Details of a Researcher - BABA Tsuyoshi

Papers - BABA Tsuyoshi

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高次施設における帝王切開率抑制の試み

染谷真行, 新開翔太, 真里谷奨, 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 - 367 2021.03

早産期の誘発分娩により帝王切開を回避し得たタナトフォリック骨異形成症の1例

佐藤由梨, 染谷真行, 長尾沙智子, 新開翔太, 真里谷奨, 森下美幸, 馬場剛, 石岡伸一, 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 ) 65 ( 1 ) 85 - 85 2021.03

開腹子宮頸部縫縮術(TAC)後妊娠初期流産症例に対するmethotrexate(MTX)療法の一例

石堂茉泉, 石岡伸一, 藤部佑哉, 鈴木美紀, 嶋田浩志, 真里谷奨, 馬場剛, 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 ) 56 ( 1 ) 198 - 202 2020.05

34歳。子宮頸癌のため腟式広汎子宮頸部摘出術+骨盤リンパ節郭清術の既往で有った。その2年後に体外受精により妊娠し、妊娠19週で帝王切開による分娩となった。この分娩から3年後にテフロンテープを用いた開腹子宮頸部縫縮術(TAC)を施行し、TAC後6ヵ月で体外受精にて妊娠したが、妊娠8週で稽留流産となった。流産後3ヵ月経過しても子宮内容物が排出されず絨毛組織の筋層内浸潤が疑われ、流産後12週よりMTX投与1日20mg・5日間を2週間毎に開始し、3コース終了後に血清ヒト絨毛性ゴナドトロピン値がほぼ正常化した。治療終了後3ヵ月で月経が再開し、その後に再度妊娠8週相当で流産となったが、子宮内容物は流産判明から1ヵ月以内に自然排出された。さらに6ヵ月後に体外受精で妊娠し、妊娠33週6日に帝王切開にて男児1912g、アプガースコア8/9点を出産し、術後経過順調で8日目に退院した。

Prune Belly Syndromeの女児が出生後に総排泄腔遺残も疑われた1例

藤部佑哉, 真里谷奨, 蛯谷由真, 水柿祐子, 川俣あかり, 水内将人, 森下美幸, 馬場剛, 石岡伸一, 長岡由修, 石郷岡哲郎, 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 ) 64 ( 1 ) 108 - 109 2020.03

当院で出生した先天性疾患児の出生前診断状況および遺伝学的対応に関する検討

真里谷奨, 斉藤公仁, 水柿祐子, 藤部佑哉, 川俣あかり, 水内将人, 森下美幸, 馬場剛, 水上都, 石川亜貴, 石岡伸一, 櫻井晃洋, 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 ) 64 ( 1 ) 108 - 108 2020.03

子宮内膜症及び腺筋症の合併が癒着胎盤を呈した妊娠の1例

蛯谷由真, 藤部佑哉, 真里谷奨, 水柿祐子, 川俣あかり, 水内将人, 森下美幸, 馬場剛, 石岡伸一, 菅原太郎, 杉田真太郎, 長谷川匡, 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 ) 64 ( 1 ) 114 - 114 2020.03

若手産婦人科医の腹腔鏡手技トレーニングにおけるタイムトライアルの有用性の検討

長尾沙智子, 玉手雅人, 藤部佑哉, 西村庸子, 松浦基樹, 寺本瑞絵, 馬場剛, 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 ) 64 ( 1 ) 102 - 102 2020.03

Pioglitazone suppresses excessive follicular development in murine preantral follicles.

