論文 - 桂木 真司
-
Tomimori-Gi K., Katsuragi S., Kodama Y., Yamada N., Sameshima H., Maekawa K., Yamashita A., Gi T., Sato Y.
Virchows Archiv 481 ( 5 ) 713 - 720 2022年11月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Virchows Archiv
Preeclampsia, a multisystem pregnancy-specific hypertensive disorder, results in significant maternal and perinatal morbidity and mortality. This condition is associated with placental histopathological abnormalities and particularly affects the decidual spiral arteries. Reportedly, aspirin prevents preeclampsia, specifically early-onset preeclampsia, although findings in decidual arteries in women treated with aspirin therapy remain unclear. We compared the clinical and histopathological placental findings between women with a history of preeclampsia, who did and did not receive low-dose aspirin therapy (LDA and non-LDA groups, respectively). We identified 26 women with a history of preeclampsia; 9 women received LDA (aspirin ≤ 100 mg/day, initiated at < 16 weeks, LDA group), and 17 women did not receive LDA (non-LDA group). The mean gestational age was higher (36.7 weeks vs. 32.3 weeks, P = 0.0221) and the incidence of preeclampsia was lower (11% vs. 59%, P = 0.0362) in the LDA than in the non-LDA group. Histopathologically, the incidence of decidual arteriopathy, particularly that of fibrinoid necrosis and thrombosis, was lower in the LDA than in the non-LDA group (44% vs. 88%, P = 0.0283). Immunohistologically, endothelial marker (CD31 and CD39) expression was stronger in the LDA than in the non-LDA group. Notably, we observed no significant intergroup differences in inflammatory changes (chronic perivasculitis, protease-activated receptor 1 expression, and CD3-positive cells). This study highlights that LDA inhibits hypertension-induced endothelial injury and thrombosis, and thereby protects maternal placental perfusion and prevents preeclampsia.
-
Fetal distress and neonatal death after thoracoamniotid shunting therapy due to hydrops associated with transient abnormal myelopoiesis 査読あり
Shinji Katsuragi
Cureus 14 ( 9 ) 2022年9月
掲載種別：研究論文（学術雑誌）
-
Fetal Distress and Neonatal Death After Thoracoamniotic Shunting Therapy Due to Hydrops Associated With Transient Abnormal Myelopoiesis.
Muraoka J, Yoshimoto N, Ohsawa A, Matsuzawa S, Katsuragi S
Cureus 14 ( 9 ) e28991 2022年9月
-
Remitting seronegative symmetrical Synovitis with pitting edema syndrome as a manifestation of recurrent ovarian cancer: A case report 査読あり
Shinji Katsuragi
Internal Medicine 62 629 - 632 2022年8月
掲載種別：症例報告
-
Low-dose aspirin therapy improves decidual arteriopathy in pregnant women with a history of preeclampsia 査読あり
Shinji Katsuragi
Virchows Archiv 481 713 - 720 2022年7月
掲載種別：研究論文（学術雑誌）
-
Tomimori K., Kodama Y., Tanaka H., Yamashita A., Gi T., Asada Y., Doi K., Katsuragi S., Sato Y.
Virchows Archiv 480 ( 6 ) 1181 - 1187 2022年6月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Virchows Archiv
Transient abnormal myelopoiesis (TAM), also known as transient myeloproliferative disorder or transient leukemia, is a self-regressing neoplasia that afflicts infants with trisomy 21. A recent review article documented “myeloid cell thrombus (MCT)” and “fetal vascular malperfusion (FVM)” in placentas with TAM, although the characteristic TAM placental findings have not been clarified. Here, we compared the clinical and pathological placental findings between trisomy 21 patients with or without TAM. In 13 cases of trisomy 21, we identified six placentas with TAM and seven placentas without TAM. The six placentas with TAM included two stillborn cases. Microscopically, MCT was noted in all the cases, and a high incidence of FVM (50%) was observed in TAM cases. Immunohistochemically, MCT was found to be a platelet-rich thrombus. The placentas were grouped according to the presence or absence of TAM and subsequently compared. Clinically, the incidences of abnormal fetal heart rate pattern and fetal or neonatal death were significantly higher in TAM cases. Pathologically, placenta in TAM cases weighted more than those in cases without TAM, and the incidence of MCT was significantly higher in placentas with TAM. Moreover, the incidence of FVM was higher in placentas with TAM, but this difference was not statistically significant. We propose that MCT is a diagnostic feature of placentas with TAM and may be associated with poor fetal outcomes.
