岡山大学法学会Acta Medica Okayama0386-3050753-420262024 Irish Dáil Éireann Election: An Analysis of NEDS 2024 Data494457ENT.NarihiroNo potential conflict of interest relevant to this article was reported.岡山大学教育推進機構 教師教育開発センターActa Medica Okayama2186-1323162026スクールカウンセラーは発達支持的生徒指導へいかに貢献できるか ―プランニングシートの活用を通した支援の拡充に向けた検討―253266ENNoriyukiHARARyoMISAWATazukoAOKI10.18926/CTED/70373 2022年に改訂された「生徒指導提要」では，すべての児童生徒の成長を支援する発達支持的生徒指導の重要性が明確に示されている。しかし，その定着には，教員の多忙化や組織的支援体制の不十分さなど，学校現場における多くの課題が指摘されている。さらに，スクールカウンセラー（SC）による支援も十分に展開されているとは言い難い。そこで本稿では，発達支持的生徒指導におけるSCの支援の拡充可能性を検討するため，現状と課題を整理した。また，プランニングシートを活用した実践事例（原他, 2024）の再分析を通して，SCと学校が教育目標を共有しながら協働的に支援を計画する枠組みの有用性を吟味した。No potential conflict of interest relevant to this article was reported.岡山大学農学部附属山陽圏フィールド科学センターActa Medica Okayama0910-8742462024奥付ENNo potential conflict of interest relevant to this article was reported.岡山大学農学部附属山陽圏フィールド科学センターActa Medica Okayama0910-8742462024センター報告投稿要領7979ENNo potential conflict of interest relevant to this article was reported.岡山大学農学部附属山陽圏フィールド科学センターActa Medica Okayama0910-8742462024資料 : 2023年度7578ENNo potential conflict of interest relevant to this article was reported.岡山大学農学部附属山陽圏フィールド科学センターActa Medica Okayama0910-8742462024運営 : 2023年度1373ENNo potential conflict of interest relevant to this article was reported.岡山大学農学部附属山陽圏フィールド科学センターActa Medica Okayama0910-8742462024地域連携 : 2023年度1111ENNo potential conflict of interest relevant to this article was reported.岡山大学農学部附属山陽圏フィールド科学センターActa Medica Okayama0910-8742462024試験研究 : 2023年度79ENNo potential conflict of interest relevant to this article was reported.岡山大学農学部附属山陽圏フィールド科学センターActa Medica Okayama0910-8742462024教育 : 2023年度16ENNo potential conflict of interest relevant to this article was reported.岡山大学農学部附属山陽圏フィールド科学センターActa Medica Okayama0910-8742462024目次iiiiENNo potential conflict of interest relevant to this article was reported.岡山大学農学部附属山陽圏フィールド科学センターActa Medica Okayama0910-8742462024序iiENNo potential conflict of interest relevant to this article was reported.岡山大学農学部附属山陽圏フィールド科学センターActa Medica Okayama0910-8742462024表紙ENNo potential conflict of interest relevant to this article was reported.岡山大学考古学研究室Acta Medica Okayama2026岡山市向場・黒住丘陵の遺跡測量調査概要報告EN10.18926/70272No potential conflict of interest relevant to this article was reported.JMIR Publications Inc.Acta Medica Okayama2369-3762122026Prescription Support Practice for Pharmacy Students: Pre-Post Educational Intervention Studye79545ENFukaAizawaClinical Research Center for Developmental Therapeutics, Tokushima University HospitalKentaYagiDepartment of Clinical Pharmacology and Therapeutics, Graduate School of Biomedical Sciences, Tokushima UniversityTsukasaHigashionnaDepartment of Pharmacy, Okayama University HospitalHirofumiHamanoDepartment of Pharmacy, Okayama University HospitalShimonTakahashiDepartment of Clinical Pharmacology and Therapeutics, Graduate School of Biomedical Sciences, Tokushima UniversityYoshitoZamamiDepartment of Pharmacy, Okayama University HospitalKazuakiShinomiyaDepartment of Pharmaceutical Care and Clinical Pharmacy, Tokushima Bunri UniversityTakahiroNiimuraClinical Research Center for Developmental Therapeutics, Tokushima University HospitalMitsuhiroGodaDepartment of Clinical Pharmacology and Therapeutics, Graduate School of Biomedical Sciences, Tokushima UniversityKeiKawadaDepartment of Clinical Pharmacology and Therapeutics, Graduate School of Biomedical Sciences, Tokushima UniversityKeisukeIshizawaClinical Research Center for Developmental Therapeutics, Tokushima University HospitalBackground: In the field of team-based care, pharmacists are vital for optimizing medication therapy. However, many medical professionals lack the opportunity to learn how to propose prescription changes with precision.<br>
Objective: This study aimed to address this knowledge gap by developing and assessing a new educational program for pharmacy students focused on prescription support and interprofessional collaboration.<br>
Methods: We recruited 191 fifth-year pharmaceutical students during the 2022‐2024 academic years. The program featured a 7-day intensive curriculum that included learning how to assist with prescriptions, analyzing clinical data, and engaging in role-playing exercises. A web-based questionnaire and a paper test were used to evaluate students’ awareness and knowledge both before and after the program. Statistical analyses were performed to verify the significance of changes; we utilized the Wilcoxon signed-rank test for the ordinal data derived from the specific behavioral objectives and 2-tailed paired t tests for the interval data from the knowledge tests. The magnitude of change was quantified using r for Wilcoxon tests and Cohen dz for 2-tailed t tests, with 95% CI calculated to ensure the stability and reliability of the observed results.<br>
Results: Analysis of the primary outcome specific behavioral objectives revealed statistically significant effects across all items (Wilcoxon signed-rank test; P<.001). Effect sizes (r=0.505‐0.835) ranged from moderate to large, with particularly large effects observed in identifying contents issue (r=0.835, 95% CI 0.126-0.330; P<.001). Knowledge test scores showed significant improvement in the following 3 subjects: pharmacology (r=−0.504, 95% CI –0.215 to 0.127; P<.001), organic chemistry (r=0.254, 95% CI –0.148 to –0.193; P=.004), and communication (r=0.221, 95% CI –0.151 to –0.190; P=.01). No significant changes were observed in pathology or pharmacokinetics.<br>
Conclusions: This program provides strong evidence that practical, hands-on learning with hospital pharmacists helps improve pharmacy students’ professional skills and optimize pharmaceutical therapies in interprofessional care. By teaching pharmacists to effectively propose prescription changes, the program equips them to become integral members of interprofessional care, ultimately leading to optimized pharmaceutical care for patients.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1435-245141112025The impact of liver transection depth on surgical difficulty in robotic versus laparoscopic limited liver resection (TAKUMI-5)22ENTomokazuFujiDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKoseiTakagiDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKazuyaYasuiDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineAteneItoDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTakeyoshiNishiyamaDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineYasuoNagaiDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineShoheiYokoyamaDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicinePurpose Although robotic liver resection (RLR) has gained popularity worldwide, limited liver resection remains the mainstay of RLR. This study aimed to investigate the effect of parameters, including liver transection depth (LTD), on surgical difficulty in limited RLR compared with limited laparoscopic liver resection (LLR).<br>
Methods This retrospective study included 105 patients who underwent limited RLR (n = 56) or LLR (n = 49) at our institution between January 2018 and December 2024. After comparing outcomes of RLR and LLR, multivariate analyses were performed to examine effect of LTD on surgical difficulty (defined as prolonged operative time). Moreover, outcomes stratified by LTD cut-off values were compared between the groups.<br>
Results Median LTD was similar between groups (RLR vs. LLR: 2.6 vs. 2.6 cm, P = 0.77). LTD was significantly correlated with operative time for both procedures (RLR, R² = 0.07, P = 0.042; LLR, R² = 0.08, P = 0.046). Multivariate analyses demonstrated that LLR (odds ratio, 6.9; P < 0.001) and LTD (odds ratio, 2.0; P = 0.004) were significant risk factors of surgical difficulty. Among patients with deeper LTD (> 2.5 cm), the RLR group had significantly shorter operative time (145 vs. 231 min, P < 0.001), less blood loss (nil vs. 100 mL, P = 0.006), and a higher rate of textbook outcomes (76.7% vs. 42.3%, P = 0.01).<br>
Conclusion This study investigated impact of LTD on surgical outcomes in patients who underwent limited RLR compared to those who underwent limited LLR. LTD may be a useful parameter for estimating surgical difficulty in limited RLR. Moreover, robotic surgery may be favorable for deeper and limited liver resections.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221612026Comparative efficacy of immune checkpoint inhibitor combination therapies by metastatic site in metastatic renal cell carcinoma3303ENShingoToyodaDepartment of Urology, Faculty of Medicine, Kindai UniversityLanInokiDepartment of Urology, Faculty of Medicine, Kindai UniversityMamoruHashimotoDepartment of Urology, Faculty of Medicine, Kindai UniversityWataruFukuokayaDepartment of Urology, The Jikei University School of MedicineKeiichiroMoriDepartment of Urology, The Jikei University School of MedicineShingoNishimuraDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineRyoichiMaenosonoDepartment of Urology, Osaka Medical and Pharmaceutical UniversityTakehiroIwataDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKensukeBekkuDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTakuhisaNukayaDepartment of Urology, Fujita-Health University School of MedicineTakafumiYanagisawaDepartment of Urology, The Jikei University School of MedicineTakuyaTsujinoDepartment of Urology, Osaka Medical and Pharmaceutical UniversityKazumasaKomuraDepartment of Urology, Kawasaki University School of MedicineKiyoshiTakaharaDepartment of Urology, Fujita-Health University School of MedicineTeruoInamotoDepartment of Urology, Hamamatsu University School of MedicineHaruhitoAzumaDepartment of Urology, Osaka Medical and Pharmaceutical UniversityKazutoshiFujitaDepartment of Urology, Faculty of Medicine, Kindai UniversityJK-FOOT study groupFew studies have investigated the efficacy of immuno-oncology (IO) combinations at different metastatic sites in renal cell carcinoma (RCC). We evaluated the differential efficacy of IO–IO and IO–tyrosine kinase inhibitor (TKI) combinations by metastatic site in metastatic RCC (mRCC). This retrospective multicenter study by the JK-FOOT Study Group included 579 patients with intermediate- or poor-risk mRCC (per International Metastatic RCC Database Consortium criteria) treated with first-line IO combinations between September 2018 and December 2024. Metastatic sites were lymph nodes, lungs, bones, liver, brain, and others. The primary endpoints were progression-free survival (PFS) and overall survival (OS); the secondary endpoint was objective response rate. Efficacy was compared between IO–IO and IO–TKI for each site. For lymph node (n = 36), lung (n = 132), or brain (n = 16) metastases, OS or PFS was not significantly different between IO–IO and IO–TKI. In bone metastases (n = 80), OS tended to favor IO–TKI (P = 0.053). In liver metastases (n = 22), OS was significantly longer with IO–TKI (P = 0.011). IO–TKI may be a more appropriate first-line option than IO–IO for mRCC with bone or liver metastases, while efficacy is similar for other sites.No potential conflict of interest relevant to this article was reported.eLife Sciences Publications, LtdActa Medica Okayama2050-084X132025Stimulatory and inhibitory G-protein signaling relays drive cAMP accumulation for timely metamorphosis in the chordate CionaRP99825ENAkikoHozumiShimoda Marine Research Center, University of TsukubaNozomu MTotsukaDepartment of Biosciences and Informatics, Faculty of Science and Technology, Keio UniversityArataOnoderaShimoda Marine Research Center, University of TsukubaYanbinWangShimoda Marine Research Center, University of TsukubaMayukoHamadaUshimado Marine Institute, Okayama UniversityAkiraShiraishiBioorganic Research Institute, Suntory Foundation for Life SciencesHonooSatakeBioorganic Research Institute, Suntory Foundation for Life SciencesTakeoHorieLaboratory for Single-cell Neurobiology, Graduate School of Frontier Biosciences, Osaka UniversityKohjiHottaDepartment of Biosciences and Informatics, Faculty of Science and Technology, Keio UniversityYasunoriSasakuraShimoda Marine Research Center, University of TsukubaLarvae of the ascidian Ciona initiate metamorphosis tens of minutes after adhesion to a substratum via their adhesive organ. The gap between adhesion and metamorphosis initiation is suggested to ensure the rigidity of adhesion, allowing Ciona to maintain settlement after losing locomotive activity through metamorphosis. The mechanism producing the gap is unknown. Here, by combining gene functional analyses, pharmacological analyses, and live imaging, we propose that the gap represents the time required for sufficient cyclic adenosine monophosphate (cAMP) accumulation to trigger metamorphosis. Not only the Gs pathway but also the Gi and Gq pathways are involved in the initiation of metamorphosis in the downstream signaling cascade of the neurotransmitter GABA, the known initiator of Ciona metamorphosis. The mutual crosstalk of stimulatory and inhibitory G-proteins functions as the accelerator and brake for cAMP production, ensuring the faithful initiation of metamorphosis at an appropriate time and in the right situation.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2688-4526722026Safety and efficacy of Rezūm water vapour energy therapy in BPH patients receiving antithrombotic therapy: A Japanese single‐centre experiencee70170ENTakatoshiMoriwakeDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYusukeTominagaDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySatoshiKatayamaDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHarukiKakuDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityIchiroTsuboiDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKasumiYoshinagaDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomoakiYamanoiDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTatsushiKawadaDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakuyaSadahiraDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakehiroIwataDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShingoNishimuraDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKensukeBekkuDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYasuhiroKatayamaDepartment of Urology, Okamura Isshindo HospitalMotooArakiDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityObjectives: The objective of this study is to evaluate the safety and efficacy of Rezūm water vapour energy therapy (WAVE) in Japanese patients with benign prostatic hyperplasia (BPH) continuing antithrombotic therapy and to validate the Okayama University Modified Clavien-Dindo classification (OU-mCD) for perioperative hematuria.<br>
Patients and Methods: We retrospectively analysed 80 consecutive patients who underwent WAVE from August 2023 to July 2024, including 37 (46.2%) continuing antithrombotic therapy perioperatively. Hematuria within 30 days was graded using conventional Clavien-Dindo classification and the OU-mCD, a novel classification focusing on intervention necessity. We assessed clinically significant hematuria (Grade ≥ Ib), catheter-free rate, prostate volume reduction and haemoglobin change.<br>
Results: Clinically significant hematuria occurred in 21.6% (8/37) of patients continuing antithrombotic therapy versus 4.7% (2/43) without (p = 0.038). All 10 Grade ≥ Ib cases occurred during hospitalization with the catheter in place and were managed conservatively with continuous bladder irrigation (median 1 day); none required transfusion or surgical reintervention. Only one patient required temporary drug discontinuation. Treatment efficacy did not differ by antithrombotic status: 86.2% achieved PVR < 50 ml with 44% mean prostate volume reduction. Multivariate analysis identified antithrombotic therapy as the sole independent risk factor for Grade ≥ Ib hematuria (OR 5.46, 95% CI 1.06–28.16, p = 0.042).<br>
Conclusion: WAVE can be safely performed with continued antithrombotic therapy. Whereas Grade ≥Ib hematuria occurred in 25% of antiplatelet/anticoagulant users (vs. 5% without), 75% had no significant bleeding, and all complications were managed conservatively without transfusion. The OU-mCD provides precise complication stratification. These findings suggest outpatient procedures may be feasible with appropriate patient selection.No potential conflict of interest relevant to this article was reported.American Medical Association (AMA)Acta Medica Okayama2574-38058112025Trastuzumab Deruxtecan for ERBB2-Mutant Metastatic Non–Small Cell Lung Cancer With or Without Brain Metastases: A Secondary Analysis of Randomized Clinical Trialse2543107ENPasi A.JänneLowe Center for Thoracic Oncology, Dana-Farber Cancer InstituteDavidPlanchardDepartment of Medical Oncology, Thoracic Cancer Group, Gustave Roussy, Medical OncologyKoichiGotoDepartment of Thoracic Oncology, Nation Cancer Center Hospital EastEgbert F.SmitDepartment of Pulmonary Diseases, Leiden University Medical CenterAdrianus Johannesde LangenDepartment of Thoracic Oncology, Netherlands Cancer InstituteYasushiGotoDepartment of Thoracic Oncology, National Cancer Center HospitalKiichiroNinomiyaCenter for Comprehensive Genomic Medicine, Okayama University HospitalToshioKuboCenter for Clinical Oncology, Okayama University HospitalMauricePérolDepartment of Medical Oncology, Centre Léon BérardEnriquetaFelipDepartment of Medical Oncology, Vall d’Hebron University and Vall d’Hebron Institute of OncologyHidetoshiHayashiDepartment of Medical Oncology, Kindai University Faculty of MedicineKazuhikoNakagawaDepartment of Medical Oncology, Kindai University Faculty of MedicineJunichiShimizuDepartment of Thoracic Oncology, Aichi Cancer CenterMisakoNagasakaDivision of Hematology-Oncology, Department of Medicine, University of California IrvineKalinePereiraDaiichi Sankyo IncAyumiTaguchiDaiichi Sankyo Co LtdAhmedAliDaiichi Sankyo Europe GmbHMahaKarnoubDaiichi Sankyo IncRieYonemochiDaiichi Sankyo IncDavidLeungDaiichi Sankyo IncBob T.LiThoracic Oncology and Early Drug Development Service, Global Research Program, Memorial Sloan Kettering Cancer CenterImportance Brain metastases reduce overall survival rates of patients with non–small cell lung cancer (NSCLC); patients with epidermal growth factor receptor 2 (ERBB2 [formerly HER2])–mutant NSCLC are more likely to have baseline brain metastases. Trastuzumab deruxtecan (T-DXd) is an approved ERBB2-directed treatment for previously treated unresectable or metastatic ERBB2-mutant NSCLC.<br>
Objective To assess the clinical effectiveness and safety of T-DXd 5.4 mg/kg and 6.4 mg/kg doses in patients with previously treated ERBB2-mutant metastatic NSCLC with or without untreated or previously treated stable brain metastases.<br>
Design, Setting, and Participants This post hoc secondary analysis pooled patients from the DESTINY-Lung01 (data cutoff date: December 3, 2021) and DESTINY-Lung02 (data cutoff date: December 23, 2022) clinical trials by T-DXd dose (5.4 mg/kg and 6.4 mg/kg). DESTINY-Lung01 was a multicenter, open-label, 2-cohort, nonrandomized phase 2 study, while DESTINY-Lung02 was a dose-blinded, multicenter, 2-cohort, randomized phase 2 study. Participants had a previously treated ERBB2-mutant metastatic NSCLC with or without untreated or previously treated stable brain metastases at baseline. All statistical analyses were performed from April 2023 to October 2024.<br>
Intervention Patients received a T-DXd dose of either 5.4 mg/kg or 6.4 mg/kg intravenously every 3 weeks.<br>
Main Outcome and Measure Systemic and intracranial effectiveness by blinded independent central review using RECIST (Response Evaluation Criteria in Solid Tumors) version 1.1, sites of progression, and safety.<br>
Results This analysis included 102 patients in the T-DXd 5.4-mg/kg dose group (65 females [64%]; median [range] age, 57.5 [37.0-83.0] years and 59.5 [30.0-79.0] years in patients with and without brain metastases, respectively) and 141 patients in the T-DXd 6.4-mg/kg dose group (94 females [67%]; median [range] age, 62.5 [29.0-88.0] years and 59.0 [27.0-83.0] years in patients with and without brain metastases, respectively). In each group, 31% (32 of 102) and 38% (54 of 141) of patients, respectively, had baseline brain metastases and 53% (17 of 32) and 44% (24 of 54), respectively, received prior brain metastasis treatment. In patients with and without brain metastases, systemic confirmed objective response rates (ORRs) were 47% (15 of 32; 95% CI, 29%-65%) and 50% (35 of 70; 95% CI, 38%-62%), respectively, with the T-DXd 5.4-mg/kg dose, and 50% (27 of 54; 95% CI, 36%-64%) and 59% (51 of 87; 95% CI, 48%-69%) with the T-DXd 6.4-mg/kg dose. Median progression-free survival was 7.1 (95% CI, 5.5-9.7) months in the T-DXd 5.4-mg/kg dose group and 7.1 (95% CI, 4.5-9.6) months in the T-DXd 6.4-mg/kg dose group of patients with baseline brain metastases. Among patients with measurable baseline brain metastases, intracranial confirmed ORRs were 50% (7 of 14; 95% CI, 23%-77%) with the T-DXd 5.4-mg/kg dose and 30% (9 of 30; 95% CI, 15%-49%) with the T-DXd 6.4-mg/kg dose. At both doses, the safety profile of T-DXd was generally manageable, regardless of baseline brain metastases, favoring the T-DXd 5.4 mg/kg dose.<br>
Conclusions and Relevance In this secondary analysis, T-DXd at the approved dose of 5.4 mg/kg showed antitumor activity in patients with previously treated ERBB2-mutant metastatic NSCLC with or without brain metastases. This finding supports T-DXd 5.4 mg/kg use in this population.No potential conflict of interest relevant to this article was reported.岡山大学文学部Acta Medica Okayama0285-4864782025文学部教員研究活動一覧（2024年度）6377ENNo potential conflict of interest relevant to this article was reported.The Japanese Society for Neuroendovascular TherapyActa Medica Okayama1882-40721912025The Qualification Examination for Specialists and Instructors in the Japanese Society of Neuroendovascular Therapy: History and Current Statussr.2024-0099ENShinichiYoshimuraDepartment of Neurosurgery, Hyogo Medical UniversityKenjiSugiuDepartment of Neurological Surgery, Okayama University Graduate School of MedicineMasaruHirohataDepartment of Neurosurgery, Kurume Medical UniversityYukikoEnomotoDepartment of Neurosurgery, Gifu University Graduate School of MedicineHirotoshiImamuraDepartment of Neurosurgery, National Cerebral and Cardiovascular CenterWataroTsurutaDepartment of Endovascular Neurosurgery, Toranomon HospitalToshiyukiFujinakaDepartment of Neurosurgery, National Hospital Organization Osaka National HospitalHitoshiHasegawaDepartment of Neurosurgery, Brain Research Institute, Niigata UniversityToshioHigashiDepartment of Neurosurgery, Fukuoka University Chikushi HospitalTakashiIzumiDepartment of Neurosurgery, Nagoya University of Graduate School of MedicineHiroKiyosueDepartment of Diagnostic Radiology, Kumamoto University Faculty of Life SciencesYasushiMatsumotoDivision of Development and Discovery of Interventional Therapy, Tohoku University HospitalHidenoriOishiOishi Neurosurgery Clinic, and Department of Neurosurgery, The Jikei University School of MedicineTetsuSatowDepartment of Neurosurgery/Stroke Center, Kindai University HospitalMichihiroTanakaDepartment of Neurosurgery and Neuroendovascular Surgery, Kameda Neurocenter, Kameda Medical CenterTomoyukiTsumotoDepartment of Neurosurgery, Showa University Fujigaoka HospitalHiroshiYamagamiDivision of Stroke Prevention and Treatment, Institute of Medicine, University of TsukubaAkiraIshiiDepartment of Neurosurgery, Juntendo University Faculty of MedicineYujiMatsumaruDepartment of Neurosurgery, Institute of Medicine, University of TsukubaShigeruMiyachiDepartment of Neurological Surgery, Aichi Medical UniveristyNeuroendovascular therapy is a key treatment for cerebrovascular disorders, driven by advancements in devices and techniques. The Japanese Society for Neuroendovascular Therapy (JSNET) established a certification system in 1997 to ensure operator competence and minimize complications, with the first examination in 2002. JSNET offers 2 main certifications: specialist and instructor. Specialists perform basic procedures, while instructors lead in practice, education, and research. In 2020, the mechanical thrombectomy practitioner qualification was added to promote mechanical thrombectomy. Applicants must have a JSNET membership, relevant certifications, training, and documented experience. The certification process includes rigorous written and practical examinations that now employ non-fluoroscopic models. Certification renewal every 5 years requires conference participation and a continuing education program. Public awareness and integration into stroke center designations have grown. Over 2200 specialists, including more than 500 instructors, have been certified, significantly advancing neuroendovascular therapy in Japan. JSNET aims to continue improving certification and education to maintain high standards.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1546-00962412026TeMPRA: advancing continuing professional development in pediatric rheumatology in JapanENHiroyukiWakiguchiDivision of General Pediatrics and Emergency Medicine, Department of Pediatrics, Oita University Faculty of MedicineKunioHashimotoDepartment of Pediatrics, Nagasaki University Graduate School of Biomedical SciencesMasatoYashiroDepartment of Pediatrics, Okayama University HospitalKenichiNishimuraDepartment of Pediatrics, Yokohama City University Graduate School of MedicineTakasukeEbatoDepartment of Pediatrics, Kitasato UniversityKeijiAkamineDepartment of Nephrology and Rheumatology, Tokyo Metropolitan Children’s Medical CenterYojiUejimaDivision of Infectious Diseases and Immunology, Saitama Children’s Medical CenterTomomiSatoClinical Education Center for Physicians, Shiga University of Medical ScienceYuichiYamasakiDepartment of Pediatrics, Kagoshima University HospitalJunkoYasumuraDepartment of Pediatrics, Hiroshima Prefectural Hospital Organization Futabanosato Prefectural HospitalFumikoOkazakiDepartment of Pediatrics, Yamaguchi University Graduate School of MedicineToshitakaKizawaDepartment of Pediatrics, Japan Community Health Care Organization Sapporo Hokushin HospitalRyuheiYasuokaDepartment of Pediatrics, Hamamatsu University School of MedicineTomoakiIshikawaDepartment of Pediatrics, Nara Medical UniversityTakeshiYamamotoDepartment of Pediatrics, Chiba University Graduate School of MedicineYujiFujitaDepartment of Pediatrics, Dokkyo Medical UniversityNaohiroItohDepartment of Pediatrics, Faculty of Medical Sciences, University of FukuiAsamiTakasakiDepartment of Pediatrics, School of Medicine, University of ToyamaNodokaSakuraiDepartment of Pediatrics, NTT East Medical Center SapporoKazuoSuzukiSuzuki Kids ClinicTasukuTamaiDivision of General Pediatrics and Emergency Medicine, Department of Pediatrics, Oita University Faculty of MedicineNaokiHiranoDepartment of Public Health and Epidemiology, Faculty of Medicine, Oita UniversityNamiOkamotoDepartment of Pediatrics, Osaka Rosai Hospital, Japan Organization of Occupational Health and SafetyMasakiShimizuDepartment of Pediatrics, Perinatal and Maternal Medicine, Graduate School of Medical and Dental Sciences, Institute of Science TokyoBackground In the context of the global shortage of pediatric rheumatologists, mid-career specialists who can play key roles in regional education, research, and clinical practice have become increasingly important. In Japan, the Team of Mid-career Pediatric Rheumatologists Alliance (TeMPRA) was founded in 2014 to support continuing professional development (CPD) and foster collaboration among mid-career pediatric rheumatologists. The aim of this study was to characterize the current status and future perspectives of the TeMPRA members.<br>
Methods In 2024, a cross-sectional, web-based survey was conducted among all 37 active members of the TeMPRA across Japan. Data were collected on career trajectories, educational roles, research activities, clinical practices, and international engagement. Categorical variables were compared using appropriate statistical tests, with a significance level of 0.05.<br>
Results Responses were obtained from 35 members (response rate: 95%). Most respondents (71%) were affiliated with university hospitals, and 60% had > 10 years of experience in pediatric rheumatology. Compared with those working in community hospitals, respondents affiliated with university hospitals were significantly more likely to be involved in research activities (50% vs. 0%, P = 0.0261) and global professional contributions (88% vs. 0%, P < 0.0001). Overall, 54% of respondents were engaged in teaching students or early-career pediatric rheumatologists, while 43% were involved in clinical or basic research, most commonly focusing on juvenile idiopathic arthritis and systemic lupus erythematosus. Collectively, respondents were responsible for the care of 1,677 children with pediatric rheumatic diseases. While all respondents reported willingness to contribute to pediatric rheumatology at the regional level, 94% and 71% reported willingness to contribute at the national and global levels, respectively.<br>
Conclusions This nationwide survey highlights the substantial educational roles, research activities, and clinical practices of mid-career pediatric rheumatologists in Japan and suggests that the TeMPRA framework can serve as a valuable model for supporting CPD and workforce sustainability. Similar alliance-based approaches may be applicable in other countries facing comparable challenges in pediatric rheumatology.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0930-27943952025Impact of visceral fat area on surgical difficulty during robotic distal pancreatectomy (TAKUMI-2)31373145ENKoseiTakagiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMotohikoYamadaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTomokazuFujiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuyaYasuiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakeyoshiNishiyamaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYasuoNagaiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNoriyukiKanehiraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground: Difficulty scoring systems (DSS) have been developed to quantify the surgical complexity of laparoscopic distal pancreatectomy (LDP). However, few studies have validated these systems in the context of robotic distal pancreatectomy (RDP). Moreover, the impact of body composition on RDP outcomes remains unexplored. This study aimed to investigate the risk factors of surgical difficulty in RDP, including body composition.<br>
Methods: This retrospective study included 72 consecutive patients who underwent RDP at our institution between April 2021 and October 2024. Using a modified DSS for LDP, patients were divided into three difficulty index groups. The association between the difficulty index and outcomes was investigated. Multivariate analyses were performed to identify risk factors associated with surgical difficulty (prolonged operative time) in RDP.<br>
Results: Patients were classified into three difficulty index groups: low (n = 28), intermediate (n = 25), and high (n = 19). Operative time was significantly associated with the surgical index (P = 0.01). Moreover, visceral fat area (VFA) was significantly correlated with operative time (r2 = 0.10, P = 0.008). The multivariate analyses found that VFA (≥ 100 cm2) (odds ratio [OR] 5.03, 95% confidence interval [CI] 1.32–22.4, P = 0.02), malignancy (OR 4.92, 95% CI 1.50–18.9, P = 0.01), and pancreatic resection on the portal vein (OR 4.14, 95% CI 1.24–15.9, P = 0.02) were significant risk factors associated with surgical difficulty.<br>
Conclusion: VFA could be a novel and useful factor for assessing the surgical difficulty associated with RDP.No potential conflict of interest relevant to this article was reported.Japan Medical AssociationActa Medica Okayama2433-3298822025A Case of Hepatocellular Carcinoma Associated with Hepatic Sarcoidosis606608ENYasuoNagaiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKoseiTakagiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuyaYasuiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuyaKariyamaDepartment of Gastroenterology, Okayama City HospitalTomokazuFujiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026ピア・AI・教員の三者協働フィードバックによるライティング授業の再設計 ―AI利用の実践報告−174194ENMarikoUzukaInstitute for Promotion of Education and Campus Life10.18926/70120本稿は、アカデミック・ライティング授業におけるピア・AI・教員のそれぞれの役割と利用順序（自分→ピア→AI→（省察）→教員）を組み込んだ三者協働モデルを設計し、2024〜2025年度に実践した内容を報告する。授業後の学生アンケートでは、AIの即時性・精緻化が評価される一方、依存や有効性の限界に関する懸念も表明された。成績分布においては、AI導入後に下位層が縮小し、学習成果の底上げが示唆された。また、AI誤用や濫用を防ぐには、教室内で建設的な利用法の具体的な指導（例：例文より診断的フィードバックを重視、AI提案の採否理由のメタ記述）が効果的であった。これらの結果から、AIの利点を活かしつつ、学生の判断を中心に据えるライティング授業設計の有効性と課題を提示する。No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841812026Saliva as a Reliable and Non-invasive Sample for Detecting Influenza A in Severe Acute Respiratory Infection Casese100872ENJunko STakeuchiDepartment of Academic-Industrial Partnerships Promotion, Center for Clinical Sciences, Japan Institute for Health SecurityNobuakiMatsunagaAntimicrobial Resistance (AMR) Clinical Reference Center, Japan Institute for Health SecurityAiTsukadaAntimicrobial Resistance (AMR) Clinical Reference Center, Japan Institute for Health SecurityNorikoIwamotoDisease Control and Prevention Center, Japan Institute for Health SecurityNorikoFuwaDisease Control and Prevention Center, Japan Institute for Health SecurityTakahiroIchikawaDepartment of Infectious Diseases, Sapporo City General HospitalYasuyukiKatoDepartment of Infectious Diseases, International University of Health and Welfare (IUHW) Narita HospitalYukaTomitaDepartment of Infectious Diseases, Japanese Red Cross Aichi Medical Center Nagoya Daini HospitalHirokiKitagawaDepartment of Infectious Diseases, Hiroshima University HospitalMasayaYamatoDepartment of General Internal Medicine and Infectious Diseases, Rinku General Medical CenterTetsujiAoyagiDepartment of Clinical Infectious Diseases, Tohoku University Graduate School of MedicineHideharuHagiyaDepartment of Infectious Diseases, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyotaHaseDepartment of Infectious Diseases, Japanese Red Cross Narita HospitalShujiHatakeyamaDivision of Infectious Diseases, Jichi Medical University HospitalTohruInabaDepartment of Infection Control and Laboratory Medicine, Kyoto Prefectural University of MedicineKoichiIzumikawaYoshioTakesueDepartment of Infectious Diseases, Nagasaki University Graduate School of Biomedical SciencesMotoKimuraDepartment of Academic-Industrial Partnerships Promotion, Center for Clinical Sciences, Japan Institute for Health SecurityNorioOhmagariDisease Control and Prevention Center, Japan Institute for Health SecurityBackground<br>
Nasopharyngeal swab sampling remains the gold standard for influenza diagnosis; however, it has several limitations, including dependence on medical staff, invasiveness, potential for nosocomial transmission, and occupational exposure risk. Non-invasive alternatives, such as saliva and nasal vestibular swabs, may improve patient comfort and participation in clinical studies. In addition, diagnosis with reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR) is often delayed because it requires trained laboratory technicians and facilities with appropriate laboratory settings. Although rapid diagnostic devices such as the GenPad® offer potential alternatives to RT-qPCR, their performance with non-invasive samples remains insufficiently explored. This study addresses the two key questions for influenza detection in severe acute respiratory infection (SARI) cases: (i) whether saliva or nasal vestibular swab samples serve as suitable alternatives to nasopharyngeal swab samples, and (ii) whether the GenPad® provides a reliable option for detecting influenza using saliva samples.<br>
Methodology<br>
A prospective observational study was conducted with 16 inpatients classified as having SARIs and diagnosed with influenza between December 2024 and March 2025 in Japan. Paired saliva and nasal vestibular swab samples were collected 1-9 (median = 3.5) days after symptom onset. RT-qPCR testing was performed according to the National Institute of Infectious Diseases protocol. Saliva samples were also tested using the GenPad® system. Comparisons between sample types and diagnostic methods were analyzed using the exact McNemar's test.<br>
Results<br>
Among the 16 influenza-positive patients, saliva samples demonstrated higher sensitivity (87.5%) than nasal vestibular swabs (31.3%) in RT-qPCR when compared with the diagnostic results obtained from nasopharyngeal swabs. A comparison of RT-qPCR results between saliva and nasal vestibular swabs revealed a total agreement of 43.8%, with exact McNemar's test showing a significant difference (p = 0.0039). While nasal vestibular swabs showed inconsistent results, saliva samples consistently tested positive, particularly within seven days of symptom onset (100% positive agreement). The GenPad®, a rapid diagnostic device, showed promising performance (92.9%) using saliva samples compared to RT-qPCR.<br>
Conclusions<br>
Saliva is a reliable non-invasive alternative to nasopharyngeal swabs for influenza detection in SARI cases, particularly within seven days of symptom onset, whereas nasal vestibular swabs show lower sensitivity. Additionally, the GenPad® provides comparable performance to RT-qPCR using saliva samples, offering a rapid, portable diagnostic option. These approaches may mitigate discomfort, minimize infection risk for healthcare workers, and improve testing capacity. However, the absence of influenza-negative controls and the small sample size (n = 16) substantially limit the assessment of diagnostic accuracy and specificity. As a result, the broader applicability of our findings should be interpreted with caution, and further studies are required to validate these observations.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8012026Metastatic Intraocular Tumor Likely from Hepatocellular Carcinoma Mimicking Panuveitis6367ENEriTakasuDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusukeShiodeDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyaKindoDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuheiKimuraDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMioHosokawaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoMatobaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiKanzakiDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTetsuroMoritaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuyaAdachiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiMorizaneDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/70074A 77-year-old man undergoing treatment for hepatocellular carcinoma (HCC) presented with blurred vision in his right eye, persisting for 2 months. Slit-lamp microscopy and fundus examination revealed inflammatory cells in the anterior chamber, severe vitreous opacities, and retinal vasculitis in the right eye. The patient underwent vitreous surgery with biopsy, and vitreous cytology confirmed a metastatic intraocular tumor originating from the HCC. Radiotherapy was administered to the right eye, with no recurrence of intraocular inflammation observed at 10 months post-irradiation.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8012026Changes in Prescribing Patterns of Antiviral Drugs before and after Public Coverage Termination among Hospitalized COVID-19 Patients in Regional Hospitals in Japan: A Retrospective, Multicenter Study5562ENHidemasaAkazawaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,HideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalShinnosukeFukushimaDepartment of Infectious Diseases, Okayama University HospitalShoheiYamamotoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,YasuhiroNakanoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,FumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,Original Article10.18926/AMO/70073In Japan, antiviral agents for COVID-19 were freely available until September 2023 as part of national policy. This study evaluated changes in these agents’ prescribing patterns and the patient outcomes following the policy shift. We conducted a multicenter retrospective study at four hospitals in Japan’s Okayama and Kagawa prefectures from January 2022 to March 2024. The study period was divided into the public-expenditure phase (January 2022 to September 2023) and the post-expenditure phase (October 2023 to March 2024). We extracted the hospitalized patients’ clinical data from the electronic database. The study’s primary outcome was the antiviral prescription rate; the secondary outcome was in-hospital mortality. Among the 302 hospitalized patients (median age 85 years), 52.0% were classified as having a mild condition. Of the patients with mild conditions, 37.7% were diagnosed in outpatient settings prior to hospitalization. During the public-expenditure phase, 47.4% of the patients received antivirals as outpatients, mainly molnupiravir (80.9%). In the post-expenditure period, 80.0% of the patients were prescribed antivirals, mostly molnupiravir (91.7%). The antiviral prescription rate was significantly higher after the policy change. The overall in-hospital mortality was 15.8%, with no significant difference between the two periods (17.0% vs. 10.5%). Despite the termination of government funding, antiviral prescriptions remained frequent at community hospitals located in highly aging regions of western Japan such as Okayama and Kagawa prefectures. Mortality remains high among the elderly, highlighting the need for continued antiviral therapy and booster vaccinations.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8012026Development of a Stroke Discharge Support Evaluation Scale for Ward Nurses in Acute Care Hospitals1730ENHidekiYanoDepartment of Nursing, Faculty of Human Health Sciences, Niimi UniversityYokoTakahataGraduate School of Health Sciences, Okayama UniversityTakeshiYamaguchiFaculty of Nursing, Shikoku UniversityShinyaSaitoGraduate School of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/70069This study aimed to develop a scale enabling nurses to objectively evaluate their own stroke discharge support, as a basis for enhancing its overall effectiveness. A draft scale was created based on a literature review, and consisted of a 51-item, 5-point Likert-type questionnaire administered to ward nurses engaged in stroke discharge support at acute care hospitals. Factor analysis was performed to refine the scale. Construct validity was assessed using the known-groups method, and reliability was evaluated through internal consistency analysis. The resulting Stroke Discharge Support Evaluation Scale comprises 29 items across 5 factors, each rated on a 5-point Likert scale. Analysis of the data collected from 237 valid responses demonstrated good internal consistency and supported the scale’s construct validity. The Stroke Discharge Support Evaluation Scale is a reliable and valid tool enabling ward nurses in acute care hospitals to evaluate their own stroke discharge support.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8012026A Novel Nomogram that Predicts Chronic Hemodialysis Patients’ Survival Based on Their Sedentary Behavior916ENKentaroSugaharaDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityTakashiKondoInnoshima General HospitalNobuyukiMiyatakeDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityHiroyukiNishiInnoshima General HospitalKazuhiroUjikeInnoshima General HospitalKiichiKoumotoInnoshima General HospitalKeiichiNamioDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityShuheiHishiiDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityAkihikoKatayamaFaculty of Social Studies, Shikokugakuin UniversityHiromiSuzukiDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityYorimasaYamamotoInnoshima General HospitalOriginal Article10.18926/AMO/70068Appropriate treatments for chronic hemodialysis patients are a public health challenge in Japan. Sedentary behavior appears to be closely associated with these patients’ survival. We thus sought to develop a nomogram that predicts survival based on the duration of chronic hemodialysis patients’ sedentary behavior. One hundred twenty-four patients under chronic hemodialysis (73 men, 51 women, age 71.7±11.1 years) were enrolled in this cohort study. The patients wore a triaxial accelerometer that measured both their sedentary behavior, i.e., total sedentary behavior (minutes) and their maximum sedentary bouts (min) on non-hemodialysis days. We obtained the Kaplan-Meier curve and used the log-rank test and a Cox proportional hazards model to evaluate the relationship between the patients’ sedentary behavior and their survival. We also used a Cox proportional hazards model to develop a nomogram for the patients’ 5-year survival rate. Forty-six patients died during the follow-up period. When we stratified the patients by the medians of total sedentary behavior and maximum sedentary bouts, we observed significant between-group differences. After adjustment for confounding factors in a Cox proportional hazards model, total sedentary behavior and maximum sedentary bouts were identified as critical survival factors, and we generated a nomogram using an index of sedentary behavior. Our analysis results demonstrated that sedentary behavior on non-dialysis days was closely associated with the survival of the chronic hemodialysis patients, suggesting that a decrease in sedentary behavior would prolong their survival. The nomogram developed herein based on sedentary behavior may be useful for predicting the outcomes of chronic hemodialysis patients.No potential conflict of interest relevant to this article was reported.岡山大学文明動態学研究所Acta Medica Okayama2436-832652026From Festivals to the Everyday: The Circulation of Kumade at the Tori no Ichi at Hanazono Shrine101114ENMiaTILLONENDepartment of English Language and Culture, FUJI WOMEN’S UNIVERSITY特集：Sacred Objects in Religions (Special Issue: Sacred Objects in Religions)10.18926/70057Every year in November, the Tori no Ichi festival draws huge crowds to the grounds of Hanazono Shrine in Shinjuku, Tokyo. The festival is centered around the buying and selling of kumade, or good luck rakes. These bold and colorful objects function as engimono, or good luck charms, purchased for business prosperity or home safety. This study explores the circulation and itinerary of kumade at the Tori no Ichi festival by analyzing the performances surrounding them. While previous scholarship on engimono has focused on their roles in domestic settings or disposal rituals, this research approaches them in situ at the festival. The study shows that these objects bridge the festival and the everyday, connecting people to the event and the sacred site through a dynamic network of social, spatial, and ritual practices. The research draws on fieldwork and in-depth interviews conducted at Hanazono Shrine between 2020 and 2024.No potential conflict of interest relevant to this article was reported.BMJActa Medica Okayama2044-605515122025Effectiveness of education programme to increase competency of health cadres in Indonesia: a cluster non-randomised controlled triale095428ENDewieSulistyoriniGraduate School of Biomedical and Health Sciences, Hiroshima UniversityK A T M EhsanulHuqGraduate School of Biomedical and Health Sciences, Hiroshima UniversityAbdulfatai OlamilekanBabaitaGraduate School of Biomedical and Health Sciences, Hiroshima UniversitySadia AAiveyGraduate School of Biomedical and Health Sciences, Hiroshima UniversityGaoHuiyingGraduate School of Biomedical and Health Sciences, Hiroshima UniversityKanaKazawaFaculty of Health Sciences, Okayama UniversityYasukoFukushimaGraduate School of Biomedical and Health Sciences, Hiroshima UniversityMayumiKakoGraduate School of Biomedical and Health Sciences, Hiroshima UniversityMichikoMoriyamaGraduate School of Biomedical and Health Sciences, Hiroshima UniversityObjectives Health cadres, who assist midwives in supporting pregnant women in community settings, need to enhance their competencies in identifying risk factors and referring high-risk pregnant women to midwives for further care. Since the capabilities of these health cadres are influenced by maternal complications, an educational programme was implemented to strengthen their skills. Therefore, this study aimed to evaluate the competency of health cadres by providing a researcher-developed educational programme.<br>
Design An open-label, cluster non-randomised controlled trial.<br>
Setting and participants Health cadres with at least 1 year of work experience were recruited at six public health centres (PHCs) in Banjarnegara Regency, Indonesia.<br>
Interventions Six PHCs were selected and allocated into intervention group (IG=3 PHCs) and control group (CG=3 PHCs) groups. A total of 133 female health cadres were enrolled across the selected PHCs. At each PHC, a systematic random sampling method was used to select the participants. The researchers and health professionals provided a 3-week period of theoretical and scenario-based simulations to the IG, while the CG received no education.<br>
Outcome measures Researcher-developed questionnaires and checklists were used to assess the knowledge, skills (health assessment, communication, attitude) and confidence. The primary endpoint was competency, a total score of knowledge and skills. The outcome domains were compared between the two groups, and a linear mixed-effect model was used to account for cluster-level variation.<br>
Results A total of 130 (97.7%) completed the study (IG:64, CG:66). The competency score showed significant improvement at endline (CG=49.5 and IG=52.5; p=0.002). The median scores for health assessment skills (CG=12 vs IG=14; p<0.001) and communication skills (CG=7 vs IG=8; p<0.001) were increased in the IG compared with the CG. Mixed-effect model indicated that groups (β (95% CI) 2.49 (0.57 to 4.41), p=0.012), baseline knowledge (β(95% CI) 0.73 (0.54 to 0.92), p<0.001) and midline health assessment skills (β (95% CI) 0.54 (0.25 to 0.82), p<0.001) were significant positive predictors, while age was negatively associated with competency (β (95% CI) −0.20 (−0.30 to −0.10), p<0.001)).<br>
Conclusion Education effectively increased the competency of health cadres. A well-structured education programme is necessary for health cadres to improve and maintain their competencies in monitoring high-risk pregnant women.<br>
Trial registration number NCT06134518.No potential conflict of interest relevant to this article was reported.The Japanese Society of Interventional RadiologyActa Medica Okayama2432-0935102025Is Saline Sealing of Needle Tract Effective to Prevent Pneumothorax after Computed Tomography-guided Lung Biopsy?e2025-0068ENSoichiroOkamotoDepartment of Radiology, Okayama University HospitalYusukeMatsuiDepartment of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKojiTomitaDepartment of Radiology, Okayama University HospitalKazuakiMunetomoDepartment of Radiology, Okayama University HospitalNoriyukiUmakoshiDepartment of Radiology, Okayama University HospitalToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Medical Development Field, Okayama UniversityToshihiroIguchiDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityTakaoHirakiDepartment of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityPurpose: To evaluate the efficacy of needle tract sealing using normal saline instillation for decreasing the risk of pneumothorax after computed tomography-guided lung biopsy.<br>
Material and Methods: This retrospective, single-institution study included 391 computed tomography-guided lung biopsies performed by 12 operators between January 2022 and October 2024. After exclusion, 298 biopsies were analyzed by comparing the saline seal (n = 138) and control (n = 160) groups. A 17/18-gauge or 19/20-gauge coaxial biopsy system was used, and tract sealing was performed by instilling 1-5 mL of normal saline during the withdrawal of the introducer needle in the saline seal group; tract sealing was not performed in the control group. After 1:1 propensity score matching was performed to balance baseline characteristics, the incidences of pneumothorax and chest tube placement were compared between the two groups using Fisher's exact test.<br>
Results: After propensity score matching, 108 pairs (mean lesion size: 17 mm) were well balanced. The incidence of pneumothorax did not differ significantly between the control and saline seal groups (50.0% vs. 60.2%, respectively; p = 0.171). Similarly, the incidence of chest tube placement was not significantly different between the two groups (7.4% vs. 13.0%, respectively; p = 0.260).<br>
Conclusions: According to the propensity score-matched analysis, normal saline instillation for tract sealing did not significantly reduce the incidence of pneumothorax or chest tube placement. In our cohort, which had a high prevalence of small lesions, saline sealing alone may be insufficient to reduce post-biopsy pneumothorax risk. Hence, combined strategies require further investigation.No potential conflict of interest relevant to this article was reported.Frontiers Media SAActa Medica Okayama1663-9812162025Regulatory considerations for developing phage therapy medicinal products for the treatment of antimicrobial resistant bacterial infections1713471ENAiFukaya-ShibaOffice of Regulatory Science Coordination, Pharmaceuticals and Medical Devices AgencyAkikoOgataOffice of Regulatory Science Coordination, Pharmaceuticals and Medical Devices AgencyRyosukeKuribayashiOffice of Cellular and Tissue-based Products, Pharmaceuticals and Medical Devices AgencyAkiraSakuraiOffice of Cellular and Tissue-based Products, Pharmaceuticals and Medical Devices AgencyKanakoSuzukiOffice of Regulatory Science Coordination, Pharmaceuticals and Medical Devices AgencyShunsukeTakadamaOffice of New Drug IV, Pharmaceuticals and Medical Devices AgencyJiheiNishimuraOffice of New Drug IV, Pharmaceuticals and Medical Devices AgencyJumpeiUchiyamaDepartment of Bacteriology, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama UniversityHirokiOhgeDepartment of Infectious Diseases, Hiroshima University HospitalTakamasaTakeuchiPathogen Genomics Center, National Institute of Infectious Diseases, Japan Institute for Health SecurityHideyukiTamakiBiomanufacturing Process Research Center, National Institute of Advanced Industrial Science and TechnologyTetsuyaMatsumotoDepartment of Infectious Diseases, International University of Health and WelfareKotaroKigaDepartment of Drug Development, National Institute of Infectious Diseases, Japan Institute for Health SecurityHidetomoIwanoLaboratory of Veterinary Biochemistry, Rakuno Gakuen University School of Veterinary MedicineRecently, there have been growing expectations that treatment of infections with bacteriophages (phages), viruses which specifically infect bacteria, can be used as a treatment option for antimicrobial resistant bacterial infections. In Europe and the United States, in addition to phage therapy as a form of personalized medicine, development of pre-defined phage therapy medicinal products (PTMPs) is progressing, and clinical trials are underway. From October 2024 to July 2025, the Pharmaceuticals and Medical Devices Agency exchanged opinions on trends and points to consider in drug development of PTMPs used for antimicrobial resistant bacterial infections with external experts. Development of PTMPs for regulatory approval requires quality control strategies, establishment of manufacturing methods, non-clinical evaluations, and clinical trial plans based on the characteristics of the phage. In this document, based on the regulatory and development trends in Europe and the United States, the current considerations on quality, non-clinical evaluation, and clinical trial planning including the Cartagena Act in the development of PTMPs in Japan are summarized. The basic concepts presented here are intended to be applied to antimicrobial resistant bacterial infections targeted by PTMPs but can be mostly applicable to bacterial infections in general. We hope that these findings will further accelerate more active development of PTMPs towards timely patient access to innovative products.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2688-1152612025Severe Intracranial Infection100026ENShinnosukeFukushimaDepartment of Infectious Diseases, Okayama University HospitalTakumiFujimoriMicrobiology Division, Clinical Laboratory, Okayama University HospitalKojiIioMicrobiology Division, Clinical Laboratory, Okayama University HospitalHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalNo potential conflict of interest relevant to this article was reported.Public Library of Science (PLoS)Acta Medica Okayama1932-62032092025Impact of COVID-19 on the awareness and interest in infectious disease specialization among Japanese medical studentse0329451ENNarutoKamadaFaculty of Medicine, Wakayama Medical UniversityHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalSatoshiKutsunaDepartment of Infection Control and Prevention, Graduate School of Medicine, Osaka UniversityBackground<br>
