American Geophysical Union (AGU)Acta Medica Okayama2169-909713142026Investigating the Detectability of Body Wave Phases From Tidal Ice Cracking Events on Titan With the Dragonfly Short-Period Seismometere2025JE009432ENL.DelaroqueUniversité Paris Cité, Institut de Physique du Globe de Paris, CNRST.KawamuraUniversité Paris Cité, Institut de Physique du Globe de Paris, CNRSA.LucasUniversité Paris Cité, Institut de Physique du Globe de Paris, CNRSS.RodriguezUniversité Paris Cité, Institut de Physique du Globe de Paris, CNRSK.OnoderaInstitute for Planetary Materials, Okayama UniversityH.ShiraishiInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencyR.YamadaThe University of AizuS.TanakaInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencyM. P.PanningJet Propulsion Laboratory, California Institute of TechnologyR. D.LorenzThe Johns Hopkins University Applied Physics LaboratoryDetecting seismic activity on Saturn's icy moon Titan during the Dragonfly mission could provide crucial information on its internal structure. The geological complexity of the moon's surface suggests significant cyclic tidal deformation, likely leading to the fracturing of the ice shell. Considering realistic source locations and fault geometries, we assess whether a vertical short-period seismometer can detect body waves from a Mw 4.0 icequake. Signal-to-noise ratios are evaluated by comparing the high-frequency content with the expected background noise and instrument capabilities for several ice attenuation scenarios and 1D interior models. Our results indicate that the high-frequency content (≥1Hz) of Mw≤4.0 tidal-induced icequakes is likely undetectable under the most unfavorable attenuation scenarios and atmospheric conditions. However, seismic signals in the 0.5–1 Hz band―where P wave reflections dominate―may still be observable for events occurring in potential seismically active regions at ∼800–1,000 km from the Dragonfly's landing site. These signals could provide constraints on the thickness of Titan's outer ice shell, provided that intrinsic attenuation is low and environmental conditions are favorable.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0040-40391792026Visible-light-induced photocatalytic intermolecular cyclization for synthesis of 2,2-diarylchromanes156034ENSakuraKodakiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMomoKondoLaboratory of Biopharmaceutics, Faculty of Pharmaceutical Sciences, Tokyo University of ScienceJuntaMinatoLaboratory of Cellular Drug Discovery and Development, Faculty of Pharmaceutical Sciences, Tokyo University of ScienceShokoItakuraLaboratory of Biopharmaceutics, Faculty of Pharmaceutical Sciences, Tokyo University of ScienceHiroyoshiTakamuraGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMakiyaNishikawaLaboratory of Biopharmaceutics, Faculty of Pharmaceutical Sciences, Tokyo University of ScienceIsaoKadotaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKosukeKusamoriLaboratory of Cellular Drug Discovery and Development, Faculty of Pharmaceutical Sciences, Tokyo University of ScienceKentaTanakaResearch Institute for Interdisciplinary Science, Okayama UniversityThe photocatalytic cyclization of salicylaldehydes with 1,1-diarylalkenes for the synthesis of 2,2-diarylchromanes has been developed. The catalytic amount of Ir photocatalyst proceeds the cyclization to give the various 2,2-diaryl chromanes under irradiation with blue LEDs. The obtained 2,2-diarylchromanes exhibit noticeable free-radical-scavenging activities, which have been largely unexplored. Notably, the chromane can convert to 2,2-diaryl-2H-naphtho[1,2-b]pyran bearing strong electron withdrawing groups, which are found in various photochromic materials. Thus, the present reaction constitutes a promising tool for the synthesis of functional materials and biologically active compounds.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2192-44491512026A case of tubulointerstitial nephritis with infiltration of neutrophils and interleukin-17-positive cells associated with Behçet’s disease35ENNaruhikoUchidaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKeikoTanakaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesNatsukiKubotaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesTakayukiKatsuyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKatsuyukiTanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesHaruhito A.UchidaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesBehçet’s disease (BD) is a non-infectious inflammatory condition characterized by neutrophilic infiltration. In addition to primary symptoms, including oral and genital ulcers, ocular involvement, and skin lesions, BD can also affect various organs. However, renal involvement, particularly in tubulointerstitial nephritis, has rarely been described. Herein, a rare case of acute tubulointerstitial nephritis in a patient clinically diagnosed with BD is reported. The renal lesion presented with other symptoms of BD and fever, and was considered to be BD-related due to the presence of neutrophilic infiltration and its responsiveness to BD-directed therapy. Alterations in T-helper (Th) 1, Th2, and Th17 cytokine profiles are associated with BD activity. Interleukin (IL)-17 plays a central role in neutrophil activation, and recent studies have demonstrated a strong correlation between IL-17A levels and BD activity. In the present case, elevated serum IL-17A levels and infiltration of IL-17A-positive cells into the renal tissue reflected an active phase of BD and a BD-associated renal lesion.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221612026Tribolium castaneum with longer duration of tonic immobility have more variations corresponding to the human Parkinson’s disease genomic region8840ENKeisukeTanakaNODAI Genome Research Center, Tokyo University of AgricultureKenSasakiGraduate School of Agriculture, Tamagawa UniversityShunsukeYajimaNODAI Genome Research Center, Tokyo University of AgricultureTakahisaMiyatakeFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityParkinson’s disease (PD) is a common neurodegenerative syndrome characterized by the loss of dopaminergic neurons and is also a progressive neurodegenerative disorder that is characterized by dopamine deficiency. We established strains artificially selected for longer and shorter durations of tonic immobility, an antipredator behavior that has received much attention recently, in the red flour beetle, Tribolium castaneum, a model insect species for molecular analyses different from Drosophila melanogaster. Previous studies have shown that the long strains (L-strain) have significantly lower levels of dopamine expression in the brain than the short strains (S-strain) and that they have an abnormal pattern of locomotor activity. Furthermore, previous studies have shown that administering dopamine to L-strain beetles reduces the duration of tonic immobility. Transcriptome analysis of brain and thorax of the L- and S-strains also showed differences in mRNA expression of genes involved in dopamine synthesis and tyrosine metabolism. These results indicate that the phenotype and molecular basis of the L-strain are similar to those of Parkinson’s syndrome symptoms. In order to establish a link between T. castaneum and PD, we compared the DNA sequences of the L- and S-strains to human genes affecting dopaminergic pathways. The DNA comparison revealed many mutated regions in these genes in the L-strain. We discuss the relationship between dopaminergic pathway genes and PD-like phenotypes across humans, Drosophila, and the red flour beetle.No potential conflict of interest relevant to this article was reported.Japan Society of Mechanical EngineersActa Medica Okayama1880-55582012025Numerical analysis validating the standard k-epsilon model for the kinetic energy of turbulence subjected to weak but long-lasting wind tunnel blockage accelerationJFST0004ENAkiraONOGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHirokiSUZUKIGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityToshinoriKOUCHIGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKentoTANAKAGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityThe aim of this study is to investigate the effect of weak but prolonged mean flow accelerations, such as those observed in wind tunnel blockage acceleration, on free-stream turbulence. Specifically, this research aims to validate a model previously developed based on the k-epsilon model. To test this model, the study focuses on scenarios where the turbulence under acceleration is steady and isotropic, since the model suggests that this type of acceleration has no effect on the turbulent kinetic energy. To examine this suggestion, the turbulence within a periodic box was analyzed using large-eddy simulation (LES) based on the conventional Smagorinsky model framework. The numerical analysis is based on a method that conserves velocity fluctuation intensities. The results show that while high rate of acceleration deviates turbulent kinetic energy, low rate acceleration has hardly any effect on turbulent kinetic energy, enstrophy, pressure fluctuation, relative pressure fluctuation intensity, and higher-order statistics of a velocity fluctuation. These results validate the accuracy of the model proposed in the previous studies. These results were obtained by focusing on differences in Reynolds numbers and the spatial scale of the forcing.No 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.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671612026コロナ禍で現地留学中断体験をした日本人学生における心理的変容 ― TEM 図を用いた体験のとらえ直し過程の分析 ―4763ENKoyuriSAKOTomokoTANAKA10.18926/70277No 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 Okayama0309-01678852025Claudin-18 expression in gastric type adenocarcinoma and HPV-associated adenocarcinoma of the uterine cervix10031015ENNobukoYasutakeDepartment of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu UniversityYukiYokawaDepartment of Pathology and Oncology, Graduate School of Medicine, Dentistry & Pharmaceutical Science, Okayama UniversityTakehiroTanakaDepartment of Pathology and Oncology, Graduate School of Medicine, Dentistry & Pharmaceutical Science, Okayama UniversityRiriMishimaDepartment of Pathology and Oncology, Graduate School of Medicine, Dentistry & Pharmaceutical Science, Okayama UniversityMisatoKomamizuDepartment of Gynecology and Obstetrics, Graduate School of Medical Sciences Kyushu University Fukuoka JapanRyosukeKugaDepartment of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu UniversityRinaJiromaruDepartment of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu UniversityShinichiroKawatokoDepartment of Medicine and Clinical Science, Kyushu University Beppu HospitalKenzoSonodaDepartment of Gynecology, Kyushu University Beppu HospitalHideakiYahataDepartment of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu UniversityKiyokoKatoDepartment of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu UniversityYoshinaoOdaDepartment of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu UniversityHidetakaYamamotoDepartment of Pathology and Oncology, Graduate School of Medicine, Dentistry & Pharmaceutical Science, Okayama UniversityAims: Claudin-18 (CLDN18) is both a marker for the gastric phenotype and a therapeutic target. However, little is known about its immunoexpression in endocervical adenocarcinomas (ECAs), particularly as detected using the clone 43-14A antibody, or about the gene expression of its isoforms in ECAs.<br>
Methods and results: We examined CLDN18, HIK1083, p16 and Rb expression by immunohistochemistry and high-risk human papillomavirus (HR-HPV) mRNA by in situ hybridization (ISH) in 121 ECAs, including 35 HPV-independent adenocarcinomas (gastric type [GAS], n = 24; non-GAS, n = 11) and 86 HPV-associated ECAs. We also analysed mRNA expression of the CLDN18.1 (lung type) and CLDN18.2 (gastric type) isoforms by quantitative polymerase chain reaction (qPCR) in selected cases. CLDN18 positivity was detected in 8/24 (33%) GASs, 0/11 (0%) non-GASs and 2/86 (2%) HPV-associated ECAs, with positivity defined as staining in ≥75% of tumour cells, as in gastric cancer. When a 5% cut-off was used, CLDN18 positivity was detected in 22/24 (92%) GASs, 0/11 (0%) non-GASs and 6/86 (7%) HPV-associated ECAs; CLDN18 expression was thus significantly associated with GAS histology (P < 0.0001). Among the 6 cases of HPV-associated ECAs with CLDN18 expression (ranging from 5% to 80%), the histological patterns included a mix of usual and mucinous features in 4 cases, pure usual type in 1 and villoglandular variant in 1. Otherwise features such as p16 overexpression and the Rb partial loss pattern were consistent with those of HPV-associated ECAs. Six of 22 (27%) CLDN18-positive GASs were also positive for p16, but their other features―such as CLDN18 expression and the Rb preserved pattern―were the same as in p16 negative GASs. Expression of CLDN18.2 mRNA but not CLDN18.1 mRNA was confirmed in both GASs and HPV-associated ECAs.<br>
Conclusions: CLDN18 (43-14A) emerged as a potential diagnostic and therapeutic marker for GAS. A minor subset of HPV-associated ECAs also can be immunoreactive for CLDN18 and express CLDN18.2 mRNA, suggesting divergent gastric phenotypic differentiation. The caution is that GAS and HPV-associated ECAs can share overlapping histological features and similar expression of CLDN18 and p16.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841772025The Challenge of Diagnosing Scirrhous Gastric Cancer by Endoscopic Biopsy: A Case Reporte87334ENYukaIkedaDepartment of Internal Medicine, Clinic IkedaDepartment of Internal Medicine, Clinic IkedaMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTadashiYoshinoDepartment of Pathology, Okayama UniversityTakehiroTanakaDepartment of Pathology, Okayama University HospitalNobumasaIkedaDepartment of Internal Medicine, Clinic IkedaMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesScirrhous gastric cancer, also known as linitis plastica, is a rare and aggressive subtype of gastric carcinoma that poses significant diagnostic challenges due to its submucosal infiltration and often normal-appearing mucosa. We report a case involving a 30-year-old Japanese woman who presented with a six-month history of epigastric pain and postprandial vomiting. Initial endoscopic examination revealed erythema and mucosal swelling, with limited antral distensibility and resistance during duodenal intubation. Despite 12 mucosal biopsies, histopathological examination revealed no evidence of malignancy. Given the strong clinical and endoscopic suspicion of scirrhous gastric cancer, additional deep sections and immunohistochemical staining were performed. These revealed scattered signet-ring cell carcinoma and poorly differentiated adenocarcinoma, with positive immunostaining for p53 and Ki67. The patient underwent total gastrectomy, and the diagnosis of scirrhous gastric cancer was confirmed on the resected specimen. This case highlights the importance of a high index of clinical suspicion, close collaboration between endoscopists and pathologists, and the utility of ancillary diagnostic tools, such as immunohistochemistry, in identifying subepithelial gastric malignancies that may be missed on conventional biopsy.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1347-90322026Clinical and Genetic Landscape of Glioblastoma, IDH-Wildtype With FGFR Gene Family AlterationsENYasuhitoKegoyaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYoshihiroOtaniDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesRyoMizutaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesRyosukeIkemachiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMakoKamiuraDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesJojiIshidaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesShinichiToyookaCenter for Comprehensive Genomic Medicine, Okayama University HospitalDaisukeEnnishiCenter for Comprehensive Genomic Medicine, Okayama University HospitalShutaTomidaCenter for Comprehensive Genomic Medicine, Okayama University HospitalShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesGlioblastoma, isocitrate dehydrogenase wildtype (GBM, IDH-wt), is a highly aggressive brain tumor with a poor prognosis. Alterations in the fibroblast growth factor receptor (FGFR) gene family―such as FGFR::TACC fusions and FGFR1 mutations―have emerged as potential therapeutic targets; however, their clinical and genetic features in GBM, IDH-wt remain unclear. We analyzed 1076 GBM, IDH-wt cases using comprehensive genomic profiling data from the Center for Cancer Genomics and Advanced Therapeutics (C-CAT) database in Japan. FGFR alterations were detected in 8.0% of patients, including FGFR::TACC fusions (3.3%) and FGFR1 mutations (2.9%). The FGFR::TACC fusion-positive group was older at diagnosis and showed higher frequencies of TERT promoter mutation and MDM2 amplification, and lower frequencies of EGFR amplification and TP53 mutation, compared with the fusion-negative group. The FGFR1 mutation-positive group was enriched for ATRX, NF1, and PIK3CA mutations and had significantly fewer TERT promoter and PTEN mutations, compared with the mutation-negative group. No significant differences in overall survival were observed, although both groups tended to have longer median overall survival compared with their respective negative groups. This study represents the largest genomic cohort to date of FGFR alterations in GBM, IDH-wt. FGFR::TACC fusion-positive and FGFR1 mutation-positive GBMs exhibited distinct genetic profiles, highlighting the clinical relevance of molecular subclassification and providing insight for future therapeutic strategies.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.The Japanese Society for Neuroendovascular TherapyActa Medica Okayama1882-40721912025The Qualification Examination for Specialists and Instructors in the Japanese Society of Neuroendovascular Therapy: History and Current Statussr.2024-0099ENShinichiYoshimuraDepartment of Neurosurgery, Hyogo Medical UniversityKenjiSugiuDepartment of Neurological Surgery, Okayama University Graduate School of MedicineMasaruHirohataDepartment of Neurosurgery, Kurume Medical UniversityYukikoEnomotoDepartment of Neurosurgery, Gifu University Graduate School of MedicineHirotoshiImamuraDepartment of Neurosurgery, National Cerebral and Cardiovascular CenterWataroTsurutaDepartment of Endovascular Neurosurgery, Toranomon HospitalToshiyukiFujinakaDepartment of Neurosurgery, National Hospital Organization Osaka National HospitalHitoshiHasegawaDepartment of Neurosurgery, Brain Research Institute, Niigata UniversityToshioHigashiDepartment of Neurosurgery, Fukuoka University Chikushi HospitalTakashiIzumiDepartment of Neurosurgery, Nagoya University of Graduate School of MedicineHiroKiyosueDepartment of Diagnostic Radiology, Kumamoto University Faculty of Life SciencesYasushiMatsumotoDivision of Development and Discovery of Interventional Therapy, Tohoku University HospitalHidenoriOishiOishi Neurosurgery Clinic, and Department of Neurosurgery, The Jikei University School of MedicineTetsuSatowDepartment of Neurosurgery/Stroke Center, Kindai University HospitalMichihiroTanakaDepartment of Neurosurgery and Neuroendovascular Surgery, Kameda Neurocenter, Kameda Medical CenterTomoyukiTsumotoDepartment of Neurosurgery, Showa University Fujigaoka HospitalHiroshiYamagamiDivision of Stroke Prevention and Treatment, Institute of Medicine, University of TsukubaAkiraIshiiDepartment of Neurosurgery, Juntendo University Faculty of MedicineYujiMatsumaruDepartment of Neurosurgery, Institute of Medicine, University of TsukubaShigeruMiyachiDepartment of Neurological Surgery, Aichi Medical UniveristyNeuroendovascular therapy is a key treatment for cerebrovascular disorders, driven by advancements in devices and techniques. The Japanese Society for Neuroendovascular Therapy (JSNET) established a certification system in 1997 to ensure operator competence and minimize complications, with the first examination in 2002. JSNET offers 2 main certifications: specialist and instructor. Specialists perform basic procedures, while instructors lead in practice, education, and research. In 2020, the mechanical thrombectomy practitioner qualification was added to promote mechanical thrombectomy. Applicants must have a JSNET membership, relevant certifications, training, and documented experience. The certification process includes rigorous written and practical examinations that now employ non-fluoroscopic models. Certification renewal every 5 years requires conference participation and a continuing education program. Public awareness and integration into stroke center designations have grown. Over 2200 specialists, including more than 500 instructors, have been certified, significantly advancing neuroendovascular therapy in Japan. JSNET aims to continue improving certification and education to maintain high standards.No potential conflict of interest relevant to this article was reported.Japan Society of Mechanical EngineersActa Medica Okayama2187-97451252025Examining OpenFOAM-based LES analysis in terms of inviscid energy conservation and viscous turbulence decay25-00095ENHirokiSUZUKIGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKentoTANAKAGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityToshinoriKOUCHIGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityThe present study examines an OpenFOAM-based LES analysis from the viewpoints of inviscid energy conservation and viscous turbulence decay. The Smagorinsky model is employed as the sub-grid scale (SGS) model, and a two-dimensional periodic analytical solution and a three-dimensional periodic Taylor-Green vortex (TGV) are employed to represent inviscid flows. The analytical relationship for the kinetic energy K, dK/dt = 0, with t as the dimensionless time, is utilized to validate the OpenFOAM results. For the viscous flow case, the TGV flow in a three-dimensional periodic cubic domain is adopted, and its turbulence kinetic energy distribution is compared with that obtained by a spectral method to examine the analysis. The OpenFOAM-based analysis exhibits energy conservation error in flows that should ideally conserve energy. For the two-dimensional flow, this error decreases with increasing grid resolution N. However, in the three-dimensional flow, the error does not improve even with higher N. In the three-dimensional TGV flow, the turbulence kinetic energy predicted by OpenFOAM exhibits a strong agreement with that from the spectral method when a standard constant value of the Smagorinsky model is employed and the mesh is sufficiently refined. Conversely, for a condition of relatively coarse mesh, the decay characteristics of turbulent kinetic energy deviate from those of the spectral method, and a higher constant value of the Smagorinsky model than the default value becomes necessary to reproduce comparable results. These results suggests that even in LES simulations where highly accurate conservation laws are not satisfied, adjusting the model constants so that the predicted values match experimental or numerical reference data can improve the apparent reliability of the turbulent kinetic energy in the decaying turbulence.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.Japan Stroke SocietyActa Medica Okayama0912-07264762025頭蓋頚椎移行部動静脈瘻の開頭手術時における上腕動脈穿刺による脳血管撮影の有用性410412ENYuichiHirataDepartment 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 SciencesSusumuSasadaDepartment 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 SciencesKyoheiKinDepartment 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 SciencesShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences頭蓋頚椎移行部動静脈瘻の手術では，異常血管の確認のため術中血管撮影が重要であるが，体位変換時のsheathの固定や撮影血管へのカテーテルの誘導が困難である．今回，頭蓋頚椎移行部動静脈瘻の開頭手術において上腕動脈穿刺によりultra-long sheathを鎖骨下動脈に留置して椎骨動脈撮影（vertebral artery angiography: VAG）を行う方法の有用性を報告する．当院で本血管撮影を施行した症例の患者背景や合併症を評価した．企図した4例，5血管でVAGを施行でき，合併症も認めなかった．体位変換も腹臥位における穿刺部の観察も簡便であり，カテーテルの操作性にも優れ，VAGを容易に施行することができた．また，管球を頭側から移動する際の術野との干渉も最小限に抑えられた．本方法は利点が多く，有用な血管撮影方法であり，頭蓋頚椎移行部動静脈瘻の手術における一助となり得ると考える．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.Springer Science and Business Media LLCActa Medica Okayama1757-22151912025Pan-cancer profiling links C1orf50 to DNA repair and immune modulation in ovarian cancer13ENAnnaRogachevskayaDepartment of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical SchoolYusukeOtaniDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineAkiraOhtsuHarvard Medical SchoolVanessa D.ChinUMass Chan Medical School, UMass Memorial Medical CenterTirsoPeñaDepartment of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical SchoolSeijiAraiDepartment of Urology, Gunma University Graduate School of MedicineShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineAtsushiFujimuraDepartment of Molecular Physiology, Faculty of Medicine, Graduate School of Medicine, Kagawa UniversityAtsushiTanakaDepartment of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical SchoolBackground C1orf50 encodes a small, evolutionarily conserved protein, the function of which remains unclear. Its significance across various human cancers, particularly its specific role in ovarian cancer within an immunogenomic context, is not yet fully understood. Utilizing The Cancer Genome Atlas and single-cell RNA sequencing (scRNA-seq) public datasets, we conducted a comprehensive profiling of C1orf50 across multiple cancer types, with a particular focus on ovarian cancer, to investigate its associations with copy-number status, genomic instability, tumor programs, and the immune microenvironment.<br>
Results Across cancer types, copy-number gain or amplification of C1orf50 was most frequent in ovarian cancer and closely tracked with higher messenger RNA levels. Higher C1orf50 expression was associated with a greater tumor mutational burden and homologous recombination deficiency, as indicated by gene-set patterns that suggested heightened cell-cycle and cellular stress responses accompanied by reduced oxidative phosphorylation, enrichment of regulatory T cells, and depletion of resting memory CD4 T cells. In ovarian cancer, focal events at chromosome 1p34.2 were accompanied by stepwise increases in C1orf50 expression by clinical stage and were linked to higher tumor mutational burden, homologous recombination deficiency, and greater loss of heterozygosity, together with more frequent gene alterations in BRCA1 or BRCA2. Immune composition clustered into profiles consistent with an immunosuppressive context in tumors with higher C1orf50 expression. The scRNA-seq data further revealed that cancer cells enhanced immune-suppressive interactions with various immune cell populations and diminished antigen-presentation signals. Analyses of genomic instability in ovarian cancer suggested mutational processes compatible with base-substitution patterns associated with cytidine deaminase activity and with insertion-deletion patterns characteristic of homologous recombination failure, while transcript-level patterns pointed to a broad downshift of canonical DNA repair activity with apparent compensatory adjustments in related pathways rather than a uniform change in any single pathway.<br>
Conclusions The overexpression of C1orf50 characterizes an aggressive immunogenomic phenotype in ovarian cancer, distinguished by genomic instability, impaired DNA repair mechanisms, and extensive immunosuppression. These findings indicate that C1orf50 warrants consideration as a potential biomarker and a prospective target for therapeutic investigation. Furthermore, they advocate for the progression to prospective validation and functional studies to ascertain its clinical significance.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2475-0328962025Surgery for Older Cancer Patients: Cross‐Organ Review and Good Practice Statement by the Japanese Geriatric Oncology Guideline Committee11281136ENChieTanakaDepartment of Gastroenterological Surgery, Nagoya University Graduate School of MedicineTakashiOfuchiDepartment of Surgery, Kyushu University Beppu HospitalKiichiroNinomiyaCenter for Comprehensive Genomic Medicine, Okayama University HospitalDaisukeInoueDepartment of Obstetrics and Gynecology, University of FukuiKenSugimotoDepartment of General Geriatric Medicine, Kawasaki Medical SchoolKeikoMurofushiDivision of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalToruOkuyamaDepartment of Psychiatry/Palliative Care Center, Nagoya City University West Medical CenterShigeakiWatanukiNational Center for Global Health and Medicine, National College of NursingChiyoImamuraAdvanced Cancer Translational Research Institute, Showa UniversityDaisukeSakaiDepartment of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of MedicineNaomiSakuraiCancer Solutions Co. LtdKiyotakaWatanabeDivision of Medical Oncology, Department of Medicine, School of Medicine, Teikyo UniversityKazuoTamuraNPO Clinical Hematology/Oncology Treatment Study GroupToshiakiSaekiBreast Oncology Service, Saitama Medical University International Medical CenterHiroshiIshiguroBreast Oncology Service, Saitama Medical University International Medical CenterBackground: Although the number of older people is increasing, there is a lack of evidence and insufficient consensus regarding postoperative complications and survival in older cancer patients. In this study, we conducted a literature search and systematic review focusing on the outcomes after surgery for older cancer patients.<br>
Methods: Literature focusing on surgical treatment for older cancer patients was extracted from Japanese clinical practice guidelines for gastric cancer, lung cancer, colorectal cancer, liver cancer, and gynecological cancers (uterine body, uterine cervix, ovary, and external genitalia and vagina). Outcomes were reviewed, and committee members determined the strength of evidence on a four-point scale (A to D), with A being the highest and D being the lowest.<br>
Results: Older cancer patients tend to have a higher incidence of postoperative complications and postoperative syndromes, and their expected survival is generally shorter compared to non-older patients. When extensive surgeries such as para-aortic lymph node dissection and/or resection with other organs are performed for older cancer patients, the postoperative mortality rates tend to increase compared to non-older patients.<br>
Conclusion: Surgical treatments for older cancer patients tend to result in higher morbidity even when the patients are in good health status. Nevertheless, there is still a possibility that a certain fraction of the patients achieve treatment outcomes comparable to those of non-older patients. Therefore, surgical indication and procedure for older cancer patients should be carefully determined based on surgical invasiveness and patient tolerability.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2352-5789592025Evaluation of platinum-free interval and chemotherapeutic effect of subsequent platinum-containing chemotherapy in patients with recurrent ovarian cancer initially treated with bevacizumab: SGSG018/Intergroup study101740ENTamakiTanakaDepartment of Perinatology and Gynecology, Kagawa University Graduate School of MedicineKazuhiroTakeharaDepartment of Gynecologic Oncology, NHO Shikoku Cancer CenterTomokaUsamiDepartment of Obstetrics and Gynecology, Ehime University Graduate School of MedicineMasakoIshikawaDepartment of Obstetrics and Gynecology, Shimane University Faculty of MedicineEijiKondoDepartment of Obstetrics and Gynecology, Mie University Graduate School of MedicineMasahiroKagabuDepartment of Obstetrics and Gynecology, Iwate Medical UniversityKeiHirabayashiDepartment of Obstetrics and Gynecology, JCHO Tokuyama Central HospitalNoriomiMatsumuraDepartment of Obstetrics and Gynecology, Kindai University Faculty of MedicineShinyaSatoDepartment of Obstetrics and Gynecology, Faculty of Medicine Tottori UniversityMasatoNishimuraDepartment of Obstetrics and Gynecology, Tokushima Prefectural Central HospitalAtsushiArakawaDepartment of Obstetrics and Gynecology, Nagoya City University West Medical CenterKeiichiroNakamuraDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYosukeKonnoDepartment of Obstetrics and Gynecology, Hokkaido University HospitalSatoeFujiwaraDepartment of Obstetrics and Gynecology, Osaka Medical and Pharmaceutical UniversityKotaroSueokaDepartment of Obstetrics and Gynecology, Yamaguchi University Graduate School of MedicineHirokoNakamuraDepartment of Obstetrics and Gynecology, NHO Kure Medical Center and Chugoku Cancer CenterIemasaKohDepartment of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Hiroshima UniversityKimihikoItoDepartment of Obstetrics and Gynecology, Kansai Rosai HospitalAtsushiHongoDepartment of Obstetrics and Gynecology, Kansai Rosai HospitalObjective: The effect of bevacizumab on platinum sensitivity in recurrent ovarian cancer remains poorly understood. This study examined the association between platinum-free interval (PFI) and sensitivity to subsequent platinum-containing chemotherapy in patients with first relapsed ovarian cancer after bevacizumab chemotherapy.<br>
Methods: We retrospectively analyzed patients who received platinum-based chemotherapy for platinum-sensitive recurrence between November 2013, and December 2019, and who were initially treated by platinum-based chemotherapy with concurrent and maintenance bevacizumab. The primary endpoint was response rate to subsequent chemotherapy after various periods of PFI. The relevance between response rate and PFI was assessed for each PFI of 6–12, 12–24 and ≧24 months using Cochran-Armitage test. The secondary endpoint was progression-free survival (PFS) defined as time from chemotherapy for first recurrence to subsequent progression and response rate to subsequent chemotherapy for each treatment-free interval since last administration of bevacizumab (Bev-TFI).<br>
Results: A total of 77 patients were eligible. The median PFI until first recurrence was 12 months (range: 6–43). The response rates of subsequent chemotherapy for patients with PFI of 6–12, ≥12-24, and 24 months were 42 %, 65 %, and 80 %, showing a linear trend (p < 0.05). Median PFS among the three groups was 8 (95 %CI: 6.7–9.2), 11 (95 %CI: 8.4–13.5) and 13 months (95 % CI: 5.4–20.5) (p = 0.107, log-rank test), respectively. By contrast, no linear trend was observed between Bev-TFI and response rate (p = 0.225)<br>
Conclusion: In patients with first relapse of primary ovarian cancer and bevacizumab beyond progression, the prolonged PFS effect of bevacizumab does not seem to affect sensitivity to subsequent platinum-based chemotherapy.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1341-96253072025How to report and discuss subgroup analyses in clinical practice guidelines? Evaluation procedure of the clinical and statistical relevancy12591267ENKiichiroNinomiyaCenter for Comprehensive Genomic Medicine, Okayama University HospitalSatoruMiuraDepartment of Internal Medicine, Niigata Cancer Center HospitalYukoOyaDepartment of Respiratory Medicine and Allergy, Fujita Health UniversityTomohiroSakamotoDivision of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, Tottori UniversityKentaroTanakaGraduate School of Medical Sciences, Research Institute for Diseases of the Chest, Kyushu UniversityShunsukeTeraokaInternal Medicine III, Wakayama Medical UniversityMasahiroMoriseDepartment of Respiratory Medicine, Nagoya University Graduate School of MedicineSatoshiMoritaDepartment of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto UniversityThe results of subgroup analyses of clinical trials are important reference information when considering the generalizability of a study treatment, i.e., providing the best treatment for each individual patient. The results of subgroup analyses are often presented in publications, etc. as forest plots focusing on patient backgrounds. However, it is important to fully understand and grasp some of the issues involved in subgroup analyses and to interpret the results carefully to apply them in clinical practice. Although the literature includes some reports on how subgroup analyses should be evaluated and handled for the purpose of establishing medical practice guidelines, most of the papers have mainly evaluated the reliability of subgroup analyses from a statistical perspective; few of them have incorporated clinical importance in their evaluations. Therefore, in December 2019, we established a Subgroup Analysis Review Committee consisting of oncologists specializing in lung cancer treatment and statistical experts among the members of the Guidelines Review Committee of the Japanese Lung Cancer Association, with the aim of appropriately reflecting subgroup analysis in Japanese lung cancer practice guidelines. We developed a new evaluation strategy to incorporate clinical aspects as well as reliability assessment. Specifically, on the basis of a clinical and statistical review of the problems with subgroup analyses presented as clinical trial results, we developed criteria and procedures to ensure consistency and fairness in the citation of clinical guidelines.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841762025Retreatment With EGFR-Tyrosine Kinase Inhibitor After Disease Progression Following Gefitinib Induction and Chemoradiotherapy in EGFR-Mutant Stage III Non-small Lung Cancer: An Efficacy and Safety Analysis of the LOGIK0902/OLCSG0905 Studye86575ENShoSaekiDepartment of Respiratory Medicine, Kumamoto University HospitalKatsuyukiHottaCenter for Innovative Clinical Medicine, Okayama University HospitalShinyaSakataDepartment of Respiratory Medicine, Kumamoto University HospitalNaohiroOdaDepartment of Respiratory Medicine, Okayama University HospitalKojiInoueDepartment of Respiratory Medicine, Kitakyushu Municipal Medical CenterTomokiTamuraDepartment of Respiratory Medicine, Okayama University HospitalRyoToyozawaDepartment of Thoracic Oncology, National Hospital Organization Kyushu Cancer CenterDaijiroHaradaDepartment of Thoracic Oncology, National Hospital Organization Shikoku Cancer CenterKentaroTanakaDepartment of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu UniversityKojiInoueDepartment of Respiratory Medicine, Ehime Prefectural Central HospitalYoshiyukiShioyamaRadiation Oncology, Ion Beam Therapy Center, SAGA HIMAT FoundationKenichiGembaDepartment of Respiratory Medicine, Chugoku Central HospitalTomonariSasakiDepartment of Radiation Oncology, Iizuka HospitalAkihiroBesshoDepartment of Respiratory Medicine, Japanese Red Cross Okayama HospitalJunjiKishimotoCenter for Clinical and Translational Research, Kyushu University HospitalKuniakiKatsuiDepartment of Radiology, Division of Radiation Oncology, Kawasaki Medical SchoolKatsuyukiKiuraDepartment of Respiratory Medicine, Okayama University HospitalKenjiSugioThoracic and Breast Surgery, Oita UniversityBackground and objective: We had previously conducted a phase II study (LOGIK0902/OLCSG0905 study) involving the eight-week administration of gefitinib, followed by cisplatin-based chemoradiotherapy, to treat locally advanced, epidermal growth factor receptor (EGFR)-mutated, non-small cell lung cancer (NSCLC). Despite favorable overall survival outcomes, more than half of the patients relapsed after the protocol therapy, highlighting the need to clarify the clinical significance of retreatment with EGFR-tyrosine kinase inhibitors (TKIs). We investigated the efficacy and safety of EGFR-TKI retreatment after disease progression.<br>
Materials and methods: We included 14 patients who relapsed after the protocol treatment and received any type of EGFR-TKI as post-progression treatment in this sub-analysis. We evaluated the efficacy and safety of retreatment with EGFR-TKI in these patients.<br>
Results: Among the 14 patients, 11 (78.6%) responded to the induction of gefitinib in the treatment protocol. After relapse, 9/14 patients (64.3%) received gefitinib, 3/14 (21.4%) received afatinib, and 2/14 (14.3%) received erlotinib monotherapy, respectively. The median duration of post-progression EGFR-TKI treatment was 17.9 (0.7-45.5) months. The overall response rate (ORR) and disease control rate were 64.3% [9/14 patients; 95% confidence interval (CI): 35.1%-87.2%] and 85.7% (12/14 patients; 95% CI: 57.2%-98.2%), respectively. The median progression-free survival (PFS) and median survival durations after the initiation of EGFR-TKI retreatment were 11.8 months (95% CI: 5.7-20.7 months) and 47.4 months (95% CI: 31.8 months to not estimable), respectively. Adverse events were comparable to those previously reported.<br>
Conclusions: Patients with disease progression after protocol therapy demonstrated sensitivity to retreatment with an EGFR-TKI, with acceptable safety.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-291864142025Myeloid Sarcoma in the Small Intestine21552159ENMasayaIwamuroDepartment 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 SciencesKatsunoriMatsuedaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesDaisukeKametakaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakehiroTanakaDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSeijiKawanoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMyeloid sarcoma is a rare extramedullary tumor of immature myeloid cells that is often associated with acute myeloid leukemia (AML). We herein report an 81-year-old man who presented with intestinal obstruction due to myeloid sarcoma of the small intestine. Diagnostic challenges were overcome using double-balloon enteroscopy and a biopsy, which confirmed the diagnosis of myeloid sarcoma. The patient subsequently developed AML but responded well to chemotherapy. This case underscores the importance of considering myeloid sarcoma in the differential diagnosis of small-bowel tumors. Highlighting the significance of a histological analysis, even in patients presenting with small bowel obstruction, the early diagnosis and treatment are crucial for improving outcomes, particularly in patients without a history of hematologic malignancies.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841752025Pseudoachalasia Due to Malignant Pleural Mesothelioma Involving the Esophaguse84161ENManamiHondaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuyaMiyamotoDepartment 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 SciencesWe report a rare case of pseudoachalasia secondary to malignant pleural mesothelioma involving the esophagus. A 66-year-old man presented with progressive dysphagia, weight loss, and postprandial hiccups. Endoscopic examination showed esophageal dilation with luminal narrowing at the esophagogastric junction, but no mucosal abnormalities. Computed tomography revealed an irregular-shaped mass extending from the peri-esophagogastric junction to the retroperitoneum, accompanied by pleural effusion, right-sided hydronephrosis, and multiple hepatic lesions. Endoscopic ultrasound-guided fine-needle aspiration from the mass lesion through the esophageal lumen revealed epithelioid malignant mesothelioma. This case highlights the importance of considering malignant mesothelioma in the differential diagnosis of pseudoachalasia, particularly when imaging reveals extrinsic esophageal compression without mucosal lesions.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 Okayama1865-72571822025Microsatellite-high intrahepatic cholangiocarcinoma with favorable treatment outcome using pembrolizumab363368ENShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalHironariKatoDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyaMiyamotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalKosakuMorimotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalAkihiroMatsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalHiroyukiTerasawaDepartment of Gastroenterology and Hepatology, Okayama University HospitalYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalTakehiroTanakaDepartment of Pathology, Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalIntrahepatic cholangiocarcinoma has a poor prognosis. In unresectable cases, the survival period is short despite combination therapy with cytotoxic anticancer agents and immune checkpoint inhibitors. The usefulness of immune checkpoint inhibitors against malignant tumors with microsatellite instability-high (MSI-H) mutations was shown in the KEYNOTE158 study; however, data for intrahepatic cholangiocarcinoma are insufficient. In the present case, a 65-year-old man with intrahepatic cholangiocarcinoma and lymph node metastasis could not be treated with a combination of gemcitabine, CDDP, and S-1. A comprehensive cancer genomic profiling (CGP) test showed MLH1 pathogenic mutation and MSI-H. When pembrolizumab was administered, the tumor shrinkage effect was rapidly observed, which was sustained even after 30 months. No pathogenic mutations were observed in the germline test, and MSI-high was considered to be due to the MLH1 pathogenic mutation occurring sporadically in somatic cells. MSI-H intrahepatic cholangiocarcinoma is extremely rare. However, because pembrolizumab is expected to be effective, CGP testing should be actively performed.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.IOP PublishingActa Medica Okayama1742-6588302712025LES analysis to investigate a random-phase forcing scheme for steadying anisotropic turbulence fields012009ENKokiMinamiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHirokiSuzukiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityToshinoriKouchiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKentoTanakaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityThe aim of this study is to investigate the effect of phase randomization on forcing mechanisms that stabilize localized turbulence. A trigonometric forcing based on vector potential is combined with uniform random numbers to create a spatially homogeneous forcing field. The analysis is performed using large-eddy simulation (LES) with the Smagorinsky model as the subgrid scale model. The results demonstrate that steady flows are generated regardless of the presence of phase randomization, successfully forming isotropic turbulence. In contrast, for anisotropic turbulent fields, the addition of phase randomization reduces the degree of anisotropy, indicating a smoothing effect on the anisotropy of the flow.No potential conflict of interest relevant to this article was reported.IOP PublishingActa Medica Okayama1742-6588302712025Fundamental examination of coherent structure model prediction using vortex cores in a two-dimensional Taylor’s analytical solution012008ENXuanyouGongGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHirokiSuzukiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityToshinoriKouchiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKentoTanakaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityThis study focuses on the possibility that flow around vortex tubes in turbulence may resemble laminar flow, and aims to describe the characteristics of turbulent fields using analytical solutions to the governing equations. In the two-dimensional analytical Taylor solution, the velocity and pressure fields are expressed by trigonometric functions, and a structure in which counter-rotating vortices are arranged in a grid pattern is demonstrated. This solution is used to verify the accuracy of numerical analyses and is expected to contribute to a simple yet unambiguous description of turbulent fields based on vortex structures. Predictions of sub-grid scale components and validation of a coherent structure model using invariants of the velocity gradient tensor are also performed.No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026心理臨床家同士のグループ体験における反省的実践1230ENRyosukeKOBASHIInstitute for Promotion of Education and Campus Life, Okayama UniversityMasashiTANAKATokai UniversityRinMURASEGraduate School of Education and Human Development, Nagoya University10.18926/70109 心理臨床家にとって反省的実践は重要であり，多様な形態のグループに参加をすることによって反省的実践を行っている。本研究では，全般的な心理臨床家同士のグループにおける体験（研究1）および継続的なグループにおける体験（研究2）を探索することを目的として，数名の心理臨床家による話し合いをKJ法を援用して分析した。その結果，心理臨床家同士のグループ体験における反省的実践には，【グループ体験が内省につながるかどうか】などの4つ側面が重要であることが示された。また，継続的なグループにおける体験では，《本来の人としての感覚や欲求》や《自分を不自由にしている要因》などの【会における気づき】が得られることが反省的実践として有意義であることが明らかになった。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 Okayama0386-300X8012026The 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.岡山大学文明動態学研究所Acta Medica Okayama2436-832652026Depicting Buddha : Practice, Prescription and Perception134152ENShijunZHANGDepartment of Sociology & Institute of Sociology and Anthropology, Peking University特集：Sacred Objects in Religions (Special Issue: Sacred Objects in Religions)10.18926/70059Tibetan thangka refers to a genre of pictorial art widely produced across the Tibetan cultural region since the 11th century. Although scroll painting is its most common form, thangkas are also created through embroidery, appliqué, and brocade weaving. The subjects depicted encompass a wide range of themes within Tibetan Buddhism and the Bön religion, including various Buddhas, bodhisattvas, deities, monks, mandalas, as well as astronomical and medical knowledge. Within Tibetan religious beliefs, thangkas are not merely visual representations; they are venerated as supports of Buddha (Tib. sku rten), understood as physical embodiments of divine presence. At the same time, the creation and veneration of thangka constitute a rich aesthetic tradition in which artists repeatedly integrate realist elements into this sacred canvas. <br>
