Publications by authors named "Katsuyuki Kinoshita"

91 Publications

Current status of community-acquired infection of COVID-19 in delivery facilities in Japan.

PLoS One 2021 20;16(5):e0251434. Epub 2021 May 20.

Seijyo Kinoshita Hospital, Tokyo, Japan.

A nationwide questionnaire survey about community-acquired infection of coronavirus disease 2019 (COVID-19) was conducted in July 2020 to identify the characteristics of and measures taken by Japanese medical facilities providing maternity services. A case-control study was conducted by including medical facilities with (Cases) and without (Control) community-acquired infection of COVID-19. Responses from 711 hospitals and 707 private clinics were assessed (72% of all hospital and 59% all private clinics provided maternity service in Japan). Seventy-five COVID-19-positive pregnant women were treated in 52 facilities. Community-acquired infection was reported in 4.1% of the facilities. Of these, 95% occurred in the hospital. Nine patients developed a community-acquired infection in the maternity ward or obstetric department. Variables that associated with community-acquired infection of COVID-19 (adjusted odds ratio [95% confidence interval]) were found to be state of emergency prefecture (4.93 [2.17-11.16]), PCR test for SARS-CoV-2 on admission (2.88 [1.59-5.24]), and facility that cannot treat COVID-19 positive patients (0.34 [0.14-0.82]). In conclusion, community-acquired infection is likely to occur in large hospitals that treat a higher number of patients than private clinics do, regardless of the preventive measures used.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0251434PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8136647PMC
June 2021

Recent Prevalence of Human T-cell Leukemia Virus Type 1 Carrier Associated with Horizontal Transmission in Pregnant Japanese Women.

Jpn J Infect Dis 2021 Apr 30. Epub 2021 Apr 30.

Japanese Foundation for Sexual Health Medicine, Japan.

The current study was conducted to examine the number of human T-cell leukemia virus type 1 (HTLV-1) carrier and how horizontal transmission affects the prevalence of HTLV-1 carrier in pregnant Japanese women in 2019. We requested 2,214 obstetrical facilities to provide information of HTLV-1 tests in pregnant women who delivered in 2019. The estimated number of HTLV-1 carrier in pregnant Japanese women was 952. At least 10% or more of the HTLV-1 carriers were those due to horizontal transmission.
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http://dx.doi.org/10.7883/yoken.JJID.2021.097DOI Listing
April 2021

Current status of cervical cytology during pregnancy in Japan.

PLoS One 2021 7;16(1):e0245282. Epub 2021 Jan 7.

Japanese Foundation for Sexual Health Medicine, Tokyo, Japan.

In Japan, uterine cancer screening during pregnancy is subsidized by public funds. We examined the current status of the results of cervical cytology conducted during pregnancy in Japan. We requested 2,293 obstetrical facilities to provide information on cervical cytology in pregnant women who delivered between October 2018 and March 2019. A total of 1,292 obstetrical facilities responded, with valid information on a total of 238,743 women. The implementation rate of cervical cytology during pregnancy was 86.8% in Japan. The prevalence of abnormal cervical cytology during pregnancy was 3.3% in total and 4.9% using a spatula/brush with liquid-based cytology (LBC). The prevalence of positive high-risk human papillomavirus (HPV) in teenagers with atypical squamous cells of undetermined significance (ASC-US) was significantly higher than women of other ages (p < 0.01). Because HPV vaccine coverage has dropped to less than 1% in Japan, a further study with various conditions will be needed to improve the accuracy of cervical cancer screening during pregnancy.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0245282PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7790376PMC
May 2021

Effectiveness of human papillomavirus vaccination in young Japanese women: a retrospective multi-municipality study.

Hum Vaccin Immunother 2021 Apr 29;17(4):950-954. Epub 2020 Oct 29.

Seijyo Kinoshita Hospital, Tokyo, Japan.

