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Article ; Online: Tourniquet, Uterine Inversion, and Placental dissection （TURIP） procedure as a novel hemostatic technique to preserve fertility for placenta accreta spectrum disorders without placenta previa.

Nii, Masafumi / Ikeda, Tomoaki

American journal of obstetrics & gynecology MFM

2023 Volume 5, Issue 12, Page(s) 101185

Abstract: The number of cases of placenta accreta spectrum disorder has been increasing with the increase in in vitro fertilization and cesarean deliveries. In addition, placenta accreta spectrum without placenta previa is difficult to diagnose before delivery and ...

Abstract	The number of cases of placenta accreta spectrum disorder has been increasing with the increase in in vitro fertilization and cesarean deliveries. In addition, placenta accreta spectrum without placenta previa is difficult to diagnose before delivery and sometimes requires a hysterectomy because of heavy bleeding. We have devised a uterus-preserving technique (referred to as the tourniquet, uterine inversion, and placental dissection procedure) for such cases. First, the bleeding is stopped by the tourniquet method, the uterus is relaxed with nitroglycerin, and the uterus is inverted to expose the adhesion site. After that, the placenta is detached by sharp dissection under direct visualization, and the detached areas are sutured, and then the tourniquet and internal rotation are released. This technique does not require advanced skills. Thus, a surgeon could avoid performing a hysterectomy and have a greater chance of uterus preservation when encountering massive hemorrhage caused by unpredictable placenta accreta spectrum without placenta previa in either cesarean deliveries or vaginal deliveries.
MeSH term(s)	Female ; Pregnancy ; Humans ; Placenta Accreta/diagnosis ; Placenta Accreta/surgery ; Placenta Previa/diagnosis ; Placenta Previa/epidemiology ; Placenta Previa/surgery ; Uterine Inversion ; Placenta ; Tourniquets ; Hemostatic Techniques ; Fertility
Language	English
Publishing date	2023-10-12
Publishing country	United States
Document type	Journal Article
ISSN	2589-9333
ISSN (online)	2589-9333
DOI	10.1016/j.ajogmf.2023.101185
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Article ; Online: Retraction notice to "Maternal blood concentration of tadalafil in pregnancy: Comparison of pregnant and non-pregnant women" [Taiwan J Obstet Gynecol 61 (2022) 230-233].

Enomoto, Naosuke / Tanaka, Hiroaki / Maki, Shintaro / Takakura, Sho / Tanaka, Kayo / Katsuragi, Shinji / Ikeda, Tomoaki

Taiwanese journal of obstetrics & gynecology

2023 Volume 62, Issue 6, Page(s) 935

Language	English
Publishing date	2023-11-25
Publishing country	China (Republic : 1949- )
Document type	Journal Article ; Retraction of Publication
ZDB-ID	2202946-1
ISSN	1875-6263 ; 1875-6263
ISSN (online)	1875-6263
ISSN	1875-6263
DOI	10.1016/j.tjog.2023.10.001
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Article: Predicting Preeclampsia Pregnancy Termination Time Using sFlt-1.

Tanaka, Hiroaki / Tanaka, Kayo / Takakura, Sho / Enomoto, Naosuke / Ikeda, Tomoaki

Frontiers in medicine

2022 Volume 9, Page(s) 900639

Abstract: Background: The aim of this study was to determine the usefulness of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) in predicting the time for pregnancy termination in pregnant women with known preeclampsia (PE) onset.: ...

