記述言語：英語   掲載種別：研究論文（学術雑誌）  

The use of angiogenesis inhibitors and poly ADP-ribose polymerase inhibitors following multi-agent chemotherapy, including platinum-based agents, has become the standard treatment for platinum-sensitive recurrent ovarian cancer (PSROC). However, the optimal maintenance therapy and selection criteria for these patients remain unclear. Thus, this study aimed to optimize the treatment options and selection criteria for patients with PSROC. The clinical data of 51 patients with PSROC admitted to Nippon Medical School Chiba Hokusoh Hospital and Nippon Medical School Hospital were retrospectively collected. The log-rank test was used for the survival analysis, and Cox proportional hazard regression analysis was used for the multivariate survival analysis. Of the 51 patients, 17 received maintenance therapy with bevacizumab (Bev), and 34 received olaparib (Ola). Recurrence-free survival (RFS) was significantly prolonged in the Ola group (27 months; 95% confidence interval (CI), 19-NA months) compared with that in the Bev group (9 months; 95% CI, 5-22 months; p = 0.000103). The efficacy of Ola was independent of background factors, including response to previous chemotherapy, homologous recombination status, histological type, or laboratory data. Ola is superior to Bev as PSROC maintenance therapy, especially in Japanese and Asian populations.

DOI： 10.3390/cancers15102869

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記述言語：日本語   出版者・発行元：(公社)日本臨床細胞学会  

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記述言語：日本語   出版者・発行元：(一社)関東連合産科婦人科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Pelvic ultrasonography and measurement of serum cancer antigen 125 (CA-125) are recommended for preoperative evaluation before performing risk-reducing salpingo-oophorectomy (RRSO). We report our experience with two patients in whom an incidental gynaecological malignancy was found using endometrial cytology as a preoperative screening test for RRSO. Patient 1 was an early 50s woman with a pathologic variant of BRCA1 Transvaginal ultrasonography showed no endometrial abnormalities, but preoperative endometrial cytology revealed high-grade serous carcinoma. The patient underwent total hysterectomy, bilateral adnexectomy, pelvic and para-aortic lymph node dissection, and omentectomy. Patient 2 was a late 40s woman with a pathological variant of BRCA1 Transvaginal ultrasonography showed mild enlargement of the left ovary, and her CA-125 level was elevated. Preoperative endometrial cytology revealed high-grade serous cancer. She underwent total hysterectomy, bilateral adnexectomy and omentectomy. These case reports illustrate the importance of preoperative screening-including endometrial cytology-before performing RRSO.

DOI： 10.1136/bcr-2022-254484

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記述言語：英語  

When a woman presents with an acute abdomen with cystic lesions in the abdominal cavity, the differential diagnosis includes torsion or rupture of an ovarian tumor. We report our experience with a 54-year-old nulliparous woman who underwent emergency surgery for a suspected ruptured ovarian tumor. Intraoperative examination revealed disruption of a cystic tumor that had developed externally from the fundus of the uterus. The patient, who was taking aspirin because of a history of medullary infarction, reported lower abdominal discomfort for several days. When she sought care, she was referred to the gynecology department where transvaginal ultrasonography and contrast-enhanced computed tomography showed a poorly toned mass with a maximum diameter of 20 cm posterior to the uterus. She also had a large amount of ascites reaching around the liver and the spleen. She underwent an emergency laparotomy for a presumed diagnosis of acute abdomen caused by a ruptured ovarian tumor with intra-abdominal bleeding. Intraoperative examination revealed normal adnexae bilaterally, but there was a cystic tumor in the pouch of Douglas that was strongly adherent to the surrounding intestines. This mass was connected to the posterior uterus by a stalk and appeared to be continuous with the uterine tissue. The postoperative pathological diagnosis was carcinosarcoma derived from subserous cystic adenomyosis. This is the first case report of carcinosarcoma developing from subserous cystic adenomyosis in the English literature as far as we know.

DOI： 10.1016/j.gore.2023.101139

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: The objective of this study was to assess the potential risk factors for abscess development in patients with endometrioma who present with an acute abdomen. MATERIALS AND METHODS: We retrospectively reviewed the records of 51 patients who underwent emergency surgery for acute abdomen involving an endometrioma at our hospital between April 2011 and August 2021. The patients were divided into an infected group (n = 22) and a control group (n = 29). We analyzed patient characteristics; imaging findings; clinical data, including bacterial cultures; and perioperative outcomes to assess for differences between groups. RESULTS: Patients in the infected group were significantly older than those in the control group (P = 0.03). They were more likely to have a history of endometriosis surgery (P = 0.04) and more likely to have undergone transvaginal manipulation within 3 months of presentation (P = 0.01). Body temperature on the day of admission was significantly higher in the infected group (P = 0.007), as were C-reactive protein levels on the day of admission and before surgery (P < 0.001; P = 0.018) and the white blood cell count on the day of admission (P = 0.016). Preoperative imaging showed significant thickening of the tumor wall (P < 0.001) and an enhanced contrast effect (P < 0.001) in the infected group. CONCLUSION: We identified several factors that suggest abscess in patients with an acute abdomen who have a complication of pathologically confirmed endometriosis. A recent vaginal procedure is a particular risk factor for abscess development in patients with endometriomas.

DOI： 10.4103/gmit.gmit_36_22

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記述言語：日本語   出版者・発行元：日本医科大学医学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIM: This study aims to examine the association between malignant peritoneal cytology and prognosis in women with endometrial cancer. METHODS: We retrospectively analyzed the records of patients with endometrial cancer who underwent surgery with intraoperative peritoneal cytology at our hospital between January 1988 and December 2012. All results were reclassified according to the 2009 International Federation of Gynecology and Obstetrics (FIGO) system, and the relation between intraoperative peritoneal cytology results and recurrence and prognosis was examined. RESULTS: Of the 908 patients analyzed, 205 (22.6%) had positive peritoneal cytology. Patients with positive peritoneal cytology had significantly lower rates of recurrence-free survival (RFS) and overall survival (OS) than those in the negative cytology group (both p < 0.001). Subgroup analysis of patients with FIGO stage I/II showed significantly lower RFS in the positive-cytology group (p = 0.005), but there was no significant difference in OS (p = 0.637). In the patients with FIGO stage III/IV or patients classified as "high risk," the RFS and OS were significantly lower in the positive-cytology group (both p < 0.001). Cox regression analysis identified positive peritoneal cytology as a significant predictor of recurrence in patients with FIGO stage I/II disease. CONCLUSIONS: Patients with positive peritoneal cytology for endometrial cancer have a high risk of recurrence, regardless of histopathologic type or FIGO stage. Peritoneal cytology has already been removed from the 2009 FIGO classification of endometrial cancer, but it may deserve reconsideration.

DOI： 10.1111/jog.15457

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記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

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記述言語：日本語   出版者・発行元：(一社)関東連合産科婦人科学会  

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記述言語：日本語   出版者・発行元：(一社)関東連合産科婦人科学会  

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記述言語：日本語   出版者・発行元：日本女性骨盤底医学会  

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記述言語：日本語   出版者・発行元：日本女性骨盤底医学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

MicroRNA-152 (miR-152) expression has been reported to be associated with poor prognosis in patients with endometrial serous carcinoma (ESC). However, the function of miR-152 in ESCs is not fully understood. The present study aimed to investigate the involvement of miR-152 in ESC progression. The influence of miR-152 overexpression on cell proliferation and motility was assessed by transfecting two human ESC cell lines, USPC-1 and SPAC-1-L, with a miR-152 precursor. MiR-152 overexpression increased apoptosis and inhibited the proliferation of the two ESC cell lines. Cell motility was also suppressed in both cell lines following precursor transfection. Conversely, miR-152 inhibitor transfection led to an increase in cell migration ability, suggesting the involvement of miR-152 in ESC cell motility. Results of the analysis of publicly available messenger RNA dataset indicated that high expression of matrix metalloproteinase 10 (MMP10), one of the predicted targets of miR-152 by microRNA target prediction database, was a poor prognostic factor for ESC. In vitro examination results revealed that miR-152 overexpression reduced MMP10 expression, and knockdown of MMP10 significantly reduced cell motility. This study elucidates the function of miR-152 as a tumor suppressor in ESCs. We demonstrated that miR-152 plays an important role in ESC cell motility by regulating MMP10 expression.

DOI： 10.1620/tjem.256.249

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(一社)東京産科婦人科学会  

不妊治療中の悪性腫瘍発見例が増えている。今回、不妊治療中に診断された卵巣癌と子宮体癌の重複例を経験した。症例は40歳0妊0産。不妊治療の経過中に経腟超音波断層法で5cm大の左卵巣嚢腫を指摘され、精査加療目的に当院紹介となった。初診時、経腟超音波断層法で左卵巣に7cm大の子宮内膜症性嚢胞および子宮内膜ポリープを認め、内膜細胞診は陰性であった。骨盤造影MRI検査でも悪性所見はなく、腹腔鏡および子宮鏡手術の方針とした。当科初診の7ヵ月後、子宮内膜症性嚢胞の悪性転化があり、最終的に根治手術を行い、術後病理診断で卵巣癌および子宮体癌の重複癌と診断した。未妊および不妊症患者は疫学的に卵巣癌発生リスクが高く、また排卵誘発剤が卵巣癌のリスクを高めると示唆されている。結論として、今回は術後病理検査により重複癌と診断したが、分子生物学的検討により転移癌と診断された報告があり、今後は分子生物学的検討も有用となる可能性がある。(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本遺伝性腫瘍学会  

遺伝性乳癌卵巣癌症候群(hereditary breast and ovarian cancer syndrome;HBOC)患者におけるリスク低減卵管卵巣摘出術(risk-reducing salpingo-oophorectomy:RRSO)はもっとも確実な卵巣癌予防法であるが,実施にはいくつかの要件が必要と考えられ,医療機関において体制整備が求められる.RRSOが保険診療となる2020年4月以前,県内にRRSO実施施設がなかったことから自施設での導入を試み,これまでに6例のRRSOを実施した.そのうちオカルト癌が認められた1例についてRRSO実施に至る過程を振り返り,自施設でのRRSO導入の意義と課題について考察する.(著者抄録)

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Zinc deficiency can cause various symptoms, including hair loss, anemia, and taste disorders. Recently, the association between cancer and zinc deficiency has received much attention with respect to its antioxidant properties. However, only a few studies have investigated the association between gynecologic cancers and zinc; to date, no studies have evaluated serum zinc status at the onset of gynecologic cancer or the relationship between zinc and cancer recurrence. The objectives of the present study were to determine whether serum zinc concentrations are associated with the development of gynecologic cancer, to clarify serum zinc dynamics between the onset and recurrence of gynecologic cancer, and to identify the associated factors. Accordingly, we retrospectively determined serum zinc concentrations before treatment in gynecologic patients with benign disease or cancer at the Nippon Medical School Chiba Hokusoh Hospital. We investigated anemia and hypoalbuminemia-the most common causes of zinc deficiency-as indicators of hyponutrition to determine the causal relationship of this deficiency with chemotherapy, radiation therapy, and recurrence, which may affect zinc concentration during cancer recurrence. The results indicated that there was no difference in zinc concentration between preoperative cancer patients and noncancer patients and that serum zinc concentrations were not associated with developing gynecologic cancers. However, patients with gynecologic cancer exhibited significantly lower serum zinc concentrations following treatment, and patients with recurrent cancer were 4.8 times more likely to develop zinc deficiency than those with nonrecurrent cancer. A serum zinc concentration of <61 μg/dL was an independent predictor of recurrence. Once zinc deficiency occurred, the recurrence rate of zinc deficiency reached as high as 69%. Overall, our study indicates that zinc deficiency is associated with recurrence in gynecological cancers and physicians should monitor zinc levels during disease management.

DOI： 10.3389/fonc.2022.1025060

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

[This corrects the article DOI: 10.18632/oncotarget.25868.].