-
特集 いま改めて妊娠高血圧症候群を考える-診療指針改訂のポイントから- 9.妊産婦死亡や重篤な後遺障害
桂木 真司
産婦人科の実際 71 ( 5 ) 499 - 507 2022年5月
-
特集 Late preterm･Early termを展望する 各論 産科編-産科合併症･合併症妊娠の最適な分娩時期 心疾患合併妊娠
桂木 真司
周産期医学 52 ( 4 ) 508 - 515 2022年4月
-
特集 循環器疾患合併妊娠患者の変化を見逃さない,妊娠から産後管理まで 治す15 循環器疾患をもつ女性の避妊と生殖医療の注意点
桂木 真司
Heart View 26 ( 3 ) 295 - 299 2022年3月
-
急速に臨床所見が進行し予後不良であったp53陽性子宮体部類内膜癌の１例 査読あり
桂木真司
宮崎県医師会医学会誌 46 ( 1 ) 32 - 37 2022年3月
担当区分：責任著者 記述言語：日本語 掲載種別：研究論文（学術雑誌）
-
出血性ショックをきたし母体救命できた卵管間質部妊娠の一例 査読あり
桂木真司
宮崎県医師会医学会誌 46 ( 1 ) 22 - 25 2022年3月
担当区分：責任著者 記述言語：日本語 掲載種別：研究論文（学術雑誌）
-
Myeloid cell thrombus and fetal vascular malperfusion in placentas with transient abnormal myelopoiesis 査読あり
Shinji Katsuragi
Virchows Archiv 480 1181 - 1187 2022年2月
記述言語：英語 掲載種別：研究論文（学術雑誌）
-
漿液性癌と未分化癌の子宮体部混合癌の１例 査読あり
桂木真司
日本婦人科病理学会誌 12 ( 1 ) 15 - 18 2022年2月
記述言語：日本語 掲載種別：研究論文（学術雑誌）
-
Hasegawa J., Tanaka H., Katsuragi S., Nii M., Sekizawa A., Ishiwata I., Ikeda T.
Journal of Maternal-Fetal and Neonatal Medicine 35 ( 26 ) 10451 - 10454 2022年
掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of Maternal-Fetal and Neonatal Medicine
Purpose: Serious group A streptococcal (GAS) infections and toxic shock syndrome (TSS) are rare conditions, but their rapid progression often results in death. The purpose of the present study was to clarify recent trend after the coronavirus disease (COVID-19) pandemic of GAS infection in Japan. Materials and Methods: Maternal death statistics were analyzed by the Japan Maternal Death Exploratory Committee. Results: Maternal deaths due to GAS–TSS accounted for 4.2% (n = 22) of all maternal deaths in Japan (n = 525) in the last 12 years. GAS–TSS remains one of the leading causes of maternal death after obstetric hemorrhage and hypertensive disorder. However, no maternal deaths due to GAS–TSS have been reported since the COVID-19 pandemic in Japan after the last death occurred in February 2020. Conclusions: The major change during this period was that most Japanese people wore facemasks at all times and did frequent disinfection. It is considered that the reduction in the incidence of GAS infections itself reduced the number of serious GAS-related maternal deaths. Wearing facemasks and frequent disinfection during pregnancy might to be recommended to prevent various infectious diseases including serious GAS infection, even after the COVID-19 pandemic era.
-
Tanaka H., Koide K., Nakamura M., Maki S., Takakura S., Enomoto N., Tanaka K., Katsuragi S., Sekizawa A., Ikeda T.
Journal of Maternal-Fetal and Neonatal Medicine 35 ( 25 ) 9131 - 9135 2022年
掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of Maternal-Fetal and Neonatal Medicine
Purpose: The aim of this study was to measure the blood levels of soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) before and after tadalafil treatment in patients with fetal growth restriction. Materials and methods: Maternal blood was collected from 13 women before and 2 weeks after tadalafil administration in the TADAFER II trial. The tadalafil treatment was conducted in addition to the conventional FGR treatment. As a control, maternal blood was also collected from 11 women before and 2 weeks after conventional treatment for fetal growth restriction. Blood sFlt-1 and PlGF were measured and the sFlt-1/PlGF ratio was calculated. Student’s t-test was used to statistically analyze differences in the sFlt-1 and PlGF levels, and in the sFlt-1/PlGF ratios. Results: In both treatment groups, the levels of sFlt-1 and PlGF before and after treatment were not significantly different from each other. The sFlt-1/PlGF ratio was 2.0 ± 1.0 before and 17.6 ± 11.3 after treatment in the control group (p=.04). The sFlt-1/PlGF ratio was 2.2 ± 1.1 before and 22.2 ± 10.6 after tadalafil treatment in the tadalafil group (p=.06). The sFlt-1/PlGF ratios before and after tadalafil treatment were significantly increased in the control group. In both treatment groups, the sFlt-1/PlGF ratios before and after treatment were less than 38. Conclusions: We conclude that the levels of sFlt-1 and PlGF were not significantly different as a result of tadalafil treatment. Further studies are needed to understand the mechanism of action of tadalafil in the treatment of fetal growth restriction.
