論文 - 金子 政時
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The estimation of a cytomegalovirus immunoglobulin G avidity using the mathematical model 招待あり 査読あり
Masatoki Kaneko
Journal of Basic and Clinical Pharmacy 13 ( 127 ) 127 2022年3月
担当区分:筆頭著者 記述言語:英語 掲載種別:研究論文(学術雑誌)
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Kaneko M., Muraoka J., Kusumoto K., Minematsu T.
Viruses 13 ( 5 ) 2021年5月
担当区分:筆頭著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Viruses
Human cytomegalovirus (CMV) is the leading cause of neurological sequelae in infants. Understanding the risk factors of primary CMV infection is crucial in establishing preventive strategies. Thus, we conducted a retrospective cohort study to identify risk factors of vertical transmission among pregnant women with immunoglobulin (Ig) M positivity. The study included 456 pregnant women with IgM positivity. Information on age, parity, occupation, clinical signs, IgM levels, and IgG avidity index (AI) was collected. The women were divided into infected and non-infected groups. The two groups showed significant differences in IgM level, IgG AI, number of women with low IgG AI, clinical signs, and number of pregnant women with single parity. In the multiple logistic regression analysis, pregnant women with single parity and low IgG AI were independent predictors. Among 40 women who tested negative for IgG antibody in their previous pregnancy, 20 showed low IgG AI in their current pregnancy. Among the 20 women, 4 had vertical transmission. These results provide better understanding of the risk factors of vertical transmission in pregnant women with IgM positivity.
DOI: 10.3390/v13050866
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Kaneko M., Ohhashi M., Fujii Y., Minematsu T., Kusumoto K.
International Journal of Infectious Diseases 100 1 - 6 2020年11月
担当区分:筆頭著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:International Journal of Infectious Diseases
Objective: To establish a model to predict high cytomegalovirus (CMV) immunoglobulin (Ig)G avidity index (AI) using clinical information, to contribute to the mental health of CMV-IgM positive pregnant women. Methods: We studied 371 women with IgM positivity at ≤14 w of gestation. Information on the age, parity, occupation, clinical signs, IgM and G values, and IgG AI was collected. The IgG AI cut-off value for diagnosing congenital infection was calculated based on a receiver operating characteristic curve analysis. Between-group differences were assessed using the Mann–Whitney U-test or χ2 analysis. The factors predicting a high IgG AI were determined using multiple logistic regression. Results: The women were divided into high or low IgG AI groups based on an IgG AI cut-off value of 31.75. There were significant differences in the IgG and IgM levels, age, clinical signs, and the number of women with one parity between the two groups. In a multiple logistic regression analysis, IgM and the number of women with one parity were independent predictors. This result helped us establish a mathematical model that correctly classified the IgG AI level for 84.6% of women. Conclusion: We established a highly effective model for predicting a high IgG AI immediately after demonstrating IgM positivity.
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Intrapartum fetal heart rate monitoring in cases of cytomegalovirus infection 査読あり
金子 政時,鮫島 浩,池田 智明,池ノ上 克,峰松 俊夫
Am. J. Obstet. Gynecol. 191 1257 - 1262 2014年9月
記述言語:英語 掲載種別:研究論文(学術雑誌)
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Impact of COVID-19 on Cytomegalovirus Immunoglobulin M Antibody Index 査読あり
Kaneko M., Muraoka J., Yang L., Tokunaga S., Minematsu T.
