（2）リウマチ科部長 平野 裕司（Annual…European…Congress…of…Rheumatology…2013…in…Madrid）
ULAR13-3460
EFFICACY… OF… TERIPARATIDE… ON… OSTEOPOROSIS… IN… PATIENTS… WITH… RHEUMATOID…
ARTHRITIS… ~IS… COMBINATION… OF… TERIPARATIDE… AND… BIOLOGICAL… AGENTS…
APPROPRIATE?~…Y.…Hirano…1,*,…Y.…Oishi…1,…G.…Takemoto…1,…T.…Kojima…2,…N.…Ishiguro…2
1Rheumatology,…Toyohashi…Municipal…Hospital,…Toyohashi,…2Orthopaedic…Surgery,…Nagoya…University…
Graduate…School…ofMedicine,…Nagoya,…Japan
My…abstract…has…been…or…will…be…presented…at…a…scientific…meeting…during…a…12…months…period…prior…
to…EULAR…2013:…No…Is…the…first…author…applying…for…a…travel…bursary?:…No…Is…the…first…author…of…this…
abstract…an…undergraduate…medical…student?:…No…Background:…Although…medication…of…rheumatoid…
arthritis…(RA)…has…been…improved…by…positive…administration…of…methotrexate…and…biological…agents…
(BIO)…for…decades,…treatment…of…concomitant…disease…in…RA…patients,…such…as…osteoporosis,…will…be…
more…important…for…better…outcome…in…RA…patients.…Osteoporosis…of…RA…patients…is…composed…from…
multifactorial…pathogenesis,…such…as…excess…of…inflammatory…cytokines,…excess…of…rest…due…to…joint…pain…
and…drugs…used…for…treatment…of…RA.
Objectives:…This…retrospective…study…investigated…the…efficacy…of…teriparatide…(TPTD)…on…osteoporosis…
in…RA…patients…and…focused…on…relationship…the…efficacy…of…TPTD…and…concomitant…drugs,…such…as…oral…
prednisolone…(PSL),…activated…vitamin…D…(actVitD)…and…BIO.
Methods:…45…cases…(44…female…and…one…male)…were…used…in…this…study.…Patients’…characteristics,…bone…
mineral…density…(BMD)…of…lumbar…spine…(LS)…and…proximal…femur…(PF)…measured…by…DEXA…and…bone…
turnover…markers…(BAP,…P1NP,…NTX,…TRACP-5b)…were…investigated.…(1)Factors…that…affect…efficacy…
of…TPTD,…(2)the…comparison…between…the…BIO-concomitant…and…the…non…BIO-concomitant…and…(3)the…
comparison…between…the…actVitD-concomitant…and…the…non…actVitD…concomitant…were…analyzed.
Results:…Mean…age…was…70.8…years…old.…Mean…RA…duration…was…19.5…years.…31…case…(68.9%)…were…
concomitant…with…oral…PSL.…15…cases…(33.3%)…were…concomitant…with…BIO.…33…cases…(73.3%)…were…
concomitant…with…actVitD.…32…cases…(71.1%)…have…the…past…history…of…fracture.…%increase…of…LS-BMD…in…
all…cases…was…7.6%…at…6month…and…11.9%…at…12month.
%increase…of…PF-BMD…in…all…cases…was…1.6%…at…6month…and…3.9%…at…12month.…Four…bone…turnover…
markers…were…significantly…increased…and…%increase…of…P1NP…was…maximum…among…them.…Significant…
low…body…mass…index…(BMI)…and…significant…low…oral…PSL…usage…were…seen…in…the…good…outcome…group…
of…LS-BMD.…P1NP…in…good…outcome…group…of…LSBMD…was…increased…more…than…that…in…non…good…
outcome…group.…Although…%increase…of…BMD…in…the…BIO-concomitant…was…low…compared…with…that…
in…the…non…BIO-concomitant,…%increase…of…bone…turnover…markers…in…the…BIO-concomitant…was…high…
compared…with…that…in…the…non…BIO-concomitant.…This…results…was…paradoxical…from…that…in…whole…
cases.…%increase…of…PF-BMD…in…the…actVitD-concomitant…was…better…than…that…in…the…non…actVitD-concomitant.…Hypercalcemia…occurred…in…18.2%…of…the…actVitD-concomitant…and…8.3%…of…non…actVitD…
concomitant…(p=0.65).
Conclusions:…TPTD…was…effective…in…osteoporosis…of…RA…patients.…Efficacy…of…TPTD…in…RA…patients…
was…affected…with…BMI,…response…of…bone…turnover…markers…and…drugs…concomitantly…used.…The…
results…suggested…that…medicinal…action…of…TPTD…might…be…interfere…with…that…of…BIO.…PF-BMD…in…
the…actVitD-concomitant…was…better…than…the…non-concomitant…and…this…result…suggested…that…some…
patients…needed…actVitD…when…treated…with…TPTD.
