 10.1007/s12522-010-0057-2

Scopus

researchmap

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

researchmap

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

researchmap

その他リンク： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=443177

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

researchmap

その他リンク： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=443841

Adiponectin is an adipocyte-derived hormone involved in glucose, lipid and energy metabolism. A low plasma adiponectin concentration is associated with insulin resistance, obesity and atherosclerosis. In women, energy homeostasis is remarkably changed during gestation and lactation in order to supply sufficient nutrition for a fetus or newborn. In this study we aimed to elucidate the physiological impact of gestation and lactation on the plasma adiponectin levels and the influence of reproduction-related hormones on adiponectin secretion. We studied the longitudinal changes in plasma adiponectin concentration during pregnancy (1st, 2nd and 3rd trimester) and lactation (3 days and 1 month after the delivery) in lean healthy women (n = 22). The plasma adiponectin level declined slightly as the pregnancy advanced and reached its lowest level during lactation (12.25 ± 0.182 μg/ml at early pregnancy vs. 6.88 ± 0.375 μg/ml at 3 days postpartum, p&lt;0.001). In order to investigate the role of the lactogenic hormone prolactin in the decrease of plasma adiponectin levels during lactation, we further performed in vitro experiments using human primary cultured adipocytes. Western blotting o

DOI： 10.1507/endocrj.K06-026

PubMed

J-GLOBAL

researchmap

記述言語：英語   出版者・発行元：日本産科婦人科学会  

CiNii Books

researchmap

その他リンク： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=438356

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：ZOOLOGICAL SOC JAPAN  

Web of Science

researchmap

出版者・発行元：日本生理学会  

In primates including humans, it is believed that there is no sex difference in the function of the hypothalamus associated with the induction of LH surge, because estrogen can induce a surge-like LH scretion in castrated males. We examined whether P could induce a surge-like LH secretion in estrogen-primed TG and TS women. Control women (N=4, 27-39 yr), TG women (N=3, 29-32 yr), and TS women (N=3, 23-29 yr) provided written informed consent. TG and TS women were diagnosed as gender identity disorder by medical specialists, and had not received any hormonal treatment. Except one in TS women, others had a regular menstrual cycle, based on the basal body temperature and the menstruation. Subjects were administered orally with 50 &amp;mu;g of ethinylestradiol (E) twice per day for 5 days from day 3. On day 7, subjects were injected s.c. with 12.5 mg of P. Blood samples were collected before and 3, 6, 9, 12, and 24 hour after the injetion. Serum concentrations of LH were assayed with a commercial LH kit. In control and TG women, P injection induced a surge-like LH secretion, but LH levels before P injection in TG women were slightly lower than in control women. In 2 of 3 TS women, P injection decreased LH levels, not inducing a surge-like secretion. One TS woman showed a surge-like LH secretion similar to those in TG women. We conclude that there is a sex difference in the central mechanism controlling the surge of LH secretion even in humans. &lt;b&gt;[Jpn J Physiol 55 Suppl:S214 (2005)]&lt;/b&gt;

researchmap

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

researchmap

その他リンク： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=436631

記述言語：日本語   出版者・発行元：日本性教育協会  

CiNii Books

researchmap

記述言語：英語   出版者・発行元：NATL ACAD SCIENCES  

We studied the signaling pathways coupling gonadotropin-releasing hormone (GRH) secretion to elevations in cAMP levels in the GT1 GnRH-secreting neuronal cell line. We hypothesized that increased cAMP could be acting directly by means of cyclic nucleotide-gated (CNG) cation channels or indirectly by means of activation of cAMP-dependent protein kinase (PKA), We showed that GT1 cells express the three CNC subunits present in olfactory neurons (CNG2, -4.3, and -5) and exhibit functional cAMP-gated cation channels. Activation of PKA does not appear to be necessary for the stimulation of GnRH release by increased levels of cAMP, In fact, pharmacological inhibition of PKA activity caused an increase in the basal secretion of GnRH, Consistent with this observation activation PKA inhibited adenylyl cyclase activity, presumably by inhibiting adenylyl cyclase V expressed in the cells. Therefore, the stimulation of GnRH release by elevations in cAMP appears to be the result of depolarization of the neurons initiated by increased cation conductance by cAMP-gated cation channels. Activation of PKA may constitute a negative-feedback mechanisms for lowering cAMP levels. We hypothesize that these mechanisms could result in oscillations in cAMP levels, providing a biochemical basis for timing the pulsatile release of GnRH.

