Nobuya Unno

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Clinical significance radadiation sennsitivity of nuclear survivin expression in uterine cervical carcinoma treated with concurrent chemoradiotherapy: prospective analysis (KGROG0501)

Journal of Clinical Oncology, May 20, 2008

16569 Background: Cytoplasmic survivin expression was reported to be correlated with radiationr-e... more

Inhibition of receptor activity–modifying protein 1 suppresses the development of endometriosis and the formation of blood and lymphatic vessels

Journal of Cellular and Molecular Medicine, Sep 1, 2020

Neuroimmune interactions are involved in the development of endometriosis. Here, we examined the ... more Neuroimmune interactions are involved in the development of endometriosis. Here, we examined the role of a neuropeptide, calcitonin gene–related peptide (CGRP), and its receptor, receptor activity–modifying protein (RAMP) 1, in growth of endometrial tissues and the formation of blood and lymphatic vessels in a mouse ectopic endometrial transplantation model. Endometrial fragments from donor wild‐type (WT) mice transplanted into the peritoneal wall of recipient WT mice grew with increased density of blood and lymphatic vessels. When tissues from RAMP1‐deficient (RAMP1−/−) mice were transplanted into RAMP1−/− mice, implant growth and angiogenesis/lymphangiogenesis were decreased. CGRP was up‐regulated in dorsal root ganglia, and CGRP+ nerve fibres were distributed into the implants from the peritoneum. RAMP1 was co‐expressed with CD11b (macrophages) and S100A4 (fibroblasts), but did not co‐localize with blood vessel endothelial cell marker CD31 or lymphatic vessel endothelial hyaluronan receptor (LYVE)‐1. Cultured with CGRP, macrophages up‐regulated vascular endothelial growth factor (VEGF)‐A, VEGF‐C and VEGF‐D, whereas fibroblasts up‐regulated VEGF‐C, but not VEGF‐A or VEGF‐D, in a RAMP1‐dependent manner. CGRP receptor antagonist CGRP8‐37 inhibited growth of and angiogenesis/lymphangiogenesis within endometrial tissue implants. These results suggest that RAMP1 signalling is crucial for growth and angiogenesis/lymphangiogenesis in endometrial tissue. Blockade of RAMP1 is a potential tool for the treatment of endometriosis.

Examination of fetal well‐being evaluation metrics for fetal growth restriction as seen from Japan Obstetric Compensation Cause Analysis Report data

Journal of Obstetrics and Gynaecology Research, Oct 18, 2021

Advances in perinatal care have improved the prognoses of both mothers and neonates; however, cer... more Advances in perinatal care have improved the prognoses of both mothers and neonates; however, cerebral palsy continues to occur. In this study, we examined methods for the intragestational evaluation of the health of infants who later developed cerebral palsy. A retrospective review was conducted on light‐for‐dates cases among the 2113 cause analysis reports issued by the Japan Obstetric Compensation System between January 2009 and September 2018. In our examination, we determined that non‐stress tests and ultrasonic Doppler tests were used to evaluate fetal well‐being. Moreover, we observed cases in which additional testing was not performed even when fetal growth restriction (FGR) was identified. Appropriate management of FGR may help reduce the incidence of cerebral palsy.

大規模災害と周産期医療―熊本地震からまなぶ各論 III.震災に対する今後の取組み被災後の取組みの方向性

周産期医学, 2017

Attitudes toward overtime work and self‐training: A survey on obstetricians and gynecologists in Japan

Journal of Obstetrics and Gynaecology Research, Mar 10, 2021

The Ministry of Health, Labour, and Welfare of Japan proposed a regulation of overtime work as a ... more The Ministry of Health, Labour, and Welfare of Japan proposed a regulation of overtime work as a reform in work style. However, the regulation may deteriorate the quality of medical services due to the reduction in training time. Thus, the study aimed to reveal perceptions in terms of generation gaps in views on self‐training and overtime work, among members of the Japan Society of Obstetrics and Gynecology (JSOG).