Sachiko Nagao, Tsuyoshi Baba, Yuya Fujibe, Sayaka Adachi, Keiko Ikeda, Miyuki Morishita, Yoshika Kuno, Hiroyuki Honnma, Toshiaki Endo, Tamotsu Kiya, Tsuyoshi Saito

Journal of ovarian research 12 ( 1 ) 82 - 82 2019.08 [International journal]

Polycystic ovary syndrome (PCOS) is an endocrine disease that is common in women in their reproductive period. Patients with this disease suffer from anovulation and hyperandrogenism. Ovulation induction with exogenous gonadotropin often causes ovarian hyperstimulation syndrome because many small antral follicles pause in their growth. Treatment with insulin sensitizers is reportedly effective for both anovulation associated with PCOS, and suppression of excessive follicular growth; however, the underlying mechanism of action remains unknown. Although pioglitazone is known as an insulin sensitizer, it also has a potent modulator of cell growth and apoptosis irrespective of insulin resistance. To clarify the effect of pioglitazone on follicular growth, we performed in vitro culture of murine preantral follicles. Secondary follicles (100-160 μm in diameter) isolated from 6-week-old ICR mice were individually cultured for 13 days. Culture conditions were as follows: 1) follicle-stimulating hormone (FSH; 33 mIU/mL; control), 2) FSH plus dihydrotestosterone (DHT; 500 ng/mL), 3) FSH plus pioglitazone (5 ng/mL), and 4) FSH plus DHT/pioglitazone. Survival rate and follicle diameter were evaluated, and concentrations of estradiol (E2) and vascular endothelial growth factor (VEGF) in culture media were measured. mRNA expression of various growth-promoting factors and Vegf within follicles were also assessed. Although no significant differences were observed with regard to survival rate, follicle diameters on day 13 were significantly different.Compared with the control group, the DHT group showed enhanced growth, while groups administered pioglitazone showed stagnation of the accelerated growth induced by DHT. Although DHT treatment enhanced the expression of bone morphogenetic protein 2 (Bmp2) mRNA, pioglitazone exposure suppressed induction of Bmp2 mRNA by DHT. Vegf mRNA and protein expression were also significantly reduced when pioglitazone was added to culture media containing DHT.Administration of pioglitazone negatively affected follicular growth and VEGF levels, which may suppress excessive follicular growth and prevent ovarian hyperstimulation syndrome.

DOI PubMed

重症子宮内膜症を有する不妊治療における手術とART介入のタイミング

森下美幸, 長尾沙智子, 新開翔太, 久野芳佳, 真里谷奨, 馬場剛, 遠藤俊明, 齋藤豪

日本産科婦人科内視鏡学会雑誌 ( (一社)日本産科婦人科内視鏡学会 ) 35 ( Suppl.I ) 252 - 252 2019.08

Obstetrical prognosis of patients who underwent vaginal radical trachelectomy during pregnancy.

Mina Umemoto, Shinichi Ishioka, Yuko Mizugaki, Yuya Fujibe, Tasuku Mariya, Akari Kawamata, Masahito Mizuuchi, Miyuki Morishita, Tsuyoshi Baba, Tsuyoshi Saito

The journal of obstetrics and gynaecology research 45 ( 6 ) 1167 - 1172 2019.06 [International journal]

AIM: Radical trachelectomy (RT) with pelvic lymphadenectomy has become an option for young patients with early invasive uterine cervical cancer who decide to maintain their fertility. However, this operative method entails a high risk for the following pregnancy due to its radicality. Therefore, RT for pregnant patients can be a challenge both for gynecologic oncologists and obstetricians. METHODS: We have performed vaginal RT for five pregnant patients with uterine cervical cancer stage 1B1 according to the method of Dargent et al. The operations were performed between 16 and 26 weeks of pregnancy, and the patients were followed up carefully according to the follow-up methods we reported previously. RESULTS: Vaginal RT was performed for five patients without any troubles. Four of the patients continued their pregnancies until almost 34 weeks or longer under our previously published follow-up schedule. The pregnancy of one patient was terminated at 26 weeks due to recurrence of the cancer. CONCLUSION: Expansion of vaginal RT for pregnant patients with uterine cervical cancer could be a practical option for pregnant patients with early invasive uterine cervical cancer.

DOI PubMed

Androgen potentiates the expression of FSH receptor and supports preantral follicle development in mice.

