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5. Rapamycin prevents cyclophosphamide-induced ovarian follicular loss and potentially inhibits tumour proliferation in a breast cancer xenograft mouse model

Author

Tanaka, Yuji, primary, Amano, Tsukuru, additional, Nakamura, Akiko, additional, Yoshino, Fumi, additional, Takebayashi, Akie, additional, Takahashi, Akimasa, additional, Yamanaka, Hiroyuki, additional, Inatomi, Ayako, additional, Hanada, Tetsuro, additional, Yoneoka, Yutaka, additional, Tsuji, Shunichiro, additional, and Murakami, Takashi, additional

Published
2024
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13. Successful ovarian tissue cryopreservation with transvaginal natural orifice transluminal endoscopic surgery: A case report.

Author

Hanada, Tetsuro, Takahashi, Akimasa, Tanaka, Yuji, Takebayashi, Akie, Matsuda, Yoshie, Kasahara, Makiko, Tsuji, Shunichiro, and Murakami, Takashi

Subjects
THERAPEUTIC use of antineoplastic agents, HEMATOPOIETIC stem cell transplantation, BIOPSY, OVUM, CRYOPRESERVATION of organs, tissues, etc., VAGINA, CANCER relapse, PRESERVATION of organs, tissues, etc., ENDOSCOPIC surgery, MINIMALLY invasive procedures, LYMPHOMAS, PREDNISOLONE, CANCER patients, ENDOSCOPIC ultrasonography, VINCRISTINE, ANAPLASTIC lymphoma kinase, DOXORUBICIN, FERTILITY preservation, STAINS & staining (Microscopy), OVARIES, OVARIECTOMY, ENDOSCOPY, CYCLOPHOSPHAMIDE
Abstract

Chemotherapy and radiation therapy can cause gonadal dysfunction in women of reproductive age. Ovarian tissue cryopreservation is performed to restore fertility by allowing transplantation of the patient's frozen-thawed ovarian tissue or through future in vitro maturation and in vitro fertilization of frozen-thawed oocytes. Herein, we describe our initial experience with vaginal natural orifice transluminal endoscopic surgery for ovarian tissue preservation in a young woman with malignant tumor. A 23-year-old woman with anaplastic lymphoma kinase-positive malignant lymphoma was scheduled for hematopoietic stem cell transplantation after experiencing relapse following R-cyclophosphamide, doxorubicin, vincristine, and prednisolone therapy. Ovarian tissue cryopreservation was selected as only MII2 oocytes were collected. Vaginal natural orifice transluminal endoscopic surgery was performed to excise the left ovary. Ovarian tissues were frozen using the vitrification method. The operative time was 37 min, and blood loss was minimal. Pathological examination revealed no metastatic findings of malignant lymphoma and no thermal damage to the ovarian tissue due to bipolar disorder. The patient was discharged on the first day postoperatively, and her postoperative course was uneventful. The vaginal natural orifice transluminal endoscopic surgery technique can provide a safe and effective alternative to laparoscopy or laparotomy for the cryopreservation of ovarian tissue in young patients with cancer. We believe this method has potential application in sexually mature female cancer survivors. Plain language summary: Ovarian tissue cryopreservation with vaginal natural orifice transluminal endoscopic surgery Chemotherapy and radiotherapy can affect a woman's ability to have children by reducing ovarian function. This can make it hard to conceive even with fertility treatments. Freezing healthy ovaries before these treatments can help restore fertility. This can be done by freezing and later transplanting ovarian tissue or by fertilizing frozen eggs in a lab. Traditional surgery to remove ovaries can cause cosmetic issues and pain. But now, a new method called vaginal spontaneous opening transperitoneal endoscopic surgery is becoming more common. This surgery is less invasive, quicker, and causes less bleeding. We recently used this method to preserve ovarian tissue in young women with cancer. The surgery was successful with minimal complications. This new approach could offer a safer option for preserving fertility in female cancer survivors. [ABSTRACT FROM AUTHOR]

Published
2024
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21. 腹腔鏡下に摘出し得た後腹膜ミュラー管嚢胞の1例

