Publications by authors named "Masakazu Terauchi"

50 Publications

Vasomotor symptoms, sleep problems, and depressive symptoms in community-dwelling Japanese women.

J Obstet Gynaecol Res 2021 Jul 18. Epub 2021 Jul 18.

Department of Women's Health, Tokyo Medical and Dental University, Tokyo, Japan.

Aim: To assess prevalence and characteristics of vasomotor symptoms in community-dwelling Japanese women.

Methods: These were cross-sectional analyses using data from the National Institute for Longevity Sciences-Longitudinal Study of Aging. The main outcome measures were prevalence and severity of hot flashes and sweating. Associations between hot flashes/sweating (slight, moderate, or severe vs none) and sleep problems were explored using logistic regression, with and without adjustment for age, daily physical activity, and number of urinations/night. Associations between hot flashes/sweating and sleep problems, depressive symptoms, and dietary variables were explored in logistic regression models or general linear models.

Results: A total of 1152 women between 40 and 91 years of age were enrolled. Hot flashes were reported by 24.5% of participants; with prevalence and severity highest in those 50-54 years or 2-5 years postmenopause. Sleep problems were reported 15 percentage points more frequently by women who reported hot flashes than by those without hot flashes. Adjusted odds ratios [95% CI] for difficulty in falling asleep and difficulty in sleeping through were 2.09 [1.565-2.796] and 2.07 [1.549-2.763]), respectively. Also, hot flashes were associated with higher risk of depressive symptoms (adjusted odds ratio [95% CI]: 2.99 [2.07-4.32]) and lower life satisfaction, self-esteem, and self-rated health status. A similar pattern was observed in women with and without sweating. No associations were found between hot flashes and dietary factors.

Conclusions: Clear associations were found between hot flashes and sleeping problems, even after adjusting for potential confounding factors. Women who reported hot flashes also reported worse mental and physical health than those who did not report hot flashes.
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http://dx.doi.org/10.1111/jog.14937DOI Listing
July 2021

Independent association of palpitation with vasomotor symptoms and anxiety in middle-aged women.

Menopause 2021 05 24;28(7):741-747. Epub 2021 May 24.

Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Tokyo, Japan.

Objective: Palpitation, or the sensation of rapid or irregular heartbeats, is common in menopausal women; however, the precise underlying mechanisms are unknown. We aimed to investigate factors associated with palpitation in middle-aged women.

Methods: Medical records of 394 women aged 40 to 59 years (108 premenopausal, 85 perimenopausal, and 201 postmenopausal) were analyzed cross-sectionally. Palpitation severity was estimated based on responses to the Menopausal Symptom Scale. Effects of background characteristics, including age, menopausal status, body composition, cardiovascular parameters, basal metabolism, physical fitness, lifestyle factors, vasomotor, and psychological symptoms on palpitation were assessed using multivariate logistic regression analysis. The association between autonomic nervous system activity and palpitation was also analyzed in 198 participants.

Results: Prevalence of palpitation by severity was as follows: none, 26.4%; mild, 32.7%; moderate, 29.4%; severe, 11.4%. In univariate analyses, the more severely the women were affected by palpitation, 1) the higher their systolic blood pressure, 2) the less exercise they performed, 3) the lower they scored in the sit-and-reach test, 4) the higher their vasomotor symptoms score in the Menopausal Health Related-Quality of Life questionnaire, and 5) the higher their Hospital Anxiety and Depression Scale. Multiple logistic regression analysis revealed that moderate to severe palpitation was independently associated with the vasomotor symptom score (adjusted odds ratio [95% confidence interval]: 1.18 [1.07-1.31]) and Hospital Anxiety and Depression Scale anxiety subscale score (1.19 [1.12-1.27]).

Conclusions: Rapid or irregular heartbeats are highly prevalent in middle-aged women. It is not associated with age, menopausal status, heart rate, arrhythmia, autonomic nervous system activity, caffeine, or alcohol consumption, but with vasomotor symptoms and anxiety.
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http://dx.doi.org/10.1097/GME.0000000000001776DOI Listing
May 2021

A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial to Investigate the Effects of Kamishoyosan, a Traditional Japanese Medicine, on Menopausal Symptoms: The KOSMOS Study.

Evid Based Complement Alternat Med 2021 26;2021:8856149. Epub 2021 Feb 26.

Department of Gynecology, Tokyo Kyosai Hospital, Tokyo, Japan.

Objective: The KOSMOS study, a multicenter, randomized, double-blind, placebo-controlled trial, investigated the effects and safety of kamishoyosan (TJ-24), a traditional Japanese medicine, in the treatment of climacteric disorder.

Methods: Japanese women with climacteric disorder were administered a placebo during a 4-week run-in period, after which they were classified as placebo responders (R group) if their score on the modified Questionnaire for the Assessment of Climacteric Symptoms in Japanese Women (m-QACS) with excitability and irritability as the primary outcome improved by ≥ 3 points and as placebo nonresponders (NR group) otherwise. Members of the NR group were randomly allocated to receive either TJ-24 or placebo. After 12 weeks, their m-QACS scores, anxiety and depression, sleep, and overall quality of life (QOL) were compared.

Results: The TJ-24 and placebo arms in the NR group included 20 patients each. The change in the m-QACS scores of members of the NR group for excitability and irritability at 12 weeks versus baseline was -3.1 ± 1.7 in the TJ-24 arm, a significant decrease, but compared with -2.7 ± 2.2 in the placebo arm, no significant difference was between two arms. However, the proportion of participants whose score improved by ≥3 points was significantly higher in the TJ-24 arm. In the subgroup analysis of premenopausal women, the changes in the score for excitability and irritability were significantly larger in the TJ-24 arm. The incidence of adverse drug reactions or adverse events did not differ between the two arms, and no serious events were reported.

Conclusion: Although no significant difference was identified for the primary outcome, a significantly higher proportion of patients who received TJ-24 displayed improvement. Its high level of safety and effects on excitability and irritability in premenopausal women suggest that TJ-24 may be a useful treatment.
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http://dx.doi.org/10.1155/2021/8856149DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7935592PMC
February 2021

The Diverse Efficacy of Food-Derived Proanthocyanidins for Middle-Aged and Elderly Women.

Nutrients 2020 Dec 15;12(12). Epub 2020 Dec 15.

