Clinical guidelines for obstetrical practice were first published by the Japan Society of Obstetrics and Gynecology (JSOG) and the Japan Association of Obstetricians and Gynecologists (JAOG) in 2008, and a revised version was published in 2011. The aims of this publication include the determination of current standard care practices for pregnant women in Japan, the widespread use of standard care practices, the enhancement of safety in obstetrical practice, the reduction in burdens associated with medico-legal and medico-economical problems, and a better understanding between pregnant women and maternity-service providers. These guidelines include a total of 87 Clinical Questions followed by several Answers (CQ&A), a Discussion, a List of References, and some Tables and Figures covering common problems and questions encountered in obstetrical practice. Each answer with a recommendation level of A, B or C has been prepared based principally on "evidence" or a consensus among Japanese obstetricians in situations where "evidence" is weak or lacking. Answers with a recommendation level of A or B represent current standard care practices in Japan. All 87 CQ&As are presented herein to promote a better understanding of the current standard care practices for pregnant women in Japan.

To determine the frequency of fetal nucleated cells in maternal peripheral blood during different stages of pregnancy, 50 primigravidas were investigated by determining the frequency of cells with the Y chromosome using fluorescence in situ hybridization (FISH) of Y-specific repetitive sequences of the DYZ1 family. Polymerase chain reaction (PCR) amplifying the same part of the DYZ1 used as the probe in FISH and a single-copy Y-specific fragment was also carried out for genomic DNA from the same samples. Cells with the hybridization signal were detected by FISH at and after 15 weeks of pregnancy in all pregnant women who gave birth to boys. The ratio of cells with the signal to those without the signal ranged from 1 in 144,000 to 1 in 4,000 with a tendency to increase as the pregnancy advanced. The frequency of fetal cells estimated by the PCR experiments was significantly and positively correlated with that found by FISH. The present study suggests that fetal nucleated cells increase in maternal peripheral blood with advancing gestation, from less than 1 in 100,000 nucleated cells in the first trimester to around 1 in 10,000 at term. These frequencies were much lower than those reported by cytological methods.

Clinical guidelines for obstetrical practice were first published by the Japan Society of Obstetrics and Gynecology (JSOG) and the Japan Association of Obstetricians and Gynecologists (JAOG) in 2008, and a revised version was published in 2011. The aims of this publication include the determination of current standard care practices for pregnant women in Japan, the widespread use of standard care practices, the enhancement of safety in obstetrical practice, the reduction in burdens associated with medico-legal and medico-economical problems, and a better understanding between pregnant women and maternity-service providers. These guidelines include a total of 87 Clinical Questions followed by several Answers (CQ&A), a Discussion, a List of References, and some Tables and Figures covering common problems and questions encountered in obstetrical practice. Each answer with a recommendation level of A, B or C has been prepared based principally on 'evidence' or a consensus among Japanese obstetricians in situations where 'evidence' is weak or lacking. Answers with a recommendation level of A or B represent current standard care practices in Japan. All 87 CQ&A are presented herein to promote a better understanding of the current standard care practices for pregnant women in Japan.

The successful establishment of human embryonic stem cell (hESC) lines has inaugurated a new era in regenerative medicine by facilitating the transplantation of differentiated ESCs to specific organs. However, problems with the safety and efficacy of hESC therapy in vivo remain to be resolved. Preclinical studies using animal model systems, including nonhuman primates, are essential to evaluate the safety and efficacy of hESC therapies. Previously, we demonstrated that common marmosets are suitable laboratory animal models for preclinical studies of hematopoietic stem cell therapies. As this animal model is also applicable to preclinical trials of ESC therapies, we have established novel common marmoset ESC (CMESC) lines. To obtain marmoset embryos, we developed a new embryo collection system, in which blastocysts can be obtained every 3 weeks from each marmoset pair. The inner cell mass was isolated by immunosurgery and plated on a mouse embryonic feeder layer. Some of the CMESC lines were cultured continuously for more than 1 year. These CMESC lines showed alkaline phosphatase activity and expressed stage-specific embryonic antigen (SSEA)-3, SSEA-4, TRA-1-60, and TRA-1-81. On the other hand, SSEA-1 was not detected. Furthermore, our novel CMESCs are pluripotent, as evidenced by in vivo teratoma formation in immunodeficient mice and in vitro differentiation experiments. Our established CMESC lines and the common marmoset provide an excellent experimental model system for understanding differentiation mechanisms, as well as the development of regenerative therapies using hESCs. Stem Cells 2005;23:1304-1313 This material is protected by U.S.

To obtain baseline data for human papillomavirus (HPV) screening and vaccination in Japan, we analyzed HPV DNA data from 2282 Japanese women ( P ersistent infection with oncogenic human papillomaviruses (HPV), most commonly types 16 and 18, leads to cervical cancer, the second most common cancer in women worldwide.(1) Therefore, oncogenic HPV testing combined with cytology was approved for primary screening in the USA, because of sensitivity and cost-effectiveness.(2) In addition, HPV vaccines have been licensed in the USA, Australia, and European and other countries, because of their efficacy and safety. Clinical studies of HPV vaccines have demonstrated close to 100% protection against HPV16-and HPV18-related infections and diseases, (3)(4)(5) implying possible cross-protection against HPV45, HPV31, and HPV52.(4,5) Based on evidence from clinical trials, (3)(4)(5)(6)(7) these two tools targeting HPV (detection assay and vaccine) are becoming increasingly attractive for cervical cancer prevention worldwide. In Japan, however, HPV DNA testing is still unavailable in mass screening and no HPV vaccine has yet been licensed. Type-specific and age-related data of HPV prevalence, both for women with normal cytology and for women with cervical diseases, are prerequisites to make a well-judged decision about the future role of HPV screening and vaccination in cervical cancer prevention, but these data are missing in Japan. A meta-analysis of Japanese HPV studies provided representative data of HPV type distribution, but no information about age-specific prevalence.In the present study, we analyzed HPV DNA data from 2282 Japanese women to obtain the prevalence data of HPV among women across a broad age range. Our data may help provide models for further evaluating potential impact and cost effectiveness of HPV screening and vaccination in Japan. Materials and MethodsStudy subjects. Our study subjects consisted of 2282 Japanese women (1517 normal HPV detection and genotyping. Exfoliated cells from the ectocervix and endocervix were collected into a tube containing 1 mL PBS and stored at -30°C until DNA extraction. We detected HPV DNA in cervical samples by PCR-based methodology described previously.(9) In brief, total cellular DNA was extracted from cervical samples by a standard sodium dodecyl sulfateproteinase K procedure. HPV DNA was amplified by PCR using consensus primers (L1C1 and L1C2 + L1C2 M) for the HPV L1 region. Direct comparisons of HPV detection methodology have demonstrated that the sensitivity of our PCR assay is higher than that of PCR assays using MY09 and MY11 and GP17 and GP18 primers. (10,11) A reaction mixture without template DNA was included in every set of PCR runs as a negative control. Also, primers for a fragment of the β-actin gene were used as a control to rule out false-negative results for samples in which HPV DNA was not detected. To avoid contamination, we used disposable utensils and discarded them after a single use. We also used aliquoted reagents and maintained separate locations ...