Author

NAKAMURA, Akiko, Takahashi, Akimasa, HORIUCHI, Tatsuro, MURAKAMI, Atsushi, KITAZAWA, Jun, NOBUTA, Yuri, KIMURA, Fuminori, and MURAKAMI, Takashi

Subjects
ミュラー管嚢胞, 後腹膜嚢胞, 腹腔鏡下手術
Abstract

ミュラー管嚢胞は泌尿生殖器系嚢胞の一種であり、後腹膜腔に発生することは非常に稀と言われている。今回、右後腹膜腔に発生した15cm大のミュラー管嚢胞を、腹腔鏡下に摘出し得た症例を経験したので報告する。 術前の画像診断では、腫瘍が後腹膜腔に位置していることが示唆された。嚢胞は単房性で壁が薄く、内部に充実成分を認めず、良性腫瘍の可能性が高いと判断し、腹腔鏡下手術を選択した。腫瘍は後腹膜脂肪織内に位置しており、周辺臓器との交通は認めなかった。腫瘍内容液の除去および核出操作にはダブルバルーンカテーテルの一種であるS.A.N.D.バルーンカテーテルを使用した。今回の方法を用いることで、腫瘍内容液の漏出を防ぎながら、嚢胞壁を残存させることなく摘出することが可能であった。術後の病理組織学的診断はミュラー管嚢胞であった。本症例の術後経過は良好で、現時点で再発徴候を認めていない。 後腹膜ミュラー管嚢胞では、嚢胞径が10cmを超える場合においても、内容液の除去方法や剥離操作を工夫することで腹腔鏡下手術が選択肢の一つになり得ることが示唆された。

Published
2020

22. CTが診断契機となったディスジャーミノーマIA期の再発症例

Author

MURAKAMI, Atsushi, Takahashi, Akimasa, KASAHARA, Kyoko, WAKINOUE, Shiro, AMANO, Tsukuru, YAMANAKA, Akiyoshi, HIGUCHI, Asuka, NISHIMURA, Hiroki, YOSHINO, Fumi, KIMURA, Fuminori, and MURAKAMI, Takashi

Subjects
ディスジャーミノーマ, 卵巣腫蕩, 傍大動脈リンパ節, 再発, CT
Abstract

ディスジャーミノーマの術後経過観察において、腫瘍マーカーや内診による身体診察が推奨される一方、CT検査での全身検索については一定の見解が得られていない。今回、ディスジャーミノーマIA期術後に、CTが診断契機となったディスジャーミノーマIA期の傍大動脈リンパ節への単独再発症例を経験したので報告する。 症例は17歳、未妊。下腹部痛を主訴に来院した。MRIで臍高に達する右卵巣の充実性腫瘍を認めた。血液検査にてLDH、ALP、CA125、β-human chorionic gonadotropin(β-hCG)は高値を示したが、α-fetoprotein(AFP)は正常値であった。ディスジャーミノーマを疑い、右付属器切除および大網切除を施行した。術前のCTおよび腹腔内検索でリンパ節腫大や播種性病変を認めなかったため、リンパ節生検は省略した。術後病理でディスジャーミノーマIA期と診断され、術後化学療法は行わず、1ヵ月間隔で経過観察した。術後いずれの腫瘍マーカーも陰性化し、身体診察でも異常を認めず経過したが、術後6ヵ月で虫垂炎を発症。その際に撮影されたCTで、偶発的に傍大動脈リンパ節腫大を認めた。腹腔鏡下傍大動脈リンパ節摘出および虫垂切除術を施行し、ディスジャーミノーマの傍大動脈リンパ節への遠隔再発と診断された。術後BEP療法を3コース行い、現在再発なく経過している。 リンパ節郭清および術後補助化学療法が省略されたディスジャーミノーマIA期は再発のリスクが高いことを認識し、CT検査を含む厳重な経過観察が必要であることが示唆された。(著者抄録)

Published
2020

28. Bevacizumab-associated events in Japanese women with cervical cancer: a multi-institutional survey of Obstetrical Gynecological Society of Kinki district, Japan