DOI： 10.1073/pnas.040545197

Web of Science

researchmap

記述言語：英語   出版者・発行元：KARGER  

Increases in the level of cAMP stimulate the secretion of GnRH from GT1 GnRH neuronal cells. We hypothesized that cyclic nucleotide phosphodiesterases (PDEs), the enzymes that hydrolyze cAMP, may constitute a negative feedback signaling mechanism for GnRH regulation by decreasing the level of cAMP. GT1 cells were shown to express three PDEs by RT-PCR analysis: the cAMP-specific PDE4B and PDE4D and the calmodulin-dependent PDE1B. A splice variant of PDE4D, PDE4D3, which is activated when phosphorylated by cAMP-dependent protein kinase (PKA), was identified in GT1 cells by Western analysis. Consistent with PDEs negatively regulating GnRH secretion, treatment with the nonselective PDE inhibitor, IBMX, stimulated GnRH secretion 137% in 30-min static cultures. Furthermore, treatment with the PDE4-specific inhibitors Rolipram and RS-25344 increased GnRH secretion 48 and 125%, while treatment with the PDE1-specific inhibitor 8-MeoM-IBMX only caused a modest increase of 28%. In perifusion studies a rapid multi-fold stimulation of GnRH secretion was observed following treatment with IBMX, Rolipram or RS-25344. In conclusion, the level of PDE activity appears to be an important negative feedback signal for GnRH secretion. We hypothesize that activation of PDE4D3 by PKA may constitute a negative feedback signaling pathway which participates in the regulation of cAMP levels.

DOI： 10.1159/000054386

Web of Science

researchmap

記述言語：英語   出版者・発行元：JAPAN ENDOCRINE SOCIETY  

Although it is well recognized that continuous administration of gonadotropin-releasing hormone agonist (GnRHa) induces pituitary desensitization, the precise molecular mechanism of this phenomenon is still unclear. To test the hypothesis that pituitary gonadotroph desensitization is mediated by a change in GnRH receptor (GnRH-R) gene expression, the GnRH-R mRNA concentration was analyzed in immature female rats during GnRHa treatment. Northern blot hybridization was used to determine the GnRH-R mRNA concentration several times after an injection of TAP-144-SR, a slow releasing GnRHa. The GnRH-R mRNA readings were 92.7 +/- 9.5%, 49.9 +/- 5.0%, 35.7 +/- 2.3% and 73.8 +/- 5.7% (Mean +/- SD) compared to each control value at 1, 2, 4 and 8 weeks, respectively, after a single injection of 0.94 mg TAP-144 SR. These changes in GnRH-R mRNA coincided with the changes in gonadotropin secretion and LH-beta mRNA in response to GnRH in the results of our previous report. The present results indicate that the reduction of the number of pituitary GnRH-R sites induced by continuous stimulation with GnRHa is regulated at a transcriptional level.

DOI： 10.1507/endocrj.43.115

Web of Science

researchmap

記述言語：英語   出版者・発行元：ENDOCRINE SOC  

Although there are some reports, including our previous study, indicating the existence and biological action of epidermal growth factor (EGF) in human decidua, the site of its synthesis remains *unknown. To clarify the EGF production during decidualization at a molecular level, gene expression of EGF in human endometrium/decidua was examined by Northern blot analysis and in situ hybridization. Northern blot hybridization using P-32-labeled human prepro-EGF complementary DNA was carried out for nonpregnant human endometria from hysterectomized uteri of leiomyoma, decidua from early pregnancy, and in vitro decidualized endometrial cells by medroxyprogesterone acetate (MPA). Although no hybridized band was found in the proliferative and secretory phase endometria, a specific band of 5 kilobases, in agreement with the size of human prepro-EGF messenger ribonucleic acid, was detected in decidua of early pregnancy as well as in in vitro MPA-induced decidual cells. In situ hybridization revealed that prepro-EGF messenger ribonucleic acid was observed in the stromal cells of decidua. These results demonstrate that the EGF gene is expressed in the process of decidualization, suggesting that EGF may play an important role in the decidualization process of human endometrium.

Web of Science

researchmap

researchmap

researchmap

researchmap

researchmap

会議種別：ポスター発表  

researchmap

会議種別：ポスター発表  

researchmap

researchmap

会議種別：ポスター発表  

researchmap

会議種別：ポスター発表  

researchmap