The SARS-CoV-2 pandemic has highlighted the critical deficiency of infectious disease (ID) specialists, a subspecialty that remains underrepresented among Japanese medical students.<br>
Methods<br>
This nationwide cross-sectional survey was administered between April and August 2024 via an online questionnaire distributed to medical students throughout Japan. The survey assessed awareness of and interest in ID specialization, categorizing students by academic year: lower (first- and second-year students), middle (third- and fourth-year students), and upper grades (fifth- and sixth-year students).<br>
Results<br>
Of 502 respondents, data for 492 medical students were eligible, of whom 69.7% demonstrated awareness of ID specialists, with recognition rates increasing proportionally with academic progression. Regarding career aspirations, 9.8% of respondents expressed interest in pursuing ID specialization, with the highest proportion observed among upper-grade students (19.4%). Male students (14.8%) expressed greater interest in ID specialization than female students (5.2%). The pandemic positively influenced 5.5% of students to consider ID specialization as a future career, whereas only 0.6% reported a negative impact.<br>
Conclusions<br>
These findings underscore the necessity of enhanced educational initiatives to promote ID specialization among medical students, addressing current shortages and future infectious disease preparedness.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2772-7076142025Genetic variability in Neisseria meningitidis strains isolated in a Japanese hospital100511ENKazuyoshiGotohDepartment of Medical Laboratory Science, Okayama University Graduate School of Health SciencesShinnosukeFukushimaDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalShumaTsujiDepartment of Medical Laboratory Science, Okayama University Graduate School of Health SciencesKojiIioMicrobiology Division, Clinical Laboratory, Okayama University HospitalOsamuMatsushitaDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesObjectives: Neisseria meningitidis is a significant pathogen causing invasive meningococcal disease, posing clinical and public health concerns worldwide. This study aimed to investigate the genetic characteristics of N. meningitidis clinical isolates at Okayama University Hospital in Japan.<br>
Methods: Between 2018 and 2023, five clinical strains were isolated, of which three were subjected to the antimicrobial susceptibility testing and whole genetic analysis using MiSeq platform (Illumina, San Diego, CA, USA).<br>
Results: One non-groupable isolate, belonging to sequence types (STs)-11026 (ST-32 complex), exhibited non-susceptibility to penicillin G, with a five-mutation pattern (F504L, A510V, I515V, H541N, and I566V) in the penA amino acid sequence and additional mutations (XXXIV and N513Y) characteristic of a mosaic penA gene. The other two isolates, ST-1655 (ST-23 complex) with serogroup Y and ST-2057 with serogroup B, were susceptible to penicillin G, neither of which contained the five-mutation pattern. Levofloxacin resistance was observed in two isolates carrying the T91I mutation in the gyrA protein.<br>
Conclusion: Our findings suggest the presence of antimicrobial-resistant N. meningitidis in Japan, underscoring the necessity for continuous local surveillance. Additional research is crucial for clarifying the ongoing spread of resistance mechanisms and for establishing effective countermeasures to reduce the clinical burden of invasive meningococcal disease.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0040-8166932025Detection of the nuclear translocation of androgen receptor using quantitative and automatic cell imaging analysis102631ENLanlanBaiGraduate School of Science and Engineering, Iwate UniversityTaoWuGraduate School of Science and Engineering, Iwate UniversityMizukiFukasawaNeuro-AI Integration Science Laboratory, Faculty of Environmental, Life, Natural Science and Technology, Okayama UniversitySayoKashiwagiRohto Pharmaceutical Co., Ltd., Basic Research Development DivisionHarukaTateGraduate School of Science and Engineering, Iwate UniversityTakuOzakiGraduate School of Science and Engineering, Iwate UniversityErikoSuganoGraduate School of Science and Engineering, Iwate UniversityHiroshiTomitaGraduate School of Science and Engineering, Iwate UniversityTsuyoshiIshiiRohto Pharmaceutical Co., Ltd., Basic Research Development DivisionTakuyaAkashiNeuro-AI Integration Science Laboratory, Faculty of Environmental, Life, Natural Science and Technology, Okayama UniversityTomokazuFukudaGraduate School of Science and Engineering, Iwate UniversityTestosterone signaling mediates diseases such as androgenetic alopecia and prostate cancer and is controlled by the activation of the androgen receptor (AR) and nuclear translocation of the ligand-receptor complex. This study established an immortalized dermal papilla cell line that stably expresses the AR labeled with a monomeric green fluorescence marker. The cells expressed the histone H2B protein as visualized using a red fluorescence marker, enabling the Detection of nuclear translocation under live cell conditions using image analysis. The AR was observed to be translocated from the cytoplasm to the nucleus of cells after stimulation with dihydrotestosterone (DHT). The signal intensity of the nuclear/cytoplasm ratio was analyzed using automatic image analysis and a newly developed algorithm. The quantitation method to detect nuclear translocation revealed that the AR nuclear signal plateaued approximately 20 min after DHT exposure. Our developed method has the potential to save human labor by the automatic process of the image.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813732025備前市における新型コロナウイルス感染症の抗体検査に関する研究の成果報告118125ENTakashiYorifujiDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Science, Okayama UniversityAyakoSasakiKurashiki City Public Health CenterNaomiMatsumotoDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Science, Okayama UniversityTomokaKadowakiCenter for Public Health Action in Applied Epidemiology, National Institute of Infectious DiseasesToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Okayama University HospitalSoshiTakaoDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Science, Okayama University We conducted two prospective cohort studies (June 2022–March 2023 and Nov 2023–Jan 2024) of 1,899 and 445 residents and other individuals who are affiliated with institutions in the city of Bizen in Japan's Okayama prefecture (population 32,320 as of 2020). We measured the subjects' titers of antibodies against SARS-CoV-2, evaluated changes in their antibody titers, and assessed the associations of the titers with the subjects' vaccination status, infection, and COVID-19 status/severity. This report summarizes the two studies' findings. These prospective studies based on a wide age range in a general population provide information that can be used to determine the appropriate timing of vaccination during a pandemic.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813732025令和６年度岡山医学会賞 胸部・循環研究奨励賞（砂田賞）9597ENShinichiKawanaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813732025令和６年度岡山医学会賞 総合研究奨励賞（結城賞）9294ENTetsuyaYumotoDepartment of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813732025令和６年度岡山医学会賞 がん研究奨励賞（林原賞・山田賞）8991ENShotaTakihiraDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.eLife Sciences Publications, LtdActa Medica Okayama2050-084X132025Redistribution of fragmented mitochondria ensures symmetric organelle partitioning and faithful chromosome segregation in mitotic mouse zygotesRP99936ENHarunaGekkoDepartment of Animal Science, Graduate School of Environment and Life Science, Okayama UniversityRuriNomuraDepartment of Animal Science, Graduate School of Environment and Life Science, Okayama UniversityDaikiKuzuharaReproductive Centre, Mio Fertility ClinicMasatoKaneyasuDepartment of Animal Science, Graduate School of Environment and Life Science, Okayama UniversityGenpeiKosekiDepartment of Animal Science, Graduate School of Environment and Life Science, Okayama UniversityDeepakAdhikariDevelopment and Stem Cell Program and Department of Anatomy and Developmental Biology, Monash Biomedicine Discovery Institute, Monash UniversityYasuyukiMioReproductive Centre, Mio Fertility ClinicJohnCarrollDevelopment and Stem Cell Program and Department of Anatomy and Developmental Biology, Monash Biomedicine Discovery Institute, Monash UniversityTomohiroKonoDepartment of Bioscience, Tokyo University of AgricultureHiroakiFunahashiDepartment of Animal Science, Graduate School of Environment and Life Science, Okayama UniversityTakuyaWakaiDepartment of Animal Science, Graduate School of Environment and Life Science, Okayama UniversityIn cleavage-stage embryos, preexisting organelles partition evenly into daughter blastomeres without significant cell growth after symmetric cell division. The presence of mitochondrial DNA within mitochondria and its restricted replication during preimplantation development makes their inheritance particularly important. While chromosomes are precisely segregated by the mitotic spindle, the mechanisms controlling mitochondrial partitioning remain poorly understood. In this study, we investigate the mechanism by which Dynamin-related protein 1 (Drp1) controls the mitochondrial redistribution and partitioning during embryonic cleavage. Depletion of Drp1 in mouse zygotes causes marked mitochondrial aggregation, and the majority of embryos arrest at the 2 cell stage. Clumped mitochondria are located in the center of mitotic Drp1-depleted zygotes with less uniform distribution, thereby preventing their symmetric partitioning. Asymmetric mitochondrial inheritance is accompanied by functionally inequivalent blastomeres with biased ATP and endoplasmic reticulum Ca2+ levels. We also find that marked mitochondrial centration in Drp1-depleted zygotes prevents the assembly of parental chromosomes, resulting in chromosome segregation defects and binucleation. Thus, mitochondrial fragmentation mediated by Drp1 ensures proper organelle positioning and partitioning into functional daughters during the first embryonic cleavage.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0169-555X4932026Coast uplifted by nearby shore-parallel active submarine faults during the 2024 Mw 7.5 Noto Peninsula earthquake110069ENHideakiGotoHiroshima UniversityTomoruYamanakaNatural History Museum and Institute ChibaTomohiroMakitaHiroshima UniversityYoshiyaIwasaUniversity of Teacher Education FukuokaTakuroOguraHyogo University of Teacher EducationKyokoKagoharaYamaguchi UniversityYasuhiroKumaharaHiroshima UniversityYasuhiroSuzukiNagoya UniversityNobuhisaMattaOkayama UniversityTatsutoAokiKanazawa UniversityWataruMoriHiroshima UniversityKentaHaranishiHiroshima UniversityTakashiNakataHiroshima UniversityAn Mw 7.5 earthquake occurred at 16:10 JST on January 1, 2024 at a depth of 16 km on the Noto Peninsula, central Japan. This earthquake was the second-largest intraplate earthquake recorded in Japan during 120 years of seismic observation, and it caused approximately 100 km of coastal seafloor emergence along the peninsula's northern coast. Herein, we mapped the emergence of this coastal seafloor and measured the uplift along the coast. The movement of the coastline led to the emergence of approximately 4.4 km2 of seafloor, which is continuous and probably the longest in the world. We determined the uplift distribution along the coast using the white remains of a reddish seaweed called Corallina pilulifera. Its upper limit exhibited a distinct horizontal line, effectively representing the uplift amount throughout the peninsula. Two large, uplifted regions were identified, around Cape Saruyama (5.21 m) in the west and Cape Kurasaki (2.70 m) in the north. Although active offshore submarine faults have been extensively researched, the fault traces remain poorly defined because they are primarily interpreted from seismic reflection profiles. We identified the distribution of active submarine faults using anaglyph-type stereoscopic images, confirming the subsurface deformation structure seen through the seismic reflection profiles. The main fault trace is primarily straight and contiguous with the nearby north coast. The uplift amount is greater near the active fault traces on the north side and diminishes sharply with increasing distance from these faults, indicating a southward tilt of surface uplift related to the active submarine faults.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0169-555X4682025Surface exposure ages of middle–late Pleistocene marine and fluvial terraces along the northern and southern Sanriku coasts, Northeast Japan109497ENSachiWakasaInstitute of Regional Innovation, Hirosaki UniversityTatsuyaIshiyamaEarthquake Research Institute, University of TokyoDaisukeHirouchiFaculty of Education, Shinshu UniversityNobuhisaMattaFaculty of Education, Okayama UniversityNatsukoFujitaTono Geoscience center, Japan Atomic Energy AgencyTomooEchigoKankyo Chisitsu, Co.To estimate long-term rates of coastal uplift along the northern Pacific coast of Northeast Japan, we determined the surface exposure ages of marine and fluvial terraces based on terrestrial in situ cosmogenic radionuclide dating of exposed bedrock surfaces. Based on reinterpretation of marine and fluvial terraces, we collected samples from the northern and southern Sanriku coast. The surface exposure ages from 10Be concentrations in quartz calculated from the measured 10Be/9Be ratios commonly suggest MIS 5 and MIS 7 for the marine and fluvial terraces and averaged coastal uplift rates of ca. 0.25 ± 0.15 and 0.4 mm/yr along the northern and southern Sanriku coast at intermediate timescales. The results may demonstrate different styles of crustal strain accommodation in the northern Northeast Japan arc above the subducting Pacific plate.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-291863132024Activated CD4+ T Cell Proportion in the Peripheral Blood Correlates with the Duration of Cytokine Release Syndrome and Predicts Clinical Outcome after Chimeric Antigen Receptor T Cell Therapy18631872ENWataruKitamuraDepartment of Hematology and Oncology, Okayama University HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalShuntaroIkegawaDepartment of Hematology and Oncology, Okayama University Hospital, JapanHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University HospitalChihiroKamoiDepartment of Hematology and Oncology, Okayama University HospitalDaisukeEnnishiCenter for Comprehensive Genomic Medicine, Okayama University HospitalHisakazuNishimoriDepartment of Hematology and Oncology, Okayama University HospitalKeikoFujiiDivision of Clinical Laboratory, Okayama University HospitalNobuharuFujiiDivision of Blood Transfusion, Okayama University HospitalKen-ichiMatsuokaDepartment of Hematology and Oncology, Okayama University HospitalYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalObjective Chimeric antigen receptor (CAR) T cell therapy is an emerging and effective therapy for relapsed or refractory diffuse large B cell lymphoma (R/R DLBCL). The characteristic toxicities of CAR T cell therapy include cytokine release syndrome (CRS) and prolonged cytopenia. We investigated the factors associated with these complications after CAR T cell therapy by analyzing lymphocyte subsets following CAR T cell infusion.<br>
Methods We retrospectively analyzed peripheral blood samples on days 7, 14, and 28 after tisagenlecleucel (tisa-cel) infusion by flow cytometry at our institution between June 2020 and September 2022.<br>
Patients Thirty-five patients with R/R DLBCL who received tisa-cel therapy were included.<br>
Results A flow cytometry-based analysis of blood samples from these patients revealed that the proportion of CD4+CD25+CD127+ T cells (hereafter referred to as "activated CD4+ T cells" ) among the total CD4+ T cells on day 7 after tisa-cel infusion correlated with the duration of CRS (r=0.79, p<0.01). In addition, a prognostic analysis of the overall survival (OS) using time-dependent receiver operating characteristic curves indicated a significantly more favorable OS and progression-free survival of patients with a proportion of activated CD4+ T cells among the total CD4+ T cells <0.73 (p=0.01, and p<0.01, respectively).<br>
Conclusion These results suggest that the proportion of activated CD4+ T cells on day 7 after tisa-cel infusion correlates with the CRS duration and predicts clinical outcomes after CAR T cell therapy. Further studies with a larger number of patients are required to validate these observations.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7962025MRI Images of a Case of Adenocarcinoma, Human Papillomavirus-Independent, Mesonephric Type, of the Uterine Cervix463468ENYudaiAsanoDepartment of Radiology, Okayama University HospitalChikaNishiharaDepartment of Radiology, Okayama University HospitalTakahiroKitayamaDepartment of Radiology, Okayama University HospitalNanakoOkawaDepartment of Radiology, Okayama University HospitalSatokoMakimotoDepartment of Radiology, Okayama University HospitalFumiyoHigakiDepartment of Radiology, Okayama University HospitalKatsuhideKojimaDepartment of Radiology, Okayama University HospitalHanakoSugiharaDepartment of Obstetrics and Gynecology, Okayama University HospitalNaoyukiIdaDepartment of Obstetrics and Gynecology, Okayama University HospitalHiroyukiYanaiDepartment of Pathology, Okayama University HospitalTakaoHirakiDepartment of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityCase Report10.18926/AMO/69850We present a case of a woman in her 70s who was diagnosed with mesonephric adenocarcinoma of the uterine cervix, following biopsy and surgery. Preoperative MRI revealed a 7-cm, well-defined circumferential cervical mass with left lateral wall predominance, bulging into the uterine cavity and vagina. The lesion showed intermediate signal intensity on T2-weighted images, diffusion restriction, and early contrast enhancement weaker than that of the myometrium, followed by washout on contrast-enhanced imaging. The circumferential growth pattern with the lateral wall predominance and its imaging characteristics may suggest this rare entity be routinely included in the differential diagnosis of cervical cancers.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7962025Exacerbation of Proteinuria in a Patient with Behçet’s Disease and IgA Nephropathy Following Colchicine Discontinuation457461ENTomohikoAsakawaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesHaruhito A.UchidaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesYuKatayamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesYoshimasaSakurabuDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKatsuyoshiKatayamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroOnishiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesNatsumiMatsuoka-UchiyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesHidemiTakeuchiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKeikoTanakaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKenjiTsujiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesRyokoUmebayashiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesRikaTakemotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/69849This case involves a 23-year-old male who was diagnosed with Behçet’s disease 5 years ago and managed with colchicine. Two months ago, he underwent renal biopsy due to abnormal urinalysis and kidney dysfunction, leading to a diagnosis of IgA nephropathy. He subsequently underwent tonsillectomy followed by glucocorticoid pulse therapy. However, after the tonsillectomy, discontinuing colchicine led to increased proteinuria, despite the glucocorticoid pulse therapy. Upon reintroducing colchicine, urinary protein excretion decreased, achieving incomplete remission. These findings suggest that colchicine may be effective in decreasing proteinuria in patients with Behçet’s disease complicated by IgA nephropathy.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7962025COVID-19 and the Risks of Migraine and Headache: A Mendelian Randomization Study413419ENZhiyunJiangDepartment of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou UniversityYingXiDepartment of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou UniversityOriginal Article10.18926/AMO/69843Several observational studies suggested that migraine headache attacks were associated with coronavirus disease 2019 (COVID-19). We investigated genetic causal links between COVID-19 phenotypes and the development of headache and migraine, including migraine with aura (MA) and migraine without aura (MO). We conducted a two-sample Mendelian randomization (MR) analysis to estimate the genetic association in European populations. The inverse-variance weighted (IVW) method was used as the main approach in the MR analyses, together with weighted median and MR-Egger methods. We also performed a series of sensitivity tests to assess the robustness of the MR results. The MR results demonstrated that COVID-19 severity, hospitalization, and susceptibility had no causal effect on the risks of headache, migraine, MA, or MO. No horizontal pleiotropy was detected, and the results were robust as supported by the sensitivity analysis findings. Our analyses identified no casual effect of COVID-19 severity, hospitalization, or susceptibility on the risks of headache or migraine in European populations.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7962025Real-World Outcomes of Anti-Vascular Endothelial Growth Factor Therapy for Neovascular Age-Related Macular Degeneration in Patients Aged 85 or Older405412ENChihiroOuchiDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMioMorizane HosokawaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuheiKimuraDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusukeShiodeDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoMatobaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTetsuroMoritaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiMorizaneDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/69842We investigated the treatment outcomes of patients aged ≥85 years with neovascular age-related macular degeneration (nAMD) who received anti-vascular endothelial growth factor (anti-VEGF) therapy using either treat-and-extend (TAE) or pro re nata (PRN) regimens for 1 year in real-world clinical practice. Eighty-five eyes from 85 patients were included. Among them, types 1, 2, and 3 macular neovascularization and polypoidal choroidal vasculopathy were present in 27.1%, 17.6%, 18.8%, and 36.5%, respectively. TAE and PRN regimens were used in 43.5% and 56.5% of patients, respectively. At baseline, the PRN group was older and had worse best-corrected visual acuity (BCVA), greater central retinal thickness, and more intraretinal fluid than the TAE group. In the TAE group, the mean number of injections was 7.6, BCVA improved significantly, and all retinal fluid rates decreased. In the PRN group, the mean number of injections was 3.9, BCVA remained unchanged, and the rates of macular fibrosis and atrophy increased. No serious adverse events were observed in either group. Anti-VEGF therapy was safe for patients aged ≥ 85 years with nAMD, and the TAE regimen effectively improved BCVA in this population. BCVA remained unchanged in the PRN-treated patients, with baseline disease severity and/or undertreatment potentially influencing the outcomes.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2076-39211492025Clinical Evaluation of Oxidative Stress Markers in Patients with Long COVID During the Omicron Phase in Japan1068ENOsamuMeseDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasueSakuradaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazukiTokumasuDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiakiSoejimaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoruMoritaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroNakanoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiHondaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkikoEguchiBiobank Center, Mie University HospitalSanaeFukudaDepartment of Health Welfare Sciences, Kansai University of Welfare SciencesJunzoNojimaDepartment of Laboratory Medicine, Yamaguchi UniversityFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTo characterize changes in markers of oxidative stress for the clinical evaluation of patients with long COVID, we assessed oxidative stress and antioxidant activity based on serum samples from patients who visited our clinic between May and November 2024. Seventy-seven patients with long COVID (41 [53%] females and 36 [47%] males; median age, 44 years) were included. Median [interquartile range] serum levels of diacron-reactive oxygen metabolites (d-ROM; CARR Unit), biological antioxidant potential (BAP; μmol/L), and oxidative stress index (OSI) were 533.8 [454.9–627.6], 2385.8 [2169.2–2558.1] and 2.0 [1.7–2.5], respectively. Levels of d-ROMs (579.8 vs. 462.2) and OSI (2.3 vs. 1.8), but not BAP (2403.4 vs. 2352.6), were significantly higher in females than in males. OSI levels positively correlated with age and body mass index, whereas BAP levels negatively correlated with these parameters. d-ROM and OSI levels were significantly associated with inflammatory markers, including C-reactive protein (CRP) and fibrinogen, whereas BAP levels were inversely correlated with CRP and ferritin levels. Notably, serum free thyroxine levels were negatively correlated with d-ROMs and OSI, whereas cortisol levels were positively correlated with d-ROMs. Among long COVID symptoms, patients reporting brain fog exhibited significantly higher OSI levels (2.2 vs. 1.8), particularly among females (d-ROMs: 625.6 vs. 513.0; OSI: 2.4 vs. 2.0). The optimal OSI cut-off values were determined to be 1.32 for distinguishing long COVID from healthy controls and 1.92 for identifying brain fog among patients with long COVID. These findings suggest that oxidative stress markers may serve as indicators for the presence or prediction of psycho-neurological symptoms associated with long COVID in a gender-dependent manner.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2077-038314142025Symptomatic Trends and Time to Recovery for Long COVID Patients Infected During the Omicron Phase4918ENHiroshiAkiyamaDepartment of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYasueSakuradaDepartment of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiroyukiHondaDepartment of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYuiMatsudaDepartment of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYukiOtsukaDepartment of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazukiTokumasuDepartment of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYasuhiroNakanoDepartment of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRyosukeTakaseDepartment of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityDaisukeOmuraDepartment of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKeigoUedaDepartment of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityFumioOtsukaDepartment of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground: Since the pathophysiology of long COVID is not yet fully understood, there are no specific methods for its treatment; however, its individual symptoms can currently be treated. Long COVID is characterized by symptoms that persist at least 2 to 3 months after contracting COVID-19, although it is difficult to predict how long such symptoms may persist. Methods: In the present study, 774 patients who first visited our outpatient clinic during the Omicron period from February 2022 to October 2024 were divided into two groups: the early recovery (ER) group (370 cases; 47.8%), who recovered in less than 180 days (median 33 days), and the persistent-symptom (PS) group (404 cases; 52.2%), who had symptoms that persisted for more than 180 days (median 437 days). The differences in clinical characteristics between these two groups were evaluated. Results: Although the median age of the two groups did not significantly differ (40 and 42 in ER and PS groups, respectively), the ratio of female patients was significantly higher in the PS group than the ER group (59.4% vs. 47.3%). There were no significant differences between the two groups in terms of the period after infection, habits, BMI, severity of COVID-19, and vaccination history. Notably, at the first visit, female patients in the PS group had a significantly higher rate of complaints of fatigue, insomnia, memory disturbance, and paresthesia, while male patients in the PS group showed significantly higher rates of fatigue and headache complaints. Patients with more than three symptoms at the first visit were predominant in the PS groups in both genders. Notably, one to two symptoms were predominant in the male ER group, while two to three symptoms were mostly reported in the female PS group. Moreover, the patients in the PS group had significantly higher scores for physical and mental fatigue and for depressive symptoms. Conclusions: Collectively, these results suggest that long-lasting long COVID is related to the number of symptoms and presents gender-dependent differences.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0960-741212012024OsHAK4 functions in retrieving sodium from the phloem at the reproductive stage of rice7690ENJingCheInstitute of Plant Science and Resources, Okayama UniversityNaokiYamajiInstitute of Plant Science and Resources, Okayama UniversityShao FeiWangKey Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of SciencesYueXiaKey Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of SciencesShun YingYangKey Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of SciencesYan HuaSuKey Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of SciencesRen FangShenKey Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of SciencesJian FengMaInstitute of Plant Science and Resources, Okayama UniversitySoil salinity significantly limits rice productivity, but it is poorly understood how excess sodium (Na+) is delivered to the grains at the reproductive stage. Here, we functionally characterized OsHAK4, a member of the clade IV HAK/KUP/KT transporter subfamily in rice. OsHAK4 was localized to the plasma membrane and exhibited influx transport activity for Na+, but not for K+. Analysis of organ- and growth stage-dependent expression patterns showed that very low expression levels of OsHAK4 were detected at the vegetative growth stage, but its high expression in uppermost node I, peduncle, and rachis was found at the reproductive stage. Immunostaining indicated OsHAK4 localization in the phloem region of node I, peduncle, and rachis. Knockout of OsHAK4 did not affect the growth and Na+ accumulation at the vegetative stage. However, at the reproductive stage, the hak4 mutants accumulated higher Na+ in the peduncle, rachis, husk, and brown rice compared to the wild-type rice. Element imaging revealed higher Na+ accumulation at the phloem region of the peduncle in the mutants. These results indicate that OsHAK4 plays a crucial role in retrieving Na+ from the phloem in the upper nodes, peduncle, and rachis, thereby preventing Na+ distribution to the grains at the reproductive stage of rice.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2504-3129642025Drip Fertigation in Greenhouse Eggplant Cultivation: Reducing N2O Emissions and Nitrate Leaching116ENWataruShiraishiKochi Prefectural Agricultural Research CenterShionNishimuraDepartment of Bioresource Production Science, United Graduate School of Agriculture, Ehime UniversityMorihiroMaedaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHidetoUenoDepartment of Bioresource Production Science, United Graduate School of Agriculture, Ehime UniversityDrip fertigation (DF) is a sustainable agricultural management technique that optimizes water and nutrient usage, enhances crop productivity, and reduces environmental impact. Herein, we compared the effects of DF and conventional fertilization (CF) with a basal fertilizer on yield, soil inorganic nitrogen dynamics, N2O emissions, and nitrogen leaching during facility-grown eggplant cultivation. The experiment was conducted in a greenhouse from September 2023 to May 2024, with treatments arranged in three rows and three replicates. Soil, gas, and water samples were collected and analyzed throughout the growing season. The results revealed that the DF treatment produced yields comparable to those obtained with the CF treatment while significantly reducing nitrogen and phosphorus inputs. DF effectively prevented excessive nitrogen accumulation in the soil and reduced nitrogen loss through leaching and gas emissions. N2O emissions were significantly lower by more than 60% under DF than under CF. Precise nutrient management in DF suppressed nitrification and denitrification processes, mitigating N2O emissions. DF also significantly reduced nitrogen leaching by more than 70% compared with that in CF. These findings demonstrate that DF effectively enhances agricultural sustainability by improving nutrient use efficiency, reducing greenhouse gas emissions, and minimizing nitrogen leaching during the cultivation of facility-grown eggplant.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama岡山大学図書館所蔵 菊池家文書（補足分）目録ENNo potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0915-56352025EUS-Guided Versus Percutaneous Transhepatic Drainage of Liver Abscesses: A Multicenter Endohepatology Study in Western Japan (EPIC-LA Study)ENTakeshiOguraPancreatobiliary Advanced Medical Center, Osaka Medical and Pharmaceutical University HospitalTairaKurodaGastroenterology Center, Ehime Prefectural HospitalTakanoriMatsuuraDivision of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of MedicineJunKitadaiDivision of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of MedicineKohKitagawaDepartment of Gastroenterology, Nara Medical UniversityMasahiroItonagaSecond Department of Internal Medicine, Wakayama Medical UniversityKotaroTakeshitaDepartment of Gastroenterology, Tane General HospitalTomoakiMatsumoriDepartment of Gastroenterology and Hepatology, Kyoto University Graduate School of MedicineTomoyaEmoriDepartment of Gastroenterology, Wakayama Rosai HospitalMamoruTakenakaDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine Graduate School of Medical SciencesHajimeImaiDepartment of Gastroenterology, Okanami General HospitalKoichiroMandaiDepartment of Gastroenterology, Kyoto Second Red Cross HospitalShuheiShintaniDepartment of Gastroenterology, Shiga University of Medical ScienceNaoFujimoriDepartment of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu UniversityHideyukiShiomiDivision of Hepatobiliary and Pancreatic Diseases, Department of Gastroenterology, Hyogo Medical UniversityMasanoriAsadaDepartment of Gastroenterology and Hepatology, Japanese Red Cross Osaka HospitalRyotaSagamiDepartment of Gastroenterology, Faculty of Medicine, Oita UniversityHirotsuguMaruyamaDepartment of Gastroenterology, Graduate School of Medicine, Osaka Metropolitan UniversityTsukasaIkeuraDivision of Gastroenterology and Hepatology, Kansai Medical University HospitalMasaakiShimataniDepartment of Gastroenterology and Hepatology, Kansai Medical University Medical CenterHidefumiNishikioriDepartment of Gastroenterology, Oita San-ai Medical CenterKazuyukiMatsumotoDepartment of Endoscopy, Okayama University HospitalMasahitoKokubuDepartment of Gastroenterology and Metabology, Ehime University Graduate School of MedicineHidekiKamadaDepartment of Gastroenterology and Neurology, Faculty of Medicine, Kagawa UniversityYusukeIshidaDepartment of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka UniversityAkitoshiHakoda2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical UniversityMasayukiKitanoSecond Department of Internal Medicine, Wakayama Medical UniversityObjective: Percutaneous transhepatic liver abscess drainage (PTAD) and endoscopic ultrasound-guided liver abscess drainage (EUS-LAD) have several limitations. Recently, because of technical improvements in echoendoscope maneuvers, EUS-guided access for the right hepatic lobe has been reported. The aim of this multicenter, retrospective study was to compare clinical outcomes of PTAD and EUS-LAD including the right hepatic lobe in West Japan.<br>
Method: This retrospective, multicenter study included consecutive patients with liver abscesses between January 2019 and November 2024. The primary outcome in this study was the clinical success rate compared between EUS-LAD and PTAD.<br>
Results: During the study period, 1012 consecutive patients developed liver abscesses. Of them, 734 patients were excluded, 43 underwent EUS-LAD and 235 patients underwent PTAD. After propensity score-matched analysis, the clinical success rate was significantly higher in the EUS-LAD group (97.7%, 42/43) than in the PTAD group (79.1%, 34/43) (p = 0.007). After a propensity score-matched analysis, 25 patients were included in each group. The clinical success rate was significantly higher in the EUS-LAD group (100%, 25/25) than in the PTAD group (84%, 21/25) (p = 0.037). Adverse events were also significantly higher in the PTAD group (16%, 5/25) than in the EUS-LAD group (p = 0.025). In addition, the median length of hospital stay was significantly shorter in the EUS-LAD group (15 days) than in the PTAD group (22 days) (p = 0.005).<br>
Conclusions: EUS-LAD using a metal stent might be one of the options, but further randomized, controlled trials are needed.No potential conflict of interest relevant to this article was reported.American Society of Clinical Oncology (ASCO)Acta Medica Okayama0732-183X2025Amivantamab Plus Lazertinib in Atypical EGFR-Mutated Advanced Non–Small Cell Lung Cancer: Results From CHRYSALIS-2JCO-24-02835ENPascaleTomasiniAix Marseille University - CNRS, INSERM, CRCM; CEPCM - AP-HM Hôpital de La TimoneYongshengWangDivision of Thoracic Tumor Multimodality Treatment, Cancer Center and Clinical Trial Center, West China Hospital, Sichuan UniversityYongshengLiChongqing University Cancer HospitalEnriquetaFelipMedical Oncology Service, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de BarcelonaLinWuDepartment of Thoracic Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South UniversityJiuweiCuiThe First Hospital of Jilin UniversityBenjaminBesseParis-Saclay University, Institut Gustave RoussyAlexander I.SpiraVirginia Cancer SpecialistsJoel W.NealStanford Cancer Institute, Stanford UniversityKoichiGotoNational Cancer Center Hospital EastChristina S.BaikUniversity of Washington Fred Hutchinson Cancer Research CenterMelina E.MarmarelisPerelman School of Medicine, University of PennsylvaniaEikiIchiharaCenter for Clinical Oncology, Okayama University HospitalYipingZhangZhejiang Cancer HospitalJong-SeokLeeSeoul National University College of Medicine and Seoul National University HospitalSe-HoonLeeSamsung Medical Center, Sungkyunkwan University School of MedicineJames Chih-HsinYangNational Taiwan University Cancer CenterSebastianMichelsDepartment I for Internal Medicine, Faculty of Medicine and University Hospital Cologne, Lung Cancer Group Cologne, Center for Integrated Oncology Aachen Köln Bonn Düsseldorf, University of CologneZachariasAnastasiouJohnson & JohnsonJoshua C.CurtinJohnson & JohnsonXuesongLyuJohnson & JohnsonJanineMahoneyJohnson & JohnsonLevonDemirdjianJohnson & JohnsonCraig S.MeyerJohnson & JohnsonYouyiZhangJohnson & JohnsonIsabelleLeconteJohnson & JohnsonPatriciaLorenziniJohnson & JohnsonRoland E.KnoblauchJohnson & JohnsonLeonardoTraniJohnson & JohnsonMahadiBaigJohnson & JohnsonJoshua M.BaumlJohnson & JohnsonByoung ChulChoDivision of Medical Oncology, Yonsei Cancer Center, Yonsei University College of MedicinePurpose For patients with advanced non–small cell lung cancer (NSCLC) harboring atypical epidermal growth factor receptor (EGFR) mutations (eg, S768I, L861Q, G719X), efficacy of current treatment options is limited.<br>
Patients and Methods CHRYSALIS-2 Cohort C enrolled participants with NSCLC harboring atypical EGFR mutations (G719X, S768I, L861Q, etc) and ≤2 previous lines of therapy. Participants were treatment-naïve or previously received first- or second-generation EGFR tyrosine kinase inhibitors. Coexisting exon 20 insertions, exon 19 deletions, or exon 21 L858R mutations were exclusionary. Participants received 1,050 mg (1,400 mg if ≥80 kg) intravenous amivantamab once weekly for the first 4 weeks and then once every 2 weeks plus 240 mg oral lazertinib once daily. The primary end point was investigator-assessed objective response rate (ORR).<br>
Results As of January 12, 2024, 105 participants received amivantamab-lazertinib. Most common atypical mutations were G719X (56%), L861X (26%), and S768I (23%), including single and compound mutations. In the overall population (median follow-up: 16.1 months), the ORR was 52% (95% CI, 42 to 62). The median duration of response (mDoR) was 14.1 months (95% CI, 9.5 to 26.2). The median progression-free survival (mPFS) was 11.1 months (95% CI, 7.8 to 17.8); median overall survival (mOS) was not estimable (NE; 95% CI, 22.8 to NE). Adverse events were consistent with previous studies and primarily grade 1 and 2. Among treatment-naïve participants, the ORR was 57% (95% CI, 42 to 71). The mPFS was 19.5 months (95% CI, 11.2 to NE), the mDoR was 20.7 months (95% CI, 9.9 to NE), and mOS was NE (95% CI, 26.3 to NE). Solitary or compound EGFR mutations had no major impact on ORR. The ORR in participants with P-loop and αC-helix compressing, classical-like, and T790M-like mutations was 45% (n = 38), 64% (n = 14), and 67% (n = 3), respectively.<br>
Conclusion In participants with atypical EGFR-mutated advanced NSCLC, amivantamab-lazertinib demonstrated clinically meaningful antitumor activity with no new safety signals.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1341-807651112025The Short‐Term Impacts of Japan's 2024 Physician Working‐Hour Limits on Labor Conditions, Self‐Directed Professional Development, and Happiness Among Obstetrician‐Gynecologistse70112ENYutoMaedaDepartment of Public Health, Institute of Science TokyoSatoruNakagawaDepartment of Obstetrics and Gynecology, Osaka UniversityKentaroNakanishiDepartment of Obstetrics and Gynecology, Asahikawa Medical UniversityEriInoueAiiku Maternal and Child Health Center, Aiiku HospitalDaisukeInoueDepartment of Obstetrics and Gynecology, University of FukuiSakiKidoDepartment of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu UniversityMichikoKidoDepartment of Obstetrics and Gynecology, Japanese Red Cross Medical CenterKaoriKogaDepartment of Obstetrics and Gynecology, Reproductive Medicine Chiba UniversityShunjiSuzukiDepartment of Obstetrics and Gynecology, Nippon Medical SchoolYukioSuzukiDepartment of Gynecology, Kanagawa Cancer CenterJunkoHaragaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHisashiMasuyamaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEikoYamamotoDepartment of Healthcare Administration, Nagoya University Graduate School of MedicineTakeshiUmazumeDepartment of Obstetrics and Gynecology, Hokkaido UniversityYoshihitoYokoyamaDepartment of Obstetrics and Gynecology, Hirosaki University Graduate School of MedicineAkiraIwaseDepartment of Obstetrics and Gynecology, Gunma University Graduate School of MedicineTomoakiIkedaSaiseikai Matsusaka General HospitalYoshioYoshidaDepartment of Obstetrics and Gynecology, University of FukuiYoshikiKudoDepartment of Obstetrics and Gynecology, Hiroshima UniversityTakashiSugiyamaDepartment of Obstetrics and Gynecology, Ehime University Graduate School of MedicineKiyonoriMiuraDepartment of Obstetrics and Gynecology, Nagasaki UniversityHideakiYahataDepartment of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu UniversityNobuyaUnnoCenter for Perinatal Medicine, JCHO Sagamino HospitalKentaroKurasawaDepartment of Obstetrics and Gynecology, Yokohama City University Graduate School of MedicineTakahideMaenakaDepartment of Obstetrics and Gynecology, Higashiosaka City Medical CenterEtsukoMiyagiDepartment of Obstetrics and Gynecology, Yokohama City University Graduate School of MedicineKiyokoKatoDepartment of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu UniversityYasuhitoKatoDepartment of Obstetrics and Gynecology, Asahikawa Medical UniversityObjective: To examine the short-term impacts of Japan's newly implemented physician working-hour limits (April 2024) on working conditions, self-directed professional development (SDPD), defined as activities undertaken outside working hours to enhance one's professional skills, and work-related happiness among obstetrician-gynecologists (OB-GYNs).<br>
Methods: An online survey was conducted between July 8 and July 31, 2024, targeting 867 Japan Society of Obstetrics and Gynecology members. Five hundred and fourteen full-time practitioners who had not changed workplaces around April 2024 and had no missing data were analyzed. Participants were stratified by regulation levels (A, B, C, discretionary labor system, those who don't know their own level), and their working hours, anticipated income, SDPD satisfaction, and happiness (0–10 scale) were assessed. We used multivariate linear regression to evaluate the influence of labor condition changes on happiness and explored interactions involving unpaid overtime, income changes, and SDPD satisfaction.<br>
Results: Compared with level A (up to 960 h of overtime per year), participants at levels B and C (up to 1860 h of overtime per year) reported significantly lower happiness (p < 0.001). Most respondents observed no major shifts in working conditions since March 2024, yet about 40% did not record SDPD hours that meet the working hour requirement as official work time. Adjusted analyses revealed that decreased income and unsatisfactory SDPD significantly lowered happiness, whereas higher SDPD satisfaction increased it (β: −0.64 [−1.07, −0.21], −0.98 [−1.46, −0.50], and 0.90 [0.44, 1.35], respectively). Subgroup analysis indicated that rising unpaid overtime further reduced happiness among those dissatisfied with SDPD (−1.43 [−2.41, −0.45]).<br>
Conclusions: The new working-hour limits had minimal impact on labor conditions in the short run. However, satisfaction with SDPD was positively associated with happiness, whereas anticipated decreases in income were correlated with lower happiness.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2073-434414102024Photocatalytic Ammonia Decomposition Using Dye-Encapsulated Single-Walled Carbon Nanotubes715ENTomoyukiTajimaGraduate School of Environmental and Life Science, Okayama UniversityKotoneYanoGraduate School of Environmental and Life Science, Okayama UniversityKazushiMukaiDepartment of Materials Design and Engineering, University of ToyamaYutakaTakaguchiDepartment of Materials Design and Engineering, University of ToyamaThe photocatalytic decomposition of ammonia to produce N2 and H2 was achieved using single-walled carbon nanotube (SWCNT) nanohybrids. The physical modification of ferrocene-dye-encapsulated CNTs by amphiphilic C60-dendron yielded nanohybrids with a dye/CNT/C60 coaxial heterojunction. Upon irradiation with visible light, an aqueous solution of NH3 and dye@CNT/C60-dendron nanohybrids produced both N2 and H2 in a stoichiometric ratio of 1/3. The action spectra of this reaction clearly demonstrated that the encapsulated dye acted as the photosensitizer, exhibiting an apparent quantum yield (AQY) of 0.22% at 510 nm (the λmax of the dye). This study reports the first example of dye-sensitized ammonia decomposition and provides a new avenue for developing efficient and sustainable photocatalytic hydrogen production systems.No potential conflict of interest relevant to this article was reported.AME Publishing CompanyActa Medica Okayama2790-885232024Airway management during sedation for dental treatment in people with intellectual disabilities: a review28ENHitoshiHiguchiDepartment of Dental Anesthesiology, Okayama University HospitalYukikoNishiokaDepartment of Dental Anesthesiology, Okayama University HospitalSakiMiyakeDepartment of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuyaMiyawakiDepartment of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesThe oral health of people with intellectual disabilities remains poor due to a complex combination of physical and social problems, and often requires invasive dental treatment. However, it can be difficult to obtain their cooperation for dental treatment because they may not fully understand the need for treatment or may experience high levels of anxiety due to lack of understanding and/or sensory aversions to stimuli present in the dental environment, and behavioral management is often necessary during such treatment. Sedation is a very useful patient management method for dental treatment for people with intellectual disabilities; however, the dental treatment-related sedation of people with intellectual disabilities has different characteristics to the dental treatment-related sedation of others or other procedure-related sedation. For example, deep sedation is required for behavioral management; drug interactions between the patient’s regular medications, such as antiepileptic and antipsychotic drugs, and anesthetics may make the depth of sedation deeper; and the prevalence rate of obesity is higher among people with intellectual disabilities. The fact that the patient is in the supine position with their mouth open also makes airway management during sedation for dental treatment more difficult. It is therefore imperative that airway management during dental treatment for people with intellectual disabilities be conducted with the utmost precision and vigilance. Various attempts have been made to improve airway management during such sedation, and new technologies, such as capnography, nasal high-flow systems, and acoustic respiration monitors, may help. The objective of this review is to enhance comprehension of the attributes of airway management in dental sedation for people with intellectual disabilities and to properly understand the usefulness of the techniques that have been attempted thus far to ensure safer and more secure airway management for this population. The ultimate goal is to provide them with safe and secure medical care and improve their health outcomes.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1473-05026462025Novel leukocytapheresis method using highly concentrated sodium citrate solution for the manufacturing of tisagenlecleucel104265ENWataruKitamuraDepartment of Hematology and Oncology, Okayama University HospitalKeikoFujiiDepartment of Hematology and Oncology, Okayama University HospitalMasayaAbeDepartment of Hematology and Oncology, Okayama University HospitalKazuhiroIkeuchiDepartment of Hematology and Oncology, Okayama University HospitalKanaWashioDepartment of Pediatrics, Okayama University HospitalFumioOtsukaDivision of Clinical Laboratory, Okayama University HospitalYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalNobuharuFujiiDepartment of Hematology and Oncology, Okayama University HospitalFor the manufacturing of tisagenlecleucel (tisa-cel) requires the non-mobilized mononuclear cell collection (MNC). CD3+ cell collection is performed using the same protocol as autologous peripheral blood stem cell harvest (auto-PBSCH), but this procedure necessitates the same target CD3+ cell yields regardless of age or body weight, which may take several days especially in pediatric and small female patients with low white blood cell counts. We previously demonstrated a novel method using highly concentration sodium citrate (HSC), which reduced the need for an anticoagulant (AC) solution and shortened the procedure time in auto-PBSCH. This novel method was expected to offer advantages for smaller patients, prompting us to investigate its application in leukocytapheresis for the manufacturing of tisa-cel. We retrospectively analyzed consecutive leukocytapheresis data obtained using Spectra Optia continuous MNC mode between November 2022 and June 2024 at our institution (n = 9). In six of nine patients, pre-leukocytapheresis CD3+ cell counts were less than 500 /μL, but all could obtain the target CD3+ cell yields in one day upon processing blood volume adjustment. When we compared patients who had received CD3+ cell collection using normal-concentration sodium citrate (NSC) as our previously reported using propensity score-matched pair analysis, the total AC solution volume was significantly lower (1168 vs. 316 mL, p < 0.001) and procedure time was significantly shorter (254 vs. 228 min, p = 0.04) in the HSC group compared to the NSC group. In conclusion, this procedure was also useful for non-mobilized MNC. Our findings warrant validation in a larger patient cohort.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Accuracy of deep learning-based attenuation correction in 99mTc-GSA SPECT/CT hepatic imagingENMasahiroMIYAIGraduate School of Health Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Coherence Generation in Atomic Cesium for Cosmic Dark Matter DetectionENJINGWANGGraduate School of Natural Science and Technology, Okayama universityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Clinical Prediction Models for Upper Airway Volume Based on Soft Palate and Airway Lumen Dimensions in Adults With Varying Vertical Skeletal PatternsENHABUMUGISHA JANVIERGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Importance of Blood Glucose Measurement for Predicting the Prognosis of Long COVID：A Retrospective Study in JapanENShoYOKOYAMAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Trends in childhood obesity in Japan: A nationwide observational study from 2012 to 2021ENShintaroFUJIWARAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Examination of yield, bacteriolytic activity and cold storage of linker deletion mutants based on endolysin S6_ORF93 derived from Staphylococcus giant bacteriophage S6ENSosukeMUNETOMOGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Somatic mutations in tumor-infiltrating lymphocytes impact on antitumor immunity ENFumiakiMUKOHARAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025High Prevalence of MYD88 and CD79B Mutations in Primary Sinonasal Diffuse Large B-Cell Lymphoma: Identification of an MCD-like SubtypeENFANGLIPENGGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Single-cell and spatial characterization of plasmablast-like lymphoma cells in primary central nervous system lymphomaENHirokiKOBAYASHIGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Exploring factors influencing the hearing test and hearing aid adoption among Japanese older adults: Implications of recognizing the hearing loss–dementia relationshipENIchiroFUKUMASUGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Repeated non-hemorrhagic and non-contusional mild traumatic brain injury in rats elicits behavioral impairment with microglial activation, astrogliosis, and tauopathy: Reproducible and quantitative model of chronic traumatic encephalopathyENChiakiSUGAHARAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1467-788126112025Missing the Target: A Scoping Review of the Use of Percent Weight Loss for Obesity Managemente13960ENDianaSherifaliMcMaster Evidence Review and Synthesis Team; School of Nursing, McMaster UniversityMeganRaceyMcMaster Evidence Review and Synthesis Team; School of Nursing, McMaster UniversityDonnaFitzpatrick‐LewisMcMaster Evidence Review and Synthesis Team; School of Nursing, McMaster UniversityMichelleGreenwayMcMaster Evidence Review and Synthesis Team; School of Nursing, McMaster UniversitySanjeevSockalingamObesity CanadaJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversitySoo HuatTeohDepartment of Clinical Medicine, Advanced Medical and Dental Institute, Universiti Sains MalaysiaIanPattonObesity CanadaDavidMacklinTemerty Faculty of Medicine, University of TorontoElizabeth F. C.van RossumDepartment of Internal Medicine, Division of Endocrinology, and Obesity Center CGG, Erasmus MC, University Medical Center RotterdamLucaBusettoDepartment of Medicine, University of PadovaDeborah BadeHornCenter of Obesity Medicine and Metabolic Performance, Department of Surgery, University of Texas McGovern Medical SchoolJ. D.Patricia NeceObesity Action CoalitionMorgan Emile Gabriel SalmonLeguedeABHispalis Spain, Alianza Hispana de Personas con Obesidad Latin AmericaNicolePearceObesity CanadaCarelLe RouxSchool of Medicine, University College DublinJamyArdSchool of Medicine, Wake Forest UniversityAngela S.AlbergaDepartment of Health, Kinesiology, and Applied Physiology, Concordia UniversityLeeKaplanObesity, Metabolism and Nutrition Institute Massachusetts General Hospital and Harvard Medical SchoolArya M.SharmaDepartment of Medicine, University of AlbertaSeanWhartonTemerty Faculty of Medicine, University of TorontoIntroduction: To co-create comprehensive targets for obesity management, we need to understand the genesis and current use of percent weight loss targets in research. The goals of our scoping review are to (1) synthesize the literature on percent weight loss targets for adults with obesity and (2) discuss the percent weight loss targets in context with their health benefits.<br>
