Publications by authors named "Shimoya Koichiro"

Placenta accreta spectrum (PAS) is a life-threatening condition characterized by abnormal placental invasion of the myometrium and is often associated with uterine surgery. However, it can also occur in unscarred uteri, particularly during pregnancies using assisted reproductive technology (ART). Following a successful pregnancy via vitrified-warmed embryo transfer, a 33-year-old nulliparous woman with systemic lupus erythematosus and long-term steroid use presented with intra-abdominal hemorrhage due to placenta percreta and spontaneous uterine perforation at week 10 of gestation.

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Introduction: The three-arm approach is mainly selected, despite the multiple robotic arms in da Vinci Xi. This type of surgical setup may provide less autonomy to the console surgeon and result in greater dependence on the bedside surgical assistant. Therefore, the 4th arm is used instead of the assist port, which is why we developed "pure" robot simple hysterectomy (PRSH) as a novel surgical technique, in which all ports are operated by robotic arms.

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Neural stem cells (NSCs) can give rise to both neurons and glia, but the regulatory mechanisms governing their differentiation transitions remain incompletely understood. Here, we address the role of cyclin-dependent kinase inhibitors (CDKIs) in the later stages of dorsal cortical development. We find that the CDKIs p18 and p27 are upregulated at the onset of astrocyte generation.

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Introduction And Hypothesis: Pelvic organ prolapse (POP) affects approximately 30% of middle-aged and older women, with 11%-19% requiring surgical intervention. Laparoscopic sacrocolpopexy preserves the vaginal axis and length but involves a steep learning curve and longer operation times. Robotic sacrocolpopexy (RSC) addresses these issues, offering enhanced surgical precision.

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Article Synopsis
  • Acute Sheehan syndrome is a rare form of hypopituitarism that can develop after significant postpartum hemorrhage, as seen in a 37-year-old woman who lost 3,000 mL of blood following a vulvar hematoma.
  • The patient presented with symptoms like anorexia and fatigue 28 days after giving birth, and MRI results confirmed swelling of the pituitary gland due to hemorrhage.
  • This case is unique as it links acute Sheehan syndrome to vulvar hematoma, emphasizing the need to consider less common complications in severe postpartum bleeding cases.
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  • * Intraoperative elastography was used during surgery to ensure complete removal of the adenomyotic tissue while protecting the endometrium, with MRI confirming no remaining adenomyosis post-surgery.
  • * The patient achieved a successful twin delivery via cesarean section after IVF, signaling the potential of elastography-guided surgery for enhancing fertility in women with adenomyosis, though more research is needed to confirm its effectiveness and safety.
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Background: Robotic simple hysterectomy (RSH) is the most common robotic gynecologic surgery in the United States. Uterine manipulators are commonly used to handle the uterus during laparoscopic surgery, but few studies have examined their necessity in RSH. This study retrospectively compares RSH cases with and without the use of manipulators, and identifies predictors for their intraoperative use.

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  • * A case study of a 39-year-old Japanese woman revealed that her right ureter had serious issues, including a complete absence of flow and kidney atrophy, due to an undetected congenital abnormality.
  • * This case highlights the importance of recognizing both normal pelvic anatomy and potential embryological abnormalities to minimize surgical complications in hysterectomy procedures.
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Japan has a particularly critical situation surrounding its collapsed HPV vaccination program for preventing HPV-caused cervical cancers, a problem exacerbated by the lack of a national immunization database. We have determined the year-to-year HPV vaccination uptake by Japanese females and analyzed by birth fiscal year (FY) the monthly number of people receiving initial HPV vaccination. Our analysis covers the period from the start of public subsidies in 2010 to September 2023, using data provided by local governments.

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  • The study investigates the role of PAR1, ARRDC3, and tumor-infiltrating lymphocyte (TIL) scores in predicting the prognosis of HPV-associated oropharyngeal cancer, comparing it with other cancer types.
  • The research involved immunohistochemical analysis of cancer samples, revealing that p16 expression was significantly associated with better outcomes in oropharyngeal cancer patients.
  • Results indicated that patients with ARRDC3-positive oropharyngeal cancer had improved disease-specific survival, while PAR1-negative patients showed better overall prognosis compared to PAR1-positive cases.
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The 2017 clinical guidelines for obstetrical practice by the Japan Society of Obstetrics and Gynecology and the Japan Association of Obstetricians and Gynecologists were revised and published as the 2020 edition (in Japanese). The aim of these guidelines is to present appropriate standard obstetric diagnosis and management procedures that have reached consensus among Japanese obstetricians. The 2020 guidelines include 113 clinical questions and an appendix, followed by answers (CQ&A; originally 112 in the 2017 edition), a discussion, list of references, and some tables and figures presenting common problems and questions encountered in obstetrical practice.

