tokai society of obstetrics and gynecologytokaiobgy.org/soukai/137-1.pdftokai society of obstetrics...

TOKAI SOCIETY OF OBSTETRICS AND GYNECOLOGY

1372 3 3 11 12

3 12

EBM

6

11

73

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29 3 11 11:10 11:40 4F 1

29 3 11 11:50 12:30 4F 1

29 3 11 12:30 12:50 4F 1

29 3 11 13:00 13:10 1 3F

29 3 11 15:15 15:30 1 3F

29 3 11 16:00 17:3029 3 12 10:00 11:30

2 4F 1 4 1F 1

29 3 11 18:30 20:30 4F

29 3 12 12:10 13:10 2 4F 1 3 1F

29 3 12 17:10 1 3F

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3 11 10:40 18:00 11:00 3 12 8:00 16:00 5,000

3 11 13:00 18:00 3 12 9:00 14:30

3 11 18:30 20:30 4F

3 11

〒460-8608 名古屋市中区錦一丁目19-30Tel. 052-231-7711（代表） www.nagoyakankohotel.co.jp

－ 6 －


0 30 30 60 100 30 50

3 12

TEL 052-851-5511 PHS3678

10

1 6 1 3

PC Windows7

10 PC20

PC Windows Power Point2007/2010/2013

OS MS MS

USBa. wmvb. Power Pointc. USB PCMacintosh PC Windows

PCMini D-Sub15pin

Macintosh WindowsPCAC

USB

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13:00 13:10

13:10 13:50 1 Letrozole Clomiphene Citrate

······································2

·································································

3 MTX 2 ·········································

4 (NIPT) ···························································

14:00 14:40 5

- - ···································

6 S S··············

7 MVA ·················

8 42 ·················································

14:50 15:05

15:30 16:30

EBM ···········

16:40 17:25 9

·········································

10 ························································

11 ·········································

12 1 ·····························································

13 ············································

－ 13 －


17:25 18:05 14 STUMP

(Smooth muscle tumor of uncertain malignant potential) 1 ·····························································

15 ························································

16 2 ··························

17 MEA ·················

13:10 13:55 18

···············································19

····················

20 ····················

21 ············································

22 ············································

16:00 17:30

－ 14 －


8:30 9:30 23 Paclitaxel Cisplatin Bevacizumab 1

············································

24 1 ··················································

25 ······························································

26 ············································

27 pagetoid spread ·······················

28 85 1 ························································

9: 40 10:40

···································

10:50 11:50

1-1 HRT ···············································

1-2 ·····················································

13:25 14:25

2-1 ············································

2-2 ·····················································

14:25 15:25

3-1 ····································································

3-2 ··············

－ 15 －


15:25 16:25 29

···························································

30 Krukenberg 1

31 ·····················································

32 ······························································

33 2 ·········································

34 16 1 ·····························

16:25 17:10

35 ············································

36 56·····························

37 2 - -

·····························································

38 Superb Microvasclar Imaging ············································

39 ··············

8:30 9:30 40

·································································

41 0 PRES 1 ·········································

42 ·········································

43 3 ··················································

44 ··················································

45 1 ············································· ,

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10:50 11:50 46 1

····································································

47 1 ·····················································

48 , 1 ···············································

49 MRSA

····································································

50 4 ······························· JA

51 balloon occlusion cesarean hysterectomy ······························································

12:10 13:10

·····················································

13:25 14:25 52 CHAOS VACTAL

···············································

53 MD BNP ···································

54 ··························

55 22 2 ···································

56 (MCA-PSV) ·································································

57 Appropriate for gestational age

···············································

14:25 15:25 58 Brain Natriuretic Peptide

59 ···············································

60 1 ···························································

61 ············································

62 ··································································

63 ·································································

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15:30 16:15 64 1

·····························

65 1·····························

66·········································

67 PlGF ··················································

68 sFlt-1/PlGF ··············

16:15 17:00 69 24

···············································

70 ······························································

71 ··············

72 ·····························································

73 ···············································

12:10 13:10

···························································

10:00 11:30

－ 18 －


EBM

Evidence based medicine

representativenesscomparability

EBM RCT RCT

RCT

RCTITT

RCT

620213

0206081522

1. 2. 3. 4.2006

－ 21 －


62626364

388

15192126

33H19

JAID/JSCWG

43 H25H16 18 WG

ICD

H17 25 H14 24 H20

H21 H22 28

H20

－ 22 －


1-1. 1-2.