Methods: We searched Cochrane, MEDLINE, and EMBASE for English language, pharmaceutical, and/or behavioral intervention studies in adults with obesity where the explicit aim of the study was weight reduction defined as a percent of body weight. Reviewers screened citations and extracted data including study characteristics.<br>
Results: From 16,164 abstracts, we included 30 citations which were mostly randomized controlled trials (RCTs) (n = 17) or quasi-experimental studies (n = 12) published between 1992 and 2024. Most of the studies had target weight loss goals between 3% and 10% of body weight (n = 28), while n = 2 had body weight loss goals of 15% or 30%. The proportion of participants who met the percent weight loss target ranged from 5.9% (nutrition only study) to 85% (pharmaceutical study). The studies reported different reasons for targeting a percentage of weight loss such as disease-specific outcomes, reduced risk of disease, or patient-reported outcomes.<br>
Conclusion: Percent weight loss targets were based on similar research and were often not feasible nor sustainable for most participants. The design of these interventions and evaluation of obesity management would benefit from more patient-focused parameters which could help to co-design comprehensive targets for research and practice.No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231902025令和６年度岡山御津高等学校「キャリア実習」における家庭科授業の実践と検討157169ENFaculty of Education, Okayama UniversityChikaHASEGAWAOkayama Mitsu Senior High School10.18926/bgeou/69619 本実践研究は，「高等学校の教育課程」の「エ 学校特設科目及び学校設定教科」の中で，岡山県立岡山御津高等学校が独自に設定している教科「総合」の中の一科目「キャリア実習」に焦点を当て，令和６年度に実施した地域協働系列２年次の「キャリア実習」における家庭科授業を分析・評価し，令和７年度に地域協働系列３年次生が履修する「キャリア実習」の在り方を検討すると共に，本校の家庭科の学びについて考えるための示唆を得ることを目的とした。No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231902025岡山大学教育学部教育実践力向上カリキュラムにおける初等家庭科内容基礎の実践 ― 2024 年度実践結果と教科内容構成力の継続的育成の検討 ―139148ENYokoSHINOHARAFaculty of Education, Okayama UniversityMiyukiHISANARI,Faculty of Education, Okayama UniversityChiharuMORIFaculty of Education, Okayama UniversityKyoungwonLEEFaculty of Education, Okayama University10.18926/bgeou/69617 岡山大学教育学部において教育実践力向上カリキュラムが始動し2 年目となる2024 年度「初等家庭科内容基礎」の実践について，学生のアンケート結果から新しいカリキュラムにおける授業評価と教科内容構成力育成の課題を検討した．授業の到達目標に係る学生の自己評価は高く，教科内容構成要素との関係から，教科内容構成力のプロセス@に係る基礎的な力は獲得できていた．授業に意欲的に取り組んだグループは授業全体の満足度が高かった．授業後は家庭科の教育内容を指導者の視点から認識できている学生が多く見られ，指導法で学ぶ家庭科の授業つくりに繋がる学修となっていることが分かった．No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221412024Association between proteinuria and mineral metabolism disorders in chronic kidney disease: the Japan chronic kidney disease database extension (J-CKD-DB-Ex)27481ENShoShimamotoDepartment of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu UniversityTakakoNakaharaDepartment of Medical Technology, Faculty of Health Science and Technology, Kawasaki University of Medical WelfareShunsukeYamadaDepartment of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu UniversityHajimeNagasuDepartment of Nephrology and Hypertension, Kawasaki Medical SchoolSeijiKishiDepartment of Nephrology and Hypertension, Kawasaki Medical SchoolNaokiNakashimaDepartment of Medical Informatics, Graduate School of Medical Science, Kyushu UniversityKazuhikoTsuruyaDepartment of Nephrology, Nara Medical UniversityHirokazuOkadaDepartment of Nephrology, Faculty of Medicine, Saitama Medical UniversityKouichiTamuraDepartment of Medical Science and Cardiorenal Medicine, Graduate School of Medicine, Yokohama City UniversityIchieiNaritaDivision of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental SciencesShoichiMaruyamaDepartment of Nephrology, Nagoya University Graduate School of MedicineYuichiroYanoDepartment of General Medicine, Juntendo University Faculty of MedicineTakashiYokooDivision of Kidney and Hypertension, Department of Internal Medicine, Jikei University School of MedicineTakashiWadaDepartment of Nephrology and Rheumatology, Kanazawa UniversityJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineEiichiroKandaDepartment of Health Data Science, Kawasaki Medical SchoolHiromiKataokaDepartment of Medical Technology, Faculty of Health Science and Technology, Kawasaki University of Medical WelfareMasaomiNangakuDivision of Nephrology and Endocrinology, University of Tokyo Graduate School of MedicineNaokiKashiharaDepartment of Nephrology and Hypertension, Kawasaki Medical SchoolToshiakiNakanoDepartment of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu UniversityChronic kidney disease-mineral and bone disorder (CKD-MBD) are recognized as a systemic disease affecting the prognosis of patients with CKD. Proper management of CKD-MBD is important to improve the prognosis of patients with CKD. Although proteinuria is recognized as a poor prognostic factor in these patients, few reports have examined its association with CKD-MBD. We examined the association between proteinuria and CKD-MBD using data from the Japan Chronic Kidney Disease Database Extension (J-CKD-DB-Ex). Among the patients registered in the J-CKD-DB-Ex, 30,977 with CKD stages G2–G5 who had serum creatinine, albumin, calcium, and phosphate concentrations measured at least once and urinalysis performed were included. The patients were divided into four groups (negative, 1+, 2+, and 3+) according to the degree of proteinuria. The association between proteinuria and CKD-MBD was examined by a logistic regression analysis. In a model adjusted for age, sex, diabetes, and the estimated glomerular filtration rate (eGFR), the odds ratio of the 3 + group compared with the negative group significantly increased to 2.67 (95% confidence interval, 2.29–3.13) for hyperphosphatemia, 2.68 (1.94–3.71) for hypocalcemia, and 1.56 (1.24–1.98) for hypomagnesemia. Proteinuria is associated with hyperphosphatemia, hypocalcemia, and hypomagnesemia in patients with CKD independently of eGFR.No potential conflict of interest relevant to this article was reported.Japan Medical AssociationActa Medica Okayama2433-3298822025Successful Transplantation of Multiple Organs from Donor after Helium Asphyxiation: First Case Report in Japan650653ENShuntaJinnoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTakashiHongoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTakafumiObaraDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTsuyoshiNojimaDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityKoheiTsukaharaDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTetsuyaYumotoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityHiromichiNaitoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityAtsunoriNakaoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityHelium inhalation has increased, but most cases are either minor injuries or deaths; there have not yet been any reported cases of brain death leading to organ donation. We report a patient who attempted helium inhalation and was declared brain dead and became an organ donor without complications. To the best of our knowledge, this is the first reported case of deceased organ donation following helium asphyxiation in Japan. The patient in cardiac arrest was found with a helium-filled vinyl bag sealed around the neck. During emergency medical transport to the hospital, a spontaneous return of circulation was obtained after 31 minutes of cardiopulmonary resuscitation. Upon hospital arrival, the physical examination revealed dilated pupils with no response to light. Electrocardiography showed widespread ST-segment depression and ST-segment elevation in augmented Vector Right, as well as elevated cardiac enzymes and decreased myocardial contractility. Head computed tomography revealed diffuse cerebral edema and loss of the gray-white matter boundary without signs of air embolism in the cerebral and coronary arteries. Despite comprehensive post-cardiac arrest care with recovery of organ function, brain death was confirmed on day 4 after hospitalization. The family consented to organ donation on the 11th day of hospitalization. The heart, lungs, liver, and two kidneys were successfully transplanted and all organs functioned. All organ grafts were functioning well at the 3-month follow-up. Our case demonstrates that brain death caused by helium inhalation is not a contraindication to organ donation.No potential conflict of interest relevant to this article was reported.BMJActa Medica Okayama2044-60551562025Protocol for a multicentre, open-label, dose-escalation phase I/II study evaluating the tolerability, safety, efficacy and pharmacokinetics of repeated continuous intravenous PPMX-T003 in patients with aggressive natural killer cell leukaemiae098532ENNorikoFukuharaHematology, Tohoku University Graduate School of MedicineMakotoOnizukaDepartment of Hematology and Oncology, Tokai University School of Medicine Graduate School of MedicineJunyaKandaDepartment of Hematology, Graduate School of Medicine, Kyoto UniversityNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalKojiKatoDepartment of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu UniversityKiyoshiAndoDepartment of Hematology, Hiroshima UniversityIntroduction Aggressive natural killer cell leukaemia (ANKL) is a rare form of NK cell lymphoma with a very low incidence and poor prognosis. While multi-agent chemotherapy including L-asparaginase has been used to treat ANKL patients, they often cannot receive adequate chemotherapy at diagnosis due to liver dysfunction. PPMX-T003, a fully human monoclonal antibody targeting the transferrin receptor 1, shows promise in treating ANKL by helping patients recover from fulminant clinical conditions, potentially enabling a transition to chemotherapy. This study aimed to evaluate the tolerability, safety, efficacy, and pharmacokinetics of repeated continuous intravenous PPMX-T003 in patients with ANKL.<br>
Methods and analysis This multicentre, open-label, dose-escalation phase I/II study will be conducted at nine hospitals in Japan. Patients diagnosed with ANKL (whether as a primary or recurrent disease) and exhibiting abnormal liver function or hepatomegaly due to the primary disease will be included. The primary endpoint is the tolerability and safety of repeated continuous intravenous administration of PPMX-T003 in the first course, based on adverse events and dose-limiting toxicities. PPMX-T003 will be administered as a continuous intravenous infusion every 24 hours for five consecutive days, followed by a 2-day break. Pretreatment will be provided to minimise the risk of infusion-related reactions. Initial doses of PPMX-T003 will be 0.5, 1.0 or 2.0 mg/kg, with subsequent dose increases determined by the Data and Safety Monitoring Committee. The sample size is set at seven participants, with enrolment increased to up to 12 participants if dose-limiting toxicities occur, based on feasibility due to the rarity of ANKL. Descriptive statistics will summarise data according to initial dose, and pharmacokinetic analysis will be conducted based on administered dose.<br>
Ethics and dissemination This study was approved by the institutional review boards at participating hospitals. The results will be disseminated in peer-reviewed journals.<br>
Trial registration number jRCT2061230008 (jRCT); NCT05863234 (ClinicalTrials.gov).No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1341-96252025Japanese society for cancer of the colon and rectum (JSCCR) guidelines 2024 for the clinical practice of hereditary colorectal cancerENKohjiTanakayaDepartment of Surgery, National Hospital Organization Iwakuni Clinical CenterTatsuroYamaguchiDepartment of Clinical Genetics, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalKeijiHirataDepartment of Surgery 1, University of Occupational and Environmental HealthMasayoshiYamadaEndoscopy Division, National Cancer Center HospitalKensukeKumamotoDepartment of Genome Medical Science and Medical Genetics, Faculty of Medicine, Kagawa UniversityYasukiAkiyamaDepartment of Surgery 1, University of Occupational and Environmental HealthKeiIshimaruDivision of Gastrointestinal Surgery and Surgical Oncology, Graduate School of Medicine, Ehime UniversityKoichiOkamotoDepartment of Gastroenterology and Oncology, Tokushima University Graduate School of Medical ScienceYukoKawasakiCollege of Nursing, University of HyogoKeigoKomineDepartment of Medical Oncology, Tohoku University HospitalAkiraSakamotoDepartment of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalKunitoshiShigeyasuDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYoshikoShibataHimawari-No-Kai (Sunflower Association), a Patient Advocacy Group for Individuals and Families Affected By Lynch SyndromeYusakuShimamotoDivision of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of MedicineHidekiShimodairaDivision of Medical Oncology, Faculty of Medicine, Tohoku Medical and Pharmaceutical UniversityShigekiSekineDepartment of Pathology, Keio University School of MedicineAkinariTakaoDepartment of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalMisatoTakaoDepartment of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalYasuyukiTakamizawaDepartment of Colorectal Surgery, National Cancer Center HospitalYojiTakeuchiDepartment of Gastroenterology and Hepatology, Gunma University Graduate School of MedicineNorikoTanabeDepartment of Clinical Genetics, Saitama Medical Center, Saitama Medical UniversityFumitakaTaniguchiDepartment of Surgery, Hiroshima City Hospital Organization Hiroshima City Hiroshima Citizens HospitalAkikoChinoDepartment of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer ResearchHourinChoEndoscopy Center, Tokyo Medical University HospitalSatoruDoiHarmony Line (Association for Patients and Families With Familial Adenomatous Polyposis)TakeshiNakajimaDivision of Hereditary Tumors, Department of Genetic Oncology, Osaka International Cancer InstituteSakikoNakamoriDepartment of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalYoshikoNakayamaDepartment of Pediatrics, Shinshu University School of MedicineToshiyaNagasakiDepartment of Gastroenterological Surgery, Saitama Cancer CenterHisashiHasumiDepartment of Urology, Yokohama City UniversityKoujiBannoCenter of Maternal -Fetal/Neonatal Medicine, Hiroshima University HospitalTakaoHinoiDepartment of Clinical and Molecular Genetics, Hiroshima University HospitalKenjiFujiyoshiDepartment of Surgery, Kurume University School of MedicineTakahiroHorimatsuInstitute for Advancement of Clinical and Translational Science, Kyoto University HospitalKentaMasudaDepartment of Obstetrics and Gynecology, Keio University School of MedicineMasashiMiguchiDepartment of Gastroenterological Surgery, Hiroshima Prefectural HospitalYusukeMizuuchiDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu UniversityYasuyukiMiyakuraDepartment of Colon and Pelvic Surgery, Cancer Prevention and Genetic Counseling, Tochigi Cancer CenterMichihiroMutohDepartment of Molecular-Targeting Prevention, Graduate School of Medical Science, Kyoto Prefectural University of MedicineTakahiroYoshiokaDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterShinjiTanakaJA Onomichi General HospitalKazuhiroSakamotoKoshigaya Municipal HospitalKentaroSakamakiFaculty of Health Data Science, Juntendo UniversityMichioItabashiSaiseikai Kazo HospitalHideyukiIshidaDepartment of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical UniversityNaohiroTomitaDivision of Cancer Treatment , Toyonaka Municipal HospitalKenichiSugiharaInstitute of Science TokyoYoichiAjiokaDivision of Molecular and Diagnostic Pathology, Graduate School of Medical and Dental Sciences, Niigata UniversityApproximately 5% of all colorectal cancers have a strong genetic component and are classified as hereditary colorectal cancer (HCRC). Some of the unique features commonly seen in HCRC cases include early age of onset, synchronous/metachronous cancer occurrence, and multiple cancers in other organs. These characteristics require different management approaches, including diagnosis, treatment or surveillance, from those used in the management of sporadic colorectal cancer. Accurate diagnosis of HCRC is essential because it enables targeted surveillance and risk reduction strategies that improve patient outcomes. Recent genetic advances revealed several causative genes for polyposis and non-polyposis syndromes. The Japanese Society for Cancer of the Colon and Rectum (JSCCR) first published guidelines for the management of HCRC in 2012, with subsequent revisions every 4 years. The 2024 update to the JSCCR guidelines for HCRC was developed by meticulously reviewing evidence from systematic reviews and the consensus of the JSCCR HCRC Guidelines Committee, which includes representatives from patient advocacy groups for FAP and Lynch syndrome. These guidelines provide an up-to-date summary of HCRC, along with clinical recommendations for managing FAP and Lynch syndrome.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1347-90322025Comparative Analysis of a Dual DNA–RNA Panel and a DNA-Only Panel for Sarcoma: Real-World Data From a Nationwide Genomic DatabaseENEijiNakataDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKiichiroNinomiyaCenter for Comprehensive Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTatsunoriOsoneDepartment of Regenerative Science, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesDaisukeEnnishiCenter for Comprehensive Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesShutaTomidaCenter for Comprehensive Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTomohiroFujiwaraDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshiyukiKunisadaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMashuFutagawaDepartment of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAkiraHirasawaDepartment of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesShinichiToyookaCenter for Comprehensive Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNext-generation sequencing-based comprehensive cancer genomic profiling is promising in cancer management; however, most studies rely on tumor-only DNA panels from single institutions. In 2023, Japan introduced an insurance-covered cancer genomic profiling test―the GenMine TOP Cancer Genome Profiling System―a dual DNA–RNA panel with matched tumor–normal testing. This study evaluated its utility compared to a conventional DNA-only test (FoundationOne CDx) in managing sarcoma patients using a nationwide genetic profiling database provided by the Center for Cancer Genomics and Advanced Therapeutics. This study included 1046 patients registered between August 2023 and October 2024. The dual DNA–RNA test identified significantly more fusion genes (20.3% vs. 7.4%, p < 0.001) and therapeutically targetable kinase fusions (3.5% vs. 1.2%, p = 0.019) than the DNA-only test. Among patients with translocation-related sarcomas, histology-specific fusion genes were identified in 77.5% using the dual panel, compared to 40.0% with the DNA-only panel (p < 0.001). In non-gastrointestinal stromal tumor sarcomas, the dual test showed a trend toward higher rates of genotype-matched therapy (4.3% vs. 2.6%, p = 0.25) and a significantly higher rate of molecular targeted therapy (4.3% vs. 1.5%, p = 0.03). Additionally, 5.7% of patients had pathogenic germline variants identified through tumor–normal matched analysis. These findings suggest that a dual DNA–RNA panel with matched tumor–normal testing may improve diagnostic accuracy and inform treatment decisions in the routine clinical management of sarcoma.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1471-22532412024Efficacy of Pericapsular Nerve Group (PENG) block in preoperative rehabilitation (Prehabilitation) for patients with femoral neck fractures: study protocol for a randomized, placebo-controlled, double-blinded trial436ENZhuanJinDepartment of Anesthesiology and Resuscitology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineDaisukeSugiyamaDepartment of Anesthesiology, Kameda Medical CenterFumiyaHigoDepartment of Rehabilitation, Kameda Medical CenterTakahiroHirataDepartment of Rehabilitation, Kameda Medical CenterOsamuKobayashiDepartment of Anesthesiology, Kameda Medical CenterHiroshiMorimatsuDepartment of Anesthesiology and Resuscitology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKenichiUedaDepartment of Anesthesiology, Kameda Medical CenterBackground Despite surgery intervention for femoral neck fractures is recommended within 48 h of admission, achieving timely surgery presents challenges for patients with severe comorbidities, or in resource-limited settings. Preoperative rehabilitation (prehabilitation) reduces bedridden time, enhances mobility, and improves postoperative outcomes for patients scheduled for hip arthroplasty due to femoral neck fractures. However, prehabilitation is hindered by insufficient pain control. The pericapsular nerve group (PENG) block provides effective analgesia while preserving motor function. We designed a study to assess the efficacy of PENG block in facilitating prehabilitation for patients with femoral neck fractures who are scheduled for hip arthroplasty.<br>
Methods This prospective randomized placebo-controlled double-blinded trial aims to enroll 100 patients with Garden 3 or 4 femoral neck fractures who are scheduled for hip arthroplasty. Participants will be randomly assigned to receive a PENG block with 0.375% ropivacaine (PENG group) or with normal saline (placebo group) before the initial prehabilitation session. The prehabilitation program comprises five items: Bed-sitting, Edge-sitting, Stand-up, Maintaining-standing, and Wheelchair-transfer, performed with the assistance of a single physical therapist. The primary outcome is the percentage of patients completing the entire prehabilitation program. Secondary outcomes during the initial prehabilitation session are the achievement of each program item and the Numerical Rating Scale (NRS) pain score. Other secondary outcomes include intraoperative bleeding amounts, thromboembolic events during postoperative day 0 to 7, postoperative 3-day cumulative Cumulated Ambulation Score (CAS), and discharge destination. The postoperative outcomes will be compared between subgroups of patients undergoing surgery within 48 h of admission and those undergoing surgery more than 48 h of admission.<br>
Discussion This is the first study aiming to assess the efficacy of PENG block in prehabilitation for patients with femoral neck fractures who are scheduled for hip arthroplasty. PENG block could be beneficial, especially for patients facing delayed surgery, providing a potential treatment option during the waiting period.<br>
Trial registration Japan Registry of Clinical Trials, jRCT1031220294, registered on August 26, 2022.No potential conflict of interest relevant to this article was reported.The Korean Society of AnesthesiologistsActa Medica Okayama2005-64197752024Utilization of the pericapsular nerve group block in preoperative rehabilitation of patients with femoral neck fractures -a case series-565569ENZhuanJinDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaisukeSugiyamaDepartment of Anesthesiology, Kameda Medical CenterFumiyaHigoDepartment of Rehabilitation, Kameda Medical CenterTakahiroHirataDepartment of Rehabilitation, Kameda Medical CenterOsamuKobayashiDepartment of Anesthesiology, Kameda Medical CenterHiroshiMorimatsuDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenichiUedaDepartment of Anesthesiology, Kameda Medical CenterBackground: Elderly patients with femoral neck fractures, particularly those with severe comorbidities or living in regions with limited medical resources, may experience delays in surgical treatment. Although the benefits of preoperative rehabilitation (prehabilitation) in hip arthroplasty have been reported, pain management remains a challenge. The pericapsular nerve group (PENG) block, known for its exceptional analgesic effect and motor function preservation, may be a promising intervention during prehabilitation in these patients.<br>
Case: We enrolled ten patients with Garden classification 3–4 femoral neck fractures scheduled for hip arthroplasty. After receiving a PENG block with 20 ml of 0.375% ropivacaine, all patients underwent initial prehabilitation sessions comprising 9 mobility levels, ranging from bed-sitting to walking. One patient was excluded due to experiencing high blood pressure during prehabilitation. Six of the nine remaining patients (66.7%) were successfully transferred from bed to wheelchair.<br>
Conclusions: The PENG block enhanced prehabilitation for patients with femoral neck fractures undergoing hip arthroplasty.No potential conflict of interest relevant to this article was reported.Microbiology SocietyActa Medica Okayama0022-131710672025Summary of taxonomy changes ratified by the International Committee on Taxonomy of Viruses (ICTV) from the Fungal and Protist Viruses Subcommittee, 2025002115ENSeadSabanadzovicInstitute for Genomics, Biocomputing and Biotechnology, Mississippi State UniversityChantalAbergelInformation Génomique & Structurale, UMR7256, CNRS & Aix-Marseille Université, Marseille, IMM, IM2B, IOMMarı́a A.AyllónDepartamento de Biotecnología-Biología Vegetal, Escuela Técnica Superior de Ingeniería Agronómica, Alimentaria y de Biosistemas, Universidad Politécnica de Madrid (UPM)LeticiaBotellaForest Protection and Wildlife Management Mendel University in BrnoMartaCanutiDepartment of Veterinary and Animal Sciences, University of CopenhagenYutoChibaSchool of Agriculture, Meiji UniversityJean-MichelClaverieInformation Génomique & Structurale, UMR7256, CNRS & Aix-Marseille Université, Marseille, IMM, IM2B, IOMRobert H.A.CouttsSchool of Health, Medicine and Life Sciences, University of HertfordshireStefaniaDaghinoInstitute for Sustainable Plant Protection, National Research Council of ItalyLiviaDonaireCentro de Edafología y Biología Aplicada del Segura-CSICMarcoForgiaInstitute for Sustainable Plant Protection, CNROndřejHejnaDepartment of Genetics and Biotechnologies, University of South BohemiaJichunJiaCollege of Plant Protection, Shanxi Agricultural UniversityDaohongJiangCollege of Plant Science and Technology, Huazhong Agricultural UniversityIolyKotta-LoizouSchool of Health, Medicine and Life Sciences, University of HertfordshireMartKrupovicInstitut Pasteur, Université Paris Cité, CNRS UMR6047, Archaeal Virology UnitAndrew S.LangDepartment of Biology, Memorial University of NewfoundlandMatthieuLegendreInformation Génomique & Structurale, UMR7256, CNRS & Aix-Marseille Université, Marseille, IMM, IM2B, IOMShin-YiLee MarzanoUnited States Department of Agriculture, Agricultural Research Service, Application Technology Research UnitLucaNervaCouncil for Agricultural Research and Economics - Research Centre for Viticulture and EnologyJuditPénzesDepartment of Entomology, Texas A&M UniversityAnnaPoimalaNatural Resources Institute Finland (Luke)SofiaRigouInformation Génomique & Structurale, UMR7256, CNRS & Aix-Marseille Université, Marseille, IMM, IM2B, IOMYukiyoSatoDepartment of Biology, Institute for Plant Sciences, University of CologneWajeehaShamsiDepartment of Molecular Biology and Genetics, Aarhus UniversityNobuhiroSuzukiInstitute of Plant Science and Resources, Okayama UniversityMassimoTurinaDepartment of Plant Protection, School of Agriculture, The University of JordanSyun-ichiUrayamaDepartment of Life and Environmental Sciences, University of TsukubaEeva J.VainioNatural Resources Institute Finland (Luke)JiataoXieCollege of Plant Science and Technology, Huazhong Agricultural UniversityThe Fungal and Protist Viruses Subcommittee (SC) of the International Committee on Taxonomy of Viruses (ICTV) has received a total of eight taxonomic proposals for the 2024 annual cycle. The extent of proposed changes varied, including nomenclatural updates, creation of new taxa and reorganization of established taxa. Following the ICTV procedures, all proposals were reviewed and voted upon by the members of the Executive Committee with ratification in March 2025. As a result, a total of 52 species in the families Botourmiaviridae and Marnaviridae were renamed to comply with the mandated binomial format. A new genus has been added to the dsRNA virus family Amalgaviridae, while two new families, Splipalmiviridae (Wolframvirales) and Mycoalphaviridae (Hepelivirales), were created to classify new groups of positive-sense (+) RNA mycoviruses. The class Arfiviricetes (Cressdnaviricota) was expanded by a new order Lineavirales and a new family Oomyviridae of ssDNA viruses. Additionally, a new class Orpoviricetes was created in the kingdom Orthornavirae to classify a group of bisegmented (+)RNA viruses reported from fungi and oomycetes. Finally, the order Pimascovirales was reorganized to better depict evolutionary relationships of pithoviruses and related viruses with large dsDNA genomes. The summary of updates in the taxonomy of fungal and protist viruses presented here is limited to taxa within the remit of this Subcommittee. For information on taxonomy changes on other fungal viruses closely related to animal and/or plant viruses, please see reports from sister ICTV Subcommittees (i.e. Plant Virus SC and Animal dsRNA and ssRNA(−) Viruses SC).No potential conflict of interest relevant to this article was reported.Copernicus GmbHActa Medica Okayama2194-9034XLVIII-4/W9-202420243D MONITORING OF COASTAL EROSION CONTROL STRUCTURES USING UAV313320ENN.SakamotoGraduate School of Environmental and Life Science, Okayama UniversityS.NishiyamaGraduate School of Environmental and Life Science, Okayama UniversityCoastal erosion has increasingly become a problem in recent years due to rising sea levels caused by global warming. To prevent further coastal erosion and damage, control structures like seawalls and breakwaters have been installed along vulnerable coastlines. However, it is crucial that these structures are regularly and thoroughly inspected for any abnormalities or deformations. At present, inspections are done manually by visual surveys which are time-consuming and inefficient. There is great potential to optimize this process using drone technology equipped with 3D laser scanners. In this study, we utilized a drone with a green laser scanner to inspect and diagnose control structures along the coast. We conducted surveys to determine the basic performance of this approach and used ICP algorithms to extract any deformations in vanishing wave blocks over two time periods. Our results showed high variability in basic performance due to the influence of waves during the surveys. However, we were still able to detect strain of around 50 cm in a submerged breakwater located 3 meters below the water's surface. Furthermore, an overall settlement of approximately 34 cm was observed in the vanishing wave blocks along with some localized movements. This demonstrates that drones can be successfully implemented for efficient inspection, diagnosis and detection of abnormalities and deformations in coastal structures that are extremely difficult to identify through visual surveys alone. The use of this advanced technology will allow for quicker identification of at-risk structures, enabling timely maintenance and prevention of further coastal erosion.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0266-352X1782025End-to-end time-dependent probabilistic assessment of landslide hazards using hybrid deep learning simulator106920ENMengluHuangDepartment of Civil and Environmental Engineering, Okayama UniversityShin-ichiNishimuraDepartment of Civil and Environmental Engineering, Okayama UniversityToshifumiShibataDepartment of Civil and Environmental Engineering, Okayama UniversityZe ZhouWangMarie Skłodowska-Curie Fellow, Department of Engineering, University of CambridgeEarly warning detection of landslide hazards often requires real-time or near real-time predictions, which can be challenging due to the presence of multiple geo-uncertainties and time-variant external environmental loadings. The propagation of these uncertainties at the system level for understanding the spatiotemporal behavior of slopes often requires time-consuming numerical calculations, significantly hindering the establishment of an early warning system. This paper presents a hybrid deep learning simulator, which fuses parallel convolutional neural networks (CNNs) and long short-term memory (LSTM) networks through attention mechanisms, termed PCLA-Net, to facilitate time-dependent probabilistic assessment of landslide hazards. PCLA-Net features two novelties. First, it is capable of simultaneously handling both temporal and spatial information. CNNs specialize in interpreting spatial data, while LSTM excels in handling time-variant data. Coupled with two attention mechanisms, the two modules are combined to probabilistically predict the spatiotemporal behavior of slopes. Second, PCLA-Net realizes end-to-end predictions. In this paper, the Liangshuijing landslide in the Three Gorges Reservoir area of China is used to illustrate PCLA-Net. It is first validated followed by a comparison with existing techniques to demonstrate its improved predictive capabilities. The proposed PCLA-Net simulator can achieve the same level of accuracy with at least 50% reduction in computation resources.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2328-95032025INF2-Related Charcot–Marie–Tooth Disease in a Japanese Cohort: Genetic and Clinical InsightsENChikashiYanoDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental SciencesMasahiroAndoDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental SciencesYujiroHiguchiDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental SciencesJun‐HuiYuanDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental SciencesAkikoYoshimuraDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental SciencesTakahiroHobaraDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental SciencesRisaNagatomoDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental SciencesFumikazuKojimaDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental SciencesYuHiramatsuDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental SciencesSatoshiNozumaDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental SciencesTomonoriNakamuraDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental SciencesYusukeSakiyamaDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental SciencesChikaMatsuokaDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToruYamashitaDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakashiKimuraDepartment of Neurology, Hyogo Medical UniversityAyakoMiyazakiDepartment of Clinical Genetics, Hyogo Medical UniversityChinatsuKinjoDepartment of Clinical Genetics, Hyogo Medical UniversityKenjiYokochiDepartment of Pediatrics, Toyohashi Municipal HospitalNanamiYamanakaDepartment of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of MedicineNozomuMatsudaDepartment of Neurology, Fukushima Medical University School of MedicineTomokiSuichiDepartment of Neurology, Graduate School of Medicine, Chiba UniversityYoshiyukiHanaokaDepartment of Pediatrics, Kurashiki Central HospitalHarukaKojimaDepartment of Neurology, Tokyo Women's Medical UniversityKenichiTodoDepartment of Neurology, Tokyo Women's Medical UniversityHiroyukiIshiuraDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunMitsuiDepartment of Precision Medicine Neurology, Graduate School of Medicine, The University of TokyoShojiTsujiDepartment of Neurology, The University of Tokyo HospitalHiroshiTakashimaDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental SciencesBackground: INF2 mutations cause focal segmental glomerulosclerosis (FSGS) and Charcot–Marie–Tooth disease (CMT). Accurate genetic diagnosis is critical, as INF2-related FSGS is typically resistant to immunotherapy yet rarely recurs after transplantation, and its associated neuropathy can mimic treatable immune-mediated disorders such as chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).<br>
Methods: We performed a multicenter study investigating 3329 Japanese patients with inherited peripheral neuropathies/CMT who underwent gene panel sequencing or whole-exome analysis between 2007 and 2024. Clinical data, including electrophysiological assessments, were obtained from the patients' medical records.<br>
Results: We identified six pathogenic INF2 variants in eight patients, all of which were located within the diaphanous inhibitory domain. Structural modeling revealed clustering of variants near the diaphanous autoregulatory domain-binding pocket, which is critical for INF2 autoinhibition. Clinically, all cases were sporadic, with a median age at neurological onset of 9 years. All patients exhibited lower limb weakness, and 6/8 (75%) had sensory disturbances. All patients also developed kidney dysfunction, with 7/8 (88%) progressing to end-stage renal disease at a median age of 15 years. Furthermore, all patients showed demyelinating neuropathy, and 2/8 (25%) received immunotherapy due to suspected immune-mediated neuropathy.<br>
Conclusion: Although INF2 variants are a rare cause of CMT in Japan, they should be considered in pediatric patients with demyelinating neuropathy and early-onset proteinuria, even in the absence of a family history. Blood and urine tests assessing renal dysfunction can provide guidance for appropriate genetic testing.No potential conflict of interest relevant to this article was reported.Springer Nature SingaporeActa Medica Okayama1865-09292025Evaluation of a Startup Program Identification for Efficient and Accurate IoT Security Investigations417431ENYutaShimamotoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityJiratchayaPhinyodomSchool of Engineering, Okayama UniversityRyotaYoshimotoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHiroyukiUekawaNTT Social Informatics LaboratoriesMitsuakiAkiyamaNTT Social Informatics LaboratoriesToshihiroYamauchiFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityNot all file in firmware are executed while using Internet of Things (IoT) devices and hundreds to approximately a thousand executable and linkable format files exist in one firmware. Therefore, security investigations without prioritization may lead to investigate programs that are not executed while using IoT devices first. This has resulted in inefficient security investigations. To perform efficient security investigations, we proposed a method that can identify programs executed during the startup process. However, only two firmware were used for the evaluation which can only evaluate one of the two startup sequences in the OpenWrt-based firmware. In addition, security investigations to validate whether the proposed method addresses the problem of inefficient security investigations were limited to OpenWrt-based firmware. In this study, we use more firmware data for evaluation and validation. We use nine firmware not used in previous studies including startup methods that have not previously been used for evaluation. In addition, we increase the number of firmware used for validation to 225. The evaluation results demonstrate that the proposed method can identify with only few false positives. The validation demonstrates that efficiency can be improved and prioritizing investigations by considering the proposed method result is worthwhile.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1876-20181082025Introduction to the “Japanese and Western approaches to psychotrauma” symposium104508ENMasanoriNagamineDivision of Behavioral Science, National Defense Medical College Research InstituteTomoyoNakaoGraduate School of Humanities and Social Sciences, Okayama UniversityLeovan BergenFreelance Medical HistorianJunShigemuraFaculty of Health Sciences, Mejiro UniversityTakuSaitoDivision of Behavioral Science, National Defense Medical College Research InstituteFlorentine H.S.van der DoesDepartment of Psychiatry, Leiden University Medical Center (LUMC)MasatoKitanoDivision of Behavioral Science, National Defense Medical College Research InstituteErik J.GiltayDepartment of Psychiatry, Leiden University Medical Center (LUMC)Nic J.van der WeeDepartment of Psychiatry, Leiden University Medical Center (LUMC)EricVermettenDepartment of Psychiatry, Leiden University Medical Center (LUMC)Understandings of psychotrauma have changed throughout medical history, shaped by cultural and social factors. Reviewing transcultural perspectives of psychotrauma helps understand its complexities and contextual impacts. This paper summarizes the Japan–Netherlands symposium on psychotrauma held on March 1, 2024. Despite experiencing psychological trauma from World War II and numerous natural disasters, Japan did not actively research post-traumatic stress disorder (PTSD) for nearly 50 years after the war. The Great Hanshin-Awaji Earthquake and the Tokyo subway Sarin gas attack (1995) popularized the term PTSD in Japan and triggered related research. The absence of psychotrauma research in Japan may reflect a form of state-level PTSD, characterized by avoidance. Japan’s collectivist culture, stigma against seeking psychological help, view of patience as a virtue, survivor guilt, and moral injury were potential related factors. Additionally, sociocultural factors (e.g., insufficient collective grieving and focusing on post-war reconstruction) were discussed as potential hinderances to discussing war experiences. From a European perspective, we examined how “Konzentrationslager” (KZ) syndrome, a trauma-related disorder, evolved independently into diverse conceptual frameworks, ultimately contributing to the acceptance of PTSD following its introduction in 1980. Beyond state compensation for concentration camp survivors, advocacy by feminist movements and veterans' groups increased awareness of psychotrauma across Europe, fostering scholarly research and public discourse. Both PTSD and KZ syndromes are diagnostic categories shaped by specific historical and cultural contexts and should not be regarded as simple, universally applicable medical conditions. They reflect how trauma is interpreted and responded to differently depending on cultural, political, and historical factors.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2666-1683802025Rectal Swab–based Targeted Prophylactic Antibiotics Reduce Infectious Complications After Transrectal Prostate Biopsy: A Systematic Review and Meta-analysis of Randomized Controlled Trials5765ENIchiroTsuboiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMehdiKardoust PariziDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaAkihiroMatsukawaDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaMarcinMiszczykDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaTamásFazekasDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaAngeloCormioDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaTatsushiKawadaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiKatayamaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakehiroIwataDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKensukeBekkuDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoichiroWadaDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaPierre I.KarakiewiczCancer Prognostics and Health Outcomes Unit, University of Montreal Health CentrePiotrChlostaDepartment of Urology, Jagiellonian University Medical CollegeAlbertoBrigantiUnit of Urology/Division of Oncology, Gianfranco Soldera Prostate Cancer Lab, IRCCS San Raffaele Scientific InstituteMotooArakiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShahrokh F.ShariatDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaBackground and objective: Transperineal ultrasound-guided prostate biopsy is the recommended approach in guidelines, while transrectal ultrasound-guided prostate biopsy (TRUS-PB) is still widely used to diagnose prostate cancer (PCa); however, it is associated with a significant rate of infectious complications. We aimed to assess the efficacy of targeted prophylactic antibiotics (TPAs), based on rectal swabs, in reducing the incidence of infectious complications after TRUS-PB compared with empiric prophylactic antibiotics.<br>
Methods: PubMed, Web of Science, and Scopus were queried in December 2024 for randomized controlled trials (RCTs) comparing infectious complications between patients who received TPAs based on rectal swab culture before TRUS-PB and those who received empiric prophylactic antibiotics before TRUS-PB (PROSPERO: CRD42024523794). The primary outcomes were the incidence rates of febrile urinary tract infection (fUTI) and sepsis.<br>
Key findings and limitations: Overall, nine RCTs (n = 3002) were included in our analyses. The incidence of fUTI was approximately half as high in patients who received TPAs as in those who received empiric prophylactic antibiotics (n = 3002, 2.7% vs 5.2%, risk ratio [RR]: 0.54, 95% confidence interval [CI]: 0.36–0.81, p = 0.003). Based on these pooled incidence rates, the number of patients needed to treat to prevent fUTI after TRUS-PB was 40; however, there was no statistically significant difference in the incidence of sepsis between patients receiving TPAs and those who received empiric antibiotic prophylaxis (n = 2735, 1.3% vs 1.8%, RR: 0.74, 95% CI: 0.31–1.75, p = 0.4).<br>
Conclusions and clinical implications: TPAs based on rectal swab culture significantly reduces the incidence of fUTI in patients who undergo TRUS-PB for PCa diagnosis compared with that in patients who receive empiric prophylactic antibiotics; however, there is insufficient evidence to assess its effect on the risk of sepsis. We recommend, based on the clinically relevant reduction in the incidence of fUTI, performing rectal swab–based TPAs in patients undergoing TRUS-PB.<br>