Department of Women's Health, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo 113-8510, Japan.

Middle-aged and elderly women are affected by various symptoms and diseases induced by estrogen deficiency. Proanthocyanidins, widely present in many kinds of fruits and berries, have many beneficial effects, such as antioxidative, anti-inflammatory, and antimicrobial activities. We researched the effects of proanthocyanidins for middle-aged and elderly women, finding that it has been revealed in many clinical trials and cohort studies that proanthocyanidins contribute to the prevention of cardiovascular disease, hypertension, obesity, cancer, osteoporosis, and urinary tract infection, as well as the improvement of menopausal symptoms, renal function, and skin damage. Thus, proanthocyanidins can be considered one of the potent representatives of complementary alternative therapy.
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http://dx.doi.org/10.3390/nu12123833DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7765374PMC
December 2020

Effects of Chlorogenic Acids on Menopausal Symptoms in Healthy Women: A Randomized, Placebo-Controlled, Double-Blind, Parallel-Group Trial.

Nutrients 2020 Dec 7;12(12). Epub 2020 Dec 7.

Personal Health Care Products Research Laboratories, Kao Corporation, Tokyo 131-8501, Japan.

A reduction in estrogen levels in the perimenopausal and postmenopausal periods causes various symptoms in women, such as hot flushes, sweats, depression, anxiety, and insomnia. Chlorogenic acids (CGAs), which are phenolic compounds widely present in plants such as coffee beans, have various physiological functions. However, the effects of CGAs on menopausal symptoms are unknown. To examine the effects of CGAs on menopausal symptoms, especially hot flushes, a randomized, placebo-controlled, double-blind, parallel-group trial was conducted in healthy women. Eighty-two subjects were randomized and assigned to receive CGAs (270 mg) tablets or the placebo for 4 weeks. After 4 weeks of intake, the number of hot flushes, the severity of hot flushes during sleep, and the severity of daytime sweats decreased significantly in the CGA group compared to the placebo group. The modified Kupperman index for menopausal symptoms decreased significantly after 2 weeks in the CGA group compared to the placebo group. Adverse effects caused by CGAs were not observed. The results show that continuous intake of CGAs resulted in improvements in menopausal symptoms, especially hot flushes, in healthy women.
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http://dx.doi.org/10.3390/nu12123757DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7762261PMC
December 2020

Depressive Symptoms in Middle-Aged and Elderly Women Are Associated with a Low Intake of Vitamin B6: A Cross-Sectional Study.

Nutrients 2020 Nov 9;12(11). Epub 2020 Nov 9.

Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Tokyo 113-8510, Japan.

This study investigated the nutritional factors that are associated with anxiety and depressive symptoms in Japanese middle-aged and elderly women. We conducted a cross-sectional study with 289 study participants aged ≥40 years (mean age = 52.0 ± 6.9 years). Their dietary habits, menopausal status and symptoms, and varied background factors, such as body composition, lifestyle factors, and cardiovascular parameters, were assessed. Their anxiety and depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS), where scores of 0-7 points, 8-10 points, and 11-21 points on either the anxiety or depression subscales were categorized as mild, moderate, and severe, respectively. The dietary consumption of nutrients was assessed using a brief self-administered diet history questionnaire. The relationships between the moderate-to-severe anxiety/depressive symptoms and the dietary intake of 43 major nutrients were investigated using multivariate logistic regression analyses. After adjusting for age, menopausal status, and the background factors that were significantly related to depressive symptoms, moderate and severe depression was significantly inversely associated with only vitamin B6 (adjusted odds ratio per 10 μg/MJ in vitamin B6 intake = 0.89, 95% confidence interval = 0.80-0.99). A higher intake of vitamin B6 could help relieve depressive symptoms for this population.
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http://dx.doi.org/10.3390/nu12113437DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7697531PMC
November 2020

Guideline for Gynecological Practice in Japan: Japan Society of Obstetrics and Gynecology and Japan Association of Obstetricians and Gynecologists 2020 edition.

J Obstet Gynaecol Res 2021 Jan 4;47(1):5-25. Epub 2020 Nov 4.

Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Japan.

Nine years after the first edition of The Guideline for Gynecological Practice, which was jointly edited by The Japan Society of Obstetrics and Gynecology and The Japan Association of Obstetricians and Gynecologists, the 4th Revised Edition was published in 2020. The 2020 Guidelines includes 4 additional clinical questions (CQ), which brings the total to 99 CQ (12 on infectious disease, 29 on oncology and benign tumors, 29 on endocrinology and infertility and 29 on healthcare for women). Currently, a consensus has been reached on the Guidelines, and therefore, the objective of this report is to present the general policies regarding diagnostic and treatment methods used in standard gynecological outpatient care that are considered appropriate. At the end of each answer, the corresponding Recommendation Level (A, B, C) is indicated.
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http://dx.doi.org/10.1111/jog.14487DOI Listing
January 2021

Annual report of the Women's Health Care Committee, Japan Society of Obstetrics and Gynecology, 2020.

J Obstet Gynaecol Res 2021 Jan 21;47(1):52-62. Epub 2020 Oct 21.

Department of Women's Health, Tokyo Medical and Dental University, Tokyo, Japan.

Our committee was founded in 2010 with the goal of improving women's health. This academic year, we focused on five activities: cooperation between the departments of pediatric surgery and obstetrics and gynecology for the treatment of persistent cloaca and Mayer-Rokitansky-Küster-Hauser syndrome in Japan; assessment of the educational training of women's health-care advisers; increasing screening for breast and cervical cancer; conducting the Nationwide Survey of Prescribing Practices for the Treatment of Menopausal Symptoms; and preventing osteoporosis in survivors of gynecologic cancer. The activities of each subcommittee are detailed below. This report is based on the Japanese version of the annual report (Acta Obst Gynaec Jpn 2020;72(6):697-707).
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http://dx.doi.org/10.1111/jog.14417DOI Listing
January 2021

Severity of subjective forgetfulness is associated with high dietary intake of copper in Japanese senior women: A cross-sectional study.

Food Sci Nutr 2020 Aug 1;8(8):4422-4431. Epub 2020 Jul 1.

Department of Obstetrics and Gynecology Tokyo Medical and Dental University Bunkyo Tokyo Japan.

