Influence of parity on second-trimester uterine artery Doppler waveforms in twin pregnancy.

We performed uterine artery Doppler velocimetry in 16 nulliparous and 16 parous women with non-preeclamptic singleton gestations and 16 nulliparous and 16 parous women with dichorionic twin gestations at 17-18 and 26-27 weeks of gestation. In both singleton and twin pregnancies, the average pulsatility index (PI) in nulliparous women was significantly higher than that in parous women at 17-18 weeks of gestation. At 26-27 weeks of gestation, however, there were no significant differences in PI between nulliparous and parous women with either singleton or twin pregnancies. During the early second-trimester of non-preeclamptic singleton and twin pregnancies, parity has a significant effect on uterine artery blood flow.     

Gastric adenosquamous carcinoma producing granulocyte-colony stimulating factor

We report a case of adenosquamous carcinoma of the stomach that produced granulocyte-colony stimulating factor (G-CSF). The patient, who had an admission diagnosis of advanced gastric cancer, had marked leukocytosis without evidence of infection. After leukemia and metastatic leukemoid reaction were excluded by bone marrow examination, a G-CSF-producing cancer was suspected as the cause of the abnormally elevated serum G-CSF level. The resected stomach tumor was histologically diagnosed as adenosquamous carcinoma; positive expression of G-CSF by tumor cells was shown with immunohistochemical detection, which confirmed the preoperative diagnosis. Recurrent disease in the liver and lymph nodes, accompanied by leukocytosis and re-elevation of serum G-CSF, developed just 3 months after the curative gastrectomy and adjuvant chemotherapy. All of the recurrent disease was resected, restoring normal levels of serum G-CSF. The patient survived for almost 2 years after the initial surgery with extensive chemotherapy, including weekly treatment with paclitaxel, before finally succumbing to liver failure secondary to extensive liver metastasis.     

A case of primary gastric small cell carcinoma with a rare pattern of lymph node metastasis

We report a very rare case of primary gastric small cell carcinoma (GSCC) that was accompanied with gastric tubular adenocarcinoma. A male in his 60s had an elevated tumor with a central ulceration in the middle stomach. The patient underwent a distal gastrectomy with lymph node dissection. The pathological examination showed two separated lesions of the stomach, which contained the components of primary GSCC and primary gastric tubular adenocarcinoma. Immunohistochemical (IHC) examination demonstrated that the tumor cells in the small cell carcinoma stained positive for synaptophysin, chromogranin A, and neural cell adhesion molecule (NCAM). GSCC cells and adenocarcinoma cells independently metastasized to each regional lymph node. Further studies on the biological behavior of individual tumors may allow the development of new treatment strategies for GSCC.     

Spirotoamides A and B, novel 6,6-spiroacetal polyketides isolated from a microbial metabolite fraction library

Two new 6,6-spiroacetal polyketides, spirotoamides A (1) and B (2), were isolated from a microbial metabolite fraction library of Streptomyces griseochromogenes JC82-1223 by screening of structurally unique compounds based on a search of spectral database. The fraction library was constructed using a systematic separation method to efficiently discover new metabolites from microbial sources such as actinomycetes and fungi. The structures of 1 and 2 were elucidated by 2D-NMR and mass spectrometric measurements. They belong to a class of polyketides, and contain a 6,6-spiroacetal core structure and a carboxamide group. The biosynthetic pathway of 1 and 2 is discussed in the text.     

Influence of intimate partner violence on mental status in Japanese women during the first trimester of pregnancy

Objective: We examined the relation between intimate partner violence (IVP) and maternal mental status such as depression and anxiety.

Methods: Between April 2016 and October 2016, we asked all Japanese women during the first trimester of pregnancy to answer the three self-administered questionnaires to screen IVP and depressive and anxiety symptoms.

Results: There were 19 women who had a high score in the modified Violence Against Women Screen (VAWS) (4.1%, IPV group) and 408 women who had a score 0 (86.8%, control group). Overall, the rate of the women with depressive, anxiety, and depressive plus anxiety symptoms were 21.3, 31.5, and 16.0%, respectively. The rate of depressive and/or anxiety symptoms in the IPV group were significantly higher than those in the control group (Odds ratio?=?5.02 and 7.40, p?X² test).

Conclusions: The significant adverse effect of IPV on maternal mental status seemed to be observed in Japanese women during the first trimester of pregnancy.     

Successful treatment with 308‐nm monochromatic excimer light and subsequent tacrolimus 0.03% ointment in refractory plasma cell cheilitis

Plasma cell cheilitis is a chronic inflammatory disease that presents with erythema, erosions, ulcers and occasional nodules within the mucosa, including the lips. It is histopathologically characterized by dense plasma cell infiltration in the lamina propria of the mucous membranes. Several treatments for plasma cell cheilitis have been reported, including topical steroids, topical antibiotics or topical tacrolimus. However, 308‐nm monochromatic excimer light (MEL) has never been reported as a treatment option, while it was reported to be very effective in treating erosive oral lichen planus. We report a 62‐year‐old man who had chronic plasma cell cheilitis on the lower lip, which was refractory to topical and systemic corticosteroid. The lesion and severe pain were significantly improved by the treatment with nine sessions of 308‐nm MEL twice per week with a total dose of 1120 mJ/cm². However, the lesion gradually worsened after treatment frequency was reduced to once per month. Subsequent tacrolimus 0.03% ointment cleared the lesion completely in a month and no recurrence was observed a year later. Refractory plasma cell cheilitis and concomitant severe pain quickly responded to 308‐nm MEL when administrated twice per week. Because the long interval between each MEL treatment seemed ineffective to improve the lesion, appropriate frequency and adequate total dose of MEL treatment may be necessary for a successful treatment.