Faculty Profiles - YAMAMOTO Eiko

Papers - YAMAMOTO Eiko

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Underlying cause of death at medical facilities in Xaiyabouli Province, Lao People's Democratic Republic.

Bounbouly Thanavanh, Singkham Hackpaserd, Souphalak Inthaphatha, Tetsuyoshi Kariya, Yunosuke Suzuki, Eiko Yamamoto, Nobuyuki Hamajima

Nagoya journal of medical science Vol. 84 ( 2 ) page： 448 - 461 2022.5

Language：English Publishing type：Research paper (scientific journal)

In Lao PDR, Ministry of Health introduced District Health Information Software 2 (DHIS2) in 2013. Although DHIS2 includes cause of death, Lao government did not request to report cause of death through DHIS2, resulting in no information on frequency of underlying cause of death even for the deaths at medical facility. This study aimed to collect the information on the underlying cause of death at all medical facilities in Xaiyabouli province, a rural area in Lao PDR. As well as the point estimate of the proportion, a 95% confidence interval (CI) based on a binomial distribution was calculated for each cause of death. According to the local government request, 226 deaths (128 males and 98 females) in 2019 were reported from all medical facilities in the province. Among them, infectious diseases were the most frequent (33.6%, 95% CI 27.5-40.2%); sepsis (16.8%, 95% CI 12.2-22.3%), pneumonia (8.8%, 95% CI 5.5-13.3%), and meningitis (4.9%, 95% CI 2.5-8.5%). Heart diseases were 15.9% (95% CI 11.4-21.4%) including heart failure and myocardial infarction. Injury was 10.2% (95% CI 6.2-14.4%) including brain injury. Neonatal death was 10.6% (95% CI 6.9-15.4%). Among those, preterm death was common (8.8%, 95% CI 5.3-13.3%). Renal failure was 8.0% (95% CI 4.8-12.3%). According to civil registration covering all deaths both at facilities and outside facilities, deaths at facilities were 16.8% of the whole deaths (1,372 deaths) in Xaiyabouli province. Although deaths outside facilities were not included, this is the first report demonstrating cause of death in one province in Lao PDR.

DOI： 10.18999/nagjms.84.2.448

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Rates and Factors Associated With Serious Outcomes of Patient Safety Incidents in Malaysia: An Observational Study. International journal

Khairulina Haireen Khalid, Eiko Yamamoto, Nobuyuki Hamajima, Tetsuyoshi Kariya

Global journal on quality and safety in healthcare Vol. 5 ( 2 ) page： 31 - 38 2022.5

Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: This study aimed to examine the reporting rate and the factors associated with serious outcomes of patient safety incidents at public hospitals in Malaysia. METHODS: All patient safety incidents reported in the e-Incident-Reporting System from January to December 2019 were included in the study. A descriptive study was used to describe the characteristics of incidents, and logistic models were used to identify factors associated with low reporting rates and severe harm or death outcomes of incidents. RESULTS: There were 9431 patient safety incidents reported in the system in 2019. The mean reporting rate was 2.1/1000 patient bed-days or 1.5% of hospital admissions. The major category of incidents was drug-related incidents (32.4%). No-harm incidents contributed to 56.1% of all the incidents, while 1.1% resulted in death. More hospitals in the eastern (odds ratio [OR], 12.1) and southern regions (OR, 6.1) had low reporting rates compared to the central region. Incidents with severe harm or death outcomes were associated with more males (OR, 1.4) than females and with the emergency department (OR, 10.6), internal medicine (OR, 5.7), obstetrics and gynecology (OR, 2.4), and surgical department (OR, 5.0) more than the pharmacy department. Compared to drug-related incidents, operation-related (OR, 3.0), procedure-related (OR, 3.5), and therapeutic-related (OR, 4.8) incidents had significantly more severe harm or death outcomes, and patient falls (OR, 0.4) had less severe harm or death outcomes. CONCLUSION: The mean reporting rate was 2.1/1000 patient bed-days or 1.5% of hospital admissions. More hospitals in the eastern and southern regions had low reporting rates. Certain categories of incidents had significantly more severe outcomes.