This study investigated the relationship between subjective forgetfulness and the dietary intake of various nutrients in middle-aged and senior women. A cross-sectional study of the first-visit records of 245 Japanese women aged 40 or over was performed. The severity of subjective forgetfulness was classified according to the Menopausal Health-Related Quality of Life Questionnaire: none and mild ("unforgetful") or moderate and severe ("forgetful"). Dietary consumption of nutrients was estimated using the brief-type self-administered diet history questionnaire. The associations between the severity of subjective forgetfulness and intake of 43 major nutrients were evaluated using multivariate logistic regression analysis separately performed for two age groups: middle-aged (40-54 years,  = 166) and senior (55 years or over,  = 79). No nutrients were found to be significantly associated with subjective forgetfulness in the middle-aged group. In senior women, a significant positive relationship between the intake of copper and forgetfulness was found (adjusted odds ratio per 10 mg/kJ increase in copper intake: 1.25; 95% confidence interval: 1.08-1.50). Thus, high copper intake is positively associated with the severity of forgetfulness in Japanese senior women. Reducing copper consumption could help improve this symptom in this population.
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http://dx.doi.org/10.1002/fsn3.1740DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7455963PMC
August 2020

Daily Coffee and Green Tea Consumption Is Inversely Associated with Body Mass Index, Body Fat Percentage, and Cardio-Ankle Vascular Index in Middle-Aged Japanese Women: A Cross-Sectional Study.

Nutrients 2020 May 11;12(5). Epub 2020 May 11.

Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo 113-8510, Japan.

This study aimed to investigate the links between coffee (CF)/green tea (GT) consumption and body composition/cardiovascular parameters in middle-aged Japanese women. We conducted a cross-sectional study of 232 Japanese women aged 40-65 years who had been referred to the menopause clinic of Tokyo Medical and Dental University Hospital between November 2007 and August 2017. Body composition, cardiovascular parameters, and CF/GT consumption frequency were evaluated on their initial visits, using a body composition analyzer, vascular screening system, and brief-type self-administered diet history questionnaire, respectively. We investigated the associations between variables using multivariate logistic regression. After adjustment for age, menopausal status, and other factors, daily CF consumption was inversely associated with high body mass index (BMI) (adjusted odds ratio, 0.14; 95% confidence interval, 0.14-0.96) and body fat percentage (BF%) (0.33; 0.14-0.82), and daily GT consumption with high BF% (0.36; 0.14-0.96). Daily CF + GT consumption was also inversely associated with high BMI (0.15; 0.05-0.50) and BF% (0.30; 0.12-0.74). In pre- and perimenopausal women, daily CF + GT consumption was inversely associated with high cardio-ankle vascular index (CAVI) (0.05; 0.003-0.743). In conclusion, daily CF/GT consumption was inversely associated with high BMI, BF%, and CAVI in middle-aged Japanese women.
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http://dx.doi.org/10.3390/nu12051370DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7284367PMC
May 2020

Management manual for cancer treatment-induced bone loss (CTIBL): position statement of the JSBMR.

J Bone Miner Metab 2020 Mar 4;38(2):141-144. Epub 2020 Feb 4.

Fujii Memorial Institute of Medical Sciences, Tokushima University, Tokushima, Japan.

Androgen deprivation therapy and aromatase inhibitors are known to cause a decrease in bone mineral density and an increase in fractures. Patients receiving these treatments have been shown to have a fracture risk equal to or greater than that of patients with osteoporosis with prevalent fractures. This manual was created to prevent fractures in patients with cancer treatment-induced bone loss with high fracture risks who cannot be treated under the current Japanese guideline for the prevention and treatment of osteoporosis. This manual recommends drug treatment for patients with BMD - 2.0 ≤ T score < - 1.5 with the family history of hip fracture or 15% or more 10-year probability of major osteoporotic fractures by FRAX; or in patients with BMD T score < - 2.0. It is important to verify whether the use of this manual can reduce fractures and improve the quality of life of patients with cancer treatment-induced bone loss by prospective studies.
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http://dx.doi.org/10.1007/s00774-020-01087-0DOI Listing
March 2020

Depressive symptoms at postpartum are associated with those at the second trimester of pregnancy and the antioxidant activity immediately after delivery.

J Psychosom Obstet Gynaecol 2020 Jan 6:1-7. Epub 2020 Jan 6.

Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Tokyo, Japan.

This study aimed to investigate whether depressive symptoms at postpartum are associated with oxidative stress and antioxidant activity, as well as the symptoms during pregnancy. This longitudinal study enrolled 84 women in their second trimester of pregnancy. Their depressive symptoms were assessed using Edinburgh postnatal depression scale (EPDS), and their oxidative stress and antioxidant activity were assessed using reactive oxygen metabolites/8-hydroxy-2'-deoxyguanosine and biological antioxidant potential (BAP) at around 26 and 36 weeks (time points 1 and 2) of gestation, and 3-6 days and 1 month (time points 3 and 4) postpartum. We evaluated the associations between EPDS at time point 4 and various parameters at the other time points. Multiple regression analysis revealed that EPDS at time point 1 (adjusted odds ratio: 1.06 per 0.1 point increase; 95% confidence interval [CI]: 1.03-1.11) and BAP at time point 3 (adjusted odds ratio: 0.93 per 10 μmol/L increase; 95% CI: 0.87-0.97) were independent predictors of EPDS at time point 4. Depressive symptoms at the second trimester of pregnancy and the antioxidant activity immediately after delivery could predict postpartum depression. UMIN-CTR UMIN000022367.
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http://dx.doi.org/10.1080/0167482X.2019.1709817DOI Listing
January 2020

Effects of Grape Seed Proanthocyanidin Extract on Vascular Endothelial Function in Participants with Prehypertension: A Randomized, Double-Blind, Placebo-Controlled Study.

Nutrients 2019 Nov 20;11(12). Epub 2019 Nov 20.

Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.

