|
所属 |
附属病院 産科婦人科 |
|
ホームページ |
研究等業績 【 表示 ／ 非表示 】
-
Shape of the first mitotic spindles impacts multinucleation in human embryos
Ono Y.
Nature Communications ( Nature Communications ) 15 ( 1 ) 2024年12月
研究論文（学術雑誌）
Abstract
During human embryonic development, early cleavage-stage embryos are more susceptible to errors. Studies have shown that many problems occur during the first mitosis, such as direct cleavage, chromosome segregation errors, and multinucleation. However, the mechanisms whereby these errors occur during the first mitosis in human embryos remain unknown. To clarify this aspect, in the present study, we image discarded living human two-pronuclear stage zygotes using fluorescent labeling and confocal microscopy without microinjection of DNA or mRNA and investigate the association between spindle shape and nuclear abnormality during the first mitosis. We observe that the first mitotic spindles vary, and low-aspect-ratio-shaped spindles tend to lead to the formation of multiple nuclei at the 2-cell stage. Moreover, we observe defocusing poles in many of the first mitotic spindles, which are strongly associated with multinucleation. Additionally, we show that differences in the positions of the centrosomes cause spindle abnormality in the first mitosis. Furthermore, many multinuclei are modified to form mononuclei after the second mitosis because the occurrence of pole defocusing is firmly reduced. Our study will contribute markedly to research on the occurrence of mitotic errors during the early cleavage of human embryos. -
Amniotic fluid glucose concentration as a predictor of fetal trisomy
Konno M.
Journal of Obstetrics and Gynaecology Research ( Journal of Obstetrics and Gynaecology Research ) 50 ( 11 ) 2076 - 2080 2024年11月
研究論文（学術雑誌）
AIM: We aimed to assess the amniotic fluid glucose concentration cut-off as an indicator of fetal chromosomal abnormalities, such as trisomy 13, 18, and 21. METHODS: This prospective observational study included pregnant females who underwent amniocentesis. Participants were divided into two groups on the border of 22 weeks of gestational age (<22 and ≥22-week groups). RESULTS: In total, 224 pregnant females were included in the analysis. In the <22 week group, 15 females had trisomies 13/18/21 and 174 females had no trisomies. In the ≥22 week group, 18 females had trisomies 13/18/21 and 17 had no trisomies. In each group, there was a difference in amniotic fluid glucose concentration between fetuses with trisomies 13, 18, and 21 and other fetuses with normal karyotype or minor chromosomal abnormalities. In both groups, the amniotic glucose concentration was noticeably lower in trisomies 13/18/21 (p = 0.002 in the <22 week group; p = 0.039 in the ≥22 week group). According to receiver operating characteristic curves, the optimal cut-off point of glucose concentration was 46 mg/dL in the <22 week group (odds ratio 6.55; 95% confidence interval 1.78-24.1) and 24 mg/dL in the ≥22 week group (odds ratio 8.40; 95% confidence interval 1.83-38.6). CONCLUSIONS: Our study suggested that glucose concentration in amniotic fluid is an indicator of trisomy 13, 18, and 21. Amniotic fluid glucose concentration itself does not diagnose fetal trisomy, but this may be helpful in selecting treatment facilities.
-
Feasibility and effectiveness of preconception check-ups at workplaces in Japan
Fujishima A.
