MDPI AG Acta Medica Okayama 2410-387X 9 4 2025 Role-Based Efficient Proactive Secret Sharing with User Revocation 80 EN Yixuan He Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Yuta Kodera Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Yasuyuki Nogami Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Samsul Huda Interdisciplinary Education and Research Field, Okayama University Proactive secret sharing (PSS), an extension of secret-sharing schemes, safeguards sensitive data in dynamic distributed networks by periodically refreshing shares to counter adversarial attacks. In our previous work, we constructed a non-interactive proactive secret scheme by integrating threshold homomorphic encryption (ThHE) while reducing the communication complexity to 𝑂(𝑛). Not only is refreshing shares important but revoking the shares of users who have left the system is also essential in practical dynamic membership scenarios. However, the previous work was insufficient for supporting explicit user revocation. This study strengthens the description of roles for authorized users and proposes a scheme to achieve non-interactive share refresh and dynamic user management. In each epoch, authorized users are classified into three roles: retain, newly join, and rejoin, and they receive a broadcast of the compact ciphertext encoding both the refresh information and the revocation instructions from the trusted center (dealer). Authorized users independently derive new shares through homomorphic computations, whereas revoked users are unable to generate new shares. Hash functions are used to bind revocation parameters to the cryptographic hashes of valid users in order to guarantee integrity during revocation, allowing for effective verification without compromising non-interactivity. Our new scheme not only extends the revocation structure but also preserves the 𝑂(𝑛) communication complexity. No potential conflict of interest relevant to this article was reported.

John Wiley & Sons Ltd. Acta Medica Okayama 2314-6133 2025 2025 Comparing the Activity of Peripheral Blood Mononuclear Cells Frozen Under Electromagnetic Field Freezing and Standard Slow-Freezing 9884345 EN Takehiro Matsubara Okayama University Hospital Biobank Mina Takagi Faculty of Health Sciences, Okayama University Medical School Takahiro Uwabo Department of Biorepository Research and Networking, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Junichi Soh Department of Thoracic Surgery, Osaka Metropolitan University Graduate School of Medicine Shinichi Toyooka Okayama University Hospital Biobank Mizuki Morita Okayama University Hospital Biobank Peripheral blood mononuclear cells (PBMCs) are cells obtained from the blood that are used not only in clinical tests but also in various research applications. The slow-freezing (SLF) method, currently the standard for PBMC cryopreservation, involves extended storage at −80°C before transfer to liquid nitrogen. Delays in this transfer, such as overnight or weekend holds, risk a gradual decline in cell viability. Additionally, variability in freezing duration can lead to inconsistent cell quality, emphasizing the need for an alternative freezing method that allows for more timely transfer to liquid nitrogen. This study is aimed at clarifying whether the method of using a freezer with an applied electromagnetic field (EMF) is superior to the currently used standard SLF method for PBMC cryopreservation. A comparison of the number of viable cells, cell viability, and cell activity showed that the EMF method was equivalent to the SLF method. However, the shortest time required for freezing was significantly shorter with the EMF method than the SLF method (0.25 vs. 3 h), allowing for earlier transfer of PBMC to liquid nitrogen. This demonstrates that the EMF method offers an advantage in operational efficiency, particularly for facilities that routinely process and store PBMCs, such as biobanks and other storage-focused departments. No potential conflict of interest relevant to this article was reported.

American Chemical Society (ACS) Acta Medica Okayama 2470-1343 11 9 2026 Water-Resistant Antibacterial Coatings Using Cetylpyridinium Chloride - Graphene Oxide Composites 14570 14577 EN Keisuke Okubo Department of Periodontics and Endodontics, Field of Medical Development, Okayama University Gen Kano Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Masato Komoda Research Institute for Interdisciplinary Science, Okayama University Kazuhiro Omori Department of Pathophysiology - Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yuta Nishina Research Institute for Interdisciplinary Science, Okayama University Shogo Takashiba Department of Pathophysiology - Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hospital-acquired infections remain a persistent threat in healthcare settings, especially with the increasing number of elderly and immunocompromised patients. In situations where the use of disposable materials is difficult, durable antibacterial surface coatings are essential. In this study, we report the structural characterization of cetylpyridinium chloride-graphene oxide (CPC–GO) hybrid materials and the sustainability of their antibacterial effects, aiming at washable antibacterial coatings for medical applications. Graphene oxide (GO) has a large surface area and numerous functional groups, while cetylpyridinium chloride (CPC) is a quaternary ammonium compound with well-documented antibacterial activity. We hypothesized that the stable incorporation of CPC through the functional groups of GO could improve surface retention and provide long-term antibacterial performance. The structural properties of the CPC–GO composites were characterized by UV–vis spectroscopy, X-ray diffraction, thermogravimetric analysis, scanning electron microscopy, and atomic force microscopy. These analyses confirmed the formation of a complex through ionic bonds and the maintenance of a planar composite structure. The antibacterial performance of the CPC–GO coatings was examined using representative bacteria. Notably, the CPC–GO coatings maintained their antibacterial activity significantly better than the negative controls even after multiple washings. The excellent surface retention of the CPC–GO composite suggests its potential as a next-generation antibacterial coating for areas where disinfection and sterilization are impossible, such as the interior of complex medical devices. This study suggests a strategy to extend the efficacy of existing antibacterial agents through the application of nanomaterials. Future studies will focus on the controlled release, long-term stability, and biocompatibility of CPC to realize clinical applications. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0021-5155 2026 Real-world six-month outcomes after switching from aflibercept 2 mg to aflibercept 8 mg for neovascular age-related macular degeneration EN Hiroya Kindo Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Mio Morizane Hosokawa Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Chihiro Ouchi Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Ryo Matoba Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Tetsuro Morita Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Junko Hayashi Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yuki Morizane Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Purpose To investigate 6-month outcomes in eyes with neovascular age-related macular degeneration (nAMD) switched from intravitreal aflibercept 2 mg to intravitreal aflibercept 8 mg.<br> Study design Retrospective observational study.<br> Methods We reviewed records of consecutive nAMD eyes switched from aflibercept 2 mg to 8 mg. In eyes continuing aflibercept 8 mg, best-corrected visual acuity (BCVA), treatment intervals, and anatomical/exudative parameters were evaluated at 6 months. In eyes that could not continue, reasons for discontinuation were examined.<br> Results Forty-four eyes from 44 patients were included. At 6 months, 35 eyes (79.5%) continued and 9 (20.5%) discontinued aflibercept 8 mg. Discontinuing eyes had significantly shorter pre-switch treatment intervals and more frequent prior therapies than continuing eyes. In the continuation group, BCVA remained stable (median 0.05 to 0.00 logMAR, P = 0.351), while the treatment interval was significantly extended (median 7.0 to 9.0 weeks, P < 0.001). Central retinal thickness and pigment epithelial detachment height decreased significantly (P = 0.035 and P = 0.021, respectively). The proportion of eyes with subretinal fluid significantly decreased from 74.3 to 37.1% (P = 0.003). Of the discontinuations, 4 were due to worsening exudation and 5 to inability to extend to ≥8 weeks as required by labeling. No intraocular inflammation or serious adverse events occurred.<br> Conclusions Switching to aflibercept 8 mg achieved anatomical improvements and longer treatment intervals in ~80% of nAMD cases, suggesting it may be a useful alternative to aflibercept 2 mg. However, continuation may be difficult in refractory cases requiring frequent injections before switching. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1123-6337 29 1 2025 Safety and feasibility of D3 lymph node dissection in oldest-old patients undergoing colorectal cancer surgery: a multi-institutional, retrospective analysis 146 EN R. Inada Department of Surgery, Kochi Health Sciences Center F. Teraishi Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences T. Mitsuhashi Center for Innovative Clinical Medicine, Okayama University Hospital S. Takanaga Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences T. Toshima Department of Surgery, Kagawa Rosai Hospital T. Ohtani Department of Surgery, Saiseikai Okayama Hospital R. Yoshida Department of Surgery, Okayama Rosai Hospital N. Hori Department of Surgery, Tottori Municipal Hospital K. Shigemitsu Department of Surgery, Tsuyama Chuo Hospital S. Yamamoto Department of Surgery, Okayama City Hospital T. Kubota Department of Surgery, Kobe Red Cross Hospital Y. Okano Department of Surgery, Onomichi City Hospital T. Nobuhisa Department of Surgery, Himeji Red Cross Hospital F. Taniguchi Department of Surgery, National Hospital Organization Iwakuni Clinical Center W. Ishikawa Department of Surgery, Fukuyama City Hospital R. Shoji Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences T. Matsuda Department of Surgery, Matsuda Hospital T. Umeoka Department of Surgery, Matsuyama City Hospital T. Fujiwara Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Setouchi Colorectal Neoplasm Registration Study Group Collaborators Background Colorectal cancer (CRC) is a significant health burden, with lymph node dissection (LND) playing a critical role in staging and guiding treatment. However, the optimal extent of LND for the oldest-old population (aged ≥ 90 years) remains undefined because of insufficient targeted clinical data. This study aimed to compare the short-term outcomes of D3 versus non-D3 LND in Stage II–III CRC in oldest-old patients.<br> Methods This retrospective cohort study utilized data from the Setouchi Colorectal Neoplasm Registration database, including 282 oldest-old patients with CRC treated between 2011 and 2022. Patients were stratified into D3 and non-D3 LND groups, with inverse-probability-weighted regression adjustment implemented to address potential confounding factors. Postoperative complications and hospital stays were analyzed using regression models and descriptive statistics.<br> Results D3 LND resulted in significantly higher lymph node harvests in both Stage II and Stage III patients (p < 0.01). There were no significant differences in overall or major postoperative complications between D3 and non-D3 groups. Hospital stays were comparable for Stage II patients but shorter for Stage III patients in the D3 group (p < 0.01). Complication rates ranged from 28% to 47.7%, with surgical site infections and pneumonia being the most common.<br> Conclusions D3 LND can be safely performed in oldest-old patients with CRC without increasing postoperative complications or extending hospital stays. These findings support the feasibility of extensive LND in this age gr No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 2168-8184 17 5 2025 Pseudoachalasia Due to Malignant Pleural Mesothelioma Involving the Esophagus e84161 EN Manami Honda Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Masaya Iwamuro Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Kazuya Miyamoto Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Takehiro Tanaka Department of Pathology, Okayama University Hospital Motoyuki Otsuka Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences We 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.

Oxford University Press (OUP) Acta Medica Okayama 2050-3911 2026 2 2026 Feedback-Controlled Beam Pattern Measurement Method Using a Power-Variable Calibration Source for Cosmic Microwave Background Telescopes 023F01 EN Haruaki Hirose Department of Physics, Graduate School of Engineering Science, Yokohama National University Masaya Hasegawa Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK) Daisuke Kaneko International Center for Quantum-field Measurement Systems for Studies of the Universe and Particles (WPI-QUP), High Energy Accelerator Research Organization (KEK) Taketo Nagasaki Accelerator Laboratory (ACCL), High Energy Accelerator Research Organization (KEK) Ryota Takaku Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Tijmen de Haan Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK) Satoru Takakura Department of Physics, Faculty of Science, The University of Tokyo Takuro Fujino International Center for Quantum-field Measurement Systems for Studies of the Universe and Particles (WPI-QUP), High Energy Accelerator Research Organization (KEK) We demonstrate a novel beam pattern measurement method for the side lobe characterization of cosmic microwave background telescopes. The method employs a power-variable artificial microwave source under feedback control from the detector under test on the telescope. It enables us to extend the dynamic range of the beam pattern measurement without introducing nonlinearity effects from the detector. We conducted a laboratory-based proof-of-concept experiment, measuring the H-plane beam pattern of a horn antenna coupled to a diode detector at 81 GHz. We gained an additional dynamic range of 60.3 dB attributed to the feedback control. In addition, we verified the measurement by comparing it with other reference measurements obtained using conventional methods. The method is also applicable to general optical measurements requiring a high dynamic range to detect subtle nonidealities in the characteristics of optical devices. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 80 1 2026 Time Course of the Development and Loss of Delta-9-tetrahydrocannabinol Tolerance: Effects on Hypothermia and Spontaneous Locomotor Activity in Mice 47 54 EN Yukiomi Eguchi Department of Physiology and Pharmacology, Faculty of Pharmaceutical Sciences, Fukuoka University Soichiro Ushio Department of Emergency and Disaster Medical Pharmacy, Faculty of Pharmaceutical Sciences, Fukuoka University Keiichi Irie Department of Physiology and Pharmacology, Faculty of Pharmaceutical Sciences, Fukuoka University Yuta Yamashita Department of Physiology and Pharmacology, Faculty of Pharmaceutical Sciences, Fukuoka University Miyu Eguchi Department of Emergency and Disaster Medical Pharmacy, Faculty of Pharmaceutical Sciences, Fukuoka University Takafumi Nakano Department of Oncology and Infectious Disease Pharmacy, Faculty of Pharmaceutical Sciences, Fukuoka University Kenichi Mishima Department of Physiology and Pharmacology, Faculty of Pharmaceutical Sciences, Fukuoka University Original Article 10.18926/AMO/70072 Deregulation of cannabis use is gradually expanding in Europe and the United States. However, the biological processes driving tolerance to delta-9-tetrahydrocannabinol (Δ9-THC), the main psychoactive component of cannabis, remain unclear. Thus, this study aimed to investigate the mechanisms and time course of tolerance development and loss to Δ9-THC in mice. Male ICR mice (7 weeks old) were administered Δ9-THC once daily for 3 days and then divided into three groups according to the washout period (3-, 10-, and 17-day washout groups). After each washout, changes in body temperature and locomotor activity were measured following re-exposure to Δ9-THC. Furthermore, the mRNA expression levels of CB1 and CB2 receptors in the brain were evaluated using real-time PCR. On day 1, significant hypothermia and reduced spontaneous locomotor activity were observed in the Δ9-THC-treated mice compared with the vehicle-treated mice. Tolerance to the hypothermic and locomotor-suppressing effects of Δ9-THC developed on days 2 and 3, respectively, and dissipated after 3 and 11 days of washout, respectively. These differences in the rates of tolerance development and recovery may reflect distinct underlying mechanisms. No significant changes in receptor mRNA expression were observed. These findings highlight the complexity of Δ9-THC tolerance and its potential implications for long-term cannabis use. No potential conflict of interest relevant to this article was reported.

岡山大学文明動態学研究所 Acta Medica Okayama 2436-8326 5 2026 Generating Sacredness in the Domestic Sphere: Wedding Rituals and the Navarātri Kolu Festival in South India 82 100 EN Mayumi IIZUKA JapanTakasaki University of Commerce 特集：Sacred Objects in Religions (Special Issue: Sacred Objects in Religions) 10.18926/70056 This article examines how domestic sacredness is dynamically generated, negotiated, and undone within South Indian Brahmin households. Based on ethnographic analysis of the wedding first-night ritual and the Navarātri kolu festival, the study shows how ritual doubling―exemplified by the marappācci dolls as symbolic doubles of the bridal couple―and the circulation of miniature utensils link life-cycle rites with annual festivals. The kolu’s stepped display condenses cosmological hierarchies while activating gendered forms of ritual practice, auspiciousness (maṅgalam) and purity (śuddham). Everyday acts such as sweeping threshold, sparkling water, drawing kolam, and lighting lamps function as “religious profane” practices that continually remake the boundaries between the mundane and the sacred. Digital sharing and online kolu competitions further extend domestic sacredness into dispersed social networks. By foregrounding materiality, gender, purity, and the ephemerality of ritual arrangements, the article demonstrates that domestic sacredness is a plural, fragile and continually renewed process of making and unmaking. No potential conflict of interest relevant to this article was reported.

Open Library of the Humanities Acta Medica Okayama 2056-6700 12 1 2026 Racialized Contagion and Defensive Biopolitics in The Last of Us EN Robert Yeates Faculty of Humanities and Social Sciences, Okayama University In the opening moments of the video game The Last of Us Part I, players are introduced to an emerging pandemic via Austin’s Texas Herald newspaper. Below a headline warning of mass hospitalizations from a 'mysterious infection', players read of a recall of imported crops 'potentially tainted with mold': 'Initial lists distributed to vendors nationwide warned against crops imported from South America. However now the scope has extended to include Central America and Mexico'. This scene immediately suggests the racialization of the franchise’s Cordyceps brain infection (CBI), with the contagion germinating in the global South, invading the US via its southern border, and spreading fastest in the nation’s diverse urban centres. By highlighting tainted crops as the vector of dispersal in the US, however, rather than infected humans, the franchise resists making this a simple invasion-scare narrative and instead suggests that the spread of the infection is in part a result of the capitalist exploitation of cheap land and labour in the global South. Despite its inconsistent record on racial representation and the near-absence of discussion of race across the franchise, the structures reflecting the racialization of contagion and the perpetuation of racialized hierarchies through defensive biopolitics remain present. Drawing connections with the discourse around immigration and the southern border and contemporary pandemics and epidemics, this article makes the case for reading the franchise in terms of racialized contagion and defensive biopolitics, a reading that highlights how the games and their television adaptation reflect urgent contemporary issues around race in America. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 1341-321X 31 12 2025 Whole-genome sequencing and in vitro characterization of a disseminated ST398 Staphylococcus aureus infection: A case report 102845 EN Yosuke Sazumi Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shinnosuke Fukushima Department of Bacteriology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hideharu Hagiya Department of Infectious Diseases, Okayama University Hospital Atsushi Kato Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Atsuhito Suyama Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kohei Oguni Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kazuyoshi Gotoh Department of Medical Laboratory Science, Okayama University Graduate School of Health Sciences Shoko Kutsuno Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Japan Institute for Health Security Junzo Hisatsune Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Japan Institute for Health Security Motoyuki Sugai Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Japan Institute for Health Security Shuma Tsuji Department of Bacteriology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Koji Iio Microbiology Division, Clinical Laboratory, Okayama University Hospital Fumio Otsuka Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Staphylococcus aureus potentially causes systemic infections such as disseminated abscesses and bloodstream infections, leading to high mortality rates. We herein describe a case of disseminated muscle abscesses caused by sequence type (ST) 398 methicillin-sensitive S. aureus (MSSA), along with in vitro investigation results for potential pathogenic factors. A 67-year-old healthy woman was admitted to our hospital with complaints of systemic body pain. Blood cultures identified MSSA and contrast-enhanced computed tomography revealed multiple muscle abscesses extending from her neck to her soles. She received antibiotic treatment with intravenous cephazolin and underwent repeated surgical drainage, and was finally discharged. Notably, the MSSA strain exclusively affected her muscle tissues, prompting us to perform genetic analysis to uncover the underlying reason. Short-read genome analysis revealed the isolate to be ST398, harboring chp and scn genes known for immune evasion from human immunity. However, no other known pathogenic factors were identified despite rigorous assays for biofilm formation, surface and cell wall proteins, protease production, and hyaluronidase activity. ST398 S. aureus is commonly isolated from livestock, and her prior experience of being flooded could be related to the disease onset. The present case underscores the possibility of severe ST398 MSSA infections in humans, even in the absence of direct animal exposure. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 2313-433X 12 1 2025 FluoNeRF: Fluorescent Novel-View Synthesis Under Novel Light Source Colors and Spectra 16 EN Lin Shi Department of Artificial Intelligence, Kyushu Institute of Technology Kengo Matsufuji Department of Artificial Intelligence, Kyushu Institute of Technology Michitaka Yoshida Department of Computer Science, Okayama University Ryo Kawahara Graduate School of Informatics, Kyoto University Takahiro Okabe Department of Computer Science, Okayama University Synthesizing photo-realistic images of a scene from arbitrary viewpoints and under arbitrary lighting environments is one of the important research topics in computer vision and graphics. In this paper, we propose a method for synthesizing photo-realistic images of a scene with fluorescent objects from novel viewpoints and under novel lighting colors and spectra. In general, fluorescent materials absorb light with certain wavelengths and then emit light with longer wavelengths than the absorbed ones, in contrast to reflective materials, which preserve wavelengths of light. Therefore, we cannot reproduce the colors of fluorescent objects under arbitrary lighting colors by combining conventional view synthesis techniques with the white balance adjustment of the RGB channels. Accordingly, we extend the novel-view synthesis based on the neural radiance fields by incorporating the superposition principle of light; our proposed method captures a sparse set of images of a scene from varying viewpoints and under varying lighting colors or spectra with active lighting systems such as a color display or a multi-spectral light stage and then synthesizes photo-realistic images of the scene without explicitly modeling its geometric and photometric models. We conducted a number of experiments using real images captured with an LCD and confirmed that our method works better than the existing methods. Moreover, we showed that the extension of our method using more than three primary colors with a light stage enables us to reproduce the colors of fluorescent objects under common light sources. No potential conflict of interest relevant to this article was reported.

International Union of Crystallography (IUCr) Acta Medica Okayama 2056-9890 82 2 2026 Crystal structure of tris[4-(3,4-dimethoxythiophen-2-yl)phenyl]amine E82 EN Masafumi Yano Kansai University Yukiyasu Kashiwagi Osaka Research Institute of Industrial Science and Technology Koki Oishi Kansai University Minori Yano Kansai University Koichi Mitsudo Okayama University In the title compound tris­[4-(3,4-di­meth­oxy­thio­phen-2-yl)phen­yl]amine (DMOT-TPA), C36H33NO6S3, the central nitro­gen atom shows no pyramidalization, with the three para-phenyl­ene rings arranged in a propeller-like geometry. Each thio­phene ring is twisted by about 25–29° relative to the adjacent phenyl­ene ring, giving a distorted π-conjugated framework. In the crystal, mol­ecules are linked through multiple C―H⋯π inter­actions into two-dimensional sheets, which extend into a three-dimensional network. A Cambridge Structural Database survey revealed no prior examples of tri­phenyl­amines bearing 3,4-di­meth­oxy­thio­phen units at the para positions. This unique structure provides new insights into the design of redox-active organic materials. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 79 6 2025 Real-World Outcomes of Anti-Vascular Endothelial Growth Factor Therapy for Neovascular Age-Related Macular Degeneration in Patients Aged 85 or Older 405 412 EN Chihiro Ouchi Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Mio Morizane Hosokawa Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shuhei Kimura Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yusuke Shiode Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Ryo Matoba Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Tetsuro Morita Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yuki Morizane Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Original Article 10.18926/AMO/69842 We investigated the treatment outcomes of patients aged ≥85 years with neovascular age-related macular degeneration (nAMD) who received anti-vascular endothelial growth factor (anti-VEGF) therapy using either treat-and-extend (TAE) or pro re nata (PRN) regimens for 1 year in real-world clinical practice. Eighty-five eyes from 85 patients were included. Among them, types 1, 2, and 3 macular neovascularization and polypoidal choroidal vasculopathy were present in 27.1%, 17.6%, 18.8%, and 36.5%, respectively. TAE and PRN regimens were used in 43.5% and 56.5% of patients, respectively. At baseline, the PRN group was older and had worse best-corrected visual acuity (BCVA), greater central retinal thickness, and more intraretinal fluid than the TAE group. In the TAE group, the mean number of injections was 7.6, BCVA improved significantly, and all retinal fluid rates decreased. In the PRN group, the mean number of injections was 3.9, BCVA remained unchanged, and the rates of macular fibrosis and atrophy increased. No serious adverse events were observed in either group. Anti-VEGF therapy was safe for patients aged ≥ 85 years with nAMD, and the TAE regimen effectively improved BCVA in this population. BCVA remained unchanged in the PRN-treated patients, with baseline disease severity and/or undertreatment potentially influencing the outcomes. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 0264-1275 260 2025 An entangled material made from fiber aerosol deposition method 115195 EN Hongwu Yu Faculty of Environmental, Life, Natural Science and Technology, University of Okayama Naoshi Ikeda Faculty of Environmental, Life, Natural Science and Technology, University of Okayama Masakazu Mori Ryukoku University Jun Kano Faculty of Environmental, Life, Natural Science and Technology, University of Okayama Jae-Hyuk Park School of Advanced Materials Science & Engineering, Sungkyunkwan University Jun Akedo National Institute of Advanced Industrial Science and Technology This study demonstrates the successful application of Aerosol Deposition (AD) technology to short carbon fibers (length < 1 mm), enabling the rapid, three-dimensional (3D) fabrication of objects with vertical growth rates up to 0.3 mm/s, a significant improvement over conventional additive manufacturing. Through a series of experiments using this novel Fiber Aerosol Deposition (FAD) technology, three fiber lengths (47, 85, and 111 μm) and four substrate materials (carbon, polypropylene, polyethylene, and acrylonitrile butadiene styrene (ABS)) were investigated. Our findings indicate that both carbon substrate entanglement and fiber length critically influence deposition efficiency. Scanning electron microscopy (SEM) and X-ray computed tomography (CT) analyses reveal that during formation, longer fibers (>100 μm) initially create a cage-like framework, which is subsequently filled by shorter fibers. Density measurements and fiber distribution analysis confirmed that structures predominantly composed of shorter fibers exhibit higher packing densities, consistent with their role as filler material. These results collectively suggest that the FAD method’s formation mechanism relies on frictional entanglement rather than the room-temperature impact consolidation (RTIC) effect characteristic of traditional AD. This breakthrough presents a promising new technique for forming short fibers into functional 3D architectures, with potential applications extending to proteins, polymer fibers, and biomaterial fibers. No potential conflict of interest relevant to this article was reported.

Biophysical Society of Japan Acta Medica Okayama 2189-4779 22 3 2025 Origin of the unique topology of the triangular water cluster in &lt;i&gt;Rubrobacter xylanophilus&lt;/i&gt; rhodopsin e220018 EN Tomoyasu Noji Department of Applied Chemistry, Graduate School of Engineering, The University of Tokyo Masaki Tsujimura Department of Advanced Interdisciplinary Studies, The University of Tokyo Keisuke Saito Department of Applied Chemistry, Graduate School of Engineering, The University of Tokyo Keiichi Kojima Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yuki Sudo Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hiroshi Ishikita Department of Applied Chemistry, Graduate School of Engineering, The University of Tokyo The crystal structure of Rubrobacter xylanophilus rhodopsin (RxR) reveals a triangular cluster of three water molecules (W413, W415, and W419) at the extracellular proton-release site, near Glu187 and Glu197. Using a quantum mechanical/molecular mechanical approach, we identified the structural nature of this unique water cluster. The triangular shape is best reproduced when all three water molecules are neutral H2O with protonated Glu187 and deprotonated Glu197. Attempts to place H3O+ at any of these water molecules result in spontaneous proton transfer to one of the acidic residues and significant distortion from the crystal structure. The plane defined by the triangular water cluster extends into the guanidinium plane of Arg71, with both aligned along the W413...W419 axis. This extended plane lies nearly perpendicular to a five-membered, ring-like H-bond network involving two carboxyl oxygen atoms from Glu187 and one from Glu197. The resulting bipartite planar architecture, defined by the water triangle, Arg71, and the Glu187/Glu197 network may reflect the exceptional thermal stability in RxR. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 1433-7851 64 13 2025 Conduction Band and Defect Engineering for the Prominent Visible‐Light Responsive Photocatalysts e202419624 EN Akira Yamakata Graduate School of Natural Science and Technology, Okayama University Kosaku Kato Graduate School of Natural Science and Technology, Okayama University Takafumi Ogawa Nanostructures Research Laboratory, Japan Fine Ceramics Center Kanta Ogawa Department of Energy and Hydrocarbon Chemistry Graduate School of Engineering, Kyoto University Makoto Ogawa Department of Energy and Hydrocarbon Chemistry Graduate School of Engineering, Kyoto University Daichi Kato Department of Energy and Hydrocarbon Chemistry Graduate School of Engineering, Kyoto University Chengchao Zhong Department of Energy and Hydrocarbon Chemistry Graduate School of Engineering, Kyoto University Akihide Kuwabara Nanostructures Research Laboratory, Japan Fine Ceramics Center Ryu Abe Department of Energy and Hydrocarbon Chemistry Graduate School of Engineering, Kyoto University Hiroshi Kageyama Department of Energy and Hydrocarbon Chemistry Graduate School of Engineering, Kyoto University Controlling trap depth is crucial to improve photocatalytic activity, but designing such crystal structures has been challenging. In this study, we discovered that in 2D materials like BiOCl and Bi4NbO8Cl, composed of interleaved [Bi2O2]2+ and Cl- slabs, the trap depth can be controlled by manipulating the slab stacking structure. In BiOCl, oxygen vacancies (VO) create deep electron traps, while chlorine vacancies (VCl) produce shallow traps. The depth is determined by the coordination around anion vacancies: VO forms strong σ bonds with Bi-6p dangling bonds below the conduction band minimum (CBM), while those around Cl are parallel, forming weak π-bonding. The strong re-hybridization makes the trap depth deeper. In Bi4NbO8Cl, VCl also creates shallow traps, but VO does not produce deep traps although Bi-6p orbitals are also forming strong σ bonding. This difference is attributed to the difference of the energy level of CBM. In both cases, the CBM consists of Bi-6p orbitals extending into the Cl layers. However, these orbitals are isolated in BiOCl, but those in Bi4NbO8Cl are bonded with each other between neighboring [Bi2O2]2+ layers. This unique bonding-based CBM prevents the formation of deep electron traps, and significantly enhances H2 evolution activity by prolonging the lifetime of highly reactive free electrons. No potential conflict of interest relevant to this article was reported.

British Editorial Society of Bone & Joint Surgery Acta Medica Okayama 2633-1462 6 8 2025 Long-term functional and quality of life outcomes after cementless minimally invasive extendable endoprosthesis replacement in skeletally immature patients with bone sarcomas at the lower limb a Japanese Musculoskeletal Oncology Group (JMOG) study 954 963 EN Yusuke Tsuda Department of Orthopaedic Surgery, The University of Tokyo Hospital Yoshihiro Nishida Department of Rehabilitation, Nagoya University Hospital Akio Sakamoto Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University Koichi Ogura Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital Tomohiro Fujiwara Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Tetsuya Sekita Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital Hirotaka Kawano Department of Orthopaedic Surgery, Teikyo University School of Medicine Hiroshi Kobayashi Department of Orthopaedic Surgery, The University of Tokyo Hospital Aims<br> Extendable endoprostheses are utilized to reconstruct segmental defects following resection of bone sarcomas in skeletally immature children. However, there remains a paucity of data regarding long-term functional and quality of life outcomes.<br> Methods<br> We conducted a retrospective, multicentre study and reviewed 45 children who underwent cementless minimally invasive extendable endoprosthetic replacement. Anatomical sites included the distal femur (n = 29), proximal femur (n = 4), proximal tibia (n = 11), and total femur (n = 1). The mean follow-up period was 12 years. The mean age at extendable endoprosthetic replacement was ten years (5 to 15). Most patients (96%, 43/45) had reached skeletal maturity at the final follow-up.<br> Results<br> The ten-year endoprosthetic failure-free survival rate was 60%. Of the 45 patients, 25 (56%) had 42 complications which were frequently related to structural failure (45%, 19/42), with extension mechanism jamming being the most common (n = 7, 17%). Excluding lengthening procedures, 20 patients (44%) underwent additional surgery with a mean of two surgeries per patient. The mean limb-length discrepancy at the final follow-up was 2.3 cm. Limb salvage was achieved in 44 (98%) patients. The mean Musculoskeletal Tumor Society (MSTS) scores, Toronto Extremity Salvage Score (TESS), and EuroQol five-dimension five-level questionnaire (EQ-5D-5L) were 78%, 92%, and 92% at the last follow-up, respectively. Multiple additional surgeries (≥ 2 times) for complications were associated with worse MSTS scores compared with those without multiple additional surgeries (p = 0.009). Moreover, limb-length discrepancy > 3 cm showed significantly worse MSTS scores compared with those ≤ 3 cm (p = 0.019).<br> Conclusion<br> Extendable endoprostheses were associated with a high complication rate and need for additional surgeries over time, especially for structural-related complications. Despite this, successful limb salvage with reasonable function/quality of life and small limb-length discrepancy were achievable in the long term. Patients’ function in the long term depended on the experience of postoperative complications and limb-length discrepancy. No potential conflict of interest relevant to this article was reported.