In Japan, government support for human papillomavirus (HPV) vaccination began in November 2010. However, the mass media repeatedly reported on severe adverse events. The Japanese Ministry of Health, Labor and Welfare suspended proactive recommendations for HPV vaccines in June 2013. Japan's HPV vaccination rate dropped from 70% to less than 1% in 2017.We examined cervical cancer screening results in terms of abnormal cytology, histology, and HPV vaccination status among 11,903 women aged 20 to 25 y in the fiscal year 2015. The overall rate of HPV vaccination was 26.1% (3,112/11,903). Regarding cytology, the rate of atypical squamous cells of undetermined significance (ASC-US) or worse was 3.3% (103/3,112) in women who received HPV vaccination (vaccine (+) women) and 5.6% (496/8,791) in women who did not (vaccine (-) women). The rate of high-grade squamous intraepithelial lesion (HSIL) or worse was 0.26% (8/3,112) in vaccine (+) women and 0.81% (72/8,791) in vaccine (-) women. Regarding histology, the rate of cervical intraepithelial neoplasia 1 or worse (CIN1+) was 1.4% (42/3,112) in vaccine (+) women and 2.1% (178/8,791) in vaccine (-) women. The rates of CIN2+ and CIN3+ were similar regardless of vaccination. We found a significantly lower incidence of CIN in vaccine (+) women. These results suggest that the resumption of recommending HPV vaccination as primary prevention for cervical cancer is needed in Japan.
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http://dx.doi.org/10.1080/21645515.2020.1817715DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8018456PMC
April 2021

Declined use of cervical ripening balloon did not reduce the incidence of umbilical cord prolapse in Japan.

J Obstet Gynaecol Res 2020 Aug 17;46(8):1349-1354. Epub 2020 Jun 17.

Seijo-Kinoshita Hospital, Tokyo, Japan.

Aim: To clarify whether the incidence of umbilical cord prolapse (UCP) at delivery is related to the cervical ripening balloon (CRB).

Methods: A postal questionnaire study was conducted in 2018 in institutions providing maternity services across Japan. Questions on the number of deliveries, labor inductions, used CRB and cases of UCP in 2017 were included. Because a similar questionnaire survey was conducted in 2012, the incidence of UCP and frequency of the use of CRB were compared.

Results: A total of 1354 answers were assessed (57% of all delivery institutions). The total number of deliveries was 490 279. Of these, 78% were transvaginal; 74 cases of UCP were reported (0.015%), while 13 cases were reported from obstetric facilities never using CRB (0.008%). The incidence of UCP (odds ratio [95% confidence interval]) was 0.036% in the intracervical type (4.3 [1.6-11.3]), 0.091% in the disk-type (11.0 [4.2-29.0]) and 0.067% in the ball-type (8.1 [2.8-22.8]). Frequencies of the use of CRB were 7.3% and 6.6% in the 2012 and 2018 surveys, respectively. The use of the intracervical type increased from 2.8% in the 2012 survey to 3.5% in the 2018 survey, while that of the disk-type and ball-type declined. However, the incidence of UCP was not different between the two surveys regardless of the use of cervical ripening balloons (0.014% vs 0.015% with CRB, 0.005% vs 0.008% without CRB).

Conclusion: Although the frequency of CRB use significantly declined, the incidence of UCP did not significantly reduce in the last 5 years.
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http://dx.doi.org/10.1111/jog.14317DOI Listing
August 2020

Decline number of uterine fundal pressure maneuver in Japan recent 5 years.

J Obstet Gynaecol Res 2020 Mar 19;46(3):413-417. Epub 2020 Jan 19.

Seijo-Kinoshita Hospital, Tokyo, Japan.

Aim: To clarify whether the incidence of uterine fundal pressure (UFP) maneuver at delivery and consequent uterine rupture were declined.

Methods: Population-based postal questionnaire study was conducted. A questionnaire was sent to obstetric institutions across Japan. Questions were included the total number of deliveries, UFP and uterine ruptures associated with UFP in 2012 and 2017. As the primary outcome, frequencies of the UFP and uterine rupture were compared between 2012 and 2017. The secondary outcomes were included improved managements of delivery regarding UFP.

