68 results on '"Yoshifumi Kasuga"'
Search Results
2. Risk factors of neonatal hypoglycemia in neonates born to mothers with gestational diabetes
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Takeshi Arimitsu, Yoshifumi Kasuga, Satoru Ikenoue, Yoshifumi Saisho, Mariko Hida, Jun Yoshino, Hiroshi Itoh, Mamoru Tanaka, and Daigo Ochiai
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Endocrinology ,Endocrinology, Diabetes and Metabolism - Published
- 2023
3. Fetal growth restriction and a single umbilical artery are independent predictors of hypospadias during pregnancy
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Miho Iida, Hiroshi Asanuma, Yoshifumi Kasuga, Mariko Hida, Daigo Ochiai, Mamoru Tanaka, Toyohide Endo, Satoru Ikenoue, Tomohiro Ishii, Yosuke Ichihashi, Tomonobu Hasegawa, Takeshi Sato, and Maki Oishi
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Male ,medicine.medical_specialty ,Pregnancy ,Hypospadias ,Fetal Growth Retardation ,Obstetrics ,Single umbilical artery ,business.industry ,Placenta ,Infant ,Obstetrics and Gynecology ,medicine.disease ,Single Umbilical Artery ,Text mining ,Reproductive Medicine ,medicine ,Fetal growth ,Humans ,Female ,business ,Retrospective Studies ,Developmental Biology - Abstract
Little is known about the association between hypospadias and small fetuses, as well as the pathological implications of fetal growth restriction (FGR). Thus, we aimed to investigate the association between hypospadias and small fetuses using a database of fetal ultrasound and obstetric events.A cohort of male singleton infants delivered after 22 weeks of gestation at Keio University Hospital between 2013 and 2019 was retrospectively reviewed. FGR was defined according to the Delphi criteria. Logistic regression analysis was performed to identify the significant predictors of hypospadias. Placental pathology was reviewed in cases with hypospadias.Of the 2,040 male infants included in the present study, 23 had hypospadias. The prevalences of a single umbilical artery (SUA), small for gestational age, maternal hypertensive disorders of pregnancy, and a small placenta, were significantly higher in infants with hypospadias. Multiple logistic regression analysis revealed that FGR (odds ratio [OR] = 9.39; 95% confidence interval [CI], 2.50-35.3) and the presence of a SUA (OR = 33.4; 95% CI, 8.00-139.5) were independently and significantly associated with hypospadias. When FGR was stratified by the time of onset, its association with hypospadias was significant regardless of the time of onset. Moreover, placental histological findings suggested that fetal vascular malperfusion might play a role in hypospadias.FGR and SUAs are independent prenatal predictors of the development of hypospadias, and fetal vascular malperfusion of the placenta may be involved in the etiology of hypospadias.
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- 2022
4. Prophylactic administration of human amniotic fluid stem cells suppresses inflammation-induced preterm birth via macrophage polarization
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Yushi Abe, Daigo Ochiai, Seiji Kanzaki, Yu Sato, Toshimitsu Otani, Satoru Ikenoue, Yoshifumi Kasuga, and Mamoru Tanaka
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Clinical Biochemistry ,Cell Biology ,General Medicine ,Molecular Biology - Abstract
Ascending inflammation from the vagina is a major cause of preterm birth. Currently, this condition-especially when uncontrolled-has no effective treatment. Human amniotic fluid stem cells (hAFSCs) are mesenchymal stem cells known to exert potent anti-inflammatory effects in animal models of perinatal diseases, such as periventricular leukomalacia, myelomeningocele, and neonatal sepsis. However, hAFSC therapy for inflammation-induced preterm birth has not been tested. In order to determine the therapeutic effect of hAFSC transplantation, we employed a preterm mouse model of ascending infection; this model was constructed by administering lipopolysaccharide to pregnant mice. We investigated the preterm birth rate and evaluated the inflammation of tissues, which is related to progressive infections, such as those involving the cervix, placenta, and lavage cells, using real-time qPCR. Further, we tracked the fluorescence of fluorescently labeled hAFSCs using an in vivo imaging system, and hAFSC aggregation was evaluated using immunohistochemistry analysis. We also investigated the presence of multiple types of peritoneal macrophages via flow cytometry analysis. Finally, we performed sphere culturing and co-culturing to determine the therapeutic effects of hAFSCs, such as their anti-inflammatory effects and their potential to alter macrophage polarization. We found that hAFSC administration to the peritoneal cavity significantly reduced inflammation-induced preterm birth in the mouse model. The treatment also significantly suppressed inflammation of the placenta and cervix. Transplanted hAFSCs may have aggregated with peritoneal macrophages, switching them from an inflammatory to an anti-inflammatory type. This property has been reported in vivo previously, but here, we examined the effect in vitro. Our findings support the hypothesis that hAFSCs suppress inflammation and reduce preterm birth by switching macrophage polarity. This study is the first to demonstrate that hAFSCs are effective in the treatment and prevention of inflammation-induced preterm birth.
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- 2022
5. Ultrasonographic Prediction of Placental Invasion in Placenta Previa by Placenta Accreta Index
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Keita Hasegawa, Satoru Ikenoue, Yuya Tanaka, Maki Oishi, Toyohide Endo, Yu Sato, Ryota Ishii, Yoshifumi Kasuga, Daigo Ochiai, and Mamoru Tanaka
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placenta accreta spectrum ,General Medicine ,ultrasonography ,placenta accreta index ,placenta previa - Abstract
This study aimed to investigate the diagnostic accuracy of the placenta accreta index (PAI) for predicting placenta accreta spectrum (PAS) in women with placenta previa. We analyzed 33 pregnancies with placenta previa at Keio University Hospital. The PAI was assessed in the early third trimester, and PAS was diagnosed histologically or clinically defined as retained placenta after manual removal attempts. The PAI and incidence of PAS were analyzed. Ten women (30%) were diagnosed with PAS and had higher volumes of perioperative bleeding (p = 0.016), higher rate of requiring uterine artery embolization (p = 0.005), and peripartum hysterectomy (p = 0.0002) than women without PAS. A PAI > 2 was the most useful cut-off point for predicting PAS and was more sensitive than prediction values using traditional evaluation (history of cesarean section and placental location). Post-hoc analysis revealed a higher rate of previous history of cesarean delivery (30% vs. 4.4%, p = 0.038), severe placental lacunae (≥grade2) (70% vs. 8.7%, p = 0.0003), thin myometrial thickness (90% vs. 22%, p = 0.0003), anterior placenta (100% vs. 30%, p = 0.0002), and presence of bridging vessels (30% vs. 0%, p = 0.0059) in PAS women. PAI could help predict the outcomes of women with placenta previa with and without a history of cesarean delivery to reduce PAS-induced perinatal complications.
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- 2023
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6. Efficacy and Safety of a Telemedicine System in Subjects with Gestational Diabetes Mellitus (TELEGLAM): Study Protocol for a Randomized Controlled Trial
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Kazuki Aoyama, Yuya Nakajima, Shu Meguro, Yasunori Sato, Rei Goto, Mariko Hida, Takeshi Arimitsu, Yoshifumi Kasuga, Mamoru Tanaka, and Hiroshi Itoh
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- 2023
7. A capture methyl-seq protocol with improved efficiency and cost-effectiveness using pre-pooling and enzymatic conversion
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Keita Hasegawa, Kazuhiko Nakabayashi, Keisuke Ishiwata, Yoshifumi Kasuga, Kenichiro Hata, and Mamoru Tanaka
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Objective The opportunities for sequencing-based methylome analysis of clinical samples are increasing. To reduce its cost and the amount of genomic DNA required for library preparation, we aimed to establish a capture methyl-seq protocol, which adopts pre-pooling of multiple libraries before hybridization capture and TET2/APOBEC-mediated conversion of unmethylated cytosine to thymine. Results We compared a publicly available dataset generated by the standard protocol of SureSelect XT Human Methyl-Seq Kit and our dataset obtained by its modified protocol that adopted sample pre-pooling and enzymatic conversion. We confirmed that the quality of DNA methylation data was comparable between the two datasets. As our protocol, EMCap, is more cost-effective and reduces the amount of input genomic DNA, it would serve as a better choice for clinical methylome sequencing.
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- 2022
8. Management of pregnancy after radical trachelectomy
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Mamoru Tanaka, Satoru Ikenoue, Yoshifumi Kasuga, and Daigo Ochiai
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0301 basic medicine ,medicine.medical_specialty ,Trachelectomy ,Anastomosis ,Miscarriage ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,medicine ,Humans ,Cervical cancer ,Obstetrics ,business.industry ,Abnormal bleeding ,Pregnancy Outcome ,Obstetrics and Gynecology ,medicine.disease ,Review article ,030104 developmental biology ,Oncology ,030220 oncology & carcinogenesis ,Female ,Varices ,business - Abstract
Radical trachelectomy (RT) is a surgery for early-stage cervical cancer treatment that preserves the childbearing ability, and its use has become increasingly common worldwide. Thus, the rate of conception in women who have undergone RT is increasing. However, pregnancy after RT is associated with a higher risk of several obstetric complications such as preterm delivery, preterm premature membrane rupture, and abnormal bleeding from varices at the site of uterovaginal anastomosis. Furthermore, since RT have a residual prophylactic cerclage, it is difficult to manage first- and second-trimester miscarriages. There is little previous data on the management of pregnancy after RT. In this review article, we summarize various management methods and experiences to provide a guide to clinicians for perinatal management after RT.
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- 2021
9. The associated factors of low birthweight among term singletons in Japan: a pregnancy birth registry analysis
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Yoshifumi Kasuga, Miho Iida, Yuya Tanaka, Masumi Tamagawa, Keita Hasegawa, Satoru Ikenoue, Yasunori Sato, Mamoru Tanaka, and Daigo Ochiai
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Epidemiology ,General Medicine - Abstract
BackgroundProgress in reducing the global low birthweight (LBW) has been insufficient. Although the focus has been on preventing preterm birth, evidence regarding LBW in term births is limited. Despite its low preterm birth prevalence, Japan has a higher LBW proportion than other developed countries. This study aimed to examine the prevalence of LBW in term singleton births and its associated factors using a national database.MethodsWe retrospectively analyzed the data of neonates registered in the Japan Society of Obstetrics and Gynecology Successive Pregnancy Birth Registry System who were born 2013-2017. Exclusion criteria included stillbirths, delivery after 42 gestational weeks, and missing data. Logistic regression analyses were performed to investigate the maternal and perinatal factors associated with LBW in term singletons using the data of 715 414 singleton neonates.ResultsThe overall prevalence of LBW was 18.3%, and 35.7% of LBWs originated from singleton term pregnancies. Multiple logistic regression analyses indicated that both modifiable and non-modifiable factors were independently associated with LBW in term neonates. The modifiable maternal factors included pre-pregnancy underweight, inadequate gestational weight gain, and smoking during pregnancy, while the non-modifiable factors included younger maternal age, nulliparity, hypertensive disorders of pregnancy, cesarean section delivery, female offspring, and congenital anomalies.ConclusionsUsing the Japanese pregnancy birth registry data, more than one-third of LBWs were found to originate from singleton term pregnancies. Both modifiable and non-modifiable factors were independently associated with LBW in term neonates. Prevention strategies on modifiable risk factor control will be effective in reducing LBW worldwide.
