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Aim Cesarean section is commonly selected in pregnancy with Moyamoya disease. We consider vaginal delivery with epidural anesthesia a viable alternative in such cases. Methods Mode of delivery and outcomes were examined in 27 pregnancies in 19 women with Moyamoya disease treated at the Department of Perinatology, National Cardiovascular Center, Japan, from 1983 to 2013. Of these 27 pregnancies, 20 were delivered vaginally with epidural anesthesia. The cerebral circulation, mode of delivery, maternal outcome (presence of symptoms due to Moyamoya disease intrapartum) and neonatal outcome (gestational week, birthweight, Apgar score at 5 min and pH of umbilical artery) were investigated. Results The cerebral circulation was judged to be good in all pregnancies. No symptoms due to Moyamoya disease intrapartum were seen in the vaginal delivery cases. Conclusion Our findings indicate that vaginal delivery is viable in pregnancy with Moyamoya disease and that unnecessary cesarean section may be avoided. These findings are limited by the retrospective nature of the study. [ABSTRACT FROM AUTHOR]

Varroa destructor is a parasite mite of the eastern honey bee Apis cerana, which is native to Asia. The European honey bee Apis mellifera was imported to Asia from Europe and the USA for apiculture in the 19th century. In a short period of time, V. destructor parasitized the artificially introduced honey bees. Varroa destructor was estimated to have spread around the world with A. mellifera when it was exported from Asia to locations worldwide about 50 years ago. The mitochondrial DNA of the parasitic honey bee mite V. destructor was analyzed using next-generation sequencing. The complete mitochondrial genome of V. destructor was identified as a 16,476-bp circular molecule containing 13 protein-coding genes (PCGs), 22 tRNA genes, two rRNA genes, and one AT-rich control region. The heavy strand was predicted to have nine PCGs and 13 tRNA genes, whereas the light strand was predicted to contain four PCGs, nine tRNA genes, and two rRNA genes. All PCGs began with ATA as the start codon, except COIII and CytB, which had ATG as the start codon. Stop codons were of two types: TAA for eight genes and TAG for five genes. Molecular phylogenetic analysis revealed that V. destructor from Japan was genetically distant from that of France. A high base substitution rate of 2.82% was also confirmed between the complete mitochondrial DNA sequences of V. destructor from Japan and the USA, suggesting that one Varroa mite strain found in the USA is not from Japan. [ABSTRACT FROM AUTHOR]