Results: A number of vaginal deliveries were significantly declined from 80.4% in 2012 to 78.1% in 2017 (P < 0.001). Frequencies of UFP per vaginal deliveries were also significantly declined 11.2% (38 973/347771) in 2012 to 9.5% (35 205/404444) in 2017 (<0.001). Number of uterine ruptures were 6 cases in 2012 (1:6496) and 11 cases in 2017 (1:3473) (P = 0.210). Compared to situation in 2012, informed consent was more frequently obtained for UFP in 2017. Written informed consent for UFP became to be obtained in 12% of institutions in 2017 from only 3% in 2012. More than 80% of institutions are performing UFP within 3 times. Regarding to uterine rupture, try of labor after the cesarean section, UFP and augmentation were improved in more than 10% of institutions. Most impact vehicle changing behavior was OBGY clinical guideline.

Conclusion: Although significant declined incidence of uterine rupture after UFP could not be demonstrated, frequency of UFP was decreased recent 5 years. This is due to improvement of obstetric management by obstetric caregivers throughout Japan.
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http://dx.doi.org/10.1111/jog.14203DOI Listing
March 2020

Decline in maternal death due to obstetric haemorrhage between 2010 and 2017 in Japan.

Sci Rep 2019 07 30;9(1):11026. Epub 2019 Jul 30.

Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan.

This descriptive study was based on the maternal death registration system established by the Japan Association of Obstetricians and Gynecologists and the Maternal Death Exploratory Committee (JMDEC). 361 women died during pregnancy or within 42 days after delivery between January 2010 and June 2017 throughout Japan were analysed, in order to investigate the trend in maternal deaths related to obstetric medical practice. Reports of maternal death were consistent, ranging from 45 cases in 2010 to 44 cases in 2017. Among all maternal deaths, the frequency of deaths due to obstetric haemorrhage ranged from 29% (2010) to 7% (2017) (p < 0.001). The causes of obstetric haemorrhage have progressively reduced, especially maternal deaths due to uterine inversion and laceration have not occurred since 2014. The remaining causes of obstetric haemorrhage-related maternal deaths were placenta accreta spectrum, placental abruption, and severe forms of uterine focused amniotic fluid embolism. We believe the activities of the JMDEC including annual recommendations and simulation programs are improving the medical practices of obstetric care providers in Japan, resulting in a reduction of maternal deaths due to obstetric haemorrhage.
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http://dx.doi.org/10.1038/s41598-019-47378-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6667693PMC
July 2019

Current status of Neisseria gonorrhoeae cervicitis in pregnant women in Japan.

PLoS One 2019 7;14(2):e0211595. Epub 2019 Feb 7.

Japanese Foundation for Sexual Health Medicine, Tokyo, JAPAN.

We evaluated the current prevalence of gonococcal cervicitis among pregnant women in institutes that either do or do not routinely screen for gonococcal infection in Japan. We requested 2,330 obstetrical facilities to provide information on Neisseria gonorrhoeae cervicitis in pregnant women. A total of 1,876 (80.5%) of them responded. The universal screening test for gonococcal cervicitis, involving nucleic acid amplification for all pregnant women, was performed in 281 institutes (13.9% of institutes across Japan). The total rate of pregnant women with gonococcal cervicitis was 1.3% in the institutes performing the screening test during pregnancy, while it was only 0.2% (p < 0.01) in those not performing it. This suggests that 84% of infected women may have been missed in the institutes that do not routinely perform the screening test for gonococcal cervicitis. It may be time to examine the cost-effectiveness of providing gonococcal screening for all pregnant women in Japan.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0211595PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366733PMC
November 2019

Current status of syphilis in pregnant women in Japan.

J Matern Fetal Neonatal Med 2017 Dec 14;30(23):2881-2883. Epub 2016 Dec 14.

b Japanese Foundation for Sexual Health Medicine , Tokyo , Japan.