Clinical and Experimental Obstetrics and Gynecology 50 ( 12 ) 2023年12月
担当区分:筆頭著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Clinical and Experimental Obstetrics and Gynecology
Background: Coronavirus disease 2019 (COVID-19) influenced the prevalence of other infectious diseases, including congenital cytomegalovirus (CMV) infection. However, the effect of COVID-19 on antibody titers has not been reported. This study aimed to explore the influence of COVID-19 on levels of CMV immunoglobulin M (IgM) in pregnant women. Methods: This cross-sectional study included pregnant women who visited the University Hospital due to CMV IgM positivity during the 7th and 8th waves of COVID-19. Data, including maternal characteristics, history of COVID-19, CMV immunoglobulin G (IgG) and IgM index, and IgG avidity index (AI) were collected. Chemiluminescent immunoassay was performed to measure levels of IgG and IgM. Polymerase chain reaction using neonatal urine was performed to confirm congenital infection. Results: Of the 89 pregnant women, 36 (40%) (low IgG AI: n = 10; high IgG AI: n = 26) contracted COVID-19. Among 21 women with low IgG AI, 9 (false IgM positive: n = 8; primary infection: n = 1) had an IgG AI of 0. Among the eight women with false IgM positivity, six (75%) contracted COVID-19. The IgM index of pregnant women with false IgM positivity was 12.6 ± 10.9. Meanwhile, the CMV IgM index of pregnant women with false IgM positivity in the non-COVID-19-infected group was 1.7 ± 0.5. When the IgM indices of women who contracted (n = 36) and did not contract (n = 53) COVID-19 were compared, the IgM index of infected women (4.4 ± 5.7) was higher than those of non-infected women (2.7 ± 3.0) (p = 0.01). Regarding IgM and IgG AI, multiple logistic regression analysis revealed that there were no significantly different variables between the two groups. Conclusions: High prevalence of false IgM positivity was observed among women who contracted COVID-19. The IgM index of pregnant women with false IgM positivity was high. Caution should be exercised in interpreting CMV IgM indices in pregnant women with a history of COVID-19.
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特集 数値からみる周産期医療 産科編 先天性感染症 査読あり
金子 政時
周産期医学 53 ( 8 ) 1214 - 1216 2023年8月
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Yamada N., Kaneko M., Yang L., Matsuzawa S., Minematsu T., Kodama Y.
Journal of Infection and Chemotherapy 29 1071 - 1074 2023年7月
担当区分:責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Journal of Infection and Chemotherapy
Human cytomegalovirus (HCMV) is the major cause of neurological sequelae in infants. Immune control of primary HCMV infection appears to depend on the interaction between humoral and cell-mediated immune responses. We report the case of an HCMV-transmitter mother observed with dissociation between humoral and cell-mediated immune responses. The patient had immunoglobulin (Ig) G and M positivity at 11 weeks of gestation and showed fetal hyperechoic bowel and minimal ascites at 21 weeks of gestation. At 25 weeks of gestation, the polymerase chain reaction result for HCMV using amniotic fluid was positive. The numbers of spots in the enzyme-linked immunosorbent spot (ELISPOT) assay at 25, 36, and 39 weeks of gestation were three, five, and six spots/2 × 105 peripheral blood mononuclear cells, respectively. Furthermore, IgG avidity indexes (AIs) at 21, 25, 36, and 39 weeks of gestation were 37.6, 49.7, 72.5, and 74.3, respectively. At 40+1 weeks of gestation, the patient delivered a symptomatic infected newborn with a weight of 2,384 g (−2.6 SD) and a head circumference of 30 cm (−2.6 SD). The neonate had a petechial rash and bilateral hearing loss although did not show liver dysfunction or thrombocytopenia. Cranial magnetic resonance imaging revealed mild ventriculomegaly, left lateral/parietal polymicrogyria, and a punctate white matter lesion. This case showed that IgG AI increased with increasing gestational age, whereas the numbers of spots in the ELISPOT assay had no change. The dissociation between humoral and cell-mediated immune responses may be characteristic of the immune response of a transmitter mother.
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子育て中の労働者がワーク・ライフ・バランスを実現するための職場環境に関する検討 ‐宮崎市の若年労働者への質問紙調査から‐ 査読あり
田邊綾子、久留葵、山本明佳、末次典恵、金子政時
南九州看護研究誌 21 ( 1 ) 1 - 8 2023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(大学,研究機関等紀要)
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母子保健コーディネーターが捉える母親達の悩みの実態 査読あり
山下華歩、山﨑圭子、松岡あやか、金子政時
南九州看護研究誌 20 ( 1 ) 9 - 16 2023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(大学,研究機関等紀要)
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Kaneko M., Yang L., Tanabe A., Fujii Y., Nakao H., Minematsu T.