DOI： 10.36401/JQSH-21-19

PubMed

Patient delay and health system delay of patients with newly diagnosed pulmonary tuberculosis in Mongolia, 2016-2017.

Batmunkh Batbayar, Tetsuyoshi Kariya, Tsolmon Boldoo, Enkhtamir Purevdorj, Naranzul Dambaa, Yu Mon Saw, Eiko Yamamoto, Nobuyuki Hamajima

Nagoya journal of medical science Vol. 84 ( 2 ) page： 339 - 351 2022.5

Language：English Publishing type：Research paper (scientific journal)

Although diagnosis and treatment of tuberculosis (TB) have been improved in many countries, delays in the diagnosis and treatment remain problematic in resource-limited countries. This study aimed to identify factors affecting delays in TB care in Mongolia. Data on TB cases registered from January 2016 to December 2017 were obtained from the national registry of TB at the Department of TB Surveillance and Research in National Center for Communicable Disease. The total number of TB cases registered in these two years was 8,166, including 3,267 cases of newly diagnosed pulmonary TB. Pulmonary TB cases (1,836 males and 1,431 females) were analyzed to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Patient delays longer than the median (28 days) were significantly associated with patient age >32 years (aOR=1.31, 95%CI: 1.14-1.51), residence in areas other than Ulaanbaatar (aimags) (aOR=1.38, 95%CI: 1.20-1.59), and smear-negative (aOR=0.57, 95%CI: 0.47-0.69). Health system delays longer than the median (7 days) were significantly associated with patient age >32 years (aOR=1.16, 95%CI: 1.00-1.33), residence in aimags (aOR=0.82, 95%CI: 0.71-0.95), special facilities including a prison hospital (aOR=4.40, 95%CI: 2.42-7.83), registration in 2017 relative to 2016 (aOR=0.83, 95%CI: 0.71-0.95), and smear-negative (aOR=1.72, 95%CI: 1.42-2.07). Total delays longer than the median (45 days) were significantly associated with patient age >32 years (aOR=1.39, 95%CI: 1.21-1.60), residence in aimags (aOR=1.27, 95%CI: 1.11-1.47), and smear-negative (aOR=0.74, 95%CI: 0.62-0.90). To shorten the total delay, improvement of the access to medical facilities in aimags is necessary.

DOI： 10.18999/nagjms.84.2.339

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Pregnancy Outcomes in Women with Thyroid Diseases

Kotani Tomomi, Imai Kenji, Ushida Takafumi, Moriyama Yoshinori, Nakano-Kobayashi Tomoko, Osuka Satoko, Tsuda Hiroyuki, Sumigama Seiji, Yamamoto Eiko, Kinoshita Fumie, Hirakawa Akihiro, Iwase Akira, Kikkawa Fumitaka, Kajiyama Hiroaki

JMA Journal Vol. 5 ( 2 ) page： 216 - 223 2022.4

Language：English Publishing type：Research paper (scientific journal) Publisher：Japan Medical Association / The Japanese Associaiton of Medical Sciences

Introduction: Overt hyperthyroidism and hypothyroidism are associated with pregnancy complications; however, most women with these conditions are diagnosed before conception and are under treatment during pregnancy, especially in high-income countries. The purpose of this study was to investigate pregnancy complications among these women.Methods: A retrospective cohort study was conducted, and data on pregnant women who gave birth to a singleton at Nagoya University Hospital in Japan in 2005-2014 was collected. The pregnancy outcomes were divided and compared among three groups: the control group (n = 3531), the hyperthyroidism group (n = 48), and the hypothyroidism group (n = 61). Additionally, risk factors for placental abruption were evaluated by multivariable logistic regression analysis. Moreover, in hyperthyroidism, thyroid function at the placentation period was compared between placental-related diseases and nonplacental-related disease groups, and the latter group included placental abruption and preeclampsia.Results: The incidence of placental abruption was higher in hyperthyroidism than in control and hypothyroidism groups. Hyperthyroidism was independently associated with an increased risk of placental abruption (adjusted odds ratio, aOR = 8.21, 95% confidence interval, CI: 1.76-38.34), as well as preeclampsia (aOR = 4.10, 95% CI: 1.13-14.76) and preterm labor (aOR = 3.38, 95% CI: 1.19-9.64). Additionally, thyroid-stimulating hormone (TSH) at the placentation period was significantly lower in the placental-related disease group than in the nonplacental-related disease group (p < 0.05).Conclusions: Pregnancy outcomes in women with hyperthyroidism and hypothyroidism would be comparable with those without thyroid disease. Hyperthyroidism was an independent risk factor for placental abruption as well as preterm labor and preeclampsia. However, its frequency was extremely low, and further research is required to validate our findings.