We examined the current status of syphilis-infected pregnant Japanese women, according to the results of syphilis screening and confirmation tests of women who gave birth in Japan between October, 2015 and March, 2016. We requested 2458 obstetrical facilities to provide information of syphilis screening tests and 78.1% of them responded. Considering the response rate and the rate of implementation of confirmation tests, the number of syphilis-infected pregnant Japanese women was estimated to be 250 (1/4022) per year.
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http://dx.doi.org/10.1080/14767058.2016.1266477DOI Listing
December 2017

Current status of women requiring perinatal mental health care for protecting their children in Japan.

Asian J Psychiatr 2016 Aug 24;22:93. Epub 2016 May 24.

Japan Association of Obstetricians and Gynecologists, Tokyo, Japan.

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http://dx.doi.org/10.1016/j.ajp.2016.05.009DOI Listing
August 2016

Current Proportion of Women Receiving Perinatal Psychosocial or Psychological Intervention in Japan.

J Clin Med Res 2016 Jun 25;8(6):472-4. Epub 2016 May 25.

Japan Association of Obstetricians and Gynecologists, Tokyo, Japan.

Background: In this study, we examined the current status of psychosocial or psychological intervention for women during pregnancy and the postpartum period in Japan.

Methods: We estimated the number of women receiving perinatal psychosocial or psychological intervention in Japan. On December 2015, we requested 2,462 obstetrical facilities that are members of the Japan Association of Obstetricians and Gynecologists (JAOG) to provide information on women who received psychosocial or psychological intervention during pregnancy, the hospitalization period for childbirth and the puerperal 1 month in 2014. A total of 1,305 (53.0%) of the 2,462 obstetrical facilities responded with valid information on a total of 515,373 women, accounting for approximately 52% of all deliveries that occurred in Japan during the study period.

Results: The number of women who received psychosocial or psychological intervention during pregnancy, the hospitalization period for childbirth and the puerperal 1 month were 4,843 (0.94%), 4,791 (0.93%) and 3,015 (0.59%), respectively. In total, 8,743 women (1.70%) received psychosocial or psychological intervention in 2014.

Conclusion: Considering the response rate, the number of women requiring perinatal psychosocial or psychological intervention was estimated to be 16,000 per year in Japan.
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http://dx.doi.org/10.14740/jocmr2568wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852780PMC
June 2016

Current status of pregnancy-related maternal mortality in Japan: a report from the Maternal Death Exploratory Committee in Japan.

BMJ Open 2016 Mar 21;6(3):e010304. Epub 2016 Mar 21.

Mie University School of Medicine, Mie, Japan.

Objective: To clarify the problems related to maternal deaths in Japan, including the diseases themselves, causes, treatments and the hospital or regional systems.

Design: Descriptive study.

Setting: Maternal death registration system established by the Japan Association of Obstetricians and Gynecologists (JAOG).

Participants: Women who died during pregnancy or within a year after delivery, from 2010 to 2014, throughout Japan (N=213).

Main Outcome Measures: The preventability and problems in each maternal death.

Results: Maternal deaths were frequently caused by obstetric haemorrhage (23%), brain disease (16%), amniotic fluid embolism (12%), cardiovascular disease (8%) and pulmonary disease (8%). The Committee considered that it was impossible to prevent death in 51% of the cases, whereas they considered prevention in 26%, 15% and 7% of the cases to be slightly, moderately and highly possible, respectively. It was difficult to prevent maternal deaths due to amniotic fluid embolism and brain disease. In contrast, half of the deaths due to obstetric haemorrhage were considered preventable, because the peak duration between the initial symptoms and initial cardiopulmonary arrest was 1-3 h.

Conclusions: A range of measures, including individual education and the construction of good relationships among regional hospitals, should be established in the near future, to improve primary care for patients with maternal haemorrhage and to save the lives of mothers in Japan.
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http://dx.doi.org/10.1136/bmjopen-2015-010304DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809072PMC
March 2016

Current Status of Condylomata Acuminata in Pregnant Japanese Women.

Jpn J Infect Dis 2016 Jul 19;69(4):347-9. Epub 2016 Feb 19.

Japan Association of Obstetricians and Gynecologists.