This paper offers a micro anthropological examination (Tanaka 2005; 田中 2006) of the depiction of thangka as a practice oscillating between inscribing the canonical and drawing the real. Through critically engaging with the theory of agency of art (Gell 1998), and the analysis of writing and drawing (Ingold 2017), this study examines the dialectical relationship between rendering sacred images and depicting worldly reality, and how such practices unfold in the tension between prescriptive authority and embodied perception.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841812026Central Serous Chorioretinopathy in Parallel With Onset and Relapses of Minimal Change Nephrotic Syndrome: A 28-Year Case Follow-Upe102426ENToshihikoMatsuoDepartment of Ophthalmology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTakehiroTanakaDepartment of Pathology, 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 UniversityCentral serous chorioretinopathy is an idiopathic disease that manifests as one or several localized, small, dome-shaped serous retinal detachments on fundus examination. The pathophysiology involves fluid leakage from the choroidal capillaries, known as the choriocapillaris, into the subretinal space through sites of damage in the retinal pigment epithelium. This case report discusses the underlying causes of central serous chorioretinopathy-like findings in minimal change nephrotic syndrome.<br>
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The patient was a 33-year-old woman who developed nephrotic syndrome that was confirmed to be minimal change disease by renal biopsy. She experienced two major relapses of nephrotic syndrome at the ages of 36 and 41 years. She also had a minor relapse at the age of 37 years, five months after the first major relapse at the age of 36 years, as well as four additional minor relapses at the ages of 44, 46, 50, and 51 years. The onset of central serous chorioretinopathy-like manifestations, which were localized to the left eye, occurred three months after the initial onset of nephrotic syndrome at the age of 33 years. Two subsequent episodes of relapse of central serous chorioretinopathy-like manifestations were observed in both eyes at intervals of five months and one month, respectively, after major relapses of nephrotic syndrome at the ages of 36 and 41 years. Thereafter, she did not develop further central serous chorioretinopathy-like manifestations.<br>
<br>
She discontinued oral prednisolone at the age of 54 years and experienced no further relapses of nephrotic syndrome through her latest visit at the age of 61 years. She maintained normal renal function and good visual acuity in both eyes. The long-term, consistent temporal association between episodes of central serous chorioretinopathy and the onset and relapses of minimal change nephrotic syndrome is strongly supported by longitudinal clinical observations spanning 28 years. This parallel course suggests a possible shared pathophysiological mechanism or common triggering factors underlying both diseases.No potential conflict of interest relevant to this article was reported.Baishideng Publishing Group Inc.Acta Medica Okayama1948-519017122025Endoscopic features of oral and pharyngolaryngeal papillomas and their role in distinguishing squamous cell carcinoma110594ENMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakehiroTanakaDepartment of Pathology, Okayama University HospitalKentaHamadaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYoshiyasuKonoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSeijiKawanoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYoshiroKawaharaDepartment of Practical Gastrointestinal Endoscopy, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBACKGROUND<br>
Oral and pharyngolaryngeal papillomas are occasionally detected during esophagogastroduodenoscopy. However, their endoscopic features have not been sufficiently investigated.<br>
AIM<br>
To distinguish oral and pharyngolaryngeal papillomas from elevated squamous carcinomas, this study examined their endoscopic features.<br>
METHODS<br>
Forty-seven patients with oral or pharyngeal papilloma participated in this study. The endoscopic characteristics of papillomas were identified by focusing on narrowband and blue laser imaging representations.<br>
RESULTS<br>
Papillomas were classified into three patterns based on their endoscopic features: Salmon roe-like polyps, polyps without capillary transparency, and pinecone-like polyps, with salmon roe-like polyps most prevalent (48.9%). We subsequently analyzed features differentiating papillomas and squamous cell carcinomas in the same region and found that squamous cell carcinomas exhibited at least one of the following three features: Uneven or absent lobulated structure, irregular morphology of capillaries, and coexistence of flat lesions. In contrast, papillomas displayed a uniform lobulated structure, homogeneous or non-visible capillaries, and an absence of flat components. When any of these characteristics were present, two endoscopic specialists evaluated the lesions for the diagnosis of squamous cell carcinoma, with sensitivities of 100% and 97.6% and specificities of 68.9% and 93.3%.<br>
CONCLUSION<br>
Understanding distinct endoscopic patterns of oropharyngeal papillomas and squamous cell carcinomas provides valuable guidance to endoscopists performing esophagogastroduodenoscopy.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama2328-89571312025Impact of Candida Care Bundle Compliance on the Prognosis of Patients With Candidemia: A Multicenter Retrospective Cohort Study With Propensity Score Matching Analysis (2016–2023)ofaf790ENHidemasaAkazawaDepartment of Infectious Diseases, Okayama University HospitalShinnosukeFukushimaDepartment of Infectious Diseases, Okayama University HospitalToshieHiguchiDepartment of General Internal Medicine, Okayama Red Cross HospitalTomokoMiyoshiCenter for Medical Education and Internationalization, Kyoto University Graduate School of MedicineYasuhiroNakanoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKojiIioMicrobiology Division, Clinical Laboratory, Okayama University HospitalYukinobuAkamatsuDepartment of General Medicine, Tottori Municipal HospitalYutoHarukiDepartment of Pharmacy, Tsuyama Chuo HospitalYoshitakaIwamotoDepartment of General Medicine, NHO Okayama Medical CenterShuichiTanakaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShunFujisatoDepartment of Pharmacy, Okayama Rousai HospitalSoichiroAkoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalBackground. Candidemia is a life-threatening infection with high mortality, and appropriate management is essential to improve patient outcomes. The Candida Care Bundle aims to standardize hospital management for patients with candidemia and reduce mortality.<br>
Methods. This retrospective multicenter cohort study included candidemia cases from 9 hospitals in Japan between 2016 and 2023. Compliance to the Candida Care Bundle was evaluated based on 5 elements: central venous catheter removal within 24 hours, appropriate antifungal therapy, ophthalmologic examination, follow-up blood cultures, and antifungal treatment for ≥2 weeks after clearance. Patients were categorized into high (4–5 items) and low (0–3 items) compliance groups. The primary and secondary outcomes were defined as 30-day survival and the development of endophthalmitis, with propensity score matching used to adjust for potential confounders.<br>
Results. Among 230 patients, 160 (69.5%) were classified into the high compliance group, which exhibited significantly lower 30-day mortality than the low compliance group (8.8% vs 57.1%, P < .01). Even after matching, the high compliance group remained independently associated with improved survival (hazard ratio [HR]: 0.15; 95% confidence interval [CI]: .08–.30). C. albicans (HR: 1.95; 95% CI: 1.01–3.52) and central line-associated bloodstream infection (HR: 2.63; 95% CI: 1.35–5.12) were associated with the fatal outcome. Endophthalmitis involved 23.6% of the patients, being associated with C. albicans (odds ratio [OR]: 8.18; 4.46–19.30) and central line-associated bloodstream infection (OR: 2.69; 1.08–6.70).<br>
Conclusions. Strict compliance to the Candida Care Bundle significantly improves survival, underscoring its importance in candidemia management.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1347-90322025Atezolizumab + Chemotherapy for Advanced Non-Small Cell Lung Cancer in Japanese Clinical Practice (J-TAIL-2)ENHiroshigeYoshiokaDepartment of Thoracic Oncology, Kansai Medical UniversityMakotoNishioDepartment of Thoracic Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer ResearchKadoakiOhashiDepartment of Respiratory Medicine, Okayama University HospitalAtsushiOsoegawaDepartment of Thoracic and Breast Surgery, Oita University Faculty of MedicineEikiKikuchiDepartment of Respiratory Medicine, Faculty of Medicine, Hokkaido UniversityHideharuKimuraDepartment of Respiratory Medicine, Kanazawa University HospitalYasushiGotoDepartment of Thoracic Oncology, National Cancer Center HospitalJunichiShimizuDepartment of Thoracic Oncology, Aichi Cancer Center HospitalEisakuMiyauchiDepartment of Respiratory Medicine, Tohoku University HospitalIchiroYoshinoInternational University of Health and Welfare, Narita HospitalToshihiroMisumiDepartment of Data Science, National Cancer Center Hospital EastYasutakaWatanabeDepartment of Thoracic Oncology, Saitama Cancer CenterAkitoHataDivision of Thoracic Oncology, Kobe Minimally Invasive Cancer CenterAkiraKisoharaDepartment of Respiratory Medicine, Kasukabe Medical CenterShoichiKuyamaDepartment of Respiratory Medicine, NHO Iwakuni Clinical CenterMasafumiYamaguchiDepartment of Thoracic Oncology, NHO Kyushu Cancer CenterAsakoMiwaChugai Pharmaceutical Co., Ltd.ShunichiroIwasawaChugai Pharmaceutical Co., Ltd.MisaTanakaChugai Pharmaceutical Co., Ltd.AkihikoGemmaNippon Medical SchoolFirst-line atezolizumab combination therapies were approved for the treatment of metastatic non-small cell lung cancer (NSCLC) based on results from the global phase 3 trials IMpower130, IMpower132, and IMpower150. These trials reported 12-month overall survival (OS) rates of 60%–67% with atezolizumab combination therapy. J-TAIL-2 (NCT04501497), a prospective, multicenter, observational study, evaluated atezolizumab combination therapy in routine clinical practice in Japan. Patients ≥ 20 years old with NSCLC received atezolizumab plus carboplatin and nab-paclitaxel (atezo + CnP), atezolizumab plus carboplatin or cisplatin plus pemetrexed (atezo + PP), or atezolizumab plus bevacizumab plus carboplatin and paclitaxel (atezo + bev + CP) in clinical practice. The primary endpoint was the 12-month OS rate. Secondary endpoints included OS, progression-free survival, and subgroup analyses, including IMpower-unlike (did not meet the main eligibility criteria of each IMpower trial) and IMpower-like patients. In total, 814 patients were enrolled (atezo + CnP, n = 217; atezo + PP, n = 211; atezo + bev + CP, n = 386). The IMpower-unlike group included patients with Eastern Cooperative Oncology Group performance status ≥ 2, autoimmune disease, or interstitial lung disease. Twelve-month OS rates (95% confidence interval [CI]) were 62.9% (55.8–69.2), 72.1% (65.2–77.9), and 68.3% (63.2–72.9) with atezo + CnP, atezo + PP, and atezo + bev + CP, respectively. OS hazard ratios (95% CI) in the IMpower-unlike vs. -like subgroups were 1.36 (0.91–2.05), 1.08 (0.70–1.68), and 1.49 (1.09–2.06), respectively. No new safety signals were observed. Real-world efficacy and safety for each atezolizumab combination were comparable to those in the relevant IMpower trials.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0301-486X19062025Prognostic Value of Serum (1→3)-β-D-Glucan Levels in Patients with Candidemia Stratified by Compliance with Candida Bundle: A Multicenter Retrospective Cohort Study (2016–2023)90ENHidemasaAkazawaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinnosukeFukushimaDepartment of Infectious Diseases, Okayama University HospitalToshieHiguchiDepartment of General Internal Medicine, Okayama Red Cross HospitalTomokoMiyoshiCenter for Medical Education and Internationalization, Kyoto University Graduate School of MedicineYasuhiroNakanoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKojiIioMicrobiology Division, Clinical Laboratory, Okayama University HospitalYukinobuAkamatsuDepartment of General Medicine, Tottori Municipal HospitalYutoHarukiDepartment of Pharmacy, Tsuyama Chuo HospitalYoshitakaIwamotoDepartment of General Medicine, NHO Okayama Medical CenterShuichiTanakaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShunFujisatoDepartment of Pharmacy, Okayama Rousai HospitalSoichiroAkoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalBackground Candidemia is a severe systemic infection with a high mortality risk. While β-D-glucan (BDG) serves as a diagnostic biomarker, its prognostic value in candidemia, particularly in association with Candida bundle compliance, remains unclear.<br>
Methods In this retrospective multicenter cohort study, we evaluated 96 patients with candidemia across nine Japanese hospitals between 2016 and 2023. Candida bundle compliance was assessed using five key components: central venous catheter removal within 24 h of diagnosis, appropriate initial antifungal therapy, ophthalmologic examination, follow-up blood cultures until clearance, and antifungal therapy for at least two weeks post-clearance. Analyses stratified patients by serum BDG status (positive/negative) and compliance with the Candida bundle (high: 4–5 points; low: 0–3 points). The primary outcome was 30-day mortality, and the secondary outcome was defined as endophthalmitis incidence.<br>
Results Of 96 eligible patients with candidemia, 70 (72.9%) were BDG-positive and 26 (27.1%) were BDG-negative. The overall 30-day mortality was 17.7%. Among BDG-positive patients, 15 (21.4%) died, while 2 (7.7%) died in BDG-negative cohorts (p = 0.09). Serum BDG positivity demonstrated a statistically significant association with decreased survival rates in the low bundle adherence group (p = 0.02), whereas this correlation was not observed among patients in the high-compliance cohort (p = 0.66). Endophthalmitis occurred in 25.0% of patients, without significant correlation to serum BDG status. C. albicans was associated with a significantly higher incidence of endophthalmitis compared with non-albicans species (45.7% vs. 8.9%).<br>
Conclusions Serum BDG positivity potentially correlates with worse survival in candidemia, particularly in patients with low bundle compliance. This emphasizes the importance of adherence to standardized Candida management protocols for optimizing patient outcomes.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2772-5723522026Feasibility and Diagnostic Utility of Mucosal T-Cell Flow Cytometry for Intestinal Graft-Versus-Host Disease100820ENMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakumiKondoDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesDaisukeEnnishiDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNobuharuFujiiDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMaiHiramatsuDivision of Medical Support, Okayama University HospitalArakiHirabataDivision of Medical Support, Okayama University HospitalTakahideTakahashiDivision of Medical Support, Okayama University HospitalTakehiroTanakaDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground and Aims: Timely diagnosis of intestinal complications after hematopoietic stem cell transplantation (HSCT), including graft-versus-host disease (GVHD), transplant-associated thrombotic microangiopathy, and cytomegalovirus infection, is essential for appropriate management. This study evaluated whether mucosal T-cell profiling from endoscopic biopsies could support the diagnosis of these post-transplant conditions.<br>
Methods: We prospectively analyzed 58 intestinal biopsy specimens from 21 post-HSCT patients. Paired samples were obtained from the stomach and duodenum during upper endoscopy and from the ileum and large intestine during colonoscopy. Lymphocytes were isolated from each specimen and analyzed using flow cytometry. These data were integrated with those of a previously collected cohort (35 patients, 51 samples) for comparative immunophenotypic analysis across histologically defined groups.<br>
Results: Duodenal biopsies yielded more lymphocytes than did gastric biopsies (mean ± standard deviation: 532 ± 823 vs 233 ± 392 cells; P = .070), with comparable yields between the ileum and colon. Among 41 evaluable cases, the CD56+:CD3+ ratio was significantly lower in patients with GVHD (5.5 ± 2.2%) than in those with nonspecific or no inflammation (28.4 ± 16.3%; P = .006). A cutoff value of <11% provided 85.7% sensitivity and 83.3% specificity for diagnosing GVHD (area under the curve = 0.91).<br>
Conclusion: Mucosal T-cell profiling using endoscopic biopsies is feasible and may aid in the diagnosis of GVHD after HSCT. A decreased CD56+:CD3+ ratio is a promising marker for distinguishing GVHD from other post-transplant intestinal conditions.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813732025令和６年度岡山医学会賞 胸部・循環研究奨励賞（砂田賞）9597ENShinichiKawanaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.Japanese Society of BreedingActa Medica Okayama1344-76107532025Polyphyletic domestication and inter-lineage hybridization magnified genetic diversity of cultivated melon, Cucumis melo L.168178ENKatsunoriTanakaFaculty of Agriculture and Life Science, Hirosaki UniversityGentaroShigitaGraduate School of Environmental and Life Science, Okayama UniversityTran PhuongDungGraduate School of Environmental and Life Science, Okayama UniversityPhan Thi PhuongNhiUniversity of Agriculture and Forestry, Hue UniversityMamiTakahashiGraduate School of Environmental and Life Science, Okayama UniversityYukiMondenGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHidetakaNishidaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityRyujiIshikawaFaculty of Agriculture and Life Science, Hirosaki UniversityKenjiKatoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMelon accessions with diverse geographical origins were classified into large and small seed-types by length of seed at the boundary of 9 mm, and into five populations based on polymorphisms in the nuclear genome. They were further divided into three maternal lineages, Ia, Ib, and Ic, by polymorphisms in the chloroplast genome. By combining these three classifications, the Europe/US subsp. melo and the East Asian subsp. agrestis were characterized as [large seed, Ib, PopA1 or A2] and [small seed, Ia, PopB1 or B2], respectively, indicating nearly perfect divergence. In South Asia, in addition to the Europe/US and East Asian types, recombinant types between the two types were detected and accounted for 34.8% of South Asian melon. The finding of such an intermixed structure of genetic variation supported the Indian origin of Ia and Ib types. As to Momordica popular in South Asia, seed length was intermediate between the large and small seed-types, and chloroplast type was a mixture of Ia and Ib, suggesting its origin from the recombinant type. In Africa, three lineages of melon were distributed allopatrically and showed distinct divergence. Subsp. agrestis of the Ic type proved to be endemic to Africa, indicating its African origin.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1347-90322025Genomic Profiling of Pediatric Solid Tumors With a Dual DNA/RNA Panel: JCCG-TOP2 StudyENKayokoTaoDepartment of Pediatrics, National Cancer Center HospitalTakakoYoshiokaDepartment of Pathology, National Center for Child Health and DevelopmentMihoKatoDepartment of Childhood Cancer Data Management, National Center for Child Health and DevelopmentKazuyukiKomatsuDepartment of Pediatrics, Hamamatsu University School of MedicineShinichiTsujimotoDepartment of Pediatrics, Yokohama City UniversityKenichiSakamotoDepartment of Pediatrics, Shinshu University School of MedicineKazukiTanimuraDepartment of Pediatrics, National Cancer Center HospitalMinakoSugiyamaDepartment of Pediatrics, National Cancer Center HospitalMasahiroSekiguchiDepartment of Pediatrics, The University of TokyoYoshikoNakanoDepartment of Pediatrics, The University of TokyoYoshihiroOtaniDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasushiYatabeDepartment of Diagnostic Pathology, National Cancer Center HospitalAkihikoYoshidaDepartment of Diagnostic Pathology, National Cancer Center HospitalHajimeOkitaDepartment of Pathology, Keio University School of MedicineJunkoHiratoDepartment of Pathology, Public Tomioka General HospitalKenichiKohashiDepartment of Pathology, Graduate School of Medicine, Osaka Metropolitan UniversityYukichiTanakaDepartment of Pathology, Kanagawa Children's Medical CenterShinjiKohsakaDivision of Cellular Signaling, National Cancer Center Research InstituteTakashiKuboDepartment of Clinical Genomics, National Cancer Center Research InstituteKunikoSunamiDepartment of Laboratory Medicine, National Cancer Center HospitalMakotoHirataDepartment of Genetic Medicine and Services, National Cancer Center HospitalShuichiTsutsumiGenome Science & Medicine Division, Research Center of Advanced Science and Technology, The University of TokyoHiroyukiAburataniGenome Science & Medicine Division, Research Center of Advanced Science and Technology, The University of TokyoKatsuyoshiKohDepartment of Hematology and Oncology, Saitama Children's Medical CenterMasahiroHirayamaDepartment of Pediatrics, Mie University Graduate School of MedicineShuheiKarakawaDepartment of Pediatrics, Hiroshima University HospitalYukayoTerashitaDepartment of Pediatrics, Hokkaido University HospitalHiroyukiFujisakiDepartment of Pediatric Hematology and Oncology, Osaka City General HospitalTakeshiYagiOkinawa Prefectural Nanbu Medical Center & Children's Medical CenterAkihiroYonedaDepartment of Pediatric Surgery, National Center for Child Health and DevelopmentShinjiMochizukiDepartment of Pediatrics, National Center for Global Health and Medicine, Japan Institute for Health SecurityHiroyukiShichinoDepartment of Pediatrics, National Center for Global Health and Medicine, Japan Institute for Health SecurityTatsuyaSuzukiDepartment of Hematology, National Cancer Center HospitalTetsuyaTakimotoDepartment of Childhood Cancer Data Management, National Center for Child Health and DevelopmentKoichiIchimuraDepartment of Pathology, Kyorin University Faculty of MedicineChitoseOgawaDepartment of Pediatrics, National Cancer Center HospitalKimikazuMatsumotoChildren's Cancer Center National Center for Child Health and DevelopmentHitoshiIchikawaDepartment of Clinical Genomics, National Cancer Center Research InstituteMotohiroKatoDepartment of Pediatrics, The University of TokyoTo develop an optimized genomic medicine platform for pediatric cancers, a nationwide cancer genome profiling project was conducted from January 2022 to February 2023 in collaboration with the Japan Children's Cancer Group. This prospective observational study analyzed matched blood and FFPE tumor samples from patients aged 0–29 years with solid tumors. Genomic analysis used the TOP2 hybrid capture–enrichment system, targeting 737 and 455 genes in the DNA and RNA panels, along with allele-specific genome copy number alterations. A total of 210 patients from 50 institutions were enrolled across Japan (median age, 8 years; range, 0–25). Of these, 154 (77%) were enrolled at diagnosis or during/after initial treatment and 56 (27%) at disease progression or relapse. The TOP2 findings had great benefits in clarifying the diagnosis of pediatric solid tumors. Among the 204 patients with genomic results, 147 (72%) had potentially actionable findings, including diagnostic, prognostic, and therapeutic findings in 111 (54%), 61 (30%), and 64 (31%), respectively. Oncogenic fusions were noted in 45 (23%) patients. A copy number alteration was identified in at least one genomic region in 170 (83%) patients. Two patients exhibited a high tumor mutation burden. Seventeen (8%) patients harbored a germline pathogenic/likely pathogenic variant in cancer-predisposing genes. This study highlighted the feasibility of implementing a nationwide precision medicine platform and the clinical utility of the TOP2 system for pediatric cancers. The results support the integration of genomic data into the standard clinical care of pediatric patients with cancer, both at diagnosis and at relapse.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 Okayama2772-3755112025Robustness of the RGB image-based estimation for rice above-ground biomass by utilizing the dataset collected across multiple locations100998ENKotaNakajimaGraduate School of Agriculture, Kyoto UniversityKazukiSaitoInternational Rice Research Institute (IRRI)YasuhiroTsujimotoJapan International Research Center for Agricultural SciencesToshiyukiTakaiJapan International Research Center for Agricultural SciencesAtsushiMochizukiCHIBA Prefectural Agriculture and Forestry Research CenterTomoakiYamaguchiFaculty of Applied Biological Sciences, Gifu UniversityAliIbrahim Africa Rice Center (AfricaRice), Regional Station for the SahelSalifou GoubeMairouaAfrica Rice Center (AfricaRice)Bruce HajaAndrianaryLaboratoire des Radioisotopes, Université d′AntananarivoKeisukeKatsuraGraduate School of Agriculture, Kyoto UniversityYuTanakaGraduate School of Environment, Life, Natural Science and Technology, Okayama UniversityAbove-ground biomass (AGB) is a critical phenotype representing crop growth. Non-invasive evaluations of AGB, including deep-learning-based red-green-blue (RGB) image analyses, are often specific to the training data. The robustness of the estimation model across untrained conditions is essential to monitor crop productivity globally, but it has yet to be fully assessed. This study aims to assess the robustness of a convolutional neural network (CNN) model for rice AGB estimation across five locations in three countries, and to demonstrate the feasibility of robust model via a practical approach. From transplanting to heading, 1957 RGB images were captured vertically downward over the rice canopy, covering approximately 1 m2. First, a base model was established using data collected from a single location. Then, its robustness was assessed using test datasets taken from the other four locations. The CNN model showed a significant variation in estimation accuracy across the untrained four locations, indicating insufficient robustness of the base model. Subsequently, we quantitatively tested the impact of improving training data diversity on model robustness by adding data from each of the four locations to the base model's training data. Adding at most 48 data points from a location achieved practical accuracy for the added location, with R2Ad above 0.8. Interestingly, adding data from one location sometimes improved the accuracy for other untrained locations as well. These findings suggest that collecting diverse training data for RGB-based estimation, combined with evaluation of robustness paves the way for on-site and instant AGB monitoring of rice.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 Okayama0386-300X7962025Exacerbation of Proteinuria in a Patient with Behçet’s Disease and IgA Nephropathy Following Colchicine Discontinuation457461ENTomohikoAsakawaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesHaruhito A.UchidaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesYuKatayamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesYoshimasaSakurabuDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKatsuyoshiKatayamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroOnishiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesNatsumiMatsuoka-UchiyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesHidemiTakeuchiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKeikoTanakaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKenjiTsujiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesRyokoUmebayashiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesRikaTakemotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/69849This case involves a 23-year-old male who was diagnosed with Behçet’s disease 5 years ago and managed with colchicine. Two months ago, he underwent renal biopsy due to abnormal urinalysis and kidney dysfunction, leading to a diagnosis of IgA nephropathy. He subsequently underwent tonsillectomy followed by glucocorticoid pulse therapy. However, after the tonsillectomy, discontinuing colchicine led to increased proteinuria, despite the glucocorticoid pulse therapy. Upon reintroducing colchicine, urinary protein excretion decreased, achieving incomplete remission. These findings suggest that colchicine may be effective in decreasing proteinuria in patients with Behçet’s disease complicated by IgA nephropathy.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7962025Effects of Thoron Inhalation and Cyclosporin A Treatment on Dextran Sulfate Sodium-Induced Oxidative Damage in Mice421429ENAyumiTanakaGraduate School of Health Sciences, Okayama UniversityShotaNaoeGraduate School of Health Sciences, Okayama UniversityReijuTakenakaGraduate School of Health Sciences, Okayama UniversityNorieKanzakiNingyo-toge Environmental Engineering Center, Japan Atomic Energy AgencyAkihiroSakodaNingyo-toge Environmental Engineering Center, Japan Atomic Energy AgencyKiyonoriYamaokaFaculty of Health Sciences, Okayama UniversityTakahiroKataokaFaculty of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/69844Radon (222Rn; Rn) and thoron (220Rn; Tn) inhalation have been reported to enhance antioxidant activity in various organs. However, the effects of Tn on the colon have not been investigated. This study aimed to clarify the effects of Tn inhalation, alone and in combination with cyclosporin A (CsA), on dextran sulfate sodium (DSS)-induced colitis, and the accompanying oxidative stress, in mice. Male BALB/c mice were subjected to continuous 8-day Tn inhalation (c-Tn, 533±128 Bq/m3) or alternate-day Tn inhalation over the same period (f-Tn, 577±63Bq/m3), followed by treatment with 3% DSS and either CsA or vehicle for 7 days. Although the disease activity index (DAI) decreased significantly by day 2 in the c-Tn group, scores remained significantly higher than those in the f-Tn group. In the c-Tn group, superoxide dismutase and catalase activity in the colon were significantly elevated compared with those in sham controls. Thus, DSS-induced damage was effectively inhibited in the earlier stages by the c-Tn mode of inhalation than by the f-Tn mode. These findings suggest that continuous Tn inhalation more effectively attenuated early colitis symptoms than alternate-day inhalation, potentially through upregulation of antioxidant defenses. Tn and CsA showed no combined effects.No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama2155-543515142025Mesoporous Oxyhalide Aggregates Exhibiting Improved Photocatalytic Activity for Visible-Light H2 Evolution and CO2 Reduction1255112562ENHirotoUekiDepartment of Chemistry, School of Science, Institute of Science TokyoToshiyaTanakaDepartment of Chemistry, School of Science, Institute of Science TokyoShujiAnabukiGraduate School of Natural Science and Technology, Okayama UniversityRyuichiNakadaDepartment of Chemistry, School of Science, Institute of Science TokyoMegumiOkazakiDepartment of Chemistry, School of Science, Institute of Science TokyoKentaAiharaDepartment of Chemistry, School of Science, Institute of Science TokyoMasashiHattoriMaterials and Structures Laboratory, Institute of Integrated Research, Institute of Science TokyoFumitakaIshiwariDepartment of Applied Chemistry, Graduate School of Engineering, Osaka UniversityRieHarukiInstitute of Materials Structure Science, High Energy Accelerator Research OrganizationShunsukeNozawaInstitute of Materials Structure Science, High Energy Accelerator Research OrganizationToshiyukiYokoiNanospace Catalysis Unit, Institute of Integrated Research, Institute of Science TokyoMichikazuHaraMaterials and Structures Laboratory, Institute of Integrated Research, Institute of Science TokyoOsamuIshitaniDepartment of Chemistry, Graduate School of Advanced Science and Engineering, Hiroshima UniversityAkinoriSaekiDepartment of Applied Chemistry, Graduate School of Engineering, Osaka UniversityAkiraYamakataGraduate School of Natural Science and Technology, Okayama UniversityKazuhikoMaedaDepartment of Chemistry, School of Science, Institute of Science TokyoOxyhalides are promising visible-light photocatalysts for water splitting and CO2 conversion; however, those exhibiting high activity for these reactions have rarely been reported. Here, we show that using water-soluble Ti complexes as precursors in the microwave-assisted hydrothermal synthesis of the oxyhalide photocatalyst Pb2Ti2O5.4F1.2 (PTOF) resulted in the production of nanoparticulate PTOF. The primary particle size of the synthesized PTOF ranged from several tens of nanometers to several hundreds of nanometers. Using Ti-citric acid or Ti-tartaric acid complexes as precursors, the PTOF was formed as mesoporous aggregates, compared with a bulky analogue (0.5–1 μm) prepared using a TiCl4 precursor. The PTOF prepared from Ti-citric acid complex had a particle size of 50–100 nm and showed a one-order-of-magnitude greater activity for H2 evolution from an aqueous ethylenediaminetetraacetic acid solution with the aid of a Rh cocatalyst. An apparent quantum yield (AQY) of 15.4 ± 1.0% at 420 nm, which is the highest among the reported oxyhalide photocatalysts, was achieved under optimal conditions. Although excess particle size reduction of PTOF lowered the H2 evolution activity, the PTOF with the smallest possible primary particle size of 15–30 nm, prepared from Ti-tartaric acid complex, showed the highest activity toward the selective reduction of CO2 into formate in a nonaqueous environment when combined with a binuclear Ru(II) complex. The CO2 reduction AQY was 10.4 ± 1.8% at 420 nm, a record-high value among metal-complex/semiconductor binary hybrid photocatalysts. This study highlights the importance of morphological control of oxyhalides for realizing their full potential as photocatalysts for artificial photosynthesis.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2399-3642812025Single-cell and spatial transcriptomic characterization of pulmonary pleomorphic carcinoma1773ENAtsushiMatsuokaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhikoShienDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShutaTomidaMasayoshiOhkiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuyaHisamatsuDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyotaFujiwaraDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoseiIshimuraDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyunosukeFujiiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomoakiHigashiharaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaohiroHayashiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhiroOkadaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoYoshichikaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFumiakiMukoharaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMaoYoshikawaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYumaFukumotoDepartment 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 SciencesYasuakiTomiokaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinTanakaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentarohMiyoshiDepartment 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 SciencesSeiichiroSugimotoDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusukeOtaniDepartment of Pathology, Beth Israel Deaconess Medical CenterAtsushiTanakaDepartment of Pathology, Beth Israel Deaconess Medical CenterHirofumiInoueCenter for Comprehensive Genomic Medicine, Okayama University HospitalYosukeTogashiDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHidetakaYamamotoDepartment of Pathology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaisukeEnnishiCenter for Comprehensive Genomic Medicine, Okayama University HospitalShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesPulmonary pleomorphic carcinoma (PPC) is a rare subtype of lung cancer that comprises both epithelial and sarcomatoid components. The molecular basis of PPC, including the cellular dynamics of its components, remains largely unknown. To elucidate potential therapeutic targets for PPC, we perform a multi-omics analysis incorporating digital spatial profiling and single-cell RNA sequencing (scRNA-seq). PPC exhibits diverse driver gene alterations, including MET exon 14 skipping mutation (METex14) and ALK fusion. In spatial transcriptomics, MET gene and protein are overexpressed exclusively within the epithelial component and not in the sarcomatoid component, even in patients harboring METex14. Epithelial-mesenchymal transition (EMT)-related transcriptional changes, along with extracellular matrix (ECM) remodeling between the epithelial and sarcomatoid components, are observed. scRNA-seq identifies cell populations within the epithelial component that contribute to the malignant transformation and differentiation of the sarcomatoid component. They are characterized by an intermediate EMT state with ECM remodeling signature, suggesting their potential as novel therapeutic targets for PPC.No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama2771-93162025Photochemical Macrolactonization of Hydroxyaldehydes via C–H BrominationENSakuraKodakiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHaruAndoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHiroyoshiTakamuraGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityIsaoKadotaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKentaTanakaResearch Institute for Interdisciplinary Science, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-291864232025Remarkable Efficacy of Capmatinib in a Patient with Cancer of Unknown Primary with MET Amplification34603464ENTakaakiTanakaDepartment of Respiratory Medicine, Okayama University HospitalGoMakimotoDepartment of Respiratory Medicine, Okayama University HospitalRyoheiSumiiDepartment of General Internal Medicine, NHO Fukuyama Medical CenterRikaOmoteDepartment of Pathology, NHO Fukuyama Medical CenterYayoiAndoClinical Research Support Office, National Cancer Center HospitalKiichiroNinomiyaCenter for Comprehensive Genomic Medicine, Okayama University HospitalEikiIchiharaCenter for Clinical Oncology, Okayama University HospitalKadoakiOhashiDepartment of Respiratory Medicine, Okayama University HospitalYoshinobuMaedaDepartment of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasahiroTabataCenter for Clinical Oncology, Okayama University HospitalThis case report describes a 70-year-old female with cancer of unknown primary origin (CUP) who exhibited multiple distant lymph node metastases. Despite conventional chemotherapy (carboplatin and paclitaxel) and immunotherapy (nivolumab), disease progression was noted. Genomic profiling revealed MET amplification, leading to the administration of capmatinib, a selective MET tyrosine kinase inhibitor. The patient experienced substantial tumor reduction with dose adjustments due to adverse effects, indicating the potential efficacy of capmatinib in treating CUP with MET amplification.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221512025Long intervals between repetitive concussions reduce risk of cognitive impairment and limit microglial activation, astrogliosis, and tauopathy in adolescent rats40522ENYuichiHirataDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University HospitalKyoheiKinDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University HospitalTakayukiNagaseDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University HospitalTatsuyaSasakiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University HospitalSusumuSasadaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University HospitalChiakiSugaharaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University HospitalTakahiroHirayamaDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University HospitalKojiKawaiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University HospitalShunTanimotoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University HospitalHayatoMiyakeDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University HospitalTomoyaSaijoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University HospitalHiromichiNaitoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University HospitalKaoriMasaiDepartment of Medical Neurobiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakaoYasuharaYasuhara ClinicShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University HospitalAlthough previous studies have demonstrated the effects of concussions do not accumulate as the time interval between injuries increases, little is known about the relationship between this interval and the effects of repetitive concussions. The objective of this study is to explore the relationship between the time interval and changes in behavior and histology following repetitive concussions. Male adolescent rats received concussions by weight drop and were randomly assigned to one of five experimental groups, receiving concussions three times either daily, every other day, once per week, once every 2 weeks, or receiving sham procedures. Only rats that received daily concussions exhibited cognitive impairment, while the other groups did not. No groups showed motor or anxiety-like impairments. Histological analysis revealed accumulation of microglia, as well as astrogliosis, in the prefrontal cortex, corpus callosum, dentate gyrus, and cornu Ammonis 1 region of the hippocampus in rats subjected to daily concussions. Accumulation of phosphorylated tau was also observed in the prefrontal cortex and cornu Ammonis 1. Longer intervals between concussions may reduce the risk of cognitive impairment and limit microglial activation, astrogliosis, and phosphorylated tau accumulation. These findings may help guide decisions on the appropriate timing for return to play in humans.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.Acta Medica Okayama2025Coherence Generation in Atomic Cesium for Cosmic Dark Matter DetectionENJINGWANGGraduate School of Natural Science and Technology, Okayama universityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025High Prevalence of MYD88 and CD79B Mutations in Primary Sinonasal Diffuse Large B-Cell Lymphoma: Identification of an MCD-like SubtypeENFANGLIPENGGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Changes of leucine-rich alpha 2 glycoprotein could be a marker of changes of endoscopic and histologic activity of ulcerative colitisENYukiAOYAMAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Repeated non-hemorrhagic and non-contusional mild traumatic brain injury in rats elicits behavioral impairment with microglial activation, astrogliosis, and tauopathy: Reproducible and quantitative model of chronic traumatic encephalopathyENChiakiSUGAHARAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Avoidant/restrictive food intake disorder prognosis and its relation with autism spectrum disorder in Japanese childrenENChieTANAKAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1465-36215542025Current management of neurotrophic receptor tyrosine kinase fusion-positive sarcoma: an updated review313326ENYutaKubotaDepartment of Orthopaedic Surgery, Faculty of Medicine, Oita UniversityMasanoriKawanoDepartment of Orthopaedic Surgery, Faculty of Medicine, Oita UniversityTatsuyaIwasakiDepartment of Orthopaedic Surgery, Faculty of Medicine, Oita UniversityIchiroItonagaDepartment of Orthopaedic Surgery, Faculty of Medicine, Oita UniversityNobuhiroKakuDepartment of Orthopaedic Surgery, Faculty of Medicine, Oita UniversityToshifumiOzakiDepartment of Orthopaedic Surgery , Science of Functional Recovery and Reconstruction, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazuhiroTanakaDepartment of Orthopaedic Surgery, Faculty of Medicine, Oita UniversityIn recent years, pembrolizumab has demonstrated significant efficacy in treating tumors characterized by a high tumor mutational burden and high microsatellite instability. Tropomyosin receptor kinase (TRK) inhibitors have shown considerable efficacy against tumors harboring neurotrophic receptor tyrosine kinase (NTRK) fusion genes, highlighting the growing importance of personalized medicine in cancer treatment. Advanced sequencing technologies enable the rapid analysis of numerous genetic abnormalities in tumors, facilitating the identification of patients with positive biomarkers. These advances have increased the likelihood of providing effective, tailored treatments. NTRK fusion genes are present in various cancer types, including sarcomas, and the TRK inhibitors larotrectinib and entrectinib have been effectively used for these malignancies. Consequently, the treatment outcomes for NTRK fusion-positive tumors have improved significantly, reflecting a shift toward more personalized therapeutic approaches. This review focuses on NTRK fusion-positive sarcomas and comprehensively evaluates their epidemiology, clinical features, and radiological and histological characteristics. We also investigated the treatment landscape, including the latest methodologies involving TRK inhibitors, and discussed the long-term efficacy of these inhibitors, and their optimal order of use. Notably, larotrectinib has demonstrated a high response rate in infantile fibrosarcoma, and its efficacy has been confirmed even in advanced cases. However, further research is warranted to optimize treatment duration and subsequent management strategies. The accumulation of clinical cases worldwide will play a pivotal role in refining the treatment approaches for tumors associated with NTRK fusion genes.