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Preventive Effects of Dental Pulp Stem Cell-conditioned Media on Anti-RANKL Antibody-Related Osteonecrosis of the Jaw
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ALPK2 prevents cardiac diastolic dysfunction in heart failure with preserved ejection fraction
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Elucidation of the role of XBP1 in the progression of complete hydatidiform mole to invasive mole through RNA-seq
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Quality Improvements in Chinese Higher Education: Spatial Dependence, Heterogeneity, and Spillover Effects
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Geographical Research on Flood Hazard Estimation and Hazard Mapping in Mongolia
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Exploring the Role of Online Community Networks in the Integration Process of Filipino Women Migrants in Japan
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Durvalumab-combined chemotherapy for biliary tract cancer in a Japanese expert center: initial 50 cases in daily practice
Get PDFCombination regimen consisting of gemcitabine, cisplatin, and durvalumab (GCD) has been employed for unresectable biliary tract cancer (BTC) since the end of 2022 in Japan. Here, we summarize our experience with GCD to demonstrate the clinical outcomes in a practical setting. Patients who underwent GCD for unresectable/recurrent BTC between January and December 2023 were investigated retrospectively. Data for maximal response rate (RR), disease control rate (DCR), and adverse events (AEs) were collected. Progression-free survival (PFS) and overall survival (OS) curves were generated using the Kaplan-Meyer method. Fifty (initially unresectable, n = 32; recurrence after surgery, n = 18) consecutive patients were enrolled, 19 of whom started GCD as second-line therapy or later. Overall RR was 24.0% including complete response in 1 (2%) patient and partial response in 11 (22%) patients; DCR was 68.0%. The median PFS and OS were 7.1 months and not reached, respectively. During a median follow-up period of 8.5 months, 8 (16%) patients underwent surgical resection. A total of 36 (72%) patients suffered Grade 3–5 AE, and 3 immune-related AE were controlled with injection of corticosteroid or observation. The efficacy of GCD for unresectable/recurrent BTC was confirmed in the practical setting, with acceptable toxicity, prolonged survival, and potential probability of resection.departmental bulletin pape
A case of innominate artery aneurysm in a pregnant woman treated by endovascular stent grafting
Get PDFInnominate artery aneurysms are rare, accounting for only 0.26% of all aneurysms. Although usually asymptomatic, they carry a significant risk of rupture, which can be fatal, making timely diagnosis and treatment essential. There is limited literature on the management of innominate artery aneurysms during pregnancy, and no established treatment guidelines exist. In this case, a 42-year-old multigravida woman was diagnosed with an innominate artery aneurysm four years prior to pregnancy. Genetic panel testing ruled out inherited connective tissue disorders, including Marfan syndrome. The aneurysm measured 24 × 36 mm and possessed a saccular configuration. At 23 weeks of gestation, due to the high risk of rupture, the patient underwent successful endovascular stent grafting without complications. Later, the patient developed preeclampsia and fetal growth restriction, necessitating an emergency cesarean section at 33 weeks. A female infant was delivered, and both mother and neonate were discharged without further complications. Open surgical intervention with cardiopulmonary bypass is the standard therapeutic approach for innominate artery aneurysms. However, maternal and fetal mortality rates associated with cardiopulmonary bypass during pregnancy are high. This case suggests that although innominate artery aneurysms during pregnancy are exceedingly rare, endovascular repair with stent grafting may be a viable treatment option to avoid the serious maternal and fetal risks associated with aneurysm rupture or open surgical repair.departmental bulletin pape