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- 2022
10. Amniotic fluid stem cells as a novel strategy for the treatment of fetal and neonatal neurological diseases
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Yu Sato, Daigo Ochiai, Satoru Ikenoue, Yushi Abe, Toshimitsu Otani, Yoshifumi Kasuga, Mamoru Tanaka, and Marie Fukutake
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0301 basic medicine ,Modern medicine ,Meningomyelocele ,Amniotic fluid ,Leukomalacia, Periventricular ,medicine.medical_treatment ,Encephalopathy ,Context (language use) ,Mesenchymal Stem Cell Transplantation ,Systemic inflammation ,Bioinformatics ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Animals ,Humans ,Medicine ,030219 obstetrics & reproductive medicine ,Periventricular leukomalacia ,business.industry ,Cerebral Palsy ,Obstetrics and Gynecology ,Mesenchymal Stem Cells ,Stem-cell therapy ,Amniotic Fluid ,medicine.disease ,Rats ,030104 developmental biology ,Reproductive Medicine ,Hypoxia-Ischemia, Brain ,Female ,Stem cell ,medicine.symptom ,business ,Developmental Biology - Abstract
Even in the context of modern medicine, infants with fetal and neonatal neurological diseases such as cerebral palsy and myelomeningocele suffer serious long-lasting impairment due to the irreversible neuronal damage. The promotion of neurologically intact survival in patients with perinatal intractable neurological diseases requires the development of novel strategies. One promising strategy involves the use of human amniotic fluid stem cells (hAFSCs), which have attracted much attention in recent years and are known to exert anti-inflammatory and neuroprotective effects. In recent years, the therapeutic effects of hAFSCs on fetal-neonatal neurological diseases have become evident as per intense research efforts by our group and others. Specifically, hAFSCs administered into the nasal cavity migrated to the brain and controlled local inflammation in a rodent model of neonatal hypoxic-ischemic encephalopathy. In contrast, hAFSCs administered intraperitoneally did not migrate to the brain; they rather formed spheroids in the abdominal cavity, resulting in the suppression of systemic inflammation (including in the brain) via the secretion of anti-inflammatory cytokines in concert with peritoneal macrophages in a rodent model of periventricular leukomalacia. Moreover, studies in a rat model of myelomeningocele suggested that hAFSCs administered in utero secreted hepatocyte growth factor and protected the exposed spinal cord during pregnancy. Importantly, autologous hAFSCs, whose use for fetal-neonatal treatment does not raise ethical issues, can be collected during pregnancy and prepared in sufficient numbers for therapeutic use. This article outlines the results of preclinical research on fetal stem cell therapy, mainly involving hAFSCs, in the context of perinatal neurological diseases.
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- 2021
11. Adenocarcinoma
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Yoshifumi, Kasuga, Satoru, Ikenoue, Hiroshi, Nishio, Wataru, Yamagami, Daigo, Ochiai, Kiyoo, Tanabe, Yasuhiro, Tashima, Nobumaru, Hirao, Kei, Miyakoshi, Kenji, Kasai, Yoshio, Suda, Taiko, Nemoto, Satoru, Shiraishi, Hiroyuki, Yoshida, Takashi, Kurahashi, Kiyoshi, Takamatsu, Shinya, Iwasaki, Hiroshi, Yamashita, Yasuo, Akiba, Toru, Arase, Sumiko, Hara, Sakura, Nakada, Mamoru, Tanaka, and Daisuke, Aoki
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Pregnancy ,Risk Factors ,Infant, Newborn ,Conization ,Humans ,Uterine Cervical Neoplasms ,Premature Birth ,Female ,Cervix Uteri ,Adenocarcinoma in Situ ,Retrospective Studies - Abstract
Pregnancy after conization is associated with a high risk of preterm delivery. However, because risk factors for preterm delivery after conization remain unknown, we conducted a multicenter observational study to investigate risk factors associated with preterm delivery.We selected patients who had previously undergone conization and reviewed medical records from 18 hospitals in cooperation with Keio University School of Medicine between January 2013 and December 2019. Women were classified as nulliparous and primiparous, and a multiple logistic regression analysis was performed to evaluate the relative contributions of the various maternal risk factors for preterm delivery (i.e. delivery before 37 gestational weeks).Among 409 pregnant women after conization, 68 women delivered preterm (17%). The incidence of nulliparity (Pregnant women who previously underwent conization are at risk for preterm delivery. The histological type of AIS and cervical cancer was evaluated as a risk factor for preterm delivery. KEY MESSAGESPrior preterm delivery, presence of a short cervix, and cervical cancer or AIS were predictors of preterm delivery after conization.The depth of conization in cervical cancer or AIS group was significantly larger than that in the CIN group.
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- 2022
12. Adenocarcinoma in situ or early-stage cervical cancer is a risk factor for preterm delivery after cervical conization: a multicenter observational study
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Yoshifumi Kasuga, Satoru Ikenoue, Hiroshi Nishio, Wataru Yamagami, Daigo Ochiai, Kiyoo Tanabe, Yasuhiro Tashima, Nobumaru Hirao, Kei Miyakoshi, Kenji Kasai, Yoshio Suda, Taiko Nemoto, Satoru Shiraishi, Hiroyuki Yoshida, Takashi Kurahashi, Kiyoshi Takamatsu, Shinya Iwasaki, Hiroshi Yamashita, Yasuo Akiba, Toru Arase, Sumiko Hara, Sakura Nakada, Mamoru Tanaka, and Daisuke Aoki
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Pediatrics, Perinatology and Child Health ,Obstetrics and Gynecology - Abstract
Pregnancy after conization is associated with a high risk of preterm delivery. However, because risk factors for preterm delivery after conization remain unknown, we conducted a multicenter observational study to investigate risk factors associated with preterm delivery. We selected patients who had previously undergone conization and reviewed medical records from 18 hospitals in cooperation with Keio University School of Medicine between January 2013 and December 2019. Women were classified as nulliparous and primiparous, and a multiple logistic regression analysis was performed to evaluate the relative contributions of the various maternal risk factors for preterm delivery (i.e. delivery before 37 gestational weeks). Among 409 pregnant women after conization, 68 women delivered preterm (17%). The incidence of nulliparity (p = .014) was higher and a history of preterm delivery (p = .0010) was more common in the preterm delivery group than in the term delivery group. Furthermore, the proportion of women diagnosed with adenocarcinoma in situ (AIS) and cervical cancer in the preterm delivery group was higher than that in the term delivery group (p = .0099 and .0004, respectively). In multiple regression models in nulliparous women, cervical cancer or AIS (Odds ratio [OR]: 4.16, 95% CI: 1.26–13.68, p = .019) and a short cervix in the second trimester (OR: 13.41, 95% CI: 3.88–46.42, p < .0001) increased the risk of preterm delivery. Furthermore, a history of preterm delivery (OR: 7.35, 95% CI: 1.55–34.86, p = .012), cervical cancer or AIS (OR: 5.07, 95% CI: 1.24–20.73, p = .024), and a short cervix in the second trimester (OR: 4.29, 95% CI: 1.11–16.62, p = .035) increased the risk of preterm delivery in the multiple regression models in primiparous women. Pregnant women who previously underwent conization are at risk for preterm delivery. The histological type of AIS and cervical cancer was evaluated as a risk factor for preterm delivery. KEY MESSAGESPrior preterm delivery, presence of a short cervix, and cervical cancer or AIS were predictors of preterm delivery after conization.The depth of conization in cervical cancer or AIS group was significantly larger than that in the CIN group. Prior preterm delivery, presence of a short cervix, and cervical cancer or AIS were predictors of preterm delivery after conization. The depth of conization in cervical cancer or AIS group was significantly larger than that in the CIN group.
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- 2022
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13. DNA methylation analysis of cord blood samples in neonates born to gestational diabetes mothers diagnosed before 24 gestational weeks
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Yoshifumi Kasuga, Tomoko Kawai, Kei Miyakoshi, Asuka Hori, Masumi Tamagawa, Keita Hasegawa, Satoru Ikenoue, Daigo Ochiai, Yoshifumi Saisho, Mariko Hida, Mamoru Tanaka, and Kenichiro Hata
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endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,Infant, Newborn ,nutritional and metabolic diseases ,Mothers ,DNA Methylation ,Glucose Tolerance Test ,RC648-665 ,Fetal Blood ,Diseases of the endocrine glands. Clinical endocrinology ,female genital diseases and pregnancy complications ,gestational diabetes mellitus ,Diabetes, Gestational ,Pregnancy ,Humans ,Female ,Pathophysiology/Complications - Abstract
IntroductionGenome-wide methylation analyses of gestational diabetes mellitus (GDM) diagnosed after 24 gestational weeks (late GDM (L-GDM)) using cord blood have been reported. However, epigenetic changes in neonates born to mothers with GDM diagnosed before 24 gestational weeks (early GDM (E-GDM)) have not been reported. We investigated DNA methylation in neonates born to mothers with E-GDM using cord blood samples.Research design and methodsGenome-wide DNA methylation analysis was performed using an Illumina EPIC array to compare methylation rates of 754 255 autosomal sites in cord blood samples from term neonates born to 162 mothers with GDM (E-GDM: n=84, L-GDM: n=78) and 60 normal glucose tolerance (normal OGTT) pregnancies. GDM was diagnosed based on Japan Society of Obstetrics and Gynecology criteria modified with International Association of Diabetes in Pregnancy Study Group criteria. In this study, all GDM mothers underwent dietary management, while self-monitoring of blood glucose and insulin administration was initiated when dietary modification did not achieve glycemic control.ResultsThere were no significant differences in genome-wide DNA methylation of cord blood samples between the GDM (E-GDM and L-GDM) groups and normal OGTT group or between the E-GDM and normal OGTT groups, L-GDM and normal OGTT groups, and E-GDM and L-GDM groups.ConclusionsThis is the first report to determine the DNA methylation patterns in neonates born to mothers with E-GDM. Neonates born to mothers with GDM, who were diagnosed based on Japan Society of Obstetrics and Gynecology criteria, may not differ in DNA methylation compared with those born to normal OGTT mothers.