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221512025Hypoglycemia and hyperinsulinemia induced by phenolic uremic toxins in CKD and DKD patients5762ENYoshiyasuTonguTohoku University School of MedicineTomokoKasaharaDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineYasutoshiAkiyamaLaboratory of Oncology, Pharmacy Practice and Sciences, Tohoku University Graduate School of Pharmaceutical SciencesTakehiroSuzukiDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineHsin-JungHoDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineYotaroMatsumotoLaboratory of Oncology, Pharmacy Practice and Sciences, Tohoku University Graduate School of Pharmaceutical SciencesRyotaKujiraiLaboratory of Oncology, Pharmacy Practice and Sciences, Tohoku University Graduate School of Pharmaceutical SciencesKoichiKikuchiDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineKojiNataDepartment of Medical Biochemistry, School of Pharmacy, Iwate Medical UniversityMakotoKanzakiDepartment of Biomedical Engineering, Tohoku UniversityKenshinSuzukiTohoku University School of MedicineShunWatanabeDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineChiharuKawabeDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineYuiMiyataDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineShunItaiDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineTakafumiToyoharaDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineChitoseSuzukiDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineTetsuhiroTanakaDivision of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of MedicineJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshihisaTomiokaLaboratory of Oncology, Pharmacy Practice and Sciences, Tohoku University Graduate School of Pharmaceutical SciencesTakaakiAbeDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicinePatients with end-stage renal disease have lower fasting plasma glucose and HbA1c levels, with significantly higher insulin levels. For a long time, it has been believed that this higher insulin level in renal failure is due to decreased insulin clearance caused by reduced renal function. However, here we reported that accumulation of the gut microbiota-derived uremic toxin, phenyl sulfate (PS) in the renal failure, increased insulin secretion from the pancreas by enhanced glucose-stimulated insulin secretion. Other endogenous sulfides compounds which accumulated as in the renal failure also increased glucose-stimulated insulin secretion from β-cell. With RNA-seq analyses and gene knock down, we demonstrated that insulin secretion evoked by PS was mediated by Ddah2. In addition, we also found that PS increased insulin resistance through lncRNA expression and Erk phosphorylation in the adipocytes. To confirm the relationship between PS and glucose metabolism in human, we recruited 2 clinical cohort studies (DKD and CKD) including 462 patients, and found that there was a weak negative correlation between PS and HbA1c. Because these trials did not measure fasting insulin level, we alternatively used the urinary C-peptide/creatinine ratio (UCPCR) as an indicator of insulin resistance. We found that PS may induce insulin resistance in patients with eGFR < 60 mL/min/1.73 m2. These data suggest that the accumulation of uremic toxins modulates glucose metabolism and induced insulin resistance in CKD and DKD patients. Considering HbA1c as a reflection of chronic hyperglycemia and UCPCR as a reflection of chronic hyperinsulinemia, our findings indicate that PS is negatively associated with hyperglycemia independent of CKD, and positively associated with hyperinsulinemia in DKD patients.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0929-19032025p53-armed oncolytic adenovirus induces apoptosis in pancreatic cancer-associated stellate cells via macropinocytosisENTakeyoshiNishiyamaDepartment 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 SciencesYasuoNagaiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoheiShojiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshinoriKajiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaoyukiHashimotoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYosukeTakahashiDepartment 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 SciencesShinjiKurodaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiakiOharaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhiroNomaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyuichiYoshidaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuzoUmedaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyoshi Y.TanakaDepartment of Pharmaceutical Biomedicine, Okayama University Graduate School of Interdisciplinary Science and Engineering in Health SystemsMitsunobu R.KanoDepartment of Pharmaceutical Biomedicine, Okayama University Graduate School of Interdisciplinary Science and Engineering in Health SystemsAtsushiMasamuneDivision of Gastroenterology, Tohoku University Graduate School of MedicineYasuoUrataOncolys BioPharma, Inc.ShunsukeKagawaDepartment 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 SciencesPancreatic ductal adenocarcinoma (PDAC)-associated pancreatic stellate cells (PSCs) promote PDAC tumor progression. Notably, PDAC tumors display enhanced macropinocytosis, resulting in enhanced uptake of extracellular particles, including nutrients and viruses. We previously demonstrated the therapeutic potential of telomerase-specific oncolytic adenoviruses OBP-301 and p53-armed OBP-702 against human PDAC cells. However, it remains unclear whether macropinocytosis promotes the virus sensitivity of PDAC-associated PSCs. Here, we show that PSCs activated by human PDAC cells (Panc-1 and BxPC-3) exhibit enhanced sensitivity to wild-type and oncolytic adenoviruses via enhanced macropinocytosis. The virus sensitivity of PSCs was analyzed for the infectivity, replication, and cytopathic activity of wild-type and oncolytic adenoviruses. PDAC-associated PSCs were more sensitive to wild-type and oncolytic adenoviruses than were control PSCs; this sensitivity was mediated by activation of macropinocytosis. In three-dimensional (3D) culture models, p53-armed OBP-702 decreased the viability of PDAC-associated PSCs more strongly than did non-armed OBP-301, reflecting induction of p53-mediated apoptosis. Co-inoculation of PSCs enhanced the growth of PDAC tumors, an effect that was attenuated by OBP-702-mediated p53 activation in the tumor stroma. Our results suggest that p53-armed oncolytic adenovirus OBP-702 eliminates PDAC-associated PSCs via enhancement of macropinocytosis-mediated virus entry and induction of p53-mediated apoptosis.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.American Society of HematologyActa Medica Okayama2473-95299182025Refinement of day 28 treatment response criteria for acute GVHD: a collaboration study of the JSTCT and MAGIC46404653ENYuAkahoshiDivision of Hematology/Medical Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount SinaiYoshihiroInamotoDepartment of Blood and Marrow Transplantation and Cellular Therapy, Fujita Health University School of MedicineNikolaosSpyrouDivision of Hematology/Medical Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount SinaiHidekiNakasoneDivision of Hematology, Jichi Medical University Saitama Medical CenterMarcio A.DinizDepartment of Population Health Science and Policy, Icahn School of Medicine at Mount SinaiNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalFrancisAyukDepartment of Stem Cell Transplantation, University Medical Center Hamburg-EppendorfHannah K.ChoeDivision of Hematology, Blood and Marrow Transplantation Program, The Ohio State University Comprehensive Cancer CenterNorikoDokiHematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalTetsuyaEtoDepartment of Hematology, Hamanomachi HospitalAaron M.EtraDivision of Hematology/Medical Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount SinaiElizabeth O.HexnerDepartment of Medicine and Abramson Cancer Center, Perelman School of Medicine, University of PennsylvaniaNobuhiroHiramotoDepartment of Hematology, Kobe City Medical Center General HospitalWilliam J.HoganDivision of Hematology, Mayo ClinicErnstHollerDepartment of Hematology and Oncology, Internal Medicine III, University of RegensburgKeisukeKataokaDivision of Molecular Oncology, National Cancer Center Research InstituteToshiroKawakitaDepartment of Hematology, National Hospital Organization Kumamoto Medical CenterMasatsuguTanakaDepartment of Hematology, Kanagawa Cancer CenterTakashiTanakaDivision of Hematopoietic Stem Cell Transplantation, National Cancer Center HospitalNaoyukiUchidaDepartment of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon HospitalIngridVasovaDepartment of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital ErlangenSatoshiYoshiharaDepartment of Hematology, Hyogo Medical University HospitalFumihikoIshimaruTechnical Department, Japanese Red Cross Blood Service HeadquartersTakahiroFukudaDivision of Hematopoietic Stem Cell Transplantation, National Cancer Center HospitalYi-BinChenHematopoietic Cell Transplant and Cellular Therapy Program, Massachusetts General HospitalJunyaKandaDepartment of Hematology, Graduate School of Medicine, Kyoto UniversityRyotaroNakamuraDepartment of Hematology and Hematopoietic Cell Transplantation, City of HopeYoshikoAtsutaJapanese Data Center for Hematopoietic Cell TransplantationJames L. M.FerraraDivision of Hematology/Medical Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount SinaiYoshinobuKandaDivision of Hematology, Jichi Medical University Saitama Medical CenterJohn E.LevineDivision of Hematology/Medical Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount SinaiTakanoriTeshimaDepartment of Hematology, Hokkaido University Faculty of Medicine and Graduate School of MedicineOverall response (OR) that combines complete (CR) and partial responses (PR) is the conventional end point for acute graft-versus-host disease (GVHD) trials. Because PR includes heterogeneous clinical presentations, reclassifying PR could produce a better end point. Patients in the primary treatment cohort from the Japanese Society for Transplantation and Cellular Therapy (JSTCT) were randomly divided into training and validation sets. In the training set, a classification and regression tree algorithm generated day 28 refined response (RR) criteria based on symptoms at treatment and day 28. We then evaluated RR for primary and second-line treatments, using the area under the receiver operating characteristic curve (AUC) and negative predictive value (NPV) for 6-month nonrelapse mortality as performance measures. RR considered patients with grade 0/1 at day 28 without additional treatment as responders. RR for primary treatment produced higher AUCs than OR with small improvement of NPVs in both validation sets: JSTCT (AUC, 0.73 vs 0.69 [P < .001]; NPV, 92.0% vs 89.6% [P < .001]) and the Mount Sinai Acute GVHD International Consortium (MAGIC; AUC, 0.71 vs 0.68 [P = .032]; NPV, 90.9% vs 89.8% [P = .009]). RR for second-line treatment produced similar AUCs but much higher NPVs than OR in both validation sets of JSTCT (AUC, 0.64 vs 0.63 [P = .775]; NPV, 74.5% vs 66.0% [P < .001]) and MAGIC (AUC, 0.67 vs 0.64 [P = .105]; NPV, 86.8% vs 76.1% [P = .004]). Classifying persistent but mild skin symptoms as responses and residual lower gastrointestinal GVHD as nonresponses were major drivers in improving the prognostic performance of RR. Our externally validated day 28 RR would serve as a better end point than conventional criteria in future first- and second-line treatment trials.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.Elsevier BVActa Medica Okayama0014-48863862025Therapeutic effects of intracerebral transplantation of human modified bone marrow-derived stromal cells (SB623) with voluntary and forced exercise in a rat model of ischemic stroke115145ENTakayukiNagaseDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakaoYasuharaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKyoheiKinDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSusumuSasadaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiKawauchiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoruYabunoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChiakiSugaharaDepartment 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 SciencesHayatoMiyakeDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTatsuyaSasakiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKojiKawaiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShunTanimotoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomoyaSaijoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesIschemic stroke results in significant long-term disability and mortality worldwide. Although existing therapies, such as recombinant tissue plasminogen activator and mechanical thrombectomy, have shown promise, their application is limited by stringent conditions. Mesenchymal stem cell (MSC) transplantation, especially using SB623 cells (modified human bone marrow-derived MSCs), has emerged as a promising alternative, promoting neurogenesis and recovery. This study evaluated the effects of voluntary and forced exercise, alone and in combination with SB623 cell transplantation, on neurological and psychological outcomes in a rat model of ischemic stroke. Male Wistar rats that had undergone middle cerebral artery occlusion (MCAO) were divided into six groups: control, voluntary exercise (V-Ex), forced exercise (F-Ex), SB623 transplantation, SB623 + V-Ex, and SB623 + F-Ex. Voluntary exercise was facilitated using running wheels, while forced exercise was conducted on treadmills. Neurological recovery was assessed using the modified neurological severity score (mNSS). Psychological symptoms were evaluated through the open field test (OFT) and forced swim test (FST), and neurogenesis was assessed via BrdU labeling. Both exercise groups exhibited significant changes in body weight post-MCAO. Both exercises enhanced the treatment effect of SB623 transplantation. The forced exercise showed a stronger treatment effect on ischemic stroke than voluntary exercise alone, and the sole voluntary exercise improved depression-like behavior. The SB623 + F-Ex group demonstrated the greatest improvements in motor function, infarct area reduction, and neurogenesis. The SB623 + V-Ex group was most effective in alleviating depression-like behavior. Future research should optimize these exercise protocols and elucidate the underlying mechanisms to develop tailored rehabilitation strategies for stroke patients.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1471-22532512025Clinical predictors of extubation failure in postoperative critically ill patients: a post-hoc analysis of a multicenter prospective observational study127ENJunHattoriFaculty of Medicine, Osaka UniversityAikoTanakaDepartment of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of MedicineJunkoKosakaDepartment of Anesthesiology and Resuscitology, Okayama University HospitalOsamuHiraoDepartment of Anesthesiology, Osaka General Medical CenterNanaFurushimaDepartment of Anesthesiology and Intensive Care Medicine, Kobe University HospitalYuichiMakiDepartment of Anesthesiology, Toho University Ohashi Medical CenterDaijiroKabataCenter for Mathematical and Data Science, Kobe UniversityAkinoriUchiyamaDepartment of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of MedicineMoritokiEgiDepartment of Anesthesia, Kyoto University HospitalHiroshiMorimatsuDepartment of Anesthesiology and Resuscitology, Okayama University HospitalSatoshiMizobuchiDepartment of Anesthesiology and Intensive Care Medicine, Kobe University HospitalYoshifumiKotakeDepartment of Anesthesiology, Toho University Ohashi Medical CenterAyumiShintaniDepartment of Medical Statistics, Graduate School of Medicine, Osaka Metropolitan UniversityYukikoKoyamaDepartment of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of MedicineTakeshiYoshidaDepartment of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of MedicineYujiFujinoDepartment of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of MedicineBackground Postoperative patients constitute majority of critically ill patients, although factors predicting extubation failure in this group of patients remain unidentified. Aiming to propose clinical predictors of reintubation in postoperative patients, we conducted a post-hoc analysis of a multicenter prospective observational study.<br>
Methods This study included postoperative critically ill patients who underwent mechanical ventilation for > 24 h and were extubated after a successful 30-min spontaneous breathing trial. The primary outcome was reintubation within 48 h after extubation, and clinical predictors for reintubation were investigated using logistic regression analyses.<br>
Results Among the 355 included patients, 10.7% required reintubation. Multivariable logistic regression identified that the number of endotracheal suctioning episodes during the 24 h before extubation and underlying respiratory disease or pneumonia occurrence were significantly associated with reintubation (adjusted odds ratio [OR] 1.11, 95% confidence interval [CI] 1.05–1.18, p < 0.001; adjusted OR 2.58, 95%CI 1.30–5.13, p = 0.007). The probability of reintubation was increased significantly with the higher frequency of endotracheal suctioning, as indicated by restricted cubic splines. Subgroup analysis showed that these predictors were consistently associated with reintubation regardless of the use of noninvasive respiratory support after extubation.<br>
Conclusions Endotracheal suctioning frequency and respiratory complications were identified as independent predictors of reintubation. These readily obtainable predictors may aid in decision-making regarding the extubation of postoperative patients.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.Japan Neurosurgical SocietyActa Medica Okayama2188-4226122025Endovascular Thrombectomy for Large Vessel Occlusion in a Patient on Venoarterial Extracorporeal Membrane Oxygenation: A Case Report445451ENYukiEBISUDANIDepartment 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 SciencesKeiichiroIWASAKIDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenjiSUGIUDepartment 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 SciencesRyuKIMURADepartment 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 SciencesYutaSOTOMEDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakahiroNISHIHARADepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinsukeYUASADepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShotaTANAKADepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesExtracorporeal membrane oxygenation is utilized in the treatment of severe acute cardiac failure and respiratory failure. While it provides the advantage of oxygenating blood through extracorporeal circulation, it also carries risks of intracranial ischemic and hemorrhagic complications due to the continuous presence of artificial materials within the body. We encountered a case in which venoarterial extracorporeal membrane oxygenation was initiated for fulminant myocarditis, and the patient subsequently developed a large vessel occlusion. The diagnosis was confirmed using perfusion computed tomography. A visible thrombus was observed on the arterial cannula of the extracorporeal membrane oxygenation circuit, and the large vessel occlusion was determined to have been caused by thromboembolism. An immediate extracorporeal membrane oxygenation circuit exchange was performed, followed by endovascular thrombectomy. The patient experienced no perioperative complications and achieved a favorable neurological outcome. Endovascular thrombectomy in extracorporeal membrane oxygenation patients requires careful perioperative management and should be promptly performed in eligible cases of thromboembolic events. Furthermore, because patients on extracorporeal membrane oxygenation are often sedated and under intensive systemic management, regular neurological assessments and intracranial monitoring are essential for the early detection of intracranial pathologies.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.Royal Society of Chemistry (RSC)Acta Medica Okayama1359-734561892025The direct photochemical cross-esterification of alcohols via site-selective C–H bromination site-selective C–H bromination1736417367ENAtsuyaMiyamotoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHiroyoshiTakamuraGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityIsaoKadotaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKentaTanakaResearch Institute for Interdisciplinary Science, Okayama UniversityWe have developed a direct photochemical cross-esterification of alcohols that proceeds via the in situ generation of acyl bromides. The C–H bond of a benzyl alcohol is selectively activated by a bromo source under light irradiation, enabling the cross-esterification to afford a variety of functionalized esters.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.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.Elsevier BVActa Medica Okayama0022-510X4782025Two Japanese families with adult-onset leukoencephalopathy caused by pathogenic variants in CST3123708ENKentaOrimoDepartment of Precision Medicine Neurology, Graduate School of Medicine, The University of TokyoTakashiMatsukawaDepartment of Neurology, Graduate School of Medicine, The University of TokyoKazutakaShiomiDivision of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of MiyazakiRyojiGotoDepartment of Neurology, Graduate School of Medicine, The University of TokyoAkihikoMitsutakeDepartment of Neurology, Graduate School of Medicine, The University of TokyoYumikoKuromiDepartment of Neurology, Fukushima Medical UniversityNozomuMatsudaDepartment of Neurology, Fukushima Medical UniversityKazuakiKanaiDepartment of Neurology, Fukushima Medical UniversityRyoKurokawaDepartment of Radiology, Graduate School of Medicine, The University of TokyoHiroyukiIshiuraDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunMitsuiDepartment of Precision Medicine Neurology, Graduate School of Medicine, The University of TokyoJunkoNomotoInstitute of Medical Genomics, International University of Health and WelfareMasakiTanakaInstitute of Medical Genomics, International University of Health and WelfareYosukeOmaeGenome Medical Science Project, National Institute of Global Health and MedicineYosukeKawaiGenome Medical Science Project, National Institute of Global Health and MedicineKatsushiTokunagaGenome Medical Science Project, National Institute of Global Health and MedicineShojiTsujiDepartment of Neurology, Graduate School of Medicine, The University of TokyoTatsushiTodaDepartment of Neurology, Graduate School of Medicine, The University of TokyoCST3 (NM_000099.4) encodes cystatin C, whose C-terminal truncating variants in this gene have recently been reported to cause adult-onset leukoencephalopathy, characterized by headaches, transient neurological symptoms, and distinct imaging findings. We present four patients from two Japanese families, including one with a novel variant (c.358-2_395del). Three patients from one family developed chronic headaches around the age of 20, whereas the patient from the other family remained asymptomatic until his fifties. mRNA analysis of the patient with c.358-2_395del revealed a splicing alteration leading to an in-frame deletion (p.Lys120_Gln133del), representing the first CST3 variant that does not result in a truncated protein. These findings broaden our understanding of the clinical and genetic spectra of CST3-related leukoencephalopathy (114 words).No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1340-28383242025Reference-based chromosome-scale assembly of Japanese barley (Hordeum vulgare ssp. vulgare) cultivar Hayakiso 2 dsaf016ENTsuyoshiTanakaBioinformatics Unit, Research Center for Advanced Analysis, National Agriculture and Food Research OrganizationYuhiHaraguchiDepartment of Crop Production and Breeding, Fukuoka Agriculture and Forestry Research CenterTakatomoTodorokiDepartment of Crop Production and Breeding, Fukuoka Agriculture and Forestry Research CenterDaisukeSaishoBarley Germplasm Center, Institute of Plant Science and Resources, Okayama UniversityTomomiAbikoLaboratory of Agroecology, Graduate School of Bioresource and Bioenvironmental Sciences, Kyushu UniversityHiroomiKaiDepartment of Crop Production and Breeding, Fukuoka Agriculture and Forestry Research CenterCurrent advances in next-generation sequencing (NGS) technology and assembling programs permit construct chromosome-level genome assemblies in various plants. In contrast to resequencing, the genome sequences provide comprehensive annotation data useful for plant genetics and breeding. Herein, we constructed a reference-based genome assembly of winter barley (H. vulgare ssp. vulgare) cv. ‘Hayakiso 2’ using long and short read NGS data and barley reference genome sequences from ‘Morex’. We constructed ‘Hayakiso 2’ genome sequences covering 4.3 Gbp with 55,477 genes. Comparative genomics revealed that 14,106 genes had orthologs to two barley data, wheat (A, B, and D homoeologs, respectively), and rice. From the gene ontology analysis, 2,494 orthologs against wheat and rice but not two barley contained agricultural important genes, such as ‘response to biotic and abiotic stress’ and ‘metabolic process’. Phylogenetic analysis using 76 pangenome data indicated that ‘Hayakiso 2’ was clustered into Japanese-type genomes with unique alleles. ‘Hayakiso 2’ genome sequences showed known genes related to flowering and facilitated barley breeding through the development of various markers related to agronomically important alleles such as tolerance to various types of biotic and abiotic stress. Therefore, ‘Hayakiso 2’ genome sequences will be used for the further barley breeding.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.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.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025Gastroduodenal Artery-Preserving Pancreatoduodenectomy after Esophagectomy with Gastric Conduit Reconstruction393398ENAkariMasunagaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoseiTakagiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuoNagaiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuyaYasuiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokazuFujiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMotohikoYamadaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakeyoshiNishiyamaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNoriyukiKanehiraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYumiSotaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/69441Pancreatoduodenectomy (PD) after esophagectomy with gastric conduit reconstruction is technically challenging. Preserving the blood supply of the gastric conduit is crucial in performing PD after esophagectomy. We report the case of a 66-year-old man who underwent gastroduodenal artery-preserving PD after esophagectomy with gastric conduit reconstruction for intraductal papillary mucinous neoplasm. The patient developed pseudoaneurysm rupture postoperatively, but was successfully treated with interventional radiology. Precise assessment is important in developing a surgical strategy depending on the patient’s specific anatomy and tumor characteristics. Moreover, special attention should be paid to avoid accidental injuries of the gastric conduit and gastric vessels during surgery.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025The Utility of a Preoperative 3D Imaging Analysis System for Trigonal Meningioma387392ENYusukeMoriDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshihiroOtaniDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoOmaeDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuichiroHiranoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJojiIshidaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaroFujiiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunHarumaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasafumiHiramatsuDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiMatsushitaDivision of Radiological Technology, Okayama University HospitalFumiyoHigakiDepartment of Radiology, Medical Development Field, Okayama UniversityKenjiSugiuDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/69440Trigonal meningiomas are rare and pose surgical challenges due to their deep location and proximity to critical neuroanatomical structures. We present the case of a 67-year-old woman with a growing trigonal meningioma successfully resected with guidance by a preoperative 3D imaging analysis system. Integration of CT and MRI including diffusion tensor imaging (DTI) enabled precise mapping of the optic radiation, guiding a middle temporal gyrus approach. Preoperative embolization reduced tumor vascularity, facilitating gross total resection with minimal blood loss. This case highlights the effectiveness of preoperative 3D imaging systems in optimizing surgical planning and improving outcomes in complex neurosurgical cases.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025Advantages of Single-Position Surgery over Posterior Fusion for Single-Level Degenerative Lumbar Diseases359368ENTomohikoHiroseDepartment of Orthopedic Surgery, Kagawa Prefectural Central HospitalHisanoriIkumaDepartment of Orthopedic Surgery, Kagawa Prefectural Central HospitalKazutoshiOtsukaOtsuka Orthopedic ClinicKeisukeKawasakiDepartment of Orthopedic Surgery, Kagawa Prefectural Central HospitalOriginal Article10.18926/AMO/69437Single-position surgery with lateral lumbar interbody fusion (LLIF) and percutaneous pedicle screws (PPSs) is gaining attention for its reduced invasiveness. We developed SPAPS, a technique allowing two surgeons to perform anterior LLIF and posterior PPS insertion simultaneously in a single lateral decubitus position. This retrospective study compared SPAPS (SPAPS-LLIF, Group SL) and minimally invasive posterior/transforaminal lumbar interbody fusion (MIS-PLIF/TLIF, Group PT) in patients treated between 2016 and 2019 with a two-year follow-up. Operative time, estimated blood loss (EBL), length of hospital stay (LOS), JOABPEQ and VAS scores, segmental lordotic angle, lumbar lordotic angle, segmental Cobb’s angle, PPS misplacement, PPS loosening, fusion status, and muscle cross-sectional areas were compared. Fifty-two patients were analyzed (Group SL: 25; Group PT: 27). SPAPS significantly reduced operative time (118.0 vs. 165.3 min, p <0.01) and estimated blood loss (8.6 vs. 164.1 mL, p<0.01). While clinical outcomes and hospital stay were comparable, Group SL had significantly lower PPS loosening (0% vs. 13%, p<0.01) and non-union rates (0% vs. 22.2%, p=0.02). Multifidus muscle atrophy was also less in Group SL (−14.3 vs. −121.5 mm2, p<0.01). SPAPS demonstrated advantages in reducing surgical invasiveness without compromising clinical efficacy, offering a promising alternative to conventional posterior fusion surgery.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025Current Status of Extracorporeal Membrane Oxygenation as a Treatment Strategy for Primary Graft Dysfunction after Lung Transplantation329337ENKeiMatsubaraDepartment of Thoracic Surgery, Hiroshima City Hiroshima Citizens HospitalKentarohMiyoshiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesReview10.18926/AMO/69433Primary graft dysfunction (PGD) is one of the major risk factors affecting patients’ short- and long-term survival after lung transplantation. No particular management strategy has been established for PGD; supportive care is the mainstay of PGD treatment. When a supportive strategy fails, the patient may require the introduction of extracorporeal membrane oxygenation (ECMO) as the last-resort measure for severe PGD. A variety of study of ECMO as a PGD treatment was reported and the management of PGD patients developed so far. Early recognition of a patient’s need for ECMO and its prompt initiation are critical to improved outcomes. The use of venovenous-ECMO became the preferred procedure for PGD rather than venoarterial-ECMO. However, the current ECMO strategy has limitations, and using ECMO to manage patients with PGD is not sufficiently effective. Further studies are required to develop this promising technology.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025A Review of the Endoscopic Treatment for Bile Leak Following Cholecystectomy and Hepatic Surgery321328ENTaisukeObataDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalReview10.18926/AMO/69432Bile leak occurs in 2-25% of liver transplant, 3-27% of hepatic resection, and 0.1-4% of cholecystectomy cases. The clinical course of bile leak varies depending on the type of surgery that caused the fistula, as well as the type, severity, and timing of bile duct injury. Although infections resulting from bile leak can be life-threatening, the introduction of endoscopic treatment has enabled some patients to avoid reoperation and has reduced the negative impact on quality of life associated with external fistulas for percutaneous drainage. Endoscopic interventions, such as sphincterotomy and stent placement, reduce the pressure gradient between the bile duct and duodenum, facilitating bile drainage through the papilla and promoting the closure of the leak. We reviewed the literature from 2004 to 2024 regarding bile leak following cholecystectomy and liver surgery, examining recommended techniques, timing, and treatment outcomes. In cases of bile leak following cholecystectomy, clinical success was achieved in 72-96% of cases, while success rates for bile leak following liver surgery ranged from 50% to 100%. Although endoscopic treatment is effective, it is not universally applicable, and its limitations must be carefully considered.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama0305-736413572025Molecular polymorphisms of the nuclear and chloroplast genomes among African melon germplasms reveal abundant and unique genetic diversity, especially in Sudan13291343ENOdirichi NnennayaImohGraduate School of Environmental and Life Science, Okayama UniversityGentaroShigitaGraduate School of Environmental and Life Science, Okayama UniversityMitsuhiroSugiyamaInstitute of Vegetable and Floriculture Science, National Agriculture and Food Research Organization (NARO)Tran PhuongDungGraduate School of Environmental and Life Science, Okayama UniversityKatsunoriTanakaFaculty of Agriculture and Life Science, Hirosaki UniversityMamiTakahashiGraduate School of Environmental and Life Science, Okayama UniversityKazusaNishimuraGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYukiMondenGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHidetakaNishidaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMashaerGodaPlant Genetic Resources Conservation and Research Center, Agricultural Research CorporationMichelPitratINRAE, UR1052, Génétique et amélioration des fruits et légumesKenjiKatoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityBackground and Aims Africa is rich in wild species of Cucumis and is considered one of the places of origin of melon. However, our knowledge of African melon is limited, and genetic studies using melon germplasms with wide geographical coverage are required. Here, we analysed the genetic structure of African melons, with emphasis on Sudan.<br>
Methods Ninety-seven accessions of African melon were examined along with 77 reference accessions representing Asian melon and major horticultural groups. Molecular polymorphisms in the nuclear and chloroplast genomes were investigated using 12 RAPD, 7 SSR and 3 SNP markers. Horticultural traits, including seed size, were measured for 46 accessions, mainly from Sudan.<br>
Key Results African melons were divided into large and small seed-types based on seed length: large seed-type from Northern Africa and small seed-type from Western and Southern Africa. Both seed types are common in Sudan. Molecular genetic diversity in these geographical populations was as high as in India, the Asian centre of melon domestication. Large seed-types from Northern Africa were assigned to Pop4 by structure analysis and had Ib cytoplasm in common with Cantalupensis, Inodorus and Flexuosus. Small seed-types were highly diversified and geographically differentiated; specifically, Pop1 with Ia cytoplasm in Southern Africa and South Asia, Pop2 with Ia in East Asia, including Conomon and Makuwa, and Pop3 with Ia or Ic in Africa. Sudanese small seed-types were grouped in Pop3, while their cytoplasm type was a mixture of Ia and Ic. Sudanese Tibish had Ic cytoplasm, which was unique in Africa, common in Western Africa and Sudan, and also found in wild or feral types.<br>
Conclusions Melon of Ic lineage, including Tibish, originated from wild melon in the ‘western Sudan region’, and independently of melon with Ia or Ib cytoplasm, which originated in Asia. This clearly indicates the polyphyletic origin of melon.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0960-741212352025RNA processing/modifying enzymes play key roles in the response to thermospermine in Arabidopsis thalianae70476ENMitsuruSaraumiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTakahiroTanakaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityDaikiKoyamaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYoshitakaNishiGraduate School of Engineering, Kyushu Sangyo UniversityYoshihiroTakahashiDepartment of Life Science, Faculty of Life Science, Kyushu Sangyo UniversityHiroyasuMotoseGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTakuTakahashiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityThermospermine is involved in negative regulation of xylem differentiation by enhancing the translation of mRNAs of the SAC51 gene family in Arabidopsis (Arabidopsis thaliana). These mRNAs contain conserved upstream open reading frames (uORFs) that interfere with the translation of the main ORF. To investigate the mechanism by which thermospermine acts in this process, we isolated mutants insensitive to thermospermine, named ‘its’. We show that the four genes responsible for these mutants, its1 to its4, encode: (i) a homolog of SPOUT RNA methyltransferase, (ii) an rRNA pseudouridine synthase CBF5/NAP57, (iii) a putative spliceosome disassembly factor STIPL1/NTR1, and (iv) a plant-specific RNA-binding protein PHIP1. These four mutants were found to have much higher levels of thermospermine than the wild-type. While all these mutants except its1 appear almost normal, they enhance the dwarf phenotype of a mutant of ACL5, which encodes thermospermine synthase, resulting in tiny plants resembling a double knockout of ACL5 and SACL3, a member of the SAC51 family. Reporter assays revealed that GUS activity from the CaMV 35S promoter-SAC51 5′-GUS fusion construct was significantly reduced in its1 and its4 or not affected in its2 and its3, while it was slightly increased in its1, its3, and its4, or not changed in its2 by thermospermine. These findings underscore the critical role of RNA processing and modification in the thermospermine-dependent translational regulation of uORF-containing transcripts.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1367-22232812024Can online interactions reduce loneliness in young adults during university closures in Japan? The directed acyclic graphs approache12658ENKoheiKambaraDoshisha UniversityAkihiroToyaHiroshima UniversitySuminLeeHiroshima UniversityHarukaShimizuNishikyushu Univ. Junior CollegeKazuakiAbeHiroshima UniversityJunShigematsuToyama UniversityQingyuanZhangHiroshima UniversityNatsukiAbeHiroshima Bunkyo UniversityRyoHayaseChubu UniversityNobuhitoAbeKyoto UniversityRyusukeNakaiKyoto UniversityShuntaroAokiFukushima Medical UniversityKoheiAsanoKyoto UniversityRyosukeAsanoKurume UniversityMakotoFujimuraFukuoka Jo Gakuin UniversityKen’ichiroFukuiKwassui Women's UniversityYoshihiroFukumotoKansai Medical UniversityKaichiroFurutaniKansai UniversityKojiHasegawaKomazawa UniversityHirofumiHashimotoOsaka Metropolitan UniversityMikotoHashimotoChukyo Gakuin UniversityHirokiHosogoshiKansai UniversityHiroshiIkedaKyushu UniversityToshiyukiIshiokaKobe UniversityChiharuItoUniversity of Human EnvironmentsSuguruIwanoFukushima Medical UniversityMasafumiKamadaShujitsu Junior CollegeYoshihiroKanaiTohoku Gakuin UniversityTomonoriKaritaEhime UniversityYuKasagiRissho UniversityEmiko S.KashimaLa Trobe UniversityJuriKatoKanazawa Institute of TechnologyYousukeKawachiTohoku UniversityJun‐ichiroKawaharaHokkaido UniversityMasanoriKimuraGraduate School of Business Administration, Kobe UniversityYugoKiraKurume UniversityYukoKiyonaga (Sakoda)Kyushu Kyoritsu UniversityHiroshiKohguchiRyutsu Keizai UniversityAsukaKomiyaHiroshima UniversityKeitaMasuiOtemon Gakuin UniversityAkiraMidorikawaChuo UniversityNobuhiroMifuneKochi University of TechnologyAkimineMizukoshiAsahi UniversityKengoNawataFukuoka UniversityTakashiNishimuraHiroshima International UniversityDaisukeNogiwaSeikei UniversityKenjiOgawaHokkaido UniversityJunkoOkadaPrefectural University of HiroshimaAkiOkamotoOkayama UniversityReikoOkamotoOsaka UniversityKyokoSasakiKanagawa University of Human ServicesKosukeSatoKurume UniversityHiroshiShimizuKwansei Gakuin UniversityAtsushiSugimuraTokai UniversityYokoSugitaniSophia UniversityHitomiSugiuraKindai UniversityKyokoSumiokaOkayama UniversityBumpeiSunaguchiGraduate School of Business Administration, Kobe UniversityMasatakaTakebeOtsuma Women's UniversityHiroki C.TanabeNagoya UniversityAyumiTanakaDoshisha UniversityMasanoriTanakaHokkai‐Gakuen UniversityJunichiTaniguchiTezukayama UniversityNamijiTokunagaEhime Prefectural University of Health SciencesRyozoTomitaMusashino UniversityYumikoUedaAsahi UniversityTomomiYamashitaJumonji UniversityKazuhoYamauraRitsumeikan UniversityMasaoYogoDoshisha UniversityKenjiYokotaniTokushima UniversityAyanoYoshidaTohoku Fukushi UniversityHiroakiYoshidaShinshu UniversityKatsueYoshiharaFukuoka Institute of Technology Junior CollegeAyumiYoshikawaOsaka Dental University Faculty of NursingKuniakiYanagisawaKobe UniversityKen'ichiroNakashimaHiroshima UniversityAs a countermeasure to the increased loneliness induced by the COVID-19 pandemic-related university closures, universities provided students with online interaction opportunities. However, whether these opportunities contributed to reducing loneliness during the university closures remains unclear, as previous studies have produced contradictory findings. We conducted a nationwide cross-sectional survey. Data were collected on demographics, social environment, social support, interactions, health and loneliness from 4949 students from 60 universities across Japan. We used psychological network and Directed Acyclic Graphs (DAGs) to examine the effect of online interactions on loneliness during university closures during COVID-19. The results showed that the frequency of online interactions with friends did not exert a significant influence on loneliness during university closures. A comparative examination of the DAGs further illuminated that the social environment exhibited fewer pathways for interpersonal interactions and social support during these closure periods. The psychosocial pathways influencing young adults' loneliness show variations contingent on the university's closure status. Notably, the impact of heightened online interactions with friends on loneliness appears to be less pronounced among young adults in the context of university closure.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0016-70374002025Lithium- and oxygen-isotope compositions of a Si-rich nebular reservoir determined from chondrule constituents in the Sahara 97103 EH3 chondrite5171ENToriiDouglas-SongThe Pheasant Memorial Laboratory Institute for Planetary Materials, Okayama UniversityTsutomuOtaThe Pheasant Memorial Laboratory Institute for Planetary Materials, Okayama UniversityMasahiroYamanakaThe Pheasant Memorial Laboratory Institute for Planetary Materials, Okayama UniversityHiroshiKitagawaThe Pheasant Memorial Laboratory Institute for Planetary Materials, Okayama UniversityRyojiTanakaThe Pheasant Memorial Laboratory Institute for Planetary Materials, Okayama UniversityChristianPotiszilThe Pheasant Memorial Laboratory Institute for Planetary Materials, Okayama UniversityTakKunihiroThe Pheasant Memorial Laboratory Institute for Planetary Materials, Okayama UniversityHere we report the in situ ion-microprobe analyses of the Li- and O-isotope compositions of enstatite, FeO-rich pyroxene, olivine, glass, and cristobalite grains from six chondrule-related objects from the Sahara 97103 EH3 chondrite. The O-isotope composition of the enstatite grains scattered around the intersection between the terrestrial fractionation and primitive chondrule minerals lines. Whereas, that of olivine varied along the primitive chondrule minerals line. Based on the mineralogy, we found cristobalite formed as a result of Si saturation, instead of the reduction of FeO-rich silicates, consistent with Si-enrichment of whole rock enstatite chondrites. Based on the mineralogy and O-isotope compositions, we infer that olivines in some chondrules are relict grains. In chondrules that contained olivine, no abundant niningerite [(Mg,Fe,Mn)S] was observed. Thus, enstatite formation can be explained by the interaction of an olivine precursor with additional SiO2 (Mg2SiO4 + SiO2 → Mg2Si2O6), instead of sulfidation (Mg2SiO4 + S → 1/2 Mg2Si2O6 + MgS + 1/2 O2). Using the equation Mg2SiO4 + SiO2 → Mg2Si2O6 and the O-isotope compositions of enstatite and olivine, the O-isotope composition of the additional SiO2 was estimated. Based on the O-isotope composition, we infer that there could be a Si-rich gas with an elevated Δ17O value similar to, or greater than the second trend line (Δ17O = 0.9 ‰) suggested by Weisberg et al. (2021), during chondrule formation. The variation in the Li-isotope compositions of enstatite and olivine grains from EH3 chondrules is smaller than that for the same phases from CV3 chondrules. The variation in the Li-isotope compositions of the enstatite and olivine grains from EH3 chondrules is also smaller than that of their O-isotope compositions. During the recycling of enstatite-chondrite chondrules, both Li- and O-isotope compositions were homogenized. Although enstatite is the major carrier of Li in EH3 chondrules, the Li-isotope composition (δ7Li) of enstatite is lower than that of whole rock EH3 chondrites, suggesting the existence of a phase with higher δ7Li. Meanwhile, the Li-isotope composition and concentration (δ7Li, [Li]) of enstatite is higher than that of olivine. The Li-isotope composition of the Si-rich gas was estimated to be δ7Li = 1 ‰, using a similar mass-balance calculation as applied for the O-isotope composition. The Li-isotope composition of the Si-rich gas from the enstatite-chondrite-chondrule forming-region, is consistent with that of whole rock EH3 chondrites, and differs significantly from that of the Si-rich gas from the carbonaceous-chondrite-chondrule forming-region (δ7Li = −11 ‰) determined by a previous study. We speculate that the Si-rich gas in the carbonaceous-chondrite-chondrule forming-region maintained the Li-isotope heterogeneity inherited from light lithium synthesized by galactic cosmic-ray spallation in the interstellar medium.No potential conflict of interest relevant to this article was reported.Royal Society of Chemistry (RSC)Acta Medica Okayama1359-73452025Generation of alkyl radicals via C(sp3)–C(sp3) bond cleavage of xanthene-based precursors for photocatalytic Giese-type reactionENShutaHoriuchiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMasatoOishiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityAsukaMizutaniGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHiroyoshiTakamuraGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityIsaoKadotaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKentaTanakaResearch Institute for Interdisciplinary Science, Okayama UniversityNovel xanthene-based alkyl radical precursors were developed and subjected to photocatalytic C(sp3)–C(sp3) bond cleavage for the efficient generation of alkyl radicals, which were subsequently reacted with various alkenes to afford the corresponding Giese-type products. After the reaction, the produced xanthones can be recovered in high yield.No potential conflict of interest relevant to this article was reported.Japan Neurosurgical SocietyActa Medica Okayama0470-81056592025Real-world Experience of Embolization for Intracranial Tumors in Japan: Analysis of 2,756 Cases from Japanese Registry of NeuroEndovascular Therapy 4396406ENJunHARUMADepartment 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 SciencesTomohitoHISHIKAWADepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYutaSOUTOMEDepartment 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 SciencesRyuKIMURADepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHisanoriEDAKIDepartment of Neurosurgery, Kawasaki Medical SchoolMasatoKAWAKAMIDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiMURAIDepartment of Neurosurgery, Kawasaki Medical SchoolMasafumiHIRAMATSUDepartment 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 SciencesTetsuSATOWDepartment of Neurosurgery, Kindai UniversityKojiIIHARADepartment of Neurosurgery, National Cerebral and Cardiovascular CenterHirotoshiIMAMURADepartment of Neurosurgery, National Cerebral and Cardiovascular CenterAkiraISHIIDepartment of Neurosurgery, Juntendo University Graduate School of MedicineYujiMATSUMARUDepartment of Neurosurgery, Institute of Medicine, University of TsukubaChiakiSAKAIDepartment of Neurosurgery, Kyoto UniversityShinichiYOSHIMURADepartment of Neurosurgery, Hyogo Medical UniversityNobuyukiSAKAIDepartment of Neurological Surgery, Shimizu HospitalJapanese Registry of Neuroendovascular Therapy (JR-NET) InvestigatorsEmbolization of intracranial tumors is predominantly performed in Japan, primarily before neurosurgical resection. The Japanese Registry of NeuroEndovascular Therapy (JR-NET) Study Group, established in 2005, aims to clarify the factors influencing the outcomes of neuroendovascular treatment. Japanese Registry of NeuroEndovascular Therapy 4 is a nationwide, multicenter retrospective observational study that evaluates real-world data on intracranial tumor embolization in Japan. Japanese Registry of NeuroEndovascular Therapy 4 is based on data collected from 166 neurosurgical centers in Japan between January 2015 and December 2019. Of 63,230 patients, 2,664 (4.2%) with intracranial tumors underwent embolization. The primary endpoint was the proportion of patients with a modified Rankin scale (mRS) score of 0-2 at 30 days post-procedure. Secondary endpoints included procedure-related complications. Among the 2,664 patients, 61 records lacked sufficient data, leaving 2,603 patients (1,612 females, median age: 61 years [interquartile range 51-71]). The proportion of patients with mRS scores ≤2 at 30 days after the procedure was 86.9%. The overall incidence of procedure-related complications was 4.8%, with 1.8% hemorrhagic, 2.0% ischemic, and 1.0% classified as other complications. In the multivariate analysis, general anesthesia and embolization of vessels other than the external carotid artery were identified as risk factors for the development of complications. Meningioma cases had a complication rate of 4.3%, with major complications occurring in 3.5%. Hemangioblastoma cases had a 14.9% complication rate, with major complications at 9.9%. Japanese Registry of NeuroEndovascular Therapy 4 provides comprehensive real-world data on intracranial tumor embolization in Japan, identifying risk factors to inform and improve the safe practice of intracranial tumor embolization in neuroendovascular therapy.