Journal of Infection and Chemotherapy 29 485 - 489 2023年
担当区分:筆頭著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Journal of Infection and Chemotherapy
Introduction: Variable rates of cytomegalovirus (CMV) seropositivity in mothers from different individual's background may translate to distinct epidemiological patterns of congenital CMV infection. Methods: The prospective cohort study was conducted in Japan to evaluate the prevalence of vertical transmission rate according to the type of maternal infection. Post hoc power as a follow-up analysis was evaluated to compare the statistical power with other studies from France, Finland and Brazil. One thousand one hundred sixty-three pregnant women were measured IgG, IgM and IgG avidity index. The urine samples of neonates of these women were evaluated using polymerase chain reaction to diagnose the vertical transmission. Results: The prevalence of congenital CMV infection in the study population was 0.4%. The proportions of patients with primary and nonprimary infections were 60% and 40%, respectively, with a maternal seroprevalence of 82.5%. The rate of vertical transmission among the seronegative pregnant women before pregnancy was statistically higher than that among the seropositive pregnant women before pregnancy (p < 0.05), with a study power of 52.7%. The same difference was observed in France and Finland for maternal seroprevalence of 61% and 72% and statistical power of 56.9% and 66.7%, respectively. Conclusion: The maternal seroprevalence of the present study conducted in Japan was much higher than that of studies in France and Finland. Nevertheless, seronegative pregnant women had a higher risk of vertical transmission before pregnancy.
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ウレアプラズマ肺炎を契機に顕在化した超早産児肺リンパ管拡張症の一例 査読あり
榊原 康平, 山田 直史, 児玉 由紀, 小畑 静, 都築 康恵, 村岡 純輔, 青木 良則, 山下 理絵, 中目 和彦, 金子 政時, 桂木 真司, 都築 諒, 佐藤 勇一郎
日本周産期・新生児医学会雑誌 59 ( 1 ) 116 - 121 2023年
記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:一般社団法人 日本周産期・新生児医学会
肺リンパ管拡張症(Pulmonary lymphangiectasia;PL)は肺リンパ管拡張を特徴とし,肺胞拡張障害をきたして重篤な呼吸不全を起こす疾患である.今回,ウレアプラズマ肺炎を契機に呼吸状態が増悪し,剖検でPLと診断された症例を報告する. 症例は超低出生体重児(在胎23週2日,610g,男児).母体は,妊娠23週1日に胎胞形成,23週2日に経腟分娩となった.児はサーファクタント投与後,安定化した状態で人工呼吸管理を行っていた.日齢15にCRP上昇と肺野の透過性低下が認められた.各種抗菌薬治療では改善なく,日齢30の気管内分泌物ウレアプラズマ培養陽性により,アジスロマイシン水和物を開始した.CRPは著減したが,呼吸不全は悪化して日齢44に死亡した.病理解剖では,肺リンパ管がびまん性に拡張したPLと診断した.臨床的にはウレアプラズマ肺炎を契機に顕在化したPLと考えられた.
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増刊号 191の疑問に答える周産期の栄養 産科編Q & A 妊娠中期 Q80 食後の胸焼けがひどくなりました。 食事はどうしたらよいですか? 薬はありますか? 査読あり
金子 政時, 前山 彩, 松岡 あやか
周産期医学 52 ( 13 ) 179 - 180 2022年11月
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Muraoka J., Kaneko M., Doi K., Kodama Y., Sameshima H.