This study aimed to investigate the effects of grape seed proanthocyanidin extract (GSPE) on blood pressure and vascular endothelial function in middle-aged Japanese adults with prehypertension. We conducted a randomized, double-blind, placebo-controlled study on 6 men and 24 women aged 40-64 years old. The participants were randomized to receive tablets containing either low-dose (200 mg/day) or high-dose (400 mg/day) GSPE, or placebo, for 12 weeks. Systolic and diastolic blood pressures (SBP and DBP, respectively), brachial flow-mediated dilation (FMD), and other cardiovascular parameters were measured before and after 4, 8, and 12 weeks of treatment. The mean SBP in the high-dose group significantly decreased by 13 mmHg after 12 weeks ( = 0.028), although FMD did not change. In an ad hoc analysis of non-smoking participants ( = 21), the mean SBP, DBP, stiffness parameter β, distensibility, incremental elastic modulus (Einc), and pulse wave velocity (PWV) also significantly improved in the high-dose group after 12 weeks. Changes in Einc and PWV from baseline to 12 weeks were significantly greater in the high-dose group than in the placebo group (Einc, = 0.023; PWV, = 0.03). GSPE consumption could help maintain vascular elasticity and normal blood pressure in this population.
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http://dx.doi.org/10.3390/nu11122844DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6950399PMC
November 2019

Bone Mineral Density in Premenopausal Women Is Associated with the Dietary Intake of α-Tocopherol: A Cross-Sectional Study.

Nutrients 2019 Oct 15;11(10). Epub 2019 Oct 15.

Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo 113-8510, Japan.

This study aimed to investigate the relationship between the consumption of various nutrients and bone mineral density (BMD) in middle-aged women. This cross-sectional survey was conducted based on the clinical records of 157 women aged 38-76. Their lumbar spine BMD was measured with dual-energy X-ray absorptiometry and dietary habits were assessed with the brief-type self-administered diet history questionnaire. Participants were divided into premenopausal ( = 46) and postmenopausal ( = 111) groups and the correlation between the BMD Z-score (Z-score) and the intakes of 43 nutrients was investigated separately for each group. In premenopausal women, the daily intake of ash, calcium, and α-tocopherol was positively correlated with the Z-score (Pearson's correlation coefficient, = 0.31, 0.34, 0.33, = 0.037, 0.020, 0.027, respectively). When dividing the consumption of ash, calcium, and α-tocopherol into low, middle, and high tertiles, the Z-score significantly differed only between the α-tocopherol tertiles. After adjustment for age, body mass index, and lifestyle factors, daily intake of α-tocopherol remained significantly associated with the Z-score (regression coefficient = 0.452, = 0.022). No nutrient was found to be significantly correlated with the Z-score in postmenopausal women. Increase in the intake of α-tocopherol could help maintain bone mass in premenopausal women.
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http://dx.doi.org/10.3390/nu11102474DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6835764PMC
October 2019

Unsalted tomato juice intake improves blood pressure and serum low-density lipoprotein cholesterol level in local Japanese residents at risk of cardiovascular disease.

Food Sci Nutr 2019 Jul 15;7(7):2271-2279. Epub 2019 May 15.

Department of Obstetrics and Gynecology Tokyo Medical and Dental University Tokyo Japan.

The aim of this study was to investigate the effects of unsalted tomato juice intake on cardiovascular risk markers in local Japanese residents. Four hundred and eighty-one local residents in Kuriyama, Japan, were enrolled in this study. Throughout the year of the study, they were provided with as much unsalted tomato juice as they wanted. Participants were screened for cardiovascular risk markers, such as blood pressure (BP), serum lipid profile, and glucose tolerance, before and after the study period. Of the study participants, 260 participated in a detailed study of their lifestyle factors. The average ages of the 184 male and 297 female participants were 56.3 ± 13.3 (mean ± ) and 58.4 ± 11.7 years, respectively. BP in 94 participants with untreated prehypertension or hypertension was significantly lowered (systolic BP, 141.2 ± 12.1-137.0 ± 16.3 mmHg,  = 0.003; diastolic BP, 83.3 ± 10.1-80.9 ± 11.1 mmHg,  = 0.012, paired test). Further, the serum low-density lipoprotein cholesterol (LDL-C) level in 125 participants with untreated dyslipidemia significantly decreased (155.0 ± 23.2-149.9 ± 25.0 mg/dl,  = 0.005, paired test). These beneficial effects were not different between sexes and among the different age groups. No significant difference in lifestyle was found before and after the study. Unsalted tomato juice intake improved systolic and diastolic BP and serum LDL-C level in local Japanese residents at risk of cardiovascular conditions.
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http://dx.doi.org/10.1002/fsn3.1066DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6657743PMC
July 2019

Guidelines for office gynecology in Japan: Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG) 2017 edition.

J Obstet Gynaecol Res 2019 Apr 24;45(4):766-786. Epub 2019 Jan 24.

Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan.

Six years after the first edition of The Guideline for Gynecological Practice, which was jointly edited by The Japan Society of Obstetrics and Gynecology and The Japan Association of Obstetricians and Gynecologists, the third revised edition was published in 2017. The 2017 Guidelines includes 10 additional clinical questions (CQ), which brings the total to 95 CQ (12 on infectious disease, 28 on oncology and benign tumors, 27 on endocrinology and infertility and 28 on healthcare for women). Currently a consensus has been reached on the Guidelines and therefore the objective of this report is to present the general policies regarding diagnostic and treatment methods used in standard gynecological outpatient care that are considered appropriate. At the end of each answer, the corresponding recommendation level (A, B, C) is indicated.
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http://dx.doi.org/10.1111/jog.13831DOI Listing
April 2019

[The effects of pregnancy and lactation on bone and mineral metabolism.]

Clin Calcium 2019;29(1):35-38

Department of Women's Health, Tokyo Medical and Dental University, Tokyo, Japan.

To meet the fetus's calcium demand in the 3rd trimester as much as 300~500 mg/day, intestinal calcium absorption in pregnant women is upregulated, without comparable increase in bone resorption. On the contrary, to provide 210 mg/day of calcium for the neonate, bone resorption by osteoclasts and osteocytes is markedly upregulated in maternal skeleton caused by low estrogen and high PTHrP as a consequence of elevated prolactin production, without any increase in intestinal calcium absorption. Breastfeeding women lose 5~10%of trabecular bone during 3 to 6 months of lactation.
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http://dx.doi.org/CliCa19013538DOI Listing
August 2019

Dizziness in peri- and postmenopausal women is associated with anxiety: a cross-sectional study.

Biopsychosoc Med 2018 12;12:21. Epub 2018 Dec 12.

2Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo, 113-8510 Japan.

