Ectopic Hormone Production from Ovarian Tumor: A Review

Although ectopic hormone-production is uncommon complication, certain tumors can produce symptoms due to the secretion of various bioactive substances accompanied by the aberrantly located tumors. Because of the potential for the ovary to act as a source of aberrant hormone secretion, in the literature, ectopic hormone production from ovarian tumor includes granulocyte-colony stimulating factor (G-CSF), parathyroid hormone-related protein (PTHrP), adrenocorticotropic hormone (ACTH), peptide-YY, gastrin and insulin. All patients may present with syndromes of hormone excess. Failure to localize the ovarian tumor preoperatively may be associated with a significantly higher risk of subsequent unnecessary ablative procedures. Better characterization of hormonal forms relatively specific for neoplasia may enhance the clinical value of ectopic hormones as tumor markers, especially in malignancies that are commonly associated with ectopic hormone production. These circumstances may recommend complete preoperative evaluation of the pelvis in female patients presenting with nonlocalizable endocrine tumors.

A Typical Case of Posterior Reversible Encephalopathy Syndrome Associated with Postpartum Eclampsia-HELLP Syndrome

Background: Posterior reversible encephalopathy syndrome (PRES) is a reversible syndrome characterized by seizures, headache, altered mentation, and loss of vision associated with white matter changes on imaging. Case: A 37-year-old multigravida woman had a severe, immediate postpartum eclampsia-HELLP syndrome (hemolysis, elevated liver enzyme levels, low platelet count) with PRES characterized by generalized seizures and altered mental status. Magnetic resonance brain imaging showed high-intensity lesions in non-posterior portions including the frontal lobe and cingulated gyrus, which resolved completely after 2 weeks along with complete symptom regression. Conclusions: Cases of postpartum PRES without involvement of posterior brain regions after eclampsia-HELLP syndrome are very rare. Patients with PRES do not always show typical manifestations. The importance of a prompt diagnosis is emphasized, as is the crucial role of rapid blood pressure reduction.

Correspondence: Newer oral rehydration solution OS-1 for emesis gravidarum

Though nausea and vomiting are quite common in pregnancy, hyperemesis is found in only 1 - 2 patients per 100. Appropriate oral fluid and electrolyte replacement is the initial treatment regimen for patients with mild to moderate emesis to avoid hyperemesis gravidarum defined as dehydration, electrolyte unbalance and ketosis. A newer oral rehydration solution OS-1 therapy may be safe and feasible in the mild to moderate emesis gravidarum population. Physicians are encouraged to use this practice to maintain the amount of water in the body and electrolytes and to improve the patient’s comfort.

Lower Incidence of Positive Gynecological Cancers in Examinees of a Unique Health Check-Up Institute, Ningen Dock in Japan, 2011-2016

The present study aims to determine the gynecologic health status of asymptomatic women at a unique Japanese Health Check-up Institute, Ningen Dock. Medical records of Japanese women, who underwent gynecological medical (health) examinations between January 2011 and December 2016, were retrospectively reviewed. Of the cervical smears from 8927 women aged 18 - 85 years, 50 (0.6%) were classified as dysplastic and malignant changes: 18 of low-grade squamous intraepithelial lesion, 10 high-grade squamous intraepithelial lesion, 21 atypical squamous cells of undetermined significance and 1 cervical squamous cell carcinoma. No case of cervical adenocarcinoma was found. Ultrasonographic examination detected uterus enlargements and ovary tumors in 2.0% and 0.9% of cases, respectively. Most of participants (95.6%) revealed no gynecologic abnormalities. The present study based on the records of Ningen Dock, where asymptomatic participants undergo a medical examination at their own expense, showed very low incidence of abnormal cytologic and/or ultrasonographic findings.

