Publications by authors named "Jun Takeda"

176 Publications

A Retrospective Multicenter Study on the Usefulness of 50 g Glucose Challenge Test in Gestational Diabetes Mellitus Screening.

JMA J 2020 Apr 6;3(2):125-130. Epub 2020 Apr 6.

Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan.

Introduction: To clarify the usefulness of glucose challenge test (GCT), the rate of gestational diabetes mellitus (GDM) detection and perinatal outcomes were compared between the groups of random blood glucose level (RBG) and 50 g GCT in this study.

Methods: The first survey was conducted at 255 institutions registered by the Kanto Society of Obstetrics and Gynecology and clinical training institutions in the Kanto Area, followed by a second survey. The included women were broadly classified into the RBG and GCT groups, according to the mid-trimester blood glucose screening method, and the perinatal outcomes of the two groups were retrospectively compared. The primary outcomes were the proportion of infants weighing 3,500 g or more and birth weight ≥90-percentile infants.

Results: The rate of GDM diagnosis was significantly higher in the GCT group (7.6%) than that in the RBG group (4.8%). However, no significant differences were observed in perinatal outcomes, i.e., the proportion of infants weighing 3,500 g or more or birth weight ≥90 percentile.

Conclusions: GCT is not superior for predicting infants weighing 3,500 g or more and birth weight ≥90 percentile, as compared with RBG.
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http://dx.doi.org/10.31662/jmaj.2019-0072DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590393PMC
April 2020

Whole exome sequencing of fetal structural anomalies detected by ultrasonography.

J Hum Genet 2021 May 3;66(5):499-507. Epub 2020 Nov 3.

Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan.

The objective of this study was to evaluate the efficacy of whole exome sequencing (WES) for the genetic diagnosis of cases presenting with fetal structural anomalies detected by ultrasonography. WES was performed on 19 cases with prenatal structural anomalies. Genomic DNA was extracted from umbilical cords or umbilical blood obtained shortly after birth. WES data were analyzed on prenatal phenotypes alone, and the data were re-analyzed after information regarding the postnatal phenotype was obtained. Based solely on the fetal phenotype, pathogenic, or likely pathogenic, single nucleotide variants were identified in 5 of 19 (26.3%) cases. Moreover, we detected trisomy 21 in two cases by WES-based copy number variation analysis. The overall diagnostic rate was 36.8% (7/19). They were all compatible with respective fetal structural anomalies. By referring to postnatal phenotype information, another candidate variant was identified by a postnatal clinical feature that was not detected in prenatal screening. As detailed phenotyping is desirable for better diagnostic rates in WES analysis, we should be aware that fetal phenotype is a useful, but sometimes limited source of information for comprehensive genetic analysis. It is important to amass more data of genotype-phenotype correlations, especially to appropriately assess the validity of WES in prenatal settings.
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http://dx.doi.org/10.1038/s10038-020-00869-8DOI Listing
May 2021

Observation of Photoinduced Terahertz Gain in GaAs Quantum Wells: Evidence for Radiative Two-Exciton-to-Biexciton Scattering.

Phys Rev Lett 2020 Oct;125(16):167401

Department of Electrical and Computer Engineering, Rice University, Houston, Texas 77005, USA.

We have observed photoinduced negative optical conductivity, or gain, in the terahertz frequency range in a GaAs multiple-quantum-well structure in a strong perpendicular magnetic field at low temperatures. The gain is narrow band: it appears as a sharp peak (linewidth <0.45  meV) whose frequency shifts with applied magnetic field. The gain has a circular-polarization selection rule: a strong line is observed for hole-cyclotron-resonance-active polarization. Furthermore, the gain appears only when the exciton 1s state is populated, which rules out intraexcitonic transitions to be its origin. Based on these observations, we propose a possible process in which the stimulated emission of a terahertz photon occurs while two free excitons scatter into one biexciton in an energy and angular-momentum conserving manner.
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http://dx.doi.org/10.1103/PhysRevLett.125.167401DOI Listing
October 2020

Interferon therapy for pregnant patients with essential thrombocythemia in Japan.

Int J Hematol 2021 Jan 23;113(1):106-111. Epub 2020 Sep 23.

Department of Hematology, Juntendo University School of Medicine, 2-1-1 Hongou, Bunkyoku, Tokyo, 113-8421, Japan.

