Successful Treatment of Gastric Cancer in Pregnancy

SummaryObjectiveGastric cancer during pregnancy is rare, and even in Japan where a high rate of gastric cancers are reported, only 0.016% of pregnant women suffer from this disease. Generally, the cancer is already advanced at the time of detection and the prognosis for the woman is usually extremely poor. Moreover, prioritizing treatment of the woman often results in a premature birth.Case ReportWe report a case of gastric cancer in a 32-year-old pregnant woman, gravida 6, para 4. The mother and the neonate had good prognoses after early diagnosis, cesarean delivery and surgery.ConclusionDiagnosis of gastric cancer in pregnant women is often delayed even when they are symptomatic, because the symptoms are taken to be symptoms of hyperemesis or expansion of the uterus. However, since the nausea and vomiting arising from hyperemesis generally improves by the 20th week of gestation, the presence of protracted digestive symptoms in the second trimester calls for prompt investigation of digestive disorders. This case highlights the importance of early detection of gastric cancer for a positive prognosis, considering the rapidity with which gastric cancer advances in pregnancy

Successful Treatment of Fetal Intraperitoneal Administration of Immunoglobulin in a Case of Fetal Hemolytic Anemia with 131,072-Fold Anti-E Alloimmunization

Object. We present here the case of severe fetal anemia caused by anti-E antibody positive, which showed a favorable course only with fetal intraperitoneal administration of immunoglobulin. Case. The mother was 31 years old, blood type B Rh : CCDee, gravida 1, with no history of transfusion. Anti-E antibody was detected in the maternal cross-match test at the 18th gestational week. In percutaneous umbilical blood sampling, the umbilical blood hemoglobin level was 9.1 g/dL and the result of the direct Coombs' test was positive at the 26th gestational week. Immunoglobulin injection into fetal abdominal cavity (IFAC) was administered a total 7 times. During the pregnancy, the indirect Coombs' test showed a 131,072-fold increase. Conclusion. In this case, IFAC to block the reticuloendothelial system Fc receptor was successful. This procedure is promising as one of the treatment options for blood group incompatible pregnancy

放線菌におけるアミノ基キャリアタンパク質を介して生合成される新規天然化合物の探索・発見とその特異なN-N結合の形成機構に関する研究

学位の種別: 課程博士審査委員会委員 : （主査）東京大学教授 西山 真, 東京大学教授 大西 康夫, 東京大学特任教授 尾仲 宏康, 東京大学准教授 作田 庄平, 東京大学准教授 葛山 智久University of Tokyo(東京大学

Genetic analysis of TP53 in childhood myelodysplastic syndrome and juvenile myelomonocytic leukemia

信州大学博士（医学）・学位論文・平成23年3月31日授与（甲第886号)・齋藤章治ArticleLEUKEMIA RESEARCH. 35(12):1578-1584 (2011)journal articl

Two Categories of Approximately mu-tau Symmetric Neutrino Mass Textures

Our approximately \mu-\tau symmetric neutrino mass textures fall into two different categories, whose behaviors in the \mu-\tau symmetric limit are characterized by either \sin(theta_{13})->0 (referred to as C1)), or \sin(theta_{12})->0 (referred to as C2)). We present ten phenomenologically viable neutrino mass textures: two for the normal mass hierarchy, three for the inverted mass hierarchy, and five for the quasi degenerate mass pattern. Tiny \mu-\tau symmetry breaking ensures that \sin^2(theta_{13}) << 1 for C1), and \Delta m^2_\odot/\Delta m^2_{atm} (\equiv R) << 1 for C2). A correlation among small quantities is provided by \cos 2(theta_{23}) \sim \sin(theta_{13}) for C1), and by either \cos(2theta_{23}) \sim R, or \cos(2theta_{23})\sin(theta_{13}) \sim R for C2). It is further shown that \tan(2theta_{12}) \sim \cos(2theta_{23})/\sin(theta_{13}) is satisfied for C2). We find specific properties for each mass ordering, which are discussed in this article.Comment: 31 pages, 15 figures (High-resolution figures can be downloaded from http://www.sp.u-tokai.ac.jp/~yasue/two_categories_of.pdf.tar.gz

