岡山大学算数・数学教育学会Acta Medica Okayama1341-3155312025学会だより6062ENNo potential conflict of interest relevant to this article was reported.岡山大学算数・数学教育学会Acta Medica Okayama1341-3155312025単元を貫く数学的活動で楽しい算数の授業 ―１年生「おおきいかず（４０までの数）」ー3441EN 本研究は、教具を体験する活動、教具を作る作業的活動、教具で説明する活動など様々な数学的活動を、同じ教具で単元をとおして行うことで、児童が意欲的に基礎的内容を理解するとともに、数学的な見方・考え方を働かせ、「１０といくつで１０いくつ」や「１０が何こで何十」「何十といくつで何十いくつ」の数の仕組みを理解できるようになっていく算数の授業実践研究である。No potential conflict of interest relevant to this article was reported.岡山大学法学会Acta Medica Okayama0386-3050753-42026PFOS・PFOA 等の残留性有機汚染物質による水質汚染に関する一考察 ― 取引上の義務の視点から―438410ENH.TsujiNo 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日韓の音楽文化交流を通した中学校音楽科におけるグローバル・シティズンシップ教育の構想 ―APCEIUでのインターンシップにおける調査の成果に基づいて―107121ENHikariKONISHIGraduate School of EducationToshinoriKUWABARAFaculty of EducationYumiKONISHIGraduate School of Education10.18926/CTED/70363 本論文は、中学校音楽科において、日本と韓国の音楽文化を取り上げて、互いの文化の違いや共通性を捉えさせたうえで相互理解を促進する、グルーバル・シティズンシップ教育（以下、GCED と表記）プログラムを構想しようとするものである。プログラムの構想の際には、筆者である小西が、韓国のソウルのAPCEIU（アジア太平洋国際理解教育センター）で行なった約一か月間のインターンシップの間の実地調査で把握した、韓国で展開されているGCED の方法を参考にした。開発プログラムでは、日韓両国の打楽器を取り上げて、その比較から互いの文化の違いを捉えさせたうえで、違いを受け入れながら、それぞれの国の音楽文化の根底にある歴史的背景に気づかせたうえで、文化の多様性や両国の文化の固有の価値に対する理解を深めることを目指した。No potential conflict of interest relevant to this article was reported.一般社団法人粉体粉末冶金協会Acta Medica Okayama0532-87997332026熱間静水圧加圧法を用いたイットリア安定化ジルコニア緻密層の低温形成5559ENKyoheiMANABEOsaka Gas Co. Ltd.MitsuakiECHIGOOsaka Gas Co. Ltd.AkiraKISHIMOTOInstitute of Academic and Research, Faculty of Environmental, Life, Natural Science and Technology, Okayama UniversityThe sintering conditions using hot isostatic press (HIP) of yttria-stabilized zirconia (YSZ) were investigated to obtain a dense YSZ layer at low sintering temperature such as 1000°C for an electrolyte of metal-supported solid oxide fuel cell. It was found that a dense YSZ pellet with relative density of 93% could be obtained under a sintering condition of 1000°C-10 hours with HIP in 195 MPa. On the other hand, in X-ray diffraction analysis of the dense YSZ pellet, peaks of the monoclinic phase were slightly detected in addition to peaks of the cubic phase. From energy dispersive X-ray spectroscopy analysis, a small amount of boron was detected in the dense YSZ pellet. It is considered that the YSZ crystalline phase transformation of cubic to monoclinic phase was occurred by the boron diffusion from the diffusion barrier coating of metal foil capsule used for the HIP.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.MDPI AGActa Medica Okayama1424-822025212025Integrated Authentication Server Design for Efficient Kerberos–Blockchain VANET Authentication6651ENMayaRahayuGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMd. BiplobHossainGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversitySamsulHudaInterdisciplinary Education and Research Field, Okayama UniversityYasuyukiNogamiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityVehicular Ad Hoc Network (VANET) is a fundamental component of the intelligent transportation systems (ITS), providing critical road information to users. However, the volatility of VANETs creates significant vulnerabilities from malicious actors. Thus, verifying joining entities is crucial to maintaining the VANET’s communication security. Authentication delays must stay below 100 ms to meet VANET requirements, posing a major challenge for security. Our previous research introduced a Kerberos–Blockchain (KBC) authentication system that contains two main components separately: Authentication Server (AS) and Ticket Granting Server (TGS). However, this KBC architecture required an additional server to accommodate increasing vehicle volumes in urban environments, leading to higher infrastructure costs. This paper presents an integrated authentication server that merges AS and TGS into a Combined Server (CBS) while retaining blockchain security. We evaluate it using OMNeT++ with SUMO for traffic simulation and Ganache for blockchain implementation. Results show that CBS removes the need for an extra server while keeping authentication delays under 100 ms. It also improves throughput by 104% and reduces signaling overhead by 45% compared to KBC. By optimizing authentication without compromising security, the integrated server greatly enhances the cost-effectiveness and efficiency of VANET systems.No potential conflict of interest relevant to this article was reported.BON VIEW PUBLISHING PTEActa Medica Okayama2810-9503512025A Study on Zeek IDS Effectiveness for Cybersecurity in Agricultural IoT Networks133142ENSamsulHudaInterdisciplinary Education and Research Field, Okayama UniversityMuhammad BisriMusthafaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityS. M.ShamimGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYasuyukiNogamiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityAs agriculture moves toward Agriculture 4.0, which uses Internet of Things (IoT) devices to collect data in real time and monitor things from a distance, these networks are becoming increasingly vulnerable to cyberattacks. A common method used to protect against these kinds of threats is the use of intrusion detection systems (IDS). However, the agricultural environment is often changing and has limited resources, which makes cybersecurity challenging. Several available IDS tools are not designed to work properly in places with few resources, intermittent access, and unpredictable network conditions. This paper investigates the performance of Zeek, an open-source IDS, in identifying potential threats in agricultural IoT networks. We performed both offline and real-time experiments: offline analysis used pcap files from the Stratosphere Laboratory dataset, and real-time evaluation involved simulated live attack scenarios, focusing on unauthorized access attempts and distributed denial-of-service (DDoS) attacks. Zeek's performance was assessed based on CPU and memory utilization, as well as quality of service (QoS) metrics. From the experimental results, we found that Zeek was quite effective in protecting agricultural IoT networks against typical threats. Memory usage remained stable around 5% during offline analysis and under 20% during active attacks. However, CPU usage was more volatile, peaking at 120% during DDoS events. In terms of QoS, the system maintained a good throughput (1,375 kbits/s) with minimal packet loss (0.000186%). Among the attack types that we tested, brute force attacks, which represent attempts at unauthorized access, had the strongest effect on network performance, increasing delay to 2.159 ms and jitter to 0.793 ms. It seems clear that a heavier traffic load during such attacks can interfere with QoS. On the basis of our observation, we recommend practical deployment strategies for agricultural IoT systems that take these limitations into consideration, aiming to keep networks both secure and efficient under pressure.No potential conflict of interest relevant to this article was reported.岡山大学大学院ヘルスシステム統合科学研究科Acta Medica Okayama2436-322762026裏表紙・英文目次ENNo potential conflict of interest relevant to this article was reported.岡山大学教育学部国語研究会Acta Medica Okayama2189-5414402026「ぼっけえ」と「でえれえ」―同義的類義語の意味用法の分析―(48)(60)ENNo potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0012-15926832026A Simple Method for RNA-Seq of Manually Isolated Chromatophores in Oryzias Fishese70044ENMakotoGodaInstitute of Photonics Medicine, Hamamatsu University School of MedicineAsukaMiyagiInstitute of Photonics Medicine, Hamamatsu University School of MedicineKeisukeSugiwakaDepartment of Biological Science, Division of Natural Science, Graduate School of Science, Nagoya UniversityMasakatsuWatanabeCellular and Structural Physiology Institute (CeSPI) and Graduate School of Pharmaceutical Sciences, Nagoya UniversityManabuBessho‐UeharaFrontier Research Institute for Interdisciplinary Science, Tohoku UniversityMasahikoHibiDepartment of Biological Science, Division of Natural Science, Graduate School of Science, Nagoya UniversityAtsushiToyodaComparative Genomics Laboratory, National Institute of GeneticsRiekoTanakaWorld Medaka Aquarium, Nagoya Higashiyama Zoo and Botanical GardensKawilarang W. A.MasengiFaculty of Fisheries and Marine Science, Sam Ratulangi UniversityKazunoriYamahiraTropical Biosphere Research Center, University of the RyukyusSatoshiAnsaiUshimado Marine Institute, Okayama UniversityHisashiHashimotoDepartment of Biological Science, Division of Natural Science, Graduate School of Science, Nagoya UniversityRNA sequencing (RNA-seq) has become an essential tool for analyzing gene expression and exploring cell type–specific transcriptomes. However, sample preparation and quality control remain challenging, as current approaches typically rely on dissecting tissues containing mixed cell populations or using flow cytometry to isolate fluorescently labeled cells. Here we present a simple and reliable method for RNA-seq of chromatophores (pigment cells) by manually isolating cells based on their natural pigmentation. We analyzed four chromatophore types―melanophores, xanthophores, iridophores, and leucophores―in medaka (Oryzias latipes). Remarkably, as few as 100 cells per type yielded reasonably high-quality transcriptomes sufficient to identify differentially expressed genes (DEGs). Furthermore, this method was successfully applied to a non-model medaka species, O. woworae, which shares the same four chromatophore types. Our approach enables efficient, low-cost, and cross-species transcriptome analysis of chromatophores without requiring transgenic markers or flow cytometry.No potential conflict of interest relevant to this article was reported.岡山大学理学部地球科学科Acta Medica Okayama1340-741432120262018年7月5日〜7日の西日本豪雨における広域降水特性3344ENKuranoshinKATOFaculty of Education, Okayama UniversityKengoMATSUMOTOOkayama Gakugeikan High SchoolKazuoOTANITV Setouchi Broadcasting Co., LTD.10.18926/ESR/70297 Large-scale rainfall characteristics at the heavy rainfall event around the western Japan for 5–7 July 2018 were analyzed with use of the 10-mimute precipitation data at the surface meteorological observation stations of the Japan Meteorological Agency, and so on. In this case, the area with 3 days total precipitation of near or more than 300 mm was distributed widely from northern Kyushu to Shiga and Fukui Prefectures. As in the many heavy rainfall events around Kyushu District in the mature stage of the Baiu season, contribution of the intense rainfall with more than 4 mm/10-minute (24 mm/h) attained about one third of the areal mean total precipitation. However, it is noted that the "not so intense rain" with less than 2 mm/10-minute (12 mm/h) also contributed to about one third of the huge total precipitation in the wide area. In short, this case could be characterized by the mixture of the western Japan type heavy rainfall event and the eastern Japan type one.No potential conflict of interest relevant to this article was reported.岡山大学理学部地球科学科Acta Medica Okayama1340-7414321202610分間降水量から大雨の特徴の多様性を捉える大学での授業の試み（防災気象リテラシー育成へ向けて）2131ENKuranoshinKATOFaculty of Education, Okayama University10.18926/ESR/70296 In the disaster prevention education on the heavy rainfall around Japan, it is also important to promote the meteorological literacy on the seasonal and regional differences of their rainfall characteristics such as the convective rain or stratiform rain, together with their total amount of precipitation and their occurrence frequency. As the first step toward the above purpose, the present study made a lesson practice for the university students by utilizing the 10-minute precipitation data for the four heavy rainfall events, in which the types of the heavy rainfall (although all the cases examined in the lesson are relating to the deep convective clouds) are rather different from each other, such as the differences of the rainfall intensity at the peak time, short-period variation of the rainfall intensity and the persistency of the rainfall including the "not so intense rainfall". The reports by the students seem to perceive the different features among these events briefly, but the students' attention to how long the intense rainfall with short-period variation or "not so intense rainfall" lasted was not so sufficient.No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671612026GARCH-MIDAS アプローチによる石油ショックが石油輸入国および輸出国の為替レートに与える影響の分析139153ENPengCHEN10.18926/70282No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465732026地域間での情報交流に関するネットワーク分析：高梁川流域圏での調査による1140ENRyoheiNakamuraNatsumiYokota10.18926/OER/70262 本稿では，岡山県の「高梁川流域連携中枢都市圏」で2014年から開催されている「高梁川流域経済成長戦略会議」における参加主体間の情報交流についてのネットワーク分析を行った。高梁川流域連携中枢都市圏（高梁川流域圏）とは，岡山県高梁川周辺に位置する現在の新見市，高梁市，総社市，早島町，倉敷市，矢掛町，井原市，浅口市，里庄町，笠岡市の10自治体が参加している連携中枢都市圏である。高梁川流域圏におけるネットワーク分析に際しては，同圏域内で展開されている事業を８つに分類し，それぞれの事業に関する参加主体間の情報交流についてアンケート調査を行った。ネットワーク指標については事業ごとに次数中心性と媒介中心性の中心性指標を，また事業別に密度，推移性，相互性を算出した。事業別にみると，観光事業についての情報交流が最も密なネットワーク構造をしており，ネットワークの視点では観光事業が高梁川流域圏内で最も勢力的に行われている事業といえる。また全事業において特定の行政主体や商工会議所をはじめとする地域経済団体等の中心性指標が全体的に大きな値をとっており，ネットワークにおいて情報交流のハブや情報の集中・分散主体として機能していることが明らかになった。分析結果を踏まえ，ネットワークの視点から高梁川流域圏の今度の地域振興について２点提言した。１つは事業によって情報交流のハブや情報の集中・分散主体を主体間で分担することによって，すべての事業で密なネットワークを築くことを目指すことである。もう１つは高梁川流域圏の情報交流ネットワークに全く参加していない主体をなくすことで，全体的に密なネットワークを目指すことである。No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-414657320261998年の外国為替及び外国貿易管理法改正と 外国通貨の譲渡による損益の所得区分 ―1998年の法改正は所得区分にどのような影響を与えたのか―110ENYoshiyukiNakagawa10.18926/OER/70261 1998年の外国為替及び外国貿易管理法の改正（以降，外国為替及び外国貿易法に改名）により，それまで外国為替公認銀行に原則として限られていた外国為替取引が，あらゆる企業及び個人に解放され，自由に行うことができるようになった。<br>
本稿は，まず課税当局の「外国通貨の譲渡による損益は雑所得に該当する」との見解の判断根拠を，国会における政府参考人答弁及び東京地裁令和５年３月９日判決から読み解き，そのうえで，1998年の法改正により外国通貨取引が対外及び国内において何人も自由に行うことができるようになったことから，外国通貨は支払手段として言わば価値の尺度として機能するようになり，資産の値上がり，値下がりを観念することができなくなった結果として，その譲渡による所得区分が譲渡所得から雑所得へと変化したとの結論を導くものである。No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2666-6065672026Alcohol consumption, smoking, and the implications of their cessations for field carcinogenesis in the esophagus: a 10-year prospective cohort study101798ENChikatoshiKatadaDepartment of Medical Oncology, Kyoto University Graduate School of MedicineTetsujiYokoyamaDepartment of Health Promotion, National Institute of Public HealthTomonoriYanoDepartment of Gastroenterology and Endoscopy, National Cancer Center Hospital EastYasuakiFurueDepartment of Endoscopy, Saitama Cancer CenterHaruhisaSuzukiDivision of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of MedicineKenjiIshidoDepartment of Gastroenterology, Kitasato University School of MedicineKeikoYamamotoDivision of Endoscopy, Hokkaido University HospitalHiroyoshiNakanishiDepartment of Gastroenterology, Ishikawa Prefectural Central HospitalTomoyukiKoikeDivision of Gastroenterology, Tohoku University Graduate School of MedicineMasashiTamaokiDepartment of Medical Oncology, Kyoto University Graduate School of MedicineNoboruKawataDivision of Endoscopy, Shizuoka Cancer CenterMotohiroHiraoDepartment of Surgery, NHO Osaka National HospitalYoshiroKawaharaDepartment of Practical Gastrointestinal Endoscopy, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiOgataDepartment of Gastrointestinal Surgery, Kanagawa Cancer CenterAtsushiKatagiriDivision of Gastroenterology, Department of Medicine, Showa Medical University HospitalTakenoriYamanouchiDepartment of Gastroenterology, Kumamoto Regional Medical CenterHirofumiKiyokawaDepartment of Gastroenterology, St. Marianna University School of MedicineHirofumiKawakuboMakiKonnoDepartment of Gastroenterology, Tochigi Cancer CenterAkiraYokoyamaDepartment of Medical Oncology, Kyoto University Graduate School of MedicineShinyaOhashiDepartment of Medical Oncology, Kyoto University Graduate School of MedicineTaiOmoriDepartment of Surgery, Kawasaki Municipal Kawasaki HospitalTadakazuShimodaDepartment of Diagnostic Pathology, Shizuoka Cancer CenterAtsushiOchiaiExploratory Oncology Research and Clinicai Trial Center, National Cancer CenterHidekiIshikawaDepartment of Molecular-Targeting Prevention, Kyoto Prefectural University of MedicineAkiraYokoyamaClinical Research Unit, National Hospital Organization Kurihama Medical and Addiction CenterManabuMutoDepartment of Medical Oncology, Kyoto University Graduate School of MedicineBackground Alcohol and tobacco are established carcinogens, which promote field carcinogenesis for esophageal squamous cell carcinoma (ESCC). This study aimed to evaluate the long-term effects of alcohol and tobacco cessations, and background mucosal status, on risk for metachronous ESCC (mESCC) after endoscopic resection (ER).<br>
Methods This was a multicentre prospective cohort study of patients with intramucosal ESCC treated by ER. All participants received structured education on cessation, and underwent regular endoscopic surveillance. Patients were stratified by Lugol-voiding lesion (LVL) grade (A: none, B: 1–9, C: ≥10). The impacts of alcohol and smoking cessation on field carcinogenesis were assessed.<br>
Findings Among 331 enrolled patients, the median follow-up was 120 months (range: 1.3–176.9). The cumulative incidences of mESCC were 10.4%, 27.2%, and 61.8% in grades A, B, and C, respectively. An increment of 1 unit (22 g ethanol) of alcohol consumption and higher LVL grade independently increased the risk for mESCC. Alcohol or smoking cessation reduced this risk (hazard ratio [HR] 0.52, 95% confidence interval [CI]: 0.31–0.88; HR 0.44, 95% CI: 0.25–0.78, respectively), and combined cessation had the greatest impact (HR 0.21, 95% CI: 0.07–0.65). Complete cessation, rather than partial reduction, was necessary to achieve meaningful risk reduction.<br>
Interpretation Alcohol and tobacco exposure, and a large number of LVL, are major determinants of mESCC. Complete cessation markedly reduces risk, underscoring the importance of behavioural interventions for secondary prevention of field carcinogenesis after ER.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1478-63622812026Real-world comparative effectiveness of sarilumab versus Janus kinase inhibitors as monotherapy in rheumatoid arthritis32ENYujiNozakiDepartment of Hematology and Rheumatology, Kindai University Faculty of MedicineKazuyaKishimotoDepartment of Hematology and Rheumatology, Kindai University Faculty of MedicineTetsuItamiDepartment of Hematology and Rheumatology, Kindai University Faculty of MedicineDaisukeTomitaDepartment of Hematology and Rheumatology, Kindai University Faculty of MedicineYumikoWadaDepartment of Internal Medicine (IV), Osaka Medical and Pharmaceutical UniversityTakuyaKotaniDepartment of Internal Medicine (IV), Osaka Medical and Pharmaceutical UniversityTohruTakeuchiDepartment of Internal Medicine (IV), Osaka Medical and Pharmaceutical UniversityToshihikoHidakaRheumatology Center, Miyazaki Zenjinkai HospitalShoichiHinoDepartment of Rheumatology and Clinical Immunology, Izumi City General Medical CenterToshiakiMiyamotoMiyamoto Internal Medicine and Rheumatology ClinicHirofumiMiyakeDepartment of General Internal Medicine, Tenri HospitalKazunariHattaDepartment of General Internal Medicine, Tenri HospitalKenjiMamotoDepartment of Orthopaedic Surgery, Graduate School of Medicine, Osaka Metropolitan UniversityYutaroYamadaCenter for Senile Degenerative Disorders (CSDD), Osaka Metropolitan University Graduate School of MedicineTadashiOkanoCenter for Senile Degenerative Disorders (CSDD), Osaka Metropolitan University Graduate School of MedicineTakaichiOkanoDepartment of Rheumatology and Clinical Immunology, Kobe University Graduate School of MedicineJunSaegusaDepartment of Rheumatology and Clinical Immunology, Kobe University Graduate School of MedicineMasahiroHoritaDepartment of Orthopaedic Surgery, Faculty of Medical Development Field, Okayama UniversityKeiichiroNishidaLocomotive Pain Center, Faculty of Medical Development Field, Okayama UniversityKojiKinoshitaDepartment of Hematology and Rheumatology, Kindai University Faculty of MedicineShinyaRaiDepartment of Hematology and Rheumatology, Kindai University Faculty of MedicineBackground: Sarilumab (SAR), an interleukin-6 receptor inhibitor (IL-6Ri), and Janus kinase inhibitors (JAKi) are approved options for rheumatoid arthritis (RA) when methotrexate (MTX) cannot be used. Real-world evidence for MTX-free monotherapy remains limited.<br>
Methods: We conducted a multicenter retrospective cohort study of RA patients receiving SAR or JAKi as MTX-free monotherapy. To reduce confounding, 1:1 propensity score matching was performed in the overall cohort (n = 252, 126 per group) and separately within treatment-line strata: Phase 2 first-line biologic/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs: 45 per group), Phase 3 second-line b/tsDMARDs (53 per group), and Phase 3 ≥ third-line b/tsDMARDs (47 per group). Outcomes over 12 months included drug retention, change in Clinical Disease Activity Index (CDAI), glucocorticoid (GC) tapering and discontinuation, low disease activity (LDA, CDAI ≤ 10), and safety profiles. Predictors of LDA were evaluated with logistic regression. This multicenter real-world.<br>
Results: Across matched strata by prior b/tsDMARDs, retention and CDAI change did not differ significantly between SAR and JAKi through 12 months. When classified by cause, adverse events (AEs)-related discontinuation was higher with JAKi, yielding lower AE-specific retention. Both groups demonstrated GC sparing overtime, with a greater increase in GC discontinuation for SAR than for JAKi in Phase 2. Baseline predictors of achieving LDA at 12 months included higher C-reactive protein (CRP) and platelet count (Plt) in both groups, with additional associations of younger age and lower hemoglobin (Hb) in the SAR. In safety analyses, overall AEs were less frequent with SAR than with JAKi, driven by lower risks of infection including herpes zoster, while other categories were similarly infrequent.<br>
Conclusion: SAR and JAKi showed no statistically significant differences in 12-month retention or disease control in MTX-free monotherapy settings. Higher CRP and Plt with lower Hb, particularly in younger patients, identified better response to SAR and support biomarker guided selection between IL-6Ri and JAKi. In Phase 2, GC discontinuation with SAR suggests a practical strategy to reduce AEs while maintaining efficacy. Prospective studies should validate these findings and define actionable thresholds.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama2752-4191562025Sex differences in the progression of cardiovascular–kidney–metabolic syndromeoeaf162ENSatoshiTayaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaroEjiriDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHidehiroKanekoDepartment of Cardiovascular Medicine, The University of TokyoYutaSuzukiDepartment of Advanced Cardiology, The University of TokyoToruMiyoshiDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsushiMizunoDepartment of Cardiology, Medical Quality Management Office, QI Center, St. Luke's International HospitalToshiyukiKoDepartment of Cardiovascular Medicine, The University of TokyoTakahiroJimbaDepartment of Cardiovascular Medicine, The University of TokyoTatsuhikoAzegamiDivision of Nephrology, Endocrinology, and Metabolism, Department of Internal Medicine, Keio University School of MedicineAkiraOkadaDepartment of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of TokyoKatsuhitoFujiuDepartment of Cardiovascular Medicine, The University of TokyoNorifumiTakedaDepartment of Cardiovascular Medicine, The University of TokyoHiroyukiMoritaDepartment of Cardiovascular Medicine, The University of TokyoKaoriHayashiDivision of Nephrology, Endocrinology, and Metabolism, Department of Internal Medicine, Keio University School of MedicineKoichiNodeDepartment of Cardiovascular Medicine, Saga UniversityMasaomiNangakuDivision of Nephrology and Endocrinology, The University of Tokyo Graduate School of MedicineHideoYasunagaDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of TokyoNorihikoTakedaDepartment of Cardiovascular Medicine, The University of TokyoShinsukeYuasaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAims Cardiovascular–kidney–metabolic (CKM) syndrome is a novel disease concept; however, sex differences in its progression remain uncertain. This study aimed to quantify the risk of cardiovascular disease (CVD) events across CKM stages and to explore sex differences in this association.<br>
Methods and results We included 1 332 436 individuals (581 423 males and 751 013 females) from the DeSC database between 2014 and 2023 who had no prior CVD (i.e. CKM Stage 4). CKM stages were categorized as follows: Stage 0 (no CKM risk factors); Stage 1 (excess or dysfunctional adiposity); Stage 2 [metabolic risk factors and chronic kidney diseases (CKD)], and Stage 3 (subclinical CVD). We used Cox models to examine the association of CKM stages with the risk of CVD events (newly developed CKM Stage 4), including myocardial infarction, stroke, heart failure, atrial fibrillation, and peripheral artery disease. The progression from CKM Stages 0 to 3 showed a dose-dependent increase in adjusted hazard ratios (HR) for developing CVD events, with the highest risk at Stage 3 [1.85 (95% CI: 1.80–1.90)]. A similar pattern was observed in both males and females. However, the magnitude of associations for CKM stages 1–3 differed between the sexes: HR by Stage 1, 1.12 (1.04–1.21) vs. 1.12 (1.07–1.16); by Stage 2, 1.78 (1.69–1.88) vs. 1.43 (1.39–1.48); by Stage 3, 1.99 (1.89–2.10) vs. 1.82 (1.76–1.88); and P-for-interaction values were 0.87, < 0.001, and 0.005, respectively.<br>
Conclusion In this large nationwide cohort, CKM stage progression was associated with higher CVD risk in both sexes, with modest sex-specific differences. These findings highlight the value of CKM staging for early risk assessment, regardless of sex.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1462-891027102025D3 lymph node dissection in colon cancer patients aged 90 years and over: Is it justified? A multi‐institutional retrospective studye70269ENFuminoriTeraishiDepartment of Gastroenterological Surgery, Okayama University HospitalSatoeTakanagaDepartment of Gastroenterological Surgery, Okayama University HospitalRyoInadaDepartment of Surgery, Kochi Health Sciences CenterToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Medical Development Field, Okayama UniversityToshiakiToshimaDepartment of Surgery, Kagawa Rosai HospitalTsuyoshiOhtaniDepartment of Surgery, Saiseikai Okayama HospitalRyosukeYoshidaDepartment of Surgery, Okayama Rosai HospitalRyoheiShojiDepartment of Gastroenterological Surgery, Okayama University HospitalToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University HospitalSetouchi Colorectal Neoplasm Registration study group collaboratorsAim: The oncological benefit of D3 lymph node dissection (D3 LND) for colon cancer in patients aged ≥90 years remains unclear. This study aimed to evaluate the impact of D3 LND on outcomes in this specific, vulnerable population.<br>
Method: This retrospective cohort study evaluated 166 patients aged ≥90 years with pathological Stages II–III colon cancer undergoing non-D3 or D3 LND from a multicentre database (2011–2022). Postoperative complications, overall survival and cancer-specific survival were compared between LND groups using propensity score-weighted analyses.<br>
Results: D3 LND group had significantly more females and laparoscopic procedures. Operation time was longer, and blood loss was lower in the D3 LND group. Postoperative complications and severe complications were significantly fewer, and postoperative hospital stay was shorter in the D3 LND group. The number of harvested lymph nodes and distal margin was significantly higher in the D3 group. While unadjusted analysis showed better overall survival with D3 LND (p < 0.001), adjusted cancer-specific survival showed no significant difference (p = 0.10). Adjusted mortality risk was significantly higher in the non-D3 group (p = 0.001).<br>
Conclusion: In nonagenarian colon cancer patients, D3 LND is safe and feasible without increasing complications, but lacks survival benefit. Careful consideration is warranted, and high-quality D2 LND must be consistently ensured when limited surgery is chosen.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1435-245141112025Surgical outcomes and patient selection in nonagenarians with colon cancer: a comparative multi-institutional study of laparoscopic and open approaches21ENRyoheiShojiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFuminoriTeraishiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoeTakanagaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Okayama University HospitalRyoInadaDepartment of Surgery, Kochi Health Sciences CenterToshiakiToshimaDepartment of Surgery, Kagawa Rosai HospitalTsuyoshiOhtaniDepartment of Surgery, Saiseikai Okayama HospitalRyosukeYoshidaDepartment of Surgery, Okayama Rosai HospitalNaotoHoriDepartment of Surgery, Tottori Municipal HospitalKaoruShigemitsuDepartment of Surgery, Tsuyama Chuo HospitalSumiharuYamamotoDepartment of Surgery, Okayama City HospitalTetsushiKubotaDepartment of Surgery, Kobe Red Cross HospitalYukaOkanoDepartment of Surgery, Onomichi City HospitalTetsujiNobuhisaDepartment of Surgery, Himeji Red Cross HospitalFumitakaTaniguchiDepartment of Surgery, National Hospital Organization Iwakuni Clinical CenterWataruIshikawaDepartment of Surgery, Fukuyama City HospitalTatsuoMatsudaDepartment of Surgery, Matsuda HospitalTatsuoUmeokaDepartment of Surgery, Matsuyama City HospitalToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSetouchi Colorectal Neoplasm Registration study group collaboratorsPurpose The appropriate surgical approach for colon cancer (CC) in nonagenarian patients remains a subject of clinical debate. This study aimed to compare the short-term outcomes of laparoscopic (Lap) versus open (Open) surgery in patients aged ≥ 90 years with resectable colon cancer.<br>
Methods This multi-institutional retrospective cohort study included oldest-old patientswith pathological Stage II/III CC who underwent elective surgery at 15 hospitals between 2011 and 2022. Patients with rectal cancer, Stage 0/I/IV disease, or emergency surgery were excluded. To address selection bias, inverse-probability-weighted regression adjustment and stabilized inverse probability of treatment weighting (sIPTW) were applied. The primary outcome was postoperative complications; secondary outcomes included overall survival (OS).<br>
Results Median age was 92 years in both groups. Before adjustment, the Lap group had a higher proportion of female patients (p = 0.038) and lower ASA scores (p = 0.01). Laparoscopic surgery was associated with a significantly longer operative time (220 vs. 171 min, p = 0.046) but less intraoperative blood loss (10 vs. 78 mL, p < 0.01). Postoperative complication rates were comparable (Lap: 31.8%, Open: 33.8%), while the Lap group had a significantly shorter hospital stay (13 vs. 17 days, p < 0.01). D3 lymph node dissection was more frequently performed in the Lap group (p < 0.01). After sIPTW, overall survival did not differ significantly between groups (p = 0.61).<br>
Conclusion Both laparoscopic and open surgery are feasible options for selected nonagenarians with colon cancer. Laparoscopic surgery may offer benefits in terms of reduced blood loss and shorter hospitalization, despite longer operative times. Careful patient selection considering frailty and comorbidities is essential in determining the most appropriate surgical approach.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0964-26337032025Prevalence and Modifiable Risk Factors of Dementia in People With Down Syndrome: Cross‐Sectional Study of Japan in Collaboration With the Intellectual Diversity for Goodness Research Consortium (INDIGO‐2019)329336ENShintaroTakenoshitaDepartment of Neuropsychiatry, Okayama University HospitalSeishiTeradaDepartment of Neuropsychiatry, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomokazuInoueAsahigawaso Research Institute, Social Welfare Corporation AsahigawasoTakuKurozumiAsahigawaso Research Institute, Social Welfare Corporation AsahigawasoManabuTakakiDepartment of Neuropsychiatry, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRyozoKuwanoAsahigawaso Research Institute, Social Welfare Corporation AsahigawasoShigeruSuemitsuAsahigawaso Research Institute, Social Welfare Corporation AsahigawasoBackground: People with Down syndrome (DS) have a strong genetic predisposition to Alzheimer's disease (AD). However, the clinical burden and associated risk factors in diverse, non-Western populations remain less understood. This study aimed to investigate the prevalence of dementia in Japanese adults with DS and to identify modifiable clinical factors associated with dementia.<br>
Methods: This cross-sectional multicentre study surveyed 133 adults with DS (mean age 50.1 years) residing in 45 welfare facilities across Japan in 2019. Dementia was diagnosed by a consensus panel of physicians using established criteria (DSM-5, ICD-10, DC-LD) after comprehensive assessments, including the Japanese version of the Dementia Screening Questionnaire for Individuals with Intellectual Disabilities (DSQIID-J). Logistic regression analysis was performed to identify factors independently associated with dementia.<br>
Results: Forty-six participants (34.6%) were diagnosed with dementia. The prevalence rose sharply with age: 0% in their 30s, 30.8% in their 40s, 31.6% in their 50s and 65.5% in their 60s. After adjusting for covariates, older age, female sex, dyslipidaemia and visual impairment were independently associated with dementia.<br>
Conclusions: This study, the largest of its kind in Asia, confirms a high prevalence of dementia in institutionalized Japanese adults with DS. Crucially, this study is the first to identify dyslipidaemia and visual impairment as independent and potentially modifiable risk factors in this population. These findings highlight tangible targets for clinical interventions aimed at mitigating dementia risk in people with DS.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1364-67532712026Compound heterozygosity of a novel missense variant and exonic deletion in hypomyelinating leukodystrophy 1516ENAkihikoMitsutakeDepartment of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Department of NeurologyTakashiMatsukawaDepartment of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Department of NeurologyKentaOrimoDepartment of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Department of NeurologyKunihiroUedaDepartment of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Department of NeurologyTomonariSekiDepartment of Neurology, Tokyo Teishin HospitalYasushiShiioDepartment of Neurology, Tokyo Teishin HospitalJunMitsuiDepartment of Precision Medicine Neurology, Graduate School of Medicine, The University of TokyoHiroyukiIshiuraDepartment of Neurology, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineHarushiMoriDepartment of Radiology, School of Medicine, Jichi Medical University,ShojiTsujiInstitute of Medical Genomics, International University of Health and WelfareTatsushiTodaDepartment of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Department of NeurologyHypomyelinating leukodystrophy 15 (HLD15) results from biallelic pathogenic variants in EPRS1, but exonic deletions have not been reported. We describe a 40-year-old woman with mild intellectual disability, ataxia, dystonia, and MRI showing hypomyelination. Whole-exome sequencing identified a heterozygous missense variant in the prolyl-tRNA synthetase domain of EPRS1 (c.3430 C > G; p.Leu1144Val, NM_004446.3), without second variant. Whole-genome sequencing revealed a heterozygous 220-bp deletion spanning exon 15 (c.1743-30_1932del), and segregation analysis confirmed compound heterozygosity. RT-PCR from lymphoblastoid cells demonstrated exon-15 skipping leading to a frameshift (p.Asn582Serfs*10) and nonsense-mediated decay, leaving predominant expression of the paternally inherited missense allele. These findings support loss-of-function for the deletion and classify c.3430 C > G as likely pathogenic under ACMG/AMP criteria (PM1, PM2, PM3, PP3). This case represents the first exonic deletion reported in EPRS1. The relatively mild, adult-onset phenotype broadens both mutational and clinical spectra of HLD15 and highlights the importance of structural-variant analNo potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1613-681021502025Collagen Signaling via DDR1 Exacerbates Barriers to Macromolecular Drug Delivery in a 3D Model of Pancreatic Cancer Fibrosise06926ENMayuOhiraDepartment of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMoeKitamuraDepartment of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiroyoIwasakiDepartment of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHarukoOhta‐OkanoDepartment of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiyoriTsujiiDepartment of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityReikaNakamuraDepartment of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakuyaNakazawaDepartment of Pharmaceutical Biomedicine, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityAkihiroNishiguchiBiomaterials Field, Research Center for Macromolecules and Biomaterials, National Institute for Materials ScienceMasayaYamamotoDepartment of Materials Processing, Graduate School of Engineering, Tohoku UniversityKensukeOsadaDepartment of Molecular Imaging and Theranostics, Institute for Quantum Medical Science, National Institutes for Quantum Sciences and Technology (QST)ShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHoracioCabralDepartment of Bioengineering, Graduate School of Engineering, The University of TokyoAtsushiMasamuneDivision of Gastroenterology, Graduate School of Medicine, Tohoku UniversityMitsunobu R.KanoDepartment of Pharmaceutical Biomedicine, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityHiroyoshi Y.TanakaDepartment of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityFibrosis is a significant barrier to drug delivery in pancreatic ductal adenocarcinoma (PDAC) and contributes to its dismal prognosis. Pancreatic stellate cells (PSCs) drive fibrosis by excessively secreting extracellular matrix proteins such as collagen I. Collagen I is thought to physically obstruct the delivery of macromolecules, such as albumin, antibodies, and nanomedicines. Apart from its structural role, collagen signals through dedicated cell surface receptors, such as the discoidin domain receptors (DDR) 1/2. However, whether and how collagen signaling contributes to fibrotic barrier generation remains uncharacterized. Here, a 3D culture model of PDAC fibrosis constructed from patient PSCs is used to assess the contribution of DDR1/2-mediated collagen signaling. DDR1/2 inhibition diminishes collagen I expression in PSCs to enhance macromolecular delivery. Moreover, MEK inhibitors exacerbate the fibrotic barrier by up-regulating collagen I, an effect reversed by inhibiting DDR1/2. Through isoform-specific targeting, inhibiting DDR1, but not DDR2, is shown to be effective. Downstream of DDR, the involvement of the PI3K/AKT/mTOR pathway is demonstrated, particularly alternative mTOR complexes involving MEAK7 and GIT1. Altogether, the results show in vitro that DDR1-mediated collagen signaling exacerbates the fibrotic barrier and may be targeted to enhance macromolecular drug delivery in PDAC.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.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231912026腎機能の理解を促すための教材開発と中学校理科における授業実践111117ENMotonoriANDOFaculty of Education, Okayama UniversityRisaIKEDASeishin Junior High School/Seishin Girls’ High SchoolFukutoTANAKASeishin Junior High School/Seishin Girls’ High School10.18926/bgeou/70200 本研究では腎臓におけるろ過後，ろ液の成分がどのような物質で構成されているのか，その後の腎臓での再吸収過程を含めて，中学生の腎機能の理解を促す教材開発を試みた。まず，市販の果汁を含む飲料水をメンブレンフィルターでろ過し，ろ液が透明になるのは不溶性物質が除去されるためであること，また，ろ液の甘さから水溶性の糖分はろ過されることを確認した。開発した腎臓糸球体モデルは，腎小体に見立てた蓋に孔を開けたプラスチック容器，赤血球や血液中に存在する様々な物質を模した色や大きさの異なるビーズ，から構成される。生徒は，この教材を用いた授業実践を経て，血球以外の水溶性成分は要不要に関わらず一旦腎小体でろ過されてしまうこと，生体に必要なブドウ糖は尿細管において能動的に再吸収されることを理解し，腎臓のろ過と再吸収に関する新しい考え方と関連する概念を獲得することができた，と考えられた。本研究で開発した教材を用いることにより，生徒の腎臓の役割についての理解を深化させること，同時に自身の健康への関心を高めさせること，について有効であることが分かった。No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2590-1397282025Flow diverter treatment for internal carotid artery aneurysm following management of distal cerebral aneurysms: Technical note100540ENYuichiHirataDepartment 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 SciencesKenjiSugiuDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFukikoBabaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJuntaroFujitaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYutaSotomeDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasatoKawakamiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyuKimuraDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiEbisudaniDepartment 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 SciencesTomohitoHishikawaDepartment of Neurosurgery, Kawasaki Medical SchoolShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground: In recent years, the effectiveness of flow diverters (FDs) for the treatment of intracranial aneurysms has been reported. While FDs are effective, their deployment involves advancing a delivery wire distally, which may pose a risk if a distal aneurysm exists within the same artery. In such cases, the delivery wire could potentially perforate the distal aneurysm. Here, we present two cases of tandem aneurysms in which an internal carotid artery (ICA) aneurysm was treated with an FD following the treatment of a distal cerebral aneurysm.<br>
Case description: A 44-year-old woman and a 67-year-old woman underwent magnetic resonance imaging for headache or abducens nerve palsy. In both cases, two aneurysms were revealed: one at the ICA and the other either at the middle cerebral artery or the top of the ICA. Due to the risk of perforation by the delivery wire during FD deployment, the distal aneurysms were treated first―either with surgical neck clipping or stent-assisted coil embolization. One month after the initial treatment, FD placement for the ICA aneurysm was performed as planned without complications in either case.<br>
Discussion: This is the first report where tandem aneurysms were successfully treated with treatment for distal cerebral aneurysms, followed by FDs for proximal ICA aneurysms. We emphasize the potential risk of perforation of the distal aneurysm by the delivery wire during FD placement.<br>