DOI： 10.18632/oncotarget.27474

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記述言語：日本語   出版者・発行元：金原出版(株)  

＜文献概要＞成熟奇形腫は悪性転化を除いて周囲組織へ浸潤し穿通することは稀である。今回,直腸に穿通した成熟奇形腫を腹腔鏡手術で治療した1例を経験したため報告する。卵巣奇形種の隣接臓器への穿通機序として,炎症性癒着による壁の菲薄化や,隣接臓器への圧排・血流障害による癒着などが考えられる。腹腔内所見からは炎症性癒着が疑われたが病理組織検査では炎症所見は認められず,穿通の原因は不明であった。低侵襲な手術を行うことで,術後の早期回復が可能であった。

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J00535&link_issn=&doc_id=20210917060018&doc_link_id=10.18888%2Fsp.0000001848&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fsp.0000001848&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Although the addition of bevacizumab to platinum-based combination chemotherapy has been recommended as a standard regimen for patients with advanced or recurrent cervical cancer, there is no clear evidence regarding the effectiveness of bevacizumab monotherapy as salvage chemotherapy. This study prospectively examined the efficacy and safety of switching from platinum-based chemotherapy combined with bevacizumab to single maintenance therapy in patients with advanced or recurrent cervical cancer. Patients were first treated with standard combination chemotherapy. However, if chemotherapy was discontinued because of an adverse event, bevacizumab monotherapy was continued for patients who agreed to participate in this study and provided written informed consent. The study protocol was approved by the Independent Review Board of Tohoku University School of Medicine (reception number 2017-1-540). A total of 15 patients (median age of 55 years, range 33-69 years) participated in this study. The median number of cycles of bevacizumab single maintenance administration was 8, and the main reasons for discontinuation were disease progression and adverse events. Bevacizumab single maintenance therapy had a disease control rate of 53.3% (CR 40%, PR 6.7%, SD 6.7%). The most frequent grade 3/4 clinical adverse events were proteinuria (5/15) and hypertension (4/15). No treatment-related deaths occurred. Bevacizumab single maintenance therapy was effective as salvage chemotherapy in patients with advanced or recurrent cervical cancer, and the safety profile was generally consistent with those reported in previous studies of bevacizumab monotherapy.

DOI： 10.1620/tjem.254.145

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記述言語：日本語   掲載種別：研究論文（大学，研究機関等紀要）   出版者・発行元：石巻赤十字病院  

CiNii Research

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Regulation of sphingolipid metabolism plays a role in cellular homeostasis, and dysregulation of these pathways is involved in cancer progression. Previously, our reports identified ceramide as an anti-metastatic lipid. In the present study, we investigated the biochemical alterations in ceramide-centered metabolism of sphingolipids that were associated with metastatic potential. We established metastasis-prone sublines of SKOV3 ovarian cancer cells using an in vivo selection method. These cells showed decreases in ceramide levels and ceramide synthase (CerS) 2 expression. Moreover, CerS2 downregulation in ovarian cancer cells promoted metastasis in vivo and potentiated cell motility and invasiveness. Moreover, CerS2 knock-in suppressed the formation of lamellipodia required for cell motility in this cell line. In order to define specific roles of ceramide species in cell motility controlled by CerS2, the effect of exogenous long- and very long-chain ceramide species on the formation of lamellipodia was evaluated. Treatment with distinct ceramides increased cellular ceramides and had inhibitory effects on the formation of lamellipodia. Interestingly, blocking the recycling pathway of ceramides by a CerS inhibitor was ineffective in the suppression of exogenous C24:1 -ceramide for the formation of lamellipodia. These results suggested that C24:1 -ceramide, a CerS2 metabolite, predominantly suppresses the formation of lamellipodia without the requirement for deacylation/reacylation. Moreover, knockdown of neutral ceramidase suppressed the formation of lamellipodia concomitant with upregulation of C24:1 -ceramide. Collectively, the CerS2-C24:1 -ceramide axis, which may be countered by neutral ceramidase, is suggested to limit cell motility and metastatic potential. These findings may provide insights that lead to further development of ceramide-based therapy and biomarkers for metastatic ovarian cancer.

DOI： 10.1096/fj.202001504RR

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Ovarian cancer is the most lethal gynecologic malignancy due to the tumor's acquisition of chemoresistance to platinum-based chemotherapy. To solve this problem, we conducted RNAi-based large-scale screening and determined that tyrosine kinase with immunoglobulin-like and EGF-like domains 1 (TIE-1) is a key molecule involved in the platinum resistance of ovarian cancer cells. Recently, a variety of studies have investigated that small extracellular vesicles (sEVs) contribute to the communication between cancer cells, including the development of chemoresistance in ovarian cancer. The purpose of our study is to determine if sEVs-derived TIE-1 is involved in the chemoresistance of ovarian cancer cells. MATERIALS AND METHODS: TIE-1-overexpressed TOV112D cells, termed TOV112DTIE-1 cells, were established, and sEVs were isolated from TOV112DTIE-1 cells supernatants by ultracentrifugation. We assessed cisplatin sensitivity in recipient cells with TOV112DTIE-1-derived sEVs by cell-Titer Glo kit. We also asked whether sEV-derived TIE-1 suppressed the DNA damage response in recipient cells and evaluated the DNA damage response by counting cells positive for DNA damage foci. RESULTS: TIE-1 was contained within sEVTIE-1 derived from the cellular supernatant of TOV112DTIE-1. We showed that sEV-derived TIE-1 decreased chemosensitivity to cisplatin by suppressing the DNA damage response in recipient cells. CONCLUSION: Our findings suggest that sEV-derived TIE-1 could be a new therapeutic target for refractory ovarian cancer.

DOI： 10.1016/j.ctarc.2021.100364

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記述言語：日本語   出版者・発行元：金原出版(株)  

＜文献概要＞卵巣癌の約10〜15%は遺伝性乳癌卵巣癌症候群(HBOC)の原因遺伝子であるBRCA1/2の生殖細胞系列変異に基づく。HBOCの最も確実なリスク低減策はリスク低減卵管卵巣摘出術(RRSO)である。今回,BRCA1変異保持者に対してRRSOを行い,術前に悪性を示唆する所見はなかったが術後病理組織学的検査で左卵巣高異型度漿液性癌(HGSC)の診断に至った1症例を経験した。HBOC患者においては所見に乏しくとも適切な年代にRRSOを行うことが望ましいと考える。

CiNii Books

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J00535&link_issn=&doc_id=20200731060019&doc_link_id=10.18888%2Fsp.0000001339&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fsp.0000001339&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MDPI  

Tyrosine kinase receptor TIE-1 plays a critical role in angiogenesis and blood-vessel stability. In recent years, increased TIE-1 expression has been observed in many types of cancers; however, the biological significance and underlying mechanisms remain unknown. Thus, in the present study, we investigated the tumor biological functions of TIE-1 in ovarian cancer. The treatment of SKOV3 ovarian-cancer cells with siRNA against TIE-1 decreased the expression of key molecules in the PI3K/Akt signaling pathway, such as p110α and phospho-Akt, suggesting that TIE-1 is related to the PI3K/Akt pathway. Furthermore, the knockdown of TIE-1 significantly decreased cell proliferation in high-PI3K-expressing cell lines (SKOV3, CAOV3) but not low-PI3K-expressing cell lines (TOV112D, A2780). These results suggested that inhibition of TIE-1 decreases cell growth in high-PI3K-expressing cells. Moreover, in low-PI3K-expressing TOV112D ovarian-cancer cells, TIE-1 overexpression induced PI3K upregulation and promoted a PI3K-mediated cell proliferative phenotype. Mechanistically, TIE-1 participates in cell growth and proliferation by regulating the PI3K/Akt signaling pathway. Taken together, our findings strongly implicate TIE-1 as a novel therapeutic target in high-PI3K-expressing ovarian-cancer cells.

DOI： 10.3390/cancers12061705

Web of Science

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記述言語：日本語   出版者・発行元：東北医学会  

J-GLOBAL

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記述言語：英語   出版者・発行元：石巻赤十字病院  

0妊0産の20歳女性。再発性発熱発作と下腹部痛を主訴とした。臨床検査で白血球増加と血清中C反応性蛋白質値上昇が認められたが、腹部CTでは異常所見は認められなかった。15歳時から、月経周期に伴い3日間以上続く周期性発熱(EF)の病歴を有していた。EFに関連する疾患として、感染症、自己免疫疾患、自己炎症性疾患、悪性腫瘍などの既往歴はなかったことから、家族性地中海熱(FMF)を疑い、遺伝子学的検査を行った。その結果、地中海熱遺伝子(G04R)にヘテロ接合突然変異が同定された。しかし、FMFの家族歴は認められなかったため、不完全型FMFと診断し、コルヒチンを投与した。月経中の発熱は解消し、現在、当院産婦人科外来にてコルヒチンの投与を続け、経過観察中である。

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記述言語：日本語   出版者・発行元：石巻赤十字病院  

当院では妊娠初期検査で全例に風疹抗体価の測定を行い、低抗体価群にはワクチン接種を推奨していたが、その際の説明は口頭のみであり、また、当院ではワクチンを打つことができないというシステムであった。この方法では低抗体価群の約90%が次回妊娠時も低抗体価のままであり、実際にワクチン接種を受け抗体価の上昇が得られているのは6%程度にすぎないことから、これまでの風疹対策では効果不十分と考え、産後の風疹ワクチン接種システムを新規導入することとした。導入にあたり解決すべき問題として、「誰が打つのか」「どのタイミングで打つのか」「在庫管理はどうするのか」「必要な本数はいつ判明し、発注はいつ行うのか」等が挙げられ、中でも最も重要な問題は「必要な本数をいかに確保するか」であった。当院が所在する石巻は風疹流行地域ではないため、ワクチン優先供給地域の対象外であり、当院が確保できる風疹ワクチンは月5本のみで、不足することが予想された。他の方法について検討したところ、ワクチンの種類として麻疹風疹混合ワクチン(MRワクチン)を推奨する指針が出ていることが分かった。MRワクチンであれば月20本確保できるため、低抗体価の全褥婦を接種対象とすることが可能となった。

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記述言語：日本語   出版者・発行元：石巻赤十字病院  

J-GLOBAL

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記述言語：日本語   出版者・発行元：石巻赤十字病院  

当科で2016〜2018年度に腹腔鏡下付属器手術を施行した421例の中から悪性卵巣腫瘍15例を抽出し、電子カルテをもとに「術前診断」「手術方法」「病理診断」「術後経過」などについて検討した。結果、15例のうち半数を超える9例で術前画像診断は悪性・境界悪性よりも良性の可能性が高いと診断していた。リスク低減卵管卵巣切除術(RRSO)後のRRSOプロトコールによる病理検査で進行がんと診断された症例があり、術前の悪性鑑別診断には限界があると考えられた。横行結腸がん転移の1例は術前のMRI診断が成熟嚢胞性奇形腫であり、核出術が選択されていた可能性も十分考えられた。バック内回収で術中破綻なしと診断した1例は現在まで再発なく経過している。

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記述言語：日本語   出版者・発行元：石巻赤十字病院  

42歳。子宮頸癌(IVA期)に対してweekly cisplatin併用で同時化学放射線療法を行ったが腫大リンパ節が残存し、TC療法を6コース追加することで腫大リンパ節は縮小した。最終投与8ヵ月後に新規の腫大リンパ節を認めたためTC療法を再開し6コース施行した。13ヵ月後に新規の腫大リンパ節が出現し、TC療法再開の方針としていたが、施行前採血で汎血球減少と芽球の出現を認め、治療関連急性骨髄性白血病の診断で治療を開始した。しかし、地固め療法に移行する前に発熱性好中球減少症から敗血症をきたし、発症1ヵ月後に死亡した。TC療法による治療関連骨髄性腫瘍の発症リスクは一般に低いとされているが、「若年」「高用量」「長期投与」「放射線治療併用」等の患者ではリスクが高まるため注意を要すると考えられた。