Background: Although dizziness is one of the most common symptoms of menopause, the underlying mechanism is not precisely known. Therefore, this study aimed to investigate the prevalence of, and the factors associated with, dizziness in peri- and postmenopausal women.

Methods: We conducted a cross-sectional study in which we analyzed the first-visit records of 471 Japanese women aged 40 to 65 years who enrolled in a health and nutrition education program at a menopause clinic. The prevalence of dizziness was estimated according to the participants' responses to the Menopausal Health-Related Quality of Life Questionnaire. The background characteristics of age, menopause status, body composition, cardiovascular parameters, basal metabolism, and physical fitness; other menopausal symptoms, including vasomotor, insomnia, depression, and anxiety symptoms; and lifestyle characteristics were assessed for their associations with dizziness.

Results: The percentage of women who suffered from dizziness once a week or more frequently was 35.7%. Compared to the women without dizziness, those with the symptom were younger; had a higher body weight, body mass index, body fat percentage, muscle mass, and waist-to-hip ratio; had higher systolic pressure; were slower in reaction time; had higher physical and psychological symptom scores of menopause; exercised less regularly; and consumed less alcohol. A multivariate logistic regression analysis revealed that the anxiety symptom, which was evaluated by the Hospital Anxiety and Depression Scale, was the sole factor that was independently associated with dizziness (adjusted odds ratio 1.14; 95% confidence interval 1.08-1.20).

Conclusions: Dizziness is highly prevalent in Japanese peri- and postmenopausal women and it is associated with anxiety. The treatment of anxiety in this population might improve the symptom.
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http://dx.doi.org/10.1186/s13030-018-0140-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6291970PMC
December 2018

Muscle and joint pains in middle-aged women are associated with insomnia and low grip strength: a cross-sectional study.

J Psychosom Obstet Gynaecol 2020 03 6;41(1):15-21. Epub 2018 Nov 6.

Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan.

Although muscle and joint pains are among the most common symptoms in menopausal transition, their underlying mechanisms are not precisely known. This study aimed to investigate the factors associated with myalgia and arthralgia in middle-aged women. We analyzed in a cross-sectional manner the first-visit records of 305 Japanese women aged 40-59 years who enrolled in a health and nutrition education program at a menopause clinic. The prevalence of muscle and joint pains was estimated according to the participants' responses to the Menopausal Health-Related Quality of Life Questionnaire. Background characteristics including age, menopause status, body composition, cardiovascular parameters and physical fitness, as well as other menopausal symptoms including vasomotor symptoms, insomnia, depression and anxiety, were assessed for associations with daily myalgia and arthralgia. The percentage of women who were bothered by muscle and joint pains almost every day of the previous week was 56.1%. Characteristics associated with these symptoms were: low stature; high body fat percentage; low grip strength; and high vasomotor, insomnia, depression and anxiety symptom scores. Multivariate logistic regression analysis revealed that independently associated factors (adjusted odds ratio [95% confidence interval]) for daily myalgia/arthralgia were low hand-grip strength (kgf) (0.92 [0.87-0.97]) and insomnia symptom score (1.20 [1.07-1.34]). Muscle and joint pains are highly prevalent in Japanese middle-aged women. Low grip strength and insomnia are independently associated with these symptoms. Treatment of insomnia in this population might improve myalgia/arthralgia, and in turn, help restore grip strength, or treatment of hand pain might conversely reduce insomnia in addition to improvement in grip strength.
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http://dx.doi.org/10.1080/0167482X.2018.1530211DOI Listing
March 2020

Normal/high-fat milk consumption is associated with higher lean body and muscle mass in Japanese women aged between 40 and 60 years: a cross-sectional study.

BMC Womens Health 2018 02 2;18(1):32. Epub 2018 Feb 2.

Departmant of Obstetrics and Gynecology, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo, 113-8510, Japan.

Background: Milk is known to contain various nutrients that may have health benefits for postmenopausal women who are at an increased risk of cardiovascular and musculoskeletal diseases. We investigated the association between normal/high- and low-fat milk consumption and body composition in Japanese women aged 40 to 60 years.

Methods: This cross-sectional study used the baseline data collected in a previous study that examined the effects of a dietary supplement on a variety of health parameters in 85 Japanese women aged 40 to 60 years. Participants had been assessed for age, menopausal status, lifestyle factors, and body composition. We estimated the consumption of normal/high- and low-fat milk using a brief-type self-administered diet history questionnaire (BDHQ). Normal/high- and low-fat milk intake were classified as consumer (drank milk at least twice a week) or non-consumer (drank milk at most once a week), in order to identify the parameters that were independently associated with the consumption of normal/high- and low-fat milk.

Results: Of the 85 participants who completed the BDHQ, 27 were categorized as non-consumers, 18 as exclusive low-fat milk consumers, and 29 as exclusive normal/high-fat milk consumers. 11 women who consumed both low-fat and normal/high-fat milk were excluded from the analysis. Compared with non-consumers and exclusive low-fat milk consumers, exclusive high-fat milk consumers had significantly higher lean body mass (mean ± standard deviation [SD], 39.4 ± 2.7 kg vs. 37.9 ± 2.2 kg and 37.6 ± 2.9 kg, P < 0.05) and muscle mass (mean ± SD, 37.2 ± 2.5 kg vs. 35.8 ± 2.0 kg and 35.5 ± 2.7 kg, P < 0.05). Both lean body and muscle masses were significantly correlated with vitamin D intake from milk (Pearson r = 0.29, P = 0.008, and Pearson r = 0.29, P = 0.008, respectively).

Conclusion: Normal/high-fat milk consumption was associated with higher lean body and muscle mass in middle-aged Japanese women presumably through high vitamin D intake.
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http://dx.doi.org/10.1186/s12905-018-0525-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5796600PMC
February 2018

Effect of soy lecithin on fatigue and menopausal symptoms in middle-aged women: a randomized, double-blind, placebo-controlled study.

Nutr J 2018 01 8;17(1). Epub 2018 Jan 8.

Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo, 113-8510, Japan.

Background: Lecithin is a complex mixture of phospholipids which compose lipid bilayer cell membranes. Lipid replacement therapy, or administration of phospholipids for the purpose of repairing the dmaged cell membranes, had been shown to alleviate fatigue. The present study aimed to investigate the effect of soy lecithin on fatigue in middle-aged women, as well as other menopausal symptoms and various health parameters.