Effects of cola intake on fertility: a review

The consumption of soft drinks has increased considerably during the last decades. Among them, the cola-based preparations are possibly the refreshments with the largest sales worldwide. During the previous years, important concerns have been raised about the effects of colas on human health. In this review, we introduce the cola effects on reproduction including pregnancy miscarriages, ovulatory and menstrual disorders, and reduced semen quality. Although caffeine intoxication may be thought to play the most important role, a component of cola other than caffeine, or in combination with caffeine, may be associated with increased risk of reproductive hazards in heavy cola (> 1 L per day)-consumers. Cola discontinuation usually leads to an uneventful recovery in the most cases suggesting justification of limitations in the maximum recommended daily dose of these soft drinks. Cola is not an essential beverage, and abstaining from drinking more than 1 L per day is a minor intrusion in one’s personal life. Despite these uncertainties, this growing know- ledge may alarm the fertility risk of chronic cola intake in peoples of childbearing age.

Granulocyte-colony stimulating factor-producing squamous cell carcinoma arising in ovarian mature cystic teratoma: A case report

Granulocyte-colony stimulating factor (G-CSF)-producing cancer has been reported to occur in various organs. It has an aggressive nature and shows resistance to conventional treatments, however, its clinical features are not well known because of the small number or reported cases. We report G-CSF-producing squamous cell carcinoma arising in malignant-transformed ovarian mature cystic teratoma. An 80-year-old woman underwent suboptimal surgical excision of stage IIIC ovarian cancer. Prior to the treatment, the patient presented severe granulocytosis and elevated serum G-CSF concentration. With the help of histopathological and immunohistochemical studies, we diagnosed this case to be a poorly differentiated squamous cell carcinoma developed in ovarian mature cystic teratoma, which highly expressed G-CSF. During radiation therapy, the patient died from rapid growth of residual tumor and peritoneal dissemination 2 months after surgery. This is the first case of G-CSF-producing squamous cell carcinoma arising in malignant-transformed ovarian mature cystic teratoma, and its prognosis was very poor.

Evaluation of a public expense-covered gynecologic screening program in Japan 2005-2009

Introduction: In Japan, there is free physical check-up programs of cancer screening, by which asymptomatic participants undergo a medical examination at public expense. The present study aims to describe their gynecologic findings and compare them with the literatures reported from general hospitals and self-paid check-up programs. Methods: Medical records of Japanese women, who underwent gynecological examinations at public expense between 2005 and 2009, were retrospectively reviewed. Results: Of the cervical smears from 2850 women aged 21 - 82 years, 33 (1.1%) were classified as dysplastic and malignant changes: 28 of low-grade squamous intraepithelial lesion (LSIL), 3 high-grade squamous intraepithelial lesion (HSIL), 2 atypical squamous cells of undeterimined significance (ASC-US). No case of cervical squamous cell carcinoma or adenocarcinoma was found. Ultrasonographic examination detected uterus enlargements and ovary tumors in less than 1% of cases. Most of participants (98%) revealed no gynecologic abnormalities. Conclusion: Annual gynecologic screening and proper follow-up programs even against asymptomatic women may remarkably reduce the probability of (pre)malignant disease.

Occurrence of myelodysplastic syndrome during paclitaxel- and carboplatin-based chemotherapy for recurrent ovarian cancer: Case report

Platinum and taxane have significant activity as key drugs in current treatment of advanced ovarian cancer. While myelodysplastic syndrome (MDS) and acute leukemia are wellknown secondary disease after administration of chemotherapy, particularly with alkylating agents, they have only rarely been reported in the context of ovarian cancer treatment. In this case report a 59-year-old Japanese developed a MSD during ongoing second induction chemotherapy with carboplatin and paclitaxel for recurrent ovarian cancer. Her second induction began 9 months after completion of her first course of chemotherapy. Cytogenetic analyses showed typical chromosomal aberration. Although the finding of pancytopenia is also seen during chemotherapy without MSD/acute leukemia, bone marrow aspiration and biopsy should be considered to confirm the clinical suspicion of the lifethreatening disease when encountered persistent pancytopenia following carboplatin and paclitaxel-based chemotherapy in an ovarian cancer patient.