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記述言語：日本語   出版者・発行元：石巻赤十字病院  

症例1は66歳で、47歳時に子宮脱でマンチェスター手術を受けた際に術前の診察で左骨盤内腫瘤を認められ、良性卵巣腫瘍として経過観察されていた。65歳時に当院外科で腹腔鏡下胆嚢摘出術を受け、術後のフォローCTで左骨盤内腫瘤の増大を認められた。PET検査で同部位に軽度集積を認められ、悪性腫瘍の可能性を指摘され、加療目的で当科(産婦人科)に紹介された。諸検査の結果から婦人科腫瘍のリンパ節転移と考えて腹式子宮全摘術+両側付属器切除術+腫瘤切除術を施行したが、病理診断は異所性平滑筋種であった。症例2は44歳で、5年前に多発子宮筋腫に対して腹式子宮全摘術を施行され、病理検査でSTUMPと診断された。術後のフォローCTで傍大動脈リンパ節腫脹を指摘され、当科に紹介された。PET検査で同部位に軽度集積を認め、STUMPのリンパ節転移を疑って開腹腫瘤切除術を施行したが、病理診断は神経鞘腫であった。

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記述言語：日本語   出版者・発行元：石巻赤十字病院  

36歳。骨盤位での選択的帝王切開を予定されていたが、妊娠35週0日に陣痛を認めたため緊急帝王切開術を施行された。直前に胎児心拍低下を認めたが、児・胎盤とも問題なく娩出された。しかし、娩出直後から血圧が急激に低下し、Shock Indexが1.57となり、腟からの大量出血を認めたため、麻酔科医が産科的危機的出血を宣言した。凝固因子の補充や原因血管の結紮によって最終的には止血が得られたが、止血には難渋し、大量の輸血を要した。羊水塞栓症の病型には、肺水腫・低血圧をきたす心肺虚脱型と、重症の弛緩出血と短時間で進行するDICを主症状とする子宮型があり、本例は子宮型であったと考えられた。子宮型は致命的病態を呈するため、病理検査による確定診断後に治療する余裕はほとんどなく、臨床症状から本症が疑われた場合には迅速に治療を行う必要がある。

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記述言語：日本語   出版者・発行元：東北医学会  

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記述言語：日本語   出版者・発行元：石巻赤十字病院  

最近のトピックスとして、初回手術で完全切除困難が予想される症例に対する術前化学療法の有効性と、遺伝性乳癌卵巣癌症候群患者に対するリスク低減手術を中心に概説した。完全切除困難例に対する術前化学療法はランダム化比較試験で非劣性が報告され、ガイドラインでも推奨されている。遺伝性乳癌卵巣癌症候群患者(BRCA 1/2遺伝子の病的変異保持者)は発癌リスクが高いため、遺伝カウンセリングを行ったうえでリスク低減卵管卵巣切除術が施行されることがある。しかし、同手術は保険適応外であり、現時点では限られた施設でのみ施行されている。

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：TOHOKU UNIV MEDICAL PRESS  

The La-related proteins (LARPs) are a family of RNA binding proteins that control the degradation and stabilization of RNAs. As emerging research reveals the biology of each LARP, it is evident that LARPs are dysregulated in some types of cancer. Upregulation of cell motility potentiates the metastatic potential of ovarian cancer cells; however, the roles of LARPs in cell motility remain unknown. In the present study, we investigated the roles of LARPs in the progression of ovarian cancer using SKOV3 human ovarian cancer cells and a public database that integrates microarray-based gene expression data and clinical data. To explore the involvement of LARPs in the cell motility, we performed RNA interference screening for LARP mRNAs in SKOV3 cells. The screening identified LARP4 as a potential suppressor of the formation of lamellipodia. Conversely, enforced expression of LARP4 suppressed the formation of lamellipodia. Moreover, cell migration was significantly increased in LARP4-depleted SKOV3 cells. Mechanistically, LARP4 depletion was associated with the decrease in RhoA protein expression. These results suggest that LARP4 may limit RhoA-dependent cell motility. In a mouse xenograft model with SKOV3 cells, LARP4 depletion potentiated peritoneal metastasis. Upon analysis of a public database of patients with ovarian cancer, the LARP4 mRNA-high expression group (n = 166) showed longer overall survival compared with the LARP4 mRNA-low expression group (n = 489), implying a positive correlation of LARP4 mRNA levels in ovarian cancer tissues with patient prognosis. Taken together, we propose that LARP4 could suppress motility and metastatic potential of ovarian cancer cells.

DOI： 10.1620/tjem.247.59

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE BV  

Objectives: Uterine fibroids are capable of causing infertility, but there are no definite criteria for which laparoscopic uterine myomectomy (LM) is known to be beneficial. To investigate the usefulness of LM, we examined pregnancy rates in patients with infertility with no obvious cause except for the presence of uterine fibroids.Materials and Methods: We retrospectively reviewed the clinical records at Suzuki Memorial Hospital between June 2010 and August 2014. We found 60 eligible patients (LM group, 46; non-LM group, 14). The criteria for performing LM were a maximal fibroid diameter of 40 mm or more or the presence of >4 fibroids.Results: The duration of infertility before the first visit was significantly longer in the LM group; although there was no significant difference in the mean patient age and body mass index. Pregnancy was achieved in 45.7% of patients (21/46) in the LM group and 28.6% (4/14) in the non-LM group. There were no pregnancies in patients with >10 fibroids. The postoperative pregnancy rate in the LM group was comparable to previously reported pregnancy rates.Conclusions: Our criteria for performing LM in patients with no obvious cause for infertility except for uterine fibroids seem appropriate, especially when the fibroids are large and the number of fibroids is between 4 and 9. However, our results suggest that the effectiveness of LM is low in patients with 10 or more uterine fibroids.

DOI： 10.4103/GMIT.GMIT_2_18

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：NATURE PUBLISHING GROUP  

Platinum resistance is one of the most challenging problems in ovarian cancer treatment. High-throughput functional siRNA screening identified tyrosine kinase with immunoglobulin-like and EGF-like domains 1 (TIE-1) as a gene that confers cells resistant to cisplatin. Conversely enforced over-expression of TIE-1 was validated to decrease cisplatin sensitivity in multiple ovarian cancer cell lines and up-regulation of TIE-1 was correlated with poor prognosis and cisplatin resistance in patients with ovarian cancer. Mechanistically, TIE-1 up-regulates the nucleotide excision repair (NER) system mediated by xeroderma pigmentosum complementation group C (XPC), thereby leading to decreased susceptibility to cisplatin-induced cell death without affecting cisplatin uptake and excretion. Importantly potentiation of therapeutic efficacy by TIE-1 inhibition was selective to DNA-adduct-type chemotherapeutic platinum reagents. Therefore, TIE-1 is suggested to promote XPC-dependent NER, rendering ovarian cancer cells resistant to platinum. Accompanied with novel findings, TIE-1 could represent as a novel therapeutic target for platinum-resistant ovarian cancer.

DOI： 10.1038/s41598-018-31069-2

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Introduction: Uterine serous carcinoma (USC) is more aggressive than other subtypes of endometrial carcinoma and is associated with a poor prognosis. We analyzed the metabolomic profile of USC with acquired resistance to paclitaxel. Results: Glutathione (GSH) concentration in PTX-1 cells was higher than in USPC-1 cells. In addition, GSH concentration in the USPC-1 cells increased after treatment with paclitaxel but was unchanged in PTX-1 cells. Glucose-6-phosphate (G6P) and ribose-5-phosphate (R5P) concentrations in PTX-1 cells were higher than those in USPC-1 cells. G6P concentration in the USPC-1 cells was unchanged after treatment with paclitaxel, while it decreased in PTX-1 cells. Conclusion: Our results indicate that increased GSH and glucose metabolism may be related to acquiring resistance to paclitaxel in USC and thus may be targets for anti-USC therapy. Materials and Methods: We compared metabolic profiles and reactions to paclitaxel in both a wild type USC cell line (USPC-1) and PTX-1, a cell line derived from USPC-1 which acquired paclitaxel resistance, using a capillary electrophoresis CE-MS/MS system.

DOI： 10.18632/oncotarget.25868

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Mature ovarian cystic teratoma (MOCT) is the most common benign neoplasm of the ovary and has a wide spectrum of radiological presentations. Our aim was to present the radiological characteristics and pathologic findings of a patient with an atypical manifestation of this common disease. A 52-year-old Japanese woman was admitted to our hospital with a large cystic mass in the pelvis and an elevated squamous cell carcinoma antigen level. Computed tomography revealed disseminated cystic lesions in the intraperitoneal and intrathoracic spaces. The lesions contained fat and featured calcifications. Laparotomy revealed many white, spherical nodules in the peritoneal cavity. The results of pathologic examination led to a presumed diagnosis of a foreign body reaction to the contents of an MOCT that leaked into the peritoneal cavity. The patient has been followed up for 13 months and remains free of symptoms without additional treatment. We describe a rare presentation of MOCT, in which we initially strongly suspected an advanced malignancy based on the results of imaging. To make an accurate diagnosis, it is necessary to understand the rare findings associated with MOCT, as well as the common signs on different imaging modalities.

DOI： 10.1016/j.radcr.2018.03.009

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Labial fusion is defined as adhesions of the labia minora or majora. Labial fusion may cause urinary retention. Surgical treatment based on an accurate anatomic assessment may be needed, but the usefulness of endoscopic examination for this disease has not been reported. CASE PRESENTATION: A 76-year-old Japanese woman undergoing chemoradiation treatment for esophageal cancer was referred to our department for evaluation of high accumulation in the vagina on a positron emission tomography scan. On physical examination, her labia were noted to be extensively fused with a pinhole opening at the midline. Endoscopic examination revealed that her vagina was filled with urine and there were no abnormalities in her urethral meatus and cervix. The adhesions were separated under anesthesia and there has been no recurrence during follow-up. CONCLUSIONS: We present a case of a postmenopausal patient with labial fusion who underwent successful surgical management. An endoscopic examination enabled us to determine the precise anatomic position and adopt a safe surgical procedure.

DOI： 10.1186/s13256-018-1568-4

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

•Neuroendocrine tumors (NETs) frequently occur in the lungs or the gastrointestinal tract; they are uncommon in the ovary.•The mammalian target of rapamycin (mTOR) pathway has been reported as a treatment for advanced NETs.•We describe a patient with an aggressive primary ovarian NET, successfully treated with everolimus (an mTOR inhibitor).

DOI： 10.1016/j.gore.2018.01.002

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：IMPACT JOURNALS LLC  

c-Myc is a master regulator of various oncogenic functions in many types of human cancers. However, direct c-Myc-targeted therapy has not been successful in the clinic. Here, we explored a novel therapeutic target, which shows synthetic lethality in c-Myc-driven ovarian cancers, and examined the molecular mechanism of the synthetic lethal interaction. By high throughput siRNA screening with a library of 6,550 genes, Furin, a pro-protein convertase, was identified as the top hit gene. Furin inhibition by siRNA or a Furin inhibitor significantly suppressed cell proliferation in high c-Myc-expressing ovarian cancer cells compared with low c-Myc-expressing cells. Conversely, Furin overexpression in the presence of high c-Myc significantly promoted cell proliferation compared with only c-Myc or Furin overexpression. Notch1, one of the Furin substrates, was upregulated by c-Myc, and Notch1 cleaved by Furin increased cell proliferation of high c-Myc-expressing ovarian cancer cells. Notch1 was involved in the cooperative pathway of c-Myc and Furin in cell proliferation. In clinical ovarian cancer specimens, co-expression of c-Myc and Furin correlated with poor survival. In conclusion, we found that c-Myc cooperates with Furin to promote cell proliferation. Furin may be a promising therapeutic target in c-Myc-driven ovarian cancer.