-
Detection of Treponema pallidum by immunocytochemistry of cervical smear: A case report
Noguchi H., Tokumitsu T., Kuroki E., Minematsu E., Asada Y., Kuroda S., Ochiai S., Kikuchi M., Fujimoto S., Onishi J., Kawagoe Y., Sameshima H., Katsuragi S., Sato Y.
Diagnostic Cytopathology 49 ( 12 ) E443 - E446 2021年12月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Diagnostic Cytopathology
Syphilis is an infectious disease caused by Treponema pallidum (T. pallidum). A cervical smear is useful when screening for sexually transmitted diseases; however, T. pallidum is not detected in the usual Papanicolaou smear. We report the detection of T. pallidum by immunocytological examination of a cervical smear. A 22-year-old woman presented with nephrotic syndrome. On admission, we performed screening tests for infections, and her serology was positive for syphilis. A Papanicolaou cervical smear (Thin-Prep) showed slight nuclear enlargement, nuclear irregularity, and mild hyperchromasia in the superficial cells, but no organism was detected. T. pallidum was detected in the remaining specimen using immunocytochemistry. We also detected the T. pallidum DNA in a cervical biopsy specimen by polymerase chain reaction (PCR). Our findings suggest that immunocytological examination and PCR assay examination are useful tests for syphilis diagnosis.
DOI： 10.1002/dc.24849
-
Kawamura T., Tanaka H., Tachibana R., Yoshikawa K., Maki S., Toriyabe K., Takeuchi H., Katsuragi S., Tanaka K., Ikeda T.
Scientific Reports 11 ( 1 ) 2021年12月
掲載種別：研究論文（学術雑誌） 出版者・発行元：Scientific Reports
We aimed to investigate the effects of maternal tadalafil therapy on fetal programming of metabolic function in a mouse model of fetal growth restriction (FGR). Pregnant C57BL6 mice were divided into the control, L-NG-nitroarginine methyl ester (L-NAME), and tadalafil + L-NAME groups. Six weeks after birth, the male pups in each group were given a high-fat diet. A glucose tolerance test (GTT) was performed at 15 weeks and the pups were euthanized at 20 weeks. We then assessed the histological changes in the liver and adipose tissue, and the adipocytokine production. We found that the non-alcoholic fatty liver disease activity score was higher in the L-NAME group than in the control group (p < 0.05). Although the M1 macrophage numbers were significantly higher in the L-NAME/high-fat diet group (p < 0.001), maternal tadalafil administration prevented this change. Moreover, the epididymal adipocyte size was significantly larger in the L-NAME group than in the control group. This was also improved by maternal tadalafil administration (p < 0.05). Further, we found that resistin levels were significantly lower in the L-NAME group compared to the control group (p < 0.05). The combination of exposure to maternal L-NAME and a high-fat diet induced glucose impairment and non-alcoholic fatty liver disease. However, maternal tadalafil administration prevented these complications. Thus, deleterious fetal programming caused by FGR might be modified by in utero intervention with tadalafil.
-
Maternal death related to sudden unexpected death in epilepsy: A nationwide survey in japan
Tanaka H., Katsuragi S., Hasegawa J., Tanaka K., Nakamura M., Hayata E., Nakata M., Sekizawa A., Ishiwata I., Ikeda T.
Brain Sciences 11 ( 8 ) 2021年8月
掲載種別：研究論文（学術雑誌） 出版者・発行元：Brain Sciences
Sudden unexpected death in epilepsy (SUDEP) is defined as the sudden death of a patient with epilepsy in the absence of an anatomic or toxicologic cause. Whether pregnancy is a risk factor for SUDEP is unclear. Using data submitted to the Japan Association of Obstetricians and Gynecologists (JAOG), which has been collating information regarding all maternal deaths in Japan since 2000, this study evaluated maternal mortality data from 2010 to 2019 to evaluate the current circumstances of maternal death related to SUDEP in Japan. Six women died due to SUDEP during this period; the maternal mortality rate related to SUDEP was 0.066/100,000 individuals. Two women each died during the second trimester, third trimester, and postpartum period. Four and two women were receiving monotherapy and no therapy with anti-epileptic drugs, respectively. The duration of epilepsy was ≤15 years in three women, >15 years in one woman, and unknown in two women. This study furthers our understanding of the prevalence of maternal deaths due to SUDEP in Japan. Further studies are needed to confirm whether pregnancy is a risk factor for SUDEP.