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2072-669417162025Prognostic Impact of Gastrointestinal Immune-Related Adverse Events Depends on Nutritional Status in Cancer Patients Treated with Immune Checkpoint Inhibitors2634ENShoichiroHirataDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshiyasuKonoDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityEmiTanakaDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasahikoSueDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYasutoTakeuchiDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomokiYoshikawaDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshieMakiDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomohiroKamioDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityDaisukeKametakaDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKatsunoriMatsuedaDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityChihiroSakaguchiDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKentaHamadaDepartment of Practical Gastrointestinal Endoscopy, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasayaIwamuroDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySeijiKawanoDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshiroKawaharaDepartment of Practical Gastrointestinal Endoscopy, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground: Gastrointestinal immune-related adverse events (GI-irAEs) are recognized complications of immune checkpoint inhibitors (ICIs), but their prognostic relevance and associated risk factors remain unclear. This study aimed to assess whether baseline nutritional status, measured using the prognostic nutritional index (PNI), modifies the prognostic impact of GI-irAEs, and to identify clinical factors associated with their occurrence. Methods: We retrospectively analyzed 1104 cancer patients treated with ICIs at a single institution. GI-irAEs were defined as gastrointestinal symptoms requiring clinical intervention. Patients were stratified by irAE type and PNI (≥40 vs. <40), and differences in survival and treatment response were evaluated. Potential risk factors for developing GI-irAEs were also examined. Results: GI-irAEs occurred in 2.7% of patients and were associated with prolonged overall survival (median: 28.7 vs. 14.0 months) among those with PNI ≥ 40. This survival advantage was not observed in patients with PNI < 40. The PNI-dependent prognostic pattern was specific to GI-irAEs and not observed for non-GI irAEs. Similar trends were confirmed in 4- and 8-week landmark analyses. Differences in objective response rate and disease control rate by PNI status were most pronounced in patients with GI-irAEs. The use of anti-CTLA-4 antibodies was significantly associated with GI-irAE development (odds ratio 4.24; 95% confidence interval 1.73–10.39). Conclusions: GI-irAEs appear to confer a survival benefit primarily in patients with preserved nutritional status. PNI may serve as a useful tool to contextualize the clinical relevance of GI-irAEs and help identify patients most likely to benefit from immune activation during ICI therapy.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841782025Craniofacial Fibrous Dysplasia to Affect or Not the Optic Nerve in Long-Term Follow-Up of Three Casese91072ENToshihikoMatsuoDepartment of Ophthalmology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama University HospitalTakehiroTanakaDepartment of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityKiyoshiYamadaDepartment of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityMitsuhiroOkanoDepartment of Otorhinolaryngology, School of Medicine, International University of Health and WelfareFibrous dysplasia of the bone is characterized by immature fibrous bones of trabeculae and fibrovascular proliferation in the medulla. In this study, we report three consecutive patients with craniofacial fibrous dysplasia with or without optic nerve involvement. In Case 1, a 43-year-old man with blurred vision in the right eye at the first visit was well until the age of 54 years, when he came back with symptoms suggestive of paranasal sinusitis. Computed tomography scans disclosed a mucocele in the right sphenoid sinus and thickened bilateral ethmoid, sphenoid, and frontal bones. He underwent an emergency nasal endoscopic surgery to make a drainage opening to the sphenoid and ethmoid sinuses on the right side with incomplete success. The pathology of the resected tissue confirmed fibrous dysplasia. With intravenous antibiotics, he recovered from blepharoptosis, complete ophthalmoplegia, and visual acuity decrease on the right side. He was well until the age of 71 years when he had a self-limiting episode of visual field cloudiness caused by the right sphenoid sinus mucocele. At the age of 75 years, he developed abrupt vision loss to no light perception in the right eye. He underwent an open skull surgery to extirpate the sphenoid mucocele on the right side and died of an unknown cause two years later. In Case 2, a 29-year-old man had a two-week-long headache, and computed tomography scans revealed fibrous dysplasia in the bilateral sphenoid bones. Nasal biopsy at the spheno-ethmoid recess proved a pathological diagnosis of fibrous dysplasia. Goldmann perimetry showed normal visual fields in both eyes. He was followed every year by magnetic resonance imaging to maintain normal visual fields until the latest visit at the age of 41 years. In Case 3, a 12-year-old girl was referred to an ophthalmologist to check her vision. She had been diagnosed with fibrous dysplasia of the left maxillary bone at the age of six years by a dentist. She had a gingival resection on the left maxilla at the age of 15 years and had a left maxillary bone resection at 18 years at another hospital. One month after the resection, Goldmann perimetry showed superior peripheral field depression in the left eye, in contrast with the normal visual field in the right eye. She maintained the visual acuity of 1.5 in both eyes until the last visit at the age of 21 years. In fibrous dysplasia as a rare disease, functional and cosmetic problems, including vision problems, should be considered in a case-based approach.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2227-905912102024Development and Characterization of a Three-Dimensional Organotypic In Vitro Oral Cancer Model with Four Co-Cultured Cell Types, Including Patient-Derived Cancer-Associated Fibroblasts2373ENYukaAizawaDivision of Biomimetics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityKentaHagaDivision of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityNagakoYoshibaDepartment of Oral Health and Welfare, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityWitsanuYortchanDivision of Biomimetics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityShoTakadaDivision of Biomimetics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityRintaroTanakaDivision of Biomimetics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityErikoNaitoDivision of Oral and Maxillofacial Surgery, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityTatsuyaAbéDivision of Oral Pathology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversitySatoshiMaruyamaDivision of Oral Pathology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityManabuYamazakiDivision of Oral Pathology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityJun-ichiTanumaDivision of Oral Pathology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityKazuyoIgawaNeutron Therapy Research Center, Okayama UniversityKeiTomiharaDivision of Oral and Maxillofacial Surgery, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityShinsakuTogoDepartment of Respiratory Medicine, Graduate School of Medicine, Juntendo UniversityKenjiIzumiDivision of Biomimetics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityBackground/Objectives: Cancer organoids have emerged as a valuable tool of three-dimensional (3D) cell cultures to investigate tumor heterogeneity and predict tumor behavior and treatment response. We developed a 3D organotypic culture model of oral squamous cell carcinoma (OSCC) to recapitulate the tumor–stromal interface by co-culturing four cell types, including patient-derived cancer-associated fibroblasts (PD-CAFs). Methods: A stainless-steel ring was used twice to create the horizontal positioning of the cancer stroma (adjoining normal oral mucosa connective tissue) and the OSCC layer (surrounding normal oral mucosa epithelial layer). Combined with a structured bi-layered model of the epithelial component and the underlying stroma, this protocol enabled us to construct four distinct portions mimicking the oral cancer tissue arising in the oral mucosa. Results: In this model, α-smooth muscle actin-positive PD-CAFs were localized in close proximity to the OSCC layer, suggesting a crosstalk between them. Furthermore, a linear laminin-γ2 expression was lacking at the interface between the OSCC layer and the underlying stromal layer, indicating the loss of the basement membrane-like structure. Conclusions: Since the specific 3D architecture and polarity mimicking oral cancer in vivo provides a more accurate milieu of the tumor microenvironment (TME), it could be crucial in elucidating oral cancer TME.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1439-75952025Recommendations for the treatment of juvenile idiopathic arthritis with oligoarthritis or polyarthritis from the 2024 update of the Japan College of Rheumatology Clinical Practice Guidelines for the management of rheumatoid arthritis including juvenile idiopathic arthritis with oligoarthritis or polyarthritis – secondary publicationroaf042ENTakakoMiyamaeDepartment of Pediatric Rheumatology, Institute of Rheumatology, Tokyo Women’s Medical University HospitalNamiOkamotoDepartment of Pediatrics, Osaka Rosai Hospital, Japan Organization of Occupational Health and SafetyYuzaburoInoueDepartment of General Medical Science, Graduate School of Medicine, Chiba UniversityTomohiroKubotaDepartment of Pediatrics, Kagoshima Prefectural Satsunan HospitalTakasukeEbatoDepartment of Pediatrics, Kitasato UniversityHitoshiIrabuDepartment of Pediatrics and Development Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental UniversityHidetoKamedaDivision of Rheumatology, Department of Internal Medicine, Toho UniversityYukoKanekoDivision of Rheumatology, Department of Internal Medicine, Keio University School of MedicineHiroshiKuboDepartment of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of MedicineKanakoMitsunagaDepartment of Allergy and Rheumatology, Chiba Children's HospitalMasaakiMoriDepartment of Lifetime Clinical Immunology, Tokyo Medical and Dental UniversityAyakoNakajimaCenter for Rheumatic Diseases, Mie University HospitalKenichiNishimuraDepartment of Pediatrics, Yokohama City University Graduate School of MedicineNaoakiOhkuboIizuka HospitalTomomiSatoClinical Education Center For Physicians, Shiga University of Medical ScienceYukoSugitaDepartment of Pediatrics, School of Medicine, Osaka Medical and Pharmaceutical UniversitySatoshiTakanashiDivision of Rheumatology, Department of Internal Medicine, Keio University School of MedicineTakayukiTanakaDepartment of Pediatrics, Japanese Red Cross Otsu HospitalHiroakiUmebayashiDepartment of Rheumatology and Infectious Diseases, Miyagi Children’s HospitalMasatoYashiroDepartment of Pediatrics, Okayama University HospitalShingoYamanishiDepartment of Pediatrics, Nippon Medical SchoolMieFusamaHealth Sciences Department of Nursing, Kansai University of International StudiesShintaroHirataDepartment of Clinical Immunology and Rheumatology, Hiroshima University HospitalMitsumasaKishimotoDepartment of Nephrology and Rheumatology, Kyorin University School of MedicineMasatakaKohnoInflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of MedicineMasayoKojimaGraduate School of Medical Sciences, Nagoya City UniversityToshihisaKojimaDepartment of Orthopedic Surgery, National Hospital Organization Nagoya Medical CenterAkioMorinobuDepartment of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto UniversityTakahikoSugiharaDivision of Rheumatology, Department of Internal Medicine, Toho University School of MedicineEiichiTanakaDivision of Rheumatology, Department of Internal Medicine, School of Medicine, Tokyo Women's Medical UniversityNobuyukiYajimaDivision of Rheumatology, Department of Medicine, Showa University School of MedicineRyoYanaiDivision of Rheumatology, Department of Medicine, Showa University School of MedicineYutakaKawahitoInflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of MedicineMasayoshiHarigaiDivision of Rheumatology, Department of Internal Medicine, School of Medicine, Tokyo Women's Medical UniversityObjectives: To conduct systematic reviews (SRs) and develop clinical practice guidelines (CPGs) for managing juvenile idiopathic arthritis (JIA) with oligoarthritis or polyarthritis.<br>
Methods: The Grading of Recommendations, Assessment, Development, and Evaluation methodology was employed to carry out SRs and formulate the CPGs. An expert panel, including patients, paediatric and nonpaediatric rheumatologists, guideline specialists, and patient representatives, used the Delphi method to discuss and agree on the recommendations.<br>
Results: Six clinical questions (CQs) on the efficacy and safety of medical treatments were evaluated. These included CQ1 on methotrexate (MTX), CQ2 on non-MTX conventional synthetic disease-modifying antirheumatic drugs, CQ3 on glucocorticoids, CQ4 on tumour necrosis factor inhibitors, CQ5 on interleukin-6 inhibitors, and CQ6 on Janus kinase inhibitors. Two randomized controlled trials were identified for CQ1, three for CQ2, two for CQ3, eight for CQ4, two for CQ5, and two for CQ6. Based on these evaluations, three strong and three conditional recommendations were established. The CPGs have been endorsed by the Japan College of Rheumatology and the Pediatric Rheumatology Association of Japan.<br>
Conclusions: The SRs provided the necessary evidence to develop the CPGs, which are intended to guide not only paediatric but also nonpaediatric rheumatologists, caregivers, patients, and their families in treatment decision-making.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama0009-26739862025Redox-potential-controlled intermolecular [2 + 2] cycloaddition of styrenes for the regio- and diastereoselective synthesis of multisubstituted halogenocyclobutanesuoaf044ENAsukaMizutaniGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMomoKondoLaboratory of Biopharmaceutics, Faculty of Pharmaceutical Sciences, Tokyo University of ScienceShokoItakuraLaboratory of Biopharmaceutics, Faculty of Pharmaceutical Sciences, Tokyo University of ScienceHiroyoshiTakamuraGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYujiroHoshinoGraduate School of Environment and Information Sciences, Yokohama National UniversityMakiyaNishikawaLaboratory of Biopharmaceutics, Faculty of Pharmaceutical Sciences, Tokyo University of ScienceIsaoKadotaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKosukeKusamoriLaboratory of Cellular Drug Discovery and Development, Faculty of Pharmaceutical Sciences, Tokyo University of ScienceKentaTanakaResearch Institute for Interdisciplinary Science, Okayama UniversityThe redox potential is an important factor for controlling the outcome of photoredox catalysis. Particularly, the selective oxidation of substrates and the control over the reactions are challenging when using photoredox catalysts that have high excited-state reduction potentials. In this study, a redox-potential-controlled intermolecular [2 + 2] cycloaddition of styrenes using a thioxanthylium organophotoredox (TXT) catalyst has been developed. This TXT catalyst selectively oxidizes β-halogenostyrenes and smoothly promotes the subsequent intermolecular [2 + 2] cycloadditions to give multisubstituted halogenocyclobutanes with excellent regio- and diastereoselectivity, which has not been effectively achieved by the hitherto reported representative photoredox catalysts. The synthesized halogenocyclobutanes exhibit interesting free radical scavenging activity. The present reaction contributes to the field of redox-potential-controlled electron transfer chemistry.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-291863232024Successful Treatment for Life Threatening Recurrent Non-traumatic Rectus Sheath Hematoma in a Case with Microscopic Polyangiitis with Rapidly Progressive Glomerulonephritis32433248ENHiroyukiNakanohDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesHidemiTakeuchiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesShihoMorimotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesYuyaTerajimaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesShugoOkamotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroOnishiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKeikoTanakaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesTakayukiKatsuyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKenjiTsujiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesYoshinoriMatsumotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKatsuyukiTanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesHiroshiMorinagaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesMayuUkaDepartment of Radiology, Okayama University HospitalKojiTomitaDepartment of Radiology, Okayama University HospitalHaruhito A.UchidaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesTakaoHirakiDepartment of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesA 68-year-old woman was admitted to our hospital because of a rapid progression of renal dysfunction with positive myeloperoxidase antineutrophil cytoplasmic antibody and was diagnosed with rapidly progressive glomerulonephritis associated with microscopic polyangiitis (MPA). Severe right rectus sheath hematoma (RSH) bleeding from the inferior epigastric artery developed after starting hemodialysis, which required 4 transarterial embolizations due to recurrent bleeding. After additional treatment with methylprednisolone pulse therapy and rituximab, no rebleeding occurred. Although the giant hematoma reached the pelvis, it shrank spontaneously without any intervention. Nontraumatic RSH should therefore be considered when treating patients with multiple risk factors.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2090-47625612025Evaluating a discretized data acquisition method for couch modeling to streamline the commissioning process of radiological instruments64ENSyoutaTomimotoDepartment of Radiological Technology, Faculty of Medicine, Graduate School of Health Sciences, Okayama UniversityYusukeSaekiDepartment of Radiological Technology, Kawasaki Medical School HospitalOkihiroMotodaDepartment of Radiological Technology, Kawasaki Medical School HospitalMasatoTanakaDepartment of Radiological Technology, Kawasaki Medical School HospitalSyoukiTsumotoDepartment of Radiological Technology, Faculty of Medicine, Graduate School of Health Sciences, Okayama UniversityHanaNishikawaDepartment of Radiological Technology, Faculty of Medicine, Graduate School of Health Sciences, Okayama UniversityYukiMiyashimaDepartment of Radiological Technology, Kawasaki Medical School HospitalMakikoHiguchiDepartment of Radiological Technology, Kawasaki Medical School HospitalTadashiTaniDepartment of Radiological Technology, Kawasaki Medical School HospitalKuniakiKatsuiDepartment of Radiology, Kawasaki Medical SchoolYoshinoriTanabeDepartment of Radiological Technology, Faculty of Medicine, Graduate School of Health Sciences, Okayama UniversityBackground The commissioning of radiotherapy treatment planning system (RTPS) involves many time-consuming tests to maintain consistency between actual and planned dose. As the number of new technologies and peripheral devices increases year by year, there is a need for time-efficient and accurate commissioning of radiation therapy equipment. Couch modeling is one type of commissioning, and there are no recommended values for CT due to differences in equipment calibration between facilities. This study evaluated the optimal electron density (ED) for the couch using discretized gantry angles.<br>
Results All discrete-angle groups showed a high correlation between the surface ED and dose difference between the actual and planned doses (|r|> 0.9). AcurosXB did not demonstrate a significant correlation between dose differences and each energy. For a small number of discretized gantry groups, the optimal couch modeling results revealed several combinations of surface and interior ED with the same score. Upon adding all couch thickness scores, all energy scores, and both algorithm scores, the optimal surface and interior EDs with the highest score across all couch thicknesses were 0.4 and 0.07, respectively.<br>
Conclusions The optimal couch surface ED dose difference trend was identified, and the effectiveness indicated using the dose difference score from discrete-angle couch modeling. Using this method, couch modeling can be evaluated in a highly precise and quick manner, which helps in the commissioning of complicated linear accelerator and radiological treatment plans.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2950-133482025Downward hyperinflation of the native lung after right single lung transplantation for COPD: A case report highlighting diaphragmatic mobility100268ENShinTanakaDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTsuyoshiRyukoDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuakiTomiokaDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhikoShienDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenSuzawaDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentarohMiyoshiDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMikioOkazakiDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeiichiroSugimotoDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinichiToyookaDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesA 60-year-old male with COPD underwent right single lung transplantation. Despite progressive hyperinflation of the native left lung, the transplanted lung maintained function, as downward expansion of the left lung displaced the diaphragm without compressing the mediastinum. This suggests diaphragm mobility, aided by the absence of the liver beneath the left diaphragm, contributes to favorable outcomes in right single lung transplantation by preventing mechanical compression of the transplanted lung.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-291863122024Gastric Mucosa-associated Lymphoid Tissue Lymphoma That Relapsed after 11 Years Subsequent to Achieving Complete Remission16971702ENShokoInooDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakehiroTanakaDepartment of Pathology, Okayama University HospitalYoshiroKawaharaDepartment of Practical Gastrointestinal Endoscopy, Okayama University HospitalMotoyukiOotukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesA 38-year-old Japanese man was diagnosed with extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue in the stomach (gastric MALT lymphoma). Fluorescence in situ hybridization analysis revealed the absence of t (11;18) (q21;q21) translocation but the presence of extra copies of MALT1, indicating tetrasomy 18. Helicobacter pylori eradication led to complete remission (CR). However, the gastric MALT lymphoma relapsed after 11 years old. This case underscores the need for long-term observation (>10 years) of patients with gastric MALT lymphoma. Further investigation is warranted to elucidate the correlation between trisomy/tetrasomy 18 and the recurrence propensity.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-291863102025Idiopathic Gastric Antral Ulcers13671371ENMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakehiroTanakaDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSeijiKawanoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYoshiroKawaharaDepartment of Practical Gastrointestinal Endoscopy, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesA Japanese woman presented with gastric antral ulcers accompanied by erosion and edema, demonstrating a chronic pattern of improvement and recurrence for more than six years. The patient had no relevant treatment history, and Helicobacter pylori infection was ruled out. Other potential etiologies contributing to gastric ulcers were eliminated on the basis of endoscopic biopsy and blood laboratory findings. Consequently, the patient was diagnosed with idiopathic gastric antral ulcer. This disease is often overlooked, and the chronological endoscopic images provided in this report can be used as a reference.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama2753-670X3822024Plasma concentrations of histidine-rich glycoprotein in primary graft dysfunction after lung transplantationivae021ENToshioShiotaniDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalSeiichiroSugimotoDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalYasuakiTomiokaDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalShinTanakaDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Okayama University HospitalKenSuzawaDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalKazuhikoShienDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalKentarohMiyoshiDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalHiromasaYamamotoDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalMikioOkazakiDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalShinichiToyookaDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalOBJECTIVES: Histidine-rich glycoprotein has been reported as an anti-inflammatory glycoprotein that inhibits acute lung injury in mice with sepsis and as a prognostic biomarker in patients with sepsis. We investigated the relationship between plasma concentrations of histidine-rich glycoprotein and the risk of occurrence of primary graft dysfunction.<br>
METHODS: According to the primary graft dysfunction grade at post-transplant 72 h, patients who underwent lung transplantation were divided into three groups: non-primary graft dysfunction group (grade 0–1), moderate primary graft dysfunction group (grade 2), and severe primary graft dysfunction group (grade 3). The plasma concentrations of histidine-rich glycoprotein measured daily during the first post-transplant 7 days were compared among the three groups. Appropriate cutoff values of the concentrations were set for survival analyses after lung transplantation.<br>
RESULTS: A total of 68 patients were included. The plasma histidine-rich glycoprotein concentration at post-transplant 72 h was significantly lower in the severe primary graft dysfunction group (n = 7) than in the other two groups [non-primary graft dysfunction group (n = 43), P = 0.042; moderate primary graft dysfunction group (n = 18), P = 0.040]. Patients with plasma histidine-rich glycoprotein concentration ≥34.4 µg/ml at post-transplant 72 h had significantly better chronic lung allograft dysfunction-free survival (P = 0.012) and overall survival (P = 0.037) than those with the concentration <34.4 µg/ml.<br>
CONCLUSIONS: Plasma histidine-rich glycoprotein concentrations at post-transplant 72 h might be associated with the risk of development of primary graft dysfunction.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1342-17512972025The association of fasting triglyceride variability with renal dysfunction and proteinuria in medical checkup participants920927ENNatsumiMatsuoka-UchiyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHaruhito A.UchidaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomohikoAsakawaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshimasaSakurabuDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKatsuyoshiKatayamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShugoOkamotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYasuhiroOnishiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKeikoTanakaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHidemiTakeuchiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRikaTakemotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRyokoUmebayashiDepartment 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 UniversityBackground The association between the variability of triglyceride (TG) and chronic kidney disease (CKD) progression remains unclear. We examined whether intraindividual variability in fasting TG was associated with the exacerbation of CKD.<br>
Methods We conducted a retrospective and observational study. 18,339 participants, who went through medical checkups and had checked their estimated glomerular filtration rate (eGFR) and semi-quantitative proteinuria by urine dipstick every year since 2017 for 4 years were registered. Variability in fasting TG was determined using the standard deviation (SD), and maximum minus minimum difference (MMD) between 2017 and 2021. The primary end point for the analysis of eGFR decline was eGFR < 60 mL/min/1.73 m2. The secondary end point for the analysis of proteinuria was the incidence of proteinuria ≥ ( ±) by urine dipstick.<br>
Results The renal survival was lower in the higher-SD, and higher-MMD groups than in the lower-SD, and lower-MMD groups, respectively (log-rank test p < 0.001, and < 0.001, respectively). Lower SD and lower MMD were significantly associated with renal survival in the adjusted model (hazard ratio (HR), 1.12; 95% confidence intervals (CI), 1.04–1.21, and HR, 1.13; 95% CI 1.05–1.23, respectively). The non-incidence of proteinuria was lower in the higher-SD, and higher-MMD groups than in the lower-SD, and lower-MMD groups, respectively (log-rank test p < 0.001 and < 0.001, respectively).<br>
Conclusion Fasting TG variability was associated with CKD progression in participants who went through medical checkups.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025A Rare Presentation of Pneumonic-Type Adenocarcinoma Hidden behind Empyema305309ENSatoruSenooDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterEitoNimanDepartment of General Thoracic Surgery, National Hospital Organization Fukuyama Medical CenterRyokoTsujiDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterKoheiTakataDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterShunsukeMatsumoriDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterFumikaMuranoDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterYukaSugisakiDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterHirokiOmoriDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterAkihikoTaniguchiDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterRikaOmoteDepartment of Diagnostic Pathology, National Hospital Organization Fukuyama Medical CenterEikiIchiharaDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterKenjiTakahashiDepartment of General Thoracic Surgery, National Hospital Organization Fukuyama Medical CenterToshiakiOkadaDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterCase Report10.18926/AMO/69158Pneumonic-type adenocarcinoma (P-ADC) can closely mimic pneumonia. We report a P-ADC initially diagnosed as pneumonia which developed into a pulmonary abscess and empyema. A 50-year-old Japanese male diagnosed with pneumonia, pulmonary abscess, and empyema was administered antibiotics and a chest tube for drainage, which improved his symptoms and blood test results. However, chest computed tomography showed an enlarged infiltrative shadow. The patient underwent bronchoscopy and was diagnosed with an adenocarcinoma. This case highlights the importance of considering P-ADC in differential diagnoses when a pneumonia-like shadow enlarges post-empyema treatment. Diagnostic and clinical tests, e.g., bronchoscopy, should be performed in such cases.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Effectiveness of Pallidal Stimulation for Dystonic Storm and Subsequent Ssevere Posterior Reversible Encephalopathy Syndrome in a Patient with GNAO1 Variant293297ENKojiKawaiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTatsuyaSasakiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShunTanimotoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomoyaSaijoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSusumuSasadaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomoyukiAkiyamaDepartment of Pediatric Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuyaHiraideDepartment of Biochemistry, Hamamatsu University School of MedicineHirotomoSaitsuDepartment of Biochemistry, Hamamatsu University School of MedicineShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/69156GNAO1 variant affects primarily the brain and neurodevelopment, leading to a range of motor disorders including seizures beginning in infancy and involuntary movements such as dyskinesia and dystonia. Our patient, a 15-year-old Japanese female, began exhibiting involuntary movements at age 4. A de novo missense mutation (NM_020988.3: c.228C>G, NP_066268.1: p.(Asn76Lys)) in the GNAO1 gene was identified when the patient was 15, and during the same year she developed influenza pneumonia, accompanied by dystonic storm. She required intensive care with mechanical ventilation and underwent a tracheostomy. She also developed posterior reversible encephalopathy syndrome. Globus pallidal stimulation was administered, leading to an improvement in the dystonic storm. Early consideration of globus pallidal stimulation is recommended when treating difficult-to-manage dystonic storms.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Parieto-Occipital Disconnection for Drug-Resistant Parieto-Occipital Lobe Epilepsy: A Case Report and Surgical Technique287292ENShunTanimotoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTatsuyaSasakiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKojiKawaiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomoyaSaijoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKyoheiKinDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSusumuSasadaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/69155We report a case of drug-resistant parieto-occipital lobe epilepsy successfully treated with parieto-occipital disconnection (POD). An 18-year-old left-handed female, who had undergone surgery for an acute subdural hematoma at 10 months of age, developed drug-resistant epilepsy at age 15. Despite antiepileptic drug treatment, her seizures remained uncontrolled, and at age 18 she was referred to our hospital for evaluation. Magnetic resonance imaging (MRI) revealed atrophy in the left occipital and parietal lobes. Ictal electroencephalography (EEG) confirmed occipital onset of seizures without temporal lobe involvement. She had pre-existing homonymous hemianopsia. POD surgery was performed, carefully preserving the temporal lobe structures. Postoperatively, she experienced transient right-sided paresis, which fully resolved, and achieved complete seizure control at 3 years without memory loss. This case demonstrates that POD, a rare surgical approach, is a viable option for parieto-occipital lobe epilepsy, effectively controlling seizures while minimizing functional impairment in the absence of temporal lobe involvement.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Outcome of Decompression Surgery Following Rapid Neurological Deterioration in Patients with Spinal Cord Injury Without Radiographic Evidence of Trauma (SCIWORET)261267ENYuichiHirataDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChiakiSugaharaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSusumuSasadaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHayatoMiyakeDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakayukiNagaseDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakaoYasuharaDepartment 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 SciencesOriginal Article10.18926/AMO/69151Cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) increase the likelihood of spinal cord injury without radiographic evidence of trauma (SCIWORET). Opinions regarding the optimal timing for surgery in such cases vary, however. We retrospectively investigated the demographics and outcomes of patients with SCIWORET who underwent surgery shortly after experiencing rapid neurological deterioration, and we matched patients who underwent standby surgery for CSM or OPLL. Although the optimal timing of surgery for SCIWORET remains unclear, our findings suggest that early stage surgery for SCIWORET may yield favorable neurological improvements.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025The Work Productivity of Cancer-survivor and Non-cancer-survivor Workers243251ENMikaKamanoDepartment of Public Health, Faculty of Medicine, Kagawa UniversityKanaeKandaDepartment of Public Health, Faculty of Medicine, Kagawa UniversityNlandu RogerNgatuDepartment of Public Health, Faculty of Medicine, Kagawa UniversityAkitsuMurakamiCancer Center, Kagawa University HospitalYusukeYamadoriDepartment of Anesthesiology, Faculty of Medicine, Kagawa UniversityTomohiroHiraoDepartment of Public Health, Faculty of Medicine, Kagawa UniversityOriginal Article10.18926/AMO/69149We investigated the work productivity levels of employed cancer survivors and non-cancer-survivor workers by conducting a cross-sectional study in Japan between February and March 2019, using an online survey. A total of 561 employed individuals aged 20-64 years were analyzed. Work productivity was assessed using the Work Productivity and Activity Impairment-General Health questionnaire which evaluates absenteeism, presenteeism, and overall work productivity loss. The questionnaire responses demonstrated that the cancer survivors within 1 year of diagnosis had significantly higher absenteeism compared to the non-cancer workers (p=0.048). Although presenteeism and overall work productivity loss were also higher in the non-cancer-survivor group, the differences were not significant. Cancer survivors within 1 year of diagnosis exhibited higher absenteeism, but their work productivity appeared to recover to levels comparable to those of the non-cancer workers over time. These findings may contribute to workplace policies supporting cancer survivors’ return to work.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1434-516169122024Association study of GBA1 variants with MSA based on comprehensive sequence analysis -Pitfalls in short-read sequence analysis depending on the human reference genome-613621ENKentaOrimoDepartment of Neurology, Graduate School of Medicine, The University of TokyoJunMitsuiDepartment of Precision Medicine Neurology, Graduate School of Medicine, The University of TokyoTakashiMatsukawaDepartment of Neurology, Graduate School of Medicine, The University of TokyoMasakiTanakaInstitute of Medical Genomics, International University of Health and WelfareJunkoNomotoInstitute of Medical Genomics, International University of Health and WelfareHiroyukiIshiuraDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYosukeOmaeGenome Medical Science Project, National Center for Global Health and MedicineYosukeKawaiGenome Medical Science Project, National Center for Global Health and MedicineKatsushiTokunagaGenome Medical Science Project, National Center for Global Health and MedicineNCBN Controls WGS ConsortiumTatsushiTodaDepartment of Neurology, Graduate School of Medicine, The University of TokyoShojiTsujiDepartment of Neurology, Graduate School of Medicine, The University of TokyoMultiple system atrophy (MSA) is a neurodegenerative disorder characterized by various combinations of autonomic failure, parkinsonism, and cerebellar ataxia. To elucidate variants associated with MSA, we have been conducting short-read-based whole-genome sequence analysis. In the process of the association studies, we initially focused on GBA1, a previously proposed susceptibility gene for MSA, to evaluate whether GBA1 variants can be efficiently identified despite its extraordinarily high homology with its pseudogene, GBA1LP. To accomplish this, we conducted a short-read whole-genome sequence analysis with alignment to GRCh38 as well as Sanger sequence analysis and compared the results. We identified five variants with inconsistencies between the two pipelines, of which three variants (p.L483P, p.A495P–p.V499V, p.L483_M489delinsW) were the results of misalignment due to minor alleles in GBA1P1 registered in GRCh38. The miscalling events in these variants were resolved by alignment to GRCh37 as the reference genome, where the major alleles are registered. In addition, a structural variant was not properly identified either by short-read or by Sanger sequence analyses. Having accomplished correct variant calling, we identified three variants pathogenic for Gaucher disease (p.S310G, p.L483P, and p.L483_M489delinsW). Of these variants, the allele frequency of p.L483P (0.003) in the MSA cases was higher than that (0.0011) in controls. The meta-analysis incorporating a previous report demonstrated a significant association of p.L483P with MSA with an odds ratio of 2.85 (95% CI; 1.05 – 7.76, p = 0.0400).No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2662-4435612025Biogeochemical impact of nickel and urea in the great oxidation event654ENDilan M.RatnayakeThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityRyojiTanakaThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityEizoNakamuraThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityThe Great Oxidation Event marks the first substantial increase in atmospheric oxygen on Earth. Despite the oxygenic photosynthesis that emerged hundreds of million years before this event, the specific biogeochemical mechanisms responsible for maintaining low oxygen levels for an extended period remain elusive. Here, we show the critical role of urea as a nitrogen source for cyanobacteria, the cascading impact of nickel on abiotic urea production, and their combined effects on the proliferation of cyanobacteria leading to the great oxidation event. Urea formation was experimentally evaluated under simulated Archean conditions and cyanobacterial growth was monitored providing urea as the nitrogen source. Our findings demonstrate that urea can be produced in the Archean cyanobacterial habitats with UV-C irradiation, shedding light on the controversy regarding the evolution of nitrogen-fixing enzymes in primitive cyanobacteria. We propose that environmental conditions in the early Archean, characterized by elevated urea and nickel concentration, may have hindered cyanobacterial expansion, contributing to the delay between the evolution of oxygenic photosynthesis and the onset of the great oxidation event.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1201-97121562025Recurrent diffuse panbronchiolitis after lung transplantation: Off-label use of inhaled tobramycin for Pseudomonas aeruginosa control in a transplant recipient107913ENShinTanakaDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTuyoshiRyukoDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuakiTomiokaDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhikoShienDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenSuzawaDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentarohMiyoshiDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalMikioOkazakiDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeiichiroSugimotoDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinichiToyookaDepartment of General Thoracic and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesObjectives: This report highlights a clinical case of recurrent diffuse panbronchiolitis (DPB) after bilateral lung transplantation (LTx), with a focus on the therapeutic impact of off-label inhaled tobramycin solution for inhalation (TSI) in managing Pseudomonas aeruginosa colonization.<br>
Methods: A Japanese woman with a history of DPB experienced disease recurrence following bilateral LTx. Persistent colonization by P. aeruginosa and recurrent respiratory symptoms were observed. Off-label TSI therapy, commonly used in cystic fibrosis, was introduced. Clinical response was assessed through radiologic imaging, bronchoscopy, and microbiological cultures.<br>
Results: TSI administration led to significant clinical and radiological improvement. P. aeruginosa was eradicated from sputum cultures within one month and remained absent throughout six months of follow-up. No hospitalizations or adverse events were reported during therapy.<br>
