Umbilical Cord Cysts from the Second Trimester of Pregnancy: Clinical Insights from 12 Cases of a 22-year Study in a Single Tertiary Center.

This study aimed to explore the clinical characteristics of umbilical cord cysts (UCCs) detected from the second trimester onwards in a single tertiary center over a 22-year period. The subjects consisted of a total of 12 cases of UCCs among 11 pregnant women (10 singleton pregnancies and 1 twin pregnancy), diagnosed at ≥ 14 weeks of gestation, and managed at Kurume University Hospital from 2000 to 2021. The maternal backgrounds, characteristics of the cysts, including their location, numbers, sizes, associated fetal/neonatal findings, and outcomes, were analyzed retrospectively.

Superb microvascular imaging for assessment of post-cesarean myometrial blood flow from 1 to 4 weeks after operation: A preliminary study.

Purpose: To evaluate superb microvascular imaging for measuring puerperal myometrial microvascular blood flows at incisional sites following cesarean delivery.

Methods: Twenty postpartum women (singleton births) were studied: 10 with cesarean and 10 with transvaginal deliveries. All cesarean cases were first operational delivery with lower uterine incision, repaired with double-layer suture.

Innovative hemostasis technique for cesarean section in placenta previa: A retrospective study.

Objective: To evaluate hemostatic efficacy, complications, and subsequent pregnancy outcomes in women with placenta previa who underwent combined vertical compression sutures in the lower uterine segment and intrauterine balloon tamponade (Hot-Dog method) to achieve hemostasis after cesarean section.

Methods: We retrospectively reviewed data for 117 women with singleton pregnancy diagnosed with placenta previa who underwent cesarean section between 29 and 38 weeks' gestation. Treatments were as follows: (1) conventional-intravenous oxytocin administration after placental detachment and suturing of bleeding points at the detachment site as needed (conventional group) (n = 47).

Alternative platelet differentiation pathways initiated by nonhierarchically related hematopoietic stem cells.

Rare multipotent stem cells replenish millions of blood cells per second through a time-consuming process, passing through multiple stages of increasingly lineage-restricted progenitors. Although insults to the blood-forming system highlight the need for more rapid blood replenishment from stem cells, established models of hematopoiesis implicate only one mandatory differentiation pathway for each blood cell lineage. Here, we establish a nonhierarchical relationship between distinct stem cells that replenish all blood cell lineages and stem cells that replenish almost exclusively platelets, a lineage essential for hemostasis and with important roles in both the innate and adaptive immune systems.

Risk factors for placenta accreta spectrum in pregnancies conceived after frozen-thawed embryo transfer in a hormone replacement cycle.

Objective: Assisted reproductive technology (ART), especially frozen-thawed embryo transfer (FET) in a hormone replacement cycle (HRC), is a risk factor for placenta accreta spectrum (PAS). This study aimed to clarify the risk factors for PAS related to the maternal background and ART techniques in pregnancies achieved after FET in an HRC.

Study Design: We performed a case-control study in two tertiary perinatal centres in Japan.

Risk Factors in Fetal Ovarian Cysts for Postnatal Adverse Outcomes.

Aim: To investigate the natural history of fetal ovarian cysts and elucidate the risk factors for postnatal adverse outcomes in fetal ovarian cysts.

Methods: The study subjects were 18 cases with ovarian cysts prenatally diagnosed using ultrasonography at our hospital between 2007 and 2020. The subjects were classified by cyst characteristics according to echogenic patterns [simple cyst (S) and complex cyst (C)], changes in echogenic patterns (S-to-S, S-to-C, and C-to-C), and diameters (<40 and ≥ 40 mm).

Identification and surveillance of rare relapse-initiating stem cells during complete remission after transplantation.

Relapse after complete remission (CR) remains the main cause of mortality after allogeneic stem cell transplantation for hematological malignancies and, therefore, improved biomarkers for early prediction of relapse remains a critical goal toward development and assessment of preemptive relapse treatment. Because the significance of cancer stem cells as a source of relapses remains unclear, we investigated whether mutational screening for persistence of rare cancer stem cells would enhance measurable residual disease (MRD) and early relapse prediction after transplantation. In a retrospective study of patients who relapsed and patients who achieved continuous-CR with myelodysplastic syndromes and related myeloid malignancies, combined flow cytometric cell sorting and mutational screening for persistence of rare relapse-initiating stem cells was performed in the bone marrow at multiple CR time points after transplantation.

A T cell receptor targeting a recurrent driver mutation in FLT3 mediates elimination of primary human acute myeloid leukemia in vivo.

Acute myeloid leukemia (AML), the most frequent leukemia in adults, is driven by recurrent somatically acquired genetic lesions in a restricted number of genes. Treatment with tyrosine kinase inhibitors has demonstrated that targeting of prevalent FMS-related receptor tyrosine kinase 3 (FLT3) gain-of-function mutations can provide significant survival benefits for patients, although the efficacy of FLT3 inhibitors in eliminating FLT3-mutated clones is variable. We identified a T cell receptor (TCR) reactive to the recurrent D835Y driver mutation in the FLT3 tyrosine kinase domain (TCR).

Unraveling the enigma: A case of dynamic morphological changes in the niche at 25 weeks of gestation recapitulating the ontogenesis of uterine scar dehiscence.

We present the first report of a case with a peculiar configurational change in the lower uterine segment detected during transvaginal ultrasonography observation over a short period of time at 25 weeks of gestation, predicting the presence of uterine scar dehiscence at term.

Integrated Genomic and Transcriptomic Analysis Improves Disease Classification and Risk Stratification of MDS with Ring Sideroblasts.