Patient summary: We reviewed infections occurring after transrectal prostate biopsy in over 3000 patients. The use of antibiotics chosen based on a simple rectal swab decreased the rate of postbiopsy fever and urinary tract infections by half compared with the use of standard antibiotics. More research is needed to understand whether this approach also prevents the rare but serious complication of sepsis.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025Gastroduodenal Artery-Preserving Pancreatoduodenectomy after Esophagectomy with Gastric Conduit Reconstruction393398ENAkariMasunagaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoseiTakagiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuoNagaiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuyaYasuiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokazuFujiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMotohikoYamadaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakeyoshiNishiyamaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNoriyukiKanehiraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYumiSotaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/69441Pancreatoduodenectomy (PD) after esophagectomy with gastric conduit reconstruction is technically challenging. Preserving the blood supply of the gastric conduit is crucial in performing PD after esophagectomy. We report the case of a 66-year-old man who underwent gastroduodenal artery-preserving PD after esophagectomy with gastric conduit reconstruction for intraductal papillary mucinous neoplasm. The patient developed pseudoaneurysm rupture postoperatively, but was successfully treated with interventional radiology. Precise assessment is important in developing a surgical strategy depending on the patient’s specific anatomy and tumor characteristics. Moreover, special attention should be paid to avoid accidental injuries of the gastric conduit and gastric vessels during surgery.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025The Utility of a Preoperative 3D Imaging Analysis System for Trigonal Meningioma387392ENYusukeMoriDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshihiroOtaniDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoOmaeDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuichiroHiranoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJojiIshidaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaroFujiiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunHarumaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasafumiHiramatsuDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiMatsushitaDivision of Radiological Technology, Okayama University HospitalFumiyoHigakiDepartment of Radiology, Medical Development Field, Okayama UniversityKenjiSugiuDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/69440Trigonal meningiomas are rare and pose surgical challenges due to their deep location and proximity to critical neuroanatomical structures. We present the case of a 67-year-old woman with a growing trigonal meningioma successfully resected with guidance by a preoperative 3D imaging analysis system. Integration of CT and MRI including diffusion tensor imaging (DTI) enabled precise mapping of the optic radiation, guiding a middle temporal gyrus approach. Preoperative embolization reduced tumor vascularity, facilitating gross total resection with minimal blood loss. This case highlights the effectiveness of preoperative 3D imaging systems in optimizing surgical planning and improving outcomes in complex neurosurgical cases.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025Immunoglobulin G4-related Disease Mimicking Portal Vein Tumor Thrombus381385ENAtsunobuSakuraiDepartment of Radiology, NHO Iwakuni Clinical CenterTakayukiYabukiDepartment of Radiology, NHO Iwakuni Clinical CenterHidekiAokiDepartment of Gastroenterological Surgery, NHO Iwakuni Clinical CenterAkikoIsekiDepartment of Pathology, NHO Iwakuni Clinical CenterCase Report10.18926/AMO/69439We report the case of a 72-year-old Japanese man with an incidental portal vein mass that was surgically resected and diagnosed as immunoglobulin G4 (IgG4)-related disease. The mass was discovered during an atrial fibrillation examination. The patient had a history of gastric cancer and was also diagnosed with rectal cancer, raising concerns about metastasis. Due to technical challenges, a biopsy was not feasible. Imaging findings suggested portal vein tumor thrombosis, complicating the diagnosis. This case highlights a rare presentation of IgG4-related disease mimicking portal vein tumor thrombus.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025Blood Pressure and Heart Rate Patterns Identified by Unsupervised Machine Learning and Their Associations with Subclinical Cerebral and Renal Damage in a Japanese Community: The Masuda Study369379ENTakashiHisamatsuDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMinakoKinutaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSosukeMunetomoDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMariFukudaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKatsuhideKojimaDepartment of Radiology, Okayama University HospitalKaoriTaniguchiDepartment of Environmental Medicine and Public Health, Izumo, Shimane University Faculty of MedicineNorikoNakahataDepartment of Health and Nutrition, The University of Shimane Faculty of Nursing and NutritionHideyukiKandaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/69438We applied unsupervised machine learning to analyze blood pressure (BP) and resting heart rate (HR) patterns measured during a 1-year period to assess their cross-sectional relationships with subclinical cerebral and renal target damage. Dimension reduction via uniform manifold approximation and projection, followed by K-means++ clustering, was used to categorize 362 community-dwelling participants (mean age, 56.2 years; 54.9% women) into three groups: Low BP and Low HR (Lo-BP/Lo-HR), High BP and High HR (Hi-BP/Hi-HR), and Low BP and High HR (Lo-BP/Hi-HR). Cerebral vessel lesions were defined as the presence of at least one of the following magnetic resonance imaging findings: lacunar infarcts, white matter hyperintensities, cerebral microbleeds, or intracranial artery stenosis. A high urinary albumin-to-creatinine ratio (UACR) was defined as the top 10% (≥ 12 mg/g) of the mean value from ≥2 measurements. Poisson regression with robust error variance, adjusted for demographics, lifestyle, and medical history, showed that the Hi-BP/Hi-HR group had relative risks of 3.62 (95% confidence interval, 1.75-7.46) for cerebral vessel lesions and 3.58 (1.33-9.67) for high UACR, and the Lo-BP/Hi-HR group had a relative risk of 3.09 (1.12-8.57) for high UACR, compared with the Lo-BP/Lo-HR group. These findings demonstrate the utility of an unsupervised, data-driven approach for identifying physiological patterns associated with subclinical target organ damage.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025Current Status of Extracorporeal Membrane Oxygenation as a Treatment Strategy for Primary Graft Dysfunction after Lung Transplantation329337ENKeiMatsubaraDepartment of Thoracic Surgery, Hiroshima City Hiroshima Citizens HospitalKentarohMiyoshiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesReview10.18926/AMO/69433Primary graft dysfunction (PGD) is one of the major risk factors affecting patients’ short- and long-term survival after lung transplantation. No particular management strategy has been established for PGD; supportive care is the mainstay of PGD treatment. When a supportive strategy fails, the patient may require the introduction of extracorporeal membrane oxygenation (ECMO) as the last-resort measure for severe PGD. A variety of study of ECMO as a PGD treatment was reported and the management of PGD patients developed so far. Early recognition of a patient’s need for ECMO and its prompt initiation are critical to improved outcomes. The use of venovenous-ECMO became the preferred procedure for PGD rather than venoarterial-ECMO. However, the current ECMO strategy has limitations, and using ECMO to manage patients with PGD is not sufficiently effective. Further studies are required to develop this promising technology.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025A Review of the Endoscopic Treatment for Bile Leak Following Cholecystectomy and Hepatic Surgery321328ENTaisukeObataDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalReview10.18926/AMO/69432Bile leak occurs in 2-25% of liver transplant, 3-27% of hepatic resection, and 0.1-4% of cholecystectomy cases. The clinical course of bile leak varies depending on the type of surgery that caused the fistula, as well as the type, severity, and timing of bile duct injury. Although infections resulting from bile leak can be life-threatening, the introduction of endoscopic treatment has enabled some patients to avoid reoperation and has reduced the negative impact on quality of life associated with external fistulas for percutaneous drainage. Endoscopic interventions, such as sphincterotomy and stent placement, reduce the pressure gradient between the bile duct and duodenum, facilitating bile drainage through the papilla and promoting the closure of the leak. We reviewed the literature from 2004 to 2024 regarding bile leak following cholecystectomy and liver surgery, examining recommended techniques, timing, and treatment outcomes. In cases of bile leak following cholecystectomy, clinical success was achieved in 72-96% of cases, while success rates for bile leak following liver surgery ranged from 50% to 100%. Although endoscopic treatment is effective, it is not universally applicable, and its limitations must be carefully considered.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2077-038314172025Risk Factors for Perioperative Urinary Tract Infection After Living Donor Kidney Transplantation Characterized by High Prevalence of Desensitization Therapy: A Single-Center Analysis6102ENShingoNishimuraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShotaInoueDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakanoriSekitoDepartment of Inflammation and Immunity, Lerner Research Institute, Cleveland ClinicIchiroTsuboiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMotoTokunagaDepartment of Urology, NHO Okayama Medical CenterKasumiYoshinagaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiMaruyamaDepartment of Inflammation and Immunity, Lerner Research Institute, Cleveland ClinicYosukeMitsuiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomoakiYamanoiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTatsushiKawadaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRisaKubotaDepartment of Urology, NHO Okayama Medical CenterTakuyaSadahiraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusukeTominagaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakehiroIwataDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiKatayamaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKensukeBekkuDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiEdamuraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoichiroWadaDepartment of Urology, Shimane University Faculty of MedicineYasuyukiKobayashiDepartment of Urology, Hiroshima City Hiroshima Citizens HospitalMotooArakiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground/Objectives: Limited research exists on risk factors for urinary tract infections (UTIs) in kidney transplant recipients, particularly in high-risk groups such as ABO-incompatible or donor-specific antibody (DSA)-positive cases. Early UTIs, especially within the first month post-transplant, impact on acute rejection and long-term graft outcomes, highlighting the need for risk factor identification and management. Methods: Among 157 living donor kidney transplant cases performed at our institution between 2009 and 2024, 128 patients were included after excluding cases with >72 h of perioperative prophylactic antibiotics or urological complications. UTI was defined as the presence of pyuria and a positive urine culture, accompanied by clinical symptoms requiring antibiotic treatment, occurring within one month post-transplantation. Results: The median onset of UTI was postoperative day 8 (interquartile range, IQR: 6.8–9.3). No subsequent acute rejection episodes were observed. The median serum creatinine at 1 month postoperatively was 1.3 mg/dL (IQR: 1.1–1.7), and this was not significantly different from those who did not develop UTI. In univariate analysis, low or high BMI (<20 or >25), longer dialysis duration (>2.5 years), desensitization therapy (plasmapheresis + rituximab), elevated preoperative neutrophil-to-lymphocyte ratio (NLR) (≥3), and longer warm ischemic time (WIT) (≥7.8 min) were significantly associated with an increased infection risk of UTI (p = 0.010, 0.036, 0.028, 0.015, and 0.038, respectively). Multivariate analyses revealed that abnormal BMI, longer dialysis duration, desensitization therapy, and longer WIT were independent risk factors for UTI (p = 0.012, 0.031, 0.008, and 0.033, respectively). The incidence of UTI increased with the number of risk factors: 0% (0/16) for zero, 10% (5/48) for one, 31% (16/51) for two, 45% (5/11) for three, and 100% (2/2) for four risk factors. Conclusions: Desensitization therapy, BMI, dialysis duration, and WIT were identified as independent risk factors for perioperative UTI. In patients with risk factors, additional preventive strategies should be considered, with extended antibiotic prophylaxis being one potential option.No potential conflict of interest relevant to this article was reported.AVES YAYINCILIK A.Ş.Acta Medica Okayama2980-14785052025A Systematic Review and Meta-Analysis of Penis Length and Circumference According to WHO Regions: Who has the Biggest One?291301ENHadiMostafaeiDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaKeiichiroMoriDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaSatoshiKatayamaDepartment of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFahadQuhalDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaBenjaminPradereDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaTakafumiYanagisawaDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaEkaterinaLaukhtinaDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaFrederikKönigDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaReza SariMotlaghDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaPawelRajwaDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaHaniehSalehi-PourmehrDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaSakinehHajebrahimiDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaShahrokh F.ShariatDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaThis study aimed to perform a systematic review and meta-analysis of stretched, erect, and flaccid penis length as well as circumference according to geographic WHO regions. PubMed, Embase, Scopus, and Cochrane Library were searched for articles published until February 2024. Studies in which a healthcare professional evaluated the penis size were considered eligible. After assessing the risk of bias, a systematic review and meta-analyses were performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement, and the outcomes were grouped based on the WHO regions. A total of 33 studies comprising 36 883 patients were included. The risk of bias in the included studies was moderate/low. A comprehensive systematic review was done and meta-analyses performed for flaccid length [n = 28 201, mean (SE) 9.22 (0.24) cm], stretched length [n = 20 814, mean (SE) 12.84 (0.32) cm], erect length [n = 5669, mean (SE) 13.84 (0.94) cm], flaccid circumference [n = 30 117, mean (SE) 9.10 (0.12) cm], and erect circumference [n = 5168, mean (SE) 11.91 (0.18) cm]. The mean length of the stretched penis was largest in Americans [14.47 (0.90) cm]. The mean length of the flaccid penis was the largest in the Americas [10.98 (0.064) cm]. The mean flaccid penile circumference was largest in Americans [n = 29 714, mean (SE) 10.00 (0.04) cm]. Penis sizes vary across WHO regions, suggesting the need to adjust standards according to geography to better understand councilmen and their partners. These data provide a framework for discussing body image expectations and therapeutic strategies in this sensitive and emotional subject matter.No potential conflict of interest relevant to this article was reported.SAGE PublicationsActa Medica Okayama2352-37271122025Advancements in systemic therapy for muscle-invasive bladder cancer: A systematic review from the beginning to the latest updates113ENTakafumiYanagisawaDepartment of Urology, The Jikei University School of MedicineAkihiroMatsukawaDepartment of Urology, The Jikei University School of MedicineJeremy Yuen-ChunTeohDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaKeiichiroMoriDepartment of Urology, The Jikei University School of MedicineTatsushiKawadaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiKatayamaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesPawełRajwaDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaFahadQuhalDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaBenjaminPradereDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaMarcoMoschiniDepartment of Urology, San Raffaele Hospital and Scientific InstituteShahrokh F.ShariatDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaJunMikiDepartment of Urology, The Jikei University School of MedicineTakahiroKimuraDepartment of Urology, The Jikei University School of MedicineContext: Several phase III randomized controlled trials (RCTs) have shown the importance of perioperative systemic therapy, especially for the efficacy of immune checkpoint inhibitors (ICIs) in both neoadjuvant and adjuvant settings for muscle-invasive bladder cancer (MIBC).<br>
Objective: To synthesize the growing evidence on the efficacy and safety of systemic therapies for MIBC utilizing the data from RCTs.<br>
Evidence acquisition: Three databases and ClinicalTrials.gov were searched in October 2024 for eligible RCTs evaluating oncologic outcomes in MIBC patients treated with systemic therapy. We evaluated pathological complete response (pCR), disease-free survival (DFS), progression-free survival (PFS), event-free survival (EFS), overall survival (OS), and adverse events (AEs).<br>
Evidence synthesis: Thirty-three RCTs (including 14 ongoing trials) were included in this systematic review. Neoadjuvant chemotherapy improved OS compared to radical cystectomy alone. Particularly, the VESPER trial demonstrated that dd-MVAC provided oncological benefits over GC alone in terms of pCR rates, OS (HR: 0.71), and PFS (HR: 0.70). Recently, the NIAGARA trial showed that perioperative durvalumab plus GC outperformed GC alone in terms of pCR rates, OS (HR: 0.75), and EFS (HR: 0.68). Despite the lack of data on overall AE rates in the VESPER trial, differential safety profiles in hematologic toxicity were reported between dd-MVAC and durvalumab plus GC regimens. In the adjuvant setting, no study provided the OS benefit from adjuvant chemotherapy. However, only adjuvant nivolumab had significant DFS and OS benefits compared to placebo.<br>
Conclusions: Neoadjuvant chemotherapy remains the current standard of care for MIBC. Durvalumab shed light on the promising impact of ICIs added to neoadjuvant chemotherapy. Nivolumab is the only ICI recommended as adjuvant therapy in patients who harbored adverse pathologic outcomes. Ongoing trials will provide further information on the impact of combination therapy, including chemotherapy, ICIs, and enfortumab vedotin, in both neoadjuvant and adjuvant settings.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1347-69478892024Solid-state cultivation of multiple industrial strains of koji mold on different Thai unpolished rice cultivars: biotransformation of phenolic compounds and their effects on antioxidant activity11171125ENJirayuJitpakdeeGraduate School of Environmental and Life Science, Okayama UniversityHideyukiYamashitaHiguchi Matsunosuke Shoten Co., Ltd. TakuroNakagawaHiguchi Matsunosuke Shoten Co., Ltd. TeruhikoNitodaGraduate School of Environmental and Life Science, Okayama UniversityHiroshiKanzakiGraduate School of Environmental and Life Science, Okayama UniversityColored rice is abundant in polyphenols, and koji molds have potential for biotransformation. This study aimed to produce Thai-colored rice koji to study its polyphenolic biotransformation. Four industrial koji mold strains: Aspergillus oryzae 6001, A. oryzae 6020, A. sojae 7009, and A. luchuensis 8035, were cultivated on unpolished Thai-colored rice (Riceberry and Sangyod), unpolished Thai white rice (RD43), and polished Japanese white rice (Koshihikari). We discovered that koji molds grew on all the rice varieties. Methanol extracts of all rice kojis exhibited an approximately 2-fold or greater increase in total phenolic content and DPPH antioxidant activity compared to those of steamed rice. Moreover, quercetin, quercetin-3-O-glucoside, isorhamnetin-3-O-glucoside, ferulic acid, caffeic acid, protocatechuic acid, vanillic acid, (+)-catechin, and (–)-epicatechin content increased in Riceberry and Sangyod koji samples. Consequently, Aspergillus solid-state cultivation on unpolished Thai-colored rice exhibited higher functionalization than the cultivation of unpolished Thai white rice and polished Japanese white rice.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0957-45223612024Optical bandgap tuning in SnO2–MoS2 nanocomposites: manipulating the mass of SnO2 and MoS2 using sonochemical solution mixing6ENChinkhaiOngSchool of Engineering and Physical Sciences, Heriot-Watt University MalaysiaWeng NamLeeHeriot-Watt Global College, Heriot-Watt University MalaysiaYee SengTanSunway Biofunctional Molecules Discovery Centre, School of Medical and Life Sciences, Sunway UniversityPatrikOhbergSchool of Engineering and Physical Sciences, Institute of Photonics and Quantum Sciences, Heriot-Watt UniversityYasuhikoHayashiFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityTakeshiNishikawaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityYuenkiatYapHeriot-Watt Global College, Heriot-Watt University MalaysiaThis study investigates controlled optical bandgap tuning through precise adjustment of the SnO2 and MoS2 mass in nanocomposites. A sonochemical solution mixing method, coupled with bath sonication, is employed for the preparation of SnO2–MoS2 nanocomposite. This approach allows for comprehensive characterization using UV–Vis FTIR, XRD, EDX, Raman spectroscopies, and FESEM, providing insights into morphology, chemical, and optical properties. Increasing the SnO2 mass leads to a linear decrease in the optical bandgap energy, from 3.0 to 1.7 eV. Similarly, increasing the MoS2 mass also results in a decrease in the optical bandgap energy, with a limitation of around 2.01 eV. This work demonstrates superior control over optical bandgap by manipulating the SnO2 mass compared to MoS2, highlighting the complexities introduced by MoS2 2D nanosheets during sonication. These findings hold significant value for optoelectronic applications, emphasizing enhanced control of optical bandgap through systematic mass manipulation.No potential conflict of interest relevant to this article was reported.Informa UK LimitedActa Medica Okayama0003-27195822024Influence of Dilution Upon the Ultraviolet-Visible Peak Absorbance and Optical Bandgap Estimation of Tin(IV) Oxide and Tin(IV) Oxide-Molybdenum(IV) Sulfide Solutions196212ENChin KhaiOngSchool of Engineering and Physical Sciences, Heriot-Watt University MalaysiaWeng NamLeeHeriot-Watt Global College, Heriot-Watt University MalaysiaMohammadKhalidSunway Centre for Electrochemical Energy and Sustainable Technology (SCEEST), School of Engineering and Technology, Sunway UniversityMuhammad Amirul AizatMohd AbdahSunway Centre for Electrochemical Energy and Sustainable Technology (SCEEST), School of Engineering and Technology, Sunway UniversityPatrikOhbergInstitute of Photonics and Quantum Sciences, School of Engineering and Physical Sciences, Heriot-Watt UniversityLing HongLimHeriot-Watt Global College, Heriot-Watt University MalaysiaYasuhikoHayashiGraduate School of Natural Science and Technology, Faculty of Engineering, Okayama UniversityTakeshiNishikawaGraduate School of Natural Science and Technology, Faculty of Engineering, Okayama UniversityYuenkiatYapHeriot-Watt Global College, Heriot-Watt University MalaysiaThe study investigated the constraints associated with the dilution technique in determining the optical bandgap of nanoparticle dispersion and modified nanocomposites, utilizing ultraviolet-visible absorbance spectra and Tauc plot analysis. A case study involving SnO2 dispersion and SnO2-MoS2 nanocomposite solutions, prepared through the direct solution mixing method, was conducted to assess the implications of dilution upon the absorbance spectra and bandgap estimation. The results emphasize the considerable impact of the dilution technique on the measured optical bandgap, demonstrating that higher dilution factors lead to shift in bandgap values. Furthermore, the study highlights that dilution can induce variations in the average nanoparticle sizes due to agglomeration, thereby influencing bandgap estimation. In the context of nanocomposites, the interaction between SnO2 nanoparticles and exfoliated MoS2 nanosheets diminishes with increasing dilution, leading to the estimated optical bandgap being primarily attributable to SnO2 nanoparticles alone. These observations underscore the necessity for caution when employing the dilution technique for bandgap estimation in nanoparticles dispersion and nanocomposites, offering valuable insights for researchers and practitioners in the field.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1875-83122025Computed tomography versus aortography for transcatheter patent ductus arteriosus closure in adultsENTakashiMikiDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineToruMiyoshiDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTeijiAkagiDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineMitsutakaNakashimaDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineRieNakayamaDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineYoichiTakayaDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKojiNakagawaDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineNorihisaTohDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineShinsukeYuasaDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineAccurate sizing of the patent ductus arteriosus (PDA) is essential for successful transcatheter closure. While aortography is the standard imaging modality, computed tomography (CT) may offer superior anatomical visualization. This study aimed to compare the accuracy and procedural outcomes of preprocedural CT versus aortography alone in adult patients undergoing transcatheter PDA closure. We retrospectively analyzed 54 adult patients who underwent PDA closure using the Amplatzer™ Duct Occluder between 2009 and 2024. Nineteen patients were treated based on aortography alone and 35 based on preprocedural CT. We compared procedural characteristics and outcomes, including device size exchange and procedure time. A simulation study was also conducted in which two blinded implanters independently predicted occluder size based on CT and aortography, with actual implanted device size used as the reference. The CT group had significantly larger PDA sizes and implanted device sizes. Device replacement was required in three patients in the aortography group but none in the CT group. Procedure time was shorter in the CT group (60 ± 9 vs. 70 ± 14 min, p = 0.003). Simulation results showed that CT more accurately predicted the actual implanted device size (85% vs. 63%, p = 0.008). PDA size at the pulmonary artery end was significantly underestimated by aortography. Preprocedural CT improved procedural efficiency and device selection accuracy in adult PDA closure. These findings suggest that CT imaging may enhance planning and safety in transcatheter PDA interventions.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1367-22232812024Can online interactions reduce loneliness in young adults during university closures in Japan? The directed acyclic graphs approache12658ENKoheiKambaraDoshisha UniversityAkihiroToyaHiroshima UniversitySuminLeeHiroshima UniversityHarukaShimizuNishikyushu Univ. Junior CollegeKazuakiAbeHiroshima UniversityJunShigematsuToyama UniversityQingyuanZhangHiroshima UniversityNatsukiAbeHiroshima Bunkyo UniversityRyoHayaseChubu UniversityNobuhitoAbeKyoto UniversityRyusukeNakaiKyoto UniversityShuntaroAokiFukushima Medical UniversityKoheiAsanoKyoto UniversityRyosukeAsanoKurume UniversityMakotoFujimuraFukuoka Jo Gakuin UniversityKen’ichiroFukuiKwassui Women's UniversityYoshihiroFukumotoKansai Medical UniversityKaichiroFurutaniKansai UniversityKojiHasegawaKomazawa UniversityHirofumiHashimotoOsaka Metropolitan UniversityMikotoHashimotoChukyo Gakuin UniversityHirokiHosogoshiKansai UniversityHiroshiIkedaKyushu UniversityToshiyukiIshiokaKobe UniversityChiharuItoUniversity of Human EnvironmentsSuguruIwanoFukushima Medical UniversityMasafumiKamadaShujitsu Junior CollegeYoshihiroKanaiTohoku Gakuin UniversityTomonoriKaritaEhime UniversityYuKasagiRissho UniversityEmiko S.KashimaLa Trobe UniversityJuriKatoKanazawa Institute of TechnologyYousukeKawachiTohoku UniversityJun‐ichiroKawaharaHokkaido UniversityMasanoriKimuraGraduate School of Business Administration, Kobe UniversityYugoKiraKurume UniversityYukoKiyonaga (Sakoda)Kyushu Kyoritsu UniversityHiroshiKohguchiRyutsu Keizai UniversityAsukaKomiyaHiroshima UniversityKeitaMasuiOtemon Gakuin UniversityAkiraMidorikawaChuo UniversityNobuhiroMifuneKochi University of TechnologyAkimineMizukoshiAsahi UniversityKengoNawataFukuoka UniversityTakashiNishimuraHiroshima International UniversityDaisukeNogiwaSeikei UniversityKenjiOgawaHokkaido UniversityJunkoOkadaPrefectural University of HiroshimaAkiOkamotoOkayama UniversityReikoOkamotoOsaka UniversityKyokoSasakiKanagawa University of Human ServicesKosukeSatoKurume UniversityHiroshiShimizuKwansei Gakuin UniversityAtsushiSugimuraTokai UniversityYokoSugitaniSophia UniversityHitomiSugiuraKindai UniversityKyokoSumiokaOkayama UniversityBumpeiSunaguchiGraduate School of Business Administration, Kobe UniversityMasatakaTakebeOtsuma Women's UniversityHiroki C.TanabeNagoya UniversityAyumiTanakaDoshisha UniversityMasanoriTanakaHokkai‐Gakuen UniversityJunichiTaniguchiTezukayama UniversityNamijiTokunagaEhime Prefectural University of Health SciencesRyozoTomitaMusashino UniversityYumikoUedaAsahi UniversityTomomiYamashitaJumonji UniversityKazuhoYamauraRitsumeikan UniversityMasaoYogoDoshisha UniversityKenjiYokotaniTokushima UniversityAyanoYoshidaTohoku Fukushi UniversityHiroakiYoshidaShinshu UniversityKatsueYoshiharaFukuoka Institute of Technology Junior CollegeAyumiYoshikawaOsaka Dental University Faculty of NursingKuniakiYanagisawaKobe UniversityKen'ichiroNakashimaHiroshima UniversityAs a countermeasure to the increased loneliness induced by the COVID-19 pandemic-related university closures, universities provided students with online interaction opportunities. However, whether these opportunities contributed to reducing loneliness during the university closures remains unclear, as previous studies have produced contradictory findings. We conducted a nationwide cross-sectional survey. Data were collected on demographics, social environment, social support, interactions, health and loneliness from 4949 students from 60 universities across Japan. We used psychological network and Directed Acyclic Graphs (DAGs) to examine the effect of online interactions on loneliness during university closures during COVID-19. The results showed that the frequency of online interactions with friends did not exert a significant influence on loneliness during university closures. A comparative examination of the DAGs further illuminated that the social environment exhibited fewer pathways for interpersonal interactions and social support during these closure periods. The psychosocial pathways influencing young adults' loneliness show variations contingent on the university's closure status. Notably, the impact of heightened online interactions with friends on loneliness appears to be less pronounced among young adults in the context of university closure.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1422-006725212024Dennd2c Negatively Controls Multinucleation and Differentiation in Osteoclasts by Regulating Actin Polymerization and Protrusion Formation11479ENYuKoyanagiDepartment of Dental Pharmacology, Graduate School of Biomedical Sciences, Nagasaki UniversityEikoSakaiDepartment of Dental Pharmacology, Graduate School of Biomedical Sciences, Nagasaki UniversityYuYamaguchiDepartment of Dental Pharmacology, Graduate School of Biomedical Sciences, Nagasaki UniversityFatimaFarhanaDepartment of Dental Pharmacology, Graduate School of Biomedical Sciences, Nagasaki UniversityYohsukeTairaDivision of Cariology and Restorative Dentistry, Department of Prosthetic Dentistry, Graduate School of Biomedical Sciences, Nagasaki UniversityKuniakiOkamotoDepartment of Dental Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiroshiMurataDivision of Cariology and Restorative Dentistry, Department of Prosthetic Dentistry, Graduate School of Biomedical Sciences, Nagasaki UniversityTakayukiTsukubaDepartment of Dental Pharmacology, Graduate School of Biomedical Sciences, Nagasaki UniversityOsteoclasts are bone-resorbing multinucleated giant cells formed by the fusion of monocyte/macrophage lineages. Various small GTPases are involved in the multinucleation and differentiation of osteoclasts. However, the roles of small GTPases regulatory molecules in osteoclast differentiation remain unclear. In the present study, we examined the role of Dennd2c, a putative guanine nucleotide exchange factor for Rab GTPases, in osteoclast differentiation. Knockdown of Dennd2c promoted osteoclast differentiation, resorption, and expression of osteoclast markers. Morphologically, Dennd2c knockdown induced the formation of larger osteoclasts with several protrusions. In contrast, overexpression of Dennd2c inhibited the multinucleation and differentiation of osteoclasts, bone resorption, and the expression of osteoclast markers. Dennd2c-overexpressing macrophages exhibited spindle-shaped mononuclear cells and long thin protrusions. Treatment of Dennd2c-overexpressing cells with the Cdc42 inhibitor ML-141 or the Rac1 inhibitor 6-thio-GTP prevented protrusion formation. Moreover, treatment of Dennd2c-overexpressing cells with the actin polymerization inhibitor latrunculin B restored multinucleated and TRAP-positive osteoclast formation. These results indicate that Dennd2c negatively regulates osteoclast differentiation and multinucleation by modulating protrusion formation in macrophages.No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama2694-2437452024New Catalytic Residues and Catalytic Mechanism of the RNase T1 Family257267ENKatsukiTakebeDepartment of Dental Pharmacology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMamoruSuzukiInstitute for Protein Research, Osaka UniversityYumikoHaraInstitute for Protein Research, Osaka UniversityTakuyaKatsutaniInstitute for Protein Research, Osaka UniversityNaomiMotoyoshiSchool of Pharmacy, Nihon UniversityTadashiItagakiSchool of Pharmacy, Nihon UniversityShuheiMiyakawaGraduate School of Pharmaceutical Sciences, Osaka UniversityKuniakiOkamotoDepartment of Dental Pharmacology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKaoriFukuzawaGraduate School of Pharmaceutical Sciences, Osaka UniversityHirokoKobayashiSchool of Pharmacy, Nihon UniversityThe ribonuclease T1 family, including RNase Po1 secreted by Pleurotus ostreatus, exhibits antitumor activity. Here, we resolved the Po1/guanosine-3′-monophosphate complex (3′GMP) structure at 1.75 Å. Structure comparison and fragment molecular orbital (FMO) calculation between the apo form and the Po1/3′GMP complex identified Phe38, Phe40, and Glu42 as the key binding residues. Two types of the RNase/3′GMP complex in RNasePo1 and RNase T1 were homologous to Po1, and FMO calculations elucidated that the biprotonated histidine on the β3 sheet (His36) on the β3 sheet and deprotonated Glu54 on the β4 sheet were advantageous to RNase activity. Moreover, tyrosine (Tyr34) on the β3 sheet was elucidated as a crucial catalytic residues. Mutation of Tyr34 with phenylalanine decreased RNase activity and diminished antitumor efficacy compared to that in the wild type. This suggests the importance of RNase activity in antitumor mechanisms.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0912-38144042024Nationwide diversity of symbolic “city flowers” in Japan is increasing463474ENYoichiTsuzukiHealth and Environmental Risk Division, National Institute for Environmental StudiesHarunaOhsakiDepartment of Biological Sciences, Tokyo Metropolitan UniversityYawako W.KawaguchiDepartment of Biological Sciences, Graduate School of Science, The University of TokyoSayakaSuzukiCenter for Ecological Research, Kyoto UniversityShogoHaradaDepartment of Biology, Graduate School of Science, Osaka City UniversityYurieOtakeCenter for Ecological Research, Kyoto UniversityNaotoShinoharaCenter for Ecological Research, Kyoto UniversityKoki R.KatsuharaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityRecognizing and maintaining locally rooted human–nature interactions is essential for utilizing ecosystem services. Although the general public's awareness of biodiversity and ecosystem services has been examined using various proxies, it remains unclear how local governments―key sectors in creating conservation policies―appreciate them within a solid local context. Here, we focused on the “city flower,” an official symbolic species of Japanese cities, as a new proxy for measuring governmental attitudes toward biota and its services. We aimed to capture temporal changes in the awareness of species with locally relevant value at the city government level by examining the changes in city flowers over more than half a century. Data from the official websites of municipalities, including the names, the adoption years, and the reasons for adoption, revealed two major periods of adoption, with a notable increase in species diversity in and after 1993. This increase could be attributed to a recent reduction in bias toward popular flowers and growing interest in alternative, less popular flowers. Analysis of the reasons for adoption suggested that the temporal change in adopted flower species was related to the increasing emphasis on species with an explicit local context, especially those with instrumental value to the city. Our findings indicate the tendency for local governments to increasingly recognize their biocultural backgrounds and the ecosystem services of plants within their regions. The growing awareness of the local governments regarding their biocultural background is a positive sign for the conservation of biodiversity and ecosystem services.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2399-3669712024Post-spinel-type AB2O4 high-pressure phases in geochemistry and materials science189ENMasakiAkaogiDepartment of Chemistry, Gakushuin UniversityTakayukiIshiiInstitute for Planetary Materials, Okayama UniversityKazunariYamauraResearch Center for Materials Nanoarchitectonics (MANA), National Institute for Materials SciencePost-spinel-type AB2O4 compounds are stable at higher pressures than spinel phases. These compounds have garnered much interest in geo- and materials science for their geochemical importance as well as potential application as high ionic conductors and materials with strongly correlated electrons. Here, large-volume high-pressure syntheses, structural features and properties of post-spinels are reviewed. Prospects are discussed for future searches for post-spinel-type phases by applying advanced large-volume high-pressure technology.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841792025Impact of a Peer-Led International Training Program on Work Motivation Among Early-Career Psychiatrists: A Mixed-Methods Studye93012ENToshihiroShimizuDepartment of Psychiatry, Saitama Prefectural Psychiatric HospitalJunkoKitaokaDepartment of Psychiatry, Fukkoukai Tarumi HospitalKenSuzutaniDepartment of Psychiatry, Aizu Medical CenterYutoSatakeDepartment of Psychiatry, The University of OsakaMasahideKodaCo-learning Community Healthcare Re-innovation Office, Graduate School of Medicine, Okayama UniversityIzumiKuramochiDepartment of Epileptology and Psychiatry, National Center of Neurology and PsychiatryNormanSartoriusPsychiatry, Association for the Improvement of Mental Health Programs (AIMHP)Background<br>
The Japan Young Psychiatrists Organization (JYPO) has conducted a Course for Academic Development of Psychiatrists (CADP), a peer-led residential international training program, since 2002 to promote the professional development of early-career psychiatrists. This study aimed to evaluate the impact of CADP on participants' work motivation using a psychometric scale and to identify the factors contributing to these changes.<br>
Methods<br>
We conducted a mixed-method study with 23 Japanese participants of the 21st CADP from March 8 to 10, 2024, in Himeji, Japan. Work motivation was assessed using the abbreviated version of the Measure of Multifaceted Work Motivations (MWM-12) at two time points: two weeks before and three months after the course. The total and subitem scores of the MWM-12 were analyzed using the Wilcoxon signed-rank test. Furthermore, free-text responses collected before and after the course were subjected to qualitative analyses.<br>
Results<br>
Significant improvements were observed in the MWM-12 total score from pre-course to post-course. Significant increases were also identified in specific sub-items: M1 (directionality of achievement-oriented motivation), M4 (directionality of competition-oriented motivation), M6 (sustainability of competition-oriented motivation), and M9 (sustainability of cooperation-oriented motivation). Qualitative analysis revealed changes in key categories, including growth as a psychiatrist, personal networking, personal growth, and increased motivation. The integration of quantitative and qualitative findings suggested that enhanced career perspectives (M1), professional growth and peer interaction (M4), and increased self-confidence and support networks (M6 and M9) contributed to improved motivation.<br>
Conclusion<br>
This study demonstrated that a three-day, two-night peer-led training program positively influenced work motivation among early-career psychiatrists.No potential conflict of interest relevant to this article was reported.Association for Research in Vision and Ophthalmology (ARVO)Acta Medica Okayama2164-259113122024Disruption of the Enterococcus faecalis–Induced Biofilm on the Intraocular Lens Using Bacteriophages25ENTatsumaKishimotoDepartment of Ophthalmology and Visual Science, Kochi Medical School, Kochi UniversityKenFukudaDepartment of Ophthalmology and Visual Science, Kochi Medical School, Kochi UniversityWakaIshidaDepartment of Ophthalmology and Visual Science, Kochi Medical School, Kochi UniversityAozoraKuwanaDepartment of Ophthalmology and Visual Science, Kochi Medical School, Kochi UniversityDaisukeTodokoroDepartment of Ophthalmology, Gunma University Graduate School of MedicineJumpeiUchiyamaDepartment of Bacteriology, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama UniversityShigenobuMatsuzakiDepartment of Medical Laboratory Science, Faculty of Health Sciences, Kochi Gakuen UniversityKenjiYamashiroDepartment of Ophthalmology and Visual Science, Kochi Medical School, Kochi UniversityPurpose: To compare the effects of bacteriophages (phages) and vancomycin on Enterococcus faecalis–induced biofilms on the intraocular lens.<br>
Methods: E. faecalis strains EF24, GU02, GU03, and phiEF14H1 were used. The expression of the enterococcus surface protein (esp) gene was analyzed using polymerase chain reaction. Phages or vancomycin was added to the biofilms formed on culture plates or acrylic intraocular lenses. The biofilms were quantified after staining with crystal violet. The structure of the biofilms was analyzed using scanning electron microscopy.<br>
Results: E. faecalis strains EF24, GU02, and GU03 formed biofilms on cell culture plates; however, the esp-negative GU03 strain had a significantly lower biofilm-forming ability than the esp-positive strains EF24 and GU02. The addition of phiEF14H1 resulted in a significant reduction in biofilm mass produced by both EF24 and GU02 compared with the untreated control. However, the addition of vancomycin did not degrade the biofilms. Phages significantly degraded biofilms and reduced the viable EF24 and GU02 bacteria on the intraocular lens.<br>
Conclusions: Phages can degrade biofilms formed on the intraocular lens and destroy the bacteria within it. Thus, phage therapy may be a new treatment option for refractory and recurrent endophthalmitis caused by biofilm-forming bacteria.<br>
Translational Relevance: Phage therapy, a novel treatment option for refractory and recurrent endophthalmitis caused by biofilm-forming bacteria, effectively lyses E. faecalis–induced biofilms.No potential conflict of interest relevant to this article was reported.IOP PublishingActa Medica Okayama2399-6528862024Inert structural transition in 4H and 6H SiC at high pressure and temperature: a Raman spectroscopy study065001ENShuhouMaitaniDepartment of Physics, School of Science and Technology, Meiji UniversityRyosukeSinmyoDepartment of Physics, School of Science and Technology, Meiji UniversityTakayukiIshiiInstitute for Planetary Materials, Okayama UniversityKenjiYozaBruker JapanWe conducted Raman spectroscopy measurements of 4H-SiC and 6H-SiC up to 69 GPa and 1023 K to assess the stability and bonding of SiC at high pressure and temperature. Both optic and acoustic modes were observed at wide pressure and temperature ranges. The temperature shifts of the Raman frequencies were fitted by the equation with the Bose–Einstein distribution function, and we found that the shifts were almost insensitive to the pressure. The mode Grüneisen coefficients weakly depend on the pressure and temperature, suggesting the sluggish transition of the crystal structure, unlike the previous experiments showing the transition or decomposition of SiC at high pressure and temperature conditions. Inert transitions are confirmed by Raman measurements and annealing experiments using multiple high-pressure apparatuses. The crystallinity may be a hidden critical parameter in the experiments to determine the stable polytypes of SiC under high pressure and temperature.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2079-63821392024Unveiling a New Antimicrobial Peptide with Efficacy against P. aeruginosa and K. pneumoniae from Mangrove-Derived Paenibacillus thiaminolyticus NNS5-6 and Genomic Analysis846ENNamfaSermkaewSchool of Pharmacy, Walailak UniversityApichartAtipairinSchool of Pharmacy, Walailak UniversitySucheewinKrobthongCenter of Excellence in Natural Products Chemistry (CENP), Department of Chemistry, Faculty of Science, Chulalongkorn UniversityChanatAonbangkhenCenter of Excellence in Natural Products Chemistry (CENP), Department of Chemistry, Faculty of Science, Chulalongkorn UniversityYodyingYingchutrakulNational Center for Genetic Engineering and Biotechnology, National Science and Technology Development AgencyJumpeiUchiyamaDepartment of Bacteriology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNuttaponSongnakaSchool of Pharmacy, Walailak UniversityThis study focused on the discovery of the antimicrobial peptide (AMP) derived from mangrove bacteria. The most promising isolate, NNS5-6, showed the closest taxonomic relation to Paenibacillus thiaminolyticus, with the highest similarity of 74.9%. The AMP produced by Paenibacillus thiaminolyticus NNS5-6 exhibited antibacterial activity against various Gram-negative pathogens, especially Pseudomonas aeruginosa and Klebsiella pneumoniae. The peptide sequence consisted of 13 amino acids and was elucidated as Val-Lys-Gly-Asp-Gly-Gly-Pro-Gly-Thr-Val-Tyr-Thr-Met. The AMP mainly exhibited random coil and antiparallel beta-sheet structures. The stability study indicated that this AMP was tolerant of various conditions, including proteolytic enzymes, pH (1.2–14), surfactants, and temperatures up to 40 °C for 12 h. The AMP demonstrated 4 µg/mL of MIC and 4–8 µg/mL of MBC against both pathogens. Time-kill kinetics showed that the AMP acted in a time- and concentration-dependent manner. A cell permeability assay and scanning electron microscopy revealed that the AMP exerted the mode of action by disrupting bacterial membranes. Additionally, nineteen biosynthetic gene clusters of secondary metabolites were identified in the genome. NNS5-6 was susceptible to various commonly used antibiotics supporting the primary safety requirement. The findings of this research could pave the way for new therapeutic approaches in combating antibiotic-resistant pathogens.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2673-6497532024Synthesis and Crystal Structure of Ilmenite-Type Silicate with Pyrope Composition394403ENTakayukiIshiiInstitute for Planetary Materials, Okayama UniversityRyosukeSinmyoDepartment of Physics, School of Science and Technology, Meiji UniversityTomooKatsuraBavarian Research Institute of Experimental Geochemistry and Geophysics, University of BayreuthAkimotoite, ilmenite-type MgSiO3 high-pressure polymorph can be stable in the lower-mantle transition zone along average mantle and subducting slab geotherms. Significant amounts of Al2O3 can be incorporated into the structure, having the pyrope (Mg3Al2Si3O12) composition. Previous studies have investigated the effect of Al2O3 on its crystal structure at nearly endmember compositions. In this study, we synthesized high-quality ilmenite-type Mg3Al2Si3O12 phase at 27 GPa and 1073 K by means of a Kawai-type multi-anvil press and refined the crystal structure at ambient conditions using a synchrotron X-ray diffraction data via the Rietveld method to examine the effect of Al2O3. The unit-cell lattice parameters were determined to be a = 4.7553(7) Å, c = 13.310(2) Å, and V = 260.66(6) Å3, with Z = 6 (hexagonal, R3̲
). The volume of the present phase was placed on the akimotoite-corundum endmember join. However, the refined structure showed a strong nonlinear behavior of the a- and c-axes, which can be explained by Al incorporation into the MgO6 and SiO6 octahedral sites, which are distinctly different each other. Ilmenite-type Mg3Al2Si3O12 phase may be found in shocked meteorites and can be a good indicator for shock conditions at relatively low temperatures of 1027–1127 K.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1751-73621812024Cyanorhodopsin-II represents a yellow-absorbing proton-pumping rhodopsin clade within cyanobacteriawrae175ENMasumiHasegawa-TakanoAtmosphere and Ocean Research Institute, The University of TokyoToshiakiHosakaLaboratory for Protein Functional and Structural Biology, RIKEN Center for Biosystems Dynamics ResearchKeiichiKojimaFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYosukeNishimuraAtmosphere and Ocean Research Institute, The University of TokyoMarieKuriharaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYuNakajimaAtmosphere and Ocean Research Institute, The University of TokyoYoshikoIshizuka-KatsuraLaboratory for Protein Functional and Structural Biology, RIKEN Center for Biosystems Dynamics ResearchTomomiKimura-SomeyaLaboratory for Protein Functional and Structural Biology, RIKEN Center for Biosystems Dynamics ResearchMikakoShirouzuLaboratory for Protein Functional and Structural Biology, RIKEN Center for Biosystems Dynamics ResearchYukiSudoFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySusumuYoshizawaAtmosphere and Ocean Research Institute, The University of TokyoMicrobial rhodopsins are prevalent in many cyanobacterial groups as a light-energy-harvesting system in addition to the photosynthetic system. It has been suggested that this dual system allows efficient capture of sunlight energy using complementary ranges of absorption wavelengths. However, the diversity of cyanobacterial rhodopsins, particularly in accumulated metagenomic data, remains underexplored. Here, we used a metagenomic mining approach, which led to the identification of a novel rhodopsin clade unique to cyanobacteria, cyanorhodopsin-II (CyR-II). CyR-IIs function as light-driven outward H+ pumps. CyR-IIs, together with previously identified cyanorhodopsins (CyRs) and cyanobacterial halorhodopsins (CyHRs), constitute cyanobacterial ion-pumping rhodopsins (CyipRs), a phylogenetically distinct family of rhodopsins. The CyR-II clade is further divided into two subclades, YCyR-II and GCyR-II, based on their specific absorption wavelength. YCyR-II absorbed yellow light (λmax = 570 nm), whereas GCyR-II absorbed green light (λmax = 550 nm). X-ray crystallography and mutational analysis revealed that the difference in absorption wavelengths is attributable to slight changes in the side chain structure near the retinal chromophore. The evolutionary trajectory of cyanobacterial rhodopsins suggests that the function and light-absorbing range of these rhodopsins have been adapted to a wide range of habitats with variable light and environmental conditions. Collectively, these findings shed light on the importance of rhodopsins in the evolution and environmental adaptation of cyanobacteria.No potential conflict of interest relevant to this article was reported.Universitas AirlanggaActa Medica Okayama2716-09203422024Depletion of Lysyl Oxidase-Like 4 (LOXL4) Attenuates Colony Formation in vitro and Collagen Deposition in vivo Breast Cancer Model6773ENNi Luh Gede Yoni KomalasariDepartment of Cell Biology, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama UniversityI Gde Haryo GaneshaDepartment of Histology, Faculty of Medicine, Udayana UniversityI Gusti Nyoman Sri WiryawanDepartment of Histology, Faculty of Medicine, Udayana UniversityNahokoTomonobuDepartment of Cell Biology, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama UniversityMasakiyoSakaguchiDepartment of Cell Biology, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama UniversityBackground: Lysyl oxidase (LOX) family proteins have recently become a topic in cancer progression. Our recent study found a high expression of LOX-like 4 (LOXL4) in MDA-MB-231 cells. Objective: To reveal the impact of depleted LOXL4 in both in vitro and in vivo breast cancer models from a histological perspective. Material and Method: Endogenous LOXL4 was depleted using the CRISPR/Cas9 on MDA-MB-231 parental cells. Based on the LOXL4 protein expression, the clone was determined for the next experiment, thus generating MDA-MB-231 LOXL4 KO. Cell assay was conducted using colony formation assay (n=3) followed by crystal violet staining. The indicated cells were inoculated orthotopically to female BALB/c nude mice (n=5). At the end of the experiment, tumors were isolated, fixed, and prepared for Masson Trichrome staining. Result: CRISPR/Cas9 completely depleted LOXL4 expression on clone number #2-22. Depletion of LOXL4 reduced the colony size formed by MDA-MB-231 cells. MDA-MB-231 LOXL4 KO #2-22 derived tumors showed depressed tumor volume compared to the parental group. Reduced collagen was also observed from the Masson Trichrome staining (p<0.001). Conclusion: Depletion of LOXL4 downregulates the growth of MDA-MB-231 cells in vitro and collagen deposition in vivo.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2077-038314172025Evaluation of the Diagnostic Performance of the Brush/Biopsy Rapid On-Site Evaluation (B-ROSE) in Cases of Bile Duct Stricture: A Prospective, Pilot Study6207ENNaoHattoriDepartment of Gastroenterology, Okayama University HospitalDaisukeUchidaDepartment of Gastroenterology, Okayama University HospitalKeiHaradaDepartment of Gastroenterology, Okayama University HospitalRyosukeSatoDepartment of Gastroenterology, Okayama University HospitalTaisukeObataDepartment of Gastroenterology, Okayama University HospitalAkihiroMatsumiDepartment of Gastroenterology, Okayama University HospitalKazuyaMiyamotoDepartment of Gastroenterology, Okayama University HospitalHiroyukiTerasawaDepartment of Gastroenterology, Okayama University HospitalYukiFujiiDepartment of Gastroenterology, Okayama University HospitalKoichiroTsutsumiDepartment of Gastroenterology, Okayama University HospitalShigeruHoriguchiDepartment of Gastroenterology, Okayama University HospitalKazuyukiMatsumotoDepartment of Gastroenterology, Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology, Okayama University HospitalsettingsOrder Article Reprints
Open AccessArticle
Evaluation of the Diagnostic Performance of the Brush/Biopsy Rapid On-Site Evaluation (B-ROSE) in Cases of Bile Duct Stricture: A Prospective, Pilot Study
by Nao Hattori 1,Daisuke Uchida 1,2,*,Kei Harada 1,Ryosuke Sato 1ORCID,Taisuke Obata 1,Akihiro Matsumi 1ORCID,Kazuya Miyamoto 1ORCID,Hiroyuki Terasawa 1ORCID,Yuki Fujii 1,Koichiro Tsutsumi 1ORCID,Shigeru Horiguchi 1,Kazuyuki Matsumoto 1ORCID andMotoyuki Otsuka 1
1
Department of Gastroenterology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
2
Center for Innovative Clinical Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(17), 6207; https://doi.org/10.3390/jcm14176207
Submission received: 23 June 2025 / Revised: 21 August 2025 / Accepted: 26 August 2025 / Published: 2 September 2025
(This article belongs to the Section Gastroenterology & Hepatopancreatobiliary Medicine)
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Abstract
Background: Biliary strictures are diagnosed using endoscopic retrograde cholangiopancreatography (ERCP) with brush cytology and biopsy. However, brush cytology shows a sensitivity of 9–56.1% and a diagnostic accuracy of 43–65.4%, while biopsy demonstrates a sensitivity of 48%. Both methods exhibit high specificity but limited sensitivity. While rapid on-site evaluation (ROSE) is effective in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), its application in ERCP-obtained samples remains underexplored. Methods: This prospective pilot study was conducted at Okayama University Hospital from April 2019 to July 2024. Patients requiring ERCP-guided sampling for bile duct strictures were included. ROSE was applied to brush cytology with up to three additional attempts and to imprint cytology from biopsy samples with up to two attempts. Diagnostic accuracy was assessed based on pathology and clinical course. Results: Among 37 patients (median age: 73 years, add range, and male–female ratio: 27:10), 18 had hilar and 19 had distal bile duct strictures. Brush cytology required one, two, or three attempts in twenty-six, six, and five cases, respectively, whereas biopsy required one or two attempts in thirty-five and two cases, respectively. Among the thirty-seven cases, thirty-five were malignant and two were benign. The B-ROSE group showed a sensitivity, specificity, and accuracy of 71.4%, 100.0%, and 73.0%, respectively, compared to lower accuracy in the conventional group, where single brush cytology attempts yielded a sensitivity of 48.6% and an accuracy of 48.6%, and single biopsy attempts showed a sensitivity of 68.6% and an accuracy of 70.3%. Conclusions: B-ROSE improves diagnostic accuracy, reduces repeat sampling, and minimizes patient burden in ERCP-based diagnosis of bile duct strictures, making it a valuable addition to current diagnostic protocols.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0915-56352025Vendor‐Agnostic Vision Transformer‐Based Artificial Intelligence for Peroral Cholangioscopy: Diagnostic Performance in Biliary Strictures Compared With Convolutional Neural Networks and EndoscopistsENRyosukeSatoDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalMasahiroTomiyaHealthcare Solutions Division, Ryobi Systems Co., LtdTakayoshiTanimotoHealthcare Solutions Division, Ryobi Systems Co., LtdAkimitsuOhtoHealthcare Solutions Division, Ryobi Systems Co., LtdKentaroOkiDepartment of Gastroenterology and Hepatology, Okayama University HospitalSatoshiKajitaniDepartment of Gastroenterology and Hepatology, Okayama University HospitalTatsuyaKikuchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalAkihiroMatsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyaMiyamotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University HospitalDaisukeUchidaDepartment of Gastroenterology and Hepatology, Okayama University HospitalKoichiroTsutsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalYoshiroKawaharaDepartment of Gastroenterology and Hepatology, Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalObjectives: Accurate diagnosis of biliary strictures remains challenging. This study aimed to develop an artificial intelligence (AI) system for peroral cholangioscopy (POCS) using a Vision Transformer (ViT) architecture and to evaluate its performance compared to different vendor devices, conventional convolutional neural networks (CNNs), and endoscopists.<br>
