記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

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記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Blood  

Occupational exposure to medical agents and ionizing radiation has been suggested as a possible risk factor for childhood cancer. However, the relationship between such exposure and pediatric malignancies has not yet been comprehensively studied. This cohort study aimed to investigate the association between parental occupational exposure to hazardous medical agents or ionizing radiation and the risk of childhood cancer in offspring. Data from a large birth cohort in Japan, which included 104,062 fetuses, were analyzed. The primary outcome was the development of leukemia or brain tumors diagnosed by community physicians during the first three years after birth. Exposure factors were medical agents, including anticancer agents, ionizing radiation, and anesthetics, handled by mothers during pregnancy or by fathers for three months prior to conception. The incidence of leukemia, but not of brain tumors, was higher in mothers exposed to anticancer drugs. Multivariable regression analysis showed that maternal exposure to anticancer drugs was associated with an increased risk of leukemia in offspring over one year of age (adjusted relative risk: 7.99 [95% confidence interval: 1.98-32.3]). Detailed information obtained from medical certificates of patients with identified leukemia revealed no infant leukemia but acute lymphoblastic leukemias in the exposed group. Our findings suggest that maternal occupational exposure to anticancer drugs may be a potential risk factor for acute lymphoblastic leukemia in offspring over one year of age. Effective prevention methods may be necessary to prevent maternal exposure to anticancer drugs and to reduce the risk of childhood malignancies.

DOI： 10.1182/blood.2023021008

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記述言語：日本語   出版者・発行元：福岡産科婦人科学会  

近年、がんの診断および治療の進歩により若年のがんサバイバーは増加しており、がん・生殖医療(Oncofertility)の必要性が高まっている。15歳以下の若年で妊孕性温存療法を施行した3症例を経験したので報告する。症例1は15歳で、原疾患はホジキンリンパ腫であった。症例2は14歳で、原疾患は急性骨髄性白血病であった。症例3は12歳で、原疾患は骨肉腫であった。いずれの症例も妊孕性温存療法として卵子凍結保存を行い、若年ならではの工夫や苦慮した点があった。また妊孕性温存療法後の原疾患の治療により早発卵巣不全(premature ovarian insufficiency:POI)となる症例もあり、妊孕性温存療法後も継続的に婦人科での月経状況の確認を行うとともに、適切な時期でのホルモン補充療法の開始などの女性ヘルスケアとしての介入が重要と考えられた。(著者抄録)

記述言語：英語  

Background: / Sleep problems and irritable temperaments are common among infants with autism spectrum disorder (ASD). The prospective association between such sleep problems and irritable temperaments and ASDs needs to be determined for elucidating the mechanism and exploring the future intervention study. Thus, in this study, we investigated whether sleep quality and temperament in 1-month-old infants are associated with the onset of ASD in 3-year-old children. We also assessed its sex-stratified associations. / Methods: / We conducted a longitudinal study using data from 69,751 mothers and infants from a large-cohort study, the Japan Environment and Children’s Study. We examined the prospective association between infant sleep quality and temperament at 1 month of age and ASD diagnosis by 3 years of age. / Results: / Here we show infants with longer daytime sleep have a higher risk of later ASD than those with shorter daytime sleep (risk ratio [RR]: 1.33, 95% confidence interval [CI]: 1.01–1.75). Infants who experienced intense crying have a higher risk of ASD than those who did not (RR: 1.31, 95% CI: 1.00–1.72). There is a difference in sex in the association between a bad mood and later ASD. In particular, female infants experiencing bad moods have a higher risk of ASD than others (RR: 3.59, 95% CI: 1.91–6.75). / Conclusions: / The study findings provide important information for future intervention to reduce the risk of future ASD.

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記述言語：その他   掲載種別：研究論文（学術雑誌）   出版者・発行元：Communications Medicine  

Abstract

Background

Sleep problems and irritable temperaments are common among infants with autism spectrum disorder (ASD). The prospective association between such sleep problems and irritable temperaments and ASDs needs to be determined for elucidating the mechanism and exploring the future intervention study. Thus, in this study, we investigated whether sleep quality and temperament in 1-month-old infants are associated with the onset of ASD in 3-year-old children. We also assessed its sex-stratified associations.

Methods

We conducted a longitudinal study using data from 69,751 mothers and infants from a large-cohort study, the Japan Environment and Children’s Study. We examined the prospective association between infant sleep quality and temperament at 1 month of age and ASD diagnosis by 3 years of age.

