Papers - SAITOU Tsuyoshi

Cervical conization with endoCUT mode applying gastrointestinal endoscopic polypectomy technique.

Masato Tamate, Motoki Matsuura, Tsuyoshi Saito

Obstetrics & gynecology science    2023.06  [International journal]

　View Summary

OBJECTIVE: To show how endoCUT (COMPANY, CITY, STATE, COUNTRY) mode can be safely managed with cervical conization. METHODS: Demonstration of the technique and explanation of endoCUT and soft coagulation mode with narrated video footage. Cervical conization is a therapeutic and diagnostic procedure performed for the diagnosis of cervical intraepithelial lesions and cervical cancer. Specific methods include cold scalpel, ultrasonically activated device and laser, and loop electrosurgical excision procedure (LEEP), which involves transpiration and partial excision. The endoCUT mode and soft coagulation in VIO3 (COMPANY, CITY, STATE, COUNTRY) were used to perform cervical conical resection safely and at low cost (Fig. 1). The endoCUT mode was originally developed for polypectomy in gastrointestinal endoscopy, where no counter traction can be applied [1,2]. RESULTS: The endoCUT mode approach to cervical conization with several key strategies to minimize blood loss and ensure safety: 1) incisions can be made in close contact; 2) resection can be performed with minimal contact with the lesion; 3) control of bleeding from the resected transection by soft coagulation; and 4) low running cost of endoCUT mode. CONCLUSION: Conventionally, cervical conical resection has been performed by using a device capable of making a close incision (cold scalpel, ultrasonically activated device and laser, and LEEP etc.), but there have been issues with bleeding control and cost. Here, we present a new technique using the endoCUT mode and several strategies for safe and effective resection.

DOI PubMed

深層学習によるHE染色データを用いた子宮内膜癌プロファイル判定の適否に関する検討

梅本 美菜, 真里谷 奨, 永田 舞, 堀米 俊弘, 新開 翔太, 杉田 真太朗, 金関 貴幸, 松浦 基樹, 岩崎 雅宏, 廣橋 良彦, 長谷川 匡, 鳥越 俊彦, 齋藤 豪, 藤野 雄一

日本医療情報学会春季学術大会プログラム・抄録集 ( (一社)日本医療情報学会 )  27回   122 - 123  2023.06

Therapeutic efficacy of a four-year treatment with eribulin in a patient with uterine leiomyosarcoma: A case report.

Motoki Matsuura, Kazuma Yorozu, Sachiko Nagao, Shoko Kurokawa, Masato Tamate, Taishi Akimoto, Tsuyoshi Saito

Gynecologic oncology reports   47   101205 - 101205  2023.06  [International journal]

　View Summary

Uterine leiomyosarcoma (LMS) is a gynecological malignancy with an extremely poor prognosis. Multiple new therapeutic agents, including pazopanib, trabectedin, and eribulin, have been clinically applied to treat uterine LMS, and their therapeutic effects are expected. We encountered one patient with advanced recurrent uterine LMS who achieved a partial response to a four-year treatment with eribulin. A 31-year-old woman was diagnosed with stage 2B LMS. After the first recurrence, Gemcitabine, Docetaxel (GD) therapy was administered, and complete response (CR) was achieved. However, 2 years and 10 months later, recurrence occurred at the vaginal cuff, and GD therapy and doxorubicin hydrochloride were administered, resulting in CR. Five months later, she experienced another recurrence at the same location and was treated with eribulin. To date, 53 courses of eribulin have been administered and are currently ongoing. Maintaining low neutrophil-to-lymphocyte ratio and low platelet-to lymphocyte ratio in this manner is considered to be one of the reasons why eribulin continues to be effective. We encountered a rare case in which eribulin was administered for the longest period of time, and produced an observable effect in uterine LMS.