Conclusion: Treatment of distal cerebral aneurysms beforehand can help ensure the safe and effective use of FDs in patients with tandem aneurysms.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0956-71351832026Monitoring postharvest water loss in eggplants (Solanum melongena L.) using UV-induced fluorescence imaging and multivariate analysis111902ENVincentRotichLaboratory of Biosensing Engineering, Graduate School of Agriculture, Kyoto UniversityTianqiGaoLaboratory of Biosensing Engineering, Graduate School of Agriculture, Kyoto UniversityPanintornPrempreeLaboratory of Biosensing Engineering, Graduate School of Agriculture, Kyoto UniversityTakahiroHayashiLaboratory of Biosensing Engineering, Graduate School of Agriculture, Kyoto UniversityKazuhikoNambaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityMitsujiMontaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityMotomiNishimotoTechnology and Innovation Center, Daikin Industries, Ltd.NaoshiKondoLaboratory of Biosensing Engineering, Graduate School of Agriculture, Kyoto UniversityEggplant (Solanum melongena L.) is susceptible to significant postharvest losses primarily due to water loss during storage, which affects market quality by causing texture and glossiness degradation. We investigated whether UV-induced fluorescence imaging and EEM (Excitation-Emission Matrix) fluorescence spectroscopy can non-destructively monitor WL under four storage regimes (10 °C/95 % RH, 20 °C/95 % RH, 20 °C/75 % RH, 10 °C/75 % RH). EEMs exhibited three regions; a 365/420 nm blue emission increased most under warm, low-humidity storage and is consistent with phenolic/lignin-related fluorescence. Side-view fluorescence (FL) images showed progressive blue-white emission and surface textural changes that tracked gravimetric water loss (WL). A PLSR model using combined color and texture features from FL and reflectance (CL) images achieved R2CV = 0.88 (RMSECV = 3.47 %) with only six features. To test a minimal predictor, we fit an Analysis of Covariance (ANCOVA) using Day-1 FL MeanBlue as a covariate and storage category as a factor with Leave One Out Cross-validation (LOOCV); this forecasted cumulative WL with R2LOOCV = 0.92 and MAE = 1.88 %. Importantly, this ANCOVA model using Day-1 blue-band fluorescence as a covariate was predictive only under 20 °C/75 % RH; under the other conditions, its contribution was weak. Linear Discriminant Analysis (LDA) and Support Vector Machine (SVM) models achieved accuracies of 94.4 % and 85.2 %, respectively, in differentiating storage conditions. These results support low-cost FL imaging as a practical tool to monitor WL and storage stress.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0969-023932162025Development of sulfation for cellulose pulp to change its fiber morphology and appearance to transparent in water96639677ENAyatoNishimuraGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTetsuyaUchidaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityCellulose pulp (CP) is composed mainly of cellulose which is one of the most useful and sustainable natural polymers. Cellulose-based materials, such as completely dispersed nanofibers and water-soluble cellulose, are transparent in water. Additionally, chemical modification of CP has been employed as a pretreatment for the preparation of nanofibers and to impart absorption properties derived from anionic functional groups. However, little is known about chemically modified CPs comprising micron-scale fibers that are transparent in water.In this study, we synthesized transparent sulfated cellulose pulp (TSCP) that exhibits good dispersion stability, high transparency in water, and highly swollen fiber structures. The sulfation method involved heating sulfamic acid and urea supported on CP. TSCP synthesized using a sulfamic acid amount relative to CP (Q) of 18.5, a molar ratio of urea to sulfamic acid (R) of 0.80, and a reaction temperature of 140 °C exhibited the highest total light transmittance (94.7%) in water, a degree of polymerization (535), and amount of sulfate groups (1.73 mmol/g). Polarization microscopy confirmed that most TSCP fibers swelled in water along the fiber width direction. The structure of hydrous-state TSCP was further confirmed using low-vacuum scanning electron microscopy. The maximum fiber width of the swollen TSCP reached 122 μm, which was approximately six times than that of CP. The crystallinity was equivalent to that of the original CP with a Cellulose I-type crystalline structure. This transparent, hydrous-state TSCP, comprising predominantly swollen CP fibers, demonstrates potential for applications as a transparent material.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841832026A Rare Association of Congenital Glaucoma and Retinitis Pigmentosa: A 22-Year Follow-Up Casee105012ENToshihikoMatsuoOphthalmology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityPrimary congenital glaucoma is a rare congenital disease with a genetic background that shows high intraocular pressure due to ocular outflow anomalies. Retinitis pigmentosa is a predominant form of inherited retinal disorders. In this study, we present the case of a patient with primary congenital glaucoma in association with retinitis pigmentosa. A four-month-old female baby was brought to the emergency department due to corneal opacity in the left eye. The intraocular pressure measured by a hand-held applanation tonometer was 40 mmHg in the right eye and 36 mmHg in the left eye. She was otherwise healthy and diagnosed with primary congenital glaucoma. She immediately underwent trabeculotomy ab externo in both eyes under general anesthesia, and the intraocular pressure was lowered to 15 mmHg in the right eye and 12 mmHg in the left eye three weeks later. At the age of nine months, she was found to have retinal degeneration along the upper and lower vascular arcades of the fundus in both eyes and was diagnosed with retinitis pigmentosa. At the age of one year and 10 months, the visual acuity was measured at 0.2 in the right eye and 0.2 in the left eye for the first time by a preferential looking procedure. The intraocular pressure was 9 mmHg in both eyes under sedation, and she did not use any topical medication. At the age of three years and three months, the uncorrected visual acuity and best-corrected visual acuity with myopic astigmatism correction were 0.1 and 0.15, respectively, in the right eye and 0.6 and 0.7, respectively, in the left eye. Occlusion therapy with an eye patch over the left eye for one hour daily was started. At the age of four years and 10 months, the best-corrected visual acuity was 0.7 in both eyes. At the age of six years, occlusion therapy was discontinued, and full-correction glasses were prescribed, based on cycloplegic refraction. The visual acuity in the right eye decreased to 0.3 at the age of 11 years and further to 0.1 at the age of 12 years, while the visual acuity in the left eye remained 0.8. Afterwards, she maintained a visual acuity of 0.1 in the right eye and 0.8 in the left eye until the age of 22 years. An incidental presence of primary congenital glaucoma in this patient led to the detection of retinitis pigmentosa in earlier years and allowed long-term follow-up for 22 years. Even though genetic testing was not performed for this patient, the abnormal function of primary cilia, designated as ciliopathy, might explain the co-occurrence of primary congenital glaucoma and retinitis pigmentosa.No potential conflict of interest relevant to this article was reported.Japanese Society for Horticultural ScienceActa Medica Okayama2189-01029442025Effects of Intermittent Low-temperature Storage Duration and Cycle on the Bolting and Flowering of Delphinium elatum in Summer522529ENMikaKawaiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMiwaFukuyasuGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYoshiyukiTanakaGraduate School of Agriculture, Kyoto UniversityYoshikuniKitamuraGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKen-ichiroYasubaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYuichiYoshidaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTanjuroGotoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityEarly-bolting in summer is a major problem when growing delphinium seedlings in summer to produce cut flowers that will be shipped in autumn and winter. In this study, an intermittent low-temperature storage (ILTS) treatment that induces flower bud differentiation in strawberry and prevents rosette formation in Eustoma significantly increased the Delphinium elatum cut flower length. Moreover, ILTS was as effective as growing seedlings under cool conditions at preventing early-bolting. We analyzed the effects of six ILTS treatments that differed regarding the treatment temperature (5 and 10°C) and treatment cycle (3 days/3 days, 6 days/6 days, and 12 days/12 days; ambient conditions/cool and dark). Cut flowers were significantly longer with the 6 days/6 days treatment at 10°C than for the control treatment. Furthermore, repeating the ILTS treatment cycle (6 days ambient conditions/6 days at 10°C) a total of four times produced high-quality cut flowers regardless of the cultivar. Therefore, this ILTS treatment may be ideal for preventing early-bolting in D. elatum.No potential conflict of interest relevant to this article was reported.Japanese Society for Horticultural ScienceActa Medica Okayama2189-01029512026Comparison of Fruit Development, Ripening, and Transcriptome Dynamics in Taiwanese and Japanese Cultivars of Japanese Apricot (Prunus mume Sieb. et Zucc.)1020ENTomoakiKashiwamotoGraduate School of Environmental and Life Science, Okayama UniversityTakashiKawaiGraduate School of Environmental and Life Science, Okayama UniversityTakaakiOeJapanese Apricot Laboratory, Wakayama Fruit Tree Experiment StationKojiNumaguchiJapanese Apricot Laboratory, Wakayama Fruit Tree Experiment StationYutoKitamuraFaculty of Agriculture, Setsunan UniversityYasutakaKuboGraduate School of Environmental and Life Science, Okayama UniversityFumioFukudaGraduate School of Environmental and Life Science, Okayama UniversityKoichiroUshijimaGraduate School of Environmental and Life Science, Okayama UniversityIn this study, we compared changes in traits associated with fruit development and ripening in Taiwanese and Japanese cultivars of Japanese apricot (Prunus mume Sieb. et Zucc.). We also analyzed transcriptome profiles to comprehensively examine different fruit development and ripening patterns between the two groups in terms of fruit characteristics and gene expression. Early fruit development in Taiwanese cultivars ‘ST’ and ‘Ellching’ and the Japanese cultivar ‘Hakuo’ was ahead of that in other three Japanese cultivars (P1). From late April to early May, around the stone-hardening stage, the developmental differences decreased to the same level. Thereafter, Japanese cultivars showed rapid growth, whereas Taiwanese cultivars showed slower growth, reversing the developmental differences between these lines (P2). Ethylene production was not detected until the full ripening stage and was detected for the first time at this stage in five cultivars, except for ‘Ellching’ (P3). In contrast, no ethylene production was observed during the entire duration of fruit development in ‘Ellching’. A multidimensional scaling plot showed that the overall transcriptome profile changed according to the three stages (P1–P3) of fruit development and ripening. At P1, gene ontologies (GOs) related to cell division, such as the cell cycle and regulation of cyclin-dependent protein serine/threonine kinase activity, were enriched for differentially expressed genes downregulated in Taiwanese cultivars as compared with their expression in Japanese cultivars. At P2, GOs related to fruit development were not enriched, but some genes related to phytohormones, such as auxin, abscisic acid, and cytokinin, which are associated with fruit development and ripening, were differentially expressed. At P3, the expression of genes such as ACS, ACO, and PG, which are involved in ethylene biosynthesis, increased in response to increased ethylene production, but not in ‘Ellching’, which showed no ethylene production. Expression analysis of 115 NAC (NAM-ATAF1/2-CUC2) family genes, which are related to fruit ripening and ripening date in other fruit species, in the ‘Ellching’ genome revealed changes in expression of NAC056 and NAC073 corresponding to fruit development and ripening in Taiwanese and Japanese cultivars. We discuss the differences in fruit development and ripening behaviors between Taiwanese and Japanese cultivars in terms of physiological and transcriptome changes.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1422-00672752026Fgf10 Gene Dosage from a Single Allele Is Insufficient for Forming Multilayered Epithelial Cells in the Murine Lacrimal Gland2113ENShioriIkedaDepartment of Cytology and Histology, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityKeitaSatoDepartment of Cytology and Histology, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityYukiTajikaDepartment of Radiological Technology, Gumma Prefectural College of Health SciencesHirofumiFujitaDepartment of Cytology and Histology, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTetsuyaBandoDepartment of Cytology and Histology, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTsutomuNohnoDepartment of Cytology and Histology, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversitySatoruMiyaishiDepartment of Legal Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityHideyoOhuchiDepartment of Cytology and Histology, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityMutations in the fibroblast growth factor 10 (FGF10) gene in humans cause aplasia of the lacrimal and salivary glands (ALSG). In patients with ALSG, heterozygous loss-of-function mutations are found, and FGF10 haploinsufficiency results in the absence of these secretory organs. Lacrimal glands (LGs) are formed through epithelial thickening, budding, and branching morphogenesis. To compare the variable phenotypes of the Fgf10+/− Harderian glands (HGs) previously reported, we examined the development of LGs in wild-type (WT), Fgf10+/−, and Fgf10-null mice. Pax6 immunostaining was performed to visualize the LG primordia from embryonic day 15.5 (E15.5) onwards. In situ hybridization of the genes encoding the epithelial receptor of FGF10, FGFR2b, and its other ligands was performed to determine their potential involvement in LG development. LG primordia were not observed in Fgf10+/− mice bilaterally at E16.5 or later stages. At E15.5, budding from the developing conjunctival epithelium (CE) was observed in a small fraction of the Fgf10+/− LG primordia. In contrast, the Fgf10-null CE failed to promote budding. Among Fgf1, Fgf3, Fgf7, Fgf10, and Fgf22, Fgf10 was expressed in the mesenchyme surrounding developing LG epithelial cells, whereas Fgf1 was expressed in the LG epithelium of WT mice. Fgf7 was initially expressed in the mesenchyme surrounding the nascent LG epithelium, but its expression subsequently became diffused. Thus, we conclude that among the FGFR2b ligands, initial LG formation is dependent on the mesenchymal factors FGF10 and FGF7, and FGF1 is likely to function as an epithelial factor in the LG primordia. A single allele of Fgf10 was found to be insufficient to support the budding process during LG morphogenesis.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.Ovid Technologies (Wolters Kluwer Health)Acta Medica Okayama2210-26121332025Robotic pancreatoduodenectomy for a giant duodenal leiomyoma: A case report and literature review111546ENSusumuDoitaDepartment 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 SciencesMotohikoYamadaDepartment 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: Duodenal leiomyomas are rare mesenchymal tumors. To date, several studies have reported on the safety and feasibility of surgical intervention for duodenal leiomyomas. However, minimally invasive surgery has rarely been performed in cases with duodenal leiomyomas. Herein, we present a case of a giant duodenal leiomyoma successfully treated with robotic pancreatoduodenectomy (RPD).<br>
Presentation of case: A 74-year-old man was referred to our hospital with a 6.5 cm duodenal tumor accompanied by gastrointestinal bleeding. The tumor was located in the second portion of the duodenum. Considering the tumor size and location, RPD was performed. Using the mesenteric Kocker maneuver, the posterior side of the duodenum was safely dissected, and the tumor was resected. The operative time was 373 min, with an estimated blood loss of 10 mL. The patient was followed up for 7 months with no recurrence.<br>
Discussion: To the best of our knowledge, this is the first to highlight the clinicopathological findings of a patient with duodenal leiomyoma undergoing RPD. To date, there have been 19 cases, including our case, reporting surgically treated duodenal leiomyoma. Treatment strategies should be decided depending on tumor characteristics, including the size, location, and histology of the tumor.<br>
Conclusion: We present a rare case of a giant duodenal leiomyoma that was successfully treated with RPD. Minimally invasive surgery can be safe and an alternative for the treatment of large duodenal tumors.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1435-245141012025Robotic distal pancreatectomy using two-surgeon technique (TAKUMI-4): a technical note and initial outcomes171ENKoseiTakagiDepartment 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 SciencesToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesPurpose With the increasing use of minimally invasive distal pancreatectomy, the use of robotic distal pancreatectomy (RDP) is also increasing worldwide. Standardized surgical protocols are essential for safe implementation of RDP. In this study, we present our surgical protocol and initial outcomes of RDP using “two-surgeon technique”.<br>
Methods Our standard RDP protocol included a two-surgeon technique for cooperation, rationality, and education. Short-term outcomes of RDP were also investigated. This retrospective study included 77 consecutive patients who underwent RDP at our institution between April 2021 and January 2025.<br>
Results The median operative time, estimated blood loss, and postoperative hospital stay were 214 min (interquartile range [IQR], 176–253), 10 mL (IQR, 0–50), and 9 days (IQR, 8–10), respectively. A textbook outcome was achieved in 84.4% of patients. Moreover, superior outcomes of RDP (n = 77) compared with those of laparoscopic distal pancreatectomy (n = 62) were confirmed in this study.<br>
Conclusion Using the two-surgeon technique, we successfully standardized and introduced the RDP program. The two-surgeon technique can contribute to the safe introduction of RDP and expansion of the program.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841742025Gastrointestinal Stromal Tumors in the Stomach With Tumor Growth and Hemorrhage During Conservative Management: A Report of Two Casese82046ENMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSatoruKikuchiDepartment 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 SciencesTakehiroTanakaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesGastrointestinal stromal tumors (GISTs) are often detected incidentally during esophagogastroduodenoscopy. Although surgical resection is the standard treatment for GISTs, patients with significant comorbidities may not be eligible for surgery and are managed conservatively. Herein, we report two cases of gastric GISTs that were initially observed during the management of other comorbidities but subsequently became enlarged, resulting in gastrointestinal bleeding. These cases highlight the potential risks of tumor progression and bleeding in patients undergoing conservative management.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841722025Gastric Metastasis of Renal Cell Carcinoma Initially Diagnosed by Esophagogastroduodenoscopye79651ENMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTomohiroKamioDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesShoichiroHirataDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakehiroTanakaDepartment of Pathology, Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHere, we report a rare case of renal cell carcinoma (RCC) initially detected as a gastric metastasis. A 58-year-old man with epigastric discomfort underwent esophagogastroduodenoscopy, which revealed a reddish semi-pedunculated lesion with a whitish coating. Biopsy and imaging confirmed clear cell RCC metastasis. Contrast-enhanced computed tomography (CT) revealed a primary renal tumor with pancreatic and lymph node metastases. Despite chemotherapy treatment, the patient died after 10 months. Gastric metastases from RCC, although rare, should be considered in highly vascular gastric lesions with white coatings. Clinicians must be vigilant for metastatic diseases with atypical gastric findings.No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026From The Odyssey to The Zahir：The Evolution of Penelopeia Across Time and Tradition120128ENSaidaKHALMIRZAEVAFaculty of General Education and Global Studies, Okayama University10.18926/70116The story of a man who leaves home and strives to return has become one of the most enduring narrative patterns in world literature and folklore. Across centuries and cultures, it has been retold in myths, epics, folktales, and modern fiction―the story of the homecoming hero who, after long absence and peril, finds his way back to the place and the person he once called his own. This study explores the persistence and transformation of this universal motif through a comparative reading of Homer’s The Odyssey and Paulo Coelho’s The Zahir. It examines the evolving image of the waiting wife―from Homer’s Penelopeia, emblem of chastity and endurance, to Coelho’s Esther, a modern woman of independence and choice. Despite differences in setting, voice, and moral vision, both works embody the same human longing: to return, to be recognized, and to rediscover love that endures time and change. Beneath their differences lies the same truth―the heart to which every journey, whether physical or spiritual, must ultimately return.No potential conflict of interest relevant to this article was reported.Ovid Technologies (Wolters Kluwer Health)Acta Medica Okayama2639-8028822026Association Between Positive End-Expiratory Pressure at Venovenous Extracorporeal Membrane Oxygenation Initiation and Liberation Outcomes in Acute Respiratory Distress Syndrome: A Multicenter Retrospective Studye1375ENTakashiHongoDepartment 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 UniversityTetsuyaYumotoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityMitsuakiNishikimiDepartment of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityShinichiroOhshimoDepartment of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityNobuakiShimeDepartment of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityAtsunoriNakaoDepartment 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 UniversityIMPORTANCE: The optimal level of positive end-expiratory pressure (PEEP) during venovenous extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS) remains uncertain.<br>
OBJECTIVES: This study aimed to evaluate the association between initial PEEP settings at ECMO initiation and the rate of successful ECMO liberation in patients with severe ARDS.<br>
DESIGN, SETTING, AND PARTICIPANTS: We conducted a post hoc analysis of the multicenter Japan Chest CT for ARDS Requiring Venovenous ECMO (J-CARVE) registry. Adult patients with severe ARDS treated with venovenous ECMO between 2012 and 2022 at 24 institutions were included. Participants were categorized into three groups according to PEEP at ECMO initiation: low (< 8 cm H2O), middle (8–10 cm H2O), and high (> 10 cm H2O).<br>
MAIN OUTCOMES AND MEASURES: The primary outcome was successful liberation from ECMO within 30 days. Multivariable Cox proportional hazards models were used to evaluate associations. Secondary outcomes included 60-day mortality, duration of ECMO support, and duration of mechanical ventilation.<br>
RESULTS: Among 683 patients analyzed, the overall ECMO liberation rate at 30 days was 69.2%. Liberation rates were 57.8% (103/178), 73.5% (259/352), and 72.5% (111/153) in the low, middle, and high PEEP groups, respectively. After adjustment, the low group had a significantly lower likelihood of successful ECMO liberation (hazard ratio [HR], 0.56; 95% CI, 0.39–0.81) compared with the middle group. No significant difference was observed between the high and middle groups (HR, 0.80; 95% CI, 0.58–1.10). The low group had longer ECMO duration; however, 60-day mortality and hospital length of stay did not differ significantly among groups.<br>
CONCLUSIONS AND RELEVANCE: Lower PEEP levels at ECMO initiation were associated with reduced likelihood of successful ECMO liberation compared with moderate PEEP, whereas estimates for high vs. moderate PEEP were not statistically significant. These findings support avoiding insufficiently low PEEP and underscore the need for prospective studies to refine optimal PEEP strategies in patients with severe ARDS.No potential conflict of interest relevant to this article was reported.Cambridge University Press (CUP)Acta Medica Okayama1460-3969252026Effects of sagging correction calibration error on radiation therapy equipment using image analysise5ENYasushiFujiiDepartment of Radiology, Chugoku Central Hospital of the Mutual Aid Association of Public School TeachersTakahiroNakayamaDepartment of Radiology, Chugoku Central Hospital of the Mutual Aid Association of Public School TeachersJunkiOshitaDepartment of Radiology, Chugoku Central Hospital of the Mutual Aid Association of Public School TeachersAyakaTsunodaDepartment of Radiology, Graduate School of Health Sciences, Okayama UniversityYusukeSaekiDepartment of Radiological Technology, Kawasaki Medical School HospitalYoshinoriTanabe Faculty of Medicine, Graduate School of Health Sciences, Okayama UniversityPurpose: This study investigates the effect of sagging correction errors on image quality and geometric coordinate accuracy.<br>
Methods: This study utilised the Elekta radiotherapy system, ball bearing (BB), Catphan phantom and MultiMet-WL phantom. Ten distinct flex maps (FMs) were acquired by positioning the BB at the accuracy isocentre and introducing shifts of 0.2, 0.4 and 0.6 mm in the left, table and up directions, respectively. Cone-beam computed tomography images of the Catphan phantom were acquired using 10 FMs. The images were analysed for modulation transfer function (MTF) values and geometric coordinates. Additionally, the Winston–Lutz (W-L) test was conducted under reference couch positions and with a 0.3 mm couch shift.<br>
Results: For the Catphan phantom analysis, the standard deviations of MTF10% across FMs were 0.19. The centre-of-gravity coordinates of the insert exhibited shifts of approximately 0.2, 0.4 and 0.6 mm when comparing reference images to those acquired with the shifted FMs. The results of the W-L test with a 0.3 mm couch shift showed radiation isocentre deviations exceeding 1 mm compared to the reference couch positions.<br>
Conclusions: Minor sagging correction calibration errors did not remarkably impact image quality; however, they altered the geometric coordinates of the image isocentre. These calibration errors decreased the accuracy of off-isocentre positioning.No potential conflict of interest relevant to this article was reported.Ovid Technologies (Wolters Kluwer Health)Acta Medica Okayama1743-915911222025Total thymectomy is oncologically superior to partial thymectomy in patients with thymic carcinoma: insights from a multicenter real-world data analysis23012310ENTatsuyaHayashiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMikioOkazakiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiharuMitsuhashiCenter of Innovative Clinical Medicine, Okayama University HospitalHidetakaYamamotoDepartment of Pathology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomohiroHabuOkayama University Thoracic Surgery Study Group (OUTSSG)KazuhikoShienDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenSuzawaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiromasaYamamotoOkayama University Thoracic Surgery Study Group (OUTSSG)TomoakiOtsukaOkayama University Thoracic Surgery Study Group (OUTSSG)MototsuguWatanabeOkayama University Thoracic Surgery Study Group (OUTSSG)TakeshiKurosakiOkayama University Thoracic Surgery Study Group (OUTSSG)EijiYamadaOkayama University Thoracic Surgery Study Group (OUTSSG)EisukeMatsudaOkayama University Thoracic Surgery Study Group (OUTSSG)TatsurouHayashiOkayama University Thoracic Surgery Study Group (OUTSSG)ToshiyaFujiwaraOkayama University Thoracic Surgery Study Group (OUTSSG)MakioHayamaOkayama University Thoracic Surgery Study Group (OUTSSG)HiroyukiTaoOkayama University Thoracic Surgery Study Group (OUTSSG)MasaomiYamaneOkayama University Thoracic Surgery Study Group (OUTSSG)HidetoshiInokawaOkayama University Thoracic Surgery Study Group (OUTSSG)YujiHiramiOkayama University Thoracic Surgery Study Group (OUTSSG)KazuhiroWashioOkayama University Thoracic Surgery Study Group (OUTSSG)TakahikoMisaoOkayama University Thoracic Surgery Study Group (OUTSSG)MotohiroYamashitaOkayama University Thoracic Surgery Study Group (OUTSSG)YoshifumiSanoOkayama University Thoracic Surgery Study Group (OUTSSG)MasaoNakataOkayama University Thoracic Surgery Study Group (OUTSSG)OsamuKawamataOkayama University Thoracic Surgery Study Group (OUTSSG)ShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground: Although total thymectomy has been the standard surgical approach for thymic epithelial tumors, an increasing number of recent reports suggest that partial thymectomy for early-stage thymomas may yield outcomes comparable to those of total thymectomy. However, whether partial thymectomy is a viable alternative for thymic carcinoma remains unclear.<br>
Materials and methods: A total of 106 patients with thymic carcinoma underwent curative intended resection at 19 institutions between January 2010 and December 2021. Excluding 14 patients with incomplete resection, 92 patients with thymic carcinoma who underwent total (n = 73) or partial thymectomy (n = 19) were compared. Overall survival (OS) and recurrence-free survival (RFS) were analyzed using Kaplan–Meier curves and Cox proportional hazard models. Overlap weighting was applied to adjust for potential confounding factors.<br>
Results: Among patients with clinical stage I disease, 79.3% were upstaged to stage II or higher postoperatively. Unadjusted analyses revealed no statistically significant differences in OS and RFS between the total and partial thymectomy groups, although a trend toward poorer outcomes in the partial thymectomy group was observed. After overlap weighting, partial thymectomy was associated with significantly poorer OS (P = 0.0027) and higher recurrence risk (P < 0.0001). Early postoperative recurrence occurred more frequently in the partial thymectomy group.<br>
Conclusion: Partial thymectomy was associated with significantly worse survival and recurrence outcomes in thymic carcinoma. Given the limitations of preoperative diagnosis, total thymectomy should remain the preferred surgical approach for undiagnosed thymic epithelial tumors to achieve optimal oncologic control and minimize the risk of recurrence.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0007-11882026Induction of IL-9-producing CD8+ T cells by ascochlorin derivativesENNatsumiImanoDepartment of Immunology, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesMikakoNishidaDepartment of Metabolic Immune Regulation, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesMihoTokumasuDepartment of Immunology, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesWeiyangZhaoDepartment of Immunology, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesNahokoYamashitaDepartment of Metabolic Immune Regulation, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesHeiichiroUdonoDepartment of Metabolic Immune Regulation, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesBackground and Purpose: Ascochlorin (ASC) is an antiviral antibiotic from the fermented broth of Ascochyta viciae which exerts an inhibitory effect to cancers. Its impact on immune cells has not been examined. In this study, we obtained ASC derivatives with less cytotoxicity and determined whether they affected T cells, indicating possible immune-mediated antitumour effects.<br>
Experimental Approach: Newly synthesised ASC derivatives were screened for inhibitory effects on T-cell antigen receptor (TCR)-stimulated proliferative responses using murine CD4+ and CD8+ T cells. Two compounds were identified that exhibited >10-fold less toxicity compared with ASC. N184, the less toxic of the two, was analysed for its in vivo antitumour effects, and in vitro effects on CD8+ T-cell proliferation, survival, cytokine production and exhaustion, using microscopy, qPCR and flow cytometry.<br>
Key Results: N184 induced limited IL-9 production in CD8+ T cells following TCR stimulation, thereby improving cell survival. It also enhanced cytokine production in the late phase of proliferation and suppressed the induction of exhaustion. N184 suppressed tumour growth in mice in a CD8+ T cell-dependent manner. The effect was partially prevented by an IL-9-neutralising antibody.<br>
Conclusion and Implications: N184 induces differentiation of IL-9-producing CD8+ T cells in vitro and elicits antitumour immunity in an IL-9-dependent manner.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8012026Effective Treatment of Advanced Hepatocellular Carcinoma with Extensive Peritoneal Dissemination Using Lenvatinib6974ENShinyaWakatsukiDepartment of Obstetrics and Gynecology, Kochi Health Sciences CenterShinyaSakamotoDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterAkikoUenoDepartment of Obstetrics and Gynecology, Kochi Health Sciences CenterTakaomiNambaDepartment of Obstetrics and Gynecology, Kochi Health Sciences CenterYoritoYamamotoDepartment of Obstetrics and Gynecology, Kochi Health Sciences CenterManabuMatsumotoDepartment of Diagnostic Pathology, Kochi Health Sciences CenterJunIwataDepartment of Diagnostic Pathology, Kochi Health Sciences CenterTakehiroOkabayashiDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterCase Report10.18926/AMO/70075Patients with hepatocellular carcinoma (HCC) and extensive peritoneal dissemination generally have a poor prognosis and are often resistant to systemic therapy. We report the case of a 47-year-old woman with HCC and massive peritoneal dissemination who presented with malignant ascites requiring repeated cell-free and concentrated ascites reinfusion therapy and peritoneovenous shunt placement, as well as malignant pleural effusion requiring pleurodesis. Combined immunotherapy with durvalumab/tremelimumab was initiated;however, disease progression was observed after three treatment courses, prompting a switch to lenvatinib therapy. Two months after initiation of lenvatinib, CT imaging demonstrated complete disappearance of arterial enhancement in the primary hepatic lesion, along with reduction in the size of peritoneal dissemination nodules. Thirteen months after switching to lenvatinib (16 months after the initial diagnosis), the alpha-fetoprotein level continued to decrease, and the disease remained stable under treatment. Despite the extremely high tumor burden, lenvatinib achieved disease stabilization and symptomatic improvement.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 Okayama0386-300X8012026Time Course of the Development and Loss of Delta-9-tetrahydrocannabinol Tolerance: Effects on Hypothermia and Spontaneous Locomotor Activity in Mice4754ENYukiomiEguchiDepartment of Physiology and Pharmacology, Faculty of Pharmaceutical Sciences, Fukuoka UniversitySoichiroUshioDepartment of Emergency and Disaster Medical Pharmacy, Faculty of Pharmaceutical Sciences, Fukuoka UniversityKeiichiIrieDepartment of Physiology and Pharmacology, Faculty of Pharmaceutical Sciences, Fukuoka UniversityYutaYamashitaDepartment of Physiology and Pharmacology, Faculty of Pharmaceutical Sciences, Fukuoka UniversityMiyuEguchiDepartment of Emergency and Disaster Medical Pharmacy, Faculty of Pharmaceutical Sciences, Fukuoka UniversityTakafumiNakanoDepartment of Oncology and Infectious Disease Pharmacy, Faculty of Pharmaceutical Sciences, Fukuoka UniversityKenichiMishimaDepartment of Physiology and Pharmacology, Faculty of Pharmaceutical Sciences, Fukuoka UniversityOriginal Article10.18926/AMO/70072Deregulation of cannabis use is gradually expanding in Europe and the United States. However, the biological processes driving tolerance to delta-9-tetrahydrocannabinol (Δ9-THC), the main psychoactive component of cannabis, remain unclear. Thus, this study aimed to investigate the mechanisms and time course of tolerance development and loss to Δ9-THC in mice. Male ICR mice (7 weeks old) were administered Δ9-THC once daily for 3 days and then divided into three groups according to the washout period (3-, 10-, and 17-day washout groups). After each washout, changes in body temperature and locomotor activity were measured following re-exposure to Δ9-THC. Furthermore, the mRNA expression levels of CB1 and CB2 receptors in the brain were evaluated using real-time PCR. On day 1, significant hypothermia and reduced spontaneous locomotor activity were observed in the Δ9-THC-treated mice compared with the vehicle-treated mice. Tolerance to the hypothermic and locomotor-suppressing effects of Δ9-THC developed on days 2 and 3, respectively, and dissipated after 3 and 11 days of washout, respectively. These differences in the rates of tolerance development and recovery may reflect distinct underlying mechanisms. No significant changes in receptor mRNA expression were observed. These findings highlight the complexity of Δ9-THC tolerance and its potential implications for long-term cannabis use.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8012026Kinesiophobia Is Associated with Disability, Poor Quality of Life, Psychological Morbidity, and Surgery Dissatisfaction in Patients with Lumbar Microdiscetomy: A Cross-Sectional Controlled Study3946ENNihalTezelDepartment of Physical and Rehabilitation Medicine, Health Sciences UniversityAslı GençayCanDepartment of Physical and Rehabilitation Medicine, Faculty of Medicine, Ankara Yıldırım Beyazıt UniversityOriginal Article10.18926/AMO/70071The study aimed to determine the prevalence of kinesiophobia in patients who had undergone lumbar microdiscectomy and to examine its associations with pain intensity, disability, quality of life, depression, anxiety, and satisfaction with surgery. Forty-eight patients with microdiscectomy and 48 healthy controls were enrolled. The Tampa Scale for Kinesiophobia (TSK), Roland-Morris Disability Index (RMDI), Hospital Anxiety and Depression Scale (HADS-A and HADS-D, respectively), and Short Form-36 Health Survey (SF-36) were administered to both groups. The scores of TSK, RMDI, HADS-A, and HADS-D were significantly higher and SF-36 scores were significantly lower in the microdiscectomy than the control group (p<0.001 for all). In the microdiscectomy group, median (min-max) RMDI, HADS-A, and HADS-D scores were 19 (4-34), 10 (0-18), and 9 (0-18), respectively, in kinesiophobic patients, and were significantly higher than 6 (2-20), 3 (0-11), 2.5 (0-11) in non-kinesiophobic patients (all p<0.001). The median (min-max) SF-36 PCS, SF-36 MCS, and VAS scores for surgery satisfaction were 36.5 (8.7-75), 52.1 (11-95), 5, 5 (0-10), respectively, in kinesiophobic patients and were significantly lower than 71 (28-95), 85.5 (9-93), 8.5 (3-10) in non-kinesiophobic patients (all p<0.05). TSK scores were significantly correlated with RMDI, HADS-A, HADS-D, SF-36, and surgery satisfaction scores (all p<0.05). Kinesiophobic patients with lumbar microdiscectomy therefore showed greater disability and psychological morbidity, poorer quality of life, and lower satisfaction with surgery.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8012026The Preoperative Anterior Pelvic Plane Angle Predicts Cup Anteversion Changes at 1 Year after Total Hip Arthroplasty3137ENKyotaIshibashiDepartment of Orthopedic Surgery, Hachinohe City HospitalHirotakaOishiDepartment of Orthopedic Surgery, Hachinohe City HospitalRyoArakiDepartment of Orthopedic Surgery, Hachinohe City HospitalKosukeKawamuraDepartment of Orthopedic Surgery, Hachinohe City HospitalIsamuSasakiDepartment of Orthopedic Surgery, Hachinohe City HospitalEijiSasakiDepartment of Orthopedic Surgery, Hirosaki University Graduate School of MedicineHikaruKamadaDepartment of Orthopedic Surgery, Hachinohe City HospitalMasakazuKogawaDepartment of Orthopedic Surgery, Hachinohe City HospitalSunaoTanakaDepartment of Orthopedic Surgery, Hachinohe City HospitalTakuyaNumasawaDepartment of Orthopedic Surgery, Hachinohe City HospitalYasuyukiIshibashiDepartment of Orthopedic Surgery, Hirosaki University Graduate School of MedicineOriginal Article10.18926/AMO/70070We investigated global alignment changes following total hip arthroplasty (THA) and predictive alignment parameters for increased cup anteversion (CA) by retrospectively analyzing the primary THA data of 75 patients treated at our hospital (49 women, 26 men; age 65.1±5.7 years, BMI 28.3±3.4 kg/m2). Global alignment parameters, i.e., the anterior pelvic plane angle (APPa) and proximal femoral shaft angle (PFSa) and other alignment parameters were measured. CA was evaluated based on the patients’ standing coronal radiographs. ΔCA was defined as the difference in CA from 2 weeks before to 1 year after each THA. We classified the cases as stable (S) (CA < 10°; n=63) and pelvic retroversion (R) (CA ≥ 10°; n=12) groups. Associations between ΔCA and alignment parameters were evaluated by linear regression and a receiver operating characteristic (ROC) analysis. A significant decrease in the PFSa occurred between the 2-week and 1-year post-THA timepoints (7.8±4.3° vs. 4.2±3.6°, p<0.001), with no notable change in other alignment parameters. At 1-year post-THA, the CA of 12 (16%) patients had increased to 4.5±4.4°. Only the preoperative APPa was positively associated with ΔCA (β=0.165, p=0.020). The ROC analysis revealed that the optimal cut-off value for increased CA in the APPa is 2.1° (area under the curve, 0.700; p=0.020; odds ratio, 4.80). The APPa change predicted increased CA, which emphasizes the importance of the use of preoperative standing radiography for identifying the optimal cup positioning for post-THA changes in CA.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 Okayama2436-832652026Materiality, Making and Movement : A commentary153155ENMasakazuTANAKAFaculty of International Fashion, PROFESSIONAL INSTITUTE OF INTERNATIONAL FASHION特集：Sacred Objects in Religions (Special Issue: Sacred Objects in Religions)10.18926/70060No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0001-690X15332026Impact of Schizophrenia Spectrum Disorders on the Receipt of Invasive and Systemic Therapy for Colorectal Cancer: A Nationwide Multicenter Retrospective Cohort Study in Japan191199ENMasakiFujiwaraDepartment of Neuropsychiatry, Medical Development Field, Okayama UniversityYutoYamadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTaisukeIshiiDivision of Health Services Research, National Cancer Center Institute for Cancer Control, National Cancer CenterTomoneWatanabeDivision of Health Services Research, National Cancer Center Institute for Cancer Control, National Cancer CenterMaikoFujimoriDivision of Survivorship Research, National Cancer Center Institute for Cancer Control, National Cancer CenterNaokiNakayaTohoku Medical Megabank Organization, Tohoku UniversityToshihikoKawamuraDepartment of Medical Informatics, Shimane University HospitalKojiOtsukiDepartment of Psychiatry, Faculty of Medicine, Shimane UniversityKunitoshiShigeyasuDepartment of Gastroenterological Surgery, Medical Development Field, Okayama UniversityTaichiShimazuDivision of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer CenterShiroHinotsuDepartment of Biostatistics and Data Management, Sapporo Medical UniversityYosukeUchitomiDepartment of Cancer Survivorship and Digital Medicine, The Jikei University School of MedicineMasatoshiInagakiDepartment of Psychiatry, Faculty of Medicine, Shimane UniversityIntroduction: This study examined treatment disparities for colorectal cancer among patients diagnosed with schizophrenia spectrum disorders (SSD), focusing on invasive treatments and stage-appropriate systemic therapy within a universal healthcare system.<br>
Method: In this nationwide retrospective cohort study (2018–2021), we identified 248,966 colorectal cancer patients, including 2337 diagnosed with SSD, using linked cancer registry and insurance claims data in Japan. The presence of SSD was classified according to ICD-10 codes F20–29. We used multivariable logistic regression to compare the odds of receiving stage-appropriate adjuvant chemotherapy and systemic therapy, as well as the odds of receiving surgical or endoscopic treatments, between the two groups. The analysis adjusted for age, sex, clinical stage, and scores on the Charlson Comorbidity Index and Barthel Index.<br>
Results: The clinical stage distribution at diagnosis for colorectal cancer differed significantly between patients with SSD and those without psychiatric disorders (p < 0.001). After adjusting for clinical stage and other covariates, patients with SSD demonstrated significantly lower odds of receiving surgical or endoscopic treatment (adjusted odds ratio [aOR], 0.83; 95% CI, 0.73–0.94). The disparities were more pronounced for systemic therapy; patients with SSD had substantially lower odds of receiving adjuvant chemotherapy for stage III disease (aOR, 0.33; 95% CI, 0.26–0.41) and systemic therapy for stage IV disease (aOR, 0.23; 95% CI, 0.17–0.31).<br>