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http://dx.doi.org/10.7883/yoken.JJID.2015.561DOI Listing
July 2016

Distribution of Chlamydia trachomatis Infection Determined by Nucleic Acid Amplification Tests in Pregnant Women in Japan.

Jpn J Infect Dis 2016 8;69(2):158-9. Epub 2016 Jan 8.

Japan Association of Obstetricians and Gynecologists.

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http://dx.doi.org/10.7883/yoken.JJID.2015.495DOI Listing
December 2016

Obstetric risk factors for umbilical cord prolapse: a nationwide population-based study in Japan.

Arch Gynecol Obstet 2016 09 29;294(3):467-72. Epub 2015 Dec 29.

Seijo-Kinoshita Hospital, Tokyo, Japan.

Objectives: To demonstrate the clinical course and the obstetric risk factors for umbilical cord prolapse.

Methods: The clinical course of reported cases of umbilical cord prolapse that occurred in Japan between 2007 and 2011 was retrospectively analyzed. The obstetric risk factors for umbilical cord prolapse were investigated by a nationwide population-based case-cohort study.

Results: Three hundred and sixty-nine cases (0.018 %) of fore-lying/prolapsed umbilical cord in 2,037,460 deliveries were analyzed. Most cases of fore-lying umbilical cord were diagnosed by an ultrasound scan (78 %), whereas umbilical cord prolapse was most frequently diagnosed by an internal examination (63 %). Umbilical cord prolapse was found to be significantly associated with the following factors: multiple pregnancy [odds ratio (OR) 3.57; 95 % confidence interval (CI) 2.60, 4.90], non-vertex presentation (OR 4.67; 95 %CI 3.73, 5.86), preterm labor (OR 2.28; 95 %CI 1.83, 2.83), premature rupture of membranes (OR 3.84; 95 %CI 3.10, 4.77), prolapsed amniotic bag (OR 12.31; 95 %CI 9.00, 16.85), polyhydramnios (OR 2.89; 95 %CI 1.49, 5.61), and a birth weight of <2500 g (OR 2.26; 95 %CI 1.84, 2.79).

Conclusion: The current study is the largest in Japan to demonstrate the obstetric clinical course and risk factors associated with umbilical cord prolapse. Prolapsed amniotic bag, labor and rupture of membrane during premature period, and fetal abnormal presentation induced by multiple pregnancy, and polyhydramnios were high risk situation for umbilical cord prolapse.
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http://dx.doi.org/10.1007/s00404-015-3996-3DOI Listing
September 2016

Clinical risk factors for poor neonatal outcomes in umbilical cord prolapse.

J Matern Fetal Neonatal Med 2016 16;29(10):1652-6. Epub 2015 Jul 16.

f Seijo-Kinoshita Hospital , Tokyo , Japan.

Objectives: To clarify the clinical risk factors associated with poor neonatal outcomes due to umbilical cord prolapse (UCP).

Methods: A postal questionnaire survey was attempted in Japan. The clinical risk factors and managements associated with poor neonatal outcomes were analyzed in cases of UCP treated in Japan.

Results: A total of 267 cases of UCP (out of 2 037 460 total deliveries) were analyzed. The rates of intrauterine death, neonatal death and survival with disability were 3.4%, 5.6% and 7.1%, respectively. The multivariate regression analysis for these poor neonatal outcomes revealed that the significant risk factors included a prolapsed amniotic sac (adjusted odds ratio (aOR), 4.49), preterm labor (aOR, 2.99) and replacement of the prolapsed umbilical cord into the uterus (aOR, 2.87). However, UCP that occurred during labor (aOR, 0.28) and emergency cesarean section (aOR, 0.11) were associated with a reduction in the rates of poor outcomes. The interval between the diagnosis of UCP and delivery was significantly longer in the infants with a poor outcome than intact survival (median 30 versus 24 min, p = 0.048).

Conclusion: An emergency cesarean section should be carried out immediately to ensure a better outcome for the infant.
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http://dx.doi.org/10.3109/14767058.2015.1058772DOI Listing
December 2016

Maternal Death Due to Stroke Associated With Pregnancy-Induced Hypertension.

