Papers - BABA Tsuyoshi

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

Aggressive angiomyxoma(AAM)合併妊娠の一例

古来 愛香, 石岡 伸一, 新開 翔太, 常松 梨紗, 真里谷 奨, 染谷 真行, 松浦 基樹, 馬場 剛, 齋藤 剛

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 ) P438 - P438  2023.06

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   43 ( 3 ) 304 - 313  2023.02  [International journal]

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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

当科における卵巣組織凍結の現状報告と北海道における小児科医の卵巣組織凍結に対する意識調査

古来 愛香, 玉手 雅人, 春日 芙貴子, 長尾 沙智子, 西村 庸子, 松浦 基樹, 久野 芳佳, 馬場 剛, 齋藤 豪

日本がん・生殖医療学会誌 ( (一社)日本がん・生殖医療学会 )  6 ( 1 ) 49 - 53  2023.02

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【緒言】小児・思春期・若年成人(children,adolescents and young adults:C-AYA)世代のがんサバイバーが増加することにともない、QOL向上の意識が高まり妊孕性温存法も発展しつつある。当科では、小児がん患者の卵巣組織凍結保存を実施してきた。今回、当院での卵巣組織凍結保存の現状報告(研究1)、および北海道内の小児科医における卵巣組織凍結に対する意識調査(研究2)について報告する。【対象と方法】研究1:2012年12月～2021年6月までに当科で卵巣組織凍結保存を目的とした卵巣摘出術手術20例を対象に、年齢、原疾患、コンサルトから手術までの期間、周術期経過、合併症などの背景を集積した。研究2:北海道内の悪性疾患を診療する小児科医に卵巣組織凍結の認識を匿名でアンケート調査した。【結果】研究1:初診時平均年齢は18.8±8.49歳。原疾患は、血液腫瘍13例、脳腫瘍3例、乳癌2例、軟部腫瘍2例であった。手術までの期間は3-99日(平均31.5±21.5日)、全例腹腔鏡手術であった。研究2:アンケートは5施設18名から回収した。卵巣組織凍結について認識している人が18名(100%)、情報提供をしたことがある人が13名(72.2%)であった。卵巣組織凍結の情報提供をしたが治療の同意が得られない理由としては、経済的理由(保険適応外)、手術のリスク、原疾患治療の遅れ、エビデンスが乏しい、などがあげられた。【結語】卵巣組織凍結保存は微小残存がん病巣(MRD:minimal residual disease)のリスクがあるが、月経発来前の女児に対して唯一の妊孕性温存療法である。しかし、社会的要因によって普及には至っていない。今後、凍結卵巣融解移植成績の発信や卵巣組織凍結の説明方法の均てん化などにより一層卵巣組織凍結という選択肢を提示していきたい。症例治療が滞りなく円滑に進むよう、主治医、生殖医、婦人科腫瘍医の連携が重要であり、今後尽力したい。(著者抄録)

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

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

Letrozole increases preantral follicle growth and decreases estradiol production without impairing follicle survival.

Fukiko Kasuga-Yamashita, Tsuyoshi Baba, Sachiko Nagao, Yuya Fujibe, Miyuki Morishita, Yoshika Kuno, Tasuku Mariya, Hiroyuki Honnma, Toshiaki Endo, Tamotsu Kiya, Tsuyoshi Saito

Journal of ovarian research   15 ( 1 ) 136 - 136  2022.12  [International journal]

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BACKGROUND: Letrozole has been reported to be effective in treating anovulation, preventing ovarian hyperstimulation syndrome (OHSS), and retrieving oocytes in breast cancer patients. However, the role and mechanism of letrozole in follicular development remain unclear. RESULTS: We treated mouse preantral follicles with various treatments; we found no significant difference in follicle survival rates in the letrozole (LET) group compared with the control group, but the average diameter of follicles in the LET group tended to be larger (CTRL vs. LET 30, p = 0.064; CTRL vs. LET 100, p = 0.025). The estradiol concentrations in culture media of the LET group were significantly lower than those observed in the control group (CTRL vs. LET 30, p = 0.038; CTRL vs. LET 100, p = 0.025). We further found a marked increase in follicle-stimulating hormone receptor (FSHR) gene expression in response to letrozole treatment (CTRL vs. LET 30, p = 0.075; CTRL vs. LET 100, p = 0.034). This result suggested that increased FSHR expression promotes follicle development. Letrozole inhibited aromatase activity, but the effect was limited. Letrozole did not significantly reduce vascular endothelial growth factor (VEGF) gene expression. CONCLUSIONS: Letrozole may promote follicle development by increasing the expression of FSHR. Letrozole may be useful for fertility preservation of patients with estrogen-dependent cancers such as breast cancer and various other cancers. Whether letrozole has a direct effect in reducing OHSS requires further investigation.