HRT (Hormone replacement therapy)

QOL

(VTE)

2002 Women`s Health Initiative (WHI) (CEE)

(MPA)HRT VTE 2

VTE HRT HRT HRT

VTE ESTHER Estrogen therapy (ET) VTE

OR 4.2 0.9

VTE

HRT

HRTHRT

HRT HR 0.82 [95 CI 0.72-0.93]

BMI

HR 0.68 [95 CI0.55-0.85] vs HR 0.87 [95 CI 0.75-1.00] p = 0.028

HRTHRT

HRT

HRTE 3 P

1

2 34 5 6

Colposcopy principles and practice, Saunders ELSEVIER

Modern Colposcopy 3rd ed, textbook &Atlas, Lippincott Williams & Wilkins

Burghatdt’s Colposcopy and Cervical Pathology, Thieme

－ 25 －


2-1. 2-2.

MRI CT

(DFI) DFIDFI 6

DFI 6

response rate(RR)10%

QOL

－ 26 －


3-1. 3-2.

Fetal growth restriction FGR2014

-1.5SD FGRFGR

well-beingwell-being

5FGR

TADAlafil for Fetus with Early-onset growth Restriction TADAFER II

TADAFER II

310%

3.2% 6%70%

41%G

25%

120 risk allele

Annexin A5

3

CT genotype

(OR 2.83, 95%CI 1.37-5.85)CC,CT,TT

S PS

PS

PS PS355 101

PS PS 90%

40% PS

risk allele

－ 27 －


1 2

1 2

1 2

1 1 1 1 1 1 1 1 1 1 2 1

1

1 2 1 1 1 1 1 1 1 1 1 1 1 1

Clomiphene Citrate CC

CCLetrozole

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2016CC 50mg 1 2 / Let 2.5mg 1

/ 5 5

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(AMH)

AMH

AMH2009 2015

53

1439

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1.92 vs. 2.98, 0.59 vs. 1.99, 0.48 vs. 2.37 ng/mL

－ 31 －


3 4

(MTX)

MTX

223 9

MTX

1

316

MTXhCG 12.9mlU ml

hCG MTX

3527.5% 2014

2013 4NIPT

3NIPT 1200

2013 4 2016 10NIPT

NIPT 44164336 80

38.2( 2.6SD)39.2( 4.8) BMI 21.0( 4.0)

NIPT 13 3 ( 22.2 ) NIPT 62 (1.4%)(21

39 18 18 13 5) 13 (0.3%) 21

35 3394.3 2

18 981.8 2 13

2 403

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0.01Whole genome

NIPT

－ 32 －


5 6

1 2

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,,

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, 1543, 12 276

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.

S PS

PS

PS PS

355101

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PSPS

PS10

PS9 (2.5%) 1 (1.0%)

PS 21.08 4.34g/ml 21.59 3.97

PS 8 PS100%(8/8)

PS 89.7% (26/29)73.1% (106/145)

PS PSPS

PS

－ 33 －


7 8

1 2 3 4

1 2 3,4 3,4

D&C

MVA

MVA

(n=29) 36.5(27-46)2.3(1-7) 5.9 2-12

1A 1A1% 10ml

1 0.5A

MVA

D&CMVA

[ ] 36%

45 60

[ ] Yahoo! JAPAN2015 2016

[ ] 125 33.7 (SD 4.0 ) 35 52

(41.6%) 40 15 (12.0%)2015

1.5 ( 2 p=0.001)2.2 ( p=0.002) 5

/

cor=0.96, p=0.003

[ ]