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- 2022
14. A case of temporary anhydramnios after COVID-19 infection
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Yoshifumi Kasuga, Yoshikazu Sou, Mio Fukuoka, Miho Kawaida, Satoru Ikenoue, Hajime Okita, Mamoru Tanaka, and Daigo Ochiai
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Reproductive Medicine ,Obstetrics and Gynecology - Published
- 2022
15. Newer Insights Into Fetal Growth and Body Composition
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Yoshifumi Kasuga, Mamoru Tanaka, Satoru Ikenoue, Toyohide Endo, and Daigo Ochiai
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Pediatric Obesity ,Mini Review ,Endocrinology, Diabetes and Metabolism ,Physiology ,030209 endocrinology & metabolism ,Body fat percentage ,Childhood obesity ,Diseases of the endocrine glands. Clinical endocrinology ,Fetal Development ,fetal growth restriction ,03 medical and health sciences ,Endocrinology ,0302 clinical medicine ,Pregnancy ,Fetal macrosomia ,medicine ,Fetal growth ,Humans ,fractional limb volume ,macrosomia ,Adiposity ,fetal subcutaneous fat ,Fetus ,Fetal Growth Retardation ,030219 obstetrics & reproductive medicine ,business.industry ,DOHaD ,medicine.disease ,RC648-665 ,Low birth weight ,predisposition ,fetal ultrasound ,fetal body composition ,embryonic structures ,Body Composition ,Lean body mass ,Female ,Metabolic syndrome ,medicine.symptom ,business - Abstract
Based on epidemiological and experimental evidence, the origins of childhood obesity and early onset metabolic syndrome can be extended back to developmental processes during intrauterine life. It is necessary to actively investigate antecedent conditions that affect fetal growth by developing reliable measures to identify variations in fetal fat deposition and body composition. Recently, the resolution of ultrasonography has remarkably improved, which enables better tissue characterization and quantification of fetal fat accumulation. In addition, fetal fractional limb volume has been introduced as a novel measure to quantify fetal soft tissue volume, including fat mass and lean mass. Detecting extreme variations in fetal fat deposition may provide further insights into the origins of altered fetal body composition in pathophysiological conditions (i.e., fetal growth restriction or fetal macrosomia), which are predisposed to the metabolic syndrome in later life. Further studies are warranted to determine the maternal or placental factors that affect fetal fat deposition and body composition. Elucidating these factors may help develop clinical interventions for altered fetal growth and body composition, which could potentially lead to primary prevention of the future risk of metabolic dysfunction.
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- 2021
16. Predictors of later insulin therapy for gestational diabetes diagnosed in early pregnancy
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Masumi Tamagawa, Maki Oishi, Yu Sato, Satoru Ikenoue, Mamoru Tanaka, Yuya Tanaka, Yoshifumi Kasuga, Keita Hasegawa, Toyohide Endo, Daigo Ochiai, and Yoshifumi Saisho
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Adult ,Blood Glucose ,medicine.medical_specialty ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Body Mass Index ,Impaired glucose tolerance ,Endocrinology ,Pregnancy ,Risk Factors ,Diabetes mellitus ,Glucose Intolerance ,Medicine ,Humans ,Hypoglycemic Agents ,Insulin ,business.industry ,Obstetrics ,nutritional and metabolic diseases ,Gestational age ,Glucose Tolerance Test ,medicine.disease ,female genital diseases and pregnancy complications ,Gestational diabetes ,Diabetes, Gestational ,Apgar score ,Female ,business ,Body mass index - Abstract
Interventions for gestational diabetes mellitus (GDM), diagnosed in early pregnancy, have been a topic of controversy. This study aimed to elucidate factors that predict patients with GDM diagnosed before 24 gestational weeks (early GDM: E-GDM) who require insulin therapy later during pregnancy. Furthermore, we identified patients whose impaired glucose tolerance should be strictly controlled from early gestation onward. Women diagnosed with GDM were categorized based on the gestational age at diagnosis into E-GDM (n = 388) or late GDM (L-GDM, diagnosed after 24 weeks, n = 340) groups. Clinical features were compared between the groups, and the predictors for insulin therapy was evaluated in the E-GDM group. There were no significant between-group differences in terms of perinatal outcomes (e.g., gestational weeks at delivery, fetal growth, hypertensive disorder of pregnancy), with the exception of the Apgar score at 5 min. Moreover, there was no significant difference in the frequency of insulin therapy during pregnancy between the two groups. Using multiple logistic regression analysis, pre-pregnancy body mass index (BMI) ≥25 kg/m2, a family history of diabetes, and higher fasting plasma glucose (FPG), 1 h-plasma glucose (PG), and 2 h-PG values increased insulin therapy risk during pregnancy in the E-GDM group. Furthermore, since E-GDM patients with abnormal levels of FPG, as well as 1 h-PG or 2 h-PG, and those with pre-pregnancy BMI ≥25 kg/m2 and a family history of diabetes had a higher risk of later insulin therapy during pregnancy, they may require more careful follow-up in the perinatal period.
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- 2021
17. Clinical utility of 1-month postpartum random plasma glucose and glycated hemoglobin combined with pre-pregnancy body mass index for detecting postpartum glucose intolerance in Japanese women with gestational diabetes
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Daigo Ochiai, Kazutoshi Sugiyama, Yoshifumi Saisho, Hiroshi Itoh, and Yoshifumi Kasuga
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Adult ,Blood Glucose ,medicine.medical_specialty ,Time Factors ,Coronavirus disease 2019 (COVID-19) ,Endocrinology, Diabetes and Metabolism ,Short Report ,Gestational diabetes mellitus ,Diseases of the endocrine glands. Clinical endocrinology ,Body Mass Index ,chemistry.chemical_compound ,Japan ,Pregnancy ,Diabetes mellitus ,Glucose Intolerance ,Internal Medicine ,medicine ,Humans ,Retrospective Studies ,Glycated Hemoglobin ,Plasma glucose ,Coronavirus disease 2019 ,business.industry ,Pre pregnancy ,Obstetrics ,Postpartum Period ,Postpartum glucose intolerance ,General Medicine ,Articles ,medicine.disease ,RC648-665 ,Gestational diabetes ,Diabetes, Gestational ,Clinical Science and Care ,chemistry ,Female ,Glycated hemoglobin ,business ,Body mass index - Abstract
During the coronavirus disease 2019 pandemic, the Japanese Society of Diabetes and Pregnancy proposed the use of random plasma glucose and glycated hemoglobin measured 1 month after delivery combined with pre‐pregnancy body mass index to detect postpartum glucose intolerance instead of carrying out the oral glucose tolerance test in women with gestational diabetes. We retrospectively evaluated the clinical utility of this strategy to detect postpartum glucose intolerance evaluated by the oral glucose tolerance test after delivery. A total of 275 Japanese women with gestational diabetes were included in the present study. The specificity of 1‐month postpartum random plasma glucose and glycated hemoglobin combined with pre‐pregnancy body mass index to predict postpartum glucose intolerance was 98.0%, with a negative predictive value of 72.6%. However, sensitivity was 6.4%, with a positive predictive value of 55.6%. In conclusion, this Japanese Society of Diabetes and Pregnancy strategy showed high specificity, but low sensitivity, for detecting glucose intolerance postpartum., During the coronavirus disease 2019 pandemic, the Japanese Society of Diabetes and Pregnancy (JSDP) proposed the use of random plasma glucose and HbA1c measured 1 month after delivery combined with pre‐pregnancy body mass index to detect postpartum glucose intolerance instead of performing oral glucose tolerance test in women with gestational diabetes. This JSDP strategy showed high specificity of 98.0% but low sensitivity of 6.4% for detecting glucose intolerance postpartum.
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- 2021
18. Epigenetic Changes in Neonates Born to Mothers With Gestational Diabetes Mellitus May Be Associated With Neonatal Hypoglycaemia
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Yoshifumi Kasuga, Tomoko Kawai, Kei Miyakoshi, Yoshifumi Saisho, Masumi Tamagawa, Keita Hasegawa, Satoru Ikenoue, Daigo Ochiai, Mariko Hida, Mamoru Tanaka, and Kenichiro Hata
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0301 basic medicine ,Adult ,Blood Glucose ,medicine.medical_specialty ,Offspring ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Diseases of the endocrine glands. Clinical endocrinology ,Infant, Newborn, Diseases ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Gene Frequency ,Pregnancy ,Internal medicine ,Medicine ,Humans ,Epigenetics ,Alleles ,Original Research ,DNA methylation ,neonatal hypoglycaemia ,epigenetics ,business.industry ,Infant, Newborn ,Methylation ,Middle Aged ,medicine.disease ,RC648-665 ,gestational diabetes mellitus ,Hypoglycemia ,Gestational diabetes ,Diabetes, Gestational ,030104 developmental biology ,CpG site ,Cord blood ,umbilical cord blood ,Gestation ,Female ,business - Abstract
The detection of epigenetic changes associated with neonatal hypoglycaemia may reveal the pathophysiology and predict the onset of future diseases in offspring. We hypothesized that neonatal hypoglycaemia reflects the in utero environment associated with maternal gestational diabetes mellitus. The aim of this study was to identify epigenetic changes associated with neonatal hypoglycaemia. The association between DNA methylation using Infinium HumanMethylation EPIC BeadChip and neonatal plasma glucose (PG) level at 1 h after birth in 128 offspring born at term to mothers with well-controlled gestational diabetes mellitus was investigated by robust linear regression analysis. Cord blood DNA methylation at 12 CpG sites was significantly associated with PG at 1 h after birth after adding infant sex, delivery method, gestational day, and blood cell compositions as covariates to the regression model. DNA methylation at two CpG sites near an alternative transcription start site of ZNF696 was significantly associated with the PG level at 1 h following birth (false discovery rate-adjusted P < 0.05). Methylation levels at these sites increased as neonatal PG levels at 1 h after birth decreased. In conclusion, gestational diabetes mellitus is associated with DNA methylation changes at the alternative transcription start site of ZNF696 in cord blood cells. This is the first report of DNA methylation changes associated with neonatal PG at 1 h after birth.
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- 2021
19. Deep neural network-based classification of cardiotocograms outperformed conventional algorithms
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Daigo Ochiai, Yasue Mitsukura, Yuji Ikegaya, Satoru Ikenoue, Masato Yasui, Yoshifumi Kasuga, Motoshige Sato, Hiroko Yamamoto, Mamoru Tanaka, and Jun Ogasawara
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musculoskeletal diseases ,congenital, hereditary, and neonatal diseases and abnormalities ,Cardiotocography ,Science ,Article ,03 medical and health sciences ,Uterine Contraction ,0302 clinical medicine ,Medical research ,Pregnancy ,medicine.artery ,Medicine ,Humans ,Cluster analysis ,030219 obstetrics & reproductive medicine ,Multidisciplinary ,medicine.diagnostic_test ,Receiver operating characteristic ,Artificial neural network ,business.industry ,Infant, Newborn ,Umbilical artery ,Heart Rate, Fetal ,Hydrogen-Ion Concentration ,Computational biology and bioinformatics ,Support vector machine ,Apgar Score ,Apgar score ,Female ,Neural Networks, Computer ,business ,F1 score ,Algorithm ,030217 neurology & neurosurgery ,Algorithms - Abstract
Cardiotocography records fetal heart rates and their temporal relationship to uterine contractions. To identify high risk fetuses, obstetricians inspect cardiotocograms (CTGs) by eye. Therefore, CTG traces are often interpreted differently among obstetricians, resulting in inappropriate interventions. However, few studies have focused on quantitative and nonbiased algorithms for CTG evaluation. In this study, we propose a newly constructed deep neural network model (CTG-net) to detect compromised fetal status. CTG-net consists of three convolutional layers that extract temporal patterns and interrelationships between fetal heart rate and uterine contraction signals. We aimed to classify the abnormal group (umbilical artery pH
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- 2021
20. New strategy for diagnosing abnormal glucose tolerance before 24 gestational weeks during the coronavirus disease 2019 pandemic
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Daigo Ochiai, Satoru Ikenoue, Yoshifumi Kasuga, Yoshifumi Saisho, Mamoru Tanaka, and Masumi Tamagawa
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Adult ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Endocrinology, Diabetes and Metabolism ,Abnormal glucose tolerance ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,030209 endocrinology & metabolism ,Gestational Age ,030204 cardiovascular system & hematology ,Diseases of the endocrine glands. Clinical endocrinology ,Letters To The Editor ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Pregnancy ,Internal medicine ,Gestational Weeks ,Diabetes mellitus ,Pandemic ,Glucose Intolerance ,Internal Medicine ,medicine ,Diabetes Mellitus ,Humans ,Retrospective Studies ,Glycated Hemoglobin ,business.industry ,SARS-CoV-2 ,COVID-19 ,General Medicine ,RC648-665 ,Diagnostic strategy ,medicine.disease ,Letter To The Editor ,Diabetes, Gestational ,Female ,business - Abstract
The Japanese abnormal glucose tolerance before 24 gestational weeks diagnostic strategy in the evolving coronavirus disease 2019 pandemic published by the Japanese Society of Diabetes and Pregnancy.