DOI： 10.18632/oncotarget.23322

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER ASSOC CANCER RESEARCH  

Ceramides are bioactive lipids that mediate cell death in cancer cells, and ceramide-based therapy is now being tested in dose-escalating phase I clinical trials as a cancer treatment. Multiple nanoscale delivery systems for ceramide have been proposed to overcome the inherent toxicities, poor pharmacokinetics, and difficult biophysics associated with ceramide. Using the ceramide nanoliposomes (CNL), we now investigate the therapeutic efficacy and signaling mechanisms of this nanoscale delivery platform in refractory ovarian cancer. Treatment of ovarian cancer cells with CNL decreased the number of living cells through necroptosis but not apoptosis. Mechanistically, dying SKOV3 ovarian cancer cells exhibit activation of pseudokinase mixed lineage kinase domain-like (MLKL) as evidenced by oligomerization and relocalization to the blebbing membranes, showing necroptotic characteristics. Knockdown of MLKL, but not its upstream protein kinases such as receptor-interacting protein kinases, with siRNA significantly abolished CNL-induced cell death. Monomeric MLKL protein expression inversely correlated with the IC50 values of CNL in distinct ovarian cancer cell lines, suggesting MLKL as a possible determinant for CNL-induced cell death. Finally, systemic CNL administration suppressed metastatic growth in an ovarian cancer cell xenograft model. Taken together, these results suggest that MLKL is a novel pronecroptotic target for ceramide in ovarian cancer models. Mol Cancer Ther; 17(1); 50-59. ©2017 AACR.

DOI： 10.1158/1535-7163.MCT-17-0173

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記述言語：英語   出版者・発行元：AMER ASSOC CANCER RESEARCH  

DOI： 10.1158/1538-8514.SYNTHLETH-A28

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：KOREAN SOC GYNECOLOGY ONCOLOGY & COLPOSCOPY  

DOI： 10.3802/jgo.2017.28.e24

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Leptomeningeal metastasis (LM) is rarely observed in gynecologic cancers. As gadolinium-enhanced magnetic resonance imaging (Gd-MRI) is highly effective for diagnosing LM, the aim of this study is to describe the clinical behaviors and outcomes of LM patients who were diagnosed by Gd-MRI. After securing institutional review board approvals, we retrospectively reviewed patient records. Eight patients were found to have LM from gynecological malignancies. Primary tumors included three ovarian cancers, one tubal cancer, one peritoneal cancer, two endometrial cancers, and one cervical cancer. Gd-MRI of the brain and the spine is indicated as the high priority inspection for the diagnosis of this devastating complication. (C) 2016 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.clinimag.2016.09.013

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Malignant tumors arising from the vulva account for only 0.6 % of all cancers in female patients. The predominant histologic type, representing about 90 % of these malignancies, is squamous cell carcinoma. Eccrine porocarcinoma is a rare malignant tumor arising from sweat glands. The incidence of eccrine porocarcinoma is estimated at 0.005-0.01 % of all cutaneous tumors. To the best of our knowledge, only seven previous cases of vulvar eccrine porocarcinoma have been reported in the English-language literature. We present the case of a patient with eccrine porocarcinoma of the vulva, and we summarize the clinical features of this disease using seven previously reported cases. CASE PRESENTATION: A 54-year-old Japanese woman visited a local hospital complaining of fever and left vulvar pain for 2 months. An initial examination revealed a 1 × 1 cm, firm, ulcerative mass in the inner aspect of the left labium minorum. With a preoperative diagnosis of vulvar squamous cell carcinoma, we performed a radical local excision followed by bilateral inguinal lymphadenectomy. Histological examination showed eccrine porocarcinoma, stage IB (T1bN0M0). Radiation therapy with weekly cisplatin administration was then given as adjuvant therapy. One month after treatment was completed, computed tomography revealed multiple metastases in the bilateral lungs and in the sacral bone. The patient received three courses of chemotherapy (paclitaxel and carboplatin) and underwent palliative radiation therapy to the sacrum. She died of her disease 12 months after surgery. CONCLUSIONS: We report the case of a patient with eccrine porocarcinoma of the vulva and summarize the clinical features and the treatment options of eccrine porocarcinoma from a few retrospective case reports. Although eccrine porocarcinoma is a rare disease, clinicians and pathologists should be aware of its clinical and histological features and its biological behavior.

DOI： 10.1186/s13256-016-1106-1

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掲載種別：研究論文（学術雑誌）  

© 2016 Macmillan Publishers Limited All rights reserved. Fallopian tubal epithelium is a candidate for the origin of high-grade serous ovarian cancer. Transferrin-containing follicular fluid and/or retrograde menstrual blood are possible risk factors for carcinogenesis. Accumulation of DNA double-strand breaks (DNA-DSBs) in the fallopian tubal epithelium is considered to play an important role in the development of cancer. However, the mechanisms by which DNA-DSBs accumulate have not yet been fully elucidated. The hydroxyl radical, which is produced in a Fenton reaction catalyzed by an iron ion, serves as a potent DNA-DSB-inducing molecule, raising the potential of an iron ion transporter of transferrin in the formation of DNA-DSBs. We studied the potential involvement of transferrin in DNA damage and the development of ovarian cancer. Treatment with transferrin facilitated the formation of histone 2AX phosphorylated at Serine 139 (γH2AX), which is known as a DNA-DSB marker, in human fallopian tube secretory epithelial cells and A2780 ovarian cancer cells. Knockdown of transferrin receptor 1 (TfR1), but not transferrin receptor 2, suppressed the transferrin uptake and consequent formation of γH2AX. As hydroxyl radicals in reactive oxygen species (ROS) are involved in DNA-DSBs, the formation of ROS was determined. Treatment with TfR1-specific small interference RNAs significantly diminished transferrin-induced formation of ROS. Moreover, TfR1-dependent uptake of transferrin was revealed to augment the formation of DNA-DSBs in the presence of hydrogen peroxide, which served as a substrate for the Fenton reaction. An ex vivo study with murine fallopian tubes further demonstrated that transferrin treatment introduced DNA-DSBs in the fallopian tubal epithelium. Collectively, these data suggested that the transferrin-TfR1 axis accounts for the induction of DNA-DSBs that potentially lead to DNA damage/genome instability. These findings also suggested that exposure to transferrin initiates and promotes the development of ovarian cancer by aiding the accumulation of DNA-DSBs in the fallopian tubal epithelium.

DOI： 10.1038/onc.2015.425

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掲載種別：研究論文（学術雑誌）  

© 2016 Macmillan Publishers Limited. Targeting cell motility, which is required for dissemination and metastasis, has therapeutic potential for ovarian cancer metastasis, and regulatory mechanisms of cell motility need to be uncovered for developing novel therapeutics. Invasive ovarian cancer cells spontaneously formed protrusions, such as lamellipodia, which are required for generating locomotive force in cell motility. Short interfering RNA screening identified class II phosphatidylinositol 3-kinase C2β (PI3KC2β) as the predominant isoform of PI3K involved in lamellipodia formation of ovarian cancer cells. The bioactive sphingolipid ceramide has emerged as an antitumorigenic lipid, and treatment with short-chain C 6 -ceramide decreased the number of ovarian cancer cells with PI3KC2β-driven lamellipodia. Pharmacological analysis demonstrated that long-chain ceramide regenerated from C 6 -ceramide through the salvage/recycling pathway, at least in part, mediated the action of C 6 -ceramide. Mechanistically, ceramide was revealed to interact with the PIK-catalytic domain of PI3KC2β and affect its compartmentalization, thereby suppressing PI3KC2β activation and its driven cell motility. Ceramide treatment also suppressed cell motility promoted by epithelial growth factor, which is a prometastatic factor. To examine the role of ceramide in ovarian cancer metastasis, ceramide liposomes were employed and confirmed to suppress cell motility in vitro. Ceramide liposomes had an inhibitory effect on peritoneal metastasis in a murine xenograft model of human ovarian cancer. Metastasis of PI3KC2β knocked-down cells was insensitive to treatment with ceramide liposomes, suggesting specific involvement of ceramide interaction with PI3KC2β in metastasis suppression. Our study identified ceramide as a bioactive lipid that limits PI3KC2β-governed cell motility, and ceramide is proposed to serve as a metastasis-suppressor lipid in ovarian cancer. These findings could be translated into developing ceramide-based therapy for metastatic diseases.

DOI： 10.1038/onc.2015.330

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記述言語：英語   出版者・発行元：SAGE PUBLICATIONS INC  

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記述言語：英語   出版者・発行元：SAGE PUBLICATIONS INC  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BIOMED CENTRAL LTD  

BACKGROUND: The vast majority of uterine cervical malignancies are primary carcinomas, and secondary neoplasms that metastasize to the uterine cervix from a distant organ are uncommon. Although relatively rare, metastases to the uterine cervix from a primary colon cancer have been reported. We report a rare case of metastatic carcinoma originating from a cecal adenocarcinoma with an unusual cytokeratin 7/cytokeratin 20 immunophenotype. CASE PRESENTATION: A 74-year-old postmenopausal Japanese woman was referred to our hospital for the evaluation of a uterine tumor. She had a past medical history of cecal cancer and had undergone laparoscopically assisted right hemicolectomy at the age of 69 years. During follow-up, she was found to have elevated levels of the tumor markers carbohydrate antigen 19-9 (179.7 IU/mL) and carcinoembryonic antigen (26.9 μg/L). Positron emission tomography/computed tomography showed a focus of high 18F-fluorodeoxyglucose uptake in her uterus. Examination of a cervical biopsy found a poorly differentiated adenocarcinoma that was immunopositive for cytokeratin (CK)7 and caudal-related homeobox 2 (CDX2) expression and immunonegative for cytokeratin 20 expression. The patient underwent radical hysterectomy and bilateral salpingo-oophorectomy. Histopathological examination found invasive growth of irregular and atypical ductal hyperplasia. Immunohistochemical staining of the tumor specimen revealed the same immunophenotype as the biopsy specimen. The cecal cancer specimen from her previous surgery was also examined and found to have the same immunophenotype. The histopathological diagnosis was cecal adenocarcinoma metastatic to the uterine cervix. The patient is currently receiving adjuvant chemotherapy and to date is without evidence of recurrent disease. CONCLUSIONS: Our report illustrates the importance of immunohistochemistry for the correct diagnosis of the origin of a uterine cervical adenocarcinoma in a patient with a medical history of colorectal cancer. Re-examination of a previous oncological specimen is critical for cases with a uterine lesion that is difficult to identify as primary or metastatic cancer.

DOI： 10.1186/s12957-016-0774-z

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記述言語：英語   出版者・発行元：AMER ASSOC CANCER RESEARCH  

DOI： 10.1158/1557-3265.OVCA15-A13

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Isolated torsion of the fallopian tube without an ovarian abnormality is an uncommon event, with an incidence of approximately 1 in 1,500,000 females. Isolated torsion of the fallopian tube occurs mostly in reproductive-aged women, and is thus extremely rare in menopausal women and pre-pubertal girls. CASE PRESENTATIONS: In case 1, 63-year-old Japanese woman presented with a 2-day history of acute lower abdominal pain. Menopause occurred at 53 years of age. Pelvic ultrasonography showed an enlarged mass (73 × 47 mm) on the right side of her uterus. An urgent laparoscopy was performed based on a presumptive diagnosis of right ovarian tumor torsion. During the laparoscopy, we noted a black, necrotic, solid tumor arising from the distal end of her right fimbria. Her right fallopian tube was twisted with the tumor, but her right ovary was normal and not involved. A laparoscopic tumorectomy with a right salpingectomy was performed. Her post-operative course was uneventful. In case 2, a 10-year-old Japanese girl presented with a 1-day history of lower abdominal pain associated with nausea and vomiting. Menarche had occurred 2 months earlier. A computed tomography and magnetic resonance imaging examination demonstrated a dilated tubal cystic mass with a normal uterus and bilateral ovaries. An urgent laparoscopy was performed based on a presumptive diagnosis of right fallopian tube torsion. During laparoscopy, her right fallopian tube was noted to be dark red, dilated, and twisted several times. Her right fimbria was necrotic-appearing and could not be preserved. Therefore, a laparoscopic right salpingectomy was performed. A histologic examination revealed ischemic changes with congestion of her right fallopian tube, which was consistent with tubal torsion. She had an uncomplicated post-operative course. CONCLUSION: We have presented two very rare cases of isolated fallopian tubal torsion. Radiologic interventions, such as computed tomography and magnetic resonance imaging, in addition to ultrasonography, are helpful diagnostic tools. Isolated torsion of the fallopian tube should be considered in the differential diagnosis of lower abdominal pain with a cystic mass and a normal ipsilateral ovary in all female patients, regardless of age.

