Objective: In Japan, perioperative prophylaxis of pulmonary embolism (PE) in gynecologic cancer patients with preoperative asymptomatic venous thromboembolism (VTE) has not been well established yet. The GOTIC-VTE trial was a prospective, multi-center, single-arm clinical trial to investigate the prevention of postoperative symptomatic PE onset by seamless anticoagulant therapy from the preoperative period to 4 weeks after surgery instead of using intermittent pneumatic compression. Methods: Anticoagulant therapy was started immediately after asymptomatic VTE diagnosis and stopped preoperatively according to the rules of each institution. Unfractionated heparin administration was resumed within 12 hours postoperatively, and this was followed by the switch to low-molecular-weight heparin and subsequently, edoxaban; this cycle was continued for 28 days. Primary outcome was the occurrence of symptomatic PE in 28 days postoperatively. Secondary outcomes were the incidence of VTE-related events in 28 days and 6 months postoperatively and protocol-related adverse events. Results: Between February 2018 and September 2020, 99 patients were enrolled; of these, 82patients were assessed as the full analysis set, including 58 for ovarian cancer, fallopian tube, or peritoneal cancer; 21 for endometrial cancer; and 3 for cervical cancer. No symptomatic PE was observed within 28 days postoperatively; two patients had bleeding events (major bleeding and clinically relevant nonmajor bleeding) and three had grade 3 adverse events (increased alanine transaminase, aspartate aminotransferase, or gamma-glutamyl transferase). Conclusion The multifaceted perioperative management for gynecologic malignancies with asymptomatic VTE effectively prevented postoperative symptomatic PE.Trial Registration: JRCT Identifier: jRCTs031180124

Objective: In Japan, perioperative prophylaxis of pulmonary embolism (PE) in gynecologic cancer patients with preoperative asymptomatic venous thromboembolism (VTE) has not been well established yet. The GOTIC-VTE trial was a prospective, multi-center, single-arm clinical trial to investigate the prevention of postoperative symptomatic PE onset by seamless anticoagulant therapy from the preoperative period to 4 weeks after surgery instead of using intermittent pneumatic compression. Methods: Anticoagulant therapy was started immediately after asymptomatic VTE diagnosis and stopped preoperatively according to the rules of each institution. Unfractionated heparin administration was resumed within 12 hours postoperatively, and this was followed by the switch to low-molecular-weight heparin and subsequently, edoxaban; this cycle was continued for 28 days. Primary outcome was the occurrence of symptomatic PE in 28 days postoperatively. Secondary outcomes were the incidence of VTE-related events in 28 days and 6 months postoperatively and protocol-related adverse events. Results: Between February 2018 and September 2020, 99 patients were enrolled; of these, 82patients were assessed as the full analysis set, including 58 for ovarian cancer, fallopian tube, or peritoneal cancer; 21 for endometrial cancer; and 3 for cervical cancer. No symptomatic PE was observed within 28 days postoperatively; two patients had bleeding events (major bleeding and clinically relevant nonmajor bleeding) and three had grade 3 adverse events (increased alanine transaminase, aspartate aminotransferase, or gamma-glutamyl transferase). Conclusion The multifaceted perioperative management for gynecologic malignancies with asymptomatic VTE effectively prevented postoperative symptomatic PE.Trial Registration: JRCT Identifier: jRCTs031180124

Objective: In Japan, perioperative prophylaxis of pulmonary embolism (PE) in gynecologic cancer patients with preoperative asymptomatic venous thromboembolism (VTE) has not been well established yet. The GOTIC-VTE trial was a prospective, multi-center, single-arm clinical trial to investigate the prevention of postoperative symptomatic PE onset by seamless anticoagulant therapy from the preoperative period to 4 weeks after surgery instead of using intermittent pneumatic compression. Methods: Anticoagulant therapy was started immediately after asymptomatic VTE diagnosis and stopped preoperatively according to the rules of each institution. Unfractionated heparin administration was resumed within 12 hours postoperatively, and this was followed by the switch to low-molecular-weight heparin and subsequently, edoxaban; this cycle was continued for 28 days. Primary outcome was the occurrence of symptomatic PE in 28 days postoperatively. Secondary outcomes were the incidence of VTE-related events in 28 days and 6 months postoperatively and protocol-related adverse events. Results: Between February 2018 and September 2020, 99 patients were enrolled; of these, 82patients were assessed as the full analysis set, including 58 for ovarian cancer, fallopian tube, or peritoneal cancer; 21 for endometrial cancer; and 3 for cervical cancer. No symptomatic PE was observed within 28 days postoperatively; two patients had bleeding events (major bleeding and clinically relevant nonmajor bleeding) and three had grade 3 adverse events (increased alanine transaminase, aspartate aminotransferase, or gamma-glutamyl transferase). Conclusion The multifaceted perioperative management for gynecologic malignancies with asymptomatic VTE effectively prevented postoperative symptomatic PE.Trial Registration: JRCT Identifier: jRCTs031180124

In food science, natural ingredients that can inhibit dipeptidyl peptidase IV ( DPP IV ) may be useful for preventing diabetes mellitus. This study aimed to evaluate the effectiveness of bonito dashi having a high DPP IV inhibitory activity (IC50 ; 3049 µg/ ml) on the postprandial increase in blood glucose levels in 14 subjects. Bonito dashi (5 g) was subsequently subjected to oral glucose tolerance tests. Blood glucose levels of all subjects were measured at fasting and at 30 min after ingesting of bonito dashi or of warmed tap water as a control, and were also measured at 30, 45, 60, 75, 90, 120, and 150 min after ingestion of cooked rice. The maximum blood glucose level between 0 and 150 min after ingesting of bonito dashi was for 30 min, of warmed tap water for 45 min ). The blood glucose levels after ingestion of bonito dashi and warmed tap water were 135.6 ± 8.7 mg/ dl and 140.3 mg/ dl, respectively at 30 min ( p = 0.602 ); 135.6 ± 8.7 mg/ dl and 144.1 ± 10.7 mg/ dl, respectively at 45 min ( p = 0.057 ); 120.0 ± 4.9 mg/ dl and 136.8 ± 7.8 mg/ dl, respectively at 60 min ( p = 0.063 ); 110.0 ± 5.9 mg/ dl and 134.9 ± 6.9 mg/ dl, respectively at 75 min ( p = 0.006 ); 110.3 ± 6.8 mg/ dl and 129.3 ± 6.6 mg/ dl, respectively, at 90 min ( p = 0.036 ); 103.4 ± 4.1 mg/ dl and 118.7 ± 8.0 mg/ dl, respectively, at 120 min ( p = 0.091 ); 91.5 ± 3.8 mg/ dl and 102.3 ± 5.9 mg/ dl, respectively, at 150 min ( p = 0.232 ). The area under the curve for blood glucose levels after ingestion of bonito dashi and warmed tap water was 4753.1 ± 439.7 mg/ dl ×min and 6879.4 ± 728.1 mg/ dl ×min, respectively ( p = 0.005 ). Postprandial increase in blood glucose levels was lower in subjects ingestion of bonito dashi than in those ingestion of the warmed tap water. No serious adverse events related to ingestion of bonito dashi were observed. Our findings suggested that the ingestion of bonito dashi (5 g) suppressed postprandial increase in blood glucose levels in our subjects.