Results

Here we show infants with longer daytime sleep have a higher risk of later ASD than those with shorter daytime sleep (risk ratio [RR]: 1.33, 95% confidence interval [CI]: 1.01–1.75). Infants who experienced intense crying have a higher risk of ASD than those who did not (RR: 1.31, 95% CI: 1.00–1.72). There is a difference in sex in the association between a bad mood and later ASD. In particular, female infants experiencing bad moods have a higher risk of ASD than others (RR: 3.59, 95% CI: 1.91–6.75).

Conclusions

The study findings provide important information for future intervention to reduce the risk of future ASD.

DOI： 10.1038/s43856-023-00314-9

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その他リンク： https://www.nature.com/articles/s43856-023-00314-9

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Science of the Total Environment  

BACKGROUND: Prenatal exposure to metal elements has been reported as a potential risk factor for congenital malformation. However, studies on the relationship with congenital anomalies of the kidney and urinary tract (CAKUT) are very scarce. METHODS: Participants of a prospective cohort from the Japan Environment and Children's Study, conducted at 15 research centers, were recruited between January 2011 and March 2014. The exposure factors were concentrations of lead (Pb), cadmium (Cd), mercury (Hg), selenium (Se), and manganese (Mn) measured from maternal whole blood in the second or third trimester. The primary outcome was CAKUT diagnosed during the first three years of life, which was classified into isolated cases and complicated cases accompanied by extrarenal congenital defects. To conduct a nested case-control design within the cohort, we selected 351 isolated cases with 1404 matched controls, and 79 complicated cases with 316 matched controls. RESULTS: A logistic regression model was used to examine the associations between individual metal concentrations and each subtype of CAKUT. A higher level of Se was associated with an increased risk of isolated CAKUT (adjusted odds ratio [95 % confidence interval]: 3.22 [1.33-7.77]). Meanwhile, higher levels of Pb and Mn were associated with a reduced risk of the complicated subtype (0.46 [0.24-0.90] and 0.33 [0.15-0.73], respectively). A Bayesian kernel machine regression model accounting for mixed effects of multiple metals further demonstrated that a higher level of Mn alone was significantly associated with a reduced occurrence of the complicated subtype. CONCLUSIONS: Using a stringent statistical approach, the present study demonstrated that a higher Mn concentration in the maternal blood was associated with a lower risk of complicated CAKUT in offspring. Further cohort and experimental studies are needed to verify the clinical impact of this finding.

DOI： 10.1016/j.scitotenv.2023.164356

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記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

日本における乳がんの罹患率は近年増加を続け,それに伴い閉経前ホルモン受容体陽性乳がんも増加している.閉経前後を問わずホルモン受容体陽性乳がんの術後内分泌療法として,選択的エストロゲン受容体モジュレーターであるTamoxifen(TAM)は広く用いられ,日本乳癌学会は閉経前ホルモン受容体陽性乳がんの術後内分泌療法として,TAM単独もしくはTAMとGonadotropin releasing hormone(GnRH)agonist併用を推奨している.一方で,閉経前ホルモン受容体陽性乳がん患者に対してのTAMによる卵巣過剰刺激作用をきたした症例が報告されている.TAMによる卵巣過剰刺激作用については,卵胞期に卵巣からのエストロゲン産生抑制による視床下部へのnegative feedback機構を介して視床下部からのGnRH分泌が促進し,続いて下垂体からのGonadotropin分泌が促進することで,卵巣過剰刺激作用を呈し,さらに排卵期のエストロゲンによる視床下部へのpositive feedback機構が抑制され,排卵せずに卵胞発育が継続することで高エストロゲン血症をきたすと考えられている.近年,多施設共同後方視的コホート研究でTAMにGnRH agonistを併用することによる卵巣過剰刺激作用の発症抑制への有効性が示唆された.今回,当院で閉経前ホルモン受容体陽性乳がんのTAM投与による卵巣過剰刺激作用を呈した2症例を経験したので報告する.TAM投与中の卵巣腫大は卵巣過剰刺激作用の可能性を考え,血中エストラジオール値を測定し,乳腺外科医と抗エストロゲン療法の内容について協議し,TAMの一時的中止やTAM再開時のGnRH agonistの併用を検討すべきである.(著者抄録)

