落合　大吾 (オチアイ　ダイゴ)

Ochiai, Daigo

写真a

所属（所属キャンパス）

医学部 産婦人科学教室（産科） （信濃町）

職名

准教授
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  • 医学部, 産婦人科学（産科）, 助教

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  • 1994年04月
    -
    2000年03月

    慶應義塾大学, 医学部

    大学, 卒業

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  • DNA methylation analysis of cord blood samples in neonates born to gestational diabetes mothers diagnosed before 24 gestational weeks

    Kasuga Y., Kawai T., Miyakoshi K., Hori A., Tamagawa M., Hasegawa K., Ikenoue S., Ochiai D., Saisho Y., Hida M., Tanaka M., Hata K.

    BMJ Open Diabetes Research and Care （BMJ Open Diabetes Research and Care)  10 （ 1 ）  2022年01月

    　概要を見る

    Introduction Genome-wide methylation analyses of gestational diabetes mellitus (GDM) diagnosed after 24 gestational weeks (late GDM (L-GDM)) using cord blood have been reported. However, epigenetic changes in neonates born to mothers with GDM diagnosed before 24 gestational weeks (early GDM (E-GDM)) have not been reported. We investigated DNA methylation in neonates born to mothers with E-GDM using cord blood samples. Research design and methods Genome-wide DNA methylation analysis was performed using an Illumina EPIC array to compare methylation rates of 754 255 autosomal sites in cord blood samples from term neonates born to 162 mothers with GDM (E-GDM: n=84, L-GDM: n=78) and 60 normal glucose tolerance (normal OGTT) pregnancies. GDM was diagnosed based on Japan Society of Obstetrics and Gynecology criteria modified with International Association of Diabetes in Pregnancy Study Group criteria. In this study, all GDM mothers underwent dietary management, while self-monitoring of blood glucose and insulin administration was initiated when dietary modification did not achieve glycemic control. Results There were no significant differences in genome-wide DNA methylation of cord blood samples between the GDM (E-GDM and L-GDM) groups and normal OGTT group or between the E-GDM and normal OGTT groups, L-GDM and normal OGTT groups, and E-GDM and L-GDM groups. Conclusions This is the first report to determine the DNA methylation patterns in neonates born to mothers with E-GDM. Neonates born to mothers with GDM, who were diagnosed based on Japan Society of Obstetrics and Gynecology criteria, may not differ in DNA methylation compared with those born to normal OGTT mothers.

  • Deep neural network-based classification of cardiotocograms outperformed conventional algorithms

    Ogasawara J., Ikenoue S., Yamamoto H., Sato M., Kasuga Y., Mitsukura Y., Ikegaya Y., Yasui M., Tanaka M., Ochiai D.

    Scientific Reports （Scientific Reports)  11 （ 1 ）  2021年12月

    　概要を見る

    Cardiotocography records fetal heart rates and their temporal relationship to uterine contractions. To identify high risk fetuses, obstetricians inspect cardiotocograms (CTGs) by eye. Therefore, CTG traces are often interpreted differently among obstetricians, resulting in inappropriate interventions. However, few studies have focused on quantitative and nonbiased algorithms for CTG evaluation. In this study, we propose a newly constructed deep neural network model (CTG-net) to detect compromised fetal status. CTG-net consists of three convolutional layers that extract temporal patterns and interrelationships between fetal heart rate and uterine contraction signals. We aimed to classify the abnormal group (umbilical artery pH < 7.20 or Apgar score at 1 min < 7) and the normal group from CTG data. We evaluated the performance of the CTG-net with the F1 score and compared it with conventional algorithms, namely, support vector machine and k-means clustering, and another deep neural network model, long short-term memory. CTG-net showed the area under the receiver operating characteristic curve of 0.73 ± 0.04, which was significantly higher than that of long short-term memory. CTG-net, a quantitative and automated diagnostic aid system, enables early intervention for putatively abnormal fetuses, resulting in a reduction in the number of cases of hypoxic injury.

  • Clinical utility of 1-month postpartum random plasma glucose and glycated hemoglobin combined with pre-pregnancy body mass index for detecting postpartum glucose intolerance in Japanese women with gestational diabetes

    Sugiyama K., Saisho Y., Kasuga Y., Ochiai D., Itoh H.