Microbiology Research 13 ( 3 ) 598 - 608 2022年9月
担当区分:責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:Microbiology Research
The use of prenatal antibiotics should be carefully considered, owing to their potential adverse effects on neonatal outcomes. This study aimed to identify the contributing factors to early-onset neonatal infection and to determine the influence of antepartum antibiotics on women and neonates. This study included 127 pregnant women without obvious intra-amniotic infection on admission, who delivered under 34 weeks of gestation. Information on maternal and neonatal characteristics was obtained from their medical charts. Vaginal swabs were taken from all women on admission. In total, 29 (22.8%) neonates developed early-onset infection. Multivariate analysis revealed that antepartum antibiotics were the most strongly associated factor for early-onset neonatal infection (odds ratio, 11.2; 95% confidence interval, 4.08–31.02). The frequency of early-onset neonatal infection was significantly higher in women who received antibiotic therapy than in those who did not; no significant difference in prolonging their gestation or neonatal morbidities was observed. The prevalence of women who hosted vaginal microorganisms on admission was similar to that in women whose infants subsequently developed early-onset neonatal infection compared with that of women whose infants did not. Among infants of the 40 women who received antepartum antibiotic therapy, 21 developed early-onset infection. Of the women who delivered these 21 infants, 62% (13/21) showed reduced lactobacilli and 43% (9/21) had resistant bacterial strains in their vaginal microbiota at the time of delivery. The use of antepartum antibiotics is the most strongly associated factor in early-onset neonatal infection; it does not prolong gestation and would change the vaginal environment.
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Association between chorioamnionitis severity and procalcitonin levels in umbilical venous blood 査読あり 国際誌
Masatoki Kaneko, Junsuke Muraoka, Naoshi Yamada, Yuki Kodama
Clinical and Experimental Obstetrics & Gynecology 49 ( 7 ) 160 2022年7月
担当区分:筆頭著者, 責任著者 記述言語:英語 掲載種別:研究論文(学術雑誌) 出版者・発行元:IMR Press
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先天性サイトメガロウイルス感染症の現状と課題 招待あり
金子政時
日本周産期・新生児医学会雑誌 57 ( 4 ) 606 - 609 2022年4月
担当区分:筆頭著者 記述言語:日本語 掲載種別:研究論文(学術雑誌)
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横抱き授乳における姿勢アライメント、肩こりの自覚および筋硬度の経時的変化と姿勢の良否における検討 査読あり
大崎愛、松岡あやか、金子政時、山﨑圭子
母性衛生 63 ( 1 ) 112 - 120 2022年4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)
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医療従事者の体調不良時の勤務実態 ‐産科3次施設で勤務する医療従事者の体調不良時の勤務実態に関する調査‐ 査読あり
今村友美、松岡あやか、金子政時
南九州看護研究誌 20 ( 1 ) 10 - 17 2022年4月
担当区分:責任著者 記述言語:日本語 掲載種別:研究論文(大学,研究機関等紀要)
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NICU入院中の超低出生体重児に対する両親の面会の実態と関連要因 査読あり
柳田紗希、金子政時、山﨑圭子、松岡あやか
母性衛生 62 ( 4 ) 771 - 778 2022年1月
担当区分:最終著者 掲載種別:研究論文(学術雑誌)
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教員と臨床看護師が連携する2年次と4年次の採血技術演習 査読あり
加藤 沙弥佳, 末次 典恵, 吉永 砂織, 鶴田 来美, 金子 政時
日本シミュレーション医療教育学会雑誌 10 ( 0 ) 43 - 50 2022年
記述言語:日本語 掲載種別:研究論文(学術雑誌) 出版者・発行元:日本シミュレーション医療教育学会
本研究の目的は、2年次と4年次の採血技術演習における、看護教員と臨床看護師の連携による教育実践を報告するとともに、学生による採血技術の自己評価と演習に対する感想を分析することで、今後の教育支援への示唆を得ることである。採血技術演習の自己評価点については、ほとんどの項目で 4 年次で自己評価点が 2 年次よりも高くなっており、その中でも統計的に有意差が確認された項目は、医療安全と静脈穿刺の手技の 2 つに大別された。また、演習に対する感想を分析した結果、演習は少人数制で目の届く指導となっており、学生に好評価であったことが示唆された。これらのことから、4 年次の学生は演習を通して自分の手技を振り返り、技術の課題を明らかにできており、採血技術に関して経験や実習での経験をふまえた学びのサイクルが展開されたことが伺えた。教育と臨床との連携による演習の取り組みは、就職前に学生の学習意欲を高め、看護基礎教育から看護継続教育へスムーズに移行していくための動機づけとなることが示 唆された。