DOI： 10.31662/jmaj.2021-0191

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CiNii Research

絨毛癌の免疫微小環境の解明 NK細胞抑制型受容体に着目して

柴田真由, 新美薫, 服部諭美, 西子裕規, 小田結加里, 渡邉絵里, 横井暁, 西野公博, 山本英子, 梶山広明

日本産科婦人科学会雑誌 Vol. 74 ( 臨増 ) page： S - 338 2022.2

絨毛癌MTX耐性株の作成と解析

西子裕規, 新美薫, 横井暁, 吉田康将, 柴田真由, 小田結加里, 渡邉絵里, 西野公博, 山本英子, 梶山広明

日本産科婦人科学会雑誌 Vol. 74 ( 臨増 ) page： S - 512 2022.2

絨毛癌MTX耐性株の作成と解析

西子裕規, 新美薫, 横井暁, 吉田康将, 柴田真由, 小田結加里, 渡邉絵里, 西野公博, 山本英子, 梶山広明

日本産科婦人科学会雑誌 Vol. 74 ( 臨増 ) page： S - 512 2022.2

絨毛癌の免疫微小環境の解明 NK細胞抑制型受容体に着目して

柴田真由, 新美薫, 服部諭美, 西子裕規, 小田結加里, 渡邉絵里, 横井暁, 西野公博, 山本英子, 梶山広明

日本産科婦人科学会雑誌 Vol. 74 ( 臨増 ) page： S - 338 2022.2

Cell surface membrane lysosome-associated membrane glycoprotein 2 promotes cell adhesion via abundant N-glycans in choriocarcinoma. International journal

Kimihiro Nishino, Yuki Nishiko, Mayu Shibata, Yukari Oda, Eri Watanabe, Kaoru Niimi, Eiko Yamamoto, Hiroaki Kajiyama

Placenta Vol. 117 page： 109 - 117 2022.1

Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: Lysosome-associated membrane glycoprotein 2 (LAMP-2) is a target protein for glycosylation by N-acetylglucosaminyltransferase IV (GnT-IV), which catalyzes the formation of β1,4GlcNAc branches on the mannose core of N-glycans in choriocarcinoma cells. However, the role of LAMP-2, especially when it is expressed in the cell surface membrane of choriocarcinoma cells, has not been well investigated in the progression of choriocarcinoma. This study aimed to elucidate the function of the cell surface membrane LAMP-2 in the malignancy of choriocarcinoma. METHODS: We evaluated the localization of LAMP-2 in some choriocarcinoma cell lines and clinical samples of choriocarcinoma, normal placenta, hydatidiform mole, and invasive mole by flow cytometry, immunocytochemistry, and immunohistochemistry. We performed functional experiments using the knockout or overexpression model of LAMP-2 in the presence or absence of galectins. RESULTS: LAMP-2 was observed in the cell surface membrane of some choriocarcinoma cell lines and tumor cells of choriocarcinoma tissue and trophoblasts of the placenta, hydatidiform mole, and invasive mole. Cell surface membrane LAMP-2 knockout decreased cell adhesion and invasion in choriocarcinoma cells. Conversely, cell surface membrane LAMP-2A overexpression increased cell adhesion and invasion. Experiments in the presence of galectins revealed that abundant N-glycans bound to the peptide core of the luminal side of the cell surface membrane LAMP-2 mediated cell adhesion of choriocarcinoma cells by interacting with galectins in the extracellular matrix (ECM). DISCUSSION: Cell surface membrane LAMP-2, which is glycosylated by GnT-IV, contributes to the malignancy of choriocarcinoma by promoting cell adhesion with the ECM via abundant N-glycans.