出版者・発行元：メディカルレビュー社  

DOI： 10.34449/j0015.30.01_0021-0028

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Nature  

Sex chromosome disorders severely compromise gametogenesis in both males and females. In oogenesis, the presence of an additional Y chromosome or the loss of an X chromosome disturbs the robust production of oocytes1-5. Here we efficiently converted the XY chromosome set to XX without an additional Y chromosome in mouse pluripotent stem (PS) cells. In addition, this chromosomal alteration successfully eradicated trisomy 16, a model of Down's syndrome, in PS cells. Artificially produced euploid XX PS cells differentiated into mature oocytes in culture with similar efficiency to native XX PS cells. Using this method, we differentiated induced pluripotent stem cells from the tail of a sexually mature male mouse into fully potent oocytes, which gave rise to offspring after fertilization. This study provides insights that could ameliorate infertility caused by sex chromosome or autosomal disorders, and opens the possibility of bipaternal reproduction.

DOI： 10.1038/s41586-023-05834-x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Cancer Gene Therapy  

Dysregulated G protein-coupled receptor signaling is involved in the formation and progression of human cancers. The heterotrimeric G protein Gα13 is highly expressed in various cancers and regulates diverse cancer-related transcriptional networks and cellular functions by activating Rho. Herein, we demonstrate that increased expression of Gα13 promotes cell proliferation through activation of Rho and the transcription factor AP-1 in human endometrial cancer. Of interest, the RhoGTPase activating protein (RhoGAP), ARHGAP35 is frequently mutated in human endometrial cancers. Among the 509 endometrial cancer samples in The Cancer Genome Atlas database, 108 harbor 152 mutations at 126 different positions within ARHGAP35, representing a somatic mutation frequency of 20.2%. We evaluated the effect of 124 tumor-derived ARHGAP35 mutations on Gα13-mediated Rho and AP-1 activation. The RhoGAP activity of ARHGAP35 was impaired by 55 of 124 tumor-derived mutations, comprised of 23 nonsense, 15 frame-shift, 15 missense mutations, and two in-frame deletions. Considering that ARHGAP35 is mutated in >2% of all tumors, it ranks among the top 30 most significantly mutated genes in human cancer. Our data suggest potential roles of ARHGAP35 as an oncogenic driver gene, providing novel therapeutic opportunities for endometrial cancer.

DOI： 10.1038/s41417-022-00547-1

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：PLoS ONE  

This study aimed to examine the association between infant sleep quality and temperament in one-month-old infants using a large cohort study data. We used data from the Japan Environment and Children’s Study, a cohort study which follows around 100,000 women from pregnancy until their children’s development. The mothers were asked about their infants’ sleep and temperament using a structured questionnaire. Frequent crying (adjusted odds ratio [AOR]: 1.05, 95% confidence interval [CI]: 1.00–1.10) and intense crying (AOR: 1.19, 95% CI: 1.13–1.25) were positively associated with longer sleep periods during the day than at night. Female infants with longer daytime sleep periods than that at nighttime were more likely to cry frequently (AOR: 1.11, 95% CI: 1.04–1.20). Parous women with infants who had frequent night awakening believed their infants cried more intensely (AOR: 1.17, 95% CI: 1.03–1.31). The study demonstrated a specific association between sleep quality and temperament in one-month-old infants. Based on the results of this study, further sleep intervention studies are required to improve infant temperament.