DOI PubMed

「助手力」の教育 助手力を構成する要素とは何か,どのように教育するのか

梅本 美菜, 松浦 基樹, 足立 岳貴, 有本 千紘, 黒川 晶子, 西村 庸子, 玉手 雅人, 秋元 太志, 幅田 周太朗, 岩崎 雅弘, 齋藤 豪

産婦人科手術 ( (株)メジカルビュー社 )  ( 34 ) 162 - 162  2023.06

深層学習によるHE染色データを用いた子宮内膜癌プロファイル判定の適否に関する検討

梅本 美菜, 真里谷 奨, 永田 舞, 堀米 俊弘, 新開 翔太, 杉田 真太朗, 金関 貴幸, 松浦 基樹, 岩崎 雅宏, 廣橋 良彦, 長谷川 匡, 鳥越 俊彦, 齋藤 豪, 藤野 雄一

日本医療情報学会春季学術大会プログラム・抄録集 ( (一社)日本医療情報学会 )  27回   122 - 123  2023.06

TLHにおける非利き手の有効率を検証する

和田 渚, 玉手 雅人, 有元 千紘, 鹿内 智史, 杉田 奈穂子, 鈴木 将裕, 松浦 基樹, 齋藤 豪

産婦人科手術 ( (株)メジカルビュー社 )  ( 34 ) 163 - 163  2023.06

機能再建手術 Thiel法固定献体における子宮移植トレーニング

玉手 雅人, 松浦 基樹, 木須 伊織, 齋藤 豪

産婦人科手術 ( (株)メジカルビュー社 )  ( 34 ) 73 - 78  2023.06

Thiel法固定献体における子宮移植

玉手 雅人, 松浦 基樹, 和田 渚, 足立 岳貴, 有元 千紘, 黒川 晶子, 西村 庸子, 秋元 太志, 木須 伊織, 齋藤 豪

産婦人科手術 ( (株)メジカルビュー社 )  ( 34 ) 146 - 146  2023.06

「助手力」の教育 助手力を構成する要素とは何か,どのように教育するのか

梅本 美菜, 松浦 基樹, 足立 岳貴, 有本 千紘, 黒川 晶子, 西村 庸子, 玉手 雅人, 秋元 太志, 幅田 周太朗, 岩崎 雅弘, 齋藤 豪

産婦人科手術 ( (株)メジカルビュー社 )  ( 34 ) 162 - 162  2023.06

巨大腺筋症に対する開腹子宮頸管縫縮術を施行し,救命可能週数まで妊娠継続できた一絨毛膜二羊膜双胎の1例

常松 梨紗, 石岡 伸一, 馬場 剛, 真里谷 奨, 染谷 真行, 新開 翔太, 齋藤 豪

日本周産期・新生児医学会雑誌 ( (一社)日本周産期・新生児医学会 )  59 ( Suppl.1 ) P322 - P322  2023.06

中心核ミオパチーの児出産を契機に発見された1型リアノジン受容体(RYR1)遺伝子の病的バリアントを有する妊婦の一例

古来 愛香, 石岡 伸一, 真里谷 奨, 藤部 佑哉, 坂井 拓朗, 染谷 真行, 齊藤 豪

日本周産期・新生児医学会雑誌 ( (一社)日本周産期・新生児医学会 )  59 ( 1 ) 111 - 115  2023.05

　View Summary

1型リアノジン受容体(RYR1)をコードする遺伝子の病的バリアントは,いくつかの先天性ミオパチーの発症に関連している.今回,未診断だったRYR1遺伝子の病的バリアントを有する妊婦の2回の妊娠出産を経験したので報告する.症例:29歳G1P0.既往歴なし.当科外来で妊婦健診を行っていたが,妊娠37週で羊水過多傾向,胎動自覚低下を認め,妊娠38週より分娩誘発を開始した.誘発中に胎児遷延徐脈を認め,緊急帝王切開となった.児は2,596gの男児,Apgar score 2/4(1分/5分)で出生し,floppy infantにて人工呼吸管理となった.その後中心核ミオパチーと判明し,母児にRYR1の病的バリアントがヘテロ接合で認められた.2年後に再び妊娠したが妊娠経過で異常は認めず,妊娠38週で選択的帝王切開となった.児は2,588g,女児,Apgar score 8/9(1分/5分)で出生し筋緊張正常であった.非常に稀だが,母体未診断であったRYR1の病的バリアントを有する症例と考えられた.(著者抄録)