Georg Thieme Verlag KG Acta Medica Okayama 0013-726X 57 S 01 2025 Underwater endoscopic papillectomy of a duodenal adenoma extending to the papilla using a forward-viewing endoscope E667 E668 EN Takashi Yamamoto Department of Gastroenterology, Okayama University Hospital Yasushi Yamasaki Department of Gastroenterology, Okayama University Hospital Yuki Fujii Department of Gastroenterology, Okayama University Hospital Kazuyuki Matsumoto Department of Gastroenterology, Okayama University Hospital Motoyuki Otsuka Department of Gastroenterology, Okayama University Hospital No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 0041-1132 65 9 2025 Novel method for autologous peripheral blood stem cell harvest using highly concentrated sodium citrate solution replacing acid citrate dextrose solution A 1662 1672 EN Wataru Kitamura Department of Hematology and Oncology, Okayama University Hospital Keiko Fujii Department of Hematology and Oncology, Okayama University Hospital Masaya Abe Department of Hematology and Oncology, Okayama University Hospital Kazuhiro Ikeuchi Department of Hematology and Oncology, Okayama University Hospital Joji Shimono Department of Hematology and Oncology, Okayama University Hospital Kana Washio Department of Pediatrics, Okayama University Hospital Fumio Otsuka Division of Clinical Laboratory, Okayama University Hospital Yoshinobu Maeda Department of Hematology and Oncology, Okayama University Hospital Nobuharu Fujii Department of Hematology and Oncology, Okayama University Hospital Background: As the processed blood volume increases, a larger amount of anticoagulant (AC) is required, which leads to a serious issue of fluid dilution in large-volume leukocytapheresis (defined as ≥3-fold total blood volume). We previously reported a novel method for allogeneic peripheral blood stem cell harvest (PBSCH) using highly concentrated sodium citrate (HSC; 5.32%), which shortened the procedure time and reduced the need for an AC solution without heparin. In this study, we extended this novel method to autologous PBSCH (auto-PBSCH) and compared it with patients who received auto-PBSCH using normal concentrated sodium citrate (NSC; 2.2%).<br> Study Design and Methods: We retrospectively analyzed consecutive auto-PBSCH data obtained using the Spectra Optia continuous mononuclear cell collection mode between May 2017 and May 2025 at our institution.<br> Results: Leukocytapheresis was performed using NSC in 36 patients and HSC in 22. In the HSC group, patients tended to be younger, had significantly lower body weight, and had significantly fewer hematopoietic tumors as primary diseases compared to the NSC group. After propensity score-matched cohort adjusted for patient background, the total amount of AC solution was significantly lower (694 [range, 77–1648] vs. 298 mL [range, 64–797], p = .02), and procedure time was significantly shorter (224 [range, 117–395] vs. 181 min [range, 103–309], p = .048) in the HSC group. Furthermore, the loss rates of magnesium and potassium were lower in the HSC group.<br> Conclusion: This novel leukocytapheresis method demonstrated the efficacy and safety in auto-PBSCH, while minimizing the patient burden. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 2168-8184 17 8 2025 Conversion to Hip Arthroplasty After Internal Fixation Failure in an Intertrochanteric Femoral Fracture: A Case Report e90112 EN Shiro Fukuoka Department of Orthopedics, Kagawa Prefectural Central Hospital Tomoo Inoue Department of Orthopedics, Kagawa Prefectural Central Hospital Motoki Takahashi Department of Orthopedics, Kagawa Prefectural Central Hospital Keisuke Kawasaki Department of Orthopedic Surgery, Kagawa Prefectural Central Hospital Toshifumi Ozaki Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science Intertrochanteric femoral fractures are mainly managed by internal fixation. However, failures such as over-telescoping, cut-out, nonunion, or implant failure can occur, especially in osteoporotic elderly patients. We report the case of a patient in whom we performed artificial hip replacement surgery after fixation failure following internal fixation of an intertrochanteric femoral fracture. We report the case of an 85-year-old woman who sustained a left intertrochanteric femoral fracture treated with a dynamic hip screw (DHS). One week postoperatively, radiographs revealed over-telescoping of the lag screw. The patient did not complain of pain, but she underwent conversion to cemented bipolar hemiarthroplasty under general anesthesia. One possible cause of over-telescoping of the lag screw after surgery was that the longitudinal fracture line in the calcar of the proximal bone fragment, as seen in the initial CT image, may have extended horizontally at the neck level. During surgery, a fracture at the same site caused the anterior medial fragment to fail, resulting in a coronal shear fracture and fixation failure. When a longitudinal fracture line is observed in the calcar of the proximal fragment, it is necessary to keep in mind that it may extend horizontally at the neck level. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 0301-679X 214 2026 The influence of lubricant additives and surface roughness and hardness of material on the damage behavior of gears 111341 EN Takuya Ohno Faculty of Environmental, Life, Natural Science and Technology, Okayama University Tadashi Shiota Faculty of Environmental, Life, Natural Science and Technology, Okayama University Masahiro Fujii Faculty of Environmental, Life, Natural Science and Technology, Okayama University This study investigates the influence of lubricant additives, surface roughness, and material hardness on gear damage behavior under boundary lubrication conditions. We conducted both the Short-term Test and the Standard Test using an FZG gear test machine to evaluate how lubricant additives and gear surface roughness influence damage progression when the surface roughness exceeds the oil-film thickness. Acid phosphate ester effectively suppressed micropitting through surface smoothing but led to severe damage such as pitting and scuffing during prolonged use. In contrast, sulfurized fatty oil promoted mild wear, delaying catastrophic failures and extending gear life. Higher surface roughness accelerated wear, while increased hardness reduced deformation but it expanded damage areas. The study found that initial surface roughness and its progress during load stages strongly correlate with gear durability. Measurement of arithmetic mean roughness after sufficient running-in under actual load conditions proved useful for predicting long-term performance. These findings highlight the importance of selecting lubricant formulations tailored to specific gear operating environments and damage modes. Understanding the interplay between lubrication chemistry and material properties enables the design of more durable gear systems. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1618-1247 2025 Admission prognostic nutritional index predicts prolonged hospitalization in severe odontogenic deep neck infections EN Eiji Iwata Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kyoichi Obata Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shogo Kikuta Dental and Oral Medical Center, Kurume University School of Medicine Naoki Kaneko Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University Kotaro Sato Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine Norio Kitagawa Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo Yohei Takeshita Department of Oral and Maxillofacial Radiology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine Katsuhisa Matsuo Dental and Oral Medical Center, Kurume University School of Medicine Junsei Sameshima Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University Akira Tachibana Department of Oral and Maxillofacial Surgery, Kakogawa Central City Hospital Shintaro Kawano Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University Jingo Kusukawa Dental and Oral Medical Center, Kurume University School of Medicine Masaya Akashi Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine Joe Iwanaga Dental and Oral Medical Center, Kurume University School of Medicine Soichiro Ibaragi Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Objectives Severe odontogenic deep neck infections (DNIs) can be life threatening. This study investigated the nutritional status of affected patients and evaluated the usefulness of the Prognostic Nutritional Index (PNI) at admission in helping maxillofacial surgeons identify, at presentation, those likely to require extended hospitalization.<br> Methods A total of 112 patients treated for odontogenic deep neck abscesses and necrotizing soft tissue infections at five hospitals in Japan. Patients were included. Patients were categorized by length of hospitalization duration and factors associated with prolonged hospitalization were analyzed using propensity score matching to minimize bias. Spearman’s rank correlation analysis was also performed to assess the relationship between PNI and hospitalization duration.<br> Results Fifty patients (44.6%) required hospitalization for more than 14 days. Multivariate analysis identified PNI ≤ 41.2 (odds ratio [OR] = 2.79) and the presence of abscesses in multiple deep neck spaces (OR = 2.76) as significant predictors of prolonged hospitalization. Propensity score analysis confirmed the significant association between PNI and length of hospitalization duration (P = 0.048). In addition, Spearman’s rank correlation coefficient was r = − 0.471 (P < 0.001), indicating a moderate negative correlation.<br> Conclusion The admission PNI may serve as a useful adjunctive indicator for predicting prolonged hospitalization in patients with severe odontogenic DNIs, as it reflects both nutritional status and systemic inflammation. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1752-1947 19 1 2025 The safety and efficacy of finasteride for transgender men with androgenetic alopecia: a case series 468 EN Yusuke Tominaga Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine Tomoko Kobayashi Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine Yuko Matsumoto Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine Tomoko Sako Department of Urology, Hiroshima City Hiroshima Citizens Hospital Takatoshi Moriwake Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine Satoshi Horii Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine Takuya Sadahira Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine Satoshi Katayama Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine Takehiro Iwata Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine Shingo Nishimura Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine Kensuke Bekku Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine Kohei Edamura Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine Masami Watanabe Center for Innovative Clinical Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine Motoo Araki Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine Background Testosterone replacement therapy is commonly used in transgender men for masculinization. One of the most common adverse effects of testosterone replacement therapy is androgenetic alopecia. In Japan, finasteride is approved exclusively for cisgender men and is not indicated for transgender men. The aim of this clinical trial was to evaluate the safety and efficacy of finasteride in transgender men with androgenetic alopecia.<br> Case presentation This study included three transgender men (assigned female at birth, identifying as male), aged 44, 43, and 29 years. All participants were of Asian ethnicity. A clinical trial was conducted from October 2021 to December 2023. Transgender men aged 20–60 years who had not undergone hysterectomy, were undergoing testosterone replacement therapy, and who had been diagnosed with stage ≥ II androgenetic alopecia on the basis of the Norwood–Hamilton scale were recruited. The participants initiated treatment with 0.2 mg of finasteride per day for 3 months (phase 1). If no adverse events above grade 2 occurred, the dose was increased to 1.0 mg per day for an additional 3 months (phase 2). The primary endpoints were the incidence of treatment-related adverse events at 1 week, 1 month, and 3 months, as well as the rate of participants continuing treatment at 3 months. None of the patients experienced serious adverse events at 3 months, and all the patients extended their treatment to a total of 6 months. Improvements of at least one stage on the N–H scale were observed, but two participants experienced resumption of menstruation.<br> Conclusion Finasteride appears to be a safe and effective treatment for androgenetic alopecia in transgender men undergoing testosterone replacement therapy. However, its potential for reducing some of the effects of testosterone replacement therapy warrants further investigation. Trial registration: jRCT, jRCTs061210040, registered 7 October 2021, https://jrct.mhlw.go.jp/latest-detail/jRCTs061210040. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 79 5 2025 Current Status of Extracorporeal Membrane Oxygenation as a Treatment Strategy for Primary Graft Dysfunction after Lung Transplantation 329 337 EN Kei Matsubara Department of Thoracic Surgery, Hiroshima City Hiroshima Citizens Hospital Kentaroh Miyoshi Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shinichi Toyooka Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Review 10.18926/AMO/69433 Primary 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.

MDPI AG Acta Medica Okayama 2077-0383 14 17 2025 Risk Factors for Perioperative Urinary Tract Infection After Living Donor Kidney Transplantation Characterized by High Prevalence of Desensitization Therapy: A Single-Center Analysis 6102 EN Shingo Nishimura Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shota Inoue Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takanori Sekito Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Ichiro Tsuboi Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Moto Tokunaga Department of Urology, NHO Okayama Medical Center Kasumi Yoshinaga Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yuki Maruyama Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Yosuke Mitsui Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Tomoaki Yamanoi Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Tatsushi Kawada Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Risa Kubota Department of Urology, NHO Okayama Medical Center Takuya Sadahira Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yusuke Tominaga Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takehiro Iwata Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Satoshi Katayama Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kensuke Bekku Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kohei Edamura Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Koichiro Wada Department of Urology, Shimane University Faculty of Medicine Yasuyuki Kobayashi Department of Urology, Hiroshima City Hiroshima Citizens Hospital Motoo Araki Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Background/Objectives: Limited research exists on risk factors for urinary tract infections (UTIs) in kidney transplant recipients, particularly in high-risk groups such as ABO-incompatible or donor-specific antibody (DSA)-positive cases. Early UTIs, especially within the first month post-transplant, impact on acute rejection and long-term graft outcomes, highlighting the need for risk factor identification and management. Methods: Among 157 living donor kidney transplant cases performed at our institution between 2009 and 2024, 128 patients were included after excluding cases with >72 h of perioperative prophylactic antibiotics or urological complications. UTI was defined as the presence of pyuria and a positive urine culture, accompanied by clinical symptoms requiring antibiotic treatment, occurring within one month post-transplantation. Results: The median onset of UTI was postoperative day 8 (interquartile range, IQR: 6.8–9.3). No subsequent acute rejection episodes were observed. The median serum creatinine at 1 month postoperatively was 1.3 mg/dL (IQR: 1.1–1.7), and this was not significantly different from those who did not develop UTI. In univariate analysis, low or high BMI (<20 or >25), longer dialysis duration (>2.5 years), desensitization therapy (plasmapheresis + rituximab), elevated preoperative neutrophil-to-lymphocyte ratio (NLR) (≥3), and longer warm ischemic time (WIT) (≥7.8 min) were significantly associated with an increased infection risk of UTI (p = 0.010, 0.036, 0.028, 0.015, and 0.038, respectively). Multivariate analyses revealed that abnormal BMI, longer dialysis duration, desensitization therapy, and longer WIT were independent risk factors for UTI (p = 0.012, 0.031, 0.008, and 0.033, respectively). The incidence of UTI increased with the number of risk factors: 0% (0/16) for zero, 10% (5/48) for one, 31% (16/51) for two, 45% (5/11) for three, and 100% (2/2) for four risk factors. Conclusions: Desensitization therapy, BMI, dialysis duration, and WIT were identified as independent risk factors for perioperative UTI. In patients with risk factors, additional preventive strategies should be considered, with extended antibiotic prophylaxis being one potential option. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0167-6903 105 4 2025 Effect of environmental conditions on seed germination and seedling growth in Cuscuta campestris 1157 1167 EN Koki Nagao Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Taku Takahashi Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Ryusuke Yokoyama Graduate School of Life Sciences, Tohoku University Dodder (Cuscuta) is an obligate parasitic plant that cannot survive without a host and causes significant damage to crop yields. To understand its growth characteristics before parasitism, we examined the effects of environmental conditions on seed germination and seedling growth in Cuscuta campestris Yunck. Among various factors, we focused on the effects of light, pH, temperature, sugars, salts, hormones, amino acids and polyamines on seeds sown on agar plates. Regarding the effect of light on germination, far-red light was preferable rather than red light and the reversible response of seeds to red and far-red light was confirmed, implicating a phytochrome-mediated signaling pathway opposite to that in many seed plants. Among the amino acids, aspartic acid and alanine had a promotive effect, while histidine had an inhibitory effect on germination. We further found that, in addition to gibberellic acid, methyl jasmonate stimulated both germination and shoot elongation. While 2,4-D extended the viability of trichomes around the root cap, kinetin induced the formation of scale leaves on the shoot and undifferentiated cell clusters at the base of the shoot and root tip. Real-time reverse transcriptase PCR (RT-PCR) experiments confirmed that the expression of a putative RbcS gene for photosynthesis showed no response to light, whereas that of a Phytochrome A homolog increased in the dark. Our results indicate that some of the molecular mechanisms involved in responding to light and hormone signals are uniquely modified in dodder seedlings, providing clues for understanding the survival strategy of parasitic plants. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 2072-6694 17 15 2025 The Concept of “Platinum Sensitivity” in Endometrial Cancer 2557 EN Shoji Nagao Department of Obstetrics and Gynecology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Atsushi Fujikawa Department of Obstetrics and Gynecology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Ryoko Imatani Department of Obstetrics and Gynecology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yoshinori Tani Department of Obstetrics and Gynecology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hirofumi Matsuoka Department of Obstetrics and Gynecology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Naoyuki Ida Department of Obstetrics and Gynecology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Junko Haraga Department of Obstetrics and Gynecology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Chikako Ogawa Department of Obstetrics and Gynecology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Keiichiro Nakamura Department of Obstetrics and Gynecology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hisashi Masuyama Department of Obstetrics and Gynecology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University The concept of “platinum sensitivity” has long guided prognostic assessment and treatment selection in recurrent ovarian cancer. However, the emergence of targeted agents, such as bevacizumab and poly (ADP-ribose) polymerase inhibitors, has complicated its clinical utility. In contrast, emerging evidence suggests that platinum sensitivity may also be applicable to recurrent endometrial cancer. As in ovarian cancer, a prolonged platinum-free interval (PFI) in recurrent endometrial cancer is associated with an improved efficacy of subsequent platinum-based chemotherapy. The PFI is linearly correlated with the response rate to platinum re-administration, progression-free survival, and overall survival. Patients are typically classified as having platinum-resistant or platinum-sensitive disease based on a PFI cutoff of 6 or 12 months. However, unlike in ovarian cancer―where the duration of response to second-line platinum-based chemotherapy rarely exceeds the prior PFI (~3%)―approximately 30% of patients with recurrent endometrial cancer exhibit a sustained response to platinum rechallenge that extends beyond their preceding PFI. Despite the incorporation of immune checkpoint inhibitors into the treatment landscape of endometrial cancer, the role of platinum sensitivity in clinical decision-making―particularly regarding treatment sequencing and drug selection―remains a critical and unresolved issue. Further research is warranted to elucidate the mechanisms underlying platinum resistance and to guide optimal therapeutic strategies. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 0924-4247 390 2025 Extension-type flexible pneumatic actuator with a large extension force using a cross-link mechanism based on pantographs 116594 EN So Shimooka Faculty of Environmental, Life, Natural Science and Technology, Okayama University Kazuma Tadachi Mechanical and Systems Engineering Program, School of Engineering, Okayama University Tetsushi Kamegawa Faculty of Environmental, Life, Natural Science and Technology, Okayama University In this study, we propose an extension-type flexible pneumatic actuator (EFPA) with a high extension force and no buckling. In a previous study, soft actuators that extended in the axial direction by applying a supply pressure were unable to generate the extension’s pushing force because the actuators buckled owing to their high flexibility. To generate a pushing force, the circumferential stiffness of an extension-type flexible soft actuator must be reinforced. Therefore, a cross-linked EFPA (CL-EFPA) was developed, inspired by a pantograph that restrains the EFPA three-dimensionally using the proposed link mechanism. The proposed CL-EFPA consists of three EFPAs and a cross-linking mechanism for integrating each EFPA circumference. The pushing force of the CL-EFPA is approximately 3.0 times compared with that generated by the previous EFPA with plates to restrain its plane. To perform various bending motions, attitude control was performed using an analytical model and a system that included valves, sensors, and controllers. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 2079-6447 3 4 2024 N-Phenylphenothiazine Radical Cation with Extended π-Systems: Enhanced Heat Resistance of Triarylamine Radical Cations as Near-Infrared Absorbing Dyes 350 359 EN Masafumi Yano Faculty of Chemistry, Material and Bioengineering, Kansai University Minami Ueda Faculty of Chemistry, Material and Bioengineering, Kansai University Tatsuo Yajima Faculty of Chemistry, Material and Bioengineering, Kansai University Koichi Mitsudo Division of Applied Chemistry, Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Yukiyasu Kashiwagi Osaka Research Institute of Industrial Science and Technology N-Phenylphenothiazine derivatives extended with various aryl groups were designed and synthesized. These derivatives have bent conformation in crystal and exhibit high solubility. Radical cations obtained by one-electron oxidation of these derivatives gave stable radical cations in solution and showed absorption in the near-infrared region. A radical cation was isolated as a stable salt, which exhibited heat resistance up to around 200 °C. A design strategy for radical cation-based near-infrared absorbing dyes, which are easily oxidized and stable not only as a solution but in solid form, is described. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1758-9193 16 1 2024 Impact of amyloid and tau positivity on longitudinal brain atrophy in cognitively normal individuals 77 EN Motonobu Fujishima Department of Radiology, Kumagaya General Hospital Yohei Kawasaki Department of Biostatistics, Graduate School of Medicine, Saitama Medical University Toshiharu Mitsuhashi Center for Innovative Clinical Medicine, Okayama University Hospital Hiroshi Matsuda Department of Biofunctional Imaging, Fukushima Medical University Background Individuals on the preclinical Alzheimer's continuum, particularly those with both amyloid and tau positivity (A + T +), display a rapid cognitive decline and elevated disease progression risk. However, limited studies exist on brain atrophy trajectories within this continuum over extended periods.<br> Methods This study involved 367 ADNI participants grouped based on combinations of amyloid and tau statuses determined through cerebrospinal fluid tests. Using longitudinal MRI scans, brain atrophy was determined according to the whole brain, lateral ventricle, and hippocampal volumes and cortical thickness in AD-signature regions. Cognitive performance was evaluated with the Preclinical Alzheimer's Cognitive Composite (PACC). A generalized linear mixed-effects model was used to examine group × time interactions for these measures. In addition, progression risks to mild cognitive impairment (MCI) or dementia were compared among the groups using Cox proportional hazards models.<br> Results A total of 367 participants (48 A + T + , 86 A + T − , 63 A − T + , and 170 A − T − ; mean age 73.8 years, mean follow-up 5.1 years, and 47.4% men) were included. For the lateral ventricle and PACC score, the A + T − and A + T + groups demonstrated statistically significantly greater volume expansion and cognitive decline over time than the A − T − group (lateral ventricle: β = 0.757 cm3/year [95% confidence interval 0.463 to 1.050], P < .001 for A + T − , and β = 0.889 cm3/year [0.523 to 1.255], P < .001 for A + T + ; PACC: β =  − 0.19 /year [− 0.36 to − 0.02], P = .029 for A + T − , and β =  − 0.59 /year [− 0.80 to − 0.37], P < .001 for A + T +). Notably, the A + T + group exhibited additional brain atrophy including the whole brain (β =  − 2.782 cm3/year [− 4.060 to − 1.504], P < .001), hippocampus (β =  − 0.057 cm3/year [− 0.085 to − 0.029], P < .001), and AD-signature regions (β =  − 0.02 mm/year [− 0.03 to − 0.01], P < .001). Cox proportional hazards models suggested an increased risk of progressing to MCI or dementia in the A + T + group versus the A − T − group (adjusted hazard ratio = 3.35 [1.76 to 6.39]).<br> Conclusions In cognitively normal individuals, A + T + compounds brain atrophy and cognitive deterioration, amplifying the likelihood of disease progression. Therapeutic interventions targeting A + T + individuals could be pivotal in curbing brain atrophy, cognitive decline, and disease progression. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 79 4 2025 Long-Term Survival Following Extended Cholecystectomy for Synchronous Gallbladder and Regional Lymph Node Metastasis of Lung Adenocarcinoma, with Subsequent Pulmonary Lobectomy 279 282 EN Mao Yoshikawa Department of General Thoracic Surgery, Okayama University Hospital Hiroyuki Tao Department of Thoracic Surgery, Japanese Red Cross Society Himeji Hospital Case Report 10.18926/AMO/69153 An 80-year-old male underwent an extended cholecystectomy for node-positive gallbladder adenocarcinoma. Two weeks later, hemoptysis revealed a left hilar tumor obstructing the bronchus, which was diagnosed as adenocarcinoma. Three months post-cholecystectomy, a left upper pulmonary lobectomy was performed. Histological similarity and positive thyroid transcription factor-1 (TTF-1) immunostaining in both tumors confirmed lung adenocarcinoma with gallbladder metastasis. Despite the generally poor prognosis for gallbladder metastasis from lung cancer, the patient achieved 3 years of survival. Patients with isolated synchronous gallbladder metastasis from lung cancer may benefit from oligometastasectomy. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 79 4 2025 Bloodstream Infections Caused by Gram-Negative Bacteria in Geriatric Patients: Epidemiology, Antimicrobial Resistance and The Factors Affecting Mortality 231 242 EN M Enes Kardan Department of Infectious Diseases, Faculty of Medicine, Namik Kemal University Ilknur Erdem Department of Infectious Diseases, Faculty of Medicine, Namik Kemal University Emre Yildiz Department of Infectious Diseases, Faculty of Medicine, Namik Kemal University Nuri Kiraz Department of Medical Microbiology, Faculty of Medicine, Namik Kemal University Aliye Çelikkol Department of Biochemistry, Faculty of Medicine, Namik Kemal University Original Article 10.18926/AMO/69148 Bloodstream infections (BSIs) are an important cause of morbidity and mortality in geriatric patients. We retrospectively analyzed the cases of geriatric patients who developed BSIs due to gram-negative bacteria in order to evaluate the epidemiology, antimicrobial resistance, and the factors affecting mortality. The cases of 110 patients aged ≥ 65 years admitted to our hospital between January 1, 2017, and December 31, 2022 were assessed; 70 (63.6%) of the BSIs were healthcare-associated BSIs. The urinary system was the most common detectable source of infection at 43.6%. The most frequently isolated bacteria were Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae, in that order. Carbapenem resistance was detected in 17 patients (15.5%), and extended-spectrum beta-lactamase (ESBL) production from Enterobacterales family members was detected in 37 (51.4%) patients. Multivariate analysis revealed that (i) the probability of mortality in the patients with total bilirubin was increased by approx. sixfold and (ii) the likelihood of mortality for those with a Pitt bacteremia score (PBS) ≥ 4 points was approx. 17 times higher. PBS and simplified qPitt scores can help predict mortality and manage geriatric patients. There is a significant increase in mortality among patients with procalcitonin (PCT) levels at ≥ 2 nm/ml. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 2662-4435 6 1 2025 Biogeochemical impact of nickel and urea in the great oxidation event 654 EN Dilan M. Ratnayake The Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama University Ryoji Tanaka The Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama University Eizo Nakamura The Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama University The 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.

American Society for Clinical Investigation Acta Medica Okayama 1558-8238 135 13 2025 LAG3 regulates antibody responses in a murine model of kidney transplantation e172988 EN Michael Nicosia Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Ran Fan Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Juyeun Lee Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic Gabriella All Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Victoria Gorbacheva Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic José I. Valenzuela Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Yosuke Yamamoto Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Ashley Beavers Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Nina Dvorina Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic William M. Baldwin Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Eduardo Chuluyan Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas, Centro de Estudios Farmacológicos y Botánicos (CEFYBO), Facultad de Medicina Motoo Araki Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Brian T. Gaudette Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Robert L. Fairchild Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Booki Min Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Anna Valujskikh Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Lymphocyte activation gene 3 (LAG3) is a coinhibitory receptor expressed by various immune cells. Although the immunomodulatory potential of LAG3 is being explored in cancer and autoimmunity, there is no information on its role after organ transplantation. Our study investigated the functions of LAG3 in a mouse model of renal allograft rejection. LAG3–/– recipients rapidly rejected MHC-mismatched renal allografts that were spontaneously accepted by WT recipients, with graft histology characteristic of antibody-mediated rejection. Depletion of recipient B cells but not CD8+ T cells significantly extended kidney allograft survival in LAG3–/– recipients. Treatment of WT recipients with an antagonistic LAG3 antibody enhanced anti-donor immune responses and induced kidney damage associated with chronic rejection. The studies of conditional LAG3–/– recipients and mixed bone marrow chimeras demonstrated that LAG3 expression on either T or B cells is sufficient to regulate anti-donor humoral immunity but not to induce acute allograft rejection. The numbers and proinflammatory functions of graft-infiltrating NK cells were markedly increased in LAG3–/– recipients, suggesting that LAG3 also regulates the effector stage of antibody-mediated rejection. These findings identified LAG3 as a regulator of immune responses to kidney allografts and a potential therapeutic target for antibody-mediated rejection prevention and treatment. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 2079-6382 14 5 2025 Distribution of Fimbrial Genes and Their Association with Virulence and Levofloxacin Resistance/Extended-Spectrum Beta-Lactamase Production in Uropathogenic Escherichia coli 468 EN Masao Mitsui Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takanori Sekito Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Mai Maruhashi Department of Bacteriology, Graduate School of Medicine, Gunma University Yuki Maruyama Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takehiro Iwata Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yusuke Tominaga Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Satoshi Katayama Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shingo Nishimura Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kensuke Bekku Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Motoo Araki Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hidetada Hirakawa Department of Bacteriology, Graduate School of Medicine, Gunma University Takuya Sadahira Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Background: Urinary tract infection (UTI) is predominantly caused by uropathogenic Escherichia coli (UPEC). Previous studies have reported that the fimbriae of UPEC are involved in virulence and antimicrobial resistance. We aimed to analyze the fimbrial gene profiles of UPEC and investigate the specificity of these expressions in symptomatic UTI, urinary device use, and levofloxacin (LVFX) resistance/extended-spectrum beta-lactamase (ESBL) production. Methods: A total of 120 UPEC strains were isolated by urine culture between 2019 and 2023 at our institution. They were subjected to an antimicrobial susceptibility test and polymerase chain reaction (PCR) to identify 14 fimbrial genes and their association with clinical outcomes or antimicrobial resistance. Results: The prevalence of the papG2 gene was significantly higher in the symptomatic UTI group by multivariate analyses (OR 5.850, 95% CI 1.390–24.70, p = 0.016). The prevalence of the c2395 gene tended to be lower in the symptomatic UTI group with urinary devices (all p < 0.05). In LVFX-resistant UPEC strains from both the asymptomatic bacteriuria (ABU) and the symptomatic UTI group, the expression of the papEF, papG3, c2395, and yadN genes tended to be lower (all p < 0.05). Conclusion: The fimbrial genes of UPEC are associated with virulence and LVFX resistance, suggesting that even UPEC with fewer motility factors may be more likely to ascend the urinary tract in the presence of the urinary devices. These findings may enhance not only the understanding of the virulence of UPEC but also the management of UTI. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 2076-2615 15 10 2025 A Canine c-kit Novel Mutation Isolated from a Gastrointestinal Stromal Tumor (GIST) Retains the Ability to Form Dimers but Lacks Autophosphorylation 1444 EN Kei Shimakawa Laboratory of Veterinary Hygiene, School of Veterinary Science, Nippon Veterinary and Life Science University So Doge Laboratory of Veterinary Pathology, School of Veterinary Science, Nippon Veterinary and Life Science University Masaki Michishita Laboratory of Veterinary Pathology, School of Veterinary Science, Nippon Veterinary and Life Science University Eri Tanabe Laboratory of Veterinary Hygiene, School of Veterinary Science, Nippon Veterinary and Life Science University Tsuyoshi Tajima Laboratory of Veterinary Pharmacology, School of Veterinary Science, Nippon Veterinary and Life Science University Masato Kobayashi Laboratory of Veterinary Reproduction, School of Veterinary Science, Nippon Veterinary and Life Science University Makoto Bonkobara Laboratory of Veterinary Clinical Pathology, School of Veterinary Science, Nippon Veterinary and Life Science University Masami Watanabe Laboratory of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kazuhiko Ochiai Laboratory of Veterinary Hygiene, School of Veterinary Science, Nippon Veterinary and Life Science University Yoshikazu Tanaka Laboratory of Veterinary Hygiene, School of Veterinary Science, Nippon Veterinary and Life Science University Gastrointestinal 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.

IEEE Acta Medica Okayama 2024 kdMonitor: Kernel Data Monitor for Detecting Kernel Memory Corruption 66 73 EN Hiroki Kuzuno Graduate School of Engineering, Kobe University Toshihiro Yamauchi Okayama University,Faculty of Environmental, Life, Natural Science and Technology Privilege escalation attacks through memory corruption via kernel vulnerabilities pose significant threats to operating systems. Although the extended Berkley Packet Filter has been employed to trace kernel code execution by inserting interrupts before and after kernel code invocations, it does not track operations before and after kernel data writes, thus hindering effective kernel data monitoring. In this study, we introduce a kernel data monitor (kdMonitor), which is a novel security mechanism designed to detect unauthorized alterations in the monitored kernel data of a dedicated kernel page. The kdMonitor incorporates two distinct methods. The first is periodic monitoring which regularly outputs the monitored kernel data of the dedicated kernel pages. The second is dynamic monitoring, which restricts write access to a dedicated kernel page, supplements any write operations with page faults, and outputs the monitored kernel data of dedicated kernel pages. kdMonitor enables real-time tracking of specified kernel data of the dedicated kernel page residing in the kernel's virtual memory space from the separated machine. Using kdMonitor, we demonstrated its capability to pinpoint tampering with user process privileged information stemming from privilege escalation attacks on the kernel. Through an empirical evaluation, we validated the effectiveness of kdMonitor in detecting privilege escalation attacks by user processes on Linux. Performance assessments revealed that kdMonitor achieved an attack detection time of 0.83 seconds with an overhead of 0.726 %. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 2045-2322 15 1 2025 Automated identification of the origin of energy loss in nonoriented electrical steel by feature extended Ginzburg–Landau free energy framework 23758 EN Michiki Taniwaki Tokyo University of Science Ryunosuke Nagaoka Tokyo University of Science Ken Masuzawa Tokyo University of Science Shunsuke Sato Tokyo University of Science Alexandre Lira Foggiatto Tokyo University of Science Chiharu Mitsumata Tokyo University of Science Takahiro Yamazaki Tokyo University of Science Ippei Obayashi Okayama University Yasuaki Hiraoka Kyoto University Yasuhiko Igarashi University of Tsukuba Yuta Mizutori University of Tsukuba Sepehri Amin Hossein NIMS Tadakatsu Ohkubo NIMS Hisashi Mogi Nippon Steel Masato Kotsugi Tokyo University of Science This study presents the automated identification of the complex magnetization reversal process in nonoriented electrical steel (NOES) using the feature extended Ginzburg–Landau (eX-GL) free energy framework. eX-GL provides a robust connection between microscopic magnetic domains and macroscopic magnetic hysteresis using a data science perspective. This method employs physically meaningful features to analyze the energy landscape, providing insights into the mechanisms behind function. We obtained features representing both the microstructure and energy of the domain wall. The causes of iron loss were traced to the original domain structure, through which we could successfully distinguish and visualize the role of pinning as a promoting and resisting factor. We found that the reversal process was governed not only by general grain boundary pinning but also by segmented magnetic domains within the grain. This method revealed the complex interplay between magnetism and metallography and introduced a new means for transformative material design, bridging structures and functions. No potential conflict of interest relevant to this article was reported.

Royal Society of Chemistry (RSC) Acta Medica Okayama 2041-6520 16 26 2025 Collective motions in the primary coordination sphere: a critical functional framework for catalytic activity of the oxygen-evolving complex of photosystem II 12024 EN Hiroshi Isobe Takayoshi Suzuki Research Institute for Interdisciplinary Science, Okayama University Michihiro Suga Research Institute for Interdisciplinary Science, Okayama University Jian-Ren Shen Research Institute for Interdisciplinary Science, Okayama University Kizashi Yamaguchi Center for Quantum Information and Quantum Biology, Osaka University Photosynthetic water oxidation, vital for dioxygen production and light energy conversion, is catalyzed by the oxygen-evolving complex of photosystem II, where the inorganic Mn4CaO5 cluster acts as the catalytic core. In this study, we investigate the functional significance of collective motions of amino acid side chains within the primary coordination sphere of the Mn cluster, focusing on their role in modulating the energetic demands for catalytic transformations in the S3 state. We applied regularized canonical correlation analysis to quantitatively correlate the three-dimensional arrangement of coordinating atoms with catalytic driving forces computed via density functional theory. Our analysis reveals that distinct collective side chain motions profoundly influence the energetic requirements for structural reconfigurations of the Mn cluster, achieved through expansion and contraction of the ligand cavity while fine-tuning its geometry to stabilize key intermediates. Complementary predictions from a neural network-based machine learning model indicate that the coordination sphere exerts a variable energetic impact on the catalytic transformations of the Mn cluster, depending on the S-state environment. Integrated computational analyses suggest that the extended lifetime of the S3YZ˙ state, consistently observed after three flash illuminations, may result from slow, progressive protein dynamics that continuously reshape the energy landscape, thereby shifting the equilibrium positions of rapid, reversible chemical processes over time. Overall, our findings demonstrate that collective motions in the primary coordination sphere constitute an active, dynamic framework essential for the efficient execution of multi-electron catalysis under ambient conditions, while simultaneously achieving a high selectivity with irreversible nature required for effective 3O2 evolution. No potential conflict of interest relevant to this article was reported.

IEEE Acta Medica Okayama 2832-1324 2023 Supporting Multiple OS Types on Estimation of System Call Hook Point by Virtual Machine Monitor 267 273 EN Masaya Sato Okayama Prefectural University Taku Omori Okayama Prefectural University Toshihiro Yamauchi Okayama University Hideo Taniguchi Okayama University Methods to hook system calls issued by a guest operating system (OS) running on a virtual machine using a virtual machine monitor are proposed. The address of the hook point is derived from the guest OS’s source code and established prior to the kernel startup process. Due to changes in system call processing in OS updates and address space layout randomization, the addresses of these hook points cannot always be pre-determined before the kernel startup process. To address this challenge, a method for estimating the system call hook point is proposed in Linux by analyzing the guest OS memory on x86-64 CPUs rather than pre-calculation. Although the method supports Linux, the method can be extended to support other OS types. In this paper, we propose a method to extend the method to support additional OSes. Specifically, we present analysis results and a novel method for estimating hook points on FreeBSD, NetBSD, and OpenBSD. The effectiveness of our proposed method is also demonstrated through evaluation. No potential conflict of interest relevant to this article was reported.

Elmer Press, Inc. Acta Medica Okayama 1923-4155 16 5 2025 Nephronophthisis and Retinitis Pigmentosa (Senior-Loken Syndrome) After Living-Donor Kidney Transplantation: Twelve-Year Follow-Up in a Young Woman 164 173 EN Toshihiko Matsuo Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Yasuhiro Onishi Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Hiroshi Morinaga Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Jun Wada Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Takehiro Tanaka Department of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Motoo Araki Department of Urology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Senior-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.