－ 34 －


9 10

20062016 5 2344

109 4.7%24

2 3

4915 45

12

2

46 239.5

WBC8400/ L CRP29.52mg/dlCT

AZM FMOX 5WBC4500/ L CRP16.85mg/dl

5WBC10600/ L CRP20.16mg/dl CT

CTRX 5WBC8500/ L CRP5.73mg/dl

4 WBC8900/ LCRP1.25mg/dl

11WBC8000/ L CRP13.20mg/dl

CTCTRX MNZ

4

CMZ7

21 CRP

－ 35 －


11 12

2008 4 1 2016 3 31 8

CT92

66 (71.7%)20 50 (54.3%)

2522.8

40(43.5%) 7 (7.6%)

7 25

3 2CTCT 68

22CT 59

6 24

402

1 2

7cm

CT MRICMZ

3 39 TAZ/PIPC

7cm

ICUMEPN DIC

12

CTRX deescaration15

－ 36 －


13 14

1 2 3

1 1 1 1

1 1 1 1 1

1 1 2 1 3 1

2008 8 2016 102

2078

9 4

1

24.6 cm2

21.3 cm2 ( ) 6.7 cm2 10.7 cm2

152.6% 4 23.2%

1 61.7%4 32.3%

156.7% 4 93.0%

1 78.2%4 39.5%

2 4952

(STUMP) 3STUMP

6STUMP 1

53 2 2 4751

CTMRI 70mm

implantation

0-5/10HPF6

STUMPSTUMP

STUMP

STUMP

STUMP

－ 37 －


15 16

2014Uterine artery embolization; UAE

UAE UAE

UAE

49 0 2644

UAE UAE

5 UAEMRI

3cm

3.9kg 16.7cm

UAE

1 39 2 1 31

1 6cm2

16cm MRI

GnRH agonist 6

TAE22cm TAE 2

2012g 6685ml4

2 71 3 3 56

8cm 15cm5 CT

10cm 611

5cm 623

4cm 38cm 5 TAE

67650g 3670ml

3 9

－ 38 －


17 18

Microwave Endometrial Ablation: MEA

11MEA TCR

1 10

GnRHa 2

70W 50 1

43.5 828.6

3 6

9

8 FSH

MEAMEA 1

QOL

20145

2016 1 10

－ 39 －


19 20

2015 9 2016 8MRI

425mm 5mm

2mm(Endo Relief ) 3Alexis (S)

(

)

68.5 (58-83) 6.5ml(1-40)20.5cm(17-23) 6000ml(5750-7300)

1 3

2 6

2014 4 2016 9TLmRH PLND

1/2 45 BMI 3535

5mm4 5mm

0

6 3946.7

42.8ml vs. 37.2 30.1ml 29.37.7 vs. 26.9 6.8 4.32.2 vs. 4.0 1.5

29918min. vs. 253 28min.

12 15mmHg 5mm

－ 40 －


21 22

2016

2016 1 7

9

54.8 16.2 BMI 24.3 4.13

2 11 1 1

+5

21

143 14

224.2 137.9 g

1

8.7 6.2

stage A2 B1

A12014 12

2016 92

2016 9 10stage B1

2

2 39608 mL 8 31

4

14

1 50 mL

6Stage B1

adenocarcinoma of the uterine cervix pT1bN0M0

radicality

－ 41 －


23 24

BevacizumabVEGF

2016 5

Paclitaxel Cisplatin Bevacizumab1 61

2 2

5 cm

Stage A2Squamous cell

carcinoma SCC non-keratinizing typeMRI 5cm PET/CT

FDG Stage B SCC of the Uterine Cervix Paclitaxel 175 mg/m2 Cisplatin 50 mg/m2 Bevacizumab 15 mg/m2 3