Methods: We retrospectively analyzed 125 patients with indeterminate biliary strictures who underwent POCS between 2012 and 2024. AI models including the ViT architecture and two established CNN architectures were developed using images from CHF-B260 or B290 (CHF group; Olympus Medical) and SpyScope DS or DS II (Spy group; Boston Scientific) systems via a patient-level, 3-fold cross-validation. For a direct comparison against endoscopists, a balanced 440-image test set, containing an equal number of images from each vendor, was used for a blinded evaluation.<br>
Results: The 3-fold cross-validation on the entire 2062-image dataset yielded a robust accuracy of 83.9% (95% confidence interval (CI), 80.9–86.7) for the ViT model. The model's accuracy was consistent between CHF (82.7%) and Spy (86.8%, p = 0.198) groups, and its performance was comparable to the evaluated conventional CNNs. On the 440-image test set, the ViT's accuracy of 78.4% (95% CI, 72.5–83.8) was comparable to that of expert endoscopists (82.0%, p = 0.148) and non-experts (73.0%, p = 0.066), with no statistically significant differences observed.<br>
Conclusions: The novel ViT-based AI model demonstrated high vendor-agnostic diagnostic accuracy across multiple POCS systems, achieving performance comparable to conventional CNNs and endoscopists evaluated in this study.No potential conflict of interest relevant to this article was reported.Fuji Technology Press Ltd.Acta Medica Okayama1883-80302042025High-Definition Topographic Archiving and Educational Applications in Regions Affected by the 2024 Noto Peninsula Earthquake401409ENTakuroOguraGraduate School of Education, Hyogo University of Teacher EducationHiroyukiYamauchiArt Research Center, Ritsumeikan UniversityTatsutoAokiFaculty of Regional Development Studies, Kanazawa UniversityNobuhisaMattaGraduate School of Education, Okayama UniversityKotaroIizukaCenter for Spatial Information Science, The University of TokyoYoshiyaIwasaFaculty of Education, University of Teacher Education FukuokaTakayukiTakahashiInternational Research Institute of Disaster Science, Tohoku UniversityKiyomiHayashiFaculty of Regional Development Studies, Kanazawa UniversityTsuyoshiHattanjiInstitute of Life and Environmental Sciences, University of TsukubaTakashiOguchiCenter for Spatial Information Science, The University of TokyoThe 2024 Noto Peninsula earthquake (Mw 7.5) caused extensive damage in Ishikawa Prefecture, Japan, and surrounding areas, with considerable coastal uplift and tsunami flooding. Past 100 years’ records show no earthquake above Mw 7.0 in the Noto Peninsula, so for everyone alive today, this event is truly without precedent. Therefore, we aimed to support disaster prevention education by developing teaching materials using unmanned aerial vehicles (UAVs) based on digitally archived topographic changes. High-definition topographic data collected from multiple UAV surveys were processed into digital and analog formats, including 3D models, spherical panorama images, and 3D printings. These materials were designed to provide detailed and intuitive representations of post-disaster landforms and were used as educational tools in schools. The learning materials were introduced during a workshop for disaster-affected teachers, featuring hands-on activities to help participants familiarize themselves with the materials, and explore their integration into geography and science classes. Feedback from participants indicated that these tools were highly effective in enhancing classroom learning. The results of this study are expected to contribute to preserving disaster records while enhancing disaster awareness in educational settings and local communities.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813722025令和６年度診療報酬改定を踏まえ急性期病院に今求められること7679ENTakahiroInoueOkayama University HospitalNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813722025令和６年度岡山医学会賞 がん研究奨励賞（林原賞・山田賞）4951ENYutoNaoiDepartment of Tumor Microenvironment, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813722025令和６年度岡山医学会賞 総合研究奨励賞（結城賞）4648ENHitoshiUrakamiDepartment of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813722025令和６年度岡山医学会賞 胸部・循環研究奨励賞（砂田賞）4345ENTakahiroNishiharaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.JMIR Publications Inc.Acta Medica Okayama1929-0748142025Optimization of Preemptive Therapy for Cytomegalovirus Infections With Valganciclovir Based on Therapeutic Drug Monitoring: Protocol for a Phase II, Single-Center, Single-Arm Triale72549ENNaokiTamuraDepartment of Pharmacy, Kobe University HospitalKotaroItoharaDepartment of Pharmacy, Kobe University HospitalYoUedaDepartment of Rheumatology and Clinical Immunology, Kobe University Graduate School of MedicineYumiKitahiroDepartment of Pharmacy, Kobe University HospitalKazuhiroYamamotoDepartment of Integrated Clinical and Basic Pharmaceutical Sciences, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomohiroOmuraDepartment of Pharmacy, Kobe University HospitalToshiyasuSakaneDepartment of Pharmaceutical Technology, Kobe Pharmaceutical UniversityJunSaegusaDepartment of Rheumatology and Clinical Immunology, Kobe University Graduate School of MedicineIkukoYanoDepartment of Pharmacy, Kobe University HospitalBackground: Valganciclovir (VGCV) is the first-line drug for preemptive therapy of cytomegalovirus (CMV) infections. However, even when administered at the dose specified in the package insert, there is significant interindividual variability in the plasma concentrations of ganciclovir (GCV). In addition, correlations have been reported between the area under the concentration–time curve and therapeutic efficacy or adverse events. Therefore, therapeutic drug monitoring (TDM) can be used to improve the efficacy and safety of preemptive VGCV therapy.<br>
Objective: This study aims to evaluate whether the dosage adjustment of VGCV based on TDM in patients undergoing preemptive therapy for CMV infections is associated with the successful completion rate of treatment without severe hematological adverse effects.<br>
Methods: This phase II, single-center, single-arm trial aims to enroll 40 patients admitted at the Department of Rheumatology and Clinical Immunology, Kobe University Hospital, who will receive oral VGCV as preemptive therapy for CMV infections. Participants will begin treatment with VGCV at the dose recommended in the package insert, with subsequent dose adjustments based on weekly TDM results. The primary end point will be the proportion of patients who achieve CMV antigenemia negativity within 3 weeks without severe hematological adverse events. The secondary end points will include weekly changes in CMV antigen levels, total VGCV dose, and duration of preemptive therapy. For safety evaluation, the occurrence, type, and severity of VGCV-related adverse events will be analyzed. Additionally, this study will explore the correlations between the efficacy and safety of preemptive therapy and the pharmacokinetic parameters of GCV, CMV-polymerase chain reaction values, and nudix hydrolase 15 (NUDT15) genetic polymorphisms. The correlation between GCV plasma concentrations obtained from regular venous blood and blood concentrations will be examined using dried blood spots.<br>
Results: This study began with patient recruitment in September 2024, with 5 participants enrolled as of June 16, 2025. The target enrollment is 40 participants, and the anticipated study completion is set for July 2027.<br>
Conclusions: This is the first study to investigate the impact of TDM intervention in patients receiving VGCV as preemptive therapy. The findings are postulated to provide valuable evidence regarding the utility of TDM in patients receiving VGCV as preemptive therapy.<br>
Trial Registration: Japan Registry of Clinical Trials jRCTs051240080; https://jrct.mhlw.go.jp/latest-detail/jRCTs051240080<br>
International Registered Report Identifier (IRRID): DERR1-10.2196/72549No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2692-4609612025Adequacy evaluation of 22‐gauge needle endoscopic ultrasound‐guided tissue acquisition samples and glass slides preparation for successful comprehensive genomic profiling testing: A single institute experiencee70104ENTamiNagataniClinical Genomic Medicine, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYojiWaniDepartment of Pathology, Japanese Red Cross Society, Himeji Red Cross HospitalMasahiroTakataniDepartment of Internal Medicine, Japanese Red Cross Society, Himeji Red Cross HospitalSoichiroFushimiDepartment of Pathology, Japanese Red Cross Society, Himeji Red Cross HospitalHirofumiInoueDivision of Medical Support, Dentistry and Pharmaceutical Science, Okayama University Graduate School of MedicineShinichiroHoriDepartment of Internal Medicine, Japanese Red Cross Society, Himeji Red Cross HospitalKyoheiKaiDepartment of Genetic Medicine, Japanese Red Cross Society, Himeji Red Cross HospitalHidekiYamamotoClinical Genomic Medicine, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTetsuyaOkazakiClinical Genomic Medicine, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMakiTaniokaClinical Genomic Medicine, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiOkadaDepartment of Internal Medicine, Japanese Red Cross Society, Himeji Red Cross HospitalAkiraHirasawaClinical Genomic Medicine, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesObjectives: This study aimed to evaluate the successful sequencing rate of Foundation One CDx (F1CDx) using small tissue samples obtained with a 22-gauge needle (22G) through endoscopic ultrasound-guided fine needle acquisition (EUS-TA) and to propose guidelines for tissue quantity evaluation criteria and proper slide preparation in clinical practice.<br>
Methods: Between June 2019 and April 2024, 119 samples of 22G EUS-TA collected for F1CDx testing at Himeji Red Cross Hospital were retrospectively reviewed. Tissue adequacy was only assessed based on tumor cell percentage (≥20%). The procedure stopped when white tissue fragments reached 20 mm during macroscopic on-site evaluation. The specimens were prepared using both ‘tissue preserving sectioning’ to retain tissue within formalin-fixed paraffin-embedded blocks and the ‘thin sectioning matched needle gauge and tissue length’ method with calculation to ensure minimal unstained slides for the 1 mm3 sample volume criterion. Tissue area from HE slides and sample volume were measured, and F1CDx reports were analyzed.<br>
Results: Of 119 samples, 108 (90.8%) were suitable for F1CDx. Excluding the cases not submitted for testing, in the 45 cases where F1CDx was done using 22G EUS-TA samples, eight (17.8%) had a sum of tissue area tissue of 25 mm2 or greater in the HE-stained sample. However, all cases met the F1CDx 1 mm3 volume criterion by submitting > 30 unstained slides per sample. As a result, 43 of 45 cases (95.6%) were successfully analyzable.<br>
Conclusions: The 22G EUS-TA needle is an effective tool for providing the sufficient tissue volume required for F1CDx.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2227-905912102024Development and Characterization of a Three-Dimensional Organotypic In Vitro Oral Cancer Model with Four Co-Cultured Cell Types, Including Patient-Derived Cancer-Associated Fibroblasts2373ENYukaAizawaDivision of Biomimetics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityKentaHagaDivision of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityNagakoYoshibaDepartment of Oral Health and Welfare, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityWitsanuYortchanDivision of Biomimetics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityShoTakadaDivision of Biomimetics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityRintaroTanakaDivision of Biomimetics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityErikoNaitoDivision of Oral and Maxillofacial Surgery, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityTatsuyaAbéDivision of Oral Pathology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversitySatoshiMaruyamaDivision of Oral Pathology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityManabuYamazakiDivision of Oral Pathology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityJun-ichiTanumaDivision of Oral Pathology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityKazuyoIgawaNeutron Therapy Research Center, Okayama UniversityKeiTomiharaDivision of Oral and Maxillofacial Surgery, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityShinsakuTogoDepartment of Respiratory Medicine, Graduate School of Medicine, Juntendo UniversityKenjiIzumiDivision of Biomimetics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityBackground/Objectives: Cancer organoids have emerged as a valuable tool of three-dimensional (3D) cell cultures to investigate tumor heterogeneity and predict tumor behavior and treatment response. We developed a 3D organotypic culture model of oral squamous cell carcinoma (OSCC) to recapitulate the tumor–stromal interface by co-culturing four cell types, including patient-derived cancer-associated fibroblasts (PD-CAFs). Methods: A stainless-steel ring was used twice to create the horizontal positioning of the cancer stroma (adjoining normal oral mucosa connective tissue) and the OSCC layer (surrounding normal oral mucosa epithelial layer). Combined with a structured bi-layered model of the epithelial component and the underlying stroma, this protocol enabled us to construct four distinct portions mimicking the oral cancer tissue arising in the oral mucosa. Results: In this model, α-smooth muscle actin-positive PD-CAFs were localized in close proximity to the OSCC layer, suggesting a crosstalk between them. Furthermore, a linear laminin-γ2 expression was lacking at the interface between the OSCC layer and the underlying stromal layer, indicating the loss of the basement membrane-like structure. Conclusions: Since the specific 3D architecture and polarity mimicking oral cancer in vivo provides a more accurate milieu of the tumor microenvironment (TME), it could be crucial in elucidating oral cancer TME.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1439-75952025Recommendations for the treatment of juvenile idiopathic arthritis with oligoarthritis or polyarthritis from the 2024 update of the Japan College of Rheumatology Clinical Practice Guidelines for the management of rheumatoid arthritis including juvenile idiopathic arthritis with oligoarthritis or polyarthritis – secondary publicationroaf042ENTakakoMiyamaeDepartment of Pediatric Rheumatology, Institute of Rheumatology, Tokyo Women’s Medical University HospitalNamiOkamotoDepartment of Pediatrics, Osaka Rosai Hospital, Japan Organization of Occupational Health and SafetyYuzaburoInoueDepartment of General Medical Science, Graduate School of Medicine, Chiba UniversityTomohiroKubotaDepartment of Pediatrics, Kagoshima Prefectural Satsunan HospitalTakasukeEbatoDepartment of Pediatrics, Kitasato UniversityHitoshiIrabuDepartment of Pediatrics and Development Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental UniversityHidetoKamedaDivision of Rheumatology, Department of Internal Medicine, Toho UniversityYukoKanekoDivision of Rheumatology, Department of Internal Medicine, Keio University School of MedicineHiroshiKuboDepartment of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of MedicineKanakoMitsunagaDepartment of Allergy and Rheumatology, Chiba Children's HospitalMasaakiMoriDepartment of Lifetime Clinical Immunology, Tokyo Medical and Dental UniversityAyakoNakajimaCenter for Rheumatic Diseases, Mie University HospitalKenichiNishimuraDepartment of Pediatrics, Yokohama City University Graduate School of MedicineNaoakiOhkuboIizuka HospitalTomomiSatoClinical Education Center For Physicians, Shiga University of Medical ScienceYukoSugitaDepartment of Pediatrics, School of Medicine, Osaka Medical and Pharmaceutical UniversitySatoshiTakanashiDivision of Rheumatology, Department of Internal Medicine, Keio University School of MedicineTakayukiTanakaDepartment of Pediatrics, Japanese Red Cross Otsu HospitalHiroakiUmebayashiDepartment of Rheumatology and Infectious Diseases, Miyagi Children’s HospitalMasatoYashiroDepartment of Pediatrics, Okayama University HospitalShingoYamanishiDepartment of Pediatrics, Nippon Medical SchoolMieFusamaHealth Sciences Department of Nursing, Kansai University of International StudiesShintaroHirataDepartment of Clinical Immunology and Rheumatology, Hiroshima University HospitalMitsumasaKishimotoDepartment of Nephrology and Rheumatology, Kyorin University School of MedicineMasatakaKohnoInflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of MedicineMasayoKojimaGraduate School of Medical Sciences, Nagoya City UniversityToshihisaKojimaDepartment of Orthopedic Surgery, National Hospital Organization Nagoya Medical CenterAkioMorinobuDepartment of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto UniversityTakahikoSugiharaDivision of Rheumatology, Department of Internal Medicine, Toho University School of MedicineEiichiTanakaDivision of Rheumatology, Department of Internal Medicine, School of Medicine, Tokyo Women's Medical UniversityNobuyukiYajimaDivision of Rheumatology, Department of Medicine, Showa University School of MedicineRyoYanaiDivision of Rheumatology, Department of Medicine, Showa University School of MedicineYutakaKawahitoInflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of MedicineMasayoshiHarigaiDivision of Rheumatology, Department of Internal Medicine, School of Medicine, Tokyo Women's Medical UniversityObjectives: To conduct systematic reviews (SRs) and develop clinical practice guidelines (CPGs) for managing juvenile idiopathic arthritis (JIA) with oligoarthritis or polyarthritis.<br>
Methods: The Grading of Recommendations, Assessment, Development, and Evaluation methodology was employed to carry out SRs and formulate the CPGs. An expert panel, including patients, paediatric and nonpaediatric rheumatologists, guideline specialists, and patient representatives, used the Delphi method to discuss and agree on the recommendations.<br>
Results: Six clinical questions (CQs) on the efficacy and safety of medical treatments were evaluated. These included CQ1 on methotrexate (MTX), CQ2 on non-MTX conventional synthetic disease-modifying antirheumatic drugs, CQ3 on glucocorticoids, CQ4 on tumour necrosis factor inhibitors, CQ5 on interleukin-6 inhibitors, and CQ6 on Janus kinase inhibitors. Two randomized controlled trials were identified for CQ1, three for CQ2, two for CQ3, eight for CQ4, two for CQ5, and two for CQ6. Based on these evaluations, three strong and three conditional recommendations were established. The CPGs have been endorsed by the Japan College of Rheumatology and the Pediatric Rheumatology Association of Japan.<br>
Conclusions: The SRs provided the necessary evidence to develop the CPGs, which are intended to guide not only paediatric but also nonpaediatric rheumatologists, caregivers, patients, and their families in treatment decision-making.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0953-418020242024Mice Recognise Mice in Neighbouring Rearing Cages and Change Their Social Behaviour9215607ENHiroshiUenoDepartment of Medical Technology, Kawasaki University of Medical WelfareYuTakahashiDepartment of Psychiatry, Kawasaki Medical SchoolSachikoMoriDepartment of Psychiatry, Kawasaki Medical SchoolShinjiMurakamiDepartment of Psychiatry, Kawasaki Medical SchoolKentaWaniDepartment of Psychiatry, Kawasaki Medical SchoolYosukeMatsumotoDepartment of Neuropsychiatry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMotoiOkamotoDepartment of Medical Technology, Graduate School of Health Sciences, Okayama UniversityTakeshiIshiharaDepartment of Psychiatry, Kawasaki Medical SchoolMice are social animals that change their behaviour primarily in response to visual, olfactory, and auditory information from conspecifics. Rearing conditions such as cage size and colour are important factors influencing mouse behaviour. In recent years, transparent plastic cages have become standard breeding cages. The advantage of using a transparent cage is that the experimenter can observe the mouse from outside the cage without touching the cage. However, mice may recognise the environment outside the cage and change their behaviour. We speculated that mice housed in transparent cages might recognise mice in neighbouring cages. We used only male mice in this experiment. C57BL/6 mice were kept in transparent rearing cages with open lids, and the cage positions were maintained for 3 weeks. Subsequently, we examined how mice behaved toward cagemate mice, mice from neighbouring cages, and mice from distant cages. We compared the level of interest in mice using a social preference test. Similar to previous reports, subject mice showed a high degree of interest in unfamiliar mice from distant cages. By contrast, subject mice reacted to mice from neighbouring cages as familiar mice, similar to cagemate mice. This suggests that mice housed in transparent cages with open lids perceive the external environment and identify mice in neighbouring cages. Researchers should pay attention to the environment outside the mouse cage, especially for the social preference test.No potential conflict of interest relevant to this article was reported.Japanese Society for Lymphoreticular Tissue ResearchActa Medica Okayama1346-42806442024Computed tomography findings of idiopathic multicentric Castleman disease subtypes292296ENToshihiroIguchiDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityAsamiNishikoriDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesYasuharuSatoDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesMidori FilizNishimuraDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesNorikoIwakiDepartment of Hematology, National Cancer Center HospitalKatsuhideKojimaDepartment of Radiology, Okayama University HospitalTakashiAsaharaDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityFumioOtsukaDepartment of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshinobuMaedaDepartment of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakaoHirakiDepartment of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityThis study retrospectively evaluated the computed tomography (CT) findings of idiopathic multicentric Castleman disease (iMCD) at a single center and compared the CT findings of iMCD-TAFRO with those of iMCD-non-TAFRO. CT images obtained within 30 days before diagnostic confirmation were reviewed for 20 patients with iMCD (8 men and 12 women, mean age 52.8 ± 12.3 years, range 25–74 years). Twelve patients were diagnosed with iMCD-TAFRO, five with iMCD-idiopathic plasmacytic lymphadenopathy, and three with iMCD-not otherwise specified. CT images revealed anasarca and lymphadenopathy in all 20 patients. The iMCD-TAFRO group showed significantly higher frequencies of ascites (100% vs. 37.5%, P = 0.004), gallbladder wall edema (75.0% vs. 12.5%, P = 0.020), periportal collar (91.7% vs. 25.0%, P = 0.004), and anterior mediastinal lesions (non-mass-forming infiltrative lesions) (66.7% vs. 12.5%, P = 0.028). Para-aortic edema tended to be more frequent in patients with the iMCD-TAFRO group (83.3% vs. 37.5%, P = 0.062), while the absence of anterior mediastinal lesions tended to be more frequent in the iMCD-non-TAFRO group (16.7% vs. 62.5%, P = 0.062). These CT findings may have clinical implications for improving the accuracy and speed of iMCD diagnosis and differentiating iMCD-TAFRO from other subtypes.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1435-245141012024An effective surgical educational system in the era of robotic surgery: “Double-Surgeon Technique” in robotic gastrectomy for minimally invasive surgery20ENYoshihikoKakiuchiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinjiKurodaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusukeYoshidaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuhikoKanayaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHajimeKashimaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoruKikuchiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShunsukeKagawaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesPurpose Gastric cancer (GC) remains a major malignancy. Robotic gastrectomy (RG) has gained popularity due to various advantages. Despite those advantages, many hospitals lack the necessary equipment for RG and are still performing laparoscopic gastrectomy (LG) due to its established minimal invasiveness and safety.<br>
Methods This study assessed the effectiveness of the “Double-Surgeon Technique” (DST) for improving surgical education and proficiency with LG. The DST involves both a console-side surgeon and a patient-side surgeon working actively in RG, enhancing the skill acquisition needed for LG and potentially reducing surgical time. Assessment of this method was performed by surgical time, and cases were divided into three groups: first half (Phase 1: P1) and second half (P2) before the introduction of DST, and after the introduction of DST (P3).<br>
Results Two surgical trainees were trained using the DST. The learning curve in both reached a plateau in P2, but descended again in P3. For one trainee, surgical time for P3 was significantly reduced compared to P1 (p = 0.001) and P2 (p = 0.0027) despite the intervals between laparoscopic distal gastrectomy as the main surgeon in P3 being significantly longer than in P2 (p = 0.0094). Other surgical results in both trainees did not differ significantly. Further, no difference in induction phase results of RG were evident between surgeons and trainees with or without DST experience.<br>
Conclusion Surgical education using the DST could be effective in the current context of the need for RG and LG.No potential conflict of interest relevant to this article was reported.IOP PublishingActa Medica Okayama1742-658828922024Crystal Grain Rotation during Tensile Test of Polycrystalline Pure Titanium Thin Sheet Based on Surface Height and Crystal Orientation012002ENNaoyaTadaOkayama UniversityHiroakiOhashiOkayama UniversityTakeshiUemoriOkayama UniversityJunjiSakamotoOkayama UniversityThin sheets and wires of polycrystalline pure titanium are important materials for various devices used in electrical, mechanical, dental, and medical fields. Since pure titanium shows strong anisotropy in elastic and plastic deformation, and the individual grains comprising a polycrystalline body have different orientations and geometries, inhomogeneous deformation always occurs on the microscopic scale. This inhomogeneity is more significant in thin films than in bulk materials. It is therefore important to investigate the inhomogeneous deformation of pure titanium thin sheets to ensure the reliability of various titanium devices. In this study, thin-sheet specimens made of polycrystalline pure titanium were subjected to tensile testing. Inhomogeneous deformation was evaluated on the basis of two kinds of crystal grain rotations based on surface height and crystal orientation. The results under elastic and plastic tensile conditions were compared.No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231892025岡山大学教育学部家政教育講座における教育実践力向上にむけた新カリキュラム初等家庭科指導法基礎および内容基礎の実践と評価 ―2024 年度指導法基礎受講学生を対象としたアンケート調査の分析を通して―111122ENChiharuMORIFaculty of Education，Okayama UniversityMiyukiHISANARIFaculty of Education，Okayama UniversityKyoung WonLEEFaculty of Education，Okayama UniversityYokoSHINOHARAFaculty of Education，Okayama University10.18926/bgeou/69242 これまで，岡山大学教育学部家政教育講座では，家庭科教員養成のコア・カリキュラムを設定し，家庭科のねらい・原理を達成できる実践的指導力の育成を行ってきた。本稿では，新カリキュラム1 年次開講科目である「初等家庭科内容基礎」と「初等家庭科指導法基礎」の二つの授業の実践について，その成果と課題を整理し，今後に向けての示唆を得ることを目的とした。学生のアンケート調査結果より，指導法基礎は，シラバスに記載した授業概要や到達目標に示した内容の理解を促すことができたと考えられた。また，本授業の成果は，内容基礎の学修成果と併せて，小学校家庭科の意義，中学校以降の学習との繋がりに対する理解を深めることができたと推察された。No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0360-31991012025Next frontier in photocatalytic hydrogen production through CdS heterojunctions173211ENAminulIslamDepartment of Petroleum and Mining Engineering, Jashore University of Science and TechnologyAbdulMalekDepartment of Petroleum and Mining Engineering, Jashore University of Science and TechnologyMd. TarekulIslamDepartment of Leather Engineering, Faculty of Mechanical Engineering, Khulna University of Engineering and TechnologyFarzana YeasminNipaDepartment of Petroleum and Mining Engineering, Jashore University of Science and TechnologyObayedRaihanDepartment of Pharmaceutical Sciences, College of Health Sciences and Pharmacy, Chicago State UniversityHasanMahmudBangladesh Energy and Power Research Council (BEPRC)Md. EliasUddinDepartment of Leather Engineering, Faculty of Mechanical Engineering, Khulna University of Engineering and TechnologyMohd LokmanIbrahimSchool of Chemistry and Environment, Faculty of Applied Sciences, Universiti Teknologi MARAG.Abdulkareem-AlsultanCatalysis Science and Technology Research Centre, Faculty of Science, Universiti Putra MalaysiaAlam HossainMondalUSAID - Bangladesh Advancing Development and Growth through Energy (BADGE) Project, Tetra TechMd. MunjurHasanDepartment of Chemistry, Graduate School of Science, Osaka UniversityMd. ShadSalmanInstitute for Chemical Research, Kyoto UniversityKhadiza TulKubraDepartment of Chemistry, Graduate School of Science, Osaka UniversityMd. NazmulHasanDepartment of Chemistry, School of Science, The University of TokyoMd. ChanmiyaSheikhDivision of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama UniversityTetsuyaUchidaDivision of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama UniversityAdiba IslamRaseeDepartment of Chemistry, Graduate School of Science, Osaka UniversityAriyan IslamRehanDepartment of Chemistry, School of Science, The University of TokyoMrs EtiAwualInstitute for Chemical Research, Kyoto UniversityMohammed SohrabHossainDepartment of Chemistry, Graduate School of Science, Osaka UniversityR.M.WaliullahInstitute for Chemical Research, Kyoto UniversityMd. RabiulAwualWestern Australian School of Mines: Minerals, Energy and Chemical Engineering, Curtin UniversityPhotocatalytic hydrogen (H₂) generation via solar-powered water splitting represents a sustainable solution to the global energy crisis. Cadmium sulfide (CdS) has emerged as a promising semiconductor photocatalyst due to its tunable bandgap, high physicochemical stability, cost-effectiveness, and widespread availability. This review systematically examines recent advancements in CdS-based heterojunctions, categorized into CdS-metal (Schottky), CdS-semiconductor (p-n, Z-scheme, S-scheme), and CdS-carbon heterojunctions. Various strategies employed to enhance photocatalytic efficiency and stability are discussed, including band structure engineering, surface modification, and the incorporation of crosslinked architectures. A critical evaluation of the underlying photocatalytic mechanisms highlights recent efforts to improve charge separation and photostability under operational conditions. This review highlights the challenges and opportunities in advancing CdS-based photocatalysts and provides a direction for future research. The insights presented aim to accelerate the development of efficient and durable CdS-based photocatalysts for sustainable H₂ production.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1341-96253012024Lymphadenectomy and chemotherapy are effective treatments for patients with 2023 international federation of gynecology and obstetrics stage IIC-high risk endometrial cancer in Japan144156ENYoshinoriTaniDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeiichiroNakamuraDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasaeYorimitsuDepartment of Obstetrics and Gynecology, Hiroshima City Hiroshima Citizens HospitalNorikoSekiDepartment of Obstetrics and Gynecology, Japanese Red Cross Society Himeji HospitalMieNakanishiDepartment of Obstetrics and Gynecology, Kagawa Prefectural Central HospitalHironoriItouDepartment of Obstetrics and Gynecology, National Hospital Organization Iwakuni Clinical CenterMiyukiShimizuDepartment of Obstetrics and Gynecology, Kagawa Rosai HospitalDanYamamotoDepartment of Obstetrics and Gynecology, National Organization Fukuyama Medical CenterEtsukoTakaharaDepartment of Obstetrics and Gynecology, Fukuyama City HospitalHisashiMasuyamaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground In early-stage endometrial cancer (EC), the treatment of aggressive histological subtypes (endometrioid carcinoma grade 3, serous carcinoma, clear-cell carcinoma, undifferentiated carcinoma, mixed carcinoma, and carcinosarcoma) is controversial. We aimed to investigate the treatment of patients with International Federation of Gynecology and Obstetrics (FIGO) stage IC and stage IIC EC according to the 2023 classification.<br>
Methods We retrospectively identified patients with FIGO 2023 stage IC, IIC-intermediate risk (IIC-I), and IIC-high risk (IIC-H) EC who underwent adjuvant therapy or observation after surgery at eight medical institutions from 2004 to 2023. Progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan–Meier estimates and univariate and multivariate analyses.<br>
Results The PFS and OS were significantly worse in patients with FIGO 2023 stage IIC-H EC than in those with FIGO 2023 stage IIC-I EC (PFS: p = 0.008 and OS: p = 0.006). According to the FIGO 2023 stage IIC-H classification, lymphadenectomy and chemotherapy resulted in better prognoses regarding both PFS and OS (p < 0.001 for both) than other treatments. Our findings suggest that lymphadenectomy and chemotherapy effectively reduced vaginal stump and lymph node metastases in FIGO 2023 stage IIC-H EC (p < 0.001 and p = 0.008, respectively). Furthermore, in the multivariate analysis, not undergoing lymphadenectomy or chemotherapy were independent predictors of recurrence and poor prognoses in patients with FIGO 2023 stage IIC-H EC (p < 0.001 and p = 0.031, respectively).<br>
Conclusion Lymphadenectomy and chemotherapy resulted in better prognoses regarding both recurrence and survival in patients with FIGO 2023 stage IIC high-risk EC.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-291863232024Successful Treatment for Life Threatening Recurrent Non-traumatic Rectus Sheath Hematoma in a Case with Microscopic Polyangiitis with Rapidly Progressive Glomerulonephritis32433248ENHiroyukiNakanohDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesHidemiTakeuchiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesShihoMorimotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesYuyaTerajimaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesShugoOkamotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroOnishiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKeikoTanakaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesTakayukiKatsuyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKenjiTsujiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesYoshinoriMatsumotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKatsuyukiTanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesHiroshiMorinagaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesMayuUkaDepartment of Radiology, Okayama University HospitalKojiTomitaDepartment of Radiology, Okayama University HospitalHaruhito A.UchidaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesTakaoHirakiDepartment of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesA 68-year-old woman was admitted to our hospital because of a rapid progression of renal dysfunction with positive myeloperoxidase antineutrophil cytoplasmic antibody and was diagnosed with rapidly progressive glomerulonephritis associated with microscopic polyangiitis (MPA). Severe right rectus sheath hematoma (RSH) bleeding from the inferior epigastric artery developed after starting hemodialysis, which required 4 transarterial embolizations due to recurrent bleeding. After additional treatment with methylprednisolone pulse therapy and rituximab, no rebleeding occurred. Although the giant hematoma reached the pelvis, it shrank spontaneously without any intervention. Nontraumatic RSH should therefore be considered when treating patients with multiple risk factors.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1068-92653222024Hemodynamic Assessment Using SPY Laser Fluorescence Imaging During Pancreatoduodenectomy with Common Hepatic Artery Resection13341336ENTomokazuFujiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKoseiTakagiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuyaYasuiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakeyoshiNishiyamaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMotohikoYamadaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYasuoNagaiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNoriyukiKanehiraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground. Pancreatectomies combined with arterial resection can be indicated for pancreatic cancer. In a pancreatectomy with arterial resection, intraoperative confirmation of blood flow through reconstructed vessels is crucial. This study highlights the usefulness of SPY laser fluorescence imaging during a pancreatoduodenectomy with common hepatic artery resection (PD-CHAR).<br>
Patient and Methods. A 55-year-old man with borderline resectable pancreatic head cancer underwent a PD-CHAR. After confirming tumor resectability, reconstruction of the CHA to the proper hepatic artery was performed. Subsequently, the superior mesenteric vein was reconstructed.<br>
Results. SPY laser fluorescence imaging demonstrated arterial blood perfusion to the liver through the reconstructed hepatic artery, followed by perfusion from the portal vein. The operation lasted 493 min, with an estimated blood loss of 400 mL. The postoperative course was uneventful with good arterial blood flow.<br>
Conclusion. The SPY Portable Handheld Imager could be valuable for visualizing blood flow in reconstructed vessels and assessing tissue perfusion during a pancreatectomy combined with vascular reconstruction.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2210-26121262025Rare internal hernia following pancreatoduodenectomy: A case report110673ENTeruyukiTsujiiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKoseiTakagiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYasuoNagaiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuyaYasuiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTomokazuFujiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesIntroduction: Pancreatoduodenectomy (PD) is a complex procedure with a high morbidity rate. Internal hernia following PD is a rare but potentially life-threatening complication. Herein, we describe a rare case of internal hernia after PD.<br>
Presentation of case: A 76-year-old man who underwent subtotal stomach-preserving PD 7 years ago presented with vomiting and abdominal pain. Abdominal computed tomography revealed an internal hernia. Because conservative treatment failed, surgical intervention was performed. Intraoperative findings revealed efferent loop herniation in the space between the afferent loop near the Braun anastomosis and transverse mesocolon. The hernia was repositioned and the mesenteric defect was closed.<br>
Discussion: This is an extremely rare case of an internal hernia that developed 7 years after PD. As conservative management provides a little chance for improvement, precise diagnosis and prompt re-intervention are essential for the management of internal hernia. In this case, the hernial orifice developed in the space between the afferent and efferent loops and the transverse mesocolon. Internal hernia could be a differential diagnosis in patients with ileus after PD.<br>
Conclusion: This study provided a detailed description of an extremely rare case of internal hernia following PD. Therefore, internal hernias should be considered in patients undergoing PD.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1068-926531132024Robot-Assisted Pancreaticoduodenectomy Using the Anterior Superior Mesenteric Artery-First Approach for Pancreatic Cancer87418743ENKoseiTakagiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTomokazuFujiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuyaYasuiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMotohikoYamadaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakeyoshiNishiyamaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYasuoNagaiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNoriyukiKanehiraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground. The superior mesenteric artery (SMA)-first approach for pancreatic cancer (PC) is common surgical technique in pancreaticoduodenectomy. To date, few studies have reported SMA-first approach in robot-assisted pancreaticoduodenectomy (RPD). Herein, we present the anterior SMA-first approach for PC during RPD.<br>
Patient and Method. A 75-year-old man with resectable PC underwent RPD after neoadjuvant chemotherapy. As pancreatic head tumor contacted with the superior mesenteric vein (SMV), the anterior SMA approach was applied. After the mesenteric Kocher maneuver, the jejunum was divided and the left side of the SMA was dissected. Subsequently, the anterior plane of the SMA was dissected. Following the division of branches from the mesenteric vessels, the SMA was taped, and the circumferential dissection around the SMA was performed to detach the pancreatic neck from the SMA completely. Finally, the dissection between the SMV and the tumor was performed under vascular control to remove the specimen.<br>
Conclusions. The anterior SMA-first approach can be optional in patients with PC undergoing RPD. This unique approach allows for the circumferential dissection around the SMA during RPD.No potential conflict of interest relevant to this article was reported.AME Publishing CompanyActa Medica Okayama2227-684X1382024The state of robotic vs. open pancreatoduodenectomy1344-1348ENKoseiTakagiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTomokazuFujiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuyaYasuiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMotohikoYamadaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakeyoshiNishiyamaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYasuoNagaiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNoriyukiKanehiraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1867-10714322024Evaluation of a novel central venous access port for direct catheter insertion without a peel-away sheath282289ENToshihiroIguchiDepartment of Radiology, Okayama University HospitalTakahiroKawabataDepartment of Radiology, Okayama University HospitalYusukeMatsuiDepartment of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKojiTomitaDepartment of Radiology, Okayama University HospitalMayuUkaDepartment of Radiology, Okayama University HospitalNoriyukiUmakoshiDepartment of Radiology, Okayama University HospitalSoichiroOkamotoDepartment of Radiology, Okayama University HospitalKazuakiMunetomoDepartment of Radiology, Okayama University HospitalTakaoHirakiDepartment of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityPurpose This study retrospectively evaluated the feasibility and safety of implanting a newly developed central venous access port (CV-port) that allows catheter insertion into a vein without the use of a peel-away sheath, with a focus on its potential to minimize risks associated with conventional implantation methods.<br>
Materials and methods All procedures were performed using a new device (P-U CelSite Port™ MS; Toray Medical, Tokyo, Japan) under ultrasound guidance. The primary endpoint was the implantation success rate. The secondary endpoints were the safety and risk factors for infection in the early postprocedural period (< 30 days).<br>
Results We assessed 523 CV-port implantations performed in a cumulative total of 523 patients (240 men and 283 women; mean age, 61.6 ± 13.1 years; range, 18–85 years). All implantations were successfully performed using an inner guide tube and over-the-wire technique through 522 internal jugular veins and one subclavian vein. The mean procedural time was 33.2 ± 10.9 min (range 15–112 min). Air embolism, rupture/perforation of the superior vena cava, or hemothorax did not occur during catheter insertion. Eleven (2.1%) intraprocedural complications occurred, including Grade I arrhythmia (n = 8) and subcutaneous bleeding (n = 1), Grade II arrhythmia (n = 1), and Grade IIIa pneumothorax (n = 1). Furthermore, 496 patients were followed up for ≥ 30 days. Six early postprocedural complications were encountered (1.1%), including Grade IIIa infection (n = 4), catheter occlusion (n = 1), and skin necrosis due to subcutaneous leakage of trabectedin (n = 1). These six CV-ports were withdrawn, and no significant risk factors for infection in the early postprocedural period were identified.<br>
Conclusion The implantation of this CV-port device demonstrated comparable success and complication rates to conventional devices, with the added potential benefit of eliminating complications associated with the use of a peel-away sheath.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2041-17231512024Neurotransmitter recognition by human vesicular monoamine transporter 27661ENDohyunImDepartment of Cell Biology, Graduate School of Medicine, Kyoto UniversityMikaJormakkaDepartment of Cell Biology, Graduate School of Medicine, Kyoto UniversityNarinobuJugeDepartment of Genomics and Proteomics, Advanced Science Research Center, Okayama UniversityJun-ichiKishikawaDepartment of Applied Biology, Kyoto Institute of TechnologyTakayukiKatoInstitute for Protein Research, Osaka UniversityYukihikoSugitaLaboratory of Ultrastructural Virology, Institute for Life and Medical Sciences, Kyoto UniversityTakeshiNodaLaboratory of Ultrastructural Virology, Institute for Life and Medical Sciences, Kyoto UniversityTomokoUemuraDepartment of Cell Biology, Graduate School of Medicine, Kyoto UniversityYukiShiimuraDepartment of Cell Biology, Graduate School of Medicine, Kyoto UniversityTakaakiMiyajiDepartment of Genomics and Proteomics, Advanced Science Research Center, Okayama UniversityHidetsuguAsadaDepartment of Cell Biology, Graduate School of Medicine, Kyoto UniversitySoIwataDepartment of Cell Biology, Graduate School of Medicine, Kyoto UniversityHuman vesicular monoamine transporter 2 (VMAT2), a member of the SLC18 family, plays a crucial role in regulating neurotransmitters in the brain by facilitating their uptake and storage within vesicles, preparing them for exocytotic release. Because of its central role in neurotransmitter signalling and neuroprotection, VMAT2 is a target for neurodegenerative diseases and movement disorders, with its inhibitor being used as therapeutics. Despite the importance of VMAT2 in pharmacophysiology, the molecular basis of VMAT2-mediated neurotransmitter transport and its inhibition remains unclear. Here we show the cryo-electron microscopy structure of VMAT2 in the substrate-free state, in complex with the neurotransmitter dopamine, and in complex with the inhibitor tetrabenazine. In addition to these structural determinations, monoamine uptake assays, mutational studies, and pKa value predictions were performed to characterize the dynamic changes in VMAT2 structure. These results provide a structural basis for understanding VMAT2-mediated vesicular transport of neurotransmitters and a platform for modulation of current inhibitor design.No potential conflict of interest relevant to this article was reported.Japan Atherosclerosis SocietyActa Medica Okayama1340-34783252025ChatGPT Responses to Clinical Questions in the Japan Atherosclerosis Society Guidelines for Prevention of Atherosclerotic Cardiovascular Disease 2022567579ENTakashiHisamatsuDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMariFukudaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMinakoKinutaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideyukiKandaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAims: Artificial intelligence is increasingly used in the medical field. We assessed the accuracy and reproducibility of responses by ChatGPT to clinical questions (CQs) in the Japan Atherosclerosis Society Guidelines for Prevention Atherosclerotic Cardiovascular Diseases 2022 (JAS Guidelines 2022).<br>
Methods: In June 2024, we assessed responses by ChatGPT (version 3.5) to CQs, including background questions (BQs) and foreground questions (FQs). Accuracy was assessed independently by three researchers using six-point Likert scales ranging from 1 (“completely incorrect”) to 6 (“completely correct”) by evaluating responses to CQs in Japanese or translated into English. For reproducibility assessment, responses to each CQ asked five times separately in a new chat were scored using six-point Likert scales, and Fleiss kappa coefficients were calculated.<br>
Results: The median (25th–75th percentile) score for ChatGPT’s responses to BQs and FQs was 4 (3–5) and 5 (5–6) for Japanese CQs and 5 (3–6) and 6 (5–6) for English CQs, respectively. Response scores were higher for FQs than those for BQs (P values ＜0.001 for Japanese and English). Similar response accuracy levels were observed between Japanese and English CQs (P value 0.139 for BQs and 0.586 for FQs). Kappa coefficients for reproducibility were 0.76 for BQs and 0.90 for FQs.<br>
Conclusions: ChatGPT showed high accuracy and reproducibility in responding to JAS Guidelines 2022 CQs, especially FQs. While ChatGPT primarily reflects existing guidelines, its strength could lie in rapidly organizing and presenting relevant information, thus supporting instant and more efficient guideline interpretation and aiding in medical decision-making.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2079-6447342024N-Phenylphenothiazine Radical Cation with Extended π-Systems: Enhanced Heat Resistance of Triarylamine Radical Cations as Near-Infrared Absorbing Dyes350359ENMasafumiYanoFaculty of Chemistry, Material and Bioengineering, Kansai UniversityMinamiUedaFaculty of Chemistry, Material and Bioengineering, Kansai UniversityTatsuoYajimaFaculty of Chemistry, Material and Bioengineering, Kansai UniversityKoichiMitsudoDivision of Applied Chemistry, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYukiyasuKashiwagiOsaka Research Institute of Industrial Science and TechnologyN-Phenylphenothiazine derivatives extended with various aryl groups were designed and synthesized. These derivatives have bent conformation in crystal and exhibit high solubility. Radical cations obtained by one-electron oxidation of these derivatives gave stable radical cations in solution and showed absorption in the near-infrared region. A radical cation was isolated as a stable salt, which exhibited heat resistance up to around 200 °C. A design strategy for radical cation-based near-infrared absorbing dyes, which are easily oxidized and stable not only as a solution but in solid form, is described.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1071-269060102024NCF-1 plays a pivotal role in the survival of adenocarcinoma cells of pancreatic and gastric origins11511159ENChiemiFuruya-IkudeDivision of Tumor Pathology, NIR-PIT Research Institute, Kansai Medical UniversityAkaneKittaDivision of Tumor Pathology, NIR-PIT Research Institute, Kansai Medical UniversityNaokoTomonobuDepartment of Cell Biology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYoshihiroKawasakiDivision of Tumor Pathology, NIR-PIT Research Institute, Kansai Medical UniversityMasakiyoSakaguchiDepartment of Cell Biology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesEisakuKondoDivision of Tumor Pathology, NIR-PIT Research Institute, Kansai Medical UniversityReactive oxygen species (ROS) play a pivotal biological role in cells, with ROS function differing depending on cellular conditions and the extracellular environment. Notably, ROS act as cytotoxic factors to eliminate infectious pathogens or promote cell death under cellular stress, while also facilitating cell growth (via ROS-sensing pathways) by modifying gene expression. Among ROS-related genes, neutrophil cytosolic factor-1 (NCF-1; p47phox) was identified as a ROS generator in neutrophils. This product is a subunit of a cytosolic NADPH oxidase complex activated in response to pathogens such as bacteria and viruses. NCF-1 has been examined primarily in terms of ROS-production pathways in macrophages and neutrophils; however, the expression of this protein and its biological role in cancer cells remain unclear. Here, we report expression of NCF-1 in pancreatic and gastric cancers, and demonstrate its biological significance in these tumor cells. Abundant expression of NCF-1 was observed in pancreatic adenocarcinoma (PDAC) lines and in patient tissues, as well as in gastric adenocarcinomas. Accumulation of the protein was also detected in the invasive/metastatic foci of these tumors. Unexpectedly, BxPC-3 underwent apoptotic cell death when transfected with a small interfering RNA (siRNA) specific to NCF-1, whereas the cells treated with a control siRNA proliferated in a time-dependent manner. A similar phenomenon was observed in HSC-58, a poorly differentiated gastric adenocarcinoma line. Consequently, the tumor cells highly expressing NCF-1 obtained coincident accumulation of ROS and reduced glutathione (GSH) with expression of glutathione peroxidase 4 (GPX4), a quencher involved in ferroptosis. Unlike the conventional role of ROS as a representative cytotoxic factor, these findings suggest that NCF-1-mediated ROS generation may be required for expansive growth of PDAC and gastric cancers.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0815-931939122024Long‐term outcomes of endoscopic resection of superficial esophageal squamous cell carcinoma in late‐elderly patients26642671ENKatsunoriMatsuedaDepartment of Gastroenterology and Hepatology, Okayama University HospitalSeijiKawanoDepartment of Gastroenterology and Hepatology, Okayama University HospitalKeisukeFukuiFaculty of Societal Safety Sciences, Kansai UniversityShoichiroHirataDepartment of Gastroenterology and Hepatology, Okayama University HospitalTakuyaSatomiDepartment of Gastroenterology and Hepatology, Okayama University HospitalShokoInooDepartment of Gastroenterology and Hepatology, Okayama University HospitalKentaHamadaDepartment of Gastroenterology and Hepatology, Okayama University HospitalYoshiyasuKonoDepartment of Gastroenterology and Hepatology, Okayama University HospitalMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University HospitalYoshiroKawaharaDepartment of Practical Gastrointestinal Endoscopy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalBackground and Aim: As the population ages, the number of elderly patients with superficial esophageal squamous cell carcinoma (ESCC) is increasing. We aimed to clarify the indications for endoscopic resection (ER) in late-elderly patients with ESCC in terms of life expectancy.<br>