Author

Mabuchi, Seiji, primary, Yamamoto, Misa, additional, Murata, Hiroko, additional, Yokoe, Takuya, additional, Hamanishi, Junzo, additional, Terai, Yoshito, additional, Imatake, Hikaru, additional, Mabuchi, Yasushi, additional, Mori, Taisuke, additional, Kitada, Fuminori, additional, Hashiguchi, Yasuhiro, additional, Takahashi, Akimasa, additional, Fujiwara, Satoe, additional, Naoi, Hirokazu, additional, and Matsubara, Sho, additional

Published
2020
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33. Endometrial Immunity for Embryo Implantation and Pregnancy Establishment

Author

Kitazawa, Jun, primary, Kimura, Fuminori, additional, Nakamura, Akiko, additional, Morimune, Aina, additional, Takahashi, Akimasa, additional, Takashima, Akiko, additional, Amano, Tsukuru, additional, Tsuji, Shunichiro, additional, Kaku, Shoji, additional, Kasahara, Kyoko, additional, and Murakami, Takashi, additional

Published
2020
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36. Review: Chronic endometritis and its effect on reproduction

Author

Kimura, Fuminori, primary, Takebayashi, Akie, additional, Ishida, Mitsuaki, additional, Nakamura, Akiko, additional, Kitazawa, Jun, additional, Morimune, Aina, additional, Hirata, Kimiko, additional, Takahashi, Akimasa, additional, Tsuji, Shoko, additional, Takashima, Akiko, additional, Amano, Tsukuru, additional, Tsuji, Shunichiro, additional, Ono, Tetsuo, additional, Kaku, Shoji, additional, Kasahara, Kyoko, additional, Moritani, Suzuko, additional, Kushima, Ryoji, additional, and Murakami, Takashi, additional

Published
2019
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37. The expression of hepatoma upregulated protein in human endometrium during the menstrual cycle.

Author

Takahashi, Akimasa, Yamanaka, Akiyoshi, Takebayashi, Akie, Kimura, Fuminori, and Murakami, Takashi

Subjects
*MENSTRUAL cycle, *ENDOMETRIUM, *HEPATOCELLULAR carcinoma, *EMBRYO implantation, *IMMOBILIZED proteins
Abstract

Human endometrium resists embryo implantation except during the window period. Currently, uterine HURP expression is known to be involved in endometrial stromal proliferation during embryo implantation of mice. Thus, we demonstrated hepatoma up-regulated protein (HURP) expression in the human endometrium during the menstrual cycle, as well as HURP regulation in endometrial stromal cells (ESCs). We collected human endometrial samples from different menstrual cycle phases (early/late proliferative, and early/mid/late secretory), and then analyzed these samples by immunohistochemistry, reverse transcription-polymerase chain reaction, and Western blotting. We also assessed the effects of two sex-steroid hormones, 17β-estradiol (E2) and 4-pregnene-3,20-dione (P4) on the cultured stromal cells. HURP protein was localized to the nucleus of the endometrial both epithelial and stromal cells in all stages. Also, HURP mRNA and protein in human endometrial tissue was significantly up-regulated during late-proliferative and secretory phase, compared with early-proliferative phase. In ESCs, HURP expression was regulated by E2, but not P4. We indicated that cyclic changes in HURP expression in human normal ESC strongly suggested up-regulation by estrogen. Taken together, since estrogen responses are fundamental in endometrial biology, uterine expression of HURP may be involved in female reproductive function during the menstrual cycle. [ABSTRACT FROM AUTHOR]

Published
2021
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41. Isolated Para-Aortic Nodal Recurrence in Endometrial Cancer

Author

Matsuura, Motoki, primary, Takahashi, Akimasa, additional, Nomura, Hidetaka, additional, Matoda, Maki, additional, Okamoto, Sanshiro, additional, Kanao, Hiroyuki, additional, Omatsu, Kohei, additional, Kato, Kazuyoshi, additional, Utsugi, Kuniko, additional, and Takeshima, Nobuhiro, additional

Published
2018
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44. Effects of high-dose dexamethasone in postpartum women with class 1 haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome.