Abstract	Background: The aim of this study was to determine the usefulness of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) in predicting the time for pregnancy termination in pregnant women with known preeclampsia (PE) onset. Methods: Forty-four pregnant women diagnosed with PE (22 weeks 0 days to 33 weeks 6 days gestation) were included in this study. The levels of sFlt-1 and PlGF, and the sFlt-1/PlGF ratio were compared between the women that delivered in <24 h (T group) and those that delivered in more than 24 h (P group), and between women that delivered in <1 week (T group) and those that delivered in more than 1 week (P group). Cutoff values were calculated for the three markers that were the most significantly correlated with predicting pregnancy termination at <24 h and <1 week. Results: Among sFlt-1, PlGF, and sFlt-1/PlGF, sFlt-1 was the most significantly associated with the timing of pregnancy termination. sFlt-1 cutoff values of 8682.1 pg/ml (AUC 0.71; 95%Cl, 0.5191-0.9052) and 7,394.5 pg/ml (AUC 0.78; 0.78, 95%Cl, 0.6394-0.9206) for delivery in <24 h and delivery within 1 week, respectively, were important predictive values. The positive predictive value for delivery within 24 h was 43.9%, with a sensitivity of 72.3% and specificity of 69.0%, when sFlt-1 was <8,682 pg/ml. A sFlt-1 level of 7,394 pg/ml or greater would result in delivery within 1 week, with a positive predictive value of 67.2%; the sensitivity was 79.0% and specificity was 72.0%. Conclusion: This study showed that sFlt-1 may be effective in predicting the timing of pregnancy termination. However, the number of cases was small and, thus, the results were not definitive. This finding should be researched further in order to predict the optimal timing of pregnancy termination in PE to reduce severe maternal complications.
Language	English
Publishing date	2022-06-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2022.900639
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Article ; Online: Suppressed or increased fetal heart rate variability: Which is more associated with intrapartum fetal compromise?

Lear, Christopher A / Nakao, Masahiro / Magawa, Shoichi / Ikeda, Tomoaki / Gunn, Alistair J

Acta obstetricia et gynecologica Scandinavica

2023 Volume 103, Issue 3, Page(s) 621–622

MeSH term(s)	Female ; Pregnancy ; Humans ; Heart Rate, Fetal ; Fetus ; Prenatal Care ; Parturition ; Fetal Monitoring ; Fetal Distress/diagnosis
Language	English
Publishing date	2023-12-29
Publishing country	United States
Document type	Letter
ZDB-ID	80019-3
ISSN	1600-0412 ; 0001-6349
ISSN (online)	1600-0412
ISSN	0001-6349
DOI	10.1111/aogs.14762
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Article ; Online: Comparison of surgical outcomes between robot-assisted laparoscopic hysterectomy and conventional total laparoscopic hysterectomy in gynecologic benign disease: a single-center cohort study.

Okumura, Asumi / Kondo, Eiji / Nii, Masafumi / Kubo-Kaneda, Michiko / Yoshida, Kenta / Ikeda, Tomoaki

Journal of robotic surgery

2023 Volume 17, Issue 5, Page(s) 2221–2228

Abstract: We compared the surgical outcomes of robot-assisted laparoscopic hysterectomy (RAH) and total laparoscopic hysterectomy (TLH). This single-center cohort study compared 139 RAH cases from January, 2017 to September, 2021 and 291 TLH cases between January, ...

Abstract	We compared the surgical outcomes of robot-assisted laparoscopic hysterectomy (RAH) and total laparoscopic hysterectomy (TLH). This single-center cohort study compared 139 RAH cases from January, 2017 to September, 2021 and 291 TLH cases between January, 2015 and December, 2020. We retrospectively evaluated surgical outcomes, including total operative time (defined as the time from port wound incision to port wound closure), net operative time (defined as the time from the start of pneumoperitoneum to the end of pneumoperitoneum), estimated blood loss, weight of excised uterus (±adnexa), and overall complications, and the relationship between surgeon experience and operative time, net operative time, and blood loss in RAH and TLH. There was no significant difference in the total operative time between the two groups. Regardless of surgeon experience, the net operative time was significantly shorter in the RAH group than in the TLH group (p <0.001) and the estimated blood loss was significantly lower in RAH cases than in TLH cases (p = 0.01). The net operative time per uterine weight was shorter in the TLH group than that in the RAH group; however, there was no significant difference. RAH resulted in statistically better surgical outcomes in terms of net operative time and blood loss, regardless of surgeon experience. However, net operative time and blood loss also seem to be significantly affected by uterus weight. Large trials are imperative to determine the more effective surgical approach between RAH and TLH for different patient subsets.
MeSH term(s)	Female ; Humans ; Cohort Studies ; Retrospective Studies ; Robotics ; Laparoscopy/methods ; Pneumoperitoneum ; Robotic Surgical Procedures/methods ; Hysterectomy/adverse effects ; Hysterectomy/methods ; Genital Diseases, Female ; Treatment Outcome
Language	English
Publishing date	2023-06-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2268283-1
ISSN	1863-2491 ; 1863-2483
ISSN (online)	1863-2491
ISSN	1863-2483
DOI	10.1007/s11701-023-01638-3
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Article ; Online: The efficacy of vaginal treatment for non-Lactobacillus dominant endometrial microbiota-A case-control study.