Methods: Patients aged ≥75 years who underwent ER for ESCC at our institution from January 2005 to December 2018 were enrolled. Clinical data, including the Eastern Cooperative Oncology Group performance status, American Society of Anesthesiologists physical status (ASA-PS), Charlson comorbidity index, and prognostic nutritional index (PNI), were collected at the time of ER. The main outcome measure was overall survival (OS).<br>
Results: Two hundred eight consecutive patients were enrolled. The patients' median age was 78 years (range, 75–89 years). The 5-year follow-up rate was 88.5% (median follow-up period, 6.6 years). The 5-year OS rate was 79.2% (95% confidence interval [CI], 72.2–84.8), and 5-year net survival standardized for age, sex, and calendar year was 1.04 (95% CI, 0.98–1.09). In the multivariate analysis, an ASA-PS of 3 (hazard ratio, 2.45; 95% CI, 1.16–5.17) and PNI of <44.0 (hazard ratio, 2.73; 95% CI, 1.38–5.40) were independent prognostic factors. When neither of these factors was met, the 5-year OS rate was 87.8% (95% CI, 80.0–92.9), and 5-year net survival was 1.08 (95% CI, 1.02–1.14).<br>
Conclusions: ER for ESCC in late-elderly patients may improve life expectancy. ER is recommended in patients with a good ASA-PS and PNI.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-291863122024Gastric Mucosa-associated Lymphoid Tissue Lymphoma That Relapsed after 11 Years Subsequent to Achieving Complete Remission16971702ENShokoInooDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakehiroTanakaDepartment of Pathology, Okayama University HospitalYoshiroKawaharaDepartment of Practical Gastrointestinal Endoscopy, Okayama University HospitalMotoyukiOotukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesA 38-year-old Japanese man was diagnosed with extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue in the stomach (gastric MALT lymphoma). Fluorescence in situ hybridization analysis revealed the absence of t (11;18) (q21;q21) translocation but the presence of extra copies of MALT1, indicating tetrasomy 18. Helicobacter pylori eradication led to complete remission (CR). However, the gastric MALT lymphoma relapsed after 11 years old. This case underscores the need for long-term observation (>10 years) of patients with gastric MALT lymphoma. Further investigation is warranted to elucidate the correlation between trisomy/tetrasomy 18 and the recurrence propensity.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-291863102025Idiopathic Gastric Antral Ulcers13671371ENMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakehiroTanakaDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSeijiKawanoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYoshiroKawaharaDepartment of Practical Gastrointestinal Endoscopy, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesA Japanese woman presented with gastric antral ulcers accompanied by erosion and edema, demonstrating a chronic pattern of improvement and recurrence for more than six years. The patient had no relevant treatment history, and Helicobacter pylori infection was ruled out. Other potential etiologies contributing to gastric ulcers were eliminated on the basis of endoscopic biopsy and blood laboratory findings. Consequently, the patient was diagnosed with idiopathic gastric antral ulcer. This disease is often overlooked, and the chronological endoscopic images provided in this report can be used as a reference.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2692-4609412023Alcohol consumption, multiple Lugol‐voiding lesions, and field cancerizatione261ENChikatoshiKatadaDepartment of Therapeutic Oncology, Graduate School of Medicine, Kyoto UniversityTetsujiYokoyamaDepartment of Health and Promotion, National Institute of Public HealthTomonoriYanoDepartment of Gastroenterology and Endoscopy, National Cancer Center Hospital EastHaruhisaSuzukiEndoscopy Division, National Cancer Center HospitalYasuakiFurueDepartment of Gastroenterology, Kitasato University School of MedicineKeikoYamamotoDivision of Endoscopy, Hokkaido University HospitalHisashiDoyamaDepartment of Gastroenterology, Ishikawa Prefectural Central HospitalTomoyukiKoikeDivision of Gastroenterology, Tohoku University Graduate School of MedicineMasashiTamaokiDepartment of Therapeutic Oncology, Graduate School of Medicine, Kyoto UniversityNoboruKawataDivision of Endoscopy, Shizuoka Cancer CenterMotohiroHiraoDepartment of Surgery, National Hospital Organization Osaka National HospitalYoshiroKawaharaDepartment of Practical Gastrointestinal Endoscopy, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiOgataDepartment of Gastroenterology, Kanagawa Cancer CenterAtsushiKatagiriDepartment of Medicine, Division of Gastroenterology, Showa University HospitalTakenoriYamanouchiDepartment of Gastroenterology, Kumamoto Regional Medical CenterHirofumiKiyokawaDivision of Gastroenterology, Department of Internal Medicine, St. Marianna University School of MedicineHirofumiKawakuboDepartment of Surgery, Kawasaki Municipal Kawasaki HospitalMakiKonnoDepartment of Gastroenterology, Tochigi Cancer CenterAkiraYokoyamaDepartment of Therapeutic Oncology, Graduate School of Medicine, Kyoto UniversityShinyaOhashiDepartment of Therapeutic Oncology, Graduate School of Medicine, Kyoto UniversityYukiKondoDepartment of Therapeutic Oncology, Graduate School of Medicine, Kyoto UniversityYoKishimotoDepartment of Otolaryngology-Head and Neck Surgery, Kyoto University HospitalKoichiKanoDepartment of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of MedicineKanaeMureDepartment of Public Health, Wakayama Medical University School of MedicineRyuichiHayashiDepartment of Head and Neck Surgery, National Cancer Center Hospital EastHidekiIshikawaDepartment of Molecular-Targeting Prevention, Kyoto Prefectural University of MedicineAkiraYokoyamaClinical Research Unit, National Hospital Organization Kurihama Medical and Addiction CenterManabuMutoDepartment of Therapeutic Oncology, Graduate School of Medicine, Kyoto UniversityThe development of multiple squamous cell carcinomas (SCC) in the upper aerodigestive tract, which includes the oral cavity, pharynx, larynx, and esophagus, is explained by field cancerization and is associated with alcohol consumption and cigarette smoking. We reviewed the association between alcohol consumption, multiple Lugol-voiding lesions, and field cancerization, mainly based on the Japan Esophageal Cohort study. The Japan Esophageal Cohort study is a prospective cohort study that enrolled patients with esophageal SCC after endoscopic resection. Enrolled patients received surveillance by gastrointestinal endoscopy every 6 months and surveillance by an otolaryngologist every 12 months. The Japan Esophageal Cohort study showed that esophageal SCC and head and neck SCC that developed after endoscopic resection for esophageal SCC were associated with genetic polymorphisms related to alcohol metabolism. They were also associated with Lugol-voiding lesions grade in the background esophageal mucosa, the score of the health risk appraisal model for predicting the risk of esophageal SCC, macrocytosis, and score on alcohol use disorders identification test. The standardized incidence ratio of head and neck SCC in patients with esophageal SCC after endoscopic resection was extremely high compared to the general population. Drinking and smoking cessation is strongly recommended to reduce the risk of metachronous esophageal SCC after treatment of esophageal SCC. Risk factors for field cancerization provide opportunities for early diagnosis and minimally invasive treatment. Lifestyle guidance of alcohol consumption and cigarette smoking for esophageal precancerous conditions, which are endoscopically visualized as multiple Lugol-voiding lesions, may play a pivotal role in decreasing the incidence and mortality of esophageal SCC.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1758-91931612024Impact of amyloid and tau positivity on longitudinal brain atrophy in cognitively normal individuals77ENMotonobuFujishimaDepartment of Radiology, Kumagaya General HospitalYoheiKawasakiDepartment of Biostatistics, Graduate School of Medicine, Saitama Medical UniversityToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Okayama University HospitalHiroshiMatsudaDepartment of Biofunctional Imaging, Fukushima Medical UniversityBackground Individuals on the preclinical Alzheimer's continuum, particularly those with both amyloid and tau positivity (A + T +), display a rapid cognitive decline and elevated disease progression risk. However, limited studies exist on brain atrophy trajectories within this continuum over extended periods.<br>
Methods This study involved 367 ADNI participants grouped based on combinations of amyloid and tau statuses determined through cerebrospinal fluid tests. Using longitudinal MRI scans, brain atrophy was determined according to the whole brain, lateral ventricle, and hippocampal volumes and cortical thickness in AD-signature regions. Cognitive performance was evaluated with the Preclinical Alzheimer's Cognitive Composite (PACC). A generalized linear mixed-effects model was used to examine group × time interactions for these measures. In addition, progression risks to mild cognitive impairment (MCI) or dementia were compared among the groups using Cox proportional hazards models.<br>
Results A total of 367 participants (48 A + T + , 86 A + T − , 63 A − T + , and 170 A − T − ; mean age 73.8 years, mean follow-up 5.1 years, and 47.4% men) were included. For the lateral ventricle and PACC score, the A + T − and A + T + groups demonstrated statistically significantly greater volume expansion and cognitive decline over time than the A − T − group (lateral ventricle: β = 0.757 cm3/year [95% confidence interval 0.463 to 1.050], P < .001 for A + T − , and β = 0.889 cm3/year [0.523 to 1.255], P < .001 for A + T + ; PACC: β = − 0.19 /year [− 0.36 to − 0.02], P = .029 for A + T − , and β = − 0.59 /year [− 0.80 to − 0.37], P < .001 for A + T +). Notably, the A + T + group exhibited additional brain atrophy including the whole brain (β = − 2.782 cm3/year [− 4.060 to − 1.504], P < .001), hippocampus (β = − 0.057 cm3/year [− 0.085 to − 0.029], P < .001), and AD-signature regions (β = − 0.02 mm/year [− 0.03 to − 0.01], P < .001). Cox proportional hazards models suggested an increased risk of progressing to MCI or dementia in the A + T + group versus the A − T − group (adjusted hazard ratio = 3.35 [1.76 to 6.39]).<br>
Conclusions In cognitively normal individuals, A + T + compounds brain atrophy and cognitive deterioration, amplifying the likelihood of disease progression. Therapeutic interventions targeting A + T + individuals could be pivotal in curbing brain atrophy, cognitive decline, and disease progression.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama2753-670X3822024Plasma concentrations of histidine-rich glycoprotein in primary graft dysfunction after lung transplantationivae021ENToshioShiotaniDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalSeiichiroSugimotoDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalYasuakiTomiokaDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalShinTanakaDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Okayama University HospitalKenSuzawaDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalKazuhikoShienDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalKentarohMiyoshiDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalHiromasaYamamotoDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalMikioOkazakiDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalShinichiToyookaDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalOBJECTIVES: Histidine-rich glycoprotein has been reported as an anti-inflammatory glycoprotein that inhibits acute lung injury in mice with sepsis and as a prognostic biomarker in patients with sepsis. We investigated the relationship between plasma concentrations of histidine-rich glycoprotein and the risk of occurrence of primary graft dysfunction.<br>
METHODS: According to the primary graft dysfunction grade at post-transplant 72 h, patients who underwent lung transplantation were divided into three groups: non-primary graft dysfunction group (grade 0–1), moderate primary graft dysfunction group (grade 2), and severe primary graft dysfunction group (grade 3). The plasma concentrations of histidine-rich glycoprotein measured daily during the first post-transplant 7 days were compared among the three groups. Appropriate cutoff values of the concentrations were set for survival analyses after lung transplantation.<br>
RESULTS: A total of 68 patients were included. The plasma histidine-rich glycoprotein concentration at post-transplant 72 h was significantly lower in the severe primary graft dysfunction group (n = 7) than in the other two groups [non-primary graft dysfunction group (n = 43), P = 0.042; moderate primary graft dysfunction group (n = 18), P = 0.040]. Patients with plasma histidine-rich glycoprotein concentration ≥34.4 µg/ml at post-transplant 72 h had significantly better chronic lung allograft dysfunction-free survival (P = 0.012) and overall survival (P = 0.037) than those with the concentration <34.4 µg/ml.<br>
CONCLUSIONS: Plasma histidine-rich glycoprotein concentrations at post-transplant 72 h might be associated with the risk of development of primary graft dysfunction.No potential conflict of interest relevant to this article was reported.Japanese Physical Therapy AssociationActa Medica Okayama2189-84482732024Association Between Early Mobilization and Postoperative Pneumonia Following Robot-assisted Minimally Invasive Esophagectomy in Patients with Thoracic Esophageal Squamous Cell Carcinoma121127ENYasuakiNOZAWADivision of Physical Medicine and Rehabilitation, Okayama University HospitalKazuhiroHARADAGraduate School of Health Science Studies, Kibi International UniversityKazuhiroNOMADepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshimiKATAYAMADivision of Physical Medicine and Rehabilitation, Okayama University HospitalMasanoriHAMADADivision of Physical Medicine and Rehabilitation, Okayama University HospitalToshifumiOZAKIDivision of Physical Medicine and Rehabilitation, Okayama University HospitalObjective: The objective of this study was to confirm that early mobilization (EM) could reduce pneumonia in patients undergoing robot-assisted minimally invasive esophagectomy (RAMIE) for thoracic esophageal squamous cell carcinoma (TESCC). Methods: Postoperative pneumonia was defined as physician-diagnosed pneumonia using the Esophagectomy Complications Consensus Group definition of pneumonia with a Clavien–Dindo classification grade II–V on postoperative day (POD) 3–5. EM was defined as achieving an ICU Mobility Scale (IMS) ≥7 by POD 2. Patients were divided into EM (n = 36) and non-EM (n = 35) groups. Barriers to EM included pain, orthostatic intolerance (OI), and orthostatic hypotension. Results: The overall incidence of postoperative pneumonia was 12.7%, with a significant difference between the EM (2.8%) and non-EM (22.9%) groups (P = 0.014). The odds ratio was 0.098 in the EM group compared to the non-EM group. A significant difference was found between the two groups in terms of the barriers to EM at POD 2 only for OI, with a higher incidence in the non-EM group. Multivariate logistic regression analysis showed that patients with OI were more likely to be unable to achieve EM than those without OI (odds ratio, 7.030; P = 0.006). Conclusion: EM within POD 2 may reduce the incidence of postoperative pneumonia in patients undergoing RAMIE for TESCC. Furthermore, it was suggested that OI can have a negative impact on the EM after RAMIE.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1434-391614512024Medial meniscus posterior root tears with advanced osteoarthritis or subchondral insufficiency fracture are good indications for unicompartmental knee arthroplasty at a minimum 2-year follow-up64ENKokiKawadaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYusukeYokoyamaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYukiOkazakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasanoriTamuraDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakayukiFurumatsuDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesIntroduction The outcomes of unicompartmental knee arthroplasty (UKA) in the presence and absence of medial meniscus posterior root tears (MMPRTs) have not been compared. This study compared the characteristics and clinical outcomes of patients undergoing UKA with and without MMPRTs.<br>
Materials and methods This study analyzed 68 patients. The presence or absence of MMPRTs was evaluated using preoperative magnetic resonance imaging. Patient characteristics, clinical scores before surgery and at the final evaluation, and imaging findings were compared between patients with and without MMPRTs. Multiple regression analysis was conducted on postoperative visual analog scale (VAS)-pain scores.<br>
Results MMPRTs were present in 64.7% (44/68) of patients. Patients with MMPRTs were significantly younger (67.8 ± 8.2 vs. 75.0 ± 7.1 years, p < 0.001) and had a shorter duration from the development of symptoms to the time of surgery than those without (6.8 ± 8.4 vs. 36.1 ± 38.9 months, p < 0.001). Component placement or lower-limb alignment did not significantly differ between the groups. Preoperative clinical scores were not significantly different between the groups; however, patients with MMPRTs showed significantly better postoperative VAS-pain scores than those without (10.0 ± 9.0 vs. 28.2 ± 26.0 points, p = 0.026). Multiple regression analysis of postoperative VAS-pain scores revealed the significant effect of duration from the development of symptoms to the time of surgery (p = 0.038).<br>
Conclusions Patients undergoing UKA with MMPRTs were younger with less radiographic osteoarthritic changes compared to those without MMPRTs, and their postoperative VAS-pain scores were significantly superior. The duration from the development of symptoms to the time of surgery significantly influenced postoperative pain in patients undergoing UKA.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1432-10683512024Association between lower limb muscle strength and musculoskeletal ambulation disability symptom complex in patients with medial meniscus posterior root tears40ENMikaoFukubaDepartment of Physical Medicine and Rehabilitation, Okayama University HospitalKokiKawadaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYukiOkazakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYoshimiKatayamaDepartment of Physical Medicine and Rehabilitation, Okayama University HospitalMasanoriHamadaDepartment of Physical Medicine and Rehabilitation, Okayama University HospitalToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakayukiFurumatsuDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesPurpose In this study, we aimed to evaluate the changes in and the relationship between lower limb muscle strength and physical function before and after medial meniscus posterior root (MMPR) repair.<br>
Methods Thirty-three patients who underwent MMPR repair were evaluated. Pain was evaluated with the numerical rating scale (NRS), and knee flexor/extensor muscle strength was assessed using a handheld dynamometer. Physical function was evaluated using a timed up and go (TUG) test. The NRS, knee flexor/extensor muscle strength, and TUG were compared preoperatively and 1 year postoperatively using the Wilcoxon signed-rank test. The correlation of patient characteristics, NRS score, knee flexor/extensor muscle strength, and preoperative TUG with the postoperative TUG was analyzed using Spearman’s correlation coefficient.<br>
Results NRS (3.5 ± 2.1 to 0.1 ± 0.5 points), knee flexor strength (111.9 ± 50.2 to 146.7 ± 51.5 Nm), knee extensor strength (181.9 ± 92.8 to 256.9 ± 107.1 Nm), and TUG (12.3 ± 5.7 to 9.2 ± 2.2 s) all improved significantly from preoperatively to 1 year postoperatively (p < 0.001). The postoperative TUG was negatively correlated with the preoperative TUG (r = 0.578, p < 0.001), preoperative knee flexor muscle strength (r = − 0.355, p = 0.042), preoperative knee extensor muscle strength (r = − 0.437, p = 0.010), and postoperative knee extensor muscle strength (r = − 0.478, p = 0.004).<br>
Conclusion In patients undergoing MMPR repair, surgery and rehabilitation significantly improve lower limb muscle strength and physical function. There was a significant correlation between lower limb muscle strength and TUG, and further strengthening of the lower limb muscles from the preoperative level is desirable to improve patients’ physical function further.<br>
Level of evidence IV.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1432-10683512024Transtibial pullout repair improved short-term clinical outcomes in patients with oblique medial meniscus posterior root tear comparable to radial root tear30ENNaohiroHigashiharaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakayukiFurumatsuDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYukiOkazakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYusukeYokoyamaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasanoriTamuraDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKokiKawadaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTsubasaHasegawaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshikiKoharaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesPurpose Medial meniscus (MM) posterior root tears (PRT) can lead to excessive knee loading and unsatisfactory clinical outcomes after non-operative treatment or meniscectomy. Although favourable clinical outcomes after MM posterior root (PR) repair have been reported, no study has specifically investigated the outcomes of different types of MMPRT. This study aimed to compare the clinical outcomes of patients with complete radial and oblique MMPRT following MMPR repair.<br>
Methods Forty patients who had undergone MMPR repair were retrospectively investigated. Patients with type 2 (20 knees) and 4 MMPRT (20 knees) were included in this study. The MMPRT type was classified according to the LaPrade classification. Plain radiographs, magnetic resonance images, arthroscopic findings, and pre- and postoperative clinical outcomes were evaluated.<br>
Results At 1 year postoperatively, clinical outcomes notably improved in patients with type 2 and 4 MMPRT. No significant differences were observed in any of the evaluations between these patients, both before and after the surgery.<br>
Conclusion Patients with type 2 and type 4 MMPRT exhibited significantly improved clinical outcomes. MMPR repair is beneficial in treating type 2 and type 4 MMPRT.<br>
Level of evidence IVNo potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025A Case of Surgical Treatment for a Large Pulmonary Artery Aneurysm with a Quadricuspid Pulmonary Valve317320ENKeiMoriokaDepartment of Cardiovascular Surgery, Okayama University HospitalYosukeKurokoDepartment of Cardiovascular Surgery, Okayama University HospitalSachikoKadowakiDepartment of Cardiovascular Surgery, Okayama University HospitalJunkoKobayashiDepartment of Cardiovascular Surgery, Okayama University HospitalYasuhiroKotaniDepartment of Cardiovascular Surgery, Okayama University HospitalShingoKasaharaDepartment of Cardiovascular Surgery, Okayama University HospitalCase Report10.18926/AMO/69160A 65-year-old man was referred to our hospital for the annual assessment of the diameter and dilation of a pulmonary artery (PA) aneurysm. He had a small ventricular septal defect (VSD) that had closed naturally. Echocardiography revealed a dilated main PA, mild pulmonary regurgitation and no VSD. Computed tomography confirmed the dilation of the main PA (66.7×47.8 mm), right PA (37.1×32.9 mm), and left PA (36.7×34.0 mm). The patient underwent pulmonary artery replacement using a prosthetic vascular graft. A quadricuspid pulmonary valve was identified intraoperatively. Early surgical intervention could help to prevent rupture and dissection of PA aneurysms.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Effectiveness of Pallidal Stimulation for Dystonic Storm and Subsequent Ssevere Posterior Reversible Encephalopathy Syndrome in a Patient with GNAO1 Variant293297ENKojiKawaiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTatsuyaSasakiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShunTanimotoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomoyaSaijoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSusumuSasadaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomoyukiAkiyamaDepartment of Pediatric Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuyaHiraideDepartment of Biochemistry, Hamamatsu University School of MedicineHirotomoSaitsuDepartment of Biochemistry, Hamamatsu University School of MedicineShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/69156GNAO1 variant affects primarily the brain and neurodevelopment, leading to a range of motor disorders including seizures beginning in infancy and involuntary movements such as dyskinesia and dystonia. Our patient, a 15-year-old Japanese female, began exhibiting involuntary movements at age 4. A de novo missense mutation (NM_020988.3: c.228C>G, NP_066268.1: p.(Asn76Lys)) in the GNAO1 gene was identified when the patient was 15, and during the same year she developed influenza pneumonia, accompanied by dystonic storm. She required intensive care with mechanical ventilation and underwent a tracheostomy. She also developed posterior reversible encephalopathy syndrome. Globus pallidal stimulation was administered, leading to an improvement in the dystonic storm. Early consideration of globus pallidal stimulation is recommended when treating difficult-to-manage dystonic storms.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Parieto-Occipital Disconnection for Drug-Resistant Parieto-Occipital Lobe Epilepsy: A Case Report and Surgical Technique287292ENShunTanimotoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTatsuyaSasakiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKojiKawaiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomoyaSaijoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKyoheiKinDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSusumuSasadaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/69155We report a case of drug-resistant parieto-occipital lobe epilepsy successfully treated with parieto-occipital disconnection (POD). An 18-year-old left-handed female, who had undergone surgery for an acute subdural hematoma at 10 months of age, developed drug-resistant epilepsy at age 15. Despite antiepileptic drug treatment, her seizures remained uncontrolled, and at age 18 she was referred to our hospital for evaluation. Magnetic resonance imaging (MRI) revealed atrophy in the left occipital and parietal lobes. Ictal electroencephalography (EEG) confirmed occipital onset of seizures without temporal lobe involvement. She had pre-existing homonymous hemianopsia. POD surgery was performed, carefully preserving the temporal lobe structures. Postoperatively, she experienced transient right-sided paresis, which fully resolved, and achieved complete seizure control at 3 years without memory loss. This case demonstrates that POD, a rare surgical approach, is a viable option for parieto-occipital lobe epilepsy, effectively controlling seizures while minimizing functional impairment in the absence of temporal lobe involvement.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Femoral and Global Femoral Offset, but not Anteroposterior Offset, to Improve Postoperative Outcomes Following Total Hip Arthroplasty: Considerations Independent of the Contralateral Side269278ENNorioImaiDivision of Comprehensive Musculoskeletal Medicine, Niigata University Graduate School of Medical and Dental SciencesYukiHiranoDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesDaisukeHommaDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesYukiEndoDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesYojiHorigomeDivision of Comprehensive Musculoskeletal Medicine, Niigata University Graduate School of Medical and Dental SciencesHayatoSuzukiDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesHiroyukiKawashimaDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesOriginal Article10.18926/AMO/69152The global femoral offset (the sum of the acetabular and femoral offsets) influences outcomes after total hip arthroplasty (THA). The optimal offset using plain radiographs has been reported, but internal and external rotations of the hip affect the offset value, producing unclear results when the nonsurgical side is not intact. We investigated the relationship between a functional hip score, i.e., the Harris Hip Score (HHS) and its effect on the post-THA anteroposterior and lateral offsets, and we sought to identify the optimal offset value. The cases of 158 patients with hemilateral hip osteoarthritis who underwent THA at a single center were retrospectively analyzed in this cross-sectional study. Three-dimensional pelvic and femoral models generated from computed tomography were used to examine several parameters, and the results revealed a significant binomial correlation among the modified HHS and femoral and global femoral offsets, with maximum values of 21.3 mm and 40 mm/100 cm body height, respectively. Pelvic and femoral parameters were measured and evaluated via alignment with a specific coordinate system. Our findings indicate that preoperative planning using these parameters may improve postoperative hip function, even when the nonoperative side is unsuitable for use as a reference, as in bilateral hip osteoarthritis cases.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025A Study of Periprosthetic Femoral Stem Fractures in Hip Arthroplasty for Femoral Neck Fracture253259ENYoshiakiMiyakeDepartment of Orthopaedic Surgery, Japanese Red Cross Okayama HospitalToruTakagiDepartment of Orthopaedic Surgery, Japanese Red Cross Okayama HospitalTaizoKonishiikeDepartment of Orthopaedic Surgery, Japanese Red Cross Okayama HospitalOriginal Article10.18926/AMO/69150This study investigated the risk factors for bone fragility and perioperative periprosthetic femoral stem fractures in patients undergoing hip arthroplasty for femoral neck fractures. The records of 215 patients (42 male, 173 female; mean age, 84.4 years) were analyzed to assess correlations among periprosthetic fracture rates and sex, age, body mass index (BMI), Dorr classification, femoral stem fixation type (cemented/cementless), and bone mineral density (BMD) of the contralateral proximal femur. The overall prevalence of perioperative periprosthetic fractures was 4.7%. All patients with periprosthetic fractures were female, and all but one were ≥ 80 years of age. Fracture rates were higher in patients with lower BMI, although this difference was not significant. The fracture rates were 0%, 4.7%, and 7.9% for Dorr types A, B, and C, respectively, and 0% and 5.3% for patients who received cemented and cementless stems, respectively. The findings indicated that female patients, those of advanced age, those with lower BMI, and those with Dorr type C had lower BMDs. Although BMD was significantly lower in patients who received cemented stems compared to those who received cementless stems, no fractures were observed in the former group, suggesting that the use of cemented stems is safe for this high-risk population.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025The Work Productivity of Cancer-survivor and Non-cancer-survivor Workers243251ENMikaKamanoDepartment of Public Health, Faculty of Medicine, Kagawa UniversityKanaeKandaDepartment of Public Health, Faculty of Medicine, Kagawa UniversityNlandu RogerNgatuDepartment of Public Health, Faculty of Medicine, Kagawa UniversityAkitsuMurakamiCancer Center, Kagawa University HospitalYusukeYamadoriDepartment of Anesthesiology, Faculty of Medicine, Kagawa UniversityTomohiroHiraoDepartment of Public Health, Faculty of Medicine, Kagawa UniversityOriginal Article10.18926/AMO/69149We investigated the work productivity levels of employed cancer survivors and non-cancer-survivor workers by conducting a cross-sectional study in Japan between February and March 2019, using an online survey. A total of 561 employed individuals aged 20-64 years were analyzed. Work productivity was assessed using the Work Productivity and Activity Impairment-General Health questionnaire which evaluates absenteeism, presenteeism, and overall work productivity loss. The questionnaire responses demonstrated that the cancer survivors within 1 year of diagnosis had significantly higher absenteeism compared to the non-cancer workers (p=0.048). Although presenteeism and overall work productivity loss were also higher in the non-cancer-survivor group, the differences were not significant. Cancer survivors within 1 year of diagnosis exhibited higher absenteeism, but their work productivity appeared to recover to levels comparable to those of the non-cancer workers over time. These findings may contribute to workplace policies supporting cancer survivors’ return to work.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Bloodstream Infections Caused by Gram-Negative Bacteria in Geriatric Patients: Epidemiology, Antimicrobial Resistance and The Factors Affecting Mortality231242ENM Enes KardanDepartment of Infectious Diseases, Faculty of Medicine, Namik Kemal UniversityIlknurErdemDepartment of Infectious Diseases, Faculty of Medicine, Namik Kemal UniversityEmreYildizDepartment of Infectious Diseases, Faculty of Medicine, Namik Kemal UniversityNuriKirazDepartment of Medical Microbiology, Faculty of Medicine, Namik Kemal UniversityAliyeÇelikkolDepartment of Biochemistry, Faculty of Medicine, Namik Kemal UniversityOriginal Article10.18926/AMO/69148Bloodstream infections (BSIs) are an important cause of morbidity and mortality in geriatric patients. We retrospectively analyzed the cases of geriatric patients who developed BSIs due to gram-negative bacteria in order to evaluate the epidemiology, antimicrobial resistance, and the factors affecting mortality. The cases of 110 patients aged ≥ 65 years admitted to our hospital between January 1, 2017, and December 31, 2022 were assessed; 70 (63.6%) of the BSIs were healthcare-associated BSIs. The urinary system was the most common detectable source of infection at 43.6%. The most frequently isolated bacteria were Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae, in that order. Carbapenem resistance was detected in 17 patients (15.5%), and extended-spectrum beta-lactamase (ESBL) production from Enterobacterales family members was detected in 37 (51.4%) patients. Multivariate analysis revealed that (i) the probability of mortality in the patients with total bilirubin was increased by approx. sixfold and (ii) the likelihood of mortality for those with a Pitt bacteremia score (PBS) ≥ 4 points was approx. 17 times higher. PBS and simplified qPitt scores can help predict mortality and manage geriatric patients. There is a significant increase in mortality among patients with procalcitonin (PCT) levels at ≥ 2 nm/ml.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Organ Donation after Extracorporeal Cardiopulmonary Resuscitation: Clinical and Ethical Perspectives221229ENTetsuyaYumotoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiromichiNaitoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiHongoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakafumiObaraDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshinoriKosakiDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoheiAgetaDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTsuyoshiNojimaDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoheiTsukaharaDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAtsunoriNakaoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityReview10.18926/AMO/69147Extracorporeal cardiopulmonary resuscitation (ECPR) has evolved into a life-saving therapy for select cardiac arrest patients, yet a growing body of evidence suggests it also holds promise as a bridge to organ donation in non-survivors. This review explores the clinical outcomes, ethical complexities, and evolving policies surrounding organ donation after ECPR. We summarize recent international and Japanese data demonstrating favorable graft function from ECPR donors, with the exception of lung transplantation. The ethical challenges ― particularly those involving brain death determination on extracorporeal membrane oxygenation and adherence to the dead donor rule ― are discussed in the context of Japan’s recent regulatory reforms. Additionally, we highlight the importance of structured end-of-life communication through multidisciplinary team meetings in facilitating ethically sound transitions from rescue efforts to donation pathways. Moving forward, improvements in donor management, standardized legal frameworks, and public and professional education are essential to optimizing the life-saving and life-giving potential of ECPR.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2197-11531142024Quadriceps muscle strength of the affected limb in medial meniscus posterior root tears is negatively correlated with the progression of postoperative medial joint space narrowinge70057ENKokiKawadaDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityMikaoFukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityYukiOkazakiDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityMasanoriTamuraDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityYusukeYokoyamaDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityToshifumiOzakiDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTakayukiFurumatsuDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityPurpose: The effect of quadriceps muscle strength on medial joint space (MJS) narrowing after repair for medial meniscus (MM) posterior root tears (MMPRTs) has not yet been determined. This study aimed to evaluate the effect of preoperative and postoperative quadriceps muscle strength on the change in MJS (ΔMJS) in MMPRTs.<br>
Methods: Thirty patients who underwent pullout repair for MMPRTs were retrospectively evaluated. The MJS width using fixed-flexion view radiographs, MM extrusion (MME) using magnetic resonance imaging, quadriceps muscle strength using the Locomo Scan-II and clinical scores were measured and compared preoperatively and 1 year postoperatively. Correlations between the ΔMJS, change in MME (ΔMME), and preoperative and postoperative quadriceps muscle strength were evaluated using Spearman's rank correlation coefficient.<br>
Results: MJS narrowing and MME progressed significantly at 1 year postoperatively (p < 0.001). Quadriceps muscle strength in MMPRT knees and all clinical scores significantly improved at 1 year postoperatively (p < 0.001). ΔMJS and ΔMME showed a significant positive correlation (0.50 ± 0.70 and 1.22 ± 0.92 mm, respectively; r = 0.516, p = 0.004). Both preoperative and postoperative quadriceps muscle strength in MMPRT knees showed significant negative correlations with ΔMJS (preoperative: r = −0.529, p = 0.003; postoperative: r = −0.477, p = 0.008) and ΔMME (preoperative: r = −0.431, p = 0.018; postoperative: r = −0.443, p = 0.014).<br>
Conclusions: In pullout repair for MMPRTs, preoperative and postoperative quadriceps muscle strength in MMPRT knees was negatively correlated with the progression of MJS narrowing and MME. Rehabilitation with a focus on quadriceps muscle strengthening, including preoperative rehabilitation, may delay knee-osteoarthritis progression after pullout repair for MMPRTs.<br>
Level of Evidence: Level IV.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1351-51013212025Lyme neuroborreliosis in Japan: Borrelia burgdorferi sensu lato as a cause of meningitis of previously undetermined etiology in hospitalized patients outside of the island of Hokkaido, 2010–2021e70005ENMasayukiOhiraDepartment of Clinical Laboratory and Internal Medicine, National Center of Neurology and PsychiatryAiTakanoDepartment of Veterinary Medicine, Joint Faculty of Veterinary Medicine, Yamaguchi UniversityKentaroYoshiNational Research Center for the Control and Prevention of Infectious Diseases, Nagasaki UniversityAkiraAraiDepartment of Neurology, Aomori Prefectural Central HospitalYashuhiroAsoDepartment of Neurology, Oita Prefectural HospitalRikiyaFurutaniDepartment of Neurology, National Hospital Organization, Shinshu Ueda General HospitalTadanoriHamanoDepartment of Neurology, University of Fukui HospitalIkukoTakahashi‐IwataDepartment of Neurology, Hokkaido University HospitalChikakoKanekoDepartment of Neurology, Southern Tohoku General HospitalTohruMatsuuraDivision of Neurology, Jichi Medical UniversityNorihisaMaedaDepartment of Neurology, National Hospital Organization Beppu Medical CenterHidetoNakajimaDepartment of Neurology, Nihon University Itabashi HospitalKatsuroShindoDepartment of Neurology, Kurashiki Central HospitalToshihikoSuenagaDepartment of Neurology, Tenri HospitalKazumaSugieDepartment of Neurology, Nara Medical University HospitalYasuhiroSuzukiDepartment of Neurology, National Hospital Organization Asahikawa Medical CenterToruYamashitaDepartment of Neurology, Okayama University HospitalFrederick J.AnguloVaccines and Antivirals Medical Affairs, Pfizer VaccinesJuanitaEdwardsVaccines and Antivirals Medical Affairs, Pfizer VaccinesCody MatthewBenderVaccines and Antivirals Medical Affairs, Pfizer VaccinesLisa R.HarperVaccines and Antivirals Medical Affairs, Pfizer VaccinesYoshikazuNakayamaVaccines Medical Affairs, Pfizer Japan IncShuheiItoVaccines Medical Affairs, Pfizer Japan IncAndreasPilzVaccines and Antivirals Medical Affairs, Pfizer VaccinesJames H.StarkVaccines and Antivirals Medical Affairs, Pfizer VaccinesJennifer C.MoïsiVaccines and Antivirals Medical Affairs, Pfizer VaccinesHidehiroMizusawaDepartment of Neurology, National Center of Neurology and PsychiatryMasakiTakaoDepartment of Clinical Laboratory and Internal Medicine, National Center of Neurology and PsychiatryBackground and Purpose: Clinical manifestations of Lyme borreliosis (LB), caused by Borrelia burgdorferi sensu lato (Bbsl), include erythema migrans, Lyme neuroborreliosis (LNB), carditis, and arthritis. LB is a notifiable disease in Japan with <30 surveillance-reported LB cases annually, predominately from Hokkaido Prefecture. However, LB, including LNB, may be under-diagnosed in Japan since diagnostic tests are not readily available. We sought to determine if LNB could be a cause of previously undiagnosed encephalitis or meningitis in Japan.<br>
Methods: Investigators at 15 hospitals in 10 prefectures throughout Japan retrieved serum and/or cerebrospinal fluid (CSF) samples collected in 2010–2021 from 517 patients hospitalized with encephalitis or meningitis which had an etiology that had not been determined. Samples were tested for Bbsl-specific antibodies using ELISA and Western blot tests. In alignment with the European Union LNB case definition, a confirmed LNB case had CSF pleocytosis and intrathecal production of Bbsl-specific antibodies and a probable LNB case had a CSF sample with pleocytosis and Bbsl-specific antibodies.<br>
Results: LNB was identified in three hospitalized patients with meningitis of previously undetermined etiology: a male resident of Aomori Prefecture was a confirmed LNB case, and two female residents of Oita Prefecture were probable LNB cases. None of the patients with confirmed or probable LNB had traveled in the month prior to symptom onset and none had samples previously tested for LB.<br>
Conclusion: The identification of previously undiagnosed LNB cases indicates a need for enhanced disease awareness in Japan, particularly beyond Hokkaido Island, and more readily available LB diagnostic testing.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0387-76044712025Hypotheses of pathophysiological mechanisms in epileptic encephalopathies: A review104318ENKatsuhiroKobayashiDepartment of Pediatrics, Asahigawaso Rehabilitation and Medical CenterTakashiShibataDepartment of Pediatric Neurology, Okayama University Hospital and Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHirokiTsuchiyaDepartment of Pediatric Neurology, Okayama University Hospital and Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMariAkiyamaDepartment of Pediatric Neurology, Okayama University Hospital and Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomoyukiAkiyamaDepartment of Pediatric Neurology, Okayama University Hospital and Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityIntroduction: Epileptic encephalopathy (EE) is a serious clinical issue that manifests as part of developmental and epileptic encephalopathy (DEE), particularly in childhood epilepsy. In EE, neurocognitive functions and behavior are impaired by intense epileptiform electroencephalogram (EEG) activity. Hypotheses of pathophysiological mechanisms behind EE are reviewed to contribute to an effective solution for EE.<br>
Review: Current hypotheses are as follows: 1) neuronal dysfunction based on genetic abnormalities that may affect neurocognitive functions and epilepsy separately; 2) impairment of synaptic homeostasis during sleep that may be responsible for DEE/EE with spike-and-wave activation in sleep; 3) abnormal subcortical regulation of the cerebral cortex; 4) abnormal cortical metabolism and hemodynamics with impairment of the neural network including default mode network; 5) neurotransmitter imbalance and disordered neural excitability; 6) the effects of neuroinflammation that may be caused by epileptic seizures and in turn aggravate epileptogenesis; 7) the interaction between physiological and pathological high-frequency EEG activity; etc. The causal relationship between epileptiform EEG activity and neurocognitive dysfunctions is small in DEE based on genetic abnormalities and it is largely unestablished in the other hypothetical mechanisms.<br>
Conclusion: We have not yet found answers to the question of whether the single-central or multiple derangements are present and what seizures and intense epileptiform EEG abnormalities mean in EE. We need to continue our best efforts in both aspects to elucidate the pathophysiological mechanisms of DEE/EE and further develop epilepsy treatment and precision medicine.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0340-535427212024Genetic and functional analyses of SPTLC1 in juvenile amyotrophic lateral sclerosis36ENSoOkuboDepartment of Neurology, Graduate School of Medicine, The University of TokyoHiroyaNaruseDepartment of Neurology, Graduate School of Medicine, The University of TokyoHiroyukiIshiuraDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsushiSudoDepartment of Neurology, Graduate School of Medicine, The University of TokyoKayokoEsakiDepartment of Biotechnology and Life Sciences, Faculty of Biotechnology and Life Sciences, Sojo UniversityJunMitsuiDepartment of Neurology, Graduate School of Medicine, The University of TokyoTakashiMatsukawaDepartment of Neurology, Graduate School of Medicine, The University of TokyoWataruSatakeDepartment of Neurology, Graduate School of Medicine, The University of TokyoPeterGreimelLaboratory for Cell Function Dynamics, RIKEN Centre for Brain SciencesNanokaShingaiDivision of Applied Life Science, Graduate School of Engineering, Sojo UniversityYasushiOyaDepartment of Neurology, National Center of Neurology and PsychiatryTakeoYoshikawaLaboratory of Molecular Psychiatry, RIKEN Center for Brain ScienceShojiTsujiDepartment of Neurology, Graduate School of Medicine, The University of TokyoTatsushiTodaDepartment of Neurology, Graduate School of Medicine, The University of TokyoIntroduction Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder of the motor system. Pathogenic variants in SPTLC1, encoding a subunit of serine palmitoyltransferase, cause hereditary sensory and autonomic neuropathy type 1 (HSAN1), and have recently been associated with juvenile ALS. SPTLC1 variants associated with ALS cause elevated levels of sphinganines and ceramides. Reports on ALS associated with SPTLC1 remain limited. This study aimed to investigate the frequency of SPTLC1 variants in ALS and relevant clinical characteristics.<br>
Methods We analyzed whole-exome and whole-genome sequence data from 40 probands with familial ALS and 413 patients with sporadic ALS without previously identified causative variants. Reverse transcription polymerase chain reaction (RT-PCR) analysis and droplet digital PCR (ddPCR) were used to assess splicing and mosaicism, respectively. Plasma sphingolipid levels were quantified to analyze biochemical consequences.<br>
Results The heterozygous c.58G>A, p.Ala20Thr variant was identified in a 21-year-old Japanese female patient presenting with symmetric weakness which slowly progressed over 15 years. RT-PCR analysis showed no splice defects. Plasma sphingolipid levels in the patient were significantly increased compared to her asymptomatic parents. ddPCR revealed that the asymptomatic father harbored a mosaic variant with 17% relative mutant allele abundance in peripheral blood leukocytes.<br>
Conclusions We identified a pathogenic c.58G>A, p.Ala20Thr SPTLC1 variant in a patient with juvenile ALS, likely inherited from an asymptomatic parent with mosaicism. Lipid analysis results are consistent with previous findings on SPTLC1-associated ALS. Further studies are necessary to determine the clinical effect of mosaic variants of SPTLC1.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1435-245140912024Subjective global assessment for nutritional screening and its impact on surgical outcomes: A prospective study in older patients with colorectal cancer356ENFuminoriTeraishiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusukeYoshidaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoheiShojiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuhikoKanayaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiMatsumiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKunitoshiShigeyasuDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshitakaKondoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShunsukeKagawaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRieTamuraPerioperative Management Center, Okayama University HospitalYoshikazuMatsuokaPerioperative Management Center, Okayama University HospitalHiroshiMorimatsuPerioperative Management Center, Okayama University HospitalToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Okayama University HospitalToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesPurpose Our perioperative management center provides preoperative intervention and functional and nutritional assessments for colorectal cancer patients aged over 75 years. This study evaluated the associations of preoperative nutritional status with postoperative outcomes and prognosis in colorectal cancer patients aged 75 years or older.<br>
Methods This was a prospective, observational study of 71 colorectal cancer patients aged 75 years or older who underwent surgery between July 2020 and September 2022. The Subjective Global Assessment (SGA) was evaluated as a nutritional index. The patients were classified into three groups: SGA-A (well nourished), B (moderately malnourished), and C (severely malnourished), and the correlations with postoperative outcomes and prognosis were examined.<br>
Results The median age of the 71 patients (34 males, 37 females) was 78 (75–92) years, and their median body mass index (BMI) was 22.3 (13.4–31.9) kg/m2. Forty-eight patients had colon cancer, and 23 had rectal cancer. On the SGA, 28 patients were SGA-A, 25 SGA-B, and 18 SGA-C. The SGA-B/C group had significantly higher BMI (p < 0.01) and more ICU admissions (p = 0.02). The G8 score was significantly lower (p = 0.03) in the SGA-B/C group, suggesting coexisting functional decline. In terms of postoperative outcomes, the SGA-B/C group had a significantly longer postoperative hospital stay (p = 0.04). The 3-year OS rates for all stages were 100% in the SGA-A group and 49.7% in the SGA-B/C group (p = 0.03), while the 3-year OS rates for patients excluding Stage IV were 100% in the SGA-A group and 68.5% in the SGA-B/C group, not significantly different (p = 0.14). The 3-year RFS rate was 95.5% in the SGA-A group and 65.3% in the SGA-B/C group (p = 0.15).<br>
Conclusion The SGA is a promising nutritional index associated with short-term outcomes in older patients undergoing colorectal cancer surgery. The SGA can be assessed in a few minutes during an outpatient visit, making it useful for routine clinical use.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2475-0328862024High risk of multiple gastric cancers in Japanese individuals with Lynch syndrome10081016ENNobuhikoKanayaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesThijs A.van SchaikDepartment of Neurosurgery, Brigham and Women's Hospital, Harvard Medical SchoolHidekiAokiDepartment of Surgery, National Hospital Organization Iwakuni Clinical CenterYumikoSatoDepartment of Pathology, National Hospital Organization Iwakuni Clinical CenterFumitakaTaniguchiDepartment of Surgery, National Hospital Organization Iwakuni Clinical CenterKunitoshiShigeyasuDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKokichiSuganoDepartment of Genetic Medicine, Kyoundo Hospital, SSasaki FoundationKiwamuAkagiDivision of Molecular Diagnosis and Cancer Prevention, Saitama Cancer CenterHideyukiIshidaDepartment of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical UniversityKohjiTanakayaDepartment of Surgery, National Hospital Organization Iwakuni Clinical CenterAim: Lynch syndrome (LS) is a dominantly inherited syndrome characterized by an increased risk for LS associated tumors such as colorectal cancer (CRC) and gastric cancer (GC). However, the clinical benefit of surveillance for GC remains unclear while it has already been recommended for CRC. This study aimed to elucidate the clinical features of GC in Japanese individuals with LS, and the risk of developing multiple GCs to build regional-tailored surveillance programs in LS patients with GC.<br>
Methods: Data on Japanese individuals with LS were retrospectively collected from a single institution. The clinical features of GC, including the cumulative risk of multiple GCs, were analyzed.<br>