A walking support/evaluation machine for patients with parkinsonism

Various walk supporting systems have been devised and developed. However, they have not been designed for supporting or evaluating the gait of parkinsonian patients, and not much consideration has been given to gait disturbances of parkinsonian patients. In this study : (a) We prepared a tentative model of walk supporting and monitoring system in consideration of typical symptoms of parkinsonism. (b) We conducted gait rehabilitation in a parkinsonian patient using the walk supporting and monitoring system and confirmed (i) the occurrence of frozen gait during walking, (ii) brachybasia, (iii) the absence of anterior tilting of the posture, pulsion symptom, and festination, and (iv) occurrence of hesitation to start walking. Therefore, typical symptoms of parkinsonism can be detected by the use of this system. (c) The medical staff can evaluate the state of recovery of patients on the basis of the data obtained from this system and use them for purposes such as guidance of rehabilitation

Combined landscape of single-nucleotide variants and copy number alterations in clonal hematopoiesis

クローン性造血の臨床予後への影響を解明 --遺伝子変異とコピー数異常の統合的な知見--. 京都大学プレスリリース. 2021-07-09.Clonal hematopoiesis (CH) in apparently healthy individuals is implicated in the development of hematological malignancies (HM) and cardiovascular diseases. Previous studies of CH analyzed either single-nucleotide variants and indels (SNVs/indels) or copy number alterations (CNAs), but not both. Here, using a combination of targeted sequencing of 23 CH-related genes and array-based CNA detection of blood-derived DNA, we have delineated the landscape of CH-related SNVs/indels and CNAs in 11, 234 individuals without HM from the BioBank Japan cohort, including 672 individuals with subsequent HM development, and studied the effects of these somatic alterations on mortality from HM and cardiovascular disease, as well as on hematological and cardiovascular phenotypes. The total number of both types of CH-related lesions and their clone size positively correlated with blood count abnormalities and mortality from HM. CH-related SNVs/indels and CNAs exhibited statistically significant co-occurrence in the same individuals. In particular, co-occurrence of SNVs/indels and CNAs affecting DNMT3A, TET2, JAK2 and TP53 resulted in biallelic alterations of these genes and was associated with higher HM mortality. Co-occurrence of SNVs/indels and CNAs also modulated risks for cardiovascular mortality. These findings highlight the importance of detecting both SNVs/indels and CNAs in the evaluation of CH

Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors Beyond Progressive Disease: A Retrospective Analysis for Japanese Patients with Activating EGFR Mutations

IntroductionIt is not determined whether the continuous use of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) is reasonable for patients with activating EGFR mutations, who have progressed with the drug.MethodsWe retrospectively analyzed the data from 2002 to 2010 of consecutive patients who had advanced non–small-cell lung cancer (NSCLC) harboring activating EGFR mutations and showed radiological disease progression after EGFR-TKI treatment as the first-line or second-line setting. We classified them into two groups: continuous EGFR-TKI and switching to chemotherapy, and compared the clinical outcomes. Multivariate analysis for survival was performed including age, sex, Eastern Cooperative Oncology Group performance status (0–1/ 2–4), brain metastasis, EGFR mutations (deletions in exon 19 versus L858R), continuous EGFR-TKI (yes/no), and initiation of EGFR-TKI (first versus second).ResultsA total of 551 NSCLC patients were screened for EGFR mutations in the period, and 186 patients had activating EGFR mutations. To explore the potential use of EGFR-TKI beyond progressive disease (PD), 64 patients were selected and analyzed. There were 13 men and 51 women, and median age was 65.5 years (range, 42–86). Among them, 31 patients had deletions in exon 19, and 33 had point mutation of L858R in exon 21. Thirty-nine patients were continuing EGFR-TKI beyond PD; 25 patients were switched to cytotoxic chemotherapy alone. The median overall survival was 32.2 months in the patients continuing EGFR-TKI, and 23.0 months in the patients switching to chemotherapy, presenting a significant difference between the two groups (p = 0.005). Cox analysis showed that continuous EGFR-TKI after PD (hazards ratio 0.42, 95% confidence interval: 0.21–0.83, p = 0.013) was associated with improved survival.ConclusionContinuous use of EGFR-TKI beyond PD may prolong overall survival compared with switching to cytotoxic chemotherapy in patients with activating EGFR mutations. A prospective study will be needed to confirm our results