Feasible Techniques Named "Pure" Robotic Simple Hysterectomy With 4 Robotic Arms "4+0" Mode for Hysterectomy in da Vinci Xi.

Introduction: The three-arm approach is mainly selected, despite the multiple robotic arms in da Vinci Xi. This type of surgical setup may provide less autonomy to the console surgeon and result in greater dependence on the bedside surgical assistant. Therefore, the 4th arm is used instead of the assist port, which is why we developed "pure" robot simple hysterectomy (PRSH) as a novel surgical technique, in which all ports are operated by robotic arms.

Identifying key predictors for uterine manipulator use in robotic simple hysterectomy: a retrospective cohort analysis.

Background: Robotic simple hysterectomy (RSH) is the most common robotic gynecologic surgery in the United States. Uterine manipulators are commonly used to handle the uterus during laparoscopic surgery, but few studies have examined their necessity in RSH. This study retrospectively compares RSH cases with and without the use of manipulators, and identifies predictors for their intraoperative use.

Clinical Determinants Affecting Indications for Surgery and Chemotherapy in Recurrent Ovarian Granulosa Cell Tumor.

Background: Because reports on the management of recurrent granulosa cell tumor have been sparse, a consensus as to which patients should undergo surgical resection and which patients should be considered for chemotherapy has not been established.

Methods: A total of 21 tumor recurrences in eight patients with granulosa cell tumor were reviewed.

Results: Surgery was performed as the main treatment for 13 recurrences, while chemotherapy was chosen as the main treatment for eight recurrences.

Erythropoietin Receptor Antagonist Suppressed Ectopic Hemoglobin Synthesis in Xenografts of HeLa Cells to Promote Their Destruction.

The aim of this study is to explore a cause-oriented therapy for patients with uterine cervical cancer that expresses erythropoietin (Epo) and its receptor (EpoR). Epo, by binding to EpoR, stimulates the proliferation and differentiation of erythroid progenitor cells into hemoglobin-containing red blood cells. In this study, we report that the HeLa cells in the xenografts expressed ε, γ, and α globins as well as myoglobin (Mb) to produce tetrameric α2ε2 and α2γ2 and monomeric Mb, most of which were significantly suppressed with an EpoR antagonist EMP9.

Erythropoietin is involved in hemoprotein syntheses in developing human decidua.

Before establishment of feto-placental circulation, decidua can synthesize hemoproteins to maintain oxygen homeostasis in situ. Using the human decidua of induced abortions ranging from 5 to 8 weeks of gestation, we determined the expression levels of erythropoietin, erythropoietin receptor, cytoglobin, myoglobin, embryonic-, fetal- and adult hemoglobin mRNA by quantitative RT-PCR analysis and identified their proteins by Western blot and immunohistochemical analyses. Erythropoietin signaling was demonstrated in phosphatidylinositol-3-kinase/protein kinase B pathway by Western blot, and the transcriptional factors for erythroid and non-erythroid heme synthesis were examined by RT-PCR analysis.

Exposure to ethinyl estradiol prenatally and/or after sexual maturity induces endometriotic and precancerous lesions in uteri and ovaries of mice.

Unrecognizable exposure to estrogenic substance may cause estrogen-dependent diseases, endometriosis and cancer. Pregnant mice (ICR/Jcl, CLEA) were exposed to 0.01 mg ethinyl estradiol (EE2 )/kg per day or vehicle (olive oil) through oral intubation from day 11 to 17 of gestation.

Case of acquired hemophilia with factor VIII inhibitor in a mother and newborn.

We report a mother and newborn in the puerperium with hemorrhage secondary to factor VIII inhibitor. A 31-year-old gravida 1 para 1 delivered at a local clinic with a massive postpartum hemorrhage. The activated partial thromboplastin time was prolonged and factor VIII inhibitor was detected.

Feasibility study of oral cyclophosphamide salvage therapy for the treatment of heavily pretreated patients with recurrent epithelial ovarian cancer.

Background: In patients with relapsed ovarian cancer, the objectives of salvage therapy are considered to be maintenance of quality of life and prolongation of patient survival. Chemotherapy using oral agents could be a good choice for salvage therapy. We reassessed the usefulness of oral cyclophosphamide (CPA) salvage therapy for heavily pretreated patients with recurrent epithelial ovarian cancer.

Erythropoietin-responsive sites in normal and malignant human lung tissues.

Preliminary findings of various types of globin expressed in the respiratory bronchiolar and alveolar epithelium prompted us to compare the expression of erythropoietin (Epo) and its receptor (EpoR) in normal (healthy) human lung tissues with that in malignant lung tissues. The expression of Epo and EpoR was examined at the transcriptional and protein levels in normal and malignant lung tissues by reverse transcription-PCR, western blot, and immunohistochemical analyses. EpoR mRNA, but not Epo mRNA, was detected in all samples.

Phase II study of single-agent gemcitabine in heavily pretreated Japanese patients with recurrent ovarian cancer.

Background: Gemcitabine has been recommended as an active agent for salvage chemotherapy in patients with recurrent epithelial ovarian cancer, but no clinical study of this agent has been conducted for Japanese women with ovarian cancer. To evaluate the efficacy and feasibility of gemcitabine for heavily pretreated Japanese patients with recurrent epithelial ovarian cancer, we conducted a single-institute phase II clinical trial.

Methods: All patients had received a minimum of two previous chemotherapy regimens, In this study, gemcitabine was administered at 1000 mg/m(2) on days 1, 8, and 15 of a 28-day cycle.

A change in promoter methylation of hMLH1 is a cause of acquired resistance to platinum-based chemotherapy in epithelial ovarian cancer.

Background: Acquired resistance to platinum-based chemotherapy (Pt-chemo) is a major problem for improving the prognosis for patients with advanced epithelial ovarian cancer (EOC). However, the molecular mechanism of acquired resistance to Pt-chemo is not well understood.

Materials And Methods: hMLH1 promoter methylation (hMLH1 MET) and hMLH1 protein expression was examined in 36 paired samples of primary and secondary resected tumors by methylation-specific polymerase chain reaction (PCR).

Successful pregnancy in a patient with double outlet left ventricle after a Rastelli operation using a prosthetic valve.

A woman with double outlet left ventricle (DOLV) had undergone a Rastelli operation using a prosthetic Björk Shiley valve and who was receiving anticoagulant drug delivered a healthy male infant. Oral warfarin was replaced by heparin from the 5th to the 13th week of gestation and for the last 5 weeks of gestation. Successful pregnancy in patients with DOLV after a Rastelli operation using a prosthetic valve is possible with careful maintenance.