MRI PET/CT

FDG 3Bevacizumab

PaclitaxelCisplatin Bevacizumab

1 Bevacizumab

,

. ,

. 46 , 4 0 , 26

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－ 42 －


25 26

63 2 1

7

MRI T2

B pT1bN0M07

[ ]

38 3 392

CT 10cm

12400/ l 81.3% CRP 22.04mg/dl MRI

N/C

PET-CT

－ 43 －


27 28

paget pagetoid spreadpagetoid

spread

50 4tamoxifen AGC

Paget

MRIPET-CT

Paget

ER(+) PgR(-)MGB1( ) GATA3(focal+) p40(focal+) HER2(2+)PAX8(-)

pT1bN0M0paget

pagetoid spread

Paget

185 2 2

55

Adenocarcinoma Serous adenocarcinoma MRI

1/2PET-CT

PS

HCG

3 HCG63.4mIU/ml

2HCG 671.1mIU/ml 5

BSC6

5 86-91%

－ 44 －


29 30

1 2

1 1 1 1

1 2

1

67 5 3 ( 2 )

9 7cm

Afatinib

hCG

hCG Krukenberg 1

40 1 11

9

2hCG

(:56mm :40mm)

CA125 171.1 U/mL CA19-9 26,440 U/mL CA72-4 155.3 U/mL CEA 6.6 ng/mL AFP 17 ng/ml HCG 26.1 IU/L CT

Krukenberg

adenocarcinoma

hCG Krukenberg 1hCG

hCG

－ 45 －


31 32

[ ]

B

[ ] 26

CT

NILM

113 weeklyTC 6

3PET-CT

7TS-1+CDDP 2

101 17

[ ]

1-2%

20%

65 2 2 55diethylstilbestrol(DES)

high-grade carcinomaMRI

T2WI DWI 16 25CT

Grade3

pT2N0M0 FIGOTC

－ 46 －


33 34

1 2

1 1 1 1

1 2

[ ] 1970 Enzinger

0.9

2

[ ] 40 2 2

1.4cm5.5cm

66cm

-

22

[ ] 40 3 1

7 [ ]

42% 23% 23%26%

3%

1616

13

CT 40cm

density MRI

AFP 3.2ng/mlhCG 2.0mU/ml CEA 23.1ng/ml CA125 291.3U/ml

FIGO stage 1A pT1ANXM08

－ 47 －


35 36

135

7 2002 20151,034

26

MLD58.0

BMI 22.7 kg/m248.9 32.3 18.8%

0.111P 0.007 BMI 0.477 P 0.001

0.447 P 0.012 0.828P 0.001

MLD

P 0.001

[ ]

[ ] 2005 1

[ ] 5617 26 11

226 15 4

11 5

(P<0.01)(P<0.05)

1433 21

(63.6%)23 21 (91.3%)

[ ]

－ 48 －


37 38

1 2 3

1 1 1 1

1 1 1 1 1

1 1 2 1

3 1

2

Bookler

isolation bag

en bloc resection

Superb Microvascular Imaging SMI

monochorome SMI mSMIcolor-coded SMI cSMI

SMI

SMI

2015 9 2016 816

Toshiba Aplio 500 CDIAdvanced Dynamic Flow ADF Power Doppler Imaging PDI mSMI cSMI

57.716.3 mm CDI ADF PDI

mSMI cSMI56.2% 81.2% 100% 100% 100% SMI

PDI

SMI

－ 49 －


39 40

5%

1986 2015

cox100

24.3 3928 33

75.8 1090.0% 94.0%

[I vs. IV ; HR 18.5 (p = 0.012)] [vs. ; HR 7.5 (p = 0.065)]

(Reversible Cerebral Vasoconstriction Syndrome; RCVS)

10%RCVS

RCVS5

RCVS5

31.61 MRA

12

3Ca 4

3 1posterior reversible encephalopathy

syndrome: PRES

RCVS

－ 50 －


41 42

1 2

1 1 1 1

1 2 2 2 1

PRES;posterior reversible encephalopathy syndrome10-25

0 PRES1

31 1 133

39 1(3194g Ap9-9)

1116g

150/90mmHg130-140/80-90mmHg8 30

JCS3CT PRES

1 MRI

JCS10010 JCS2

22

0 PRES1

PRES

45 0 0

32137mg/dl 35

85mg/dl35 4

25mg/dl

636mg/dl APTT28.7

in vitro PT

5g 37 4

1069g 425mg/dl

7

－ 51 －


43 44

.