- Published
- 2021
21. Sonographic findings of cervical laceration caused by vaginal delivery in pregnancy after radical trachelectomy
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Toyohide Endo, Yoshifumi Kasuga, Takashi Takeda, Masaru Nakamura, Mamoru Tanaka, Kei Miyakoshi, and Daigo Ochiai
- Subjects
medicine.medical_specialty ,Pregnancy ,business.industry ,Obstetrics ,Vaginal delivery ,Ultrasound ,MEDLINE ,Trachelectomy ,General Medicine ,medicine.disease ,Text mining ,Medicine ,Radiology, Nuclear Medicine and imaging ,business - Published
- 2020
22. Impaired early phase insulin secretion associated with gestational diabetes mellitus in underweight women
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Kei Miyakoshi, Yoshifumi Kasuga, Satoru Ikenoue, Yoshifumi Saisho, Mamoru Tanaka, and Daigo Ochiai
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Blood Glucose ,medicine.medical_specialty ,endocrine system diseases ,030209 endocrinology & metabolism ,03 medical and health sciences ,0302 clinical medicine ,Thinness ,Pregnancy ,Insulin Secretion ,Humans ,Insulin ,Medicine ,030212 general & internal medicine ,Insulin secretion ,business.industry ,Obstetrics ,nutritional and metabolic diseases ,Obstetrics and Gynecology ,Glucose Tolerance Test ,medicine.disease ,Gestational diabetes ,Diabetes, Gestational ,Pediatrics, Perinatology and Child Health ,Female ,Underweight ,medicine.symptom ,Early phase ,business - Abstract
No reports have focused on the clinical and metabolic characteristics of gestational diabetes (GDM) in underweight women. The aim of this study is to investigate the clinical and metabolic features of underweight GDM (pregravid BMI,18.5 kg/mWomen diagnosed with GDM were categorized based on their pre-pregnancy BMI as either underweight (There were no notable differences in maternal age at delivery and the rate of nulliparous between the U-GDM and N-GDM groups. Regarding antepartum oral glucose tolerance test profiles, women with U-GDM exhibited significantly lower fasting plasma glucose (FPG) levels than those with N-GDM (Impaired early phase insulin secretion was associated with GDM onset in underweight women.
- Published
- 2020
23. Transvaginal ultrasound features of the residual cervix in pregnancy after radical trachelectomy
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Kei Miyakoshi, Mamoru Tanaka, and Yoshifumi Kasuga
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Pregnancy ,medicine.medical_specialty ,business.industry ,Ultrasound ,Trachelectomy ,General Medicine ,medicine.disease ,Transvaginal ultrasound ,medicine.anatomical_structure ,Medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,business ,Cervix - Published
- 2020
24. Changes in bone metabolic profile associated with pregnancy or lactation
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Kei Miyakoshi, Mamoru Tanaka, Satoru Ikenoue, Yuiko Sato, Masaya Nakamura, Yoshifumi Kasuga, Yuji Nishiwaki, Kana Miyamoto, Takeshi Miyamoto, and Morio Matsumoto
- Subjects
0301 basic medicine ,Adult ,Bone density ,Osteocalcin ,Breastfeeding ,Physiology ,Mothers ,lcsh:Medicine ,Bone and Bones ,Collagen Type I ,Article ,03 medical and health sciences ,Fractures, Bone ,Young Adult ,Prognostic markers ,0302 clinical medicine ,Bone Density ,Pregnancy ,Lactation ,Medicine ,Humans ,lcsh:Science ,reproductive and urinary physiology ,Bone mineral ,Multidisciplinary ,biology ,business.industry ,Tartrate-Resistant Acid Phosphatase ,lcsh:R ,Middle Aged ,medicine.disease ,030104 developmental biology ,medicine.anatomical_structure ,Breast Feeding ,Parathyroid Hormone ,biology.protein ,Gestation ,Osteoporosis ,Calcium ,Female ,lcsh:Q ,business ,Peptides ,Breast feeding ,030217 neurology & neurosurgery ,Biomarkers - Abstract
Calcium and nutrients are transferred from mothers to fetuses or infants during pregnancy or lactation, respectively, promoting metabolic changes in the mother, many uncharacterized. To evaluate these changes, we undertook two parallel studies. In one we analyzed fourteen clinical cases of vertebral fragility fractures, at or before three months after partum, in mothers who breastfed their infants. In the other, we enrolled 79 additional pregnant subjects, some who chose to breastfeed and others who did not, and analyzed changes in bone metabolic status starting between 34 and 36 weeks of gestation and ending one month after partum. In the larger group, bone-resorbing and bone-forming parameters such as serum TRACP5b and osteocalcin, respectively, significantly increased after partum. Among parameters that changed after partum, serum PTH and the bone-resorbing markers serum TRACP5b and urine NTX were significantly higher in mothers who only breastfed infants compared to mothers who fed infants formula or a mix of both. However, bone-forming parameters were comparable between breastfeeding and non-breast-feeding groups after partum, suggesting that elevated bone-resorption occurs only in the breastfeeding group. Radiographic analysis after partum demonstrated that no subject among the 79 analyzed showed vertebral fractures, even those who breastfed exclusively. Among fracture cases analyzed, subjects exhibited significantly lower bone mineral density than did non-fracture cases in breastfeeding-only subjects. We conclude that bone metabolic status significantly changes over the period between pregnancy and post-partum lactation, and that low bone mineral density seen in a small subset of breastfeeding-only cases likely causes post-partum vertebral fragility fractures.
- Published
- 2019
25. Size for gestational age at birth according to offspring sex and gestational weight gain in underweight women
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Yoshifumi Kasuga, D. Shigemi, T. Suzuki, Takayuki Higuchi, S.-H. Kim, Sakura Nakada, H. Yasunaga, and M. Tamagawa
- Subjects
Adult ,Male ,medicine.medical_specialty ,Offspring ,Medicine (miscellaneous) ,Gestational Age ,Fetal Development ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Japan ,Thinness ,Pregnancy ,Risk Factors ,Birth Weight ,Humans ,Medicine ,030212 general & internal medicine ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics ,Infant, Newborn ,Gestational age ,Odds ratio ,medicine.disease ,Gestational Weight Gain ,Infant, Small for Gestational Age ,Gestation ,Small for gestational age ,Female ,medicine.symptom ,Underweight ,business ,Weight gain ,Body mass index - Abstract
Although maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) are related to fetal growth, there is a paucity of data regarding how offspring sex affects the relationship between maternal BMI in underweight mothers (pre-pregnancy BMI 2) and size for gestational age at birth. The aim of this study was to investigate the effect of offspring sex on the relationships among maternal pre-pregnancy BMI, GWG and size for gestational age at birth in Japanese underweight mothers. Records of women with full-term pregnancies who underwent perinatal care at Kawasaki Municipal Hospital (Kawasaki, Japan) between January 2013 and December 2017 were retrospectively reviewed. The study cohort included underweight (n=566) and normal-weight women (18.5 kg/m2⩽pre-pregnancy BMI2; n=2671). The incidence of small for gestational age (SGA) births in the underweight group was significantly higher than that in the normal-weight group (PPP=0.30) neonates. In the women with female neonates, pre-pregnancy underweight was associated with a significantly increased probability of SGA (odds ratio [OR]: 1.80; PP=0.11). In contrast, in women with male neonates, inadequate GWG was associated with a significantly increased probability of SGA (OR: 1.53; P=0.03), but not with pre-pregnancy underweight (OR: 1.30; P=0.10). In conclusion, the present results suggest that pre-pregnancy underweight is associated with SGA in female offspring but not in male offspring.
- Published
- 2019
26. Glycemic and metabolic features in gestational diabetes: singleton versus twin pregnancies
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Yoshifumi Kasuga, Satoru Ikenoue, Daigo Ochiai, Mamoru Tanaka, Yohei Akiba, Kei Miyakoshi, Yoshifumi Saisho, and Tadashi Matsumoto
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medicine.medical_specialty ,Pregnancy ,endocrine system diseases ,Obstetrics ,business.industry ,Endocrinology, Diabetes and Metabolism ,Insulin ,medicine.medical_treatment ,Dietary management ,nutritional and metabolic diseases ,030209 endocrinology & metabolism ,medicine.disease ,female genital diseases and pregnancy complications ,Gestational diabetes ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,030220 oncology & carcinogenesis ,Diabetes mellitus ,medicine ,Gestation ,business ,Twin Pregnancy ,Glycemic - Abstract
A number of data on gestational diabetes mellitus (GDM) in singleton pregnancy is available, however, little is known about the glycemic characteristics of twin pregnancy with GDM. The aim of this study was to compare the severity of dysglycemia between twin and singleton pregnancies with GDM (T-GDM and S-GDM). We retrospectively analyzed pregnancies with GDM defined by the Japan Diabetes Society criteria (T-GDM, n = 20; S-GDM, n = 451) in our hospital. During the study period, women with GDM underwent self-monitoring of blood glucose measurements as well as dietary management. Insulin treatment was initiated when dietary treatment did not achieve the glycemic goal. The glycemic and metabolic characteristics were compared between T-GDM and S-GDM, as follows: gestational week at the diagnosis of GDM, 75 g oral glucose tolerance test (OGTT) results, HbA1c, insulin secretion (i.e. insulinogenic index [IGI] and Insulin Secretion-Sensitivity Index-2 [ISSI-2]), and insulin requirement before delivery. The rate of one abnormal OGTT value in T-GDM was similar to that in S-GDM (60% vs. 71%). There were no significant differences in gestational week and levels of HbA1c at diagnosis, levels of IGI and ISSI-2 between T-GDM and S-GDM (median, 20 weeks vs. 17 weeks, 5.0% vs. 5.2%, 0.58 vs. 0.71, 1.7 vs. 1.8, respectively). The rate of insulin treatment and a median dosage of insulin needed before delivery was comparable between the two groups (T-GDM vs. S-GDM: 45% vs. 32% and 14 vs. 13 unit/day). Our data suggested that the severity of dysglycemia in T-GDM was similar to that in S-GDM during pregnancy.