DOI： 10.1371/journal.pone.0274610

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Scientific Reports  

Compared with the relatively well-investigated effects of childhood exposure to lead on neurocognitive deficits, those of prenatal exposure remain relatively inconclusive. We aimed to investigate the association between prenatal blood lead levels and neurodevelopmental delay during the first three years of life. From a prospective cohort of the Japan Environment and Children's Study, we analyzed a total of 80,759 children. The exposure factors were prenatal lead concentrations measured from maternal whole blood in the second/third trimesters and umbilical cord blood at birth. Neurodevelopment was assessed at 6, 12, 18, 24, 30, and 36 months old using a screening tool, the Ages and Stages Questionnaires, third edition (ASQ). The outcome measures were any suspected neurodevelopmental delay (sNDD) identified via the ASQ during the first (sNDD-1Y), second (sNDD-2Y), and third (sNDD-3Y) years of life. sNDD-1Y, 2Y, and 3Y were identified in 18.0%, 16.2%, and 17.2% of children, respectively. The geometric means of blood lead concentration in this study were much lower (0.62 μg/dL in maternal blood and 0.50 μg/dL in cord blood) than previously investigated levels. Multivariable regression models revealed that there were no associations between maternal blood lead and sNDD-1Y and 2Y and between cord blood lead and sNDD-1Y, 2Y, and 3Y. Although a higher maternal blood lead was associated with a reduced risk of sNDD-3Y (adjusted relative risk: 0.84, 95% confidence interval 0.75-0.94, per 1 increase in common logarithm of lead concentration), there were no dose-response relationships in the analysis using quintiles of lead concentrations. Using a large-scale data set, the present study demonstrated no convincing evidence for an inverse association between levels of prenatal blood lead and neurodevelopment in early childhood. Longitudinal measurements of prenatal and postnatal lead levels are needed to understand the relationship between lead exposure and neurocognitive development.

DOI： 10.1038/s41598-022-19509-6

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：EMBO Journal  

The mammalian germline is characterized by extensive epigenetic reprogramming during its development into functional eggs and sperm. Specifically, the epigenome requires resetting before parental marks can be established and transmitted to the next generation. In the female germline, X-chromosome inactivation and reactivation are among the most prominent epigenetic reprogramming events, yet very little is known about their kinetics and biological function. Here, we investigate X-inactivation and reactivation dynamics using a tailor-made in vitro system of primordial germ cell-like cell (PGCLC) differentiation from mouse embryonic stem cells. We find that X-inactivation in PGCLCs in vitro and in germ cell-competent epiblast cells in vivo is moderate compared to somatic cells, and frequently characterized by escaping genes. X-inactivation is followed by step-wise X-reactivation, which is mostly completed during meiotic prophase I. Furthermore, we find that PGCLCs which fail to undergo X-inactivation or reactivate too rapidly display impaired meiotic potential. Thus, our data reveal fine-tuned X-chromosome remodelling as a critical feature of female germ cell development towards meiosis and oogenesis.

DOI： 10.15252/embj.2021109457

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Nature  

Background:: We hypothesized that maternal lifestyle factors, such as physical activity and sleep habits, may be associated with autism spectrum disorder (ASD) in infants. This study aimed to investigate the association between maternal physical activity and sleep before and during pregnancy with infant ASD diagnosed by the age of 3 years. Methods:: We used the data from the Japan Environment and Children’s Study between 2011 and 2014. The study included 103,060 pregnant women, among which, 69,969 women were analyzed. Participants were asked about their physical activity and sleep before and during pregnancy using questionnaires during pregnancy. Maternal physical activity was estimated using the international physical activity questionnaire. Based on the levels of physical activity before or during pregnancy, the participants were divided into five groups. Maternal sleep was analyzed based on sleep duration and bedtime. The outcome was diagnosis of ASD in 3-year-old infants. Results:: In mothers with higher physical activity levels during pregnancy, the risk ratios (RR) for ASD in their 3-year-old infants were lower (RR = 0.61, 95% confidence interval (CI) = 0.42–0.90). In contrast, too short (<6 h) and too long (>10 h) sleep durations during pregnancy were associated with higher risk ratios for ASD than 7–8 h sleep duration (too short: RR = 1.87, 95% CI = 1.21–2.90; too long: RR = 1.56, 95% CI = 1.00–2.48). These associations were not observed before pregnancy. Conclusion:: Maternal physical activity and sleep duration during pregnancy may be associated with ASD in infants.

DOI： 10.1038/s43856-022-00101-y

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：American Journal of Kidney Diseases  

