Sampling, identification and sensory evaluation of odors of a newborn baby’s head and amniotic fluid

For baby odor analyses, noninvasive, stress-free sample collection is important. Using a simple method, we succeeded in obtaining fresh odors from the head of five newborn babies. These odors were chemically analyzed by two-dimensional gas chromatography coupled with mass spectrometry (GC x GC-MS), and compared with each other or with the odor of amniotic fluid from the baby\u27s mother. We identified 31 chemical components of the volatile odors from neonate heads and 21 from amniotic fluid. Although 15 of these components were common to both sources, there was an apparent difference in the GC x GC patterns between the head and amniotic fluid odors, so the neonate head odor might be individually distinct immediately after birth. Therefore, we made artificial mixtures of the major odor components of the neonate head and maternal amniotic fluid, and used psychological tests to examine whether or not these odors could be distinguished from each other. Our data show that the artificial odor of a neonate head could be distinguished from that of amniotic fluid, and that the odors of artificial head odor mixtures could be correctly discriminated for neonates within an hour after birth and at 2 or 3 days of age

Annual report of Subcommittee for Examination of Causes of Maternal Death and their Prevention in Perinatology Committee, Japan Society of Obstetrics and Gynecology, 2013

As the fibrinogen level decreases early in atonic bleeding, early administration of FFP may be important as an initial approach to treat atonic bleeding.Amniotic fluid embolism is classified into 2 types, conventional type and uterus-type

A case of mucoepidermoid carcinoma arising in mature cystic teratoma

卵巣粘表皮癌は卵巣悪性腫瘍の中で極めてまれな組織型に分類される。今回、我々は成熟嚢胞性奇形種より発生した卵巣粘表皮癌の症例を経験したので報告する。症例は、69歳、女性、両側の成熟嚢胞性奇形腫を認めたが、SCC 高値とCT、MRI にて左側の腫瘍内に造影される充実性部分を認めたこと、小腸に浸潤を疑う所見を認めたこと、から悪性転化を疑い、手術を施行した。開腹時、両側卵巣腫瘍を認め、左卵巣腫瘍はS状結腸と強固に癒着していた。卵巣腫瘍充実性部分の迅速病理にて低分化癌と診断し、単純子宮全摘出術、両側付属器摘出術、S状結腸合併切除、骨盤リンパ節郭清術、大網切除術を施行した。病理組織学的には、左卵巣腫瘍の嚢胞壁肥厚部に皮膚付属器、脂肪織、軟骨組織、リンパ球集簇、卵巣間質を認め、充実成分に低分化な浸潤性扁平上皮癌を認めた。充実成分には、粘表皮癌に特徴的な、豊富な胞体粘液（PASおよびAlcian blue 染色陽性）を有する異型細胞が胞巣状~不完全な腺管状を呈する領域があり、成熟嚢胞性奇形腫より発生した卵巣粘表皮癌IIb期(pT2bN0M0)と診断した。術後補助化学療法としてDC（ドセタキセル、カルボプラチン）療法を施行し、術後1年8ヶ月現在、再発を認めない。雑誌掲載論

Squamous cell carcinoma antigenは羊水塞栓症診断の新しいマーカーとなり得る

AIM: We aimed to evaluate the clinical usefulness of serum squamous cell carcinoma (SCC) antigen for the diagnosis of amniotic fluid embolism (AFE). METHODS: Sera and information of 20 patients with AFE (autopsy-proven AFE, four cases; clinical AFE, 16 cases) were obtained from the Japan Amniotic Fluid Embolism Registration Center at Hamamatsu University School of Medicine. As controls, we included 74 gestational-age-matched healthy women who gave birth to healthy newborns during the period from December 2012 to January 2014. Receiver-operator curves (ROC) were used to evaluate the diagnostic performance of SCC levels for prediction of AFE. RESULTS: Serum SCC antigen levels in women with autopsy-proven AFE (112.0 ± 169.4 ng/mL, P = 0.001) and clinical AFE (9.5 ± 10.3 ng/mL, P = 0.004) were significantly higher than those in healthy controls with normal delivery (4.4 ± 2.2 ng/mL). On ROC analysis, the optimal cut-off value for SCC antigen levels was 7.15 ng/mL, for which the sensitivity and specificity for AFE prediction was 60.0% and 89.2%, respectively (area under the ROC, 0.785; 95% confidence interval, 0.663-0.908; P < 0.001). CONCLUSION: Serum SCC antigen may be a promising predictor of the entry of amniotic fluid into the maternal circulation, potentially serving as a candidate marker for noninvasive diagnosis of AFE.博士（医学）・乙第1436号・令和元年9月27日© 2017 Japan Society of Obstetrics and GynecologyThis is the peer reviewed version of the following article: [https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/jog.13453], which has been published in final form at [https://doi.org/10.1111/jog.13453]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions

Urinary trypsin inhibitor suppresses the production of interstitial procollagenase/proMMP-1 and prostromelysin 1/proMMP-3 in human uterine cervical fibroblasts and chorionic cells

AbstractThe mechanisms by which urinary trypsin inhibitor (UTI) prevents preterm premature rupture of fetal membrane and premature cervical ripening were investigated. We, therefore, examined the effects of UTI on the production of matrix metalloproteinases (MMPs) which closely participate in the breakdown of extracellular matrix in cultured human uterine cervical fibroblasts and human chorionic cells. UTI suppressed specifically the production of interstitial procollagenase/proMMP-1 and prostromelysin 1/proMMP-3 from both cells in a dose-dependent manner (0.32-1.28 μM). This suppression was accompanied by a decrease in steady-state levels of their mRNAs. These results indicate for the first time that UTI down-regulates the production of proMMP-1 and proMMP-3 accompanying with the decrease in the expression of their mRNAs, and therefore UTI actually participates in the maintenance of fetal membranes and/or uterine cervix by overall suppression of MMP production along with the known inhibitory actions towards serine proteinases

Antithrombin deficiency in pregnancy

Background and Aim: Liver dysfunction with decreased antithrombin activity (AT) and/or thrombocytopenia is life-threatening in pregnant women. Whether AT is clinically useful for prediction of liver dysfunction remains unclear. Methods: A total of 541 women were registered prospectively at gestational week 34.7 (20.0 - 41.4) with available data on antenatal AT and platelet count (PLC). Results: Liver dysfunction defined as serum AST > 45 IU/L concomitant with lactate dehydrogenase (LDH) > 400 IU/L occurred in five women antenatally (≤ 2 weeks before delivery) and in 17 women postpartum (within 1 week postpartum). Median (5th - 95th) antenatal value was 85 (62 - 110)% for AT and 202 (118 - 315)×10^9/L for PLC in the 541 women, and was significantly lower in women with than without perinatal liver dysfunction; 75 (51 - 108) vs. 86 (62 - 110)% and 179 (56 - 244) vs. 203 (121 - 316)×10^9/L, respectively. Nineteen (86%) women with liver dysfunction showed AT ≤ 62% or thrombocytopenia (PLC ≤ 118×10^9/L) perinatally, but five lacked thrombocytopenia throughout the perinatal period. The best cut-off (AT, 77%; PLC, 139×10^9/L) suggested by receiver operating characteristic curve gave antenatal AT and PLC sensitivity of 59% and 41% with positive predictive value (PPV) of 8.6% and 14%, respectively, and combined use of AT and PLC improved sensitivity to 73% (16/22) with PPV of 9.2% for prediction of perinatal liver dysfunction. Conclusions: Reduced AT not accompanied by thrombocytopenia can precede liver dysfunction. Clinical introduction of AT may enhance safety of pregnant women