DOI： 10.1016/j.placenta.2021.11.005

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Factors associated with severe dengue in Savannakhet Province, Lao People's Democratic Republic.

Phetvilay Senavong, Eiko Yamamoto, Phouvilay Keomoungkhoune, Nouda Prasith, Virasack Somoulay, Tetsuyoshi Kariya, Yu Mon Saw, Tiengkham Pongvongsa, Nobuyuki Hamajima

Nagoya journal of medical science Vol. 83 ( 4 ) page： 749 - 763 2021.11

Language：English Publishing type：Research paper (scientific journal)

This study aimed to describe the socio-demographic and clinical characteristics of dengue inpatients at a provincial hospital, and to identify factors associated with severe dengue. This is a retrospective study involving 402 dengue patients admitted to the Savannakhet Provincial Hospital, Lao People's Democratic Republic (Lao PDR), between January 2018 and April 2019. Socio-demographic factors, clinical signs and laboratory data on admission, final diagnosis, use of health care services before admission, admission date, and hospitalization period were collected from patient records. The number of dengue inpatients was higher in the rainy season than in the dry season. Of the 402 patients, 205 patients (51.0%) were finally diagnosed with severe dengue. Children aged <15 years had more symptoms, higher proportion of severe dengue (69.8% vs. 35.9%), and longer hospitalization (3.5 days vs. 3.0 days) than adults aged ≥15 years. In multivariable analyses, factors associated with severe dengue were nausea on admission (adjusted odds ratio=3.57, 95% CI=1.05-12.09, P=0.04) in children and persistent vomiting on admission (adjusted odds ratio=3.82, 95% CI=1.23-11.92, P=0.02) in adults. In adults, the creatinine level on admission was significantly higher in patients with a final diagnosis of severe dengue compared to the others. The proportion of severe dengue in our study was higher than that in other countries. Nausea and persistent vomiting on admission were suggested to be predictive factors for severe dengue. To reduce the incidence of severe dengue in Lao PDR, improvements in access to health care, referral system, and training of health care workers are needed.

DOI： 10.18999/nagjms.83.4.749

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The current situation of health services for hydatidiform mole in Cambodia. International journal

Eiko Yamamoto, Koum Kanal, Sann Chan Soeung, Noriko Fujita, Sidonn Krang, Puthik Long-Hay, Kimihiro Nishino, Kaoru Niimi, Nobuyuki Hamajima

The journal of obstetrics and gynaecology research Vol. 47 ( 10 ) page： 3652 - 3660 2021.10

Language：English Publishing type：Research paper (scientific journal)

AIM: Management of hydatidiform mole is important to reduce the mortality and morbidity of choriocarcinoma. This study aims to understand the existing health services for hydatidiform mole and to estimate the incidence of gestational trophoblastic disease (GTD) in Cambodia. METHODS: A questionnaire was used to collect information on the existing health services for pregnancy and hydatidiform mole at health facilities from attendants of the 16th Annual Conference of the Cambodian Society of Gynecology and Obstetrics in 2017. The incidence of GTD in 2014-2017 was estimated using Health Information System data. RESULTS: A total of 126 attendants, who were from all provinces except three provinces, answered the questionnaire. The work places were national hospitals (n = 29), provincial hospitals (n = 42), district hospitals (n = 20), health centers (n = 6), and others (n = 29). The answers of participants from the public sector suggested the following: Ultrasonography is available at all hospitals but not health centers; Human chorionic gonadotropin (hCG) measurement is only available at national hospitals; Treatment of hydatidiform mole is performed at national hospitals and provincial hospitals; and Treatment of gestational trophoblastic neoplasia (GTN) is provided at national hospitals. The incidence of hydatidiform mole and GTN at health facilities in the public sector in 2014-2017 was 0.95 per 1000 deliveries and 6.58 per 100 000 deliveries, respectively. CONCLUSIONS: The results suggest that provincial hospitals are important to detect suspected invasive mole and refer to national hospitals for diagnosis and treatment. Further studies on the management of GTD and development of the guidelines of GTD are needed.