Conclusion: This case suggests the potential of TSI as a therapeutic approach for managing recurrent DPB and indicates its role in stabilizing post-transplant outcomes. Further studies may clarify its efficacy and expand its application in broader DPB management strategies.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1201-97121542025Secondary pneumothorax due to Aspergillus welwitschiae in a lung transplant recipient107863ENShinnosukeFukushimaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalSayakaBanMedical Mycology Research Center, Chiba UniversityTakashiYaguchiMedical Mycology Research Center, Chiba UniversityAkiraWatanabeMedical Mycology Research Center, Chiba UniversityShinTanakaDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalSeiichiroSugimotoDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalNo potential conflict of interest relevant to this article was reported.Life Science Alliance, LLCActa Medica Okayama2575-10777122024Chromosome-specific barcode system with centromeric repeat in cultivated soybean and wild progenitore202402802ENAhmet LTekDepartment of Agricultural Genetic Engineering, Ayhan Şahenk Faculty of Agricultural Sciences and Technologies, Niğde Ömer Halisdemir UniversityKiyotakaNagakiInstitute of Plant Science and Resources, Okayama UniversityHümeyraYıldız AkkamışDepartment of Agricultural Genetic Engineering, Ayhan Şahenk Faculty of Agricultural Sciences and Technologies, Niğde Ömer Halisdemir UniversityKeisukeTanakaNODAI Genome Research Center, Tokyo University of AgricultureHisatoKobayashiNODAI Genome Research Center, Tokyo University of AgricultureWild soybean Glycine soja is the progenitor of cultivated soybean Glycine max. Information on soybean functional centromeres is limited despite extensive genome analysis. These species are an ideal model for studying centromere dynamics for domestication and breeding. We performed a detailed chromatin immunoprecipitation analysis using centromere-specific histone H3 protein to delineate two distinct centromeric DNA sequences with unusual repeating units with monomer sizes of 90–92 bp (CentGm-1) and 413-bp (CentGm-4) shorter and longer than standard nucleosomes. These two unrelated DNA sequences with no sequence similarity are part of functional centromeres in both species. Our results provide a comparison of centromere properties between a cultivated and a wild species under the effect of the same kinetochore protein. Possible sequence homogenization specific to each chromosome could highlight the mechanism for evolutionary conservation of centromeric properties independent of domestication and breeding. Moreover, a unique barcode system to track each chromosome is developed using CentGm-4 units. Our results with a unifying centromere composition model using CentGm-1 and CentGm-4 superfamilies could have far-reaching implications for comparative and evolutionary genome research.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1439-75953542025Telemedicine as an alternative to in-person care in the field of rheumatic diseases: A systematic scoping review715721ENKen-eiSadaDepartment of Clinical Epidemiology, Kochi Medical SchoolShigeruIwataDepartment of Rheumatology and Clinical Immunology, Wakayama Medical UniversityYuzaburoInoueDepartment of General Medical Science, Graduate School of Medicine, Chiba UniversityEiichiTanakaDepartment of Rheumatology, Tokyo Women’s Medical University School of MedicineKeiichiroNishidaLocomotive Pain Center, Okayama University HospitalYutakaKawahitoInflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of MedicineAsamiAbeDepartment of Rheumatology, Niigata Rheumatic CenterAtsushiKawakamiDepartment of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical SciencesTakakoMiyamaeDepartment of Pediatric Rheumatology, Institute of Rheumatology, Tokyo Women’s Medical UniversityObjective: The COVID-19 pandemic prompted the widespread adoption of telemedicine as an alternative to in-person care. This systematic scoping review evaluated the effectiveness, cost-efficiency, and challenges of telemedicine for patients with rheumatic diseases.<br>
Methods: A comprehensive search of the MEDLINE database was conducted using specific terms related to rheumatoid or juvenile arthritis, and telemedicine. The literature search included studies published up to March, 2024. In this review, we only considered studies assessing telemedicine as an alternative to in-person care.<br>
Results: The search, conducted on 15 March 2024, generated 258 references. Eight reports from three randomized controlled trials and three observational studies were included. Randomized controlled trials have shown that the outcomes of telemedicine intervention are comparable to those of in-person care in terms of disease activity, functional status, and quality of life, while enabling fewer outpatient visits and cost-effectiveness. However, the high dropout rates highlight the importance of patient preferences and comprehensive education. Observational studies revealed similar findings but were limited by a high confounding bias.<br>
Conclusion: Telemedicine offers economic advantages and maintains clinical outcomes comparable to those of in-person care. Its success depends on structured patient education and alignment with patient preferences. Further research is required, particularly in the context of healthcare in Japan.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-291863242024A Preliminary Survey of Rheumatologists on the Management of Late-onset Rheumatoid Arthritis in Japan32993306ENSatoshiTakanashiDivision of Rheumatology, Department of Internal Medicine, Keio University School of MedicineYukoKanekoDivision of Rheumatology, Department of Internal Medicine, Keio University School of MedicineYutakaKawahitoInflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of MedicineTakashiKidaInflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of MedicineTakahikoSugiharaDivision of Rheumatology, Department of Internal Medicine, Toho University School of MedicineToshihisaKojimaNational Hospital Organization Nagoya Medical Center, Orthopaedic Surgery and RheumatologyRyozoHaradaDepartment of Orthopaedic Surgery, Kurashiki Sweet HospitalMichinoriIshitokuDepartment of Clinical Immunology and Rheumatology, Hiroshima University HospitalShintaroHirataDepartment of Clinical Immunology and Rheumatology, Hiroshima University HospitalMotomuHashimotoDepartment of Clinical Immunology, Osaka Metropolitan University Graduate School of MedicineToshihikoHidakaMiyazaki-Zenjinkai HospitalAsamiAbeDepartment of Rheumatology, Niigata Rheumatic CenterHajimeIshikawaDepartment of Rheumatology, Niigata Rheumatic CenterHiromuItoKurashiki Central HospitalMitsumasaKishimotoDepartment of Nephrology and Rheumatology, Kyorin University School of MedicineKazuoMatsuiDepartment of Rheumatology, Teine Keijinkai HospitalToshihiroMatsuiDepartment of Rheumatology Research, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National HospitalIsaoMatsushitaDepartment of Rehabilitation Medicine, Kanazawa Medical UniversityAkiraOnishiDepartment of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto UniversityAkioMorinobuDepartment of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto UniversityKeiichiroNishidaDepartment of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShujiAsaiDepartment of Orthopaedic Surgery and Rheumatology, Nagoya University Graduate School of MedicineEiichiTanakaDivision of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of MedicineMasayoshiHarigaiDivision of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of MedicineMasayoKojimaDepartment of Public Health, Nagoya City University Graduate School of Medical SciencesObjective We investigated the current perspectives regarding the management of late-onset rheumatoid arthritis (LORA) among rheumatologists in clinical practice.<br>
Methods This study was performed in October 2021, and included 65 rheumatologists certified by the Japan College of Rheumatology, who were administered questionnaires (including multiple choice and descriptive formulae) regarding the management of LORA. We aggregated and analyzed the responses.<br>
Results All 65 rheumatologists responded to the survey; 47 (72%) answered that >50% of newly diagnosed patients were aged ≥65 years, 42 (65%) answered that achievement of remission or low disease activity was the treatment goal, and 40 (62%) considered patient safety to be the highest priority. Most rheumatologists are concerned about the management of conditions other than RA, such as comorbidities, financial constraints, and life circumstances that interfere with standard or recommended treatment implementation.<br>
Conclusion This preliminary survey highlighted various rheumatologists' perspectives regarding the management of LORA.No potential conflict of interest relevant to this article was reported.JMIR Publications Inc.Acta Medica Okayama2561-326X92025Usefulness of Interventions Using a Smartphone Cognitive Behavior Therapy Application for Children With Mental Health Disorders: Prospective, Single-Arm, Uncontrolled Clinical Triale60943ENShinichiroNagamitsuDepartment of Pediatrics, Faculty of Medicine, Fukuoka UniversityAyumiOkadaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoichiSakutaChild Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical CenterRyutaIshiiDepartment of Pediatrics & Child Health, Kurume University, School of MedicineKenshiKoyanagiNagasaki Prefectural Center of Medicine and Welfare for ChildrenChizuHabukawaDepartment of Pediatric Allergy, Minami Wakayama Medical CenterTakashiKatayamaL2B IncMasayaItoNational Center for Cognitive Behavior Therapy and Research, National Center of Neurology and PsychiatryAyakoKanieNational Center for Cognitive Behavior Therapy and Research, National Center of Neurology and PsychiatryRyokoOtaniChild Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical CenterTakeshiInoueChild Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical CenterTasukuKitajimaChild Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical CenterNaokiMatsubaraChild Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical CenterChieTanakaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChikakoFujiiDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshieShigeyasuDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMichikoMatsuokaDepartment of Neuropsychiatry, Kurume University School of MedicineTatsuyukiKakumaBiostatistics Center, Kurume UniversityMasaruHorikoshiNational Center for Cognitive Behavior Therapy and Research, National Center of Neurology and PsychiatryBackground: The prevalence of mental health disorders among children in Japan has increased rapidly, and these children often show depressive symptoms and reduced quality of life (QOL). We previously developed a smartphone-based self-monitoring app to deliver cognitive behavioral therapy (CBT), implemented it in healthy children, and reported its effectiveness for health promotion.<br>
Objective: This study aims to examine the usefulness of the CBT app for improvement in depressive symptoms and QOL in children with mental health disorders.<br>
Methods: The participants were 115 children with mental health disorders (eg, school refusal, orthostatic hypotension, eating disorders, developmental disorders, among others) and aged 12‐18 years. The CBT app–based program comprised 1 week of psychoeducation followed by 1 week of self-monitoring. After reading story-like scenarios, participants created a self-monitoring sheet with 5 panels: events, thoughts, feelings, body responses, and actions. All participants received regular mental health care from physicians in addition to the app-based program. To evaluate the participants’ depressive symptoms and QOL, Patient Health Questionnaire for Adolescents (PHQ-9A), Depression Self-Rating Scale for Children (DSRS-C), and Pediatric Quality of Life Inventory (PedsQL) were measured at the beginning of the intervention, and at 2 and 6 months thereafter. Questionnaire for Triage and Assessment with 30 items (QTA30), and Rosenberg Self-Esteem Scale (RSES) were also used to measure their health and self-esteem. Participants were divided into 4 groups on the basis of the PHQ-9A score (above or below the cutoff; PHQ-9A≥5 or PHQ-9A<5) and completion or noncompletion of the CBT app–based program (app [+] or app [-]). The primary outcome was improvement in the DSRS-C score, and secondary outcomes were improvement in other psychometric scales including PedsQL, QTA30, and RSE. A paired-samples t test was used for statistical analysis. The Medical Ethics Committee of Fukuoka University Faculty of Medicine (approval U22-05-002) approved the study design.<br>
Results: There were 48, 18, 18, and 7 participants in the PHQ-9A≥5 app (+), PHQ-9A≥5 app (-), PHQ-9A<5 app (+), and PHQ-9A<5 app (-) groups, respectively. A total of 24 participants dropped out. No improvement in the DSRS-C score was observed in all groups. However, PedsQL scores improved significantly at 2 and 6 months in the PHQ-9A<5 app (+) group (t17=6.62; P<.001 and t17=6.11; P<.001, respectively). There was a significant positive correlation between the PHQ-9A scores and the number of self-monitoring sheets completed.<br>
Conclusions: The CBT app was useful for improving PedsQL scores of children with mental health disorders. However, a higher-intensity CBT program is necessary for more severely depressed children.<br>
Trial Registration: University Hospital Medical Information Network Clinical Trials Registry UMIN000046775; center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000053360No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2692-4609612025A Case of Gastric Atypical Lipomatous Tumor/Well‐Differentiated Liposarcoma With Endoscopic Morphological Changese70146ENRikaOmoteDepartment of Diagnostic Pathology, NHO Fukuyama Medical CenterShizumaOmoteDepartment of Internal Medicine, Fukuyama Minami HospitalHiroshiSonobeDepartment of Diagnostic Pathology, NHO Fukuyama Medical CenterRyosukeHamanoDepartment of Surgery, NHO Fukuyama Medical CenterTatsuyaToyokawaDepartment of Gastroenterology, NHO Fukuyama Medical CenterShinyaOtsukaDepartment of Surgery, NHO Fukuyama Medical CenterTakehiroTanakaDepartment of Pathology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiYanaiDepartment of Pathology, Okayama University HospitalMasaruInagakiDepartment of Surgery, NHO Fukuyama Medical CenterHidetakaYamamotoDepartment of Pathology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtypical lipomatous tumor/well-differentiated liposarcoma is a locally aggressive mesenchymal neoplasm composed of adipocytes and stromal cells. Gastric cases are exceedingly rare, and their malignant potential remains unclear. We report a case of a woman in her 60s who was found to have multiple submucosal tumor-like lesions of the stomach. Over time, the tumors increased in size, requiring a laparoscopic partial gastrectomy. Histological examination revealed a tumor composed of both fatty tissue and fibrous stroma with nuclear atypia. Immunohistochemistry showed positivity for CDK4 and MDM2, and fluorescence in situ hybridization confirmed MDM2 amplification, leading to a diagnosis of atypical lipomatous tumor/well-differentiated liposarcoma. This case presented an unusual gastric manifestation, with multiple submucosal tumor-like lesions on endoscopy and exhibiting progressive morphological changes over several years.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2075-44181552025Review Article: Diagnostic Paradigm Shift in Spine Surgery594ENAras EfeLeventDepartment of Orthopedic Surgery, Okayama Rosai HospitalMasatoTanakaDepartment of Orthopedic Surgery, Okayama Rosai HospitalChetanKumawatDepartment of Orthopedic Surgery, Okayama Rosai HospitalChristianHengDepartment of Orthopedic Surgery, Okayama Rosai HospitalSalamalikisNikolaosDepartment of Orthopedic Surgery, Okayama Rosai HospitalKajetanLatkaDepartment of Orthopedic Surgery, Okayama Rosai HospitalAkiyoshiMiyamotoDepartment of Orthopedic Surgery, Okayama Rosai HospitalTadashiKomatsubaraDepartment of Orthopedic Surgery, Okayama Rosai HospitalShinyaAratakiDepartment of Orthopedic Surgery, Okayama Rosai HospitalYoshiakiOdaDepartment of Orthopedic Surgery, Okayama University HospitalKensukeShinoharaDepartment of Orthopedic Surgery, Okayama University HospitalKojiUotaniDepartment of Orthopedic Surgery, Okayama University HospitalMeticulous clinical examination is essential for spinal disorders to utilize the diagnostic methods and technologies that strongly support physicians and enhance clinical practice. A significant change in the approach to diagnosing spinal disorders has occurred in the last three decades, which has enhanced a more nuanced understanding of spine pathology. Traditional radiographic methods such as conventional and functional X-rays and CT scans are still the first line in the diagnosis of spinal disorders due to their low cost and accessibility. As more advanced imaging technologies become increasingly available worldwide, there is a constantly increasing trend in MRI scans for detecting spinal pathologies and making treatment decisions. Not only do MRI scans have superior diagnostic capabilities, but they also assist surgeons in performing meticulous preoperative planning, making them currently the most widely used diagnostic tool for spinal disorders. Positron Emission Tomography (PET) can help detect inflammatory lesions, infections, and tumors. Other advanced diagnostic tools such as CT/MRI fusion image, Functional Magnetic Resonance Imaging (fMRI), Upright and Kinetic MRI, magnetic resonance spectroscopy (MRS), diffusion-weighted imaging (DWI), and diffusion tensor imaging (DTI) could play an important role when it comes to detecting more special pathologies. However, some technical difficulties in the daily praxis and their high costs act as obstacles to their further spread. Integrating artificial intelligence and advancements in data analytics and virtual reality promises to enhance spinal procedures’ precision, safety, and efficacy. As these technologies continue to develop, they will play a critical role in transforming spinal surgery. This paradigm shift emphasizes the importance of continuous innovation and adaptability in improving the diagnosis and treatment of spinal disorders.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1648-91446042024A Novel Technique for Basilar Invagination Treatment in a Patient with Klippel–Feil Syndrome: A Clinical Example and Brief Literature Review616ENMasatoTanakaDepartment of Orthopaedic Surgery, Okayama Rosai HospitalAbd El Kader AlAskarDepartment of Orthopaedic Surgery, Okayama Rosai HospitalChetanKumawatDepartment of Orthopaedic Surgery, Okayama Rosai HospitalShinyaAratakiDepartment of Orthopaedic Surgery, Okayama Rosai HospitalTadashiKomatsubaraDepartment of Orthopaedic Surgery, Okayama Rosai HospitalTakuyaTaokaDepartment of Orthopaedic Surgery, Okayama Rosai HospitalKojiUotaniDepartment of Orthopaedic Surgery, Okayama University HospitalYoshiakiOdaDepartment of Orthopaedic Surgery, Okayama University HospitalObjectives and Background: To present a novel technique of treatment for a patient with basilar invagination. Basilar invagination (BI) is a congenital condition that can compress the cervicomedullary junction, leading to neurological deficits. Severe cases require surgical intervention, but there is debate over the choice of approach. The anterior approach allows direct decompression but carries high complication rates, while the posterior approach provides indirect decompression and offers good stability with fewer complications. Materials and Methods: A 15-year-old boy with severe myelopathy presented to our hospital with neck pain, bilateral upper limb muscle weakness, and hand numbness persisting for 4 years. Additionally, he experienced increased numbness and gait disturbance three months before his visit. On examination, he exhibited hyperreflexia in both upper and lower limbs, muscle weakness in the bilateral upper limbs (MMT 4), bilateral hypoesthesia below the elbow and in both legs, mild urinary and bowel incontinence, and a spastic gait. Radiographs revealed severe basilar invagination (BI). Preoperative images showed severe BI and that the spinal cord was severely compressed with odontoid process. Results: The patient underwent posterior surgery with the C-arm free technique. All screws including occipital screws were inserted into the adequate position under navigation guidance. Reduction was achieved with skull rotation and distraction. A follow-up at one year showed the following results: Manual muscle testing results and sensory function tests showed almost full recovery, with bilateral arm recovery (MMT 5) and smooth walking. The cervical Japanese Orthopedic Association score of the patient improved from 9/17 to 16/17. Postoperative images showed excellent spinal cord decompression, and no major or severe complications had occurred. Conclusions: Basilar invagination alongside Klippel–Feil syndrome represents a relatively uncommon condition. Utilizing a posterior approach for treating reducible BI with a C-arm-free technique proved to be a safe method in addressing severe myelopathy. This novel navigation technique yields excellent outcomes for patients with BI.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2075-441814232024Predicting Surgical Site Infections in Spine Surgery: Association of Postoperative Lymphocyte Reduction2715ENAkiyoshiMiyamotoDepartment of Orthopedic Surgery, Okayama Rosai HospitalMasatoTanakaDepartment of Orthopedic Surgery, Okayama Rosai HospitalAngel Oscar PazFloresDepartment of Orthopedic Surgery, Okayama Rosai HospitalDongwooYuDepartment of Orthopedic Surgery, Okayama Rosai HospitalMukulJainDepartment of Orthopedic Surgery, Okayama Rosai HospitalChristanHengDepartment of Orthopedic Surgery, Okayama Rosai HospitalTadashiKomatsubaraDepartment of Orthopedic Surgery, Okayama Rosai HospitalShinyaAratakiDepartment of Orthopedic Surgery, Okayama Rosai HospitalYoshiakiOdaDepartment of Orthopedic Surgery, Okayama University HospitalKensukeShinoharaDepartment of Orthopedic Surgery, Okayama University HospitalKojiUotaniDepartment of Orthopedic Surgery, Okayama University HospitalObjective: Postoperative lymphopenia is reported as an excellent indicator to predict surgical-site infection (SSI) after spine surgery. However, there is still controversy concerning which serological markers can predict spinal SSI. This study aims to evaluate excellent and early indicators for detecting SSI, focusing on spine instrumented surgery. Materials and Methods: This study included 268 patients who underwent spinal instrumented surgery from January 2022 to December 2023 (159 female and 109 male, average 62.9 years). The SSI group included 20 patients, and the non-SSI group comprised 248 patients. Surgical time, intraoperative blood loss, and glycemic levels were measured in both groups. The complete blood cell counts, differential counts, albumin, and C-reactive protein (CRP) levels were measured pre-surgery and postoperative on Days 1, 3, and 7. In comparing the groups, the Mann–Whitney U test analysis was used for continuous variables, while the chi-squared test and Fisher’s exact test were used for dichotomous variables. Results: The incidence of SSI after spinal instrumentation was 7.46% and was relatively higher in scoliosis surgery. The SSI group had significantly longer surgical times (248 min vs. 180 min, p = 0.0004) and a higher intraoperative blood loss (772 mL vs. 372 mL, p < 0.0001) than the non-SSI group. In the SSI group, the Day 3 (10.5 ± 6.2% vs. 13.8 ± 6.0%, p = 0.012) and Day 7 (14.4 ± 4.8% vs. 18.8 ± 7.1%, p = 0.012) lymphocyte ratios were lower than the non-SSI group. Albumin levels on Day 1 in the SSI group were lower than in the non-SSI group (2.94 ± 0.30 mg/dL vs. 3.09 ± 0.38 mg/dL, p = 0.045). There is no difference in CRP and lymphocyte count between the two groups. Conclusions: SSI patients had lower lymphocyte percentages than non-SSI patients, which was a risk factor for SSI, with constant high inflammation. The Day 3 lymphocyte percentage may predict SSI after spinal instrumented surgery.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1648-91446042024Retrospective Cohort Study of Early versus Delayed Ballon Kyphoplasty Intervention for Osteoporotic Vertebral Fracture Treatment519ENAkiyoshiMiyamotoDepartment of Orthopaedic Surgery, Okayama Rosai HospitalUmeshPariharDepartment of Orthopaedic Surgery, Okayama Rosai HospitalChetanKumawatDepartment of Orthopaedic Surgery, Okayama Rosai HospitalAbdEl Kader Al AskarDepartment of Orthopaedic Surgery, Okayama Rosai HospitalMasatoTanakaDepartment of Orthopaedic Surgery, Okayama Rosai HospitalSharvariGunjotikarDepartment of Orthopaedic Surgery, Okayama Rosai HospitalTakuyaTaokaDepartment of Orthopaedic Surgery, Okayama Rosai HospitalTadashiKomatsubaraDepartment of Orthopaedic Surgery, Okayama Rosai HospitalYoshihiroFujiwaraDepartment of Orthopaedic Surgery, Okayama Rosai HospitalKojiUotaniDepartment of Orthopaedic Surgery, Okayama University HospitalShinyaAratakiDepartment of Orthopaedic Surgery, Okayama Rosai HospitalObjectives: To investigate the outcomes of early balloon kyphoplasty (BKP) intervention compared with late intervention for osteoporotic vertebral fracture (OVF). Background: Osteoporotic vertebral fracture can lead to kyphotic deformity, severe back pain, depression, and disturbances in activities of daily living (ADL). Balloon kyphoplasty has been widely utilized to treat symptomatic OVFs and has proven to be a very effective surgical option for this condition. Furthermore, BKP is relatively a safe and effective method due to its reduced acrylic cement leakage and greater kyphosis correction. Materials and Methods: A retrospective cohort study was conducted at our hospital for patients who underwent BKP for osteoporotic vertebral fractures in the time frame between January 2020 and December 2022. Ninety-nine patients were included in this study, and they were classified into two groups: in total, 36 patients underwent early BKP intervention (EI) at <4 weeks, and 63 patients underwent late BKP intervention (LI) at ≥4 weeks. We performed a clinical, radiological and statistical comparative evaluation for the both groups with a mean follow-up of one year. Results: Adjacent segmental fractures were more frequently observed in the LI group compared to the EI group (33.3% vs. 13.9%, p = 0.034). There was a significant improvement in postoperative vertebral angles in both groups (p = 0.036). The cement volume injected was 7.42 mL in the EI, compared with 6.3 mL in the LI (p = 0.007). The mean surgery time was shorter in the EI, at 30.2 min, compared with 37.1 min for the LI, presenting a significant difference (p = 0.0004). There was no statistical difference in the pain visual analog scale (VAS) between the two groups (p = 0.711), and there was no statistical difference in cement leakage (p = 0.192). Conclusions/Level of Evidence: Early BKP for OVF treatment may achieve better outcomes and fewer adjacent segmental fractures than delayed intervention.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1328-80676712025Avoidant/restrictive food intake disorder prognosis and its relation with autism spectrum disorder in Japanese childrene70040ENChieTanakaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAyumiOkadaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesManaHanzawaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChikakoFujiiDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshieShigeyasuDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkikoSugiharaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMakikoHoriuchiClinical Psychology Section, Department of Medical Support, Okayama University HospitalTakashiYorifujiDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHirokazuTsukaharaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground: There is a lack of reported clinical factors associated with the outcomes of children and adolescents with avoidant/restrictive food intake disorder (ARFID) in Japan. This study aimed to identify these clinical factors and explore the relationship between ARFID and autism spectrum disorder (ASD).<br>
Methods: This retrospective study analyzed data from 48 Japanese children and adolescents with ARFID who visited Okayama University Hospital between January 2011 and March 2022. Clinical characteristics were assessed using medical records and natural history questionnaires. The study compared patients with good and poor prognosis groups and used multiple logistic regression analysis to determine factors influencing prognosis.<br>
Results: The study included 33 patients with good prognoses and 15 with poor prognoses. Comorbid ASD was more prevalent in the poor prognosis group (60%) compared to the good prognosis group (21%). Additionally, more than half of the ARFID patients with comorbid ASD were initially undiagnosed. Multivariate analysis revealed that older age at first visit (p = 0.022) and comorbid ASD (p = 0.022) were statistically significant factors associated with poor prognosis in ARFID patients. There were no significant differences in body mass index standard deviation score and maximal weight loss between the two groups.<br>
Conclusions: The poor prognosis group had a higher prevalence of comorbid ASD diagnoses. Therefore, it is crucial to evaluate patient's developmental characteristics early in treatment and consider these characteristics throughout the course of care.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1467-30454762025Artificial Intelligence Approach in Machine Learning-Based Modeling and Networking of the Coronavirus Pathogenesis Pathway466ENShihoriTanabeDivision of Risk Assessment, Center for Biological Safety and Research, National Institute of Health SciencesSabinaQuaderInnovation Centre of NanoMedicine (iCONM), Kawasaki Institute of Industrial PromotionRyuichiOnoDivision of Cellular and Molecular Toxicology, Center for Biological Safety and Research, National Institute of Health SciencesHiroyoshi Y.TanakaDepartment of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAkihisaYamamotoDepartment of Mechanical Systems Engineering, Graduate School of Systems Design Tokyo Metropolitan UniversityMotohiroKojimaDepartment of Surgical Pathology, Kyoto Prefecture University of MedicineEdward J.PerkinsUS Army Engineer Research and Development CenterHoracioCabralDepartment of Bioengineering, Graduate School of Engineering, The University of TokyoThe coronavirus pathogenesis pathway, which consists of severe acute respiratory syndrome (SARS) coronavirus infection and signaling pathways, including the interferon pathway, the transforming growth factor beta pathway, the mitogen-activated protein kinase pathway, the apoptosis pathway, and the inflammation pathway, is activated upon coronaviral infection. An artificial intelligence approach based on machine learning was utilized to develop models with images of the coronavirus pathogenesis pathway to predict the activation states. Data on coronaviral infection held in a database were analyzed with Ingenuity Pathway Analysis (IPA), a network pathway analysis tool. Data related to SARS coronavirus 2 (SARS-CoV-2) were extracted from more than 100,000 analyses and datasets in the IPA database. A total of 27 analyses, including nine analyses of SARS-CoV-2-infected human-induced pluripotent stem cells (iPSCs) and iPSC-derived cardiomyocytes and fibroblasts, and a total of 22 analyses of SARS-CoV-2-infected lung adenocarcinoma (LUAD), were identified as being related to “human” and “SARS coronavirus 2” in the database. The coronavirus pathogenesis pathway was activated in SARS-CoV-2-infected iPSC-derived cells and LUAD cells. A prediction model was developed in Python 3.11 using images of the coronavirus pathogenesis pathway under different conditions. The prediction model of activation states of the coronavirus pathogenesis pathway may aid in treatment identification.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2076-261515102025A Canine c-kit Novel Mutation Isolated from a Gastrointestinal Stromal Tumor (GIST) Retains the Ability to Form Dimers but Lacks Autophosphorylation1444ENKeiShimakawaLaboratory of Veterinary Hygiene, School of Veterinary Science, Nippon Veterinary and Life Science UniversitySoDogeLaboratory of Veterinary Pathology, School of Veterinary Science, Nippon Veterinary and Life Science UniversityMasakiMichishitaLaboratory of Veterinary Pathology, School of Veterinary Science, Nippon Veterinary and Life Science UniversityEriTanabeLaboratory of Veterinary Hygiene, School of Veterinary Science, Nippon Veterinary and Life Science UniversityTsuyoshiTajimaLaboratory of Veterinary Pharmacology, School of Veterinary Science, Nippon Veterinary and Life Science UniversityMasatoKobayashiLaboratory of Veterinary Reproduction, School of Veterinary Science, Nippon Veterinary and Life Science UniversityMakotoBonkobaraLaboratory of Veterinary Clinical Pathology, School of Veterinary Science, Nippon Veterinary and Life Science UniversityMasamiWatanabeLaboratory of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazuhikoOchiaiLaboratory of Veterinary Hygiene, School of Veterinary Science, Nippon Veterinary and Life Science UniversityYoshikazuTanakaLaboratory of Veterinary Hygiene, School of Veterinary Science, Nippon Veterinary and Life Science UniversityGastrointestinal stromal tumors (GISTs) are mesenchymal tumors that develop in the gastrointestinal tract; KIT mutations are present in both canine and human GISTs. In this study, genomic DNA was extracted from formalin-fixed paraffin-embedded (FFPE) sections of 55 canine GIST cases, and mutation searches were performed for exons 8, 9, and 11. The results revealed novel mutations, A434T and F436S, in exon 8. In contrast to the A434T mutation without functional changes, the F436S mutant retained its dimerization ability, but lost its phosphorylation function and attenuated downstream Akt signaling, which is reflected in wound healing and migration activities. A comparison of the subcellular localization of WT KIT and the F436S mutant revealed no differences. In silico simulations indicated that the F436S mutation alters the structure of the near-membrane region and that its effects may extend to the transmembrane and intracellular domains compared to the WT. F436S is a point mutation that affects the entire molecule because co-mutation with the F436S mutation and the known autophosphorylation mutation reduces the autophosphorylation abilities.No potential conflict of interest relevant to this article was reported.Asian Spine Journal (ASJ)Acta Medica Okayama1976-19021932025More postoperative complications and revision surgery after occipitocervical fusion than after atlantoaxial fusion: a retrospective multicenter cohort study444451ENKojiUotaniDepartment of Orthopaedic Surgery, Okayama University HospitalAngel Oscar PazFloresDepartment of Orthopaedic Surgery, Okayama Rosai HospitalMasatoTanakaDepartment of Orthopaedic Surgery, Okayama Rosai HospitalShashank JEkadeDepartment of Orthopaedic Surgery, Okayama Rosai HospitalShinyaAratakiDepartment of Orthopaedic Surgery, Okayama Rosai HospitalTadashiKomatsubaraDepartment of Orthopaedic Surgery, Okayama Rosai HospitalYoshiakiOdaDepartment of Orthopaedic Surgery, Okayama University HospitalKensukeShinoharaDepartment of Orthopaedic Surgery, Okayama University HospitalToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University HospitalStudy Design: A retrospective multicenter cohort study.<br>
Purpose: We sought to determine whether occipitocervical (OC) fusion is followed by more postoperative complications and revision surgery than is atlantoaxial (AA) fusion. We aim to compare postoperative complications and revision surgery associated with OC fusion and AA fusion.<br>
Overview of Literature: OC and AA fusion are established techniques for restoring upper cervical stability. However, the outcomes of the two methods have not been compared.<br>
Methods: This study included 90 patients who underwent upper spinal fusion surgery for mechanical instability, performed by three surgeons in two hospitals from 2011 to 2023; OC fusion was indicated for irreducible AA subluxation, os odontoideum, and severe upper C1 fracture. Of the patients, 38 (mean age, 58.7 years) underwent OC fusion, and 52 (mean age, 62.8 years) underwent AA fusion. To evaluate surgical outcomes, we documented surgical time, intraoperative blood loss, postoperative complications, and the rate of revision surgery. Radiographs were obtained to identify screw malposition, rod breakage, and nonunion. To compare the outcomes of the two techniques, we used the Mann-Whitney U test for continuous variables and the chi-square or Fisher’s exact test for dichotomous variables.<br>
Results: OC fusion took significantly longer (175.4 minutes) than AA fusion (150.7 minutes, p=0.020) and had a higher complication rate (39.5% vs. 11.5%, p<0.0001). The reoperation rate was 23.7% (9/38) after OC fusion and 3.8% (2/52) after AA fusion; the difference was statistically significant (p=0.0073). Average amounts of blood loss were 224 mL during OC fusion and 224 mL during AA fusion; the difference was not significant (p=0.947).<br>
Conclusions: Although OC fusion is indispensable for certain conditions, particularly basilar invagination, it entails more risk than dose AA fusion; the choice of technique thus warrants careful consideration.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1040-46513772025Pancentromere analysis of Allium species reveals diverse centromere positions in onion and gigantic centromeres in garlickoaf142ENKiyotakaNagakiInstitute of Plant Science and Resources, Okayama UniversityKoichiroUshijimaGraduate School of Environmental and Life Science, Okayama UniversityTakashiAkagiGraduate School of Environmental and Life Science, Okayama UniversityKeisukeTanakaNODAI Genome Research Center, Tokyo University of AgricultureHisatoKobayashiNODAI Genome Research Center, Tokyo University of AgricultureIn eukaryotes, centromeres interact with the kinetochore for distribution of genetic information in cell division, yet their sequence and size are diverse among species. However, their position on chromosomes is considered to be conserved within a species. In this study, we analyzed the centromeres of 3 Allium species, namely, Welsh onion (Allium fistulosum), onion (Allium cepa), and garlic (Allium sativum) via pancentromere analysis and repetitive sequence analysis of centromeres and their neighborhoods and revealed their mobility, sequence organization, and size. Among the 3 species, Welsh onion and garlic had stable centromeres, but the onion centromere appeared to be polymorphic and frequently differed in position by up to 28.0 Mb among cultivars and between multiple individuals of the same cultivar. This mobility was stabilized by hybridization with Welsh onions. Furthermore, these 3 species have very different centromere sequence organization, including differences in the existence and maturity of centromeric satellites, and differences in centromere size, with Welsh onion having a centromere of 1.9 Mb, and garlic having a centromere of ∼10.6 Mb, the largest of any organism with monocentric chromosomes analyzed to date. Our pancentromere analysis of these Allium species reveals the variation in sequence organization, size, and position of this important chromosomal region.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841772025Six-Year Remission With No Relapse After Four-Time Weekly Rituximab Only for Bilateral Ocular Adnexal Follicular Lymphomae88945ENToshihikoMatsuoOphthalmology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, and Okayama University HospitalTakehiroTanakaDepartment of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityNobuharuFujiiDivision of Transfusion and Cell Therapy, Department of Hematology and Oncology, Okayama University HospitalFollicular lymphoma mostly takes an indolent course, and thus, observation with watchful waiting is a main therapeutic strategy. Recent long-term studies suggest earlier treatment with rituximab monotherapy may benefit patients by delaying the need for treatment in the later phase of exacerbation. In this study, we reported a patient with bilateral orbital follicular lymphoma who received four-time weekly rituximab monotherapy as an induction therapy only and maintained the remission for 5 years with no treatment. The patient was a 51-year-old woman who developed a right upper orbital mass and was diagnosed with follicular lymphoma grade 1 by the excisional biopsy. Two years later, at the age of 53 years, she developed a left lacrimal gland mass and underwent excision. The pathological diagnosis was follicular lymphoma grade 1. She did not have any other systemic lesions by fluorodeoxyglucose positron emission tomography. At the age of 54 years, she developed a new mass on the nasal side of the right orbit and underwent weekly rituximab monotherapy (375 mg/m2) four times a month, leading to the reduction of the mass in 3 months. Two high uptake sites on the temporal and nasal side of the right superior orbit by fluorodeoxyglucose positron emission tomography disappeared one year later at the age of 55 years. She was followed with no treatment for 6 years until the age of 60 years at the latest visit. In case of a local orbital relapse, local radiotherapy would be the standard, but rituximab monotherapy as an induction therapy only was chosen in the present patient. Rituximab monotherapy in place of local radiotherapy would be a treatment option for orbital follicular lymphoma.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0960-741212152025Spider mite tetranins elicit different defense responses in different host habitatse70046ENYukikoEndoDepartment of Biological Science and Technology, Faculty of Advanced Engineering, Tokyo University of ScienceMikuTanakaDepartment of Biological Science and Technology, Faculty of Advanced Engineering, Tokyo University of ScienceTakuyaUemuraDepartment of Biological Science and Technology, Faculty of Advanced Engineering, Tokyo University of ScienceKaoriTanimuraDepartment of Biological Science and Technology, Faculty of Advanced Engineering, Tokyo University of ScienceYoshitakeDesakiDepartment of Biological Science and Technology, Faculty of Advanced Engineering, Tokyo University of ScienceRikaOzawaCenter for Ecological Research, Kyoto UniversitySaraBonzanoDepartment of Life Sciences and Systems Biology, Plant Physiology Unit, University of TurinMassimo E.MaffeiDepartment of Life Sciences and Systems Biology, Plant Physiology Unit, University of TurinTomonoriShinyaInstitute of Plant Science and Resources (IPSR), Okayama UniversityIvanGalisInstitute of Plant Science and Resources (IPSR), Okayama UniversityGen‐ichiroArimuraDepartment of Biological Science and Technology, Faculty of Advanced Engineering, Tokyo University of ScienceSpider mites (Tetranychus urticae) are a major threat to economically important crops. Here, we investigated the potential of tetranins, in particular Tet3 and Tet4, as T. urticae protein-type elicitors that stimulate plant defense. Truncated Tet3 and Tet4 proteins showed efficacy in activating the defense gene pathogenesis-related 1 (PR1) and inducing phytohormone production in leaves of Phaseolus vulgaris. In particular, Tet3 caused a drastically higher Ca2+ influx in leaves, but a lower reactive oxygen species (ROS) generation compared to other tetranins, whereas Tet4 caused a low Ca2+ influx and a high ROS generation in the host plants. Such specific and non-specific elicitor activities were examined by knockdown of Tet3 and Tet4 expressions in mites, confirming their respective activities and in particular showing that they function additively or synergistically to induce defense responses. Of great interest is the fact that Tet3 and Tet4 expression levels were higher in mites on their preferred host, P. vulgaris, compared to the levels in mites on the less-preferred host, Cucumis sativus, whereas Tet1 and Tet2 were constitutively expressed regardless of their host. Furthermore, mites that had been hosted on C. sativus induced lower levels of PR1 expression, Ca2+ influx and ROS generation, i.e., Tet3- and Tet4-responsive defense responses, in both P. vulgaris and C. sativus leaves compared to the levels induced by mites that had been hosted on P. vulgaris. Taken together, these findings show that selected tetranins respond to variable host cues that may optimize herbivore fitness by altering the anti-mite response of the host plant.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0012-821X6532025Meteoritic and asteroidal amino acid heterogeneity: Implications for planetesimal alteration conditions and sample return missions119205ENChristianPotiszilPheasant Memorial Laboratory, Institute for Planetary Materials, Okayama UniversityTsutomuOtaPheasant Memorial Laboratory, Institute for Planetary Materials, Okayama UniversityMasahiroYamanakaPheasant Memorial Laboratory, Institute for Planetary Materials, Okayama UniversityKatsuraKobayashiPheasant Memorial Laboratory, Institute for Planetary Materials, Okayama UniversityRyojiTanakaPheasant Memorial Laboratory, Institute for Planetary Materials, Okayama UniversityEizoNakamuraPheasant Memorial Laboratory, Institute for Planetary Materials, Okayama UniversityCarbonaceous chondrites (CC) and asteroid return samples contain amino acids (AA), which are essential for an origin of life on the early Earth and can provide important information concerning planetesimal alteration processes. While many studies have investigated AA from CC, separate studies have often found differing abundances for the same meteorite. Accordingly, analytical bias, differing terrestrial contamination levels and intrinsic sample heterogeneity have been proposed as potential reasons. However, current analytical techniques allow for the analysis of several mg-sized samples and can thus enable an investigation of AA heterogeneity within single meteorite specimens. Here, such an analytical technique is applied to characterise the AA in triplicate aliquots of three CCs. The results indicate that CCs are heterogenous in terms of their AA at the mm-scale. Furthermore, the results help to further constrain the effects of planetesimal alteration on organic matter and the requirements of future sample return missions that aim to obtain organic-bearing extraterrestrial materials.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0040-40391692025Recent progress on phenothiazine organophotoredox catalysis155745ENKentaTanakaResearch Institute for Interdisciplinary Science, Okayama UniversityHiroyoshiTakamuraGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityIsaoKadotaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityPhotoredox catalysis has garnered significant attention in recent years due to its broad applicability in visible-light-induced organic transformations. While significant progress has been made in the development of highly oxidizing catalysts, such as acridinium catalysts, there remains a notable shortage of strongly reducing organophotoredox catalysts. Phenothiazines are widely used as photoredox catalysts owing to their unique redox potentials, particularly their low excited-state oxidation potentials (Eox* = −1.35 V to −3.51 V vs. SCE). Thus, they can be applied to a variety of photoredox reactions with oxidative-quenching cycles, and effectively reduce various organic molecules, such as aryl and alkyl halides, alkenes, malonyl peroxides, cobalt complexes, and redox-active esters. Due to their unique properties, this review focuses on the recent advances in phenothiazine organophotoredox catalysis.No potential conflict of interest relevant to this article was reported.American Astronomical SocietyActa Medica Okayama0004-637X96512024Unraveling the Cr Isotopes of Ryugu: An Accurate Aqueous Alteration Age and the Least Thermally Processed Solar System Material52ENRyojiTanakaThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityDilan M.RatnayakeThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityTsutomuOtaThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityNoahMiklusicakThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityTakKunihiroThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityChristianPotiszilThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityChieSakaguchiThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityKatsuraKobayashiThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityHiroshiKitagawaThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityMasahiroYamanakaThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityMasanaoAbeInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencyAkikoMiyazakiInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencyAikoNakatoInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencySatoruNakazawaInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencyMasahiroNishimuraInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencyTatsuakiOkadaInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencyTakanaoSaikiInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencySatoshiTanakaInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencyFuyutoTeruiInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencyYuichiTsudaInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencyTomohiroUsuiInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencySei-ichiroWatanabeDepartment of Earth and Planetary Sciences, Nagoya UniversityToruYadaInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencyKasumiYogataInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencyMakotoYoshikawaInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencyEizoNakamuraThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityThe analysis of samples returned from the C-type asteroid Ryugu has drastically advanced our knowledge of the evolution of early solar system materials. However, no consensus has been obtained on the chronological data, which is important for understanding the evolution of the asteroid Ryugu. Here, the aqueous alteration age of Ryugu particles was determined by the Mn–Cr method using bulk samples, yielding an age of 4.13 + 0.62/−0.55 Myr after the formation of Ca–Al-rich inclusions (CAI). The age corresponds to 4563.17 + 0.60/−0.67 Myr ago. The higher 55Mn/52Cr, ε54Cr, and initial ε53Cr values of the Ryugu samples relative to any carbonaceous chondrite samples implies that its progenitor body formed from the least thermally processed precursors in the outermost region of the protoplanetary disk. Despite accreting at different distances from the Sun, the hydrous asteroids (Ryugu and the parent bodies of CI, CM, CR, and ungrouped C2 meteorites) underwent aqueous alteration during a period of limited duration (3.8 ± 1.8 Myr after CAI). These ages are identical to the crystallization age of the carbonaceous achondirtes NWA 6704/6693 within the error. The ε54Cr and initial ε53Cr values of Ryugu and NWA 6704/6693 are also identical, while they show distinct Δ'17O values. This suggests that the precursors that formed the progenitor bodies of Ryugu and NWA 6703/6693 were formed in close proximity and experienced a similar degree of thermal processing in the protosolar nebula. However, the progenitor body of Ryugu was formed by a higher ice/dust ratio, than NWA6703/6693, in the outer region of the protoplanetary disk.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1471-24662512025Co-occurrence of interstitial lung disease and pulmonary embolism as adverse events of adjuvant osimertinib treatment for EGFR mutant non-small cell lung cancer: a case report311ENKentaManabeDepartment of Thoracic Surgery, Okayama University HospitalKazuhikoShienDepartment of Thoracic Surgery, Okayama University HospitalShinichiFurukawaDepartment of Thoracic Surgery, Okayama University HospitalTomoyaSenoDepartment of Thoracic Surgery, Okayama University HospitalKouseiIshimuraDepartment of Thoracic Surgery, Okayama University HospitalShinTanakaDepartment of Thoracic Surgery, Okayama University HospitalKenSuzawaDepartment of Thoracic Surgery, Okayama University HospitalMikioOkazakiDepartment of Thoracic Surgery, Okayama University HospitalSeiichiroSugimotoDepartment of Thoracic Surgery, Okayama University HospitalShinichiToyookaDepartment of Thoracic Surgery, Okayama University HospitalBackground Postoperative osimertinib for EGFR mutant non-small cell lung cancer has become the standard of care. However, its adverse events in clinical practice remain unclear. We report a case of interstitial lung disease and pulmonary embolism occurring simultaneously as adverse events during adjuvant osimertinib treatment.<br>