Methods: This randomized, double-blind, placebo-controlled study included 96 women aged 40 to 60 years who complained of fatigue. The participants were randomized to receive active tablets containing high-dose (1200 mg/day; n = 32) or low-dose (600 mg/day; n = 32) soy lecithin, or placebo (n = 32), for 8 weeks. The following parameters were evaluated: age, menopausal status, lifestyle factors, physical and psychological symptoms of menopause, subjective symptoms of insomnia and fatigue, body composition, cardiovascular parameters, and physical activities and objective sleep states obtained from actigraphy before and 4 and 8 weeks after treatment. Fatigue was evaluated using the Profile of Mood States (POMS)-brief, Menopausal Health-Related Quality of Life questionnaire, Chalder Fatigue Scale, and Brief Fatigue Inventory.

Results: Eighty-nine women completed the study. There were no significant differences in the changes in Chalder Fatigue Scale score (placebo vs low-dose vs high-dose groups: -2.9 ± 1.1, -3.2 ± 1.1, and -3.5 ± 1.0; P = 0.79). On the other hand, the improvements were greater in the high-dose group compared with the placebo group concerning vigor scores in the POMS-brief (1.9 ± 0.7 vs 0.2 ± 0.6; P = 0.02), diastolic blood pressure (-4.1 ± 1.8 vs 1.2 ± 1.9; P = 0.05), and cardio-ankle vascular index (-0.4 ± 0.2 vs 0.07 ± 0.1; P = 0.03) after 8 weeks of treatment.

Conclusions: High-dose (1200 mg/day) soy lecithin not only increases vigor, but also lowers the diastolic blood pressure and cardio-ankle vascular index in middle-aged women who present with fatigue.

Trial Registration: UMIN-CTR UMIN000017127 .
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http://dx.doi.org/10.1186/s12937-018-0314-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5757297PMC
January 2018

Higher intake of cryptoxanthin is related to low body mass index and body fat in Japanese middle-aged women.

Maturitas 2017 Feb 16;96:89-94. Epub 2016 Nov 16.

Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo 113-8510, Japan. Electronic address:

Objectives: The prevalence of cardiovascular diseases increases with age, especially in postmenopausal women. In this study, we investigated the dietary patterns associated with body mass and body fat in Japanese middle-aged women.

Study Design: Cross-sectional.

Main Outcome Measures: This study used baseline data collected in a previous study in 88 women aged 40-60 years. Participants were assessed for age, menopausal status, lifestyle factors, body composition, and dietary habits using a brief-type self-administered diet history questionnaire, which provides information on the amounts of nearly 100 nutritional factors consumed during the previous month. Classifying body mass index (BMI) as low (≤22kg/m) or high (>22kg/m) and percentage body fat as low (≤25%) or high (>25%), we sought to identify the nutritional factors associated with BMI and percentage body fat.

Results: Consumption differences between high/low BMI and high/low body fat percentage groups were not significant for any nutritional factors except cryptoxanthin. Multiple logistic regression analysis adjusting for age, menopausal status, working, exercise, and smoking revealed that higher cryptoxanthin intake was associated with low BMI (adjusted odds ratio, 1.22 per 100μg/day increase of cryptoxanthin intake; 95% confidence interval, 1.01-1.52) and low body fat percentage (adjusted odds ratio, 1.36 per 100μg/day increase of cryptoxanthin intake; 95% confidence interval, 1.13-1.70).

Conclusions: Higher intake of cryptoxanthin was shown to be related to low body mass and body fat in Japanese middle-aged women.
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http://dx.doi.org/10.1016/j.maturitas.2016.11.008DOI Listing
February 2017

[Pharmacokinetics of selective estrogen receptor modulators(SERMs).]

Clin Calcium 2016;26(11):1571-1581

Department of Women's Health, Tokyo Medical and Dental University, Japan.

Selective estrogen receptor modulators(SERMs), or estrogen receptor agonists/antagonists(ERAAs), are a class of compounds that function as estrogen receptor(ER)agonists or antagonists tissue-dependently. Two types of SERMs are currently used in Japan to treat osteoporosis, raloxifene(RLX:Evista)and bazedoxifene(BZA:Viviant). This article describes the pharmacokinetics of these two drugs.
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http://dx.doi.org/CliCa161115711581DOI Listing
March 2017

Depressive symptoms are associated with oxidative stress in middle-aged women: a cross-sectional study.

Biopsychosoc Med 2016 26;10:12. Epub 2016 Apr 26.

Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo, 113-8510 Japan.

Background: Oxidative stress is known to be a factor in various diseases. In this study, we investigated whether physical and psychological symptoms of menopause, cardiovascular parameters, body composition, and lifestyle factors are associated with oxidative stress in middle-aged women.

Methods: This cross-sectional study used baseline data collected in a previous study that examined the effects of a dietary supplement on a variety of health parameters in 95 women aged 40 to 60 years. Participants had been assessed for age, menopausal status, body composition, cardiovascular parameters, physical and psychological symptoms of menopause, and lifestyle factors. Urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) level, an oxidative stress marker, had also been measured. Dichotomizing 8-OHdG levels as low (≤25 ng/mg creatinine) and high (>25 ng/mg creatinine), we sought to identify the health parameters that are associated with high 8-OHdG level.

Results: Women with a high 8-OHdG level had lower body weight, lower body mass index, lower body fat mass, higher body temperature, scored higher for both anxiety and depression on the Hospital Anxiety and Depression Scale (HADS), and consumed more alcohol. Multiple logistic regression analysis revealed that the HADS-depression subscale (HADS-D) score was the sole independent contributor to high 8-OHdG level (adjusted odds ratio, 1.23 per point increase in HADS-D score; 95 % confidence interval, 1.06-1.45).

Conclusion: Depressive symptom score was shown to be independently associated with high 8-OHdG level in middle-aged women, suggesting a link between mood disorder and oxidative stress.

Trial Registration: UMIN-CTR UMIN000009353.
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http://dx.doi.org/10.1186/s13030-016-0066-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4845355PMC
April 2016

Low-dose isoflavone aglycone alleviates psychological symptoms of menopause in Japanese women: a randomized, double-blind, placebo-controlled study.