Conclusion: Patients with SSD encounter substantial disparities in accessing standard colorectal cancer care, particularly systemic therapies. These findings highlight the urgent need for interventions to ensure equitable cancer treatment for this vulnerable population.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0028-646X2026Starch Synthase 3 isoforms are essential for normal starch granule initiation in wheat endospermENJinjinDingJohn Innes Centre, Norwich Research ParkBrendanFahyJohn Innes Centre, Norwich Research ParkRyoMatsushimaInstitute of Plant Science and Resources, Okayama UniversityQiantaoJiangState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Triticeae Research Institute, Sichuan Agricultural UniversityDavidSeungJohn Innes Centre, Norwich Research ParkNo potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0031-931717812026Reactive Carbonyl Species Mediate Isothiocyanate Signaling Pathway in Arabidopsis thaliana Guard Cellse70775ENSumaiyaFarzanaGraduate School of Environmental and Life Science, Okayama UniversityMd. MoshiulIslamGraduate School of Environmental and Life Science, Okayama UniversityToshiyukiNakamuraGraduate School of Environmental and Life Science, Okayama UniversityYoshimasaNakamuraGraduate School of Environmental and Life Science, Okayama UniversityShintaroMunemasaGraduate School of Environmental and Life Science, Okayama UniversityJun'ichiManoScience Research Center, Yamaguchi UniversityYoshiyukiMurataGraduate School of Environmental and Life Science, Okayama UniversityOur previous results demonstrated that depletion of glutathione (GSH) rather than elevation of levels of reactive oxygen species (ROS) is highly correlated with the decrease in stomatal aperture induced by isothiocyanates (ITCs), although ROS is considered a key second messenger in stomatal closure, suggesting that another signal component regulates stomatal apertures along with GSH depletion. This study, using Arabidopsis, clarified that reactive carbonyl species (RCS), especially acrolein and 4-hydroxy-(E)-2-nonenal, are determinants of stomatal aperture responses to ITCs. All tested ITCs, allyl isothiocyanate (AITC), sulforaphane (SFN), benzyl isothiocyanate (BITC), and phenethyl isothiocyanate (PEITC), significantly induced stomatal closure, which was inhibited by the RCS scavengers, carnosine and pyridoxamine. The RCS scavengers suppressed ITC-induced depletion of GSH but not elevation of ROS levels. All tested ITCs (AITC, SFN, BITC, and PEITC) increased levels of RCS and non-RCS aldehydes in the epidermal tissues. However, acrolein, 4-hydroxy-(E)-2-nonenal, crotonaldehyde, and (E)-2-pentenal induced stomatal closure at 10 and 100 μM, whereas propionaldehyde, butyraldehyde, and n-pentanal did not at concentrations up to 100 μM. Acrolein and 4-hydroxy-(E)-2-nonenal more effectively induced stomatal closure and GSH depletion than crotonaldehyde and (E)-2-pentenal did. The contents of RCS were more strongly correlated with GSH levels and stomatal closure than with ROS levels. These results suggest that RCS, especially acrolein and 4-hydroxy-(E)-2-nonenal, acts as key regulators of stomatal closure in guard cells in response to ITCs.No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025裏表紙・英文目次ENNo potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025奥付ENNo potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025菊舎の太宰春台詩受容について(41)(58)ENMENGHUANLI10.18926/70034No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025「有翼の天女図」十三考― 竹内栖鳳による東本願寺御影堂門の天井画とその周辺 ―(21)(39)ENYukoTATSUNO10.18926/70033No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025『論語集注』訳注（子罕第九 （一））(1)(20)ENLuyiSUN10.18926/70032No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025日本語版 The Passive Aggression Scaleの作成および信頼性と妥当性の検討245260ENAyakaSHIGETOUYoung-OkLimKyung-HyunSuhKyokoSUMIOKA10.18926/70031No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025台湾の工業及びサービス業をめぐる低賃金及び賃金格差問題について225244ENHONG TINGCHIANG10.18926/70030No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025日本の一地方の中小企業の貿易・投資相談事例分析― アクションリサーチ及びショーン（1983）の「省察的実践論」を活用した直近三年間の相談事例の現況分析の試み ―205224ENMasaakiNAGAMITSU10.18926/70029No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025「じゃあ」との共起から見た日本語の勧誘文― 談話構造に着目して ―187204ENLizhongXING10.18926/70028No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025科学を担う他者たち：清末科学小説における親縁と鏡像の表象分析169185ENXIAOXUANWU10.18926/70027No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025漢語接尾辞「派」による派生語について― 前接語が固有名詞の場合 ―157168ENXUELI10.18926/70026No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025『本朝小説』における引用の分析― 引用内容と文脈の関連性について ―139156ENJIAJIALIU10.18926/70025No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025現代日本語における「わりに（は）」の用法について129137ENWENHUAYANG10.18926/70024No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025外国人技能実習生のキャリア形成と日本語学習の意味付け― 日本でキャリアを継続するベトナム人技能実習生の語りから ―109128ENNgoc Bich TranHOANG10.18926/70023No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025現代日本語の会話における「で」のフィラー的な使用について89107ENYANGLIU10.18926/70022No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025動作の主体を主語とする難易文について7188ENHUIXINSUN10.18926/70021No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025フッサールの発生的現象学に関する先行研究の整理と比較検討―― 方法論的問題を中心に ――5169ENDaisukeSATO10.18926/70020No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025ライプニッツの「人間学」―『定義集』の叙述を中心に―3150ENTsuyoshiMATSUDA10.18926/70019No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025卑弥呼の残像（下）――明清通俗文学作品に描かれた日本人女性と日本イメージ――1929ENToruYUSA10.18926/70018No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025大田植の分布と種類に関する検討（3）―岡山県・広島県の自治体史等における記述・資料―118ENHiroshiTAKANO10.18926/70017No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025表紙ENNo potential conflict of interest relevant to this article was reported.The Japan Institute of Heterocyclic Chemistry Acta Medica Okayama0385-541485102012Synthetic Studies on Natural Pterin Glycosides23752390ENTadashiHanayaDepartment of Chemistry, Faculty of Science, Okayama UniversityHiroshiYamamotoSchool of Pharmacy, Shujitsu UniversitySome pterins having various kind of sugars attached to the hydroxyalkyl side-chain at C-6 are known to occur in certain prokaryotes as exemplified by 2'-O-(α-D-glucopyranosyl)biopterin isolated from various kinds of cyanobacteria. A synthetic exploration of various types of glycosides of biopterin and related pterins has been undertaken owing to a marked interest in their physiological functions and biological activities as well as the structural proof of those natural products. This review summarizes our synthetic studies on natural pterin glycosides by employing the appropriately protected N2-(N,N-dimethylaminomethylene)-3-[2-(4-nitrophenyl)ethyl]pterin derivatives as glycosyl accepters.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0022-152X62122025An Improved Synthesis of a Key Intermediate for Glycosylation of Biopterin and Its Application for the First Synthesis of Microcystbiopterin B20212029ENTadashiHanayaDepartment of Chemistry, Faculty of Science, Okayama UniversityYutaMaedaDepartment of Chemistry, Faculty of Science, Okayama UniversityKatsuyaIwasakiDepartment of Chemistry, Faculty of Science, Okayama UniversityA key intermediate for the selective 2′-O-glycosylation of biopterin, N2-(N,N-dimethylaminomethylene)-1′-O-(4-methoxybenzyl)-3-[2-(4-nitrophenyl)ethyl]biopterin (12), was efficiently synthesized via a novel route starting from d-glucose, leading to an improved overall yield. This new pathway involves the preparation of a 5-deoxy-l-arabinose phenylhydrazone derivative (9) as a crucial intermediate in the construction of the pteridine ring. Utilizing compound 12, the first synthesis of microcystbiopterin B (4) was accomplished by glycosylation of 12 with 4,6-di-O-acetyl-2-O-(4-methoxybenzyl)-3-O-methyl-α-d-glucopyranosyl bromide (19) in the presence of silver triflate and tetramethylurea, followed by stepwise deprotection.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1687-8728202612026Experimental Analysis of Automatic Discrimination Performance Between Simulated Bruxism and Non‐Bruxism Under Conscious Conditions Using Electromyography and Machine Learning7874254ENHajimeMinakuchiDepartment of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMitsuhiroNagasakiDepartment of Electrical Engineering and Information Systems, Graduate School of Engineering, The University of TokyoLộc HoàngĐìnhDepartment of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHarunaMikiDepartment of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoOmoriDepartment of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTazukoNishimuraDepartment of Electrical Engineering and Information Systems, Graduate School of Engineering, The University of TokyoTakuoKubokiDepartment of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuakiMinematsuDepartment of Electrical Engineering and Information Systems, Graduate School of Engineering, The University of TokyoPurpose: This study aimed to evaluate the potential use of machine learning to automatically classify electromyography (EMG) data into bruxism simulated movement with tooth contact (BMwTC), bruxism simulated movement without tooth contact (BMwoTC), and non-bruxism movement (non-BM).<br>
Methods: Twelve eligible healthy participants (female/male: 2/10, mean age: 35.3 ± 8.4 years) were asked to perform the simulated movements (all the tasks were performed five times for 5 s each with a 30-s rest interval). The electrodes were placed on the masseter, infrahyoid, inframandibular, and chin muscles. A sound sensor was placed adjacent to the masseter. The EMG and sound data were sampled at 1 and 44.1 kHz, respectively. Single- and multi-stream hidden Markov models (HMMs) were used to automatically discriminate the tested behavior from the others using a hamming window with 100 ms and shift length of 50 ms. The leave-one-out method was used for training and testing the model, with data from 11 participants used for training and one for testing. Each participant was evaluated, and the final performance was measured by averaging the results of 12 classification trials. The validity of the discrimination was assessed by calculating the harmony mean values using six EMG signals and the sound data.<br>
Results: The masseter EMG demonstrated significantly higher discrimination accuracy in the single-stream model (p < 0.05, One-way ANOVA, Tukey HDS). The multi-stream model also demonstrated higher accuracy; however, no significant difference was observed. Notably, the accuracy of BMwoTC was less than 0.5.<br>
Conclusion: The machine-learning-based discriminative system accurately discriminates BMwTC from non-BM using masseter EMG.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1873-149X3312026Bridging the Gap Between Static Histology and Dynamic Organ-on-a-Chip Models10ENZheyiWangDepartment of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKeijiNaruseDepartment of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKenTakahashiDepartment of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityFor more than a century, pathology has served as a cornerstone of modern medicine, relying primarily on static microscopic assessment of tissue morphology―such as H&E staining―which remains the “gold standard” for disease diagnosis. However, this conventional paradigm provides only a snapshot of disease states and often fails to capture their dynamic evolution and complex functional mechanisms. Moreover, animal models are constrained by marked interspecies differences, creating a persistent gap in translational research. To overcome these limitations, we propose the concept of New Pathophysiology, a research framework that transcends purely morphological descriptions and aims to resolve functional dynamics in real time. This approach integrates Organ-on-a-Chip (OOC) technology, multi-omics analyses, and artificial intelligence to reconstruct the entire course of disease initiation and to enable personalized medicine. In this review, we first outline the foundations and limitations of traditional pathology and animal models. We then systematically summarize more than one hundred existing OOC disease models across multiple organs―including the kidney, liver, and brain. Finally, we elaborate on how OOC technologies are reshaping the study of key pathological processes such as inflammation, metabolic dysregulation, and fibrosis by converting them into dynamic, mechanistic disease models, and we propose future perspectives in the field. This review adopts a relatively uncommon classification strategy based on pathological mechanisms (mechanism-based), rather than organ-based categorization, allowing readers to recognize shared principles underlying different diseases. Moreover, the focus of this work is not on emphasizing iteration or replacement of existing approaches, but on preserving past achievements from a historical perspective, with an emphasis on overcoming current limitations and enabling new advances.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.American Geophysical Union (AGU)Acta Medica Okayama2169-931313112026Electrical Conductivity of Carbonatite Melts to 20 GPa: Constraints on Partial Melting Atop the 410‐km Discontinuity and in the Lower Mantle Transition Zonee2025JB033390ENBinZhaoInstitute for Planetary Materials, Okayama UniversityJintaoZhuInstitute for Planetary Materials, Okayama UniversityQiChenCenter for Advanced Radiation Sources, University of ChicagoTakashiYoshinoInstitute for Planetary Materials, Okayama UniversityDeep-origin carbonatite melts are considered to be the products of partial-melting of the oceanic crust in the subduction zones. In this study, we conducted electrical conductivity (EC) measurements on two samples, the composition of which resemble the partial-melting products atop the 410-km discontinuity and in the lower part of the transition zone. The EC of carbonatite melts was investigated using impedance spectroscopy combined with a multi-anvil press up to 20 GPa. Pressure has a great effect on the EC of the carbonatite melts. While the EC dropped overall by 0.6 log unit from 3 to 20 GPa for varying compositions, the pressure effect becomes weaker above 10 GPa. The Hashin-Shtrikman mixing model indicates that melt fraction of 0–0.3 vol% is necessary to account for the EC atop the 410-km discontinuity beneath NE China, north Philippine Sea, north Pacific, and Australian craton. However, this value soars to 1–4.5 vol% for the lower part of the transition zone in the same regions, and further increases to 3.7–7.3 vol% for cold subduction regions if the slab surface temperature is 300 K lower. The difference in the needed melt fraction at different depths implies that the magnitude of partial melting is much larger in the lower part of the mantle transition zone, and it is thus likely to be the main barrier to the recycled carbonates towards the deep interior.No potential conflict of interest relevant to this article was reported.Pharmaceutical Society of JapanActa Medica Okayama0918-61584912026Exploratory Analysis for Development Predictive Models of Immune Checkpoint Inhibitor-Induced Myocarditis Using a Nationwide Claims Database6673ENReinaYamamotoDepartment of Medicinal Pharmacology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityHirofumiHamanoDepartment of Pharmacy, Okayama University HospitalKokiNakagomiDepartment of Clinical Pharmacy, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityMiyuUchiyamaDepartment of Clinical Pharmacy, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityAyanaMichiharaDepartment of Pharmacy, Okayama University HospitalAya F.OzakiDepartment of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of CaliforniaPranav M.PatelDivision of Cardiology, School of Medicine, University of CaliforniaMakiTaniokaMedical AI Project, Dentistry and Pharmaceutical Science, Okayama University Graduate School of MedicineYoshitoZamamiDepartment of Pharmacy, Okayama University HospitalTakashiUeharaDepartment of Medicinal Pharmacology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityImmune checkpoint inhibitors (ICIs), essential in cancer therapy, can cause severe immune-related adverse events (irAEs), including myocarditis with a high fatality rate. Currently, the pathogenesis, biomarkers, and risk factors of ICI-induced myocarditis (ICIM) are not fully understood. This exploratory study aimed to develop machine learning-based models to predict the onset of ICIM within 3 months of starting ICI therapy, using a large health insurance database. The models were constructed using the Light Gradient Boosting Machine (LightGBM) and Random Forest algorithms, incorporating clinical variables such as comorbidities and prior medication classifications. In this study, a strategy combining undersampling and bagging was used to minimize the impact of highly imbalanced datasets. The Random Forest model demonstrated superior performance compared with the LightGBM model, and the SHapley Additive exPlanations (SHAP) analysis for the Random Forest model revealed that the concurrent use of ICIs was the most important variable for predictions. Although predictive performance remains limited (AUROC ≈ 0.63), this exploratory framework demonstrates the feasibility of developing data-driven risk prediction models for ICIM. Future studies with expanded datasets and integration of laboratory parameters are warranted to improve predictive accuracy and potential clinical applicability.No potential conflict of interest relevant to this article was reported.Japan Oil Chemists' SocietyActa Medica Okayama1345-895774112025Bioconversion and Metabolic Fate of the n-1 Polyunsaturated Fatty Acids, 6,9,12,15- Hexadecatetraenoic (C16:4 n-1) and 8,11,14,17- Octadecatetraenoic (C18:4 n-1) Acids, in HepG2 Cells10231032ENKokiSugimotoFaculty of Food and Nutritional Sciences, Toyo UniversityHidetoNishiguchiFaculty of Chemistry, Materials, and Bioengineering, Kansai UniversityRyotaHosomiFaculty of Chemistry, Materials, and Bioengineering, Kansai UniversityToshifumiTanizakiBizen Chemical Co., Ltd.TadahiroTsushimaBizen Chemical Co., Ltd.NaomichiBabaBizen Chemical Co., Ltd.YoshihisaMisawaBizen Chemical Co., Ltd.ZiyiWangDepartment of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMitsuakiOnoDepartment of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiMurakamiDepartment of Hygiene and Public Health, Kansai Medical UniversitySeijiKandaDepartment of Hygiene and Public Health, Kansai Medical UniversityKenjiFukunagaFaculty of Chemistry, Materials, and Bioengineering, Kansai UniversityFish oil contains not only major fatty acids with double bonds at the n-3, n-6, n-7, and n-9 positions but also those with a double bond at the n-1 position, such as 6,9,12,15-hexadecatetraenoic acid (C16:4 n-1; HDTA). However, intracellular bioconversion and metabolic fate of n-1 polyunsaturated fatty acids (PUFA) remain unclear. Therefore, in this study, we aimed to assess the intracellular bioconversion and metabolic fate of HDTA and its metabolite, 8,11,14,17- octadecatetraenoic acid (C18:4 n-1; ODTA), using HepG2 cells. Based on the results of cell viability and cytotoxicity assays for HDTA and ODTA, the concentration of each fatty acid supplemented in the experiments was set at 10 μM. HepG2 cell culture with HDTA revealed C20:4 n-1 as a new HDTA metabolite, along with previously reported ODTA. Our findings suggest that the HDTA taken up by HepG2 cells undergoes elongation to form ODTA and C20:4 n-1. Following supplementation with HDTA, ODTA, and 5,8,11,14,17-eicosapentaenoic acid (C20:5 n-3; EPA), fatty acids disappeared from the culture medium within 24 h. Notably, the total relative level of HDTA and its metabolites, including ODTA and C20:4 n-1 in HDTA- and ODTA-supplemented cells were significantly lower than the total relative level of EPA and its metabolites, including 7,10,13,16,19-docosapentaenoic acid (C22:5 n-3), C24:6 n-3, and 4,7,10,13,16,19-docosahexaenoic acid (C22:6 n-3) in the EPA-supplemented cells. Except for a portion that was intracellularly elongated, most HDTA was taken up by HepG2 cells and may undergo rapid fatty acid β-oxidation. However, RNA-sequencing and real-time polymerase chain reaction analysis revealed no significant changes in fatty acid β-oxidation–related gene expression levels in HDTA-supplemented cells. Collectively, these results provide novel insights into the intracellular bioconversion mechanisms and metabolic fate of HDTA and ODTA in HepG2 cells, suggesting that the metabolic fate of n-1 PUFA is distinct from that of common PUFA.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1341-321X31122025Clinical and molecular characteristics of urinary catheter-associated Pseudomonas aeruginosa prostatic infection: A case series of four postoperative nosocomial infections102853ENShinnosukeFukushimaDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakayukiSanoLaboratory of Veterinary Public Health, School of Veterinary Medicine and Animal Sciences, Kitasato UniversityTakashigeKashimotoLaboratory of Veterinary Public Health, School of Veterinary Medicine and Animal Sciences, Kitasato UniversityHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalPseudomonas aeruginosa is a causative pathogen of nosocomial catheter-associated urinary tract infections (CAUTI), but prostate involvement, including prostatitis and prostatic abscess, is rare. The clinical characteristics of P. aeruginosa-associated CAUTI with prostatic lesions, as well as the contribution of genetic backgrounds remain unclear. We describe four cases of urinary catheter-associated prostatic infection caused by P. aeruginosa following postoperative catheterization. All patients developed fever within 10 days after surgery, and three of the four patients developed bacteremia. Three patients were diagnosed with prostatic abscess by contrast-enhanced computed tomography or magnetic resonance imaging, while one case presented with prostatitis without abscess formation. Prostate-specific antigen levels were elevated over 20 ng/mL in all three measured cases. All patients were treated successfully with prolonged antibiotic therapy (28–39 days) without surgical drainage. Notably, all three abscess cases were successfully managed with fluoroquinolone-based combination therapy, highlighting its potential role in the management of prostatic abscesses. Three of four isolates were submitted for molecular investigations. All isolates harbored exoT and exoY, whereas exoU was absent. Biofilm-associated genes were detected in two cases, but not in the remaining case. Our findings suggested that P. aeruginosa strains carrying T3SS genes (exoT and exoY) potentially develop prostatic infections, independent of biofilm-associated genes. Host and iatrogenic factors, such as catheter manipulation, may play more critical roles in the development of prostatic pathology than strain-specific determinants. Assessment of prostate-specific antigen levels and early imaging may facilitate appropriate diagnosis and effective management when P. aeruginosa is detected as a cause of CAUTI.No potential conflict of interest relevant to this article was reported.American Association for the Advancement of Science (AAAS)Acta Medica Okayama2375-254811442025Structural insights into the divergent evolution of a photosystem I supercomplex in Euglena graciliseaea6241ENKojiKatoResearch Institute for Interdisciplinary Science, Advanced Research Field, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYoshikiNakajimaResearch Institute for Interdisciplinary Science, Advanced Research Field, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityRunaSakamotoResearch Institute for Interdisciplinary Science, Advanced Research Field, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMinoruKumazawaInstitute of Low Temperature Science, Hokkaido UniversityKentaroIfukuGraduate School of Agriculture, Kyoto UniversityTakahiroIshikawaInstitute of Agricultural and Life Sciences, Academic Assembly, Shimane UniversityJian-RenShenResearch Institute for Interdisciplinary Science, Advanced Research Field, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityAtsushiTakabayashiInstitute of Low Temperature Science, Hokkaido UniversityRyoNagaoFaculty of Agriculture, Shizuoka UniversityPhotosystem I (PSI) forms supercomplexes with light-harvesting complexes (LHCs) to perform oxygenic photosynthesis. Here, we report a 2.82-angstrom cryo–electron microscopy structure of the PSI-LHCI supercomplex from Euglena gracilis, a eukaryotic alga with secondary green alga-derived plastids. The structure reveals a PSI monomer core with eight subunits and 13 asymmetrically arranged LHCI proteins. Euglena LHCIs bind diadinoxanthin, which is one of the carotenoids typically associated with red-lineage LHCs and is not present in the canonical LHCI belt found in green-lineage PSI-LHCI structures. Phylogenetic analysis shows that the Euglena LHCIs originated from LHCII-related clades rather than from the green-lineage LHCI group and that the nuclear-encoded PSI subunit PsaD likely originated from cyanobacteria via horizontal gene transfer. These observations indicate a mosaic origin of the Euglena PSI-LHCI. Our findings uncover a noncanonical light-harvesting architecture and highlight the structural and evolutionary plasticity of photosynthetic systems, illustrating how endosymbiotic acquisition and lineage-specific adaptation shape divergent light-harvesting strategies.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2366-10701342025Asian Subgroup Analysis of Patients in the Phase 2 DeLLphi-301 Study of Tarlatamab for Previously Treated Small Cell Lung Cancer10411054ENMyung-JuAhnHematology-Oncology Department, Samsung Medical Center (SMC), Sungkyunkwan University School of MedicineByoung ChulChoMedical Oncology Department-501, ABMRC, Yonsei UniversityKadoakiOhashiDepartment of Respiratory Medicine, Okayama University HospitalHirokiIzumiThoracic Oncology, National Cancer Center Hospital EastJong-SeokLeeHematology/Oncology, Seoul National University Bundang HospitalJi-YounHanCenter for Lung Cancer, National Cancer Center-Graduate School of Cancer Science and PolicyChi-LuChiangDepartment of Chest Medicine, Taipei Veterans General HospitalShuangHuangAmgen Inc.AliHamidiAmgen Inc.SujoyMukherjeeAmgen Inc.Krista LinXuAmgen Asia Pacific Pte. Ltd.HiraokiAkamatsuInternal Medicine III, Wakayama Medical UniversityIntroduction: Tarlatamab is a bispecific T-cell engager (BiTE®) immunotherapy that binds delta-like ligand 3 on the surface of small cell lung cancer (SCLC) cells and CD3 on T cells, facilitating T cell-mediated cancer cell lysis. In the primary analysis of the phase 2 DeLLphi-301 study (NCT05060016), tarlatamab showed a favourable benefit-to-risk profile with durable objective responses and promising survival outcomes in patients with previously treated SCLC. Here, phase 2 data for the Asia region subgroup are presented.<br>
Methods: Patients with previously treated, advanced SCLC received 10 mg tarlatamab every 2 weeks. The primary endpoint was objective response rate (ORR) by blinded independent central review (RECIST version 1.1). Key secondary endpoints included duration of response (DOR), progression-free survival (PFS), overall survival (OS) and safety. The present analysis includes patients enrolled at sites in Asia.<br>
Results: A total of 43 patients were enrolled at sites in Asia. ORR was 46.3% (95% confidence interval [CI], 30.7–62.6) and median DOR was 7.2 months (95% CI 3.9 to not estimable). The median follow-up was 16.6 months for PFS and 21.2 months for OS. Median PFS was 5.4 months (95% CI 3.0–8.1) and median OS was 19.0 months (95% CI 11.4 to not estimable). The most common treatment-emergent adverse event (AE) was cytokine release syndrome (48.8%), and all such events were grade 1 or 2. There were no discontinuations due to treatment-related AEs.<br>
Conclusions: Tarlatamab demonstrated durable responses and promising survival outcomes with a manageable safety profile in this post hoc analysis of patients from Asia with previously treated SCLC.<br>
Trial Registration: ClinicalTrials.gov, NCT05060016.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0919-81722025Daytime Bladder Control Status in Toddlerhood Is Associated With Subsequent Bedwetting in Preschool Years: A Nationwide Cohort Study of Over 30 000 Japanese ChildrenENTakatoshiMoriwakeDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNaomiMatsumotoDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYusukeTominagaDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKensukeUraguchiDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomokoKobayashiDepartment 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 University Okayama JapanTakuyaSadahiraDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySatoshiKatayamaDepartment 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 UniversityKoheiEdamuraDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySoshiTakaoDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiYorifujiDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMotooArakiDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityObjectives: Nocturnal enuresis is common in early childhood. While daytime bladder control typically precedes nighttime continence, the temporal relationship between early daytime bladder control and subsequent bedwetting remains unclear. We investigated whether daytime bladder control status at age 2.5 years―as indicated by diaper use―is associated with bedwetting at age 4.5 years in a Japanese nationwide cohort.<br>
Methods: We analyzed data from the Japanese Longitudinal Survey of Newborns in the 21st Century (2010 cohort). Daytime bladder control was assessed at age 2.5 years through caregiver-reported diaper use, and bedwetting frequency at age 4.5 years through parental questionnaires. Modified Poisson regression estimated risk ratios (RRs), adjusting for birth-related factors, socioeconomic status, daycare attendance, and developmental milestones.<br>
Results: Among 32 168 children, 26 651 (82.8%) still used diapers at 2.5 years. Bedwetting prevalence at 4.5 years was 42.2%: 34.5% in children who achieved daytime bladder control at 2.5 years versus 43.9% in those still using diapers. After multivariable adjustment, incomplete daytime bladder control at 2.5 years was associated with higher bedwetting risk (adjusted RR 1.25; 95% CI, 1.20–1.31). Multinomial regression revealed dose–response relationships: odds ratios 1.41 (95% CI, 1.30–1.52) for “sometimes” and 1.58 (95% CI, 1.42–1.77) for “often” bedwetting.<br>
Conclusions: Daytime bladder control status at 2.5 years was associated with a 25% increased bedwetting risk at 4.5 years. This association likely reflects individual differences in bladder control maturation rather than causal effects. While daytime bladder control may serve as a developmental marker, its validity as an intervention target remains unestablished.No potential conflict of interest relevant to this article was reported.European Respiratory Society (ERS)Acta Medica Okayama2312-05411162025Global trends in idiopathic pulmonary fibrosis mortality rates during 2001–202200362-2025ENKoHaradaBrookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount SinaiYoshitoNishimuraDivision of Hematology/Oncology, Mayo ClinicQuynh ThiVuDepartment of Health Data Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMakiYamamotoDepartment of Health Data Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshihiroKoyamaDepartment of Health Data Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalBackground Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive and ultimately fatal lung disease. Updated global mortality data, especially from underexplored countries, are limited. This study aimed to understand the current global trends in IPF-associated mortality rates.<br>
Methods This observational study used the World Health Organization Mortality Database to analyse data stratified by sex, age and geographic region, encompassing 64 countries between 2001 and 2022. IPF was defined according to the International Code for Diseases-10 code J84.1. Crude and age-standardised mortality rates per 100 000 individuals were calculated to estimate long-term mortality trends. Mortality rates were calculated by dividing IPF-associated deaths by the corresponding population, with age-specific rates determined for each 5-year age group. Trends in the 2001–2022 period were analysed using a locally weighted regression model, and the average annual percentage change in mortality rates between 2010 and 2022 was estimated using joinpoint regression analysis.<br>
Results Overall, 874 998 deaths associated with IPF were analysed. The LOESS-smoothed crude mortality rate increased from 2.10 (95% confidence interval (CI) 1.77–2.43) per 100 000 in 2001 to 3.14 (95% CI 2.71–3.57) per 100 000 by 2022. The LOESS-smoothed age-standardised mortality rates increased overall, peaking at 1.59 (95% CI 1.51–1.67) per 100 000 in 2018 and declining slightly to 1.57 (95% CI 1.35–1.79) per 100 000 in 2022. Mortality was higher among males than females; furthermore, 87.5% of deaths occurred in individuals aged ≥65 years. Mortality rates were highest among the American population, with a notable increase in Latin American countries.<br>
Conclusion IPF-associated mortality rates have increased globally, particularly in males. Significant geographical, age and sex disparities were observed, emphasising the need for targeted public health measures and improved disease management.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2050-090413102025Recurrent Septic Shock in Immunosuppressed Patientse71249ENShinnosukeFukushimaDepartment of Infectious Diseases, Okayama University HospitalKojiFujitaDepartment of General Medicine and Infectious Diseases, Tsuyama Chuo HospitalHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalCytomegalovirus gastroenteritis presents with diarrhea and abdominal pain in immunosuppressed patients, and histopathological examination is essential by endoscopy. This case illustrates that cytomegalovirus enteritis may develop insidiously and possibly invoke shock in immunocompromised patients, warranting its inclusion in the differential diagnosis of recurrent septic shock.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2575-6265652025Seaweed Extracts Improve Salinity Tolerance in Cereal Crops―A Meta‐Analysise70094ENMd.NuruzzamanDepartment of Plant Resources, College of Industrial Sciences, Kongju National UniversityMd.Tahjib‐Ul‐ArifDepartment of Biochemistry and Molecular Biology, Bangladesh Agricultural UniversityMd. AbdulHannanDepartment of Biochemistry and Molecular Biology, Bangladesh Agricultural UniversityYoshiyukiMurataGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityM. AfzalHossainDepartment of Biochemistry and Molecular Biology, Bangladesh Agricultural UniversitySeaweeds are considered an essential component of the blue economy. Because seaweed extracts are rich in bioactive compounds that enhance plant stress resilience, exploiting this resource could offer a sustainable solution for crop production. Salinity is a major abiotic challenge that significantly impacts crop yield and food security. Through meta-analysis, we explored whether the exogenous application of seaweed extracts improves the salt tolerance of cereal crops. All the studies chosen for this study utilized aqueous seaweed extracts as foliar sprays. A multi-level meta-analysis with a mixed effects model was performed to determine the effect size. This meta-analysis demonstrated that applying aqueous seaweed extracts enhanced the shoot and root biomass under normal and salinity stress conditions, suggesting that seaweed extract can help improve crop stress tolerance. The seaweeds studied belonged to three classes: Phaeophyceae, Rhodophyta, and Chlorophyta, with extracts from Chlorophyta and Phaeophyceae significantly enhancing biomass production under salinity conditions. Applying aqueous seaweed extracts effectively improved salinity tolerance at both 34.2–100 mM and 101–400 mM NaCl equivalent salinity stress. Moreover, exogenous foliar application of ≤ 25% aqueous seaweed extracts was most effective for improving salinity tolerance in cereals. The impact of seaweed extracts on cereal crop yields has not been extensively reported; therefore, further studies should focus on this aspect.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1340-68683262025Clinical significance on switching CDK4/6 inhibitors among 13,284 patients with metastatic breast cancer14051416ENTakuyaNishinaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityMakiTaniokaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityKenjiTakadaMedical AI Project, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTakahiroTsukiokiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityYukoTakahashiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTadahikoShienDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityRecent clinical trials have shown that switching to a combination therapy of a cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) and endocrine therapy (ET) prolongs progression-free survival (PFS) compared with ET monotherapy. Reports indicate that abemaciclib provides benefits regardless of the PIK3CA mutation status; however, its clinical benefits remain insufficient. This study aimed to evaluate the clinical significance of switching CDK4/6i + ET in a large real-world cohort. Using a medical database, we identified 13,284 patients with hormone receptor–positive/human epidermal growth factor receptor 2–negative advanced breast cancer who received CDK4/6i + ET between 2008 and 2022. Patients were categorized into five groups based on their first- and second-line therapy patterns. We compared the median time to discontinuation (TTD) among the groups. In patients who switched from one CDK4/6i + ET to another CDK4/6i + ET, the second-line TTD and total TTD of first- and second-line therapies (n = 542) were significantly longer than those in patients who switched from CDK4/6i + ET to ET monotherapy (n = 490) (the second-line TTD: 11.2 vs. 4.9 months, p < 0.01; total TTD: 25.1 vs. 20.5 months, p < 0.01). The order of palbociclib and abemaciclib administration did not significantly affect the second-line or total TTD in patients who switched from one CDK4/6i + ET to another CDK4/6i + ET. Switching from one CDK4/6i + ET to another CDK4/6i + ET resulted in a significantly longer TTD than switching to ET monotherapy. Considering the phase III clinical trial results of capivasertib, switching to CDK4/6i + ET is a viable therapeutic option regardless of the PIK3CA mutation status.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2405-6316362025A multi-institutional dummy run on segmentation variability and plan quality of stereotactic body radiotherapy for oligometastatic disease100857ENHideakiHirashimaDepartment of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto UniversityYukinoriMatsuoDepartment of Radiation Oncology, Kindai University Faculty of MedicineSatoshiIshikuraDepartment of Radiation Oncology, St. Luke’s International Hospital, St. Luke’s International UniversityMitsuhiroNakamuraDepartment of Advanced Medical Physics, Graduate School of Medicine, Kyoto UniversityIkunoNishibuchiDepartment of Radiation Oncology, Graduate School of Biomedical Health Sciences, Hiroshima UniversityDaisukeKawaharaDepartment of Radiation Oncology, Graduate School of Biomedical Health Sciences, Hiroshima UniversityYoshihisaShimadaDepartment of Surgery, Tokyo Medical UniversityYoshiroNakaharaDepartment of Respiratory Medicine, Kitasato University HospitalTeijiNishioMedical Physics Laboratory, Division of Health Science, Graduate School of Medicine, The University of OsakaNaotoShikamaDepartment of Radiation Oncology, Juntendo University Graduate School of MedicineShun-ichiWatanabeDepartment of Thoracic Surgery, National Cancer Center HospitalIsamuOkamotoDepartment of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu UniversityToshiyukiIshibaDepartment of Breast Surgery, Institute of Science TokyoFumikataHaraDepartment of Breast Oncology, Aichi Cancer Center HospitalTadahikoShienDepartment of Breast and Endocrine Surgery, Okayama University HospitalTakashiMizowakiDepartment of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto UniversityBackground and purpose: Oligometastatic disease represents limited metastatic burden, and local ablative therapies such as stereotactic body radiotherapy (SBRT) may improve survival. However, inter-institutional variability in target segmentation and treatment planning can compromise treatment quality. This study aimed to evaluate the segmentation variability and dose distribution quality of SBRT in oligometastatic settings using a multi-institutional dummy run approach.<br>
Methods and materials: Sixty-nine institutions were provided with two anonymized cases of adrenal and spine metastases to delineate targets and organs at risk (OARs) and create intensity-modulated radiotherapy plans following a protocol. Variability was quantified using the Dice similarity coefficient (DSC), Hausdorff distance, and mean distance to agreement. Plan qualities were assessed using the Paddick conformity index, modified gradient index, and a new three-dimensional conformity–gradient index (3D-CGI). Knowledge-based planning (KBP) was applied to explore potential improvements in OAR sparing.<br>
Results: All submitted plans met protocol dose constraints. However, substantial segmentation variability was observed, particularly for the spine case. Among 136 plans, 79% demonstrated acceptable conformity and dose gradients, with 3D-CGI < 6 correlating with favorable distributions. Mean DSC was 0.93 for the clinical target volume and 0.76 for the cauda equina, which showed the highest variability. KBP reduced OAR doses for the adrenal case but showed limited impact for the spine case.<br>
Conclusions: Although dose constraints were achieved, segmentation variability remained substantial, particularly for the cauda equina in the spine case. These findings emphasize inter-institutional differences and the need for standardization and tools to improve SBRT consistency.No potential conflict of interest relevant to this article was reported.Japanese Association of Rehabilitation MedicineActa Medica Okayama2432-1354102025Reliability and Validity of the Japanese Perme ICU Mobility Score: An Initial Psychometric Evaluation20250037ENShoKatayamaDepartment of Rehabilitation Medicine, Okayama University HospitalTomohiroIkedaDepartment of Rehabilitation Medicine, Okayama University HospitalNobutoNakanishiDepartment of Disaster and Emergency Medicine, Graduate School of Medicine, Kobe UniversityHajimeKatsukawaDepartment of Scientific Research, Japanese Society for Early MobilizationRicardo KenjiNawaDepartment of Critical Care Medicine, Hospital Israelita Albert EinsteinChristianePermeDepartment of Rehabilitation Services, Houston Methodist HospitalToshifumiOzakiDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasanoriHamadaDepartment of Rehabilitation Medicine, Okayama University HospitalIkumiSatoAcademic Field of Health Science, Okayama UniversitySatoshiHirohataAcademic Field of Health Science, Okayama UniversityObjectives : The Perme ICU Mobility Score is widely used to assess functional status, but no version of this assessment tool has been validated for use in Japan. This study aimed to translate the Perme Score into Japanese and evaluate its reliability and validity.<br>
Methods : Following forward–backward translation, the Japanese Perme Score was tested at ICU discharge. Inter-rater reliability was examined using weighted kappa coefficient. Construct validity was assessed through correlations with the Medical Research Council Sum Score (MRC-SS), Functional Status Score for the ICU (FSS-ICU), and ICU Mobility Scale (IMS). Predictive validity for activities of daily living (ADL) independence (Barthel Index ≥ 85) and discharge destination was evaluated using Receiver operating characteristic (ROC) analysis. Floor and ceiling effects were also analyzed.<br>
Results : In 69 patients, the Japanese Perme Score showed high inter-rater reliability (κ=0.83). It showed moderate correlation with FSS-ICU (rho=0.61) and IMS (rho=0.73), and it showed weak correlation with MRC-SS (rho=0.36). Predictive validity for ADL independence and home discharge yielded AUCs of 0.76 and 0.73, respectively. A ceiling effect was noted in 10% of cases, with no floor effect.<br>