DOI： 10.1111/jog.14955

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Short tandem repeat analysis to identify the causative pregnancy of high-risk gestational trophoblastic neoplasia: Molar versus nonmolar pregnancy and its relation to the outcome. International journal

Kimihiro Nishino, Eiko Yamamoto, Yukari Oda, Eri Watanabe, Kaoru Niimi, Toshimichi Yamamoto, Hiroaki Kajiyama

Placenta Vol. 112 page： 28 - 35 2021.9

Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: Gestational trophoblastic neoplasia (GTN) include a group of malignant neoplasms that originate from the trophoblasts of placental tissue in molar or nonmolar pregnancy. Currently, it is unclear whether the prognosis of high-risk GTN or gestational choriocarcinoma succeeding molar pregnancy or that following a nonmolar one is better. Comparison of the genetic short tandem repeat (STR) patterns of the DNA extracted from the tumor, patient, and her partner allows the genetic origins of the choriocarcinoma to be distinguished - whether it is gestational or non-gestational and whether it is derived from a molar or nonmolar pregnancy in the event it is gestational. This study aimed to investigate the causative pregnancy of patients with high-risk GTN, especially those with poor outcomes, and assess the impact of the causative pregnancy on patient outcome. METHODS: We evaluated 24 patients who were diagnosed with high-risk GTN between January 2000 and October 2019, including 15 cases of pathologically proven gestational choriocarcinomas and the causative pregnancy was investigated by STR analysis in which tumor DNA could be extracted. RESULTS: In high-risk GTN without history of anteceding molar pregnancies, nonmolar pregnancy was the causative pregnancy, which was confirmed in three cases. Molar pregnancy appeared be the causative pregnancy of high-risk GTN in patients with a history of antecedent molar pregnancies either with or without interruption by subsequent nonmolar pregnancies prior to developing high-risk GTN. High-risk GTN in most of the evaluated deceased cases (three of four) was due to nonmolar pregnancy, while all but one case with molar pregnancy as the causative pregnancy survived. DISCUSSION: STR analysis can distinguish the causative pregnancy of high-risk GTN, and nonmolar pregnancy as the causative pregnancy might have negative effects on the outcome of the disease.

DOI： 10.1016/j.placenta.2021.06.015

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Core 2 β1,6-N-acetylglucosaminyltransferases accelerate the escape of choriocarcinoma from natural killer cell immunity. International journal

Kenichi Nakamura, Kaoru Niimi, Eiko Yamamoto, Yoshiki Ikeda, Kimihiro Nishino, Shiro Suzuki, Hiroaki Kajiyama, Fumitaka Kikkawa

Biochemistry and biophysics reports Vol. 26 page： 100951 - 100951 2021.7

Language：English Publishing type：Research paper (scientific journal)

Hyperglycosylated human chorionic gonadotropin (H-hCG) is secreted from choriocarcinoma and contains a core2 O-glycan formed by core2 β1,6-N-acetylglucosaminyl transferase (C2GnT). Choriocarcinoma is considered immunogenic as it is gestational and contains paternal chromosomal components. Here we examined the function of C2GnT in the evasion of choriocarcinoma cells from natural killer (NK) cell-mediating killing. We determined that C2GnT is highly expressed in malignant gestational trophoblastic neoplasms. C2GnT KO downregulates core2 O-glycan expression in choriocarcinoma cells, which are more efficiently killed by NK cells than control cells. C2GnT KO cell containing tumor necrosis factor-related apoptosis inducing ligand have lower viability than control cells. Additionally, poly-N-acetyllactosamine in core2 branched oligosaccharides on MHC class I-related chain A (MICA) and mucin1 (MUC1) is significantly reduced in C2GnT KO cells. Meanwhile, the cumulative survival rate of nude mice inoculated with C2GnT KO tumors was higher than that of the control group. These findings suggest that choriocarcinoma cells may escape NK cell-mediated killing via glycosylation of MICA and MUC1.