    Journal of Diabetes Investigation （Journal of Diabetes Investigation)  12 （ 12 ） 2242 - 2246 2021年12月

    ISSN  20401116

    　概要を見る

    During the coronavirus disease 2019 pandemic, the Japanese Society of Diabetes and Pregnancy proposed the use of random plasma glucose and glycated hemoglobin measured 1 month after delivery combined with pre-pregnancy body mass index to detect postpartum glucose intolerance instead of carrying out the oral glucose tolerance test in women with gestational diabetes. We retrospectively evaluated the clinical utility of this strategy to detect postpartum glucose intolerance evaluated by the oral glucose tolerance test after delivery. A total of 275 Japanese women with gestational diabetes were included in the present study. The specificity of 1-month postpartum random plasma glucose and glycated hemoglobin combined with pre-pregnancy body mass index to predict postpartum glucose intolerance was 98.0%, with a negative predictive value of 72.6%. However, sensitivity was 6.4%, with a positive predictive value of 55.6%. In conclusion, this Japanese Society of Diabetes and Pregnancy strategy showed high specificity, but low sensitivity, for detecting glucose intolerance postpartum.

  • Prepregnancy assessment of liver function to predict perinatal and postpregnancy outcomes in biliary atresia patients with native liver

    Takahashi N., Ochiai D., Yamada Y., Tamagawa M., Kanamori H., Kato M., Ikenoue S., Kasuga Y., Kuroda T., Tanaka M.

    Journal of Clinical Medicine （Journal of Clinical Medicine)  10 （ 17 ）  2021年09月

    　概要を見る

    Considering that some biliary atresia (BA) survivors with native liver have reached reproductive age and face long‐lasting complications, specific attention needs to be paid to pregnant cases. This study aimed to investigate the relationship between liver function, perinatal outcomes, and prognosis. A database review was conducted to identify pregnant BA cases with native liver and perinatal data, and clinical information on BA‐related complications was analyzed. Perinatal serum cholinesterase (ChE) levels, model for end‐stage liver‐disease (MELD) score, and platelet trends were analyzed, and the association between these indicators and perinatal outcomes was investigated. Patients were categorized into three groups according to the perinatal clinical outcomes: favorable (term babies with or without several episodes of cholangitis; n = 3), borderline (term baby and following liver dysfunction; n = 1), and unfavorable (premature delivery with subsequent liver failure; n = 1). Lower serum ChE levels, lower platelet counts, and higher MELD scores were observed in the unfavorable category. Borderline and unfavorable patients displayed a continuous increase in MELD score, with one eventually needing a liver transplantation. Pregnancy in patients with BA requires special attention. Serum ChE levels, platelet counts, and MELD scores are all important markers for predicting perinatal prognosis.

  • The efficacy of transarterial embolization for postpartum hemorrhage complicated with disseminated intravascular coagulation: A single‐center experience

    Ochiai D., Nakatsuka S., Abe Y., Ikenoue S., Kasuga Y., Inoue M., Jinzaki M., Tanaka M.

    Journal of Clinical Medicine （Journal of Clinical Medicine)  10 （ 18 ）  2021年09月

    　概要を見る

    Indications for the use of transarterial embolization (TAE) for postpartum hemorrhage (PPH) have been established. However, the efficacy of TAE for PPH complicated by disseminated intravascular coagulation (DIC) remains controversial. In this study, we investigated the efficacy of TAE for PPH complicated by DIC. A database review was conducted to identify patients who were treated with TAE for PPH at our hospital. TAE was performed in 41 patients during the study period. Effective hemostasis was achieved in all cases, but additional procedures, such as reembolization or hysterectomy, were required in five patients (12.2%). The typical causes of PPH included uterine atony (18 cases), placenta previa (15 cases), amniotic fluid embolism (DIC‐type) (11 cases), and placenta accreta spectrum (10 cases). The mean blood loss was 3836 mL. The mean obstetrical DIC and the International Society on Thrombosis and Hemostasis DIC scores were 7.9 and 2.6, respectively. The efficacy of hemostasis was comparable between patients with and without DIC. However, the complete success rate of TAE was lower in patients with DIC as the condition worsened than that in non‐DIC patients. Overall, TAE is effective as a minimally invasive treatment for PPH complicated by DIC.

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    2020年04月
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    2023年03月

    文部科学省・日本学術振興会, 科学研究費助成事業, 落合 大吾, 基盤研究(C), 補助金,  研究代表者

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    文部科学省・日本学術振興会, 科学研究費助成事業, 落合　大吾, 若手研究, 補助金,  研究代表者

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    2015年04月
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    文部科学省・日本学術振興会, 科学研究費助成事業, 落合　大吾, 基盤研究(C), 補助金,  研究代表者

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