Conclusions: The Japanese Perme Score is a reliable, valid instrument for evaluating physical function at ICU discharge.No potential conflict of interest relevant to this article was reported.American Society for MicrobiologyActa Medica Okayama0066-480469122025Genomic portrayal of emerging carbapenem-resistant El Tor variant Vibrio cholerae O1e00740-25ENSreejaShawICMR-National Institute for Research in Bacterial InfectionsAgila KumariPragasamV. Ramalingaswami Bhawan, Indian Council of Medical ResearchGoutamChowdhuryICMR-National Institute for Research in Bacterial InfectionsProsenjitSamantaICMR-National Institute for Research in Bacterial InfectionsDeboleenaRoyICMR-National Institute for Research in Bacterial InfectionsDebjaniGhoshICMR-National Institute for Research in Bacterial InfectionsThandavarayanRamamurthyICMR-National Institute for Research in Bacterial InfectionsJignaKariaMedical College BarodaGovindNinamaMedical College BarodaShin-ichiMiyoshiOkayama UniversityYukihiroAkedaNational Institute of Infectious DiseasesHemantaKoleyICMR-National Institute for Research in Bacterial InfectionsAsish KumarMukhopadhyayICMR-National Institute for Research in Bacterial InfectionsThe escalating prevalence of carbapenem-resistant (CR) enteric pathogens elicits significant challenges to public health management and effective antimicrobial therapy. While carbapenem resistance is rare in Vibrio cholerae O1 (VC), the recent emergence of CR strains reveals a concerning shift in their antimicrobial resistance (AMR) landscape. This study aims to characterize the resistance mechanisms in newly identified El Tor CRVC isolated from cholera patients in Gujarat, India during 2019. Fifty VC isolates were screened for major virulence-associated genes along with the determination of their antibiotic resistance profiles using Kirby-Bauer disk diffusion and MIC assays. Whole-genome sequencing (WGS) was employed to investigate the underlying mechanisms of CR. All the isolates exhibited hypervirulent Haitian alleles of major virulence genes and AMR profiles of typical multidrug resistance (MDR). Strikingly, 12% (6/50) of them were resistant to carbapenems and other antibiotics. Molecular analysis revealed that these CR isolates were clonally related and harbored a 142 kbp IncA/C type conjugative mega-plasmid with several AMR encoding genes, including blaNDM-1, that can be easily transferred to other bacterial species and confer donor AMR patterns. The plasmid’s competence for horizontal gene transfer presents a significant risk of dissemination to other enteric pathogens and thereby may complicate the treatment. This finding emphasizes the urgent need for enhanced genomic surveillance and robust antimicrobial stewardship programs aimed at curbing the spread of CRVC strains and mitigating their impact on cholera treatment and containment strategies.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1432-08517512025Gut microbial metabolite butyrate boosts p53-expressing telomerase-specific oncolytic adenovirus efficacy by enhancing infectivity and activating MHC-I/cGAS-STING10ENMasakiSakamotoDepartment 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 SciencesTetsuyaKatayamaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuMikaneDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShunyaHanzawaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaisukeKadowakiDepartment 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 SciencesYukiHamadaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyomaSugimotoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChiakiYagiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasashiHashimotoDepartment 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 SciencesYoshihikoKakiuchiDepartment 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 SciencesKunitoshiShigeyasuDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroshiTazawaDepartment 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 SciencesYasuoUrataOncolys BioPharma, Inc.ToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesThe gut microbiota plays an essential role in regulating host immunity, and its metabolites such as butyrate exert immunomodulatory effects by acting as histone deacetylase inhibitors. Oncolytic virotherapy has emerged as a promising approach for cancer treatment, and we have developed OBP-702, a telomerase-specific oncolytic adenovirus that expresses p53 and elicits strong systemic antitumor responses. In this study, the potential synergy between butyrate and OBP-702 was investigated in colorectal cancer models. Using human and murine colorectal carcinoma cell lines, butyrate was found to directly enhance the infectivity of OBP-702 by upregulating CAR and integrins, thereby promoting apoptosis and autophagy in tumor cells. In addition, butyrate indirectly boosted systemic antitumor immunity by upregulating MHC-I expression through activation of the cGAS-STING pathway and enhancing CD8 + T cell recruitment via CXCL10 secretion. These findings were supported by in vivo experiments using CT26 subcutaneous, bilateral, and orthotopic tumor models, in which the combination of oral butyrate and intratumoral OBP-702 administration produced synergistic antitumor effects. These results highlight the therapeutic potential of integrating gut microbial metabolites with oncolytic virotherapy as a novel immunotherapeutic strategy for colorectal cancer.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813732025ポストコロナの感染症140143ENKazuhiroUdaDepartment of Pediatric Regional Healthcare, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHirokazuTsukaharaDepartment of Pediatrics, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama0006-296064202025Characterization of Autonomous and Ca2+/Calmodulin-Dependent Activities of CaMKK Isoforms In Vitro and in Mouse Tissues43094317ENSatomiOhtsukaApplied Cell Biology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityYerunChenApplied Cell Biology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityMasakiMagariApplied Cell Biology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTeruhikoIshikawaDepartment of Science Education, Graduate School of Education, Okayama UniversityHiroyukiSakagamiDepartment of Anatomy, Kitasato University School of MedicineFutoshiSuizuClinical Examination Department, Kagawa Prefectural University of Health SciencesHiroshiTokumitsuApplied Cell Biology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityCa2+/CaM-dependent protein kinase kinase (CaMKK) phosphorylates and activates downstream kinases, including CaMKI, CaMKIV, PKB, and AMPK, regulating various cellular functions such as neuronal morphogenesis, metabolic control, and pathophysiological pathways, such as cancer progression. CaMKKα/1 is tightly regulated by an autoinhibitory mechanism. CaMKKβ/2 activity is highly Ca2+/CaM-independent (autonomous activity) in vitro and Ca2+/CaM-dependent in cultured cells. Whether these two activity states of CaMKKβ/2 exist in vivo and the detailed regulatory mechanisms for the transition of both activity states remain unclear due to the difficulty in distinguishing the two activity states. In this study, we detected Ca2+-dependent and autonomous CaMKK activity in HeLa cells and successfully separated both activity states of CaMKKβ/2 in mouse brain and testis extracts using a recently developed CaMKK inhibitor (TIM-063)-coupled sepharose, which binds to the catalytic domain in the active state but not in the autoinhibited state. Furthermore, lambda protein phosphatase treatment converted the Ca2+/CaM-dependent form to the autonomous form of CaMKKβ/2, which was not affected by Ala mutation of Ser128, Ser132, and Ser136. The two activity forms of CaMKKβ/2 had equivalent Ca2+/CaM-binding ability. The findings demonstrate the presence of autonomous and Ca2+/CaM-dependent forms of CaMKKβ/2 independently in mouse tissues and cultured cells. The transition of these states of CaMKKβ/2 may be dynamically regulated by the phosphorylation/dephosphorylation of serine residues in the N-terminal regulatory domain.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2059-702910112025Association between adjuvant chemotherapy and outcomes in resected locoregional recurrence of hormone receptor-positive HER2-negative breast cancer: a multi-institutional retrospective study105889ENY.OzakiDepartment of Breast Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer ResearchE.TokudaDepartment of Medical Oncology, Fukushima Medical UniversityY.SagaraDepartment of Breast Surgery, Social Medical Corporation Hakuaikai Sagara HospitalF.HaraDepartment of Breast Oncology, Aichi Cancer Center HospitalS.SasadaDepartment of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima UniversityM.SawakiDepartment of Breast Oncology, Aichi Cancer Center HospitalC.KanbayashiDepartment of Breast Oncology, Niigata Cancer Center HospitalT.YamanakaDepartment of Breast Surgery and Oncology, Kanagawa Cancer CenterT.OnishiDepartment of Breast Oncology, National Cancer Center Hospital EastY.FujikiDepartment of Breast Surgery, Social Medical Corporation Hakuaikai Sagara HospitalA.SutoDepartment of Breast Oncology, National Cancer Center HospitalY.TakahashiDepartment of Breast and Endocrine Surgery, Okayama University HospitalE.TokunagaDepartment of Breast Oncology, National Hospital Organization Kyushu Cancer CenterT.ArugaTokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalR.NakamuraDivision of Breast Surgery, Chiba Cancer CenterT.FujisawaDepartment of Breast Oncology, Gunma Prefectural Cancer CenterS.SajiDepartment of Medical Oncology, Fukushima Medical UniversityH.IwataDepartment of Advanced Clinical Research and Development, Nagoya City UniversityT.ShienDepartment of Breast and Endocrine Surgery, Okayama University HospitalBackground: To evaluate the association of adjuvant chemotherapy and prognosis for locoregional recurrence (LRR) in hormone receptor (HR)-positive human epidermal growth factor receptor 2 (HER2)-negative subtype breast cancer.<br>
Patients and methods: We carried out a multi-institutional retrospective cohort study in patients with breast cancer who developed HR-positive HER2-negative LRR. Patients who underwent curative surgery for LRR between 2014 and 2018 were categorized based on whether they received adjuvant chemotherapy for LRR (CTx versus no-CTx). Invasive disease-free survival (iDFS) was evaluated between the groups by Cox proportional hazards analysis. The primary analysis used a double-robust Cox model incorporating inverse probability of treatment weighting, and a sensitivity analysis using propensity score matching was also carried out.<br>
Results: A total of 958 patients were included. The median time from the primary surgery to LRR diagnosis was 9.5 years (interquartile range 3.1-10.1 years). There were 235 patients (25%) in the CTx group and 722 (75%) in the no-CTx group. Among all patients, the 5-year iDFS rate was 75.4% [95% confidence interval (CI) 72.4% to 78.2%]. Multivariate analysis showed better iDFS in the CTx group (hazard ratio 0.70, 95% CI 0.49-0.99, P = 0.045). Sensitivity analysis supported these findings. Subgroup analyses showed that the CTx group had better iDFS in cases with non-ipsilateral breast tumor recurrence (IBTR), recurrences during adjuvant endocrine therapy for primary breast cancer, and without perioperative chemotherapy for primary breast cancer. Secondary analysis showed no significant difference with a worse trend toward overall survival in the CTx group with multivariate Cox proportional hazards analysis.<br>
Conclusion: Adjuvant chemotherapy for HR-positive HER2-negative LRR was associated with better iDFS, particularly in cases of non-IBTR, recurrences during adjuvant endocrine therapy, and no prior perioperative chemotherapy for their primary tumor. However, the retrospective design and inability to distinguish true recurrences from new primary tumors in IBTR warrant cautious interpretation.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0718-95082025Suppression of Na+ Uptake Via Apoplastic Flow by Chitosan in RiceENMaoxiangZhaoGraduate School of Environmental and Life Science, Okayama UniversityMd. Asadulla AlGalibGraduate School of Environmental and Life Science, Okayama UniversityToshiyukiNakamuraGraduate School of Environmental and Life Science, Okayama UniversityYoshimasaNakamuraGraduate School of Environmental and Life Science, Okayama UniversityYoshihikoHiraiGraduate School of Environmental and Life Science, Okayama UniversityYoshitakaNakashimaShintaroMunemasaGraduate School of Environmental and Life Science, Okayama UniversityIzumi C.MoriInstitute of Plant Science and Resources, Okayama UniversityYoshiyukiMurataGraduate School of Environmental and Life Science, Okayama UniversityPurpose: Chitosan enhances tolerance to salinity in rice. Apoplastic flow plays a crucial role in the accumulation of sodium (Na+) in rice under salinity. This study investigated the effects of exogenous chitosan on apoplastic flow and Na+ uptake in NaCl-treated rice seedlings. Methods: We employed an apoplastic tracer, trisodium salt of 8-hydroxy-1,3,6-pyrenetrisulphonic acid (PTS), in order to evaluate apoplastic flow in rice (Oryza sativa L., cv. Nipponbare) seedlings that were hydroponically grown in the solution containing NaCl (0 and 25 mM), and chitosan (0 mg L− 1, 10 mg L− 1, and 50 mg L− 1). Results: Application of 25 mM NaCl significantly increased PTS uptake and Na+ content in shoots but did not affect K+ content, resulting in a lower K+/Na+ ratio although 25 mM NaCl did not affect the seedling growth. The application of chitosan suppressed Na+-enhanced PTS uptake and Na+ accumulation in shoots without affecting the K+ content, which led to a higher K+/Na+ ratio. Moreover, chitosan did not affect the reducing sugar content or electrical conductivity in the solution containing NaCl. Conclusions: These results suggest that application of chitosan suppressed Na+-enhanced apoplastic flow to reduce Na+ uptake in rice seedlings.No potential conflict of interest relevant to this article was reported.American Society for Clinical InvestigationActa Medica Okayama2379-370810242025Enhancement of drug delivery through fibroblast activation protein–targeted near-infrared photoimmunotherapye195776ENSeitaroNishimuraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceKazuhiroNomaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceTasukuMatsumotoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceYasushigeTakedaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceTatsuyaTakahashiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceHijiriMatsumotoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceKentoKawasakiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceHotakaKawaiDepartment of Oral Pathology and Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceTomoyoshiKunitomoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceMasaakiAkaiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceTerukiKobayashiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceNoriyukiNishiwakiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceHajimeKashimaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceTakuyaKatoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceSatoruKikuchiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceShunsukeTanabeDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceToshiakiOharaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceHiroshiTazawaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceYasuhiroShirakawaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencePeter L.ChoykeMolecular Imaging Branch, Center for Cancer Research, National Cancer Institute, NIHHisatakaKobayashiMolecular Imaging Branch, Center for Cancer Research, National Cancer Institute, NIHToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceThe tumor microenvironment plays a key role in cancer progression and therapy resistance, with cancer-associated fibroblasts (CAFs) contributing to desmoplasia, extracellular matrix (ECM) remodeling, and elevated interstitial fluid pressure, all of which hinder drug delivery. We investigated fibroblast activation protein–targeted (FAP-targeted) near-infrared photoimmunotherapy (NIR-PIT) as a strategy to improve drug penetration in CAF-rich tumors. In clinical esophageal cancer samples, FAP expression strongly correlated with increased collagen I, hyaluronic acid, and microvascular collapse. CAF-rich 3D spheroids demonstrated elevated ECM deposition and significantly impaired drug uptake compared with CAF-poor models. FAP-targeted NIR-PIT selectively reduced CAFs, reduced ECM components, and restored drug permeability. In vivo, FAP-targeted NIR-PIT enhanced the accumulation of panitumumab and Abraxane in CAF-rich tumors and improved antitumor efficacy when combined with chemotherapy. These findings highlight FAP-targeted NIR-PIT as a promising therapeutic approach to remodel the tumor stroma and overcome drug resistance in desmoplastic solid tumors.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0006-29282025German Chamomile (Matricaria chamomilla) Induces Cytochrome P450 Expression Through Increased BMAL1 Protein Expression in Liver NucleiENMokaIkedaDivision of Pharmaceutics, Faculty of Pharmaceutical Sciences, Sanyo-Onoda City UniversityYuyaTsurudomeDivision of Pharmaceutics, Faculty of Pharmaceutical Sciences, Sanyo-Onoda City UniversityMaiEnrinDivision of Pharmaceutics, Faculty of Pharmaceutical Sciences, Sanyo-Onoda City UniversityYukiyoWadaDivision of Pharmaceutics, Faculty of Pharmaceutical Sciences, Sanyo-Onoda City UniversityMichikoHoriguchiDepartment of Regenerative and Therapeutic Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKentaroUshijimaDivision of Pharmaceutics, Faculty of Pharmaceutical Sciences, Sanyo-Onoda City UniversityGerman chamomile (Matricaria chamomilla) is a medicinal herb that promotes improved digestion and reduces insomnia. Although it is widely used worldwide, the mechanism of induction of drug-metabolizing enzymes is unknown. We found that German chamomile extracts induced cytochrome P450 expression at the transcriptional stage. Cyp3a11 expression is decreased at night in wild-type mice, but German chamomile extract induced nocturnal Cyp3a11 and Cyp1a2 expression. German chamomile extract increased the nuclear protein expression of the clock gene BMAL1, which drives and abolishes the rhythm of Cyp3a11 expression. By contrast, German chamomile extract did not significantly alter clock gene expression in the suprachiasmatic nucleus (SCN). Similarly, it did not affect the mRNA expression of the clock genes in the kidneys. Because it did not induce the mRNA expression of ATP-binding cassette (ABC) transporters (Abcb1a, Abcc2, Abcc4, and Abcg2) in the kidney, German chamomile extract had no effect on the transcription of pharmacokinetics-related molecules other than CYPs. German chamomile extract promoted liver-selective nuclear transfer rhythm changes in clock genes and induced the expression of CYPs. This study may help to explain the mechanism of drug interactions associated with chronic German chamomile extract consumption.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0897-38063822025Ethical Use of Cadaveric Images in Anatomical Textbooks, Atlases, and Journals: A Consensus Response From Authors and Editors222225ENJoeIwanagaDepartment of Neurosurgery, Tulane University School of MedicineHee‐JinKimDivision in Anatomy & Development Biology, Department of Oral Biology, Yonsei University College of DentistryKeiichiAkitaDepartment of Clinical Anatomy, Tokyo Medical and Dental University (TMDU)Bari M.LoganUKRalph T.HutchingsUKNicolásOttoneDepartment of Integral Adult Dentistry, Center for Research in Dental Sciences (CICO), Dental School, Universidad de La FronteraYoichiNonakaDepartment of Neurosurgery, Tokai University School of MedicineMahindraAnandDepartment of Anatomy, Rama Medical College & Research CentreDannyBurnsDepartment of Anatomical Sciences, School of Medicine, St. George's UniversityVishramSinghDepartment of Anatomy, Kasturba Medical College Mangalore, Manipal Academy of Higher EducationMariaPeris‐CeldaDepartment of Neurologic Surgery, Mayo ClinicFranciscoMartinez‐SorianoDepartment of Anatomy, University of ValenciaNihalApaydinDepartment of Anatomy, Faculty of Medicine, Ankara UniversityAmgadHannaDepartment of Neurological Surgery, University of WisconsinNobutakaYoshiokaDepartment of Neuroplastic and Reconstructive Surgery Social Medical Corporation Kotobukikai Tominaga HospitalJuanFernandez‐MirandaDepartment of Neurosurgery, Stanford University School of MedicineMi‐SunHurDepartment of Anatomy, Daegu Catholic University School of MedicineMohammadali M.ShojaDepartment of Medical Education, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University (NSU) FarhoodSaremiDepartment of Radiological Sciences, David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center FranciscoReinaMedical Sciences Department, Faculty of Medicine, Clinical Anatomy, Embryology and Neuroscience Research Group, University of GironaYokoTabiraDivision of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of MedicineAnnaCarreraMedical Sciences Department, Faculty of Medicine, Clinical Anatomy, Embryology and Neuroscience Research Group, University of GironaJonathan D.SprattUniversity Hospital of North DurhamS. YenHoCardiac Morphology, Royal Brompton & Harefield HospitalsShumpeiMoriUniversity of California Los Angeles (UCLA) Cardiac Arrhythmia Center, Cardiovascular and Interventional Programs, UCLA Health System, David Geffen School of Medicine at UCLA NoritakaKomuneDepartment of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu UniversityKoichiWatanabeDivision of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of MedicineAlbertoPrats‐GalinoLaboratory of Surgical NeuroAnatomy (LSNA), director of the Body Donation and Dissection Rooms Service, Faculty of Medicine and Health of Science, University of BarcelonaJoseDe AndrésSurgery Specialties Department, University of ValenciaMiguel AngelReinaCEU‐San‐Pablo University School of MedicinePeter H.AbrahamsWarwick Medical SchoolRobert H.AndersonBiosciences Institute, Newcastle UniversitySoichiroIbaragiDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMariosLoukasDepartment of Anatomical Sciences, School of Medicine, St. George's UniversityR. ShaneTubbsDepartment of Neurosurgery, Tulane University School of MedicineNowadays, consent to use donor bodies for medical education and research is obtained from the body donors and their families before the donation. Recently, the International Federation of Associations of Anatomists (IFAA) published guidelines that could restrict the appearance of cadaveric images in commercial anatomical resources such as textbooks and other educational products. These guidelines state that the donor must expressly consent to using such images for this purpose. Cadaveric photos and drawings made from dissections of cadavers have been used in anatomy textbooks and atlases for hundreds of years. They are invaluable for anatomy students and clinical/surgical practitioners. The IFAA guidelines should not restrict the use of those older books; to do so would infringe the rights of those seeking knowledge from these resources. As the images in such textbooks and atlases are anonymized and are used for teaching and research, and the donors and their families are informed about this before the donation, we believe no additional consent is needed. It is impossible to separate educational from “commercial” usage entirely in any situation, e.g., publications from publishers and the use of cadavers in medical schools. Therefore, our best efforts to avoid unethical use of cadaveric images by following traditional consent processes are still needed so that more people will reap the benefits from them. As senior textbook/atlas authors/editors from over 10 countries, we believe that using cadaveric images in anatomy textbooks is appropriate, and no additional consent should be necessary. Such usage falls within the good faith of professionals using these invaluable gifts.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2399-3642812025A genome-wide association study identifies the GPM6A locus associated with age at onset in ALS1720ENRyoichiNakamuraDepartment of Neurology, Aichi Medical University School of MedicineGenkiTohnaiDivision of ALS Research, Aichi Medical University School of MedicineNaokiAtsutaDepartment of Neurology, Aichi Medical University School of MedicineYumiMatsudaPublic Health Informatics Unit, Department of Integrated Health Sciences, Nagoya University Graduate School of MedicineSatoruMorimotoKeio University Regenerative Medicine Research Center, KawasakiDaisukeItoDepartment of Neurology, Nagoya University Graduate School of MedicineMasahisaKatsunoDepartment of Neurology, Nagoya University Graduate School of MedicineYuishinIzumiDepartment of Neurology, Tokushima University Graduate School of Biomedical SciencesMitsuyaMoritaDivision of Neurology, Department of Internal Medicine, Jichi Medical UniversityIkukoIwataDepartment of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityIchiroYabeDepartment of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityTomokoNakazatoDepartment of Neurology, Juntendo University School of MedicineNobutakaHattoriDepartment of Neurology, Juntendo University School of MedicineTakehisaHirayamaDepartment of Neurology, Toho University Faculty of MedicineOsamuKanoDepartment of Neurology, Toho University Faculty of MedicineAsakoTamuraDepartment of Neurology, Mie University Graduate School of MedicineNaokiSuzukiDepartment of Neurology, Tohoku University Graduate School of MedicineMasashiAokiDepartment of Neurology, Tohoku University Graduate School of MedicineKazumotoShibuyaDepartment of Neurology, Graduate School of Medicine, Chiba UniversitySatoshiKuwabaraDepartment of Neurology, Graduate School of Medicine, Chiba UniversityMasayaOdaDepartment of Neurology, Vihara Hananosato HospitalRinaHashimotoDepartment of Neurology, NHO Higashinagoya National HospitalIkukoAibaDepartment of Neurology, NHO Higashinagoya National HospitalTomohikoIshiharaDepartment of Neurology, Brain Research Institute, Niigata UniversityOsamuOnoderaDepartment of Neurology, Brain Research Institute, Niigata UniversityToruYamashitaDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiIshiuraDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKotaBokudaDepartment of Neurology, Tokyo Metropolitan Neurological HospitalToshioShimizuDepartment of Neurology, Tokyo Metropolitan Neurological HospitalYoshioIkedaDepartment of Neurology, Gunma University Graduate School of MedicineKazukoHasegawaDivision of Neurology, NHO Sagamihara National HospitalFumiakiTanakaDepartment of Neurology and Stroke Medicine, Yokohama City University Graduate School of MedicineTakanoriYokotaDepartment of Neurology and Neurological Science, NucleoTIDE and PepTIDE Drug Discovery Center (TIDE), Institute of Science TokyoKazuakiKanaiDepartment of Neurology, Fukushima Medical University School of MedicineYu-ichiNotoDepartment of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of MedicineRyujiKajiDepartment of Neurology, Tokushima University Graduate School of Biomedical SciencesHirohisaWatanabeDepartment of Neurology, Fujita Health UniversityTomokoKonishiDivision of ALS Research, Aichi Medical University School of MedicineMikikoHasegawaDivision of ALS Research, Aichi Medical University School of MedicineHozukiFukayaDivision of ALS Research, Aichi Medical University School of MedicineJun-ichiNiwaDepartment of Neurology, Aichi Medical University School of MedicineManabuDoyuDepartment of Neurology, Aichi Medical University School of MedicineYoheiOkadaDepartment of Neurology, Aichi Medical University School of MedicineShihoNakamuraKeio University Regenerative Medicine Research Center, KawasakiFumikoOzawaKeio University Regenerative Medicine Research Center, KawasakiHideyukiOkanoKeio University Regenerative Medicine Research Center, KawasakiMasahiroNakatochiPublic Health Informatics Unit, Department of Integrated Health Sciences, Nagoya University Graduate School of MedicineGenSobueDivision of ALS Research, Aichi Medical University School of MedicineAmyotrophic lateral sclerosis (ALS) exhibits considerable clinical variability, such as differences in age at onset (AAO). Multiple factors, including genetic factors, may underlie this variability; however, the specific determinants remain unclear. To identify genes affecting AAO, we have conducted a genome-wide association study in Japanese patients with ALS (discovery cohort: n = 1808; replication cohort: n = 207). Here, we show that the minor A allele of rs113161727 at the ADAM29-GPM6A locus is associated with a younger AAO in the discovery cohort (effect, -4.27 years; p = 4.60 × 10-8); this finding has been confirmed in the replication cohort (p = 0.0068) and meta-analysis (p = 1.08 × 10−9). Among 65 ALS patients with a SOD1 mutation, the AAO has been found to be 10.2 years younger in those with the A allele than in those without it (p = 0.002). This variant correlates with GPM6A upregulation in iPSC-derived motor neurons, suggesting GPM6A as a candidate AAO modifier. Overall, our study highlights the impact of genetic modifiers on ALS heterogeneity and provides a potential target for delaying disease onset.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2949-774432025Efficient variant phasing utilizing a replication cycle reaction system103457ENAkihikoMitsutakeDepartment of Neurology, Graduate School of Medicine, The University of TokyoHiroyukiIshiuraDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakashiMatsukawaDepartment of Neurology, Graduate School of Medicine, The University of TokyoJunMitsuiDepartment of Precision Medicine Neurology, Graduate School of Medicine, The University of TokyoShojiTsujiDepartment of Precision Medicine Neurology, Graduate School of Medicine, The University of TokyoTatsushiTodaDepartment of Neurology, Graduate School of Medicine, The University of TokyoPurpose: When 2 heterozygous variants are detected in autosomal recessive disease genes, determining whether they are in cis or in trans is essential. Subcloning polymerase chain reaction products or complementary DNA is limited by variant distance (up to 10 kb) and complementary DNA availability. Droplet digital polymerase chain reaction, effective up to 100 kb, faces probe design challenges. We used replication cycle reaction (RCR), which replicates large DNA fragments based on E. coli chromosome replication, to phase widely spaced heterozygous variants.<br>
Methods: Circular DNA molecules were formed by ligating CRISPR/Cas9-cleaved genomic fragments with an oriC-AmpR cassette, then amplified by RCR. Using a genomic DNA (gDNA) sample that is previously analyzed by long-read sequencing, we optimized reaction conditions (including gDNA to oriC-AmpR cassette ratios) and validated phasing accuracy via electrophoresis and Sanger sequencing. Finally, we applied this method to 7 patients harboring 2 heterozygous pathogenic variants (4.3-152 kb apart).<br>
Results: RCR amplified genomic regions up to 104 kb. Lower gDNA-to-cassette ratios favored monoallelic amplification, enabling straightforward phasing, whereas higher ratios yielded biallelic products requiring transformation-based allele separation. For variants 152 kb apart, an intervening single-nucleotide variant enabled phased reconstruction. Ultimately, RCR confirmed compound heterozygosity in all 7 patients.<br>
Conclusion: This method effectively phases multiple heterozygous variants across large genomic distances.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-818417122025Sequential Bilateral Central Retinal Vein Occlusion With Differential Long-Term Outcomes Following Cardiac Surgerye100045ENToshihikoMatsuoOphthalmology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama University HospitalZenichiMasudaCardiovascular Surgery, Okayama University HospitalHirokiSugiyamaCardiovascular Medicine, Okayama University HospitalKazufumiNakamuraCardiovascular Medicine and Center for Advanced Heart Failure, Okayama University HospitalBilateral central retinal vein occlusion (CRVO) is rare and is associated with systemic diseases such as hypertension, diabetes, dyslipidemia, and coagulopathy. In this study, we showed that the sequential development of bilateral CRVO in an elderly patient was related to increased venous pressure in the right heart system. A 71-year-old man developed CRVO in the right eye, and one year later, he developed CRVO in the left eye. He had undergone pacemaker implantation for sick sinus syndrome 10 years earlier and had started hemodialysis three months prior for chronic renal failure, probably caused by hypertensive nephrosclerosis. The right CRVO resulted in neovascular glaucoma and loss of light perception despite intensive treatment with panretinal laser photocoagulation, intravitreal bevacizumab injection, and additional laser therapy. In contrast, the left CRVO remained at an impending stage, was treated only with panretinal laser photocoagulation, and had a favorable outcome for 11 years until his death. In retrospect, half a year after the onset of left CRVO, the patient underwent open-heart surgery to repair aortic, mitral, and tricuspid valve regurgitation through aortic valve replacement, mitral valve annuloplasty, and tricuspid valve annuloplasty, respectively. Based on the temporal sequence of events, elevated venous pressure due to right heart dysfunction may have contributed to the poor outcome of the right CRVO, whereas improvement of venous stasis after cardiac surgery may have led to the better long-term outcome of the left CRVO. Venous stasis in the right heart system should therefore be considered an underlying factor in the development of bilateral CRVO.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2467-981X102025Favorable outcomes of epilepsy with gait-induced seizures after resection of the unilateral supplementary motor area489492ENSatoshiKodamaDepartment of Neurology, Graduate School of Medicine, The University of TokyoNaotoKuniiDepartment of Neurosurgery, Jichi Medical UniversityYuichiroShirotaDepartment of Neurology, Graduate School of Medicine, The University of TokyoTakuseiChouDepartment of Neurology, Graduate School of Medicine, The University of TokyoMizuhoKawaiDepartment of Neurology, Graduate School of Medicine, The University of TokyoSeijiroShimadaDepartment of Neurosurgery, Graduate School of Medicine, The University of TokyoMeikoMaedaDepartment of Neurology, Graduate School of Medicine, The University of TokyoHiroyukiIshiuraDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasashiHamadaDepartment of Neurology, Graduate School of Medicine, The University of TokyoMasakoIkemuraDepartment of Pathology, Graduate School of Medicine, The University of TokyoYukoSaitoDepartment of Neuropahtology (Brain Bank for Aging Research), Tokyo Metropoliran Institute for Geriatrics and GerontologyNaokiAkamatsuDepartment of Neurology, International University of Health and Walfare Narita HospitalTairaUeharaDepartment of Neurology, International University of Health and Walfare Narita HospitalNobuhitoSaitoDepartment of Neurosurgery, Graduate School of Medicine, The University of TokyoTatsushiTodaDepartment of Neurology, Graduate School of Medicine, The University of TokyoBackground: Gait-induced seizures are a rare manifestation of reflex epilepsy. Pathophysiology of this phenomenon has not been fully understood.<br>
Case presentation: A 28-year-old woman presented with a long history of “falls” following paroxysmal bilateral leg stiffness triggered by walking. Scalp electroencephalogram (EEG) revealed low-amplitude rhythmic beta activity, maximal at the Cz electrode, during these events. Magnetoencephalography demonstrated repetitive sharp waves source-localized to the right primary motor cortex. Multiple anti-seizure medications failed to improve her symptoms; however, the clinical manifestation was consistent with epilepsy with gait-induced seizures. Intracranial subdural EEG recording was performed and confirmed ictal activity originating from the right supplementary motor area. Resection of this area resulted in complete resolution of her symptoms.<br>
Discussion: This is the first reported case of successful resective surgery for epilepsy with gait-induced seizure. Brain networks involving cortical regions responsible for the initiation or execution of walking presumably played a key role in the generation of gait-induced seizures. Careful assessment using non-invasive neurophysiological studies facilitated accurate diagnosis, successful intracranial recordings, and effective resective surgery.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.Japanese Society for Horticultural ScienceActa Medica Okayama2189-01029432025Effect of Storage Temperature and a Sugar-ester Edible Coating on Postharvest Quality and Storage Life of ‘Fuyu’ Persimmon (Diospyros kaki Thunb.)401407ENMaqsoodMuqadasGraduate School of Environmental, Life Science, Natural Science and Technology Okayama UniversityOscar W.MitaloFaculty of Life and Environmental Sciences, University of TsukubaKyoheiOhashiGraduate School of Environmental, Life Science, Natural Science and Technology Okayama UniversityTakumiOtsukiGraduate School of Environmental, Life Science, Natural Science and Technology Okayama UniversityChikaraYanoGraduate School of Environmental, Life Science, Natural Science and Technology Okayama UniversityZiaurrahmanHejaziGraduate School of Agriculture, University of MiyazakiNatsukiHiraShiga R&D Center, Mitsubishi Chemical CorporationKoichiroUshijimaGraduate School of Environmental, Life Science, Natural Science and Technology Okayama UniversityYasutakaKuboGraduate School of Environmental, Life Science, Natural Science and Technology Okayama UniversityIn ‘Fuyu’ persimmons (Diospyros kaki Thunb.), crunchiness is a preferred postharvest attribute among both distributors and consumers. The present study first examined softening characteristics during storage at 0, 5, 10, 15, 20, and 25°C. Fruit stored at 0°C remained firm for 84 d, while that stored at 5°C had a 100% softening rate within 35 d. At 10 and 15°C, over 70% of fruit softened within 49 d and 63 d, respectively. The softening rate was relatively slower at 20 and 25°C, with only 27% softened fruit after 56 d at 25°C. The potential of a newly developed sugar-ester (SE) edible coating to delay fruit softening and maintain postharvest quality was then assessed during storage at 0 and 25°C. Uncoated fruit stored at 0°C for 56 d developed chilling injury (CI) symptoms (rapid fruit softening and peel browning) within 2 d of rewarming at 20°C. These CI symptoms were notably mitigated in SE-coated fruit. At 25°C, SE coating also delayed fruit softening and peel color change in addition to reducing fruit shrinkage. In conclusion, in ‘Fuyu’ persimmons ambient temperature (20–25°C) storage in combination with an edible SE coating is recommended for the high demand Christmas and new year seasons and 0°C storage with an edible SE coating is suitable for longer storage and distribution.No potential conflict of interest relevant to this article was reported.American Astronomical SocietyActa Medica Okayama0004-637X99212025Observing Supernova Neutrino Light Curves with Super-Kamiokande. VI. A Practical Data Analysis Technique Considering Realistic Experimental Backgrounds27ENFumiNakanishiDepartment of Physics, Okayama UniversityKen’ichiroNakazatoFaculty of Arts and Science, Kyushu UniversityMasayukiHaradaKamioka Observatory, Institute for Cosmic Ray Research, The University of TokyoYusukeKoshioDepartment of Physics, Okayama UniversityRyuichiroAkahoFaculty of Science and Engineering, Waseda UniversityYosukeAshidaDepartment of Physics, Tohoku UniversityAkiraHaradaNational Institute of Technology, Ibaraki CollegeMasamitsuMoriDivision of Science, National Astronomical Observatory of JapanKohsukeSumiyoshiNational Institute of Technology, Numazu CollegeYudaiSuwaDepartment of Earth Science and Astronomy, The University of TokyoRoger A.WendellKavli Institute for the Physics and Mathematics of the Universe (Kavli IPMU, WPI), Todai Institutes for Advanced Study, The University of TokyoMasamichiZaizenDepartment of Earth Science and Astronomy, The University of TokyoNeutrinos from supernovae, especially those emitted during the late phase of core collapse, are essential for understanding the final stages of massive star evolution. We have been dedicated to developing methods for the analysis of neutrinos emitted during the late phase and observed at Super-Kamiokande (SK). Our previous studies have successfully demonstrated the potential of various analysis methods in extracting essential physical properties; however, the lack of background consideration has limited their practical application. In this study, we address this issue by incorporating a realistic treatment of the experimental signal and background events with the on-going SK experiment. We therefore optimize our analysis framework to reflect realistic observational conditions, including both signal and background events. Using this framework we study several long-time supernova models, simulating the late phase neutrino observation in SK and focusing in particular on the identification of the last observed event. We discuss the possibility of model discrimination methods using timing information from this last observed event.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2452-199X572026Robust adhesion between solid-state hydroxyapatite and bone tissue through surface demineralization632645ENShichaoXieDepartment of Biomaterials, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasahiroOkadaDivision of Biomaterials Science and Engineering, Graduate School of Dentistry, Tohoku UniversityHaruyukiAoyagiDepartment of Biomaterials, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAkihisaOtakaDepartment of Biomaterials, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityXiaofengYangDepartment of Biomaterials, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakayoshiNakanoDivision of Materials and Manufacturing Science, Graduate School of Engineering, The University of OsakaTakuyaMatsumotoDepartment of Biomaterials, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityObjective: Current bone adhesives typically lack adequate mechanical strength, long-term stability, or biocompatibility. To address these limitations, we designed a new adhesion strategy using a solid-state hydroxyapatite (HAp) adhesive in combination with bone surface demineralization.<br>
Methods: Solid-state HAp adhesives were synthesized via wet chemical precipitation and heat treatment. Cortical bone specimens were partially demineralized with phosphoric acid (H3PO4) or ethylenediaminetetraacetic acid (EDTA), and characterized using scanning electron microscopy (SEM) and attenuated total reflectance–Fourier transform infrared spectroscopy (ATR-FTIR). Shear adhesion strength of HAp to demineralized bone was measured over time. In vivo fixation was assessed in rats using micro-computed tomography and histology. Statistical analysis used Tukey-Kramer tests after normality and variance checks.<br>
Results: Although the HAp adhesive failed to adhere to non-demineralized bone, effective adhesion was achieved on the surface-demineralized bone tissue. Shear adhesion strength was significantly higher in EDTA-treated samples (238.4 kPa at 10 h) compared to H3PO4-treated samples (102.9 kPa at 1 h), with performance correlating with demineralization depth. ATR-FTIR and SEM analyses revealed that EDTA preserved collagen's triple-helix structure and free water content, both enhancing adhesion. Animal experiments confirmed stable fixation of HAp adhesive to demineralized bone tissue.<br>
Conclusions: Surface demineralization enabled strong adhesion of the solid-state HAp adhesive to bone by exposing collagen swollen with water. Adhesion strength was influenced by structural changes in the demineralized layer, and the adhesive provided stable in vivo fixation, supporting its potential for bone-anchored biomedical applications.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7962025Ileus Tube-Related Intussusception: A Case Report and Review of 80 Previously Reported Cases469474ENTeruyukiTsujiiDepartment of Surgery, Matsuda HospitalTatsuoMatsudaDepartment of Surgery, Matsuda HospitalYujiKimuraDepartment of Surgery, Matsuda HospitalRyoichiKatsubeDepartment of Surgery, Matsuda HospitalHironoriIwadouDepartment of Surgery, Matsuda HospitalSadamiFunabikiDepartment of Surgery, Matsuda HospitalYasuakiKamikawaDepartment of Surgery, Matsuda HospitalTadakazuMatsudaDepartment of Surgery, Matsuda HospitalCase Report10.18926/AMO/69851We report a rare case of ileus tube-related intussusception in an adult. A 56-year-old man with adhesive bowel obstruction was treated with a nasointestinal ileus tube. Although his condition initially improved, persistent abdominal pain led to the diagnosis of intussusception via CT imaging. Manual repositioning of the tube resolved the intussusception without the need for bowel resection. A review of 80 previously reported cases of ileus tube-associated intussusception (total 81 cases, 95 lesions) highlighted the timing of onset, treatment strategies, and precautions. Early detection and diagnosis are crucial to prevent severe complications and preserve bowel function.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 Okayama0386-300X7962025Association of Weekend Admission and In-Hospital Mortality in Adult Patients with Acute Myeloid Leukemia in Japan431436ENTakahiroInoueHealthcare Management Research Center, Chiba University HospitalHiroyoKuwabaraHealthcare Management Research Center, Chiba University HospitalKohYamamotoDepartment of Hematology, Yokohama City Minato Red Cross HospitalOriginal Article10.18926/AMO/69845The effect of weekend admission on patient mortality has been investigated in several therapeutic areas, including acute myeloid leukemia (AML), but the investigations’ results are controversial. We evaluated the relationship between in-hospital mortality and weekend admission in adult patients with AML in Japan by conducting a retrospective observational study using administrative data from 144 acute care hospitals from which patients were discharged between April 2014 and March 2019. The primary endpoint was in-hospital mortality, compared between weekend and weekday admissions. Among the 1,340 eligible patients, 11% (150) were admitted during a weekend. The in-hospital mortality rates of the patients admitted during weekends and those admitted on a weekday were 28% (42/150) and 17% (204/1190), respectively. After an adjustment for covariates, weekend admission was associated with a significantly higher risk of in-hospital mortality than weekday admission (HR 1.70, 95%CI: 1.20-2.40; p=0.003). However, such an association was not observed in patients treated in a bio-clean room (HR 1.26, 95%CI: 0.65-2.42). Our results demonstrate that for patients with AML, weekend admission was independently associated with a higher risk of death during hospitalization. An appropriate system is necessary for these patients.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.MDPI AGActa Medica Okayama2076-342515112025Sensory Modality-Dependent Interplay Between Updating and Inhibition Under Increased Working Memory Load: An ERP Study1178ENYuxiLuoGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityAoGuoDepartment of Psychology, Institute of Education, China West Normal UniversityJinglongWuFaculty of Biomedical Engineering, Shenzhen University of Advanced TechnologyJiajiaYangGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityBackground/Objectives: Working memory (WM) performance relies on the coordination of updating and inhibition functions within the central executive system. However, their interaction under varying cognitive loads, particularly across sensory modalities, remains unclear. Methods: This study examined how sensory modality modulates flanker interference under increasing WM loads. Twenty-two participants performed a visual n-back task at three load levels (1-, 2-, and 3-back) while ignoring visual (within-modality) or auditory (cross-modality) flankers. Results: Behaviorally, increased WM load (2- and 3-back) led to reduced accuracy (AC) and prolonged reaction times (RTs) in both conditions. In addition, flanker interference was observed under the 2-back condition in both the visual within-modality (VM) and audiovisual cross-modality (AVM) tasks. However, performance impairment emerged at a lower load (2-back) in the VM condition, whereas in the AVM condition, it only emerged at the highest load (3-back). Significant performance impairment in the AVM condition occurred at higher WM loads, suggesting that greater WM load is required to trigger interference. Event-related potential (ERP) results showed that N200 amplitudes increased significantly for incongruent flankers under the highest WM load (3-back) in the visual within-modality condition, reflecting greater inhibitory demands. In the cross-modality condition, enhanced N200 was not observed across all loads and even reversed at low load (1-back). Moreover, the results also showed that P300 amplitude increased with load in the within-modality condition but decreased in the cross-modality condition. Conclusions: These results demonstrated that the interaction between updating and inhibition is shaped by both WM load and sensory modality, further supporting a sensory modality-specific resource allocation mechanism. The cross-modality configurations may enable more efficient distribution of cognitive resources under high load, reducing interference between concurrent executive demands.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2666-084930322025Guide Tip Damage Due to Rotablation105347ENSatoshiTayaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceMasatokiYoshidaDepartment of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKentaroEjiriDepartment of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesHironobuTodaDepartment of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKazufumiNakamuraDepartment of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesHiroshiMoritaDepartment of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesShinsukeYuasaDepartment of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesBackground: The rotational atherectomy system can effectively debulk calcified coronary lesions. However, rare complications specific to that system have been reported.<br>