腹腔鏡下子宮筋腫核出術後に発生した多発parasitic myomaの1例

岩崎 雅宏, 幅田 周太朗, 野藤 五沙, 松浦 基樹, 玉手 雅人, 齋藤 豪

産婦人科の実際 ( 金原出版(株) )  72 ( 5 ) 533 - 536  2023.05

　View Summary

＜文献概要＞Parasitic myomaは,筋腫が子宮と遊離した状態で他の臓器からの栄養血管を得て生着する疾患である。症例はモルセレーターを用いた腹腔鏡下子宮筋腫核出術既往がある47歳女性で,子宮筋腫の増大を認めたため腹式単純子宮全摘出術を施行した際,多発性の子宮と連続性のない筋腫parasitic myomaを認めた。モルセレーターを用いた腹腔鏡下子宮全摘出術や腹腔鏡下子宮筋腫核出術ではparasitic myomaを予防するため,組織飛散防止回収袋を用いた回収や十分な腹腔内洗浄を心がける必要がある。

卵巣癌・子宮体癌症例における細胞診検体(LBC検体を含む)を用いたNGSの有用性 LBC検体によるNGSを子宮体癌早期スクリーニングにどう応用するべきか

松浦 基樹, 玉手 雅人, 秋元 太志, 幅田 周太朗, 岩崎 雅宏, 畠山 晴良, 高根 希世子, 山口 貴世志, 古川 洋一, 齋藤 豪

日本臨床細胞学会雑誌 ( (公社)日本臨床細胞学会 )  62 ( Suppl.1 ) 174 - 174  2023.05

Mailing human papillomavirus self-sampling kits to women under-screened for cervical cancer improved detection in cervical cancer screening in a general population study in Japan.

Yoko Nishimura, Motoki Matsuura, Noriko Terada, Sachiko Nagao, Hiroshi Shimada, Kyoko Isoyama, Masato Tamate, Masahiro Iwasaki, Tsuyoshi Saito

BMC public health   23 ( 1 ) 473 - 473  2023.03  [International journal]

　View Summary

BACKGROUND: One cause of the increase in cervical cancer rates in Japan is the long-term stagnation in the cervical cancer screening consultation rate. Therefore, improving the screening consultation rate is of urgent concern to reduce cervical cancer incidence. Self-collected human papilloma virus (HPV) tests have been successfully adopted in several countries, such as the Netherlands and Australia, as a measure of individuals who have not undergone cervical cancer screening in national programs. This study aimed to verify whether self-collected HPV tests presented an effective countermeasure for individuals who had not undergone the recommended cervical cancer screenings. METHODS: This study was conducted from December 2020 to September 2022 in Muroran City, Japan. The primary evaluated endpoint was the percentage of citizens who underwent cervical cancer screening at a hospital with positive self-collected HPV test results. The secondary endpoint was the percentage of included participants who were diagnosed with cervical intraepithelial neoplasia (CIN) or higher among those who visited a hospital and underwent cervical cancer screening. RESULTS: The included study participants were 7,653 individuals aged 20-50 years with no record of previous cervical cancer examination in the past 5 years. We mailed these participants information on self-administered HPV tests as an alternative screening procedure and sent the kit to 1,674 women who requested the test. Among them, 953 returned the kit. Among the 89 HPV-positive individuals (positive rate, 9.3%), 71 (79.8%) visited the designated hospital for an examination. A closer examination revealed that 13 women (18.3% of hospital visits) had a CIN finding of CIN2 or higher, among whom one each had cervical cancer and vulvar cancer, eight presented with CIN3, and three presented with CIN2; two cases of invasive gynecologic cancer were also identified. CONCLUSIONS: We conclude that the self-collected HPV tests showed a certain efficacy as a measure of individuals who had not undergone the recommended cervical cancer screening. We devised ways to have the unexamined patients undergo HPV testing and ensure that HPV-positive individuals visited the hospital. Despite a few limitations, our findings suggest the effectiveness of this public health intervention.