Sakamoto, Mito / Tanaka, Hiroaki / Enomoto, Sayako / Takeuchi, Hiroki / Nishioka, Mikiko / Tanaka, Kayo / Takayama, Erina / Maezawa, Tadashi / Kondo, Eiji / Ikeda, Tomoaki

The journal of obstetrics and gynaecology research

2024 Volume 50, Issue 4, Page(s) 604–610

Abstract: Aim: Reduced Lactobacillus occupancy in the uterine microflora has been associated with implantation failure. This study aimed to evaluate a treatment for improving the uterine microflora.: Methods: This study included patients diagnosed with ... ...

Abstract	Aim: Reduced Lactobacillus occupancy in the uterine microflora has been associated with implantation failure. This study aimed to evaluate a treatment for improving the uterine microflora. Methods: This study included patients diagnosed with repeated implantation failure-defined as failure to achieve pregnancy after two or more transfers of viable embryos-who were classified as non-Lactobacillus dominant. Treatment A comprised oral administration of antibiotics for 1 week, followed by oral probiotic butyrate tablets (3 g/day) for approximately 30 days. Treatment B comprised a 1-week course of oral (750 mg/day) and vaginal (250 mg/day) metronidazole, followed by a 1-week intravaginal administration of probiotic capsules (1 capsule/day) and continued oral administration of probiotics (1 capsule/day). Both treatments were compared in terms of efficacy in improving vaginal flora. Improvement was defined as Lactobacillus occupancy >90% or an increase in Lactobacillus occupancy >20%. Results: Seven (41.2%) of 17 patients in the Treatment A group improved in response to the treatment. Contrastingly, 9 (90.0%) of 10 patients improved in the Treatment B group (p = 0.0127). Following treatment, Lactobacillus occupancy in the Treatment B group (62.9% ± 12.7%) was significantly higher than that in the Treatment A group (5.7% ± 9.8%) (p = 0.0242). Conclusions: This study demonstrates the effectiveness of combining antibiotics and probiotics in vaginal formulations for treating abnormal uterine microflora. However, its potential impact on in vitro fertilization outcomes remains unclear and warrants further investigation through larger, more comprehensive studies.
MeSH term(s)	Female ; Pregnancy ; Humans ; Administration, Intravaginal ; Lactobacillus ; Vaginosis, Bacterial/drug therapy ; Vaginosis, Bacterial/diagnosis ; Case-Control Studies ; Vagina ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Treatment Outcome ; Microbiota
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2024-02-02
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1327307-3
ISSN	1447-0756 ; 1341-8076
ISSN (online)	1447-0756
ISSN	1341-8076
DOI	10.1111/jog.15897
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Article ; Online: Balloon Trocar Is a Suitable Instrument for Retroperitoneal Para-aortic Lymphadenectomy in Gynecologic Malignant Diseases.

Kondo, Eiji / Kubo-Kaneda, Michiko / Nii, Masafumi / Yoshida, Kenta / Okamoto, Kota / Ikeda, Tomoaki

Journal of minimally invasive gynecology

2023 Volume 30, Issue 7, Page(s) 531–532

Abstract: Objective: To demonstrate the surgical technique of retroperitoneal para-aortic lymphadenectomy to prevent peritoneal rupture in gynecologic malignant disease. In this video, the authors describe how to use a balloon trocar to create a safe and ... ...