Case Summary: A 77-year-old man with a heavily calcified lesion in the right coronary artery (RCA) ostium underwent percutaneous coronary intervention in an 8-F system. During the procedure, rotablation with a 2.25-mm burr was required. After the percutaneous coronary intervention, partial loss of the tip of the guide was observed. He had no clinical sequelae despite the presumed retained catheter material in his body.<br>
Discussion: Although insufficient guide coaxiality has been suggested as the primary cause of guide tip fracture during RCA ostial ablation, other factors may have contributed: the application of force to the tip and a small difference in size between the guide and the burr.<br>
Take-Home Message: When ablating RCA ostial lesions, positioning the burr platform outside the guide may help prevent similar complications in future cases.No potential conflict of interest relevant to this article was reported.AIP PublishingActa Medica Okayama0021-9606163222025Fourier-transform infrared spectroscopy of hydrogen fluoride dimers in solid parahydrogen224312ENYukiMiyamotoResearch Institute for Interdisciplinary Science, Okayama UniversityHirokiOoeGraduate School of Natural Science and Technology, Okayama UniversitySusumuKumaDepartment of Physics, Rikkyo UniversityWe investigate the Fourier-transform infrared spectra of hydrogen fluoride dimers in solid parahydrogen, the detailed analysis of which has remained unexplored. We propose a plausible analysis based on concentration dependence, light polarization, annealing, and time evolution. The absorption lines exhibited multiple peaks, with intensity ratios significantly altered by annealing and by time evolution at a constant temperature. The spectral patterns and isotopic effects suggest that the dimers do not rotate freely in solid parahydrogen, while multiple peaks arise from different stable structures, including single and double substitution sites. Unlike in the gas phase and helium droplets, no tunneling splitting was observed. The broad ν1 band suggests that some dimer structures may exhibit axial rotation. Spectral changes due to annealing likely result from site conversion, while observed IR-induced changes indicate preferential dissociation of dimers in double substitution sites. These findings still remain tentative, necessitating further experimental and theoretical studies.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2189-79482642025Video review by utilizing asynchronous video communication platform375378ENYukiOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEikoMitsudaKato & Namiki-dori HospitalYukichikaYamamotoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsushiKatoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesManoSoshiBonBon, IncMasayaHiguchiHarvard Medical SchoolMikakoObikaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTadayukiHashimotoDepartment of Emergency Medicine, Brigham and Women's HospitalBackground: Video review is widely recognized as an effective method for teaching communication; however, it can increase educators' workload and learners' stress.<br>
Methods: We utilized Tsucom, an online platform developed by BonBon, Inc., which enables asynchronous video communication instead of traditional styles. An 11-min and 42-s consultation video from a fifth-year resident was uploaded, and 10 physicians provided 30 text-based feedback.<br>
Results: In this pilot survey, the utility and ease of use were rated 4.4 and 4.1 out of 5, respectively.<br>
Conclusions: While asynchronous online video reviews provided flexibility and greater participation, challenges remain, and further trials and evaluations were deemed necessary.No potential conflict of interest relevant to this article was reported.Pharmaceutical Society of JapanActa Medica Okayama0009-23637352025New Nucleoside Derivatives for Hybridization-Assisted Catalysis of Site-Selective Acetylation of 2′-OH of RNA457466ENHayateTakasakiGraduate School of Pharmaceutical Sciences, Kyushu UniversityKentaroKitazakiGraduate School of Pharmaceutical Sciences, Kyushu UniversityYurieHadanoGraduate School of Pharmaceutical Sciences, Kyushu UniversityHirotakaMuraseFaculty of Pharmaceutical Sciences, Sojo UniversityJeongsuLeeGraduate School of Pharmaceutical Sciences, Nagasaki International UniversityYosukeTaniguchiFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShigekiSasakiGraduate School of Pharmaceutical Sciences, Kyushu UniversityNew nucleoside derivatives containing the imidazole (Imd), pyridine or pyrimidine catalytic group were designed for site-specific acetylation of 2′-OH of the RNA ribose moiety. When the RNA substrate was acetylated in the presence of acetic anhydride under alkaline conditions, Probe (Imd) containing the imidazole catalytic group acetylated with a high selectivity to the 2′-OH of the uridine opposite the catalytic nucleotide. Probe (Py-4N) containing the pyridine group showed a higher catalytic activity under neutral conditions with a high selectivity for the 2′-OH group of the 5′ side of the uridine opposite the catalytic nucleotide in about 80% modification yield within 10 min. This study has shown that the oligodeoxynucleotide incorporating the new nucleotide derivative with the catalytic group can be a useful tool for site-selective acetylation of RNA 2′-OH.No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama2574-0962862025Effects of Metal-Cation Doping on Photocatalytic H2 Evolution Activity of Layered Perovskite Oxynitride K2LaTa2O6N35413552ENHideyaTsuchikadoDepartment of Chemistry, School of Science, Institute of Science TokyoShujiAnabukiGraduate School of Natural Science and Technology, Okayama UniversityOvidiuCretuElectron Microscopy Group, National Institute for Materials Science (NIMS)YukiKinoshitaDepartment of Chemical Science and Engineering, School of Materials and Chemical Technology, Institute of Science TokyoMasashiHattoriInstitute of Integrated Research, Institute of Science TokyoYutaShiromaDepartment of Chemistry, School of Science, Institute of Science TokyoDongxiaoFanInstitute of Materials Structure Science High Energy Accelerator Research OrganizationMegumiOkazakiDepartment of Chemistry, School of Science, Institute of Science TokyoTakutoSomaDepartment of Chemical Science and Engineering, School of Materials and Chemical Technology, Institute of Science TokyoFumitakaIshiwariDepartment of Applied Chemistry, Graduate School of Engineering, Osaka UniversityShunsukeNozawaInstitute of Materials Structure Science High Energy Accelerator Research OrganizationToshiyukiYokoiInstitute of Integrated Research, Institute of Science TokyoMichikazuHaraInstitute of Integrated Research, Institute of Science TokyoKojiKimotoElectron Microscopy Group, National Institute for Materials Science (NIMS)AkiraYamakataGraduate School of Natural Science and Technology, Okayama UniversityAkinoriSaekiDepartment of Applied Chemistry, Graduate School of Engineering, Osaka UniversityKazuhikoMaedaDepartment of Chemistry, School of Science, Institute of Science TokyoAliovalent cation doping into a heterogeneous photocatalyst affects several of its physicochemical properties, including its morphological characteristics, optical absorption behavior, and charge carrier dynamics, causing a drastic change in its photocatalytic activity. In the present work, we investigated the effects of aliovalent cation doping on the visible-light H2-evolution photocatalytic activity of the Ruddlesden–Popper layered perovskite oxynitride K2LaTa2O6N. The photocatalytic activity toward H2 evolution from an aqueous NaI solution was found to be enhanced by an increase in the specific surface area of the K2LaTa2O6N photocatalyst, which could be realized upon doping with lower-valence cations (e.g., Mg2+, Al3+, and Ga3+). Among the dopants examined at 1 mol % doping, Ga resulted in the highest activity. The activity of the Ga-doped specimen was further improved with increasing Ga concentration, where the maximal activity was obtained at 10 mol %, corresponding to an apparent quantum yield of 2.7 ± 0.4% at 420 nm from aqueous methanol. This number is the highest reported for a layered oxynitride photocatalyst. In the Ga-doped K2LaTa2O6N, a trade-off was observed between the Ga concentration and the photocatalytic activity. Although doping with Ga reduced the particle size of K2LaTa2O6N and suppressed undesirable charge recombination, it led to an enlarged bandgap, unsuitable for visible-light absorption.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2041-17231612025Efficient and stable n-type sulfide overall water splitting with separated hydrogen production8786ENHaolinLuoResearch Center for Combustion and Environment Technology, Shanghai Jiao Tong UniversityZhixiLiuResearch Center for Combustion and Environment Technology, Shanghai Jiao Tong UniversityHaifengLvState Key Laboratory of Precision and Intelligent Chemistry, School of Chemistry and Material Sciences, and Collaborative Innovation Center of Chemistry for Energy Materials (iChEM), University of Science and Technology of ChinaJunie Jhon M.VequizoInstitute of Aqua Regeneration, Shinshu UniversityMengtingZhengCollege of Chemical and Biological Engineering, Zhejiang UniversityFengHanResearch Center for Combustion and Environment Technology, Shanghai Jiao Tong UniversityZhenYeResearch Center for Combustion and Environment Technology, Shanghai Jiao Tong UniversityAkiraYamakataFaculty of Natural Science and Technology, Okayama UniversityWenfengShangguanResearch Center for Combustion and Environment Technology, Shanghai Jiao Tong UniversityAdam F.LeeCentre for Catalysis and Clean Energy, School of Environment and Science, Griffith UniversityXiaojunWuState Key Laboratory of Precision and Intelligent Chemistry, School of Chemistry and Material Sciences, and Collaborative Innovation Center of Chemistry for Energy Materials (iChEM), University of Science and Technology of ChinaDomenKazunariInstitute of Aqua Regeneration, Shinshu UniversityJunLuCollege of Chemical and Biological Engineering, Zhejiang UniversityZhiJiangResearch Center for Combustion and Environment Technology, Shanghai Jiao Tong UniversityN-type sulfide semiconductors are promising photocatalysts due to their broad visible-light absorption, facile synthesis and chemical diversity. However, photocorrosion and limited electron transport in one-step excitation and solid-state Z-scheme systems hinder efficient overall water splitting. Liquid-phase Z-schemes offer a viable alternative, but sluggish mediator kinetics and interfacial side reactions impede their construction. Here we report a stable Z-scheme system integrating n-type CdS and BiVO₄ with a [Fe(CN)₆]³⁻/[Fe(CN)₆]⁴⁻ mediator, achieving 10.2% apparent quantum yield at 450 nm with stoichiometric H₂/O₂ evolution. High activity reflects synergies between Pt@CrOx and Co3O4 cocatalysts on CdS, and cobalt-directed facet asymmetry in BiVO₄, resulting in matched kinetics for hydrogen and oxygen evolution in a reversible mediator solution. Stability is dramatically improved through coating CdS and BiVO4 with different oxides to inhibit Fe4[Fe(CN)6]3 precipitation and deactivation by a hitherto unrecognized mechanism. Separate hydrogen and oxygen production is also demonstrated in a two-compartment reactor under visible light and ambient conditions. This work unlocks the long-sought potential of n-type sulfides for efficient, durable and safe solar-driven hydrogen production.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1340-28383262025MedakaBase as a unified genomic resource platform for medaka fish biologydsaf030ENKenjiMorikamiMolecular Life History Laboratory, Department of Genomics and Evolutionary Biology, National Institute of Genetics, Research Organization of Information and SystemsYasuhiroTanizawaGenome Informatics Laboratory, National Institute of Genetics, Research Organization of Information and SystemsMasaruYaguraMolecular Life History Laboratory, Department of Genomics and Evolutionary Biology, National Institute of Genetics, Research Organization of Information and SystemsMikaSakamotoGenome Informatics Laboratory, National Institute of Genetics, Research Organization of Information and SystemsShokoKawamotoDepartment of Genetics, Sokendai (Graduate University for Advanced Studies)YasukazuNakamuraGenome Informatics Laboratory, National Institute of Genetics, Research Organization of Information and SystemsKatsushiYamaguchiTrans-Omics Facility, National Institute for Basic BiologyShujiShigenobuTrans-Omics Facility, National Institute for Basic BiologyKiyoshiNaruseLaboratory of Bioresources, National Institute for Basic Biology, National Institutes of Natural SciencesSatoshiAnsaiUshimado Marine Institute, Okayama UniversityShigehiroKurakuMolecular Life History Laboratory, Department of Genomics and Evolutionary Biology, National Institute of Genetics, Research Organization of Information and SystemsMedaka, a group of small, mostly freshwater fishes in the teleost order Beloniformes, includes the rice fish Oryzias latipes, a useful model organism studied in diverse biological fields. Chromosome-scale genome sequences of the Hd-rR strain of this species were obtained in 2007, and its improved version has facilitated various genome-wide studies. However, despite its widespread utility, omics data for O. latipes are dispersed across various public databases and lack a unified platform. To address this, the medaka section of the National Bioresource Project (NBRP) of Japan established a genome informatics team in 2022 tasked with providing various in silico solutions for bench biologists. This initiative led to the launch of MedakaBase (https://medakabase.nbrp.jp), a web server that enables gene-oriented analysis including exhaustive sequence similarity searches. MedakaBase also provides on-demand browsing of diverse genome-wide datasets, including tissue-specific transcriptomes and intraspecific genomic variations, integrated with gene models from different sources. Additionally, the platform offers gene models optimized for single-cell transcriptome analysis, which often requires coverage of the 3′ untranslated region (UTR) of transcripts. Currently, MedakaBase provides genome-wide data for seven Oryzias species, including original data for O. mekongensis and O. luzonensis produced by the NBRP team. This article outlines technical details behind the data provided by MedakaBase.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2211-546315102025Osmotic pressure‐induced calcium response states17141722ENZidanGaoDepartment of Cardiovascular Physiology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeijiNaruseFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Okayama JapanMasatoshiMorimatsuFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Okayama JapanOsmotic pressure is essential for maintaining cellular homeostasis; however, the mechanisms by which cells sense and respond to acute osmotic stress remain incompletely understood. Here, we applied rapid osmotic pressure stimulation to cultured HEK293T cells and observed dynamic intracellular calcium responses. Acute hypotonic stimulation evoked calcium response patterns, whereas hypertonic and isotonic stress did not elicit similar effects. Mechanistically, these calcium signals originated from the endoplasmic reticulum via ryanodine receptor 2 and propagated to neighboring cells through Connexin 43-mediated gap junctions. These findings reveal a previously unrecognized role for calcium signaling in the acute cellular response to osmotic stress, providing new insights into the mechanisms of intercellular communication during osmotic adaptation.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0944-117460122025Combination chemotherapy for older patients with unresectable biliary tract cancer: a prospective observational study using propensity-score matched analysis (JON2104-B)15841595ENSatoshiKobayashiDepartment of Gastroenterology, Kanagawa Cancer CenterKoheiNakachiDepartment of Medical Oncology, Tochigi Cancer CenterKoujiYamamotoDepartment of Biostatistics, Yokohama City University School of MedicineMakotoUenoDepartment of Gastroenterology, Kanagawa Cancer CenterYutaMarukiKenjiIkezawaDepartment of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer InstituteTakeshiTerashimaDepartment of Gastroenterology, Kanazawa University HospitalSatoshiShimizuDepartment of Gastroenterology, Kanazawa University HospitalKotoeOshimaDivision of Gastrointestinal Oncology, Shizuoka Cancer CenterKunihiroTsujiDepartment of Gastroenterology, Ishikawa Prefectural Central HospitalYoshiharuMasakiDepartment of Gastroenterology and Hepatology, Sapporo Medical University School of MedicineHidetakaTsumuraDepartment of Gastroenterological Oncology, Hyogo Cancer CenterTaroShibukiDepartment of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital EastMasatoOzakaHepato-Biliary-Pancreatic Medicine Department, Cancer Institute Hospital of Japanese Foundation for Cancer ResearchNaohiroOkanoDepartment of Medical Oncology, Kyorin University Faculty of MedicineYukiyasuOkamuraDivision of Digestive Surgery, Department of Surgery, Nihon University School of MedicineKumikoUmemotoDepartment of Clinical Oncology, St. Marianna University School of MedicineTatsunoriSatohDepartment of Gastroenterology, Shizuoka General HospitalYasushiKojimaDepartment of Gastroenterology, National Center for Global Health and MedicineKazuhikoShiojiDepartment of Gastroenterology, Niigata Cancer Center HospitalHirokoNebikiDepartment of Gastroenterology, Osaka City General HospitalToshifumiDoiDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of MedicineAtsushiNaganumaDepartment of Gastroenterology, National Hospital Organization Takasaki General Medical CenterShigekiKataokaDepartment of Clinical Oncology, Graduate School of Medicine Faculty of Medicine, Kyoto UniversityEmiriKitaDepartment of Gastroenterology, Chiba Cancer CenterHiroyukiAsamaDepartment of Gastroenterology, Fukushima Medical UniversityKaoruTsuchiyaDepartment of Gastroenterology and Hepatology, Musashino Red Cross HospitalMichiakiUnnoDepartment of Surgery, Tohoku University Graduate School of MedicineReikoAshidaSecond Department of Internal Medicine, Wakayama Medical UniversityKazuyukiMatsumotoDepartment of Gastroenterology, Okayama University Graduate School of MedicineIzumiOhnoDepartment of Gastroenterology, Chiba University Graduate School of MedicineTakaoItoiDepartment of Gastroenterology, Tokyo Medical UniversityYujiNegoroDepartment of Oncologial Medicine, Kochi Health Sciences CenterYasunariSakamotoDepartment of Gastroenterology and Hepatology, International University of Health and Welfare Atami HospitalShihoArimaDigestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental SciencesAkinoriAsagiDepartment of Gastroenterology, National Hospital Organization Shikoku Cancer CenterHiroyukiOkuyamaDepartment of Medical Oncology, Kagawa University HospitalYoshitoKomatsuDepartment of Cancer Chemotherapy, Hokkaido University Hospital Cancer CenterNoritoshiKobayashiDepartment of Oncology, School of Medicine Graduate School of Medicine, Yokohama City UniversityHiroakiNaganoDepartment of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of MedicineJunjiFuruseDepartment of Gastroenterology, Kanagawa Cancer CenterBackground: Systemic chemotherapy with gemcitabine plus S-1 (GEM + S-1), GEM + CDDP plus S-1 (GEM + CDDP + S-1), or gemcitabine plus cisplatin (GEM + CDDP) is standard treatment for advanced biliary tract cancer (aBTC). We aimed to evaluate the efficacy and safety of combination chemotherapy in older patients with aBTC.<br>
Methods: This multicenter prospective observational study (JON2104-B, UMIN000045156) included patients aged ≥ 70 years with aBTC. Inverse-probability weighting propensity-score analyses (IPW) were used to compare overall survival (OS) as the primary endpoint and progression-free survival (PFS) across treatment groups.<br>
Results: This study included 305 patients between August 2021 and January 2023. Of them, 75, 131, 26, 52, and 10 received GEM + CDDP + S-1, GEM + CDDP, GEM + S-1, gemcitabine, and S-1; their median ages were 74, 75, 77.5, 80, and 80 years, and approximately 24%, 16.8%, 23.1%, 9.6%, and 0% had G-8 scores of > 14, respectively. GEM + CDDP had a safety profile comparable to that of GEM + CDDP + S-1 but was more toxic than gemcitabine. Per IPW, the hazard ratio (HR) for GEM + CDDP + S-1 versus GEM + CDDP was 0.80 for OS (95% confidence interval [CI], 0.55–1.17) and 0.55 for PFS (95% CI 0.38–0.80). The HR for GEM + CDDP versus gemcitabine was 0.74 for OS (95% CI 0.42–1.29) and 0.79 for PFS (95% CI 0.42–1.49).<br>
Conclusions: GEM + CDDP + S-1 was associated with longer PFS without additional toxicity than GEM + CDDP for fit older patients. However, the OS for both were not statistically different. The efficacies of GEM + CDDP and gemcitabine for vulnerable older patients did not also differ significantly. These findings highlight the importance of vulnerability in patients with aBTC.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1556-08642052025Amivantamab Plus Lazertinib in Patients With EGFR-Mutant NSCLC After Progression on Osimertinib and Platinum-Based Chemotherapy: Results From CHRYSALIS-2 Cohort A651664ENBenjaminBesseParis-Saclay University, Institut Gustave RoussyKoichiGotoNational Cancer Center Hospital EastYongshengWangInstitute of Clinical Trial Center and Cancer Center, West China Hospital, Sichuan UniversitySe-HoonLeeSamsung Medical Center, Sungkyunkwan University School of MedicineMelina E.MarmarelisUniversity of Pennsylvania, Perelman School of MedicineYuichiroOheNational Cancer Center HospitalReyesBernabe CaroHospital Universitario Virgen Del RocioDong-WanKimSeoul National University College of Medicine and Seoul National University HospitalJong-SeokLeeSeoul National University College of Medicine and Seoul National University HospitalSophieCousinInstitut BergoniéEikiIchiharaCenter for Clinical Oncology, Okayama University HospitalYongshengLiChongqing University Cancer HospitalLuisPaz-AresHospital Universitario 12 de OctubreAkiraOnoShizuoka Cancer CenterRachel E.SanbornEarle A. Chiles Research Institute, Providence Cancer InstituteNaohiroWatanabeDepartment of Thoracic Oncology, Aichi Cancer Center HospitalMaria Josede MiguelSTART Madrid-CIOCC, Hospital HM SanchinarroCaroleHelisseyClinical Research unit, Military Hospital BeginCatherine A.ShuColumbia University Medical CenterAlexander I.SpiraVirginia Cancer SpecialistsPascaleTomasiniAix Marseille University - CNRS, INSERM, CRCM; CEPCM - AP-HM Hopital de La TimoneJames Chih-HsinYangNational Taiwan University Cancer CenterYipingZhangZhejiang Cancer HospitalEnriquetaFelipMedical Oncology Service, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron University Hospital Campus, Universitat Autonoma de BarcelonaFrankGriesingerPius-Hospital, University Medicine of OldenburgSaiama N.WaqarDivision of Oncology, Washington University School of MedicineAntonioCallesHospital General Universitario Gregorio MarañónJoel W.NealStanford University Medical CenterChristina S.BaikUniversity of Washington, Fred Hutchinson Cancer CenterPasi A.JänneLowe Center for Thoracic Oncology, Dana Farber Cancer InstituteS. MartinShreeveJohnson & JohnsonJoshua C.CurtinJohnson & JohnsonBharvinPatelJohnson & JohnsonMichaelGormleyJohnson & JohnsonXuesongLyuJohnson & JohnsonJunChenJohnson & JohnsonPei-LingChuJohnson & JohnsonJanineMahoneyJohnson & JohnsonLeonardoTraniJohnson & JohnsonJoshua M.BaumlJohnson & JohnsonMeenaThayuJohnson & JohnsonRoland E.KnoblauchJohnson & JohnsonByoung ChulChoDivision of Medical Oncology, Yonsei Cancer Center, Yonsei University College of MedicineIntroduction: Treatment options for patients with EGFR-mutated NSCLC with disease progression on or after osimertinib and platinum-based chemotherapy are limited.<br>
Methods: CHRYSALIS-2 cohort A evaluated amivantamab plus lazertinib in patients with EGFR exon 19 deletion- or L858R-mutated NSCLC with disease progression on or after osimertinib and platinum-based chemotherapy. Primary end point was investigator-assessed objective response rate (ORR). The patients received 1050 mg of intravenous amivantamab (1400 mg if ≥ 80 kg) plus 240 mg of oral lazertinib.<br>
Results: In cohort A (N = 162), the investigator-assessed ORR was 28% (95% confidence interval [CI]: 22–36). The blinded independent central review–assessed ORR was 35% (95% CI: 27–42), with a median duration of response of 8.3 months (95% CI: 6.7–10.9) and a clinical benefit rate of 58% (95% CI: 50–66). At a median follow-up of 12 months, 32 of 56 responders (57%) achieved a duration of response of more than or equal to 6 months. Median progression-free survival by blinded independent central review was 4.5 months (95% CI: 4.1–5.8); median overall survival was 14.8 months (95% CI: 12.2–18.0). Preliminary evidence of central nervous system antitumor activity was reported in seven patients with baseline brain lesions and no previous brain radiation or surgery. Exploratory biomarker analyses using next-generation sequencing of circulating tumor DNA revealed responses in patients with and without EGFR- or MET-dependent resistance. The most frequent adverse events were rash (grouped term; 81%), infusion-related reaction (68%), and paronychia (52%). The most common grade greater than or equal to 3 treatment-related adverse events were rash (grouped term; 10%), infusion-related reaction (9%), and hypoalbuminemia (6%).<br>
Conclusions: For patients with limited treatment options, amivantamab plus lazertinib demonstrated an antitumor activity with a safety profile characterized by EGFR- or MET-related adverse events, which were generally manageable.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.IEEEActa Medica Okayama2158-40012025A Linear Search Algorithm for Resource Allocation in Frequency Domain Non-Orthogonal Multiple AccessENSatoshiDennoFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityYutoOhbaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityYafeiHouFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityThis paper proposes a linear search algorithm for resource allocation in frequency domain non-orthogonal multiple access based on the low-density signature (LDS). Although the proposed linear search enables the non-orthogonal multiple access to achieve superior transmission performance, the proposed linear search makes the resource allocation implemented with lower and fixed computational complexity. The performance of the non-orthogonal access based on the proposed linear search is evaluated by computer simulation. The proposed linear search algorithm makes the non-orthogonal multiple access achieve a gain of about 6 dB at the BER of 10–5 when the overloading ratio is set to 2. The complexity of the non-orthogonal access based on the proposed linear search algorithm is approximately half as much as that of the conventional low complexity resource allocation when the overloading ratio is 2, if the complexity is evaluated in terms of the number of additions.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2078-248916102025A Comparative Study of Authoring Performances Between In-Situ Mobile and Desktop Tools for Outdoor Location-Based Augmented Reality908ENKomang CandraBrataDepartment of Information and Communication Systems, Okayama UniversityNobuoFunabikiDepartment of Information and Communication Systems, Okayama UniversityHtoo HtooSandi KyawDepartment of Information and Communication Systems, Okayama UniversityPrismahardi AjiRiyantokoDepartment of Information and Communication Systems, Okayama UniversityNopriantoDepartment of Information and Communication Systems, Okayama UniversityMustikaMentariDepartment of Information and Communication Systems, Okayama UniversityIn recent years, Location-Based Augmented Reality (LAR) systems have been increasingly implemented in various applications for tourism, navigation, education, and entertainment. Unfortunately, the LAR content creation using conventional desktop-based authoring tools has become a bottleneck, as it requires time-consuming and skilled work. Previously, we proposed an in-situ mobile authoring tool as an efficient solution to this problem by offering direct authoring interactions in real-world environments using a smartphone. Currently, the evaluation through the comparison between the proposal and conventional ones is not sufficient to show superiority, particularly in terms of interaction, authoring performance, and cognitive workload, where our tool uses 6DoF device movement for spatial input, while desktop ones rely on mouse-pointing. In this paper, we present a comparative study of authoring performances between the tools across three authoring phases: (1) Point of Interest (POI) location acquisition, (2) AR object creation, and (3) AR object registration. For the conventional tool, we adopt Unity and ARCore SDK. As a real-world application, we target the LAR content creation for pedestrian landmark annotation across campus environments at Okayama University, Japan, and Brawijaya University, Indonesia, and identify task-level bottlenecks in both tools. In our experiments, we asked 20 participants aged 22 to 35 with different LAR development experiences to complete equivalent authoring tasks in an outdoor campus environment, creating various LAR contents. We measured task completion time, phase-wise contribution, and cognitive workload using NASA-TLX. The results show that our tool made faster creations with 60% lower cognitive loads, where the desktop tool required higher mental efforts with manual data input and object verifications.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1616-301X2025A Biologically-Architected Wear and Damage-Resistant Nanoparticle Coating From the Radular Teeth of Cryptochiton stellerie21664ENTaifengWangDepartment of Materials Science and Engineering, University of CaliforniaYuChenLyles School of Civil and Construction Engineering, Purdue UniversityEzraSarmientoDepartment of Materials Science and Engineering, University of CaliforniaTaigeHaoMaterials and Manufacturing Technologies Program, University of CaliforniaAtsushiArakakiDivision of Biotechnology and Life Science, Institute of Engineering, Tokyo University of Agriculture and Technology MichikoNemotoGraduate School of Environmental and Life Science, Okayama UniversityPabloZavattieriLyles School of Civil and Construction Engineering, Purdue UniversityDavidKisailusDepartment of Materials Science and Engineering, University of CaliforniaNature utilizes simple building blocks to construct mechanically robust materials that demonstrate superior performance under extreme conditions. These exquisite structures result from the controlled synthesis and hierarchical assembly of nanoscale organic and mineral components that have provided critical evolutionary advantages to ensure survival. One such example is the ultrahard radular teeth found in mollusks, which are used to scrape against rock to feed on algae. Here, it is reported that the leading edges of these teeth consist of a wear-resistant coating that is comprised of densely packed ≈65 nm magnetic nanoparticles integrated within an organic matrix of chitin and protein. These mesocrystalline magnetite-based structures are assembled from smaller, highly aligned nanocrystals with inter/intracrystalline organics introduced during the crystallization process. Nanomechanical testing reveals that this multi-scale, nano-architected coating has a combination of increased hardness and a slight decrease in modulus versus geologic magnetite provides the surface of the chiton tooth with superior abrasion resistance. The mesocrystalline structures fracture at primary domain interfaces, corroborated by computational models, providing significant toughening to the tooth under extreme contact stresses. The design features revealed provide insight for the design and fabrication of next-generation advanced wear- and impact-resistant coatings for tooling, machinery, wind turbines, armor, etc.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-818417102025Association of Use of GRADE, Protocol Registration, and Journal Impact Factor With Reporting and Methodological Quality of Systematic Reviews Published in Rehabilitation Journals: A Meta-Epidemiological Studye95695ENTakahiroTsugeDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNorioYamamotoSystematic Reviewers, Scientific Research WorkS Peer Support Group (SRWS-PSG)YosukeTomitaPhysical Therapy, Faculty of Health Care, Takasaki University of Health and WelfareAkikazuHagiyamaDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityDaijoShiratsuchiPhysical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima UniversityMasatsuguOkamuraSystematic Reviewers, Scientific Research WorkS Peer Support Group (SRWS-PSG)TakaoKanekoRehabilitation, Yamagata Prefectural Central HospitalKosukeSuzukiRehabilitation, Yamagata Saisei HospitalYukiNakashimaSystematic Reviewers, Scientific Research WorkS Peer Support Group (SRWS-PSG)ShunsukeTaitoSystematic Reviewers, Scientific Research WorkS Peer Support Group (SRWS-PSG)TakashiYorifujiDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityThis study aimed to identify factors associated with the reporting and methodological quality of systematic reviews (SRs) published in rehabilitation journals. We conducted a meta-epidemiological study as a secondary analysis of a previous study. The study protocol was registered in the Open Science Framework. We analyzed 219 SRs from rehabilitation journals published since 2020. We assessed reporting quality using the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) 2020 and methodological quality using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2. Multiple linear regression and Spearman's correlation were used to identify factors associated with quality, including Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and the Journal Impact Factor (JIF). Multivariate analysis revealed PRISMA 2020 adherence was significantly associated with use of GRADE (β = 4.33; 95% confidence interval (CI): 3.24-5.42), protocol registration (β = 3.40; 95% CI: 2.32-4.47), and the JIF (2023) (β = 0.69; 95% CI: 0.42-0.95). AMSTAR 2 adherence was also significantly associated with use of GRADE (β = 2.52; 95% CI: 1.88-3.17), protocol registration (β = 2.07; 95% CI: 1.44-2.70), and the JIF (2023) (β = 0.29; 95% CI: 0.14-0.45). Weak positive correlations were observed between the JIF (2023) and both PRISMA 2020 and AMSTAR 2 adherence (ρ = 0.27 and ρ = 0.22, respectively; both P < 0.01). It should be noted that these findings reflect associations and do not imply causality. To enhance the quality of SRs in rehabilitation, researchers should prioritize adherence to PRISMA 2020, particularly the use of GRADE and protocol registration, which this study identified as key associated factors.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1422-006726192025Critical Requirement of Senescence-Associated CCN3 Expression in CD44-Positive Stem Cells for Osteoarthritis Progression9630ENJanvierHabumugishaDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyuichiroOkudaDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazukiHiroseDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMihoKuwaharaDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesZiyiWangDepartment of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMitsuakiOnoDepartment of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroshiKamiokaDepartment of Orthodontics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiKubotaDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakakoHattoriDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOsteoarthritis (OA) is a degenerative joint disease characterized by progressive cartilage breakdown, synovial inflammation, and subchondral bone remodeling. Previous studies have shown that cellular communication network factor 3 (CCN3) expression increases with age in cartilage, and its overexpression promotes OA-like changes by inducing senescence-associated secretory phenotypes. This study aimed to investigate the effect of Ccn3 knockout (KO) on OA development using a murine OA model. Destabilization of the medial meniscus (DMM) surgery was performed in wild-type (WT) and Ccn3-KO mice. Histological scoring and staining were used to assess cartilage degeneration and proteoglycan loss. Gene and protein expressions of catabolic enzyme (Mmp9), hypertrophic chondrocyte marker (Col10a1), senescence marker, and cyclin-dependent kinase inhibitor 1A (Cdkn1a) were evaluated. Single-cell RNA sequencing (scRNA-seq) data from WT and Sox9-deficient cartilage were reanalyzed to identify Ccn3+ progenitor populations. Immunofluorescence staining assessed CD44 and Ki67 expression in articular cartilage. The effects of Ccn3 knockdown on IL-1β-induced Mmp13 and Adamts5 expression in chondrocytes were examined in vitro. Ccn3 KO mice exhibited reduced cartilage degradation and catabolic gene expression compared with WT mice post-DMM. scRNA-seq revealed enriched Ccn3-Cd44 double-positive cells in osteoblast progenitor, synovial mesenchymal stem cell, and mesenchymal stem cell clusters. Immunofluorescence showed increased CCN3+/CD44+ cells in femoral and tibial cartilage and meniscus. Ki67+ cells were significantly increased in DMM-treated Ccn3 KO cartilage, mostly CD44+. In vitro Ccn3 knockdown attenuated IL-1β-induced Mmp13 and Adamts5 expressions in chondrocytes. Ccn3 contributes to OA pathogenesis by promoting matrix degradation, inducing hypertrophic changes, and restricting progenitor cell proliferation, highlighting Ccn3 as a potential therapeutic target for OA.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2050-65112612025PEGylation of liposome-encapsulated midazolam does not improve the bioavailability of midazolam when administered orally166ENYukikoNishiokaDepartment of Dental Anesthesiology, Okayama University HospitalYanyinLuDepartment of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHitoshiHiguchiDepartment of Dental Anesthesiology, Okayama University HospitalSakiMiyakeDepartment of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMakiFujimotoDepartment of Dental Anesthesiology, Okayama University HospitalMidoriHamaoka-InoueDepartment of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroshiTanimuraDepartment of Dental Anesthesiology and Special Care Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHitomiUjitaDepartment of Dental Anesthesiology, Okayama University HospitalShigeruMaedaDepartment 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 SciencesBackground Liposomes are closed vesicles made of the same phospholipid bilayer as biological membranes and are capable of containing drugs, and so they have been investigated as useful drug carriers for drug delivery. We previously developed liposome-encapsulated midazolam (LE-midazolam) for oral administration, but midazolam is metabolized in the liver, and for clinical use the encapsulation of the liposomes needed to be improved to increase the bioavailability of midazolam. The surfaces of pharmaceutical liposomes are generally coated with polyethylene glycol (PEGylation) because it prevents their capture by phagocytes and helps them to avoid the reticuloendothelial system. Therefore, we considered that PEGylation could reduce the metabolism of orally administered encapsulated midazolam in the liver.<br>
Methods Midazolam solution, LE-midazolam solution, and PEGylated liposome-encapsulated midazolam (PEG-LE-midazolam) solution were prepared, and the characteristics of the liposomes in these solutions were evaluated. Furthermore, these solutions were orally administered to rabbits, and the resultant plasma midazolam concentrations were measured. The effects of the PEGylation of LE-midazolam on the plasma concentration and bioavailability of orally administered midazolam were also evaluated.<br>
Results The PEG-LE-midazolam solution contained a higher percentage of larger liposomes than the LE-midazolam solution. The area under the concentration-time curve (AUC) of the LE-midazolam solution was significantly higher than that of the midazolam solution, but there was no difference between the AUC values of the PEG-LE-midazolam and midazolam solutions.<br>
Conclusions These findings suggest that liposome encapsulation may reduce the first-pass effect following oral administration, but PEGylation is not expected to improve the bioavailability of orally administered midazolam.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1433-73982025A rare case of supratentorial ependymosarcoma harboring ZFTA::RELA fusionENYujiMatsumotoDepartment of Neurological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineYasukiSurugaDepartment of Neurological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKaishiSatomiDepartment of Pathology, Faculty of Medicine, Kyorin UniversityYoheiInoueDepartment of Neurological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineYasuhikoHattoriDepartment of Neurological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineJojiIshidaDepartment of Neurological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKazuhikoKurozumiDepartment of Neurosurgery, Hamamatsu University HospitalSumihitoNobusawaDepartment of Human Pathology, Gunma University School of MedicineJunkoHiratoDepartment of Pathology, Public Tomioka General HospitalTakehiroTanakaDepartment of Pathology, Okayama University HospitalHiroyukiYanaiDepartment of Pathology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKanaWashioDepartment of Pediatrics, Okayama University HospitalKoichiIchimuraDepartment of Pathology, Faculty of Medicine, Kyorin UniversityTomotsuguIchikawaDepartment of Neurosurgery, Kagawa Prefectural Central HospitalYoshihiroOtaniDepartment of Neurological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineShotaTanakaDepartment of Neurological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineEpendymosarcoma is an exceedingly rare variant of ependymoma characterized by a mixture of ependymomatous and sarcomatous components. We report a case of supratentorial ependymosarcoma harboring a ZFTA::RELA fusion in a 10-year-old girl. Histologically, the tumor comprised an ependymomatous component resembling clear cell ependymoma and a sarcomatous component. ZFTA::RELA fusion was confirmed in both components. Genome-wide methylation profiling classified both components as supratentorial ependymoma, ZFTA fusion–positive by the German Cancer Research Center (DKFZ) CNS tumor classifier v12b8. However, their copy number alteration profiles were distinct. The ependymomatous component exhibited a gain of chromosome 1q and a loss of chromosomes 1p, 9, and 19q, while the sarcomatous component showed a loss of chromosome 14. These findings suggest that both components may have differentiated from a common precursor despite their distinct morphologies. The patient underwent gross total resection followed by adjuvant chemoradiotherapy and remains recurrence-free eight years post-treatment. Further investigation of additional cases is warranted to better understand the pathogenesis of this rare tumor.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-818417102025Risk Stratification for the Prediction of Skeletal-Related Events in Patients With Bone Metastases From Non-small Cell Lung Cancere95808ENYoshihiroSakamotoDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEijiNakataDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasanoriHamadaDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshimiKatayamaDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinsukeSugiharaDepartment of Orthopedic Surgery, Shikoku Cancer CenterToshifumiOzakiDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSkeletal-related events (SREs) frequently occur in patients with bone metastases from non-small cell lung cancer (NSCLC). This study aimed to identify risk factors for SREs in patients with NSCLC. Based on these factors, we also aimed to stratify patients into subgroups to facilitate the assessment of SRE risk. This retrospective analysis used medical records of 139 patients with NSCLC bone metastases who received treatment at our institution between 2011 and 2014. The incidence of SREs was assessed, and SRE-free survival was analyzed using the Kaplan-Meier method. Clinical information collected at registration was assessed to identify factors associated with the onset of SREs within six months. Univariate analysis was performed using Fisher’s exact test, and multivariate analysis was performed using Cox regression. Of the 139 patients, 36 (26%) developed SREs after registration. The SRE-free survival rates were 80% and 64% at 6 and 12 months, respectively. The univariate and multivariate analyses revealed that the absence of epidermal growth factor receptor (EGFR) mutations or anaplastic lymphoma kinase (ALK) rearrangement (hazard ratio (HR): 4.51, 95% confidence interval (CI): 1.32-15.7, p = 0.017) and a lactate dehydrogenase (LDH) level ≥400 U/L (HR: 8.08, 95% CI: 1.78-36.6, p = 0.0067) were risk factors for SRE presentation within six months. Patients were classified into the following three subgroups: with EGFR mutation or ALK rearrangement and LDH level <400 U/L; without EGFR mutation or ALK rearrangement and LDH level <400 U/L; with/without EGFR mutation or ALK rearrangement and LDH level ≥400 U/L. The corresponding six-month SRE-free survival rates were 92%, 69%, and 34%, respectively, showing significant differences (p < 0.001). Close monitoring is recommended for patients with LDH levels ≥400 U/L in daily clinical practice, particularly with the help of the proficiency of orthopedic and radiological experts, to prevent complications such as pathological fractures and paraplegia.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841762025Clinical Outcomes and Biomechanical Evaluation of the Cement-Catching Screw Technique for Osteoporotic Vertebral Fracturese85955ENHisakazuShitozawaDepartment of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHaruoMisawaDepartment of Orthopaedic Surgery, Ryusou Orthopaedic HospitalYoshiakiOdaDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRyojiJokoDepartment of Orthopaedic Surgery, Japanese Red Cross Okayama HospitalMasayaTakahashiDepartment of Orthopaedic Surgery, Japanese Red Cross Okayama HospitalKojiUotaniDepartment of Orthopaedic Surgery, Okayama University HospitalYasuyukiShiozakiDepartment of Orthopaedic surgery, Mitoyo General HospitalTomokoTetsunagaDepartment of Orthopaedic Surgery, Okayama University HospitalKensukeShinoharaDepartment of Sports Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRyoNakamichiDepartment of Orthopaedic Surgery, Okayama University HospitalMasatakaUedaDepartment of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoTakatoriDepartment of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazutakaYamashitaDepartment of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityObjectives: We developed a cement-catching screw (CCS) technique for pedicle screw insertion into hardened cement, connecting anterior and posterior vertebral elements during balloon kyphoplasty (BKP) for osteoporotic vertebral fractures (OVFs). This study reports the CCS technique, clinical outcomes, and biomechanical properties.<br>