Case presentation A 74-year-old woman, diagnosed with left lower lobe lung adenocarcinoma harboring an EGFR mutation, underwent a left lower lobectomy with lymph node dissection. During adjuvant osimertinib therapy, the patient developed respiratory distress with hypoxia, leading to the diagnosis of interstitial lung disease. Despite immediate steroid therapy, respiratory distress persisted, the patient developed leg edema. She was diagnosed with deep vein thrombosis and pulmonary embolism via contrast-enhanced computed tomography scan. Following treatment with steroid and anticoagulation, her clinical symptoms improved rapidly, and she showed no recurrence of interstitial lung disease, pulmonary embolism, or lung cancer over the following nine months.<br>
Conclusions We encountered a case of interstitial lung disease and pulmonary embolism occurring simultaneously as adverse events during adjuvant osimertinib treatment. In patients with osimertinib-induced interstitial lung disease, particularly when respiratory symptoms show poor improvement with steroid treatment, the possibility of pulmonary embolism complications should be suspected.No potential conflict of interest relevant to this article was reported.BMJActa Medica Okayama2632-6140712025Reversible cerebral vasoconstriction syndrome in idiopathic multicentric Castleman disease under treatment with tocilizumabe000923ENNaoyaKamimuraDepartment of Neurology, Yokohama City University Medical CenterNaohisaUedaDepartment of Neurology, Yokohama City University Medical CenterKatsuoKimuraDepartment of Neurology, Yokohama City University Medical CenterAsamiNishikoriYasuharuSatoHitaruKishidaDepartment of Neurology, Yokohama City University Medical CenterFumiakiTanakaDepartment of Neurology and Stroke Medicine, Yokohama City University Graduate School of MedicineBackground Idiopathic multicentric Castleman disease (iMCD) is a rare polyclonal lymphoproliferative disorder characterised by systemic inflammation resulting from overproduction of interleukin 6 (IL-6). While iMCD primarily affects the lymph nodes and related tissues, it can also rarely involve the central nervous system.<br>
Case presentation We report the case of a 58-year-old female patient with at least a 3-year history of iMCD, who experienced acute thunderclap headaches due to reversible cerebral vasoconstriction syndrome (RCVS). RCVS occurred 3 months after initiating treatment with tocilizumab, a humanised anti-IL-6 receptor monoclonal antibody, and was accompanied by focal cortical subarachnoid haemorrhage (SAH). Elevated IL-6 levels were found in both serum and cerebrospinal fluid. MR angiography revealed multiple diffuse stenotic lesions in the bilateral middle and posterior cerebral arteries, which, along with bilateral cerebral oedema, resolved within 3 months. The diffuse nature of the cerebral vasospasm and the presence of bilateral brain oedema suggested that cerebral vasospasm was due to RCVS rather than SAH.<br>
Conclusions In patients with Castleman disease, RCVS may occur due to IL-6-dependent chronic cerebral vascular inflammation, either as a primary condition or as a complication of tocilizumab treatment.No potential conflict of interest relevant to this article was reported.International Institute of Anticancer ResearchActa Medica Okayama1109-65352242025C1orf50 Drives Malignant Melanoma Progression Through the Regulation of Stemness510524ENYUSUKEOTANIDepartment of Pathology, Beth Israel Deaconess Medical CenterMASAKIMAEKAWADepartment of Pathology, Beth Israel Deaconess Medical CenterATSUSHITANAKADepartment of Pathology, Beth Israel Deaconess Medical CenterTIRSOPEÑADepartment of Pathology, Beth Israel Deaconess Medical CenterVANESSA D.CHINUMass Chan Medical School, UMass Memorial Medical CenterANNAROGACHEVSKAYADepartment of Pathology, Beth Israel Deaconess 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: Recent advancements in omics analysis have significantly enhanced our understanding of the molecular pathology of malignant melanoma, leading to the development of novel therapeutic strategies that target specific vulnerabilities within the disease. Despite these improvements, the factors contributing to the poor prognosis of patients with malignant melanoma remain incompletely understood. The aim of this study was to investigate the role of C1orf50 (Chromosome 1 open reading frame 50), a gene previously of unknown function, as a prognostic biomarker in melanoma.<br>
Materials and Methods: We performed comprehensive transcriptome data analysis and subsequent functional validation of the human Skin Cutaneous Melanoma project from The Cancer Genome Atlas (TCGA).<br>
Results: Elevated expression levels of C1orf50 correlated with worse survival outcomes. Mechanistically, we revealed that C1orf50 plays a significant role in the regulation of cell cycle processes and cancer cell stemness, providing a potential avenue for novel therapeutic interventions in melanoma.<br>
Conclusion: This study is the first to identify C1orf50 as a prognostic biomarker in melanoma. The clinical relevance of our results sheds light on the importance of further investigation into the biological mechanisms underpinning C1orf50’s impact on melanoma progression and patient prognosis.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841762025Managing Persistent Pupillary Membranes With Surgery or Medication: A Report of Three Casese86695ENToshihikoMatsuoDivision of Healthcare Science, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTakehiroTanakaDepartment of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityThe persistent pupillary membrane, as a congenital anomaly, is a remnant of a network of feeding blood vessels for the lens of the eye, called tunica vasculosa lentis. This study reports three patients with persistent pupillary membrane in both eyes who presented in different situations and were managed differently to achieve better vision. The first child (Case 1) who had been seen initially at the age of two years complained of severe photophobia even though he had good visual acuity, and hence, he and his family chose surgical resection of the pupillary membrane in both eyes at the age of six years just before the admission to an elementary school. He did not develop any surgical complications, such as cataract and glaucoma, and maintained the visual acuity in decimals of 1.2 in both eyes at the age of 17 years.<br>
The second child (Case 2), who was seen first at the age of one month, had persistent pupillary membranes in both eyes, together with Peters' anomaly in the left eye. The iris process adhesion to the corneal inner surface was visualized later by optical coherence tomography. She wore full-correction glasses and obtained the visual acuity of 0.7 in the right eye, so she had no problem studying at an elementary school. She used topical 1% atropine once a week in both eyes to maintain pupillary dilation and also used 0.5% timolol and 1% brinzolamide as pressure-lowering eye drops in the left eye with Peters' anomaly.<br>
The third patient (Case 3) with persistent pupillary membranes in both eyes complained of vision problems for the first time at the age of 49 years when she developed cataract. Surgical resection of the pupillary membrane was done in the initial phase of cataract surgery with intraocular lens implantation in both eyes. At surgical resection of the pupillary membrane, a safe and efficient way was to cut the root of the pupillary membrane on the iris surface with scissors, and then the isolated tissues of the pupillary membrane were pulled out with forceps from the side port at the corneal limbus. Pathological examinations of the excised tissues showed blood vessels with red blood cells in the lumen. In such a rare congenital disease as the persistent pupillary membrane, a case-based approach to choose a better option in different conditions from individual to individual is still required to have a better vision in learning at school and in daily working life.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841762025Whole-Eye Radiation for the Local Control of Choroidal Lymphoma in Primary Central Nervous System Lymphoma: A 14-Year Case Studye85680ENToshihikoMatsuoGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTomofumiYanoDepartment of Internal Medicine, Okayama Rosai HospitalKotaroYoshioDepartment of Radiology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTakehiroTanakaDepartment of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityHirotakeNishimuraDepartment of Pathology, Kawasaki Medical SchoolKen-ichiMatsuokaDepartment of Hematology and Oncology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityInvolved-site radiation therapy is effective for curative and palliative treatments of cancers, including lymphoma. This case study describes the use of whole-eye radiation for primary intraocular lymphoma occurring during primary central nervous system lymphoma. The patient, a 68-year-old man, developed personality changes and apathy two weeks after cataract surgery combined with vitrectomy for vitreous opacity in the left eye. Magnetic resonance imaging revealed a mass lesion in the left frontal lobe, and biopsy by craniotomy confirmed diffuse large B-cell lymphoma. He underwent chemotherapy using rituximab combined with high-dose methotrexate and high-dose cytarabine in association with intrathecal methotrexate and cytarabine injections, leading to complete remission. At age 75, he noticed forgetfulness, and fluorodeoxyglucose positron emission tomography and magnetic resonance imaging revealed a relapse of lymphoma in the splenium of the corpus callosum. He underwent chemotherapy using rituximab combined with high-dose methotrexate, followed by monthly rituximab monotherapy for one year and then rituximab monotherapy every two months for one year. He maintained complete remission with no treatment until age 78, when he developed subretinal choroidal lesions in the left eye and underwent whole-eye radiation at 40 Gy. One year later, he developed subretinal choroidal lesions in the right eye and underwent whole-eye radiation at 40 Gy. At age 81, he had lower limb weakness with disorientation. Magnetic resonance imaging showed a relapse of lymphoma in the right frontal to temporal lobe. The brain lesions showed a marked response to four weeks of oral tirabrutinib as a salvage therapy, but the lesions regrew, and the patient died seven months later. Throughout the treatment, he maintained a visual acuity of 0.7 (decimal scale) in both eyes. In conclusion, whole-eye radiation should be considered as a treatment option for the local control of active intraocular lymphoma, especially choroidal lesions, for patients with primary central nervous system lymphoma with no active brain lesions and without systemic treatment.No potential conflict of interest relevant to this article was reported.Elmer Press, Inc.Acta Medica Okayama1923-41551652025Nephronophthisis and Retinitis Pigmentosa (Senior-Loken Syndrome) After Living-Donor Kidney Transplantation: Twelve-Year Follow-Up in a Young Woman164173ENToshihikoMatsuoGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityYasuhiroOnishiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityHiroshiMorinagaDepartment 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 UniversityTakehiroTanakaDepartment of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityMotooArakiDepartment of Urology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversitySenior-Loken syndrome is a hereditary ciliopathy with recessive trait that manifests as nephronophthisis and retinitis pigmentosa. This report described an 18-year-old woman who was referred to a University Hospital to set up a treatment plan for chronic renal failure of an unknown cause. She had experienced nocturnal polyurea from the age of 12 years and was found to have an elevated level of serum creatinine at 3 mg/dL at the age of 15 years. She underwent renal biopsy at a hometown regional hospital which showed global glomerulosclerosis in six of the 13 glomeruli examined, renal tubular dilation in irregular shape, and marked interstitial fibrosis with lymphocytic infiltration. At the age of 19 years, she received a living-donor kidney transplant from her 46-year-old father as a preemptive therapy. At surgery, biopsy of the father’s donor kidney showed two glomeruli with global sclerosis out of 24 glomeruli examined, in association with minimal interstitial fibrosis and lymphocytic infiltration. She began to have extended-release tacrolimus 4 mg daily and mycophenolate mofetil 1,000 mg daily. According to the standard protocol, she underwent biopsy of the transplanted donor kidney to reveal interstitial fibrosis and lymphocytic infiltration, in addition to no sign of rejection and no glomerular deposition of immunoglobulins and complements, both 4 weeks and 14 months after the kidney transplantation. At the age of 23 years, 4 years after the kidney transplantation, she was, for the first time, diagnosed retinitis pigmentosa, and hence, Senior-Loken syndrome. She was followed up in the stable condition with basal doses of tacrolimus 5 mg daily, mycophenolate mofetil 1,000 mg daily, and prednisolone 5 mg daily up until now in 12 years after the kidney transplantation. The interstitial fibrosis with lymphocytic infiltration in the donor kidney might be a milder presentation of the disease with recessive inheritance.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841752025Detailed Ophthalmic and Pathological Features of Choroidal Metastasis From Breast Cancer: A Case Series of Five Patientse83484ENToshihikoMatsuoDivision of Healthcare Science, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTakehiroTanakaDepartment of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTadahikoShienDepartment of Breast and Endocrine Surgery, Okayama University HospitalAtsushiMuraokaDepartment of Surgery, Kagawa Rosai HospitalHiroyoshiDoiharaDepartment of Breast and Endocrine Surgery, Okayama University HospitalBreast cancer causes choroidal metastases on rare occasions. This study presented the eye manifestations of choroidal metastases from breast cancer and their response to treatments in detail as well as their pathological correlation in five patients. The patients' age at the diagnosis of breast cancer ranged from 24 to 69 years (median: 37 years). The time from the diagnosis of breast cancer to the detection of metastases was concurrent in one patient, two years later in three patients, and six years later in the other patient. The time from the detection of systemic metastases to the detection of choroidal metastases was the same in one patient, while it ranged from one to seven years later in four patients. Choroidal metastases were in the unilateral eye of four patients, whereas they were in both eyes of one patient. Choroidal metastases manifested as one or a few nodular or flat choroidal lesions with serous retinal detachment. As for the treatment of choroidal metastases, enucleation of the right eye was chosen based on the patient's wish as well as the family's wish in the earliest patient when cancer notification was not the norm in Japan. In the other four patients, whole-eye radiation was performed to reduce the choroidal metastatic lesions. As regards the prognosis, which was available in four patients, three patients died within one year from the diagnosis of choroidal metastases, while one patient died one year and eight months later. Regarding the pathology of breast cancer, which was available in four patients, immunostaining of the preserved enucleated eye in the earliest patient revealed that breast cancer cells in the choroidal metastatic lesion were positive for estrogen receptor and negative for progesterone receptor and human epidermal growth factor receptor 2 (HER2). Invasive ductal carcinoma in two patients was positive for estrogen receptor and negative for HER2, while invasive ductal carcinoma in the other patient was triple-negative for estrogen receptor, progesterone receptor, and HER2 with a high Ki-67 index. In conclusion, the prognosis for life was poor in patients with breast cancer who developed choroidal metastases. Choroidal metastatic lesions showed a response to whole-eye radiation to improve the quality of vision at the end of life. Vision-related symptoms should be monitored in the course of chemotherapy for systemic metastases. No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2666-63673162025Clinical effects of granulocyte colony-stimulating factor administration and the timing of its initiation on allogeneic hematopoietic cell transplantation outcomes for myelodysplastic syndrome388.e1388.e14ENTakaakiKonumaDepartment of Hematology/Oncology, The Institute of Medical Science, The University of TokyoMachikoFujiokaDepartment of Hematology, Sasebo City General HospitalKyokoFuseFaculty of Medicine, Department of Hematology, Endocrinology and Metabolism, Niigata UniversityHirokiHosoiDepartment of Hematology/Oncology, Wakayama Medical UniversityYosukeMasamotoDepartment of Cell Therapy and Transplantation Medicine, The University of Tokyo HospitalNorikoDokiHematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalNaoyukiUchidaDepartment of Hematology, Toranomon HospitalMasatsuguTanakaDepartment of Hematology, Kanagawa Cancer CenterMasashiSawaDepartment of Hematology and Oncology, Anjo Kosei HospitalTetsuyaNishidaDepartment of Hematology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi HospitalJunIshikawaDepartment of Hematology, Osaka International Cancer InstituteNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalHirohisaNakamaeDepartment of Hematology, Osaka Metropolitan University Graduate School of MedicineYutaHasegawaDepartment of Hematology, Hokkaido University HospitalMakotoOnizukaDepartment of Hematology and Oncology, Tokai University School of MedicineTakeshiMaedaDepartment of Hematology and oncology, Kurashiki Central HospitalTakahiroFukudaDepartment of Hematopoietic Stem Cell Transplantation, National Cancer Center HospitalKojiKawamuraDepartment of Hematology, Tottori University HospitalYoshinobuKandaDivision of Hematology, Jichi Medical UniversityMarieOhbikiJapanese Data Center for Hematopoietic Cell TransplantationYoshikoAtsutaJapanese Data Center for Hematopoietic Cell TransplantationHidehiroItonagaTransfusion and Cell Therapy Unit, Nagasaki University HospitalGranulocyte colony-stimulating factor (G-CSF) accelerates neutrophil recovery after allogeneic hematopoietic cell transplantation (HCT). However, the optimal use of G-CSF and the timing of its initiation after allogeneic HCT for myelodysplastic syndrome (MDS) according to graft type have not been determined. This retrospective study aimed to investigate the effects of using G-CSF administration and the timing of its initiation on transplant outcomes in adult patients with MDS undergoing allogeneic HCT. Using Japanese registry data, we retrospectively investigated the effects of G-CSF administration and the timing of its initiation on transplant outcomes among 4140 adults with MDS after bone marrow transplantation (BMT), peripheral blood stem cell transplantation (PBSCT), or single-unit cord blood transplantation (CBT) between 2013 and 2022. Multivariate analysis showed that early (days 0 to 4) and late (days 5 to 10) G-CSF administration significantly accelerated neutrophil recovery compared with no G-CSF administration following BMT, PBSCT, and CBT, but there was no benefit of early G-CSF initiation for early neutrophilic recovery regardless of graft type. Late G-CSF initiation was significantly associated with a higher risk of overall chronic GVHD following PBSCT (hazard ratio [HR], 1.63; 95% confidence interval [CI], 1.18 to 2.24; P = .002) and CBT (HR, 2.09; 95% CI, 1.21 to 3.60; P = .007) compared with no G-CSF administration. Late G-CSF initiation significantly improved OS compared with no G-CSF administration only following PBSCT (HR, 0.74; 95% CI, 0.58 to 0.94; P = .015). However, G-CSF administration and the timing of its initiation did not affect acute GVHD, relapse, or non-relapse mortality, irrespective of graft type. These results suggest that G-CSF administration significantly accelerated neutrophil recovery after BMT, PBSCT, and CBT, but increased risk of overall chronic GVHD after PBSCT and CBT. However, the effect of early and late G-CSF initiation on transplant outcomes needs further study in adult patients with MDS.
No potential conflict of interest relevant to this article was reported.International Union of Crystallography (IUCr)Acta Medica Okayama1600-57675832025Enhanced estimation method for partial scattering functions in contrast variation small-angle neutron scattering via Gaussian process regression with prior knowledge of smoothness976991ENIppeiObayashiCenter for Artificial Intelligence and Mathematical Data Science, Okayama UniversityShinyaMiyajimaFaculty of Science and Engineering, Iwate UniversityKazuakiTanakaGlobal Center for Science and Engineering, Waseda UniversityKoichiMayumiInstitute for Solid State Physics, University of TokyoContrast variation small-angle neutron scattering (CV-SANS) is a powerful tool for evaluating the structure of multi-component systems. In CV-SANS, the scattering intensities I(Q) measured with different scattering contrasts are decomposed into partial scattering functions S(Q) of the self- and cross-correlations between components. Since the measurement has a measurement error, S(Q) must be estimated statistically from I(Q). If no prior knowledge about S(Q) is available, the least-squares method is best, and this is the most popular estimation method. However, if prior knowledge is available, the estimation can be improved using Bayesian inference in a statistically authorized way. In this paper, we propose a novel method to improve the estimation of S(Q), based on Gaussian process regression using prior knowledge about the smoothness and flatness of S(Q). We demonstrate the method using synthetic core–shell and experimental polyrotaxane SANS data.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Effect of Radon Inhalation on Murine Brain Proteins : Investigation Using Proteomic and Multivariate AnalysesENShotaNAOEGraduate School of Health Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Effect of continuous sweet gustatory stimulation on salivary flow rate over timeENRankoYAMADAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Trabecular bone scores in children with osteogenesis imperfecta respond differently to bisphosphonate treatment depending on disease severityENNatsukoFUTAGAWAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama2632-2498712025Evaluating short-term survivors of glioblastoma: A proposal based on SEER registry datavdaf036ENYusukeTomitaDepartment of Neurological Surgery, Okayama University Medical SchoolYoshihiroOtaniDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoOmaeDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoMizutaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJojiIshidaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuyukiHirotsuneDepartment of Neurosurgery and Neuroendovascular Surgery, Hiroshima City Hiroshima Citizens HospitalShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground: Glioblastomas (GBMs) are central nervous system tumors with a poor prognosis and limited treatment options. Although small subsets of GBM patients survive longer than 3 years, there is little evidence regarding the prognostic factors of GBM. Therefore, we conducted a thorough characterization of GBM in the United States.<br>
Methods: We queried the Surveillance, Epidemiology, and End Results database between 2000 and 2021 to extract age-adjusted incidence rates (AAIRs), age-adjusted mortality rates (AAMRs), and survival data for GBM. We compared trends in AAIR, AAMR, and survival time across age groups 0–14, 15–39, 40–69, and 70+ years. Also, we employed the Fine–Gray competing risk model among short-term survivors (STSs), defined as those with a survival time of 6 months or less, and long-term survivors (LTSs), defined as those with a survival time of 3 years or more.<br>
Results: This study included 60 615 incident GBM cases, 54 998 GBM-specific deaths, and 47 207 GBM patients with available survival time between 2000 and 2021. The mortality-to-incidence ratio was constant among STSs, whereas it increased with age among LTSs. Higher age and male sex were significantly associated with GBM-specific death among LTSs, whereas non-Hispanic White and less intensive treatments were associated with GBM-specific deaths among STSs. Interestingly, higher age was significantly associated with other causes of death among STSs.<br>
Conclusions: STSs partially consist of populations who died from causes other than GBM. It is important to include only GBM-specific deaths in STS groups to conduct reproducible research comparing STSs and LTSs.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7932025A Case of Aniline Poisoning Manifesting as Cyanosis with Unknown Cause209212ENKenichiTaguchiDepartment of Gastroenterology, NHO Iwakuni Clinical CenterKazuyaNishiiDepartment of Respiratory Medicine, NHO Iwakuni Clinical CenterSakuraHataDepartment of Gastroenterology, NHO Iwakuni Clinical CenterShoichiKuyamaShoichiTanakaDepartment of Gastroenterology, NHO Iwakuni Clinical CenterCase Report10.18926/AMO/68729A 38-year-old man was brought to the hospital for emergency treatment of cyanosis. The patient exhibited generalized cyanosis and impaired consciousness despite adequate oxygen therapy. Arterial blood was black, and arterial blood gas analysis revealed an abnormally high methemoglobin level of 67.8%. We later interviewed his colleagues regarding his exposure to aniline while working at the factory and diagnosed him with methemoglobinemia due to aniline poisoning. The patient was administered methylene blue (MB) after being transferred to another hospital, where this treatment was available, resulting in an improvement in symptoms. Although rare, methemoglobinemia is serious. A good understanding of the circumstances at disease onset, characteristic findings, and abnormal values of methemoglobinemia is important. In addition, MB is an important therapeutic for the treatment of methemoglobinemia; if MB is not available at a particular hospital, transfer of the patient to a hospital that stocks MB should be considered.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7932025Promising Effectiveness of Combined Chemotherapy and Immunotherapy in Patients with Advanced Non-small Cell Lung Cancer: A Real-World Prospective Observational Study (CS-Lung-003)167176ENNobuhiroKanajiDepartment of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa UniversityKazuyaNishiiDepartment of Respiratory Medicine, National Hospital Organization Iwakuni Clinical CenterYukariTsubataDepartment of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of MedicineMikaNakaoDepartment of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of MedicineTakaeOkunoDepartment of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of MedicineSachiOkawaDepartment of Allergy and Respiratory Medicine, Okayama University HospitalKenjiTakataDepartment of Allergy and Respiratory Medicine, Okayama University HospitalMasahiroKodaniDivision of Medical Oncology and Molecular Respirology, Faculty of Medicine, Tottori UniversityMasahiroYamasakiDepartment of Respiratory Disease, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors HospitalKazunoriFujitakaDepartment of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityTetsuyaKubotaDepartment of Respiratory Medicine and Allergology, Kochi UniversityMasaakiInoueDepartment of Chest Surgery, Shimonoseki City HospitalNaokiWatanabeDepartment of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa UniversityKatsuyukiHottaCenter for Innovative Clinical Medicine, Okayama University HospitalCS-Lung-003 InvestigatorOriginal Article10.18926/AMO/68724This prospective observational study investigated the clinical status of patients with advanced non-small cell lung cancer (NSCLC) treated with cytotoxic chemotherapy+an immune checkpoint inhibitor (chemo + IO) as first-line treatment in a real-world setting. The cases of 98 patients treated with chemo + IO were prospectively collected and analyzed for effectiveness and safety. The response rate to chemo + IO was 46.9%, and the disease control rate was 76.5%. The median progression-free survival and overall survival (OS) in the total population were 5.2 and 22.3 months, respectively. The patients positive for PD-L1 (≥ 1%) showed significantly longer OS than the negative group (<1%) (median 26.7 vs. 18.7 months, p=0.04). Pre-existing interstitial lung disease (ILD) was associated with shorter OS than the absence of ILD (median 9.0 vs. 22.6 months, p<0.01). Immunerelated adverse events (irAEs) were observed in 28 patients (28.6%). The most frequent irAE was ILD (n=11); Grade 1 (n=1 patient), G2 (n=5), G3 (n=4), and only a single patient with a G5 irAE. In this CS-Lung-003 study, first-line chemo + IO in a real-world setting showed good effectiveness, comparable to that observed in international clinical trials. In real-world practice, chemo + IO is a promising and steadfast strategy.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-29186432025Characteristics of Early Gastric Cancer in a Patient with a History of Helicobacter pylori Infection and No History of Eradication Therapy343350ENSakikoKuraokaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeijiKawanoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShokoInoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuyaSatomiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaHamadaDepartment of Practical Gastrointestinal Endoscopy, Okayama University HospitalYoshiyasuKonoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiroKawaharaDepartment of Practical Gastrointestinal Endoscopy, Okayama University HospitalTakehiroTanakaDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiOkadaDepartment 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 SciencesObjective The characteristics of gastric cancer in patients with atrophic mucosa and no apparent history of Helicobacter pylori eradication have not been thoroughly investigated. Therefore, this study examined the clinicopathological characteristics of gastric cancer in these patients.<br>
Methods We retrospectively examined the endoscopic and pathological characteristics of gastric cancer in patients who underwent endoscopic submucosal dissection.<br>
Patients We divided the patients into 2 groups: those with gastric atrophy and no history of eradication (group A; n=102) and those with a history of eradication (group B; n=161). In group A, patients were further divided into mild atrophy (group C) and severe atrophy (group D) groups, while group B was further divided into those who underwent eradication treatment >5 years ago (group E) and those who underwent eradication 1-5 years ago (group F).<br>
Results Group A comprised significantly older individuals (75±8.0 vs. 71±7.5 years old, p<0.001) with a higher frequency of elevated gastric cancer than group B (32.4% vs. 17.4%, p=0.006). Compared with group E, group A was older and had a greater incidence of elevated gastric cancer. The incidence of gastric cancer in the U or M region was lower in group C than in group D.<br>
Conclusion Gastric cancer in patients with gastric atrophy and no history of eradication was associated with an older age and higher frequency of elevated-type morphology than in those with a history of eradication.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2397-9070942025Frequency and Characteristics of Gastrointestinal Diseases in Patients With Neurofibromatosise70151ENManamiHondaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakehiroTanakaDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYasushiYamasakiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeijiKawanoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSakikoHiraokaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiroKawaharaDepartment of Practical Gastrointestinal Endoscopy,Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground and Aim: Patients with neurofibromatosis (NF) frequently experience gastrointestinal symptoms, but the specific characteristics of these lesions are not well understood.<br>
Methods: To investigate the prevalence and nature of gastrointestinal diseases in this population, we analyzed the gastrointestinal lesions identified through endoscopic examinations in patients with NF.<br>
Results: We included 225 patients with NF type 1 (NF1) and 15 with NF type 2 (NF2). None of the NF2 patients underwent endoscopy. Among the NF1 patients, 27 received endoscopies, and 13 (59%) had gastrointestinal lesions. These 13 patients were predominantly male (10 males and three females), with a median age of 53 years (range: 19-76 years). The identified lesions included colorectal polyps (n = 6), gastrointestinal stromal tumors ([GIST], n = 4), subepithelial lesions (n = 3), gastric fundic gland polyps (n = 3), diffuse intestinal ganglioneuromatosis (n = 2), esophageal polyps (n = 2), a Schwann cell hamartoma (n = 1), esophageal cancer (n = 1), and a gastric hyperplastic polyp (n = 1). All GISTs and one case of diffuse intestinal ganglioneuromatosis were surgically resected. Interestingly, six out of 13 patients were asymptomatic. Additionally, all patients who required surgery were 40 years of age or older.<br>
Conclusions: These findings suggest that routine endoscopic examinations, along with imaging techniques like computed tomography and magnetic resonance imaging, could be beneficial for the early detection of gastrointestinal lesions in NF1 patients aged 40 and above.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7922025Safe Resection of Esophageal Cancer with a Non-Recurrent Inferior Laryngeal Nerve Associated with an Aberrant Right Subclavian Artery Using Intraoperative Nerve Monitoring139144ENYasushigeTakedaDepartment of Gastroenterological Surgery, Okayama University HospitalKazuhiroNomaDepartment of Gastroenterological Surgery, Okayama University HospitalNaoakiMaedaDepartment of Gastroenterological Surgery, Okayama University HospitalYoheiMizusawaDepartment of Gastroenterological Surgery, Okayama University HospitalHijiriMatsumotoDepartment of Gastroenterological Surgery, Okayama University HospitalYuheiKondoDepartment of Gastroenterological Surgery, Okayama University HospitalTomoyoshiKunitomoDepartment of Gastroenterological Surgery, Okayama University HospitalYukinoriTanoueDepartment of Gastroenterological Surgery, Okayama University HospitalMasashiHashimotoDepartment of Gastroenterological Surgery, Okayama University HospitalShunsukeTanabeDepartment of Gastroenterological Surgery, Okayama University HospitalToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University HospitalCase Report10.18926/AMO/68654In thoracic esophageal cancer, lymph node dissection around the recurrent laryngeal nerve is crucial but poses a risk of nerve palsy, affecting postoperative quality of life. In cases with an aberrant right subclavian artery (ARSA), the right recurrent laryngeal nerve is absent, and the non-recurrent inferior laryngeal nerve (NRILN) enters the larynx directly from the vagus nerve in the cervical region. Identifying the course of the NRILN is vital to avoid injury. A case of esophageal cancer with an ARSA, in which the course of the NRILN was preserved using the Nerve Integrity Monitoring (NIM) system during surgery, is described.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7922025Calcified Amorphous Tumor of the Left Ventricle with Paroxysmal Atrial Fibrillation135138ENYasufumiFujitaDepartment of Cardiovascular Surgery, Kure Kyosai HospitalShujiShimizuDepartment of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMakotoMohriDepartment of Cardiovascular Surgery, Japanese Red Cross Society Himeji HospitalCase Report10.18926/AMO/68653Cardiac calcified amorphous tumor (CAT) is a rare, benign non-neoplastic mass of the heart that is sometimes found due to embolic events. Most cases of CAT are treated with surgical removal to prevent future embolic events. However, the treatment strategy for CAT complicated by atrial fibrillation has remained to be determined. Here we report a case of left ventricular CAT complicated by paroxysmal atrial fibrillation (PAF) that was successfully treated with surgical removal and pulmonary vein isolation. Pulmonary vein isolation can be a simple and effective procedure for PAF, even during surgical removal of CAT.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7922025Clinical Outcomes of Neoadjuvant Paclitaxel/Cisplatin/Gemcitabine Compared with Gemcitabine/Cisplatin for Muscle-Invasive Bladder Cancer8192ENTatsushiKawadaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuyukiKobayashiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakujiTsugawaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazumaTsuboiDepartment of Urology, Hiroshima City Hiroshima Citizens HospitalSatoshiKatayamaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakehiroIwataDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKensukeBekkuDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokoKobayashiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiEdamuraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinEbaraDepartment of Urology, Hiroshima City Hiroshima Citizens HospitalMotooArakiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/68646We retrospectively evaluated the oncologic outcomes of paclitaxel, cisplatin, and gemcitabine (PCG) with those of gemcitabine and cisplatin (GC) as neoadjuvant chemotherapy in muscle-invasive bladder cancer (MIBC) patients. The primary outcome was efficacy: pathological complete response (pCR), ypT0N0; and pathological objective response (pOR), ypT0N0, ≤ ypT1N0, or ypT0N1. Secondary outcomes included overall survival (OS), recurrence-free survival (RFS), predictive factors for pOR, OS, and RFS, and hematologic adverse events (AEs). Among 113 patients treated (PCG, n=28; GC, n=85), similar pOR and pCR rates were achieved by the groups (pOR: PCG, 57.1% vs. GC, 49. 4%; p=0.52; pCR: PCG, 39.3% vs. GC, 29.4%; p=0.36). No significant differences were observed in OS (p=1.0) or RFS (p=0.20). Multivariate logistic regression analysis showed that hydronephrosis (odds ratio [OR] 0.32, 95%CI: 0.11-0.92) and clinical node-positive status (cN+) (OR 0.22, 95%CI: 0.050-0.99) were significantly associated with a decreased probability of pOR. On multivariate Cox regression analyses, pOR achievement was associated with improved OS (hazard ratio [HR] 0.23, 95%CI: 0.10-0.56) and RFS (HR 0.30, 95%CI: 0.13-0.67). There were no significant between-group differences in the incidence of grade ≥ 3 hematologic AEs or dose-reduction required, but the PCG group had a higher incidence of grade 4 neutropenia.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7922025Association between the Pretreatment Body Mass Index and Anamorelin’s Efficacy in Patients with Cancer Cachexia: A Retrospective Cohort Study6573ENMasatoshiMakiDepartment of Hospital Pharmacy, NHO Fukuyama Medical CenterRyoTakadaDepartment of Hospital Pharmacy, NHO Fukuyama Medical CenterTomoyukiIshigoDepartment of Pharmacy, Sapporo Medical University HospitalMikiFujiwaraDepartment of Hospital Pharmacy, NHO Fukuyama Medical CenterYokoTakahashiDepartment of Hospital Pharmacy, NHO Fukuyama Medical CenterShinyaOtsukaDepartment of Surgery, NHO Fukuyama Medical CenterKojiTamuraDepartment of Hospital Pharmacy, NHO Fukuyama Medical CenterTerutakaHamaokaDepartment of Hospital Pharmacy, NHO Fukuyama Medical CenterOriginal Article10.18926/AMO/68644Anamorelin (ANAM) is used to treat cancer-associated cachexia, a syndrome involving muscle loss and anorexia. The timing of the initiation of ANAM treatment is crucial to its efficacy. Although the body mass index (BMI) is a diagnostic criterion for cancer cachexia, no studies have explored its association with ANAM efficacy. We conducted a single-center, retrospective cohort study to investigate the association between the pre-treatment BMI and ANAM efficacy in patients with cancer-associated cachexia (n=47). The ANAM treatment was considered effective if the patient’s appetite improved within 30 days of treatment initiation. We calculated a BMI cutoff value (19.5 kg/m2) and used it to divide the patients into high- and low-BMI groups. Their background, clinical laboratory values, cancer types, and treatment lines were investigated. Twenty (42.6%) had a high BMI (≥ 19.5 kg/m2) and 27 (57.4%) had a low BMI (< 19.5 kg/m2). High BMI was significantly associated with ANAM effectiveness (odds ratio 7.86, 95% confidence interval 1.99-31.00, p=0.003). Together these results indicate that it is beneficial to initiate ANAM treatment before a patient’s BMI drops below 19.5 kg/m2. Our findings will help advance cancer cachexia treatment and serve as a reference for clinicians to predict ANAM’s efficacy.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841742025Bilateral Scleritis and Neutrophilic Dermatosis With Cytogenetic Chromosomal Aberrancy Related to Pyoderma Gangrenosum: A Case Report of a 20-Year Follow-Upe82348ENToshihikoMatsuoDepartment of Ophthalmology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTakehiroTanakaDepartment of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityNoboruAsadaDepartment of Hematology and Oncology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityMikakoObikaDepartment of General Internal Medicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityRyotaroOmichiDepartment of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityKeijiIwatsukiDepartment of Dermatology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityPyoderma gangrenosum is a non-infectious autoimmune disease with skin plaques and ulcers in the entity of neutrophilic dermatosis and may have a background of myelodysplastic syndromes. This study reported a 20-year follow-up of a patient with pyoderma gangrenosum and scleritis who showed chromosomal aberrancy from the initial phase and later in the course developed thrombocythemia. A 51-year-old man presented with widespread indurated erythematous plaques with scaling and pustules on the forehead, bilateral eyelids, and nasal bridge, in addition to nodular scleritis in the left eye and ulcer formation of the plaques in the lower legs. Skin biopsy revealed massive dermal infiltration mainly with neutrophils in the absence of neutrophilic vasculitis. Suspected of myelodysplastic syndromes, bone marrow biopsy was normal, while chromosomal aberrancy, 46, XY, del (20) (q11q13.3), was detected. In the diagnosis of neutrophilic dermatosis, probably of pyoderma gangrenosum, he began to have oral prednisolone 20 mg daily and colchicine 1 mg daily, leading to the subsidence of skin lesions. Four months later, he developed nodular scleritis in the right eye and began to use topical 0.1% betamethasone in both eyes. He was stable with only prednisolone 12.5 mg daily until the age of 55.5 years, when he showed an increase of serum lactate dehydrogenase. The bone marrow aspirate disclosed neither blast cell increase nor atypical cells. The same chromosomal aberrancy was repeatedly detected. One year later, he developed breathing difficulty and underwent tracheostomy. Laryngeal lesion biopsy disclosed squamous cell papilloma with human papillomavirus-6. At 60 years old, he showed marginal corneal infiltration in the left eye, and at 61 years old, hypopyon in the right eye. Platelets tended to increase up to 1000 × 103/µL, and bone marrow examinations were recommended but refused by the patient. At the latest follow-up at 71 years old, he was ambulatory in health and stable with a tracheostomy cannula. In conclusion, pyoderma gangrenosum with scleritis occurred in an undetermined hematological malignancy with chromosomal aberrancy.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1432-10683512025Primary chest wall sarcoma: advances in surgical management and outcomes141ENShinTanakaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEijiNakataTsuyoshiRyukoDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakutoItanoDepartment of Orthopedic Surgery, Okayama University HospitalYasuakiTomiokaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhikoShienDepartment 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 SciencesKentarohMiyoshiDepartment 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 SciencesSeiichiroSugimotoDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopedic Surgery, Okayama University HospitalShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesPurpose Although rare, primary chest wall sarcomas are complex malignancies necessitating optimal local control and comprehensive treatment. This study aimed to review 9 years of cases of primary chest wall sarcomas at a single institution, focusing on their histology, surgical management, and prognosis.<br>
Methods A retrospective analysis was performed on 19 patients undergoing chest wall resection for sarcoma from 2012 to 2020. Data on demographics, tumor specifics, resection extent, and adjuvant therapies were collected. Surgical and postoperative outcomes were also assessed.<br>
Results The median patient age was 64 years. Chondrosarcoma was the most common histology. R0 resection was achieved in all patients, with early postoperative complications occurring in 11% of the patients. Robust chest wall reconstruction was performed, resulting in minimal respiratory complications. The 5-year overall survival and disease-free survival rates were 94% and 68%, respectively. Tumor size and patient age were significant prognostic factors for local recurrence.<br>