Abstract	Objective: To demonstrate the surgical technique of retroperitoneal para-aortic lymphadenectomy to prevent peritoneal rupture in gynecologic malignant disease. In this video, the authors describe how to use a balloon trocar to create a safe and efficient working space without peritoneal rupture. Design: A step-by-step video demonstration of a surgical technique. Setting: Department of Gynecology and Obstetrics, Mie University, Tsu, Japan. Interventions: Para-aortic lymphadenectomy is a part of most gynecologic oncology procedures for primary and recurrent gynecologic malignancies. There are 2 approaches to para-aortic lymphadenectomy: transperitoneal and retroperitoneal approaches. Although there are no significant differences between these approaches (such as in terms of the number of isolated lymph nodes or related complications), they are performed based on the operator's preference. The retroperitoneal approach is an unfamiliar surgical technique compared with usual laparotomy and laparoscopic surgery, and its disadvantages include a steeper learning curve for attaining proficiency. It is also difficult to develop the retroperitoneal space without a peritoneal rupture. In this video, we demonstrate the use of balloon trocars to create a retroperitoneal compartment. The patient was placed in the lithotomy position with the pelvis elevated at 5° to 10°. The left internal iliac approach, which is considered the standard approach, was used in this case (Fig 1). After identifying the left psoas muscles and the ureter crossing the common iliac artery, dissection of the left para-aortic lymph node was initiated (Supplemental Video 1, 2). Conclusion: Herein, we demonstrated a successful surgical technique for retroperitoneal para-aortic lymphadenectomy to prevent peritoneal ruptures.
MeSH term(s)	Female ; Humans ; Neoplasm Recurrence, Local/surgery ; Lymph Node Excision/methods ; Lymph Nodes/pathology ; Dissection/methods ; Laparoscopy/methods ; Genital Neoplasms, Female/surgery ; Surgical Instruments ; Carcinoma/surgery
Language	English
Publishing date	2023-04-09
Publishing country	United States
Document type	Video-Audio Media ; Journal Article
ZDB-ID	2186934-0
ISSN	1553-4669 ; 1553-4650
ISSN (online)	1553-4669
ISSN	1553-4650
DOI	10.1016/j.jmig.2023.03.022
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Zs.A 4205: Show issues

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Article ; Online: Modified Rankin scale assessment by telephone using a simple questionnaire.

Yi, Kenichiro / Nakajima, Makoto / Ikeda, Tomoaki / Yoshigai, Mineko / Ueda, Mitsuharu

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

2022 Volume 31, Issue 10, Page(s) 106695

Abstract: Purpose: The modified Rankin Scale (mRS) is widely used as a measure of post-stroke physical disability in clinical stroke trials; however, it is affected by inter-rater discrepancies. A Japanese version of the simplified mRS questionnaire (J-RASQ) has ... ...

Abstract	Purpose: The modified Rankin Scale (mRS) is widely used as a measure of post-stroke physical disability in clinical stroke trials; however, it is affected by inter-rater discrepancies. A Japanese version of the simplified mRS questionnaire (J-RASQ) has the potential to overcome the inter-rater discrepancies and might be feasible for clinical surveys. We aimed to determine the reliability of J-RASQ in a telephone survey administered by non-medical staff. Methods: We recruited 103 patients (age = 73 ± 11 years; 57% males) with a history of ischemic stroke who visited the outpatient clinic of the department of neurology at our hospital between March and May, 2021. After obtaining informed consent for participation in the study, a stroke neurologist assessed the mRS score during the visit using the Japanese version of mRS. On the same day, a clerk telephoned the patient or his/her family members to administer the J-RASQ. The percentage of agreement between mRS and J-RASQ scores was evaluated using the kappa coefficient and weighted kappa coefficient. Results: The median time for the telephone survey was 85 s (interquartile range = 70-135 s). The mRS and J-RASQ scores had an agreement of 63.1%, with a kappa statistic of 0.51 (95% confidence interval [CI] = 0.39-0.63). The weighted kappa statistic, which takes into account the extent of disagreement, was 0.81 (95% CI = 0.75-0.88). Conclusion: J-RASQ is easy to administer and reliable for assessment in telephone-based surveys performed by non-medical staff.
MeSH term(s)	Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; Stroke/diagnosis ; Stroke/therapy ; Surveys and Questionnaires ; Telephone
Language	English
Publishing date	2022-08-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	1131675-5
ISSN	1532-8511 ; 1052-3057
ISSN (online)	1532-8511
ISSN	1052-3057
DOI	10.1016/j.jstrokecerebrovasdis.2022.106695
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Zs.A 3519: Show issues

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Article ; Online: Surgical technique for fertility preservation for placenta accreta spectrum without previa: Tourniquet, uterus inversion and placental dissection procedure.