Methods: This retrospective study included 59 patients (20 men, 39 women; mean age, 77.4 ± 8.7 years) who underwent BKP with one-above-one-below posterior fixation for OVFs between 2020 and 2023. Patients were divided into CCS (−) (without intermediate screws, n = 28) and CCS (+) (with intermediate CCSs, n = 31) groups. Clinical and radiographic outcomes, including activities of daily living, vertebral wedge angle (VWA), surgical level Cobb angle (CA), anterior vertebral body height (AVBH), screw loosening, pullout, and adjacent vertebral fractures, were evaluated preoperatively, postoperatively, and at the final follow-up (≥6 months). Biomechanical pullout strength was assessed at different insertion depths (5, 10, and 15 mm) using polymethylmethacrylate cement.<br>
Results: No significant differences were observed between groups in age, sex, follow-up duration, or blood loss; however, the operation time was significantly longer in the CCS (+) group than in the CCS (−) group (P < 0.0001). Radiographic outcomes showed no significant differences in the VWA, CA, AVBH, adjacent vertebral fracture rates, and reoperation rates. However, the incidence of adjacent pedicle screws loosening and pullout was significantly higher in the CCS (−) group than in the CCS (+) group (P = 0.046 and 0.0084, respectively). The correction loss of the CA was significantly lower in the CCS (+) group (CCS (−), 5.6° ± 4.8°; CCS (+), 3.5° ± 4.8°, P = 0.023). The biomechanical test revealed pullout strengths of 683 ± 164, 2231 ± 208, and 3477 ± 393 N for insertion depths of 5, 10, and 15 mm, respectively, with significant increases by depth (P = 0.003 and 0.009).<br>
Conclusions: The CCS technique improves anterior-posterior vertebral body stability, enhances fixation strength, and contributes to better surgical outcomes in OVFs treatment.No 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.MDPI AGActa Medica Okayama1648-91446162025Accuracy Verification of a Computed Tomography-Based Navigation System for Total Hip Arthroplasty in Severe Hip Dysplasia: A Simulation Study Using 3D-Printed Bone Models of Crowe Types II, III, and IV973ENRyuichiroOkudaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomonoriTetsunagaDepartment of Musculoskeletal Health Promotion, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazukiYamadaDepartment of Orthopaedic Surgery, Okayama University HospitalTomokoTetsunagaDepartment of Sports Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiKouraDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomohiroInoueDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasutakaMasadaDepartment 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 SciencesToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground and Objective: The use of computed tomography (CT)-based navigation systems has been shown to improve surgical accuracy in total hip arthroplasty. However, there is limited literature available about the application of CT-based navigation systems in severe hip dysplasia. This study aimed to evaluate the accuracy of a CT-based navigation system in patients with severe hip dysplasia using three-dimensional (3D)-printed bone models. Methods: 3D-printed bone models were generated from CT data of patients with severe hip dysplasia (Crowe type II, 10 hips; type III, 10 hips; and type IV, 10 hips). The accuracy of automatic segmentation, success rate, point-matching accuracy across different registration methods, and deviation values at reference points after registration were assessed. Results: For the combined cohort of Crowe II, III, and IV cases (n = 30), the Dice Similarity Coefficient and Jaccard Index were 0.99 ± 0.01 and 0.98 ± 0.02, respectively. These values indicate a high level of segmentation accuracy. The “Matching with true and false acetabulum + iliac crest” method achieved a 100% success rate across all groups, with mean deviations of 0.08 ± 0.28 mm in the Crowe II group, 0.12 ± 0.33 mm in the Crowe III group, and 0.14 ± 0.50 mm in the Crowe IV group (p = 0.572). In the Crowe IV group, the anterior superior iliac spine deviation was significantly lower using the “Matching with true and false acetabulum + iliac crest” method compared to the “Matching with true and false acetabulum” method (0.28 ± 0.49 mm vs. 3.29 ± 2.56 mm, p < 0.05). Conclusions: This study demonstrated the high accuracy of automatic AI-based segmentation, with a Dice Similarity Coefficient of 0.99 ± 0.01 and a Jaccard Index of 0.98 ± 0.02 in the combined cohort of Crowe type II, III, and IV cases (n = 30). The matching success rate was 100%, with additional points on the iliac crest, which improved matching accuracy and reduced deviations, depending on the case.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1869-695316122025A Multicenter, Prospective, Observational, and Single-Arm Interventional Study of Mirogabalin in Diabetic Peripheral Neuropathic Pain: Rationale and Design of Dia-NeP23512363ENHidekiKamiyaDivision of Diabetes, Department of Internal Medicine, Aichi Medical University School of MedicineRyoSuzukiDepartment of Diabetes, Metabolism and Endocrinology, Tokyo Medical UniversityJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama UniversityTakahisaDeguchiDepartment of Diabetes, Metabolism and Endocrinology, Kagoshima University Graduate School of Medical and Dental SciencesTatsuhitoHimenoDivision of Diabetes, Department of Internal Medicine, Aichi Medical University School of MedicineShuheiYamamotoData Intelligence Department, Daiichi Sankyo Co., Ltd.TaikiToyamaPrimary Medical Science Department, Daiichi Sankyo Co., Ltd.JiroNakamuraDivision of Diabetes, Department of Internal Medicine, Aichi Medical University School of MedicineBackground/Objectives: The exact prevalence of and recent changes in diabetic polyneuropathy (DPN) and diabetic peripheral neuropathic pain (DPNP) in Japan are unclear. The oral gabapentinoid, mirogabalin besylate (mirogabalin), is effective with a good safety profile for DPNP with moderate-to-severe pain (numerical rating scale [NRS] scores ≥ 4). However, clinical evidence for mild pain (NRS scores ≤ 3) is unclear. The Dia-NeP study aims to examine: (1) the prevalences of DPN and DPNP and background factors in patients with type 2 diabetes mellitus (T2DM); and (2) the efficacy and safety of mirogabalin in patients with DPNP, including those with mild pain.<br>
Methods: The Dia-NeP study is a multicenter, prospective study consisting of two parts, a baseline survey and an interventional study, to be conducted from March 2025 to August 2026 in patients with T2DM in Japan. The baseline survey is the observational study investigating the epidemiology of DPN and DPNP, and the interventional study is an exploratory, single-arm, open-label study of 12-week mirogabalin treatment. Of patients with T2DM enrolled in the baseline survey, those diagnosed with DPNP who have an NRS score for pain ≥ 1 will be included in the interventional study. The target sample size is 1000 to 3000 patients for the baseline survey and 100 for the interventional study.<br>
Planned Outcomes: The primary endpoint is the change from baseline in the NRS score at week 12 in the interventional study. The safety endpoint is adverse events. This study will not only show the latest prevalence of DPN and DPNP in Japan, but is also the first study to investigate the efficacy and safety of mirogabalin in patients with DPNP having mild pain, as well as moderate-to-severe pain, and is expected to provide useful evidence for future DPN and DPNP treatment.<br>
Trial Registration: Japan Registry of Clinical Trials (jRCTs031240623, registered 20/January/2025, https://jrct.mhlw.go.jp/en-latest-detail/jRCTs031240623).No 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声楽の発声指導における共鳴に関する研究 ― 教員養成学部学生を対象とした質問紙調査を踏まえて ―109125ENMasakoMUSHIAKIFaculty of Education, Okayama University10.18926/bgeou/69615 本稿では，歌唱における発声について，共鳴の視点から，発声を習得する上での問題点や共鳴に対する課題について検討した。合唱指揮者や指導者等の発声における共鳴の捉え方では，共鳴は，頭蓋骨のすべての共鳴腔，音高と声区，声量，顎の開き，蝶形骨等の骨との密接な関係があり，音色形成との複雑な関連性があることを確認した。次に小中学校の学習指導要領や音楽教科書の発声記述について概観した結果，小中学校を通して，段階的に共鳴について，イメージと生理学的面から児童生徒に学習させていることが示された。教員養成学部に在籍する学生に対する発声の質問紙による実態調査では，共鳴は難しい領域という共通認識があり，特に，発声の自己評価が低めのグループにその傾向が強くみられた。生理学的な理解，イメージ的な表現，実際に生成される声，これら相互の関係を解明する必要がある。No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1342-175129102025First-time diagnosis and referral practices for individuals with CKD by primary care physicians: a study of electronic medical records across multiple clinics in Japan13421353ENHaruhito A.UchidaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYujiNagaoMedicine Division, Nippon Boehringer Ingelheim Co., Ltd.KatsuhitoIharaMedicine Division, Nippon Boehringer Ingelheim Co., Ltd.Background Chronic kidney disease (CKD) is a major public health burden in Japan. Japanese primary care physicians (PCPs) are expected to play an important role in the early diagnosis and management of CKD, but comprehensive data on their role are limited.<br>
Methods This observational study examined data from individuals who underwent tests for CKD diagnosis between January 2017 and September 2023 in the Japan Medical Data Survey (JAMDAS) database of primary care clinics in Japan. The primary outcome was the proportion of individuals with CKD without the registration of a CKD-related disease code. Time to CKD diagnosis and referral were also assessed.<br>
Results Among 1,188,543 eligible individuals who underwent kidney-related laboratory tests, 183,473 (15.4%) met CKD diagnosis criteria according to the Japanese Clinical Practice Guideline for CKD. The mean (± SD) age was 77.4 ± 11.0 years, 57.1% were female, and 71.8% had CKD stage 3a. Over 98% of individuals who met CKD diagnosis criteria did not receive an insurance diagnosis code within 90 days after meeting the criteria. Among referrable individuals, 89.7% did not receive a referral within 90 days of meeting the referral criteria.<br>
Conclusion These results suggest CKD may be underdiagnosed and under-referred in Japanese clinics. Measures should be taken to increase detection and diagnosis according to the Japanese Clinical Practice Guideline for CKD.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-818417102025Bladder Trigone as a Sensory Hub: A Narrative Reviewe94951ENTakuyaSadahiraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiMaruyamaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYosukeMitsuiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakanoriSekitoDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomofumiWatanabeDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasamiWatanabeDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesThe bladder trigone is an anatomically and functionally distinct region within the lower urinary tract (LUT), characterized by a dense network of afferent sensory fibers, specialized urothelial interactions, and prominent mechanotransduction mechanisms. Its intricate neuroarchitecture enables precise detection of bladder filling and coordination of micturition, whereas dysregulation of these pathways contributes to lower urinary tract symptoms (LUTS), including urgency, frequency, and bladder pain. Despite its recognized clinical relevance, the structural and functional basis of trigonal sensory signaling - and its role - remain incompletely understood.<br>
This review synthesizes current evidence on trigonal afferent organization, integrating data from anatomical mapping, receptor profiling, electrophysiological characterization, and translational research. Seminal anatomical observations are combined with recent advances in mechanotransduction and purinergic, peptidergic, and transient receptor potential (TRP) signaling to provide a comprehensive perspective. The trigone exhibits three principal afferent classes: (1) intraepithelial fibers penetrating umbrella cells, marked by P2X purinoceptor 3 (P2X3), transient receptor potential vanilloid 1 (TRPV1), calcitonin gene-related peptide (CGRP), and substance P (SP); (2) subepithelial plexuses surrounding microvasculature, enriched in vasoactive neuropeptides and exhibiting plastic hypertrophy in overactive bladder (OAB) and interstitial cystitis/bladder pain syndrome (IC/BPS); and (3) encapsulated corpuscular endings at the lamina propria-detrusor junction, expressing PIEZO1/2 and acid-sensing ion channels (ASICs) for rapid adaptation. In trigeminal dorsal root ganglion (DRG) neurons, high expression of PIEZO2, P2RX3, and voltage-gated sodium channel, type 1.8 (Nav1.8) was observed, revealing their role as the foundation for multisensory information processing. Functional assays highlight distinct mechanotransductive and chemosensory pathways, with aging, inflammation, and neurotrophic factors driving afferent plasticity underlying abnormal bladder sensation, such as urgency, frequency, and pain. Early clinical trials of P2X3 antagonists and intravesical TRPV1 inhibitors demonstrate promising symptomatic benefits. Collectively, evidence positions the bladder trigone as a critical sensory hub where neuronal, urothelial, and immune signals converge to regulate bladder sensation. Understanding its molecular and structural specialization may inform the development of region-specific neuromodulatory therapies targeting sensory urgency and afferent-driven bladder dysfunction.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0006-291X7862025Hydrogen-rich gas enhances mitochondrial membrane potential and respiratory function recovery in Caco-2 cells post-ischemia-reperfusion injury152753ENMizukiSeyaDepartment of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiyukiAokageBiological Process of Aging, Tokyo Metropolitan Institute for Geriatrics and GerontologyYingMengDepartment of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakahiroHirayamaDepartment of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakafumiObaraDepartment of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTsuyoshiNojimaDepartment of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKosakiYoshinoriDepartment of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTetsuyaYumotoDepartment of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkihiroWatanabeDepartment of Emergency, Disaster and Critical Care Medicine, Hyogo Medical UniversityTaiheiYamadaDepartment of Emergency, Disaster and Critical Care Medicine, Hyogo Medical UniversityHiromichiNaitoDepartment of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsunoriNakaoDepartment of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground: Ischemia-reperfusion (I/R) injury induces oxidative stress, leading to damage in highly susceptible intestinal tissues. Molecular hydrogen (H2) has shown therapeutic potential in I/R injuries, with our prior research showing its efficacy in improving outcomes in rat intestinal transplantation models. However, its impact on mitochondrial function remain insufficiently understood. This study aims to elucidate how H2 modulates mitochondrial function impaired by I/R injury.<br>
Methods: To assess the effects of H2 on I/R injury, cells were divided into three groups: a control group, a hypoxic group (99 % N2, 1 % O2, without H2 for 3, 6, or 24 h), and a hypoxic-H2 group (99 % H2, 1 % O2, for the same durations). After treatment, cells were reoxygenated under normoxic conditions (21 % O2) for 1, 2, 4, or 6 h. Mitochondrial membrane potential, oxygen consumption, and ATP production were measured. Reactive oxygen species production and apoptotic and metabolic regulators were also assessed.<br>
Results: H2 markedly promoting mitochondrial recovery following I/R injury, by enhancing ATP production, restoring mitochondrial membrane potential, and improving oxygen consumption. It also reduced ROS levels and suppressed pro-apoptotic signaling. Notably, H2 suppressed the expression of HIF1α and PDK1, suggesting that H2 may act upstream of hypoxia-driven signaling pathways. These changes promoted oxidative phosphorylation and overall cellular function during reperfusion.<br>
Conclusions: Our findings reveal that H2 therapy supports mitochondrial function, suppresses ROS, and modulates hypoxia-driven pathways in I/R injury. These insights advance the understanding of H2's potential in addressing I/R injury and provide a foundation for its application in other hypoxia-related conditions.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1085-32782025Enhancing Soil Aggregation and Water Retention by Applying Kaolinite Clay to Post‐Tin‐Mined Land on Belitung Island, IndonesiaENHirmas F.PutraGraduate School of Environmental and Life Science, Okayama UniversityYasushiMoriGraduate School of Environmental and Life Science, Okayama UniversityPost-mining sandy soils have low water retention, which causes soil particle separation and persistent soil erosion. Although organic matter is commonly used for soil restoration, it is lightweight, washes away during heavy rain, and decomposes under strong sunlight. The high potential for extreme rainfall events in tropical regions poses significant challenges to restoration projects. Therefore, we investigated the impact of kaolinite clay particles on enhancing soil stability in post-mining sandy soils. Soil samples were collected from three sites representing different succession stages of post-mined land (0, 1, and 6 years since mining cessation) and an adjacent natural forest as the reference site on Belitung Island, Indonesia. Soil samples were treated with 1% or 5% kaolinite or left untreated (control) and incubated at 34°C to mimic the local conditions of the study area. The samples were then analyzed to determine the soil aggregate distribution, water holding capacity, and soil erodibility, and SEM imaging was performed to examine the soil particle morphology. The results revealed an increasing trend in the silt-sized aggregate content and a 2%–5% increase in water retention in the 6-year soils relative to the untreated soils. The highest water retention was observed in the 6-year post-mining soil sample. Kaolinite amendment significantly reduced soil erodibility by 40%–50% compared to the untreated soils, even in the early restoration period (0–1 year post-mining). Kaolinite improved soil aggregation and water retention in post-mining sandy soils while reducing soil erodibility―highlighting its potential for accelerating land restoration in mining-affected areas.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1865-13801812025Tattoo-associated toxic shock syndrome: a case report185ENTakuyaKuboDepartment 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 UniversityHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalKojiIioMicrobiology Division, Clinical Laboratory, Okayama University HospitalHiromichiNaitoDepartment 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 UniversityBackground: Toxic shock syndrome (TSS) is a rare but life-threatening complication occasionally reported after tattooing.<br>
Case presentation: : A 29-year-old Japanese man was admitted to Okayama University Hospital, Okayama, Japan, in early spring 2025, one week after receiving a tattoo on his right shoulder and upper arm in Osaka. He presented with fever, gastrointestinal symptoms, hypotension, and multi-organ failure. Despite a failure to isolate a causative pathogen, he met clinical criteria for TSS. Supportive care and broad-spectrum antibiotics led to full recovery.<br>
Conclusions: TSS can occur after tattooing, even in individuals without apparent immunodeficiency. Pathogenic organisms may be unidentifiable; however, clinical diagnosis should not be delayed, and early therapeutic interventions are essential to improve outcomes.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2470-92391032025Decreased homovanillic acid and 5‐hydroxyindoleacetic acid levels in the cerebrospinal fluid of patients with Dravet syndrome with parkinsonism965970ENRyoSugiyamaDepartment of Child Neurology, National Center Hospital, National Center of Neurology and PsychiatryTakashiSaitoDepartment of Child Neurology, National Center Hospital, National Center of Neurology and PsychiatryAtsukoKatsumotoDepartment of Neurology, National Center Hospital, National Center of Neurology and PsychiatryShotaYonenoDepartment of Child Neurology, National Center Hospital, National Center of Neurology and PsychiatryTomoyukiAkiyamaDepartment of Pediatric Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University HospitalHirofumiKomakiDepartment of Child Neurology, National Center Hospital, National Center of Neurology and PsychiatryDravet syndrome (DS) is an early onset, developmental, and epileptic encephalopathy characterized by drug-resistant seizures and multiple comorbidities. It has been reported that in adulthood, it may be accompanied by parkinsonism, but the pathogenesis of this condition remains unclear. We performed dopamine transporter single-photon emission computed tomography (DAT SPECT) and measured monoamine metabolite levels in the cerebrospinal fluid (CSF) in two adult patients with DS who developed parkinsonism around the age of 30 years. DAT SPECT showed no abnormalities in either patient, whereas CSF tests revealed significant decreases in the levels of homovanillic and 5-hydroxyindoleacetic acids. One patient with severe symptoms was treated with levodopa–carbidopa, which improved parkinsonism manifestations. The other patient initiated treatment with a low dose and has been continuing the treatment without any reported side effects. In conclusion, CSF testing can detect a decrease in dopamine synthesis and may be useful in monitoring the efficacy of levodopa treatment in patients with DS and parkinsonism.<br>
Plain Language Summary: Dravet syndrome (DS) is an early onset, developmental, and epileptic encephalopathy. DS can lead to the development of parkinsonism in adulthood, a clinical syndrome characterized by tremor, slowed movements, and rigidity. Although parkinsonism is a significant issue for patients, its underlying pathology has not yet been elucidated. In this study, we confirmed that the levels of monoamine metabolites in the CSF were low in two patients, potentially shedding light on the pathology involved.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0007-10482025Impact of methotrexate-dosing regimens for GVHD prophylaxis on clinical outcomes of HLA-matched allogeneic HSCTENTomotakaSuzukiDepartment of Hematology and Oncology, Nagoya City University Graduate School of Medical SciencesTomoyasuJoDepartment of Hematology, Graduate School of Medicine, Kyoto UniversityKotaYoshifujiDepartment of Hematology, Institute of Science TokyoTadakazuKondoDepartment of Hematology, Graduate School of Medicine, Kyoto UniversityNorikoDokiHematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome HospitalYoshinobuKandaDivision of Hematology, Jichi Medical University Saitama Medical CentreTetsuyaNishidaDepartment of Hematology, Japanese Red Cross Aichi Medical Centre Nagoya Daiichi HospitalYasushiOnishiDepartment of Hematology, Tohoku University HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalTakahiroFukudaDepartment of Haematopoietic Stem Cell Transplantation, National Cancer Centre HospitalMasashiSawaDepartment of Hematology and Oncology, Anjo Kosei HospitalYutaHasegawaDepartment of Hematology, Hokkaido University HospitalKentaroSerizawaDepartment of Hematology and Rheumatology, Kindai University Faculty of MedicineShuichiOtaDepartment of Hematology, Sapporo Hokuyu HospitalMasatsuguTanakaDepartment of Hematology, Kanagawa Cancer CentreMakotoYoshimitsuDepartment of Hematology and Rheumatology, Graduate School of Medical and Dental Sciences, Kagoshima UniversityYoshikoAtsutaJapanese Data Centre for Haematopoietic Cell TransplantationJunyaKandaDepartment of Hematology, Graduate School of Medicine, Kyoto UniversitySevere graft-versus-host disease (GVHD) remains a major complication of allogeneic haematopoietic stem cell transplantation (allo-HSCT), necessitating optimal immunosuppressive strategies. This retrospective study used data from the Japanese Transplant Registry Unified Management Program to compare three methotrexate (MTX)-dosing regimens for GVHD prophylaxis in patients undergoing human leucocyte antigen (HLA)-matched allo-HSCT: a low-dose 3-day regimen (Ld3:10 mg/m2 on day 1, 7 mg/m2 on days 3 and 6), a low-dose 4-day regimen (Ld4: Ld3 with an additional 7 mg/m2 on day 11) and an original-dose 3-day regimen (Od3: 15 mg/m2 on day 1, 10 mg/m2 on days 3 and 6). Among 2537 analysed patients, Ld3 was the most commonly used regimen. Multivariate analyses showed no significant differences in the cumulative incidence of grade II–IV acute GVHD among regimens. However, Od3 was associated with an increased risk of grade III–IV acute GVHD, and Ld4 was linked to delayed neutrophil engraftment. This study is the first large-scale retrospective analysis of the impact of different MTX-dosing regimens on the outcomes of HLA-matched allo-HSCT, providing valuable insights into optimal MTX-dosing strategies in clinical practice.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0007-10482025Efficacy of ciclosporin monotherapy in non-severe aplastic anaemia not requiring transfusions: Results from a multicentre phase II studyENKenIshiyamaDepartment of Hematology, Kanazawa University HospitalMasahideYamazakiDepartment of Internal Medicine, Keiju Medical CenterHiroyukiMaruyamaDepartment of Hematology, Kanazawa University HospitalNaokoHosonoDepartment of Hematology and Oncology, University of Fukui HospitalHirokiYamaguchiDepartment of Hematology, Nippon Medical SchoolNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalKazukiTanimotoDepartment of Hematology and Oncology, Japanese Red Cross Fukuoka HospitalHiroyukiSugiuraDepartment of Hematology, Chugoku Central Hospital of Japan Mutual Aid Association of Public School TeachersKensukeUsukiDepartment of Hematology, NTT Medical Center TokyoKenichiYoshimuraDepartment of Biostatistics and Health Data Science, Graduate School of Medical Science, Nagoya City UniversitySeishiOgawaDepartment of Pathology and Tumor Biology, Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto UniversityYuzuruKanakuraSumitomo HospitalItaruMatsumuraDepartment of Hematology and Rheumatology, Kindai University Faculty of MedicineKoichiAkashiDepartment of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical SciencesShinjiNakaoDepartment of Hematology, Kanazawa University HospitalThe efficacy of ciclosporin (CsA) to treat transfusion-independent non-severe aplastic anaemia (TI-NSAA) has not yet been systematically evaluated. We conducted a prospective trial in patients with TI-NSAA treated with CsA monotherapy. CsA (3.5 mg/kg/day) was administered to patients with TI-NSAA aged ≥16. The CsA dose was adjusted to maintain a blood CsA level of ≥600 ng/mL at 2 h post-administration. Blood cell counts were assessed after 8, 16 and 52 weeks of therapy. Thirty-two evaluable patients from 21 institutions were enrolled. The median age was 63.5 (range: 16–83) years. At 8 weeks, haematological improvement, with increases in haemoglobin (Hb) ≥1.5 g/dL (haematological improvement in erythrocytes [HI-E]) and platelet count ≥30 × 109/L (haematological improvement in platelets [HI-P]), was observed in 0/25 (0%) and 6/32 (19%) evaluable cases respectively. HI-E and HI-P occurred in 1/25 (4%) and 10/32 (31%) patients at 16 weeks, respectively, and at 52 weeks in 5/25 (20%) and 16/32 (50%) patients respectively. Nine grade 3 adverse events (AEs) occurred in six patients, but there were no grade ≥4 AEs. Ten of the 32 patients experienced grade 2 renal toxicity. Low-dose CsA is effective in TI-NSAA patients and demonstrates minimal renal toxicity. However, at least 16 weeks are necessary to adequately evaluate its efficacy.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0040-8166982026The vicious cycle between nutrient deficiencies and antibiotic-induced nutrient depletion at the host cell-pathogen interface: Coenzyme Q10 and omega-6 as key molecular players103224ENDarabGhadimiDepartment of Microbiology and Biotechnology, Max Rubner-InstitutSophiaBlömerFaculty of Medicine, Christian-Albrechts-University of KielAyselŞahi̇n KayaDepartment of Nutrition and Dietetics, Faculty of Health Sciences, Antalya Bilim UniversitySandraKrügerInstitute of Pathology, Kiel University, University Hospital, Schleswig-HolsteinChristophRöckenInstitute of Pathology, Kiel University, University Hospital, Schleswig-HolsteinHeinerSchäferLaboratory of Molecular Gastroenterology & Hepatology, Christian-Albrechts-University & UKSH Campus KielJumpeiUchiyamaDepartment of Bacteriology, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama UniversityShigenobuMatsuzakiDepartment of Medical Laboratory Science, Faculty of Health Sciences, Kochi Gakuen UniversityWilhelmBockelmannDepartment of Microbiology and Biotechnology, Max Rubner-InstitutThe increasing prevalence of antibiotic resistance and pathological inflammation underscores the importance of understanding the underlying biochemical and immune processes that govern the host-pathogen interface. Nutrient deficiency, compounded by antibiotic-induced nutrient depletion, forms a vicious cycle of overt inflammation, contributing to bacterial toxin translocation in human inter-organ and intra-organs milieus. Coenzyme Q10 (CoQ10) and omega-6 linoleic acid (LA 18:2ω6) are integral to cellular membrane integrity and immune defense. However, the complex enzymatic steps at the host cell-pathogen interface remain poorly understood. This study is particularly timely, as it explores these knowledge gaps, which can inform the development of nutritional and therapeutic strategies that modulate or target these mechanisms. Using an infectious-inflamed cell co-culture model of the gut-liver axis, we exposed triple cell co-cultures of human intestinal epithelial cells (T84), macrophage-like THP-1 cells, and hepatic cells (Huh7) to linoleic acid-producing Lactobacillus casei (L. casei) and Pseudomonas aeruginosa strain PAO1 (PAO1). The cultures were incubated for 6 h in medium with or without ceftazidime antibiotic. PAO1 and L. casei exerted opposing effects on the secretion of Th1 cytokines IL-1β, IL-6, and the Th 2-type cytokine IL-10. Inoculation with PAO1 decreased CoQ10 and linoleic acid levels compared to uninfected controls. L. casei restored cellular health and biofunctionality impaired by PAO1, indicating its benefit to the host's well-being. The antibiotic ceftazidime exerted dual effects, alleviating PAO1 toxicity while marginally disrupting the beneficial effects of L. casei. Our results show how the vicious cycle of nutrient deficiency and antibiotic-induced nutrient loss reinforces pathological inflammation at the host cell-pathogen interface and highlights the need for more appropriate targeted antibiotic use that preserves essential nutrients like CoQ10 and omega-6 fatty acids. Inflammatory responses driven by opportunistic pathogens and LA-producing bacteria represent opposing immunometabolic pathways that may provide insights into novel approaches for treating infection and reducing antibiotic resistance.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.Springer Science and Business Media LLCActa Medica Okayama2168-818417112025Long-Term Outcome of Xenon-Arc Photocoagulation for Retinopathy of Prematurity in the 1970s in Japan: Eleven Patients With 32- to 49-Year Follow-Upe97797ENToshihikoMatsuoHealthcare Science, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityNobuhikoMatsuoOphthalmology, Okayama University Medical SchoolObjectives: Photocoagulation or cryocautery, or their combinations, are the standard of care for retinopathy of prematurity at the recommended timing, which is based on the International Classification of Retinopathy of Prematurity. In Japan, the effectiveness of xenon-arc photocoagulation and cryocautery in retinopathy of prematurity was reported on an empirical basis first in 1968, and became the standard of care in retinopathy of prematurity in the 1970s, 10 years earlier compared with the other countries. In this study, we reported the up to 49 years visual outcome of 11 patients with retinopathy of prematurity who underwent xenon-arc photocoagulation and cryocautery in the 1970s.<br>
Methods: A retrospective review was made on the medical records of 11 consecutive patients who underwent xenon-arc photocoagulation for retinopathy of prematurity in the years 1974 to 1980, and were followed up until the period from 2009 to 2025. The birthweight ranged from 865 g to 2300 g at a median of 1350 g, and the gestational age at birth ranged from 27 weeks to 36 weeks at a median of 30 weeks. The corrected gestational age at the time of photocoagulation ranged from 32 weeks to 53 weeks, with a median of 37 weeks. Oxygen was given to all 11 patients, except for one who was born in the earliest year 1974. The retinopathy of prematurity was at stage 3 in both eyes of seven patients, with plus disease signs in four patients, at stage 2 with and without plus disease in two patients, at stage 2 and stage 3 in each eye of one patient, and at stage 1 with plus disease in both eyes of one patient. The entire 360-degree photocoagulation was given in seven patients, while partial photocoagulation was applied in four patients. Additional cryocautery was applied in six patients.<br>
Results: The age at the last visit ranged from 32 to 49 years with a median of 46 years. At the last visit, seven patients showed the best-corrected visual acuity in decimals of 0.8 or better in both eyes. One dizygotic twin showed no light perception in the phthisic right eye and 0.1 in the left eye with macular degeneration and nystagmus after he underwent cataract surgery at the age of 34 years. The other twin had the best-corrected visual acuity of 0.5 in the right eye and 0.02 in the left eye due to macular degeneration after he underwent cataract surgeries in both eyes at the age of 36 years. Two patients developed rhegmatogenous retinal detachment in one eye at the age of 44 and 41 years, respectively, and underwent vitrectomy with silicone oil tamponade, resulting in visual acuity of 0.1 and 0.3, respectively. Two patients experienced vitreous hemorrhage in one eye, which was absorbed spontaneously at the ages of 37 years and 42 years, respectively. One patient underwent partial scleral buckling for localized rhegmatogenous retinal detachment. No patient used intraocular pressure-lowering eyedrops.<br>
Conclusion: Most patients with xenon-arc photocoagulation for retinopathy of prematurity in the 1970s maintained standard levels of visual acuity up to 49 years in the follow-up. Cataract, retinal detachment, and vitreous hemorrhage were noted as late complications and were coped with on an individual basis. The conclusion would have a meaning, even though not novel, that the patients with retinopathy of prematurity would have benefited from the xenon-arc photocoagulation and cryocautery.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.The Japanese Society of Interventional RadiologyActa Medica Okayama2432-0935102025Optimal Virtual-target Definition for Detecting Feeding Arteries of Renal Cell Carcinoma Using Automated Feeder-detection Softwaree2025-0034ENSoichiroOkamotoDepartment of Radiology, Medical Development Field, Okayama UniversityYusukeMatsuiDepartment of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakahiroKawabataDepartment of Radiology, Tsuyama Chuo HospitalKojiTomitaDepartment of Radiology, Medical Development Field, Okayama UniversityKazuakiMunetomoDepartment of Radiology, Medical Development Field, Okayama UniversityNoriyukiUmakoshiDepartment of Radiology, Medical Development Field, Okayama UniversityFumiyoHigakiDepartment of Radiology, 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 determine the optimal virtual-target definition for detecting renal cell carcinoma feeders using transarterial computed tomography angiography with automated feeder-detection software.<br>
Material and Methods: This retrospective study included 17 patients with 17 renal cell carcinomas who underwent transarterial ethiodized-oil marking before cryoablation. Tumor feeders were automatically detected on transarterial renal computed tomography angiography images using the automated feeder-detection software with three virtual-target definitions: small (ellipsoidal area maximized within the tumor contour), medium (ellipsoidal area covering the entire tumor with a minimal peripheral margin), and large (ellipsoidal area including the tumor and a 5-mm peripheral margin). The detected feeders were classified as true or false positives according to the findings of selective renal arteriography, by consensus of two interventional radiologists. Feeder-detection sensitivity and the mean number of false-positive feeders per tumor were calculated for each virtual-target definition.<br>
Results: For 17 tumors, 25 feeding arteries were identified on the arteriography. The feeder-detection sensitivity of the software was 80.0% (20/25), 88.0% (22/25), and 48.0% (12/25) for small, medium, and large virtual targets, respectively. The mean ± standard deviation number of false-positive feeders per tumor was 0.82 ± 1.3, 1.41 ± 1.1, and 2.82 ± 1.6 when using small, medium, and large virtual-target definitions, respectively.<br>
Conclusions: The detection rate of renal cell carcinoma feeders with the automated feeder-detection software varies according to the virtual-target definition. Using a medium virtual target, covering the entire tumor with a minimal peripheral margin, may provide the highest sensitivity and an acceptable number of false-positive feeders.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465722025介護離職の社会的損失―アップデートと時系列推移―116ENKensakuKishida10.18926/OER/69550 Kishida（2020）estimated the number of labor force exiters unemployed due to family care and their lost income. We updated the result of Kishida（2020）and modified the estimation method of the lost income. We defined labor force exiters as those who were out of work 2 years after they exited. The results using the latest Employment Status Survey for 2022 are as follow. Among the 10.6 thousand annual care leavers, 35.9％ restarted work and the remaining 64.1％ exited the labor market. Three-fourths of returned to the exiters were non-regular workers. Among the care leavers previously in regular employment who returned to the labor market, 34.4％ of them restarted work as regular workers and the remainder restarted work as non-regular workers. Among the exiters, the ratio of care leavers to all exiters was 3.8％ . More than 10％ of women exiters of 40-50 years of age were care leavers. Hence, the loss of middle-aged employment due to care leavers is significant.<br>
The wages of care leavers' previous jobs are indispensable for calculating the loss of income. However, our data did not contain the necessary information. Hence, as a proxy variable, we used the wages of workers whose attributes are similar to the ones of the care leavers. Additionally, in the loss of income calculation, we considered the income accrued from restarting work.<br>
The total loss of income during one year after care leave was 187.4 billion yen. We decomposed the income loss into the loss incurred by being unemployed and the loss incurred by getting a job that pays less than the previous one. The former loss was 77.1％ and the latter one was 22.9％ . Approximately 70％ of the income loss due to wage declines was due to previous full-time employment, and 86.3％ of that was due to resuming work as non-full-time employment with significantly lower wages. If the separation period lasts for more than one year, the income loss for society as a whole is the sum of the income losses in the years when the separation period is different. Based on our calculations, the annual income loss was at least 403.2 billion yen.<br>
The number of people leaving the labor market was 74,400 in 2012, 63,700 in 2017, and 68,100 in 2022. In 2012, when the unemployment rate was high, the return to work rate was lower than in 2017 and 2022, and the number of people leaving the labor market was relatively high. Income losses were 382.1 billion yen in 2012, 363.9 billion yen in 2017, and 399.2 billion yen in 2022. The breakdown of income losses by cause was roughly the same.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0276-34782025DSOK-0011 Potentially Regulates Circadian Misalignment and Affects Gut Microbiota Composition in Activity-Based Anorexia ModelENHirokiKawaiDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNanamiWadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinjiSakamotoDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenjiMiyazakiSumitomo Pharma Co. LtdTaroKatoSumitomo Pharma Co. LtdYoshihiroHoriuchiSumitomo Pharma Co. LtdHiroshiKiriiDepartment of Animal Applied Microbiology, Okayama University Graduate School of Environmental, Life, Natural Science and TechnologyHoang DuyNguyenDepartment of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenjiHinotsuDepartment of Neuropsychiatry, Okayama University HospitalYoshioOhyaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakahiroAsadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkiyoshiYokodeDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukoOkahisaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHarukoMiyazakiDepartment of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshitakaOohashiDepartment of Molecular Biology and Biochemistry, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesManabuTakakiDepartment of Neuropsychiatry, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesObjective: Anorexia nervosa (AN) is a metabolic-psychiatric disorder characterized by severe weight loss, hypercortisolemia, and hypothalamic–pituitary–adrenal (HPA) axis activation. In this study, we investigated the effect of inhibiting cortisol regeneration via the enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) on the pathophysiology of AN.<br>
Method: Female C57BL/6J mice underwent a 7-day activity-based anorexia (ABA) paradigm, involving 3 h daily feeding and free access to wheels, until 25% body weight loss or experiment completion. Mice were orally treated once daily with a potent 11β-HSD1 inhibitor, DSOK-0011, or vehicle. Body weight, food intake, and activity transitions were recorded; plasma corticosterone and cholesterol levels were measured using a fluorometric assay; gut microbiota were analyzed using 16S rRNA sequencing; and hippocampal glial cells were analyzed using immunohistochemistry.<br>
Results: DSOK-0011-treated mice exhibited a modest but significant increase in postprandial wheel-running activity compared to baseline (4–5 p.m., p = 0.018; 5–6 p.m., p = 0.043), whereas vehicle-treated mice showed higher preprandial activity (9–10 a.m., p = 0.0229). Gut microbiota analysis revealed increased alpha diversity in ABA mice, with a specific enrichment of the Lachnospiraceae family in the DSOK-0011 group. However, DSOK-0011 did not significantly affect body weight, food intake, corticosterone, and lipid levels, or hippocampal glial cell populations.<br>