岡山大学理学部地球科学科 Acta Medica Okayama 1340-7414 31 1 2025 南西諸島の前弧域における付加体を含む堆積層のモデル化 1 15 EN Masanao KOMATSU Okayama Gakuin University Sohei URAKAMI Formerly Department of Earth Sciences, Okayama University Taro OKAMOTO Department of Earth and Planetary Sciences, School of Science, Institute of Science Tokyo Hiroshi TAKENAKA Department of Earth Sciences, Okayama University 10.18926/ESR/68676 　We combine the recent seismic reflection profiles to construct a new seismic velocity model of the sedimentary layer incorporating the accretionary prism along the Ryukyu trench. In constructing the new model, we refer to the zoning (ZONE1 to ZONE4) identified by Okamura et al. (2017, Tectonophys.). The construction process consists of the following steps: First, we digitize either unconformities or VP=4 to 5 km/s lines as the seismic basement, whichever is more clearly identifiable. Second, the digitized thickness data of the sedimentary layer from the reflection profiles are geometrically modeled and interpolated to make the three-dimensional structure model. Finally, we supplement the external region of the constructed 3-D sedimentary model using the J-SHIS model provided by the NIED to complete the velocity structure model in the entire Ryukyu arc. The main features of our model are as follows: In ZONE1, off Ishigaki-jima island, the thick sedimentary layer extends about 50 km wide from the Ryukyu trench. In ZONE2, off Miyako-jima island, the thinner layer compared to the other zones is found near the trench, with a thin sedimentary terrace covering the area behind it. In ZONE3, off Okinawa-jima island, the sedimentary layer deepens as it approaches the trench. In ZONE4, off Tokara islands, the deepest layer among all zones is identified. We then conduct 3-D finite-difference simulations of seismic wave propagation using the new and the previous models to confirm the improvement of the new model. In the simulations, the effects of the accretionary prism along the Ryukyu trench on the seismic wave propagation are clearly identified. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 2050-0904 13 4 2025 A Case of a Metal Foreign Object Remaining in the Maxillary Bone for an Extended Period: A Case Report e9631 EN Koichi Kadoya Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Yuki Kunisada Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Kyoichi Obata Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Hiroaki Takakura Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Tatsuo Ogawa Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Soichiro Ibaragi Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences We report a rare case in which a metallic foreign body remained undetected in a patient's maxilla for nearly 40 years after a childhood bicycle accident. Despite the accident, the implant remained in place without causing infection due to the lack of imaging studies at the time. The metal was accidentally discovered during a routine dental imaging examination 40 years later and subsequently surgically removed. This case highlights the importance of comprehensive imaging and the dangers of overlooking foreign bodies, especially in the vulnerable head and neck region. The patient, 53 years old at the time of discovery, presented to the dentist due to discomfort in the palate and nasal cavity. During this visit, radiographs were taken and a foreign body was discovered. Surgical removal of the foreign body revealed significant corrosion and surrounding granulation tissue indicative of foreign body granuloma. Elemental analysis of the foreign body confirmed that it was an iron-based metal, unlike biocompatible materials such as titanium. These findings reinforce the need for close post-trauma evaluation and follow-up, especially in cases of pediatric trauma, to avoid the possibility of long-term complications arising from unnoticed foreign bodies in anatomically significant areas. No potential conflict of interest relevant to this article was reported.

Department of Mathematics, Faculty of Science, Okayama University Acta Medica Okayama 0030-1566 67 1 2025 Tsetlin library on p-colored permutations and q-analogue 133 147 EN Yuto Nakagawa Mathematical Institute, Tohoku University Fumihiko Nakano Mathematical Institute, Tohoku University K. Brown [1] studied the random to top shuffle (the Tsetlin libary) by semigroup method. In this paper, (i) we extend his results to the colored permutation groups, and (ii) we consider a q-analogue of Tsetlin library which is different from what is studied in [1]. In (i), the results also extends those results for the top to random shuffle [4],[5], [6] to arbitrary distribution of choosing cards, but we still have derangement numbers in the multiplicity of each eigenvalues. In (ii), a version of q-analogue of derangement numbers by Chen-Rota [3] appears in the multiplicity of eigenvalues. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 1999-5903 17 3 2025 Facial Privacy Protection with Dynamic Multi-User Access Control for Online Photo Platforms 124 EN Andri Santoso Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Samsul Huda Green Innovation Center, Okayama University Yuta Kodera Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Yasuyuki Nogami Graduate School of Environmental, Life, Natural Science and Technology, Okayama University In the digital age, sharing moments through photos has become a daily habit. However, every face captured in these photos is vulnerable to unauthorized identification and potential misuse through AI-powered synthetic content generation. Previously, we introduced SnapSafe, a secure system for enabling selective image privacy focusing on facial regions for single-party scenarios. Recognizing that group photos with multiple subjects are a more common scenario, we extend SnapSafe to support multi-user facial privacy protection with dynamic access control designed for online photo platforms. Our approach introduces key splitting for access control, an owner-centric permission system for granting and revoking access to facial regions, and a request-based mechanism allowing subjects to initiate access permissions. These features ensure that facial regions remain protected while maintaining the visibility of non-facial content for general viewing. To ensure reproducibility and isolation, we implemented our solution using Docker containers. Our experimental assessment covered diverse scenarios, categorized as "Single", "Small", "Medium", and "Large", based on the number of faces in the photos. The results demonstrate the system's effectiveness across all test scenarios, consistently performing face encryption operations in under 350 ms and achieving average face decryption times below 286 ms across various group sizes. The key-splitting operations maintained a 100% success rate across all group configurations, while revocation operations were executed efficiently with server processing times remaining under 16 ms. These results validate the system's capability in managing facial privacy while maintaining practical usability in online photo sharing contexts. 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 Okayama 2186-1323 15 2025 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 297 311 EN Junko TANAKA Okayama Municipal Hosen Junior High School Ryo MISAWA Faculty of Education, Okayama University 10.18926/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.

Society for Hard Tissue Regenerative Biology Acta Medica Okayama 1341-7649 34 1 2025 Evaluation of CT Findings in Squamous and Non-Squamous Cell Carcinomas of the Maxillary Sinus 35 40 EN Yuka Asaumi Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Mamiko Fujikura Department of Oral and Maxillofacial Radiology, Okayama University Hospital Miki Hisatomi Department of Oral and Maxillofacial Radiology, Okayama University Hospital Wlla E. Al-Hammad Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yohei Takeshita Department of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shunsuke Okada Department of Oral and Maxillofacial Radiology, Okayama University Hospital Toshiyuki Kawazu Department of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yoshinobu Yanagi Department of Dental Informatics, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Junichi Asaumi Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University The aim of the present study was to compare CT images between squamous cell carcinoma (SCC) and non-SCC found in the maxillary sinus, and to identify features that could be used to differentiate between SCC and non-SCC. Patients who visited the Faculty of Dentistry, Okayama University Hospital, between April 2007 and March 2023, underwent head and neck CT, and had tumors extending into the maxillary sinus that were diagnosed histopathologically as malignancy, were enrolled. The main seat of the mass, bony changes in the maxillary sinus wall, and extension into the surrounding area were assessed. These imaging features were evaluated according to SCC or non-SCC, and the characteristics of the two classes were assessed. Comparisons between the two groups were made using the Fisher exact probability test. There were 11 cases each of SCC and non-SCC. In 11 SCC and 7 non-SCC cases, the main seat of the mass occupied the entire maxillary sinus. The frequency of mass occupying the whole sinus was significantly higher in SCC than in non-SCC (p<0.05). Bone-thickening type disease was found only in squamous cell carcinoma 4/11 (36.4%), with there being a significant difference between SCC and non-SCC (p<0.05). Occupancy of the entire maxillary sinus by the mass and bone thickening on CT images were useful for differentiating between SCC and non-SCC arising in the maxillary sinus. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0003-6862 2025 Effects of caffeine on the longevity and locomotion activity of the common green bottle fly, Lucilia sericata (Diptera: Calliphoridae) EN Shine Shane Naing Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Haruna Fujioka Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Teruhisa Matsuura Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Takahisa Miyatake Graduate School of Environmental, Life, Natural Science and Technology, Okayama University The common green bottle fly, Lucilia sericata (Meigen) (Diptera: Calliphoridae), is a promising and useful managed pollinator for greenhouse agricultural crops. The fly can pollinate at lower and higher temperatures than European honeybee. However, management of the longevity of pollinators is important for growers using greenhouses. Previous studies using other insects showed that caffeine affects insect longevity and behaviors. For instance, European honeybee live longer and have increased memory after caffeine consumption. How caffeine affects the longevity and behavior of pollinators is worth investigating because it can affect pollinator’s behavior, extend longevity, or be an insecticide against pollinators. In the present study, therefore, the longevity and locomotion of L. sericata were investigated when they were given different caffeine concentrations. First, the longevity of L. sericata with five different caffeine concentrations was compared to the control. The results showed that higher concentrations of caffeine (2%, 1%, and 0.5%) significantly decreased the life span compared to lower concentrations (0.05% and 0.01%). Second, the locomotion activities of L. sericata were examined at those two caffeine concentrations with treated and control male and female flies utilizing a Drosophila Activity Monitor (DAM). Treatment with 0.05% caffeine dramatically reduced locomotion, but treatment of 0.01% caffeine did not. We also compared lipid concentrations of flies: flies treated with 0.05% caffeine had a lower lipid concentration compared to flies treated with 0% and 0.01% caffeine. These results indicate that caffeine had negative effects on the longevity and locomotion activities of the pollinator L. sericata in laboratory conditions. No potential conflict of interest relevant to this article was reported.

Institute of Electrical and Electronics Engineers (IEEE) Acta Medica Okayama 1745-1345 E108-B 1 2024 Overloaded MIMO Spatial Multiplexing Independent of Antenna Setups 1 13 EN Satoshi Denno Faculty of Environmental, Life, Natural Science and Technology, Okayama University Takumi Sugimoto Graduate School of Natural Science and Technology, Okayama University Koki Matoba Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Yafei Hou Faculty of Environmental, Life, Natural Science and Technology, Okayama University This paper proposes overloaded MIMO spatial multiplexing that can increase the number of spatially multiplexed signal streams despite of the number of antennas on a terminal and that on a receiver. We propose extension of the channel matrix for the spatial multiplexing to achieve the superb multiplexing performance. Precoding based on the extended channel matrix plays a crucial role in carrying out such spatial multiplexing. We consider three types of QR-decomposition techniques for the proposed spatial multiplexing to improve the transmission performance. The transmission performance of the proposed spatial multiplexing is evaluated by computer simulation. The simulation reveals that the proposed overloaded MIMO spatial multiplexing can implement 6 stream-spatial multiplexing in a 2×2 MIMO system, i.e., the overloading ratio of 3.0. The superior transmission performance is achieved by the proposed overloaded MIMO spatial multiplexing with one of the QR-decomposition techniques. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2079-9292 13 24 2024 An Implementation of Web-Based Answer Platform in the Flutter Programming Learning Assistant System Using Docker Compose 4878 EN Lynn Htet Aung Department of Information and Communication Systems, Okayama University Soe Thandar Aung Department of Information and Communication Systems, Okayama University Nobuo Funabiki Department of Information and Communication Systems, Okayama University Htoo Htoo Sandi Kyaw Department of Computer and Information Science, Tokyo University of Agriculture and Technology Wen-Chung Kao Department of Electrical Engineering, National Taiwan Normal University Programming has gained significant importance worldwide as societies increasingly rely on computer application systems. To support novices in learning various programming languages, we have developed the Programming Learning Assistant System (PLAS). It offers several types of exercise problems with different learning goals and levels for step-by-step self-study. As a personal answer platform in PLAS, we have implemented a web application using Node.js and EJS for Java and Python programming. Recently, the Flutter framework with Dart programming has become popular, enabling developers to build applications for mobile, web, and desktop environments from a single codebase. Thus, we have extended PLAS by implementing the Flutter environment with Visual Studio Code to support it. Additionally, we have developed an image-based user interface (UI) testing tool to verify student source code by comparing its generated UI image with the standard one using the ORB and SIFT algorithms in OpenCV. For efficient distribution to students, we have generated Docker images of the answer platform, Flutter environment, and image-based UI testing tool. In this paper, we present the implementation of a web-based answer platform for the Flutter Programming Learning Assistant System (FPLAS) by integrating three Docker images using Docker Compose. Additionally, to capture UI images automatically, an Nginx web application server is adopted with its Docker image. For evaluations, we asked 10 graduate students at Okayama University, Japan, to install the answer platform on their PCs and solve five exercise problems. All the students successfully completed the problems, which confirms the validity and effectiveness of the proposed system. No potential conflict of interest relevant to this article was reported.

American Chemical Society (ACS) Acta Medica Okayama 1936-0851 18 52 2024 Bright Quantum-Grade Fluorescent Nanodiamonds 35202 35213 EN Keisuke Oshimi Department of Chemistry, Graduate School of Life, Environmental, Natural Science and Technology, Okayama University Hitoshi Ishiwata The National Institutes for Quantum Science and Technology (QST), Institute for Quantum Life Science (iQLS) Hiromu Nakashima Department of Chemistry, Graduate School of Life, Environmental, Natural Science and Technology, Okayama University Sara Mandić Department of Chemistry, Graduate School of Life, Environmental, Natural Science and Technology, Okayama University Hina Kobayashi Department of Chemistry, Graduate School of Life, Environmental, Natural Science and Technology, Okayama University Minori Teramoto Advanced Materials Laboratory, Sumitomo Electric Industries, Ltd. Hirokazu Tsuji Advanced Materials Laboratory, Sumitomo Electric Industries, Ltd. Yoshiki Nishibayashi Advanced Materials Laboratory, Sumitomo Electric Industries, Ltd. Yutaka Shikano Institute of Systems and Information Engineering, University of Tsukuba Toshu An School of Materials Science, Japan Advanced Institute of Science and Technology Masazumi Fujiwara Department of Chemistry, Graduate School of Life, Environmental, Natural Science and Technology, Okayama University Optically accessible spin-active nanomaterials are promising as quantum nanosensors for probing biological samples. However, achieving bioimaging-level brightness and high-quality spin properties for these materials is challenging and hinders their application in quantum biosensing. Here, we demonstrate bright fluorescent nanodiamonds (NDs) containing 0.6–1.3-ppm negatively charged nitrogen-vacancy (NV) centers by spin-environment engineering via enriching spin-less 12C-carbon isotopes and reducing substitutional nitrogen spin impurities. The NDs, readily introduced into cultured cells, exhibited improved optically detected magnetic resonance (ODMR) spectra; peak splitting (E) was reduced by 2–3 MHz, and microwave excitation power required was 20 times lower to achieve a 3% ODMR contrast, comparable to that of conventional type-Ib NDs. They show average spin-relaxation times of T1 = 0.68 ms and T2 = 3.2 μs (1.6 ms and 5.4 μs maximum) that were 5- and 11-fold longer than those of type-Ib, respectively. Additionally, the extended T2 relaxation times of these NDs enable shot-noise-limited temperature measurements with a sensitivity of approximately 0.28K/√Hz. The combination of bulk-like NV spin properties and enhanced fluorescence significantly improves the sensitivity of ND-based quantum sensors for biological applications. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 2050-0904 13 1 2025 Undetermined Ruptured Low-Grade Appendiceal Mucinous Neoplasm Following High-Energy Blunt Abdominal Trauma Requiring Emergency Laparotomy e70071 EN Ippei Matsuo Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Tetsuya Yumoto Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Akari Tsuji Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Ryo Tanabe Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Toshihisa Matsumura Department of Digestive Surgery, Japanese Red Cross Okayama Hospital Mikoto Shimabara Department of Digestive Surgery, Japanese Red Cross Okayama Hospital Masaaki Akai Department of Digestive Surgery, Japanese Red Cross Okayama Hospital Shoji Takagi Department of Digestive Surgery, Japanese Red Cross Okayama Hospital Hiromichi Naito Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Atsunori Nakao Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Blunt abdominal trauma causing intraperitoneal injury and/or bleeding can be life-threatening, requiring immediate intervention. Diagnosing these cases can be challenging, especially when pre-existing conditions are involved. Low-grade appendiceal mucinous neoplasm (LAMN) is a rare tumor of the appendix that can lead to pseudomyxoma peritonei. Herein, we present a case of ruptured LAMN following blunt abdominal trauma after a high-energy head-on collision, complicating the differentiation from other intraperitoneal injuries. A 42-year-old Japanese female was brought to our hospital following high-energy head-on collision. She presented with stable vital signs, complaining of anterior chest pain and abdominal tenderness without peritoneal irritation. Computed tomography scans indicated multiple fractures in her chest and complex fluid around the Douglas fossa extending to the ileocecal area, with a slightly dilated appendix tip. Despite stable vitals, emergency laparotomy was needed for suspected peritonitis and/or intraperitoneal hemorrhage. Emergency laparotomy revealed yellowish, jelly-like ascites and a ruptured appendiceal tumor. LAMN was suspected, and the appendix was completely resected, with cytoreductive surgery carefully performed. Histopathological examination confirmed the diagnosis of LAMN. Postoperative course was uneventful, and the patient was discharged on Day 13 and referred for further LAMN management. This case report highlights the diagnostic difficulties of LAMN rupture following blunt abdominal trauma, stressing the need to consider rare conditions like LAMN in differential diagnoses of acute abdomen posttrauma. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 2210-2612 126 2025 Laparoscopic resection for oesophageal duplication cyst: A case report 110572 EN Tomohiro Hamazaki Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kazuhiro Noma Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kento Kawasaki Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Masashi Hashimoto Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shunsuke Tanabe Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Toshiyoshi Fujiwara Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Introduction: Oesophageal duplication cyst is a congenital malformation and rare tumour, clinically manifesting as dysphagia, epigastric pain, or respiratory distress. Duplicate cysts associated with abscess formation or mediastinal penetration and malignancies have been reported, necessitating surgical resection. <br> Presentation of case: A 55-year-old woman had chest discomfort for 1 year. Preoperative imaging, including computed tomography (CT), upper gastrointestinal endoscopy, and endoscopic ultrasound, revealed a tumour extending from the anterior wall to the lesser curvature of the near the oesophagogastric junction (OGJ) and a suspected mural nodule within the tumour. Contrast-enhanced CT revealed a cystic nodule on the wall of the lesser curvature of the OGJ, with an unclear boundary between the cystic nodule and the oesophageal wall. Magnetic resonance imaging showed an isointense signal on T1-weighted imaging and hyperintensity on T2weighted imaging. Laparoscopic lower oesophagectomy and proximal gastrectomy with lymph node dissection were performed to the confirm mucinous cyst. Pathological findings revealed a cystic lesion in the muscularis propria of the OGJ filled with mucinous components and lined with multilayered columnar epithelial cells. The cyst was diagnosed as a duplicate without malignancy. <br> Discussion: Since the border between the cyst and the oesophageal walls was unclear, and the cyst potentially contained a malignant component, instead of cystectomy, lower oesophagectomy and proximal gastrectomy with lymph node dissection were performed with oesophagogastric anastomosis using the double-flap technique, tailored specifically for OGJ cancer. <br> Conclusions: Oesophageal duplication cysts are rare. Lower oesophagectomy and proximal gastrectomy are selective surgical approaches for cyst duplication at the OGJ. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2313-433X 10 10 2024 Searching Method for Three-Dimensional Puncture Route to Support Computed Tomography-Guided Percutaneous Puncture 251 EN Yusuke Gotoh Faculty of Environmental, Life, Natural Science and Technology, Okayama University Aoi Takeda Graduate School of Natural Science and Technology, Okayama University Koji Masui Department of Radiology, Kyoto Prefectural University of Medicine Koji Sakai Department of Radiology, Kyoto Prefectural University of Medicine Manato Fujimoto Graduate School of Informatics, Osaka Metropolitan University In CT-guided percutaneous punctures-an image-guided puncture method using CT images-physicians treat targets such as lung tumors, liver tumors, renal tumors, and intervertebral abscesses by inserting a puncture needle into the body from the exterior while viewing images. By recognizing two-dimensional CT images prior to a procedure, a physician determines the least invasive puncture route for the patient. Therefore, the candidate puncture route is limited to a two-dimensional region along the cross section of the human body. In this paper, we aim to construct a three-dimensional puncture space based on multiple two-dimensional CT images to search for a safer and shorter puncture route for a given patient. If all puncture routes starting from a target in the three-dimensional space were examined from all directions (the brute-force method), the processing time to derive the puncture route would be very long. We propose a more efficient method for three-dimensional puncture route selection in CT-guided percutaneous punctures. The proposed method extends the ray-tracing method, which quickly derives a line segment from a given start point to an end point on a two-dimensional plane, and applies it to three-dimensional space. During actual puncture route selection, a physician can use CT images to derive a three-dimensional puncture route that is safe for the patient and minimizes the puncture time. The main novelty is that we propose a method for deriving a three-dimensional puncture route within the allowed time in an actual puncture. The main goal is for physicians to select the puncture route they will use in the actual surgery from among the multiple three-dimensional puncture route candidates derived using the proposed method. The proposed method derives a three-dimensional puncture route within the allowed time in an actual puncture. Physicians can use the proposed method to derive a new puncture route, reducing the burden on patients and improving physician skills. In the evaluation results of a computer simulation, for a 3D CT image created by combining 170 two-dimensional CT images, the processing time for deriving the puncture route using the proposed method was approximately 59.4 s. The shortest length of the puncture route from the starting point to the target was between 20 mm and 22 mm. The search time for a three-dimensional human body consisting of 15 CT images was 4.77 s for the proposed method and 2599.0 s for a brute-force method. In a questionnaire, physicians who actually perform puncture treatments evaluated the candidate puncture routes derived by the proposed method. We confirmed that physicians could actually use these candidates as a puncture route. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 1347-9032 115 11 2024 High-quality expert annotations enhance artificial intelligence model accuracy for osteosarcoma X-ray diagnosis 3695 3704 EN Joe Hasei Department of Medical Information and Assistive Technology Development, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Ryuichi Nakahara Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yujiro Otsuka Department of Radiology, Juntendo University School of Medicine Yusuke Nakamura Department of Radiology, Juntendo University School of Medicine Tamiya Hironari Department of Musculoskeletal Oncology Service, Osaka International Cancer Institute Naoaki Kahara Department of Orthopedic Surgery, Mizushima Central Hospital Shinji Miwa Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences Shusa Ohshika Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine Shunji Nishimura Department of Orthopedic Surgery, Kindai University Hospital Kunihiro Ikuta Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine Shuhei Osaki Department of Musculoskeletal Oncology, National Cancer Center Hospital Aki Yoshida Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Tomohiro Fujiwara Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Eiji Nakata Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Toshiyuki Kunisada Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Toshifumi Ozaki Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Primary malignant bone tumors, such as osteosarcoma, significantly affect the pediatric and young adult populations, necessitating early diagnosis for effective treatment. This study developed a high-performance artificial intelligence (AI) model to detect osteosarcoma from X-ray images using highly accurate annotated data to improve diagnostic accuracy at initial consultations. Traditional models trained on unannotated data have shown limited success, with sensitivities of approximately 60%–70%. In contrast, our model used a data-centric approach with annotations from an experienced oncologist, achieving a sensitivity of 95.52%, specificity of 96.21%, and an area under the curve of 0.989. The model was trained using 468 X-ray images from 31 osteosarcoma cases and 378 normal knee images with a strategy to maximize diversity in the training and validation sets. It was evaluated using an independent dataset of 268 osteosarcoma and 554 normal knee images to ensure generalizability. By applying the U-net architecture and advanced image processing techniques such as renormalization and affine transformations, our AI model outperforms existing models, reducing missed diagnoses and enhancing patient outcomes by facilitating earlier treatment. This study highlights the importance of high-quality training data and advocates a shift towards data-centric AI development in medical imaging. These insights can be extended to other rare cancers and diseases, underscoring the potential of AI in transforming diagnostic processes in oncology. The integration of this AI model into clinical workflows could support physicians in early osteosarcoma detection, thereby improving diagnostic accuracy and patient care. No potential conflict of interest relevant to this article was reported.

Institute of Electrical and Electronics Engineers Acta Medica Okayama 2169-3536 12 2024 Adaptive Resonance Theory-Based Global Topological Map Building for an Autonomous Mobile Robot 111371 111385 EN Yuichiro Toda Faculty of Environmental, Life, Natural Science and Technology, Okayama University Naoki Masuyama Graduate School of Informatics, Osaka Metropolitan University 3D space perception is one of the key technologies for autonomous mobile robots that perform tasks in unknown environments. Among these, building global topological maps for autonomous mobile robots is a challenging task. In this study, we propose a method for learning topological structures from unknown data distributions based on competitive learning, a type of unsupervised learning. For this purpose, adaptive resonance theory-based Topological Clustering (ATC), which can avoid catastrophic forgetting of previously measured point clouds, is applied as a learning method. Furthermore, by extending ATC with Different Topologies (ATC-DT) with multiple topological structures for extracting the traversable information of terrain environments, a path planning method is realized that can reach target points set in an unknown environment. Path planning experiments in unknown environments show that, compared to other methods, ATC-DT can build a global topology map with high accuracy and stability using only measured 3D point cloud and robot position information. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 78 4 2024 Middle-Ear Salivary Gland Choristoma with Congenital, Single-Sided Hearing Loss 349 355 EN Yuichiro Tominaga Department of Otolaryngology, Head and Neck Surgery, Hiroshima City, Hiroshima Citizens Hospital Akiko Sugaya Department of Otolaryngology, Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shin Kariya Department of Otolaryngology, Head and Neck Surgery, Kawasaki Medical School Hospital Aiko Shimizu Department of Otolaryngology, Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yuko Kataoka Department of Otolaryngology, Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Mizuo Ando Department of Otolaryngology, Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Case Report 10.18926/AMO/67554 Middle-ear salivary gland choristoma (SGCh) is a rare, benign tumor that causes conductive hearing loss owing to middle-ear morphological abnormalities. Early diagnosis is challenging, and surgical resection is indispensable for a definitive diagnosis. We report the case of a 3-year-old boy diagnosed with middle-ear SGCh during the follow-up period for left-sided hearing loss discovered at newborn hearing screening (NHS). Long-term follow-up after the NHS result, subsequent computed tomography/magnetic resonance imaging, and surgical resection led to its relatively early diagnosis and treatment. No potential conflict of interest relevant to this article was reported.

Royal Society of Chemistry Acta Medica Okayama 2633-0679 5 9 2024 Novel strategy for activating gene expression through triplex DNA formation targeting epigenetically suppressed genes 884 890 EN Ryotaro Notomi Graduate School of Pharmaceutical Sciences, Kyushu University Shigeki Sasaki Graduate School of Pharmaceutical Sciences, Nagasaki International University Yosuke Taniguchi Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Triplex DNA formation is a useful genomic targeting tool that is expected to have a wide range of applications, including the antigene method; however, there are fundamental limitations in its forming sequence. We recently extended the triplex DNA-forming sequence to methylated DNA sequences containing 5mCG base pairs by developing guanidino-dN, which is capable of recognizing a 5mCG base pair with high affinity. We herein investigated the effect of triplex DNA formation using TFOs with guanidino-dN on methylated DNA sequences at the promoter of the RASSF1A gene, whose expression is epigenetically suppressed by DNA methylation in MCF-7 cells, on gene expression. Interestingly, triplex DNA formation increased the expression of the RASSF1A gene at the transcript and protein levels. Furthermore, RASSF1A-activated MCF-7 cells exhibited cell growth suppressing activity. Changes in the expression of various genes associated with the promotion of apoptosis and breast cancer survival accompanied the activation of RASSF1A in cells exhibited antiproliferative activity. These results suggest the potential of increases in gene expression through triplex DNA formation as a new genomic targeting tool. No potential conflict of interest relevant to this article was reported.

American Society for Microbiology Acta Medica Okayama 2379-5042 9 8 2024 New lineages of RNA viruses from clinical isolates of Rhizopus microsporus revealed by fragmented and primer-ligated dsRNA sequencing (FLDS) analysis EN Wasiatus Sa'diyah Institute of Plant Science and Resources, Okayama University Yan-Jie Zhao Department of Life and Environmental Sciences, Laboratory of Fungal Interaction and Molecular Biology (Donated by IFO), University of Tsukuba Yuto Chiba Department of Life and Environmental Sciences, Laboratory of Fungal Interaction and Molecular Biology (Donated by IFO), University of Tsukuba Hideki Kondo Institute of Plant Science and Resources, Okayama University Nobuhiro Suzuki Institute of Plant Science and Resources, Okayama University Sayaka Ban Medical Mycology Research Center, Chiba University Takashi Yaguchi Medical Mycology Research Center, Chiba University Syun-Ichi Urayama Department of Life and Environmental Sciences, Laboratory of Fungal Interaction and Molecular Biology (Donated by IFO), University of Tsukuba Daisuke Hagiwara Department of Life and Environmental Sciences, Laboratory of Fungal Interaction and Molecular Biology (Donated by IFO), University of Tsukuba Rhizopus microsporus is a species in the order Mucorales that is known to cause mucormycosis, but it is poorly understood as a host of viruses. Here, we examined 25 clinical strains of R. microsporus for viral infection with a conventional double-stranded RNA (dsRNA) assay using agarose gel electrophoresis (AGE) and the recently established fragmented and primer-ligated dsRNA sequencing (FLDS) protocol. By AGE, five virus-infected strains were detected. Then, full-length genomic sequences of 12 novel RNA viruses were revealed by FLDS, which were related to the families Mitoviridae, Narnaviridae, and Endornaviridae, ill-defined groups of single-stranded RNA (ssRNA) viruses with similarity to the established families Virgaviridae and Phasmaviridae, and the proposed family "Ambiguiviridae." All the characterized viruses, except a potential phasmavirid with a negative-sense RNA genome, had positive-sense RNA genomes. One virus belonged to a previously established species within the family Mitoviridae, whereas the other 11 viruses represented new species or even new genera. These results show that the fungal pathogen R. microsporus harbors diverse RNA viruses and extend our understanding of the diversity of RNA viruses in the fungal order Mucorales, division Mucoromycota. Identifying RNA viruses from clinical isolates of R. microsporus may expand the repertoire of natural therapeutic agents for mucormycosis in the future. No potential conflict of interest relevant to this article was reported.

American Association for the Advancement of Science Acta Medica Okayama 2375-2548 9 43 2023 Structure of a diatom photosystem II supercomplex containing a member of Lhcx family and dimeric FCPII eadi8446 EN Yue Feng Photosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of Sciences Zhenhua Li Photosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of Sciences Xiaoyi Li Photosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of Sciences Lili Shen Photosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of Sciences Xueyang Liu Photosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of Sciences Cuicui Zhou Photosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of Sciences Jinyang Zhang Photosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of Sciences Min Sang China National Botanical Garden Guangye Han Photosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of Sciences Wenqiang Yang Photosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of Sciences Tingyun Kuang Photosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of Sciences Wenda Wang Photosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of Sciences Jian-Ren Shen Research Institute for Interdisciplinary Science, Graduate School of Natural Science and Technology, Okayama University Diatoms rely on fucoxanthin chlorophyll a/c-binding proteins (FCPs) for their great success in oceans, which have a great diversity in their pigment, protein compositions, and subunit organizations. We report a unique structure of photosystem II (PSII)-FCPII supercomplex from Thalassiosira pseudonana at 2.68-angstrom resolution by cryo-electron microscopy. FCPIIs within this PSII-FCPII supercomplex exist in dimers and monomers, and a homodimer and a heterodimer were found to bind to a PSII core. The FCPII homodimer is formed by Lhcf7 and associates with PSII through an Lhcx family antenna Lhcx6_1, whereas the heterodimer is formed by Lhcf6 and Lhcf11 and connects to the core together with an Lhcf5 monomer through Lhca2 monomer. An extended pigment network consisting of diatoxanthins, diadinoxanthins, fucoxanthins, and chlorophylls a/c is revealed, which functions in efficient light harvesting, energy transfer, and dissipation. These results provide a structural basis for revealing the energy transfer and dissipation mechanisms and also for the structural diversity of FCP antennas in diatoms. No potential conflict of interest relevant to this article was reported.

Hindawi Acta Medica Okayama 2090-8113 2024 2024 Circadian Rhythms Fluctuate the Treatment Effects of Intravesical Treatments on Rat Urinary Frequency Models 6505595 EN Tomofumi Watanabe Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takuya Sadahira Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yusuke Tominaga Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yuki Maruyama Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Naoya Nagasaki Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takanori Sekito Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kohei Edamura Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Toyohiko Watanabe Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Motoo Araki Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Masami Watanabe Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Objectives. It is still not clear how the intravesical instillation of drugs affects rat urinary frequency. This study aimed to examine the dynamics of intravesical treatments' treatment effect on rat urinary frequency models by real-time and extended monitoring using a novel continuous urination monitoring system. Methods. Nine eleven-week-old female Wistar rats were divided into three groups to receive intravesical instillation of 0.1% acetic acid (AA), 1.0% AA, or phosphate-buffered saline (PBS). Thirty minutes later, these drugs were voided, and rats were moved to a continuous urination monitoring system, UM-100. UM-100 monitored rat urination quantitatively and continuously for 24 hours. Rats were then euthanized, and histopathologic examinations using a damage score validated the severity of bladder inflammation. We used nine additional rats to determine the treatment effect of various drugs against the urinary frequency. These rats were also treated with 1.0% AA in the same way and divided into three groups (n = 3 each) to receive intravesical instillation of lidocaine, silver nitrate (AgNO3), or dimethyl sulfoxide (DMSO), respectively. Thirty minutes later, rats were catheterized again and moved to the UM-100, and their voiding was monitored for 24 hours. Results. Intravesical instillation of AA increased the urinary frequency and decreased the mean voided volume (VV) in a concentration-dependent manner, with statistical significance at a concentration of 1.0% (urinary frequency; p = 0.0007 , mean VV; p = 0.0032 , respectively) compared with PBS. Histopathological analysis of these models demonstrated a significantly higher damage score of bladder mucosa in both 0.1% AA and 1.0% AA compared with PBS, with the severity in concordance with the clinical severity of urinary frequency (0.1% AA: p < 0.0001 , 1.0% AA: p < 0.0001 ). Moreover, intravesical instillation of lidocaine, AgNO3, and DMSO decreased the urinary frequency. Continuous monitoring with UM-100 also demonstrated that the treatment effect of these intravesically instilled drugs occurred only at night. Conclusions. The extended monitoring of rat urination by UM-100 revealed a significant fluctuation in the treatment effect of intravesically instilled drugs between day and night. These findings may help establish novel therapies for urinary frequency. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 78 3 2024 Organized Chronic Subdural Hematoma (OCSDH) Mimicking Meningioma 285 290 EN Shuichiro Hirano Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yoshihiro Otani Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kentaro Fujii Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Isao Date Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Case Report 10.18926/AMO/67204 Organized chronic subdural hematoma (OCSDH) is a relatively rare condition that forms over a longer period of time compared to chronic subdural hematoma and is sometimes difficult to diagnose with preoperative imaging. We resected an intracranial lesion in a 37-year-old Japanese man; the lesion had been increasing in size for >17 years. The preoperative diagnosis based on imaging findings was meningioma; however, pathological findings revealed OCSDH. Clinicians should be aware that OCSDH mimics other tumors and consider surgical strategies for this disease. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 78 3 2024 Effect of Lipopolysaccharide on the Duration of Zolpidem-Induced Loss of Righting Reflex in Mice 227 235 EN Yudai Wada Department of Clinical Pharmacy, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Soichiro Ushio Department of Pharmacy, Okayama University Hospital Yoshihisa Kitamura Department of Clinical Pharmacy, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yoshito Zamami Department of Clinical Pharmacy, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Toshiaki Sendo Department of Clinical Pharmacy, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Original Article 10.18926/AMO/67197 Zolpidem, a non-benzodiazepine hypnotic, is primarily used to treat insomnia. In a previous study, pior treatment with non-benzodiazepine receptor agonists was associated with inflammation. The present study aimed to clarify the association between the effects of zolpidem and inflammation in mice treated with lipopolysaccharide (LPS), a known model of inflammation. We assessed the zolpidem-induced loss of righting reflex (LORR) duration 24 h after LPS treatment in mice. Additionally, the expressions of γ-aminobutyric acid (GABA)A receptor subunit and K+-Cl− cotransporter isoform 2 (KCC2) mRNA in the hippocampus and frontal cortex were examined in LPS-treated mice. Pretreatment with LPS was associated with significantly prolonged duration of zolpidem-induced LORR compared to control mice. This effect was significantly attenuated by administering bicuculline, a GABAA receptor antagonist, or flumazenil, a benzodiazepine receptor antagonist, in LPS-treated mice. Compared to controls, LPS-treated mice showed no significant change in the expression of GABAA receptor subunits in the hippocampus or frontal cortex. Bumetanide, an Na+-K+-2Cl− cotransporter isoform 1 blocker, attenuated the extended duration of zolpidem-induced LORR observed in LPS-treated mice. LPS significantly decreased Kcc2 mRNA expression in the hippocampus and the frontal cortex. These findings suggest that inflammation increases zolpidem-induced LORR, possibly through a reduction in KCC2 expression. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1352-4739 2024 The optimum quantity of debt for an aging Japan: welfare and demographic dynamics EN Akira Okamoto Faculty of Economics, Okayama University Japan’s government is heavily indebted, and the current net debt tends to increase. This paper uses an extended life-cycle general equilibrium model with endogenous fertility to investigate an optimal size of government debt from two viewpoints: individual welfare and future demographic dynamics. A simulation analysis finds that the level of net government debt, which maximizes per-capita utility, is negative at − 220% of Japan’s gross domestic product (GDP). The results also indicate that the net debt-to-GDP ratio of − 220% produces a considerable per-capita welfare gain; however, compared to the baseline simulation with a debt-to-GDP ratio of 150%, it substantially decreases the total population in the long run. No potential conflict of interest relevant to this article was reported.