Yuya Fujibe, Tsuyoshi Baba, Sachiko Nagao, Sayaka Adachi, Keiko Ikeda, Miyuki Morishita, Yoshika Kuno, Masahiro Suzuki, Masahito Mizuuchi, Hiroyuki Honnma, Toshiaki Endo, Tsuyoshi Saito

Journal of ovarian research 12 ( 1 ) 31 - 31 2019.04 [International journal]

Hyperandrogenism is one of the cardinal symptoms in polycystic ovary syndrome and plays a key role in the pathogenesis of polycystic ovary syndrome. However, the precise effects and mechanisms of excess androgen during follicular development are still unclear. Here we investigated the effects of androgen on mouse follicle development in vitro. Androgen did not affect the growth of follicles smaller than 160-180 μm in the presence of follicle-stimulating hormone (FSH). However, in the presence of low FSH, androgen supported the growth of follicles larger than 160-180 μm, a size at which growing follicles acquire FSH-dependency. Androgen did not change the mRNA expression of various growth-promoting factors but did increase mRNA expression of the FSH receptor. We suggest that androgen has a positive impact on follicle development by augmentation of the actions of FSH. Therefore, FSH-responsive but FSH-independent follicles grow in the presence of a certain level of FSH or androgen, and androgen compensates for FSH deficiency in FSH-dependent follicles.

DOI PubMed

自然消失した子宮動脈仮性動脈瘤の超音波パワードップラー法所見の変化

嶋田浩志, 野藤五沙, 鈴木美紀, 幅田周太朗, 藤部佑哉, 水内将人, 馬場剛, 石岡伸一, 齋藤豪

超音波医学 ( (公社)日本超音波医学会 ) 46 ( Suppl. ) S719 - S719 2019.04

Association Between Maternal Serum Folate Concentrations in the First Trimester and the Risk of Birth Defects: The Hokkaido Study of Environment and Children's Health

Kumiko Ito, Tomoyuki Hanaoka, Naomi Tamura, Seiko Sasaki, Chihiro Miyashita, Atsuko Araki, Sachiko Ito, Hisanori Minakami, Kazutoshi Cho, Toshiaki Endo, Tsuyoshi Baba, Toshinobu Miyamoto, Kazuo Sengoku, Akiko Tamakoshi, Reiko Kishi

JOURNAL OF EPIDEMIOLOGY ( JAPAN EPIDEMIOLOGICAL ASSOC ) 29 ( 4 ) 164 - 171 2019.04 [Refereed] [International journal]

Background: Low red blood cell folate concentrations during early pregnancy might cause neural tube defects. However, the association between folate concentrations and birth defects of other neural crest cell-derived organs remains unknown. We investigated the associations between birth defects and first-trimester serum folate concentrations in a birth-cohort study in Japan.Methods: In total, 14,896 women who were prior to 13 weeks of gestation were enrolled from 2003 through 2012. Birth defect information was obtained from medical records and questionnaires. The association between folate levels in the first trimester and birth defects categorized as ICD-10 cord defects and neural crest cell-derived organ defects was examined. The crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) per log-transformed folate concentration were calculated using logistic regression.Results: Blood samples were obtained at a mean of 10.8 weeks of gestation. Median serum folate level was 16.5 (interquartile range, 13.4-21.5) nmol/L, and the deficiency level (less than 6.8 nmol/L) was 0.7%. There were 358 infants with birth defects. The adjusted odds ratio for any birth defect, ventricular septal defects, and cleft lip was 0.99 (95% CI, 0.74-1.32), 0.63 (95% CI, 0.30-1.33), and 4.10 (95% CI, 0.96-17.58), respectively. There were no significant associations between first-trimester maternal serum folate and the risk of birth defects.Conclusions: We were unable to demonstrate a relationship between maternal serum folate in the first trimester and birth defects. Potential confounding factors may have influenced our results.