- Published
- 2019
27. Human Amniotic Fluid Stem Cells Ameliorate Thioglycollate-Induced Peritonitis by Increasing Tregs in Mice
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Yushi Abe, Daigo Ochiai, Masako Taguchi, Seiji Kanzaki, Satoru Ikenoue, Yoshifumi Kasuga, and Mamoru Tanaka
- Subjects
Inflammation ,amniotic fluid stem cells ,mesenchymal stem cells ,peritonitis ,Treg ,Stem Cells ,Organic Chemistry ,General Medicine ,Peritonitis ,Amniotic Fluid ,Catalysis ,Computer Science Applications ,Inorganic Chemistry ,Mice ,Thioglycolates ,Animals ,Humans ,Physical and Theoretical Chemistry ,Molecular Biology ,Cells, Cultured ,Spectroscopy - Abstract
Mesenchymal stem cells (MSCs) affect immune cells and exert anti-inflammatory effects. Human amniotic fluid stem cells (hAFSCs), a type of MSCs, have a high therapeutic effect in animal models of inflammation-related diseases. hAFSCs can be easily isolated and cultured from amniotic fluid, which is considered a medical waste. Hence, amniotic fluid can be a source of cells for MSC therapy of inflammatory diseases. However, the effect of hAFSCs on acquired immunity in vivo, especially on regulatory T cells, has not yet been fully elucidated. Therefore, in this study, we aimed to understand the effects of hAFSCs on acquired immunity, particularly on regulatory T cells. We showed that hAFSCs ameliorated the thioglycollate-induced inflammation by forming aggregates with host immune cells, such as macrophages, T cells, and B cells in the peritoneal cavity. Further, the regulatory T cells increased in the peritoneal cavity. These results indicated that, in addition to helping the innate immunity, hAFSCs could also aid the acquired immune system in vivo against inflammation-related diseases by increasing regulatory T cells.
- Published
- 2022
28. Clinical and genetic characteristics of abnormal glucose tolerance in Japanese women in the first year after gestational diabetes mellitus
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Yoshifumi Saisho, Daigo Ochiai, Kei Miyakoshi, Naoko Arata, Yoshifumi Kasuga, Mamoru Tanaka, Satoru Ikenoue, Atsushi Tajima, Kenichiro Hata, and Tadashi Matsumoto
- Subjects
0301 basic medicine ,Adult ,Blood Glucose ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Physiology ,030209 endocrinology & metabolism ,Type 2 diabetes ,Polymorphism, Single Nucleotide ,Diseases of the endocrine glands. Clinical endocrinology ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Japan ,Pregnancy ,Diabetes mellitus ,Glucose Intolerance ,Internal Medicine ,medicine ,Humans ,Prediabetes ,Gestational diabetes ,Retrospective Studies ,Glycated Hemoglobin ,Glucose tolerance test ,medicine.diagnostic_test ,business.industry ,Insulin ,Type 2 Diabetes Mellitus ,General Medicine ,Odds ratio ,Articles ,Glucose Tolerance Test ,Middle Aged ,RC648-665 ,medicine.disease ,Prognosis ,Diabetes, Gestational ,030104 developmental biology ,Clinical Science and Care ,Single‐nucleotide polymorphism ,Diabetes Mellitus, Type 2 ,Original Article ,Female ,business ,Biomarkers ,Follow-Up Studies - Abstract
Aims/Introduction Risk factors of type 2 diabetes mellitus in Japanese women with recent gestational diabetes mellitus are unknown. The objective of the present study was to investigate the clinical and genetic characteristics associated with postpartum abnormal glucose tolerance in Japanese women with gestational diabetes mellitus. Materials and Methods A total of 213 Japanese women with recent gestational diabetes mellitus who underwent a postpartum 2‐h oral glucose tolerance test were investigated. The association between antepartum clinical characteristics and postpartum abnormal glucose tolerance (diabetes or prediabetes based on the Japan Diabetes Society criteria) was examined. Frequencies of 45 known type 2 diabetes mellitus‐associated genetic variants were also compared between women with and without postpartum abnormal glucose tolerance. Results A total of 59 women showed postpartum abnormal glucose tolerance (prediabetes, n = 51; diabetes, n = 8). Plasma glucose levels at 1 or 2 h, the insulinogenic index and the insulin secretion‐sensitivity index‐2 of the antepartum oral glucose tolerance test were independent of postpartum abnormal glucose tolerance risk factors (P = 0.006, P = 0.00002, P = 0.01 and P = 0.006, respectively). Four genetic variants (rs266729 [ADIPOQ], rs6017317 [HNF 4A], rs5215 [KCNJ 11] and rs7177055 [HMG 20A]) showed a nominally significant association with postpartum abnormal glucose tolerance (P
- Published
- 2018
29. Expectant management for early pregnancy miscarriage after radical trachelectomy: A single hospital-based study
- Author
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Yoshifumi Kasuga, Mamoru Tanaka, Satoru Ikenoue, Maki Oishi, Yu Sato, Toyohide Endo, Yuya Tanaka, Masumi Tamagawa, Daigo Ochiai, and Keita Hasegawa
- Subjects
Adult ,medicine.medical_specialty ,medicine.medical_treatment ,Trachelectomy ,Uterine Cervical Neoplasms ,Miscarriage ,Pregnancy ,medicine ,Humans ,Cervical cerclage ,Watchful Waiting ,Cervix ,Cervical cancer ,Obstetrics ,business.industry ,Pregnancy Outcome ,Obstetrics and Gynecology ,General Medicine ,medicine.disease ,Curettage ,Abortion, Spontaneous ,medicine.anatomical_structure ,Treatment Outcome ,Female ,Endometritis ,business ,Pregnancy Complications, Neoplastic ,Follow-Up Studies - Abstract
Introduction Women who have undergone radical trachelectomy as a fertility-sparing treatment for early-stage cervical cancer may be at higher risk for retained tissues after early-term miscarriage due to cervical cerclage or cervical necrosis. Dilatation and curettage or aspiration may present additional risks in these women. The aim of this study was to assess the efficacy of expectant management for early pregnancy miscarriage after radical trachelectomy. Material and methods Keio University Hospital records were reviewed for women who conceived after abdominal radical trachelectomy and received perinatal care between 1 April 2012 and 31 March 2020. A total of 62 women (76 pregnancies) were identified, and 13 of these women experienced miscarriage before 12 gestational weeks. The management and outcome of these cases were reviewed in detail. Results The median maternal age at miscarriage was 39 years (range 31-42 years) and the median duration from abdominal radical trachelectomy to conception was 2.60 years (range 0.49-7.30 years). Cervical necrosis before conception occurred in one case (8%). One patient requested treatment with aspiration and the remaining 12 cases were managed with observation for a median of 23 days (range 7-50 days). There were no cases of endometritis or cases requiring dilatation and curettage for residue tissue. Further, no cases developed laceration of the residual cervix and no loss of cerclage sutures after discharge was noted. Conclusions Expectant management seems to be safe and appropriate for first trimester miscarriage after abdominal radical trachelectomy.
- Published
- 2021
30. The Causes of Low Birthweight Among Term Singletons in Japan: National Database Analysis
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Daigo Ochiai, Keita Hasegawa, Satoru Ikenoue, Yuya Tanaka, Yoshifumi Kasuga, Miho Iida, Masumi Tamagawa, Yasunori Sato, and Mamoru Tanaka
- Subjects
History ,Pregnancy ,medicine.medical_specialty ,Polymers and Plastics ,Obstetrics ,business.industry ,Odds ratio ,medicine.disease ,female genital diseases and pregnancy complications ,Industrial and Manufacturing Engineering ,Obstetrics and gynaecology ,medicine ,Gestation ,Term Birth ,Small for gestational age ,Business and International Management ,Underweight ,medicine.symptom ,business ,Developed country ,reproductive and urinary physiology - Abstract
Background: Progress on reducing global low birthweight (LBW) prevalence has been insufficient. Although focus has been on preventing preterm birth, evidence surrounding LBW in term birth is limited. Japan has a higher LBW proportion despite a low preterm birth prevalence than other developed countries. The study aim is to examine LBW prevalence in term singleton birth and investigate their causes using a national database. Methods: Retrospective analysis was conducted on 852,351 babies born between 2013 and 2017 registered in the Japan Society of Obstetrics and Gynecology Successive Pregnancy Birth Registry System. Findings: Prevalence of LBW was 18·3%, and a third (35·7%) of LBW derived from singleton term pregnancy. Multiple logistic regression analysis indicated various factors to be independently associated with LBW in term babies. Modifiable maternal factors included pre-pregnancy underweight (adjusted odds ratios [aOR] 1·65, 95% confidence intervals [CI] 1·62-1·69), inadequate gestational weight gain (aOR 1·90, 1·86-1·94), and smoking during pregnancy (aOR 1·78, 1·71-1·85). Non-modifiable factors included younger maternal age, nulliparity, hypertensive disorder of pregnancy, pre-eclampsia, delivery at 37 gestational weeks, cesarean section, female offspring, and congenital anomaly. Interpretation: LBW in term singleton birth was as common as in multiple and preterm births in Japan. Factors causing LBW in term singletons were similar to those in preterm birth, including maternal malnutrition, suggesting that strategies to reduce preterm birth could be equally effective in preventing LBW in term pregnancy. Evaluating the status and monitoring progress within countries on this issue may contribute to the overall reduction of LBW worldwide. Funding: None to declare. Declaration of Interest: None to declare. Ethical Approval: This study was approved by the Ethics committee of the Keio University School of Medicine, Tokyo, Japan (No. 20190220, approved November 25, 2019) and the Clinical Research Review Board, Japan Society of Obstetrics and Gynecology, Tokyo, Japan, (No. 2019-15, approved September 14, 2020).
- Published
- 2021
31. Defining the Normal Growth Curve of Fetal Fractional Limb Volume in a Japanese Population
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Yoshifumi Kasuga, Satoru Ikenoue, Kazumi Yakubo, Mamoru Tanaka, Toyohide Endo, Daigo Ochiai, Ryota Ishii, and Yohei Akiba
- Subjects
medicine.medical_specialty ,Percentile ,Birth weight ,lcsh:Medicine ,Article ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Linear regression ,medicine ,fractional limb volume ,030212 general & internal medicine ,Fetus ,fetal soft tissue ,030219 obstetrics & reproductive medicine ,Japanese population ,business.industry ,fractional arm volume ,Ultrasound ,lcsh:R ,Gestational age ,General Medicine ,third trimester of gestation ,body regions ,fetal ultrasound ,embryonic structures ,Cardiology ,Gestation ,business ,fractional thigh volume - Abstract
Fetal fractional limb volume is a useful measure for predicting birth weight and newborn adiposity, however, a normal growth curve has been reported solely in the United States. As the birth weight of neonates in Japan is significantly lower than that in the US, fetal fractional limb volume is likely to be smaller in the Japanese population. This study aimed to define the normal growth curve of fractional arm volume (AVol) and thigh volume (TVol) in the Japanese population. Ultrasound scans of 453 AVol and TVol pairs were obtained, each AVol and TVol percentile at each gestational age was calculated. The measured AVol and TVol at each gestational week were also converted to z-scores based on a previous report. The growth curves increased linearly until the second trimester and exponentially in the third trimester. Linear regression showed a significant negative correlation between gestational age and AVol and TVol z-scores. The growth pattern of fetal fractional limb volume in the Japanese population is consistent with, but smaller than, that reported in the US, this difference becomes greater as the gestational age progresses.