American Chemical Society Acta Medica Okayama 2470-1343 9 19 2024 Superstructure of Fe5–xGeTe2 Determined by Te K-Edge Extended X-ray Absorption Fine Structure and Te Kα X-ray Fluorescence Holography 21287 21297 EN Ritsuko Eguchi Research Institute for Interdisciplinary Science, Okayama University Halubai Sekhar Department of Physical Science and Technology, Nagoya Institute of Technology Koji Kimura Department of Physical Science and Technology, Nagoya Institute of Technology Hirokazu Masai Department of Materials and Chemistry, National Institute of Advanced Industrial Science and Technology (AIST) Naohisa Happo Graduate School of Information Sciences, Hiroshima City University Mitsuki Ikeda Research Institute for Interdisciplinary Science, Okayama University Yuki Yamamoto Research Institute for Interdisciplinary Science, Okayama University Masaki Utsumi Research Institute for Interdisciplinary Science, Okayama University Hidenori Goto Research Institute for Interdisciplinary Science, Okayama University Yasuhiro Takabayashi Department of Physical Science and Technology, Nagoya Institute of Technology Hiroo Tajiri Japan Synchrotron Radiation Research Institute (JASRI) Koichi Hayashi Department of Physical Science and Technology, Nagoya Institute of Technology Yoshihiro Kubozono Research Institute for Interdisciplinary Science, Okayama University The local structure of the two-dimensional van der Waals material, Fe5–xGeTe2, which exhibits unique structural/magnetic phase transitions, was investigated by Te K-edge extended X-ray absorption fine structure (EXAFS) and Te Kα X-ray fluorescence holography (XFH) over a wide temperature range. The formation of a trimer of Te atoms at low temperatures has been fully explored using these methods. An increase in the Te–Fe distance at approximately 150 K was suggested by EXAFS and presumably indicates the formation of a Te trimer. Moreover, XFH displayed clear atomic images of Te atoms. Additionally, the distance between the Te atoms shortened, as confirmed from the atomic images reconstructed from XFH, indicating the formation of a trimer of Te atoms, i.e., a charge-ordered (3⎯⎯√×3⎯⎯√)𝑅30◦ superstructure. Furthermore, Te Kα XFH provided unambiguous atomic images of Fe atoms occupying the Fe1 site; the images were not clearly observed in the Ge Kα XFH that was previously reported because of the low occupancy of Fe and Ge atoms. In this study, EXAFS and XFH clearly showed the local structure around the Te atom; in particular, the formation of Te trimers caused by charge-ordered phase transitions was clearly confirmed. The charge-ordered phase transition is fully discussed based on the structural variation at low temperatures, as established from EXAFS and XFH. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 1201-9712 141 2024 Vibriosis in South Asia: A systematic review and meta-analysis 106955 EN Basilua Andre Muzembo Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kei Kitahara Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Ayumu Ohno Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Januka Khatiwada Social Work Institute Shanta Dutta Division of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases Shin-Ichi Miyoshi Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Objectives: South Asia remains home to foodborne diseases caused by the Vibrio species. We aimed to compile and update information on the epidemiology of vibriosis in South Asia. <br> Methods: For this systematic review and meta-analysis, we searched PubMed, Web of Science, EMBASE, and Google Scholar for studies related to vibriosis in South Asia published up to May 2023. A random-effects meta-analysis was used to estimate the pooled isolation rate of non-cholera-causing Vibrio species. <br> Results: In total, 38 studies were included. Seven of these were case reports and 22 were included in the meta-analysis. The reported vibriosis cases were caused by non-O1/non-O139 V. cholerae, V. parahaemolyticus, V. fluvialis, and V. vulnificus. The overall pooled isolation rate was 4.0% (95% confidence interval [CI] 3.0-5.0%) in patients with diarrhea. Heterogeneity was high (I-2 = 98.0%). The isolation rate of non-O1/non-O139 V. cholerae, V. parahaemolyticus, and V. fluvialis were 9.0 (95% CI 7.0-10.0%), 1.0 (95% CI 1.0-2.0%), and 2.0 (95% CI: 1.0-3.0%), respectively. Regarding V. parahaemolyticus, O3:K6 was the most frequently isolated serotype. Cases peaked during summer. Several studies reported antibiotic-resistant strains and those harboring extended-spectrum beta-lactamases genes. <br> Conclusions: This study demonstrates a high burden of infections caused by non-cholera-causing Vibrio species in South Asia. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1434-5161 68 3 2023 Recent advances in CGG repeat diseases and a proposal of fragile X-associated tremor/ataxia syndrome, neuronal intranuclear inclusion disease, and oculophryngodistal myopathy (FNOP) spectrum disorder 169 174 EN Hiroyuki Ishiura Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shoji Tsuji Department of Neurology, Graduate School of Medicine, The University of Tokyo Tatsushi Toda Department of Neurology, Graduate School of Medicine, The University of Tokyo While whole genome sequencing and long-read sequencing have become widely available, more and more focuses are on noncoding expanded repeats. Indeed, more than half of noncoding repeat expansions related to diseases have been identified in the five years. An exciting aspect of the progress in this field is an identification of a phenomenon called repeat motif–phenotype correlation. Repeat motif–phenotype correlation in noncoding repeat expansion diseases is first found in benign adult familial myoclonus epilepsy. The concept is extended in the research of CGG repeat expansion diseases. In this review, we focus on newly identified CGG repeat expansion diseases, update the concept of repeat motif–phenotype correlation in CGG repeat expansion diseases, and propose a clinical concept of FNOP (fragile X-associated tremor/ataxia syndrome, neuronal intranuclear inclusion disease, and oculopharyngodistal myopathy)-spectrum disorder, which shares clinical features and thus probably share some common disease pathophysiology, to further facilitate discussion and progress in this field. No potential conflict of interest relevant to this article was reported.

Nature Portfolio Acta Medica Okayama 2045-2322 14 1 2024 Assessing the efficacy of simulation-based education for paramedics in extended focused assessment with sonography for trauma under physician guidance 4190 EN Akiko Ohira Department of Obstetrics and Gynecology, and Department of Emergency and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Jota Maki Department of Obstetrics and Gynecology, and Department of Emergency and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kohei Ageta Department of Obstetrics and Gynecology, and Department of Emergency and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hikari Nakato Department of Obstetrics and Gynecology, and Department of Emergency and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hikaru Oba Department of Obstetrics and Gynecology, and Department of Emergency and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Tomohiro Mitoma Department of Obstetrics and Gynecology, and Department of Emergency and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Sakurako Mishima Department of Obstetrics and Gynecology, and Department of Emergency and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kazumasa Tani Department of Obstetrics and Gynecology, and Department of Emergency and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Satoe Kirino Department of Obstetrics and Gynecology, and Department of Emergency and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Eriko Eto Department of Obstetrics and Gynecology, and Department of Emergency and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Atsunori Nakao Department of Obstetrics and Gynecology, and Department of Emergency and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hisashi Masuyama Department of Obstetrics and Gynecology, and Department of Emergency and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences We investigated the effectiveness of simulation-based education in Focused Assessment with Sonography for Trauma (FAST) to increase the number of Emergency Medical Technicians (EMTs) capable of performing ultrasound examinations in vehicles under the guidance of a physician. Twenty-eight paramedics watched a 14-min video on the features of the ultrasound system, its use, and the scanning method for each part of the body. Each participant performed four FAST examinations using a portable ultrasound device, and the task performance was rated using the Task Specific Checklist (TSC) and Global Rating Scale (GRS). The time required for visualizing each examination site and each FAST was assessed. The mean time required for the first and fourth FAST was 144.6 ± 52.4 s and 90.5 ± 31.0 s, respectively. The time required for each test significantly decreased with repeated testing (p < 0.001). The time to complete FAST was significantly shortened for the pericardial cavity (33.4 ± 23.1/15.3 ± 10.6 s, p < 0.01), right thoracic cavity (25.2 ± 11.8/12.1 ± 8.3 s, p < 0.01), Morrison fossa (19.1 ± 10.8/10.8 ± 6.3 s, p < 0.05), and left thoracic cavity (19.0 ± 8.3/15.6 ± 8.3 s, p < 0.05). TSC and GRS scores were elevated, and all EMTs could obtain valid images. The combination of a brief video lecture and hands-on training significantly reduced the time required for FAST performance. Moreover, repeated practice enabled the EMTs to efficiently obtain accurate and clinically useful images. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 2189-7948 25 2 2024 Treatment interruption in hypertensive patients during the COVID-19 pandemic: An interrupted time series analysis using prescription data in Okayama, Japan 102 109 EN Naoko Nakamura Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Toshiharu Mitsuhashi Center for Innovative Clinical Medicine, Okayama University Hospital Naomi Matsumoto Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shunsaku Hayase Academic Affairs Division, Okayama University Takashi Yorifuji Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Background: The COVID- 19 pandemic has impacted healthcare behaviors, leading to fewer pediatric visits in Japan and potentially fewer visits by adult patients. However, existing Japanese studies on treatment interruptions have generally relied on questionnaire- based methods. In this study, we assessed the impact of the pandemic on antihypertensive treatment interruption using real- world prescription data. <br> Methods: We conducted an interrupted time series analysis using the National Health Insurance Database in Okayama Prefecture, Japan. Participants included individuals aged 40-69 years with at least one antihypertensive prescription between 2018 and 2020. Treatment interruption was defined as a 3- month or longer gap in prescriptions after medication depletion. We used segmented Poisson regression with models unadjusted and adjusted for seasonality and over- dispersion to assess monthly treatment interruptions before and after Japan's April 2020 emergency. <br> Results: During the study period, 23.0% of 55,431 participants experienced treatment interruptions. Cyclical fluctuations in interruptions were observed. The crude analysis indicated a 1.2 - fold increase in treatment interruptions following the pandemic; however, the adjusted models showed no significant changes. Even among higher- risk groups, such as women, younger adults, and those with shorter prescriptions, no significant alterations were observed. <br> Conclusion: We found no significant impact of the COVID- 19 pandemic on antihypertensive treatment interruption in Okayama Prefecture. The less severe outbreak in the area or increased use of telemedicine and extended prescriptions may have contributed to treatment continuity. Further research is needed using a more stable and comprehensive database, broader regional data, and detailed prescription records to validate and extend our findings. No potential conflict of interest relevant to this article was reported.

American Chemical Society (ACS) Acta Medica Okayama 1549-9596 64 2 2023 pSPICA Force Field Extended for Proteins and Peptides 532 542 EN Yusuke Miyazaki Research Institute for Interdisciplinary Science, Okayama University Wataru Shinoda Research Institute for Interdisciplinary Science, Okayama University Many coarse-grained (CG) molecular dynamics (MD) studies have been performed to investigate biological processes involving proteins and lipids. CG force fields (FFs) in these MD studies often use implicit or nonpolar water models to reduce computational costs. CG-MD using water models cannot properly describe electrostatic screening effects owing to the hydration of ionic segments and thus cannot appropriately describe molecular events involving water channels and pores through lipid membranes. To overcome this issue, we developed a protein model in the pSPICA FF, in which a polar CG water model showing the proper dielectric response was adopted. The developed CG model greatly improved the transfer free energy profiles of charged side chain analogues across the lipid membrane. Application studies on melittin-induced membrane pores and mechanosensitive channels in lipid membranes demonstrated that CG-MDs using the pSPICA FF correctly reproduced the structure and stability of the pores and channels. Furthermore, the adsorption behavior of the highly charged nona-arginine peptides on lipid membranes changed with salt concentration, indicating the pSPICA FF is also useful for simulating protein adsorption on membrane surfaces. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 0531-5565 180 2023 Attenuation of pulmonary damage in aged lipopolysaccharide-induced inflammation mice through continuous 2 % hydrogen gas inhalation: A potential therapeutic strategy for geriatric inflammation and survival 112270 EN Toshiyuki Aokage Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Masumi Iketani Biological Process of Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology Mizuki Seya Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Ying Meng Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kohei Ageta Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hiromichi Naito Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Atsunori Nakao Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Ikuroh Ohsawa Biological Process of Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology Introduction: With the global population aging, there is an increased prevalence of sepsis among the elderly, a demographic particularly susceptible to inflammation. This study aimed to evaluate the therapeutic potential of hydrogen gas, known for its anti-inflammatory and antioxidant properties, in attenuating inflammation specifically in the lungs and liver, and age-associated molecular markers in aged mice.<br> Methods: Male mice aged 21 to 23 months, representative of the human elderly population, were subjected to inflammation via intraperitoneal injection of lipopolysaccharide (LPS). The mice were allocated into eight groups to examine the effects of varying durations and concentrations of hydrogen gas inhalation: control, saline without hydrogen, saline with 24-hour 2 % hydrogen, LPS without hydrogen, LPS with 24-hour 2 % hydrogen, LPS with 6-hour 2 % hydrogen, LPS with 1-hour 2 % hydrogen, and LPS with 24-hour 1 % hydrogen. Parameters assessed included survival rate, activity level, inflammatory biomarkers, and organ injury.<br> Results: Extended administration of hydrogen gas specifically at a 2 % concentration for 24 h led to a favorable prognosis in the aged mice by reducing mRNA expression of inflammatory biomarkers in lung and liver tissue, mitigating lung injury, and diminishing the expression of the senescence-associated protein p21. Moreover, hydrogen gas inhalation selectively ameliorated senescence-related markers in lung tissue, including C-X-C motif chemokine 2, metalloproteinase-3, and arginase-1. Notably, hydrogen gas did not alleviate LPS-induced liver injury under the conditions tested.<br> Conclusion: The study highlights that continuous inhalation of hydrogen gas at a 2 % concentration for 24 h can be a potent intervention in the geriatric population for improving survival and physical activity by mitigating pulmonary inflammation and modulating senescence-related markers in aged mice with LPS-induced inflammation. This finding paves the way for future research into hydrogen gas as a therapeutic strategy to alleviate severe inflammation that can lead to organ damage in the elderly. 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 Okayama 2436-8326 3 2024 文禄五年閏七月九日の伊予・豊後地震に関する特性化震源モデルを用いた中央構造線活断層帯の断層パラメータの検証 21 40 EN Yurie OKUMA School of Science, Okayama University Takashi KUMAMOTO School of Science, Okayama University 論文 (Research article) 10.18926/66189 The purpose of this study is to verify the fault length and earthquake magnitude of the Iyo-Bungo earthquake in 1596 estimated by Ishibashi (2019) using historical documents written in the same period. According to Ishibashi (2019), the length of the source fault was estimated to have been less than 100 km and the earthquake magnitude was roughly estimated to have been around 7.5. In order to attempt to reproduce the interpretation, we conducted two different strong ground motion simulations: the attenuation equation method and the characterized source model method, both used in the Headquarters for Earthquake Research Promotion. We simulated earthquake ground motions based on several source fault models including estimation by Ishibashi (2019). For the length of the fault, a 100 km length corresponding to the Iyonada segment of the Median Tectonic Line active fault system was the first model and 130 km and 160 km models extending onshore to the northeast were taken into account as epistemic uncertainties. Regarding the dip angle of the fault, both 40 and 90 degree models were considered also as epistemic uncertainties. Our calculation with other uncertainties shows that the models with a fault length of 100 km with a dip angle of 90 or 40 degrees are consistent with the seismic intensity and seismogenic fault length of offshore fault estimated by Ishibashi (2019) based on reliable first-grade documents. If low-certainty intensity estimates by Ishibashi (2019) are used to evaluate fault length in our calculation, the possibility of 130 or 160 km length models with additional onshore faults will remain. Our results show that the strong ground motion simulation could reinforce the expert’s interpretation of historical documents and propose quantitative source fault models for historical earthquakes. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 77 6 2023 Cochlear Implantation in the Poorer-Hearing Ear Is a Reasonable Choice 589 593 EN Ryotaro Omichi Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shin Kariya Department of Otolaryngology-Head and Neck Surgery, Kawasaki Medial University Yukihide Maeda Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kunihiro Fukushima Hayashima Clinic of Otolaryngology and Dermatology Yuko Kataoka Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Akiko Sugaya Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kazunori Nishizaki Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Mizuo Ando Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Original Article 10.18926/AMO/66150 Choosing the optimal side for cochlear implantation (CI) remains a major challenge because of the lack of evidence. We investigated the choice of the surgery side for CI (i.e., the better- or poorer-hearing ear) in patients with asymmetric hearing. Audiological records of 74 adults with a unilateral hearing aid who had undergone surgery at Okayama University Hospital were reviewed. The definition of ‘better-hearing ear’ was the aided ear, and the unaided ear was considered the poorer-hearing ear. We performed a multiple regression analysis to identify potential predictors of speech recognition performance after unilateral CI in the patients. Fifty-two patients underwent CI in the poorer-hearing ear. The post-Ci bimodal hearing rate was far higher in the poorer-ear group (77.8% vs. 22.2%). A multivariate analysis revealed that prelingual hearing loss and the patient’s age at CI significantly affected the speech recognition outcome (beta coefficients: 24.6 and −0.33, 95% confidence intervals [11.75-37.45] and [−0.58 to −0.09], respectively), but the CI surgery side did not (−6.76, [−14.92-1.39]). Unilateral CI in the poorer-hearing ear may therefore be a reasonable choice for adult patients with postlingual severe hearing loss, providing a greater opportunity for postoperative bimodal hearing. No potential conflict of interest relevant to this article was reported.

American Physical Society (APS) Acta Medica Okayama 2470-0010 105 10 2022 Axion cosmology in the presence of nontrivial Nambu-Goldstone modes 103522 EN M. Yoshimura Axion cosmology is reexamined taking into account the effect of kinetic pseudo-NambuGoldstone modes. When Peccei-Quinn (PQ) symmetry is broken by a chiral U(1) singlet, we find that the effect of the kinetic Nambu-Goldstone mode makes the axion dark matter untenable. When PQ symmetry is extended and is broken by two singlets, we find that axion cosmology works, but there are several differences from the axion cosmology studied in the literature. The differences are (1) an ordinary type of dark matter scaling of 1/cosmic scale factor(3) arising from a modulus field and not from the usual angular field, (2) the mass of the dark matter quantum in the ultralight range (10(-32)-10(-14)) eV, (3) the emergence of dark energy with a present density of order (a few meV)(4), consistent with observations, (4) the presence of a long-range spin-dependent force, and (5) slow-roll inflation after PQ symmetry breaking when conformal coupling to gravity is introduced. No potential conflict of interest relevant to this article was reported.

Department of Mathematics, Faculty of Science, Okayama University Acta Medica Okayama 0030-1566 66 1 2024 Several homotopy fixed point spectral sequences in telescopically localized algebraic K-theory 135 157 EN Daniel G. Davis Department of Mathematics, University of Louisiana at Lafayette Let n ≥ 1, p a prime, and T(n) any representative of the Bousfield class of the telescope v−1n F(n) of a finite type n complex. Also, let En be the Lubin-Tate spectrum, K(En) its algebraic K-theory spectrum, and Gn the extended Morava stabilizer group, a profinite group. Motivated by an Ausoni-Rognes conjecture, we show that there are two spectral sequences<br> IEs,t2 ⇒ πt−s((LT(n+1)K(En))hGn) ⇐ IIEs,t2<br> with common abutment π∗(−) of the continuous homotopy fixed points of LT(n+1)K(En), where IEs,t2 is continuous cohomology with coefficients in a certain tower of discrete Gn-modules. If the tower satisfies the Mittag-Leffler condition, then there are isomorphisms with continuous cochain cohomology groups:<br> IE∗,∗2 ≅ H∗cts(Gn, π∗(LT(n+1)K(En))) ≅ IIE∗,∗2.<br> We isolate two hypotheses, the first of which is true when (n, p) = (1, 2), that imply (LT(n+1)K(En))hGn ≃ LT(n+1)K(LK(n)S0). Also, we show that there is a spectral sequence<br> Hscts(Gn, πt(K(En) ⊗ T(n + 1))) ⇒ πt−s((K(En) ⊗ T(n + 1))hGn). No potential conflict of interest relevant to this article was reported.

Royal Society of Chemistry (RSC) Acta Medica Okayama 1477-0520 2023 Relative stereochemical determination of the C61–C83 fragment of symbiodinolide using a stereodivergent synthetic approach EN Hiroyoshi Takamura Department of Chemistry, Graduate School of Natural Science and Technology, Okayama University Kosuke Hattori Department of Chemistry, Graduate School of Natural Science and Technology, Okayama University Takumi Ohashi Department of Chemistry, Graduate School of Natural Science and Technology, Okayama University Taichi Otsu Department of Chemistry, Graduate School of Natural Science and Technology, Okayama University Isao Kadota Department of Chemistry, Graduate School of Natural Science and Technology, Okayama University Structural determination is required in the use of marine natural products to create novel drugs and drug leads in medicinal chemistry. Symbiodinolide, which is a polyol marine natural product with a molecular weight of 2860, increases the intracellular Ca2+ concentration and exhibits inhibitory activity against cyclooxygenase-1. Seventy percent of the structure of symbiodinolide has been stereochemically clarified. Herein, we report the elucidation of the relative configuration of the C61–C83 fragment, which is among the remaining thirty percent, using a stereodivergent synthetic strategy. We first assigned the relative configuration of the C61–C74 fragment. Two candidate diastereomers of the C61–C74 fragment were synthesized, and their NMR data were compared with those of the natural product, revealing the relative stereochemistry of this component. We then narrowed down the candidate compounds for the C69–C83 fragment from 16 possible diastereomers by analyzing the NMR data of the natural product, and we thus selected eight candidate diastereomers. Stereodivergent synthesis of the candidates for this fragment and comparison of the NMR data of the natural product and the eight synthetic products resulted in the relative stereostructural clarification of the C69–C83 fragment. These individually determined relative stereochemistries of the C61–C74 and C69–C83 fragments were connected via the common C69–C73 tetrahydropyran moiety of the fragments. Finally, the relative configuration of the C61–C83 fragment of symbiodinolide was determined. The stereodivergent synthetic approach used in this study can be extended to the stereochemical determination of other fragments of symbiodinolide. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 0196-6553 51 9 2023 Increased evidence for no benefit of contact precautions in preventing extended-spectrum β-lactamases-producing Enterobacteriaceae: Systematic scoping review 1056 1062 EN Hideharu Hagiya Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fumio Otsuka Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Introduction: Extended-spectrum β-lactamases-producing Enterobacteriaceae (ESBL-E) is a critical antimicrobial resistance pathogen, to which we need to pay the greatest attention. This study was aimed at uncovering the present evidence for the preventive effectiveness of contact precautions for patients colonized or infected with ESBL-E.<br> Methods: According to the Preferred Reporting Items for Systemic Reviews and Meta-analyses (PRISMA) Extension for Scoping Reviews, we searched MEDLINE for articles with relevant keywords from the beginning of 2010 to October 18, 2022.<br> Results: Of the 355 articles found, 9, including 8 observational studies and 1 randomized controlled trial, were selected. Safety of discontinuing contact precautions was evaluated mainly in acute-care and long-term care hospitals. Consistently, all authors concluded that contact precautions can be safely discontinued in patients colonized or infected with ESBL-E.<br> Conclusion: The clinical impact of discontinuing contact precautions for patients with ESBL-E is minimal and can be safely withdrawn at acute, noncritical, adult care wards. Relevant data from pediatric and geriatric wards, as well as intensive care units, were insufficient and should be investigated in future research. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 0924-4247 361 2023 A soft rotary actuator with a flexible shaft using flexible pneumatic actuators 114603 EN So Shimooka Faculty of Natural Science and Technology, Okayama University Miku Kawanaka Faculty of Interdisciplinary Science and Engineering in Health Systems, Okayama University Akio Gofuku Faculty of Interdisciplinary Science and Engineering in Health Systems, Okayama University This paper proposes a soft rotary actuator that can rotate even when its shaft is bent. The tested rotary actuator consists of three Extension-type Flexible Pneumatic Actuators (EFPA), flexible plates for restraining the EFPAs geometrically, and a polyurethane tube as a shaft. The EFPA consists of a silicone rubber tube covered with a sleeve that can expand significantly in the axial direction when the tube is pressurized. By restraining the EFPA to a helical shape using plates, the proposed rotary actuator can rotate when the three EFPAs are extended in the rotational direction upon the application of pressure. It is confirmed that the tested actuator could rotate even if the shaft is bent, because the shaft and EFPAs consist of flexible materials. The maximum rotation angle and torque are approximately 400° and 0.5 Nm, respectively, for an input pressure of 500 kPa. An analytical model of the tested actuator is proposed to predict the relationship between the rotation angle and the input pressure. A comparison between the calculated and experimental rotation angles reveals that the experimental results can be accurately predicted using the proposed analytical model, which considers the effects of EFPA friction and restraining. No potential conflict of interest relevant to this article was reported.

SAGE Publications Acta Medica Okayama 2324-7096 11 2023 Resection of Orbital Myxoma With Magnetic Resonance Imaging Evidence of Ethmoid Sinus Origin: Case Report and Review of 20 Patients in the Literature 1 6 EN Toshihiko Matsuo Okayama University Takehiro Tanaka Okayama University A 41-year-old woman showed a palpable mass at the superonasal orbital edge on the right side. Magnetic resonance imaging demonstrated a lobulated fluid-containing tubular mass which extended anteriorly to posteriorly along the medial orbital wall, nasal to the eyeball. She was followed once a year for 8 years until the age of 49 years when she decided to undergo surgical resection because of the enlarged mass. The lobulated large mass was resected and the pathology showed sparsely distributed spindle cells, positive for CD34, in alcian blue-positive mucous substances, indicative of myxoma. Postoperative magnetic resonance imaging showed residual lobulated tubular mass along the optic nerve on the medial side and superior to the eyeball. The residual orbital mass showed stable structure with more evident connection with the ethmoid sinus lesion, suggestive of the ethmoid origin, in 12 years until the age of 61 years. In the review of 20 patients with orbital myxomas in the literature, in addition to this case, roughly classified locations in the orbit were retrobulbar in 8 patients, on the lateral side of the orbit in 4, on the superior side in 6, on the medial side in 1 (this patient), and in the orbit with no specific description in 2. In pathological examinations, immunohistochemistry was not done in 8 patients, done but all negative in 2, and positive in 11 patients: nerve sheath myxoma was diagnosed in 3 patients based on positive S100 staining. Orbital myxoma is rare but considered in differential diagnosis of orbital masses. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2313-433X 9 6 2023 White Box Watermarking for Convolution Layers in Fine-Tuning Model Using the Constant Weight Code 117 EN Minoru Kuribayashi Graduate School of Natural Science and Technology, Okayama University Tatsuya Yasui Graduate School of Natural Science and Technology, Okayama University Asad Malik Department of Computer Science, Aligarh Muslim University Deep neural network (DNN) watermarking is a potential approach for protecting the intellectual property rights of DNN models. Similar to classical watermarking techniques for multimedia content, the requirements for DNN watermarking include capacity, robustness, transparency, and other factors. Studies have focused on robustness against retraining and fine-tuning. However, less important neurons in the DNN model may be pruned. Moreover, although the encoding approach renders DNN watermarking robust against pruning attacks, the watermark is assumed to be embedded only into the fully connected layer in the fine-tuning model. In this study, we extended the method such that the model can be applied to any convolution layer of the DNN model and designed a watermark detector based on a statistical analysis of the extracted weight parameters to evaluate whether the model is watermarked. Using a nonfungible token mitigates the overwriting of the watermark and enables checking when the DNN model with the watermark was created. No potential conflict of interest relevant to this article was reported.

nature portfolio Acta Medica Okayama 2045-2322 13 1 2023 Semiconductor-metal transition in Bi2Se3 caused by impurity doping 537 EN Takaki Uchiyama Research Institute for Interdisciplinary Science, Okayama University Hidenori Goto Research Institute for Interdisciplinary Science, Okayama University Eri Uesugi Research Institute for Interdisciplinary Science, Okayama University Akihisa Takai Research Institute for Interdisciplinary Science, Okayama University Lei Zhi Research Institute for Interdisciplinary Science, Okayama University Akari Miura Research Institute for Interdisciplinary Science, Okayama University Shino Hamao Research Institute for Interdisciplinary Science, Okayama University Ritsuko Eguchi Research Institute for Interdisciplinary Science, Okayama University Hiromi Ota Advanced Science Research Center, Okayama University Kunihisa Sugimoto Faculty of Science and Engineering, Kindai University Akihiko Fujiwara Department of Nanotechnology for Sustainable Energy, Kwansei Gakuin University Fumihiko Matsui Institute for Molecular Science, UVSOR Synchrotron Facility Koji Kimura Department of Physical Science and Engineering, Nagoya Institute of Technology Kouichi Hayashi Department of Physical Science and Engineering, Nagoya Institute of Technology Teppei Ueno Research Institute for Interdisciplinary Science, Okayama University Kaya Kobayashi Research Institute for Interdisciplinary Science, Okayama University Jun Akimitsu Research Institute for Interdisciplinary Science, Okayama University Yoshihiro Kubozono Research Institute for Interdisciplinary Science, Okayama University Doping a typical topological insulator, Bi2Se3, with Ag impurity causes a semiconductor-metal (S-M) transition at 35 K. To deepen the understanding of this phenomenon, structural and transport properties of Ag-doped Bi2Se3 were studied. Single-crystal X-ray diffraction (SC-XRD) showed no structural transitions but slight shrinkage of the lattice, indicating no structural origin of the transition. To better understand electronic properties of Ag-doped Bi2Se3, extended analyses of Hall effect and electric-field effect were carried out. Hall effect measurements revealed that the reduction of resistance was accompanied by increases in not only carrier density but carrier mobility. The field-effect mobility is different for positive and negative gate voltages, indicating that the E-F is located at around the bottom of the bulk conduction band (BCB) and that the carrier mobility in the bulk is larger than that at the bottom surface at all temperatures. The pinning of the E-F at the BCB is found to be a key issue to induce the S-M transition, because the transition can be caused by depinning of the E-F or the crossover between the bulk and the top surface transport. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 77 3 2023 Current Prevalence of Antimicrobial Resistance in Okayama from a National Database between 2018 and 2021 255 262 EN Shinnosuke Fukushima Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hideharu Hagiya Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kazuhiro Uda Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kazuyoshi Gotoh Department of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fumio Otsuka Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Original Article 10.18926/AMO/65490 Antimicrobial resistance is an emerging global threat that must be addressed using a multidisciplinary approach. This study aimed to raise awareness of high-level antimicrobial-resistant (AMR) pathogens in Japan by comparing their recent prevalences among prefectures, particularly Okayama. Data for the isolation proportions of meropenem-resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus faecium, cefotaxime-resistant Escherichia coli and Klebsiella pneumoniae, and levofloxacin-resistant E. coli and K. pneumoniae were collected from the Japan Nosocomial Infections Surveillance, a national database sponsored by the Japanese Ministry of Health, Labour, and Welfare, between 2018 and 2021. The average isolated proportions of the seven AMR pathogens were higher in Okayama compared to other prefectures: the worst (19.9%) was meropenem-resistant P. aeruginosa, the sixth worst (57.2%) was methicillin-resistant S. aureus, the eighth worst (3.3%) was vancomycin-resistant E. faecium, the second (37.8%) and fifth worst (17.6%) were cefotaxime-resistant E. coli and K. pneumoniae, respectively, and the fourth (49.9%) and third worst (8.7%) were levofloxacin-resistant E. coli and K. pneumoniae, respectively. Our study highlights the notably high prevalences of representative AMR pathogens in Okayama, suggesting the need for fundamental infection prevention and control by healthcare professionals, promoting antimicrobial stewardship, and educating undergraduates and postgraduates in Okayama. No potential conflict of interest relevant to this article was reported.

Springer Acta Medica Okayama 2168-8184 15 4 2023 Laparoscopic and Endoscopic Cooperative Surgery for Gastric Submucosal Tumor Near Esophagogastric Junction With Sliding Hiatal Hernia e37902 EN Hajime Kashima Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Satoru Kikuchi Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shinji Kuroda Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Toshiyoshi Fujiwara Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences The usefulness of laparoscopic and endoscopic cooperative surgery (LECS) for gastric submucosal tumors in the cardiac region has been reported in recent years. However, LECS for submucosal tumors at the esophagogastric junction with hiatal sliding esophageal hernia has not been reported, and its validity as a treatment method is unknown. The patient was a 51-year-old man with a growing submucosal tumor in the cardiac region. Surgical resection was indicated because a definitive diagnosis of the tumor was not determined. The lesion was a luminal protrusion tumor, located on the posterior wall of the stomach 20 mm from the esophagogastric junction, and had a maximum diameter of 16.3 mm on endoscopic ultrasound examination. Because of the hiatal hernia, the lesion could not be detected from the gastric side by endoscopy. Local resection was considered to be feasible because the resection line did not extend into the esophageal mucosa and the resection site could be less than half the circumference of the lumen. The submucosal tumor was resected completely and safely by LECS. The tumor was diagnosed as a gastric smooth muscle tumor finally. Nine months after surgery, a follow-up endoscopy showed reflux esophagitis. LECS was a useful technique for submucosal tumors of the cardiac region with hiatal hernia, but fundoplication might be considered for preventing backflow of gastric acid. No potential conflict of interest relevant to this article was reported.