DOI PubMed

The roles of metformin and pravastatin on Placental endoplasmic reticulum stress and Placental growth factor in human villous-like trophoblastic BeWo cells

Masahiro Suzuki, Masahito Mizuuchi, Tsuyoshi Baba, Yuya Fujibe, Yoshihiko Ino, Shinichi Ishioka, Tsuyoshi Saito

Sapporo Medical journal ( Sapporo Medical University ) 87 ( 1-6 ) 75 - 84 2018.12

Preeclampsia (PE) is related to an imbalance of angiogenic factors. Placental growth factor (P1GF) is reduced in early onset PE. Recent evidence indicates that metformin and statins may suppress endoplasmic reticulum (ER) stress. We previously reported that the unfolded protein response activated by ER stress down-regulated P1GF protein expression and predicted these drugs could prevent placental ER stress and up-regulate P1GF protein expression in trophoblast-like cells. In this study, we aimed to establish the effects of these drugs on P1GF and activating transcription factor 4 (ATF4) protein expression. We confirmed that P1GF messenger RNA (mRNA) levels were decreased under ER stress induced by thapsigargin and that ATF4 mRNA was increased under the same conditions and then administered metformin to it. Transcript analysis showed increased P1GF mRNA compared with thapsigargin only treatment and that this was dependent on metformin levels. Under ER stress, western blot showed high levels of ATF4 and phosphorylated-eukaryotic initiation factor 2 subunit a (p-eIF2a) but low levels of P1GF protein. By contrast, compared with thapsigargin alone, ATF4 and p-eIF2a levels were low and P1GF levels were high when metformin and thapsigargin were given, but these were again dependent on metformin concentrations. Western blot also confirmed that pravastatin attenuated ER stress and increased P1GF protein expression. In conclusion, metformin and pravastatin suppressed ER stress and restored P1GF levels in trophoblastlike cells. However, although these results indicate that these drugs have a potential for preventing or treating PE, the lack of clarity on the mechanism requires further study.

DOI

Rare case of occult testosterone-producing ovarian tumor that was diagnosed by selective venous hormone sampling.

Yoshika Kuno, Tsuyoshi Baba, Takafumi Kuroda, Mizue Teramoto, Naoki Hirokawa, Toshiaki Endo, Tsuyoshi Saito

Reproductive medicine and biology 17 ( 4 ) 504 - 508 2018.10 [Domestic journal]

CASE: A 32 year old woman was referred because of secondary amenorrhea, hirsutism, and voice deepening. OUTCOME: The blood testosterone level was markedly high. A transvaginal ultrasound revealed a small region in the left ovary, but whether or not it was a tumor was unclear. Therefore, selective ovarian venous sampling was performed. Consequently, the testosterone level was selectively increased in a blood sample that was taken from the left ovarian vein, the tumor was successfully localized, and a laparoscopic left oophorectomy was performed. Although the left ovary appeared to be normal at laparoscopy, the androgen-secreting tumor was located within it. The tumor was diagnosed as a Leydig cell tumor by histopathological analyses. CONCLUSION: This report demonstrates that selective blood sampling from ovarian veins before an operation is effective in localizing an androgen-producing ovarian tumor that is difficult to diagnose by imaging studies.

DOI PubMed

2009年IOM指針に基づいた推奨妊娠中体重増加における出生児体重の検討

嶋田浩志, 高田さくら, 恐神博行, 水内将人, 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 ) 54 ( 2 ) 717 - 717 2018.06

Bakriバルーンの前置胎盤・低置胎盤帝王切開症例における予防的止血効果の検討

梅本美菜, 黒田敬史, 水内将人, 野呂薫, 柏木葉月, 伊野善彦, 杉田菜穂子, 鈴木将裕, 森下美幸, 馬場剛, 石岡伸一, 齋藤豪

日本産婦人科・新生児血液学会誌 ( 日本産婦人科・新生児血液学会 ) 28 ( 1 ) 30 - 31 2018.05

当院前置胎盤・低置胎盤の帝王切開時にBakriバルーンを使用した14例を対象に、予防的止血効果に関する検討を行った。その結果、全例がBakriによる止血奏効例で、Bakri予防使用群は6例、非予防使用群は8例であった。分娩第3期の出血量は2群間で有意差を認めなかったが、分娩第4期の出血量はBakri予防使用群で有意に少なかった。今回の検討から、帝王切開時におけるBakriの予防的使用は、前置・低置胎盤に対する術中および分娩第4期の止血法として有効であることが示唆された。

