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Neoadjuvant chemotherapy for locally advanced cervical cancer

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Chinese Journal of Cancer Research 2016年第2期28卷 235-240页

作者： Takashi Iwata Azumi Miyauchi Yukako Suga Hiroshi Nishio Masaru Nakamura Akiko Ohno Nobumaru Hirao Tohru Morisada Kyoko Tanaka Hiroki Ueyama Hidemichi Watari daisuke aoki Department of Obstetrics and Gynecology Keio University School of Medicine Department of Obstetrics and Gynecology Hokkaido University Graduate School of Medicine

Neoadjuvant chemotherapy followed by surgery （NCS） has not been fully evaluated clinically. Currently, the main regimen of neoadjuvant chemotherapy （NAC） used in NCS includes cisplatin. The antitumor effects of NAC reduce lymph node metastasis and the tumor diameter in patients prior to surgery, and this can reduce the number of high risk patients who require postoperative radiation therapy. Many randomized controlled trials （RCTs） have examined the long-term prognosis of NCS compared to primary surgery, but the utility of NCS remains uncertain. The advent of concurrent chemoradiotherapy （CCRT） has markedly improved the outcome of radiotherapy （RT）, and CCRT is now used as a standard method in many cases of advanced bulky cervical cancer. NCS gives a better treatment outcome than radiation therapy alone, but it is important to verify that NCS gives a similar or better outcome compared to CCRT.

关键词： Neoadjuvant chemotherapy (NAC) cervical cancer

Gynecological tumors in patients with Peutz-Jeghers syndrome (PJS)

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Open Journal of Genetics 2011年第3期1卷 65-69页

作者： Arisa Ueki Iori Kisu Kouji Banno Megumi Yanokura Kennta Masuda Yusuke Kobayashi Akira Hirasawa daisuke aoki 不详

Peutz-Jeghers syndrome (PJS) is an autosomal dominant disorder characterized by the development of hamartomatous polyposis in the gastrointestinal tract and melanin-pigmented macules on the skin mucosa. The responsible gene is a tumor suppressor, STK11/LKB1, on chromosome 19p13.3. PJS complicates with benign and malignant tumors in various organs. In gynecology, there has been a particular focus on complications of PJS with sex cord tumor with annular tubules (SCTAT) and minimal deviation adenocarcinoma (MDA), which are rare diseases. Approximately 36% of patients with SCTAT are complicated with PJS and these patients are characterized by multifocal, bilateral, small and benign lesions that develop into tumors with mucinous to serous ratios of 8:1. In addition, 10% of cases of MDA are complicated with PJS and mutation of STK11, the gene responsible for PJS, has a major effect on onset and prognosis. The disease concept of lobular endocervical glandular hyper-plasia (LEGH) has recently been proposed and LEGH is thought to be a potential premalignant lesion of MDA, however, the relationship between PJS and LEGH remains unclear. Several case reports of PJS patients complicated with gynecological tumors have been published and further studies are needed to determine the underlying

关键词： Gynecologic Tumor Minimal Deviation Adenocarcinoma Peutz-Jeghers Syndrome Sex Cord Tumor STK11/LKB1

Oncofertility in Gynecologic Malignant Tumors

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Journal of Cancer Therapy 2015年第14期6卷 1176-1191页

作者： Masataka Adachi Kouji Banno Iori Kisu Megumi Yanokura Moito Iijima Takashi Takeda Kiyoko Umene Yuya Nogami Eiichiro Tominaga daisuke aoki Department of Obstetrics and Gynecology Keio University School of Medicine Tokyo Japan

Long-term survival is the priority in treatment of patients with malignant tumors. In the field of gynecology, fertility preservation has also recently become an important objective due to improved treatment outcomes and different needs of patients. Methods for fertility preservation include cervical conization, ovarian protection against radiation or chemotherapy for ovarian cancer since the ovary is hypersensitive to cancer therapies, treatment of gynecological cancer during pregnancy, and cryopreservation of oocytes, embryos or ovarian tissue before treatment of malignant tumors. Radical trachelectomy for early cervical cancer and treatment with medroxy progesterone acetate for early endometrial carcinoma are also options for fertility preservation, but the efficacy and risk of recurrence have yet to be fully evaluated. The first childbirth following uterine transplantation was also achieved last year and this success has expanded the potential for pregnancy and delivery among cancer survivors.