Phase II study of radiation therapy combined with weekly nedaplatin in locally advanced uterine cervical carcinoma (LAUCC): Kitasato Gynecologic Radiation Oncology Group (KGROG 0501)--initial analysis

European Journal of Gynaecological Oncology, 2008

In order to evaluate the safety and efficacy of chemoradiotherapy using nedaplatin for locally ad... more In order to evaluate the safety and efficacy of chemoradiotherapy using nedaplatin for locally advanced uterine cervical carcinoma in Japanese patients, we have started a single-institute phase II trial. Eligibility criteria include: (i) pathologically proven squamous cell carcinoma or adenocarcinoma, (ii) clinical FIGO stage Ib, IIa, or IIb with bulky tumor (.40 mm) or pelvic lymph node swelling, or (iii) clinical FIGO stage IIIa, IIIb and IVa, (iv) no para-aortic lymph node swelling. A combination of external beam radiation and high dose rate intracavitary irradiation is given. Nedaplatin (30 mg/m 2) is intravenously infused on a weekly basis for five times. The primary endpoint is 3-year overall survival, and the secondary endpoints are tumor response, 2-year overall survival, 3-year progression-free survival, acute adverse events, protocol treatment compliance, and late adverse events. We plan to recruit 45 patients within 3 years.

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Unpaid doctors in Japanese university hospitals

The Lancet, Mar 1, 2019

The Abe Administration has promoted a socalled workstyle reform as part of its agenda. Consequent... more The Abe Administration has promoted a socalled workstyle reform as part of its agenda. Consequently, legislation that sets an upper limit for overtime at 80 h per month has been introduced. Health care is no exception. A com mittee organised by the Ministry of Health, Labour and Welfare (MHLW) is discussing the new legislation for doctors, which will be implemented

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BRIEF REPORT Pregnancy

outcomes of women exposed to laninamivir during pregnancy

ネダプラチンを用いる局所進行子宮頚部癌に対する同時併用化学放射線療法(KGROG0501):最終結果

Number of currently working Obstetricians and Midwives in Health Care Facilities that performed Deliveries in Japan, 2011

Development of "Disaster Liaison in Pediatrics and Perinatal Medicine (DLPPM)

CD206-positive M2 Macrophage (MΦ) is an exacerbating factor and a new therapeutic target in endometriosis

Journal of Reproductive Immunology, 2020

Intracranial hemorrhage in full-term infants following vaginal delivery in a Japanese perinatal center

The Kitasato medical journal, Sep 1, 2011

Objective: This study was performed to characterize neonatal intracranial hemorrhage (ICH) in ful... more Objective: This study was performed to characterize neonatal intracranial hemorrhage (ICH) in fullterm vaginal delivery by mode of delivery (epidural analgesia or mechanical assistance such as vacuum extraction (V/E) or forceps delivery) in a Japanese perinatal center. Methods: In a retrospective observational case series study, we examined 6,600 consecutive term singleton vertex vaginal deliveries. Cases with neonatal symptomatic ICH were extracted, and the clinical backgrounds, the delivery courses and the neonatal outcomes of these cases were analyzed. Results: Maternal epidural analgesia significantly increased deliveries with mechanical assistance. ICH was identified in 8 cases (5 in deliveries with V/E and 3 in unassisted deliveries). The incidence of neonatal ICH was 0.24% in deliveries with V/E and 0.07% in unassisted deliveries. Conclusion: The incidence of neonatal ICH in full-term deliveries in a certain Japanese perinatal center was similar to previous reports of such incidence in other countries.