DOI： 10.1186/s13256-015-0745-y

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掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s10147-014-0777-0

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER JAPAN KK  

Background This study aimed to evaluate surgical, pregnancy, and prognostic outcomes of radical abdominal trachelectomy (RAT) for Japanese patients with early-stage cervical cancer.Methods This was a multicenter prospective cohort study conducted in member facilities of Tohoku Gynecologic Cancer Unit. Patients with FIGO 1A-1B1 squamous cell carcinoma were included.Results A total of 42 patients were registered in this study, and all patients underwent planned RAT. The median stromal invasion and median horizontal spread of resected specimens were 4.6 (range 1.0-10.0) and 12.4 mm (range 3.0-28.0), respectively. The median surgical time and median blood loss were 304 min (range 233-611) and 848 mL (range 250-3984), respectively. Five patients (11.9 %) received blood transfusion. Five of 18 (27.8 %) patients who attempted to conceive achieved pregnancy, and 3 patients had healthy babies. However, all pregnancies required assisted reproductive technology with in-vitro fertilization and embryo transfer. Four patients (9.5 %) received postoperative adjuvant therapy, and 3 patients (7.1 %) developed disease recurrence.Conclusions RAT may be safely performed for Japanese patients with FIGO 1A-1B1 squamous cell carcinoma of the cervix, even in educational medical facilities. However, less-invasive surgery should be considered more often to improve pregnancy outcomes.

DOI： 10.1007/s10147-014-0763-6

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記述言語：英語   出版者・発行元：SPRINGER JAPAN KK  

DOI： 10.1007/s10147-014-0777-0

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER JAPAN KK  

The aim of this study was to evaluate prognostic factors including efficacy of postoperative chemotherapy in Japanese patients with uterine carcinosarcoma.We conducted a retrospective survey of seven medical facilities in the Tohoku Gynecologic Cancer Unit.A total of 45 patients who had undergone hysterectomy and bilateral salpingo-oophorectomy were enrolled. No significant difference was observed in overall survival according to patient age (a parts per thousand currency sign50 years vs > 50 years) or retroperitoneal lymphadenectomy (performed vs. not performed). However, the International Federation of Gynecology and Obstetrics stage (stage I/II vs stage III/IV) and postoperative chemotherapy (provided vs not provided) were significant prognostic factors in both univariate and multivariate analyses for the 25-month median follow-up period.Our results revealed that postoperative chemotherapy should be considered for all uterine carcinosarcoma stages in Japanese patients.

DOI： 10.1007/s10147-014-0732-0

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記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Spontaneous rupture of an ovarian artery aneurysm is extremely rare. Although a majority of these cases have been associated with pregnancy, there have been recent reports and reviews of rare cases that were not directly associated with pregnancy. Transcatheter arterial embolization is considered to be an alternative therapy to surgery. CASE PRESENTATION: A 44-year-old Japanese woman, gravida 3 para 3, presented to our emergency room complaining of intermittent right flank pain. She had undergone a cesarean section 2 years previously, and had no history of abdominal trauma. On admission, her blood pressure was 115/78 mmHg, pulse 70 beats per minute, and hemoglobin concentration 9.8 g/dL. Abdominal ultrasonography and contrast-enhanced dynamic computed tomography revealed a large retroperitoneal hematoma. Findings on three-dimensional computed tomography angiography suggested ruptured aneurysm of her right ovarian artery. A selective right ovarian artery angiogram revealed a tortuous aneurysm. Transcatheter arterial embolization using N-butyl-2-cyanoacrylate was performed. The aneurysm was successfully embolized, and her course after embolization was uneventful. She has remained symptom-free during 3 months of follow-up. CONCLUSIONS: This was a very rare case of a patient who had a retroperitoneal hemorrhage originating from an ovarian artery aneurysm. A review of published case reports found that contrast-enhanced computed tomography with reconstruction images is an excellent imaging tool. Diagnostic angiography and subsequent transcatheter arterial embolization are thought to be very effective for this condition.

DOI： 10.1186/s13256-015-0553-4

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記述言語：英語   出版者・発行元：SAGE PUBLICATIONS INC  

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記述言語：英語   出版者・発行元：SAGE PUBLICATIONS INC  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Solitary uterine metastases from extragenital cancers are very rare. Breast cancer is the most frequent primary site of metastasis to the uterine corpus, with invasive lobular carcinoma more likely to spread to gynecologic organs than invasive ductal carcinoma. CASE PRESENTATION: A 62-year-old postmenopausal Japanese woman was diagnosed with uterine leiomyomata more than 20 years ago and had been managed conservatively until menopause. Seven years prior to her presentation, she was diagnosed with breast cancer and underwent a partial resection of her right breast for stage IIA invasive lobular carcinoma. She underwent adjuvant chemotherapy, radiotherapy, and five years of anastrozole hormonal therapy. She presented with a growing uterine mass. Her tumor marker levels were markedly increased over the course of her follow-up, but a systemic examination revealed only a solitary uterine tumor. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. A histopathological examination, including detailed immunohistochemistry, confirmed metastatic invasive lobular carcinoma, infiltrating both her uterine myometrium and fibroid tissue. CONCLUSION: We report a very rare metastatic pattern of invasive lobular carcinoma and demonstrate that gross cystic disease fluid protein-15 and mammaglobin are useful in the diagnosis of metastatic breast cancer.

DOI： 10.1186/s13256-014-0511-6

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：TAYLOR & FRANCIS INC  

Plasminogen activator inhibitor (PAI)-1 is predictive of poor outcome in several types of cancer. The present study investigated the biological role for PAI-1 in ovarian cancer and potential of targeted pharmacotherapeutics. In patients with ovarian cancer, PAI-1 mRNA expression in tumor tissues was positively correlated with poor prognosis. To determine the role of PAI-1 in cell proliferation in ovarian cancer, the effects of PAI-1 inhibition were examined in PAI-1-expressing ovarian cancer cells. PAI-1 knockdown by small interfering RNA resulted in significant suppression of cell growth accompanied with G2/M cell cycle arrest and intrinsic apoptosis. Similarly, treatment with the small molecule PAI-1 inhibitor TM5275 effectively blocked cell proliferation of ovarian cancer cells that highly express PAI-1. Together these results suggest that PAI-1 promotes cell growth in ovarian cancer. Interestingly, expression of PAI-1 was increased in ovarian clear cell carcinoma compared with that in serous tumors. Our results suggest that PAI-1 inhibition promotes cell cycle arrest and apoptosis in ovarian cancer and that PAI-1 inhibitors potentially represent a novel class of anti-tumor agents.

DOI： 10.1080/15384047.2014.1001271

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER JAPAN KK  

Paclitaxel and carboplatin (PC) have shown antitumor activity in carcinosarcoma of the uterus (CS). The purpose of this prospective multi-institutional study was to determine the response rate (RR), progression-free survival (PFS) and overall survival (OS) and to assess the toxicity of paclitaxel and carboplatin in patients with CS.We conducted a phase II study in which patients were administered paclitaxel 175 mg/m(2) over a 3-h period followed by carboplatin (area under the serum concentration-time curve = 6) intravenously over a 30-min period on day 1 of each treatment cycle (3 weeks) until disease progression or adverse effects prohibited further therapy. Eligible patients had histologically confirmed, advanced stage (III or IV), persistent or recurrent measurable disease, and no prior chemotherapy.Six patients were enrolled between February 2006 and April 2009. The median age of the patients was 61 (range 48-77) years; one patient was stage IIIC (17 %) and five were stage IVB (83 %). Three patients (50 %) (1 at stage IIIC and 2 at stage IVB) received total abdominal hysterectomy plus bilateral salpingo-oophorectomy as part of the initial treatment; five (83 %) had homologous tumors and one (17 %) had a heterologous tumor. The median cycle number administered was 4.8 (range 2-7). The RR was 66.7 % (complete response, 2; partial response, 2); the PFS was 9.1 months and OS was not reached. The frequently observed Grade 4 toxicities were neutropenia (3 patients, 50 %). Manageable neutropenic sepsis developed in one patient.This is the first prospective multi-institutional study in Asia showing that PC may be effective and tolerable for the treatment of advanced or recurrent CS.

DOI： 10.1007/s10147-013-0658-y

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER JAPAN KK  

Uterine leiomyosarcoma (LMS) and undifferentiated endometrial sarcoma (UES) are rare, aggressive malignancies. Both are treated similarly; however, few chemotherapy agents are effective. Recently, the combination of gemcitabine (900 mg/m(2), days 1 and 8) plus docetaxel (100 mg/m(2), day 8) with granulocyte colony-stimulating factor (G-CSF, 150 mu g/m(2), days 9-15) has been shown to have activity in LMS. In Japan, neither prophylactic G-CSF at a dose of 150 mu g/m(2) nor docetaxel at a dose of 100 mg/m(2) are approved for use. For this reason, we evaluated the combination of 900 mg/m(2) gemcitabine plus 70 mg/m(2) docetaxel regimen without prophylactic G-CSF support in advanced or recurrent LMS and UES in Japanese patients.Eligible women with advanced or recurrent LMS and UES were treated with 900 mg/m(2) gemcitabine on days 1 and 8, plus 70 mg/m(2) docetaxel on day 8, every 3 weeks. The primary endpoint was overall response rate, defined as a complete or partial response.Of the eleven women enrolled, 10 were evaluated for a response. One complete response and 2 partial responses were observed (30 %) with an additional 4 (40 %) having stable disease. Mean progression-free survival was 5.4 months (range 1.3-24.8 months), and overall survival was 14 months (range 5.3-38.4 months). Grade 4 neutropenia was the major toxicity (50 %). The median number of cycles was 5 (range 2-18). Twenty-two cycles (44 %) employed G-CSF.The gemcitabine plus docetaxel regimen without prophylactic G-CSF support was tolerable and highly efficacious in Japanese patients with advanced or recurrent LMS and UES.

DOI： 10.1007/s10147-013-0627-5

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記述言語：日本語   出版者・発行元：岩手県立病院医学会  

子宮留膿腫は一般外来で遭遇することが多い疾患である。様々な原因で発症し、初発症状・重症度は多岐にわたり、緊急手術が必要となるほど重篤化する場合もある。今回我々は全身治療を要した子宮留膿腫の2例を経験した。治療のポイントとして、子宮頸管拡張によるドレナージ・De-escalationの概念に則った適切な抗菌剤投与が挙げられる。(著者抄録)

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER JAPAN KK  

Background Pelvic exenteration has attained an important role in the treatment of advanced or recurrent cervical cancer for obtaining a complete cure or longer disease-free survival. The purpose of this study was to evaluate patients undergoing pelvic exenteration and to determine the clinical features associated with outcome and survival.Methods We retrospectively analyzed the records of 12 patients who underwent pelvic exenteration for uterine cervical cancer between July 2002 and August 2011.Results Two patients had primary stage IVA cervical adenocarcinoma and 10 patients had recurrent cervical cancer. Eight patients underwent anterior pelvic exenteration, 3 patients underwent total pelvic exenteration, and 1 patient underwent posterior pelvic exenteration. With a median duration of follow-up of 22 months (range 3-116 months), 5 patients were alive without recurrence. Of 5 patients with no evidence of disease, 4 were recurrent or residual tumor, all of whom had common factors, such as a tumor size <= 30 mm, negative surgical margins, complete resection, and no lymph node involvement. The 5-year overall survival rate for 12 patients was 42.2 %. Ileus was the most common complication (42 %) and postoperative intestinal anastomosis leaks developed in 3 patients, but no ureteral anastomosis leaks occurred.Conclusions Pelvic exenteration is a feasible surgical procedure in advanced and/or recurrent cervical cancer patients with no associated post-operative mortality, and the only therapeutic option for complete cure or long-term survival; however, post-operative complications frequently occur.