31 40 3 0

30 IgA 36IVF-ET 419 6

528 6

343 1884g2 27 0 1

204 18 5

296 38 639 1 2488g 3

38 4 1 2711 19

20 36

4 185 28

637 3 2530g

3

hematopoietic stem cell transplant (HSCT)

HSCT

HSCT

HSCT

HSCT HSCT

HSCT6 27.5

(24-33 ) 6 HSCT3

1 11 1

1 1PIH 27 32

133 2

1 HSCT1

HSCT 6HSCT

PIHHSCT

HSCT

－ 52 －


45 46

,

Xp

36 3 1 40 4

AFI2.8 NST40

6 50bpm 5

2242g 47 Apgar Score8/8NICU

ALP Xp

GNPTAB

3

PNH PNH

PNH

28 18/

CyA CyA22 PNH

27

CyA

4040 3

2706g Apgar score 8 1 /95

PNH

CyA

PNH

－ 53 －


47 48

[ ]

361

[]27 1 1

365

11300/ l996/ l 63mg/dl

23 1

56

7

3250g Apgar score 9/10

13 22/ l16 [

]2/3

36

DIC. 60 80

. , ,

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98%( 10L).

, 25.0 mg/dl, FDP800.0 g/ml , D 300.0

g/ml , AT- 69.0DIC . NST ,

. , .

8000ml RCC20 , FFP30, 20 , 5g

ICU . 3425g, Apgar score 1 2 , 5 4pH7.164, BE-7.0 NICU .

2 DIC . 24 .

STNZn-CP1

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., DIC

DIC .

－ 54 －


49 50

1 2 JA

1 1 1 1

2

MRSA

(SIRS) 5(MOF)

(ARDS)

MRSA ARDSMOF

38 0 07

AIH 13 31

33 1(PIPC)

33 539 CTG

1218 24

SpO2DIC

MRSA

MRSA

[ ]

2 4[ 1]34 0 0

41 52/3 5000ml

ICU

11[ 2]30 1 0

40 21/3 2000ml

ICU8

[ 3]303 1 37 6

1/21200ml RCC4U

310

4[ 4]38 1 0

40 5

2/3 8

10 5[ ]

－ 55 －


51 52

balloon occlusion CIABOcesarean hysterectomy

CHCIABO

CH2010 8 CIABO CH

2016 38

2007 CIABOCH 12

80 1

1 5 2 34 2

224 34 1 36 4 37 2

653 7

inflation inflation20 15-24 CIABO

4000g132

102-151 /107 67-202 2213g683-3953 /2247g 1344-5500 0 /2 13

2 25 /6 50CIABO CH 4

21 1

1 61 CIABO CHCH

CHAOS(Congenital high airway obstruction syndrome)

VACTERLV: A: C: TE:

R: L: 63

MD 1

23 MD15 1

17 1

CHAOS VACTERL46XY

24

28 MRI VACTAL

well-beingwell-being

301

33 1NICU

1

－ 56 －


53 54

BNP BNP

MDBNP

MD 22MVP 12cm 4cm24

TR 27MVP 2.8

TR 128cm/sec28

BNP30

BNP 57.1 pg/dl 36pg/dl

PIPI 0.90 95%tile MPI

MPI 0.53 0.33 0.0531

2 2067g1523g BNP

BNP BNP430.7pg/dl BNP 39.8pg/dl

4TR

BNPBNP

cut-off

1 33 2 1

4320gAP3/4 PH7.340Hb2.2

Hb-F 5.5 AFP 12743

Hb-F 5.5 AFP 127437

1

－ 57 －


55 56

22 1)2) clinicalCAM 3)