RATIONALE & OBJECTIVE: Several maternal chronic diseases have been reported as risk factors for congenital anomalies of the kidney and urinary tract (CAKUT) in offspring. However, these investigations used case-control designs, and cases with isolated genitourinary CAKUT (CAKUT) were not distinguished from cases where CAKUT was present with extrarenal congenital anomalies (complicated CAKUT). We examined the association of maternal diseases with isolated and complicated CAKUT in offspring using data from a prospective cohort study. STUDY DESIGN: A nationwide prospective birth cohort study. SETTING & PARTICIPANTS: 100,239 children enrolled in the Japan Environment and Children's Study between January 2011 and March 2014 at 15 research centers. Physicians' diagnoses in mothers and children were collected from medical record transcripts and questionnaires. EXPOSURES: Medical histories of maternal non-communicable illness including obesity, hypertension, diabetes mellitus, kidney disease, hyperthyroidism, hypothyroidism, psychiatric disease, epilepsy, cancer, and autoimmune disease. OUTCOMES: CAKUT diagnosed during the first three years of life classified as isolated or complicated. ANALYTICAL APPROACH: Multivariable Poisson regression with generalized estimating equations accounting for clustering by clinical center. RESULTS: Among the 100,239 children, 560 (0.6&#37;) had CAKUT, comprising 454 (81&#37;) isolated and 106 (19&#37;) complicated forms. The risk of isolated CAKUT was elevated in children of mothers who experienced kidney disease (adjusted risk ratio (RR): 1.80, 95&#37; confidence interval (CI): 1.12-2.91) or cancer (RR: 2.11, CI: 1.15-3.86). Furthermore, the risk of complicated CAKUT was increased in children of mothers with diabetes mellitus (RR: 3.04, CI: 1.64-5.61). LIMITATIONS: Lack of standardization or pre-specification of clinical definitions, diagnostic criteria, measurements, and testing. Genetic testing was not performed. CONCLUSIONS: Isolated CAKUT and complicated CAKUT were associated with different maternal diseases. The results may inform clinical management of pregnancy and highlight potential differences in the genesis of isolated and complicated forms of CAKUT.

DOI： 10.1053/j.ajkd.2022.03.003

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Health Science Reports  

Background and Aims: Maternal hemoglobin concentration during pregnancy is reported to be associated with various perinatal outcomes and may also be associated with infant development. This study aims to investigate the association between maternal hemoglobin levels during early or mid-pregnancy and sleep and developmental problems in 1-year-old infants. Methods: We used the data of 66,935 pregnant women who were participants of the Japan Environment and Children's Study, a nationwide cohort study in Japan, between 2011 and 2014. Maternal hemoglobin level was examined at recruitment (mean gestational age, 15.3 weeks; SD, 2.85 weeks; range, 6-22 weeks). Information on infant sleep and development at the age of 1 year was acquired using a questionnaire. Infant development was evaluated using the Ages and Stages Questionnaire (ASQ). Results: The mean (SD) maternal hemoglobin level was 12.0 (1.0) g/dl. Maternal hemoglobin levels were not associated with the majority of infant sleep and developmental outcomes. In the group with maternal hemoglobin <10.0 g/dl, the risk ratio (RR) for sleep at 22:00 or later was higher than that in the reference group with 11.0 g/dl ≤ hemoglobin < 14.0 g/dl (RR 1.12, 95&#37; confidence interval = 1.00-1.25). In the analysis with maternal hemoglobin level as a continuous variable, both high and low hemoglobin levels were associated with a higher RR of a late bedtime. In addition, a low maternal hemoglobin level was associated with a higher RR for abnormal fine motor skills in the ASQ. Conclusion: Our results suggest that a low level of maternal hemoglobin during pregnancy is associated with late bedtime and abnormal fine motor skills in 1-year-old infants. Conversely, a high level of maternal hemoglobin may also be associated with the infant's late bedtime.

DOI： 10.1002/hsr2.552

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1038/s41586-020-3027-9

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1371/journal.pgen.1008676

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1073/pnas.1817223116

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1038/nature20104

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記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

日本における乳がんの罹患率は近年増加を続け,それに伴い閉経前ホルモン受容体陽性乳がんも増加している.閉経前後を問わずホルモン受容体陽性乳がんの術後内分泌療法として,選択的エストロゲン受容体モジュレーターであるTamoxifen(TAM)は広く用いられ,日本乳癌学会は閉経前ホルモン受容体陽性乳がんの術後内分泌療法として,TAM単独もしくはTAMとGonadotropin releasing hormone(GnRH)agonist併用を推奨している.一方で,閉経前ホルモン受容体陽性乳がん患者に対してのTAMによる卵巣過剰刺激作用をきたした症例が報告されている.TAMによる卵巣過剰刺激作用については,卵胞期に卵巣からのエストロゲン産生抑制による視床下部へのnegative feedback機構を介して視床下部からのGnRH分泌が促進し,続いて下垂体からのGonadotropin分泌が促進することで,卵巣過剰刺激作用を呈し,さらに排卵期のエストロゲンによる視床下部へのpositive feedback機構が抑制され,排卵せずに卵胞発育が継続することで高エストロゲン血症をきたすと考えられている.近年,多施設共同後方視的コホート研究でTAMにGnRH agonistを併用することによる卵巣過剰刺激作用の発症抑制への有効性が示唆された.今回,当院で閉経前ホルモン受容体陽性乳がんのTAM投与による卵巣過剰刺激作用を呈した2症例を経験したので報告する.TAM投与中の卵巣腫大は卵巣過剰刺激作用の可能性を考え,血中エストラジオール値を測定し,乳腺外科医と抗エストロゲン療法の内容について協議し,TAMの一時的中止やTAM再開時のGnRH agonistの併用を検討すべきである.(著者抄録)