DOI： 10.1007/s10147-013-0534-9

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ACADEMIC PRESS INC ELSEVIER SCIENCE  

Objective. The aim of the present study was to clarify the most effective combination of injected tracer types and injection sites in order to detect sentinel lymph nodes (SLNs) in early endometrial cancer.Patients and methods. The study included 100 consecutive patients with endometrial cancer treated at Tohoku University Hospital between June 2001 and December 2012. The procedure for SLN identification entailed either radioisotope (RI) injection into the endometrium during hysteroscopy (55 cases) or direct RI injection into the uterine cervix (45 cases). A combination of blue dye injected into the uterine cervix or uterine body intraoperatively in addition to preoperative RI injection occurred in 69 of 100 cases. All detected SLNs were recorded according to the individual tracer and the resultant staging from this method was compared to the final pathology of lymph node metastases including para-aortic nodes.Results. SLN detection rate was highest (96%) by cervical RI injection; however, no SLNs were detected in para-aortic area. Para-aortic SLNs were detected only by hysteroscopic RI injection (56%). All cases with pelvic lymph node metastases were detected by pelvic SLN biopsy. Isolated positive para-aortic lymph nodes were detected in 3 patients. Bilateral SLN detection rate was high (96%; 26 of 27 cases) by cervical RI injection combined with dye.Conclusion. RI injection into the uterine cervix is highly sensitive in detection of SLN metastasis in early stage endometrial cancer. It is a useful and safe modality when combined with blue dye injection into the uterine body. (C) 2013 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.ygyno.2013.08.018

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD  

The present study examined the association between food intake and endometrial cancer restricted to endometrial endometrioid adenocarcinoma (EEA) using a case-control study in Japanese women. One hundred sixty-one cases and 380 controls who completed a questionnaire regarding demographic, lifestyle, and food frequency questionnaire were analyzed. Odds ratio (OR) between selected food intakes and EEA were calculated by logistic regression analysis. After adjustment putative confounding factors, the higher intakes of vegetables [odds ratio (OR) = 0.47, 95% confidence interval (CI) = 0.26-0.83], peanuts (OR = 0.48, CI = 0.27-0.86), fish (OR = 0.52, CI = 0.29-0.93), boiled egg (OR = 0.24, CI = 0.33-0.92), instant noodles (OR = 1.94, CI = 1.12-3.34), instant food items (OR = 2.21, CI = 1.31-3.74), and deep-fried foods (OR = 2.87, CI = 1.58-5.21) were associated with a risk for EEA. The inverse association with a risk of EEA was also seen in higher intakes (g/1000 kcal) for vegetables (0.45, CI = 0.25-0.81) and fish (0.53, CI = 0.30-0.94) as compare to lower intake. Higher intake of vegetables, peanuts, fish, and boiled egg was associated with a reduced risk for EEA, whereas instant noodles, instant food items, and deep-fried foods was associated with an increased risk for EAA as compared to lower levels of intake.

DOI： 10.1080/01635581.2013.818158

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記述言語：英語   出版者・発行元：AMER ASSOC CANCER RESEARCH  

DOI： 10.1158/1535-7163.PMS-IA11

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：TOHOKU UNIV MEDICAL PRESS  

Small cell carcinoma of the uterine cervix (SCCC) is a rare subtype of cervical cancer with an aggressive behavior. Although SCCC has a worse prognosis than other histological types of uterine cervical cancer such as squamous cell carcinoma or adenocarcinoma, standard therapy for SCCC remains to be established due to its rarity. The purpose of this study was to evaluate the efficacy and toxicity of concurrent chemoradiotherapy (CCRT) using a regimen consisting of vincristine, adriamycin, and cyclophosphamide alternating with cisplatin and etoposide (VAC/PE). We analyzed a series of 9 patients with SCCC. Five patients with stage IB disease underwent radical hysterectomy followed by CCRT. Four patients with advanced stage disease received CCRT primarily. With a median follow-up duration of 47.4 months (range, 10.5 to 86.4 months), 4 out of 5 patients with stage IB disease were alive without recurrence. In 4 patients with advanced stage disease, the response rate was 75% (complete response, 1; partial response, 2; progressive disease, 1). One patient with stage IVB disease remained without recurrence for 89.5 months. At 5 years, overall survival (OS) and progression-free survival for all patients was 52% and 56%, respectively. Patients with early-stage disease had an 80% 5-year OS rate compared to 25% for patients with advanced stage disease. Although all patients developed grade 3-4 neutropenia, CCRT using VAC/PE is feasible in both the primary and adjuvant settings for SCCC. In particular, this combined modality therapy may improve both local control and survival as postoperative treatment in patients with early-stage disease.

DOI： 10.1620/tjem.229.75

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記述言語：英語   出版者・発行元：日本産科婦人科内視鏡学会  

Objective: To report a case of a quiescent Nuck's hydrocele with endometriosis revealed after laparoscopic surgery.<BR>Design: Case report.<BR>Setting: Department of Obstetrics and Gynecology, Tohoku University Hospital.<BR>Patient: A 36-year-old woman who was diagnosed with bilateral endometrial cysts underwent laparoscopic surgery.<BR>Main Outcome Measures: Ultrasonography, CT, MRI, and histologic examination.<BR>Results: We performed a laparoscopic bilateral ovarian cystectomy and pelvic adhesiolysis with &le; 10 mm Hg intra-abdominal pressure. Postoperatively, however, the tumor appeared to be enlarging with increased pain in her left groin. Before the laparoscopic surgery, she was aware of something swelling and then resolving spontaneously; however, she assumed that it was one of the multiple myoma lesions palpable on her abdominal wall. We could not diagnose it as a Nuck's hydrocele by ultrasonography. An MRI taken before laparoscopy was reviewed and found to show a Nuck's hydrocele with endometriosis. An open surgery was planned and the preoperative CT showed a Nuck's hydrocele enhanced with previous contrast agent used in hysterosalpingogram. We removed the Nuck's hydrocele and reinforced the surgical site with mesh. Histological examination confirmed a Nuck's hydrocele with endometriosis and inflammation.<BR>Conclusions: A Nuck's hydrocele in an adult female is very rare; to the best of our knowledge, this is the first case revealed following laparoscopic surgery. The Japanese literature contains only 5 case reports of a Nuck's hydrocele with endometriosis. We assume that a quiescent Nuck's hydrocele with endometriosis can be revealed with laparoscopic intra-abdominal pressure and imaging enhancement with contrast dye. We recommend that a quiescent inguinal hernia or Nuck's hydrocele should be identified prior to laparoscopic surgery because high laparoscopic intra-abdominal pressure might exacerbate those conditions.

DOI： 10.5180/jsgoe.29.168

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：TOHOKU UNIV MEDICAL PRESS  

Endometrial cancer (EC) is the most prevalent gynecologic malignancy in Japan. Atypical endometrial hyperplasia (AEH) is viewed as the premalignant lesion of EC, however it is often difficult to distinguish EC from AEH. The rate of concurrent EC in women diagnosed preoperatively with AEH based on endometrial biopsy was reported as 17-52%. Although hysteroscopic inspection and total curettage are considered as useful methods to make diagnosis of endometrial lesions, there is no report using this combined method to discriminate EC from AEH. The purpose of this study was to examine whether hysteroscopic inspection and total curettage improve the prevalence of EC among women diagnosed preoperatively with AEH. We reviewed 22 patients who underwent hysteroscopic inspection and total curettage and were diagnosed with AEH before undergoing hysterectomy between November 2001 and May 2011. The diagnosis made with the hysterectomy specimens revealed AEH in 10 patients (45.5%), endometrial hyperplasia without atypia in 3 (13.6%), and endometrioid adenocarcinoma, the most common type of EC, in 9 (40.9%). Endometrioid adenocarcinoma included 7 patients without myometrial invasion (31.8%) and 2 patients with superficial myometrial invasion (9.1%). There was no hysteroscopic finding that was specific for EC or AEH. In conclusion, about 41% of women who underwent hysterectomy under a diagnosis of AEH were found to have coexisting adenocarcinoma, although the prevalence of EC among those women was similar to that in earlier reports with endometrial biopsy. Accordingly, we must be careful in planning the therapeutic strategy for women with a preoperative diagnosis of AEH.

DOI： 10.1620/tjem.228.365

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記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：NATL ACAD SCIENCES  

MYC oncogene family members are broadly implicated in human cancers, yet are considered "undruggable" as they encode transcription factors. MYC also carries out essential functions in proliferative tissues, suggesting that its inhibition could cause severe side effects. We elected to identify synthetic lethal interactions with c-MYC overexpression (MYC-SL) in a collection of similar to 3,300 druggable genes, using high-throughput siRNA screening. Of 49 genes selected for follow-up, 48 were confirmed by independent retesting and approximately one-third selectively induced accumulation of DNA damage, consistent with enrichment in DNA-repair genes by functional annotation. In addition, genes involved in histone acetylation and transcriptional elongation, such as TRRAP and BRD4, were identified, indicating that the screen revealed known MYC-associated pathways. For in vivo validation we selected CSNK1e, a kinase whose expression correlated with MYCN amplification in neuroblastoma (an established MYC-driven cancer). Using RNAi and available small-molecule inhibitors, we confirmed that inhibition of CSNK1e halted growth of MYCN-amplified neuroblastoma xenografts. CSNK1e had previously been implicated in the regulation of developmental pathways and circadian rhythms, whereas our data provide a previously unknown link with oncogenic MYC. Furthermore, expression of CSNK1e correlated with c-MYC and its transcriptional signature in other human cancers, indicating potential broad therapeutic implications of targeting CSNK1e function. In summary, through a functional genomics approach, pathways essential in the context of oncogenic MYC but not to normal cells were identified, thus revealing a rich therapeutic space linked to a previously "undruggable" oncogene.

DOI： 10.1073/pnas.1121119109

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記述言語：日本語   出版者・発行元：(株)メジカルビュー社  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER ASSOC CANCER RESEARCH  

MYC-induced DNA damage is exacerbated in WRN-deficient cells, leading to replication stress and accelerated cellular senescence. To determine whether WRN deficiency impairs MYC-driven tumor development, we used both xenograft and autochthonous tumor models. Conditional silencing of WRN expression in c-MYC over-expressing non-small cell lung cancer xenografts impaired both tumor establishment and tumor growth. This inhibitory effect of WRN knockdown was accompanied by increased DNA damage, decreased proliferation, and tumor necrosis. In the E mu-Myc mouse model of B-cell lymphoma, a germline mutation in the helicase domain of Wrn (Wrn(Delta hel/Delta hel)) resulted in a significant delay in emergence of lethal lymphomas, extending tumor-free survival by more than 30%. Analysis of preneoplastic B cells from E mu-Myc Wrn mutant mice revealed increased DNA damage, elevation of senescence markers, and decreased proliferation in comparison with cells from age-matched E mu-Myc mice. Immunohistochemical and global gene expression analysis of overt E mu-Myc Wrn(Delta hel/Delta hel) lymphomas showed a marked increase in expression of the CDK inhibitor, p16(Ink4a), as well as elevation of TAp63, a known mediator of senescence. Collectively, these studies show that in the context of Myc-associated tumorigenesis, loss of Wrn amplifies the DNA damage response, both in preneoplastic and neoplastic tissue, engaging activation of tumor suppressor pathways. This leads to inhibition of tumor growth and prolonged tumor-free survival. Targeting WRN or its enzymatic function could prove to be an effective strategy in the treatment of MYC-associated cancers. Mol Cancer Res; 10(4); 535-45. (C)2012 AACR.