Pioglitazone is effective for multiple phenotyepes of the Zucker fa/fa rat with polycystc ovary morphology and insulin resistance.

Miyuki Morishita, Toshiaki Endo, Tsuyoshi Baba, Yoshika Kuno, Keiko Ikeda, Tamotsu Kiya, Hiroyuki Honnma, Tsuyoshi Saito

Journal of ovarian research 11 ( 1 ) 24 - 24 2018.03 [International journal]

BACKGROUND: Hyperandrogenism and insulin resistance may be related to the etiology of PCOS. Zucker fa/fa rats with polycystic ovary are obese, have insulin resistance without diabetes mellitus or hyperandrogenism and can be utilized as PCOS model rats without effects of hyperandrogenemia. PCOS patients are reported to have elevated levels of serum anti-Mullerian hormone (AMH), which has an inhibitory action on folliculogenesis, and low levels of serum adiponectin, which blocks apoptosis and induces biological effects in some tissues. Pioglitazone, an insulin sensitizer, is administered to PCOS patients with insulin resistance to induce ovulation but the mechanisms by which this occurs have not been elucidated. METHODS: We purchased 4-week-old female fatty Zucker fa/fa rats as well as lean Zucker +/+ rats for use as control rats with normal insulin sensitivity. The Zucker fa/fa rats were administered pioglitazone (2.5 mg/kg body weight/day) or a vehicle every day for 14 days in separate groups. The Zucker +/+ rats were also administered the vehicle. After 2 weeks of treatment, they were euthanized and we obtained serum samples and both ovaries and determined the body weight, ovarian weight, and serum AMH, adiponectin, testosterone, and androstenedione levels. We also examined ovarian histology to check follicle numbers by using hematoxylin-eosin staining, and the number of atretic follicles using Tdt-mediated dUTP nick end labeling (TUNEL) methods. RESULTS: The Zucker fa/fa rats used as PCO model rats and Pioglitazone treated PCO model rats were significantly heavier than the Zucker +/+ control rats (p < 0.05) at 15 day old. Pioglitazone treatment did not influence body weight or ovarian weight in either group. However, the total number of follicles was significantly larger in the PCO model rats than in the control rats (P < 0.05). Although pioglitazone treatment appeared to decrease the total number of follicles in the PCO model rats, the decrease was not statistically significant. However, pioglitazone treatment significantly decreased the total number of atretic follicles and the rate of atreteic follicles in the PCO model rats (P < 0.05). The serum AMH level was significantly higher in the PCO model rats than in the control rats. Pioglitazone treatment significantly decreased the serum AMH level and significantly increased the serum adiponectin level in the PCO model rats (P < 0.05). Serum testosterone and androstenedione levels were quite low or undetectable in the 3 groups of rats, and were not influenced by pioglitazone treatment. CONCLUSION: In this study, pioglitazone treatment reduced the serum AMH level and increased the serum adiponectin level in PCO model rats. These effects are related to reduction of the total number of atretic follicles and rate of atretic follicles. This proves that pioglitazone treatment improves healthy follicle growth in these PCO model rats with insulin resistance.