Essential thrombocythemia (ET) mainly affects the elderly, but can also develop in women of childbearing age. The risk of miscarriage and other complications during pregnancy in ET patients are reported to be higher than that compared to the general population. Therefore, management of pregnancy in ET patients requires special considerations. Several groups recommend interferon (IFN) therapy for ET patients with high-risk pregnancies, but currently no guidelines are available in Japan. We report the outcomes of nine ET patients with ten consecutive high-risk pregnancies. All patients were successfully managed with IFN-α during their pregnancies. All patients also received aspirin and switched to unfractionated heparin around 36 weeks of gestation. As for the seven pregnancies in which IFN-α was started after detection of pregnancy, median platelet counts decreased from 910 to 573 × 10/L after 2 months of IFN-α therapy, and median platelet counts at the time of delivery for all ten pregnancies was 361 × 10/L. All patients gave birth to healthy children. IFN-α was well tolerated, safe, and effective as a cytoreductive therapy for all patients. Although evidence is limited and the use of IFN is not approved in Japan, we suggest considering IFN therapy for high-risk ET pregnancies.
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http://dx.doi.org/10.1007/s12185-020-03001-wDOI Listing
January 2021

L-Arginine prevents cereblon-mediated ubiquitination of glucokinase and stimulates glucose-6-phosphate production in pancreatic β-cells.

Commun Biol 2020 09 8;3(1):497. Epub 2020 Sep 8.

Department Aging Intervention, National Center for Geriatrics and Gerontology, Obu, Aichi, 474-8511, Japan.

We sought to determine a mechanism by which L-arginine increases glucose-stimulated insulin secretion (GSIS) in β-cells by finding a protein with affinity to L-arginine using arginine-immobilized magnetic nanobeads technology. Glucokinase (GCK), the key regulator of GSIS and a disease-causing gene of maturity-onset diabetes of the young type 2 (MODY2), was found to bind L-arginine. L-Arginine stimulated production of glucose-6-phosphate (G6P) and induced insulin secretion. We analyzed glucokinase mutants and identified three glutamate residues that mediate binding to L-arginine. One MODY2 patient with GCK demonstrated lower C-peptide-to-glucose ratio after arginine administration. In β-cell line, GCK reduced L-arginine-induced insulin secretion compared with GCK. In addition, we elucidated that the binding of arginine protects glucokinase from degradation by E3 ubiquitin ligase cereblon mediated ubiquitination. We conclude that L-arginine induces insulin secretion by increasing G6P production by glucokinase through direct stimulation and by prevention of degradation.
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http://dx.doi.org/10.1038/s42003-020-01226-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7479149PMC
September 2020

Effect of hypertriglyceridemia in dyslipidemia-induced impaired glucose tolerance and sex differences in dietary features associated with hypertriglyceridemia among the Japanese population: The Gifu Diabetes Study.

J Diabetes Investig 2021 May 7;12(5):771-780. Epub 2020 Oct 7.

Takeda hospital, Kyoto, Japan.

Aims/introduction: The mechanisms underlying hypertriglyceridemia-induced impaired glucose tolerance in Japanese individuals remain unclear. We aimed to evaluate the effect of hypertriglyceridemia on glucose metabolism in comparison with that of increased low-density lipoprotein or decreased high-density lipoprotein levels and to elucidate the sex differences in hypertriglyceridemia-related dietary intake among Japanese individuals.

Materials And Methods: We randomly selected 898 (384 men and 514 women) participants aged 40-78 years in the Gifu Diabetes Study; those taking medication for dyslipidemia or diabetes mellitus were excluded. Serum levels of glucose metabolism parameters and the food frequency were measured cross-sectionally. The glycated hemoglobin was measured again after 5 years.

Results: Glucose metabolism parameters and the percentage of individuals with impaired glucose tolerance were significantly higher in the high triglyceride group in men and women. Similar trends were observed in the low high-density lipoprotein group, but only in men. Meanwhile, only the homeostasis model assessment of insulin resistance was higher in the high low-density lipoprotein group. In non-obese men, the percentage of energy intake from alcohol per total daily energy intake was significantly greater in the high triglyceride group. In obese women, the total energy intake was significantly greater in the high triglyceride group. At the 5-year follow up, the risk of elevated glycated hemoglobin levels with hypertriglyceridemia was increased in men.

Conclusions: Hypertriglyceridemia is a stronger risk factor for impaired glucose tolerance than increased low-density lipoprotein or decreased high-density lipoprotein. For dietary habits, increased daily alcohol energy intake in non-obese men and increased total energy intake in obese women were associated with hypertriglyceridemia.
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http://dx.doi.org/10.1111/jdi.13398DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8089021PMC
May 2021

Comparison of the labor curves with and without combined spinal-epidural analgesia in nulliparous women- a retrospective study.

BMC Pregnancy Childbirth 2020 Aug 15;20(1):467. Epub 2020 Aug 15.

Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.

Background: Neuraxial labor analgesia is known to increase the rate of instrumental delivery and prolong the second stage of labor; however, there is no standard method to evaluate the progress of labor under analgesia. Friedman curve is considered the gold standard for evaluating the progress of labor. However, it included not only neuraxial labor analgesia but also labor without analgesia. Thus we compared the labor curves of primiparous women undergoing labor with and without neuraxial labor analgesia, to understand the progress of labor in both groups and to arrive at a standard curve to monitor the progress of labor under neuraxial analgesia.