DOI： 10.1016/j.bbrep.2021.100951

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Next-generation genome sequencing of a matched normal-tumor pair from a patient with intractable gestational choriocarcinoma: A case report. International journal

Kaoru Niimi, Eiko Yamamoto, Sachi Morita, Maki Morikawa, Hikaru Hattori, Miki Hatakeyama, Mami Morita, Kimihiro Nishino, Yukari Oda, Eri Watanabe, Toshimichi Yamamoto, Hiroaki Kajiyama, Fumitaka Kikkawa

Molecular and clinical oncology Vol. 15 ( 1 ) page： 143 - 143 2021.7

Language：English Publishing type：Research paper (scientific journal)

Gestational choriocarcinoma is a gestational trophoblastic neoplasia (GTN) originating from trophoblastic cells with abnormal proliferation. Although chemotherapy is effective for treating this cancer, when patients develop chemoresistance, personalized treatment, such as the use of drugs matching their genomes, is required. The present report describes a case of intractable gestational choriocarcinoma identified using a next-generation sequencing (NGS)-based tumor panel. A 51-year-old woman was diagnosed with gestational choriocarcinoma via pathological and short tandem repeat analyses. The patient did not achieve remission despite many regimens of chemotherapy, including high-dose therapy with autologous peripheral blood stem cell transplantation. To identify drugs tailored to this particular choriocarcinoma, NGS was performed on the tumor of the patient, and the tumor genome was compared with that of the patient's blood sample using the NCC Oncopanel System. Consequently, 245 single nucleotide variants (SNVs) with a mean SNV allele frequency of 63.1% were identified. This high frequency was because the genome of the gestational choriocarcinoma contained part of the genome of the partner. Therefore, our experience of the present intractable case of choriocarcinoma suggested that matched normal-tumor pair analysis is not appropriate for treatment decisions in GTN cases. When using an NGS-based tumor panel to assess choriocarcinoma, researchers must consider whether the genomic DNA of the patient and their partner are involved in the GTN.

DOI： 10.3892/mco.2021.2305

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Assessment of myocardial performance index in late-onset fetal growth restriction.

Tran Thao Nguyen Nguyen, Tomomi Kotani, Kenji Imai, Takafumi Ushida, Yoshinori Moriyama, Tomoko Kobayashi, Kaoru Niimi, Seiji Sumigama, Eiko Yamamoto, Van Duc Vo, Minh Tam Le, Lam Huong Le, Dac Nguyen Nguyen, Vu Quoc Huy Nguyen, Quang Vinh Truong, Ngoc Thanh Cao, Fumitaka Kikkawa

Nagoya journal of medical science Vol. 83 ( 2 ) page： 259 - 268 2021.5

Language：English Publishing type：Research paper (scientific journal)

The aim of this study is to determine whether the myocardial performance index (MPI) is increased in fetal growth restriction (FGR) fetuses and if increased MPI is related to adverse outcomes of FGR. This is a prospective cross-sectional study. Seventy-three late-onset FGR fetuses and 97 gestational-age matched control fetuses were enrolled in this study. Fetal blood flow parameters including MPI values were measured and compared between the two groups. For the effect of severity of growth restriction on MPI value, they were also compared with < 3rd and 3rd - 10th centile groups. FGR fetuses were divided into two groups by favorable and adverse outcome and ultrasound parameters were compared between these two groups. Moreover, significant factors related to adverse outcomes by univariate analysis were analyzed by multivariate logistic regression analysis. Pulsatility index of umbilical arterial flow (UA-PI), MPI and amniotic fluid index in the FGR were significantly different from the control fetuses. However, no significant difference between < 3rd and 3rd - 10th centile groups was detected in MPI and UA-PI. The increased levels of MPI and UA-PI were independently related with adverse outcome of late-onset FGR pregnancy. In conclusion, MPI values were increased in late-onset FGR pregnancy, and the higher level of MPI could predict adverse outcome as well as the measurement of UA-PI. Clinicians should consider cardiac dysfunction in FGR through increased MPI.

