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Yuichiro Imai,1 Yasushi Adachi,2,3 Takashi Kimura,4 Chikara Nakano,5 Toshiki Shimizu,4 Ming Shi,2 Mitsuhiko Okigaki,6 Tomohiko Shimo,1 Kazunari Kaneko,1 Susumu Ikehara2 1Department of Pediatrics, Kansai Medical University, Osaka, 2Department of Stem Cell Disorders, Kansai Medical University, Osaka, 3Division of Clinical Pathology, Toyooka Hospital, Hyogo, 4First Department of Internal Medicine, Kansai Medical University, Osaka, 5Second Department of Internal Medicine, Kansai Medical University, Osaka, 6Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine, Kyoto, Japan Abstract: For immunodeficient patients, fungi are life-threatening pathogens. In this paper, we present an autopsy case of combined zygomycosis and aspergillosis. A female in her 70s on chronic hemodialysis was admitted to a hospital suffering bloody sputum, dyspnea, and fever, probably due to perinuclear anti-neutrophil cytoplasmic antibody-related vasculitis. Antibiotics were administered and immunosuppressive therapy was started, resulting in an improvement in her condition. Pneumonia later developed, followed by pulmonary bleeding and intractable pneumothorax from which she ultimately died. On autopsy, the upper lobe of the left lung was found to have hemorrhagic necrosis and showed a large longitudinal fissure. Microscopically, Zygomycota were observed in both the lungs and heart, while Aspergillus was found in the middle lobe of the right lung. Zygomycosis, which usually has a poor prognosis, is assumed to have induced hemorrhagic infarction of the lungs, inducing pulmonary bleeding and necrosis, despite the use of lipid formulations of amphotericin B, which are effective medicines against Zygomycota. Keywords: pulmonary fissure, zygomycosis, aspergillosis, lung, immunosuppression

Ming Shi, Ming Li, Susumu IkeharaDepartment of Stem Cell Disorders, Kansai Medical University, Moriguchi City, Osaka, JapanAbstract: Bone marrow transplantation (BMT) has evolved into an effective strategy for the treatment of hematological and oncological disorders. Radiotherapy and chemotherapy are used as conditioning regimens prior to BMT to suppress host immunity and reduce tumor burden. High doses of total body irradiation are conventionally administered along with alkylating agents, ie, the myeloablative regimen, to help ensure rapid engraftment of donor cells and to prevent relapse. However, the toxicity of the myeloablative conditioning regimen and unacceptable nonrelapse mortality rules out this approach for older patients by whom less intense preparative regimens are likely to be better tolerated. The reduced-intensity and nonmyeloablative conditioning regimens have been demonstrated by many investigators to be novel approaches resulting in a lower nonrelapse mortality rate and lower incidence of severe acute graft versus host disease. Here, we review the conditioning regimens employed as a pretreatment for BMT, and focus on the novel conditioning regimens and cutting edge developments.Keywords: myeloablative conditioning regimen, reduced-intensity conditioning, nonmyeloablative conditioning regimen, relapse, nonrelapse mortality, graft versus host disease

Objective: To examine the association between maternal alcohol consumption during pregnancy and the risk of preterm delivery.Design: Prospective cohort study.Setting: The Japan Environment and Children's Study (JECS).Population: A total of 94 349 singleton pregnancies.Methods: Participants completed questionnaires detailing alcohol consumption during the first trimester and during the second and third trimesters. Participants were divided into four categories according to alcohol consumption (non-drinkers, consumers of 1-149 g, 150-299 g and ≥300 g ethanol/week). We examined the effect of alcohol consumption during different stages of pregnancy on the risk of preterm delivery. Odds ratios (OR) and 95% CI were calculated relative to non-drinkers using logistic regression.Main Outcome Measures: Medical record-based preterm delivery.Results: Alcohol consumption during the second and third trimesters, but not during the first trimester, was associated with increased risk of preterm delivery. Heavy alcohol consumption (≥300 g ethanol/week) during the second and third trimesters was associated with a four-fold higher risk compared with non-drinkers (multivariable OR 4.52; 95% CI 1.68-12.2). Light alcohol consumption (1-149 g ethanol/week) tended to be associated with lower risk of preterm delivery (multivariable OR 0.78; 95% CI 0.60-1.00).Conclusions: Heavy alcohol consumption during the second and third trimesters was associated with increased risk of preterm delivery among pregnant women.Tweetable Abstract: Heavy drinking during pregnancy may increase the risk of preterm delivery. [ABSTRACT FROM AUTHOR]