Methods: Primiparous women with cephalic singleton pregnancies who delivered at term from 2016 to 2017 were included. Two hundred patients who opted for combined spinal-epidural (CSE) labor analgesia were included in the CSE group and 200 patients who did not undergo CSE were included in the non-CSE group. In all, 400 cases were examined retrospectively. The evaluation parameters were cervical dilation and fetal station, and we calculated the average value per hour to plot the labor curves.

Results: The labor curve of the non-CSE group was significantly different from the Friedman curve. In the CSE group, the time from 4 cm dilation of the cervix to full dilation was 15 h; in addition, the speed of cervical dilation was different from that in the non-CSE group. The progress of labor in the CSE group was faster than that in the non-CSE group during the latent phase; however, the progress in the CSE group was slower than that in the non-CSE group during the active phase.

Conclusions: Neuraxial labor analgesia results in early cervical dilation and descent of the fetal head; thus, appropriate advance planning to manage the delivery may be essential.
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http://dx.doi.org/10.1186/s12884-020-03161-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7429797PMC
August 2020

Antepartum eclampsia with reversible cerebral vasoconstriction and posterior reversible encephalopathy syndromes.

J Obstet Gynaecol Res 2020 Oct 10;46(10):2147-2152. Epub 2020 Aug 10.

Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan.

A 39-year-old pregnant woman was experienced thunderclap headache due to reversible cerebral vasoconstriction syndrome (RCVS) as a prodromal symptom. Two days after, she was brought to our hospital after an eclamptic seizure at 35 weeks of gestation. After management with magnesium sulphate, a cesarean delivery was performed, and passed without eclamptic seizure recurrence with calcium channel blocker (CCB) administration for hypertension and prophylaxis of another seizure. Antepartum eclampsia is sometimes complicated by headache as a prodromal symptom. Cerebrovascular diseases in the perinatal period include eclampsia, RCVS and posterior reversible encephalopathy syndrome, which have potentially overlapping pathologies. Here, we first report a case of overlapping those three diseases in the antepartum period. Our best literature review showed that antepartum RCVS is severe and has complications besides thunderclap headache, and there is a case report which CCB administration was shown to be effective in the treatment of antepartum RCVS. If thunderclap headache is recognized, prediction of eclampsia and getting better course of RCVS with CCB administration may be possible.
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http://dx.doi.org/10.1111/jog.14410DOI Listing
October 2020

Cesarean Section for Placenta Previa and Placenta Previa Accreta Spectrum.

Surg J (N Y) 2020 Jul 9;6(Suppl 2):S110-S121. Epub 2020 Mar 9.

Department of Obstetrics and Gynecology, Faculty of Medicine, Juntendo University, Tokyo, Japan.

According to the increase in the rate of cesarean section and the increase of high-aged pregnancy, we seem to more often encounter cases with placenta previa and placenta previa accrete spectrum. There are concerns about these cases, such as difficulty in controlling bleeding from the separation surface of placenta previa, the need for hysterectomy as a life-saving procedure, systemic management and hemostasis during massive hemorrhage, and treatment of disseminated intravascular coagulation (DIC). These cases are most frequently associated with cesarean hysterectomy.
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http://dx.doi.org/10.1055/s-0039-3402036DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7396465PMC
July 2020

Clinical Tips of Cesarean Section in Case of Breech, Transverse Presentation, and Incarcerated Uterus.

Surg J (N Y) 2020 Jul 18;6(Suppl 2):S81-S91. Epub 2020 Mar 18.

Department of Obstetrics and Gynecology, Faculty of Medicine, Juntendo University, Tokyo, Japan.

Cesarean section in breech or transverse presentation involves more complicated procedures than cesarean section in cephalic presentation because the former requires additional manipulations for guiding the presenting part of the fetus, liberation of the arms, and the after-coming head delivery; therefore, those cesarean sections are likely to be more invasive. Making a rather wide uterine incision to prevent uterine injury during delivery of the fetus facilitates smooth delivery of the fetus. Furthermore, in cases of breech or transverse presentation, it is important to initially identify the presenting part of the fetus and guide it to the incision opening in the lower uterine segment, because delivering the presenting part of the fetus first is a basic rule of delivery of the fetus. Smooth delivery of the fetus by means of breech extraction can prevent excessive stress or injury to the fetus. Therefore, it is important to acquire the knowledge and skills necessary to perform these techniques, including the internal version. Smooth delivery of the fetus is also less invasive for the mother because an extension of the uterine excision or injury to arteries and veins in the uterus and parametrium can be avoided. Incarcerated uterus occurring in cases of pregnancy with intrapelvic adhesion, endometriosis, cervical myoma, or extended cervix may result in excessive uterine and cervical injury when a transverse incision of the lower uterine segment is performed without caution. These conditions may result in difficulty in fetal delivery. Therefore, it is important to identify risks in advance and to choose the incision line with great care. Countermeasures for difficult delivery of the fetus need to be mastered by all practitioners of obstetrics. If the transverse incision fails to reach the uterine cavity, an inverted T-shaped or J-shaped incision should be made. Risks of complications such as injury to the cervical canal, the vagina, the bladder or ureter, and massive hemorrhage must be kept in mind.
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http://dx.doi.org/10.1055/s-0040-1702985DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7396468PMC
July 2020

Pure 9p duplication syndrome with aplasia of the middle phalanges of the fifth fingers.