DOI PubMed

Transabdominal cerclage (TAC) for patients with ultra-short uterine cervix after uterine cervix surgery and its impact on pregnancy

Shinichi Ishioka, Miseon Kim, Yuko Mizugaki, Saori Kon, Kyoko Isoyama, Masahito Mizuuchi, Miyuki Morishita, Tsuyoshi Baba, Takao Sekiya, Tsuyoshi Saito

Journal of Obstetrics and Gynaecology Research ( Blackwell Publishing ) 44 ( 1 ) 61 - 66 2018.01 [Refereed] [International journal]

Aim: Patients with an ultra-short uterine cervix as a result of large conization, repeated conization or radical trachelectomy (RT), are at high risk of preterm premature rupture of the membrane, which leads to preterm birth. We have commenced performing transabdominal cerclage (TAC) of the uterine cervix for these patients. In this study, we examined the safety of TAC and its impact on pregnancy. Methods: We have performed TAC in 11 patients before pregnancy: in six after large cervical operations, such as repeated conization and in five for difficulties with cervical cerclage after RT. After laparotomy, a Teflon thread was placed in the avascular space between the uterine vessels and the uterine muscle, and tied. The clinical course of the patients after TAC and their pregnancy course were retrospectively reviewed. Results: TAC was performed safely without any complications. The mean operative duration was 53 ± 10 min, and the mean blood loss during the operation was 49 ± 64 mL. Seven women conceived within 2 years after TAC. Their pregnancy courses were favorable. Five of the women underwent scheduled cesarean sections, while two pregnancies are ongoing. Conclusions: Although there are risks of various complications as a result of the use of non-absorbable thread and the need for two extra laparotomies, TAC can be a safe and useful option for patients who show cervical incompetence after large uterine cervical operations, such as RT or large conization.

DOI PubMed

Prevalence and risk of birth defects observed in a prospective cohort study: The Hokkaido study on environment and children’s health

Tomoyuki Hanaoka, Naomi Tamura, Kumiko Ito, Seiko Sasaki, Atsuko Araki, Tamiko Ikeno, Chihiro Miyashita, Sachiko Ito, Hisanori Minakami, Kazutoshi Cho, Toshiaki Endo, Tsuyoshi Baba, Toshinobu Miyamoto, Kazuo Sengoku, Reiko Kishi, H. Goudarzi, M. Minatoya, S. Kobayashi, K. Yamazaki, S. Nishihara, Y. Ait Bamai, R. Miura, S. Kobayashi, A. Uno, S. Katoh, T. Baba, T. Yila, T. Braimoh, I. Kashino, S. Nakajima, T. Baba, Y. Saijyo, E. Yoshioka, T. Miyamoto, K. Okuyama, F. Sata, T. Kita

Journal of Epidemiology 28 ( 3 ) 125 - 132 2018 [Domestic journal]

© 2017 Tomoyuki Hanaoka et al. Background: Prevalence rates of all anomalies classified as birth defects, including those identified before the 22nd gestational week, are limited in published reports, including those from the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR). In our birth cohort study, we collected the data for all birth defects after 12 weeks of gestation. Methods: Subjects in this study comprised 19,244 pregnant women who visited one of 37 associated hospitals in the Hokkaido Prefecture from 2003 through 2012, and completed follow-up. All birth defects after 12 weeks of gestation, including 55 marker anomalies associated with environmental chemical exposures, were recorded. We examined parental risk factors for birth defects and the association between birth defects and risk of growth retardation. Results: Prevalence of all birth defects was 18.9=1,000 births. The proportion of patients with birth defects delivered between 12 and 21 weeks of gestation was approximately one-tenth of all patients with birth defects. Among those with congenital malformation of the nerve system, 39% were delivered before 22 weeks of gestation. All patients with anencephaly and encephalocele were delivered before 22 weeks of gestation. We observed different patterns of parental risk factors between birth defect cases included in ISBDSR and cases not included. Cases included in ISBDSR were associated with an increased risk of preterm birth. Cases not included in ISBDSR were associated with an increased risk of being small for gestational age at term. Conclusions: Data from our study complemented the data from ICBDSR. We recommend that birth defects not included in ICBDSR also be analyzed to elucidate the etiology of birth defects.

DOI PubMed

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