4

2

26 1G0P 1819

25 8

34 5

dry lung syndromePVL 29

362G1P 1019 3

20 5

CAM3 22 5

stage1 CAM

22

(MCA-PSV)

40 3 036

(MCA-PSV)1.29MoM

2374g Apgar score 1 8 59 pH

7.331 pCO2 40.1 HCO3 21.4 BE -3.4 Lac2.6

Hb7.0g/dl Ht22.330ml 12ml/kg

HbF4.3 AFP 1917ng/dl

MCA-PSV

－ 58 －


57 58

1 2

3

1 1 2 3

1

37Appropriate for gestational age

PI MCA-PI PICerebro-placental ratio CPR MCA-PI

CPR 7

2424

209 108101 24

1333

MCA-PI CPR 3033 3437 MCA-PI CPR

24 24MCA-PI

97.5±27.1% vs 96.7±27.3%, p=0.929 CPR1.04 0.40% vs 1.00 0.41, p=0.728

MCA-PI 88.217.6% vs 102.3 29.7%, p=0.051 CPR

84.9 21.1% vs 101.1 37.1, p=0.068

MCA-PI CPR

40 50%Brain Natriuretic Peptide (BNP)

BNPBNP

2013 1 2015 7773

36 4 1 BNP36

HELLP

BNP58

35.634.1

(p=0.014) BNP (95% )11.0 (0 - 27.5) pg/mL

36 17.9 (0 - 44.7) pg/mL p 0.001 442.5 (0 - 112.6) pg/mL p 0.001 116.1 (0 - 43.9) pg/mL p=0.001

BNP1

4 BNP 95%

100 pg/mL BNP

－ 59 －


59 60

(Cockayne syndrome) 1002.7

26

27

TORCH33

OCT978g(-3.5SD) Apgar score

5 /8 1 /5 NICU

201 5

FGRTORCH

32 1 1 16 C30

25 6

37 3CTG

3188g1 9 /10 10 HCU

amphetamine

7 10

13

－ 60 －


61 62

1 2

1 1 1 1 1 2 1

[ ] 21

[ ]

[ ] 78

111

7 31.3

556g 42872

2 3 1

5

1 [ ]

2013 2015 356

() 2

243233 (23-42 ) 38

(33-39 ) 33(24-43 ) 37 (33-40 )

2 (p=0.03)

－ 61 －


63 64

1 2 1 2 3

1 1 1 1 1 1 1 1 1 1

1 2 1

1 2 2 2 2 2 2 3

1 34 G0P0 1732 31

037 3

730

2 29 G0P020 3

40 53

53 24 G0P0

14 5

3537 3

1

ICU 7

124

14 1160cm 46kg

2 316 1

20 1 270g

1 1.2 4175 13

200

8922

－ 62 －


65 66

1 2 3

1 2 2 2 2 2 2 3

19

25 3 1 11 2150cm

70kg 2

TSH

19 114mm

(BPD:46mm, +0.3SD

18 10mm

MRI

Chiari II

20 5 313g

15.7 40 3

Chiari II

MRI

(FGR5

Ca2+

FGR

22 34-1.5SD FGR FGR3 Fibonacci

10-40mg/37

2

1430 24 -33-2.0 SD(-1.6SD -2.5SD)

340mg

20mg

8.5 5.0g/19.5 4.0g/ P=0.011

1/3NRFS non reassuring fetal states

20mgFGR

－ 63 －


67 68

(FGR) PDE5FGR

27 7 28 10FGR16

PlGF

27 (24 33 )-2.1SD(-2.9- -1.7SD)

PlGF121.5pg/ml(40.1 595.0pg/ml) PlGF

33 (26 34 ) PlGF118.3pg/ml(29.7 795.0pg/ml)