Eur J Med Genet 2020 Oct 18;63(10):104005. Epub 2020 Jul 18.

Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan.

9p duplication syndrome is a common congenital anomaly syndrome with specific facial features, mental and developmental retardations, and characteristic fingers. Pure 9p duplication without other chromosomal structural variations is very rare. It has recently been reported that cases with partial 9p duplication including SMARCA2 have phenotypes overlapping with Coffin-Siris syndrome (CSS). Herein, we present a family with pure 9p duplication syndrome in which phenotypes partially characteristic of CSS were identified. In one of two siblings, X-ray examination revealed hypoplasia of the distal phalanges of the fifth fingers, aplasia of the middle phalanges of the fifth fingers, and aplasia of the distal phalanges of the second to fifth toes. In pure 9p duplication together with our one affected case, 9 out of 14 cases (64.3%), excluding cases whose clinical data were unavailable, presented the absence or hypoplasia of the middle phalanges of fingers or toes. Interestingly, there are no reports on CSS with aplasia or hypoplasia of the middle phalanx. Therefore, this family might suggest that the aplasia or hypoplasia of the middle phalanges of the fifth fingers or toes is a distinct finding that can distinguish between pure 9p duplication and CSS.
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http://dx.doi.org/10.1016/j.ejmg.2020.104005DOI Listing
October 2020

Spatially resolved spectral phase interferometry with an isolated attosecond pulse.

Opt Express 2020 Jul;28(14):21025-21034

We demonstrate spatially resolved supercontinuum spectral phase interferometry with an isolated attosecond pulse (IAP). The measured spatial-spectral interferogram over the broadband region indicates a high degree of IAP coherence in both spatial and spectral domains. In addition, the spectral-delay interferogram shows periodic temporal oscillations over the full IAP continuous spectrum, which indicates high temporal coherence. The supercontinuum spectral phase interferometry with broadband IAP will contribute to exploring spatiotemporal dispersive electronic dynamics through phase-based spectroscopy in the future.
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http://dx.doi.org/10.1364/OE.393922DOI Listing
July 2020

Macroscopic Ionic Flow in a Superionic Conductor Na^{+} β-Alumina Driven by Single-Cycle Terahertz Pulses.

Phys Rev Lett 2020 Apr;124(14):147401

Toyota Physical and Chemical Research Institute, Nagakute, Aichi 480-1192, Japan.

Ionic motion significantly contributes to conductivity in devices such as memory, switches, and rechargeable batteries. In our work, we experimentally demonstrate that intense terahertz electric-field transients can be used to manipulate ions in a superionic conductor, namely Na^{+} β-alumina. The cations trapped in the local potential minima are accelerated using single-cycle terahertz pulses, thereby inducing a macroscopic current flow on a subpicosecond timescale. Our results clearly show that single-cycle terahertz pulses can be used to significantly modulate the nature of superionic conductors and could possibly serve as a basic tool for application in future electronic devices.
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http://dx.doi.org/10.1103/PhysRevLett.124.147401DOI Listing
April 2020

Laparoscopic Removal of Modified Vertical Uterine Compression Sutures due to Postoperative Focal Pain.

Surg J (N Y) 2020 Apr 31;6(2):e67-e70. Epub 2020 Mar 31.

Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan.

Previously we reported laparoscopic removal of compression sutures due to uterine ischemia and related pain, which has two of the difficult aspects: (1) maneuvering the curved needle to perform compression suturing in the narrow surgical field, and (2) distinguishing between the threads of the cesarean section wound sutures versus the vertical compression sutures during removal, as the threads are the same white color. We performed vertical compression sutures for intrapartum hemorrhage with total placental previa, and modified both the needle type and the color of the thread used for uterine compression sutures during cesarean section. After the operation, we performed successful laparoscopic removal of compression sutures for postoperative focal pain. Changing the needle type and color helped to perform operations. The present case supports the concept that the laparoscopic removal of uterine compression suturing is useful for controlling pain in cases where general analgesics are ineffective.
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http://dx.doi.org/10.1055/s-0040-1708865DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7108947PMC
April 2020

Use of sound-elicited fetal heart rate accelerations to assess fetal hearing in the second and third trimester.

Int J Pediatr Otorhinolaryngol 2020 Jun 13;133:110001. Epub 2020 Mar 13.

Department of Otorhinolaryngology, Juntendo University Faculty of Medicine, Tokyo, Japan. Electronic address:

Objectives: We previously reported that fetal heart rate (FHR) accelerations could be obtained after fetal sound stimulation. We examined FHR accelerations during 20-37 weeks gestational age (GA) in order to assess the optimal time for the test.