Conclusion Comprehensive surgical resection, coupled with multidisciplinary preoperative planning, achieves favorable outcomes. Patients aged ≥ 70 years and with tumor size ≥ 5 cm (P = .047) should be carefully followed up for local recurrence.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841732025A Natural Course From Primary Intraocular Lymphoma to Brain Lymphoma in Four Years According to Patient's Choicee81476ENToshihikoMatsuoDepartment of Ophthalmology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTakehiroTanakaDepartment of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityJojiIshidaDepartment of Neurological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityShotaroKondoDepartment of Internal Medicine, Kurashiki Municipal HospitalKen-ichiMatsuokaDepartment of Hematology and Oncology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityPrimary intraocular lymphoma or vitreoretinal lymphoma is a rare entity of diffuse large B-cell lymphoma that presents vitreous opacity and retinal and choroidal infiltration. Primary central nervous system lymphoma would occur previously, later, or concurrently with respect to primary intraocular lymphoma. This study reported a 72-year-old patient with a pathological diagnosis of primary intraocular lymphoma who developed central nervous system lymphoma four years later in the course of no treatment. She presented with a four-year history of blurred vision in both eyes after cataract surgeries. Three weeks previously, she underwent a vitrectomy in the left eye at a clinic, and measurements of the vitreous fluid showed a high level of interleukin-10 at 5739 pg/mL, in contrast with interleukin-6 at 142 pg/mL. Cytology of the vitreous fluid was class III on the Papanicolaou classification. Head magnetic resonance imaging detected nothing abnormal. She underwent vitrectomy in the right eye as a diagnostic procedure to show large cells in the vitreous which were positive for CD20 and Ki-67 and negative for CD3, leading to a pathological diagnosis of large B-cell lymphoma. Prophylactic chemotherapy with high-dose methotrexate was recommended as a therapeutic option, but she chose observation since she did not have any eye or systemic symptoms. In the follow-up every three months by an oncologist and an ophthalmologist, she did not have any symptoms, and serum levels of soluble interleukin-2 receptor were in the normal range at each visit. She was well for four years until the age of 76 years when she fell and hit her head, and an emergency head computed tomography scan showed a mass in the left occipital lobe. Magnetic resonance imaging demonstrated a well-defined circular mass in the left occipital lobe with a hyperintense signal in the T2-weighted fluid-attenuated inversion recovery (FLAIR) image and diffusion-weighted image. Fluorodeoxyglucose positron emission tomography showed no abnormal uptake systemically, except for the left occipital lesion. She underwent a brain biopsy by craniotomy to pathologically prove diffuse large B-cell lymphoma. She was recommended to receive first-line chemotherapy as the standard treatment but chose observation with no treatment and died of brain lymphoma nine months later. This case happened to illustrate a natural course of primary intraocular lymphoma which proceeded to central nervous system lymphoma four years later.No potential conflict of interest relevant to this article was reported.American Association for Cancer Research (AACR)Acta Medica Okayama0008-54728562025Myeloid Cells Induce Infiltration and Activation of B Cells and CD4+ T Follicular Helper Cells to Sensitize Brain Metastases to Combination Immunotherapy10821096ENToshifumiNinomiyaDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNaoyaKemmotsuDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityFumiakiMukoharaDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasakiMagariApplied Cell Biology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityAiMiyamotoMedical Protein Engineering, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityYoukiUedaDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakamasaIshinoDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJojiNagasakiDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomohiroFujiwaraDepartment of Orthopaedic Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityHidetakaYamamotoDepartment of Pathology and Oncology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHidetoshiHayashiDepartment of Medical Oncology, Kindai University Faculty of MedicineKotaTachibanaDepartment of Dermatology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityJojiIshidaDepartment of Neurological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshihiroOtaniDepartment of Neurological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShotaTanakaDepartment of Neurological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShinichiToyookaDepartment of General Thoracic Surgery, Breast and Endocrinological Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Science, Okayama UniversityIsamuOkamotoDepartment of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu UniversityYosukeTogashiDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBrain metastasis is a poor prognostic factor in patients with cancer. Despite showing efficacy in many extracranial tumors, immunotherapy with anti–PD-1 mAb or anti–CTLA4 mAb seems to be less effective against intracranial tumors. Promisingly, recent clinical studies have reported that combination therapy with anti–PD-1 and anti–CTLA4 mAbs has a potent antitumor effect on brain metastasis, highlighting the need to elucidate the detailed mechanisms controlling the intracranial tumor microenvironment (TME) to develop effective immunotherapeutic strategies. In this study, we analyzed the tumor-infiltrating lymphocytes in murine models of brain metastasis that responded to anti–CTLA4 and anti–PD-1 mAbs. Activated CD4+ T follicular helper (TFH) cells with high CTLA4 expression characteristically infiltrated the intracranial TME, which were activated by combination anti–CTLA4 and anti–PD-1 treatment. The loss of TFH cells suppressed the additive effect of CTLA4 blockade on anti–PD-1 mAb. B-cell–activating factor belonging to the TNF family (BAFF) and a proliferation-inducing ligand (APRIL) produced by abundant myeloid cells, particularly CD80hiCD206lo proinflammatory M1-like macrophages, in the intracranial TME induced B-cell and TFH-cell infiltration and activation. Furthermore, the intracranial TME of patients with non–small cell lung cancer featured TFH- and B-cell infiltration as tertiary lymphoid structures. Together, these findings provide insights into the immune cell cross-talk in the intracranial TME that facilitates an additive antitumor effect of CTLA4 blockade with anti–PD-1 treatment, supporting the potential of a combination immunotherapeutic strategy for brain metastases.<br>
Significance: B-cell and CD4+ T follicular helper cell activation via BAFF/APRIL from abundant myeloid cells in the intracranial tumor microenvironment enables a combinatorial effect of CTLA4 and PD-1 blockade in brain metastases.No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323152025主体的・自律的な学びを萌芽させる「授業と授業をつなぐ家庭学習」の探究297311ENJunkoTANAKAOkayama Municipal Hosen Junior High SchoolRyoMISAWAFaculty of Education, Okayama University10.18926/CTED/68500 生徒が自ら学習を進めていく力を身に付けるには，授業内だけでなく，家庭など授業外の場での学習経験を積む必要がある。つまり，学習は授業内だけで完結するのではなく，広範な活動を通して成立する。本研究では，公立中学校の第2学年を対象に授業と家庭学習を連携させる実践を行い，生徒の「主体的・自律的な学び」を萌芽させることを目指した。教師が学習方略や目標設定の重要性を伝え，メタ認知を促すことで，生徒は自己調整学習のサイクルを意識し，自分なりの学習方略を探求するようになった。また，家庭学習で授業につながる課題に取り組むことで，授業への主体的な参加と，授業外で自律的に学ぶ意欲が促されることも示唆された。No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1863-67052025Novel pulmonary abdominal normothermic regional perfusion circuit for simultaneous in-donor evaluation and preservation of lungs and abdominal organs in donation after circulatory deathENShinTanakaDepartment of General Thoracic and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineMasashiUmedaDepartment of General Thoracic and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineHiroyukiUjikeDepartment of General Thoracic Surgery, Shimane University Graduate School of MedicineTsuyoshiRyukoDepartment of General Thoracic and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineYasuakiTomiokaDepartment of General Thoracic and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKentarohMiyoshiDepartment of General Thoracic and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineMikioOkazakiDepartment of General Thoracic and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineSeiichiroSugimotoDepartment of General Thoracic and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineShinichiToyookaDepartment of General Thoracic and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineObjective To overcome limitations of traditional ex vivo lung perfusion (EVLP) for controlled donation after circulatory death (cDCD) lungs, this study aimed to evaluate a novel pulmonary abdominal normothermic regional perfusion (PANRP) technique, which we uniquely designed, for in situ assessment of lungs from cDCD donors.<br>
Methods We modified the abdominal normothermic regional perfusion circuit for simultaneous lung and abdominal organ assessment using independent extracorporeal membrane oxygenation components. Blood was oxygenated via a membrane oxygenator and returned to the body, with pulmonary flow adjusted to maintain pressure < 25 mmHg. Femoral cannulation was performed, and the lungs were ventilated with standard settings. Organ function was assessed over 2 h using PaO2/FiO2, AST, ALT, BUN, and Cr measurements to monitor perfusion and oxygen delivery.<br>
Results PANRP maintained stable lung function, with P/F ratios above 300, and preserved abdominal organ parameters, including stable AST, ALT, BUN, and Cr levels. Adequate urine output was observed, indicating normal renal function. Pulmonary artery pressure remained < 20 mmHg, and pulmonary vascular resistance was kept at 400 dyn・s/cm5, showing no signs of lung dysfunction or injury throughout the circuit.<br>
Conclusions PANRP offers a promising alternative to traditional EVLP for cDCD lung evaluation, allowing in situ assessment of multiple organs simultaneously. This approach may overcome logistical and economic challenges associated with ex vivo techniques, enabling a more efficient evaluation process. Further studies are warranted to confirm its clinical applicability and impact on long-term outcomes.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1878-87501952025Utility of Surgical Simulation for Tubular Retractor Surgery Using Three-Dimensional Printed Intraventricular Tumor Models: Case Series123743ENRyoOmaeDepartment 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 SciencesYoshihiroOtaniDepartment 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 SciencesTomoyaSaijoDepartment 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 SciencesShoheiNishigakiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyosukeIkemachiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuichiroHiranoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJojiIshidaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaroFujiiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakaoYasuharaDepartment 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 SciencesObjective: The utility of the tubular retractor for deep-seated tumors, including intraventricular tumors, has recently been reported. However, the surgical field’s depth and narrowness can lead to blind spots, and it is crucial to prevent damage to the cortex and white matter fibers in eloquent areas. Therefore, preoperative simulation is critical for tubular retractor surgery. In this study, we investigated the benefits of threedimensional (3D)-printed intraventricular tumor models for tubular retractor surgery.<br>
Methods: Nine patients with intraventricular central neurocytoma who underwent tubular retractor surgery at our institution between March 2013 and August 2023 were retrospectively reviewed. Fusion images and 3D-printed intraventricular tumor models were developed from preoperative computed tomography (CT) and magnetic resonance imaging (MRI). The puncture points of the tubular retractor were simulated using fusion images and 3D-printed intraventricular tumor models by 11 neurosurgeons (3 experts in brain tumors, 2 experts in areas other than brain tumors, and 6 residents). The dispersion of puncture points among 8 neurosurgeons (excluding brain tumor experts) was compared in each simulation model.<br>
Results: These cases were categorized into two groups based on the dispersion of puncture points simulated by fusion images. Puncture point dispersion was markedly smaller in all cases when using 3D-printed intraventricular tumor models compared to simulations solely based on fusion images.<br>
Conclusions: In intraventricular tumor surgery using a tubular retractor, 3D-printed intraventricular tumor models proved more beneficial in preoperative simulation compared to fusion images.No potential conflict of interest relevant to this article was reported.Nature PortfolioActa Medica Okayama2045-23221512025Changes of leucine-rich alpha 2 glycoprotein could be a marker of changes of endoscopic and histologic activity of ulcerative colitis5248ENYukiAoyamaDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySakikoHiraokaDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityErikoYasutomiDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshihiroInokuchiDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakehiroTanakaDepartment of Pathology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKensukeTakeiDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShokoIgawaDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKeikoTakeuchiDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasahiroTakaharaDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJunkiToyosawaDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYasushiYamasakiDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHideakiKinugasaDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJunKatoDepartment of Gastroenterology, Graduate School of Medicine, Chiba UniversityHiroyukiOkadaDepartment of Gastroenterology, Japanese Red Cross Society Himeji HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityLeucine-rich alpha 2 glycoprotein (LRG) is one of the serum biomarkers for disease activity of ulcerative colitis (UC). We focused on the correlation between the changes of LRG and the changes of endoscopic and histologic activity of UC, in comparison to the changes of fecal calprotectin (Fcal), fecal immunochemical test (FIT), and C-reactive protein (CRP). Seventy-nine patients with two or more colonoscopies were enrolled, and 123 paired colonoscopies and 121 paired biopsies were examined. With regard to the change of endoscopic/histologic activity between the preceding and subsequent colonoscopy, there was improvement (n = 29/45), unchanging (n = 63/36), and worsening (n = 31/40). The correlations between the changes of marker levels and endoscopic/histologic activity were Fcal; r = 0.50/0.39 and FIT; r = 0.41/0.40, LRG; r = 0.42/0.40 and CRP; r = 0.22/0.17. Furthermore, when the correlation between the changes of LRG levels and the changes of endoscopic/histological activity was compared with those of other markers, the correlation of LRG tended to be superior to those of CRP (CRP vs. LRG; p = 0.08/0.01). LRG is equivalent to fecal markers and superior to CRP, when inferring changes in disease activity of UC based on changes in its level.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1612-18722025Antifouling Activity of Xylemin, Its Structural Analogs, and Related Polyaminese202403213ENHiroyoshiTakamuraDepartment of Chemistry, Graduate School of Natural Science and Technology, Okayama UniversityTakefumiYorisueInstitute of Natural and Environmental Sciences, University of HyogoKentaTanakaResearch Institute for Interdisciplinary Science, Okayama UniversityIsaoKadotaDepartment of Chemistry, Graduate School of Natural Science and Technology, Okayama UniversityBiofouling, which is the accumulation of organisms on undersea structures, poses significant global, social, and economic issues. Although organotin compounds were effective antifoulants since the 1960s, they were banned in 2008 due to their toxicity to marine life. Although tin-free alternatives have been developed, they also raise environmental concerns. This underscores the need for effective, nontoxic antifouling agents. We previously synthesized N-(4-aminobutyl)propylamine (xylemin) and its structural analogs. In this study, we assayed the antifouling activity and toxicity of xylemin, its structural analogs, and related polyamines toward cypris larvae of the barnacle Amphibalanus amphitrite. Xylemin and its Boc-protected analog exhibited antifouling activities with 50% effective concentrations (EC50) of 4.25 and 6.11 µg/mL, respectively. Four xylemin analogs did not show a settlement-inhibitory effect at a concentration of 50 µg/mL. Putrescine, spermidine, spermine, and thermospermine, which are xylemin-related polyamines, did not display antifoulant effects (EC50 > 50 µg/mL). All evaluated compounds were nontoxic at a concentration of 50 µg/mL. These findings indicate that the size and structure of the N-alkyl group are essential for the antifouling activity of xylemin. Therefore, xylemin and its analogs hold promise as nontoxic, eco-friendly antifouling agents, offering a sustainable solution to biofouling in marine environments.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841722025Presumed Autoimmune Keratitis in Both Eyes Without Systemic Manifestations: A 40-Year Course of a Patient With Corneal Infiltrates and Melte79852ENToshihikoMatsuoDepartment of Ophthalmology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTakehiroTanakaDepartment of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityPeripheral corneal infiltration, corneal ulcer, and melt are recognized complications linked to systemic immunological diseases, such as antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. These manifestations, which occur in isolation, might be autoimmune keratitis but are difficult to prove underlying immunological abnormalities. This report described a patient with presumed autoimmune keratitis who repeatedly presented corneal infiltration and perforation in both eyes even after penetrating keratoplasty. The 68-year-old patient with a stable condition of keratoconjunctivitis sicca, in a 28-year follow-up, abruptly developed mild infiltrates in the corneal center of the right eye and white dense infiltrates in the peripheral and central cornea of the left eye. He was treated with topical 0.1% betamethasone eye drops and oral prednisolone tapering from 30 mg daily. The patient underwent cataract surgeries in both eyes 10 months after the onset of corneal infiltration and subsequently underwent penetrating keratoplasty in both eyes due to abrupt corneal perforation in the left eye 14 months after the onset of corneal infiltration. Six months post-keratoplasty, he experienced a recurrence of infiltrates in the corneal grafts in both eyes, leading to corneal leukoma in the left eye. The corneal graft in the right eye maintained its integrity with relatively mild opacity until approximately 3.5 years post-keratoplasty, when he abruptly developed white dense infiltration of both the corneal graft and his own peripheral cornea at the age of 73. In response to oral prednisolone tapered from 15 mg daily, the corneal infiltration in the right eye resolved but resulted in graft failure. Since he did not exhibit systemic symptoms and signs throughout the course, the repeat episodes of infiltration in both his own cornea and the corneal graft would be the manifestations of autoimmune keratitis. The entity of autoimmune keratitis in isolation would be beneficial to establish a therapeutic strategy for long-term immunosuppression in light of a risk for steroid side effects and a high rate of corneal graft failure.No potential conflict of interest relevant to this article was reported.American Physical Society (APS)Acta Medica Okayama2469-995011162025Josephson effect and odd-frequency pairing in superconducting junctions with unconventional magnets064502ENYuriFukayaFaculty of Environmental Life, Natural Science and Technology, Okayama UniversityKazukiMaedaDepartment of Applied Physics, Nagoya UniversityKeijiYadaDepartment of Applied Physics, Nagoya UniversityJorgeCayaoDepartment of Physics and Astronomy, Uppsala UniversityYukioTanakaDepartment of Applied Physics, Nagoya UniversityBoLuCenter for Joint Quantum Studies, Tianjin Key Laboratory of Low Dimensional Materials Physics and Preparing Technology, Department of Physics, Tianjin UniversityWe consider Josephson junctions formed by coupling two conventional superconductors via an unconventional magnet and investigate the formation of Andreev bound states, their impact on the Josephson effect, and the emergent superconducting correlations. In particular, we focus on unconventional magnets known as 𝑑-wave altermagnets and 𝑝-wave magnets. We find that the Andreev bound states in 𝑑-wave altermagnet and 𝑝𝑦-wave magnet Josephson junctions strongly depend on the transverse momentum, with a spin splitting and low-energy minima as a function of the superconducting phase difference 𝜑. In contrast, the Andreev bound states for 𝑝𝑥-wave magnets are insensitive to the transverse momentum. We then show that the Andreev bound states can be probed by the local density of states in the middle of the junction, which also reveals that 𝑑𝑥2−𝑦2- and 𝑝-wave magnet junctions are prone to host zero energy peaks. While the zero-energy peak in 𝑑𝑥2−𝑦2-wave altermagnet junctions tends to oscillate with the magnetic order, it remains robust in 𝑝-wave magnet junctions. We then discover that the Josephson current in 𝑑-wave altermagnet junctions is composed of higher harmonics of 𝜑, which originate a 𝜙-Josephson junction behavior entirely controlled by the magnetic order in 𝑑𝑥𝑦-wave altermagnets. In contrast, the Josephson current in Josephson junctions with 𝑝-wave magnets exhibits a conventional sinelike profile with a fast sign change at 𝜑=𝜋 due to zero-energy Andreev bound states. We also demonstrate that the critical currents in 𝑑-wave altermagnet Josephson junctions exhibit an oscillatory decay with the increase of the magnetic order, while the oscillations are absent in 𝑝-wave magnet junctions albeit the currents exhibit a slow decay. Furthermore, we also demonstrate that the interplay of the Josephson effect and unconventional magnetic order of 𝑑-wave altermagnets and 𝑝-wave magnets originates from odd-frequency spin-triplet 𝑠-wave superconducting correlations that are otherwise absent. Our results can serve as a guide to pursue the new functionality of Josephson junctions based on unconventional magnets.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1865-72571822025A case of pancreatic ductal adenocarcinoma growing within the pancreatic duct mimicking an intraductal tubulopapillary neoplasm376382ENRyosukeSatoDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalMayuUkaDepartment of Radiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKoseiTakagiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKenjiNishidaDepartment of Pathology, Dentistry and Pharmaceutical Science, Okayama University Graduate School of MedicineTakehiroTanakaDepartment of Pathology, Dentistry and Pharmaceutical Science, Okayama University Graduate School of MedicineYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKoichiroTsutsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalWe herein report a case of pancreatic ductal adenocarcinoma (PDAC) that developed within the pancreatic duct and was initially diagnosed as an intraductal tubulopapillary neoplasm (ITPN). A 76-year-old man presented with weight loss and main pancreatic duct dilation. The imaging studies revealed a 30-mm hypovascular tumor within the main duct of the pancreatic head. An endoscopic examination with a biopsy revealed high-grade atypical epithelial cells with immunostaining patterns suggestive of ITPN. Following robot-assisted pancreaticoduodenectomy, postoperative pathology revealed conflicting features: nodular/cribriform infiltrations typical of ITPN and non-lobular replacement with scattered infiltrations characteristic of PDAC. A comprehensive genomic profiling test detected KRAS and TP53 mutations, leading to the final diagnosis of PDAC (fT3N1aM0, stage IIB). The patient received adjuvant S-1 chemotherapy and remained recurrence-free for 15 months post-surgery. This case highlights the diagnostic challenges of differentiating intraductal pancreatic tumors and demonstrates the utility of integrating genetic testing with conventional diagnostic modalities for an accurate diagnosis and appropriate treatment selection.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7912025Photoinitiators Induce Histamine Production in Human Mast Cells5158ENTaroMiuraDepartment of Clinical Pharmacy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoichiKawasakiLaboratory of Clinical Pharmacology and Therapeutics, Kagawa School of Pharmaceutical Sciences, Tokushima Bunri UniversityHirofumiHamanoDepartment of Clinical Pharmacy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshitoZamamiDepartment of Clinical Pharmacy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiakiSendoDepartment of Clinical Pharmacy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/68362Photoinitiators are used in the manufacture of many daily products, and may produce harmful effects due to their cytotoxicity. They have also been detected in human serum. Here, we investigated the histamine-producing effects in HMC-1 cells and the inflammatory cytokine release effects in RAW264 cells for four photoinitiators: 1-hydroxycyclohexyl phenyl ketone; 2-isopropylthioxanthone; methyl 2-benzoylbenzoate; and 2-methyl-4´-(methylthio)-2-morpholinopropiophenone. All four promoted histamine production in HMC-1 cells; however, they did not significantly affect the release of inflammatory cytokines in RAW264 cells. These findings suggest that these four photoinitiators induce inflammatory cytokine-independent histamine production, potentially contributing to histamine-mediated chronic inflammation in vitro.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7912025Gastrectomy Causes an Imbalance in the Trunk Muscles919ENNanamiIkeyaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsushiOkitaDepartment of Surgery, Okayama City HospitalShinsukeHashidaDepartment of Surgery, Okayama City HospitalSumiharuYamamotoDepartment of Surgery, Okayama City HospitalHirokuniIkedaDepartment of Surgery, Okayama City HospitalKazunoriTsukudaDepartment of Surgery, Okayama City HospitalShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/68354Muscle loss negatively affects gastrectomy prognosis. However, muscle loss is recognized as a systemic change, and individual muscle function is often overlooked. We investigated changes in the muscle volume of individual muscles after gastrectomy to identify clues for prognostic factors and optimal rehabilitation programs. Patients who underwent R0 gastrectomy for Stage I gastric cancer at our hospital from 2015 to 2021 were retrospectively selected to minimize the effects of malignancy and chemotherapy. Trunk muscle volume was measured by computed tomography to analyze body composition changes. Statistical analysis was performed to identify risk factors related to body composition changes. We compared the preoperative and 6-month postoperative conditions of 59 patients after gastrectomy. There was no difference in the psoas major muscle, a conventional surrogate marker of sarcopenia. There were significant decreases in the erector spinae (p=0.01) and lateral abdominal (p=0.01) muscles, and a significant increase in the rectus abdominis muscle (p=0.02). No significant correlation was found between these muscle changes and nutritional status. Body composition imbalance may serve as a new indicator of the general condition of patients after gastrectomy. Rehabilitation to correct this imbalance may improve prognosis after gastrectomy.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0167-594X17222025Identification of factors related to functional prognoses in craniopharyngiomas471479ENTsuyoshiUmedaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshihiroOtaniDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaroFujiiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJojiIshidaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuichiroHiranoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasukiSurugaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaoyaKemmotsuDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyojiImotoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuhitoKegoyaRyoMizutaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoheiInoueDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMadokaHokamaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeiichiroMakiharaDepartment of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoseiHasegawaDepartment of Pediatrics, Okayama University HospitalKenichiInagakiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakaoYasuharaDepartment 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 SciencesPurpose Craniopharyngiomas are histologically benign tumors, but their proximity to vital neurovascular structures can significantly deteriorate functional prognoses and severely restrict patients’ social interaction and activity. We retrospectively identified risk factors related to the functional prognoses in patients with craniopharyngioma treated at our center.<br>
Methods A retrospective analysis was conducted on 40 patients who underwent surgery for craniopharyngioma and follow-up at our institution between 2003 and 2022. Functional prognoses were evaluated in terms of obesity (body mass index [BMI] ≥ 25 for adults, BMI-Z ≥ 1.65 for children), visual function, endocrine function, and social participation. We investigated whether patient characteristics, tumor size, tumor location, hypothalamic involvement, surgical hypothalamic damage, extent of resection, and recurrence rate correlated with these functional prognostic factors.<br>
Results The median age at diagnosis was 28.0 years, with a median follow-up of 80.5 months. Postoperative obesity was present in 22 patients, and those with postoperative obesity had a significantly higher preoperative BMI or BMI-Z (preoperative BMI for adults: p = 0.074; preoperative BMI-Z for children: p = 0.020) and were significantly correlated with preoperative hypothalamic involvement grade 2 (p = 0.012) and surgical hypothalamic damage grade II (p = 0.0001). Deterioration in social participation was significantly associated with a larger tumor size (p = 0.023) and tumor recurrence (p = 0.0047).<br>
Conclusions Patients with higher preoperative BMI or BMI-Z and hypothalamic involvement have a greater risk of postoperative obesity, and larger tumor size and recurrence can significantly deteriorate the rate of patients’ social participation.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 Okayama1881-1671582024介護士に必要なソーシャルスキル――教育実践に向けた研究課題の展望――119134ENSayumiMIYAKEYoichiYAMANOTomokoTANAKA10.18926/68308No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2052-88171112024Characteristics and outcomes of subarachnoid hemorrhage from vertebral artery dissection: A comparative study with other non-traumatic etiologiese70031ENShuOshitaOkayama University Medical SchoolTetsuyaYumotoDepartment of Emergency, Critical Care, and Disaster Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShuntaJinnoDepartment of Emergency, Critical Care, and Disaster Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityIppeiMatsuoDepartment of Emergency, Critical Care, and Disaster Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiHongoDepartment of Emergency, Critical Care, and Disaster Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiromichiNaitoDepartment of Emergency, Critical Care, and Disaster Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasafumiHiramatsuDepartment of Neurological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJunHarumaDepartment of Neurological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKenjiSugiuDepartment of Neurological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShotaTanakaDepartment of Neurological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAtsunoriNakaoDepartment of Emergency, Critical Care, and Disaster Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAim: Vertebral artery dissection (VAD) is a rare cause of non-traumatic subarachnoid hemorrhage (SAH) with significant clinical implications. This study compared the clinical characteristics and outcomes of SAH from intracranial VAD rupture to those from other etiologies, primarily aneurysmal rupture. <br>
Methods: This single-center retrospective cohort study at Okayama University Hospital included patients with non-traumatic SAH diagnosed between 2019 and 2023. Patients were categorized into "VAD rupture" and "other etiologies" groups. The main outcome was clinical presentation and symptoms. Additional outcomes included ICU mortality, in-hospital mortality, and unfavorable outcomes at discharge and 6 months, defined as a modified Rankin Scale score of 3-6. <br>
Results: A total of 66 patients were included, with 14 in the VAD rupture group and 52 in the other etiologies group. The VAD rupture group was younger (median age 49 vs. 64 years, p = 0.003) and had a higher incidence of out-of-hospital cardiac arrest (42.9% vs. 9.6%, p = 0.011). Preceding headache was more common in the VAD rupture group (78.6% vs. 11.5%, p < 0.001), with a median duration of 36 h before presentation. ICU and in-hospital mortality was higher in the VAD rupture group (both 50.0% vs. 19.3%, p = 0.019). No significant differences were found in unfavorable neurological outcomes at hospital discharge and 6 months. <br>
Conclusions: VAD-related SAH often presents with prodromal headaches, severe symptoms like out-of-hospital cardiac arrest, and higher ICU and in-hospital mortality than other SAH causes, though long-term outcomes are similar. Larger, prospective studies are needed to refine interventions.No potential conflict of interest relevant to this article was reported.BMCActa Medica Okayama1751-07591812024Psychogenic fever and neurodevelopmental disorders among Japanese children23ENAyumiOkadaDepartment of Pediatrics, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshieShigeyasuDepartment of Pediatrics, Okayama University HospitalChikakoFujiiDepartment of Pediatrics, Okayama University HospitalChieTanakaDepartment of Pediatrics, Okayama University HospitalManaHanzawaDepartment of Pediatrics, Okayama University HospitalAkikoSugiharaDepartment of Pediatrics, Okayama University HospitalMakikoHoriuchiDepartment of Pediatrics, Okayama University HospitalHirokazuTsukaharaDepartment of Pediatrics, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground Psychosocial stress can induce various physical symptoms, including fever, which is a commonly seen symptom in pediatric practice. In cases of unexplained fever, psychogenic fever should be considered as a potential cause. Children with neurodevelopmental disorders may be more vulnerable to stress and therefore more prone to developing somatic symptoms than their peers. This study aimed to elucidate the characteristics of children with psychogenic fever and comorbidity.<br>
Methods This study included 21 patients with psychogenic fever who visited the Department of Pediatric Psychosomatic Medicine, Okayama University Hospital. Information on age, sex, disease onset, final estimated diagnosis, comorbidities, treatment course, and outcome was obtained from the patients' medical records.<br>
Results Of the 21 patients included, 7 were boys and 14 were girls, and their median age was 13.0 (range: 8.6-14.6) years. A total of 19 patients had no attendance at school, and all patients showed signs of maladjustment in school. The comorbidities included orthostatic dysregulation (n = 4) and migraine (n = 3). Neurodevelopmental disorders were observed in nine patients, eight of whom were diagnosed after the initial visit. The mean treatment duration was 37.2 months. The outcomes were complete remission (n = 9), improvement (n = 4), discontinuation (n = 1), and referral to another physician (n = 7).<br>
Conclusion Various comorbidities were observed in the patients of this study with psychogenic fever, including the coexistence of neurodevelopmental disorders, such as autistic spectrum disorder. Children with neurodevelopmental disorders are prone to psychological stress resulting from difficulties in social adjustment. It is crucial to understand the developmental characteristics and environmental adaptation of patients to facilitate accurate diagnosis and treatment.No potential conflict of interest relevant to this article was reported.AIP PublishingActa Medica Okayama0021-9606159192023Efficiency and energy balance for substitution of CH4 in clathrate hydrates with CO2 under multiple-phase coexisting conditions194504ENHidekiTanakaResearch Institute for Interdisciplinary Science, Okayama UniversityMasakazuMatsumotoResearch Institute for Interdisciplinary Science, Okayama UniversityTakumaYagasakiDivision of Chemical Engineering, Graduate School of Engineering Science, Osaka UniversityMany experimental and theoretical studies on CH4–CO2 hydrates have been performed aiming at the extraction of CH4 as a relatively clean energy resource and concurrent sequestration of CO2. However, vague or insufficient characterization of the environmental conditions prevents us from a comprehensive understanding of even equilibrium properties of CH4–CO2 hydrates for this substitution. We propose possible reaction schemes for the substitution, paying special attention to the coexisting phases, the aqueous and/or the fluid, where CO2 is supplied from and CH4 is transferred to. We address the two schemes for the substitution operating in three-phase and two-phase coexistence. Advantages and efficiencies of extracting CH4 in the individual scheme are estimated from the chemical potentials of all the components in all the phases involved in the substitution on the basis of a statistical mechanical theory developed recently. It is found that although substitution is feasible in the three-phase coexistence, its working window in temperature–pressure space is much narrower compared to the two-phase coexistence condition. Despite that the substitution normally generates only a small amount of heat, a large endothermic substitution is suggested in the medium pressure range, caused by the vaporization of liquid CO2 due to mixing with a small amount of the released CH4. This study provides the first theoretical framework toward the practical use of hydrates replacing CH4 with CO2 and serves as a basis for quantitative planning.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-291863212024Endoscopic and Histological Gastritis in University Students with Helicobacter pylori Infection28752884ENShotaroOkanoueDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiSakaeDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenjiYokotaDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakehiroTanakaDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukaObayashiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMakotoAbeDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiyasuKonoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiromitsuKanzakiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeijiKawanoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiroKawaharaDepartment of Practical Gastrointestinal Endoscopy, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHiroyukiYanaiDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiOkadaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesObjective Although the characteristics of Helicobacter pylori infection have been extensively reported, there is a lack of consensus regarding its characteristics in young adults. The present study examined the endoscopic and histological characteristics of young adults who underwent eradication therapy for H. pylori infection.<br>
Methods We examined the H. pylori infection status of first-year students at Okayama University School of Medicine and Dentistry between 2014 and 2020. A total of 152 (6.8%) students who were positive for H. pylori antibody or pepsinogen tests were enrolled in the study. Among them, 107 students underwent endoscopy, and their biopsy samples were investigated. Seventy-five students were diagnosed with H. pylori infections.<br>
Results Of 75 H. pylori-positive patients, 57 (76.0%) had endoscopic atrophic gastritis, and 42 (56.0%) had histological atrophy. A few patients had severe atrophic gastritis. All 65 patients who underwent an eradication assessment were successfully treated. After successful eradication, 26 patients underwent endoscopic follow-up. The mean follow-up period was 32.9 months. A histological evaluation revealed that gastric antrum atrophy had subsided in 11 of 14 patients, and atrophy in the lesser curvature of the gastric body had subsided in 7 of 8 patients.<br>
Conclusion More than half of young adults with H. pylori infection had atrophic gastritis. We found mild atrophy in young adults, which subsided shortly after eradication treatment. This study provides a foundation for future studies to evaluate the validity of eradication therapy in preventing gastric cancer in patients.No potential conflict of interest relevant to this article was reported.ElsevierActa Medica Okayama0006-497114582025Oral Inflammation and Microbiome Dysbiosis Exacerbate Chronic Graft-versus-host Disease881896ENYuiKambaraDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Medical SchoolHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University HospitalAkiraYamamotoDepartment of Hematology and Oncology, Okayama University HospitalKazuyoshiGotohDepartment of Medical Laboratory Science, Okayama University Graduate School of Health SciencesShumaTsujiDepartment of Microbiology and Genetics, Okayama University Graduate School of Health SciencesMariKunihiroDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTadashiOyamaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshikiTeraoDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAyameSatoDivision of Hospital Dentistry, Okayama University HospitalTakehiroTanakaDepartment of Pathology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDanielPeltierDivision of Pediatric Hematology, Oncology, and Stem Cell Transplantation, Department of Pediatrics, Herman B Wells Center for Pediatric Research, Simon Cancer Center, Indiana University School of MedicineKeisukeSeikeDepartment of Hematology and Oncology, Okayama University HospitalHisakazuNishimoriDepartment of Hematology and Oncology, Okayama University HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalDaisukeEnnishiCenter for Comprehensive Genomic Medicine, Okayama University HospitalKeikoFujiiDepartment of Clinical Laboratory, Okayama University HospitalNobuharuFujiiDivision of Blood Transfusion, Okayama University HospitalKen-ichiMatsuokaDepartment of Hematology and Oncology, Okayama University HospitalYoshihikoSogaDivision of Hospital Dentistry, Okayama University HospitalPavanReddyDan L Duncan Comprehensive Cancer Center, Baylor College of MedicineMaedaYoshinobuDepartment of Hematology and Oncology, Okayama University HospitalThe oral microbiota, second in abundance to the gut, is implicated in chronic systemic diseases, but its specific role in graft-versus-host disease (GVHD) pathogenesis has been unclear. Our study finds that mucositis-induced oral dysbiosis in patients after hematopoietic cell transplantation (HCT) associated with increased chronic GVHD (cGVHD), even in patients receiving posttransplant cyclophosphamide. In murine HCT models, oral dysbiosis caused by bilateral molar ligatures exacerbated cGVHD and increased bacterial load in the oral cavity and gut, with Enterococcaceae significantly increasing in both organs. In this model, the migration of Enterococcaceae to cervical lymph nodes both before and after transplantation activated antigen-presenting cells, thereby promoting the expansion of donor-derived inflammatory T cells. Based on these results, we hypothesize that pathogenic bacteria increase in the oral cavity might not only exacerbate local inflammation but also enhance systemic inflammation throughout the HCT course. Additionally, these bacteria translocated to the gut and formed ectopic colonies, further amplifying systemic inflammation. Furthermore, interventions targeting the oral microbiome mitigated murine cGVHD. Collectively, our findings highlight the importance of oral dysbiosis in cGVHD and suggest that modulation of the oral microbiome during transplantation may be an effective approach for preventing or treating cGVHD.No potential conflict of interest relevant to this article was reported.ElsevierActa Medica Okayama1053-24984422024Loss of Nr4a1 ameliorates endothelial cell injury and vascular leakage in lung transplantation from circulatory-death donor249260ENShinichiKawanaDepartment 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 SciencesTomohisaSakaueDepartment of Cardiovascular and Thoracic Surgery, Ehime University Graduate School of MedicineKoheiHashimotoDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaroNakataDepartment of Surgery, Division of Cardiovascular and Thoracic Surgery, Duke University School of MedicineHarukiChoshiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinTanakaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentarohMiyoshiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinjiOhtaniDepartment of Cell Growth and Tumor Regulation, Proteo-Science Center (PROS), Ehime UniversityToshiakiOharaDepartment of Pathology and Experimental Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeiichiroSugimotoDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkihiroMatsukawaDepartment of Pathology and Experimental Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground: Ischemia-reperfusion injury (IRI) stands as a major trigger for primary graft dysfunction (PGD) in lung transplantation (LTx). Especially in LTx from donation after cardiac death (DCD), effective control of IRI following warm ischemia (WIRI) is crucial to prevent PGD. This study aimed to identify the key factors affecting WIRI in LTx from DCD.<br>
Methods: Previously reported RNA-sequencing dataset of lung WIRI was reanalyzed to identify nuclear receptor subfamily 4 group A member 1 (NR4A1) as the immediate early gene for WIRI. Dynamics of NR4A1 expression were verified using a mouse hilar clamp model. To investigate the role of NR4A1 in WIRI, a mouse model of LTx from DCD was established using Nr4a1 knockout (Nr4a1−/−) mice.<br>
Results: NR4A1 was located around vascular cells, and its protein levels in the lungs increased rapidly and transiently during WIRI. LTｘ from Nr4a1−/− donors significantly improved pulmonary graft function compared to wild-type donors. Histological analysis showed decreased microvascular endothelial cell death, neutrophil infiltration, and albumin leakage. Evans blue permeability assay demonstrated maintained pulmonary microvascular barrier integrity in grafts from Nr4a1−/− donors, correlating with diminished pulmonary edema. However, NR4A1 did not significantly affect the inflammatory response during WIRI, and IRI was not suppressed when a wild-type donor lung was transplanted into the Nr4a1−/− recipient.<br>