Circ J 2015 26;79(8):1835-40. Epub 2015 May 26.

Department of Obstetrics and Gynecology, Showa University School of Medicine.

Background: The aim of this study was to clarify the clinical features of maternal death due to stroke associated with pregnancy-induced hypertension (PIH) in Japan.

Methods And Results: Reported maternal deaths occurring between 2010 and 2012 throughout Japan were analyzed by the Maternal Death Exploratory Committee. Among a total of 154 reports of maternal death, those due to stroke with (n=12) or without (n=13) PIH were compared. Cerebral stroke occurred more frequently in the third trimester and during the second stage of labor in deaths with PIH, whereas it occurred at any time point in deaths not involving PIH. Although 83% of patients with PIH who died had experienced initial symptoms in a hospital, more than half of them required maternal transport due to lack of medical resources. Among the patients without PIH, some vascular abnormalities were identified, but no evidence was found among the patients with PIH. In addition, 58% of PIH cases resulting in stroke were complicated by hemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome.

Conclusions: Appropriate management of PIH during pregnancy and labor, including anti-hypertensive therapy and early maternal transport to tertiary hospital, may reduce the maternal death rate.
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http://dx.doi.org/10.1253/circj.CJ-15-0297DOI Listing
April 2016

The use of balloons for uterine cervical ripening is associated with an increased risk of umbilical cord prolapse: population based questionnaire survey in Japan.

BMC Pregnancy Childbirth 2015 Jan 22;15. Epub 2015 Jan 22.

Seijo-Kinoshita Hospital, Tokyo, Japan.

Background: To clarify whether the use of balloons for cervical ripening is associated with the incidence of umbilical cord prolapse.

Methods: A postal questionnaire survey was distributed in Japan. Cases of umbilical cord prolapse occurring during labor in association with the use of balloons for cervical ripening between 2007 and 2011 in Japan were analyzed.

Results: Answers from 942 institutions were obtained. The subjects included 369 patients with fore-lying or prolapse of the umbilical cord among a total of 2,037,460 deliveries. Among the singleton vertex cases, fore-lying or prolapse of the umbilical cord during labor were observed in 88 (0.005%) of 1,891,189 deliveries not associated with the use of balloons for cervical ripening and in 93 (0.064%) of 146,271 deliveries associated with the use of balloons for cervical ripening (Odds ratio 13.67, 95% confidence interval 10.21, 18.30). All types of balloons were significantly associated with the occurrence of fore-lying or prolapse of the umbilical cord. A total of 39% of cases of umbilical cord prolapse occurred during manual or spontaneous balloon removal, while 53% of cases occurred after a while not directly associated with balloon removal.

Conclusion: The risk of umbilical cord prolapse was significantly increased during the use of balloons for cervical ripening, especially in cases involving the use of disk-type and ball-type balloons filled with large amounts of water.
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http://dx.doi.org/10.1186/s12884-015-0432-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310172PMC
January 2015

Uterine rupture after the uterine fundal pressure maneuver.

J Perinat Med 2015 Nov;43(6):785-8

Objective: To clarify the incidence of uterine fundal pressure at delivery and its effect on uterine rupture.

Study Design: A questionnaire was sent to 2518 institutions in Japan. We received a response from 1430.

Results: Of reporting institutions, 89.4% used fundal pressure in at least some of their deliveries. Among the 347,771 women who delivered vaginally in this study, 38,973 (11.2%) were delivered with the assistance of fundal pressure. There were six cases of uterine rupture associated with uterine fundal pressure, with one case resulting in maternal death secondary to amniotic fluid embolism.

Conclusion: Since uterine fundal pressure may potentially cause serious injury to either the mother and/or neonates, the indications for application need to be clearly elucidated, and obstetric care providers also need comprehensive education and training.
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http://dx.doi.org/10.1515/jpm-2014-0284DOI Listing
November 2015

Instruction of feeding methods to Japanese pregnant women who cannot be confirmed as HTLV-1 carrier by western blot test.