SAGE Publications Acta Medica Okayama 1721-727X 21 2023 Hydrogen gas treatment improves survival in a rat model of crush syndrome by ameliorating rhabdomyolysis EN Tetsuya Yumoto Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Toshiyuki Aokage Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Takahiro Hirayama Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hirotsugu Yamamoto Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Takafumi Obara Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Tsuyoshi Nojima Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hiromichi Naito Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Atsunori Nakao Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Objectives: Crush syndrome (CS) is characterized by a systemic manifestation of traumatic rhabdomyolysis, leading to multiple organ dysfunction and death. Ischemia-reperfusion (IR) injury is commonly responsible for systemic response. Extending studies have shown that hydrogen gas treatment ameliorated IR injury in numerous experimental models; however, its effect on CS has not been well examined. This study aimed to investigate the effects of hydrogen gas inhalation following crush injury in an experimental model of CS.<br> Methods: Male Sprague-Dawley rats were subjected to experimental CS by applying a total of 3.0 kg weight to both hindlimb under general anesthesia for 6 h. Immediately after decompression, the animals were randomly placed in a gas chamber filled with either air or 1.3% hydrogen gas. Animals were sacrificed 18 h or 24 h following gas exposure for non-survival studies or for survival study, respectively.<br> Results: The rats with hydrogen treatment (n = 6) had a higher 24-h survival than the rats with air treatment (n = 9) (100% vs. 44%, p = 0.035). Lactate concentrations (2.9 +/- 0.2 vs. 2.2 +/- 0.2 mmol/L, p = 0.040) and creatine kinase (34,178 +/- 13,580 vs. 5005 +/- 842 IU/L, p = 0.016) were lower in the hydrogen group compared with the air group 18 h after decompression (n = 4 in the air group, and n = 5 in the H-2 group). Histological analysis revealed that the damage to the rectus femoris muscle and kidney appeared to be ameliorated by hydrogen treatment.<br> Conclusion: Hydrogen gas inhalation may be a promising therapeutic approach in the treatment of CS. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2079-6382 12 3 2023 The Genotypic and Phenotypic Characteristics Contributing to Flomoxef Sensitivity in Clinical Isolates of ESBL-Producing E. coli Strains from Urinary Tract Infections 522 EN Kazuma Sakaeda Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Takuya Sadahira Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yuki Maruyama Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Takehiro Iwata Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Masami Watanabe Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Koichiro Wada Koichiro Wada Department of Urology, School of Medicine, Shimane University Motoo Araki Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University We carried out a molecular biological analysis of extended-spectrum beta-lactamase (ESBL)-producing E. coli strains and their sensitivity to flomoxef (FMOX). Sequence type (ST) analysis by multilocus sequence typing (MLST) and classification of ESBL genotypes by multiplex PCR were performed on ESBL-producing E. coli strains isolated from urine samples collected from patients treated at our institution between 2008 and 2018. These sequences were compared with results for antimicrobial drug susceptibility determined using a micro-liquid dilution method. We also analyzed cases treated with FMOX at our institution to examine its clinical efficacy. Of the 911 E. coli strains identified, 158 (17.3%) were ESBL-producing. Of these, 67.7% (107/158) were strain ST-131 in ST analysis. Nearly all (154/158; 97.5%) were CTX-M genotypes, with M-14 and M-27 predominating. The isolated strains were sensitive to FMOX in drug susceptibility tests. Among the patient samples, 33 cases received FMOX, and of these, 5 had ESBL-producing E. coli. Among these five cases, three received FMOX for surgical prophylaxis as urinary carriers of ESBL-producing E. coli, and postoperative infections were prevented in all three patients. The other two patients received FMOX treatment for urinary tract infections. FMOX treatment was successful for one, and the other was switched to carbapenem. Our results suggest that FMOX has efficacy for perioperative prophylactic administration in urologic surgery involving carriers of ESBL-producing bacteria and for therapeutic administration for urinary tract infections. Use of FMOX avoids over-reliance on carbapenems or beta-lactamase inhibitors and thus is an effective antimicrobial countermeasure. No potential conflict of interest relevant to this article was reported.

岡山大学経済学会 Acta Medica Okayama 2433-4146 54 3 2023 ベトナム経済の労働投入と生産性の半世紀 37 59 EN Koji Nomura 10.18926/OER/65011 　本稿は，1970−2020年のベトナム経済における品質調整済み労働投入量（quality-adjusted labor input: QALI）の測定により，半世紀にわたる生産性の変化を分析することを目的としている。ベトナム経済の生産性統計の構築における最大の障壁は，同国SNA統計（VSNA）では雇用者報酬が推計されていないことである。本稿は，断片的な資料に基づきながらも，性，学歴，年齢，就業形態別のクロス分類によって定義された労働時間と賃金率の時系列データを構築し，QALIとともにミクロ的な基盤を持つ雇用者報酬と労働分配率の測定へと接近する。また2022年８月には2008 SNAに基づくVSNAが公表され，GDPは大幅な上方改定となった。新しい基準のVSNAに基づき1970年まで遡及した本稿での測定結果によれば，労働投入における質的改善のスピードは1970−2000年の年率0.6％から，2000−20年には（おもに学歴改善を通じて）年率2.0％へと加速し，それは同期間のQALI拡大の65％を牽引し，また労働生産性改善の14％を説明する要因となったと評価される。そしてベトナム経済で全要素生産性が改善を始めた時期は，旧基準に基づく分析結果よりも遅く，2010年代後半に顕著となったことが見出される。 No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 77 1 2023 A Case of Radiation-Induced Osteosarcoma with RB1 Gene Alteration Treated by Skull Base Surgery and Craniofacial Reconstruction 85 90 EN Yuki Matsuda Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yoshihiro Otani Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takao Yasuhara Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Mizuo Ando Department of Otolaryngology-Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takaya Higaki Department of Otolaryngology-Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takuma Makino Department of Otolaryngology-Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hiroshi Matsumoto Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Tadashi Oyama Department of Hematology and Oncology, Okayama University Hospital Hisakazu Nishimori Department of Hematology and Oncology, Okayama University Hospital Isao Date Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Case Report 10.18926/AMO/64367 A 35-year-old female presented with headache, photophobia and developed sudden loss of vision after having undergone right-side ophthalmectomy and radiochemotherapy for retinoblastoma in infancy. A neoplastic lesion was found in the left middle cranial fossa and was surgically removed. The diagnosis was radiation-induced osteosarcoma with RB1 gene alteration. Although she received chemotherapy for the residual tumor, it progressed 17 months later. Maximal surgical resection with craniofacial reconstruction was required. We utilized two three-dimensional models for surgical planning. She was discharged without neurological deficits other than loss of light perception subsequent to left ophthalmectomy. In cases where retinoblastoma is treated with radiotherapy, long-term follow-up is necessary to monitor for radiation-induced tumor development. No potential conflict of interest relevant to this article was reported.

Royal Society of Chemistry (RSC) Acta Medica Okayama 1477-0520 21 3 2022 Chemical synthesis and antifouling activity of monoterpene–furan hybrid molecules 632 638 EN Hiroyoshi Takamura Department of Chemistry, Graduate School of Natural Science and Technology, Okayama University Yuya Kinoshita Department of Chemistry, Graduate School of Natural Science and Technology, Okayama University Takefumi Yorisue Institute of Natural and Environmental Sciences, University of Hyogo Isao Kadota Department of Chemistry, Graduate School of Natural Science and Technology, Okayama University Geraniol, a monoterpene, and furan are structural motifs that exhibit antifouling activity. In this study, monoterpene-furan hybrid molecules with potentially enhanced antifouling activity were designed and synthesized. The nine synthetic hybrids showed antifouling activity against the cypris larvae of the barnacle Balanus (Amphibalanus) amphitrite with EC50 values of 1.65-4.70 mu g mL(-1). This activity is higher than that of geraniol and the reference furan compound. This hybridization approach to increase antifouling activity is useful and can also be extended to other active structural units. No potential conflict of interest relevant to this article was reported.

American Chemical Society (ACS) Acta Medica Okayama 1523-7060 24 42 2022 Total Synthesis of Scabrolide F 7845 7849 EN Hiroyoshi Takamura Department of Chemistry, Graduate School of Natural Science and Technology, Okayama University Yuki Sugitani Department of Chemistry, Graduate School of Natural Science and Technology, Okayama University Ryohei Morishita Department of Chemistry, Graduate School of Natural Science and Technology, Okayama University Isao Kadota Department of Chemistry, Graduate School of Natural Science and Technology, Okayama University The first total synthesis of scabrolide F, a norcembranolide isolated from the soft coral Sinularia scabra, is described. Hydroxycarboxylic acid, which is the key synthetic intermediate, was synthesized in a convergent manner by fragment coupling. The obtained hydroxycarboxylic acid was subjected to macrolactonization and subsequent transannular ring-closing metathesis (RCM) to furnish scabrolide F. The synthetic protocol can be extended to the total synthesis of other norcembranolides. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 1226-8615 25 4 2022 Longevity of Lucilia sericata (Meigen, 1826) used as pollinator 101999 EN Koichi Shimomae Graduate School of Environmental and Life Science, Okayama University Takuya Sato Japan Maggot Company, Co. Ltd. Yuichi Yoshida Graduate School of Environmental and Life Science, Okayama University Shine Shane Naing Graduate School of Environmental and Life Science, Okayama University Takahisa Miyatake Graduate School of Environmental and Life Science, Okayama University Pollinators play an important role in the production of many agricultural products. Honeybees, Apis mellifera L., are leading pollinators, but the number of honeybees in the world is declining. Finding alternatives is beginning to be important. In the present study, we compared the longevity of Lucilia sericata (Meigen, 1826), which is used as a pollinator, in cages in the laboratory and in a vinyl greenhouse under controlled feeding conditions. First, we showed that the longevity of the flies was significantly extended (c.a. 40 days) in the laboratory when water and sugar were supplied compared to the cases without sugar and/or water. Second, we found that the average longevity was 20 days with water and sugar in cages kept in a vinyl greenhouse during the summer. Finally, we released marked flies into a vinyl greenhouse where strawberries were cultivated without feeding water or sugar in the spring. As a result, fewer than 10% of the flies survived 10 days after release. Based on the result, we discuss the use of this species as a pollinator in the context of its survival rate. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 76 6 2022 A Case of Paraplegia Treated with Cerebrospinal Fluid Drainage and Permissive Hypertension after Graft Replacement of the Ascending Aorta and the Total Aortic Arch for Acute Aortic Dissection Stanford Type A 737 742 EN Masakazu Yamaoka Department of Anesthesiology, Japanese Red Cross Society Himeji Hospital Yumi Yamamoto Department of Anesthesiology and Critical Care Medicine, Hiroshima Citizens Hospital Eriko Minami Department of Anesthesiology, Japanese Red Cross Society Himeji Hospital Case Report 10.18926/AMO/64125 Paraplegia after an operation for acute aortic dissection Stanford type A (AADA) is fairly uncommon, and there is no consensus about optimal treatment. We present a case in which cerebrospinal fluid drainage (CSFD) and permissive hypertension were used for treatment of paraplegia. When the patient showed complete bilateral paraplegia after operation for AADA, we immediately began CSFD and maintained mean arterial blood pressure at over 90 mmHg. His neurological deficit gradually recovered, and he was eventually able to walk without support. The combination of CSFD and permissive hypertension could be a first-line emergent treatment for postoperative paraplegia after AADA surgery. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 1341-321X 28 11 2022 High frequency of extended-spectrum beta-lactamase-producing Enterobacteriaceae carriers at a Japanese long-term care hospital 1578 1581 EN Hideharu Hagiya Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yuji Onishi Clinical Laboratory, Marugame Medical Center Natsumi Shinohara Clinical Laboratory, Marugame Medical Center Mayumi Tokuyasu Department of Nursing, Marugame Medical Center Aki Imanishi Department of Nursing, Marugame Medical Center Shinnosuke Fukushima Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Lutfun Nahar Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Koji Iio Microbiology Division, Clinical Laboratory, Okayama University Hospital Fumio Otsuka Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Introduction: Long-term care hospitals (LTCHs) are at a high risk for the inflow and spread of antimicrobial resistance (AMR) pathogens. However, owing to limited laboratory resources, little is known about the extent to which AMR organisms are endemic.<br> <br> Methods: We performed active surveillance for carbapenem-resistant Enterobacteriaceae (CRE) and extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) in newly admitted patients at Marugame Medical Center, a nearly 200-bedded LTCH located in Kagawa, Japan. From August to December 2021, we tested stool samples from patients wearing diapers and confirmed the genetic variants using specific PCR assays. We also collected clinical variables and compared them between AMR carriers and non-carriers.<br> <br> Results: Stool samples were collected from 75 patients, with a median age of 84 years. CRE strain was not detected, but 37 strains of ESBL-E were isolated from 32 patients (42.7%). During the study period, 4.9% of in-hospital patients (37 per 756 patients) were identified to be ESBL-E carriers in the routine microbiological processing, suggesting that active surveillance detected approximately 9-fold more ESBL-E carriers. The bla(CTM-M-9) group was the most common (38.5%), followed by the bla(TEM) (26.9%). The clinical backgrounds of the ESBL-E non-carriers and carriers were not significantly different.<br> <br> Conclusion: Our active screening demonstrated that nearly half of the patients hospitalized or transferred to a Japanese LTCH were colonized with ESBL-E. We highlight the enforcement of universal basic infection prevention techniques at LTCHs where patients carrying AMR pathogens gather. No potential conflict of interest relevant to this article was reported.

Springer Nature Acta Medica Okayama 2055-0936 8 1 2022 Colonization with extended-spectrum beta-lactamase-producing Escherichia coli and traveler's diarrhea attack rates among travelers to India: a systematic review and meta-analysis 22 EN Basilua Andre Muzembo Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kei Kitahara Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Ayumu Ohno Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Keinosuke Okamoto Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shin-Ichi Miyoshi Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Background India is an attractive destination for travelers. Unfortunately, numerous reports exist on traveler's diarrhea (TD) and fecal colonization with extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-EC) among international travelers visiting India. Here, we systematically reviewed studies published on the acquisition of ESBL-EC and TD attack rates among international visitors to India. Methods Design: Systematic review and meta-analysis. A systematic search was performed using Google Scholar, PubMed, EMBASE, Web of Science, and gray literature from 2000 to December 2021, for studies containing data for ESBL-EC acquisition or TD experience related to a trip to India. Random effects models were used to compute the prevalence of ESBL-EC acquisition and TD attack. Results The literature search yielded a total of 5023 records. Of these, 31 met our inclusion criteria for systematic review and only 17 could be meta-analyzed (9 for TD, and 8 for ESBL-EC). The overall pooled attack rate of TD was 39% (95% confidence interval, CI: 25-53%). In studies where travelers' memory was used to diagnose TD, the pooled attack rate of TD was slightly higher (42%, 95% CI: 21-64%) compared to those where TD was objectively documented (33%, 95% CI: 17-49%). There were significant risks to be colonized with ESBL-EC among the travelers who experienced TD. The pooled rate of ESBL-EC colonization was 72% (CI: 67-78%). Most ESBL-EC produced CTX-M-15 enzyme. Furthermore, most of the travelers who acquired ESBL-EC were from highly industrialized countries recruited from travel clinics: Canada (n = 80), Germany (n = 69), Netherlands (n = 20), Sweden (n = 18), Japan (n = 10), Finland (n = 8), USA (n = 7), Spain (n = 5), and Denmark (n = 3). Conclusions TD pooled attack rate and ESBL-EC acquisition among international travelers visiting India were high in this study. However, we cannot make generalizations based upon this TD pooled attack rate for the current situation, due to a lack of current data. Our study highlights that travelers should be advised on TD to ensure that they do not disregard the risk of contracting TD and be better prepared as a result. It also illustrates the importance of international travel in acquiring antibiotic-resistant Escherichia coli. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 76 4 2022 Molecular-targeted Therapy for Metastatic Renal Cell Carcinoma As First-line Therapy: A Single Institution 13-year Experience 465 472 EN Kensuke Bekku Department of Urology, Hiroshima City Hiroshima Citizens Hospital Takuji Tsugawa Department of Urology, Hiroshima City Hiroshima Citizens Hospital Kazuma Tsuboi Department of Urology, Hiroshima City Hiroshima Citizens Hospital Gaku Noda Department of Urology, Hiroshima City Hiroshima Citizens Hospital Yousuke Inoue Department of Urology, Hiroshima City Hiroshima Citizens Hospital Wataru Murao Department of Urology, Hiroshima City Hiroshima Citizens Hospital Shin Ebara Department of Urology, Hiroshima City Hiroshima Citizens Hospital Original Article 10.18926/AMO/63906 We aimed to identify the role of first-line monotherapy with vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKI) in patients with metastatic RCC. Eligible patients were categorized into three groups (favorable, intermediate, and poor risk) according to the International Metastatic RCC Database Consortium risk criteria. Overall survival (OS) was the primary endpoint. Survival was compared using the log-rank test. A total of 108 patients were retrospectively analyzed. The numbers of patients in the favorable-, intermediate-, and poor-risk groups were 32 (30%), 66 (61%), and 10 (9%), repestively. The median OS values in the entire cohort was 36 months (95% confidence interval [CI] 29-53). The median OS in the favorable, intermediate, and poor risk groups were 94 months (95% CI: 43-Not reached), 30 months (95% CI: 20-38), and 8 months (95% CI: 0-Not reached), respectively (p<0.05). Prior nephrectomy, clear cell histology, clinical T stage ≤2, no metastasis at the time of diagnosis, nivolumab beyond first-line therapy, and objective response to VEGFR-TKIs were factors significantly prolonging OS on univariate analysis. VEGFR-TKI monotherapy as first-line therapy was an effective treatment option for patients with metastatic clear cell RCC with favorable risk. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2075-4426 12 8 2022 Robotic Mediastinal Tumor Resections: Position and Port Placement 1195 EN Mikio Okazaki Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science Kazuhiko Shien Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science Ken Suzawa Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science Seiichiro Sugimoto Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science Shinichi Toyooka Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science This study aimed to determine the optimal position and port placement during robotic resection for various mediastinal tumors. For anterior mediastinal tumors, total or extended thymectomy is commonly performed in the supine position using the lateral or subxiphoid approach. Although it is unclear which approach is better during robotic thymectomy, technical advantages of subxiphoid approach are beneficial for patients with myasthenia who require extended thymectomy. Partial thymectomy is performed in the supine position using a lateral approach. Superior, middle, and posterior mediastinal tumors are resected in the decubitus position using the lateral approach, whereas dumbbell tumor resection, which requires a posterior approach, can be performed in the prone position. The position and port placement should be chosen depending on the size, location, and aggressiveness of the tumor. In this study, we describe how to choose which of these different robotic approaches can be used based on our experience and previous reports. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2078-2489 13 5 2022 A Proposal of the Fingerprint Optimization Method for the Fingerprint-Based Indoor Localization System with IEEE 802.15.4 Devices 211 EN Yuanzhi Huo Department of Electrical and Communication Engineering, Okayama University Pradini Puspitaningayu Department of Electrical and Communication Engineering, Okayama University Nobuo Funabiki Department of Electrical and Communication Engineering, Okayama University Kazushi Hamazaki Department of Electrical and Communication Engineering, Okayama University Minoru Kuribayashi Department of Electrical and Communication Engineering, Okayama University Kazuyuki Kojima Mechanical Engineering, Shonan Institute of Technology Nowadays, human indoor localization services inside buildings or on underground streets are in strong demand for various location-based services. Since conventional GPS cannot be used, indoor localization systems using wireless technologies have been extensively studied. Previously, we studied a fingerprint-based indoor localization system using IEEE802.15.4 devices, called FILS15.4, to allow use of inexpensive, tiny, and long-life transmitters. However, due to the narrow channel band and the low transmission power, the link quality indicator (LOI) used for fingerprints easily fluctuates by human movements and other uncontrollable factors. To improve the localization accuracy, FILS15.4 restricts the detection granularity to one room in the field, and adopts multiple fingerprints for one room, considering fluctuated signals, where their values must be properly adjusted. In this paper, we present a fingerprint optimization method for finding the proper fingerprint parameters in FILS15.4 by extending the existing one. As the training phase using the measurement LQI, it iteratively changes fingerprint values to maximize the newly defined score function for the room detecting accuracy. Moreover, it automatically increases the number of fingerprints for a room if the accuracy is not sufficient. For evaluations, we applied the proposed method to the measured LQI data using the FILS15.4 testbed system in the no. 2 Engineering Building at Okayama University. The validation results show that it improves the average detection accuracy (at higher than 97%) by automatically increasing the number of fingerprints and optimizing the values. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 0022-4049 226 8 2022 Indecomposable integrally closed modules of arbitrary rank over a two-dimensional regular local ring 107026 EN Futoshi Hayasaka Department of Environmental and Mathematical Sciences, Okayama University In this paper, we construct indecomposable integrally closed modules of arbitrary rank over a two-dimensional regular local ring. The modules are quite explicitly constructed from a given complete monomial ideal. We also give structural and numerical results on integrally closed modules. These are used in the proof of indecomposability of the modules. As a consequence, we have a large class of indecomposable integrally closed modules of arbitrary rank whose ideal is not necessarily simple. This extends the original result on the existence of indecomposable integrally closed modules and strengthens the non-triviality of the theory developed by Kodiyalam. No potential conflict of interest relevant to this article was reported.

Frontiers Media Acta Medica Okayama 1662-5196 15 2022 Counterfactual Explanation of Brain Activity Classifiers Using Image-To-Image Transfer by Generative Adversarial Network 802938 EN Teppei Matsui Department of Biology, Okayama University Masato Taki Graduate School of Artificial Intelligence and Science, Rikkyo University Trung Quang Pham Supportive Center for Brain Research, National Institute for Physiological Sciences Junichi Chikazoe Supportive Center for Brain Research, National Institute for Physiological Sciences Koji Jimura Department of Biosciences and Informatics, Keio University Deep neural networks (DNNs) can accurately decode task-related information from brain activations. However, because of the non-linearity of DNNs, it is generally difficult to explain how and why they assign certain behavioral tasks to given brain activations, either correctly or incorrectly. One of the promising approaches for explaining such a black-box system is counterfactual explanation. In this framework, the behavior of a black-box system is explained by comparing real data and realistic synthetic data that are specifically generated such that the black-box system outputs an unreal outcome. The explanation of the system's decision can be explained by directly comparing the real and synthetic data. Recently, by taking advantage of advances in DNN-based image-to-image translation, several studies successfully applied counterfactual explanation to image domains. In principle, the same approach could be used in functional magnetic resonance imaging (fMRI) data. Because fMRI datasets often contain multiple classes (e.g., multiple behavioral tasks), the image-to-image transformation applicable to counterfactual explanation needs to learn mapping among multiple classes simultaneously. Recently, a new generative neural network (StarGAN) that enables image-to-image transformation among multiple classes has been developed. By adapting StarGAN with some modifications, here, we introduce a novel generative DNN (counterfactual activation generator, CAG) that can provide counterfactual explanations for DNN-based classifiers of brain activations. Importantly, CAG can simultaneously handle image transformation among all the seven classes in a publicly available fMRI dataset. Thus, CAG could provide a counterfactual explanation of DNN-based multiclass classifiers of brain activations. Furthermore, iterative applications of CAG were able to enhance and extract subtle spatial brain activity patterns that affected the classifier's decisions. Together, these results demonstrate that the counterfactual explanation based on image-to-image transformation would be a promising approach to understand and extend the current application of DNNs in fMRI analyses. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 76 2 2022 Retrospective Cohort Study of Clinical Efficacy and Safety of Cefozopran for Treating Febrile Neutropenia during Chemotherapy in Patients with Lung Cancer 167 172 EN Tsukasa Higashionna Department of Pharmacy, Okayama University Hospital Soichiro Ushio Department of Pharmacy, Okayama University Hospital Satoru Esumi Department of Pharmacy, Okayama University Hospital Kiminaka Murakawa Department of Pharmacy, Okayama University Hospital Yoshihisa Kitamura Department of Pharmacy, Okayama University Hospital Toshiaki Sendo Department of Pharmacy, Okayama University Hospital Original Article 10.18926/AMO/63410 Febrile neutropenia (FN) is a serious side effect in patients undergoing cancer chemotherapy and frequently proves fatal. Since infection control is crucial in the management of FN, the antimicrobial agent cefozopran (CZOP) has been recommended but not approved for routine use in clinical care of FN in Japan. However, few studies of CZOP in the management of FN have used a thrice daily dose schedule. The aim of this study was to retrospectively compare the efficacy and safety of CZOP at a dose of 1 g three times daily to those of cefepime (CFPM) in the treatment of FN in our lung cancer patients. The response rates of the CZOP and CFPM groups were 89.5% (17/19 cases) and 83.0% (39/47 cases), respectively, with no significant difference between the two groups. The median duration of antimicrobial treatment was 6 days (4-10 days) in the CZOP group and 7 days (3-13 days) in the CFPM group, with no significant difference between groups. The incidence rates of adverse events were 21.1% (4/19 cases) in the CZOP group and 19.1% (9/47 cases) in the CFPM group. No adverse events of Grade 3 or higher were observed in either group. The findings of the present study suggest that CZOP administration at a dose of 1 g three times per day as an antimicrobial treatment alternative against FN. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 0732-3123 66 2022 Cultural relevance of validation during mathematical modeling and word problem-solving: Reconceptualizing validation as an integration of possible fictional worlds 100934 EN Ippo Ishibashi Okayama University Yusuke Uegatani Hiroshima University High School This study proposes a theoretical view for bridging mathematical modeling and word problem-solving activities. We introduce and elaborate on two theoretical ideas of the fictionality of word problems and the creation of possible fictional worlds. A world described by a word problem exists only fictionally (or potentially). A fictional world includes any imaginable world, any model for the real world, and any mathematical model. We developed a semi-open problem based on these theoretical ideas and observed Japanese eighth-grade students’ activity when solving it in an experimental lesson. Consequently, we identified a theoretically overlooked type of validation: considering the cultural relevance of solutions. The most important implication we draw from our observation is that the current definition of validation as a comparison between two stages in modeling should be extended to consider the integration of a target into a base possible fictional world. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1868-4483 7 2 2016 Thrombolysis with Low-Dose Tissue Plasminogen Activator 3–4.5 h After Acute Ischemic Stroke in Five Hospital Groups in Japan 111 119 EN Ryuta Morihara Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Syoichiro Kono Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kota Sato Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Nozomi Hishikawa Yasuyuki Ohta epartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Toru Yamashita epartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kentaro Deguchi epartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yasuhiro Manabe Okayama National Hospital Medical Center Yoshiki Takao Okayama National Hospital Medical Center Kenichi Kashihara Okayama National Hospital Medical Center Satoshi Inoue Okayama National Hospital Medical Center Hideki Kiriyama Okayama National Hospital Medical Center Koji Abe Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Clinical data from Japan on the safety and real-world outcomes of alteplase (tPA) thrombolysis in the extended therapeutic window are lacking. The aim of this study was to assess the safety and real-world outcomes of tPA administered within 3-4.5 h of stroke onset. The study comprised consecutive acute ischemic stroke patients (n = 177) admitted across five hospitals between September 2012 and August 2014. Patients received intravenous tPA within <3 or 3-4.5 h of stroke onset. Endovascular therapy was used for tPA-refractory patients. In the 3-4.5 h subgroup (31.6 % of patients), tPA was started 85 min later than the <3 h group (220 vs. 135 min, respectively). However, outcome measures were not significantly different between the <3 and 3-4.5 h subgroups for recanalization rate (67.8 vs. 57.1 %), symptomatic intracerebral hemorrhage (2.5 vs. 3.6 %), modified Rankin Scale score of 0-1 at 3 months (36.0 vs. 23.4 %), and mortality (6.9 vs. 8.3 %). We present data from 2005 to 2012 using a therapeutic window <3 h showing comparable results. tPA following endovascular therapy with recanalization might be superior to tPA only with recanalization (81.0 vs. 59.1 %). Compared with administration within 3 h of ischemic stroke onset, tPA administration within 3-4.5 h of ischemic stroke onset in real-world stroke emergency settings at multiple sites in Japan is as safe and has the same outcomes. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 76 1 2022 Rapidly Progressive Stenosis of the Left Main Trunk Ostium Starting 21 Months After Stent Implantation 99 104 EN Yoichiro Naito Department of Cardiovascular Medicine, Fukuyama City Hospital Masaki Yoshikawa Department of Cardiovascular Medicine, Fukuyama City Hospital Kazufumi Nakamura Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Motoki Kubo Department of Cardiovascular Medicine, Fukuyama City Hospital Hiroyasu Sugiyama Department of Cardiovascular Medicine, Fukuyama City Hospital Hideyuki Suzuki Department of Cardiovascular Medicine, Fukuyama City Hospital Shinpei Fujita Department of Cardiovascular Medicine, Fukuyama City Hospital Yasunori Arai Department of Cardiovascular Medicine, Fukuyama City Hospital Sho Takahashi Department of Cardiovascular Medicine, Fukuyama City Hospital Yuichi Kato Department of Cardiovascular Medicine, Fukuyama City Hospital Yu Yoshida Department of Cardiovascular Medicine, Fukuyama City Hospital Hiroaki Akai Department of Cardiovascular Medicine, Fukuyama City Hospital Shuhei Murakami Department of Cardiovascular Medicine, Fukuyama City Hospital Hiroshi Ito Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Case Report 10.18926/AMO/63219 Rapidly progressive in-stent restenosis (ISR) after stent deployment from the left main trunk (LMT) to the left anterior descending artery (LAD) without plaque at the LMT ostium has not been reported. A 60-year-old Japanese man with a history of scleroderma, pulmonary fibrosis, and type 2 diabetes developed acute myocardial infarction of the right coronary artery (RCA) and was treated by emergency percutaneous coronary intervention (PCI) for RCA. Nine days later he underwent PCI from the LMT to the LAD. Follow-up coronary angiography (CAG) at 9 and 21 months post-PCI did not reveal ISR in any lesion, but the patient experienced cardiac arrest at 25 months post-PCI. Emergency CAG after resuscitation revealed ISR of the LMT ostium; emergency PCI was conducted. The development of ISR at the ostium of the LMT although the patient was free of plaque 4 months before is extremely unusual. This rare ISR of the LMT ostium progressed rapidly after follow-up CAG revealed no ISR at 21 months post-stent implantation. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 76 1 2022 Extending Treatment Intervals of R-CHOP Therapy Might Be Acceptable for Some Patients with Non-indolent Non-Hodgkin’s B-cell Lymphoma 17 24 EN Keigo Fujishita Department of Hematology and Blood Transfusion, Kochi Health Sciences Center Sando Yasuhisa Department of Hematology and Blood Transfusion, Kochi Health Sciences Center Satoshi Oka Department of Hematology and Blood Transfusion, Kochi Health Sciences Center Yuka Fujisawa Department of Hematology and Blood Transfusion, Kochi Health Sciences Center Takuya Machida Department of Hematology and Blood Transfusion, Kochi Health Sciences Center Toshi Imai Department of Hematology and Blood Transfusion, Kochi Health Sciences Center Original Article 10.18926/AMO/63204 R-CHOP therapy is generally performed every 3 weeks. We investigated the effects of extending the interval of R-CHOP therapy for > 1 week on the prognoses of patients with non-indolent non-Hodgkin’s B-cell lymphoma. Among the 338 patients with non-indolent non-Hodgkin’s B-cell lymphoma who received initial chemotherapy at our institution, we focused on 178 patients who received R-CHOP therapy and analyzed the outcomes of the patients stratified by the treatment intervals. The estimated 3-year overall survival (OS) for the entire population was 82.1%. Patients treated at intervals of ≥ 4 weeks were significantly older, and they had significantly longer follow-up periods and lower relative dose intensity. But the estimated 3-year OS was comparable to those treated at <4 weeks (83.3% vs. 80.5% p=0.947). In a multivariate analysis, age and the dose of anti-cancer agents had significant impacts on OS, but there was no significant relationship regarding the treatment intervals. Propensity score matching confirmed the same result. R-CHOP therapy every around 4 weeks could achieve relatively good survival in some selected patients with non-indolent non-Hodgkin’s B-cell lymphoma. No potential conflict of interest relevant to this article was reported.

American Physical Society (APS) Acta Medica Okayama 2469-9950 105 3 2022 Magnetotransport studies of the Sb square-net compound LaAgSb2 under high pressure and rotating magnetic fields 035108 EN Kazuto Akiba Graduate School of Natural Science and Technology, Okayama University Nobuaki Umeshita Graduate School of Natural Science and Technology, Okayama University Tatsuo C. Kobayashi Graduate School of Natural Science and Technology, Okayama University Square-net-layered materials have attracted attention as an extended research platform of Dirac fermions and of exotic magnetotransport phenomena. In this study, we investigated the magnetotransport properties of LaAgSb2, which has Sb-square-net layers and shows charge density wave (CDW) transitions at ambient pressure. The application of pressure suppresses the CDWs, and above a pressure of 3.2 GPa a normal metallic phase with no CDWs is realized. By utilizing a mechanical rotator combined with a high-pressure cell, we observed the angular dependence of the Shubnikov–de Haas (SdH) oscillation up to 3.5 GPa, and we confirmed the notable two-dimensional nature of the Fermi surface. In the normal metallic phase, we also observed a remarkable field-angular-dependent magnetoresistance (MR), which exhibited a “butterflylike” polar pattern. To understand these results, we theoretically calculated the Fermi surface and conductivity tensor at the normal metallic phase. We showed that the SdH frequency and Hall coefficient calculated based on the present Fermi surface model agree well with the experiment. The transport properties in the normal metallic phase are mostly dominated by the anisotropic Dirac band, which has the highest conductivity due to linear energy dispersions.We also proposed that momentum-dependent relaxation time plays an important role in the large transverse MR and negative longitudinal MR in the normal metallic phase, which is experimentally supported by the considerable violation of Kohler’s scaling rule. Although quantitatively complete reproduction was not achieved, the calculation showed that the elemental features of the butterfly MR could be reasonably explained as the geometrical effect of the Fermi surface. No potential conflict of interest relevant to this article was reported.