- Published
- 2021
32. What are the causes for low birthweight in Japan? A single hospital-based study
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Toyohide Endo, Maki Oishi, Yu Sato, Yasunori Sato, Miho Iida, Daigo Ochiai, Masumi Tamagawa, Satoru Ikenoue, Yoshifumi Kasuga, and Mamoru Tanaka
- Subjects
Male ,Physiology ,Epidemiology ,Maternal Health ,Vasa Previa ,Blood Pressure ,Vascular Medicine ,Body Mass Index ,Labor and Delivery ,Japan ,Pregnancy ,Risk Factors ,Medicine and Health Sciences ,Birth Weight ,reproductive and urinary physiology ,Multidisciplinary ,Obstetrics ,Obstetrics and Gynecology ,Gestational Weight Gain ,female genital diseases and pregnancy complications ,Physiological Parameters ,Hypertension ,Infant, Small for Gestational Age ,Term Birth ,Gestation ,Medicine ,Female ,Infant, Premature ,Research Article ,medicine.medical_specialty ,Birth weight ,Science ,Preterm Birth ,Hypertensive Disorders in Pregnancy ,parasitic diseases ,medicine ,Humans ,Risk factor ,Retrospective Studies ,business.industry ,Body Weight ,Infant, Newborn ,Biology and Life Sciences ,Neonates ,Infant, Low Birth Weight ,medicine.disease ,Pregnancy Complications ,Medical Risk Factors ,Birth ,Small for gestational age ,Women's Health ,business ,Body mass index ,Developmental Biology - Abstract
Low-birthweight (LBW
- Published
- 2021
33. A safe delivery system to prevent COVID-19 transmission without negative-pressure isolation delivery rooms: Experience from a hospital with nosocomial outbreak
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Maki Oishi, Yu Sato, Mamoru Tanaka, Masumi Tamagawa, Satoru Ikenoue, Yoshifumi Kasuga, Miho Iida, Daigo Ochiai, and Toyohide Endo
- Subjects
Adult ,2019-20 coronavirus outbreak ,Delivery rooms ,Coronavirus disease 2019 (COVID-19) ,Isolation (health care) ,lcsh:Gynecology and obstetrics ,Infant, Newborn, Diseases ,law.invention ,Disease Outbreaks ,law ,Pregnancy ,Obstetrics and Gynaecology ,Disease Transmission, Infectious ,Research Letter ,Medicine ,Humans ,Pregnancy Complications, Infectious ,Tokyo ,lcsh:RG1-991 ,Nosocomial outbreak ,Cross Infection ,business.industry ,SARS-CoV-2 ,Delivery Rooms ,Infant, Newborn ,Obstetrics and Gynecology ,COVID-19 ,Safe delivery ,medicine.disease ,Delivery, Obstetric ,Hospitals ,Transmission (mechanics) ,COVID-19 Nucleic Acid Testing ,Female ,Medical emergency ,business ,Disease transmission - Published
- 2021
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34. Vasa previa with fetal vessels running transversely across the cervix: a diagnostic pitfall
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Daigo Ochiai, Sa. Ikenoue, Mamoru Tanaka, Toyohide Endo, Yoshifumi Kasuga, and Maki Oishi
- Subjects
Gynecology ,medicine.medical_specialty ,Fetus ,Radiological and Ultrasound Technology ,business.industry ,Vasa Previa ,Obstetrics and Gynecology ,General Medicine ,medicine.anatomical_structure ,Reproductive Medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,business ,Cervix - Published
- 2021
35. Prophylactic Therapy with Human Amniotic Fluid Stem Cells Improves Long-Term Cognitive Impairment in Rat Neonatal Sepsis Survivors
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Yoshifumi Kasuga, Seiji Kanzaki, Mamoru Tanaka, Yu Sato, Daigo Ochiai, Satoru Ikenoue, and Yushi Abe
- Subjects
Male ,medicine.medical_specialty ,Amniotic fluid ,neonatal sepsis ,medicine.drug_class ,hippocampus ,Antibiotics ,Mesenchymal Stem Cell Transplantation ,Catalysis ,Article ,lcsh:Chemistry ,Inorganic Chemistry ,Rats, Sprague-Dawley ,amniotic fluid stem cells ,Internal medicine ,Intensive care ,medicine ,Animals ,Humans ,Cognitive Dysfunction ,Gliosis ,Physical and Theoretical Chemistry ,lcsh:QH301-705.5 ,Molecular Biology ,Spectroscopy ,Cells, Cultured ,Neonatal sepsis ,business.industry ,Organic Chemistry ,Organ dysfunction ,Amniotic stem cells ,Mesenchymal Stem Cells ,General Medicine ,medicine.disease ,Amniotic Fluid ,prophylactic therapy ,Computer Science Applications ,Astrogliosis ,Rats ,lcsh:Biology (General) ,lcsh:QD1-999 ,Stem cell ,medicine.symptom ,business - Abstract
A systemic inflammatory response induces multiple organ dysfunction and results in poor long-term neurological outcomes in neonatal sepsis. However, there is no effective therapy for treating or preventing neonatal sepsis besides antibiotics and supportive care. Therefore, a novel strategy to improve neonatal sepsis-related morbidity and mortality is desirable. Recently, we reported that prophylactic therapy with human amniotic stem cells (hAFSCs) improved survival in a rat model of lipopolysaccharide (LPS)-induced neonatal sepsis through immunomodulation. Besides improving the mortality, increasing survival without major morbidities is an important goal of neonatal intensive care for neonatal sepsis. This study investigated long-term neurological outcomes in neonatal sepsis survivors treated with hAFSCs using the LPS-induced neonatal sepsis model in rats. We found that prophylactic therapy with hAFSCs improved spatial awareness and memory-based behavior in neonatal sepsis survivors at adolescence in rats. The treatment suppressed acute reactive gliosis and subsequently reduced astrogliosis in the hippocampal region over a long period of assessment. To the best of our knowledge, this is the first report that proves the concept that hAFSC treatment improves cognitive impairment in neonatal sepsis survivors. We demonstrate the efficacy of hAFSC therapy in improving the mortality and morbidity associated with neonatal sepsis.
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- 2020
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36. A case of abdominal compartment syndrome caused by amniotic fluid embolism treated with ABTHERA™ therapy: World's first report in the obstetric field
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Akina Haiden, Satoru Ikenoue, Mamoru Tanaka, Yoshifumi Kasuga, Momo Hirata, Keita Hasegawa, Daigo Ochiai, Ryo Yamamoto, and Junichi Sasaki
- Subjects
Adult ,Embolism, Amniotic Fluid ,Open Abdomen Techniques ,medicine.medical_specialty ,Abdominal compartment syndrome ,business.industry ,Obstetrics and Gynecology ,Abdominal Wound Closure Techniques ,Gynecology and obstetrics ,Amniotic Fluid ,medicine.disease ,Obstetric Labor Complications ,Surgery ,Amniotic fluid embolism ,Treatment Outcome ,Pregnancy ,RG1-991 ,medicine ,Humans ,Female ,Intra-Abdominal Hypertension ,business ,Negative-Pressure Wound Therapy - Published
- 2021
37. Cell sheets using human amniotic fluid stem cells reduce tissue fibrosis in murine full-thickness skin wounds
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Daigo Ochiai, Yoshifumi Kasuga, Yushi Abe, Marie Fukutake, Satoru Ikenoue, Mamoru Tanaka, Yu Sato, and Hirotaka Masuda
- Subjects
0301 basic medicine ,Male ,Pathology ,medicine.medical_specialty ,Amniotic fluid ,Biology ,Immunophenotyping ,03 medical and health sciences ,0302 clinical medicine ,Fibrosis ,medicine ,Animals ,Humans ,Cells, Cultured ,Skin ,Mice, Inbred BALB C ,Wound Healing ,integumentary system ,Tissue Engineering ,Regeneration (biology) ,Stem Cells ,Mesenchymal stem cell ,Cell Membrane ,Granulation tissue ,Cell Differentiation ,Cell Biology ,General Medicine ,medicine.disease ,Amniotic Fluid ,030104 developmental biology ,medicine.anatomical_structure ,Granulation Tissue ,Female ,Collagen ,Stem cell ,Epidermis ,Wound healing ,030217 neurology & neurosurgery ,Type I collagen ,Developmental Biology - Abstract
The use of mesenchymal stem cell sheets is a promising strategy for skin regeneration. The injection of dissociated human amniotic fluid stem cells (hAFSCs) was recently found to accelerate cutaneous wound healing with reduced fibrotic scarring, similar to fetal wound healing. However, the use of hAFSCs in applications of cell sheet technology remains limited. The aim of this study was to determine the in vivo efficacy of in vitro-cultured hAFSC sheets in wound healing. The cell sheets were characterized by immunohistochemistry and RT-qPCR and grafted onto full-thickness wounds in BALB/c mice. The wound size was measured, and re-epithelialization, granulation tissue area, and collagen content of the regenerated wound were analyzed histologically. Although the hAFSC sheet contained abundant extracellular matrix molecules and expressed high levels of anti-fibrotic mediators, its grafting did not affect wound closure or the size of the granulation tissue area. In contrast, the organization of type I collagen bundles in the regenerated wound was markedly reduced, while the levels of type III collagen were increased after implantation of the hAFSC sheet. These results suggest that hAFSC sheets can exert anti-fibrotic properties without delaying wound closure.