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Thiobarbituric acid-reactive substances during arteriovenous bypass in goat fetuses

Artificial Organs Today (Japan), 1996

東日本大震災と周産期復興に向けて MCAT構想

周産期医学, 2012

Absence of neonatal intensive care units in secondary medical care zones is an independent risk factor of high perinatal mortality in Japan

Journal of Obstetrics and Gynaecology Research, 2016

Aim: National medical projects are carried out according to medical care plans directed by the Me... more Aim: National medical projects are carried out according to medical care plans directed by the Medical Care Act of Japan. In order to improve Japanese perinatal medical care, it is necessary to determine the factors that might influence perinatal outcome. Methods: Statistical data of births and perinatal deaths were obtained for all municipalities in Japan from 2008 to 2012 from the Portal Site of Official Statistics of Japan (e-Stat). The perinatal mortality of all 349 Japanese secondary medical care zones was calculated. The number of neonatal intensive care units (NICUs), maternal-fetal intensive care units (MFICUs), pediatricians and obstetricians in 2011 were also obtained from e-Stat. Nine secondary medical care zones in two prefectures, Fukushima (7) and Miyagi (2) were excluded to eliminate the influence of the 2011 Great East Japan Earthquake. Results: The 340 secondary medical care zones were divided into three groups according to population size and density: metropolis, provincial city, and depopulation. The number of secondary medical care zones in each group were 52, 168, and 120, respectively. The secondary medical care zones in the depopulation group had fewer pediatricians and significantly fewer NICUs and MFICUs than the metropolis group, but there was no significant difference in perinatal mortality. The only independent risk factor for high perinatal mortality, determined by multivariable analysis, was the absence of an NICU (P = 0.011). Conclusions: To consider directions in perinatal medical care, planned arrangement and appropriate access to NICUs is indispensable.

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Current Concepts of Fetal Therapy

Asia-Oceania Journal of Obstetrics and Gynaecology, 2010

The development of fetal diagnostic techniques has facilitated the analysis of pathological condi... more The development of fetal diagnostic techniques has facilitated the analysis of pathological conditions in abnormal fetuses. This has led to systematic fetal therapy for such diseases as fetal hydronephrosis and fetal struma. In this report, general characteristics and problems of fetal therapy are discussed and several representative diseases that have been treated by surgical and pharmaceutical methods are outlined.

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Vaginal Delivery Under Epidural Analgesia in Pregnant Women with a Diagnosis of Moyamoya Disease

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, Jan 21, 2015

Moyamoya disease more commonly occurs in young people and women, so patients with this disease ma... more Moyamoya disease more commonly occurs in young people and women, so patients with this disease may experience pregnancy and delivery. Cesarean section (CS) is often chosen as the mode of delivery for these patients in Japan. No appropriate mode of delivery has yet been established for pregnant women with moyamoya disease in terms of stroke prevention. We have used vaginal delivery under epidural analgesia (EA) in such patients unless CS has been indicated for the maternal or fetal reasons. This study retrospectively analyzed our patients with moyamoya disease who gave birth to confirm the safety of vaginal delivery under EA. Twelve consecutive patients diagnosed with moyamoya disease had 14 deliveries at our hospital between September 2004 and January 2013. The incidences of intrapartum stroke were compared between cases of vaginal delivery under EA and CS cases. Ten vaginal deliveries under EA and 4 elective CSs were performed. No intrapartum stroke was observed during either vagin...

Abscopal effect of radiation on toruliform para-aortic lymph node metastases of advanced uterine cervical carcinoma--a case report

Anticancer research

The case of a 69-year-old woman with advanced uterine cervical carcinoma with toruliform para-aor... more The case of a 69-year-old woman with advanced uterine cervical carcinoma with toruliform para-aortic lymph node metastases that showed an abscopal effect of radiation therapy (effect out of irradiated field) is reported. The patient was admitted to our University Hospital in March 2005, and treated with radiation therapy only for the primary pelvic lesions without chemotherapy because of her severe economic status. After the treatment, not only did the cervical tumor in the irradiated field disappear, but the toruliform para-aortic lymph node swelling outside the irradiated field also spontaneously disappeared. The patient is still alive and well without relapse. This case is the first clinical demonstration of an abscopal effect in advanced uterine cervical carcinoma.

[Postpartum hemorrhage and disseminated intravascular coagulation]

Nihon Sanka Fujinka Gakkai zasshi, 1994

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