关键词： Gynecological Cancer Fertility Preservation Cryopreservation Uterine Transplantation Pregnancy

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房中的闸门

中国建筑装饰装修 2012年第12期 54-59页

作者：中佐昭夫 daisuke aoki Toshiyuki Yano

该项目是原有建筑的室内改造项目．即在房子的中间建造一个木头“箱体”。

关键词：建筑装饰建筑装修室内改造项目房子

Total Laparoscopic Hysterectomy for Diagnosis and Treatment of Cervical Cystic Lesions: A Case Series

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Open Journal of Obstetrics and Gynecology 2020年第3期10卷 357-364页

作者： Tohru Morisada Kohsei Tanaka Tomoko Iijima Azumi Nishizawa Hiroshi Nishio Yusuke Kobayashi Masaru Nakamura Shigenori Hayashi Fumio Kataoka Takashi Iwata daisuke aoki Department of Obstetrics and Gynecology Keio University School of Medicine Tokyo Japan

Objective: Cervical cystic lesions are often observed in gynecological clinical practice. Many are caused by benign diseases such as lobular endocervical glandular hyperplasia (LEGH), and it is important to differentiate these lesions from those due to malignant diseases such as minimal deviation adenocarcinoma (MDA). In cases in which fertility preservation is not a concern, the final pathology is often confirmed by hysterectomy. To investigate the feasibility and safety of laparoscopic surgery for cervical cystic lesions, we retrospectively examined cases in which total laparoscopic hysterectomy (TLH) was performed for diagnosis and treatment. Methods: The subjects were 28 women who underwent TLH from April 2012 to March 2017 at Keio University Hospital. The pre- and post-operative courses of these patients were examined. Results: The average age was 49.4 (range 39 - 65) years and the mean body mass index was 21.7 (16.8 - 30.5) kg/m2. The average operation time was 159 (101 - 314) min and the average bleeding volume was 106.8 (0 - 600) g. There were no severe perioperative complications. The average hospital stay was 8.4 (7 - 14) days. In postoperative pathological diagnosis, 13 cases had benign diseases such as Nabot cysts, there were 14 cases of LEGH, and one patient was diagnosed with MDA. In the MDA case, additional bilateral salpingo-oophorectomy and pelvic lymph node dissection were performed at a later date. No metastasis was observed in these excised specimens. Conclusions: Our results suggest that TLH for cervical cystic lesions can be performed safely. However, it is important to consider the TLH indication before surgery based on the possibility of malignant disease.

关键词： Lobular Endocervical Glandular Hyperplasia Minimum Deviation Adenocarcinoma Total Laparoscopic Hysterectomy Uterine Cervix

Metformin: A possible drug for treatment of endometrial cancer

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Open Journal of Obstetrics and Gynecology 2012年第1期2卷 1-6页

作者： Kosuke Tsuji Iori Kisu Kouji Banno Megumi Yanokura Arisa Ueki Kenta Masuda Yusuke Kobayashi Wataru Yamagami Hiroyuki Nomura Nobuyuki Susumu daisuke aoki Department of Obstetrics and Gynecology School of Medicine Keio University Tokyo Japan

Metformin is a widely used first-line drug for treatment of type 2 diabetes mellitus. In recent years, it has been reported that administration of metformin can reduce carcinogenic risk and inhibit proliferation of cancer cells including those from glioma and breast cancer. The underlying mechanism is thought to involve increased LKB-1 phosphorylation induced by metformin, followed by LKB-1 phosphorylation and activation of AMP-activated protein kinase (AMPK), which then inhibits the mammalian target of rapamycin (mTOR) pathway and results in inhibition of cell proliferation. In endometrial cancer, metformin causes cell cycle arrest in vitro, reduces hTERT mRNA, inhibits the mTOR pathway via AMPK, and is involved in inhibition of phosphorylation of S6 ribosomal protein (S6RP). Metformin promotes expression of progesterone receptor by an action opposite to that of insulin-like growth factor-2 (IGF-2) when used in combination with medroxyprogesterone acetate. This enhances the antitumor effect and this approach may be applicable in a clinical setting.