Methods: The fetus was stimulated from the maternal abdomen with pure tone 2000 Hz, 90 dB, 5 s. Changes in the FHR before and after the sound stimulation were measured by a cardiotocometer.

Results: Compared with the positive rate of FHR accelerations at 20-21 weeks GA, significant increases were recognized in 26-27, 28 to 29, 30 to 31, and 34-35 weeks GA. Comparing the positive rate of FHR accelerations between the minimal and moderate variability of FHR baseline, no significant differences were observed at 20-27 weeks GA. On the other hand, at 28-37 weeks GA, the positive rate to detect FHR accelerations due to sound stimulation was 100% in moderate FHR baseline variability.

Conclusion: Considering development of human fetal hearing, the method should be performed between 28 and 37 weeks GA and during moderate FHR variability corresponding to active sleep conditions. The method developed in the present study may provide a promising tool for evaluating the fetal hearing.
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http://dx.doi.org/10.1016/j.ijporl.2020.110001DOI Listing
June 2020

Retrospective study of the recurrence risk of preterm birth in Japan.

J Matern Fetal Neonatal Med 2020 Feb 18:1-5. Epub 2020 Feb 18.

Department of Obstetrics and Gynecology, Juntendo University, Tokyo, Japan.

A history of preterm birth is a risk factor for preterm birth in a future pregnancy, and there are some reports of prevention methods, such as the administration of progesterone. However, the rate of recurrence of preterm birth in Japan has not been clarified, and there is no data for judging whether these preventive methods are effective. To clarify the risk of recurrence of preterm birth and preterm prelabor rupture of membranes (pPROM) in Japan. A retrospective study was conducted using the perinatal registration database of the Japan Obstetrics and Gynecology Society for the Perinatal Center from 2014 to 2016. There were 704,418 subjects, of which 190,990 were excluded those with unknown maternal information, those under the age of 20 years, those with perinatal disease related to preterm birth, and first-time mothers. Logistic model unavailable and multivariate analysis were performed. An analysis of the preterm birth history indicated the risk of preterm birth in the current pregnancy, and the odds ratio for preterm birth recurrence once, twice, and three times or more was 3.3, 6.6, and 7.8, respectively. As a secondary analysis, we analyzed whether the history of pPROM is a risk factor of recurrence of pPROM and found a significant association with an odds ratio of 3.4. Having a preterm birth history increases the risk of recurrence of preterm birth, and the risk of recurrent preterm birth increases as the number of preterm births increases. Although this report is intended for high-risk pregnancies wherein the rate of preterm birth is high, as previously reported, our data indicate that in Japan, preterm birth is a risk factor of recurrent preterm birth.
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http://dx.doi.org/10.1080/14767058.2020.1727435DOI Listing
February 2020

Assessment of extravasation on ruptured uterine artery pseudoaneurysm using contrast-enhanced ultrasonography during uterine balloon tamponade.

J Int Med Res 2020 Apr 20;48(4):300060519893166. Epub 2019 Dec 20.

Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan.

Objective: Contrast-enhanced ultrasonography (CEU) has been used in critical trauma situations to visualize extravasation; however, its use is limited in the field of obstetrics. Cases of ruptured uterine artery pseudoaneurysm (UAP) were analyzed to clarify the efficacy to CEU during uterine balloon tamponade.

Methods: Cases of ruptured UAP diagnosed at a teaching university hospital from January 2015 to December 2017 were retrospectively analyzed. UAP was diagnosed using color Doppler ultrasonography. Extravasation was identified using computed tomography and double checked using CEU with an intravenously administered contrast agent (Sonazoid; Daiichi Sankyo Company, Ltd., Tokyo, Japan) and an ultrasound instrument (HI VISION Preirus; Hitachi Aloka Medical, Ltd., Tokyo, Japan). A balloon was then inserted into the uterine cavity and inflated at the point of bleeding until extravasation ceased.

Results: Three patients exhibited ruptured UAP during the study period. Bleeding points were successfully identified using CEU in all cases, and hemostasis was achieved using uterine balloon tamponade. Obliteration of UAP was confirmed using magnetic resonance imaging, and no patients developed recurrent UAP or any complications.

Conclusion: CEU can be used at the bedside to promptly diagnose ruptured UAP. Moreover, it precisely facilitates balloon compression at the point of bleeding.
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http://dx.doi.org/10.1177/0300060519893166DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7645375PMC
April 2020

Hereditary angioedema with deep vein thrombosis and pulmonary thromboembolism during pregnancy.

Taiwan J Obstet Gynecol 2019 Nov;58(6):895-896

Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan.

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http://dx.doi.org/10.1016/j.tjog.2019.04.003DOI Listing
November 2019

Fetal umbilical cord cyst may evolve to omphalocele during pregnancy.

J Clin Ultrasound 2020 Mar 14;48(3):181-183. Epub 2019 Nov 14.

Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan.