Journal of Occupational Health ( Journal of Occupational Health ) 66 ( 1 ) n/a 2024年01月
研究論文（学術雑誌）
<p><b>Objectives</b>: Despite the recent increase in infertility and perinatal complications, preconception care is not commonly available in Japan. Working women are considered to have the greatest need for preconception care, as increasingly they marry and have children later in life. This study aimed to assess the feasibility and effectiveness of preconception check-ups in the workplace.</p><p><b>Methods</b>: We provided 51 female employees aged 18-39 years with free preconception check-ups, including additional blood tests and an online medical questionnaire, during mandatory health check-ups at their workplace. A doctor provided online counseling based on the check-up results. We assessed fertility knowledge using the Cardiff Fertility Knowledge Scale (CFKS-J) and childbearing desire pre- and postintervention.</p><p><b>Results</b>: Preconception check-ups revealed various potential risk factors for future pregnancies, including underweight (12%), obesity (20%), <i>Chlamydia trachomatis</i> IgG antibody positivity (22%), low rubella IgG antibody levels (47%), iron deficiency (12%), and 25-hydroxyvitamin D levels <30 ng/mL (98%). Postintervention, the participants reported high satisfaction with the check-ups and significantly advanced their reproductive plans (<i>P</i> = .008). Furthermore, 95% of the participants indicated an intention to seek medical attention or make lifestyle changes. The postintervention CFKS-J score (mean [SD]) was higher than the preintervention score (71.7 [19.3] vs 63.0 [22.0]; <i>P</i> = .006).</p><p><b>Conclusions</b>: We developed a preconception check-up package that can be integrated into workplace health examinations, complemented by tailored counseling. This novel check-up package is a feasible and effective approach for improving preconception health and fertility awareness.</p>
-
Okabe M.
Reproductive Medicine and Biology ( Reproductive Medicine and Biology ) 22 ( 1 ) 2023年01月 [査読有り]
研究論文（学術雑誌）
-
Fujishima A.
Tohoku Journal of Experimental Medicine ( Tohoku Journal of Experimental Medicine ) 259 ( 4 ) 327 - 333 2023年
研究論文（学術雑誌）
<p>Gestational diabetes mellitus (GDM) is a state of pre-diabetic impaired glucose tolerance initially occurring during pregnancy. Although abnormalities in glucose metabolism normally resolve rapidly after delivery, women with GDM have a higher lifetime risk of developing diabetes mellitus than those without GDM; thus, postpartum healthcare is essential. Of all GDM patients, 5%-10% test positive for diabetes-related autoantibodies, which increase the risk of developing type 1 diabetes mellitus (T1DM). Autoantibody measurement in GDM screening remains debatable; however, it may be useful for the postnatal follow-up of GDM patients at high risk of developing T1DM. We treated a 29-year-old woman who was GDM positive for anti-glutamic acid decarboxylase