DOI PubMed

Clinical application of long-read nanopore sequencing in a preimplantation genetic testing pre-clinical workup to identify the junction for complex Xq chromosome rearrangement-related disease.

Tasuku Mariya, Yui Shichiri, Takeshi Sugimoto, Rie Kawamura, Syunsuke Miyai, Hidehito Inagaki, Eiji Sugihara, Keiko Ikeda, Tsuyoshi Baba, Aki Ishikawa, Michiko Ammae, Yoshiharu Nakaoka, Tsuyoshi Saito, Akihiro Sakurai, Hiroki Kurahashi

Prenatal diagnosis    2023.02  [International journal]

　View Summary

OBJECTIVE: Xq chromosome duplication with complex rearrangements is generally acknowledged to be associated with neurodevelopmental disorders such as Pelizaeus-Merzbacher disease (PMD) and MECP2 duplication syndrome. For couples who required a PGT-M (pre-implantation genetic testing for monogenic disease) for these disorders, junction-specific PCR is useful to directly detect pathogenic variants. Therefore, pre-clinical workup for PGT-M requires the identification of the junction of duplicated segments in PMD and MECP2 duplication syndrome, which is generally difficult. METHODS: In this report, we used nanopore long-read sequencing targeting the X chromosome using an adaptive sampling method to identify breakpoint junctions in disease-causing triplications. RESULTS: By long-read sequencing, we successfully identified breakpoint junctions in one PMD case with PLP1 triplication and in another MECP2 triplication case in a single sequencing run. Surprisingly, the duplicated region involving MECP2 was inserted 45 Mb proximal to the original position. This inserted region was confirmed by FISH analysis. With the help of precise mapping of the pathogenic variant, we successfully re-established STR haplotyping for PGT-M and avoided any potential misinterpretation of the pathogenic allele due to recombination. CONCLUSION: Long-read sequencing with adaptive sampling in a PGT-M pre-clinical workup is a beneficial method for identifying junctions of chromosomal complex structural rearrangements. This article is protected by copyright. All rights reserved.

DOI PubMed

Cell-free RNA発現プロファイルを根拠とした新規無侵襲着床前胚染色体異数性検査アルゴリズムの構築について

真里谷 奨, 齋藤 豪, 倉橋 浩樹

日本産科婦人科学会雑誌 ( (公社)日本産科婦人科学会 )  75 ( 臨増 ) S - 430  2023.02

Cell-free RNA発現プロファイルを根拠とした新規無侵襲着床前胚染色体異数性検査アルゴリズムの構築について

真里谷 奨, 齋藤 豪, 倉橋 浩樹

日本産科婦人科学会雑誌 ( (公社)日本産科婦人科学会 )  75 ( 臨増 ) S - 430  2023.02

深層学習を用いたHE染色からの子宮内膜癌分子生物学的プロファイル推定の適否に関する検討

梅本 美菜, 真里谷 奨, 新開 翔太, 松浦 基樹, 岩崎 雅宏, 齋藤 豪

日本産科婦人科学会雑誌 ( (公社)日本産科婦人科学会 )  75 ( 臨増 ) S - 260  2023.02

深層学習を用いたHE染色からの子宮内膜癌分子生物学的プロファイル推定の適否に関する検討

梅本 美菜, 真里谷 奨, 新開 翔太, 松浦 基樹, 岩崎 雅宏, 齋藤 豪

日本産科婦人科学会雑誌 ( (公社)日本産科婦人科学会 )  75 ( 臨増 ) S - 260  2023.02

中心核ミオパチーの児出産を契機に発見された1型リアノジン受容体(RYR1)遺伝子のバリアントを有する妊婦の一例

古来 愛香, 石岡 伸一, 新開 翔太, 真里谷 奨, 常松 梨紗, 染谷 真行, 小川 万梨絵, 森下 美幸, 馬場 剛, 齋藤 豪

日本産科婦人科学会雑誌 ( (公社)日本産科婦人科学会 )  75 ( 臨増 ) S - 459  2023.02