Omphalocele is rarely complicated by umbilical cord cysts. In our case, an umbilical cord cyst and fetal ascites were detected at 26 weeks' gestation in a fetus with trisomy 13. This changed to omphalocele with subsequently absorbed fetal ascites at 35 weeks' gestation. We propose two hypotheses. The abdominal wall may have been physically pierced or an omphalocele might have preexisted, and the intestinal tract in the hernia sac was pushed by fetal ascites.
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http://dx.doi.org/10.1002/jcu.22786DOI Listing
March 2020

Subcycle mid-infrared coherent transients at 4  MHz repetition rate applicable to light-wave-driven scanning tunneling microscopy.

Opt Lett 2019 Nov;44(21):5350-5353

We produce subcycle mid-infrared (MIR) pulses at a 4 MHz repetition rate via the optical rectification (OR) of sub-10 fs near-infrared pulses delivered by an optical parametric chirped pulse amplifier. The coherent MIR pulses generated in a GaSe crystal under an ultrabroadband phase-matching condition contain only 0.58-0.85 oscillation cycles within the full width at half-maximum of the intensity envelope. The use of OR enables excellent phase stability of 56 mrad over 5.6 h, which is confirmed by field-resolved detection using electro-optic sampling. An electromagnetic simulation using a finite integration technique reveals that the peak field strength can easily exceed 10 V/nm owing to the field enhancement resulting from focusing MIR pulses onto a tunnel junction.
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http://dx.doi.org/10.1364/OL.44.005350DOI Listing
November 2019

Characteristics of labor-onset hypertension persist after neuraxial labor analgesia.

J Obstet Gynaecol Res 2020 Jan 16;46(1):104-109. Epub 2019 Oct 16.

Department of Obstetrics and Gynecology, Juntendo University, Tokyo, Japan.

Aim: This study aimed to investigate the rate of labor-onset hypertension (LOH) under neuraxial labor analgesia and the effect of neuraxial labor analgesia on LOH.

Methods: A retrospective study was conducted in a tertiary university hospital from 2015 to 2016. Patients who were admitted to the hospital for vaginal delivery under combined spinal and epidural anesthesia were selected. LOH was defined as the elevation of systolic blood pressure (BP) to ≥140 mmHg or diastolic BP to ≥90 mmHg for the first time after the onset of labor. Cases of LOH that persisted after neuraxial labor analgesia (prolonged LOH) were further analyzed to determine the hypertension severity and therapeutic intervention rate.

Results: Among 775 patients, 213 (28.4%) developed LOH. Prolonged LOH was observed in 30 patients (3.9%). LOH severity and the likelihood of prolonged LOH were positively correlated. Therapeutic intervention was administered only to the patients with prolonged LOH, that is, to 100% of those with emergent hypertension, to 21.1% of those with severe hypertension during labor, and to 36.8% of those with severe hypertension, to 55.6% of those with mild hypertension in the post-partum period.

Conclusion: The rate of LOH was reduced significantly after neuraxial labor analgesia. Patients with prolonged LOH should be carefully followed up during labor and in the post-partum period because such patients often require antihypertensive therapy.
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http://dx.doi.org/10.1111/jog.14140DOI Listing
January 2020

Management of disseminated intravascular coagulation associated with placental abruption and measures to improve outcomes.

Obstet Gynecol Sci 2019 Sep 23;62(5):299-306. Epub 2019 Jul 23.

Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan.

Placental abruption is a condition that should be carefully considered in perinatal management because it is associated with serious events in both the mother and neonate, such as intrauterine fetal death, cerebral palsy, obstetric critical bleeding, and uncontrollable bleeding. The concomitant presence of disseminated intravascular coagulation (DIC) more easily causes critical bleeding that may necessitate hysterectomy or multi-organ failure resulting in maternal death. Therefore, early management should be provided to prevent progression to serious conditions by performing both hemostatic procedures and DIC treatment. To take measures to improve the outcomes in both the mother and neonate, health guidance for pregnant women, early diagnosis, early treatment, development of the emergency care system, and provision of a system for transport to higher-level medical institutions should be implemented.
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http://dx.doi.org/10.5468/ogs.2019.62.5.299DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6737058PMC
September 2019

Glucose-responsive Insulinoma with Insulin Hypersecretion Suppressed by Metformin.

Intern Med 2019 Dec 28;58(24):3563-3568. Epub 2019 Aug 28.

Division of Nephrology and Diabetology, Narita Memorial Hospital (Meiyokai Medical Corporation), Japan.

In type 2 diabetes mellitus, metformin suppresses excessive insulin secretion in relation to the intake of glucose. We herein report the case of a 45-year-old man with glucose-responsive insulinoma whose responsive hypoglycemia was alleviated by metformin. The patient had a history of a postprandial loss of consciousness, resulting in hospital admission. He refused surgery and diazoxide administration. A 75-g oral glucose tolerance test after metformin administration revealed the suppression of glucose-responsive insulin hypersecretion and responsive hypoglycemia. Pancreatic head duodenectomy was performed, which alleviated the symptoms. Metformin administration in patients with glucose-responsive insulinoma may therefore be effective for preventing responsive hypoglycemia and hyperinsulinemia.
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http://dx.doi.org/10.2169/internalmedicine.3318-19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6949461PMC
December 2019

Selective Reduction Mechanism of Graphene Oxide Driven by the Photon Mode the Thermal Mode.