American Chemical Society (ACS) Acta Medica Okayama 2637-6105 4 1 2021 Multilayer Poly(ionic liquid) Microcapsules Prepared by Sequential Phase Separation and Subsequent Photopolymerization in Ternary Emulsion Droplets 348 356 EN Takaichi Watanabe Department of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama University, 3-1-1, Tsushima-naka, Kita-ku, Okayama 700-8530, Japan Yuka Yasuhara Department of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama University, 3-1-1, Tsushima-naka, Kita-ku, Okayama 700-8530, Japan Tsutomu Ono Department of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama University, 3-1-1, Tsushima-naka, Kita-ku, Okayama 700-8530, Japan We report a simple microfluidic process to prepare multilayer poly(ionic liquid)s (PILs) microcapsules via sequential liquid-liquid phase separation within ternary emulsion droplets followed by the photopolymerization of ionic liquid (IL) monomerrich phases. The emulsion droplets, consisting of a hydrophobic IL monomer, water, and　N,N-dimethylformamide (DMF) are first formed in a microfluidic device, and the droplets are then carried by a continuous aqueous phase. Subsequently, DMF diffuses from the droplets into the continuous aqueous phase, resulting in the sequential internal phase separation of the IL-rich and water-rich phases, generating multilayer emulsion droplets comprising alternating IL-rich and water-rich phases. The number of droplet layers was controlled from one to five by varying the initial composition of the dispersed phase. Furthermore, in the conditions where higher-order emulsion droplets were formed, the time scale between the onset of phase separation and the formation of each layer became shorter. Additionally, the IL-rich phases in the multilayer emulsion droplets were easily solidified via photopolymerization, resulting in PILs microcapsules with multilayer structures. Anion exchange of the obtained PILs microcapsules effectuated their transition from a hydrophobic to a hydrophilic nature, resulting in PILs microcapsules with diverse swelling properties and PILs layers permeability across various solvents. We believe that the sequential phase separation system observed in the ternary emulsion droplets can pave the way for the design of PILs-based colloidal materials with thermodynamically non-equilibrium structures, thereby extending their application in functional materials. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 75 6 2021 Clinical Efficacy and Safety of Sitafloxacin 200 mg Once Daily for Refractory Genitourinary Tract Infections 763 766 EN Takehiro Iwata Department of Urology, Okayama University Hospital Takuya Sadahira Department of Urology, Okayama University Hospital Yuki Maruyama Department of Urology, Okayama University Hospital Takanori Sekito Department of Urology, Okayama University Hospital Kasumi Yoshinaga Department of Urology, Okayama University Hospital Shogo Watari Department of Urology, Okayama University Hospital Kentaro Nagao Department of Urology, Okayama University Hospital Tatsushi Kawada Department of Urology, Okayama University Hospital Yusuke Tominaga Department of Urology, Okayama University Hospital Shingo Nishimura Department of Urology, Okayama University Hospital Atsushi Takamoto Department of Urology, Okayama University Hospital Tomoko Sako Department of Urology, Okayama University Hospital Kohei Edamura Department of Urology, Okayama University Hospital Yasuyuki Kobayashi Department of Urology, Okayama University Hospital Motoo Araki Department of Urology, Okayama University Hospital Ayano Ishii Department of Urology, Okayama University Hospital Masami Watanabe Department of Urology, Okayama University Hospital Toyohiko Watanabe Department of Urology, Okayama University Hospital Yasutomo Nasu Department of Urology, Okayama University Hospital Koichiro Wada Department of Urology, Okayama University Hospital Clinical Study Protocol 10.18926/AMO/62820 The aim of this ongoing trial is to evaluate the clinical efficacy and safety of sitafloxacin (STFX) 200 mg once daily (QD) for 7 days in patients with refractory genitourinary tract infections, which include recurrent or complicated cystitis, complicated pyelonephritis, bacterial prostatitis, and epididymitis. The primary endpoint is the microbiological efficacy at 5-9 days after the last administration of STFX. Recruitment began in February 2021, and the target total sample size is 92 participants. No potential conflict of interest relevant to this article was reported.

Department of Mathematics, Faculty of Science, Okayama University Acta Medica Okayama 0030-1566 64 1 2022 Notes on the filtration of the K-theory for abelian p-groups 109 116 EN Nobuaki Yagita Department of Mathematics Faculty of Education Ibaraki University Let p be a prime number. For a given finite group G, let gr^*_&gamma;(BG) be the associated ring of the gamma filtration of the topological K-theory for the classifying space BG. In this paper, we study gr^*_&gamma;(BG) when G are abelian p-groups which are not elementary. In particular, we extend related Chetard’s results for such 2-groups to p-groups for odd p. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 75 5 2021 A Clinical Trial Evaluating the Usefulness of Tailored Antimicrobial Prophylaxis Using Rectal-culture Screening Media Prior to Transrectal Prostate Biopsy: A Multicenter, Randomized Controlled Trial 663 667 EN Takuya Sadahira Department of Urology, Okayama University Hospital Yuki Maruyama Department of Urology, Okayama University Hospital Yoshiki Hiyama Hakodate Goryoukaku Hospital Hiroyuki Kitano Hiroshima University Hospital Hiroki Yamada Jikei University Katsushika Medical Center Takayuki Goto Kyoto University Hospital Tsubasa Kondo Nagasaki University Hospital Katsumi Shigemura Kobe University Hospital Yosuke Mitsui Department of Urology, Okayama University Hospital Takehiro Iwata Department of Urology, Okayama University Hospital Kohei Edamura Department of Urology, Okayama University Hospital Motoo Araki Department of Urology, Okayama University Hospital Masami Watanabe Department of Urology, Okayama University Hospital Tadasu Takenaka Japanese Red Cross Okayama Hospital Jun Teishima Hiroshima University Hospital Yasuyoshi Miyata Nagasaki University Hospital Kiyohito Ishikawa Fujita Health University Hospital Ei-Ichiro Takaoka Internationla University of Health and Welfare Hospital Jun Miyazaki Internationla University of Health and Welfare Hospital Satoshi Takahashi Sapporo Medical University Hospital Naoya Masumori Sapporo Medical University Hospital Hiroshi Kiyota Jikei University Katsushika Medical Center Masato Fujisawa Kobe University Hospital Shingo Yamamoto Hyogo College of Medicine College Hospital Takafumi Sakuma Okayama Medical Center Norihiro Kusumi Okayama Medical Center Takaharu Ichikawa Okayama Medical Center Toyohiko Watanabe Department of Urology, Okayama University Hospital Yoshitsugu Nasu Okayama Rosai Hospital Masaya Tsugawa Okayama City General Medical Center Yasutomo Nasu Department of Urology, Okayama University Hospital Koichiro Wada Department of Urology, Okayama University Hospital Clinical Study Protocol 10.18926/AMO/62782 The aim of this report is to introduce an on-going, multicenter, randomized controlled trial to evaluate whether tailored antimicrobial prophylaxis guided by rectal culture screening prevents acute bacterial prostatitis following transrectal prostate biopsy (TRPB). Patients will be randomized into an intervention or non-intervention group; tazobactam-piperacillin or levofloxacin will be prophylactically administered according to the results of rectal culture prior to TRPB in the intervention group whereas levofloxacin will be routinely given in the non-intervention group. The primary endpoint is the occurrence rate of acute bacterial prostatitis after TRPB. Recruitment begins in April, 2021 and the target total sample size is 5,100 participants. No potential conflict of interest relevant to this article was reported.

Elsevier Inc Acta Medica Okayama 00219258 297 2021 A structural model for (GlcNAc)2 translocation via a periplasmic chitooligosaccharide-binding protein from marine Vibrio bacteria 101071 EN Yoshihito Kitaoku School of Biomolecular Science and Engineering (BSE), Vidyasirimedhi Institute of Science and Technology (VISTEC) Tamo Fukamizo School of Biomolecular Science and Engineering (BSE), Vidyasirimedhi Institute of Science and Technology (VISTEC) Sawitree Kumsaoad School of Biomolecular Science and Engineering (BSE), Vidyasirimedhi Institute of Science and Technology (VISTEC) Prakayfun Ubonbal School of Biomolecular Science and Engineering (BSE), Vidyasirimedhi Institute of Science and Technology (VISTEC) Robert C. Robinson Research Institute for Interdisciplinary Science, Okayama University Wipa Suginta School of Biomolecular Science and Engineering (BSE), Vidyasirimedhi Institute of Science and Technology (VISTEC) VhCBP is a periplasmic chitooligosaccharide-binding protein mainly responsible for translocation of the chitooligosaccharide (GlcNAc)2 across the double membranes of marine bacteria. However, structural and thermodynamic understanding of the sugar-binding/-release processes of VhCBP is relatively less. VhCBP displayed the greatest affinity toward (GlcNAc)2, with lower affinity for longer-chain chitooligosaccharides [(GlcNAc)3–4]. (GlcNAc)4 partially occupied the closed sugar-binding groove, with two reducing-end GlcNAc units extending beyond the sugar-binding groove and barely characterized by weak electron density. Mutation of three conserved residues (Trp363, Asp365, and Trp513) to Ala resulted in drastic decreases in the binding affinity toward the preferred substrate (GlcNAc)2, indicating their significant contributions to sugar binding. The structure of the W513A–(GlcNAc)2 complex in a ‘half-open’ conformation unveiled the intermediary step of the (GlcNAc)2 translocation from the soluble CBP in the periplasm to the inner membrane–transporting components. Isothermal calorimetry data suggested that VhCBP adopts the high-affinity conformation to bind (GlcNAc)2, while its low-affinity conformation facilitated sugar release. Thus, chitooligosaccharide translocation, conferred by periplasmic VhCBP, is a crucial step in the chitin catabolic pathway, allowing Vibrio bacteria to thrive in oceans where chitin is their major source of nutrients. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 1467-7644 2021 Regulation of germination by targeted mutagenesis of grain dormancy genes in barley 1 10 EN Hiroshi Hisano Institute of Plant Science and Resources, Okayama University Robert E. Hoffie Leibniz Institute of Plant Genetics and Crop Plant Research (IPK) Gatersleben Fumitaka Abe Institute of Crop Science, NARO Hiromi Munemori Institute of Plant Science and Resources, Okayama University Takakazu Matsuura Institute of Plant Science and Resources, Okayama University Masaki Endo Institute of Agrobiological Sciences, NARO Masafumi Mikami Institute of Agrobiological Sciences, NARO Shingo Nakamura Institute of Crop Science, NARO Jochen Kumlehn Leibniz Institute of Plant Genetics and Crop Plant Research (IPK) Gatersleben Kazuhiro Sato Institute of Plant Science and Resources, Okayama University High humidity during harvest season often causes pre-harvest sprouting in barley (Hordeum vulgare). Prolonged grain dormancy prevents pre-harvest sprouting; however, extended dormancy can interfere with malt production and uniform germination upon sowing. In this study, we used Cas9-induced targeted mutagenesis to create single and double mutants in QTL FOR SEED DORMANCY 1 (Qsd1) and Qsd2 in the same genetic background. We performed germination assays in independent qsd1 and qsd2 single mutants, as well as in two double mutants, which revealed a strong repression of germination in the mutants. These results demonstrated that normal early grain germination requires both Qsd1 and Qsd2 function. However, germination of qsd1 was promoted by treatment with 3% hydrogen peroxide, supporting the notion that the mutants exhibit delayed germination. Likewise, exposure to cold temperatures largely alleviated the block of germination in the single and double mutants. Notably, qsd1 mutants partially suppress the long dormancy phenotype of qsd2, while qsd2 mutant grains failed to germinate in the light, but not in the dark. Consistent with the delay in germination, abscisic acid accumulated in all mutants relative to the wild type, but abscisic acid levels cannot maintain long-term dormancy and only delay germination. Elucidation of mutant allele interactions, such as those shown in this study, are important for fine-tuning traits that will lead to the design of grain dormancy through combinations of mutant alleles. Thus, these mutants will provide the necessary germplasm to study grain dormancy and germination in barley. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 75 4 2021 Usefulness of Middle Colic Artery Transposition Technique for Hepatic Arterial Reconstruction in Conversion Surgery for an Initially Unresectable, Locally Advanced Pancreatic Cancer 543 548 EN Ryuichi Yoshida Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takahito Yagi Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kazuya Yasui Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yuzo Umeda Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kazuhiro Yoshida Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Tomokazu Fuji Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kosei Takagi Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kenjiro Kumano Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Masashi Yoshimoto Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Toshiyoshi Fujiwara Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Case Report 10.18926/AMO/62410 The outcomes of pancreatectomy with resection and reconstruction of the involved arteries for locally advanced pancreatic cancer following chemotherapy have improved in recent years. In pancreatic head cancers in which there is contact with the common and proper hepatic arteries, margin-negative resection requires pancreati-coduodenectomy, with the resection of these arteries and the restoration of hepatic arterial flow. Here, we describe a middle colic artery transposition technique in hepatic arterial reconstruction during pancreatoduo-denectomy for an initially unresectable locally advanced pancreatic cancer. This technique was effective and may provide a new option for hepatic artery reconstruction in such cases. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1023-3830 2021 Anti-high mobility group box 1 monoclonal antibody suppressed hyper-permeability and cytokine production in human pulmonary endothelial cells infected with influenza A virus EN Takahiro Namba Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Mitsuru Tsuge Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Masato Yashiro Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Yukie Saito Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Keyue Liu Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Masahiro Nishibori Department of Pharmacology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Tsuneo Morishima Department of Pediatrics, Aichi Medical University Hirokazu Tsukahara Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Objective<br> High mobility group box-1 (HMGB1) has been reported to be involved in influenza A virus-induced acute respiratory distress syndrome (ARDS). We studied the efficacy of an anti-HMGB1 mAb using an in vitro model of TNF-α stimulation or influenza A virus infection in human pulmonary microvascular endothelial cells (HMVECs).<br> <br> Methods<br> Vascular permeability of HMVECs was quantified using the Boyden chamber assay under tumor necrosis factor-α (TNF-α) stimulation or influenza A virus infection in the presence of anti-HMGB1 mAb or control mAb. The intracellular localization of HMGB1 was assessed by immunostaining. Extracellular cytokine concentrations and intracellular viral mRNA expression were quantified by the enzyme-linked immunosorbent assay and quantitative reverse transcription PCR, respectively.<br> <br> Results<br> Vascular permeability was increased by TNF-α stimulation or influenza A infection; HMVECs became elongated and the intercellular gaps were extended. Anti-HMGB1 mAb suppressed both the increase in permeability and the cell morphology changes. Translocation of HMGB1 to the cytoplasm was observed in the non-infected cells. Although anti-HMGB1 mAb did not suppress viral replication, it did suppress cytokine production in HMVECs.<br> <br> Conclusion<br> Anti-HMGB1 mAb might be an effective therapy for severe influenza ARDS. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0304-8608 166 2021 A second capsidless hadakavirus strain with 10 positive-sense single-stranded RNA genomic segments from Fusarium nygamai 2711 2722 EN Haris Ahmed Khan Atta-ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST) Yukiyo Sato Institute of Plant Science and Resources, Okayama University Hideki Kondo Institute of Plant Science and Resources, Okayama University Atif Jamal Crop Diseases Research Institute, National Agricultural Research Centre Muhammad Faraz Bhatti Atta-ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST) Nobuhiro Suzuki Institute of Plant Science and Resources, Okayama University A unique capsidless virus with a positive-sense, single-stranded RNA genome (hadakavirus 1, HadV1), a member of the extended picorna-like supergroup, was isolated previously from the phytopathogenic fungus Fusarium oxysporum. Here, we describe the molecular and biological characterisation of a second hadakavirus strain from Fusarium nygamai, which has not been investigated in detail previously as a virus host. This virus, hadakavirus 1 strain 1NL (HadV1-1NL), has features similar to the first hadakavirus, HadV1-7n, despite having a different number of segments (10 for HadV1-1NL vs. 11 for HadV1-7n). The 10 genomic RNA segments of HadV1-1NL range in size from 0.9 kb to 2.5 kb. All HadV1-1NL segments show 67% to 86% local nucleotide sequence identity to their HadV1-7n counterparts, whereas HadV1-1NL has no homolog of HadV1-7n RNA8, which encodes a zinc-finger motif. Another interesting feature is the possible coding incapability of HadV1-1NL RNA10. HadV1-1NL was predicted to be capsidless based on the RNase A susceptibility of its replicative form dsRNA. Phenotypic comparison of multiple virus-infected and virus-free single-spore isolates indicated asymptomatic infection by HadV1-1NL. Less-efficient vertical transmission via spores was observed as the infected fungal colonies from which the spores were derived became older, as was observed for HadV1-7n. This study shows a second example of a hadakavirus that appears to have unusual features. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0942-2056 30 4 2021 Postoperative external tibial rotation is correlated with inferior meniscal healing following pullout repair of a medial meniscus posterior root tear 1491 1498 EN Takaaki Hiranaka Department of Orthopaedic Surgery, Okayama University Hospital Takayuki Furumatsu Department of Orthopaedic Surgery, Okayama University Hospital Yuki Okazaki Department of Orthopaedic Surgery, Kousei Hospital Keisuke Kintaka Department of Orthopaedic Surgery, Okayama University Hospital Yusuke Kamatsuki Department of Orthopaedic Surgery, Kochi Health Sciences Center Ximing Zhang Department of Orthopaedic Surgery, Okayama University Hospital Haowei Xue Department of Orthopaedic Surgery, Okayama University Hospital Toshifumi Ozaki Department of Orthopaedic Surgery, Okayama University Hospital Purpose: The purpose of this study was to evaluate the influence of tibial rotation on the postoperative healing status of the medial meniscus (MM) following pullout repair of MM posterior root tear (MMPRT).<br><br> Methods: Ninety-one patients (68 women and 23 men, mean age: 63.3 ± 8.8 years) who had undergone transtibial pullout repair of MMPRT were enrolled in the study. The tibial external rotation angle (ERA) in each patient was measured postoperatively using computed tomography in the extended knee position. The meniscal healing status following transtibial pullout repair was assessed by second-look arthroscopy (mean postoperative period: 12 months) using a previously published scoring system (range 0–10). The association between ERA and meniscal healing score was investigated using univariate linear regression models. The ERA cut-off for improved meniscal healing score (≥ 7) was determined using receiver-operating characteristic analysis. <br><br> Results: The ERA and meniscal healing score were significantly associated, this confirming increased ERAs to be correlated with worse meniscal healing status (R = -0.28; P < 0.001). The optimum ERA cut-off was 0.69º, with a sensitivity of 65% and a specificity of 66%. The mean meniscal healing score was 7.2 among patients with an ERA of < 0.69º, and 6.1 among patients with an ERA of ≥ 0.69º (P < 0.001). <br><br> Conclusion: This study demonstrated that ERA was significantly correlated with postoperative meniscal healing status. Postoperative tibial rotation could be one of the causes affecting postoperative outcomes of pullout repair of MMPRT. Surgeons should consider some protective strategies for the repaired meniscus in patients with large postoperative tibial external rotation. No potential conflict of interest relevant to this article was reported.

Frontiers Media SA Acta Medica Okayama 1662-5161 15 2021 Exclusion of the Possibility of "False Ripples" From Ripple Band High-Frequency Oscillations Recorded From Scalp Electroencephalogram in Children With Epilepsy 696882 EN Katsuhiro Kobayashi Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University Hospital Takashi Shibata Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University Hospital Hiroki Tsuchiya Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University Hospital Tomoyuki Akiyama Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University Hospital Aim Ripple-band epileptic high-frequency oscillations (HFOs) can be recorded by scalp electroencephalography (EEG), and tend to be associated with epileptic spikes. However, there is a concern that the filtration of steep waveforms such as spikes may cause spurious oscillations or "false ripples." We excluded such possibility from at least some ripples by EEG differentiation, which, in theory, enhances high-frequency signals and does not generate spurious oscillations or ringing. Methods The subjects were 50 pediatric patients, and ten consecutive spikes during sleep were selected for each patient. Five hundred spike data segments were initially reviewed by two experienced electroencephalographers using consensus to identify the presence or absence of ripples in the ordinary filtered EEG and an associated spectral blob in time-frequency analysis (Session A). These EEG data were subjected to numerical differentiation (the second derivative was denoted as EEG ''). The EEG '' trace of each spike data segment was shown to two other electroencephalographers who judged independently whether there were clear ripple oscillations or uncertain ripple oscillations or an absence of oscillations (Session B). Results In Session A, ripples were identified in 57 spike data segments (Group A-R), but not in the other 443 data segments (Group A-N). In Session B, both reviewers identified clear ripples (strict criterion) in 11 spike data segments, all of which were in Group A-R (p < 0.0001 by Fisher's exact test). When the extended criterion that included clear and/or uncertain ripples was used in Session B, both reviewers identified 25 spike data segments that fulfilled the criterion: 24 of these were in Group A-R (p < 0.0001). Discussion We have demonstrated that real ripples over scalp spikes exist in a certain proportion of patients. Ripples that were visualized consistently using both ordinary filters and the EEG '' method should be true, but failure to clarify ripples using the EEG '' method does not mean that true ripples are absent. Conclusion The numerical differentiation of EEG data provides convincing evidence that HFOs were detected in terms of the presence of such unusually fast oscillations over the scalp and the importance of this electrophysiological phenomenon. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0217-4561 39 4 2021 Foreign investment or divestment as a near-term solution to performance shortfalls? The moderating role of vicarious learning 1481 1509 EN Kent Ngan-Cheung Hui School of Management, Xiamen University Yuanyuan Gong Discovery Program for Global Learners, Okayama University Qi Cui Department of Organization and Human Resources, Renmin University Naipeng Jiang Tourism Department, Fudan University Most studies on problemistic search do not pay sufficient attention to how below-aspiration organizations decide what types of strategic actions to use to cope with performance shortfalls. In this study, we examine the preferences of multinational corporations (MNCs) for selecting foreign investment or divestment as a near-term solution to performance shortfalls. We first argue that foreign divestment is generally a more preferred performance solution. Drawing on the literature on vicarious learning, we further argue that MNCs are more likely to engage in foreign investment or foreign divestment to combat large performance shortfalls if peers recently and actively undertook the same type of strategic action. Moreover, they are less likely to undertake the other type of strategic action simultaneously because they adopt the satisficing principle and time constraints deter them from implementing multiple types of strategic action substantially. The analysis of the data about Japanese manufacturing MNCs reveals that vicarious learning influences MNCs’ selection preferences in certain conditions, thereby extending the literature on problemistic search. No potential conflict of interest relevant to this article was reported.

BMC Acta Medica Okayama 1474-760X 22 1 2021 Cellular and transcriptomic analyses reveal two-staged chloroplast biogenesis underpinning photosynthesis build-up in the wheat leaf EN Naresh Loudya Department of Biological Sciences, Royal Holloway University of London Priyanka Mishra Department of Biological Sciences, Royal Holloway University of London Kotaro Takahagi RIKEN Center for Sustainable Resource Science Yukiko Uehara-Yamaguchi RIKEN Center for Sustainable Resource Science Komaki Inoue RIKEN Center for Sustainable Resource Science Laszlo Bogre Department of Biological Sciences, Royal Holloway University of London Keiichi Mochida Institute of Plant Science and Resources, Okayama University Enrique Lopez-Juez Department of Biological Sciences, Royal Holloway University of London Background The developmental gradient in monocot leaves has been exploited to uncover leaf developmental gene expression programs and chloroplast biogenesis processes. However, the relationship between the two is barely understood, which limits the value of transcriptome data to understand the process of chloroplast development. Results Taking advantage of the developmental gradient in the bread wheat leaf, we provide a simultaneous quantitative analysis for the development of mesophyll cells and of chloroplasts as a cellular compartment. This allows us to generate the first biologically-informed gene expression map of this leaf, with the entire developmental gradient from meristematic to fully differentiated cells captured. We show that the first phase of plastid development begins with organelle proliferation, which extends well beyond cell proliferation, and continues with the establishment and then the build-up of the plastid genetic machinery. The second phase is marked by the development of photosynthetic chloroplasts which occupy the available cellular space. Using a network reconstruction algorithm, we predict that known chloroplast gene expression regulators are differentially involved across those developmental stages. Conclusions Our analysis generates both the first wheat leaf transcriptional map and one of the most comprehensive descriptions to date of the developmental history of chloroplasts in higher plants. It reveals functionally distinct plastid and chloroplast development stages, identifies processes occurring in each of them, and highlights our very limited knowledge of the earliest drivers of plastid biogenesis, while providing a basis for their future identification. No potential conflict of interest relevant to this article was reported.

International Institute of Anticancer Research Acta Medica Okayama 0250-7005 41 5 2021 Relevance of CYP3A5 Expression on the Clinical Outcome of Patients With Renal Cell Carcinoma 2511 2521 EN Jun Matsumoto Department of Personalized Medicine and Preventive Healthcare Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yumi Kotera Department of Personalized Medicine and Preventive Healthcare Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shogo Watari Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Koichi Takeuchi Department of Personalized Medicine and Preventive Healthcare Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hideo Ueki Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Toshihiro Koyama Department of Pharmaceuticals Biomedicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Koichiro Wada Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Masachika Fujiyoshi Department of Personalized Medicine and Preventive Healthcare Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yasutomo Nasu Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Noritaka Ariyoshi Department of Personalized Medicine and Preventive Healthcare Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Background/Aim: This study aimed to elucidate the detailed characteristics of CYP3A5 expression and the association between CYP3A5 expression and clinical outcomes in patients with renal cell carcinoma (RCC). Patients and Methods: This study retrospectively enrolled 124 Japanese patients with RCC treated at the Okayama University Hospital. The commonest CYP3A5 gene polymorphism, CYP3A5*3, and expression levels of CYP3A5 mRNA and protein in each tissue were examined. Results: Expression of CYP3A5 mRNA and protein in RCC tissues was significantly down-regulated compared to that in adjacent normal tissues. High level of CYP3A5 mRNA expression significantly extended cancer-specific survival (p=0.004) and overall survival (p=0.002). The CYP3A5 mRNA expression level was identified as a significant independent prognostic factor for both cancer-specific survival and overall survival. Conclusion: CYP3A5 could serve as a potential marker for prognostication and treatment planning for patients with RCC. No potential conflict of interest relevant to this article was reported.

岡山大学理学部地球科学教室 Acta Medica Okayama 1340-7414 27 1 2021 水平成層構造における地中の近地理論地震記象 29 38 EN Hiroshi Takenaka Graduate School of Natural Science and Technology, Okayama University Tomotsugu Watanabe Graduate School of Natural Science and Technology, Okayama University 10.18926/ESR/61956 We extend the computational code of Takenaka and Sasatani (2000) for synthetic nearfield seismograms for horizontally layered elastic media, based on the reflection/transmission matrices and the discrete wavenumber summation method, to calculate seismic motion and its spatial derivatives at a subsurface position in the attenuative media. In this paper we describe the theory of this extension and show some numerical examples to verify the extended code. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 0065-1583 59 1 2020 Immunocytochemical Analysis of α-Tubulin Distribution Before and After Rapid Axopodial Contraction in the Centrohelid Raphidocystis contractilis 1 12 EN Risa Ikeda Laboratory of Cell Physiology, Department of Science Education, Graduate School of Education, Okayama University Miki Kurokawa Laboratory of Cell Physiology, Department of Science Education, Graduate School of Education, Okayama University Momoka Murai Laboratory of Cell Physiology, Department of Science Education, Graduate School of Education, Okayama University Noboru Saito Laboratory of Animal Physiology and Pharmacology, Department of Animal Science, Graduate School of Environmental and Life Science, Okayama University Motonori Ando Laboratory of Cell Physiology, Department of Science Education, Graduate School of Education, Okayama University The centrohelid Raphidocystis contractilis is a heliozoan that has many radiating axopodia, each containing a bundle of microtubules. Although the rapid contraction of the axopodia at nearly a video rate (30 frames/s) is induced by mechanical stimuli, the mechanism underlying this phenomenon in R. contractilis has not yet been elucidated. In the present study, we described for the first time an adequate immunocytochemical fixation procedure for R. contractilis and the cellular distribution of α-tubulin before and after rapid axopodial contraction. We developed a flow-through chamber equipped with a micro-syringe pump that allowed the test solution to be injected at a flow rate below the threshold required to induce rapid axopodial contraction. Next, we used this injection method for evaluating the effects of different combinations of two fixatives (paraformaldehyde or glutaraldehyde) and two buffers (phosphate buffer or PHEM) on the morphological structure of the axopodia. A low concentration of glutaraldehyde in PHEM was identified as an adequate fixative for immunocytochemistry. The distribution of α-tubulin before and after rapid axopodial contraction was examined using immunocytochemistry and confocal laser scanning fluorescence microscopy. Positive signals were initially detected along the extended axopodia from the tips to the bases and were distributed in a non-uniform manner within the axopodia. Conversely, after the induction of a rapid axopodial contraction, these positive signals accumulated in the peripheral region of the cell. These results indicated that axopodial microtubules disassemble into fragments and/ or tubulin subunits during rapid axopodial contraction. Therefore, we hypothesize that the mechanism of extremely rapid axopodial contraction accompanied by cytoskeletal microtubule degradation in R. contractilis involves microtubule-severing at multiple sites. No potential conflict of interest relevant to this article was reported.

American Society for Biochemistry and Molecular Biology Acta Medica Okayama 0021-9258 295 14 2020 In vivo crystals reveal critical features of the interaction between cystic fibrosis transmembrane conductance regulator (CFTR) and the PDZ2 domain of Na+/H+ exchange cofactor NHERF1 4464 4476 EN Eleanor R. Martin School of Biological Sciences, Faculty of Biology Medicine and Health, Michael Smith Building, The University of Manchester Alessandro Barbieri School of Biological Sciences, Faculty of Biology Medicine and Health, Michael Smith Building, The University of Manchester Robert C. Ford School of Biological Sciences, Faculty of Biology Medicine and Health, Michael Smith Building, The University of Manchester Robert C. Robinson Research Institute for Interdisciplinary Science, Okayama University Crystallization of recombinant proteins has been fundamental to our understanding of protein function, dysfunction, and molecular recognition. However, this information has often been gleaned under extremely nonphysiological protein, salt, and H+ concentrations. Here, we describe the development of a robust Inka1-Box (iBox)–PAK4cat system that spontaneously crystallizes in several mammalian cell types. The semi-quantitative assay described here allows the measurement of in vivo protein-protein interactions using a novel GFP-linked reporter system that produces fluorescent readouts from protein crystals. We combined this assay with in vitro X-ray crystallography and molecular dynamics studies to characterize the molecular determinants of the interaction between the PDZ2 domain of Na+/H+ exchange regulatory cofactor NHE-RF1 (NHERF1) and cystic fibrosis transmembrane conductance regulator (CFTR), a protein complex pertinent to the genetic disease cystic fibrosis. These experiments revealed the crystal structure of the extended PDZ domain of NHERF1 and indicated, contrary to what has been previously reported, that residue selection at positions −1 and −3 of the PDZ-binding motif influences the affinity and specificity of the NHERF1 PDZ2-CFTR interaction. Our results suggest that this system could be utilized to screen additional protein-protein interactions, provided they can be accommodated within the spacious iBox-PAK4cat lattice. No potential conflict of interest relevant to this article was reported.

Physical Society of Japan Acta Medica Okayama 0031-9015 89 1 2019 Sparse Modeling in Quantum Many-Body Problems 012001 EN Junya Otsuki Research Institute for Interdisciplinary Science, Okayama University Masayuki Ohzeki Graduate School of Information Sciences, Tohoku University Hiroshi Shinaoka Department of Physics, Saitama University Kazuyoshi Yoshimi 4Institute for Solid State Physics, University of Tokyo This review paper describes the basic concept and technical details of sparse modeling and its applications to quantum many-body problems. Sparse modeling refers to methodologies for finding a small number of relevant parameters that well explain a given dataset. This concept reminds us physics, where the goal is to find a small number of physical laws that are hidden behind complicated phenomena. Sparse modeling extends the target of physics from natural phenomena to data, and may be interpreted as “physics for data”. The first half of this review introduces sparse modeling for physicists. It is assumed that readers have physics background but no expertise in data science. The second half reviews applications. Matsubara Green’s function, which plays a central role in descriptions of correlated systems, has been found to be sparse, meaning that it contains little information. This leads to (i) a new method for solving the ill-conditioned inverse problem for analytical continuation, and (ii) a highly compact representation of Matsubara Green’s function, which enables efficient calculations for quantum many-body systems. No potential conflict of interest relevant to this article was reported.

ELSEVIER SCI LTD Acta Medica Okayama 1882-7616 56 1 2020 Evaluation of dental caries, tooth crack, and age-related changes in tooth structure using optical coherence tomography 109 118 EN Yasushi Shimada Department of Operative Dentistry, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Masahiro Yoshiyama Department of Operative Dentistry, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Junji Tagami Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University Yasunori Sumi Department for Advanced Dental Research, Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology Optical coherence tomography (OCT) is an imaging technique that can visualize the internal biological structure without X-ray exposure. Swept-source OCT (SS-OCT) is one of the latest version of OCT, wherein the light source is a tunable laser that sweeps near-infrared wavelength light to achieve real-time imaging. The imaging depth of OCT is highly influenced by the translucency of the medium. The medium that does not transmit light and the deeper structure beyond the range of light penetration depth are not relevant for OCT imaging. In OCT, sound enamel is almost transparent at the OCT wavelength range, and enamel and dentin can be distinguished from each other as the dentin-enamel junction (DEJ) appears as a dark border. Demineralized enamel and dentin are imaged as bright zones because of the formation of numerous micro-porosities where the backscatter of OCT signal is increased. In cavitated caries at interproximal or occlusal hidden zone, the upper margin of the cavity reflects the signal showing a distinct bright border in the SS-OCT image. SS-OCT is capable of determining crack penetration depth even when the cracks extended beyond the DEJ. SS-OCT has a high degree of sensitivity and specificity for the detection of dental caries and tooth cracks. SS-OCT is also capable of detecting non-carious cervical lesions and occlusal tooth wear in cross-sectional views to estimate the amount of tooth structure loss. No potential conflict of interest relevant to this article was reported.