18.0g(3.2 22.4g) PlGF

PlGFR2 0.17 30 11

R2 0.75

30 FGR PlGF

II

soluble fms-like tyrosine kinase 1sFlt-1 placental growth factor PlGF

sFlt-1/PlGF 381

85

sFlt-1/PlGF2016 4

11 FGR

sFlt-1 PlGF 16sFlt-1 PlGF sFlt-1/PlGF

32.8 sFlt-17580.8 pg/mL PlGF 182.2 pg/mL

sFlt-1/PlGF 156.416 13

13 4HELLP

3 sFlt-1/PlGF 55.1

9 sFlt-1/PlGF 326.44 sFlt-1/PlGF 34.6

sFlt-1/PlGFsFlt-1/PlGF

sFlt-1/PlGF

－ 64 －


69 70

(SPE)24 34

(34 )(MgSO4

24 48 )

24 SPE(Alb)

25

23 2175/101mmHg 4+

350g(-2.4SD)

5 7g/Alb 1g/dl

Alb24 4

30 /

25 5454g (-3.0SD) Ap1/4 1,000ml

( 3,900ml/ ) 2 1g/

110/70mmHg 301+ 3

156

SPE

FGRPE

FGR PEPhosphodiesterase 5 (PDE 5 )

1 35 27 7 FGR PE

40mg/day160/95mmHg 7.67g g/cr

7120/76mmHg 2.26g g/cr

14

Well-being874

sFlt-1

PE

－ 65 －


71 72

(Hypertensive Disorder of Pregnancy: HDP)

HDP

HDP

HDP 138HDP 18

160 mmHg110 mmHg 2

1 3

left ventricular ejection fraction (LVEF)

early transmitral velocity/early diastolic velocity of the mitral annulus (E/e )

87 5118 BMI

LVEF1

LVEFHDP

HDP1

HDP

PIH

PIH

2014 4 2016 3 PIH72

39 33

Apgar score 1

2769 13 39

35.2 2.6 37.6 3.0

2014610 2725 765

Apgar score 17.0 1.9

7.9 1.8

－ 66 －


73

(PE)(GH) (CHT)

(LOH GH )

( 160/110mm)10 (PE 3 GH 5 CHT 2)

PE2 1GH4 LOH 1CHT1

(1mg/ml) 0.5mg/hr2.5mg/hr

30160/110mmg 0.5mg/hr

1.1 0.60 mg109 1554

( 180/120mm) 3 GHLOH (<140/90mmHg)

GH CHT PE

(SBP)

LOH

PE

(SBP level1 160-179mmHg Level II 180mmHg )

－ 67 －


LS1.

hypophosphatasia; HPP (TNSALP)

5

CT

HPP 10perinatal lethal type

2015

10 HPP 30CT

QOL

1986 3 1986 1989 1989 1993 1993 1996 1996 1999 1999 2001 2002 2004 2004 2007 2007 2009 2009 9 2010 4

－ 71 －


LS2. Why not MVA? ”

MVA

D&C WHOD&C

2015 10MVA MVA

MVAD&C 2

MVA (n=29) 36.5(27-46) 2.3(1-7)5.9 2-12 1A 1A 1%

10ml 1 0.5A

MVAD&C MVA

MVA

20102015

－ 72 －


80%

PROMPT Naegele Naegele

Naegele

6 6 8 12 18 19

ALSO

－ 73 －


2003 600

3 4/10,000Microwave Endometrial Ablation ( MEA)

Microwave

2007 8 IRBMEA 2009 6 4

MEA 2012 4 1 MEA K863-3 17,810200 MEA MEA

MEAMEA

MEAMEA

1996 1996 2004 2006 2008 2016 2016

Johns Hopkins

IGCS AACR

Editorial board BMC Cancer, Associate Editor2005 2011 2011

HERA Ovarian Cancer Award

－ 74 －


50

29 2 17

－ 75 －

tokai society of obstetrics and gynecologytokaiobgy.org/soukai/137-1.pdftokai society of obstetrics...

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