Nii, Masafumi / Enomoto, Naosuke / Takakura, Sho / Maki, Shintaro / Tanaka, Hiroaki / Ikeda, Tomoaki

The journal of obstetrics and gynaecology research

2023 Volume 49, Issue 8, Page(s) 2188–2193

Abstract: The placenta accreta spectrum without previa is difficult to diagnose before delivery and sometimes requires hysterectomy. A fertility preservation procedure is useful when placenta accreta spectrum is unexpectedly encountered. A 38-year-old woman, ... ...

Abstract	The placenta accreta spectrum without previa is difficult to diagnose before delivery and sometimes requires hysterectomy. A fertility preservation procedure is useful when placenta accreta spectrum is unexpectedly encountered. A 38-year-old woman, conceived by in vitro fertilization (IVF), was not diagnosed of placenta accreta spectrum until delivery. A cesarean section was performed for fetal breech presentation. The placenta could not be detached from the uterine fundus and marked bleeding started. We conducted the "TURIP" procedure: ensured hemostasis with tourniquet of uterine isthmus, uterus inversion to expose the adhesion site with intra-venous nitroglycerin administration, placental detachment by sharp dissection under direct visualization. The detached areas were sutured for hemostasis. The patient recovered uneventfully and achieved the second pregnancy by IVF 1 year later. The TURIP procedure is useful to preserve fertility in unpredicted placenta accreta spectrum without previa, even in undiagnosed cases before delivery.
MeSH term(s)	Pregnancy ; Female ; Humans ; Adult ; Cesarean Section/methods ; Placenta Accreta/surgery ; Uterine Inversion ; Fertility Preservation ; Tourniquets ; Placenta ; Placenta Previa/surgery ; Retrospective Studies
Language	English
Publishing date	2023-05-30
Publishing country	Australia
Document type	Case Reports
ZDB-ID	1327307-3
ISSN	1447-0756 ; 1341-8076
ISSN (online)	1447-0756
ISSN	1341-8076
DOI	10.1111/jog.15701
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Article ; Online: The development of early human lymphatic vessels as characterized by lymphatic endothelial markers.

Yamaguchi, Shoichiro / Minamide, Natsuki / Imai, Hiroshi / Ikeda, Tomoaki / Watanabe, Masatoshi / Imanaka-Yoshida, Kyoko / Maruyama, Kazuaki

The EMBO journal

2024 Volume 43, Issue 5, Page(s) 868–885

Abstract: Lymphatic vessel development studies in mice and zebrafish models have demonstrated that lymphatic endothelial cells (LECs) predominantly differentiate from venous endothelial cells via the expression of the transcription factor Prox1. However, LECs can ... ...

Abstract	Lymphatic vessel development studies in mice and zebrafish models have demonstrated that lymphatic endothelial cells (LECs) predominantly differentiate from venous endothelial cells via the expression of the transcription factor Prox1. However, LECs can also be generated from undifferentiated mesoderm, suggesting potential diversity in their precursor cell origins depending on the organ or anatomical location. Despite these advances, recapitulating human lymphatic malformations in animal models has been difficult, and considering lymphatic vasculature function varies widely between species, analysis of development directly in humans is needed. Here, we examined early lymphatic development in humans by analyzing the histology of 31 embryos and three 9-week-old fetuses. We found that human embryonic cardinal veins, which converged to form initial lymph sacs, produce Prox1-expressing LECs. Furthermore, we describe the lymphatic vessel development in various organs and observe organ-specific differences. These characterizations of the early development of human lymphatic vessels should help to better understand the evolution and phylogenetic relationships of lymphatic systems, and their roles in human disease.
MeSH term(s)	Humans ; Animals ; Mice ; Endothelial Cells ; Phylogeny ; Zebrafish ; Lymphatic Vessels ; Transcription Factors ; Embryonic Structures ; Portal System/embryology
Chemical Substances	Transcription Factors
Language	English
Publishing date	2024-02-14
Publishing country	England
Document type	Journal Article
ZDB-ID	586044-1
ISSN	1460-2075 ; 0261-4189
ISSN (online)	1460-2075
ISSN	0261-4189
DOI	10.1038/s44318-024-00045-0
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