Arch Gynecol Obstet 2016 Mar 21;293(3):609-15. Epub 2015 Aug 21.

Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo, 113-8510, Japan.

Purpose: Many studies have demonstrated the effectiveness of isoflavones on menopausal symptoms; however, these mostly used high dosages. Because high-dose isoflavone may result in endometrial hyperplasia, we investigated whether low-dose isoflavone aglycone alleviates menopausal symptoms similarly to high dosages.

Methods: We conducted a randomized, double-blind, placebo-controlled study in 90 healthy women aged 40-60 years who had at least one menopausal symptom on the Menopausal Symptom Scale (MSS). The participants were randomized to receive active tablets containing ultralow-dose (12.5 mg/day; n = 30) or low-dose (25 mg/day; n = 30) isoflavone aglycone, or placebo (n = 30) tablets, for 8 weeks. Their menopausal symptoms were evaluated using MSS, Hospital Anxiety and Depression Scale (HADS), and Athens Insomnia Scale (AIS) before, and 4 and 8 weeks after treatment.

Results: Eighty-seven women (97 %) completed the 8-week treatment. In the low-dose group, significant improvement was observed from baseline, in the following parameters: (1) HADS-depression subscale score, (2) AIS score, (3) MSS-somatic symptom score after 4 and 8 weeks of treatment, and (4) MSS-vasomotor symptom score after 8 weeks of treatment. The changes in scores on HADS-depression subscale and AIS from baseline to 8 weeks were significantly higher in the low-dose group than in the placebo group.

Conclusions: Low-dose (25 mg/day) isoflavone aglycone significantly alleviated symptoms of depression and insomnia in Japanese middle-aged women. Clinical Trial Registration UMIN-CTR UMIN000011876.
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http://dx.doi.org/10.1007/s00404-015-3849-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4757620PMC
March 2016

Tomato juice intake increases resting energy expenditure and improves hypertriglyceridemia in middle-aged women: an open-label, single-arm study.

Nutr J 2015 Apr 8;14:34. Epub 2015 Apr 8.

Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo, 113-8510, Japan.

Background: Tomato-based food products have health-promoting and disease-preventing effects. Some tomato juice ingredients may have health benefits for middle-aged women, including women with menopausal symptoms and cardiovascular diseases. We investigated the net effect of tomato juice intake on several health parameters in women in this age group.

Methods: An open-label, single-arm study was conducted, involving 95 women (40-60-years-old) who had at least one menopausal symptom. The participants refrained from foods and drinks rich in tomato and tomato-based products for 2 weeks prior to the study and during the 8 weeks of tomato juice consumption. After the run-in period, the women were asked to consume 200 mL of unsalted tomato juice, twice daily for 8 weeks. Their menopausal symptoms were evaluated using the Menopausal Symptom Scale (MSS), Hospital Anxiety and Depression Scale (HADS), and Athens Insomnia Scale (AIS) before the study, and at 4 and 8 weeks after study commencement. At the same times, body composition; blood pressure; heart rate; resting energy expenditures (REEs); and serum levels of triglyceride (TG), cholesterol, glucose, and hemoglobin A1c were measured.

Results: Ninety-three women (98%) completed the study. The following parameters showed significant changes, compared with baseline, at study weeks 4 and 8 (mean ± standard deviation at baseline, week 4, and week 8): (1) the MSS score improved (9.9 ± 5.2, 8.5 ± 5.0, 8.3 ± 5.0; P < 0.0001, repeated measures analysis of variance(ANOVA)), (2) the HADS-anxiety subscale score improved (5.3 ± 2.7, 4.8 ± 2.4, 4.9 ± 2.9; P = 0.041, Friedman test), (3) heart rate increased (62.6 ± 9.4 bpm, 64.4 ± 8.6 bpm, 63.8 ± 8.2 bpm; P = 0.028, Friedman test), (4) REE increased (1980 ± 368 kcal/day, 2108 ± 440 kcal/day, 2149 ± 470 kcal/day; P = 0.0030, repeated measures ANOVA), (5) serum TG level decreased in the subgroup of women (n = 22) who had high TG (150 mg/dL or higher) at baseline (237.8 ± 88.9 mg/dL, 166.7 ± 86.1 mg/dL, 170.9 ± 109.7 mg/dL; P = 0.0002, Friedman test).

Conclusions: Tomato juice intake alleviated menopausal symptoms, including anxiety, increased REEs and heart rate, and lowered high baseline serum TG levels in middle-aged women.

Trial Registration: UMIN-CTR UMIN000011877 .
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http://dx.doi.org/10.1186/s12937-015-0021-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4406031PMC
April 2015

Prevalence and predictors of storage lower urinary tract symptoms in perimenopausal and postmenopausal women attending a menopause clinic.

Menopause 2015 Oct;22(10):1084-90

1Department of Women's Health, Tokyo Medical and Dental University, Tokyo, Japan 2Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Tokyo, Japan.

Objective: This study was undertaken to evaluate the prevalence and predictors of storage lower urinary tract symptoms (LUTS) in perimenopausal and postmenopausal women attending a menopause clinic.

Methods: The records of 351 women aged 40 to 76 years who enrolled in a health and nutrition education program at a menopause clinic were analyzed cross-sectionally. The prevalence of frequency, nocturia, urge incontinence, and stress incontinence was estimated based on women's responses to the Menopausal Health-Related Quality of Life Questionnaire. Effects of background characteristics, including age, menopause status, vaginal dryness, body composition, cardiovascular parameters, physical fitness, and psychological symptoms, on storage LUTS were assessed using multivariate logistic regression analysis.

Results: Frequency, nocturia, urge incontinence, and stress incontinence were reported by 45.9%, 10.8%, 11.4%, and 32.8% of women, respectively. Multiple logistic regression analysis revealed independent associations between storage LUTS and the following predictors after adjustment: frequency was associated with nonrestorative sleep score (odds ratio, 1.63; 95% CI, 1.35-1.95); nocturia was associated with nonrestorative sleep score (odds ratio, 2.26; 95% CI, 1.57-3.25) and waist-to-hip ratio (odds ratio, 1.12; 95% CI, 1.05-1.18); urge incontinence was associated with reaction time (odds ratio, 1.10; 95% CI, 1.01-1.19); and stress incontinence was associated with body fat (odds ratio, 1.06; 95% CI, 1.03-1.09).