BMC Acta Medica Okayama 1471-2482 20 1 2020 Hemobilia after bile duct resection: perforation of pseudoaneurysm into intra-pancreatic remnant bile duct: a case report 307 EN Kazuhiro Yoshida Department of Gastroenterological Surgery and Surgical Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yuzo Umeda Department of Gastroenterological Surgery and Surgical Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Masaya Iwamuro Gastroenterology and Hepatology Department, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kazuyuki Matsumoto Gastroenterology and Hepatology Department, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hironari Kato Gastroenterology and Hepatology Department, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Mayu Uka Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yusuke Matsui Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Ryuichi Yoshida Department of Gastroenterological Surgery and Surgical Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takashi Kuise Department of Gastroenterological Surgery and Surgical Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kazuya Yasui Department of Gastroenterological Surgery and Surgical Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kosei Takagi Department of Gastroenterological Surgery and Surgical Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hiroyuki Araki Department of Gastroenterological Surgery and Surgical Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takahito Yagi Department of Gastroenterological Surgery and Surgical Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Toshiyoshi Fujiwara Department of Gastroenterological Surgery and Surgical Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Background</br> Hemobilia occurs mainly due to iatrogenic factors such as impairment of the right hepatic or cystic artery, and/or common bile duct in hepatobiliary-pancreatic surgery. However, little or no cases with hemobilia from the intra-pancreatic remnant bile duct after bile duct resection (BDR) has been reported. Here, we report a case of massive hemobilia due to the perforation of psuedoaneurysm of the gastroduodenal artery (GDA) to the intra-pancreatic remnant bile duct after hepatectomy with BDR.</br> Case presentation</br> A 68-year-old male underwent extended right hepatectomy with BDR for gallbladder carcinoma. He presented with upper gastrointestinal bleeding 2 months after the initial surgery. Upper endoscopy identified a blood clot from the ampulla of Vater and simultaneous endoscopic balloon tamponade contributed to temporary hemostasis. Abdominal CT and angiography revealed a perforation of the psuedoaneurysm of the GDA to the intra-pancreatic remnant bile duct resulting in massive hemobilia. Subsequent selective embolization of the pseudoaneurysm with micro-coils could achieve complete hemostasis. He survived without any recurrence of cancer and bleeding.</br> Conclusion</br> Hemobilia could occur in a patient with BDR due to perforation of the pseudoaneurysm derived from the GDA to the intra-pancreatic remnant bile duct. Endoscopic balloon tamponade was useful for a temporal hemostasis and a subsequent radiologic interventional approach. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 1882-7616 56 1 2020 Evaluation of dental caries, tooth crack, and age-related changes in tooth structure using optical coherence tomography 109 118 EN Yasushi Shimada Department of Operative Dentistry, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Masahiro Yoshiyama Department of Operative Dentistry, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Junji Tagami Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University Yasunori Sumi Department for Advanced Dental Research, Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology Optical coherence tomography (OCT) is an imaging technique that can visualize the internal biological structure without X-ray exposure. Swept-source OCT (SS-OCT) is one of the latest version of OCT, wherein the light source is a tunable laser that sweeps near-infrared wavelength light to achieve real-time imaging. The imaging depth of OCT is highly influenced by the translucency of the medium. The medium that does not transmit light and the deeper structure beyond the range of light penetration depth are not relevant for OCT imaging. In OCT, sound enamel is almost transparent at the OCT wavelength range, and enamel and dentin can be distinguished from each other as the dentin–enamel junction (DEJ) appears as a dark border. Demineralized enamel and dentin are imaged as bright zones because of the formation of numerous micro-porosities where the backscatter of OCT signal is increased. In cavitated caries at interproximal or occlusal hidden zone, the upper margin of the cavity reflects the signal showing a distinct bright border in the SS-OCT image. SS-OCT is capable of determining crack penetration depth even when the cracks extended beyond the DEJ. SS-OCT has a high degree of sensitivity and specificity for the detection of dental caries and tooth cracks. SS-OCT is also capable of detecting non-carious cervical lesions and occlusal tooth wear in cross-sectional views to estimate the amount of tooth structure loss. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 1996-1944 13 21 2020 Effect of Honeycomb β-TCP Geometrical Structure on Bone Tissue Regeneration in Skull Defect 4761 EN Toshiyuki Watanabe Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kiyofumi Takabatake Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hidetsugu Tsujigiwa Department of Life Science, Faculty of Science, Okayama University Science Satoko Watanabe Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Ryoko Nakagiri Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Keisuke Nakano Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hitoshi Nagatsuka Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yoshihiro Kimata Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University The effect of the geometric structure of artificial biomaterials on skull regeneration remains unclear. In a previous study, we succeeded in developing honeycomb beta-tricalcium phosphate (beta-TCP), which has through-and-through holes and is able to provide the optimum bone microenvironment for bone tissue regeneration. We demonstrated that beta-TCP with 300-mu m hole diameters induced vigorous bone formation. In the present study, we investigated how differences in hole directions of honeycomb beta-TCP (horizontal or vertical holes) influence bone tissue regeneration in skull defects. Honeycomb beta-TCP with vertical and horizontal holes was loaded with BMP-2 using Matrigel and Collagen gel as carriers, and transplanted into skull bone defect model rats. The results showed that in each four groups (Collagen alone group, Matrigel alone group, Collagen + BMP group and Matrigel + BMP-2), vigorous bone formation was observed on the vertical beta-TCP compared with horizontal beta-TCP. The osteogenic area was larger in the Matrigel groups (with and without BMP-2) than in the Collagen group (with and without BMP-2) in both vertical beta-TCP and horizontal beta-TCP. However, when BMP-2 was added, the bone formation area was not significantly different between the Collagen group and the Matrigel group in the vertical beta-TCP. Histological finding showed that, in vertical honeycomb beta-TCP, new bone formation extended to the upper part of the holes and was observed from the dura side to the periosteum side as added to the inner walls of the holes. Therefore, we can control efficient bone formation by creating a bone microenvironment provided by vertical honeycomb beta-TCP. Vertical honeycomb beta-TCP has the potential to be an excellent biomaterial for bone tissue regeneration in skull defects and is expected to have clinical applications. No potential conflict of interest relevant to this article was reported.

Department of Mathematics, Faculty of Science, Okayama University Acta Medica Okayama 0030-1566 63 1 2021 A note on products in stable homotopy groups of spheres via the classical Adams spectral sequence 107 122 EN Ryo Kato Faculty of Fundamental Science, National Institute of Technology, Niihama College katsumi Shimomura Department of Mathematics, faculty of Science and Technology, Kochi University In recent years, Liu and his collaborators found many non-trivial products of generators in the homotopy groups of the sphere spectrum. In this paper, we show a result which not only implies most of their results, but also extends a result of theirs. No potential conflict of interest relevant to this article was reported.

岡山大学経済学会 Acta Medica Okayama 2433-4146 52 2 2020 垂直統合企業の中間財価格決定と戦略的な経営権委任：池間カーブの応用 1 11 EN 10.18926/OER/60792 　Once a fi rm is vertically integrated, it is well-known that such a firm has an incentive to delegate quantity decision to its downstream affiliate to increase its total profits by manipulating its input price. This kind of analysis has been analytically done but this note applies Ikema's diagrammatic demonstration to the model with a vertically integrated fi rm to show how to derive the market equilibrium in "quantity-price" plane diagrammatically. First, we derive the locus that firms' optimal supplies at any price level, which is called "Cournot-Ikema curve" and derive the equilibrium point which is identifi ed with the intersection of a demand curve and the Cournot-Ikema curve. This paper fi nds that strategic delegation rotates the curve clockwise with a fixed point at a price level equal to marginal cost. Finally, our model is extended to the case that a multinational enterprise manipulates transfer price, and shows that such a tax motivated transfer price further rotates the curve. No potential conflict of interest relevant to this article was reported.

American Institute of Physics Acta Medica Okayama 0021-9606 153 11 2020 Structure and phase behavior of high-density ice from molecular-dynamics simulations with the ReaxFF potential 114501 EN Yuji Adachi Graduate School of Natural Sciences, Okayama University Kenichiro Koga 2Department of Chemistry, Okayama University We report a molecular dynamics simulation study of dense ice modeled by the reactive force field (ReaxFF) potential, focusing on the possibility of phase changes between crystalline and plastic phases as observed in earlier simulation studies with rigid water models. It is demonstrated that the present model system exhibits phase transitions, or crossovers, among ice VII and two plastic ices with face-centered cubic (fcc) and body-centered cubic (bcc) lattice structures. The phase diagram derived from the ReaxFF potential is different from those of the rigid water models in that the bcc plastic phase lies on the high-pressure side of ice VII and does the fcc plastic phase on the low-pressure side of ice VII. The phase boundary between the fcc and bcc plastic phases on the pressure, temperature plane extends to the high-temperature region from the triple point of ice VII, fcc plastic, and bcc plastic phases. Proton hopping, i.e., delocalization of a proton, along between two neighboring oxygen atoms in dense ice is observed for the ReaxFF potential but only at pressures and temperatures both much higher than those at which ice VII–plastic ice transitions are observed. No potential conflict of interest relevant to this article was reported.

American Society for Microbiology Acta Medica Okayama 2150-7511 11 3 2020 Hadaka Virus 1: a Capsidless Eleven-Segmented Positive-Sense Single-Stranded RNA Virus from a Phytopathogenic Fungus, Fusarium oxysporum e00450-20 EN Yukiyo Sato Institute of Plant Science and Resources, Okayama University Wajeeha Shamsi Institute of Plant Science and Resources, Okayama University Atif Jamal Crop Diseases Research Institute, National Agricultural Research Centre Muhammad Faraz Bhatti Atta-ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST) Hideki Kondo Institute of Plant Science and Resources, Okayama University Nobuhiro Suzuki Institute of Plant Science and Resources, Okayama University The search for viruses infecting fungi, or mycoviruses, has extended our knowledge about the diversity of RNA viruses, as exemplified by the discovery of polymycoviruses, a phylogenetic group of multisegmented RNA viruses with unusual forms. The genomic RNAs of known polymycoviruses, which show a phylogenetic affinity for animal positive-sense single-stranded RNA [(+)RNA] viruses such as caliciviruses, are comprised of four conserved segments with an additional zero to four segments. The double-stranded form of polymycovirus genomic RNA is assumed to be associated with a virally encoded protein (proline-alanine-serine-rich protein [PASrp]) in either of two manners: a capsidless colloidal form or a filamentous encapsidated form. Detailed molecular characterizations of polymycoviruses, however, have been conducted for only a few strains. Here, a novel polymyco-related virus named Hadaka virus 1 (HadV1), from the phytopathogenic fungus Fusarium oxysporum, was characterized. The genomic RNA of HadV1 consisted of an 11-segmented positive-sense RNA with highly conserved terminal nucleotide sequences. HadV1 shared the three conserved segments with known polymycoviruses but lacked the PASrp-encoding segment. Unlike the known polymycoviruses and encapsidated viruses, HadV1 was not pelleted by conventional ultracentrifugation, possibly due to the lack of PASrp. This result implied that HadV1 exists only as a soluble form with naked RNA. Nevertheless, the 11 genomic segments of HadV1 have been stably maintained through host subculturing and conidiation. Taken together, the results of this study revealed a virus with a potential novel virus lifestyle, carrying many genomic segments without typical capsids or PASrp-associated forms. IMPORTANCE Fungi collectively host various RNA viruses. Examples include encapsidated double-stranded RNA (dsRNA) viruses with diverse numbers of genomic segments (from 1 to 12) and capsidless viruses with nonsegmented (+)RNA genomes. Recently, viruses with unusual intermediate features of an infectious entity between encapsidated dsRNA viruses and capsidless (+)RNA viruses were found. They are called polymycoviruses, which typically have four to eight dsRNA genomic segments associated with one of the virus-encoded proteins and are phylogenetically distantly related to animal (+)RNA caliciviruses. Here, we identified a novel virus phylogenetically related to polymycoviruses, from the phytopathogenic fungus Fusarium oxysporum. The virus, termed Hadaka virus 1 (HadV1), has 11 (+)RNA genomic segments, the largest number in known (+)RNA viruses. Nevertheless, HadV1 lacked a typical structural protein of polymycoviruses and was not pelleted by standard ultracentrifugation, implying an unusual capsidless nature of HadV1. This study reveals a potential novel lifestyle of multisegmented RNA viruses. No potential conflict of interest relevant to this article was reported.

Springer Acta Medica Okayama 0941-1291 50 8 2020 Pulmonary aspergillosis as a late complication after surgery for locally advanced non-small cell lung cancer treated with induction chemoradiotherapy 863 871 EN Seiichiro Sugimoto Department of General Thoracic Surgery, Okayama University Hospital Junichi Soh Department of General Thoracic Surgery, Okayama University Hospital Ken Suzawa Department of General Thoracic Surgery, Okayama University Hospital Kentaroh Miyoshi Department of General Thoracic Surgery, Okayama University Hospital Shinji Otani Department of General Thoracic Surgery, Okayama University Hospital Hiromasa Yamamoto Department of General Thoracic Surgery, Okayama University Hospital Mikio Okazaki Department of General Thoracic Surgery, Okayama University Hospital Masaomi Yamane Department of General Thoracic Surgery, Okayama University Hospital Takahiro Oto Department of General Thoracic Surgery, Okayama University Hospital Susumu Kanazawa Department of Radiology, Okayama University Hospital Katsuyuki Kiura Department of Respiratory Medicine, Okayama University Hospital Shinichi Toyooka Department of General Thoracic Surgery, Okayama University Hospital Purpose</br> Some long-term survivors after surgery for locally advanced non-small cell lung cancer (NSCLC) treated with induction chemoradiotherapy (trimodality treatment) develop chronic pulmonary aspergillosis (CPA). The aim of our study was to assess the characteristics and outcomes of CPA that develops after trimodality treatment. Methods</br> We retrospectively reviewed the data of 187 NSCLC patients who underwent trimodality treatment between 1999 and 2018.</br> Results</br> Six male ever-smoker patients developed CPA. All 6 patients had undergone extended resection for NSCLC and had a history of either adjuvant chemotherapy (n = 3) or radiation pneumonitis (n = 4). Among the 4 patients with CPA localized in a single lung, 3 patients were treated surgically (completion pneumonectomy or cavernostomy) and 1 patient was treated with antifungal therapy alone. Both treatments led to the improved control of CPA. In contrast, patients with CPA in both lungs were not candidates for surgery, and died of CPA. The survival rates after trimodality treatment in the CPA group and the group without CPA were comparable (10-year survival rate, 50.0% vs. 57.6%, P = 0.59).</br> Conclusion</br> The early diagnosis of CPA localized in a single lung after NSCLC surgery is critical to improving control and survival in patients with CPA. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 1661-6596 21 12 2020 The Effects of Mutual Interaction of Orexin-A and Glucagon-Like Peptide-1 on Reflex Swallowing Induced by SLN Afferents in Rats 4422 EN Motoi Kobashi Department of Oral Physiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yuichi Shimatani Department of Medical Engineering, Faculty of Science and Engineering, Tokyo City University Masako Fujita Department of Oral Physiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yoshihiro Mitoh Department of Oral Physiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Ryusuke Yoshida Department of Oral Physiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Ryuji Matsuo Department of Oral Physiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences (1) Background: Our previous studies revealed that orexin-A, an appetite-increasing peptide, suppressed reflex swallowing via the commissural part of the nucleus tractus solitarius (cNTS), and that glucagon-like peptide-1 (GLP-1), an appetite-reducing peptide, also suppressed reflex swallowing via the medial nucleus of the NTS (mNTS). In this study, we examined the mutual interaction between orexin-A and GLP-1 in reflex swallowing. (2) Methods: Sprague-Dawley rats under urethane-chloralose anesthesia were used. Swallowing was induced by electrical stimulation of the superior laryngeal nerve (SLN) and was identified by the electromyographic (EMG) signals obtained from the mylohyoid muscle. (3) Results: The injection of GLP-1 (20 pmol) into the mNTS reduced the swallowing frequency and extended the latency of the first swallow. These suppressive effects of GLP-1 were not observed after the fourth ventricular administration of orexin-A. After the injection of an orexin-1 receptor antagonist (SB334867) into the cNTS, an ineffective dose of GLP-1 (6 pmol) into the mNTS suppressed reflex swallowing. Similarly, the suppressive effects of orexin-A (1 nmol) were not observed after the injection of GLP-1 (6 pmol) into the mNTS. After the administration of a GLP-1 receptor antagonist (exendin-4(5-39)), an ineffective dose of orexin-A (0.3 nmol) suppressed reflex swallowing. (4) Conclusions: The presence of reciprocal inhibitory connections between GLP-1 receptive neurons and orexin-A receptive neurons in the NTS was strongly suggested. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 0288-4534 36 2019 Direct Measurement of Interaction Forces between Surfaces in Liquids Using Atomic Force Microscopy 187 200 EN Naoyuki Ishida Graduate School of Natural Science and Technology, Okayama University Vincent S. J. Craig Department of Applied Mathematics, RSPE, Australian National University The stability of particle suspensions, which is important in numerous industrial processes, is generally dominated by the interaction forces between the suspended particles. Understanding the interaction forces between surfaces in liquids is therefore fundamentally important in order to evaluate and control how particulates, including fluid droplets in emulsions and air bubbles in foams, behave in various systems. The invention of the surface force apparatus (SFA) enabled the direct measurement of interaction forces in liquids with molecular level resolution and it has led to remarkable progress in understanding surface forces in detail. Following the SFA, the application of atomic force microscopy (AFM) to force measurement has further extended the possibility of force measurements to a broad field of research, mainly due to the range of materials that can be employed. This review provides an overview of developments in the investigation of interaction forces between surfaces using AFM. The properties of various interaction forces, important in particle technology, revealed by the studies using AFM are described in detail. No potential conflict of interest relevant to this article was reported.

Cell Press Acta Medica Okayama 25890042 23 4 2020 Cytotoxic T Lymphocytes Regenerated from iPS Cells Have Therapeutic Efficacy in a Patient-Derived Xenograft Solid Tumor Model 100998 EN Soki Kashima Laboratory of Immunology, Institute for Frontier Life and Medical Sciences, Kyoto University Takuya Maeda Laboratory of Immunology, Institute for Frontier Life and Medical Sciences, Kyoto University Kyoko Masuda Laboratory of Immunology, Institute for Frontier Life and Medical Sciences, Kyoto University Seiji Nagano Laboratory of Immunology, Institute for Frontier Life and Medical Sciences, Kyoto University Takamitsu Inoue Department of Urology, Akita University Graduate School of Medicine Masashi Takeda Department of Urology, Kyoto University Graduate School of Medicine Yuka Kono Laboratory of Immunology, Institute for Frontier Life and Medical Sciences, Kyoto University Takashi Kobayashi Department of Urology, Kyoto University Graduate School of Medicine Shigeyoshi Saito Department of Medical Physics and Engineering, Division of Health Sciences, Osaka University Takahiro Higuchi Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine Hiroshi Ichise Laboratory of Immunology, Institute for Frontier Life and Medical Sciences, Kyoto University Yuka Kobayashi Laboratory of Immunology, Institute for Frontier Life and Medical Sciences, Kyoto University Keiko Iwaisako Department of Medical Life Systems, Faculty of Life and Medical Sciences, Doshisha University Koji Terada Department of Biochemistry and Molecular Biology, Shiga University of Medical School Yasutoshi Agata Department of Biochemistry and Molecular Biology, Shiga University of Medical School Kazuyuki Numakura Department of Urology, Akita University Graduate School of Medicine Mitsuru Saito Department of Urology, Akita University Graduate School of Medicine Shintaro Narita Department of Urology, Akita University Graduate School of Medicine Masaki Yasukawa Department of Hematology, Clinical Immunology and Infectious Diseases, Graduate School of Medicine, Ehime University Osamu Ogawa Department of Urology, Kyoto University Graduate School of Medicine Tomonori Habuchi Department of Urology, Akita University Graduate School of Medicine Hiroshi Kawamoto Laboratory of Immunology, Institute for Frontier Life and Medical Sciences, Kyoto University Current adoptive T cell therapies conducted in an autologous setting are costly, time consuming, and depend on the quality of the patient's T cells. To address these issues, we developed a strategy in which cytotoxic T lymphocytes (CTLs) are regenerated from iPSCs that were originally derived from T cells and succeeded in regenerating CTLs specific for the WT1 antigen, which exhibited therapeutic efficacy in a xenograft model of leukemia. In this study, we extended our strategy to solid tumors. The regenerated WT1-specific CTLs had a strong therapeutic effect in orthotopic xenograft model using a renal cell carcinoma (RCC) cell line. To make our method more generally applicable, we developed an allogeneic approach by transducing HLA-haplotype homozygous iPSCs with WT1-specific TCR α/β genes that had been tested clinically. The regenerated CTLs antigen-specifically suppressed tumor growth in a patient-derived xenograft model of RCC, demonstrating the feasibility of our strategy against solid tumors. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 09445013 223-225 2019 Quorum-dependent expression of rsmX and rsmY, small non-coding RNAs, in Pseudomonas syringae 72 78 EN Yukiko Nakatsu Graduate School of Environmental and Life Science, Okayama University Hidenori Matsui Graduate School of Environmental and Life Science, Okayama University Mikihiro Yamamoto Graduate School of Environmental and Life Science, Okayama University Yoshiteru Noutoshi Graduate School of Environmental and Life Science, Okayama University Kazuhiro Toyoda Graduate School of Environmental and Life Science, Okayama University Yuki Ichinose Graduate School of Environmental and Life Science, Okayama University Pseudomonas syringae pathovars are known to produce N-acyl-homoserine lactones (AHL) as quorum-sensing molecules. However, many isolates, including P. syringae pv. tomato DC3000 (PtoDC3000), do not produce them. In P. syringae, psyI, which encodes an AHL synthase, and psyR, which encodes the transcription factor PsyR required for activation of psyI, are convergently transcribed. In P. amygdali pv. tabaci 6605 (Pta6605), there is one nucleotide between the stop codons of both psyI and psyR. However, the canonical stop codon for psyI in PtoDC3000 was converted to the cysteine codon by one nucleotide deletion, and 23 additional amino acids extended it to a C-terminal end. This resulted in overlapping of the open reading frame (ORF) for psyI and psyR. On the other hand, stop codons in the psyR ORF of P. syringae 7 isolates, including pv. phaseolicola and pv. glycinea, were found. These results indicate that many pathovars of P. syringae have genetically lost AHL production ability by the mutation of their responsible genes. To examine whether PtoDC3000 modulates the gene expression profile in a population-dependent manner, we carried out microarray analysis using RNAs prepared from low- and high-density cells. We found the expressions of rsmX and rsmY remarkably activated in high-density cells. The activated expressions of rsmX and rsmY were confirmed by Northern blot hybridization, but these expressions were abolished in a ΔgacA mutant of Pta6605. These results indicate that regardless of the ability to produce AHL, P. syringae regulates expression of the small noncoding RNAs rsmX/Y by currently unknown quorum-sensing molecules. No potential conflict of interest relevant to this article was reported.

American Chemical Society Acta Medica Okayama 0006-2960 59 3 2019 The Unlimited Potential of Microbial Rhodopsins as Optical Tools 218 229 EN Keiichi Kojima Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Atsushi Shibukawa Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Yuki Sudo Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Microbial rhodopsins, a photoactive membrane protein family, serve as fundamental tools for optogenetics, an innovative technology for controlling biological activities with light. Microbial rhodopsins are widely distributed in nature and have a wide variety of biological functions. Regardless of the many different known types of microbial rhodopsins, only a few of them have been used in optogenetics to control neural activity to understand neural networks. The efforts of our group have been aimed at identifying and characterizing novel rhodopsins from nature and also at engineering novel variant rhodopsins by rational design. On the basis of the molecular and functional characteristics of those novel rhodopsins, we have proposed new rhodopsin-based optogenetics tools to control not only neural activities but also "non-neural" activities. In this Perspective, we introduce the achievements and summarize future challenges in creating optogenetics tools using rhodopsins. The implementation of optogenetics deep inside an in vivo brain is the well-known challenge for existing rhodopsins. As a perspective to address this challenge, we introduce innovative optical illumination techniques using wavefront shaping that can reinforce the low light sensitivity of the rhodopsins and realize deep-brain optogenetics. The applications of our optogenetics tools could be extended to manipulate non-neural biological activities such as gene expression, apoptosis, energy production, and muscle contraction. We also discuss the potentially unlimited biotechnological applications of microbial rhodopsins in the future such as in photovoltaic devices and in drug delivery systems. We believe that advances in the field will greatly expand the potential uses of microbial rhodopsins as optical tools. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 2405-8440 5 8 2019 Stroking hardness changes the perception of affective touch pleasantness across different skin sites e02141 EN Jiabin Yu Cognitive Neuroscience Laboratory, Graduate School of Natural Science and Technology, Okayama University Jiajia Yang Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary, Science and Engineering in Health Systems, Okayama University Yinghua Yu Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary, Science and Engineering in Health Systems, Okayama University Qiong Wu Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary, Science and Engineering in Health Systems, Okayama University Satoshi Takahashi Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary, Science and Engineering in Health Systems, Okayama University Yoshimichi Ejima Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary, Science and Engineering in Health Systems, Okayama University Jinglong Wu Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary, Science and Engineering in Health Systems, Okayama University Human unmyelinated tactile afferents (CT afferents) in hairy skin are thought to be involved in the transmission of affective aspects of touch. How the perception of affective touch differs across human skin has made substantial progress; however, the majority of previous studies have mainly focused on the relationship between stroking velocities and pleasantness ratings. Here, we investigate how stroking hardness affects the perception of affective touch. Affective tactile stimulation was given with four different hardness of brushes a three different forces, which were presented to either palm or forearm. To quantify the physical factors of the stimuli (brush hardness), ten naive, healthy participants assessed brush hardness using a seven-point scale. Based on these ten participants, five more participants were added to rate the hedonic value of brush stroking using a visual analogue scale (VAS). We found that pleasantness ratings over the skin resulted in a preference for light, soft stroking, which was rated as more pleasant when compared to heavy, hard stroking. Our results show that the hairy skin of the forearm is more susceptible to stroking hardness than the glabrous of the palm in terms of the perception of pleasantness. These findings of the current study extend the growing literature related to the effect of stroking characteristics on pleasantness ratings. No potential conflict of interest relevant to this article was reported.

Springer Acta Medica Okayama 0941-1291 49 3 2018 Feasibility of lung transplantation from donors mechanically ventilated for prolonged periods 254 260 EN Seiichiro Sugimoto Department of General Thoracic SurgeryOkayama University Hospital Takeshi Kurosaki Department of Organ Transplant CenterOkayama University Hospital Shinji Otani Department of Organ Transplant CenterOkayama University Hospital Shin Tanaka Department of General Thoracic SurgeryOkayama University Hospital Yukiko Hikasa Department of Anesthesiology and ResuscitologyOkayama University Hospital Masaomi Yamane Department of General Thoracic SurgeryOkayama University Hospital Shinichi Toyooka Department of General Thoracic SurgeryOkayama University Hospital Motomu Kobayashi Department of Anesthesiology and ResuscitologyOkayama University Hospital Takahiro Oto Department of Organ Transplant CenterOkayama University Hospital PURPOSE:<br/> When patients are mechanically ventilated for more than 5 days, they are usually declined as donors for lung transplantation (LTx); thus, the long-term outcomes of LTx from such donors remain unclear. We investigated the feasibility of LTx from donors that had been mechanically ventilated for prolonged periods.<br/> METHODS:<br/> The subjects of this retrospective comparative investigation were 31 recipients of LTx from donors who had been mechanically ventilated for < 5 days (short-term group) and 50 recipients of LTx from donors who had been mechanically ventilated for ≥ 5 days (long-term group).<br/> RESULTS:<br/> The median duration of donor mechanical ventilation was 3 days in the short-term group and 8.5 days in the long-term group. However, other than the difference in the duration of donor ventilation, there were no significant differences in the clinical characteristics of the donors or recipients between the groups. The overall survival rate after LTx was comparable between the long-term group and short-term group (5-year survival rate, 66.6% vs. 75.2%).<br/> CONCLUSION:<br/> The potential inclusion of donors who have been on mechanical ventilation for more than 5 days could be a feasible strategy to alleviate donor organ shortage. No potential conflict of interest relevant to this article was reported.

Nature Publishing Group Acta Medica Okayama 2045-2322 9 2019 Imaging Amyloplasts in the Developing Endosperm of Barley and Rice 3745 EN Ryo Matsushima Institute of Plant Science and Resources, Okayama University Hiroshi Hisano Institute of Plant Science and Resources, Okayama University Amyloplasts are plant-specific organelles responsible for starch biosynthesis and storage. Inside amyloplasts, starch forms insoluble particles, referred to as starch grains (SGs). SG morphology differs between species and SG morphology is particularly diverse in the endosperm of Poaceae plants, such as rice (Oryza sativa) and barley (Hordeum vulgare), which form compound SGs and simple SGs, respectively. SG morphology has been extensively imaged, but the comparative imaging of amyloplast morphology has been limited. In this study, SG-containing amyloplasts in the developing endosperm were visualized using stable transgenic barley and rice lines expressing amyloplast stroma-targeted green fluorescent protein fused to the transit peptide (TP) of granule-bound starch synthase I (TP-GFP). The TP-GFP barley and rice plants had elongated amyloplasts containing multiple SGs, with constrictions between the SGs. In barley, some amyloplasts were connected by narrow protrusions extending from their surfaces. Transgenic rice lines producing amyloplast membrane-localized SUBSTANDARD STARCH GRAIN6 (SSG6)-GFP were used to demonstrate that the developing amyloplasts contained multiple compound SGs. TP-GFP barley can be used to visualize the chloroplasts in leaves and other plastids in pollen and root in addition to the endosperm, therefore it provides as a useful tool to observe diverse plastids. No potential conflict of interest relevant to this article was reported.

Nature Publishing Group Acta Medica Okayama 2045-2322 9 2019 Synthesis of the extended phenacene molecules, [10]phenacene and [11]phenacene, and their performance in a field-effect transistor 4009 EN Hideki Okamoto Department of Chemistry, Okayama University Shino Hamao Research Institute for Interdisciplinary Science, Okayama University Ritsuko Eguchi Research Institute for Interdisciplinary Science, Okayama University Hidenori Goto Research Institute for Interdisciplinary Science, Okayama University Yasuhiro Takabayashi Department of Chemistry, Okayama University Paul Yu-Hsiang Yen Department of Physics, National Tsing Hua University Luo Uei Liang Department of Physics, National Tsing Hua University Chia-Wei Chou Department of Physics, National Tsing Hua University Germar Hoffmann Department of Physics, National Tsing Hua University Shin Gohda NARD Co Ltd Hisako Sugino NARD Co Ltd Yen-Fa Liaos National Synchrotron Radiation Center Hirofumi Ishii National Synchrotron Radiation Center Yoshihiro Kubozono Research Institute for Interdisciplinary Science, Okayama University The [10]phenacene and [11]phenacene molecules have been synthesized using a simple repetition of Wittig reactions followed by photocyclization. Sufficient amounts of [10]phenacene and [11]phenacene were obtained, and thin-film FETs using these molecules have been fabricated with SiO2 and ionic liquid gate dielectrics. These FETs operated in p-channel. The averaged measurements of field-effect mobility, <μ>, were 3.1(7) × 10-2 and 1.11(4) × 10-1 cm2 V-1 s-1, respectively, for [10]phenacene and [11]phenacene thin-film FETs with SiO2 gate dielectrics. Furthermore, [10]phenacene and [11]phenacene thin-film electric-double-layer (EDL) FETs with ionic liquid showed low-voltage p-channel FET properties, with <μ> values of 3(1) and 1(1) cm2 V-1 s-1, respectively. This study also discusses the future utility of the extremely extended π-network molecules [10]phenacene and [11]phenacene as the active layer of FET devices, based on the experimental results obtained. No potential conflict of interest relevant to this article was reported.

Nature Publishing Group Acta Medica Okayama 2045-2322 9 2019 Long-term stabilization of hydrogen peroxide by poly(vinyl alcohol) on paper-based analytical devices 12951 EN Tuchpongpuch Boonpoempoon Department of Chemistry, Faculty of Science and Technology, Suan Sunandha Rajabhat University Wanida Wonsawat Department of Chemistry, Faculty of Science and Technology, Suan Sunandha Rajabhat University Takashi Kaneta Department of Chemistry, Graduate School of Natural Science and Technology, Okayama University Stabilizing reagents that can be deposited onto paper is an important issue for researchers who depend on paper-based analytical devices (PADs), because long-term stability of the devices is essential in pointof-care testing. Here, we found that poly(vinyl alcohol) (PVA) would stabilize hydrogen peroxide placed on a paper substrate following exposure to air. Horseradish peroxidase was employed as a sample in colorimetric measurements of PADs after hydrogen peroxide and 3,3',5,5'-tetramethylbenzidine were deposited as substrates in an enzymatic reaction. The addition of PVA to hydrogen peroxide significantly suppressed its degradation. Concentrations of PVA that ranged from 0.5 to 2%, increased the duration of the stability of hydrogen peroxide, and the results for a PVA concentration of 1% approximated those of 2% PVA. Storage of the PADs at 4 degrees C in a refrigerator extended the stability of the hydrogen peroxide containing 2% PVA by as much as 30 days. The stability of hydrogen peroxide without PVA was degraded after one day under room temperature. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 73 6 2019 Two-year Results of Intravitreal Ranibizumab Injections Using a Treat-and-extend Regimen for Macular Edema due to Branch Retinal Vein Occlusion 517 522 EN Mika Hosogi Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yusuke Shiode Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yuki Morizane Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shuhei Kimura Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Mio Hosokawa Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shinichiro Doi Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shinji Toshima Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kosuke Takahashi Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Atsushi Fujiwara Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fumio Shiraga Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Original Article 10.18926/AMO/57716 We investigated the effectiveness of a treat-and-extend regimen (TAE) of intravitreal ranibizumab injections for macular edema (ME) due to branch retinal vein occlusion (BRVO). We retrospectively examined 2-year results of 32 eyes of 32 patients who underwent TAE to treat ME due to BRVO. The patients whose treatment interval extended to ≥ 12 weeks were switched to a pro re nata regimen (PRN). For the patients whose treatment interval was <12 weeks, TAE was continued. At 2 years, 10 eyes had required no additional injections after the initial treatment period [recurrence(−) group], whereas the other 22 eyes required additional treatment [recurrence(+) group]. Among the recurrence(+) patients, 11 eyes (34.4% of total) were eventually switched from TAE to PRN; the other 11 eyes (34.4%) continued TAE for 2 years. Visual acuity and central retinal thickness were significantly improved in both the recurrence(+) and (−) groups, and there was no significant betweengroup difference in visual acuity at 2 years. Univariate analyses revealed significant differences in visual acuity (p=0.004), age (p=0.014), and vessel occlusion site (p=0.018) between these groups. Our results suggest that TAE may be effective for BRVO patients with lower visual acuity, older age, and occlusion of a major vein. No potential conflict of interest relevant to this article was reported.