DOI： 10.18999/nagjms.83.2.259

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A poor prognostic metastatic nongestational choriocarcinoma of the ovary: a case report and the literature review. International journal

Kimihiro Nishino, Eiko Yamamoto, Yoshiki Ikeda, Kaoru Niimi, Toshimichi Yamamoto, Hiroaki Kajiyama

Journal of ovarian research Vol. 14 ( 1 ) page： 56 - 56 2021.4

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Pure ovarian choriocarcinoma can be gestational or nongestational in origin. Nongestational pure ovarian choriocarcinoma is extremely rare and the prognosis is thought to be worse than that of the gestational type in patients with metastatic disease. We present a case of metastatic pure ovarian choriocarcinoma with poor prognosis in which the origin was identified as nongestational by DNA short tandem repeat (STR) analysis. CASE PRESENTATION: A nulliparous woman in her thirties with metastatic choriocarcinoma was referred to our hospital after initial treatment proved unsuccessful. Two months earlier, she had undergone brain tumor resection and histological examination confirmed choriocarcinoma. Serum human chorionic gonadotropin (hCG) concentration at initial diagnosis was 5030 IU/L. Two cycles of a combination chemotherapy regimen of methotrexate, etoposide, and actinomycin-D (MEA therapy), which is commonly used for gestational choriocarcinoma, was administered. However, the disease could not be controlled. Imaging modalities at presentation revealed tumor present in the left ovary and left lung, but not in the uterus, which led us think that the choriocarcinoma was nongestational. Bleomycin, etoposide, and cisplatin (BEP therapy) which is commonly used for nongestational choriocarcinoma (malignant germ cell tumor) and surgical resection of the uterus, bilateral ovaries, and an affected part of the left lung led to the nadir level of hCG, but the tumor relapsed and levels of hCG again increased. To investigate the origin of choriocarcinoma, we performed DNA STR analysis of tumor cells and oral mucosal cells. Analysis revealed the origin of the choriocarcinoma as nongestational, as the genotype of tumor cells entirely corresponded with that of oral mucosal cells. BEP therapy and chemotherapy regimens administered for nongestational choriocarcinoma and gestational choriocarcinoma proved ineffective, and the patient died 21 months after diagnosis of metastatic choriocarcinoma. CONCLUSION: Metastaic nongestational pure choriocarcinoma of ovary is an extremely rare and an aggressive disease, frequently resulting in poor outcome.

DOI： 10.1186/s13048-021-00810-3

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妊娠24週で高度貧血によりterminationとなるも生児を得た胎児共存奇胎の一例

渡邉絵里, 新美薫, 牛田貴文, 小田結加里, 西野公博, 小谷友美, 山本英子, 梶山広明

日本産科婦人科学会雑誌 Vol. 73 ( 臨増 ) page： S - 576 2021.3

Factors associated with neonatal mortality in a tertiary hospital in Phnom Penh, Cambodia Reviewed International coauthorship

Leak P, Yamamoto E, Noy P, Keo D, Krang S, Kariya T, Saw YM, Siek M, Hamajima N.

Nagoya Jouranl of Medical Science Vol. 83 ( 1 ) page： 113 - 124 2021.2

Rate of achievement of therapeutic outcomes and factors associated with control of non-communicable diseases in rural east Malaysia: implications for policy and practice Reviewed International coauthorship

Keng ZY, Saw YM, Thung SC, Chong WW, Albert A, Kariya T, Yamamoto E, Hamajima N.

Scientific Reports Vol. 11 ( 1 ) page： 3812 - 3812 2021.2

Core 2 β1,6-N-acetylglucosaminyltransferases accelerate the escape of choriocarcinoma from natural killer cell immunity Reviewed

Nakamura K, Niimi K, Yamamoto E, Ikeda Y, Nishino K, Suzuki S, Kajiyama H, Kikkawa F.

Biochem Biophys Rep . Vol. 26 page： 100951 - 100951 2021.2

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Papers - YAMAMOTO Eiko