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- 2020
38. Prophylactic therapy with human amniotic fluid stem cells improved survival in a rat model of lipopolysaccharide-induced neonatal sepsis through immunomodulation via aggregates with peritoneal macrophages
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Masayuki Shimoda, Satoru Ikenoue, Yoshifumi Kasuga, Yae Kanai, Daigo Ochiai, Hirotaka Masuda, Yushi Abe, Marie Fukutake, Yu Sato, and Mamoru Tanaka
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Lipopolysaccharides ,medicine.medical_treatment ,Macrophage polarization ,Medicine (miscellaneous) ,Inflammation ,Biochemistry, Genetics and Molecular Biology (miscellaneous) ,Immunomodulation ,lcsh:Biochemistry ,Andrology ,Sepsis ,medicine ,Animals ,Humans ,lcsh:QD415-436 ,lcsh:R5-920 ,Neonatal sepsis ,business.industry ,Stem Cells ,Research ,Mesenchymal stem cell ,Cell Biology ,Amniotic Fluid ,Inflammatory cytokines ,medicine.disease ,Rats ,Transplantation ,Human amniotic fluid stem cells ,Cytokine ,Macrophages, Peritoneal ,Mesenchymal stem cells ,Molecular Medicine ,medicine.symptom ,Stem cell ,lcsh:Medicine (General) ,business - Abstract
Background Despite recent advances in neonatal care, sepsis remains a leading cause of mortality in neonates. Mesenchymal stem cells derived from various tissues, such as bone marrow, umbilical cord, and adipose tissue, have beneficial effects on adult sepsis. Although human amniotic fluid stem cells (hAFSCs) have mesenchymal stem cell properties, the efficacy of hAFSCs on neonatal sepsis is yet to be elucidated. This study aimed to investigate the therapeutic potential of hAFSCs on neonatal sepsis using a rat model of lipopolysaccharide (LPS)-induced sepsis. Methods hAFSCs were isolated as CD117-positive cells from human amniotic fluid. Three-day-old rat pups were intraperitoneally treated with LPS to mimic neonatal sepsis. hAFSCs were administered either 3 h before or at 0, 3, or 24 h after LPS exposure. Serum inflammatory cytokine levels, gene expression profiles from spleens, and multiple organ damage were analyzed. hAFSC localization was determined in vivo. In vitro LPS stimulation tests were performed using neonatal rat peritoneal macrophages co-cultured with hAFSCs in a cell-cell contact-dependent/independent manner. Immunoregulation in the spleen was determined using a DNA microarray analysis. Results Prophylactic therapy with hAFSCs improved survival in the LPS-treated rats while the hAFSCs transplantation after LPS exposure did not elicit a therapeutic response. Therefore, hAFSC pretreatment was used for all subsequent studies. Inflammatory cytokine levels were elevated after LPS injection, which was attenuated by hAFSC pretreatment. Subsequently, inflammation-induced damages in the brain, lungs, and liver were ameliorated. hAFSCs aggregated with peritoneal macrophages and/or transiently accumulated in the liver, mesentery, and peritoneum. Paracrine factors released by hAFSCs induced M1-M2 macrophage polarization in a cell-cell contact-independent manner. Direct contact between hAFSCs and peritoneal macrophages further enhanced the polarization. Microarray analysis of the spleen showed that hAFSC pretreatment reduced the expression of genes involved in apoptosis and inflammation and subsequently suppressed toll-like receptor 4 signaling pathways. Conclusions Prophylactic therapy with hAFSCs improved survival in a rat model of LPS-induced neonatal sepsis. These effects might be mediated by a phenotypic switch from M1 to M2 in peritoneal macrophages, triggered by hAFSCs in a cell-cell contact-dependent/independent manner and the subsequent immunomodulation of the spleen.
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- 2020
39. Universal screening for SARS‐CoV‐2 in asymptomatic obstetric patients in Tokyo, Japan
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Yoshifumi Kasuga, Mamoru Tanaka, Daigo Ochiai, Satoru Ikenoue, and Miho Iida
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medicine.medical_specialty ,Retrospective review ,Nosocomial outbreak ,030219 obstetrics & reproductive medicine ,Coronavirus disease 2019 (COVID-19) ,Transmission (medicine) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Obstetrics and Gynecology ,General Medicine ,University hospital ,Asymptomatic ,03 medical and health sciences ,0302 clinical medicine ,Emergency medicine ,Healthcare settings ,Obstetrics and Gynaecology ,medicine ,030212 general & internal medicine ,medicine.symptom ,business - Abstract
Asymptomatic transmission of SARS-CoV-2 is a major issue in healthcare settings, and management in perinatal wards requires particular caution. Located in central Tokyo as a tertiary center, Keio University Hospital implemented universal PCR testing on patients before admission starting April 6 2020, in response to a nosocomial outbreak of COVID-19. The present study reports a retrospective review of 52 obstetric patients universally tested for SARS-CoV-2 admitted to this hospital between April 6 and April 27, 2020.
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- 2020
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40. A new diagnostic strategy for gestational diabetes during the <scp>COVID</scp> ‐19 pandemic for the Japanese population
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Satoru Ikenoue, Yoshifumi Saisho, Yoshifumi Kasuga, Mamoru Tanaka, and Daigo Ochiai
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Adult ,Blood Glucose ,Male ,Pediatrics ,medicine.medical_specialty ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,Endocrinology, Diabetes and Metabolism ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Pneumonia, Viral ,Betacoronavirus ,Young Adult ,COVID-19 Testing ,Endocrinology ,Japan ,Pregnancy ,COVID‐19 ,Commentaries ,Diabetes mellitus ,Diagnosis ,Pandemic ,Internal Medicine ,medicine ,Humans ,Pregnancy Complications, Infectious ,Pandemics ,Gestational diabetes ,Retrospective Studies ,Glycated Hemoglobin ,Clinical Laboratory Techniques ,SARS-CoV-2 ,business.industry ,COVID-19 ,Middle Aged ,Japanese population ,Prognosis ,Diagnostic strategy ,medicine.disease ,Diabetes, Gestational ,Practice Guidelines as Topic ,Commentary ,Japanese ,Female ,Coronavirus Infections ,business ,Biomarkers ,Follow-Up Studies - Published
- 2020
41. Insufficient gestational weight gain associated with higher DNA methylation in cord blood cells
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Tomoko Kawai, Kei Miyakoshi, Yoshifumi Kasuga, Shiori Kinoshita New, Mamoru Tanaka, and Kenichiro Hata
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Background Gestational weight gain (GWG) is one of the crucial factors affecting fetal growth as well as the in utero environment, influencing fetal cell programming during development. We reported previously that GWG affected the occurrence of outlying CpG methylation values of placental DNA in a U-shaped manner, with the occurrence of outlying values from adequate GWG subjects positioned at the bottom of the curve. In the present study, we aimed to elucidate the effects of GWG on the infant epigenome by the view that the influence of insufficient GWG on infant DNA methylation may turn in some other direction at the borderline of the optimal weight gain. Method We collected cord blood from 60 subjects with uncomplicated term delivery whose mean pre-pregnancy body mass index and mean GWG was 19.8 ± 1.9 and 8.1 ± 4.3 kg, respectively. Cord blood DNA was underwent analysis using the Infinium MethylationEPIC BeadChip to profile genome-wide methylation status. Results GWG was continuously associated with cord blood DNA methylation at five CpG loci significantly (multiple test corrected p-value, 0.043) in the lower than upper limit of the recommended GWG group (n = 51). The significant association between DNA methylation levels and GWG was disappeared when added 9 subjects who gained weight more than upper limit of recommendation during pregnancy. The methylation plot of the five loci plateaued or traced a U-curve near the border of the upper limit of the GWG recommendation. Cord blood DNA methylation of these five were all negatively associated with GWG. Validation using deep targeted bisulfite sequencing reproduced negative correlations between GWG and methylation levels within one of the five targets; at the upstream of LINC01816 . This region has been annotated as a promoter or an enhancer depending on blood cell types based on their epigenetic marks. Conclusions It is known that demethylation at enhancer region in genome is one of the features during late fetal development. We found that insufficient GWG showed higher methylation status in some enhancer-candidate loci in cord blood cells, which may indicate incomplete demethylation during in utero development.
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- 2020
42. Differences in fetal fractional limb volume changes in normal and gestational diabetic pregnancies: an exploratory observational study
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Satoru Ikenoue, Yasutada Akiba, Toyohide Endo, Kei Miyakoshi, Yoshifumi Kasuga, Mamoru Tanaka, Ryota Ishii, Daigo Ochiai, and Kazumi Yakubo
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Adult ,medicine.medical_specialty ,endocrine system diseases ,Gestational Age ,Ultrasonography, Prenatal ,Fetal Development ,03 medical and health sciences ,0302 clinical medicine ,Fetus ,Obstetrics and gynaecology ,Japan ,Pregnancy ,medicine ,Humans ,Femur ,030219 obstetrics & reproductive medicine ,Obstetrics ,business.industry ,Significant difference ,nutritional and metabolic diseases ,Obstetrics and Gynecology ,Gestational age ,Organ Size ,Humerus ,medicine.disease ,Gestational diabetes ,Diabetes, Gestational ,Thigh ,Arm ,Gestation ,Observational study ,Limb volume ,Female ,Diaphyses ,business - Abstract
OBJECTIVE Fetal fractional limb volume has been proposed as a useful measure for quantifying fetal soft tissue development. The aim of this study was to investigate the growth of fractional arm volume (AVol) and fractional thigh volume (TVol) of fetuses with maternal gestational diabetes (GDM) compared with those of fetuses with normal glucose tolerance (NGT). We hypothesised fetal fractional limb volume would be larger in the GDM group than in the NGT group in late gestation. DESIGN Exploratory observational study. SETTING Saitama Municipal Hospital. SAMPLE A total of 165 (125 NGT and 40 GDM) singleton Japanese pregnant women. METHODS AVol and TVol were assessed between 20 and 37 weeks' gestation as cylindrical limb volumes based on 50% of the fetal humeral or femoral diaphysis length. Women were diagnosed as GDM based on the criteria of the Japan Society of Obstetrics and Gynecology. MAIN OUTCOME MEASURES AVol and TVol were compared between women with NGT and those with GDM at each gestational age period (2-week intervals from 20 to 37 weeks' gestation). RESULTS Overall, 287 ultrasound scans were performed (NGT group, 205 scans; GDM group, 82 scans). There was no significant difference of AVol between the groups before 32 weeks' gestation. AVol was significantly larger in the GDM group than in the NGT group after 32 weeks' gestation (P
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- 2020
43. 483 Sonographic prediction of placental invasion in placenta previa using placenta accreta index
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Masumi Tamagawa, Mamoru Tanaka, Satoru Ikenoue, Toyohide Endo, Yoshifumi Kasuga, Keita Hasegawa, Daigo Ochiai, and Maki Oishi
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medicine.medical_specialty ,business.industry ,Placenta accreta ,Obstetrics ,Obstetrics and Gynecology ,Medicine ,business ,medicine.disease ,Placenta previa - Published
- 2021
44. Clinical Results of a Massive Blood Transfusion Protocol for Postpartum Hemorrhage in a University Hospital in Japan: A Retrospective Study
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Ryuji Tanosaki, Rie Yamazaki, Daigo Ochiai, Yushi Abe, Tomoe Uemura, Hiroko Matsuhashi, Ayako Toriumi, Mamoru Tanaka, Yoshifumi Kasuga, Yuya Tanaka, and Satoru Ikenoue
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Medicine (General) ,Resuscitation ,medicine.medical_specialty ,Blood transfusion ,medicine.medical_treatment ,Fibrinogen ,Article ,Hospitals, University ,R5-920 ,Japan ,Pregnancy ,medicine ,Humans ,Blood Transfusion ,Retrospective Studies ,Prothrombin time ,Disseminated intravascular coagulation ,medicine.diagnostic_test ,business.industry ,Obstetrics ,General Medicine ,medicine.disease ,massive blood transfusion protocol ,postpartum hemorrhage ,Female ,Maternal death ,Fresh frozen plasma ,delivery ,business ,Partial thromboplastin time ,medicine.drug - Abstract
Background and objectives: Massive postpartum hemorrhage (PPH) is the most common cause of maternal death worldwide. A massive transfusion protocol (MTP) may be used to provide significant benefits in the management of PPH, however, only a limited number of hospitals use MTP protocol to manage massive obstetric hemorrhages, especially in Japan. This study aimed to assess the clinical outcomes in patients in whom MTP was activated in our hospital. Materials and Methods: We retrospectively reviewed the etiology of PPH, transfusion outcomes, and laboratory findings among the patients treated with MTP after delivery in our hospital. Results: MTP was applied in 24 cases (0.7% of deliveries). Among them, MTP was activated within 2 h of delivery in 15 patients (62.5%). The median estimated blood loss was 5017 mL. Additional procedures to control bleeding were performed in 19 cases, including transarterial embolization (18 cases, 75%) and hysterectomy (1 case, 4.2%). The mean number of units of red blood cells, fresh frozen plasma, and platelets were 17.9, 20.2, and 20.4 units, respectively. The correlation coefficients of any two items among red blood cells, fresh frozen plasma, platelets, blood loss, and obstetrical disseminated intravascular coagulation score ranged from 0.757 to 0.892, indicating high levels of correlation coefficients. Although prothrombin time and activated partial thromboplastin time levels were significantly higher in the <, 150 mg/dL fibrinogen group than in the ≥150 mg/dL fibrinogen group at the onset of PPH, the amount of blood loss and blood transfusion were comparable between the two groups. Conclusions: Our MTP provides early access to blood products for patients experiencing severe PPH and could contribute to improving maternal outcomes after resuscitation in our hospital. Our study suggests the implementation of a hospital-specific MTP protocol to improve the supply and utilization of blood products to physicians managing major obstetric hemorrhage.