DOI PubMed

Self-administration of gender-affirming hormones and supratherapeutic dosing are relatively common in Japanese transgender women.

Tsuyoshi Baba, Toshiaki Endo, Utako Ikeda, Hiroshi Ikeda, Koji Ichihara, Naoya Masumori, Tsuyoshi Saito

The journal of obstetrics and gynaecology research   48 ( 8 ) 2208 - 2213  2022.08  [International journal]

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AIM: This study was performed to determine the proportion of transgender women with self-adjusted hormone administration and excess dosing. METHODS: The medical records of 87 transgender women who visited our gender clinic from 2010 through 2019 were reviewed. The complete blood count and serum concentrations of D-dimer, gonadotropins, and sex steroids were compared between transgender women who were self-administering gender-affirming hormones and women not using such hormones. RESULTS: Fifty-eight of 87 (66.7%) transgender women had contravened the guideline and self-adjusted their hormone administration. The hormonal data of one woman with hypopituitarism were eliminated from the analyses. The serum gonadotropin and testosterone levels were significantly lower in the self-administration group than in the hormone-naïve group. Gonadotropin levels below the lower limit of normal were found in 32/86 (37.2%) transgender women. The testosterone levels in six transgender women were not analyzed because these women had undergone sex reassignment surgery before visiting our hospital. Testosterone levels below the lower limit of normal men were found in 36/80 (45.0%) transgender women. Unexpectedly, 29/36 (80.6%) transgender women who were classified as having suppressed serum testosterone levels had testosterone levels of <0.6 ng/mL, which corresponds to the levels in cisgender women. The white blood cell count and hemoglobin concentration were significantly different between the groups. CONCLUSION: Self-initiated hormonal treatments seem to affect the serum concentrations of gonadotropin and sex steroids and the complete blood count. The prevalence of transgender women with self-adjusted use of gender-affirming hormones is high, and an excess dose of hormones occasionally occurs.

DOI PubMed

当科における分娩時hysterectomy症例の検討

石岡 伸一, 染谷 真行, 柏木 葉月, 藤部 佑哉, 真里谷 奨, 馬場 剛, 斎藤 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 )  58 ( Suppl.1 ) 297 - 297  2022.06

児の緩和的対応を前提とした新生児予後不良な妊娠における,適切な医療体制について

染谷 真行, 古来 愛香, 真里谷 奨, 馬場 剛, 石岡 伸一, 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 )  58 ( Suppl.1 ) 310 - 310  2022.06

妊娠中の脳腫瘍に対し,周期的なテモゾロミド投与を行った一例

齋藤 晋平, 古来 愛香, 真里谷 奨, 馬場 剛, 石岡 伸一, 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 )  58 ( Suppl.1 ) 323 - 323  2022.06

液体クロマトグラフィー・タンデム質量分析(LC-MS/MS)法にて診断した偽性高テストステロン血症の一例

小川 万梨絵, 馬場 剛, 春日 芙貴子, 玉手 雅人, 池田 桂子, 森下 美幸, 久野 芳佳, 遠藤 俊明, 齋藤 豪

北海道産科婦人科学会会誌 ( 北海道産科婦人科学会 )  66 ( 1 ) 55 - 58  2022.03

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日常診療におけるホルモン検査は,主に免疫学的測定法を用いて行われるが,時に臨床所見と検査所見の乖離をみることがある。今回,無月経を主訴に来院された女性で,男性化徴候がないにもかかわらず高テストステロン血症を呈した偽性高テストステロン血症の症例を経験したので報告する。症例は17歳女性,続発性無月経のため前医を受診したところ,高テストステロン血症を認めた。経腹超音波検査で明らかな卵巣腫瘍もなく,また単純MRIでも明らかな副腎腫瘍もないため,精査加療目的に当科に紹介受診となった。当科初診時の免疫学的測定法で遊離テストステロンは基準値内であったが,総テストステロンは前医同様に高値であった。男性化徴候がないことと,総テストステロン値と遊離テストステロン値とに大きな乖離を認めたため,異好抗体による偽性高値を疑い液体クロマトグラフィー-タンデム質量分析(liquid chromatography-tandem mass spectrometry:LC-MS/MS)法にてテストステロン測定を行った。結果は総テストステロンも遊離テストステロンも基準値内であった。今回使用した免疫学的測定法において,総テストステロン検査にはヒツジ由来の抗体が,遊離テストステロン検査にはウサギ由来の抗体が用いられていたため,当患者の血漿中にヒツジの抗体に非特異的に反応する異好抗体の存在が疑われた。無月経の原因として,2年前に減量を行い,BMI:22から16に低下して以来無月経となった経緯があり,体重減少性無月経が第一に考えられた。今回LC-MS/MSにて測定を行うことで,侵襲の高い選択的副腎・卵巣静脈血サンプリングを回避し診断することができた。臨床所見と検査所見に乖離がある場合には,異好抗体の存在を念頭に検査法を検討する必要がある。(著者抄録)