关键词： Metformin Endometrial Cancer Type 2 Diabetes Mellitus Mammalian Target of Rapamycin (mTOR) Progesterone Receptor (PR)

Epigenetic Aberrant Hypermethylation of DNA in Endometrial Cancer: Application as a Biomarker

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Journal of Cancer Therapy 2011年第5期2卷 610-615页

作者： Asuka Ono Iori Kisu Kouji Banno Megumi Yanokura Kenta Masuda Yusuke Kobayashi Kosuke Tsuji Arisa Ueki Wataru Yamagami Hiroyuki Nomura Nobuyuki Susumu daisuke aoki 不详

Endometrial cancer is the seventh most common cancer worldwide among females and accounts for about 40% of cancers of the uterus in Japan. An increase in incidence and a reduction in onset age of this disease are also likely, which makes it important to define the pathogenesis and develop effective treatment. However, the mechanism of canceration in the endometrium is unclear and development of endometrial cancer cannot be explained only by mutations of cancer-related genes. In contrast, epigenetic analyses have shown the importance of aberrant DNA hypermethylation in the canceration mechanism. In development of type 1 endometrial cancer, breakdown of the DNA mismatch repair system plays a large role, with changes in the human mutL homologue 1 (hMLH1) gene being of most importance. Studies to detect aberrant DNA hypermethylation of cancer cells present in microscopic amounts in vivo and to apply these data to diagnosis of cancer have been started. Epigenetic changes have also been examined as a marker of sensitivity to anticancer drugs. Aberrant hypermethylation of checkpoint with forkhead-associated and ring finger (CHFR), a mitotic phase checkpoint gene, is correlated with sensitivity to treatment with microtubule inhibitors and may be a marker for the response of endometrial cancer to anticancer drugs. Epigenetic aberrant DNA methylation of other genes may also be useful as clinical biomarkers for diagnosis and treatment of endometrial cancer.

关键词： Epigenetics Endometrial Cancer Aberrant DNA Hypermethylation hMLH1 CHFR Biomarker

Atypical Polypoid Adenomyoma (APAM) of the Uterine: Relationship with Endometrial Cancer

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Journal of Cancer Therapy 2011年第4期2卷 458-462页

作者： Iori Kisu Kouji Banno Megumi Yanokura Yusuke Kobayashi Arisa Ueki Asuka Ono Kennta Masuda Wataru Yamagami Hiroyuki Nomura Akira Hirasawa Nobuyuki Susumu daisuke aoki 不详

Atypical polypoid adenomyoma (APAM) is a rare polypoid tumor that generally occurs in women of reproductive age who have abnormal genital bleeding. The tumor was reported as a new disease concept by Mazur in 1981. Pathologically, APAM consist of irregularly proliferated endometrial gland cells and interlacing bundles of smooth muscle cells within the stroma, and have a similar form to adenocarcinoma, adenofibroma, adenosarcoma, and carcinosarcoma. Therefore, differential diagnosis is required in many cases. APAM is pathologically classified as a benign lesion and clinically has a comparatively favorable outcome. However, treatment and follow-up observation should be performed carefully because recurrence and residual lesions occur in many patients after conservative treatment. Concomitant development of endometrial adenocarcinoma also occurs in many cases and it is difficult to differentiate this disease from APAM. Thus, diagnosis of APAM should be made carefully, particularly since the number of cases of endometrial adenocarcinoma has increased in recent years. Furthermore, APAM tends to develop during a woman’s reproductive years, and fertility sparing treatment should be considered. Here, we review the clinicopathological characteristics of APAM, including the difficulty of diagnosis as a benign or malignant uterine tumor, and we examine the relationship between APAM and endometrial cancer.

关键词： Atypical Polypoid Adenomyoma Endometrial Adenocarcinoma Atypical Endometrial Hyperplasia Transcervical Resectoscope Fertility Sparing

Attenuation and Distortion of Compression Waves Propagating in Very Long Tube

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Journal of Thermal Science 2011年第1期20卷 53-57页

作者： Shinya NAKAMURA daisuke SASA Toshiyuki aoki Graduate School of Engineering Sciences Kyushu UniversityKasugaFukuoka816-8580Japan

A lot of phenomena related to propagating various waves are seen when the high-speed train goes through the tunnel,the gas pipeline is broken due to an accident or the air brake of the wagon *** instance,a compression wave generated ahead of a high-speed train entering a tunnel propagates to the tunnel exit and spouts as a micro pressure wave,which causes an exploding *** order to estimate the magnitude correctly,the mechanism of the attenuation and distortion of a compression wave propagating along a very long tunnel must be understood and the experimental information on these phenomena is *** experimental investigation is carried out to clarify the attenuation and distortion of the propagating compression wave in a very long *** results show that the strength of a compression wave decreases with *** attenuation and distortion of compression waves are affected by the initial waveform of the compression wave and by the unsteady boundary layer induced by the propagating *** shape of a compression wave becomes different with the propagating distance;that is,a shock wave appears just head of a wavefront and an overshoot on pressure distribution is observed behind a shock wave due to the transition of the unsteady boundary layer.

关键词： Propagating Compression Wave Very Long Tube Micro-pressure Wave High-Speed Train