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- 2021
45. The Efficacy of Transarterial Embolization for Postpartum Hemorrhage Complicated with Disseminated Intravascular Coagulation: A Single-Center Experience
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Seishi Nakatsuka, Masahiro Jinzaki, Daigo Ochiai, Yushi Abe, Mamoru Tanaka, Satoru Ikenoue, Yoshifumi Kasuga, and Masanori Inoue
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medicine.medical_specialty ,Placenta accreta ,medicine.medical_treatment ,Article ,placenta accreta spectrum ,Amniotic fluid embolism ,transarterial embolization ,hemic and lymphatic diseases ,Medicine ,disseminated intravascular coagulation ,placenta previa ,Disseminated intravascular coagulation ,Hysterectomy ,business.industry ,General Medicine ,uterine atony ,medicine.disease ,Thrombosis ,Surgery ,Placenta previa ,Uterine atony ,postpartum hemorrhage ,Hemostasis ,business ,circulatory and respiratory physiology - Abstract
Indications for the use of transarterial embolization (TAE) for postpartum hemorrhage (PPH) have been established. However, the efficacy of TAE for PPH complicated by disseminated intravascular coagulation (DIC) remains controversial. In this study, we investigated the efficacy of TAE for PPH complicated by DIC. A database review was conducted to identify patients who were treated with TAE for PPH at our hospital. TAE was performed in 41 patients during the study period. Effective hemostasis was achieved in all cases, but additional procedures, such as re-embolization or hysterectomy, were required in five patients (12.2%). The typical causes of PPH included uterine atony (18 cases), placenta previa (15 cases), amniotic fluid embolism (DIC-type) (11 cases), and placenta accreta spectrum (10 cases). The mean blood loss was 3836 mL. The mean obstetrical DIC and the International Society on Thrombosis and Hemostasis DIC scores were 7.9 and 2.6, respectively. The efficacy of hemostasis was comparable between patients with and without DIC. However, the complete success rate of TAE was lower in patients with DIC as the condition worsened than that in non-DIC patients. Overall, TAE is effective as a minimally invasive treatment for PPH complicated by DIC.
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- 2021
46. Prepregnancy Assessment of Liver Function to Predict Perinatal and Postpregnancy Outcomes in Biliary Atresia Patients with Native Liver
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Satoru Ikenoue, Daigo Ochiai, Hiroki Kanamori, Yohei Yamada, Masumi Tamagawa, Mototoshi Kato, Yoshifumi Kasuga, Mamoru Tanaka, Tatsuo Kuroda, and Nobuhiro Takahashi
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medicine.medical_specialty ,Pregnancy ,liver transplantation ,Serum cholinesterase ,business.industry ,Obstetrics ,Brief Report ,medicine.medical_treatment ,MELD score ,biliary atresia ,Reproductive age ,General Medicine ,Liver transplantation ,medicine.disease ,Biliary atresia ,Medicine ,chorine esterase ,In patient ,pregnancy ,Liver function ,Liver dysfunction ,business - Abstract
Considering that some biliary atresia (BA) survivors with native liver have reached reproductive age and face long-lasting complications, specific attention needs to be paid to pregnant cases. This study aimed to investigate the relationship between liver function, perinatal outcomes, and prognosis. A database review was conducted to identify pregnant BA cases with native liver and perinatal data, and clinical information on BA-related complications was analyzed. Perinatal serum cholinesterase (ChE) levels, model for end-stage liver-disease (MELD) score, and platelet trends were analyzed, and the association between these indicators and perinatal outcomes was investigated. Patients were categorized into three groups according to the perinatal clinical outcomes: favorable (term babies with or without several episodes of cholangitis; n = 3), borderline (term baby and following liver dysfunction; n = 1), and unfavorable (premature delivery with subsequent liver failure; n = 1). Lower serum ChE levels, lower platelet counts, and higher MELD scores were observed in the unfavorable category. Borderline and unfavorable patients displayed a continuous increase in MELD score, with one eventually needing a liver transplantation. Pregnancy in patients with BA requires special attention. Serum ChE levels, platelet counts, and MELD scores are all important markers for predicting perinatal prognosis.
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- 2021
47. Mid-trimester residual cervical length and the risk of preterm birth in pregnancies after abdominal radical trachelectomy: a retrospective analysis
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Mamoru Tanaka, Satoru Ikenoue, Naoaki Kuji, Kei Miyakoshi, Kyoko Tanaka, Tadashi Matsumoto, Yoshifumi Kasuga, Yasutada Akiba, Kazuhiro Minegishi, Daigo Ochiai, Toshimitsu Otani, Daisuke Aoki, Marie Fukutake, R Roberts, and Hiroshi Nishio
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Adult ,medicine.medical_specialty ,Trachelectomy ,medicine.medical_treatment ,Population ,Uterine Cervical Neoplasms ,Cervix Uteri ,Residual ,Ultrasonography, Prenatal ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Predictive Value of Tests ,Pregnancy ,Humans ,Medicine ,Cervical cerclage ,education ,Cervix ,Cerclage, Cervical ,Retrospective Studies ,Gynecology ,education.field_of_study ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics ,Infant, Newborn ,Obstetrics and Gynecology ,Gestational age ,Retrospective cohort study ,Treatment Outcome ,medicine.anatomical_structure ,ROC Curve ,Cervical Length Measurement ,Pregnancy Trimester, Second ,030220 oncology & carcinogenesis ,Premature Birth ,Gestation ,Female ,business ,Pregnancy Complications, Neoplastic - Abstract
Objective To investigate the association between mid-trimester residual cervical length (CL) and the risk of preterm birth in pregnancies after abdominal radical trachelectomy (RT). Design Retrospective cohort study. Setting University hospital. Population A total of 33 deliveries after 22 weeks’ gestation in 30 women who underwent abdominal RT including prophylactic cervical cerclage and perinatal care between January 2002 and May 2016. Methods The association between mid-trimester residual CL (the distance between the cerclage and the external cervical os) and gestational age at delivery was investigated. Receiver–operating characteristics (ROC) curve analysis was performed to estimate the optimal cut-off values of the mid-trimester residual CL for the prediction of preterm birth. Main outcome measures Preterm birth before 34 weeks’ gestation. Results Mid-trimester residual CL showed a significant correlation with gestational age at delivery (r = 0.36, P
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- 2017
48. 537: Sonographic evaluation of fetal fractional limb volume across gestation in gestational diabetes
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Kei Miyakoshi, Yohei Akiba, Mamoru Tanaka, Kazumi Yakubo, Daigo Ochiai, Yoshifumi Kasuga, Satoru Ikenoue, and Toyohide Endo
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Gestational diabetes ,Fetus ,medicine.medical_specialty ,business.industry ,Obstetrics ,medicine ,Obstetrics and Gynecology ,Gestation ,Limb volume ,medicine.disease ,business - Published
- 2020
49. Intrauterine Protrusion of Metal Coils: A Rare Complication of Uterine Artery Embolization
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Takayuki Higuchi, Yoshifumi Kasuga, Bao Liang Lin, and Takuma Yoshimura
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Uterus ,Obstetrics and Gynecology ,Middle Aged ,Uterine Artery Embolization ,Surgery ,Text mining ,Foreign-Body Migration ,Uterine artery embolization ,Metals ,medicine ,Humans ,Female ,Complication ,business - Published
- 2019
50. Glycemic and metabolic features in gestational diabetes: singleton versus twin pregnancies
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Yohei, Akiba, Kei, Miyakoshi, Satoru, Ikenoue, Yoshifumi, Saisho, Yoshifumi, Kasuga, Daigo, Ochiai, Tadashi, Matsumoto, and Mamoru, Tanaka
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Adult ,Blood Glucose ,Glucose Tolerance Test ,Diabetes, Gestational ,Japan ,Pregnancy ,Case-Control Studies ,Insulin-Secreting Cells ,Glucose Intolerance ,Pregnancy, Twin ,Humans ,Insulin ,Female ,Insulin Resistance ,Retrospective Studies - Abstract
A number of data on gestational diabetes mellitus (GDM) in singleton pregnancy is available, however, little is known about the glycemic characteristics of twin pregnancy with GDM. The aim of this study was to compare the severity of dysglycemia between twin and singleton pregnancies with GDM (T-GDM and S-GDM). We retrospectively analyzed pregnancies with GDM defined by the Japan Diabetes Society criteria (T-GDM, n = 20; S-GDM, n = 451) in our hospital. During the study period, women with GDM underwent self-monitoring of blood glucose measurements as well as dietary management. Insulin treatment was initiated when dietary treatment did not achieve the glycemic goal. The glycemic and metabolic characteristics were compared between T-GDM and S-GDM, as follows: gestational week at the diagnosis of GDM, 75 g oral glucose tolerance test (OGTT) results, HbA1c, insulin secretion (i.e. insulinogenic index [IGI] and Insulin Secretion-Sensitivity Index-2 [ISSI-2]), and insulin requirement before delivery. The rate of one abnormal OGTT value in T-GDM was similar to that in S-GDM (60% vs. 71%). There were no significant differences in gestational week and levels of HbA1c at diagnosis, levels of IGI and ISSI-2 between T-GDM and S-GDM (median, 20 weeks vs. 17 weeks, 5.0% vs. 5.2%, 0.58 vs. 0.71, 1.7 vs. 1.8, respectively). The rate of insulin treatment and a median dosage of insulin needed before delivery was comparable between the two groups (T-GDM vs. S-GDM: 45% vs. 32% and 14 vs. 13 unit/day). Our data suggested that the severity of dysglycemia in T-GDM was similar to that in S-GDM during pregnancy.
- Published
- 2019
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