胎児超音波にて屈曲肢骨異形成症を疑い,胎盤絨毛の遺伝子検査で診断確定した一例

小川 万梨絵, 寺本 瑞絵, 染谷 真行, 石堂 茉泉, 新開 翔太, 真里谷 奨, 池田 桂子, 森下 美幸, 久野 芳佳, 馬場 剛, 石岡 伸一, 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 )  74 ( 臨増 ) S - 374  2022.02

CD138免疫染色と子宮内microbiotaのcombined testに子宮内pH測定を加えた慢性子宮内膜炎の病態整理

遠藤 俊明, 池田 詩子, 逸見 博文, 本間 寛之, 木谷 保, 真里谷 奨, 久野 芳佳, 馬場 剛, 山田 秀人, 東口 篤司, 藤井 美穂, 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 )  74 ( 臨増 ) S - 359  2022.02

Guidelines for Reproductive Medicine in Japan.

Mitsutoshi Yamada, Tomonori Ishikawa, Takeshi Iwasa, Hajime Oishi, Satoko Osuka, Kenji Oka, Shuichi Ono, Masanori Ono, Makoto Orisaka, Haruhiko Kanasaki, Yasushi Kawano, Kazuhiro Kawamura, Hiroshi Kishi, Fuminori Kimura, Shinnosuke Kuroda, Akira Kuwahara, Hideyuki Kobayashi, Akira Komiya, Hidekazu Saito, Kenji Sato, Suguru Sato, Koji Shiraishi, Hiromitsu Shirasawa, Tatsuya Suzuki, Yasushi Takai, Seido Takae, Toshifumi Takahashi, Tsuyoshi Takiuchi, Masahito Tachibana, Isao Tamura, Hiroshi Tamura, Seung Chik Jwa, Tsuyoshi Baba, Miyuki Harada, Tetsuya Hirata, Atsushi Fukui, Yusuke Fukuda, Shinichiro Fukuhara, Tetsuo Maruyama, Yasushi Yumura, Osamu Yoshino, Yasushi Hirota, Akira Tsujimura, Naoaki Kuji, Yutaka Osuga

Reproductive medicine and biology   21 ( 1 ) e12483  2022  [Domestic journal]

DOI PubMed

PGT-SRの結果とStengel-R法による主たる不均衡型転座の予測との一致率

遠藤 俊明, 馬場 剛, 久野 芳佳, 池田 詩子, 本間 寛之, 逸見 博文, 稲木 誠, 原 鐵晃, 尾崎 守, 倉橋 浩樹, 斎藤 豪

日本IVF学会誌 ( (一社)日本IVF学会 )  24 ( 2 ) 60 - 60  2021.09

Prenatal alcohol exposure and adverse fetal growth restriction: findings from the Japan Environment and Children's Study.

Kazutoshi Cho, Sumitaka Kobayashi, Atsuko Araki, Chihiro Miyashita, Sachiko Itoh, Yasuaki Saijo, Yoshiya Ito, Kazuo Sengoku, Tsuyoshi Baba, Hisanori Minakami, Yuichi Nakamura, Reiko Kishi

Pediatric research   92 ( 1 ) 291 - 298  2021.06  [International journal]

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BACKGROUNDS: Japanese studies on the association between maternal alcohol consumption and fetal growth are few. This study assessed the effect of maternal alcohol consumption on fetal growth. METHODS: This prospective birth cohort included 95,761 participants enrolled between January 2011 and March 2014 in the Japan Environment and Children's Study. Adjusted multiple linear and logistic regression models were used to assess the association between prenatal alcohol consumption and infant birth size. RESULTS: Consumption of a weekly dose of alcohol in the second/third trimester showed a significant negative correlation with standard deviation (SD; Z) scores for body weight, body length, and head circumference at birth, respectively. Consumption of a weekly dose of alcohol during the second/third trimester had a significant positive correlation with incidences of Z-score ≤ -1.5 for birth head circumference. Associations between alcohol consumption in the second/third trimester and Z-score ≤ -1.5 for birth weight or birth length were not significant. Maternal alcohol consumption in the second/third trimester above 5, 20, and 100 g/week affected body weight, body length, and head circumference at birth, respectively. CONCLUSION: Low-to-moderate alcohol consumption during pregnancy might affect fetal growth. Public health policies for pregnant women are needed to stop alcohol consumption during pregnancy. IMPACT: This study examined the association between maternal alcohol consumption and fetal growth restriction in 95,761 pregnant Japanese women using the prospective birth cohort. Maternal alcohol consumption in the second/third trimester more than 5, 20, and 100 g/week might affect fetal growth in body weight, body length, and head circumference, respectively. The findings are relevant and important for educating pregnant women on the adverse health effects that prenatal alcohol consumptions have on infants.