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  • This nationwide study in Japan examined how healthcare facilities manage term premature rupture of membrane (PROM) and its effects on maternal and neonatal health outcomes.
  • The survey of 415 facilities revealed that most hospitals followed a management protocol that allowed up to 3 days for delivery after PROM and emphasized addressing bacterial infections.
  • Results indicated that waiting up to 48 hours for labor after PROM did not raise the risk of complications like postpartum fever when compared to immediate labor induction.
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The prognosis of the patients with inoperable or advanced granulosa cell tumors (GCTs) is still poor, and therefore it is important to establish a novel treatment strategy. Here we investigated the in vitro effects of a histone deacetylase inhibitor, panobinostat (PS) on two GCT cell lines (KGN and COV434). GCT cell lines were found to be susceptible to PS treatment and it inhibited cell growth mainly by apoptosis.

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Ovarian abscess is thought to be caused by ascending infection. We experienced a case with ovarian abscess caused by Salmonella. The patient had been monitored for endometrial cysts at an outpatient clinic.

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Pregnancy and childbirth have various effects on the physical as well as mental aspects of women. Therefore, appropriate considerations must be given to the mental health of pregnant women. The Guideline Review Committee of the Japanese Society of Psychiatry and Neurology launched a liaison meeting for the Japanese Society of Psychiatry and Neurology and the Japan Society of Obstetrics and Gynecology, with a view to creating a "Clinical guide for women with mental health problems during the perinatal period" by cooperation of these two fields.

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Advances in perinatal care have improved the prognoses of both mothers and neonates; however, cerebral palsy continues to occur. In this study, we examined methods for the intragestational evaluation of the health of infants who later developed cerebral palsy. A retrospective review was conducted on light-for-dates cases among the 2113 cause analysis reports issued by the Japan Obstetric Compensation System between January 2009 and September 2018.

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Seprafilm is an adhesion barrier sheet. However, it is difficult to handle it through a 5-mm trocar. We have devised a method of applying Seprafilm safely and reliably through a 5-mm trocar by using a holder that comes with the film.

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Twin-twin transfusion syndrome (TTTS) complicates approximately 10% of monochorionic twin pregnancies and is associated with almost 90% mortality if left untreated. Fetoscopic laser photocoagulation (FLP) is the first-line therapy for TTTS, and an overall twin survival rate of 75% and at least one survival rate of 90% have been established. We report a case of TTTS complicated with bleeding from the uterine wall by inserting the procedure after FLP.

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Article Synopsis
  • * By transplanting tumors with a significant amount of surrounding tissue, the establishment rate of tumors in nude mice increased from 14% to 66%.
  • * This enhanced method could enable more cancer patients to have personalized mouse models for testing how effective various drugs may be for their specific tumors.
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Background/aim: Matrix-producing breast carcinoma (MPBC) is a rare and usually aggressive triple-negative breast cancer (TNBC). In the present report, we determined the drug sensitivity for a triple-negative MPBC using a patient-derived orthotopic xenograft (PDOX) model.

Materials And Methods: The PDOX model was established in the left 2 mammary by surgical orthotopic implantation (SOI).

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Purpose: Cervical cancer is a recalcitrant disease. To help overcome this problem, we previously established a patient-derived orthotopic xenograft (PDOX) model of cervical cancer. In the previous study, we found the tumor to be resistant to nab-paclitaxal (nab-PTX).

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Uterine choriocarcinoma is a trophoblastic neoplasm that is most commonly gestational but can also be non-gestational in origin. However, primary non-gestational uterine choriocarcinoma is very rare, with only few cases having been reported. We report a case of a premenopausal woman who had initially been diagnosed with myoma delivery but who was discovered to have primary non-gestational uterine choriocarcinoma.

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Purpose: Recently, endoscopic surgeries are widely performed in the gynecological field. Several studies on the use of local anesthesia for pain control after laparoscopic surgery have been conducted; however, its effects remain controversial. Herein, a randomized control study on gynecological laparoscopic surgeries was conducted to analyze the effectiveness of local anesthesia on postoperative pain.

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A 33-year-old woman became aware of a right breast mass at her 28th week of pregnancy. From the biopsy results, we diagnosed her with right breast cancer. At her 33rd week of pregnancy, she underwent modified radical mastectomy (pT2N3aM0, Stage III C, ER-negative, PR-negative, HER2-positive), and she elected to receive adjuvant therapy after the surgery during her pregnancy.

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