J Matern Fetal Neonatal Med 2014 Sep 24;27(13):1392-3. Epub 2013 Oct 24.

Department of Obstetrics and Gynecology, Japanese Red Cross Katshushika Maternity Hospital , Tateishi, Katsushika-ku , Japan and.

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http://dx.doi.org/10.3109/14767058.2013.852175DOI Listing
September 2014

Current status of HTLV-1 carrier in Japanese pregnant women.

J Matern Fetal Neonatal Med 2014 Feb 9;27(3):312-3. Epub 2013 Jul 9.

Department of Obstetrics and Gynecology, Japan Association of Obstetricians and Gynecologists , Tokyo , Japan.

We examined the current status of human T-cell leukemia virus type 1 (HTLV-1) carrier in Japanese pregnant women, according to the results of HTLV-1 screening and confirmation tests of women who gave birth in Japan in 2011. We requested 2642 obstetrical facilities to provide information of HTLV-1 tests and 71.3% of them responded. Considering the response rate and the rate of implementation of confirmation tests, the number of HTLV-1 carrier in Japanese pregnant women was estimated to be 1620 (0.16%) per year.
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http://dx.doi.org/10.3109/14767058.2013.814631DOI Listing
February 2014

Vascular, renal and placental effects on pregnant offspring of protein-restricted rat dams.

J Obstet Gynaecol Res 2011 Apr 27;37(4):343-51. Epub 2011 Jan 27.

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

Aim: Our previous study showed that a maternal low-protein diet induced hypertension and vascular dysfunction in rat offspring after day 175. In the present study, we hypothesized that these female offspring would develop hypertension in their own pregnancies even at ages less than 175 days because potential vascular dysfunction is exacerbated by the circulatory demands of pregnancy.

Material And Methods: Wistar rats were fed an isocaloric diet containing either 18% (control group) or 9% (low-protein group) casein throughout pregnancy. The female offspring were fed standard chow and mated between days 70 and 125. At the end of pregnancy, blood pressure was measured, and the uterine arteries were dissected and investigated with a wire myograph.

Results: Placental weights were significantly lower in offspring of the low-protein group versus control. There were no significant differences in blood pressure. Renal expression of AT1 receptor mRNA was greater, and of AT2 receptor was less, in the low-protein group versus control. Vasoconstriction of uterine arteries to phenylephrine and U46619 was increased in the low-protein group, and vasodilatation to sodium nitroprusside was also increased.

Conclusion: Low-protein diet induces vascular effects on female offspring in their pregnancy, in terms of increased uterine artery vasoconstriction. This may be compensated for by increased sensitivity to nitric oxide (NO), maintaining blood pressure normal in the face of the demands of pregnancy. Such renal and vascular effects, combined with placental size, may transmit risk of vascular dysfunction to subsequent generations.
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http://dx.doi.org/10.1111/j.1447-0756.2010.01351.xDOI Listing
April 2011

Induction of senescence by progesterone receptor-B activation in response to cAMP in ovarian cancer cells.

Gynecol Oncol 2009 May 10;113(2):270-6. Epub 2009 Feb 10.

Department of Molecular Genetics, Division of Molecular and Cell Therapeutics, Medical Institute of Bioregulation, Kyushu University, Fukuoka, Japan.

Objective: Progesterone receptor (PR) expression is a favorable prognostic marker in ovarian cancer. We previously demonstrated that the induction of PR-B by treatment with cAMP was associated with G0/G1 arrest of the cell cycle and growth inhibition in NIH 3T3 cells. In this study, we examined the effect of cAMP treatment on cell growth in Ras-transformed NIH3T3 cells and ovarian cancer cells.

Methods: 1) The levels of PR-B and cell cycle associated proteins (p21, p27 and Rb) following treatment with cAMP in the Ras-transformed NIH3T3 cells (K12V) and ovarian cancer cell lines (SKOV cells) were investigated by Western blots. 2) The effects of PR overexpression following treatment with cAMP or after infection of an adenovirus expressing PR-B on cell growth and tumorigenicity in a soft agar culture were examined.