Conclusions: Donor NR4A1 plays a specialized role in the positive regulation of endothelial cell injury and microvascular hyperpermeability. These findings demonstrate the potential of targeting NR4A1 interventions to alleviate PGD and improve outcomes in LTx from DCD.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2050-09041312025Eyelid Spindle Cell Lipoma: Case Report and Review of Three Patients in Literaturee70097ENToshihikoMatsuoGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityKiyoshiYamadaPlastic and Reconstructive Surgery, Kousei HospitalYasumasaMonobeDepartment of Pathology, General Medical Center, Kawasaki Medical SchoolTakehiroTanakaDepartment of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityA 39-year-old woman presented a saucer-shaped mass in the left upper eyelid and underwent the extirpation at local anesthesia. Pathologically, collagen fibers, capillaries, small vessels, and CD34-positive spindle cells were dispersed among mature adipose tissues, indicative of spindle cell lipoma. Long-lasting cyst-like eyelid masses would be usually dermoid cysts, and spindle cell lipoma would be listed as a rare pathological diagnosis in differential diagnoses of cyst-like lesions in the upper and lower eyelid.No potential conflict of interest relevant to this article was reported.Elmer Press, Inc.Acta Medica Okayama1923-41551612025Local Control of Conjunctival Malignant Melanoma by Proton Beam Therapy in a Patient With No Metastasis in Six Years From in Situ to Nodular Lesions2836ENToshihikoMatsuoRegenerative and Reconstructive Medicine (Ophthalmology), Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTakeshiOgataDepartment of Radiology, Proton Beam Center, Tsuyama Chuo HospitalTakahiroWakiDepartment of Radiology, Proton Beam Center, Tsuyama Chuo HospitalTakehiroTanakaDepartment of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityKotaTachibanaDepartment of Dermatology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTomokazuFujiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTakuyaAdachiDepartment of Gastroenterology and Hepatology, Okayama University HospitalOsamuYamasakiDepartment of Dermatology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityConjunctival malignant melanoma is extremely rare, with no standard of care established at moment. Here we report a 65-year-old woman, as a hepatitis B virus (HBV) carrier, who presented concurrently a liver mass and lower bulbar conjunctival pigmented lesions in the right eye. Needle liver biopsy and excisional conjunctival biopsy showed hepatocellular carcinoma and conjunctival malignant melanoma in situ, respectively. The priority was given to segmental liver resection for hepatocellular carcinoma after transcatheter arterial chemoembolization. In 1 year, she underwent second and third resection of bulbar conjunctival pigmented lesions, and the pathological examinations constantly showed melanoma in situ. In the course, she showed gradual widening of pigmented lesions to upper bulbar conjunctiva and lower palpebral conjunctiva and lower eyelid. About 2.5 years from the initial visit, the lower eyelid lesion was resected for a genomic DNA-based test of BRAF mutations which turned out to be absent, and then, she began to have intravenous anti-programmed cell death-1 (PD-1), nivolumab every 3 or 4 weeks. She developed iritis in the right eye with conjunctival melanoma as an immune-related adverse event, 3 months after the beginning of nivolumab, and so she used daily topical 0.1% betamethasone eye drops to control the intraocular inflammation. She showed no metastasis in 6 years of follow-up, but later in the course, 5 years from the initial visit, she developed abruptly a non-pigmented nodular lesion on the temporal side of the bulbar conjunctiva along the corneal limbus, accompanied by two pigmented nodular lesions in the upper and lower eyelids in a few months. She thus, underwent proton beam therapy toward the conjunctival melanoma and achieved the successful local control. Proton beam therapy is a treatment option in place of orbital exenteration, and multidisciplinary team collaboration is desirable to achieve better cosmetic and functional outcomes in conjunctival malignant melanoma.No potential conflict of interest relevant to this article was reported.Frontiers MediaActa Medica Okayama2296-2360122024Trabecular bone scores in children with osteogenesis imperfecta respond differently to bisphosphonate treatment depending on disease severity1500023ENNatsukoFutagawaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoseiHasegawaDepartment of Pediatrics, Okayama University HospitalHiroyukiMiyaharaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiTanakaDepartment of Pediatrics, Okayama Saiseikai General HospitalHirokazuTsukaharaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesIntroduction: Osteogenesis imperfecta (OI) is a congenital skeletal disorder characterized by bone fragility. Bisphosphonates (BISs) have become the mainstream treatment in children with OI. However, an optimal treatment protocol has not yet been established, while BIS treatment tends to be administered to normalize bone mineral density (BMD). Bone quality is an important component of bone strength. The trabecular bone score (TBS) is a quantitative measure of the microstructure that affects bone quality. This study investigated the TBS during BIS treatment in children with OI. Materials and methods: Twenty-nine children with OI were enrolled and classified into two groups: mild (type 1) and moderate to severe (types 3 and 4). Dual-energy x-ray absorptiometry images were retrospectively analyzed for TBS calculation. The relationship between the areal BMD (aBMD), its Z-score, height-adjusted BMD (BMDHAZ) Z-score, TBS, and TBS Z-score with the treatment duration was assessed for each group. Results: In the mild group, the aBMD, its Z-score, and BMDHAZ Z-score showed a significant positive correlation with treatment duration (r = 0.68, 0.68, 0.72, respectively, p < 0.01). The TBS Z-score tended to increase with treatment duration, albeit without reaching significance. In the moderate to severe group, the TBS Z-score showed a significant positive correlation with treatment duration (r = 0.48, p < 0.01), in contrast to the aBMD Z-score, which did not increase. Finally, the BMDHAZ Z-score only showed a weak positive correlation with treatment duration (r = 0.37, p < 0.01). Conclusion: Because BIS affect the BMD and TBS differently based on the severity of OI, treatment goals may need to be stratified by disease severity.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7862024C-arm Free Unilateral Biportal Endoscopic Discectomy: A Technical Note475483ENHongfeiXiangDepartment of Orthopaedic Surgery, Okayama Rosai HospitalKajetanLatkaDepartment of Orthopaedic Surgery, Okayama Rosai HospitalPrafulMasteDepartment of Orthopaedic Surgery, Okayama Rosai HospitalMasatoTanakaDepartment of Orthopaedic Surgery, Okayama Rosai HospitalChetanKumawatDepartment of Orthopaedic Surgery, Okayama Rosai HospitalShinyaAratakiDepartment of Orthopaedic Surgery, Okayama Rosai HospitalYoshihiroFujiwaraDepartment of Orthopaedic Surgery, Okayama Rosai HospitalTakuyaTaokaDepartment of Orthopaedic Surgery, Okayama Rosai HospitalAkiyoshiMiyamotoDepartment of Orthopaedic Surgery, Okayama Rosai HospitalCase Report10.18926/AMO/67878This report presents a new unilateral biportal endoscopic (UBE) technique for lumbar disc herniation without C-arm guidance. Lumbar disc herniation requires surgical intervention when conservative methods fail. Shifts towards minimally invasive percutaneous endoscopic lumbar discectomy, including uniportal and biportal approaches, have been hindered by challenges such as steep learning curves and reliance on radiation-intensive C-arm guidance. We here describe the use of standard intraoperative navigation in UBE to reduce radiation exposure and increase surgical accuracy. A 24-year-old man with low back and bilateral leg pain with gait disturbance was referred to our hospital. He had had conservative treatment for 12 months in another hospital before admission, but this proved unsuccessful. On admission he had low back pain (VAS 4/10) and bilateral leg pain (VAS 8/10), muscle weakness of the bilateral legs (manual muscle testing (MMT) grade of the extensor hallucis longus: 4/4), and numbness of the bilateral lower legs. Preoperative lumbar MRI showed L4/5 large central disc herniation. He underwent C-arm free UBE discectomy under the guidance of O-arm navigation. The surgery was successful, with postoperative lumbar MRI showing good decompression of the dural sac and bilateral L5 nerve roots. The MMT grade and sensory function of both legs had recovered fully on final follow-up at one year. The new UBE technique under navigation guidance was shown to be useful for lumbar disc herniation. This innovative technique was safe and accurate for the treatment of lumbar intervertebral disc herniation, and minimized radiation exposure to surgeons.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7862024Treatment of Tenosynovial Giant Cell Tumor of the Cervical Spine with Postoperative Anti-RANKL Antibody (Denosumab) Administration469474ENYuichiHirataDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakayukiNagaseDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSusumuSasadaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiyukiAyadaDepartment of Pathology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHayatoMiyakeDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChiakiSugaharaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHidetakaYamamotoDepartment of Pathology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshinaoOdaDepartment of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu UniversityTakaoYasuharaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/67877Tenosynovial giant cell tumor (TGCT) is a fibrous histiocytic tumor originating in the synovial membrane. While cervical TGCT may not be considered a common diagnosis preoperatively because it is relatively rare, it has a high recurrence rate and should be considered. Total resection is preferable, but it can be challenging due to the risk of damaging the vertebral artery. Denosumab has shown effectiveness as a postoperative treatment for osteolytic bone lesion. Denosumab administration coupled with close follow-up might offer an effective postoperative treatment option for unresectable TGCT with bone invasion.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7862024Case of Radiation-Induced Angiosarcoma after Breast-Conserving Surgery with Hypofractionated Radiotherapy in a Japanese Patient453458ENYujiroKawataDepartment of Radiology, Kawasaki Medical SchoolKentaWatanabeDepartment of Radiology, Kawasaki Medical SchoolRyojiTokiyaDepartment of Radiology, Kawasaki Medical SchoolTakeshiMatsunoDepartment of Pathology, Kawasaki Medical SchoolRyoTanakaDepartment of Dermatology, Kawasaki Medical SchoolNarutoTairaDepartment of Breast and Thyroid Surgery, Kawasaki Medical SchoolKuniakiKatsuiDepartment of Radiology, Kawasaki Medical SchoolCase Report10.18926/AMO/67871Radiation-induced angiosarcoma (RIAS) is a rare, late adverse event of radiotherapy comprising approximately half of all radiation-induced sarcomas. It has a relatively short latency period and generally unfavorable prognosis. This study presents a case of RIAS that developed 5 years and 11 months after the completion of hypofractionated radiotherapy (42.56 Gy/16 fractions) following partial mastectomy. The patient was diagnosed with RIAS 10 months after the onset of skin redness. She underwent skin tumor resection, followed by paclitaxel, then pazopanib administration, but no radiotherapy. At 6 years and 2 months after surgery, no RIAS recurrence has been detected.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7862024Closure of Ventricular Septal Rupture through a Left Thoracotomy in a Patient with a History of Esophageal Reconstruction449452ENGentaroKatoDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalTatsuyaOgawaDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalTomohiroHayashidaDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalShujiShimizuDepartment of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University HospitalShuYamamotoDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalTakeshiShichijoDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalCase Report10.18926/AMO/67870A 73-year-old man who had undergone esophagectomy and retrosternal gastric tube reconstruction for esophageal cancer 8 years prior was transferred to our hospital for the treatment of an acute myocardial infarction. Emergent percutaneous coronary intervention for the left anterior descending artery (#7) was successfully performed. However, echocardiography revealed a ventricular septal rupture (25×27 mm). Seventeen days after admission, the rupture was successfully treated with a double-patch closure via a left anterolateral thoracotomy to avoid a surgical injury to his retrosternal gastric tube. Determining the best surgical approach to the heart is important for safe cardiac surgery in patients after esophageal reconstruction.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7862024Risk Factors for Gangrenous Cholecystitis and the Outcomes of Early Cholecystectomy: A Retrospective Study of a Single-Center City General Hospital439447ENMampeiYamashitaDepartment of Surgery, Sasebo City General HospitalTakayukiTanakaDepartment of Surgery, Sasebo City General HospitalYorihisaSumidaDepartment of Surgery, Sasebo City General HospitalShotoYamazakiDepartment of Surgery, Sasebo City General HospitalYukiHaraDepartment of Surgery, Sasebo City General HospitalAkikoFukudaDepartment of Surgery, Sasebo City General HospitalMakotoHisanagaDepartment of Surgery, Sasebo City General HospitalKokiWakataDepartment of Surgery, Sasebo City General HospitalMasatoArakiDepartment of Surgery, Sasebo City General HospitalSusumuEguchiDepartment of Surgery, Nagasaki University Graduate School of Biomedical ScienceOriginal Article10.18926/AMO/67869Gangrenous cholecystitis (GC) is classified as moderate acute cholecystitis according to the Tokyo Guidelines from 2018 (TG18). We evaluated the risk factors for GC and the outcomes of early cholecystectomy. A total of 136 patients who underwent emergency cholecystectomy for acute cholecystitis were retrospectively analyzed; 58 of these patients (42.6%) were diagnosed with GC (GC group) based on our retrospective pathologic diagnosis. We comparatively evaluated the patient backgrounds and surgical outcomes between the GC group and non-GC group. The GC group was significantly older and included more hypertensive patients than the non-GC group. The GC group was prescribed more antibiotics as initial treatment than the non-GC group, and they had more days between onset and surgery. The preoperative white blood cell count and C-reactive protein values were significantly higher in the GC group than in the non-GC group, and these values were predictive factors for GC. Cholecystectomy required a longer operation time and caused greater blood loss in the GC group. The GC group also had longer hospitalization times than the non-GC group; however, no significant differences were observed in terms of postoperative complications. In conclusion, gangrenous changes should be assessed when diagnosing cholecystitis, and appropriate treatment, such as surgery or drainage, should be undertaken.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7862024Partial versus Radical Nephrectomy for Small Renal Cancer: Comparative Propensity Score-Matching Analysis of Cardiovascular Event Risk429437ENRisaKubotaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKensukeBekkuDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiKatayamaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakehiroIwataDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShingoNishimuraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiEdamuraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokoKobayashiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuyukiKobayashiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMotooArakiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/67868Although partial nephrectomy (PN) is preferred over radical nephrectomy (RN) for preserving renal function in patients with cT1 renal cancer, its impact on cardiovascular events (CVe) remains controversial. This study aimed to compare PN and RN in regard to the occurrence of CVe, including cerebrovascular events and exacerbation of hypertension (HT). We retrospectively analyzed 418 consecutive patients who underwent PN or RN for cT1 renal cancer. Propensity score-matching analysis was used to adjust for imbalances between patients who underwent PN and RN, leaving 102 patients in each group. The 5-year probability of cumulative CVe incidence was 6% in the PN group and 12% in the RN group (p=0.03), with a median follow-up of 73.5 months. The statistical significance was retained after propensity score matching for patients without preoperative proteinuria (p=0.03). For all CVe including cerebrovascular events and exacerbation of HT analyzed, PN provided a lower probability of occurrence than RN in patients with small renal cancers.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1340-68683222024The role of C1orf50 in breast cancer progression and prognosis292305ENYusukeOtaniDepartment of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA Harvard Medical SchoolAtsushiTanakaDepartment of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA Harvard Medical SchoolMasakiMaekawaDepartment of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA Harvard Medical SchoolTirsoPeñaDepartment of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA Harvard Medical SchoolAnnaRogachevskayaDepartment of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA Harvard Medical SchoolTeruhikoAndoDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakutoItanoDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHaruyoshiKatayamaDepartment 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 SciencesToshifumiOzakiDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyoshiDoiharaDepartment of General Surgery, Kawasaki Medical School General Medical CenterMichael H.RoehrlDepartment of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA Harvard Medical SchoolAtsushiFujimuraDepartment of Cellular Physiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAlthough the prognosis of breast cancer has significantly improved compared to other types of cancer, there are still some patients who expire due to recurrence or metastasis. Therefore, it is necessary to develop a method to identify patients with poor prognosis at the early stages of cancer. In the process of discovering new prognostic markers from genes of unknown function, we found that the expression of C1orf50 determines the prognosis of breast cancer patients, especially for those with Luminal A breast cancer. This study aims to elucidate the molecular role of C1orf50 in breast cancer progression. Bioinformatic analyses of the breast cancer dataset of TCGA, and in vitro analyses, reveal the molecular pathways influenced by C1orf50 expression. C1orf50 knockdown suppressed the cell cycle of breast cancer cells and weakened their ability to maintain the undifferentiated state and self-renewal capacity. Interestingly, upregulation of C1orf50 increased sensitivity to CDK4/6 inhibition. In addition, C1orf50 was found to be more abundant in breast cancer cells than in normal breast epithelium, suggesting C1orf50’s involvement in breast cancer pathogenesis. Furthermore, the mRNA expression level of C1orf50 was positively correlated with the expression of PD-L1 and its related factors. These results suggest that C1orf50 promotes breast cancer progression through cell cycle upregulation, maintenance of cancer stemness, and immune evasion mechanisms. Our study uncovers the biological functions of C1orf50 in Luminal breast cancer progression, a finding not previously reported in any type of cancer.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2192-31831412024Successful immunotherapy with ipilimumab and nivolumab in a patient with pulmonary sclerosing pneumocytoma6063ENYumiInukai-MotokuraDepartment of Allergy and Respiratory Medicine, Okayama University HospitalKiichiroNinomiyaDepartment of Allergy and Respiratory Medicine, Okayama University HospitalTakahiroBabaDepartment of Allergy and Respiratory Medicine, Okayama University HospitalHirokiOmoriDepartment of Allergy and Respiratory Medicine, Okayama University HospitalTetsuyaTakeguchiDepartment of Allergy and Respiratory Medicine, Okayama University HospitalMariUnoDepartment of Allergy and Respiratory Medicine, Okayama University HospitalYoshiyukiAyadaDepartment of Pathology, Okayama University HospitalTakehiroTanakaDepartment of Pathology and Oncology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshinobuMaedaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKadoakiOhashiDepartment of Allergy and Respiratory Medicine, Okayama University HospitalPulmonary sclerosing pneumocytoma (PSP) is a rare form of lung cancer that occasionally presents with lymph node and extrapulmonary metastases, and multiple lesions. The treatment of metastatic PSP remains undefined. This study reports the case of a 48-year-old female patient diagnosed with PSP following surgical intervention for a solitary nodule in the left lower lobe. Four years later, recurrence occurred in the left hilar and mediastinal lymph nodes, necessitating an additional resection. Concurrently, sacral metastases developed and required palliative radiotherapy. Genetic analysis identified an AKT1 E17K mutation, characteristic of PSP, and absence of programmed cell death ligand 1 (PD-L1) expression in the tumor. Two years post-recurrence, the tumor recurred in the left mammary gland and mediastinal lymph nodes. Combination immunotherapy with ipilimumab and nivolumab yielded a significantly positive response in this metastatic PSP case. This is the first reported case of successful treatment of multiple distant metastatic PSP with ipilimumab and nivolumab, following the failure of various local treatments. Further case series are warranted to validate the efficacy of immunotherapy in metastatic PSP.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2024Establishment and Analysis of Novel In Vitro 3D Cell Culture Models of the Fibrotic Tumor Microenvironment in Pancreatic CancerENHiroyoshiTANAKAOkayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2024胆汁酸塩をco-formerとしたbrick dust AntiY5R の共非晶質化と溶解性改善ENShoheiAIKAWAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2024Utility of neutrophil-to-lymphocyte ratio as an indicator of tumor immune status in non-small cell lung cancerENKazumaIWATAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2024Radiological characteristics of skeletal growth in neonates and infants with achondroplasiaENDaisukeMIYAHARAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0305-05481692024The parallel stack loading problem of minimizing the exact number of relocations106712ENShunjiTanakaFaculty of Environmental, Life and Natural Science and Technology, Okayama UniversityMohamedElWakilDepartment of Production Engineering and Mechanical Design, Faculty of Engineering, Tanta UniversityAmrEltawilDepartment of Industrial and Manufacturing Engineering, Egypt Japan University of Science and TechnologyThis study addresses the parallel stack loading problem, a general optimization problem arising in storage facilities such as container yards, slab yards, and warehouses. In this problem, we load incoming items into parallel stacks in the loading phase to minimize the number of relocations in the subsequent retrieval phase. Because of difficulties in treating the nested problem structure originating from the mutual dependence of the two phases, the existing studies approximately minimized the number of relocations using surrogate objective functions. In contrast, this study considers the parallel stack loading problem aiming to minimize the exact number of relocations. We first provide an integer programming formulation and next develop a nested branch-and-bound algorithm. In a computational study, we verify the effectiveness of the proposed branch-and-bound algorithm and evaluate the known surrogate objective functions based on the exact minimization.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-818416112024Axillary Reactive Lymphoid Hyperplasia, Likely Due to Unicentric Castleman Disease, and the Concurrent Presence of Orbital Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma: A Six-Year Follow-Up Studye73775ENToshihikoMatsuoDepartment of Ophthalmology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTakehiroTanakaDepartment of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTomokazuFujiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityDaisukeEnnishiDepartment of Hematology and Oncology, Center for Comprehensive Genomic Medicine, Okayama University HospitalCastleman disease is a lymphadenopathy of unknown cause at a single site, which is designated as unicentric Castleman disease, or at multiple sites designated as multicentric Castleman disease. We present a patient who showed axillary reactive lymphoid hyperplasia, likely due to unicentric Castleman disease, and orbital extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) lymphoma in a six-year follow-up. A 76-year-old man had a painless left axillary mass for an unknown period and also left complete blepharoptosis with no other systemic symptoms. Suspected of lymphoma, iliac bone marrow biopsy showed no anomalous cells, and positron emission tomography demonstrated abnormal uptake at the left axilla and in the left superior anterior orbit. Incisional biopsy of the left axillary mass demonstrated hyperplastic lymphoid follicles with an atrophic germinal center and prominent small vessels in the follicular center, indicative of unicentric Castleman disease. One year later, annual follow-up positron emission tomography disclosed a high uptake site, next to the previously-identified cyst, in the pancreatic body. Trans-gastric fine needle pancreatic biopsy proved adenocarcinoma and he underwent subtotal stomach-preserving pancreaticoduodenectomy with jejunal anastomosis. He was well for six months after the surgery and thus, underwent resection of the left orbital lesion at 78 years old. The pathology of the orbital lesion showed ambiguous nodular structure with massive infiltration with CD20-positive medium-sized lymphoid cells which were κ monotype in immunoglobulin light chain restriction, indicative of MALT lymphoma. In the four-year period of the COVID-19 pandemic, he was healthy and followed with no treatment until the age of 82 years when he underwent radiation (46 Gy) to the left axillary lesion which did not regress. He then underwent eyelid levator muscle plication for left blepharoptosis since the left orbital lesion remained unpalpable. The six-year follow-up showed that concurrent and independent orbital MALT lymphoma and axillary reactive lymphoid hyperplasia, likely due to unicentric Castleman disease, were both stable. The present case illustrates how important it is to make pathological diagnoses in different anatomical lesions after the initial diagnosis of Castleman disease.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1433-73984212024Tectal glioma: clinical, radiological, and pathological features, and the importance of molecular analysis111ENRyojiImotoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshihiroOtaniDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaroFujiiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJojiIshidaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuichiroHiranoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaoyaKemmotsuDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasukiSurugaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoMizutaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuhitoKegoyaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoheiInoueDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTsuyoshiUmedaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMadokaHokamaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKanaWashioDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiYanaiDepartment of Pathology, Okayama University HospitalShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKaishiSatomiDepartment of Pathology, Kyorin University Faculty of MedicineKoichiIchimuraDepartment of Brain Disease Translational Research, Juntendo University Graduate School of MedicineIsaoDateDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTectal glioma (TG) is a rare lower grade glioma (LrGG) that occurs in the tectum, mainly affecting children. TG shares pathological similarities with pilocytic astrocytoma (PA), but recent genetic analyses have revealed distinct features, such as alterations in KRAS and BRAF. We conducted a retrospective review of cases clinically diagnosed as TG and treated at our institute between January 2005 and March 2023. Six cases were identified and the median age was 30.5 years. Four patients underwent biopsy and two patients underwent tumor resection. Histological diagnoses included three cases of PA, one case of astrocytoma, and two cases of high-grade glioma. The integrated diagnosis, according to the fifth edition of the World Health Organization Classification of Tumours of the central nervous system, included two cases of PA and one case each of diffuse high-grade glioma; diffuse midline glioma H3 K27-altered; glioblastoma; and circumscribed astrocytic glioma. Among the three patients who underwent molecular evaluation, two had KRAS mutation and one had H3-3A K27M mutation. Our results demonstrate the diverse histological and molecular characteristics of TG distinct from other LrGGs. Given the heterogeneous pathological background and the risk of pathological progression in TG, we emphasize the importance of comprehensive diagnosis, including molecular evaluation.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7852024Occult Nesidioblastosis Detected by 111In-Pentetreotide Single-Photon Emission Computed Tomography423428ENShinyaSakamotoDepartment of Gastroenteorlogical Surgery, Kochi Health Sciences CenterMotoyasuTabuchiDepartment of Gastroenteorlogical Surgery, Kochi Health Sciences CenterRikaYoshimatsuDepartment of Radiology, Kochi Health Sciences CenterAiHishidaDepartment of Endocrinology and Metabolism, Kochi Health Sciences CenterManabuMatsumotoDepartment of Diagnostic Pathology, Kochi Health Sciences CenterJunIwataDepartment of Diagnostic Pathology, Kochi Health Sciences CenterTakehiroOkabayashiDepartment of Gastroenteorlogical Surgery, Kochi Health Sciences CenterCase Report10.18926/AMO/67667Nesidioblastosis, also known as persistent hyperinsulinemic hypoglycemia, is usually observed in children and infants, although more recently adult-onset nesidioblastosis has also been described. We present a case of nesidioblastosis in a 78-year-old man that was detected by 111In-pentetreotide single photon emission computed tomography (SPECT/CT). The patient was transferred to our hospital’s emergency department in a hypoglycemic coma. Dynamic enhanced CT could detect no lesion in the pancreas, but an 111In-pentetreotide SPECT/CT scan performed after a similar episode four weeks later showed increased focal uptake at the head of the pancreas. The results of a selective arterial calcium injection test were negative. After careful consideration and discussion among colleagues, surgical intervention was selected, and a pancreaticoduodenectomy was performed. On histology, there were elevated numbers of Langerhans islets in the pancreatic head, and the islets themselves appeared enlarged. Hypertrophic β-cells comprised the majority, but α-cells, δ-cells and pancreatic polypeptide were also detected in the islets. Based on the histopathological results and repeated hyperinsulinemic hypoglycemic crises, the patient was finally diagnosed with adult-onset nesidioblastosis. He had no hypoglycemic symptoms during outpatient follow-up examination. Since 111In-pentetreotide SPECT/CT may be able to detect nesidioblastosis, clinicians should consider this relatively new-modality examination when encountering such cases.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7852024Pediatric Severe Febrile Thrombocytopenia Syndrome: A Case Report and Literature Review401405ENYusukeToyotaDepartment of Pediatrics, NHO Iwakuni Clinical CenterKazuhiroUdaDepartment of Pediatrics, NHO Iwakuni Clinical CenterKomeiShirabeYamaguchi Prefectural Institute of Public Health and EnvironmentTadashiMoriwakeDepartment of Pediatrics, NHO Iwakuni Clinical CenterCase Report10.18926/AMO/67664Severe febrile thrombocytopenia syndrome (SFTS) is a tick-borne infectious disease that is endemic in parts of eastern Asia. Few pediatric cases have been reported. We describe a case of SFTS in a seven-year-old girl who presented with prolonged fever and gastrointestinal symptoms. Leukopenia and thrombocytopenia on hematology, and a history of outdoor activity led us to diagnose SFTS, although the patient had no tick bite marks. We also review the literature and discuss the characteristics of pediatric SFTS. Physicians should consider SFTS in the differential diagnosis of fever with thrombocytopenia in children living in endemic areas.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7852024Effect of Radon Inhalation on Murine Brain Proteins: Investigation Using Proteomic and Multivariate Analyses387399ENShotaNaoeGraduate School of Health Sciences, Okayama UniversityAyumiTanakaGraduate School of Health Sciences, Okayama UniversityNorieKanzakiNingyo-toge Environmental Engineering Center, Japan Atomic Energy AgencyReijuTakenakaGraduate School of Health Sciences, Okayama UniversityAkihiroSakodaNingyo-toge Environmental Engineering Center, Japan Atomic Energy AgencyTakaakiMiyajiAdvanced Science Research Center, Okayama UniversityKiyonoriYamaokaFaculty of Health Sciences, Okayama UniversityTakahiroKataokaFaculty of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/67663Radon is a known risk factor for lung cancer; however, it can be used beneficially, such as in radon therapy. We have previously reported the enhancement of antioxidant effects associated with trace amounts of oxidative stress as one of the positive biological effects of radon inhalation. However, the biological effects of radon inhalation are incompletely understood, and more detailed and comprehensive studies are required. Although several studies have used proteomics to investigate the effects of radon inhalation on body proteins, none has focused on brain proteins. In this study, we evaluated the expression status of proteins in murine brains using proteomic and multivariate analyses to identify those whose expressions changed following two days of radon inhalation at a concentration of 1,500 Bq/m3. We found associations of radon inhalation with the expressions of seven proteins related to neurotransmission and heat shock. These proteins may be proposed as biomarkers indicative of radon inhalation. Although further studies are required to obtain the detailed biological significance of these protein alterations, this study contributes to the elucidation of the biological effects of radon
inhalation as a low-dose radiation.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7852024Small-for-Gestational-Age Status and the Risk of Kawasaki Disease: A Nationwide Birth Cohort in Japan363370ENSatoeTakanagaDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaomiMatsumotoDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomokaKadowakiDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSoshiTakaoDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiYorifujiDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityOriginal Article10.18926/AMO/67656Kawasaki disease (KD) is a pediatric disease of unknown etiology that commonly affects infants in East Asia. Infants born small for gestational age (SGA) have weaker immune systems and are more susceptible to infection. Using data from a nationwide Japanese birth cohort study conducted in 2010 (n=34,579), we investigated whether SGA increases the risk of KD. SGA was defined as birth weight below the 10th percentile for gestational age. The outcome was hospitalization for KD between 6 and 30 months of age. The association between SGA and hospitalization for KD, adjusted for child and maternal factors, was examined using logistic regression. Of the 231 children hospitalized for KD, 9.5% were SGA. Further statistical analysis showed that SGA did not increase the odds ratio (OR) of hospitalization for KD (adjusted OR 1.12, 95% confidence interval 0.71-1.75). This result was not changed with stratification by early daycare attendance and preterm status. Reasons for the lack of association may include the multifactorial pathogenesis of KD; in addition, the types of infections to which SGA infants are predisposed may differ from those triggering KD. Overall, our large nationwide study found no association between SGA and KD.No potential conflict of interest relevant to this article was reported.BMCActa Medica Okayama1751-07591812024Assessment of the renal function of patients with anorexia nervosa19ENHiroyukiMiyaharaDepartment of Clinical Pediatrics, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical SciencesYoshieShigeyasuDepartment of Pediatrics, Okayama University HospitalChikakoFujiiDepartment of Pediatrics, Okayama University HospitalChieTanakaDepartment of Pediatrics, Okayama University HospitalHanzawaManaDepartment of Pediatrics, Okayama University HospitalAkikoSugiharaClinical Psychology Section, Department of Medical Support, Okayama University HospitalAyumiOkadaDepartment of Pediatrics, Okayama University HospitalHirokazuTsukaharaDepartment of Pediatrics, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineBackground A decreased glomerular filtration rate (GFR), estimated using creatinine (Cr- eGFR), is often found at the initial presentation of anorexia nervosa (AN). Its pathophysiology has been explained mainly by dehydration, and chronic hypokalemia is also thought to be a cause. However, because we have often experienced cases of AN with decreased Cr-eGFR without these conditions, we must consider different etiologies. The focus of this paper is on low free triiodothyronine (FT3) syndrome. We also discuss the utility of eGFR, estimated using cystatin-C (CysC-eGFR), for these patients.<br>
Methods The data of 39 patients diagnosed with AN between January 2005 and December 2023 was available for study. The characteristics of patients at the lowest and highest body mass index standard deviation score (BMI-SDS) were examined. Data on the parameters Cr-eGFR, CysC-eGFR, dehydration markers, potassium (K), and hormonal data and BMI-SDS were assessed during the treatment course to evaluate the correlations in these parameters. Blood hematocrit, uric acid (UA), blood urine nitrogen (BUN) level, and urine specific gravity were adopted as dehydration markers; FT3, free thyroxine, thyroid stimulating hormone, and insulin-like growth factor were adopted as hormonal data. Cr-eGFR and simultaneously evaluated dehydration markers, K, or hormonal data were extracted and correlations associated with the changes in BMI-SDS were examined. Furthermore, Cr-eGFR and simultaneously assessed CysC-eGFR were compared.<br>
Results When the BMI-SDS was at the lowest value, low-FT3 syndrome was shown. Severe hypokalemia was not found in our study. A linear relation was not found between Cr-eGFR and BMI-SDS. A statistically significant correlation was found between Cr-eGFR and FT3 (p = 0.0025). Among the dehydration markers, statistically significant correlations were found between Cr-eGFR and BUN or UA. The difference between Cr-eGFR and CysC-eGFR was prominent, and CysC-eGFR showed much higher values.<br>
Conclusions Our data indicates that low-FT3 syndrome and dehydration were related to the renal function of our patients with AN. Furthermore, our data suggest that caution is needed in the interpretation of kidney function evaluation when using CysC-eGFR in cases of AN.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-818416102024Presumed Choroidopathy of IgG4-Related Disease Discovered During 16-Year Follow-Up of a Patient With Polycystic Kidney Diseasee70865ENToshihikoMatsuoOphthalmology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTakehiroTanakaPathology, Okayama University HospitalKenjiTsujiNephrology, Okayama University HospitalImmunoglobulin G4 (IgG4)-related disease is characterized by infiltration with IgG4-producing plasma cells in different organs and the elevation of serum IgG4. We present a patient with polycystic kidney disease in long-term follow-up who developed bilateral lacrimal gland enlargement and presumed IgG4-related choroidopathy at different time points. A 45-year-old woman developed bilateral upper eyelid swelling. Head MRI showed bilateral lacrimal gland enlargement, and the resection on both sides revealed foci of infiltration with lymphocytes and plasma cells in bilateral lacrimal glands. The IgG4-immunostaining did not satisfy the diagnostic criteria. She had been taking oral valsartan 40 mg daily for hypertension with polycystic kidney disease.<br>
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The patient was well until the age of 49 years, when she noticed yellowish vision in the right eye compared to the left eye. The right eye showed multiple yellowish spotty lesions in the deep retina to choroid with a mildly hyperemic optic disc, while the left eye showed the normal fundus. No inflammation was noted in the anterior segments of both eyes. Fundus angiography demonstrated early-phase no-filling with late-phase leakage by fluorescein dye and both early-phase and late-phase no-filling by indocyanine green dye, leading to the diagnosis of acute posterior multifocal placoid pigment epitheliopathy (APMPPE). She began to have oral prednisolone tapered from 30 mg daily and discontinued in a year. At the age of 52 years, she switched to candesartan 8 mg daily and began to have tolvaptan (a selective competitive vasopressin receptor 2 (V2) antagonist) 90 mg daily for polycystic kidney disease with liver cysts. At that time, the lesions in the right eye had mild degeneration.<br>
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The patient was followed once a year ophthalmologically to maintain good vision. At 57 years, serum IgG4, which was measured for the first time on suspicion of IgG4-related disease, was elevated to 269.6 mg/dL. In the following four years to the latest visit at 61 years, she kept stable but high levels of serum IgG4 around 300 mg/dL. Serum IgG4 measurement is helpful to make a clinical diagnosis and, hence, a clinical decision since the spectrum of IgG4-related disease remains obscure.No potential conflict of interest relevant to this article was reported.BMCActa Medica Okayama1472-68312412024Histological differences related to autophagy in the minor salivary gland between primary and secondary types of Sjögren's syndrome1099ENHitomiOno-MinagiDepartment of Cytology and Histology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTsutomuNohnoDepartment of Cytology and Histology, Okayama University Medical SchoolKiyofumiTakabatakeDepartment of Oral Pathology and Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakehiroTanakaDepartment of Pathology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakayukiKatsuyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University HospitalKohtaMiyawakiDivision of Precision Medicine, Kyushu University School of MedicineJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySoichiroIbaragiDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySeijiIidaDepartment of Oral and Maxillofacial Reconstructive Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTadashiYoshinoDepartment of Pathology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineHitoshiNagatsukaDepartment of Oral Pathology and Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakayoshiSakaiDepartment of Rehabilitation for Orofacial Disorders, Osaka University Graduate School of DentistryHideyoOhuchiDepartment of Cytology and Histology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySome forms of Sjögren’s syndrome (SS) follow a clinical course accompanied by systemic symptoms caused by lymphocyte infiltration and proliferation in the liver, kidneys, and other organs. To better understand the clinical outcomes of SS, here we used minor salivary gland tissues from patients and examine their molecular, biological, and pathological characteristics. A retrospective study was performed, combining clinical data and formalin-fixed paraffin-embedded (FFPE) samples from female patients over 60 years of age who underwent biopsies at Okayama University Hospital. We employed direct digital RNA counting with nCounter® and multiplex immunofluorescence analysis with a PhenoCycler™ on the labial gland biopsies. We compared FFPE samples from SS patients who presented with other connective tissue diseases (secondary SS) with those from stable SS patients with symptoms restricted to the exocrine glands (primary SS). Secondary SS tissues showed enhanced epithelial damage and lymphocytic infiltration accompanied by elevated expression of autophagy marker genes in the immune cells of the labial glands. The close intercellular distance between helper T cells and B cells positive for autophagy-associated molecules suggests accelerated autophagy in these lymphocytes and potential B cell activation by helper T cells. These findings indicate that examination of FFPE samples from labial gland biopsies can be an effective tool for evaluating molecular histological differences between secondary and primary SS through multiplexed analysis of gene expression and tissue imaging.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama1996-194417162024Effect of Scaffold Geometrical Structure on Macrophage Polarization during Bone Regeneration Using Honeycomb Tricalcium Phosphate4108ENKiyofumiTakabatakeDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHidetsuguTsujigiwaDepartment of Life Science, Faculty of Science, Okayama University of ScienceKeisukeNakanoDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAnqiChangDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTianyanPiaoDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYasunoriInadaDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakumaArashimaDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAyumiMorimatsuDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAyumiTanakaDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHotakaKawaiDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHitoshiNagatsukaDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityThe polarization balance of M1/M2 macrophages with different functions is important in osteogenesis and bone repair processes. In a previous study, we succeeded in developing honeycomb tricalcium phosphate (TCP), which is a cylindrical scaffold with a honeycomb arrangement of straight pores, and we demonstrated that TCP with 300 and 500 mu m pore diameters (300TCP and 500TCP) induced bone formation within the pores. However, the details of the influence of macrophage polarization on bone formation using engineered biomaterials, especially with respect to the geometric structure of the artificial biomaterials, are unknown. In this study, we examined whether differences in bone tissue formation due to differences in TCP geometry were due to the polarity of the assembling macrophages. Immunohistochemistry for IBA-1, iNOS, and CD163 single staining was performed. The 300TCP showed a marked infiltration of iNOS-positive cells, which are thought to be M1 macrophages, during the osteogenesis process, while no involvement of CD163-positive cells, which are thought to be M2 macrophages, was observed in the TCP pores. In addition, 500TCP showed a clustering of iNOS-positive cells and CD163-positive cells at 2 weeks, suggesting the involvement of M2 macrophages in the formation of bone tissue in the TCP pores. In conclusion, we demonstrated for the first time that the geometrical structure of the artificial biomaterial, i.e., the pore size of honeycomb TCP, affects the polarization of M1/2 macrophages and bone tissue formation in TCP pores.No potential conflict of interest relevant to this article was reported.