Conclusions: Storage LUTS are highly prevalent in perimenopausal and postmenopausal women attending a menopause clinic. Nonrestorative sleep score is associated with frequency and nocturia; body fat and visceral fat accumulation are associated with nocturia and stress incontinence; and delayed reaction time is associated with urge incontinence. Careful evaluation of nonrestorative sleep, body fat and visceral fat accumulation, or delayed reaction time might reveal undisclosed storage LUTS in this population.
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http://dx.doi.org/10.1097/GME.0000000000000432DOI Listing
October 2015

Dkk-3 induces apoptosis through mitochondrial and Fas death receptor pathways in human mucinous ovarian cancer cells.

Int J Gynecol Cancer 2015 Mar;25(3):372-9

Departments of *Comprehensive Reproductive Medicine, and †Women's Health, Tokyo Medical and Dental University; and ‡Department of Gynecology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.

Objective: Dkk-3 is a Wnt signaling inhibitor that is frequently inactivated in human cancers. Dkk-3 possesses an antiproliferative activity and induces apoptosis in tumor cells, suggesting that it functions as a tumor suppressor. In this study, we investigated the molecular function of Dkk-3 in human ovarian cancer cells.

Methods: We assessed the levels of Dkk-3 protein expression in human mucinous and clear cell ovarian cancer cells, and compared cell viabilities between cell lines that expressed Dkk-3 and those that did not, as well as between cells that expressed Dkk-3 and those whose expression of Dkk-3 was reduced by small interfering RNA. We also evaluated the characteristic fragmentation of DNA to detect apoptosis in Dkk-3-deficient cells. To further investigate the molecular mechanisms of apoptosis, we assessed the expression of molecules involved in apoptosis signaling pathways in Dkk-3-deficient cells.

Results: The expression of the Dkk-3 protein was observed in most of the ovarian cancer cell lines tested. Dkk-3-deficient cells showed faster growth than Dkk-3-replete cells. The characteristic fragmentation of DNA was not observed in Dkk-3-deficient cells, which showed decreased levels of expression in caspase-3, activated caspase-9, Bax, p53, activated caspase-8, and Fas/CD95, as well as an increase in Bcl-2 expression.

Conclusions: Although Dkk-3 expression was observed in most of human ovarian cancer cell lines, Dkk-3 has a tumor-suppressive function and a proapoptotic effect, inducing apoptosis through mitochondrial and Fas death receptor pathways in human mucinous ovarian cancer MCAS cells.
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http://dx.doi.org/10.1097/IGC.0000000000000340DOI Listing
March 2015

Subgrouping of Japanese middle-aged women attending a menopause clinic using physical and psychological symptom profiles: a cross-sectional study.

BMC Womens Health 2014 Nov 25;14:148. Epub 2014 Nov 25.

Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo, 113-8510, Japan.

Background: Women in the menopausal transition and the postmenopausal period are affected with vasomotor symptoms, urogenital atrophy, sexual dysfunction, somatic symptoms, cognitive difficulty, sleep disturbance, and psychological problems. It is important to gain a better understanding of the complexity and diversity of climacteric disturbance in order to optimize treatments for individual patients. The aim of this study was to identify subgroups of Japanese perimenopausal and postmenopausal women attending a menopause clinic based on their physical and psychological symptom profiles.

Methods: We administered the Menopausal Health-Related Quality of Life questionnaire to 491 Japanese women aged 40-64 years who had enrolled in the Systematic Health and Nutrition Education Program at the Menopause Clinic of the Tokyo Medical and Dental University Hospital between 2005 and 2012. We performed a principal component analysis followed by a hierarchical cluster analysis of the responses to 9 physical and 12 psychological items on the questionnaire.

Results: The first analysis extracted 3 principal components that defined the variance of physical and psychological symptom profiles: depression, somatic, and vasomotor/sleep. A subsequent cluster analysis was performed based on the 3 principal components to generate 4 clusters, CL8 (N = 162; 33.0%), CL6 (N = 111; 22.6%), CL5 (N = 102; 20.8%), and CL4 (N = 116; 23.6%). CL8 included women who only had mild-to-moderate musculoskeletal pains and tiredness. All women in CL6, CL5, and CL4 described their musculoskeletal pains and tiredness as moderate to severe. The women in CL5 also had moderate-to-severe vasomotor symptoms, while the women in CL4 also suffered from moderate-to-severe psychological symptoms, such as depression, anxiety, and insomnia.

Conclusions: Distinct subgroups of Japanese perimenopausal and postmenopausal women were identified based on their symptom profiles. Menopausal symptoms were shown to accumulate in this population in the order of musculoskeletal pains and tiredness, vasomotor symptoms, and psychological symptoms.
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http://dx.doi.org/10.1186/s12905-014-0148-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4247616PMC
November 2014

Effects of the kampo formula tokishakuyakusan on headaches and concomitant depression in middle-aged women.

Evid Based Complement Alternat Med 2014 4;2014:593560. Epub 2014 Feb 4.

Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo 113-8510, Japan.

Objectives. To identify the correlates of headaches in middle-aged women and investigate the effects of Tokishakuyakusan (TJ-23), a formula of traditional Japanese herbal therapy Kampo, on headache and concomitant depression. Methods. We examined cross-sectionally the baseline records of 345 women aged 40-59 years who visited our menopause clinic. Among them, 37 women with headaches were treated with either hormone therapy (HT) or TJ-23; the data of these women were retrospectively analyzed to compare the effects of the treatment. Results. The women were classified into 4 groups on the basis of their headache frequency, and no significant intergroup differences were noted in the physical or lifestyle factors, except age. Multiple logistic regression analysis revealed that the significant contributors to the women's headaches were their age (adjusted OR 0.92 (95% CI 0.88-0.97)) and their depressive symptoms (adjusted OR 1.73 (95% CI 1.39-2.16)). Compared to women treated with HT, women treated with TJ-23 reported relief from headaches (65% versus 29%) and concomitant depression (60% versus 24%) more frequently. Improvement in the scores of headaches and depression correlated significantly with TJ-23 treatment. Conclusions. Headache in middle-aged women is significantly associated with depression; TJ-23 could be effective for treating both of these symptoms.
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http://dx.doi.org/10.1155/2014/593560DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3932270PMC
March 2014
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