ACS Nano 2019 Sep 27;13(9):10103-10112. Epub 2019 Aug 27.

School of Science , Tokyo Institute of Technology , Tokyo 152-8551 , Japan.

A two-dimensional nanocarbon, graphene, has attracted substantial interest due to its excellent properties. The reduction of graphene oxide (GO) has been investigated for the mass production of graphene used in practical applications. Different reduction processes produce different properties in graphene, affecting the performance of the final materials or devices. Therefore, an understanding of the mechanisms of GO reduction is important for controlling the properties of functional two-dimensional systems. Here, we determined the average structure of reduced GO prepared heating and photoexcitation and clearly distinguished their reduction mechanisms using ultrafast time-resolved electron diffraction, time-resolved infrared vibrational spectroscopy, and time-dependent density functional theory calculations. The oxygen atoms of epoxy groups are selectively removed from the basal plane of GO by photoexcitation (photon mode), in stark contrast to the behavior observed for the thermal reduction of hydroxyl and epoxy groups (thermal mode). The difference originates from the selective excitation of epoxy bonds an electronic transition due to their antibonding character. This work will enable the preparation of the optimum GO for the intended applications and expands the application scope of two-dimensional systems.
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http://dx.doi.org/10.1021/acsnano.9b03060DOI Listing
September 2019

PUB4, a CERK1-Interacting Ubiquitin Ligase, Positively Regulates MAMP-Triggered Immunity in Arabidopsis.

Plant Cell Physiol 2019 Nov;60(11):2573-2583

Department of Life Sciences, School of Agriculture, Meiji University, Kawasaki, Kanagawa, Japan.

Lysin motif (LysM) receptor-like kinase CERK1 is a co-receptor essential for plant immune responses against carbohydrate microbe-associated molecular patterns (MAMPs). Concerning the immediate downstream signaling components of CERK1, receptor-like cytoplasmic kinases such as PBL27 and other RLCK VII members have been reported to regulate immune responses positively. In this study, we report that a novel CERK1-interacting E3 ubiquitin ligase, PUB4, is also involved in the regulation of MAMP-triggered immune responses. Knockout of PUB4 resulted in the alteration of chitin-induced defense responses, indicating that PUB4 positively regulates reactive oxygen species generation and callose deposition but negatively regulates MAPK activation and defense gene expression. On the other hand, detailed analyses of a double knockout mutant of pub4 and sid2, a mutant of salicylic acid (SA) synthesis pathway, showed that the contradictory phenotype of the pub4 mutant was actually caused by abnormal accumulation of SA in this mutant and that PUB4 is a positive regulator of immune responses. The present and recent findings on the role of PUB4 indicate that PUB4 is a unique E3 ubiquitin ligase involved in the regulation of both plant immunity and growth/development.
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http://dx.doi.org/10.1093/pcp/pcz151DOI Listing
November 2019

Adding "pregnancy" to the Centor score, aim to reduce maternal death.

J Infect Chemother 2019 10 26;25(10):835. Epub 2019 Jul 26.

Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan.

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http://dx.doi.org/10.1016/j.jiac.2019.07.012DOI Listing
October 2019

Evaluation of the Diabetes Regional Coordination Path using the Diabetes Coordination Notebook in community-based diabetes care.

Diabetol Int 2019 Jul 20;10(3):188-197. Epub 2018 Oct 20.

1Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194 Japan.

Aims: A number of epidemiologic surveys have demonstrated that improving lifestyle habits, providing patient education, and regular screening of patients for early diabetic symptoms and complications through multidisciplinary collaboration are crucial for the management of diabetes.

Methods: To evaluate the Diabetes Coordination Notebook and the Diabetes Regional Coordination Path in management of diabetes, 217 community pharmacies conducted a survey by questionnaire in Gifu Prefecture, Japan.

Results: A reply to the questionnaire was obtained from 27,016 individuals, of whom 5,572 claimed to have diabetes or prediabetes. The rate of usage of the Diabetes Coordination Notebook and the Diabetes Regional Coordination Path was 40% and 7%, respectively. Interestingly, patients using the Diabetes Regional Coordination Path more frequently visited an ophthalmic clinic (< 0.001) and a dental clinic (< 0.05) than those not using it. Furthermore, multivariate logistic regression analysis revealed that use of the Diabetes Regional Coordination Path was the only factor associated with control of HbA1c < 7.0% (OR: 0.613, 95% CI: 0.395-0.951, = 0.029).

Conclusions: The usage of the Diabetes Regional Coordination Path together with the Diabetes Coordination Notebook is associated not only with regular visits to both an ophthalmic clinic and a dental clinic but also with the maintenance of appropriate HbA1c.
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http://dx.doi.org/10.1007/s13340-018-0379-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6592995PMC
July 2019

An echelon-based single shot optical and terahertz Kerr effect spectrometer.