Conclusion: Inhibition of 11β-HSD1 by DSOK-0011 was associated with microbiota alterations and subtle shifts in activity timing under energy-deficient conditions. These findings suggest that peripheral glucocorticoid metabolism may influence microbial and behavioral responses in the ABA model, although its metabolic impact appears limited in the acute phase.No potential conflict of interest relevant to this article was reported.Spandidos PublicationsActa Medica Okayama1791-29973312025Protective impact of landiolol against acute lung injury following hemorrhagic shock and resuscitation in rats22ENRisaSakamotoDepartment of Anesthesiology and Resuscitology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHirokoShimizuDepartment of Anesthesiology and Resuscitology, Okayama University Medical SchoolRyuNakamuraDepartment of Anesthesiology and Resuscitology, Okayama University Medical SchoolYifuLuDepartment of Human Anatomy, Shantou University Medical CollegeYaqiangLiDepartment of Anesthesiology and Resuscitology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEmikoOmoriDepartment of Anesthesiology and Resuscitology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToruTakahashiDepartment of Anesthesiology, Okayama Saidaiji HospitalHiroshiMorimatsuDepartment of Anesthesiology and Resuscitology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHemorrhagic shock and resuscitation (HSR) induces pulmonary inflammation, leading to acute lung injury (ALI). Notably, blocking β1 receptors can lead to organ protection through anti‑inflammatory and anti‑apoptotic effects. Additionally, although the β1 receptor pathway is blocked by the β1 blocker, the β2 receptor pathway may be preserved and activate the 5' adenosine monophosphate‑activated protein kinase (AMPK) pathway. The present study aimed to examine whether administration of the β1 blocker landiolol could achieve lung protection in a model of HSR‑ALI, alongside improvements in inflammation and apoptosis. Male Sprague‑Dawley rats underwent hemorrhage keeping their mean arterial pressure at 30 mmHg for 1 h. Resuscitation by reinfusion was initiated to restore blood pressure to pre‑hemorrhage levels for >15 min, followed by a 45‑min stabilization period to create the HSR‑ALI model. Landiolol (100 mg/kg/min) or saline was continuously administered after resuscitation. The lung tissues, which were collected for assessing inflammation and apoptosis‑related damage, underwent analyses, including histological examination, neutrophil count, assessment of lung wet/dry weight ratio, detection of the mRNA levels of tumor necrosis factor‑α (TNF‑α) and inducible nitric oxide synthase (iNOS), identification of terminal deoxynucleotidyl transferase dUTP nick‑end labeling (TUNEL)‑positive cells, and evaluation of caspase‑3 expression. In addition, phosphorylated AMPKα (pAMPKα) expression was tested via western blotting. Compared with the HSR/saline group, the HSR/landiolol group demonstrated a reduction in lung tissue damage score, and significant reductions in neutrophil count, lung wet/dry weight ratio, lung TNF‑α and iNOS mRNA levels, TUNEL‑positive cells and cleaved caspase‑3 expression. Furthermore, landiolol administration following HSR treatment increased pAMPKα expression. No significant hypotension occurred between the HSR/landiolol and HSR/saline groups; and blood loss did not differ significantly between the groups. In conclusion, landiolol administration after HSR reduced lung inflammation and apoptosis, suggesting a potential improvement in tissue damage. Furthermore, pAMPKα activation in the HSR/landiolol group may be the mechanism underlying the pulmonary protective effects of landiolol.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2363-90241112025Venous air embolism induced by burr hole drilling before dural incision in craniotomy: two case reports59ENYoheiMotoiDepartment of Anesthesiology and Resuscitology, Okayama University HospitalShujiOkaharaDepartment of Anesthesiology and Resuscitology, Okayama University HospitalMakikoTaniDepartment of Anesthesiology and Resuscitology, Okayama University HospitalNobushigeTsuboiDepartment of Neurosurgery, Okayama Red Cross HospitalHiroshiMorimatsuDepartment of Anesthesiology and Resuscitology, Okayama University HospitalBackground: Venous air embolism (VAE) is a rare but potentially fatal complication in neurosurgery typically caused by injury to dura mater, especially venous sinuses, during craniotomy. We report two cases of VAE that occurred before dural incision.<br>
Case presentation: Both patients underwent craniotomy under general anesthesia in a head-up position. Hemodynamic and respiratory deterioration occurred during or immediately after burr hole drilling with abnormal vital signs and transesophageal echocardiography findings, raising suspicion for VAE. Immediate management, including surgical field protection and cardiopulmonary support, stabilized the patients’ conditions. The procedure was subsequently discontinued in case 1 and modified to limited resection in case 2. Postoperative computed tomography revealed intracranial venous air within the internal jugular vein, cavernous sinus, and diploic veins.<br>
Conclusion: These cases highlight that VAE can occur even before dural incision. Vigilant intraoperative monitoring and prompt intervention are essential for preventing potentially fatal outcomes.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.Elsevier BVActa Medica Okayama0300-95722152025Compression only CPR and mortality in pediatric out-of-hospital cardiac arrest during COVID-19 pandemic110706ENTakafumiObaraDepartment 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 UniversityNaomiMatsumotoDepartment of Epidemiology, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityKoheiTsukaharaDepartment 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 UniversityTsuyoshiNojimaDepartment 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 UniversityTakashiYorifujiDepartment of Epidemiology, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityAtsunoriNakaoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityBackground: The COVID-19 pandemic influenced resuscitation practices worldwide, leading to a notable decline in rescue breathing cardiopulmonary resuscitation (RB-CPR), even in pediatric out-of-hospital cardiac arrest (OHCA). Understanding the impact of this decline is important to assess the role of rescue breathing in pediatric resuscitation. This study aimed to evaluate the impact of the reduced RB-CPR during the COVID-19 pandemic on mortality and neurological outcomes among pediatric OHCA patients in Japan.<br>
Methods: This retrospective cohort study utilized data from the nationwide All-Japan Utstein Registry for pediatric OHCA patients (≤17 years) who received bystander CPR between January 2017 and December 2021. Data were compared in pre-COVID-19 (2017–2019) versus pandemic (2020–2021) periods. Bystander CPR were classified as RB-CPR or chest compression-only CPR (CO-CPR). The primary outcome was 30-day mortality, with secondary outcomes including the absence of return of spontaneous circulation and unfavorable neurological outcomes (Cerebral Performance Category scores of 3–5). Adjusted risk ratios (aRR) with 95 % confidence intervals (CI) were estimated using Poisson regression.<br>
Results: Of 7,162 pediatric OHCA cases, 3,352 (46.8 %) received bystander CPR. RB-CPR decreased from 33.0 % pre-pandemic to 21.1 % during the pandemic. CO-CPR was associated with higher 30-day mortality (aRR: 1.16; 95 % CI: 1.08–1.24) and unfavorable neurological outcomes (aRR: 1.10; 95 % CI: 1.05–1.16). These trends were consistent across age groups and arrest etiologies, particularly for non-cardiac causes. More significantly, the decrease in RB-CPR was estimated to contribute to 10.7 excess deaths annually during the pandemic.<br>
Conclusions: The findings highlight the importance of rescue breathing in pediatric OHCA. CO-CPR, while suitable for adults, may compromise outcomes in children. Emphasizing rescue breathing in pediatric resuscitation training and integrating infection control measures is essential for future public health emergencies.No potential conflict of interest relevant to this article was reported.Public Library of Science (PLoS)Acta Medica Okayama1932-620320102025Relationship between obesity indices and cognitive function in Japanese men: A cross-sectional studye0332595ENSatoshiMatsunoDepartment of Psychiatry, Shiga University of Medical ScienceYujiOzekiDepartment of Psychiatry, Shiga University of Medical ScienceSayakaKadowakiNCD Epidemiology Research Center, Shiga University of Medical ScienceSayukiToriiNCD Epidemiology Research Center, Shiga University of Medical ScienceKeikoKondoNCD Epidemiology Research Center, Shiga University of Medical ScienceNaokoMiyagawaDepartment of Preventive Medicine and Public Health, Keio University School of MedicineAzusaShimaDepartment of Clinical Nursing, Shiga University of Medical ScienceMizukiOhashiNCD Epidemiology Research Center, Shiga University of Medical ScienceItsukoMiyazawaDepartment of Medicine, Shiga University of Medical ScienceHiroyoshiSegawaNCD Epidemiology Research Center, Shiga University of Medical ScienceTakashiHisamatsuDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAyaKadotaNCD Epidemiology Research Center, Shiga University of Medical ScienceKatsuyukiMiuraNCD Epidemiology Research Center, Shiga University of Medical ScienceWe aimed to investigate the associations among various obesity indices, including visceral (VAT) and subcutaneous adipose tissue (SAT), and cognitive function in community-dwelling Japanese men. This population-based cross-sectional study used data of 853 men who participated in the follow-up examinations of the Shiga Epidemiological Study of Subclinical Atherosclerosis. Among them, we analyzed data of 776 men who completed the Cognitive Abilities Screening Instrument (CASI) and had abdominal VAT and SAT areas measured using computed tomography. The VAT-to-SAT ratio (VSR) was calculated; participants were categorized into VSR quartiles. Using analysis of covariance, we computed crude and adjusted means of the CASI total and domain scores across VSR quartiles, adjusting for potential confounders. No significant differences were observed in total CASI scores among body mass index, VAT, or SAT quartiles. However, in the multivariable-adjusted model, participants in the lowest VSR quartile (Q1) had significantly lower CASI total scores than those in the third quartile (Q3) (Q1: 89.5, Q3: 90.9). Low VSR was independently associated with lower cognitive function in a community-based sample of middle-aged and older Japanese men. In summary, VSR may be associated with cognitive function in Japanese men, highlighting the importance of fat distribution in cognitive health and highlighting VSR as a useful indicator.No potential conflict of interest relevant to this article was reported.Journal of Neurosurgery Publishing Group (JNSPG)Acta Medica Okayama2694-190210132025Endovascular treatment for a symptomatic dissecting ophthalmic artery aneurysm occurring in the orbit: illustrative caseCASE25483ENKoheiIzumiharaDepartment 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 SciencesKenjiSugiuDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFukikoBabaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJuntaroFujitaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuichiHirataDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYutaSotomeDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasatoKawakamiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyuKimuraDepartment 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 SciencesShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBACKGROUND: Peripheral ophthalmic artery aneurysms (POAAs) arising from the main trunk or branches of the ophthalmic artery (OphA) are extremely rare. However, their epidemiology and optimal management remain poorly understood. The authors report a rare case of a symptomatic POAA caused by arterial dissection that was successfully treated using endovascular therapy, leading to favorable visual recovery.<br>
OBSERVATIONS: A 77-year-old woman presented with sudden-onset visual impairment in the right eye. Ophthalmological examination revealed a defect in the right visual field. CT angiography revealed a fusiform aneurysm in the right intraorbital OphA. Digital subtraction angiography revealed a pearl and string sign, consistent with a dissecting aneurysm. A balloon test occlusion (BTO) of the OphA origin confirmed collateral circulation from the external carotid artery. Internal trapping of the OphA was performed under general anesthesia. Postoperatively, the patient’s visual function gradually improved, and complete recovery was achieved within 3 months.<br>
LESSONS: Although POAAs are exceptionally rare, they may lead to significant visual dysfunction owing to optic nerve compression. When visual symptoms are present, prompt intervention may reverse the symptoms. Preoperative assessment of collateral circulation using BTO is essential for treatment planning. Internal trapping may be an effective strategy when sufficient collateral flow is confirmed.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2077-038314172025Potential of Kidney Exchange Programs (KEPs) in Japan for Donor-Specific Antibody-Positive Kidney Transplants: A Questionnaire Survey on KEPs and a Multi-Institutional Study Conducting Virtual Cross-Matching Simulations6122ENTaiheiItoDepartment of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health UniversityMikiItoDepartment of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health UniversityNaohiroAidaDepartment of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health UniversityKeiKuriharaDepartment of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health UniversityAkihiroTeraoDepartment of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health UniversityYoshihikoWataraiDepartment of Transplant Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daini HospitalMitsuruSaitoDivision of Blood Purification, Akita University HospitalKeizoKakuDepartment of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu UniversityDaisukeIshiiDepartment of Urology, Kitasato University of MedicineSatoshiSekiguchiTransplantation Surgery, Japan Community Healthcare Organization Sendai HospitalTatsuoYonedaUnit of Dialysis, Department of Urology, Nara Medical UniversityKoheiUnagamiOrgan Transplant Medicine, Tokyo Women’s Medical UniversityMasayukiTasakiDivision of Urology, Department of Regenerative & Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata UniversityHitoshiIwamotoDepartment of Kidney Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterMotooArakiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhiroTakahashiDepartment of Gastrointestinal and Hepatobiliary Pancreatic Surgery, University of TsukubaKazuakiYamanakaDepartment of Urology, Osaka University Graduate School of MedicineMikioSugimotoDepartment of Urology, Faculty of Medicine, Adrenal Surgery and Renal Transplantation, Kagawa UniversityKouheiNishikawaDepartment of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of MedicineChikashiSetoDepartment of Urology, Toyama Prefectural Central HospitalMasakiMuramatsuDepartment of Nephrology, Toho University Faculty of MedicineToshihiroAsaiDepartment of Kidney Transplant and Dialysis, Osaka City General HospitalDaikiIwamiDivision of Renal Surgery and Transplantation, Department of Urology, Jichi Medical UniversityYasutoshiYamadaDepartment of Blood Purification, Kagoshima University HospitalShigeyoshiYamanagaDepartment of Transplant Surgery, Japanese Red Cross Kumamoto HospitalTomonoriKomatsuDepartment of Urology, Chukyo Hospital, Japan Community Healthcare OrganizationMasayoshiMiuraDepartment of Renal Transplantation Surgery and Urology, Sapporo Hokuyu HospitalTakahiroNoharaDepartment of Urology, Kanazawa University HospitalMichihiroMaruyamaDepartment of Frontier Surgery, Chiba University School of MedicineYukiMiyauchiDepartment of Urology, Ehime UniversityToshiakiTanakaDepartment of Urology, Sapporo Medical UniversityMichioNakamuraDepartment of Transplant Surgery, Tokai University School of MedicineKiyohikoHottaDepartment of Renal and Genitourinary Surgery, Faculty of Medicine, Hokkaido UniversityTakashiKenmochiDepartment of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health UniversityObjectives: To clarify the need for a kidney exchange program (KEP) in Japan by conducting a questionnaire survey on KEPs and simulated KEPs by virtual cross-matching based on past cases of transplantation avoidance. Methods: In addition to the content regarding KEPs, an electronic survey was conducted to investigate the number of cases of kidney transplant abandonment due to “immunological” reasons over the past 10 years (2012–2021). Virtual cross-matching was conducted to simulate the feasibility of avoiding immunological risks and enabling kidney transplantation in patients who were previously unable to undergo the procedure. Results: The survey received responses from 107 facilities (response rate: 81.7%). In response to the question about the necessity of a KEP in Japan, 71 facilities (66.4%) indicated that KEPs are necessary. In addition, 251 living-donor kidney transplants were abandoned for “immunological” reasons over the past decade (2012–2021). Among the 80 pairs for which detailed information was available, virtual cross-matching simulations showed that 37/80 pairs (46.3%) were donor-specific antibody (DSA)-negative for blood type-matched combinations, and 41/80 pairs (51.3%) were DSA-negative for blood type-incompatible transplants. Conclusions: The need for a KEP in Japan and its potential usefulness were demonstrated.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0385-24072025A Case of Netherton Syndrome/SPINK5-Syndromic Epidermal Differentiation Disorder Evaluated by Serial Tape-Stripping: Persistent Elevation of Serine Protease Activities Despite Clinical ImprovementENShinMorizaneDepartment of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAnriMoritaDepartment of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoSunagawaDepartment of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHayatoNomuraDepartment of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKen‐IchiHasuiDepartment of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiHondaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMamoruOuchidaDepartment of Molecular Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.Frontiers Media SAActa Medica Okayama2673-661662025Maternal circulating GPIHBP1 levels and neonatal outcomes in patients with gestational diabetes mellitus: a pilot study1682012ENMayuWatanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesJunEguchiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesNaokoKurookaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesErikoEtoDepartment of Obstetrics and Gynecology, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesHisashiMasuyamaDepartment of Obstetrics and Gynecology, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesIntroduction: The prevalence of gestational diabetes mellitus (GDM) is significantly increasing. Hyperglycaemia and dyslipidaemia have been demonstrated to contribute to endothelial dysfunction linked to foetal–placental circulation. Glycosylphosphatidylinositol-anchored high-density lipoprotein-binding protein 1 (GPIHBP1) is crucial for the lipolytic processing of TG-rich lipoproteins through the anchoring of lipoprotein lipase (LPL). In this study, circulating GPIHBP1 levels during pregnancy were evaluated, and their associations with hypertriglyceridaemia and the perinatal outcomes of GDM were evaluated.<br>
Methods: This study included 12 pregnant women with GDM and 21 pregnant women with normal glucose tolerance (NGT).<br>
Results: No significant differences in obstetrical outcomes were detected between the two groups. In participants with NGT, circulating GPIHBP1 levels were markedly lower in the 3rd trimester than in the 2nd trimester and at delivery. In women with GDM, circulating GPIHBP1 levels were unchanged during the 3rd trimester, and circulating GPIHBP1 levels throughout the 3rd trimester were negatively correlated with neonatal birth weight percentile and umbilical venous pO2 (ρ=-0.636, p=0.026; ρ=-0.657, p=0.020).<br>
Discussion: Our findings suggest a possible association between circulating GPIHBP1 levels and perinatal outcomes in patients with GDM.No potential conflict of interest relevant to this article was reported.Ovid Technologies (Wolters Kluwer Health)Acta Medica Okayama0194-911X82102025Redefining AT1 Receptor PET Imaging: Introducing the Radiotracer [18F]DR2916261637ENXinyuChenNuclear Medicine, Faculty of Medicine, University of AugsburgHiroyukiKimuraAgency for Health, Safety and Environment, Kyoto UniversityTakanoriSasakiFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKonradKlimekGoethe University Frankfurt, University Hospital, Clinic for Radiology and Nuclear Medicine, Department of Nuclear MedicineSaskiaMühligDepartment of Nuclear Medicine and Comprehensive Heart Failure Center (DZHI), University Hospital WürzburgAnahi PaulaArias-LozaDepartment of Nuclear Medicine and Comprehensive Heart Failure Center (DZHI), University Hospital WürzburgNaokoNoseFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYusukeYagiFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySteven PRoweMolecular Imaging and Therapeutics, Department of Radiology, School of Medicine, University of North Carolina, Chapel HillConstantinLapaNuclear Medicine, Faculty of Medicine, University of AugsburgRudolf A.WernerDepartment of Nuclear Medicine, LMU Hospital, Ludwig-Maximilians-University of MunichTakahiroHiguchiFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBACKGROUND: AT1R (angiotensin II type 1 receptors) are central to the renin-angiotensin system and are involved in regulating blood pressure and renal physiology. This study introduces [18F]DR29, a fluorine-18-labeled radiotracer for positron emission tomography imaging, to enable noninvasive visualization of AT1R expression. Its potential applications in understanding AT1R-associated renal processes are explored in healthy and hypertensive rat models.<br>
METHODS: Radiolabeling was established, and biodistribution studies were conducted on healthy Wistar rats with and without the AT1R antagonist candesartan and transporter inhibitors. Dynamic positron emission tomography imaging assessed tracer specificity, and feasibility for renal AT1R quantification was explored using a hypertensive rat model.<br>
RESULTS: [18F]DR29 was radiolabeled with a yield of 36±6%. High kidney uptake was observed, significantly reduced by candesartan (kidney-to-blood ratio, 0.43±0.01 versus 4.54±1.59 in vehicle, where vehicle refers to saline without any treatment). Transporter inhibition protocols targeting organic anion transporting polypeptides (liver) and organic anion transporters (kidneys) successfully reduced radiotracer clearance, increasing the specific accumulation of [18F]DR29 in the kidneys and improving renal imaging contrast. Positron emission tomography imaging revealed rapid kidney uptake and stable retention over 2 hours. In hypertensive rats, kidney uptake was higher, aligning with AT1R expression levels.<br>
CONCLUSIONS: These results support [18F]DR29 as a promising tool for the noninvasive evaluation of renal AT1R expression in healthy and diseased states. The findings lay the groundwork for clinical translation, offering potential applications in diagnosing and managing kidney-related diseases, including hypertension and other conditions involving AT1R dysregulation.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1939-59812025Effect of Repeated Gravity Casting on the Microstructure and Mechanical Properties of 6061 Aluminum AlloyENMitsuhiroOkayasuDepartment of Mechanical Systems and Engineering, Okayama UniversityShoueiMakinoDepartment of Mechanical Systems and Engineering, Okayama UniversityShotaNakagawaResearch & Development Center, Marketing & Technology Division, UACJ CorporationShuheiTakeuchiDepartment of Mechanical Systems and Engineering, Okayama UniversityYoshifumiShinzatoResearch & Development Center, Marketing & Technology Division, UACJ CorporationTadashiMinodaResearch & Development Center, Marketing & Technology Division, UACJ CorporationNaotakaOhtsukaResearch & Development Center, Marketing & Technology Division, UACJ CorporationThis study systematically investigates the effects of repeated gravity casting on the microstructure and mechanical properties of 6061 aluminum alloy. With an increasing number of casting cycles from one to ten, grain coarsening and a decrease in dislocation density were observed, mainly due to the significant depletion of magnesium from 1.03 to 0.01% and titanium from 0.009 to 0.005%. These microstructural changes led to a decrease in solid-solution strengthening and grain-boundary strengthening, resulting in a 30% reduction in tensile strength, while ductility increased by about three times. Moreover, work hardening decreased with increasing the casting cycle, which can be attributed not only to the microstructural changes but also to the increase in stacking fault energy (SFE) associated with compositional evolution. From the transmission electron microscopy (TEM) observations, in the 1-cycle sample, Mg2Si precipitates were finely dispersed and a high amount of Mg element in the matrix, resulting in significant dislocation accumulation, whereas the 10-cycle sample exhibited weaker dislocation tangling. These microstructural evolutions provide insight into the degradation of mechanical performance in aluminum alloys subjected to multiple casting processes.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2510-15602025Enhanced electric power generation in PZT ceramics via stress controlENMitsuhiroOkayasuDepartment of Mechanical Systems and Engineering, Okayama UniversityItsukiShimazuDepartment of Mechanical Systems and Engineering, Okayama UniversityThis study aimed to enhance the electric power generation of lead zirconate titanate piezoelectric (PZT) ceramics by optimizing stress distribution. Specifically, it focused on applying high stress over a broad area of the PZT ceramic to induce shape deformation in the PZT plate. Pre-straining the PZT plate into an arch shape improved voltage generation, reaching its peak at a maximum deflection of 0.04 mm due to the expanded and intensified stress distribution. However, exceeding this deflection threshold led to a decline in voltage output due to material degradation, including crack formation and 90° domain switching. Finite element analysis confirmed that the increased stress distribution in the pre-strained PZT plate contributed to higher voltage output. Additionally, electron backscatter diffraction analysis revealed that at higher pre-strains (deflection of 0.08 mm), 90°domain switching occurred, resulting in increased internal strain and potential crack formation. Experimental investigations using bulk PZT rods further demonstrated that moderate pre-straining effectively enhanced voltage output.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1939-59812025Upgrading Recycle Technology for Iron Removal in ADC12 Alloy Using Gravity and Magnetic ForceENM.OkayasuDepartment of Mechanical Systems and Engineering, Okayama UniversityS.TakeuchiDepartment of Mechanical Systems and Engineering, Okayama UniversityM.SyahidDepartment of Mechanical Engineering, Hasanuddin UniversityT.IkedaDepartment of Mechanical Systems and Engineering, Okayama UniversityAs there is a technical issue to remove iron elements during aluminum recycling process, an attempt was made to evaluate the effectiveness of magnetic and gravitational separation methods for removing iron from Al-Si-Cu alloy (ADC12). A rare-earth samarium–cobalt (SmCo) magnet was employed during the solidification process to attract Fe-rich eutectic structures. The microstructural analysis revealed that block-like Fe-Cr-Si-based phases formed preferentially near the magnet and at the bottom of the crucible, suggesting that magnetic and gravity attraction contributed to the localized segregation of these phases. However, other Fe-based phases, including Fe-Si-based ones, are not strongly affected by magnet. Additionally, prolonged heating in the solid–liquid coexistence (SLC) region at 577 °C for 10 h led to the settling of a largely grown Fe-Cr-Si-rich crystal at the bottom of the crucible due to gravity. Other structures, such as Si-rich eutectic phases, were not influenced by gravity, which may be caused by the low density of Si compared to Fe one. From this approach, combining magnetic attraction and gravitational settling is a promising method to promote the removal of iron impurities from aluminum alloys.No potential conflict of interest relevant to this article was reported.American Society for MicrobiologyActa Medica Okayama0022-538X99102025Human herpesvirus 6B U65 binds to histone proteins and suppresses interferon productione00984-25ENHaokunLiDepartment of Virology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHirohitoOgawaDepartment of Virology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityDaTengDepartment of Virology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYukiOkameDepartment of Virology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHikaruNambaDepartment of Virology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomoyukiHondaDepartment of Virology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHuman herpesvirus 6B (HHV-6B), a member of the Betaherpesvirinae subfamily, is a T-lymphotropic virus that causes exanthem subitum and has been implicated in neuroinflammatory conditions such as multiple sclerosis. The tegument proteins, which are characteristic of herpesviruses, play a crucial role in the envelopment of virions and evasion of host immune defenses, such as the interferon β (IFNβ) signaling pathway. However, the precise mechanisms through which the HHV-6B tegument proteins modulate the IFNβ pathway are not yet fully understood. In this study, we identified a novel function of the HHV-6B tegument protein U65 as an inhibitor of IFNβ production. Additionally, two host histone proteins, hCG_2039566 (H2ACG) and H2AC7, were identified as positive regulators of innate immune pathways. U65 interacts with H2ACG and H2AC7, impairing their ability to promote the IFNβ pathway. Furthermore, we demonstrated that U65 plays critical roles during HHV-6B infection. This study highlights a critical strategy employed by HHV-6B to evade immune defenses, shedding light on its mechanisms for counteracting host responses.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1365-2672136102025Gut dysbiosis allows foodborne salmonella colonization in edible crickets: a probiotic strategy for enhanced food safetylxaf217ENShumaTsujiDepartment of Medical Laboratory Science, Okayama University Graduate School of Health SciencesOsamuMatsushitaDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJumpeiUchiyamaDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenjiYokotaDepartment of Medical Laboratory Science, Okayama University Graduate School of Health SciencesTetsuyaBandoDepartment of Cytology and Histology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideyoOhuchiDepartment of Cytology and Histology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuyoshiGotohDepartment of Medical Laboratory Science, Okayama University Graduate School of Health SciencesAims: Edible insects, including crickets, represent a promising protein source, yet concerns over foodborne pathogens limit consumer acceptance. This study investigated whether gut microbiota modulates colonization by Salmonella enterica subsp. enterica serovar Enteritidis (SE) in the two-spotted cricket (Gryllus bimaculatus).<br>
Methods and Results: Under standard conditions, SE was undetectable in crickets despite prolonged exposure; however, antibiotic-induced dysbiosis enabled stable SE colonization. Long-read 16S rRNA sequencing revealed significant microbiota shifts, notably a reduction in Lactococcus garvieae. In vitro assays showed strong inhibitory effects of L. garvieae against SE, and supplementation of dysbiotic crickets with L. garvieae reduced SE colonization by ∼1000-fold.<br>
Conclusions: The native cricket gut microbiota, especially L. garvieae, plays a protective role against SE colonization. Enhancing beneficial gut bacteria could mitigate pathogen risks and promote edible insects as a sustainable protein.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2075-172915112025Kidney Organoids: Current Advances and Applications1680ENHiroyukiNakanohDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKenjiTsujiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazuhikoFukushimaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNaruhikoUchidaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySoichiroHaraguchiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShinjiKitamuraDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKidney organoids, derived from stem cells, including pluripotent stem cells and adult progenitor cells, have been reported as three-dimensional in vitro models that reflect key aspects of kidney development, structure, and function. Advances in differentiation protocols and tissue engineering have enabled the generation of organoids that exhibit nephron-like structures, including glomerular and tubular structures. Kidney organoids have been widely applied in several directions, including disease modeling and therapeutic screening, drug nephrotoxicity evaluation, and regenerative medicine. In particular, kidney organoids offer a promising platform for studying genetic kidney diseases, such as polycystic kidney disease and congenital anomalies of the kidney and urinary tract (CAKUT), by allowing patient-specific modeling for the analysis of pathophysiology and therapeutic screening. Despite several current limitations, such as incomplete maturation, lack of full nephron segmentation, and variability between protocols and cell conditions, further technological innovations such as microfluidics and bioengineering may refine kidney organoid systems. This review highlights recent advances in kidney organoid research, outlines major applications, and discusses future directions to enhance their physiological relevance, functional maturity, and translational integration into preclinical and clinical nephrology.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0385-240752102025Biologics and Small‐Molecule Therapies in Netherton Syndrome: A Comprehensive Review14831493ENShinMorizaneDepartment of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomoyukiMukaiDepartment of Immunology and Molecular Genetics, Kawasaki Medical SchoolKoSunagawaDepartment of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKen‐ichiHasuiDepartment of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAnriMoritaDepartment of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHayatoNomuraDepartment of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMamoruOuchidaDepartment of Molecular Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNetherton syndrome (NS) is a rare congenital ichthyosis caused by loss-of-function mutations in the SPINK5 gene, leading to defective expression of the serine protease inhibitor LEKTI. Dysregulated epidermal protease activity results in impaired skin barrier function and chronic inflammation, accompanied by complex immune profiles. NS patients commonly show activation of the inflammatory axis, centered on IL-17 and IL-36, in the skin and blood, and show a psoriasis-like shift to Th17. Conversely, the immune profile differs depending on the clinical type, with ichthyosis linearis circumflexa type characterized by complement activation and Th2-type allergic responses, and scaly erythroderma type characterized by a type I IFN signature and Th9-type allergic responses. While symptomatic treatments such as emollients and topical corticosteroids have been the mainstay of care, recent advances have opened new therapeutic avenues involving biologic agents and oral small-molecule immunomodulators. This review provides a comprehensive overview of the current clinical landscape and future directions of biologics (e.g., dupilumab, secukinumab, ustekinumab) and small-molecule therapies (e.g., JAK inhibitors such as tofacitinib, baricitinib, and upadacitinib) in the treatment of NS. Though evidence remains limited to case reports and small series, preliminary data suggest that cytokine-targeted interventions―particularly those inhibiting IL-4, IL-13, IL-17, IL-36, and JAK pathways―may offer tangible clinical benefits. Well-designed clinical trials and mechanistic investigations are crucial to establishing their place in NS management.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2072-669417202025Tertiary Lymphoid Structures Are Associated with Favorable Clinical Outcomes and Negatively Correlated with Cancer-Associated Fibroblasts in Esophageal Cancer3351ENTomoyoshiKunitomoDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazuhiroNomaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNoriyukiNishiwakiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySeitaroNishimuraDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYasushigeTakedaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHijiriMatsumotoDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTatsuyaTakahashiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKentoKawasakiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasaakiAkaiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNaoakiMaedaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySatoruKikuchiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShunsukeTanabeDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshiakiOharaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiroshiTazawaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYasuhiroShirakawaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground: Esophageal cancer remains a highly aggressive malignant tumor with poor prognosis, despite advances in combination therapies and novel immunotherapies. Tertiary lymphoid structures (TLSs), characterized by densely packed CD20+ B cells in a germinal-center-like structure, have recently been recognized as immune-stimulating components within the tumor microenvironment. In contrast, cancer-associated fibroblasts (CAFs) are stromal cells expressing fibroblast-activating protein (FAP) involved in immunosuppression. Methods: In this retrospective study, 124 clinical samples from patients who underwent radical surgery for esophageal cancer at our institute were analyzed. We investigated whether TLSs could serve as a prognostic factor and examined their association with tumor microenvironment factors. Results: The presence of TLSs was an independent prognostic factor for overall and progression-free survival in multivariate analyses. A high level of TLS formation correlated with better nutritional status, fewer M2 macrophages, and greater plasma cell infiltration. Additionally, little TLS formation was observed in areas with abundant CAFs, and quantitative analyses revealed a significant negative correlation between TLSs and CAFs. Conclusions: TLSs enhance antitumor immunity via macrophages and plasma cells and can be a valuable prognostic indicator in patients undergoing surgery for esophageal cancer. Targeting CAFs may prove to be a promising therapeutic strategy to enhance tumor-immunity-related TLSs.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1752-805418102025Effectiveness of Statins for Oxaliplatin‐Induced Peripheral Neuropathy: A Multicenter Retrospective Observational Studye70318ENKenshiTakechiDepartment of Drug Information Analysis, College of Pharmaceutical Sciences, Matsuyama UniversityTakehiroKawashiriDepartment of Clinical Pharmacy and Pharmaceutical Care, Graduate School of Pharmaceutical Sciences, Kyushu UniversityKeisukeMineDepartment of Clinical Pharmacy and Pharmaceutical Care, Graduate School of Pharmaceutical Sciences, Kyushu UniversitySoichiroUshioDepartment of Emergency and Disaster Medical Pharmacy, Faculty of Pharmaceutical Sciences, Fukuoka UniversityHirofumiHamanoDepartment of Pharmacy, Okayama University HospitalNorikoHidaDepartment of Clinical Research and Development, Graduate School of Pharmacy, SHOWA Medical University KenjiMomoDepartment of Hospital Pharmaceutics, Graduate School of Pharmacy, SHOWA Medical UniversityMasanobuUchiyamaDepartment of Oncology and Infectious Disease Pharmacy, Faculty of Pharmaceutical Sciences, Fukuoka UniversityMamiUchidaDepartment of Pharmacy, Fukuoka University HospitalMamoruTanakaDivision of Pharmacy, Ehime University HospitalNoriakiHidakaDivision of Pharmacy, Ehime University HospitalHidekiYasuiCenter for Clinical Research, Hamamatsu University HospitalMasahiroUedaFaculty of Pharmaceutical Sciences, Setsunan UniversityRyoheiFujiiDepartment of Pharmacy, Kansai Medical University HospitalMisakiHashimotoDepartment of Pharmacy, Kansai Medical University HospitalYasutakaSakamotoDepartment of Pharmacy, Yokohama City University HospitalKanaUyamaDepartment of Pharmacy, Yokohama City University HospitalTakahiroNiimuraDepartment of Clinical Pharmacology and Therapeutics, University of Tokushima Graduate School of Biomedical SciencesYukiHanaiDepartment of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Toho UniversityAyakaTsuboyaDepartment of Pharmacy, Kawasaki Municipal Tama HospitalKeisukeSuzukiInnovation Center for Translational Research, National Center for Geriatrics and GerontologyNaoyaKamiyamaAsahikawa Medical University HospitalHiromiHagiwaraNagoya City University HospitalNaotoOkadaPharmacy Department, Yamaguchi University Hospital YoshitoZamamiDepartment of Pharmacy, Okayama University HospitalKeisukeIshizawaDepartment of Clinical Pharmacology and Therapeutics, University of Tokushima Graduate School of Biomedical SciencesChemotherapy-induced peripheral neuropathy, including oxaliplatin-induced peripheral neuropathy (OIPN), can have a negative impact on patient quality of life for months or even years after discontinuation of chemotherapy. Statins are commonly used for lowering cholesterol; however, evidence indicates that statins have multiple pleiotropic effects. Although statins are anticipated to exert neuroprotective actions against OIPN, no large-scale investigations have been conducted in real-world clinical settings. Our investigation aimed to determine if statins protected against OIPN. This multicentre retrospective study enrolled Japanese patients with cancer, including those with colorectal cancer (CRC), who received oxaliplatin-containing chemotherapy between April 2009 and December 2019. Propensity score matching between groups was performed to assess the relationship between the occurrence of OIPN and statin use. Among the examined 2657 patients receiving oxaliplatin, 24.7% had Grade ≥ 2 OIPN. There was no significant difference in the incidence of OIPN between the statin and non-statin groups, even after propensity score matching. However, among the matched patients with CRC (n = 510), statin use was associated with a significantly lower incidence of Grade ≥ 2 OIPN than no statin use (19.8% vs. 28.3%, respectively; p = 0.029). Our findings indicate that statins may protect against OIPN in patients with CRC.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2666-0873762025Risk of Heart Failure Hospitalization in Patients Treated With Osimertinib738748ENYasuhisaTatebeDepartment of Pharmacy, Okayama University HospitalYutaTanakaDepartment of Pharmacy, Okayama University HospitalYoheiManabeDepartment of Pharmacy, Okayama University HospitalShinobuOkanoDepartment of Pharmacy, Okayama University HospitalTsukasaHigashionnaDepartment of Pharmacy, Okayama University HospitalHirofumiHamanoDepartment of Pharmacy, Okayama University HospitalKiminakaMurakawaDepartment of Pharmacy, Okayama University HospitalYoshitoZamamiDepartment of Pharmacy, Okayama University HospitalBackground Osimertinib, an oral epidermal growth factor receptor tyrosine kinase inhibitor, is used to treat patients with epidermal growth factor receptor–mutant non–small-cell lung cancer. Although osimertinib has been linked to heart failure (HF), detailed risk estimates remain unclear.<br>
Objectives The aim of this study was to examine the association between osimertinib use and HF hospitalization.<br>
Methods In this retrospective cohort study using a large-scale Japanese claims database, patients diagnosed with lung cancer between April 2008 and December 2021 who received cancer therapy were identified. Patients were categorized into osimertinib and control groups according to treatment received. The incidence of HF hospitalization during the treatment period was compared between the groups. Multivariable analyses were performed before and after propensity score matching.<br>
Results The osimertinib and control groups included 11,391 and 108,144 patients, respectively. Among the entire cohort, the median age was 70 years (Q1-Q3: 64-76 years), and the median follow-up duration was 173 days (Q1-Q3: 73-448 days). The incidence of HF hospitalization was 9.9 and 4.1 cases per 1,000 person-years in the osimertinib and control groups, respectively. In multivariable analysis, osimertinib was associated with a higher risk for HF hospitalization than control therapy (subdistribution HR: 2.56; 95% CI: 2.07-3.18; P < 0.001). This association remained significant after propensity score matching (subdistribution HR: 2.29; 95% CI: 1.62-3.24; P < 0.001).<br>