DOI： 10.1158/1541-7786.MCR-11-0508

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記述言語：英語   出版者・発行元：AMER ASSOC CANCER RESEARCH  

DOI： 10.1158/1538-7445.AM2012-5139

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記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

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記述言語：日本語   出版者・発行元：金原出版(株)  

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記述言語：日本語   出版者・発行元：医学書院  

CiNii Books

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その他リンク： http://search.jamas.or.jp/link/ui/2010181001

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY  

In order to facilitate the discovery and investigation of anti-cancer therapeutics under physiological conditions, we have engineered the ovarian cancer cell line, HM-1/luc, in mice. This cell stably expresses firefly luciferase and produces light that can be detected using an in vivo imaging system (IVIS). Parental HM-1 cells cause severe carcinomatous peritonitis to B6C3F1 mice, but not to C57BL6 mice. Established HM-1/luc cells showed pathologically similar findings to HM-1 cells. HM-1/luc cells were injected into the peritoneal cavity of B6C3F1 mice and IVIS 2000 was conducted weekly after inoculation to monitor intraperitoneal tumor growth. The mice were divided into three groups: non-CDDP-treated (control) and CDDP-treated (0.2 and 0.4 mg). A disease-suppressive effect of the CDDP was reflected by the significantly prolonged survival of the CDDP-treated mice (control 23 +/- 1.9 days, CDDP 0.2 mg 29.6 +/- 2.9 days; p < 0.05); the total photon and area of flux were decreased. The optical imaging of intraperitoneal tumors via in vivo bioluminescence is effective for noninvasive monitoring and semi-quantitative analysis. Our syngeneic mouse model has the relevant clinical features of ovarian cancer, which makes it a useful model for developing new ovarian cancer therapies. Copyright (C) 2009 John Wiley & Sons, Ltd.

DOI： 10.1002/bio.1112

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記述言語：日本語   出版者・発行元：(公社)日本医師会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

The endosomal sorting complex required for transport (ESCRT) proteins form multimolecular complexes that control multivesicular body formation, endosomal sorting, and transport ubiquitinated membrane proteins (including cell-surface receptors) to the endosomes for degradation. There is accumulating evidence that endosomal dysfunction is linked to neural cell degeneration in vitro, but little is known about the relationship between neural disorders and ESCRT proteins in vivo. Here we specifically deleted the brs gene, ESCRT-0, in the neurons of mice by crossing loxP-flanked brs mice with transgenic mice expressing the synapsin-I Cre protein (SynI-cre). Histological analyses revealed that both apoptosis and a loss of hippocampal CA3 pyramidal neurons occurred in the hrs(flox/flox);SynI-cre mice. Notably, the hrs(flox/flox);SynI-cre mice accumulated ubiquitinated proteins, such as glutamate receptors and an autophagy-regulating protein, p62. These molecules are particularly prominent in the hippocampal CA3 neurons and cerebral cortex with advancing age. Accordingly, we found that both locomotor activity and learning ability were severely reduced in the hrs(flox/flox);SynI-cre mice. These data suggest that Hrs plays an important role in neural cell survival in vivo and provide an animal model for neurodegenerative diseases that are known to be commonly affected by the generation of proteinaceous aggregates. (Am J Pathol 2008, 173:1806-1817; DOI: 10.2353/ajpath.2008.080684)

DOI： 10.2353/ajpath.2008.080684

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記述言語：日本語   出版者・発行元：(公社)日本婦人科腫瘍学会  

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記述言語：日本語   出版者・発行元：(株)文光堂  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：TOHOKU UNIV MEDICAL PRESS  

Radical hysterectomy has been performed for invasive cervical cancer, and autonomic nerve-sparing procedures have been developed to preserve bladder function. To perform and improve the nerve-sparing radical hysterectomy, it is important to understand anatomy of the intra pelvic fasciae, specially vesico-uterine ligament (VUL), because most of injuries to the nerves occurred during incision of the VUL in radical hysterectomy procedures. The objectives of the present study were to provide histological understanding of major structures found in nerve-sparing radical hysterectomy. Serial macroscopic slices (15-20 mm thick) from five female pelves were trimmed and prepared for paraffin-embedded histology. We noted an anatomical entity as "the visceroparietal fascial bridge", which corresponds with the macroscopically identified arcus tendineus fasciae pelvis. A histologically identifiable neurovascular pedicle to the bladder neck corresponded with the deep portion of VUL. These findings could help better preservation of autonomic nerves during radical hysterectomy and improve patient's quality of life after the operation. Translation of surgical anatomy into anatomic terminology enables us to have fruitful discussions with persuasive power by excluding any bias from individual surgeons.

DOI： 10.1620/tjem.212.403

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER ASSOC CANCER RESEARCH  

Abnormally high signals from receptor tyrosine kinases (RTK) are associated with carcinogenesis, and impaired deactivation of RTKs may also be a mechanism in cancer. Hepatocyte growth factor-regulated tyrosine kinase substrate (Hrs) is one of the master regulators that sort activated receptors toward lysosomes and shut down their signals. Hrs contains a ubiquitin-interacting motif and is involved in the endosomal sorting of monoubiquitinated membrane proteins, such as growth factor receptor and E-cadherin. Here, we investigated the role of Hrs in determining the malignancy of cancer cells and discovered that the targeted disruption of Hrs by small interfering RNA effectively attenuated the proliferation, anchorage-independent growth, tumorigenesis, and metastatic potential of HeLa cells in vitro and in vivo. The restoration of Hrs expression increased cell proliferation and anchorage-independent growth in a mouse embryonic fibroblast line established from a Hrs knockout mouse. Further analysis revealed that Hrs depletion was associated with the up-regulation of E-cadherin and reduced beta-catenin signaling. The aberrant accumulation of E-cadherin most likely resulted from impaired E-cadherin degradation in lysosomes. These results suggest that Hrs may play a critical role in determining the malignancy of cancer cells by regulating the degradation of F-cadherin.

DOI： 10.1158/0008-5472.CAN-06-2756

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The therapeutic effect of a combination of paclitaxel (PTX) and platinum (PLT) in ovarian clear cell adenocarcinoma (CC) patients with measurable disease has yet to be elucidated. In this study, we used retrospective review to evaluate the results of treatment with a combination of PTX and PLT in CC patients with measurable disease. A total of 28 patients with measurable residual CC (15 cases with primary disease, 13 cases with recurrent disease) treated with combination PTX-PLT chemotherapy was identified through medical records from ten institutions. Clinical response to chemotherapy was evaluated using Response Evaluation Criteria in Solid Tumors criteria. Of the 28 cases, 8 of 15 patients with primary disease (53.3%) and 3 of 13 patients with recurrent disease (23.1%) responded to PTX-PLT chemotherapy. The response rate for cases with late recurrent disease (>12 months) was 20% (1/5), whereas the rate was 25% (2/8) for cases with early recurrent (<12 months) or refractory disease. Our results indicate that the combination of PTX and PLT may have greater efficacy against CC than conventional PLT-based chemotherapy that does not include PTX. © 2006, IGCS.

DOI： 10.1111/j.1525-1438.2006.00289.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：KARGER  

Aims: The aims of this study were to evaluate the factors affecting prognosis in patients with uterine sarcomas and to demonstrate that carcinosarcoma bears a similarity to high-grade endometrial carcinoma in terms of its prognosis and clinicopathological parameters. Methods: In June 2004, 17 Japanese institutions received questionnaires regarding uterine sarcomas. Study patients had uterine sarcomas initially treated at each institution between January 1990 and May 2004. Survival analyses and comparisons were performed by univariate methods. Patient data of 921 cases of endometrial adenocarcinoma were also analyzed and compared to the data with the uterine sarcomas. Results: One hundred twenty- one patients with uterine sarcomas were identified who met study eligibility criteria. In uterine sarcomas, carcinosarcoma had a worse prognosis than other sarcomas, but the difference was not significant ( p = 0.302). In carcinosarcoma, significant differences were observed with age ( p = 0.0388), stage ( p < 0.01) and surgical procedure ( with or without pelvic lymphadenectomy, p = 0.0316). In carcinosarcoma and G3 adenocarcinoma, no significant difference was identified with regard to overall survival in univariate ( p = 0.191) and multivariate ( p = 0.168) analyses. Conclusion: Our results demonstrate that the clinical behavior of carcinosarcoma strongly resembles that of G3 endometrial adenocarcinoma, setting it apart from other `pure' uterine sarcomas. Copyright c 2006 S. Karger AG, Basel.

DOI： 10.1159/000107107

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background. Epithelioid leiomyosarcomas arising from the uterine cervix are extremely rare neoplasms, with only three cases reported in the English literature. Case. A 53-year-old Japanese woman was admitted to our university hospital due to massive vaginal bleeding from a cervical tumor. A total hysterectomy with bilateral salpingo-oophorectomy was performed. Histological findings, including immunohistochemical study using desmin, SMA, cytokeratin, S-100, HMB-45, vimentin, melan-A, and CD68, led to a diagnosis of epithelioid leiomyosarcoma of the uterine cervix. The patient underwent adjuvant chemotherapy and has been disease-free for over 20 months. Conclusion. Immunohistochemical studies may be needed to differentiate among the alternative diagnoses of malignant melanoma, metastatic carcinoma, and epithelioid sarcoma. Additional cases are needed to develop optimal management strategies and to predict prognosis. © 2005 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.ygyno.2005.02.028

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Primary vaginal adenosarcomas are extremely rare, and typical adenosarcomas are of low malignancy. However, aggressive forms with sarcomatous overgrowth have been reported, those appear to have a poor prognosis. A 52-year-old woman who had undergone prior surgery for uterine leiomyoma and an ovarian cyst (total abdominal hysterectomy and left salpingo-oophorectomy) presented 10 years later with a rapidly enlarging tumor arising from the vaginal cuff. Repetitive biopsy samples revealed a mixture of benign epithelial gland and malignant stromal components with periglandular stromal hypercellularity and sarcomatous overgrowth. A histological diagnosis of mullerian adenocarcinoma was made. The patient died from recurrent disease 9 months after surgery. Regardless of primary focus, adenosarcoma with sarcomatous overgrowth is associated with postoperative recurrence and a fatal outcome. © 2004 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.ygyno.2004.08.004

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: The purpose of the study was to evaluate the efficacy of combination chemotherapy with paclitaxel and carboplatin in patients with advanced or recurrent carcinosarcoma of the uterus. METHODS: A retrospective review was carried out at Miyagi Prefecture Cancer Research Center Hospital. Six patients pathologically diagnosed with uterine carcinosarcoma were treated with paclitaxel (175 mg/m(2) given intravenously over 3 h) and carboplatin (dosed at AUC 6) every 3 weeks at our center between 1997 and 2003. Responses and adverse effects were assessed according to Response Evaluation Criteria in Solid Tumors and National Cancer Institute-Common Toxic Criteria, respectively. RESULTS: All six patients were evaluable for toxicity, and no unacceptably severe toxicities were reported. Grades 3 and 4 hematologic toxicities occurred, but all of them were overcome by adequate treatment with granulocyte colony-stimulating factor and blood transfusions. Five of six patients had measurable disease and thus were evaluable for response: Four patients had a complete response (CR) and the remaining patient had progressive disease (PD). The median progression-free interval (PFI) for all six cases was 18 months, with a median overall survival of 25 months. CONCLUSIONS: Although the number of cases was small, the regimen evaluated in the current study demonstrated higher activity and lesser toxicity than those found in previous studies in patients with advanced or recurrent uterine carcinosarcoma. Additional phase II clinical studies are necessary to evaluate fully the benefits of this regimen.