Rev Sci Instrum 2019 May;90(5):053107

Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, California 91125, USA.

We report on the design and performance of an echelon-based single shot visible/near-infrared spectrometer with adequate sensitivity to measure the nonlinear optical and terahertz Kerr effects in neat molecular liquids at room temperature. Useful molecular information spanning tens of picoseconds can be measured in just a few milliseconds, and the signal-to-noise performance scales favorably with respect to the standard stage scan technique. These results demonstrate the viability of stage-free nonlinear Kerr effect measurements and provide a route for improvements to the speed of future multidimensional Kerr effect studies.
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http://dx.doi.org/10.1063/1.5088377DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842322PMC
May 2019

Knowledge of diabetes and its determinants: a cross-sectional study among adults in a Japanese community.

BMJ Open 2019 05 30;9(5):e024556. Epub 2019 May 30.

Department of Diabetes and Endocrinology, Gifu University School of Medicine Graduate School of Medicine, Gifu, Japan.

Objective: To assess general knowledge of diabetes and its determinants among adult men and women in a Japanese community.

Setting: A cross-sectional study with the residential registry in Gifu City. Blood tests were conducted to measure fasting blood glucose levels and the levels after 2 hours of a 75-gram oral glucose load. Participants' previous diagnosis of diabetes and demographic status were identified from a questionnaire. A validated food frequency questionnaire was also administered. To assess the association between good knowledge of diabetes and the level of each factor, a logistic regression was utilised with adjustments for age, education and parental history of diabetes.

Participants: A total of 1019 men and women aged 40-78 years.

Primary Outcome Measure: The Diabetes Knowledge Questionnaire was administered. Participants with ≥75% of answers correct were defined as having a good knowledge of diabetes.

Results: Previous diagnosis of diabetes was significantly associated with good knowledge of diabetes (OR=2.36; 95% CI 1.19 to 4.68). Among individuals with no previous diagnosis of diabetes, age ≥60 years (OR=0.55; 95% CI 0.36 to 0.86, p value for trend=0.02) and education <12 years (OR=0.54; 95% CI 0.30 to 0.97) were significantly associated with low knowledge of diabetes. The highest tertile intakes of green-yellow vegetables (OR=1.77; 95% CI 1.07 to 2.91, p value for trend=0.03) and seafood (OR=1.76; 95% CI 1.04 to 2.95, p value for trend=0.03) were associated with high knowledge of diabetes.

Conclusions: Some diabetes risk factors were implied to determine the general knowledge of diabetes. Conducting further studies of knowledge in various populations is warranted.
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http://dx.doi.org/10.1136/bmjopen-2018-024556DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6549608PMC
May 2019

Periodontal Disease May be Associated With the Occurrence of Diabetic Retinopathy: A Subgroup Analysis of The Survey of the Diabetes Coordination Notebook in Gifu.

Exp Clin Endocrinol Diabetes 2020 Apr 11;128(4):231-238. Epub 2019 Apr 11.

Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, Gifu, Japan.

Aims: A questionnaire survey of the prevalence of diabetic retinopathy was recently conducted in Japan. A subgroup analysis to examine the association of periodontal disease with diabetic retinopathy in subjects with diabetes and prediabetes was conducted.

Methods: The association of the presence of periodontal disease with the occurrence of diabetic retinopathy was examined using multivariate logistic regression analysis.

Results: Of 27 016 subjects who completed a survey at 217 community pharmacies, 5 572 had diabetes or prediabetes, among whom 522 and 1 421 had retinopathy or periodontal disease, respectively. Therapy duration≥10 years (OR: 2.73, 95% CI: 2.17-3.43, P<0.001), periodontal disease (OR: 2.10, 95% CI: 1.68-2.62, P<0.001) and glycated hemoglobin (HbA1c) ≥ 7.0% (OR: 1.64, 95% CI: 1.32-2.04, P<0.001) were significantly associated with the occurrence of retinopathy, while retinopathy (OR: 2.11, 95% CI: 1.: 69-2.63, P<0.001) and therapy duration ≥10 years (OR: 1.24, 95% CI: 1.06-1.46, P=0.007) were significantly associated with the occurrence of periodontal disease. The prevalence of retinopathy was much higher in diabetic subjects with periodontal disease than in those without it (15.1% vs. 7.8%, P<0.001). Notably, the difference of prevalence of retinopathy between subjects with and without periodontal disease was statistically significant even at HbA1c 6.0-6.9% (15.2% vs. 7.3%, P<0.01).

Conclusions: These findings indicate that the target HbA1c level for diabetes patients with periodontal disease may be set lower than for those without it, and that regular dental visits should be prescribed for the management of periodontal disease and the prevention of diabetic retinopathy.
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http://dx.doi.org/10.1055/a-0879-1890DOI Listing
April 2020