DOI PubMed

What is the most anticipated change induced by treatment using gender-affirming hormones in individuals with gender incongruence?

Naoya Masumori, Tsuyoshi Baba, Teruo Abe, Koji Niwa

International journal of urology : official journal of the Japanese Urological Association   28 ( 5 ) 526 - 529  2021.05  [International journal]

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OBJECTIVES: To identify the most eagerly anticipated change resulting from hormone therapy using gender-affirming hormones for patients with gender incongruence undergoing a clinical trial. METHODS: Patients diagnosed with gender identity disorders based on the International Classification of Diseases 10th revision classification at three institutions in Japan for whom hormone therapy using gender-affirming hormones was initiated were analyzed. They were asked what the most anticipated change was due to gender-affirming hormone that they had thought of between giving informed consent and the first administration of the drug. RESULTS: The responders were 336 transgender men who were administered androgens and 48 transgender women who received estrogens. The median age at commencement of hormone therapy was 24 years for transgender men and 28 years for transgender women. For transgender men, the most frequent answer was cessation of menses (52.7%) followed by a deepened voice (32.4%). For transgender women, breast development (35.4%) was the most anticipated change, followed by gynoid fat deposition (29.2%). CONCLUSIONS: Cessation of menses in transgender men and breast development/gynoid fat deposition in transgender women might represent primary end-points in clinical trials evaluating the efficacy of hormonal treatment in these patients.

DOI PubMed

Mediating Factors Between Parental Socioeconomic Status and Small for Gestational Age in Infants: Results from the Hokkaido Study on Environment and Children's Health.

Naomi Tamura, Tomoyuki Hanaoka, Kumiko Ito, Atsuko Araki, Chihiro Miyashita, Sachiko Ito, Sumitaka Kobayashi, Yoichi Ito, Hisanori Minakami, Kazutoshi Cho, Toshiaki Endo, Tsuyoshi Baba, Kazuo Sengoku, Toshinobu Miyamoto, Katsuhiko Ogasawara, Reiko Kishi

Maternal and child health journal ( SPRINGER/PLENUM PUBLISHERS )  25 ( 4 ) 645 - 655  2021.04  [International journal]

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OBJECTIVES: Previous studies indicated a significant association between small for gestational age (SGA) in infants and their parents' socioeconomic status (SES). Thus, this study aimed to examine if parental factors, such as maternal smoking, and the pre-pregnancy body mass index (BMI) could mediate the associations between parental SES and SGA. METHODS: The participants of this study were pregnant women who enrolled in an ongoing birth cohort study, the Hokkaido study, during the first trimester of their pregnancies. A total of 14,593 live singleton births were included in the statistical analysis, of which 1011 (6.9%) were SGA. Two structural equation models were employed to evaluate the associations between parental SES, parental characteristics, and SGA. RESULTS: The effect of low SES on SGA was directly mediated by maternal pre-pregnancy BMI, smoking during the third trimester, and alcohol consumption during the first trimester in the first model, which was based the assumption of independent associations between mediating factors. In the second model, which additionally considered the mediating factors from the first model, smoking during pregnancy mediated decline in parental SES, consequently increased SGA. Moreover, an increase in pregnancy smoking status increased the prevalence of lower maternal pre-pregnancy BMI and its effect on SGA. CONCLUSIONS FOR PRACTICE: In this study, we observed the independent mediating effect of maternal pre-pregnancy BMI, smoking, and alcohol consumption during pregnancy on low SES and, consequently, SGA, with the additional mediating pathway of SES to smoking to low BMI on SGA.

DOI PubMed

PSGファミリーの異常浸潤性胎盤診断バイオマーカーとしての可能性

柏木 葉月, 真里谷 奨, 新開 翔太, 染谷 真行, 小川 万梨絵, 森下 美幸, 馬場 剛, 石岡 伸一, 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 )  73 ( 臨増 ) S - 611  2021.03