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：克誠堂出版(株)  

子宮動脈塞栓術(UAE)の治療を選択した患者13症例を対象とし,0.2%ロピバカイン5ml・hr-1の持続注入を基本とした硬膜外麻酔を施行した.硬膜外麻酔の有効範囲は,冷感でT7-8からL3であり,針刺激痛覚検査でT10-L1であった.触覚は維持されていた.硬膜外麻酔薬以外のフルルビプロフェン50mgなど他の鎮痛薬を投与したものは,術後経過中2時間までに4症例,2〜6時間では6症例,6〜16時間では5症例であった.16時間以内に3症例において硬膜外麻酔以外の鎮痛を必要としなかった.嘔気がみられた4症例中3症例でメトクロプラミドを投与した.嘔吐や掻痒感を訴えた症例はなかった.5症例では16時間以降も軽度疼痛が持続し,経口の鎮痛薬を必要とした.硬膜外麻酔を行わなかった1症例では,UAE直後に陣痛様の疼痛(VAS 100mm)を訴えたため塩酸モルヒネ20mgを投与した.その後2時間ごとにペンタゾシン15mgずつ総量45mgの投与を行ったが,VASは50mm以上で経過した.24時間後以降はVAS30mm以下であった

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2004&ichushi_jid=J01397&link_issn=&doc_id=20040419100003&doc_link_id=40006162728&url=http%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F40006162728&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

記述言語：日本語   出版者・発行元：特定非営利活動法人 日本臨床細胞学会  

背景:上皮性卵巣癌の転移様式としてリンパ行性転移は播種性転移とならび重要であるが, 臨床的に浅鼠径リンパ節転移で卵巣癌が発見される例は非常にまれである<BR>症例:患者は52歳女性, 左浅鼠径リンパ節腫大を主訴に受診.リンパ節穿刺吸引細胞診にて卵巣原発腺癌が推定された.左鼠径リンパ節生検では卵巣由来の漿液性乳頭状腺癌のリンパ節転移が疑われたため開腹手術を施行した.卵巣は肉眼的に正常大であったが, 左卵巣実質の一部に小結節があり, 病理組織学的に癌細胞の増殖を認めた.免疫組織化学染色ではEMA・Ber-EP4・CK7は陽性, calretinin・vimentin・CK20は陰性であり, 卵巣原発の漿液性乳頭状腺癌の診断が確定した.<BR>結論:浅鼠径リンパ節転移で正常大卵巣癌症候群が発見された非常にまれな症例を経験し, その診断過程をretrospectiveに検討した, 画像上, 腹腔や骨盤内に明らかな病巣が存在せず, 浅鼠径リンパ節転移の腺癌が見つかった場合には卵巣癌の可能性も考慮する必要があると考えられた.

DOI： 10.5795/jjscc.43.125

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記述言語：日本語   出版者・発行元：(一財)秋田県農村医学会  

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記述言語：日本語   出版者・発行元：(一財)秋田県農村医学会  

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記述言語：日本語   出版者・発行元：(公社)日本婦人科腫瘍学会  

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記述言語：日本語   出版者・発行元：(公社)日本婦人科腫瘍学会  

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

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記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

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記述言語：日本語   出版者・発行元：東北連合産科婦人科学会・北日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

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記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

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記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

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記述言語：日本語   出版者・発行元：日本遺伝カウンセリング学会  

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記述言語：日本語   出版者・発行元：東北連合産科婦人科学会・北日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：東北連合産科婦人科学会・北日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

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記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

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記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

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記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

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記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

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記述言語：日本語   出版者・発行元：(公社)日本リハビリテーション医学会  

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記述言語：日本語   出版者・発行元：東北連合産科婦人科学会・北日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：東北連合産科婦人科学会・北日本産科婦人科学会  

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記述言語：英語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：英語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：英語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：英語   出版者・発行元：John Wiley & Sons Australia, Ltd  

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記述言語：英語   出版者・発行元：John Wiley & Sons Australia, Ltd  

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記述言語：英語   出版者・発行元：John Wiley & Sons Australia, Ltd  

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記述言語：英語   出版者・発行元：John Wiley & Sons Australia, Ltd  

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記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

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記述言語：日本語   出版者・発行元：(公社)日本臨床細胞学会  

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記述言語：日本語   出版者・発行元：東北連合産科婦人科学会・北日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：東北連合産科婦人科学会・北日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

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記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

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記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

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記述言語：日本語   出版者・発行元：日本脂質生化学会  

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記述言語：日本語   出版者・発行元：(株)メジカルビュー社  

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記述言語：日本語   出版者・発行元：(株)メジカルビュー社  

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記述言語：日本語   出版者・発行元：(公社)日本婦人科腫瘍学会  

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記述言語：日本語   出版者・発行元：(公社)日本婦人科腫瘍学会  

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記述言語：日本語   出版者・発行元：(公社)日本婦人科腫瘍学会  

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記述言語：日本語   出版者・発行元：(公社)日本婦人科腫瘍学会  

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記述言語：日本語   出版者・発行元：(公社)日本婦人科腫瘍学会  

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記述言語：日本語   出版者・発行元：(公社)日本婦人科腫瘍学会  

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記述言語：日本語   出版者・発行元：(公社)日本婦人科腫瘍学会  

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記述言語：日本語   出版者・発行元：(公社)日本臨床細胞学会  

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記述言語：日本語   出版者・発行元：(公社)日本臨床細胞学会  

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記述言語：日本語   出版者・発行元：(公社)日本薬学会  

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記述言語：英語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：英語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：英語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：診断と治療社  

2010年1月〜2015年6月の6年6ヵ月の間に当院で治療を行った婦人科悪性疾患患者のうち、血栓症合併33例について診断時期および診断契機に注目し、生命予後との相関を検討した。初診時に血栓症を認めた症例のうち、がん随伴症状を主訴とした群は、血栓症症状を主訴とした群と比較して病期が進んでいた。担がん無治療時期に血栓症の診断に至る場合、予後が不良であった。(著者抄録)

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その他リンク： http://search.jamas.or.jp/link/ui/2016409746

記述言語：日本語   出版者・発行元：(公社)日本臨床細胞学会  

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記述言語：日本語   出版者・発行元：(公社)日本臨床細胞学会  

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記述言語：日本語   出版者・発行元：(公社)日本生化学会  

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記述言語：日本語   出版者・発行元：(公社)日本生化学会  

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記述言語：日本語   出版者・発行元：(公社)日本婦人科腫瘍学会  

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記述言語：日本語   出版者・発行元：東北連合産科婦人科学会・北日本産科婦人科学会  

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記述言語：日本語   出版者・発行元：(公社)日本婦人科腫瘍学会  

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記述言語：日本語   出版者・発行元：(公社)日本婦人科腫瘍学会  

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記述言語：日本語   出版者・発行元：日本脂質生化学会  

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記述言語：日本語   出版者・発行元：日本脂質生化学会  

卵巣がんは女性の悪性腫瘍の中で高い死亡率を示す。その治療には、新たな治療戦略の登場が求められている。セラミド製剤は種々のがん治療において重要な役割を担っていると考えられているが、卵巣がんにおいては未だ不明な点が多い。そこで我々は、卵巣がん細胞でのセラミドナノリポソーム製剤の抗腫瘍効果を検証した。その結果、本製剤は卵巣がん細胞に対して抗増殖効果を示したことが分かった。そして、セラミドナノリポソーム製剤は細胞のアポトーシスを起こすのではなく、ネクロプトーシスを誘導すると考えられた。これらの結果から、セラミドナノリポソーム製剤は新しいタイプの抗腫瘍薬であると思われる。(著者抄録)

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

J-GLOBAL

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その他リンク： http://dl.ndl.go.jp/info:ndljp/pid/10734407

記述言語：英語   出版者・発行元：日本産科婦人科学会  

CiNii Books

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その他リンク： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=456085

記述言語：英語   出版者・発行元：日本産科婦人科学会  

CiNii Books

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その他リンク： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=455932

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

J-GLOBAL

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その他リンク： http://dl.ndl.go.jp/info:ndljp/pid/10734987

J-GLOBAL

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記述言語：日本語   出版者・発行元：東北連合産科婦人科学会・北日本産科婦人科学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：北海道産科婦人科学会  

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記述言語：日本語   出版者・発行元：北海道産科婦人科学会  

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(公社)日本医学放射線学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

J-GLOBAL

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その他リンク： http://dl.ndl.go.jp/info:ndljp/pid/10732237

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

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その他リンク： http://dl.ndl.go.jp/info:ndljp/pid/10732239

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

J-GLOBAL

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その他リンク： http://dl.ndl.go.jp/info:ndljp/pid/10731885

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

J-GLOBAL

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その他リンク： http://dl.ndl.go.jp/info:ndljp/pid/10731971

記述言語：日本語   出版者・発行元：国立病院総合医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：東北連合産科婦人科学会・北日本産科婦人科学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本エンドメトリオーシス学会  

初診時45歳女。以前より子宮筋腫を指摘されていたが、筋腫の増大を認めた。子宮前壁に7cmの漿膜下筋腫を認め、右卵巣は3cmに腫大しており、チョコレート嚢胞と考えられた。所見ではダグラス窩に有痛性の硬い腫瘤を触知し、子宮の可動性は不良、腸管子宮内膜症の存在も疑った。大腸内視鏡では大腸粘膜面は正常であったが、伸展不良な部位を認めた。注腸造影所見では、S状結腸下部からRa領域に約3cmの狭少化、外圧排を認めた。Gn-RH agonist療法後、原則として腸管切除を行わずに子宮摘出術を行う方針とした。また、年齢、再発予防の観点から両側付属器切除術を施行することとした。術後のホルモン補充療法は行わずに経過観察しているが、術後約2年を経過した現在、特記すべき異常を認めていない。

J-GLOBAL

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記述言語：日本語   出版者・発行元：東北連合産科婦人科学会・北日本産科婦人科学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本脂質生化学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

J-GLOBAL

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その他リンク： http://dl.ndl.go.jp/info:ndljp/pid/10730718

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

J-GLOBAL

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その他リンク： http://dl.ndl.go.jp/info:ndljp/pid/10730981

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

J-GLOBAL

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その他リンク： http://dl.ndl.go.jp/info:ndljp/pid/10730015

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

J-GLOBAL

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その他リンク： http://dl.ndl.go.jp/info:ndljp/pid/10730020

記述言語：日本語   出版者・発行元：東北連合産科婦人科学会・北日本産科婦人科学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：東北連合産科婦人科学会・北日本産科婦人科学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(公社)日本婦人科腫瘍学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(公社)日本婦人科腫瘍学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本脂質生化学会  

CiNii Books

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記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(公社)日本産科婦人科学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

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その他リンク： http://dl.ndl.go.jp/info:ndljp/pid/10728868

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

J-GLOBAL

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その他リンク： http://dl.ndl.go.jp/info:ndljp/pid/10727936

記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

J-GLOBAL

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その他リンク： http://dl.ndl.go.jp/info:ndljp/pid/10728935

J-GLOBAL

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記述言語：英語   出版者・発行元：日本産科婦人科学会  

CiNii Books

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その他リンク： https://projects.repo.nii.ac.jp/?action=repository_uri&item_id=451402

記述言語：英語   出版者・発行元：日本癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本産科婦人科内視鏡学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

J-GLOBAL

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その他リンク： http://dl.ndl.go.jp/info:ndljp/pid/10726905

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

J-GLOBAL

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その他リンク： http://dl.ndl.go.jp/info:ndljp/pid/10726366

記述言語：英語   出版者・発行元：日本癌学会  

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記述言語：日本語   出版者・発行元：(公社)日本婦人科腫瘍学会  

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記述言語：日本語   出版者・発行元：北海道産科婦人科学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

CiNii Research

J-GLOBAL

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その他リンク： http://dl.ndl.go.jp/info:ndljp/pid/10724575

J-GLOBAL

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記述言語：英語   出版者・発行元：日本癌学会  

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J-GLOBAL

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記述言語：日本語   出版者・発行元：日本産科婦人科学会-東北連合地方部会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本産科婦人科学会-東北連合地方部会  

J-GLOBAL

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CiNii Research

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記述言語：日本語   出版者・発行元：(一社)日本女性医学学会  

J-GLOBAL

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J-GLOBAL

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記述言語：日本語   出版者・発行元：日本産科婦人科学会  

CiNii Books

J-GLOBAL

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その他リンク： http://dl.ndl.go.jp/info:ndljp/pid/10716863

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本癌学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本産科婦人科学会-東北連合地方部会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本産科婦人科学会-東北連合地方部会  

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記述言語：日本語   出版者・発行元：特定非営利活動法人日本臨床細胞学会  

CiNii Books

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本産科婦人科学会-東北連合地方部会  

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記述言語：日本語   出版者・発行元：日本産科婦人科学会-東北連合地方部会  

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.88.332_3

CiNii Research

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その他リンク： https://search.jamas.or.jp/link/ui/1997141215

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