Conclusions Osimertinib use was associated with an increased risk for HF hospitalization. Cardiac function should be closely monitored in patients receiving osimertinib.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1439-01082025Coupling effects of biochar and sediment microbial fuel cells on CH4 and CO2 emissions from straw-amended paddy soilENAdhena TesfauBekeleGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMorihiroMaedaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityNozomiNakaharaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityAyumiHashiguchiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHiroakiSomuraGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversitySatoshiAkaoFaculty of Science and Engineering, Doshisha UniversityChiyuNakanoDepartment of Comprehensive Technical Solutions, Okayama UniversityYutaNishinaResearch Institute for Interdisciplinary Science, Okayama UniversityPurpose The independent incorporation of biochar and sediment microbial fuel cells (SMFCs) into paddy soil has been shown to reduce methane (CH4) emissions. However, the application of rice straw into paddy soil enhances the availability of labile carbon that stimulates methanogen growth, counteracting the mitigation effects of both methods. This study, therefore, aimed to investigate the effect of coupling biochar and SMFC on CH4 and CO2 emissions from straw-amended paddy soil.<br>
Materials and methods Single chamber SMFC setups constructed using acrylic columns (height, 25 cm; inner diameter, 9 cm) with six treatments were established using soil amended with 0% (0BC), 1% (1BC), and 2% (2BC) biochar: with and without SMFC conditions. Stainless steel mesh (15 × 3 cm) and graphite felt (6 × 5 cm) were used as anode and cathode materials, respectively.<br>
Results Cumulative emission of CH4 in the 0BC treatment with SMFC was 39% less than in that without SMFC. Biochar addition and SMFC operation together further reduced CH4 emission by 57% and 60% in 1BC and 2BC treatments, respectively, compared to that in the 0BC treatment without SMFC operation. The relative abundance of microbial communities indicated methane-oxidizing bacteria were enriched in the presence of biochar and hydrogenotrophic Methanoregula were suppressed by SMFC operation. This suggested that SMFC mainly inhibited CH4 production by outcompeting hydrogenotrophic archaea.<br>
Conclusion The use of biochar made from leftover rice straw has an interactive effect on SMFC operation and both methods can be used to reduce CH4 emission from straw-amended paddy soil.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-818417102025Histopathological Study of Regenerative Endodontic Therapy on an Immature Mandibular Second Premolar With Pulp Necrosis: A Case Reporte95647ENHidefumiSakoDepartment of Periodontics and Endodontics, Division of Dentistry, Okayama University HospitalKazuhiroOmoriDepartment of Pathophysiology - Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYukiShinoda-ItoDepartment of Pathophysiology - Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKiyofumiTakabatakeDepartment of Oral Pathology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHitoshiNagatsukaDepartment of Oral Pathology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShogoTakashibaDepartment of Pathophysiology - Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRegenerative endodontic therapy (revascularization) for immature permanent teeth with pulp necrosis and/or apical periodontitis is an effective treatment to promote root maturation. Previous histological studies have reported the formation of cementoid or osteoid tissue and periodontal ligament-like tissue within the root canals. This case report presents the histopathological findings of a human immature permanent tooth with pulp necrosis following revascularization.<br>
<br>
A 11-year-old male patient presented with tenderness on biting and the formation of a sinus tract in the mandibular right second premolar (tooth #29), diagnosed as pulp necrosis with symptomatic apical periodontitis. Revascularization was performed using calcium hydroxide as an intracanal medicament, with reference to the American Association of Endodontists (AAE) 2018 Position Paper on Regenerative Endodontics. At the 12-month follow-up, radiographs showed thickening of the canal walls, apical narrowing, root elongation, and recovery of pulp sensibility. The tooth was later extracted for orthodontic reasons at 42 months and processed for histological examination.<br>
<br>
Histological evaluation revealed cementum-like hard tissue continuous with the existing dentin in the apical region, suggesting apical closure. In contrast, the coronal portion showed less mature cementum-like tissue accompanied by loose connective tissue and neovascularization. These findings indicate that revascularization with calcium hydroxide can induce the formation of cementum-like and dentin-like tissues with vascular regeneration in immature permanent teeth with pulp necrosis.No potential conflict of interest relevant to this article was reported.IOP PublishingActa Medica Okayama1882-077818102025Multichannel topological elastic waveguide in a multilayer Kagome phononic crystal107001ENYusukeHataDepartment of Electrical and Electronic Engineering, Okayama UniversityKenjiTsurutaDepartment of Electrical and Electronic Engineering, Okayama UniversityBy examining the geometric characteristics of various boundaries formed within the Kagome phononic lattice and vertically stacking the lattices, we designed an elastic waveguide that enables selective propagation of topologically protected edge modes across layers in a bilayer system. This layer-selective transmission is manifested as polarized boundary modes that appear in phononic dispersions of the systems incorporating the bridge, zigzag, and armchair boundaries. We numerically demonstrated that efficient elastic layer converters and splitters can be designed, thereby paving the way for the practical development of three-dimensional elastic-wave devices.No potential conflict of interest relevant to this article was reported.International Institute of Anticancer ResearchActa Medica Okayama1109-65352262025C1orf50 Accelerates Epithelial-Mesenchymal Transition and the Cell Cycle of Hepatocellular Carcinoma836849ENATSUSHITANAKADepartment of Pathology, Beth Israel Deaconess Medical CenterYUSUKEOTANIDepartment of Pathology, Beth Israel Deaconess Medical CenterMASAKIMAEKAWADepartment of Pathology, Beth Israel Deaconess Medical CenterANNAROGACHEVSKAYADepartment of Pathology, Beth Israel Deaconess Medical CenterTIRSOPEÑADepartment of Pathology, Beth Israel Deaconess Medical CenterVANESSA D.CHINUMass Chan Medical School, UMass Memorial Medical CenterSHINICHITOYOOKADepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMICHAEL H.ROEHRLDepartment of Pathology, Beth Israel Deaconess Medical CenterATSUSHIFUJIMURADepartment of Cellular Physiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground/Aim: Hepatocellular carcinoma (HCC) is a heterogeneous liver cancer with limited treatment options and a poor prognosis in advanced stages. To identify novel biomarkers and therapeutic targets, we investigated the role of chromosome 1 open reading frame 50 (C1orf50), a gene with a previously uncharacterized function in HCC.<br>
Materials and Methods: We performed a comprehensive transcriptome data analysis of the human hepatocellular carcinoma project from The Cancer Genome Atlas (TCGA) and subsequently validated the oncogenic roles of C1orf50 using HCC cell lines.<br>
Results: Using transcriptomic and clinical data from TCGA, we stratified 355 primary HCC samples based on C1orf50 expression levels. Patients with high C1orf50 expression exhibited significantly shorter overall survival, suggesting its association with aggressive tumor behavior. Differential expression and enrichment analyses revealed that C1orf50-high tumors were enriched in oncogenic pathways, including epithelial-mesenchymal transition (EMT), cell cycle activation, and stemness-related properties. Transcriptional regulatory network analysis detected 456 significantly dysregulated regulons, including ZEB1/2 and E2F2, key drivers of EMT and cell cycle, in the C1orf50-high group. In addition, we observed increased YAP1/TAZ signaling, further linking C1orf50 to stemness and therapeutic resistance. Functional data from CRISPR-based dependency screening suggested that several transcription factors up-regulated in the C1orf50-high state, such as ZBTB11 and CTCE, are essential for the survival of HCC cells. These findings indicate potential therapeutic vulnerabilities and support the rationale for targeting C1orf50-associated pathways.<br>
Conclusion: C1orf50 is a novel biomarker of poor prognosis in HCC and a key regulator of oncogenic features such as EMT, cell cycle progression, and stemness. This study highlights the therapeutic potential of targeting C1orf50-related networks in aggressive subtypes of liver cancer.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1086-93792025The effect of pressure on dihedral angle between liquid Fe‐S and orthopyroxene: Implication for percolative core formation in planetesimals and planetary embryosENTakumiMiuraDepartment of Earth and Space Science, Osaka UniversityHidenoriTerasakiDepartment of Earth Sciences, Okayama UniversityHyuTakakiDepartment of Earth Sciences, Okayama UniversityKotaroKobayashiDepartment of Earth Sciences, Okayama UniversityGeoffrey DavidBromileySchool of Geosciences, The University of EdinburghTakashiYoshinoInstitute for Planetary Materials, Okayama UniversityDuring precursor stages of planet formation, many planetesimals and planetary embryos are considered to have differentiated, forming an iron-alloy core and silicate mantle. Percolation of liquid iron-alloy in solid silicates is one of the major possible differentiation processes in these small bodies. Based on the dihedral angles between Fe-S melts and olivine, a criterion for determining whether melt can percolate through a solid, it has been reported that Fe-S melt can percolate through olivine matrices below 3 GPa in an oxidized environment. However, the dihedral angle between Fe-S melts and orthopyroxene (opx), the second most abundant mineral in the mantles of small bodies, has not yet been determined. In this study, high-pressure and high-temperature experiments were conducted under the conditions of planetesimal and planetary embryo interiors, 0.5–5.0 GPa, to determine the effect of pressure on the dihedral angle between Fe-S melts and opx. Dihedral angles tend to increase with pressure, although the pressure dependence is markedly reduced above 4 GPa. The dihedral angle is below the percolation threshold of 60° at pressures below 1.0–1.5 GPa, indicating that percolative core formation is possible in opx-rich interiors of bodies where internal pressures are lower than 1.0–1.5 GPa. The oxygen content of Fe-S melt decreases with increasing pressure. High oxygen contents in Fe-S melt reduce interfacial tension between Fe-S melt and opx, resulting in reduced dihedral angles at low pressure. Combined with previous results for dihedral angle variation of the olivine/Fe-S system, percolative core formation possibly occurs throughout bodies up to a radius of 1340 km for an olivine-dominated mantle, and up to 770 km for an opx-dominated mantle, in the case of S-rich cores segregating under relatively oxidizing conditions. For mantles of small bodies in which abundant olivine and opx coexist, the mineral with the largest volume fraction and/or smallest grain size will allow formation of interconnected mineral channels, and, therefore, the wetting property of this mineral determines the wettability of the melt, that is, controls core formation.No potential conflict of interest relevant to this article was reported.American Geophysical Union (AGU)Acta Medica Okayama2169-9313130102025Electrical Conductivity of Carbonated Hydrous Basaltic Melt: Implications for the Conductivity Anomaly Beneath the Ocean Floorse2025JB032215ENBinZhaoInstitute for Planetary Materials, Okayama UniversityJintaoZhuInstitute for Planetary Materials, Okayama UniversityJinzeHeInstitute for Planetary Materials, Okayama UniversityTakashiYoshinoInstitute for Planetary Materials, Okayama UniversityWe measured the electrical conductivity of CO2 and H2O-bearing basaltic melts up to 1750 K at 2 GPa, corresponding to pressure around the lithosphere-asthenosphere boundary. The electrical conductivity of the dry and hydrous samples is comparable to those reported by previous studies on the Fe-free basaltic melt. The substantial CO2 can limit the water solubility in basaltic melt at 2 GPa. Both CO2 and H2O, which cannot completely dissolve in the melt, coexist as fluid phases, resulting in reduced electrical conductivity of the basaltic melt, which has a lower water content relative to the amount of volatile components in the bulk starting system. The activation enthalpy of basaltic melt is markedly higher than those of more evolved silicate melts, especially on the H2O-poor condition, due to the more enriched alkaline earth elements. The present results suggest that an overall melt fraction of 0.1–5.3 vol% is needed to account for the high electrical conductivity anomalies (10−1.3 to 10−0.3 S/m) beneath the oceanic plate near the East Pacific Rise and Cocos plate. However, for those regions where the electrical conductivity is extremely high (≥10−0.3 S/m), more than 6 wt% H2O is expected to incorporate to maintain a melt fraction that will not trigger mechanical instability. In turn, it requires a low CO2 budget or degree of carbonation within these regions.No potential conflict of interest relevant to this article was reported.Ovid Technologies (Wolters Kluwer Health)Acta Medica Okayama2376-78391152025Vanishing White Matter Disease With EIF2B2 c.254T >A Variante200293ENToshiyukiKakumotoDepartment of Neurology, Graduate School of Medicine, The University of TokyoTakashiMatsukawaDepartment of Neurology, Graduate School of Medicine, The University of TokyoRyoTokimuraDepartment of Neurology, Graduate School of Medicine, The University of TokyoYokoTsuboyamaDepartment of Neurology, Graduate School of Medicine, The University of TokyoYasufumiHayashiDepartment of Neurology, Graduate School of Medicine, The University of TokyoAkihikoMitsutakeDepartment of Neurology, Graduate School of Medicine, The University of TokyoAtsushiIwataDepartment of Neurology, Graduate School of Medicine, The University of TokyoMeiko HashimotoMaedaDepartment of Neurology, Graduate School of Medicine, The University of TokyoJunShimizuDepartment of Neurology, Graduate School of Medicine, The University of TokyoWataruGonoiDepartment of Radiology, Graduate School of Medicine, The University of TokyoHiroyukiIshiuraDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunMitsuiDepartment of Neurology, Graduate School of Medicine, The University of TokyoShojiTsujiDepartment of Molecular Neurology, Graduate School of Medicine, The University of TokyoTatsushiTodaDepartment of Neurology, Graduate School of Medicine, The University of TokyoObjectives<br>
Typical MRI findings of vanishing white matter disease (VWM) include diffuse white matter lesions with cystic degeneration. However, mild cases may lack these typical features, posing diagnostic challenges.<br>
Methods<br>
We describe 2 of 3 individuals carrying the homozygous c.254T >A variant in EIF2B2 identified at our hospital, excluding 1 previously reported case.1 Genetic analyses were performed using whole-genome sequence or whole-exome sequence analysis, and detected variants were confirmed by direct nucleotide sequence analysis. Brain MRI findings and clinical features were reviewed for the 2 individuals along with other cases in the literature with the same variant.<br>
Results<br>
A 69-year-old woman presented with recurrent transient dizziness and secondary amenorrhea. MRI of the brain revealed small T2-hyperintense lesions confined to the subcortical white matter with hyperintensities on diffusion-weighted images and mildly elevated apparent diffusion coefficient values. A 28-year-old woman presented with transient dizziness and secondary amenorrhea. MRI of the brain showed mild T2-hyperintense lesions in the cerebral white matter with frontal predominance.<br>
Discussion<br>
This report highlights the clinically mild cases of VWM with subtle abnormalities on brain MRI who had the homozygous c.254T >A in EIF2B2, further expanding the clinical spectrum of VWM and underscoring the importance of genetic assessments in the diagnosis of individuals with mild clinical and MRI findings.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841782025Subacute Progression of Gait Disturbance and Consciousness Impairment Due to Communicating Hydrocephalus Associated With Vestibular Schwannomae89880ENSatokaYanoDepartment of Neurology, The University of Tokyo Graduate School of Medicine and Faculty of MedicineAkatsukiKubotaDepartment of Neurology, The University of Tokyo Graduate School of Medicine and Faculty of MedicineMizuhoKawaiDepartment of Neurology, The University of Tokyo Graduate School of Medicine and Faculty of MedicineDaikiYashitaDepartment of Neurology, The University of Tokyo Graduate School of Medicine and Faculty of MedicineHiroyukiIshiuraDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesWataruSatakeDepartment of Neurology, The University of Tokyo Graduate School of Medicine and Faculty of MedicineKaoruYamadaDepartment of Neuropathology, The University of Tokyo Graduate School of Medicine and Faculty of MedicineYukiShinyaDepartment of Neurosurgery, The University of Tokyo Graduate School of Medicine and Faculty of MedicineSatoruMiyawakiDepartment of Neurosurgery, The University of Tokyo Graduate School of Medicine and Faculty of MedicineTakeshiIwatsuboDepartment of Neuropathology, The University of Tokyo Graduate School of Medicine and Faculty of MedicineTatsushiTodaDepartment of Neurology, The University of Tokyo Graduate School of Medicine and Faculty of MedicinePatients with vestibular schwannomas (VSs) present with vestibulocochlear nerve dysfunction such as vertigo and tinnitus. VSs occasionally develop communicating hydrocephalus as a complication, which is typically characterized by an insidious progression of symptoms. We report a case of an 84-year-old female patient with a VS who developed gait disturbance and consciousness impairment over a three-week period, ultimately resulting in an inability to walk and communicate. A thorough evaluation ruled out encephalitis and other differential diagnoses. Imaging studies demonstrated findings consistent with communicating hydrocephalus, and a tap test temporarily improved her consciousness disturbances. The patient underwent ventriculoperitoneal shunting and stereotactic radiosurgery (SRS), after which both consciousness and gait disturbances dramatically improved 10 days postoperatively. The subacute development of symptoms due to normal pressure hydrocephalus associated with VSs is rare. Furthermore, to the best of our knowledge, this is the first reported case of severe gait impairment and disturbance of consciousness progressing within a short period. This case highlights the importance of considering communicating hydrocephalus associated with VSs as a differential diagnosis, even in cases of subacute consciousness disturbance. We also discuss the pathophysiology of hydrocephalus in relation to cerebrospinal fluid (CSF) clearance into the extracranial space. 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.American Physical Society (APS)Acta Medica Okayama0031-9007135102025Terahertz Field Control of Electronic-Ferroelectric Anisotropy at Room Temperature in LuFe2O4106504ENHirotakeItohTohoku UniversityRyuseiMinakamiTohoku UniversityHongwuYuInstitute of Science TokyoRyoheiTsuruokaTohoku UniversityTatsuyaAmanoTohoku UniversityYoheiKawakamiTohoku UniversityShin-yaKoshiharaInstitute of Science TokyoKosukeFujiwaraOkayama UniversityNaoshiIkedaOkayama UniversityYoichiOkimotoInstitute of Science TokyoShinichiroIwaiTohoku UniversityElectronic ferroelectrics, with polarization 𝑷 induced by strongly correlated charges, are expected to show ultrafast, huge, and flexible responses required in future optoelectronics. Although the challenges for ultrafast manipulation of such a polarization are ongoing, the expected advantages have been unclear. In this Letter, we demonstrate an unprecedentedly large increase by a factor of 2.7 in optical second harmonic generation at room temperature in the prototypical electronic ferroelectrics, the rare-earth ferrite LuFe2O4, by applying a terahertz field of 260 kV/cm. The transient anisotropy indicates that the direction of macroscopic polarization can be controlled three dimensionally on subpicosecond timescales, offering additional degrees of freedom in controlling polarization. Although the polarization response is in phase concerning the terahertz field, its sensitivity increased with delay, indicating that cooperative interactions among microscopic domains play an important role in the unprecedented response.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0916-70052025Refinement of interval approximations for fully commutative quiversENYasuakiHiraokaKyoto UniversityKenNakashimaShimane UniversityIppeiObayashiOkayama UniversityChenguangXuKyoto UniversityA central challenge in the theory of multiparameter persistence modules lies in defining effective descriptors for representations of infinite or wild type. In this work, we propose a novel framework for analyzing interval approximations of fully commutative quivers, which offers a tunable trade-off between approximation resolution and computational complexity. Our approach is evaluated on commutative ladder modules of both finite and infinite type. For finite-type cases, we establish an efficient method for computing indecomposable decompositions using solely one-parameter persistent homology. For infinite-type cases, we introduce a new invariant that captures persistence in the second parameter by connecting standard persistence diagrams through interval approximations. Furthermore, we present several models for constructing commutative ladder filtrations, providing new insights into the behavior of random filtrations and demonstrating the utility of our framework in topological analysis of material structures.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2196-29951212025Natural Effects and Separable Effects: Insights into Mediation Analysis20ENEtsujiSuzukiDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomohiroShinozakiInterfaculty Initiative in Information Studies, the University of TokyoEijiYamamotoOkayama University of SciencePurpose of Review We compare natural effects and separable effects under nonparametric structural equation models with independent errors, highlighting their similarities and differences. By examining their required properties and sufficient conditions for identification, we aim to provide deeper insights into mediation analysis.<br>
Recent Findings If certain assumptions about confounding, positivity, and consistency are met, we can identify natural direct and indirect effects under nonparametric structural equation models with independent errors. However, these effects have been criticized because they rely on a specific cross-world quantity, and the so-called cross-world independence assumption cannot be empirically verified. Furthermore, interventions on the mediator may sometimes be challenging to even conceive. As an alternative approach, separable effects have recently been proposed and applied in mediation analysis, often under finest fully randomized causally interpretable structured tree graph models. These effects are defined without relying on any cross-world quantities and are claimed to be identifiable under assumptions that are testable in principle, thereby addressing some of the challenges associated with natural direct and indirect effects.<br>
Summary To conduct meaningful mediation analysis, it is crucial to clearly define the research question of interest, and the choice of methods should align with the nature of the question and the assumptions researchers are willing to make. Examining the underlying philosophical perspectives on causation and manipulation can provide valuable insights.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0013-87032025Artificial Selections for Life-History Traits Affect Effective Cumulative Temperature and Developmental Zero Point in Zeugoducus cucurbitaeENTakahisaMiyatakeGraduate School of Environment, Life, Natural Science and Technology, Okayama UniversityKentarouMatsumuraDepartment of General Systems Studies, Graduate School of Arts and Sciences, the University of TokyoEffective cumulative temperature and developmental zero point are important indicators for estimating the timing of organism development and the area of distribution. These indicators are generally considered to have unique values for different species of organisms and are also important for predicting the distribution range of animals and plants, especially insect pests. These values generally are species-specific, but there is variation within populations in traits having a genetic component. However, there are no studies on what kind of selection pressure affects these indicator values. To address this issue, it would be worthwhile to compare these values using individuals of strains that have been artificially selected for life-history traits by rearing them at various temperatures and calculating these indicators from developmental days and temperatures. In the present study, eggs were taken from adults of strains with many generations of artificial selection on two life-history traits (age at reproduction and developmental period) of the melon fly, Zeugodacus cucurbitae, under constant temperature conditions. Eggs were reared at five different temperatures, and the effective cumulative temperatures and developmental zero points of the larval and developmental periods were compared. The results demonstrate that artificial selection on life-history traits in Z. cucurbitae induces evolutionary changes in both the effective cumulative temperature and the developmental zero point across successive generations.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0003-68622025Comparison of flight behaviors among laboratory and field strains in Tribolium castaneum (Coleoptera: Tenebrionidae) using a simple method to measure flight abilityENSotaSoneFaculty of Environment, Life, Natural Science and Technology, Okayama UniversityTakahisaMiyatakeFaculty of Environment, Life, Natural Science and Technology, Okayama UniversityMost insects can fly. The acquisition of flight is a factor that allows insects to prosper on Earth. On the other hand, in the same species and population, individual differences in flight ability may occur. Flight ability can vary due to geographical conditions and cumulative rearing. Investigating these changes in flight performance is important for understanding dispersal polymorphism and the evolution of flight performance. Thus, in the present study, the flight behaviors between cumulative rearing and field strains and changes in flight behaviors between strains of the red flour beetle, Tribolium castaneum Herbst (Coleoptera: Tenebrionidae), which is distributed around the world were compared. Tribolium castaneum is a worldwide pest of stored grains. Its body length is about 3–4 mm. Previous studies have investigated the influence of environmental and physiological factors on the flight of this species, but no studies have examined individual differences or polymorphism in flight behaviors within this species. In this study, we developed a simple apparatus that can quantify the flight behavior of this species. The experimental apparatus was set up as a double structure with two different size containers. This apparatus was able to assess the flight activity of insects by counting individuals in a big container because insects transfer to the big container only by flight. Moreover, upward flight ability was possible to be assessed by the apparatus adding the barrier. Then, the flight behavior was compared between strains of this species that have been bred in the laboratory for more than 45 years and several strains of this species collected in the field. The results showed no variation in flight activity between strains, but flying ability was higher in strains originating from warmer regions. Here, we discussed the variations in flight behavior of T. castaneum.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-818417102025Primary Lacrimal Sac Diffuse Large B-cell Lymphoma Treated With Local Radiotherapy Alone: A Case With No Relapse After 21 Years of Follow-Upe95411ENToshihikoMatsuoHealthcare Science, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTakehiroTanakaPathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityMitsuhiroTakemotoRadiotherapy, Himeji Red Cross HospitalPrimary lacrimal sac lymphoma is rare and diagnosed as diffuse large B-cell lymphoma in a predominant histopathological type. Systemic chemotherapy would be the standard of care, but local radiotherapy may be a treatment option toward a localized lesion. The present patient is a 54-year-old otherwise healthy woman with a right lacrimal sac mass, which was proven by excisional biopsy to be diffuse large B-cell lymphoma. Since she did not have any other systemic lesions on gallium scintigraphy and neck-to-abdominal computed tomography scans, which were the standard procedure at that time, she underwent local radiotherapy at 40 Gy. Two years later, at the age of 56 years, she developed radiation retinopathy with macular edema in the right eye and had spotty laser photocoagulation in the nasal half of the fundus. At the age of 57 years, she developed radiation cataract and underwent cataract surgery with intraocular lens implantation in the right eye. At the age of 58 years, the macular edema in the right eye became worse and remained active, resulting in poor visual acuity of 0.1. She thus underwent 25-gauge vitrectomy in the right eye to peel off the adhering posterior vitreous surface, together with the internal limiting membrane, as the standard procedure at that time. The visual acuity in the right eye was elevated to 0.6. She maintained the visual acuity afterward and had no relapse of lymphoma in 21 years from the diagnosis of primary right lacrimal sac diffuse large B-cell lymphoma. Local radiotherapy would still be a treatment option for localized lymphoma lesions such as primary lacrimal sac lymphoma.No potential conflict of interest relevant to this article was reported.Informa UK LimitedActa Medica Okayama0960-34092025Creep damage parameters based on the distribution of cavities on grain boundariesENNaoyaTadaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityWhen polycrystalline heat-resistant steels are subjected to static or cyclic loading at high temperatures, they can exhibit various fracture modes and processes. This paper begins by outlining representative methods for life assessment under creep-dominated conditions. It then discusses the fracture processes and the underlying mechanisms. Under creep-dominated conditions, the initiation and growth of cavities serve as the primary form of material damage, making their quantitative assessment essential. Several parameters have been proposed to evaluate cavity distributions quantitatively. However, the relationship between these parameters and the actual cavity distribution in materials, as well as their physical significance, has remained unclear. In this study, a simple cavity distribution model was employed to clarify these issues. The results suggest that the area fraction of cavities is an appropriate damage evaluation parameter for transgranular fracture, while the fraction of cavities on grain boundary line is suitable for intergranular fracture.No potential conflict of interest relevant to this article was reported.岡山大学環境管理センターActa Medica Okayama0917-1533472025岡山大学環境管理センター報 第47号ENNo potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1345-26302025Comparative analysis of interactions between five strains of Pseudomonas syringae pv. tabaci and Nicotiana benthamianaENYunaNakaoGraduate School of Medicine, Science and Technology, Shinshu UniversityShutaAsaiGraduate School of Environmental, Natural Science and Technology, Okayama UniversityHidenoriMatsuiGraduate School of Environmental, Natural Science and Technology, Okayama UniversityYukiIchinoseGraduate School of Environmental, Natural Science and Technology, Okayama UniversityShinpeiKatouGraduate School of Medicine, Science and Technology, Shinshu UniversityPseudomonas syringae pv. tabaci 6605 (Pta 6605), the agent of wildfire disease in tobacco, has been used as a model strain for elucidating the virulence mechanisms of Pta. However, the host genes involved in resistance or susceptibility to Pta remain largely unknown. Nicotiana benthamiana is a model plant species in the Solanaceae family and is useful in functional analyses of genes. We herein compared five Pta strains (6605, 6823, 7372, 7375, and 7380) in terms of their phenotypes on medium and interactions with N. benthamiana. Pta 6605 and Pta 6823 showed more active proliferation than the other strains in a high cell density culture. Moreover, Pta 6605 exhibited markedly higher swarming motility than the other strains. In inoculated leaves of N. benthamiana, Pta 6605 and Pta 6823 caused more severe disease symptoms and proliferated to a higher cell density than the other strains. However, Pta 6823 as well as Pta 7372 and Pta 7380 induced the high accumulation of salicylic acid (SA). Moreover, the inoculations of Pta 6823 and Pta 7372 resulted in the upregulation of ethylene biosynthesis genes. On the other hand, Pta 6605 induced neither SA accumulation nor the expression of ethylene biosynthesis genes, and suppressed the expression of jasmonate biosynthesis genes. Moreover, chlorosis was clearly induced in the upper uninoculated leaves of Pta 6605-infected plants. These results suggest that Pta 6605 escapes from or suppresses plant immune systems and, thus, is the most virulent on N. benthamiana among the five strains tested.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1422-006726202025Neurofibromin Encoded by the Neurofibromatosis Type 1 (NF1) Gene Promotes the Membrane Translocation of SPRED2, Thereby Inhibiting the ERK Pathway in Breast Cancer Cells10072ENNang TheeSu PwintDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityChunningLiDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTongGaoDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYuzeWangDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasayoshiFujisawaDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshiakiOharaDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasakiyoSakaguchiDepartment of Cell Biology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTeizoYoshimuraDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAkihiroMatsukawaDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNeurofibromin (NF) inhibits the RAS/RAF/ERK pathway through its interaction with SPRED1 (Sprouty-related EVH1 domain-containing protein 1). Here, we investigated the functional relationship between NF and SPRED2 in breast cancer (BC). Human BC cell lines were transfected to downregulate or overexpress NF and SPRED2 and subsequently subjected to functional assays. Protein and mRNA levels were analyzed by Western blotting and RT-qPCR, respectively. Protein–protein interactions were examined by immunoprecipitation. Database analyses and immunohistochemistry (IHC) of BC tissues were performed to validate the in vitro findings. Downregulating NF or SPRED2 expression in BC cells enhanced cell proliferation, migration and invasion accompanied by RAF/ERK activation, whereas overexpression produced opposite effects. NF formed a protein complex with SPRED2 and facilitated its translocation to the plasma membrane. By IHC, SPRED2 membrane localization was absent in NF-negative luminal A and triple-negative BC (TNBC) but present in a subset of luminal A BC. By database analyses, both NF1 and SPRED2 mRNA levels were reduced in BC tissues, and luminal A BC patients with high expression of both NF1 and SPRED2 mRNA exhibited improved relapse-free survival. These results suggest a critical role for the NF–SPRED2 axis in BC progression and highlight it as a potential therapeutic target.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2072-669417202025Impact of Neoadjuvant Chemotherapy with Gemcitabine Plus S-1 in Patients with Resectable Pancreatic Ductal Adenocarcinoma3287ENKazuyaYasuiDepartment 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 SciencesTomokazuFujiDepartment 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 SciencesKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,YukiFujiiDepartment 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 SciencesToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground/Objectives: Although neoadjuvant chemotherapy (NAC) is not universally recommended for resectable pancreatic ductal adenocarcinoma (PDAC), NAC with gemcitabine plus S-1 (NAC-GS) has become a commonly used regimen for resectable PDAC in Japan. Furthermore, the impact of achieving textbook outcomes (TO) in patients receiving NAC-GS remains unclear. Methods: This retrospective study included 265 patients who were diagnosed with resectable PDAC at our institution between January 2009 and December 2023. Patients were categorized into two groups: the NAC-GS group (n = 81; 2019–2023) and the upfront surgery (UFS) group (n = 164; 2009–2018). After comparing the clinical outcomes between groups, multivariate analyses for survival were performed. Additionally, outcomes stratified by the achievement of the modified TO were analyzed in the NAC-GS group. Results: The completion rate of NAC-GS was 90.1%. Patients in the NAC-GS group exhibited significantly longer survival than those in the UFS group (2-year recurrence-free survival: 61.4% vs. 37.9%, p < 0.01; 2-year overall survival: 83.2% vs. 61.2%, p < 0.01). Multivariate analyses identified lymph node metastasis, NAC-GS induction, and completion of adjuvant chemotherapy as factors significantly associated with improved survival. Moreover, among patients who received NAC-GS, those who achieved modified TO demonstrated significantly longer survival than those who did not. Conclusions: This study demonstrated the clinical efficacy of NAC-GS in patients with resectable PDAC. Induction of NAC-GS was significantly associated with improved long-term outcomes. In multidisciplinary treatment strategies for PDAC, achieving a modified TO may lead to improved survival of patients undergoing NAC-GS.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0929-19032025ATPase copper transporting beta contributes to cisplatin resistance as a regulatory factor of extracellular vesicles in head and neck squamous cell carcinomaENTatsuoOgawaDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKishoOnoDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShojiRyumonDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHotakaKawaiDepartment of Oral Pathology and Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoheiSatoDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKokiUmemoriDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKunihiroYoshidaDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKyoichiObataDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYukiKunisadaDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTatsuoOkuiDepartment of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima UniversityKuniakiOkamotoDepartment of Dental Pharmacology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHitoshiNagatsukaDepartment of Oral Pathology and Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityFatemehMomen-HeraviDepartment of Orofacial Sciences, School of Dentistry, University of California San FranciscoSoichiroIbaragiDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityCisplatin (CDDP) resistance remains a major clinical challenge in the treatment of head and neck squamous cell carcinoma (HNSC). Our group identified ATPase copper transporting beta (ATP7B) as a mediator of CDDP resistance through its role in drug efflux and small extracellular vesicle (sEV) secretion. Herein, we uncovered a novel mechanism by which ATP7B regulates sEV dynamics and the intercellular transmission of CDDP resistance. Using transcriptomic analyses of HNSC datasets, we demonstrate that ATP7B expression correlates with endocytosis- and epithelial-mesenchymal transition (EMT)-related gene sets and with elevated levels of EV-associated proteins. CDDP-resistant HNSC cells exhibited upregulated ATP7B, Rab5/Rab7, and preferentially secreted HSP90- and EpCAM-rich sEVs. These sEVs were leading to increased ATP7B expression and reduced CDDP sensitivity in recipient cells. A pharmacological inhibition of sEV biogenesis with GW4869 suppressed ATP7B and Atox1 expressions, inhibited late endosome maturation, and significantly enhanced CDDP-induced apoptosis in HNSC cells. In vivo, GW4869 reduced the sEV protein content and ATP7B expression in xenograft tumors. These findings establish that ATP7B is a critical modulator of sEV cargo and resistance propagation. Our results highlight a previously unrecognized ATP7B–sEV axis driving chemoresistance and identify sEV inhibition as a promising strategy to overcome therapeutic failure in HNSC.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0921-883136102025Evaluating the effects of electrolytes on the interaction forces between alumina surfaces in polyacrylic acid solutions using atomic force microscopy105028ENNaotoKishimotoGraduate School of Natural Science and Technology, Okayama UniversityRyotaKajiFaculty of Science and Engineering, Doshisha UniversityKatsumiTsuchiyaFaculty of Science and Engineering, Doshisha UniversityKoreyoshiImamuraGraduate School of Natural Science and Technology, Okayama UniversityNaoyukiIshidaFaculty of Science and Engineering, Doshisha UniversityEvaluation and control of ceramic slurry at the microscopic level are critical to ensure consistent quality in manufactured ceramics. Notably, metal ions such as Mg2+ and Al3+ are common in ceramic slurries and significantly influence the stability of particle. This study applied atomic force microscopy to investigate the interaction forces between alumina particle surfaces in the presence of different concentrations of three metal ions and polyacrylic acid (PAA), a widely used dispersant.<br>
The attractive forces observed at low PAA concentrations were attributed to polymer bridging between alumina surfaces, whereas the repulsive forces observed at high PAA concentrations were attributed to the domination of steric repulsion between adsorbed PAA molecules. The presence of multivalent metal ions, such as Mg2+ and Al3+, modulated these interactions; an increasing ion valence induced a transition from repulsive to attractive force, primarily owing to electrostatic screening, which caused conformational collapse of the PAA chains and diminished the range of steric repulsion. Similarly, increasing the concentration of these metal ions decreased the range of repulsive forces, eventually resulting in a net attraction driven by the same electrostatic and polymer conformation mechanisms. Notably, the addition of 0.1 M AlCl3 produced an anomalous long-range attraction between surfaces that could not be explained by conventional mechanisms, such as polymer bridging or electrostatic interactions between charge domains.No potential conflict of interest relevant to this article was reported.岡山大学文明動態学研究所文化遺産マネジメント部門Acta Medica Okayama2758-963332025ARCH：岡山大学文明動態学研究所文化遺産マネジメント部門ニュースレター 第3号ENCultural Heritage Management Division, Research Institute for the Dynamics of Civilizations, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0962-88193412025Highly efficient transgenesis mediated by Tip100 transposon system in medaka46ENYoshitakaTanakaUshimado Marine Institute (UMI), Okayama UniversityTakahideSekiDepartment of Integrative Life Sciences, Graduate School of Life Sciences, Tohoku UniversityAtsushiHoshinoNational Institute for Basic BiologySatoshiAnsaiUshimado Marine Institute (UMI), Okayama UniversityTransgenesis mediated by transposon is an effective approach for introducing exogenous DNA into the nuclear genome and establishing stable transgenic strains that efficiently express genetic tools. Although the DNA transposon Tol2 is widely used for transgenesis in zebrafish, its endogenous transpositional activity can lead to unintended transgene mobilization, making it unsuitable for transgenesis in medaka (Oryzias latipes). Here, we demonstrated that the DNA transposon Tip100, originally identified in the common morning glory (Ipomoea purpurea), an ornamental plant, can serve as a useful tool for transgenesis in Japanese medaka. The GFP transgene cassette, when co-injected with Tip100 transposase mRNA, was expressed in significantly higher number of somatic cells in the injected fish. Furthermore, a transgene flanked by truncated recognition sequences (100 bp each) exhibited expression levels comparable to those of the original vector containing the full 2.2 kb recognition sequence. Injection of a transgene driven by a germline-specific promoter revealed that fish injected with Tip100 mRNA exhibited a significantly higher germline transmission rate (42/68; 62.7%) compared to those injected without the mRNA (13/62; 21.0%). We successfully established transgenic strains by outcrossing injected founders with GFP-positive germ cells (7/7; 100%) and demonstrated that the transgenes were randomly integrated into the medaka genome, generating 8-bp duplications at the insertional sites–an insertional signature of the hAT superfamily of transposons. Our findings indicate that the Tip100 system is a promising tool for generating stable transgenic strains that express various genetic tools in medaka and potentially other fish species.No potential conflict of interest relevant to this article was reported.