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記述言語：日本語  

＜文献概要＞哺乳類の生殖細胞は,雌では卵子,雄では精子へと分化する。卵子と精子は融合して受精卵となり新しい個体が誕生し,その遺伝情報およびエピジェネティック情報を次世代に伝える。近年,多能性幹細胞であるiPS細胞/ES細胞を用いて,体外培養で生殖細胞の発生を再現する研究が進んでいる。これらの研究は,生殖細胞発生のメカニズムをさらに解明するための基盤となる。今後,体外培養によるiPS細胞からの卵子形成過程の観察をヒトに応用して不妊症の病態解明に寄与することなど,生殖医療への応用が期待される。

記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

＜文献概要＞哺乳類の生殖細胞は,雌では卵子,雄では精子へと分化する。卵子と精子は融合して受精卵となり新しい個体が誕生し,その遺伝情報およびエピジェネティック情報を次世代に伝える。近年,多能性幹細胞であるiPS細胞/ES細胞を用いて,体外培養で生殖細胞の発生を再現する研究が進んでいる。これらの研究は,生殖細胞発生のメカニズムをさらに解明するための基盤となる。今後,体外培養によるiPS細胞からの卵子形成過程の観察をヒトに応用して不妊症の病態解明に寄与することなど,生殖医療への応用が期待される。

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J02833&link_issn=&doc_id=20230306130005&doc_link_id=10.34449%2FJ0015.30.01_0021-0028&url=https%3A%2F%2Fdoi.org%2F10.34449%2FJ0015.30.01_0021-0028&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

＜文献概要＞哺乳類の生殖細胞は,雌では卵子,雄では精子へと分化する。卵子と精子は融合して受精卵となり新しい個体が誕生し,その遺伝情報およびエピジェネティック情報を次世代に伝える。近年,多能性幹細胞であるiPS細胞/ES細胞を用いて,体外培養で生殖細胞の発生を再現する研究が進んでいる。これらの研究は,生殖細胞発生のメカニズムをさらに解明するための基盤となる。今後,体外培養によるiPS細胞からの卵子形成過程の観察をヒトに応用して不妊症の病態解明に寄与することなど,生殖医療への応用が期待される。

記述言語：日本語  

記述言語：日本語  

記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(一社)日本疫学会  

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記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

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記述言語：日本語   出版者・発行元：(公社)日本新生児成育医学会  

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記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

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記述言語：日本語  

記述言語：日本語   出版者・発行元：福岡産科婦人科学会  

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記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語  

記述言語：日本語   出版者・発行元：(一社)日本病態栄養学会  

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J-GLOBAL

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記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

総排泄腔遺残症は、尿道、腟、直腸が総排泄腔という共通管に合流し、共通管のみが会陰部に開口する女性特有の疾患であり、先天性難治性稀少泌尿生殖器疾患群の一つである。治療は出生後の外科的治療に開始するが、不妊治療や妊娠成立後の妊娠管理・分娩様式の選択に関して症例の報告は多くなく、確立した治療指針は未だない。今回われわれが経験した症例は、1歳時の腹仙骨会陰式肛門腟形成術、尿道形成術に始まり、17歳での内膜症に対する開腹術を経て、28歳でAssisted Reproductive Technology(ART)により妊娠が成立した。妊娠初期に排尿障害増悪のため膀胱瘻の造設、妊娠中期から排便困難症状・早産リスク管理のため入院を要したが、妊娠を正期産時期まで継続、帝王切開分娩へと導き生児を得ることができた。稀少疾患であること、症例個々がvariationに富むことから問題点は症例ごとに異なるが、それぞれのステージでの問題点を認識し、複数科で適切な連携管理を行うことが肝要と考える。(著者抄録)