Author

Takahashi, Akimasa, Kita, Nobuyuki, Tanaka, Yuji, Tsuji, Shunichiro, One, Tetsuo, Ishiko, Akiko, Kimura, Fuminori, Takahashi, Kentaro, and Murakami, Takashi

Subjects
*HELLP syndrome, *LIVER enzymes, *PUERPERAL disorders, *ASPARTATE aminotransferase, *DEXAMETHASONE, *MEDICAL sciences, *ADRENOCORTICAL hormones, *ALANINE aminotransferase
Abstract

This study was performed to investigate the effectiveness of dexamethasone in the management of postpartum women with class 1 haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome. This retrospective study was conducted on 18 women with class 1 HELLP syndrome at the Shiga University of Medical Science. They were divided into two groups: Group A comprised participants who did not receive dexamethasone, and Group B comprised participants that intravenously received dexamethasone. The main outcomes were the serum laboratory values, mortality and morbidity. The only significant difference between the two groups in baseline characteristics was the aspartate aminotransferase levels. The linear regression analysis showed a significant difference between the two groups in the recovery of platelet counts (p = .046) and aspartate aminotransferase (p = .009). These findings support the use of high-dose dexamethasone to promote recovery of the platelet counts and aspartate aminotransferase levels in postpartum women with class 1 HELLP syndrome. Impact statement What is already known on this subject? Haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is one of the most dangerous complications that can occur during pregnancy and is considered a particularly serious variant of severe preeclampsia. Several clinical trials have been performed since 1994 because it was expected that corticosteroid therapy, primarily with dexamethasone, accelerates recovery after delivery. However, the effect of dexamethasone therapy on class 1 HELLP syndrome is unclear. What do the results of this study add? In this retrospective study, we demonstrated that dexamethasone administration significantly improved the recovery of the platelet count in postpartum women with class 1 HELLP syndrome, and did not increase the rate of maternal postpartum complications. What are the implications of these findings for clinical practice and/or further research? The use of high-dose dexamethasone in postpartum women with class 1 HELLP syndrome might be effective to promote recovery of the platelet count, and contributes a shorter duration of hospitalisation. Because the number of patients with class 1 HELLP syndrome is small, it is important to confirm these findings with well-designed multicentre prospective studies. [ABSTRACT FROM AUTHOR]

Published
2019
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50. Anaplastic lymphoma kinase-negative uterine inflammatory myofibroblastic tumor containing the ETV6-NTRK3fusion gene: a case report

Author

Takahashi, Akimasa, Kurosawa, Manabu, Uemura, Mao, Kitazawa, Jun, and Hayashi, Yoshihiko

Abstract

Inflammatory myofibroblastic tumors (IMTs) are neoplasms with low malignant potential, and the most common tumor in the lung and orbit. Their occurrence in the uterus is rare. Approximately 50% of IMT patients have anaplastic lymphoma kinase gene (ALK) rearrangements. Recent studies described novel fusions involving ROS1, platelet-derived growth factor receptor beta (PDGFR-β), and ETS translocation variant (ETV6) genes in a subset of ALK-negative patients. We report a 44-year-old woman with anemia and uterine IMT. Ultrasonography and magnetic resonance imaging revealed a myxoid degenerative myoma-like mass, 7.4 cm in maximum diameter, on the left uterine side wall. Hysterectomy was performed as a definitive treatment. Microscopic examination revealed spindle cell proliferation with numerous lymphocytes and plasma cells. Immunohistochemically, the spindle cells were negative for ALK-1, desmin, and smooth muscle actin. The pathological diagnosis was IMT arising from the uterus. Fluorescence in situhybridization demonstrated an ETV6–neurotrophic tyrosine kinase, receptor, type 3 gene (NTRK3) translocation but no ALK, ROS1, or PDGFR-βtranslocations. Lung and abdomen computed tomography at 31 months postoperatively revealed no disease recurrence. This association of an ETV6–NTRK3fusion oncogene with an ALK-negative uterine IMT increases our understanding of this neoplasm, which may help the development of specific therapies.

Published
2018
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