Purpose: Ring sideroblasts (RS) define the low-risk myelodysplastic neoplasm (MDS) subgroup with RS but may also reflect erythroid dysplasia in higher risk myeloid neoplasm. The benign behavior of MDS with RS (MDSRS+) is limited to SF3B1-mutated cases without additional high-risk genetic events, but one third of MDSRS+ carry no SF3B1 mutation, suggesting that different molecular mechanisms may underlie RS formation. We integrated genomic and transcriptomic analyses to evaluate whether transcriptome profiles may improve current risk stratification.

Difficulty in the Diagnosis of Biliary Atresia Splenic Malformation Syndrome In Utero.

The fetus of a 30-year-old pregnant Japanese woman was diagnosed with absence of inferior vena cava (IVC) and azygos continuation of interrupted IVC without cardiac anomalies at 34 weeks of gestation, and a healthy male neonate weighing 2,910 g was delivered at 37 weeks of gestation. On day 42 after birth, direct bilirubin predominant hyperbilirubinemia and high serum gamma-GTP levels were detected. Computed tomography revealed the presence of a lobulated and accessory spleen, and laparotomy demonstrated type III biliary atresia (BA), confirming the final diagnosis of BA splenic malformation (BASM) syndrome.

Novel application to evaluate endometrial blood flow using transvaginal superb microvascular imaging: A preliminary study describing physiological changes from ovulation to mid-luteal phase.

Introduction: We aimed to describe physiological changes in endometrial blood flow (minute arterioles running through the endometrium) from ovulation to the mid-luteal phase using superb microvascular imaging.

Material And Methods: The study involved 17 women (median age, 32.5 years; first to third interquartile range, 29.

Gestational age-related changes in cervical gland length in normal singleton pregnancies from 17 to 36 weeks of gestation.

Aim: To determine the gestational age-related changes in cervical gland length in relation to cervical length (CL) in normal singleton pregnancies.

Methods: We studied 363 women with an uncomplicated singleton pregnancy (188 nulliparous and 175 multiparous women with one or more previous transvaginal deliveries). A total of 1138 cervical gland and CLs were measured longitudinally at 17-36 weeks of gestation using transvaginal ultrasonography along the curvature from the external os to the lower uterine segment and the internal end of the cervical gland area (CGA), respectively.

A Case of Urinary Extravasation and Urolithiasis During Pregnancy.

Renal pelvis rupture during pregnancy is rare. Although the most common cause is urolithiasis, no cases of pregnant women with ureterorenal stones have been reported. We report on a 33-year-old pregnant woman with renal pelvis rupture and a stone at the ureteropelvic junction with an abrupt onset of severe flank pain at 37 weeks' gestation.

Related Factors for Abnormal Umbilical Cord Insertion: A Preliminary Study Based on Two Regional Tertiary Hospitals in Japan.

Objective: We elucidated maternal background, perinatal complications and outcomes as potential related factors for abnormal umbilical cord insertion (ACI) -velamentous and marginal- based on data from two tertiary perinatal hospitals in Japan.

Materials And Methods: The subjects were 3,741 women with singleton pregnancies who delivered at ≥ 22 weeks' gestation in Kurume University Hospital and St. Mary's Hospital, Kurume, Japan from January 2013 to December 2015.

New ultrasonographic risk assessment of uterine scar dehiscence in pregnancy after cesarean section.

Purpose: We performed a new ultrasonographic risk assessment of uterine scar dehiscence, which is a potential risk factor for uterine rupture, in pregnancy after cesarean section. We attempted to shed light on the natural course of the change in the lower uterine segment by means of a longitudinal investigation through quantitative and qualitative evaluations.

Methods: This retrospective single-center study involved 31 women with a normal singleton pregnancy delivered by elective cesarean section between 2020 and 2021, with all women showing a "niche" in the lower uterine segments.

Germ line DDX41 mutations define a unique subtype of myeloid neoplasms.

Germ line DDX41 variants have been implicated in late-onset myeloid neoplasms (MNs). Despite an increasing number of publications, many important features of DDX41-mutated MNs remain to be elucidated. Here we performed a comprehensive characterization of DDX41-mutated MNs, enrolling a total of 346 patients with DDX41 pathogenic/likely-pathogenic (P/LP) germ line variants and/or somatic mutations from 9082 MN patients, together with 525 first-degree relatives of DDX41-mutated and wild-type (WT) patients.

Targeting stem cells in myelodysplastic syndromes and acute myeloid leukemia.

The genetic architecture of cancer has been delineated through advances in high-throughput next-generation sequencing, where the sequential acquisition of recurrent driver mutations initially targeted towards normal cells ultimately leads to malignant transformation. Myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) are hematologic malignancies frequently initiated by mutations in the normal hematopoietic stem cell compartment leading to the establishment of leukemic stem cells. Although the genetic characterization of MDS and AML has led to identification of new therapeutic targets and development of new promising therapeutic strategies, disease progression, relapse, and treatment-related mortality remain a major challenge in MDS and AML.

Stereoselective Covalent Adduct Formation of Acyl Glucuronide Metabolite of Nonsteroidal Anti-Inflammatory Drugs with UDP-Glucuronosyltransferase.

A reactive metabolite of nonsteroidal anti-inflammatory drugs (NSAIDs), acyl-β-D-glucuronide (AG), covalently binds to endogenous proteins. The covalent adduct formation of NSAIDs-AG may lead to the dysfunction of target proteins. Therefore, it is important to clarify the detailed characterization of the formation of covalent protein adducts of NSAID-AG.