Results: 1) Treatment with cAMP increased PR-B and p27 levels in K12V cells and inhibited cell growth by inducing premature senescence. Induction of senescence was specific to the transformed cells. 2) In SKOV cells, treatment with cAMP induced PR-B, p27 and p21 expression, reduced the level of phosphorylated Rb, caused accumulation of cells in the G0/G1 fraction of the cell cycle, and induced senescence. 3) Both anchorage-dependent and -independent SKOV cell growths were inhibited by cAMP treatment. 4) Induction of both the expression and transcriptional activity of PR-B is critical for the induction of senescence and suppression of tumorigenicity.

Conclusion: Treatment of cAMP, through activation of PR-B, induced senescence and suppressed tumorigenicity in ovarian cancer cells.
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http://dx.doi.org/10.1016/j.ygyno.2008.12.032DOI Listing
May 2009

NKG2A inhibits invariant NKT cell activation in hepatic injury.

J Immunol 2009 Jan;182(1):250-8

Department of Immunology, Niigata University School of Medicine, Niigata, Japan.

Activation of invariant NKT (iNKT) cells in the liver is generally regarded as the critical step for Con A-induced hepatitis, and the role of NK cell receptors for iNKT cell activation is still controversial. In this study we show that blockade of the NKG2A-mediated inhibitory signal with antagonistic anti-NKG2A/C/E mAb (20d5) aggravated Con A-induced hepatitis in wild-type, Fas ligand (FasL)-mutant gld, and IL-4-deficient mice even with NK cell and CD8 T cell depletion, but not in perforin-, IFN-gamma-, or IFN-gamma- and perforin-deficient mice. Consistently, 20d5 pretreatment augmented serum IFN-gamma levels and perforin-dependent cytotoxicity of liver mononuclear cells following Con A injection, but not their FasL/Fas-dependent cytotoxicity. However, blockade of NKG2A-mediated signals during the cytotoxicity effector phase did not augment cytotoxic activity. Activated iNKT cells promptly disappeared after Con A injection, whereas NK1(-) iNKT cells, which preferentially expressed CD94/NKG2A, predominantly remained in the liver. Pretreatment with 20d5 appeared to facilitate disappearance of iNKT cells, particularly NK1(-) iNKT cells. Moreover, Con A-induced and alpha-galactosylceramide-induced hepatic injury was very severe in CD94/NKG2A-deficient DBA/2J mice compared with CD94/NKG2A-intact DBA/2JJcl mice. Overall, these results indicated that a NKG2A-mediated signal negatively regulates iNKT cell activation and hepatic injury.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2841747PMC
http://dx.doi.org/10.4049/jimmunol.182.1.250DOI Listing
January 2009

Small cell carcinoma of the uterine cervix metastasizing to the bone marrow: a case report.

J Obstet Gynaecol Res 2008 Aug;34(4 Pt 2):692-5

Department of Obstetrics, School of Medicine, Juntendo University, Tokyo, Japan.

We report a case of small cell carcinoma (SmCC) of the uterine cervix that metastasized to the bone marrow. A 60-year-old woman with stage IIB SmCC of the cervix was treated with three courses of neoadjuvant chemotherapy followed by radical hysterectomy. Because of the presence of a large residual tumor, the patient underwent postoperative adjuvant chemotherapy. Two months after the last course of chemotherapy, severe pancytopenia developed, and erythroblastic cells were found in the peripheral blood. The hematological disorder was shown to be secondary to bone marrow metastasis, and no other metastases were found. The patient died of the disease 8 months after the initial diagnosis. This case suggests that SmCC of the cervix can metastasize to bone marrow, that such metastasis can occur in isolation and lead to severe pancytopenia, influencing the clinical course of the disease.
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http://dx.doi.org/10.1111/j.1447-0756.2008.00731.xDOI Listing
August 2008

[Legislation for setting up the committee to investigate medical safety].

Nihon Geka Gakkai Zasshi 2008 Sep;109 Suppl 3:21-5

Japan medical association, Japan.

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September 2008