Results: Among 96 individuals with LS (MLH1/MSH2/MSH6, 75:20:1), 32 GC lesions were detected in 15 individuals with LS (male/female, 11:4). The median age at initial GC diagnosis was 52.7 y (range: 28–71). Histological examination revealed a predominance of intestinal type (19/24: 87.5%). Moreover, the majority of the GC lesions (82%) were determined to have high-frequency of microsatellite instability. The cumulative risk of individuals with LS developing GC at 70 y was 31.3% (MLH1 36.1%, MSH2 18.0%). Notably, the cumulative risk of individuals with LS developing metachronous and/or synchronous GCs at 0, 10 and 20 y after initial diagnosis of GC was 26.7%, 40.7%, and 59.4%, respectively.<br>
Conclusion: Due to a higher risk of developing multiple GCs, intensive surveillance might be especially recommended for Japanese individuals with LS associated initial GC.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0090-82581922025Effectiveness of exercise therapy on chemotherapy-induced peripheral neuropathy in patients with ovarian cancer: A scoping review155162ENMasanoriKonumaDepartment of Rehabilitation Medicine, Okayama University HospitalTomohiroIkedaDepartment of Rehabilitation Medicine, Okayama University HospitalTomohiroMitomaDepartment of Obstetrics and Gynecology, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama UniversityShinsukeShirakawaDepartment of Obstetrics and Gynecology, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama UniversityJotaMakiDepartment of Obstetrics and Gynecology, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshimiKatayamaDepartment of Rehabilitation Medicine, Okayama University HospitalMasanoriHamadaDepartment of Rehabilitation Medicine, Okayama University HospitalShojiNagaoDepartment of Obstetrics and Gynecology, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama UniversityToshifumiOzakiDepartment of Rehabilitation Medicine, Okayama University HospitalBackground & aims. Exercise therapy is a potentially beneficial treatment option for chemotherapy-induced peripheral neuropathy (CIPN). However, there is a lack of consensus on the management of CIPN in patients with ovarian cancer. The purpose of this scoping review was to evaluate the evidence on the effectiveness of exercise therapy in patients with ovarian cancer and explore key physical fitness parameters.<br>
Methods. A systematic electronic search was conducted using the MEDLINE, CINAHL, Web of Science, PEDro, and ClinicalTrials.gov databases. Two independent reviewers summarized the features and data from the literature regarding the effectiveness of exercise therapy for CIPN and the association between CIPN and physical fitness parameters.<br>
Results. Ten articles involving 3402 participants were reviewed. The study design included one randomized controlled trial, one single-arm trial, one prospective cohort study, five retrospective cohort studies, and two cross-sectional studies. The mean patient age was >60 years in three studies and 50–60 years in six studies. The mean body mass index was >25.0 kg/m2 in six studies and not stated in four studies. In six references, patients received platinum and taxane-based chemotherapy. The effectiveness of an exercise therapy program for CIPN was reported in a randomized controlled trial. Two cross-sectional studies highlighted the association between daily physical inactivity and CIPN; two retrospective cohort studies showed an association between low skeletal muscle density and CIPN; one article demonstrated an association between physical dysfunction and CIPN.<br>
Conclusion. This scoping review indicates that although evidence is lacking, exercise intervention programs for CIPN in patients with ovarian cancer have potential benefits, especially when focused on daily physical activity, skeletal muscle density, and physical function.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2049-41731252024The Japan MSA registry: A multicenter cohort study of multiple system atrophy271277ENAyakaChikadaDepartment of Neurology, Graduate School of Medicine, The University of TokyoKentaOrimoDepartment of Neurology, Graduate School of Medicine, The University of TokyoJunMitsuiDepartment of Neurology, Graduate School of Medicine, The University of TokyoTakashiMatsukawaDepartment of Neurology, Graduate School of Medicine, The University of TokyoHiroyukiIshiuraDepartment of Neurology, Okayama University Graduate School of Medicine and DentistryTatsushiTodaDepartment of Neurology, Graduate School of Medicine, The University of TokyoHidehiroMizusawaDepartment of Neurology, Graduate School of Medicine, The University of TokyoYujiTakahashiDepartment of Neurology, Graduate School of Medicine, The University of TokyoMasahisaKatsunoDepartment of Neurology, Nagoya University Graduate School of MedicineKazuhiroHaraDepartment of Neurology, Nagoya University Graduate School of MedicineOsamuOnoderaDepartment of Neurology, Brain Research Institute, Niigata UniversityTomohikoIshiharaDepartment of Neurology, Brain Research Institute, Niigata UniversityMasayoshiTadaDepartment of Neurology, Brain Research Institute, Niigata UniversitySatoshiKuwabaraDepartment of Neurology, Graduate School of Medicine, Chiba UniversityAtsuhikoSugiyamaDepartment of Neurology, Graduate School of Medicine, Chiba UniversityYoshitakaYamanakaDepartment of Neurology, Graduate School of Medicine, Chiba UniversityRyosukeTakahashiDepartment of Neurology, Kyoto University Graduate School of MedicineNobukatsuSawamotoDepartment of Human Health Sciences, Kyoto University Graduate School of MedicineYusukeSakatoDepartment of Neurology, Kyoto University Graduate School of MedicineTomoyukiIshimotoDepartment of Neurology, Kyoto University Graduate School of MedicineRitsukoHanajimaDivision of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori UniversityYasuhiroWatanabeDivision of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori UniversityHiroshiTakigawaDivision of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori UniversityTadashiAdachiDivision of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori UniversityKojiAbeDepartment of Neurology, Okayama University Graduate School of Medicine and DentistryToruYamashitaDepartment of Neurology, Okayama University Graduate School of Medicine and DentistryHiroshiTakashimaDepartment of Neurology and Geriatrics, Graduate School of Medical and Dental Sciences, Kagoshima UniversityKeikoHigashiDepartment of Neurology and Geriatrics, Graduate School of Medical and Dental Sciences, Kagoshima UniversityJunichiKiraDepartment of Neurology, Graduate School of Medical Sciences, Kyushu UniversityIchiroYabeDepartment of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityMasaakiMatsushimaDepartment of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityKatsuhisaOgataDepartment of Neurology, Higashi-Saitama National HospitalKinyaIshikawaDepartment of Neurology and Neurological Science, Tokyo Medical and Dental UniversityYoichiroNishidaDepartment of Neurology and Neurological Science, Tokyo Medical and Dental UniversityTaroIshiguroDepartment of Neurology and Neurological Science, Tokyo Medical and Dental UniversityKokoroOzakiDepartment of Neurology and Neurological Science, Tokyo Medical and Dental UniversityTetsuyaNagataDepartment of Neurology and Neurological Science, Tokyo Medical and Dental UniversityShojiTsujiDepartment of Neurology, Graduate School of Medicine, The University of TokyoBackground: Multiple system atrophy (MSA) is a neurodegenerative disorder characterized by autonomic failure and various motor symptoms. While MSA-C (cerebellar type) predominates in East Asia, MSA-P (parkinsonian type) predominates in Europe and North America. This nationwide patient registry aimed to (1) conduct a prospective natural history study of MSA in Japan, (2) facilitate patient recruitment for clinical trials, and (3) deposit bioresources and clinical information in a biobank.<br>
Methods: Thirteen institutions participated in this study. Clinical information was obtained by neurologists from the patients visiting the hospital every 12 months to assess the UMSARS Part 2 scores and by telephone interviews by nurses every 6 months to assess UMSARS Part 1 scores and to determine whether clinical events had occurred.<br>
Results: Demographic data from 329 MSA patients (216 MSA-C and 113 MSA-P) were analyzed. The mean age at symptom onset was 58.2 years (standard deviation, 8.9); the mean duration of symptoms at enrollment was 3.5 years (standard deviation, 2.2). The mean 12-month changes in the UMSARS Part 1 and Part 2 scores were 7.9 (standard deviation, 5.6) and 6.4 (standard deviation, 5.9), respectively. The patient registry proved useful in recruiting participants for clinical trials, including those with gene variants. Clinical information and biospecimens were deposited in a biobank.<br>
Discussion: The study highlighted the importance of telephone interviews in minimizing drop-out rates in natural history studies and demonstrated similar MSA progression rates across populations. The deposited bioresources are available to researchers upon request, aiming to contribute to future MSA researches.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2049-41731322024A novel de novo disease-causing variant in ATL1 in a pediatric patient with spastic paraplegia159161ENAyumiNakamuraDepartment of Neurology, Graduate School of Medicine, The University of TokyoHiroyaNaruseDepartment of Neurology, Graduate School of Medicine, The University of TokyoAkihikoMitsutakeDepartment of Neurology, Graduate School of Medicine, The University of TokyoJunMitsuiDepartment of Neurology, Graduate School of Medicine, The University of TokyoShinichiMorishitaDepartment of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of TokyoMieIwakoshiDepartment of Nursing, Faculty of Health Sciences, Kobe Tokiwa UniversityHiroyukiIshiuraDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShojiTsujiInstitute of Medical Genomics, International University of Health and WelfareTatsushiTodaDepartment of Neurology, Graduate School of Medicine, The University of TokyoNo potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1434-516169122024Association study of GBA1 variants with MSA based on comprehensive sequence analysis -Pitfalls in short-read sequence analysis depending on the human reference genome-613621ENKentaOrimoDepartment of Neurology, Graduate School of Medicine, The University of TokyoJunMitsuiDepartment of Precision Medicine Neurology, Graduate School of Medicine, The University of TokyoTakashiMatsukawaDepartment of Neurology, Graduate School of Medicine, The University of TokyoMasakiTanakaInstitute of Medical Genomics, International University of Health and WelfareJunkoNomotoInstitute of Medical Genomics, International University of Health and WelfareHiroyukiIshiuraDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYosukeOmaeGenome Medical Science Project, National Center for Global Health and MedicineYosukeKawaiGenome Medical Science Project, National Center for Global Health and MedicineKatsushiTokunagaGenome Medical Science Project, National Center for Global Health and MedicineNCBN Controls WGS ConsortiumTatsushiTodaDepartment of Neurology, Graduate School of Medicine, The University of TokyoShojiTsujiDepartment of Neurology, Graduate School of Medicine, The University of TokyoMultiple system atrophy (MSA) is a neurodegenerative disorder characterized by various combinations of autonomic failure, parkinsonism, and cerebellar ataxia. To elucidate variants associated with MSA, we have been conducting short-read-based whole-genome sequence analysis. In the process of the association studies, we initially focused on GBA1, a previously proposed susceptibility gene for MSA, to evaluate whether GBA1 variants can be efficiently identified despite its extraordinarily high homology with its pseudogene, GBA1LP. To accomplish this, we conducted a short-read whole-genome sequence analysis with alignment to GRCh38 as well as Sanger sequence analysis and compared the results. We identified five variants with inconsistencies between the two pipelines, of which three variants (p.L483P, p.A495P–p.V499V, p.L483_M489delinsW) were the results of misalignment due to minor alleles in GBA1P1 registered in GRCh38. The miscalling events in these variants were resolved by alignment to GRCh37 as the reference genome, where the major alleles are registered. In addition, a structural variant was not properly identified either by short-read or by Sanger sequence analyses. Having accomplished correct variant calling, we identified three variants pathogenic for Gaucher disease (p.S310G, p.L483P, and p.L483_M489delinsW). Of these variants, the allele frequency of p.L483P (0.003) in the MSA cases was higher than that (0.0011) in controls. The meta-analysis incorporating a previous report demonstrated a significant association of p.L483P with MSA with an odds ratio of 2.85 (95% CI; 1.05 – 7.76, p = 0.0400).No potential conflict of interest relevant to this article was reported.XMLinkActa Medica Okayama2005-78061642024A novel brief questionnaire using a face rating scale to assess dental anxiety and fear244254ENTakuyaMinoDepartment of Oral Rehabilitation and Regenerative Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical SciencesAyaKimura-OnoDepartment of Oral Rehabilitation and Regenerative Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical SciencesHikaruArakawaDepartment of Oral Rehabilitation and Regenerative Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical SciencesKanaTokumotoDepartment of Oral Rehabilitation and Regenerative Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical SciencesYokoKurosakiDepartment of Oral Rehabilitation and Regenerative Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical SciencesYoshizoMatsukaDepartment of Stomatognathic Function and Occlusal Reconstruction, Graduate School of Biomedical Sciences, Tokushima UniversityKenjiMaekawaDepartment of Removable Prosthodontics and Occlusion, Osaka Dental UniversityTakuoKubokiDepartment of Oral Rehabilitation and Regenerative Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical SciencesPURPOSE This study aimed to evaluate the reliability and validity of a four-item questionnaire using a face rating scale to measure dental trait anxiety (DTA), dental trait fear (DTF), dental state anxiety (DSA), and dental state fear (DSF).<br>
MATERIALS AND METHODS Participants were consecutively selected from patients undergoing scaling (S-group; n = 47) and implant placement (I-group; n = 25). The S-group completed the questionnaire both before initial and second scaling, whereas the I-group responded on the pre-surgery day (Pre-day), the day of implant placement (Imp-day), and the day of suture removal (Post-day).<br>
RESULTS The reliability in the S-group was evaluated using the test-retest method, showing a weighted kappa value of DTA, 0.61; DTF, 0.46; DSA, 0.67; DSF, 0.52. Criterion-related validity, assessed using the State-Trait Anxiety Inventory’s trait anxiety and state anxiety, revealed positive correlations between trait anxiety and DTA/DTF (DTA, ρ = 0.30; DTF, ρ = 0.27, ρ: correlation coefficient) and between state anxiety and all four items (DTA, ρ = 0.41; DTF, ρ = 0.32; DSA, ρ = 0.25; DSF, ρ = 0.25). Known-group validity was assessed using the initial data and Imp-day data from the S-group and I-group, respectively, revealing significantly higher DSA and DSF scores in the I-group than in the S-group. Responsiveness was gauged using I-group data, showing significantly lower DSA and DSF scores on post-day compared to other days.<br>
CONCLUSION The newly developed questionnaire has acceptable reliability and validity for clinical use, suggesting its usefulness for research on dental anxiety and fear and for providing patient-specific dental care.No potential conflict of interest relevant to this article was reported.Japanese Circulation SocietyActa Medica Okayama1346-98438892024Morphological Features of Patent Foramen Ovale Compared Between Older and Young Patients With Cryptogenic Ischemic Stroke13981405ENMitsutakaNakashimaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoichiTakayaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRieNakayamaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasahiroTsujiDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTeijiAkagiDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakashiMikiDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazufumiNakamuraDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinsukeYuasaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground: The morphology of a patent foramen ovale (PFO) with a high-risk for cryptogenic ischemic stroke (CS) is an important factor in the selection of patients for transcatheter closure, but the morphological features of PFO in older patients with a history of CS are less known because the most data are obtained from younger patients.<br>
Methods and Results: The study included 169 patients who had a history of CS and PFO. The prevalence of high-risk morphologies of PFO assessed by transesophageal echocardiography was compared between patients aged ≥60 years and patients aged <60 years. We also assessed the presence of septal malalignment of PFO on the aortic wall. The probability of CS due to PFO was evaluated using the PFO-Associated Stroke Causal Likelihood classification system. Patients aged ≥60 years had a significantly higher prevalence of atrial septal aneurysm than patients aged <60 years. The prevalence of large right-to-left shunt, long-tunnel of PFO, or Eustachian valve or Chiari’s network was similar between patients aged ≥60 years and <60 years. Septal malalignment was observed more frequently in patients aged ≥60 years than in those <60 years old. Nearly 90% of patients aged ≥60 years were classified as ‘possible’ in the PFO-Associated Stroke Causal Likelihood classification system.<br>
Conclusions: High-risk morphologies of PFO are common in older patients with a history of CS, as well as in younger patients.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1346-45235132024Severe traumatic tricuspid regurgitation detected 8 years after chest trauma525526ENTakahiroNishiharaDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineYoichiTakayaDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineNorihisaTohDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineShinsukeYuasaDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineNo potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1071-269060102024Enhanced design of pCMViR-TSC plasmid vector for sustainably high cargo gene expression in mammalian cells12151227ENMasakiyoSakaguchiDepartment of Cell Biology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineRieKinoshitaDepartment of Cell Biology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineNahokoTomonobuDepartment of Cell Biology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineYoshihikoSakaguchiDepartment of Microbiology, Tokushima Bunri UniversityJunichiroFutamiDepartment of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityAkiraYamauchiDepartment of Biochemistry, Kawasaki Medical SchoolHitoshiMurataDepartment of Cell Biology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKen-ichiYamamotoDepartment of Cell Biology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTettaTakahashiDepartment of Cell Biology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineYumaGoharaDepartment of Cell Biology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineToshikiOchiDepartment of Cell Biology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineFanJiangDepartment of Cell Biology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineNi Luh Gede YoniKomalasariFaculty of Medicine, Udayana UniversityYouyiChenDepartment of Breast Surgery, The First Affiliated Hospital, Zhejiang University School of MedicineI Made WinarsaRumaFaculty of Medicine, Udayana UniversityI WayanSumardikaFaculty of Medicine, Udayana UniversityJinZhouMedical Oncology Department of Gastrointestinal Tumors, Liaoning Cancer Hospital & Institute, Cancer Hospital of the Dalian University of TechnologyTomokoHonjoDepartment of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityFutoshiKuribayashiDepartment of Biochemistry, Kawasaki Medical SchoolKazumiSagayamaOrganization for Research and Innovation Strategy, Okayama UniversityShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineEisakuKondoDivision of Tumor Pathology, Near InfraRed Photo-Immuno-Therapy Research Institute, Kansai Medical UniversityYusukeInoueFaculty of Science and Technology, Division of Molecular Science, Gunma UniversityThe first-generation pCMViR-TSC, implemented through the promoter sandwich rule, yields 10- to 100-fold higher gene expression than the standard plasmid used with the CMV (cytomegalovirus) or CAG promoter. However, the vector’s shortcomings limit its utility to transient expression only, as it is not suitable for establishing stable transformants in mammalian cells. To overcome this weakness, we here introduce the improved plasmid vector pSAKA-4B, derived from pCMViR-TSC as a second-generation chromosome-insertable vector. This vector facilitates the linear entry of the expression unit into the TTAA site of DNA universally with transposase assistance. The vector is helpful for the indefinite expression of our target gene. The new vector system is proven here to be efficient in establishing stable transformants with a high likelihood of positive clones that exhibit significantly elevated expression levels of the delivered foreign gene. This system, alongside the first-generation vector, is therefore instrumental for diverse basic research endeavors concerning genes, proteins, cells, and animals, and potentially for clinical applications such as gene therapy.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2452-3216682025Method for predicting crack size using amplitude change in titanium alloy under bending vibration13191323ENJunjiSakamotoOkayama University, Faculty of Environmental, Life, Natural Science and TechnologyNaoyaTadaOkayama University, Faculty of Environmental, Life, Natural Science and TechnologyTakeshiUemoriOkayama University, Faculty of Environmental, Life, Natural Science and TechnologyThe natural frequency of a material decreases owing to the presence of cracks. Thus, when a crack initiates in a material under vibration, the amplitude of the vibration changes with the crack propagation. In this study, we investigated a method for predicting crack size using the amplitude change in a plate specimen of a titanium alloy under bending vibration. The bending displacement amplitudes were measured using high-speed camera images of the specimens. The crack sizes were measured using optical microscopy images of plastic replicas of the specimen surfaces that were obtained after interrupting tests at specified intervals. By using the relationship between the total area of the cracks and bending displacement amplitude for tests at two different vibration frequencies as well as the relationship between the vibration frequency and bending displacement amplitude for an undamaged specimen, the bending displacement amplitude at any vibration frequency can be monitored to predict the total area of the cracks.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2198-40341012024Implant-supported fixed prostheses with cantilever: a systematic review and meta-analysis57ENYusukeKondoClinical Guideline Task-Force Members (2018-), Japanese Society of Oral Implantology (JSOI)KiyoshiSakaiClinical Guideline Task-Force Members (2018-), Japanese Society of Oral Implantology (JSOI)HajimeMinakuchiDepartment of Oral Rehabilitation and Implantology, Okayama University HospitalTakuyaHorimaiThe Library, School of Dentistry, Nihon UniversityTakuoKubokiDepartment of Oral Rehabilitation and Regenerative Medicine, Okayama University Faculty of Medicine Dentistry and Pharmaceutical SciencesJSOI Clinical Guideline Working Group collaboratorsPurpose This systematic review (SR) aimed to investigate whether the presence of a cantilever affects the results of implant treatment for partial edentulism, including an analysis of the anterior and posterior regions of the dental arches.<br>
Methods An electronic search was performed, and original articles published between 1995 and November 2023 were included. The outcomes were the implant survival rate, patient satisfaction, occurrence of mechanical complications, and marginal bone loss around the implants. Two SR members independently examined the validity of the studies, extracted evidence from the included studies, and performed risk of bias assessment, comprehensive evidence evaluation, and meta-analysis.<br>
Results Nine studies met our inclusion criteria. Implant survival rate tended to be lower in the cantilever group, and marginal bone loss tended to be higher in the cantilever group; however, there was no significant difference. There was no significant difference in patient satisfaction based on the presence or absence of a cantilever. Moreover, the incidence of mechanical complications was significantly higher in the cantilever group. According to the analysis of anterior and posterior regions, implant survival rate tended to be lower in the cantilever group of the posterior region, and marginal bone loss around the implants tended to be higher in the cantilever group of the anterior region.<br>
Conclusion Implant-supported fixed prostheses with cantilevers did not negatively affect implant survival rate, marginal bone loss, or patient satisfaction. However, the incidence of mechanical complications significantly increased in the cantilever group.No potential conflict of interest relevant to this article was reported.SAGE PublicationsActa Medica Okayama2473-0114932024A Characteristic Magnetic Resonance Imaging Finding to Identify Morton Neuroma: The Slug SignENMasahiroHoritaDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityKentaSaigaDepartment of Sports Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTomohiroFujiwaraDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityEijiNakataDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityToshifumiOzakiDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityBackground: Morton neuroma is a common cause of forefoot pain and sensory disturbances, but it is difficult to identify on magnetic resonance imaging (MRI). The aim of this study was to verify the usefulness of a characteristic MRI finding (slug sign) for identifying Morton neuroma and to clarify the relationship between excised neuroma characteristics and preoperative MRI findings.<br>
Methods: Twenty-two web spaces were retrospectively assessed from the second and third intermetatarsal spaces of 11 feet of 10 patients (7 women and 3 men, aged average 59.5 years) who underwent surgical excision of Morton neuroma between 2017 and 2022. Asymptomatic web spaces were used as control. Neuromas with 2 branches of the plantar digital nerves on axial T1-weighted MRI (MRI-T1WI) were considered the slug sign. We investigated the preoperative presence of the slug sign in Morton neuroma and asymptomatic control web spaces. We also investigated the relationship between the maximum transverse diameter of the excised specimen and that estimated on coronal MRI-T1WI.<br>
Results: A total of 15 Morton neuromas were excised and assessed. The slug signs were present in 10 intermetatarsal spaces in 15 web spaces with Morton neuroma whereas the sign was found in 1 intermetatarsal space in 7 asymptomatic web spaces. The sensitivity and specificity for the slug sign to diagnose Morton neuroma was 66.7% and 85.7%, respectively. The positive and negative predictive values were 90.9% and 54.5%, respectively. The mean maximum transverse diameter of excised neuromas was 4.7 mm. The mean maximum transverse diameter of neuromas on coronal MRI-T1WI was 3.4 mm. A significant positive correlation was found between the maximum transverse diameters of excised specimens and diameters estimated on coronal MRI-T1WI (r = 0.799, P < .001).<br>
Conclusion: The slug sign may be a useful indicator of Morton neuroma on MRI to confirm nerve involvement after bifurcation.<br>
Level of Evidence: Level IV, retrospective series.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2304-676712112024Coronal Cementum and Reduced Enamel Epithelium on Occlusal Surface of Impacted Wisdom Tooth in a Human348ENNaohiroHorieDivision of Reconstructive Surgery for Oral and Maxillofacial Region, School of Dentistry, Health Sciences University of HokkaidoMasaruMurataDivision of Regenerative Medicine, School of Dentistry, Health Sciences University of HokkaidoYasuhitoMinamidaDivision of Oral and Maxillofacial Surgery, School of Dentistry, Health Sciences University of HokkaidoHirokiNagayasuDivision of Oral and Maxillofacial Surgery, School of Dentistry, Health Sciences University of HokkaidoTsuyoshiShimoDivision of Reconstructive Surgery for Oral and Maxillofacial Region, School of Dentistry, Health Sciences University of HokkaidoToshiyukiAkazawaIndustrial Technology and Environment Research Development, Hokkaido Research OrganizationHidetsuguTsujigiwaDepartment of Life Science, Faculty of Science, Okayama University of ScienceYoussefHaikelDepartment of Biomaterials and Bioengineering, Institut National de la Santé et de la Recherche médicale Unité Mixte de Recherche (INSERM UMR) _S 1121, University of StrasbourgHitoshiNagatsukaDepartment of Oral Pathology and Medicine Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground: There is only limited research on the coronal cementum of a tooth, and the mechanisms of its forming process are not well-defined. This report presents a coronal cementum on the occlusal surfaces of enamel in an impacted wisdom tooth in a human, which is not nearly the cervical portion. Materials and Methods: The tooth (Tooth #1) was derived from a 46-year-old female. Histological analysis, including hematoxylin and eosin (HE) and toluidine blue (TB) staining, and Scanning Electron Microscopy and Energy Dispersive X-ray Spectrometer (SEM-EDS) analysis of the extracted tooth were conducted. Radiographic examination showed that Tooth #1 was horizontally impacted in the maxilla and had the apex of a single root placed between the buccal and palatal roots of Tooth #2. Results: Coronal cementum was distributed widely on the enamel, and reduced enamel epithelium was also found with enamel matrix proteins histologically. The formation of acellular cementum was observed to be more predominant than that of the cellular cementum in Tooth #1. SEM showed that the occlusal cementum connected directly with enamel. Calcium mapping revealed an almost similar occlusal cementum and enamel. In addition, the spectrum of elements in coronal cementum resembled the primary cementum according to SEM-EDS. Discussion: Thus, coronal cementogenesis in impacted human teeth might be related to the existence of reduced enamel epithelium.No potential conflict of interest relevant to this article was reported.Life Science Alliance, LLCActa Medica Okayama2575-10777122024Chromosome-specific barcode system with centromeric repeat in cultivated soybean and wild progenitore202402802ENAhmet LTekDepartment of Agricultural Genetic Engineering, Ayhan Şahenk Faculty of Agricultural Sciences and Technologies, Niğde Ömer Halisdemir UniversityKiyotakaNagakiInstitute of Plant Science and Resources, Okayama UniversityHümeyraYıldız AkkamışDepartment of Agricultural Genetic Engineering, Ayhan Şahenk Faculty of Agricultural Sciences and Technologies, Niğde Ömer Halisdemir UniversityKeisukeTanakaNODAI Genome Research Center, Tokyo University of AgricultureHisatoKobayashiNODAI Genome Research Center, Tokyo University of AgricultureWild soybean Glycine soja is the progenitor of cultivated soybean Glycine max. Information on soybean functional centromeres is limited despite extensive genome analysis. These species are an ideal model for studying centromere dynamics for domestication and breeding. We performed a detailed chromatin immunoprecipitation analysis using centromere-specific histone H3 protein to delineate two distinct centromeric DNA sequences with unusual repeating units with monomer sizes of 90–92 bp (CentGm-1) and 413-bp (CentGm-4) shorter and longer than standard nucleosomes. These two unrelated DNA sequences with no sequence similarity are part of functional centromeres in both species. Our results provide a comparison of centromere properties between a cultivated and a wild species under the effect of the same kinetochore protein. Possible sequence homogenization specific to each chromosome could highlight the mechanism for evolutionary conservation of centromeric properties independent of domestication and breeding. Moreover, a unique barcode system to track each chromosome is developed using CentGm-4 units. Our results with a unifying centromere composition model using CentGm-1 and CentGm-4 superfamilies could have far-reaching implications for comparative and evolutionary genome research.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0021-88207782024Synthesis and biochemical characterization of naphthoquinone derivatives targeting bacterial histidine kinases522532ENTeruhikoIshikawaGraduate School of Education, Okayama UniversityYokoEguchiDepartment of Science and Technology on Food Safety, Faculty of Biology-Oriented Science and Technology, Kindai UniversityMasayukiIgarashiInstitute of Microbial Chemistry (BIKAKEN)ToshihideOkajimaSANKEN (The Institute of Scientific and Industrial Research), Osaka UniversityKoheiMitaGraduate School of Education, Okayama UniversityYuriYamasakiGraduate School of Education, Okayama UniversityKahoSumikuraGraduate School of Education, Okayama UniversityTaiseiOkumuraGraduate School of Education, Okayama UniversityYunaTabuchiGraduate School of Education, Okayama UniversityChigusaHayashiInstitute of Microbial Chemistry (BIKAKEN)MartinaPasquaIstituto Pasteur Italy, Department of Biology and Biotechnology, “C. Darwin”, Sapienza University of RomeMarcoColucciaIstituto Pasteur Italy, Department of Biology and Biotechnology, “C. Darwin”, Sapienza University of RomeGianniProssedaIstituto Pasteur Italy, Department of Biology and Biotechnology, “C. Darwin”, Sapienza University of RomeBiancaColonnaIstituto Pasteur Italy, Department of Biology and Biotechnology, “C. Darwin”, Sapienza University of RomeChieKohayakawaDepartment of Lead Exploration Units, Graduate School of Pharmaceutical Sciences, Osaka UniversityAkiyoshiTaniCompound Library Screening Center, Graduate School of Pharmaceutical Sciences, Osaka UniversityJun-ichiHarutaDepartment of Lead Exploration Units, Graduate School of Pharmaceutical Sciences, Osaka UniversityRyutaroUtsumiSANKEN (The Institute of Scientific and Industrial Research), Osaka UniversityWaldiomycin is an inhibitor of histidine kinases (HKs). Although most HK inhibitors target the ATP-binding region, waldiomycin binds to the intracellular dimerization domain (DHp domain) with its naphthoquinone moiety presumed to interact with the conserved H-box region. To further develop inhibitors targeting the H-box, various 2-aminonaphthoquinones with cyclic, aliphatic, or aromatic amino groups and naphtho [2,3-d] isoxazole-4,9-diones were synthesized. These compounds were tested for their inhibitory activity (IC50) against WalK, an essential HK for Bacillus subtilis growth, and their minimum inhibitory concentrations (MIC) against B. subtilis. As a result, 11 novel HK inhibitors were obtained as naphthoquinone derivatives (IC50: 12.6–305 µM, MIC: 0.5–128 µg ml−1). The effect of representative compounds on the expression of WalK/WalR regulated genes in B. subtilis was investigated. Four naphthoquinone derivatives induced the expression of iseA (formerly yoeB), whose expression is negatively regulated by the WalK/WalR system. This suggests that these compounds inhibit WalK in B. subtilis cells, resulting in antibacterial activity. Affinity selection/mass spectrometry analysis was performed to identify whether these naphthoquinone derivatives interact with WalK in a manner similar to waldiomycin. Three compounds were found to competitively inhibit the binding of waldiomycin to WalK, suggesting that they bind to the H-box region conserved in HKs and inhibit HK activity.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1439-75953542025Telemedicine as an alternative to in-person care in the field of rheumatic diseases: A systematic scoping review715721ENKen-eiSadaDepartment of Clinical Epidemiology, Kochi Medical SchoolShigeruIwataDepartment of Rheumatology and Clinical Immunology, Wakayama Medical UniversityYuzaburoInoueDepartment of General Medical Science, Graduate School of Medicine, Chiba UniversityEiichiTanakaDepartment of Rheumatology, Tokyo Women’s Medical University School of MedicineKeiichiroNishidaLocomotive Pain Center, Okayama University HospitalYutakaKawahitoInflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of MedicineAsamiAbeDepartment of Rheumatology, Niigata Rheumatic CenterAtsushiKawakamiDepartment of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical SciencesTakakoMiyamaeDepartment of Pediatric Rheumatology, Institute of Rheumatology, Tokyo Women’s Medical UniversityObjective: The COVID-19 pandemic prompted the widespread adoption of telemedicine as an alternative to in-person care. This systematic scoping review evaluated the effectiveness, cost-efficiency, and challenges of telemedicine for patients with rheumatic diseases.<br>
Methods: A comprehensive search of the MEDLINE database was conducted using specific terms related to rheumatoid or juvenile arthritis, and telemedicine. The literature search included studies published up to March, 2024. In this review, we only considered studies assessing telemedicine as an alternative to in-person care.<br>
Results: The search, conducted on 15 March 2024, generated 258 references. Eight reports from three randomized controlled trials and three observational studies were included. Randomized controlled trials have shown that the outcomes of telemedicine intervention are comparable to those of in-person care in terms of disease activity, functional status, and quality of life, while enabling fewer outpatient visits and cost-effectiveness. However, the high dropout rates highlight the importance of patient preferences and comprehensive education. Observational studies revealed similar findings but were limited by a high confounding bias.<br>
Conclusion: Telemedicine offers economic advantages and maintains clinical outcomes comparable to those of in-person care. Its success depends on structured patient education and alignment with patient preferences. Further research is required, particularly in the context of healthcare in Japan.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2666-1683732025Incidence, Management, and Prevention of Gynecomastia and Breast Pain in Patients with Prostate Cancer Undergoing Antiandrogen Therapy: A Systematic Review and Meta-analysis of Randomized Controlled Trials3142ENIchiroTsuboiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRobert J.SchulzDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaEkaterinaLaukhtinaDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaKoichiroWadaDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaPierre I.KarakiewiczCancer Prognostics and Health Outcomes Unit, University of Montreal Health CentreMotooArakiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShahrokh F.ShariatDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaBackground and objective: In patients with prostate cancer treated with antiandrogen monotherapy, gynecomastia and breast pain are relatively common. In the setting of androgen receptor pathway inhibitors (ARPIs), the incidence of these adverse events (AEs) remains unclear. In addition, the effect of prophylactic treatment on gynecomastia remains uncertain. We aimed to evaluate the incidence of gynecomastia and breast pain in prostate cancer patients treated with ARPIs compared with androgen deprivation therapy (ADT) and the effect of prophylactic treatment for these AEs due to antiandrogen therapy.<br>
Methods: In June 2024, we queried four databases―PubMed, Scopus, Web of Science, and Embase―for randomized controlled trials (RCTs) investigating prostate cancer treatments involving antiandrogen therapy. The endpoints of interest were the incidence of these AEs due to ARPIs and the effect of prophylactic treatment for these.<br>
Key findings and limitations: Eighteen RCTs, comprising 5036 patients, were included in the systematic review and meta-analysis. ARPIs included enzalutamide, darolutamide, and apalutamide. The results indicated that patients who received ARPI monotherapy had a significantly higher incidence of gynecomastia than those who received ADT monotherapy (risk ratio [RR]: 5.19, 95% confidence interval [CI]: 3.58–7.51, p < 0.001). There was no significant difference in the incidence of gynecomastia between ARPI plus ADT therapy and ADT monotherapy (RR: 1.27, 95% CI: 0.84–1.93, p = 0.2). Prophylactic tamoxifen or radiotherapy reduced significantly the incidence of gynecomastia and breast pain caused by bicalutamide monotherapy.<br>
Conclusions and clinical implications: We found that ARPI monotherapy increases the incidence of these AEs significantly compared with ADT. In contrast, ARPI plus ADT therapy did not result in a higher incidence of AEs. The use of either tamoxifen or radiotherapy was effective in reducing the incidence of these AEs due to bicalutamide monotherapy. These prophylactic treatments could reduce the incidence of AEs due to ARPI monotherapy. However, further studies are needed to clarify their efficacy.<br>
Patient summary: Although androgen deprivation therapy (ADT) improves overall survival in patients with prostate cancer, it is associated with several complications. Androgen receptor pathway inhibitor (ARPI) monotherapy has emerged as a promising strategy for improving oncological outcomes in these patients. However, ARPI monotherapy increases gynecomastia and breast pain in prostate cancer patients compared with ADT, while ARPI plus ADT did not result in a higher incidence of adverse events.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0962-88193332024Generation and characterization of cerebellar granule neurons specific knockout mice of Golli-MBP99117ENHarukoMiyazakiDepartment of Molecular Biology and Biochemistry, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineSakiNishiokaDepartment of Experimental Genome Research, Research Institute for Microbial Diseases, Osaka UniversityTomoyukiYamanakaLaboratory of Structural Neuropathology, Graduate School of Brain Science, Doshisha UniversityManabuAbeDepartment of Animal Model Development, Brain Research Institute, Niigata UniversityYukioImamuraLaboratory of Structural Neuropathology, Graduate School of Brain Science, Doshisha UniversityTomohiroMiyasakaFaculty of Life and Medical Sciences, Doshisha UniversityNobutoKakudaFaculty of Life and Medical Sciences, Doshisha UniversityToshitakaOohashiDepartment of Molecular Biology and Biochemistry, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTomomiShimogoriLaboratory for Molecular Mechanisms of Brain Development, RIKEN Center for Brain ScienceKazuhiroYamakawaLaboratory for Neurogenetics, RIKEN Center for Brain ScienceMasahitoIkawaDepartment of Experimental Genome Research, Research Institute for Microbial Diseases, Osaka UniversityNobuyukiNukinaLaboratory of Structural Neuropathology, Graduate School of Brain Science, Doshisha UniversityGolli–myelin basic proteins, encoded by the myelin basic protein gene, are widely expressed in neurons and oligodendrocytes in the central nervous system. Further, prior research has shown that Golli–myelin basic protein is necessary for myelination and neuronal maturation during central nervous system development. In this study, we established Golli–myelin basic protein-floxed mice to elucidate the cell-type-specific effects of Golli–myelin basic protein knockout through the generation of conditional knockout mice (Golli–myelin basic proteinsfl/fl; E3CreN), in which Golli–myelin basic proteins were specifically deleted in cerebellar granule neurons, where Golli–myelin basic proteins are expressed abundantly in wild-type mice. To investigate the role of Golli–myelin basic proteins in cerebellar granule neurons, we further performed histopathological analyses of these mice, with results indicating no morphological changes or degeneration of the major cellular components of the cerebellum. Furthermore, behavioral analysis showed that Golli–myelin basic proteinsfl/fl; E3CreN mice were healthy and did not display any abnormal behavior. These results suggest that the loss of Golli–myelin basic proteins in cerebellar granule neurons does not lead to cerebellar perturbations or behavioral abnormalities. This mouse model could therefore be employed to analyze the effect of Golli–myelin basic protein deletion in specific cell types of the central nervous system, such as other neuronal cells and oligodendrocytes, or in lymphocytes of the immune system.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0919-81723212024What is the identity of Gerota fascia? Histological study with cadavers6268ENYasuyukiKobayashiMinimally Invasive Therapy Center, Okayama University HospitalKoheiEdamuraDepartment of Urology, Okayama University HospitalTakuyaSadahiraDepartment of Urology, Okayama University HospitalYusukeTominagaDepartment of Urology, Okayama University HospitalSatoshiKatayamaDepartment of Urology, Okayama University HospitalTakehiroIwataDepartment of Urology, Okayama University HospitalShingoNishimuraOrgan Transplant Center, Okayama University HospitalTomokoKobayashiDepartment of Urology, Okayama University HospitalKeitaSatoDepartment of Cytology and Histology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakaakiKomiyamaDepartment of Human Morphology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyusukeMomotaDepartment of Human Morphology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideyoOhuchiDepartment of Cytology and Histology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMotooArakiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesObjectives: The advancement of laparoscopic surgery has allowed surgeons to see finer anatomical structures during surgery. As a result, several issues have arisen regarding Gerota fascia that cannot be explained by previous interpretations, such as its various forms observed during surgery. To address these issues, we histologically examined the structure of Gerota fascia.<br>
Methods: Specimens for study were prepared from kidneys with Gerota fascia from four cadavers, and the structure was studied histologically. Its thickness and collagen fiber area ratios were measured using ImageJ and compared to those of the epimysium of the rectus abdominis muscle.<br>
Results: Connective tissue that appeared to be Gerota fascia was observed in 26 specimens. Histologically, the basic structure of Gerota fascia was a sandwich-like structure with a thin layer of thick, long collagen fibers in the central layer, and small granular collagen fibers scattered at the edges. However, not all areas observed had a similar structure; eight specimens were composed only of small granular collagen fibers. The average thickness of the Gerota fascia was 466 μm, and the area ratio of collagen was 27.1%. In contrast, the epimysium was much thicker than Gerota fascia, and its collagen fibers were much thicker and denser.<br>
Conclusions: Gerota fascia, unlike the epimysium, was a very thin and fragile layer of collagen fibers, and its structure was diverse. This explains why Gerota fascia was observed in various states during surgery. It is important for surgeons to understand the properties of Gerota fascia and to treat it appropriately.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-291863242024A Preliminary Survey of Rheumatologists on the Management of Late-onset Rheumatoid Arthritis in Japan32993306ENSatoshiTakanashiDivision of Rheumatology, Department of Internal Medicine, Keio University School of MedicineYukoKanekoDivision of Rheumatology, Department of Internal Medicine, Keio University School of MedicineYutakaKawahitoInflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of MedicineTakashiKidaInflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of MedicineTakahikoSugiharaDivision of Rheumatology, Department of Internal Medicine, Toho University School of MedicineToshihisaKojimaNational Hospital Organization Nagoya Medical Center, Orthopaedic Surgery and RheumatologyRyozoHaradaDepartment of Orthopaedic Surgery, Kurashiki Sweet HospitalMichinoriIshitokuDepartment of Clinical Immunology and Rheumatology, Hiroshima University HospitalShintaroHirataDepartment of Clinical Immunology and Rheumatology, Hiroshima University HospitalMotomuHashimotoDepartment of Clinical Immunology, Osaka Metropolitan University Graduate School of MedicineToshihikoHidakaMiyazaki-Zenjinkai HospitalAsamiAbeDepartment of Rheumatology, Niigata Rheumatic CenterHajimeIshikawaDepartment of Rheumatology, Niigata Rheumatic CenterHiromuItoKurashiki Central HospitalMitsumasaKishimotoDepartment of Nephrology and Rheumatology, Kyorin University School of MedicineKazuoMatsuiDepartment of Rheumatology, Teine Keijinkai HospitalToshihiroMatsuiDepartment of Rheumatology Research, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National HospitalIsaoMatsushitaDepartment of Rehabilitation Medicine, Kanazawa Medical UniversityAkiraOnishiDepartment of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto UniversityAkioMorinobuDepartment of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto UniversityKeiichiroNishidaDepartment of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShujiAsaiDepartment of Orthopaedic Surgery and Rheumatology, Nagoya University Graduate School of MedicineEiichiTanakaDivision of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of MedicineMasayoshiHarigaiDivision of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of MedicineMasayoKojimaDepartment of Public Health, Nagoya City University Graduate School of Medical SciencesObjective We investigated the current perspectives regarding the management of late-onset rheumatoid arthritis (LORA) among rheumatologists in clinical practice.<br>
Methods This study was performed in October 2021, and included 65 rheumatologists certified by the Japan College of Rheumatology, who were administered questionnaires (including multiple choice and descriptive formulae) regarding the management of LORA. We aggregated and analyzed the responses.<br>
Results All 65 rheumatologists responded to the survey; 47 (72%) answered that >50% of newly diagnosed patients were aged ≥65 years, 42 (65%) answered that achievement of remission or low disease activity was the treatment goal, and 40 (62%) considered patient safety to be the highest priority. Most rheumatologists are concerned about the management of conditions other than RA, such as comorbidities, financial constraints, and life circumstances that interfere with standard or recommended treatment implementation.<br>
Conclusion This preliminary survey highlighted various rheumatologists' perspectives regarding the management of LORA.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0169-50021992025Real-world status of multimodal treatment of Stage IIIA-N2 non-small cell lung cancer in Japan: Results from the SOLUTION study, a non-interventional, multicenter cohort study108027ENHidehitoHorinouchiDepartment of Thoracic Oncology, National Cancer Center HospitalHaruyasuMurakamiDepartment of Thoracic Oncology, Shizuoka Cancer CenterHideyukiHaradaDivision of Radiation Therapy, Shizuoka Cancer CenterTomotakaSobueDivision of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka UniversityTomohiroKatoDepartment of Respiratory Medicine, National Hospital Organization Himeji Medical CenteShinjiAtagiDepartment of Thoracic Oncology, National Hospital Organization Kinki-Chuo Chest Medical CenterToshiyukiKozukiDepartment of Thoracic Oncology and Medicine, National Hospital Organization Shikoku Cancer CenterTakaakiTokitoDivision of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University HospitalSatoshiOizumiDepartment of Respiratory Medicine, National Hospital Organization Hokkaido Cancer CenterMasahiroSeikeDepartment of Pulmonary Medicine and Oncology, Nippon Medical School HospitalKadoakiOhashiDepartment of Respiratory Medicine, Okayama University HospitalTadashiMioDepartment of Respiratory Medicine, National Hospital Organization Kyoto Medical CenterTakashiSoneDepartment of Respiratory Medicine, Kanazawa University HospitalChikakoIwaoDepartment of Medical, AstraZeneca K.K.TakeshiIwaneDepartment of Medical, AstraZeneca K.K.RyoKotoDepartment of Medical, AstraZeneca K.K.MasahiroTsuboiDepartment of Thoracic Surgery, National Cancer Center Hospital EastObjectives: There is limited consensus on resectability criteria for Stage IIIA-N2 non-small cell lung cancer (NSCLC). We examined the patient characteristics, N2 status, treatment decisions, and clinical outcomes according to the treatment modality for Stage IIIA-N2 NSCLC in Japan.<br>
Materials and methods: Patients with Stage IIIA-N2 NSCLC in Japan were consecutively registered in the SOLUTION study between 2013 and 2014. Patients were divided according to treatment (chemoradiotherapy [CRT], surgery + perioperative therapy [neoadjuvant and/or adjuvant therapy], surgery alone). Demographic characteristics, N2 status (number and morphological features), pathological information, and treatments were analyzed descriptively. Overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) were estimated using the Kaplan–Meier method.<br>
Results: Of 227 patients registered, 133 underwent CRT, 56 underwent surgery + perioperative therapy, and 38 underwent surgery alone. The physicians reported the following reasons for unresectability for 116 of 133 CRT patients: large number of metastatic lymph nodes (70.7 %), extranodal infiltration (25.0 %), poor surgical tolerance (19.0 %), or other reasons (18.1 %). CRT was more frequently performed in patients whose lymph nodes had an infiltrative appearance (64.3 %) and was the predominant treatment in patients with multiple involved stations (discrete: 60.0 %; infiltrative: 80.4 %). Distant metastasis with/without local progression was found in 50.4 %, 50.0 %, and 36.8 % of patients in the CRT, surgery + perioperative therapy, and surgery alone groups, respectively. The respective 3-year OS and DFS/PFS rates (median values) were as follows: surgery + perioperative therapy―61.9 % (not reached) and 37.1 % (22.4 months; DFS); CRT group―42.2 % (31.9 months) and 26.8 % (12.0 months; PFS); surgery alone group―37.7 % (26.5 months) and 28.7 % (12.6 months; DFS).<br>
Conclusion: This study has illuminated the real-world decision rules for choosing between surgical and non-surgical approaches in patients with Stage IIIA-N2 NSCLC. Our landmark data could support treatment decision making for using immune checkpoint inhibitors and targeted therapy for driver oncogenes in the perioperative therapy era.
