〈Originals〉Treatment of trisomy 18 at 2 Japanese hospitals during a 10-year period

[Abstract] Introduction. Trisomy 18 is a chromosomal abnormality associated with a poor prognosis. It is difficult to determine the proper treatment for patients with trisomy 18 because of ethical considerations. Materials and methods. We encountered 29 infants with trisomy 18 between 2005 and 2015 at Kindai University Hospital and Kindai University Nara Hospital. Of these, 22 cases, which were treated at our hospitals since their neonatal period, were examined. Results. Of the 22 infants, 13 were male and 9 were female. In 4 cases, a definitive diagnosis of trisomy 18 was made antenatally. The median birth of the 22 infants weight was 1723 g. Ventricular septal defect was present in all infants, Esophageal atresia was noted in 7 patients and omphalocele was observed in 3 patients. Pulmonary artery banding was performed in 4 infants, and a tracheostomy was performed in 4 infants. Twelve infants were discharged at least once. Seventeen infants died, with a median age at death of 3 months. Three of the 5 surviving children are now older than 1 year. A tracheostomy was performed in all 3 children, while pulmonary artery banding was performed for 2 children. The oldest patient is now 7 years of age. Conclusion. Results of treatment of our patients suggest that reduction of pulmonary hypertension by pulmonary artery banding, tracheostomy, and gastrostomy can contribute to an improved prognosis and quality of life of patients with trisomy 18, although these outcomes vary because of concurrent anomalies

A Report from the 2013 International Symposium: The Evaluation of the Effects of Low-Dose Radiation Exposure in the Life Span Study of Atomic Bomb Survivors and Other Similar Studies

The RERF International Low-Dose Symposium was held on December 5-6, 2013, at the RERF campus in Hiroshima, Japan, to discuss the issues facing the LSS and other low-dose studies. Topics included current status of low-dose risk detection, strategies for low-dose epidemiological and statistical research, methods to improve communication between epidemiologists and biologists, and current status of radiological studies and tools. Key points made by the participants included the necessity of pooling materials over multiple studies to gain greater insight where data from single studies is insufficient, generating models that reflect epidemiological, statistical, and biological principles simultaneously, understanding confounders and effect modifiers in the current data, and taking into consideration less studied factors such as the impact of dose rate. It is the hope of all participants that this symposium be used as a trigger for further studies, especially those using pooled data, in order to reach a greater understanding of the health effects of low-dose radiation