Disclosure…of…Interest:…None…Declared
（3）小児科第二部長 幸脇 正典 （Ⅺ World…Congress…of…Perinatal…Medicine…19-22…June…2013 Moscow,…Russia）
Spontaneous…movements…in…the…supine…position…of…healthy…term…infants…and…preterm…infants…with…or…
without…periventricular…leukomalacia
Masanori…Kouwaki,…PhD1.…Mitsuko…Yokochi,…OTR2.…Yasuko…Togawa,…MD3.…Takeshi…Kamiya,…RPT4.…
Kenji…Yokochi,…PhD5.
1Department…of…Neonatal…Medical…Center,…4Department…of…Rehabilitation…Center,…Toyohashi…Municipal…
Hospital,…Toyohashi,…Aichi,…Japan
2Department… of… Rehabilitation,… 5Department… of… Pediatric… Neurology,… Seirei-Mikatahara… General…
Hospital,…Hamamatsu,…Shizuoka,…Japan
3Department…of…Pediatrics,…Atsumi…Hospital,…Tahara,…Aichi,…Japan
Abstract Aim
The…individual…motor…elements…presumed…to…be…essential…for…motor…development…were…determined…
from…spontaneous…movements…involving…the…entire…body…of…normal…term…and…preterm…infants.…Then,…
diagnostic…items…for…motor…abnormality…in…infants…with…periventricular…leukomalacia…(PVL)…were…
investigated.
Methods
Video…recordings…of…24…healthy…term…infants,…21…normal…preterm…infants…(8…males,…13…females;…median…
gestational…age…30…weeks;…median…birth…weight…1216…g)…and…14…preterm…infants…with…PVL…(6…males,…8…
females;…median…gestational…age…30…weeks;…median…birth…weight…1360…g)…were…analyzed.
Results
In…healthy…term…infants,…predominant…shoulder…rotation…was…noticed…until…1…month…of…age.…After…2…
months…of…age,…isolated…movements…of…the…shoulder,…elbow,…hip,…knee,…and…ankle…frequently…emerged.…
In…preterm…infants…with…PVL…at…the…corrected…age…of…2…months,…startle…response…and…predominant…
shoulder…rotation…were…more…frequently…seen…and…isolated…neck,…shoulder,…elbow,…hip,…knee,…and…ankle…
movements…were…less…frequently…seen…than…in…the…normal…preterm…infants…(Fisher’s…exact…test,…
p<0.025).…
Interpretation
At…2…months…of…age,…isolated…movements…evolve,…and…their…failure…to…occur…is…suggested…to…be…a…useful…
sign…for…the…diagnosis…of…cerebral…motor…disorders.…
（4）産婦人科（生殖医療）部長 安藤 寿夫（69th…Annual…Meetng…of…the…American…Society…for…
Reproductive…Medicine…2013）
Title:… TIME-LAPSE… BASED… BEST… FRESH… EMBRYO:… SHOULD… IT… BE… REPLACED… NOW… OR…
FROZEN…WITH…OTHER…GOOD…EMBRYOS?
Hisao…Ando1,…Takeshi…Takayanagi1,…Chihiro…Banno1…and…Kyohei…Yamaguchi1.…1Center…for…Reproductive…
Medicine…and…Surgery,…Toyohashi…Municipal…Hospital,…50…Hachiken-Nishi,…Aotake-cho…Toyohashi,…
Aichi,…Japan,…441-8570.…
Objective:… Endometrium… in… the… oocyte… retrieval… cycle… does… not… allow… suitable… receptivity… for…
embryo… implantation… compared… with… that… in… the… frozen-thaw… embryo… transfer… cycle.… However,…
cryopreservation…of…all…good…embryos…without…fresh…embryo…replacement…might…take…the…chance…of…
immediate…conception…at…the…lower…cost.…We…analyzed…our…time-lapse…data…for…the…future…consideration…
of…criteria…for…executing…fresh…embryo…replacement…or…freezing…of…all…good…embryos.
Design:…Retrospective…analysis…of…time-lapse…based…data…between…2007…and…2013…in…a…single…ART…
center.
Materials…and…Methods:…We…retrieved…181…fresh…embryo…replacement…cycles…with…positive…pregnancy…
test…including…103…live-births.…In…all…of…the…cycles,…at…least…one…good…frozen…embryo…was…available.…We…
also…retrieved…117…fresh…embryo…replacement…cycles…with…negative…pregnancy…test…followed…by…the…
frozen-thaw…embryo…replacement…cycles…with…positive…pregnancy…test…including…71…live-births.
Results:…Patient…backgrounds…such…as…ages…and…etiologies,…controlled…ovarian…stimulation…protocols,…
endometrial…thickness,…and…IVF/ICSI…ratio…were…similar…between…the…two…groups.…However,…average…
frozen…embryo…numbers…were…significantly…different…(
P
=0.002)…between…positive…(3.51…±…2.53)…and…negative…(4.52…±…3.02)…pregnancy…groups.
Conclusions:…When…using…time-lapse…based…embryo…evaluation,…cryopreservation…of…all…good…embryos…
might…be…considered…if…more…rather…than…fewer…good…embryos…were…available.
Support:…None.