Photoperiodic flowering in Arabidopsis:Multilayered regulatory mechanisms of CONSTANS and the florigen FLOWERING LOCUS T

The timing of flowering affects the success of sexual reproduction.This developmental event also determines crop yield,biomass,and longevity.Therefore,this mechanism has been targeted for improvement along with crop domestication.The underlying mechanisms of flowering are highly conserved in angiosperms.Central to these mechanisms is how environmental and endogenous conditions control transcriptional regulation of the FLOWERING LOCUS T(FT)gene,which initiates floral development under long-day conditions in Arabidopsis.Since the identification of FT as florigen,efforts have been made to understand the regulatory mechanisms of FT expression.Although many transcriptional regulators have been shown to directly influence FT,the question of how they coordinately control the spatiotemporal expression patterns of FT still requires further investigation.Among FT regulators,CONSTANS(CO)is the primary one whose protein stability is tightly controlled by phosphorylation and ubiquitination/proteasome-mediated mechanisms.In addition,various CO interaction partners,some of them previously identified as FT transcriptional regulators,positively or negatively modulate CO protein activity.The FT promoter possesses several transcriptional regulatory"blocks,"highly conserved regions among Brassicaceae plants.Different transcription factors bind to specific blocks and affect FT expression,often causing topological changes in FT chromatin structure,such as the formation of DNA loops.We discuss the current understanding of the regulation of FT expression mainly in Arabidopsis and propose future directions related to this topic.

Typhoon parameter sensitivity of storm surge in the semi-enclosed Tokyo Bay

In this study,a storm surge model of the semi-enclosed Tokyo Bay was constructed to investigate its hydrodynamic response to major typhoon parameters,such as the point of landfall,approach angle,forward speed,size,and intensity.The typhoon simulation was validated for Typhoon Lan in 2017,and 31 hypothetical storm surge scenarios were generated to establish the sensitivity of peak surge height to the variation in typhoon parameters.The maximum storm surge height in the upper bay adjacent to the Tokyo Metropolitan Area was found to be highly sensitive to the forward speed and size of the passing typhoon.However,the importance of these parameters in disaster risk reduction has been largely overlooked by researchers and disaster managers.It was also determined that of the many hypothetical typhoon tracks evaluated,the slow passage of a large and intense typhoon transiting parallel to the longitudinal axis of Tokyo Bay,making landfall 25 km southwest,is most likely to cause a hazardous storm surge scenario in the upper-bay area.The results of this study are expected to be useful to disaster managers for advanced preparation against destructive storm surges.

Short-fetch high waves during the passage of 2019 Typhoon Faxai over Tokyo Bay

The risk of wind waves in a bay is often overlooked,owing to the belief that peninsulas and islands will inhibit high waves.However,during the passage of a tropical cyclone,a semi-enclosed bay is exposed to twodirectional waves:one generated inside the bay and the other propagated from the outer sea.Typhoon Faxai in 2019 resulted in the worst coastal disaster in Tokyo Bay in the last few decades.The authors conducted a post-disaster survey immediately after this typhoon.Numerical modeling was also performed to reveal the mechanisms of unusual high waves.No significant high-wave damage occurred on coasts facing the Pacific Ocean.By contrast,Fukuura-Yokohama,which faces Tokyo Bay,suffered overtopping waves that collapsed seawalls.To precisely reproduce multi-directional waves,the authors developed an extended parametric typhoon model,which was embedded in the JMA mesoscale meteorological model(JMA-MSM).The peak wave height was estimated to be 3.4 m off the coast of Fukuura,in which the contribution of the outer-sea waves was as low as 10%–20%.A fetchlimited wave developed over a short distance in the bay is considered the primary mechanism of the high wave.The maximum wave occurred on the left-hand side of the typhoon track in the bay,which appears to be contrary to the common understanding that it is safer within the semicircle of a storm than on the opposite side.Typhoon Faxai was a small typhoon;however,if the radius was tripled,it is estimated that the wave height would exceed 3 m over the entire bay and surpass 4 m off the coasts of Yokohama and Chiba.