antibody (GADA) requiring high-dose insulin therapy during pregnancy. As the patient tested positive for GADA, she received judicious postpartum management, allowing for early diagnosis of T1DM and resumption of treatment. Her insulin secretory capacity was preserved at 1 year after parturition, suggesting either slowly progressive insulin-dependent T1DM or latent autoimmune diabetes in adults. This was a rare case of slowly progressive insulin-dependent T1DM or latent autoimmune diabetes in adults in the early postpartum period, but the fact that GADA was positive during pregnancy enabled early treatment without overlooking it. Measuring diabetes-related autoantibodies in patients considered to be at a high risk for T1DM, such as those who are of slim build, young, or suffering from autoimmune thyroid disorders, may be important for appropriate individualized follow-up.</p>
-
特集 産婦人科医が知っておきたい プレコンセプションケアの最前線Ⅱ 5.卵巣機能とプレコンセプションケア
岩澤 卓也, 藤嶋 明子, 白澤 弘光, 寺田 幸弘
産婦人科の実際 ( 金原出版 ) 73 ( 6 ) 557 - 562 2024年06月
-
胎児形態スクリーニング超音波検査の成績報告および評価に影響を与える因子の検討
福岡 日向, 小野寺 洋平, 藤嶋 明子, 三浦 広志, 寺田 幸弘
東北連合産科婦人科学会総会・学術講演会プログラム・抄録集 ( 東北連合産科婦人科学会・北日本産科婦人科学会 ) 155回 82 - 82 2024年05月
-
秋田県における帝王切開術式の調査
小野寺 洋平, 藤嶋 明子, 三浦 広志, 寺田 幸弘
東北連合産科婦人科学会総会・学術講演会プログラム・抄録集 ( 東北連合産科婦人科学会・北日本産科婦人科学会 ) 155回 71 - 71 2024年05月
-
小児期の放射線照射後に後期流産を繰り返した1症例
岩澤 卓也, 福岡 日向, 堀井 駿, 津谷 明香里, 坂口 太一, 藤嶋 明子, 尾野 夏紀, 小野寺 洋平, 白澤 弘光, 三浦 広志, 熊澤 由紀代, 寺田 幸弘
日本生殖医学会雑誌 ( (一社)日本生殖医学会 ) 69 ( 1-2 ) 114 - 114 2024年04月
-
当院における胎児中枢神経症例および二分脊椎症例の後方視的検討 脊髄髄膜瘤の胎児治療を見据えて
福岡 日向, 小野寺 洋平, 堀井 駿, 藤嶋 明子, 三浦 広志, 寺田 幸弘
秋田県産科婦人科学会誌 ( 秋田県産科婦人科学会 ) 29 27 - 33 2024年03月
二分脊椎のうち出生前診断が望まれる疾患として脊髄髄膜瘤(myelomeningocele:MMC)、脊髄脂肪腫がある。MMCを持つ胎児では、二分脊椎により露出された脊髄が子宮内で物理的・化学的刺激を受けることで神経損傷し、妊娠後期に非可逆的な神経障害を生じる。生後の脊髄神経機能温存を目的としたMMC胎児手術の臨床研究が本邦でも開始され、今後の普及が期待される。今回我々は、当院産科への胎児精査目的の紹介状況を調査するとともに、MMC及び脊髄脂肪腫症例の診断状況を調査し、MMCの胎児治療を見据えた課題抽出を行った。2023年に当院産科を胎児中枢神経精査のために紹介された妊婦について、紹介週数、超音波所見、転帰を調査した。また、2018年1月から2023年5月に当院で二分脊椎と診断された症例を対象とし、出生前診断の有無、診断時期、診断の契機となった胎児超音波所見、転帰について調査した。2023年の胎児中枢神経精査目的の紹介症例は8症例で、胎児発育不全、正常が2例ずつ、MMC、全前脳胞症、無頭蓋症、中脳水道狭窄が1例ずつだった。二分脊椎について、MMC4例、脊髄脂肪腫3例の計7症例を対象とした。MMCは4例、脊髄脂肪腫は1例で出生前診断された。MMCは75%(3/4)が側脳室拡大を契機に精査されていた。MMCと出生前診断された4症例のうち、妊娠22週未満の2例は人工妊娠中絶を選択、残りの2例は新生児治療が可能な施設へ転院しMMC新生児手術を受けた。MMC胎児手術が可能な週数は妊娠19週0日から25週6日であり、手術適応が厳密に定められている。MMC胎児手術に向けて疾患について理解を深めるとともに妊婦が意思決定するための情報提供が必要である。胎児治療の考慮・妊婦の意思決定のために早期の出生前診断が必要となり、地域単位での胎児形態スクリーニング超音波検査体制の強化を目指していきたい。(著者抄録)
◆原著論文【 表示 ／ 非表示 】
◆その他【 表示 ／ 非表示 】
科研費（文科省・学振）獲得実績 【 表示 ／ 非表示 】
-
鉄欠乏と妊娠貧血・妊娠高血圧症候群との関連を解明する周産期縦断的・母児横断的研究
若手研究
研究期間: 2023年04月 - 2026年03月 代表者: 藤嶋 明子
-
タイムラプス蛍光ライブセルイメージングで検証するヒト第一細胞分裂
基盤研究(B)
研究期間: 2021年04月 - 2024年03月 代表者: 寺田 幸弘, 藤嶋 明子, 白澤 弘光, 高橋 和政
-
タイムラプス蛍光ライブセルイメージングで検証するヒト第一細胞分裂
基盤研究(B)
研究期間: 2021年04月 - 2024年03月 代表者: 寺田 幸弘, 藤嶋 明子, 白澤 弘光, 高橋 和政
-
タイムラプス蛍光ライブセルイメージングで検証するヒト第一細胞分裂
基盤研究(B)
研究期間: 2021年04月 - 2024年03月 代表者: 寺田 幸弘, 藤嶋 明子, 白澤 弘光, 高橋 和政
-
ヒト胚発育動態と細胞内外の電解質の時間的・空間的変化との関連
基盤研究(C)
研究期間: 2021年04月 - 2024年03月 代表者: 熊澤 由紀代, 藤嶋 明子, 寺田 幸弘, 高橋 和政