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

生殖細胞系列の根幹である始原生殖細胞(primordial germ cells:PGCs)の数は非常に少なく,解析方法が限られていたが,iPS細胞/ES細胞から始原生殖細胞様細胞(primordial germ cell-like cells:PGCLCs)を分化誘導することにより数量制限を解決することができた.PGCLCsから卵子までの分化過程を体外培養で行うことにより,卵子形成過程を直接観察することが可能となった.今後,体外培養によるiPS細胞からの卵子形成過程の観察をヒトへ応用することにより不妊症の病態解明に寄与することが期待される.(著者抄録)

記述言語：日本語  

記述言語：日本語  

記述言語：英語  

記述言語：日本語  

記述言語：日本語  

患者は37歳、2経産。妊娠29週2日に胎動消失を主訴に当科を受診した。受診時、胎児心拍数陣痛図はnon-reactive patternで、経腹超音波検査では胎動がほとんど認められず、胎児機能不全疑いの診断で入院となった。入院後も引き続き胎動は無く、さらにBiophysical Profile Scoring 2点と低下していたため、胎児機能不全の診断で緊急帝王切開術を施行した。児は1512gの女児で、Apgarスコアは1分後3点、5分後7点、臍帯動脈血pH 7.334であった。胎児付属物所見では著明な羊水混濁と胎盤表面の膿瘍形成が認められた。術前の母体血液培養およびグラム染色でリステリア菌が推定されたため、母児双方に関してリステリア感染症を念頭に置いた抗菌薬治療を開始した結果、良好な転帰を得た。(著者抄録)

記述言語：日本語  

若年子宮頸癌患者の増加や妊娠年齢の高齢化のため、浸潤子宮頸癌に対する妊孕性温存を目的とした子宮頸部摘出術を行う症例が増加している。当科においても2011年6月より腹式広汎(準広汎)子宮頸部摘出術を開始し、現在までに3例を経験した。うち1例は、術後自然妊娠、分娩に至り生児を得ることができた。手術適応を慎重に評価し、十分なインフォームドコンセントの上であれば、本術式は浸潤子宮頸癌治療の選択肢になり得ると考えられる。(著者抄録)

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

33歳(2経妊1経産)。前医にて前置胎盤が疑われ、妊娠21週5日に紹介受診した。胎盤は前壁から左側壁にかけて付着する全前置胎盤であり、妊娠26週5日に低置胎盤となった。妊娠34週1日のMRIでは早期濃染される絨毛膜が脱落膜を介さず直接筋層と接していた。妊娠37週3日に選択的帝王切開術を行い、2550gの女児をApgar score 8点/9点で娩出した。子宮は著しい弛緩状態のため胎盤剥離は行わず、オキシトシン、メチルエルゴメトリンマレイン酸を投与し、PGF2αを子宮筋層内に局注した。胎盤が部分的に剥離して出血が生じ、子宮底マッサージを加えつつ胎盤を用手的に剥離した。子宮下部の胎盤剥離面からの出血を結紮止血した。子宮の弛緩が改善せず出血が持続したため、子宮内バルーンタンポナーデ法による止血で内腔からの出血は止血した。出血量は羊水込みで2430gであり自己血800mLを返血した。全身状態が良好となり、術後8日目に退院した。

記述言語：日本語  

36歳(0経妊0経産)。妊婦健診にて胎児水腫を指摘され、精査加療目的に妊娠21週3日目に著者らの施設へ紹介となった。超音波断層法にて胎児の腹腔内に腹水の貯留と皮下浮腫、胸水の貯留が認められた。また、児頭大横径の基準断面像で正中線が右側に偏位しており、左頭蓋骨下に境界明瞭な半月状の高輝度エコー像が認められた。以上、これらの所見より本症例は胎児左硬膜外血腫が疑われた。また、中大脳動脈の収縮期最高血流速度が56.0cm/secと高値であったため、胎児貧血も示唆された。以後、妊娠21週6日目に人工妊娠中絶を施行した結果、臍帯血の血液一般検査にて貧血、血小板滅少、凝固機能障害が認められたほか、胎盤および胎児の病理組織検査にてcytomegalovirus placentitis、congenital cytomegalovirus infectionが診断された。

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語