No potential conflict of interest relevant to this article was reported.Informa UK LimitedActa Medica Okayama1479-669420402024Plain language summary: tarlatamab for patients with previously treated small cell lung cancer3355-3364ENMyung-JuAhnSamsung Medical Center, Sungkyunkwan University School of MedicineByoung ChulChoYonsei Cancer Center, Yonsei University College of MedicineEnriquetaFelipVall d’Hebron University Hospital and Vall d’Hebron Institute of OncologyIppokratisKorantzisDepartment of Medical Oncology, Saint Loukas HospitalKadoakiOhashiDepartment of Respiratory Medicine, Okayama University HospitalMargaritaMajemHospital de la Santa Creu i Sant PauOscarJuan-VidalSabinHandzhievKlinische Abteilung für Pneumologie, Universitätsklinikum KremsHirokiIzumiDepartment of Thoracic Oncology, National Cancer Center Hospital EastJong-SeokLeeSeoul National University Bundang HospitalRafalDziadziuszkoDepartment of Oncology and Radiotherapy and Early Phase Clinical Trials Center, Medical University of GdanskJürgenWolfDepartment of Internal Medicine, Center for Integrated Oncology, University Hospital CologneFionaBlackhallChristie NHS Foundation Trust and University of ManchesterMartinReckLungen Clinic, Airway Research Center North, German Center for Lung ResearchJean BustamanteAlvarezWest Virginia University Health Sciences CenterHorst-DieterHummelTranslational Oncology–Early Clinical Trial Unit, Comprehensive Cancer Center Mainfranken and Bavarian Cancer Research Center, Universitätsklinikum WürzburgAnne-Marie C.DingemansDepartment of Pulmonary Medicine, Erasmus MC Cancer InstituteJacobSandsDana–Farber Cancer Institute, Harvard Medical SchoolHiroakiAkamatsuWakayama Medical University HospitalTaofeek K.OwonikokoDivision of Hematology–Oncology, Hillman Cancer Center, University of Pittsburgh Medical CenterSuresh S.RamalingamWinship Cancer Institute of Emory UniversityHosseinBorghaeiFox Chase Cancer CenterMelissa L.JohnsonSarah Cannon Research Institute at Tennessee OncologyShuangHuangAmgenSujoyMukherjeeAmgenMukulMinochaAmgenTonyJiangAmgenPabloMartinezAmgenErik S.AndersonAmgenLuisPaz-AresHospital Universitario 12 de Octubre, CNIO-H12o Lung Cancer Unit, Complutense University and CiberoncNo potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2075-44181552025Review Article: Diagnostic Paradigm Shift in Spine Surgery594ENAras EfeLeventDepartment of Orthopedic Surgery, Okayama Rosai HospitalMasatoTanakaDepartment of Orthopedic Surgery, Okayama Rosai HospitalChetanKumawatDepartment of Orthopedic Surgery, Okayama Rosai HospitalChristianHengDepartment of Orthopedic Surgery, Okayama Rosai HospitalSalamalikisNikolaosDepartment of Orthopedic Surgery, Okayama Rosai HospitalKajetanLatkaDepartment of Orthopedic Surgery, Okayama Rosai HospitalAkiyoshiMiyamotoDepartment of Orthopedic Surgery, Okayama Rosai HospitalTadashiKomatsubaraDepartment of Orthopedic Surgery, Okayama Rosai HospitalShinyaAratakiDepartment of Orthopedic Surgery, Okayama Rosai HospitalYoshiakiOdaDepartment of Orthopedic Surgery, Okayama University HospitalKensukeShinoharaDepartment of Orthopedic Surgery, Okayama University HospitalKojiUotaniDepartment of Orthopedic Surgery, Okayama University HospitalMeticulous clinical examination is essential for spinal disorders to utilize the diagnostic methods and technologies that strongly support physicians and enhance clinical practice. A significant change in the approach to diagnosing spinal disorders has occurred in the last three decades, which has enhanced a more nuanced understanding of spine pathology. Traditional radiographic methods such as conventional and functional X-rays and CT scans are still the first line in the diagnosis of spinal disorders due to their low cost and accessibility. As more advanced imaging technologies become increasingly available worldwide, there is a constantly increasing trend in MRI scans for detecting spinal pathologies and making treatment decisions. Not only do MRI scans have superior diagnostic capabilities, but they also assist surgeons in performing meticulous preoperative planning, making them currently the most widely used diagnostic tool for spinal disorders. Positron Emission Tomography (PET) can help detect inflammatory lesions, infections, and tumors. Other advanced diagnostic tools such as CT/MRI fusion image, Functional Magnetic Resonance Imaging (fMRI), Upright and Kinetic MRI, magnetic resonance spectroscopy (MRS), diffusion-weighted imaging (DWI), and diffusion tensor imaging (DTI) could play an important role when it comes to detecting more special pathologies. However, some technical difficulties in the daily praxis and their high costs act as obstacles to their further spread. Integrating artificial intelligence and advancements in data analytics and virtual reality promises to enhance spinal procedures’ precision, safety, and efficacy. As these technologies continue to develop, they will play a critical role in transforming spinal surgery. This paradigm shift emphasizes the importance of continuous innovation and adaptability in improving the diagnosis and treatment of spinal disorders.No potential conflict of interest relevant to this article was reported.SAGE PublicationsActa Medica Okayama2192-56821542024Effects of Palliative Surgical Treatment for Spinal Metastases on the Patient’s Quality of Life With a Focus on the Segment of the Metastasis: A Prospective Multicenter Study22862299ENNaokiSegiDepartment of Orthopaedic Surgery, Nagoya University Graduate School of MedicineHiroakiNakashimaDepartment of Orthopaedic Surgery, Nagoya University Graduate School of MedicineSadayukiItoDepartment of Orthopaedic Surgery, Nagoya University Graduate School of MedicineJunOuchidaDepartment of Orthopaedic Surgery, Nagoya University Graduate School of MedicineYukiShirataniDepartment of Orthopaedic Surgery, Chiba University HospitalTakakiShimizuDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityAkinobuSuzukiDepartment of Orthopaedic Surgery, Osaka Metropolitan UniversityHidetomiTeraiDepartment of Orthopaedic Surgery, Osaka Metropolitan UniversityKenichiroKakutaniDepartment of Orthopaedic Surgery, Kobe University Graduate School of MedicineYutaroKandaDepartment of Orthopaedic Surgery, Kobe University Graduate School of MedicineHiroyukiTominagaDepartment of Orthopedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima UniversityIchiroKawamuraDepartment of Orthopedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima UniversityMasayukiIshiharaDepartment of Orthopaedic Surgery, Kansai Medial University HospitalMasaakiPakuDepartment of Orthopaedic Surgery, Kansai Medial University HospitalYoheiTakahashiDepartment of Orthopaedic Surgery, Keio UniversityMasahiroFunabaDepartment of Orthopaedics Surgery, Yamaguchi University Graduate school of MedicineToruFunayamaDepartment of Orthopaedic Surgery, Institute of Medicine, University of TsukubaHideakiNakajimaDepartment of Orthopaedics and Rehabilitation Medicine, University of Fukui Faculty of Medical SciencesKojiAkedaDepartment of Orthopaedic Surgery, Mie University Graduate School of MedicineTakashiHiraiDepartment of Orthopedic Surgery, Tokyo Medical and Dental UniversityHirokazuInoueRehabilitation Center, Jichi Medical University HospitalKazuoNakanishiDepartment of Orthopaedic Surgery, Kawasaki Medical SchoolHarukiFunaoDepartment of Orthopaedic Surgery, International University of Health and Welfare Narita HospitalTsutomuOshigiriDepartment of Orthopaedic Surgery, Sapporo Medical University School of MedicineBungoOtsukiDepartment of Orthopaedic Surgery, Kyoto University HospitalKazuKobayakawaDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu UniversityShinjiTanishimaDivision of Orthopedic Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori UniversityKoHashimotoDepartment of Orthopaedic Surgery, Tohoku University Graduate School of MedicineTakuyaIimuraDepartment of Orthopaedic Surgery, Dokkyo Medical UniversityHirokatsuSawadaDepartment of Orthopaedic Surgery, Nihon University School of MedicineKojiUotaniDepartment of Orthopaedic Surgery, Okayama University HospitalHiroakiManabeDepartment of Orthopedics, Tokushima UniversityChizuoIwaiDepartment of Orthopaedic Surgery, Gifu University HospitalDaisukeYamabeDepartment of Orthopaedic Surgery, Iwate Medical UniversityAkihikoHiyamaDepartment of Orthopaedic Surgery, Tokai University School of MedicineShojiSekiDepartment of Orthopaedic Surgery, University of ToyamaYutaGotoDepartment of Orthopaedic Surgery, Nagoya City UniversityMasashiMiyazakiDepartment of Orthopaedic Surgery, Faculty of Medicine, Oita UniversityKazuyukiWatanabeDepartment of Orthopaedic Surgery, Fukushima Medical University School of MedicineToshioNakamaeDepartment of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityTakashiKaitoDepartment of Orthopaedic Surgery, Osaka University Graduate School of MedicineNarihitoNagoshiDepartment of Orthopaedic Surgery, Keio UniversitySatoshiKatoDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityKotaWatanabeDepartment of Orthopaedic Surgery, Keio UniversityShiroImagamaDepartment of Orthopaedic Surgery, Nagoya University Graduate School of MedicineGenInoueDepartment of Orthopaedic Surgery, Kitasato University School of MedicineTakeoFuruyaDepartment of Orthopaedic Surgery, Chiba University HospitalStudy Design: Prospective multicenter study.<br>
Objectives: Palliative surgery is crucial for maintaining the quality of life (QOL) in patients with spinal metastases. This study aimed to compare the short-term outcomes of QOL after palliative surgery between patients with metastatic spinal tumors at different segments.<br>
Methods: We prospectively compared the data of 203 patients with spinal metastases at 2-3 consecutive segments who were divided into the following three groups: cervical, patients with cervical spine lesions; thoracic, patients with upper–middle thoracic spine lesions; and TL/L/S, patients with lesions at the thoracolumbar junction and lumbar and sacral regions. Preoperative and postoperative EuroQol 5-dimension (EQ5D) 5-level were compared.<br>
Results: All groups exhibited improvement in the Frankel grade, performance status, pain, Barthel index, EQ5D health state utility value (HSUV), and EQ5D visual analog scale (VAS) postoperatively. Although preoperative EQ5D HSUVs did not significantly differ between the groups (cervical, 0.461 ± 0.291; thoracic, 0.321 ± 0.292; and TL/L/S, 0.376 ± 0.272), the thoracic group exhibited significantly lower postoperative EQ5D HSUVs than the other two groups (cervical, 0.653 ± 0.233; thoracic, 0.513 ± 0.252; and TL/L/S, 0.624 ± 0.232). However, postoperative EQ5D VAS was not significantly different between the groups (cervical, 63.4 ± 25.8; thoracic, 54.7 ± 24.5; and TL/L/S, 61.7 ± 21.9).<br>
Conclusions: Palliative surgery for metastatic spinal tumors provided comparable QOL improvement, irrespective of the spinal segment involved. Patients with upper and middle thoracic spinal metastases had poorer QOL outcomes than those with metastases in other segments; however, sufficient QOL improvement was achieved.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1648-91446042024A Novel Technique for Basilar Invagination Treatment in a Patient with Klippel–Feil Syndrome: A Clinical Example and Brief Literature Review616ENMasatoTanakaDepartment of Orthopaedic Surgery, Okayama Rosai HospitalAbd El Kader AlAskarDepartment of Orthopaedic Surgery, Okayama Rosai HospitalChetanKumawatDepartment of Orthopaedic Surgery, Okayama Rosai HospitalShinyaAratakiDepartment of Orthopaedic Surgery, Okayama Rosai HospitalTadashiKomatsubaraDepartment of Orthopaedic Surgery, Okayama Rosai HospitalTakuyaTaokaDepartment of Orthopaedic Surgery, Okayama Rosai HospitalKojiUotaniDepartment of Orthopaedic Surgery, Okayama University HospitalYoshiakiOdaDepartment of Orthopaedic Surgery, Okayama University HospitalObjectives and Background: To present a novel technique of treatment for a patient with basilar invagination. Basilar invagination (BI) is a congenital condition that can compress the cervicomedullary junction, leading to neurological deficits. Severe cases require surgical intervention, but there is debate over the choice of approach. The anterior approach allows direct decompression but carries high complication rates, while the posterior approach provides indirect decompression and offers good stability with fewer complications. Materials and Methods: A 15-year-old boy with severe myelopathy presented to our hospital with neck pain, bilateral upper limb muscle weakness, and hand numbness persisting for 4 years. Additionally, he experienced increased numbness and gait disturbance three months before his visit. On examination, he exhibited hyperreflexia in both upper and lower limbs, muscle weakness in the bilateral upper limbs (MMT 4), bilateral hypoesthesia below the elbow and in both legs, mild urinary and bowel incontinence, and a spastic gait. Radiographs revealed severe basilar invagination (BI). Preoperative images showed severe BI and that the spinal cord was severely compressed with odontoid process. Results: The patient underwent posterior surgery with the C-arm free technique. All screws including occipital screws were inserted into the adequate position under navigation guidance. Reduction was achieved with skull rotation and distraction. A follow-up at one year showed the following results: Manual muscle testing results and sensory function tests showed almost full recovery, with bilateral arm recovery (MMT 5) and smooth walking. The cervical Japanese Orthopedic Association score of the patient improved from 9/17 to 16/17. Postoperative images showed excellent spinal cord decompression, and no major or severe complications had occurred. Conclusions: Basilar invagination alongside Klippel–Feil syndrome represents a relatively uncommon condition. Utilizing a posterior approach for treating reducible BI with a C-arm-free technique proved to be a safe method in addressing severe myelopathy. This novel navigation technique yields excellent outcomes for patients with BI.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2075-441814232024Predicting Surgical Site Infections in Spine Surgery: Association of Postoperative Lymphocyte Reduction2715ENAkiyoshiMiyamotoDepartment of Orthopedic Surgery, Okayama Rosai HospitalMasatoTanakaDepartment of Orthopedic Surgery, Okayama Rosai HospitalAngel Oscar PazFloresDepartment of Orthopedic Surgery, Okayama Rosai HospitalDongwooYuDepartment of Orthopedic Surgery, Okayama Rosai HospitalMukulJainDepartment of Orthopedic Surgery, Okayama Rosai HospitalChristanHengDepartment of Orthopedic Surgery, Okayama Rosai HospitalTadashiKomatsubaraDepartment of Orthopedic Surgery, Okayama Rosai HospitalShinyaAratakiDepartment of Orthopedic Surgery, Okayama Rosai HospitalYoshiakiOdaDepartment of Orthopedic Surgery, Okayama University HospitalKensukeShinoharaDepartment of Orthopedic Surgery, Okayama University HospitalKojiUotaniDepartment of Orthopedic Surgery, Okayama University HospitalObjective: Postoperative lymphopenia is reported as an excellent indicator to predict surgical-site infection (SSI) after spine surgery. However, there is still controversy concerning which serological markers can predict spinal SSI. This study aims to evaluate excellent and early indicators for detecting SSI, focusing on spine instrumented surgery. Materials and Methods: This study included 268 patients who underwent spinal instrumented surgery from January 2022 to December 2023 (159 female and 109 male, average 62.9 years). The SSI group included 20 patients, and the non-SSI group comprised 248 patients. Surgical time, intraoperative blood loss, and glycemic levels were measured in both groups. The complete blood cell counts, differential counts, albumin, and C-reactive protein (CRP) levels were measured pre-surgery and postoperative on Days 1, 3, and 7. In comparing the groups, the Mann–Whitney U test analysis was used for continuous variables, while the chi-squared test and Fisher’s exact test were used for dichotomous variables. Results: The incidence of SSI after spinal instrumentation was 7.46% and was relatively higher in scoliosis surgery. The SSI group had significantly longer surgical times (248 min vs. 180 min, p = 0.0004) and a higher intraoperative blood loss (772 mL vs. 372 mL, p < 0.0001) than the non-SSI group. In the SSI group, the Day 3 (10.5 ± 6.2% vs. 13.8 ± 6.0%, p = 0.012) and Day 7 (14.4 ± 4.8% vs. 18.8 ± 7.1%, p = 0.012) lymphocyte ratios were lower than the non-SSI group. Albumin levels on Day 1 in the SSI group were lower than in the non-SSI group (2.94 ± 0.30 mg/dL vs. 3.09 ± 0.38 mg/dL, p = 0.045). There is no difference in CRP and lymphocyte count between the two groups. Conclusions: SSI patients had lower lymphocyte percentages than non-SSI patients, which was a risk factor for SSI, with constant high inflammation. The Day 3 lymphocyte percentage may predict SSI after spinal instrumented surgery.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1648-91446042024Retrospective Cohort Study of Early versus Delayed Ballon Kyphoplasty Intervention for Osteoporotic Vertebral Fracture Treatment519ENAkiyoshiMiyamotoDepartment of Orthopaedic Surgery, Okayama Rosai HospitalUmeshPariharDepartment of Orthopaedic Surgery, Okayama Rosai HospitalChetanKumawatDepartment of Orthopaedic Surgery, Okayama Rosai HospitalAbdEl Kader Al AskarDepartment of Orthopaedic Surgery, Okayama Rosai HospitalMasatoTanakaDepartment of Orthopaedic Surgery, Okayama Rosai HospitalSharvariGunjotikarDepartment of Orthopaedic Surgery, Okayama Rosai HospitalTakuyaTaokaDepartment of Orthopaedic Surgery, Okayama Rosai HospitalTadashiKomatsubaraDepartment of Orthopaedic Surgery, Okayama Rosai HospitalYoshihiroFujiwaraDepartment of Orthopaedic Surgery, Okayama Rosai HospitalKojiUotaniDepartment of Orthopaedic Surgery, Okayama University HospitalShinyaAratakiDepartment of Orthopaedic Surgery, Okayama Rosai HospitalObjectives: To investigate the outcomes of early balloon kyphoplasty (BKP) intervention compared with late intervention for osteoporotic vertebral fracture (OVF). Background: Osteoporotic vertebral fracture can lead to kyphotic deformity, severe back pain, depression, and disturbances in activities of daily living (ADL). Balloon kyphoplasty has been widely utilized to treat symptomatic OVFs and has proven to be a very effective surgical option for this condition. Furthermore, BKP is relatively a safe and effective method due to its reduced acrylic cement leakage and greater kyphosis correction. Materials and Methods: A retrospective cohort study was conducted at our hospital for patients who underwent BKP for osteoporotic vertebral fractures in the time frame between January 2020 and December 2022. Ninety-nine patients were included in this study, and they were classified into two groups: in total, 36 patients underwent early BKP intervention (EI) at <4 weeks, and 63 patients underwent late BKP intervention (LI) at ≥4 weeks. We performed a clinical, radiological and statistical comparative evaluation for the both groups with a mean follow-up of one year. Results: Adjacent segmental fractures were more frequently observed in the LI group compared to the EI group (33.3% vs. 13.9%, p = 0.034). There was a significant improvement in postoperative vertebral angles in both groups (p = 0.036). The cement volume injected was 7.42 mL in the EI, compared with 6.3 mL in the LI (p = 0.007). The mean surgery time was shorter in the EI, at 30.2 min, compared with 37.1 min for the LI, presenting a significant difference (p = 0.0004). There was no statistical difference in the pain visual analog scale (VAS) between the two groups (p = 0.711), and there was no statistical difference in cement leakage (p = 0.192). Conclusions/Level of Evidence: Early BKP for OVF treatment may achieve better outcomes and fewer adjacent segmental fractures than delayed intervention.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1550-41313722025Maternal circadian rhythms during pregnancy dictate metabolic plasticity in offspring395412.e6ENNaYaoDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineKenichiroKinouchiDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineManamiKatohDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of TokyoKousha ChangiziAshtianiDepartment of Computer Science, University of CaliforniaSherifAbdelkarimDepartment of Computer Science, University of CaliforniaHiroyukiMorimotoDepartment of Integrative Anatomy, Nagoya City University Graduate School of Medical SciencesTakutoTorimitsuDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineTakahideKozumaDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineAkihideIwaharaDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineShotaroKosugiDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineJinKomuroDepartment of Cardiology, Keio University School of MedicineKyosukeKatoDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineShunTonomuraDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineToshifumiNakamuraDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineArataItohDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineShintaroYamaguchiDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineJunYoshinoDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineJunichiroIrieDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineHisayukiHashimotoDepartment of Cardiology, Keio University School of MedicineShinsukeYuasaDepartment of Cardiovascular Medicine, Academic Field, Dentistry and Pharmaceutical Sciences, Okayama UniversityAkikoSatohDepartment of Integrative Physiology, Institute of Development, Aging and Cancer, Tohoku UniversityYoheiMikamiDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of MedicineShusakuUchidaDepartment of Integrative Anatomy, Nagoya City University Graduate School of Medical SciencesTakatoshiUekiDepartment of Integrative Anatomy, Nagoya City University Graduate School of Medical SciencesSeitaroNomuraDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of TokyoPierreBaldiDepartment of Computer Science, University of CaliforniaKaoriHayashiDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineHiroshiItohDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineTissue-level oscillation is achieved by tissue-intrinsic clocks along with network-dependent signals originating from distal organs and organismal behavior. Yet, it remains unexplored whether maternal circadian rhythms during pregnancy influence fetal rhythms and impact long-term susceptibility to dietary challenges in offspring. Here, we demonstrate that circadian disruption during pregnancy decreased placental and neonatal weight yet retained transcriptional and structural maturation. Intriguingly, diet-induced obesity was exacerbated in parallel with arrhythmic feeding behavior, hypothalamic leptin resistance, and hepatic circadian reprogramming in offspring of chronodisrupted mothers. In utero circadian desynchrony altered the phase-relationship between the mother and fetus and impacted placental efficiency. Temporal feeding restriction in offspring failed to fully prevent obesity, whereas the circadian alignment of caloric restriction with the onset of the active phase virtually ameliorated the phenotype. Thus, maternal circadian rhythms during pregnancy confer adaptive properties to metabolic functions in offspring and provide insights into the developmental origins of health and disease.No potential conflict of interest relevant to this article was reported.Microbiology SocietyActa Medica Okayama0022-131710672025Summary of taxonomy changes ratified by the International Committee on Taxonomy of Viruses (ICTV) from the Animal dsRNA and ssRNA(−) Viruses Subcommittee, 2025002112ENHolly R.HughesCenters for Disease Control and PreventionMatthew J.BallingerBiological Sciences, Mississippi State UniversityYimingBaoNational Genomics Data Center, China National Center for Bioinformation; Beijing Institute of Genomics, Chinese Academy of Sciences; University of Chinese Academy of SciencesNicolasBejermanConsejo Nacional de Investigaciones Científicas y Técnicas (CONICET) and Instituto Nacional de Tecnología Agropecuaria (INTA)Kim R.BlasdellCSIRO Health and BiosecurityThomasBrieseCenter for Infection and Immunity, and Department of Epidemiology, Mailman School of Public Health, Columbia UniversityJuliaBrignoneInstituto Nacional de Enfermedades Virales Humanas Dr. Julio I. Maiztegui. INEVH -ANLISJean PaulCarreraInstituto Conmemorativo Gorgas de Estudios de la SaludLanderDe ConinckDivision of Clinical and Epidemiological Virology, KU LeuvenWilliam Marcielde SouzaDepartment of Microbiology, Immunology and Molecular Genetics, University of KentuckyHumbertoDebatInstituto Nacional de Tecnología Agropecuaria (INTA)Ralf G.DietzgenQAAFI, The University of QueenslandRalfDürrwaldRobert Koch InstitutMertErdinDepartment of Virology, University of HelsinkiAnthony R.FooksAnimal and Plant Health Agency (APHA)Kristian M.ForbesDepartment of Biological Sciences, University of ArkansasJulianaFreitas-AstúaEmbrapa Cassava and FruitsJorge B.GarciaInstituto Nacional de Enfermedades Virales Humanas Dr. Julio I. Maiztegui. INEVH -ANLISJemma L.GeogheganDepartment of Microbiology and Immunology, University of OtagoRebecca M.GrimwoodDepartment of Microbiology and Immunology, University of OtagoMasayukiHorieOsaka International Research Center for Infectious Diseases, Osaka Metropolitan UniversityTimothy H.HyndmanSchool of Veterinary Medicine, Murdoch UniversityReimarJohneGerman Federal Institute for Risk AssessmentJohn D.KlenaViral Special Pathogens Branch, The Centers for Disease Control and PreventionHidekiKondoInstitute of Plant Science and Resources, Okayama UniversityEugene V.KooninComputational Biology Branch, Division of Intramural Research National Library of Medicine, National Institutes of HealthAlexei Y.KostygovUniversity of OstravaMartKrupovicInstitut Pasteur, Université Paris Cité, CNRS UMR6047, Archaeal Virology UnitJens H.KuhnIntegrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of HealthMichaelLetkoPaul G. Allen School for Global Health, Washington State UniversityJun-MinLiInstitute of Plant Virology, Ningbo UniversityYiyunLiuNational Genomics Data Center, China National Center for Bioinformation; Beijing Institute of Genomics, Chinese Academy of Sciences; University of Chinese Academy of SciencesMaria LauraMartinInstituto Nacional de Enfermedades Virales Humanas Dr. Julio I. Maiztegui. INEVH -ANLISNathanielMullDepartment of Natural Sciences, Shawnee State UniversityYaelNazarInstituto Nacional de Enfermedades Virales Humanas Dr. Julio I. Maiztegui. INEVH -ANLISNorbertNowotnyCollege of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai HealthMárcio Roberto TeixeiraNunesUniversidade Federal do ParáArnfinn LoddenØklandPharmaq AnalytiqDennisRubbenstrothInstitute of Diagnostic Virology, Friedrich-Loeffler-InstitutBrandy J.RussellCenters for Disease Control and PreventionEricSchottInstitute of Marine and Environmental Technology, University of Maryland Center for Environmental ScienceStephanieSeifertPaul G. Allen School for Global Health, Washington State UniversityCarinaSenInstituto Nacional de Enfermedades Virales Humanas Dr. Julio I. Maiztegui. INEVH -ANLISElizabethShedroffViral Special Pathogens Branch, The Centers for Disease Control and PreventionTarjaSironenDepartment of Virology, University of HelsinkiTeemuSmuraDepartment of Virology, University of HelsinkiCamila Prestes Dos SantosTavaresIntegrated Group of Aquaculture and Environmental Studies, Federal University of ParanáRobert B.TeshDepartment of Pathology, The University of Texas Medical BranchNatasha L.TilstonDepartment of Microbiology and Immunology, Indiana University School of MedicineNoëlTordoInstitut PasteurNikosVasilakisDepartment of Pathology, The University of Texas Medical BranchPeter J.WalkerUniversity of QueenslandFeiWangWuhan Institute of Virology, Chinese Academy of SciencesAnna E.WhitfieldNorth Carolina State UniversityShannon L.M.WhitmerViral Special Pathogens Branch, The Centers for Disease Control and PreventionYuri I.WolfComputational Biology Branch, Division of Intramural Research National Library of Medicine, National Institutes of HealthHanXiaWuhan Institute of Virology, Chinese Academy of SciencesGong-YinYeInstitute of Insect Sciences, Zhejiang UniversityZhuangxinYeInstitute of Plant Virology, Ningbo UniversityVyacheslavYurchenkoUniversity of OstravaMingliZhaoDepartment of Pathobiology and Population Sciences, Royal Veterinary CollegeRNA viruses are ubiquitous in the environment and are important pathogens of humans, animals and plants. In 2024, the International Committee on Taxonomy of Viruses Animal dsRNA and ssRNA(−) Viruses Subcommittee submitted 18 taxonomic proposals for consideration. These proposals expanded the known virosphere by classifying 9 new genera and 88 species for newly detected virus genomes. Of note, newly established species expand the large family of Rhabdoviridae to 580 species. A new species in the family Arenaviridae includes a virus detected in Antarctic fish with a unique split nucleoprotein ORF. Additionally, four new species were established for historically isolated viruses with previously unsequenced genomes. Furthermore, three species were abolished due to incomplete genome sequence information, and one family was moved from being unassigned in the phylum Negarnaviricota into a subphylum and order. Herein, we summarize the 18 ratified taxonomic proposals and the general features of the current taxonomy, thereby supporting public and animal health responses.No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama1554-892919122024Discovery of a Compound That Inhibits IRE1α S-Nitrosylation and Preserves the Endoplasmic Reticulum Stress Response under Nitrosative Stress24292437ENHarunaKurogiDepartment of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNobumasaTakasugiDepartment of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShoKubotaDepartment of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAshutoshKumarLaboratory for Structural Bioinformatics, Center for Biosystems Dynamics Research, RIKENTakehiroSuzukiBiomolecular Characterization Unit, Technology Platform Division, RIKEN Center for Sustainable Resource ScienceNaoshiDohmaeBiomolecular Characterization Unit, Technology Platform Division, RIKEN Center for Sustainable Resource ScienceDaisukeSawadaDepartment of Fine Organic Synthesis, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKam Y.J.ZhangLaboratory for Structural Bioinformatics, Center for Biosystems Dynamics Research, RIKENTakashiUeharaDepartment of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityInositol-requiring enzyme 1α (IRE1α) is a sensor of endoplasmic reticulum (ER) stress and drives ER stress response pathways. Activated IRE1α exhibits RNase activity and cleaves mRNA encoding X-box binding protein 1, a transcription factor that induces the expression of genes that maintain ER proteostasis for cell survival. Previously, we showed that IRE1α undergoes S-nitrosylation, a post-translational modification induced by nitric oxide (NO), resulting in reduced RNase activity. Therefore, S-nitrosylation of IRE1α compromises the response to ER stress, making cells more vulnerable. We conducted virtual screening and cell-based validation experiments to identify compounds that inhibit the S-nitrosylation of IRE1α by targeting nitrosylated cysteine residues. We ultimately identified a compound (1ACTA) that selectively inhibits the S-nitrosylation of IRE1α and prevents the NO-induced reduction of RNase activity. Furthermore, 1ACTA reduces the rate of NO-induced cell death. Our research identified S-nitrosylation as a novel target for drug development for IRE1α and provides a suitable screening strategy.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1471-24312412024Body weight and eating attitudes influence improvement of depressive symptoms in children and pre-adolescents with eating disorders: a prospective multicenter cohort study551ENYuichiSuzukiDepartment of Pediatrics, Fukushima Medical University School of MedicineShinichiroNagamitsuDepartment of Pediatrics, Fukuoka University Faculty of MedicineNobuokiEshimaDepartment of Pediatrics, Kurume University School of MedicineTakeshiInoueChild Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical CenterRyokoOtaniChild Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical CenterRyoichiSakutaChild Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical CenterToshiyukiIguchiDepartment of Pediatrics, Hoshigaoka Maternity HospitalRyutaIshiiDepartment of Pediatrics and Child Health, Kurume University School of MedicineSohUchidaKaramun`S Forest Children`S ClinicAyumiOkadaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinjiKitayamaHimeji City Center for the DisabledKenshiKoyanagiNagasaki Prefectural Center of Medicine and Welfare for ChildrenYukiSuzukiDepartment of Pediatrics, National Hospital Organization Mie National HospitalYoshinoSumiMental and Developmental Clinic for Children “Elm Tree”ShizuoTakamiyaTakamiya Psychiatry ClinicChikakoFujiiDepartment of Pediatrics/Child Psychosomatic Medicine, Okayama University HospitalYoshimitsuFukaiDepartment of Pediatrics, St. Luke’s International HospitalBackground Pediatric patients with eating disorders in a multicenter joint study on 11 facilities were enrolled and prospectively investigated to determine whether improvement in body weight, eating attitudes, and psychosocial factors in children with eating disorders would also improve depressive symptoms.<br>
Methods In this study, 91 patients were enrolled between April 2014 and March 2016. The severity of underweight was assessed using the body mass index-standard deviation score (BMI-SDS), eating behavior was assessed using the children's eating attitude test (ChEAT26), the outcome of childhood eating disorders was assessed using the childhood eating disorder outcome scale, and depressive symptoms were assessed using the Children's Depression Inventory (CDI) score.<br>
Results After 12 months of treatment, depressive symptoms were evaluated in 62 of the 91 cases where it was evaluated at the initial phase. There was no difference in background characteristics between the included patients and the 29 patients who dropped out. A paired-sample t-test revealed a significant decrease in CDI scores after 12 months of treatment (p < 0.001, 95% CI: 2.401–7.373) and a significant increase in the BMI-SDS (p < 0.001, 95% CI: − 2.41973–1.45321). Multiple regression analysis revealed that BMI-SDS and ChEAT26 scores at the initial phase were beneficial in CDI recovery. In addition, BMI-SDS at the initial phase was useful for predicting BMI-SDS recovery after 12 months of treatment.<br>
Conclusions Depressive symptoms in children with eating disorders improved with therapeutic intervention on body weight and eating attitudes.<br>
Trial registration The Clinical Trial Number for this study is UMIN000055004.No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama2575-9108792024Rethinking Thin-Layer Chromatography for Screening Technetium-99m Radiolabeled Polymer Nanoparticles26042611ENKathrinSchorrDepartment of Pharmaceutical Technology, University of RegensburgXinyuChenNuclear Medicine, Faculty of Medicine, University of AugsburgTakanoriSasakiFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAnahi PaulaArias-LozaDepartment of Nuclear Medicine and Comprehensive Heart Failure Center, University Hospital WürzburgJohannesLangDepartment of Pharmaceutical Technology, University of RegensburgTakahiroHiguchiFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAchimGoepferichDepartment of Pharmaceutical Technology, University of RegensburgThin-layer chromatography (TLC) is commonly employed to screen technetium-99m labeled polymer nanoparticle batches for unreduced pertechnetate and radio-colloidal impurities. Although this method is widely accepted, our findings applying radiolabeled PLGA/PLA–PEG nanoparticles underscore its lack of transferability between different settings and its limitations as a standalone quality control tool. While TLC profiles may appear similar for purified and radiocolloid containing nanoparticle formulations, their in vivo behavior can vary significantly, as demonstrated by discrepancies between TLC results and single-photon emission computed tomography (SPECT) and biodistribution data. This highlights the urgent need for a case-by-case evaluation of TLC methods for each specific nanoparticle type. Our study revealed that polymeric nanoparticles cannot be considered analytically uniform entities in the context of TLC analysis, emphasizing the complex interplay between nanoparticle composition, radiolabeling conditions, and subsequent biological behavior.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1536-16322622024Evaluating the Patterns of FAPI Uptake in the Shoulder Joint: a Preliminary Study Comparing with FDG Uptake in Oncological Studies294300ENYohjiMatsusakaDepartment of Nuclear Medicine and Comprehensive Heart Failure Center (CHFC), Molecular Imaging of the Heart, University Hospital of WürzburgRudolf A.WernerDepartment of Nuclear Medicine and Comprehensive Heart Failure Center (CHFC), Molecular Imaging of the Heart, University Hospital of WürzburgSebastian E.SerflingDepartment of Nuclear Medicine and Comprehensive Heart Failure Center (CHFC), Molecular Imaging of the Heart, University Hospital of WürzburgAndreas K.BuckDepartment of Nuclear Medicine and Comprehensive Heart Failure Center (CHFC), Molecular Imaging of the Heart, University Hospital of WürzburgAleksanderKosmalaDepartment of Nuclear Medicine and Comprehensive Heart Failure Center (CHFC), Molecular Imaging of the Heart, University Hospital of WürzburgTakanoriSasakiFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAlexanderWeichDepartment of Nuclear Medicine and Comprehensive Heart Failure Center (CHFC), Molecular Imaging of the Heart, University Hospital of WürzburgTakahiroHiguchiFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground Fibroblast activation protein inhibitor (FAPI) targeting PET has been introduced as a novel molecular imaging modality for visualizing cancer-associated fibroblasts. There have also been reports suggesting incidental findings of localized accumulation in the shoulder joints. However, further characterization in a larger patient cohort is still lacking.<br>
Methods 77 consecutive patients (28 females; mean age, 63.1 ± 11.6) who underwent Ga-68 FAPI-04 PET/CT for diagnosis of solid tumors were included. The incidence and localization of tracer uptake in shoulder joints were investigated and compared with available F-18 FDG scans serving as reference.<br>
Results Ga-68 FAPI-04 uptake was evaluated in 77 patients (154 shoulder joints), of whom 54 subjects (108 shoulder joints) also had available F-18 FDG scans for head-to-head comparison. On FAPI-targeted imaging, 67/154 shoulders (43.5%) demonstrated increased radiotracer accumulation in target lesions, which were distributed as follows: acromioclavicular (AC) joints in 25/67 (37.3%), followed by glenohumeral and subacromial (GH + SA) joints in 23/67 (34.3%), or both (AC and GH + SA joints) in the remaining 19/67 (28.4%). Ga-68 FAPI-04 correlated with quantified F-18 FDG uptake (r = 0.69, p < 0.0001). Relative to the latter radiotracer, however, in-vivo FAP expression in the shoulders was significantly increased (Ga-68 FAPI-04, 4.7 ± 3.2 vs F-18 FDG, 3.6 ± 1.3, p < 0.001).<br>
Conclusion Our study revealed focal accumulation of Ga-68 FAPI-04 in the shoulders, particularly in the AC joints, with higher uptake compared to the inflammatory-directed PET radiotracer F-18 FDG in oncological studies. As a result, further trials are warranted to investigate the potential of FAPI-directed molecular imaging in identifying chronic remodeling in shoulder joints. This could have implications for initiating anti-FAP targeted photodynamic therapy based on PET signal strength.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1471-24902512025Impact of concomitant medications on the oncologic efficacy of systemic therapy in patients with advanced or metastatic urothelial carcinoma: a systematic review and meta-analysis107ENIchiroTsuboiDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineAkihiroMatsukawaDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaMehdi KardoustPariziDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaMarcinMiszczykDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaTamásFazekasDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaRobert JSchulzDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaEkaterinaLaukhtinaDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaTatsushiKawadaDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineSatoshiKatayamaDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTakehiroIwataDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKensukeBekkuDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicinePawelRajwaDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaKoichiroWadaDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaKatharinaObernederDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaPiotrChlostaDepartment of Urology, Medical College, Jagiellonian UniversityPierre I.KarakiewiczCancer Prognostics and Health Outcomes Unit, University of Montreal Health CentreMotooArakiDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineShahrokh F.ShariatDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaBackground: Immune checkpoint inhibitors (ICI) and chemotherapy, including antibody-drug conjugates, are widely used for the treatment of patients with advanced unresectable or metastatic urothelial carcinoma (UC). The majority of elderly patients receive concomitant medications to address various comorbidities. We aimed to evaluate the impact of concomitant medications on oncological outcomes in patients with advanced unresectable or metastatic UC treated with systemic therapy.<br>
Material & methods: In August 2024, three datasets were queried for studies evaluating concomitant medications in patients with advanced unresectable or metastatic UC. The review protocol was registered in PROSPERO (CRD42024547335). The primary outcome was overall survival (OS). A fixed- or random-effects model was used for meta-analysis depending on the heterogeneity.<br>
Results: We identified 16 eligible studies (3 prospective and 13 retrospective) comprising 4,816 patients. Most reported concomitant medications included proton pump inhibitors (PPIs), antibiotics, steroids, and opioids. The use of concomitant PPIs, antibiotics, steroids or opioids during ICI therapy was associated with worsened OS (PPIs: HR: 1.43, 95% CI: 1.31–1.57, p < 0.001; antibiotics: HR: 1.2, 95% CI: 1.04–1.38, p = 0.01; steroids: HR: 1.45, 95% CI: 1.25–1.67, p < 0.001; and opioids: HR: 1.74, 95% CI: 1.46–2.07, p < 0.001). Concomitant use of antibiotics during chemotherapy did not impact OS (HR: 1.01, 95% CI: 0.67–1.51).<br>
Conclusions: When treating advanced unresectable or metastatic UC with ICI therapy, we need to pay attention to concomitant medications, such as PPIs and antibiotics to avoid reducing the efficacy of ICI therapy. The mechanism of action of these drugs on ICI efficacy requires further examination.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0919-81723232024Postoperative infections after robotic‐assisted radical prostatectomy in a single large institution: Effect of type and duration of prophylactic antibiotic administration258263ENMasaoMitsuiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuyaSadahiraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaoyaNagasakiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiMaruyamaTakanoriSekitoDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakehiroIwataDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiKatayamaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKensukeBekkuDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMotooArakiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesObjective: We evaluated the incidence of and risk factors for postoperative infections after robotic-assisted radical prostatectomy (RARP) according to the type and duration of prophylactic antibiotic administration.<br>
Methods: A total of 1038 patients underwent RARP at our institution from 2010 to 2021; 1026 patients (201 in the cefazolin [CEZ] group and 825 in the ampicillin/sulbactam [ABPC/SBT] group) were analyzed, and 12 who used other antibiotics were excluded. The primary endpoint was the incidence of urinary tract infection (UTI), surgical site infection (SSI), and remote infection (RI). T-tests, propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were performed. Multivariate logistic regression analysis was performed to evaluate the effect of type and duration of prophylactic antibiotic administration.<br>
Results: The incidence of UTI was 2.5% (5/201) in the CEZ group and 3.2% (26/825) in the ABPC/SBT group, with no significant difference between groups (p = 0.622). The rates of SSI and RI were comparable between groups (p = 0.680 and 0.906, respectively). Although the duration of antimicrobial therapy was longer in the ABPC/SBT group (p < 0.001), there was no significant difference in the incidence of UTI/SSI/RI after PSM and IPTW (all p > 0.05). Multivariate logistic regression analysis showed that neither the type of antibiotic nor the duration of administration affected the incidence of UTI/SSI/RI.<br>
Conclusion: The risk of postoperative UTI/SSI/RI after RARP did not change with the type and duration of antimicrobial therapy.No potential conflict of interest relevant to this article was reported.