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ObjectiveTo clarify the problems related to maternal deaths in Japan, including the diseases themselves, causes, treatments and the hospital or regional systems.DesignDescriptive study.SettingMaternal death registration system established by the Japan Association of Obstetricians and Gynecologists (JAOG).ParticipantsWomen who died during pregnancy or within a year after delivery, from 2010 to 2014, throughout Japan (N=213).Main outcome measuresThe preventability and problems in each maternal death.ResultsMaternal deaths were frequently caused by obstetric haemorrhage (23%), brain disease (16%), amniotic fluid embolism (12%), cardiovascular disease (8%) and pulmonary disease (8%). The Committee considered that it was impossible to prevent death in 51% of the cases, whereas they considered prevention in 26%, 15% and 7% of the cases to be slightly, moderately and highly possible, respectively. It was difficult to prevent maternal deaths due to amniotic fluid embolism and brain disease. In contrast, half of the deaths due to obstetric haemorrhage were considered preventable, because the peak duration between the initial symptoms and initial cardiopulmonary arrest was 1–3 h.ConclusionsA range of measures, including individual education and the construction of good relationships among regional hospitals, should be established in the near future, to improve primary care for patients with maternal haemorrhage and to save the lives of mothers in Japan.

An assay for the Maillard reaction has been developed to screen efficiently inhibitors from natural resources such as extracts of plants. The fluorometric analysis of fluorescent material based on advanced glycation endproducts (AGEs) was applied to measurement of an inhibitory index of the Maillard reaction to detect all of the inhibitors at each step of the complicated reaction. To solve the two major problems, slowness of the reaction rate and the existence of interfering substances such as quencher and fluorescent material in the screening sources, we devised the following procedures. Slowness of the reaction rate was solved by raising the reaction temperature to 60°C at which the conformation of bovine serum albumin (BSA) did not change greatly. To remove the interfering substances, AGEs-BSA was precipitated from the reaction mixture. Thus, an efficient assay system by measuring the fluorescent intensity based on AGEs was established to isolate the glycation inhibitors from natural product extracts.

ObjectivesResults Logistic regression analysis revealed that advanced maternal age (odds ratio (OR), 5.4; 95% CI, previous Cesarean section (OR, 20.4; 95% CI,) and sponge-like findings in the cervix (OR, 5.6; 95% CI, were associated with massive bleeding (> 2500 mL). Placental adherence occurred in five cases and was more frequent in cases where the placenta was located at the site of the scar of a previous Cesarean section (OR, 123.1; 95% CI, and where there was lack of a clear zone (OR, 48.0; 95% CI,. Conclusions

Proteases of the caspase family, especially caspase-1 (ICE)(-like), caspase-3 (CPP32/Yama/apopain)(-like) and caspase-8 (MACH/FLICE/Mch5) proteases, are implicated in Fas (APO-1/CD95)-mediated apoptosis. Here, we show that the caspase-4 (TX/ICH-2/ICE rel II)(-like) protease, another member of the caspase family, is also involved in Fas-mediated apoptosis, based upon the observations: (i) caspase-4 is processed in response to an agonistic anti-Fas antibody treatment, (ii) overexpression of a mutant caspase-4 with active site mutations in both p20 and p10 subunits delays Fas-mediated apoptosis, (iii) microinjected anti-caspase-4 antibodies inhibit Fasmediated apoptosis. Together with our observations that the mutant caspase-4 inhibits the Fas-mediated activation of caspase-3(-like) proteases and puri®ed caspase-4 cleaves pro-caspase-3 to generate a subunit of active form, these results suggest that Fas-mediated apoptosis is driven by a caspase cascade in which the caspase-4(-like) protease transmits a death signal from caspase-8 to caspase-3(-like) proteases probably through directly cleaving pro-caspase-3(-like) proteases.

Estrogens play important hormonal roles in all vertebrates. Animal estrogens are exclusively steroidal compounds, and the principal physiological estrogen in most species is 17b-estradiol. Many plants produce isoflavones that possess estrogenic activity in animals and are, thus, called phytoestrogens. Two estrogen receptors (ERs) have been identified to date 1,2) and the physiological responses to estrogen are known to be mediated within specific tissues by at least these two receptors. The ERs are a 3A member of the nuclear hormone receptor family and act as ligand-activated nuclear transcription factors. 3)Among the foods consumed by humans, soybeans contain the highest concentration of isoflavones. We have examined the estrogenic activity of these soy isoflavones (e.g., daidzin, genistin and glycitin) and their metabolites (e.g., daidzein, genistein, glycitein, equol, dihydrogenistein and dihydroglycitein) by enteric bacteria in the previous paper. 4) In this paper, we examined the estrogenic activities of several other isoflavone derivatives by (A) binding to human estrogen receptor (hER) a and b, and (B) effect on estrogen receptordependent transcriptional expression. 4) MATERIALS AND METHODS

Using a newly developed assay of telomerase reverse transcriptase (hTERT) mRNA in serum by real-time RT-PCR, we previously reported this assay to be superior to other tumor markers for hepatoma. In this study, we aimed to clarify its clinical significance as a biomarker for lung cancer. In 112 patients with lung tumor and 80 individuals without cancer, we measured serum hTERT mRNA and epidermal growth factor receptor (EGFR) mRNA levels, using a quantitative one-step real-time RT-PCR assay. We examined its sensitivity and specificity in lung cancer diagnosis, its clinical significance in comparison with other tumor markers, and its correlation with the clinical parameters using multivariate analyses and correlation relative tests. The copy number of serum hTERT mRNA was independently correlated with tumor size, tumor number, presence of metastasis and recurrence, and smoking (all P < 0.05). EGFR mRNA correlated with tumor number and clinical stage (both P < 0.05). The sensitivity and specificity in lung cancer diagnosis were 89.0% and 72.7% for hTERT mRNA, and 71.3% and 80.0% for EGFR mRNA, respectively. hTERT mRNA was superior to other tumor markers in lung cancer diagnosis. For both mRNAs, serum levels were significantly correlated with levels in lung cancer tissues (both P < 0.05). The copy number of hTERT mRNA significantly decreased after the surgical treatment. The data suggest that hTERT mRNA, especially when combined with EGFR mRNA, is a novel and excellent biomarker for pulmonary malignancies to diagnose and assess the clinical stage. (Cancer Sci 2006; 97: 1366-1373) L ung cancer is the leading cause of malignancy-related mortality (1) with little change in the survival rates over the past two decades.(2) NSCLC now accounts for about three-quarters of all cases of lung cancer (3) and most patients continue to die of progressive metastatic disease despite the development of new therapeutic strategies and advances in surgical treatment. Serum tumor markers are non-invasive diagnostic tools for malignant tumors and they are commonly used for the screening of cancer and as an indicator of the treatment effect. In SCLC, neuronspecific enolase and pro-gastrin-releasing peptide are effective markers. In NSCLC, CEA, SCCA, and CYFRA 21-1 are commonly used for screening, and at least one marker among CEA, SCCA and CYFRA is positive in approximately 70% of patients with NSCLC.(4) According to the histological category, the positive rates of CEA and CYFRA are high in patients with ADC, and the positive rates of CYFRA and SCCA are high in patients with SCC. Although the standard diagnostic procedures such as X-ray examinations, conventional tumor markers, and bronchial lavage are important for the detection of lung cancer, they are not still sensitive enough to detect lung cancer at an early clinical stage.Tyrosine kinase activity of EGFR promotes tumor cell proliferation, cell survival, angiogenesis, invasion, and metastasis, and its specific inhibition by gefitinib, a synthetic anilinoquinazoline, has been demonstr...