American Chemical Society Acta Medica Okayama 15237060 19 11 2017 Synthesis of 3-Benzo[b]thienyl 3-Thienyl Ether via an Addition-Elimination Reaction and Its Transformation to an Oxygen-Fused Dithiophene Skeleton: Synthesis and Properties of Benzodithienofuran and Its π-Extended Derivatives 2821 2824 EN Koichi Mitsudo Division of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama University Yuji Kurimoto Division of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama University Hiroki Mandai Division of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama University Seiji Suga Division of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama University The synthesis of 3-benzo[b]thienyl 3-thienyl ether and its dehydrogenative cyclization leading to benzodithienofuran (BDTF; [1]benzothieno[3,2-b]thieno[2,3-d]furan) are described for the first time. Further transformation of BDTF to more π-extended BDTF derivatives and their fundamental physical properties are also studied. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 73 5 2019 “Active Guide” Brochure Reduces Sedentary Behavior of Elderly People: A Randomized Controlled Trial 427 432 EN Yutaka Owari Shikoku Medical College Hiromi Suzuki Department of Hygiene, Faculty of Medicine, Kagawa University Nobuyuki Miyatake Department of Hygiene, Faculty of Medicine, Kagawa University Original Article 10.18926/AMO/57373 The aim of this study was to examine in a randomized controlled trial how much the sedentary behavior (sitting time) of community-dwelling elderly Japanese subjects decreased as a result of using the “Active Guide” brochure published by the Ministry of Health, Labour and Welfare (2013) and additional documents related to the benefits of reducing sedentary behavior. A total of 86 elderly people who participated in health-club activities for one year were randomly allocated to two groups. Subjects in the intervention group received explanations of the importance of physical activity using the “Active Guide” brochure (n=42) and additional documents, while subjects in the control group did not (n=44). Physical activity was measured using a triaxial accelerometer for two weeks at baseline and again after one year. After one year of intervention, the difference in the sedentary behavior rate from baseline was −2.2% for the intervention group (n=40) and +2.5% for controls (n=40) (Welch’s t-test, p=0.007). Use of the “Active Guide” brochure and additional documents may reduce the sedentary behavior of community dwelling elderly people in Japan. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 24058440 5 8 2019 Stroking hardness changes the perception of affective touch pleasantness across different skin sites e02141 EN Jiabin Yu Cognitive Neuroscience Laboratory, Graduate School of Natural Science and Technology, Okayama University Jiajia Yang Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary, Science and Engineering in Health Systems, Okayama University Yinghua Yu Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary, Science and Engineering in Health Systems, Okayama University Qiong Wu Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary, Science and Engineering in Health Systems, Okayama University Satoshi Takahashi Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary, Science and Engineering in Health Systems, Okayama University Yoshimichi Ejima Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary, Science and Engineering in Health Systems, Okayama University Jinglong Wu Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary, Science and Engineering in Health Systems, Okayama University Human unmyelinated tactile afferents (CT afferents) in hairy skin are thought to be involved in the transmission of affective aspects of touch. How the perception of affective touch differs across human skin has made substantial progress; however, the majority of previous studies have mainly focused on the relationship between stroking velocities and pleasantness ratings. Here, we investigate how stroking hardness affects the perception of affective touch. Affective tactile stimulation was given with four different hardness of brushes at three different forces, which were presented to either palm or forearm. To quantify the physical factors of the stimuli (brush hardness), ten naïve, healthy participants assessed brush hardness using a seven-point scale. Based on these ten participants, five more participants were added to rate the hedonic value of brush stroking using a visual analogue scale (VAS). We found that pleasantness ratings over the skin resulted in a preference for light, soft stroking, which was rated as more pleasant when compared to heavy, hard stroking. Our results show that the hairy skin of the forearm is more susceptible to stroking hardness than the glabrous of the palm in terms of the perception of pleasantness. These findings of the current study extend the growing literature related to the effect of stroking characteristics on pleasantness ratings. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 1341-321X 25 6 2019 Second nationwide surveillance of bacterial pathogens in patients with acute uncomplicated cystitis conducted by Japanese Surveillance Committee from 2015 to 2016: antimicrobial susceptibility of Escherichia coli, Klebsiella pneumoniae, and Staphylococcus saprophyticus 413 422 EN Hiroshi Hayami The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID and the Japanese Society for Clinical Microbiology (JSCM) Satoshi Takahashi The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID and the Japanese Society for Clinical Microbiology (JSCM) Kiyohito Ishikawa The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID and the Japanese Society for Clinical Microbiology (JSCM) Mitsuru Yasuda The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID and the Japanese Society for Clinical Microbiology (JSCM) Shingo Yamamoto The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID and the Japanese Society for Clinical Microbiology (JSCM) Koichiro Wada The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID and the Japanese Society for Clinical Microbiology (JSCM) Kanao Kobayashi The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID and the Japanese Society for Clinical Microbiology (JSCM) Ryoichi Hamasuna The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID and the Japanese Society for Clinical Microbiology (JSCM) Shinichi Minamitani The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID and the Japanese Society for Clinical Microbiology (JSCM) Tetsuya Matsumoto The Surveillance Committee of JSC, JAID and JSCM Hiroshi Kiyota The Surveillance Committee of JSC, JAID and JSCM Kazuhiro Tateda The Surveillance Committee of JSC, JAID and JSCM Junko Sato The Surveillance Committee of JSC, JAID and JSCM Hideaki Hanaki Infection Control Research Center, Kitasato University Naoya Masumori Department of Urology, Sapporo Medical University School of Medicine Hiroyuki Nishiyama Department of Urology, University of Tsukuba Jun Miyazaki Department of Urology, University of Tsukuba Kiyohide Fujimoto Department of Urology, Nara Medical University Kazushi Tanaka Division of Urology, Department of Surgery Related Faculty of Medicine, Kobe University Graduate School of Medicine Shinya Uehara Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Akio Matsubara Department of Urology, Institute of Biomedical & Health Sciences, Hiroshima University Kenji Ito iClinic Kenji Hayashi Tomakomai Urology and Cardiology Clinic Yuichiro Kurimura Tomakomai Urology and Cardiology Clinic Shin Ito iClinic Toshimi Takeuchi Takeuchi Urology and Dermatology Clinic Harunori Narita Narita Clinic Masanobu Izumitani Izumitani Fureai Clinic Hirofumi Nishimura Nishimura Urology Clinic Motoshi Kawahara Kawahara Urology Clinic Makoto Hara Department of Urology, Tsujinaka Hospital Kashiwanoha Takahide Hosobe Hosobe Clinic Kenji Takashima Takashima Urology Clinic Hirofumi Chokyu Cyokyu Tenma Clinic Masaru Matsumura Matsumura Urology Clinic Hideari Ihara Ihara Clinic Satoshi Uno Hirajima Clinic Koichi Monden Araki Urological Clinic Toru Sumii Shuichi Kawai Sumii Clinic Satoru Kariya Ootemachi Clinic Takashi Sato Nissin Urological Clinic Masaru Yoshioka Yoshioka Urology Clinic Hitoshi Kadena Kadena Urological Clinic Shinji Matsushita Department of Urology, Kagoshima Prefectural Ohshima Hospital Shohei Nishi Nishi Urology and Dermatology Clinic Yukinari Hosokawa Department of Urology, Tane General Hospital Takeshi Shirane Shirane Urology Clinic Mutsumasa Yoh Yoh Urology and Dermatology Clinic Syuji Watanabe Department of Urology, Saiseikai Chuwa Hospital Shinichi Makinose Makinose Urological Clinic Tetsuji Uemura Remedy Kitakyushu Nephro Clinic Hirokazu Goto Department of Urology, Fuji City Genaral Hospital The Japanese Surveillance Committee conducted a second nationwide surveillance of antimicrobial susceptibility patterns of uropathogens responsible for acute uncomplicated cystitis (AUC) in premenopausal patients aged 16–40 years old at 31 hospitals throughout Japan from March 2015 to February 2016. In this study, the susceptibility of causative bacteria (Escherichia coli, Klebsiella pneumoniae, Staphylococcus saprophyticus) for various antimicrobial agents was investigated by isolation and culturing of organisms obtained from urine samples. In total, 324 strains were isolated from 361 patients, including E. coli (n = 220, 67.9%), S. saprophyticus (n = 36, 11.1%), and K. pneumoniae (n = 7, 2.2%). The minimum inhibitory concentrations (MICs) of 20 antibacterial agents for these strains were determined according to the Clinical and Laboratory Standards Institute (CLSI) manual. At least 93% of the E. coli isolates showed susceptibility to fluoroquinolones and cephalosporins, whereas 100% of the S. saprophyticus isolates showed susceptibility to fluoroquinolones and aminoglycosides. The proportions of fluoroquinolone-resistant and extended-spectrum β-lactamase (ESBL)-producing E. coli strains were 6.4% (13/220) and 4.1% (9/220), respectively. The antimicrobial susceptibility of K. pneumoniae was retained during the surveillance period, while no multidrug-resistant strains were identified.</br> In summary, antimicrobial susceptibility results of our second nationwide surveillance did not differ significantly from those of the first surveillance. Especially the numbers of fluoroquinolone-resistant and ESBL-producing E. coli strains were not increased in premenopausal patients with AUC in Japan. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2019 One-year outcomes of a treat-and-extend regimen of intravitreal aflibercept for polypoidal choroidal vasculopathy EN Mio Hosokawa Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2019 Results of a Treat-and-Eextend Regimen of Intravitreal Ranibizumab Injection for Macular Edema due to Branch Retinal Vein Occlusion EN Mika Hosogi Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 73 1 2019 Congenital Multiple Ocular Motor Nerve Palsy Complicated by Splitting of the Lateral Rectus Muscle 67 70 EN Reika Kono Department of Ophthalmology, Okayama University Hospital Takehiro Shimizu Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hiroshi Ohtsuki Division of Ophthalmology, Okayama Saiseikai General Hospital Ichiro Hamasaki Department of Ophthalmology, Okayama University Hospital Kiyo Shibata Department of Ophthalmology, Okayama University Hospital Fumiko Kishimoto Division of Ophthalmology, Ibara City Hospital Yuki Morizane Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fumio Shiraga Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Case Report 10.18926/AMO/56460 We report a case of congenital multiple ocular motor nerve palsy combined with splitting of the lateral rectus muscle (LR). A 59-year-old Japanese female was investigated for worsening esotropia after corrective surgery. She presented with left hypertropia (35Δ) and esotropia (45-50Δ). Orbital magnetic resonance imaging (MRI) showed reduced belly sizes in the superior rectus, inferior rectus, and superior oblique muscles and splitting of the LR, extending from the origin to the belly, in the left eye. Splitting of the LR belly was detected on MRI in a case of congenital multiple ocular motor nerve palsy. No potential conflict of interest relevant to this article was reported.

American Physical Society Acta Medica Okayama 24699950 98 9 2018 Temperature-dependent local structure and superconductivity of BaPd2As2 and SrPd2As2 094525 EN K. Terashima Research Institute for Interdisciplinary Science, Okayama University E. Paris Dipartimento di Fisica, Universitá di Roma “La Sapienza” L. Simonelli CELLS - ALBA Synchrotron Radiation Facility E. Salas-Colera Spanish CRG BM25 Spline, ESRF - The European Synchrotron A. Puri CRG-LISA, ESRF T. Wakita Research Institute for Interdisciplinary Science, Okayama University Y. Yamada Research Institute for Interdisciplinary Science, Okayama University S. Nakano Research Institute for Interdisciplinary Science, Okayama University H. Idei Research Institute for Interdisciplinary Science, Okayama University K. Kudo Research Institute for Interdisciplinary Science, Okayama University M. Nohara Research Institute for Interdisciplinary Science, Okayama University Y. Muraoka Research Institute for Interdisciplinary Science, Okayama University T. Mizokawa Department of Applied Physics, Waseda University T. Yokoya Research Institute for Interdisciplinary Science, Okayama University N. L. Saini Dipartimento di Fisica, Universitá di Roma “La Sapienza” The local structures of 122-type paradium arsenides, namely BaPd2As2 and SrPd2As2, are examined by As K-edge extended x-ray absorption fine structure measurements to find a possible correlation between the variation of their superconducting transition temperature and the local structure. The local atomic distances are found to be consistent with average distances measured by diffraction techniques. The temperature dependence of mean square relative displacements reveal that, while BaPd2As2 is characterized by a local As-Pd soft mode, albeit with larger atomic disorder, SrPd2As2 shows anomalous As-Pd correlations with a kink at similar to 160 K due to hardening by raising temperature. We have discussed implications of these results and possible mechanisms of differing superconducting transition temperature in relation with the structural instability. No potential conflict of interest relevant to this article was reported.

Department of Mathematics, Faculty of Science, Okayama University Acta Medica Okayama 0030-1566 61 1 2019 Complex interpolation of smoothness Triebel-Lizorkin-Morrey spaces 99 128 EN Denny Ivanal Hakim Department of Mathematics and Information Sciences, Tokyo Metropolitan University Toru Nogayama Department of Mathematics and Information Sciences, Tokyo Metropolitan University Yoshihiro Sawano Department of Mathematics and Information Sciences, Tokyo Metropolitan University This paper extends the result in [8] to Triebel-Lizorkin-Morrey spaces which contains 4 parameters p, q, r, s. This paper reinforces our earlier paper [8] by Nakamura, the first and the third authors in two different directions. First, we include the smoothness parameter s and the second smoothness parameter r. In [8] we assumed s = 0 and r = 2. Here we relax the conditions on s and r to s ∈ R and 1 < r ≤ ∞. Second, we apply a formula obtained by Bergh in 1978 to prove our main theorem without using the underlying sequence spaces. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 72 4 2018 Impact of Polyp Regression on 2-year Outcomes of Intravitreal Aflibercept Injections: A Treat-and-Extend Regimen for Polypoidal Choroidal Vasculopathy 379 385 EN Mio Morizane-Hosokawa Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yuki Morizane Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shuhei Kimura Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yusuke Shiode Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Masayuki Hirano Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shinichiro Doi Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shinji Toshima Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Mika Hosogi Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Atsushi Fujiwara Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fumio Shiraga Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Original Article 10.18926/AMO/56175 We conducted intravitreal aflibercept injections (IVAs) for 37 Japanese patients (28 males, 9 females, mean age 73.4 years) with polypoidal choroidal vasculopathy (PCV), with a treat-and-extend regimen (TER). We evaluated the impact of polyp regression after a loading dose (2-mg IVA 1×/month for 3 months) on the patients' 2-year treatment outcomes. Thirty-seven eyes were treated with IVA by a TER for 2 years. We divided the patients into 2 groups based on their polyp status after the loading dose: polyp regression (PR+) (n=19) and no polyp regression (PR−) (n=18). We compared the groups’ best-corrected visual acuity (BCVA), central retinal thickness (CRT), recurrence rate, total number of injections, and final treatment interval. Both the BCVA and CRT were significantly improved by the treatment in both groups, with no between-group difference in the amount of change (p=0.769). In the polyp regression (+) group, recurrence was significantly less common (p=0.03), the mean total number of injections was significantly lower (p=0.013), and the mean treatment interval was significantly longer (0.042). Regarding the 2-year outcomes for PCV, the eyes with post-loading-dose polyp regression demonstrated less frequent recurrence and required fewer numbers of injections compared to the eyes without polyp regression. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 72 1 2018 Results of a Treat-and-Extend Regimen of Intravitreal Ranibizumab Injection for Macular Edema due to Branch Retinal Vein Occlusion 39 45 EN Mika Hosogi Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yuki Morizane Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yusuke Shiode Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shinichiro Doi Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fumiaki Kumase Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shuhei Kimura Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Mio Hosokawa Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Masayuki Hirano Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shinji Toshima Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kosuke Takahashi Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Atsushi Fujiwara Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fumio Shiraga Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Original Article 10.18926/AMO/55661 To investigate the effectiveness of a treat-and-extend regimen (TAE) of intravitreal ranibizumab injections (IVR) for macular edema (ME) due to branch retinal vein occlusion (BRVO). We retrospectively examined 35 eyes of 35 patients with ME due to BRVO who underwent TAE for 1 year. Patients whose treatment interval extended to 12 weeks were switched to a pro re nata regimen (PRN; TAE to PRN group), while TAE was continued for patients whose treatment interval was less than 12 weeks (continued TAE group). Changes in best-corrected visual acuity (BCVA), central retinal thickness (CRT), and predictive factors for inclusion in the TAE to PRN group were analyzed. BCVA and CRT both improved significantly at 1 year compared with baseline (p<0.001). Sixteen eyes (45.7%) were included in the TAE to PRN group, while 19 eyes (54.3%) were included in the continued TAE group. BCVA in the TAE to PRN group was significantly better than that in the continued TAE group at 1 year (p=0.047). BCVA at baseline and macular BRVO were significant predictive factors for inclusion in the TAE to PRN group. TAE was effective for improving BCVA and CRT. The TAE to PRN group showed significantly better prognosis. No potential conflict of interest relevant to this article was reported.

岡山大学理学部地球科学教室 Acta Medica Okayama 1340-7414 23 1 2016 ヨーロッパの冬から春にかけての 低気圧活動に関する事例解析（2000年を例に） 33 42 EN Yusuke Kuwana Faculty of Education, Okayama University Kuranoshin Kato Graduate School of Education, Okayama University Yumi Takigawa Faculty of Education, Okayama University Yumi Kojima Faculty of Education, Okayama University Kazuo Otani Graduate School of Natural Science and Technology, Okayama University 10.18926/ESR/55324 Although the extratropical cyclone is one of the basic systems that characterize the weather and climate in mid-latitude regions with the large meridional temperature gradient, its activity and characteristics would be greatly influenced by the seasonal transition and regional differences of the mean atmospheric fields such as between Europe and East Asia. Furthermore, detailed knowledge of the daily cyclone activity would help to understand deeply the differences of regional climatology including seasonal cycles among various areas. In such interest, the present study performed a case study on the cyclone activity around Europe from winter to spring of 2000. In winter, intraseasonal variation of the Icelandic Low was dominant. In the stage when such intraseasonal-scale Icelandic Low approached to the northwestern Europe, the several lows passed eastward with a few days interval around the intraseasonal-scale low pressure area or its southern edge where the baroclinicity was relatively strong. It is also noted that their center pressure was rather low (below 980hPa). After April, when the seasonal mean Icelandic low had disappeared, different types of the intra-seasonal-scale cyclones and anticyclones were dominantly observed. In the lower SLP stage of the intraseasonal variation in Europe, the low to the southwest of England in the middle of April was of the equivalent barotropic structure and persisted for about ten days. On the other hand, high pressure area extending from England to the northern coast of Germany also persisted for about half month. The southern half of that high area was also of equivalent barotropic structure with warmer air there. No potential conflict of interest relevant to this article was reported.

岡山大学理学部地球科学教室 Acta Medica Okayama 1340-7414 23 1 2016 九州南部における4月頃の大雨日の降水の特徴と 大気場に関する総観気候学的解析 17 32 EN Kuranoshin Kato Graduate School of Education, Okayama University Nozomi Morizuka Faculty of Education, Okayama University (Kengo Matsumoto Graduate School of Education, Okayama University Kazuo Otani Graduate School of Natural Science and Technology, Okayama University 10.18926/ESR/55323 Around April, total precipitation in southern Kyushu already attains rather large value due to the increase in contribution of the “heavy rainfall days” (with daily precipitation more the 50 mm/day, referred to as HRD). The present study examined the rainfall features and atmospheric conditions on the HRDs at Kagoshima in southern Kyushu, based on the operational observation data from 1990 to 2009. The HRDs there in April appeared mainly associated with the extratropical cyclone passage, together with tentative appearance of the stationary front. The mean daily precipitation on the HRDs was 82 mm and contribution of the intense rainfall more than 10 mm/h attained up to 38 mm, which accounted for 46 % of the daily total precipitation. In April, the high specific humidity area in the time mean field was still located far to the south of the Japan Islands and the stratification around the Japan Islands was very stable for deep moist convection. However, the zone with rather strong seasonal mean baroclinicity extended to rather southern area near 20°N. This would provide a favorable condition for the long-distance moistur No potential conflict of interest relevant to this article was reported.

岡山大学環境理工学部 Acta Medica Okayama 2187-6940 22 1 2017 Tourism Inventory of Okayama Prefecture: An Analysis on Main Sightseeing Spots in terms of the Number of Tourists 1 28 EN Fumikazu Ichiminami Faculty of Environmental Science and Technology, Okayama University Meltem Okur DİNCSOY Faculty of Economics and Administrative Sciences, Trakya Universit Enver Erdinc DİNCSOY Department of Banking, School of Applied Sciences, Trakya University 10.18926/fest/54860 At the early stage of this paper, Okayama prefecture was analyzed by the author focusing on the tendency of main sightseeing-areas based on the number of tourists for three decades (Ichiminami, 2002). In this study, the main sightseeing spots in Okayama pref. are also examined and the developments are explained in a more detailed and updated perspective by extending over current features and the number of tourists. One of the important reasons in a significant increase in tourists in Okayama is the opening of the highways, the bullet train and cross-linking of the Seto Ohashi Bridge. At the same time, there are some waves in the increase or decrease of the tourist trends appearing from several vital developments such as environmental, climatic, social, economic and spatial. In this regard, research objectives of the study are mainly based on investigating and making a comprehensive study on main sightseeing spots in Okayama pref. to find new tourism values and to provide a tourism inventory of Okayama pref. by means of information, data and clues from the field in/between the tourist destinations such as hotel guests, gardens and castles. Therefore, Okayama pref. has a rich potential of historical and cultural heritage in terms of spatial planning and growth. The important point is that the structural adaptation between historical and cultural assets and the city life should be provided and protected for domestic and foreign tourism as much as creating better futures in health tourism, gastronomy tourism, cultural tourism, belief tourism, congress tourism, thematic tourism and local tourism. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 1 2016 原発性十二指腸粘液癌の一例― 本邦報告16例の検討― 21 25 EN Ikumi Hamano Yusuke Matsumoto Yoshikatsu Endo Naoki Watanabe Kyouhei Kai Shizou Sato Yoji Wani 　Primary mucinous adenocarcinoma of the duodenum is rare. Here we report a case we recently encountered, and we review 16 cases reported in Japan. An 82-year-old Japanese woman was admitted to our hospital complaining of abdominal pain and heartburn. An endoscopic examination revealed a Type 2 tumor in the descending limb of the duodenum, and endoscopically obtained specimens revealed a poorly differentiated adenocarcinoma. We performed a curative pancreatoduodenectomy with lymph node resection, and the surgical specimen revealed that the duodenum was the primary site of the mucinous adenocarcinoma. The patient is currently alive ＞ 1 year after the operation without any evidence of recurrence. Of the 16 patients reviewed, all patients had advanced tumors those depth were T3-T4. 9 patients had lymph node metastasis and 4 patients had peritoneal dissemination at the time of surgery. Since mucinous adenocarcinoma of the duodenum is often progressive cancer at a diagnosis, which is tend to have a worse prognosis than other histological types. No potential conflict of interest relevant to this article was reported.

岡山大学文学部 Acta Medica Okayama 0285-4864 45 2006 スキナー以後の行動分析学(16): 長期的な視点で行動を捉える 11 26 EN Yoshinori Hasegawa 10.18926/okadai-bun-kiyou/53879 No potential conflict of interest relevant to this article was reported.

Springer International Publishing Acta Medica Okayama 2193-1801 4 2015 Clinical decision upon resection or observation of ocular surface dermoid lesions with the visual axis unaffected in pediatric patients 534 EN Toshihiko Matsuo Ocular surface or epibulbar dermoid lesions may present as limbal dermoids at the corneal limbus or dermolipomas in the conjunctival fornix. The purpose of this study is to review clinical features of ocular surface dermoids (grade I), with the visual axis unaffected, in pediatric patients, in order to find key features for making clinical decision, either resection or observation. The study involved 13 consecutive patients with limbal dermoids or fornix dermolipomas which did not affect the visual axis, seen in 11 years at a referral-based institution. Eight patients underwent surgical resection at the age, ranging from 1 to 18 (median, 4) years, with concurrent preauricular appendage resection in 3 patients. Limbal dermoids in 6 patients presented dome-shaped elevation from the ocular surface, and extended in inferotemporal quadrant for 1-2 clock hours. The remaining 2 patients showed dermolipomas in the temporal conjunctival fornix. Postoperative astigmatism at the final visit ranged from 0 to 7 (median, 2.9) diopters in 6 patients with limbal dermoids while ranged from 0 to 1 diopters in 2 patients with fornix dermolipomas. All patients with meaningful astigmatism wore glasses before and after the surgery, resulting in no apparent ametropic or anisometropic amblyopia. Observation was chosen in 5 patients with the age at initial visit, ranging from 0 to 2 (median, 1) years, and the age at the final visit, ranging from 2 to 6 (median, 3) years. Flat limbal dermoids, extending for 1-2 clock hours, were noted in 3 patients, a dome-shaped limbal dermoid for 1 clock hour in one, and a fornix dermolipoma in one. Three patients had preauricular appendages. No patient, except for one with a dome-shaped limbal dermoid, showed astigmatism, greater than one diopter. In conclusions, dome-shaped limbal dermoids were excised while flat limbal dermoids observed. The age at surgery varied largely in pediatric patients with limbal dermoids (grade I) or fornix dermolipomas which did not affect the visual axis. The surgical timing was influenced by surgical scheduling for preauricular appendage resection, determined by a plastic surgeon. Surgical decision was made for cosmetic purposes, but not for medical needs to avoid amblyopia. No potential conflict of interest relevant to this article was reported.

Nature Publishing Group Acta Medica Okayama 0028-0836 517 2015 Native structure of photosystem II at 1.95 Å resolution viewed by femtosecond X-ray pulses 99 103 EN Michihiro Suga Fusamichi Akita Kunio Hirata Go Ueno Hironori Murakami Yoshiki Nakajima Tetsuya Shimizu Keitaro Yamashita Masaki Yamamoto Hideo Ago Jian-Ren Shen Photosynthesis converts light energy into biologically useful chemical energy vital to life on Earth. The initial reaction of photosynthesis takes place in photosystem II (PSII), a 700-kilodalton homodimeric membrane protein complex which catalyses photo-oxidation of water into dioxygen through an S-state cycle of the oxygen evolving complex (OEC). The structure of PSII has been solved by X-ray diffraction (XRD) at 1.9-ångström (Å) resolution, which revealed that the OEC is a Mn4CaO5-cluster coordinated by a well-defined protein environment1. However, extended X-ray absorption fine structure (EXAFS) studies showed that the manganese cations in the OEC are easily reduced by X-ray irradiation2, and slight differences were found in the Mn–Mn distances between the results of XRD1, EXAFS3–7 and theoretical studies8–14. Here we report a ‘radiation-damage-free’ structure of PSII from Thermosynechococcus vulcanus in the S1 state at a resolution of 1.95 Å using femtosecond X-ray pulses of the SPring-8 ångström compact free-electron laser (SACLA) and a huge number of large, highly isomorphous PSII crystals. Compared with the structure from XRD, the OEC in the X-ray free electron laser structure has Mn–Mn distances that are shorter by 0.1–0.2 Å. The valences of each manganese atom were tentatively assigned as Mn1D(III), Mn2C(IV), Mn3B(IV) and Mn4A(III), based on the average Mn–ligand distances and analysis of the Jahn–Teller axis on Mn(III). One of the oxo-bridged oxygens, O5, has significantly longer Mn–O distances in contrast to the other oxo-oxygen atoms, suggesting that it is a hydroxide ion instead of a normal oxygen dianion and therefore may serve as one of the substrate oxygen atoms. These findings provide a structural basis for the mechanism of oxygen evolution, and we expect that this structure will provide a blueprint for design of artificial catalysts for water oxidation. No potential conflict of interest relevant to this article was reported.

National Academy of Sciences. Acta Medica Okayama 0027-8424 112 27 2015 Solid-liquid critical behavior of water in nanopores 8221 8226 EN Kenji Mochizuki Kenichiro Koga Nanoconfined liquid water can transform into low-dimensional ices whose crystalline structures are dissimilar to any bulk ices and whose melting point may significantly rise with reducing the pore size, as revealed by computer simulation and confirmed by experiment. One of the intriguing, and as yet unresolved, questions concerns the observation that the liquid water may transform into a low-dimensional ice either via a first-order phase change or without any discontinuity in thermodynamic and dynamic properties, which suggests the existence of solid−liquid critical points in this class of nanoconfined systems. Here we explore the phase behavior of a model of water in carbon nanotubes in the temperature−pressure−diameter space by molecular dynamics simulation and provide unambiguous evidence to support solid−liquid critical phenomena of nanoconfined water. Solid−liquid first-order phase boundaries are determined by tracing spontaneous phase separation at various temperatures. All of the boundaries eventually cease to exist at the critical points and there appear loci of response function maxima, or the Widom lines, extending to the supercritical region. The finite-size scaling analysis of the density distribution supports the presence of both first-order and continuous phase changes between solid and liquid. At around the Widom line, there are microscopic domains of two phases, and continuous solid−liquid phase changes occur in such a way that the domains of one phase grow and those of the other evanesce as the thermodynamic state departs from the Widom line. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2015 Effectiveness of Extending Treatment Duration in Therapy with Pegylated Interferon and Ribavirin for Genotype 2 Hepatitis C Virus Infection EN Shintarou Nanba No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 69 4 2015 Effectiveness of Extending Treatment Duration in Therapy with Pegylated Interferon and Ribavirin for Genotype 2 Hepatitis C Virus Infection 237 244 EN Shintarou Nanba Fusao Ikeda Shin-ichi Fujioka Yasuyuki Araki Kouichi Takaguchi Noriaki Hashimoto Hiroyuki Seki Akinobu Takaki Yoshiaki Iwasaki Kazuhide Yamamoto Original Article 10.18926/AMO/53560 The effectiveness of extending treatment duration as response guided therapy was previously reported for chronic hepatitis C (CHC) genotype 1, but is still controversial for genotype 2. The present study is a retrospective cohort study to investigate the effectiveness of extending treatment duration in therapy with pegylated interferon and ribavirin for patients with CHC genotype 2 by focusing on the timing at which patients obtained undetectable HCV RNA. A total of 306 patients who obtained undetectable HCV RNA by week 24 of treatment and completed 24 weeks of treatment were enrolled. Rapid virological response (RVR) to standard therapy was achieved by 122 patients (51ｵ), and 89ｵ of them obtained sustained virological response (SVR), while 69ｵ of non-RVR patients achieved SVR. Non-RVR patients with undetectable HCV RNA at week 8, and insufficient adherence＜80ｵ pegylated interferon and ribavirin during the first 24 weeks, significantly improved their SVR rate by extended therapy. Among patients receiving extended therapy, drug adherences did not differ between SVR and non-SVR patients, indicating that extending treatment duration might compensate for insufficient antiviral effects due to insufficient drug adherences. This finding might be useful in creating a guideline for extending treatment duration for patients with CHC genotype 2. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2015 CRYOPRESERVATION OF BOAR SPERMATOZOA USING TREHALOSE IN A GLYCEROL-FREE FREEZING EXTENDER EN GALABADA RALALAGE RUKMALI RUWANTHIKA ATHURUPANA No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 68 6 2014 Visualization of Astrocytic Primary Cilia in the Mouse Brain by Immunofluorescent Analysis Using the Cilia Marker Arl13b 317 322 EN Kyosuke Kasahara Ko Miyoshi Shinki Murakami Ikuko Miyazaki Masato Asanuma Original Article 10.18926/AMO/53020 In vertebrates, almost all somatic cells extend a single immotile cilium, referred to as a primary cilium. Increasing evidence suggests that primary cilia serve as cellular antennae in many types of tissues by sensing chemical or mechanical stimuli in the milieu surrounding the cells. In rodents an antibody to adenylyl cyclase 3 (AC3) has been widely used to label the primary cilia of neurons in vivo by immunostaining, whereas the lack of markers for the primary cilia of astrocytes has made it difficult to observe astrocytic primary cilia in vivo. Here, we obtained a visualization of astrocytic primary cilia in the mouse brain. In the somatosensory cortex, a large portion of neurons and astrocytes at postnatal day 10 (P10), and of neurons at P56 had AC3-positive primary cilia, whereas only approx. one-half of the astrocytes in the P56 mice carried primary cilia weakly positive for AC3. In contrast, the majority of astrocytes had ADP-ribosylation factor-like protein 13B (Arl13b)-positive primary cilia in the somatosensory cortex and other brain regions of P56 mice. The lengths of astrocytic primary cilia positive for Arl13b varied among the brain regions. Our data indicate that Arl13b is a noteworthy marker of astrocytic primary cilia in the brain. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 0022-5223 146 6 2013 Unilateral lung transplantation using right and left upper lobes: An experimental study 1534 1537 EN Hitoshi Nishikawa Takahiro Oto Shinji Otani Masaaki Harada Norichika Iga Kentaroh Miyoshi Shinichiro Miyoshi Objective: The shortage of organ donors is a serious problem in Japan. The right and left upper lobes of rejected extended-criteria lungs have the potential to be used for downsized lung transplantation; however, the 2 upper lobes are too small for a size-matched recipient. The present study investigated the feasibility of unilateral transplantation using the right and left upper lobes. Methods: After harvesting the heart-lung block from donor swine, a left lung graft was created using the right and left upper lobes and transplanted into the left thoracic space of the recipient swine (group A, n = 5). We then evaluated graft function for 6 hours and compared these results with those of a control group (group B, n = 5), in which orthotopic left lung transplantation had been performed. Results: The mean partial pressure of oxygen in the arterial blood gas after reperfusion was 507 mm Hg in group A and 463 mm Hg in group B (P = .2). The mean pulmonary arterial pressure was 30.3 mm Hg in group A and 27.5 mm Hg in group B (P = .4). The mean airway pressure was 6.4 mm Hg in group A and 6.2 mm Hg in group B (P = .7). Conclusions: Our results suggest that unilateral left lung transplantation using the right and left upper lobes is technically and functionally feasible for size-matched recipients. In addition, this technique enables the use of rejected lungs if the upper lobes are still intact. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 1344-7610 59 4 2009 Validation of rice blast resistance genes in barley using a QTL mapping population and near-isolines 341 349 EN Phinyarat Kongprakhon Alfonso Cuesta-Marcos Patrick M. Hayes Kelley L. Richardson Pattama Sirithunya Kazuhiro Sato Brian Steffenson Theerayuth Toojinda There are prior reports of Pyricularia grisea-the causal agent of blast of rice-causing disease in barley. In order to determine the specificity of this resistance in barley, we extended our previous mapping efforts to include blast isolates from barley and rice grown in Thailand and we assessed two resistance phenotypes: leaf blast (LB) and neck blast (NB). The largest-effect resistance QTL, on chromosome I H, was associated with NB and LB and is located in a region rich in resistance genes, including QTL conferring resistance to stripe rust (incited by Puccinia striiformis f. sp. hordei) and the mildew (Blumeria graminis f. sp. hordei) resistance gene Mla. The LB, NB and mildew resistance alleles trace to one parent (Baronesse) whereas the stripe rust resistance allele traces to the other parent (BCD47) of the mapping population. Baronesse is the susceptible recurrent parent of a set of near-isogenic lines (NILs) for three stripe rust resistance QTL, including one on 1H. Unigene (EST) derived single nucleotide polymorphism haplotypes of these NILs were aligned with the blast mapping population QTL using Mla as an anchor. Baronesse and all NILs without the 1H introgression were resistant to LB and NB. However, two NILs with the I H introgression were resistant to LB and NB. Both are resistant to stripe rust. Therefore, the QTL conferring resistance to stripe rust is separable by recombination from the blast resistance QTL. No potential conflict of interest relevant to this article was reported.

Department of Mathematics, Faculty of Science, Okayama University Acta Medica Okayama 0030-1566 56 1 2014 THE BEST CONSTANT OF L^p SOBOLEV INEQUALITY CORRESPONDING TO DIRICHLET-NEUMANN BOUNDARY VALUE PROBLEM 145 155 EN Hiroyuki Yamagishi Kohtaro Watanabe Yoshinori Kametaka 10.18926/mjou/52074 We have obtained the best constant of the following L^p Sobolev inequality sup _0≤y≤1| u^(j)(y)| ≤C (∫ <doubleint>₀¹ </doubleint> | u^(M)(x)| ^p dx)^1/p , where u is a function satisfying u^(M) ∈ L^p(0, 1), u⁽²ⁱ⁾(0) = 0 (0 ≤i ≤ [(M − 1)/2]) and u⁽²ⁱ⁺¹⁾(1) = 0 (0 ≤ i ≤ [(M − 2)/2]), where u⁽ⁱ⁾ is the abbreviation of (d/dx)ⁱu(x). In [9], the best constant of the above inequality was obtained for the case of p = 2 and j = 0. This paper extends the result of [9] under the conditions p > 1 and 0 ≤ j ≤ M −1. The best constant is expressed by Bernoulli polynomials. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 67 6 2013 A New Navigation System for Minimally Invasive Total Knee Arthroplasty 351 358 EN Yusuke Yokoyama Nobuhiro Abe Kazuo Fujiwara Masahiko Suzuki Yoshikazu Nakajima Naohiko Sugita Mamoru Mitsuishi Yoshio Nakashima Toshifumi Ozaki Original Article 10.18926/AMO/52008 A computer-assisted navigation system to be used for total knee arthroplasties (TKAs) was reported to improve the accuracy of bone resection and result in precise implant placement, but the concomitant surgical invasion and time consumption are clinical problems. We developed a computed tomography (CT)-based navigation system (NNS) to be used for minimally invasive TKA. It requires only the reference points from a small limited area of the medial femoral condyle and proximal tibia through a skin incision to obtain optical images. Here we evaluated the usefulness and accuracy of the NNS in comparison with the commercially available BrainLAB image-free navigation system (BLS). In a clinical experiment, the registration times obtained with the NNS tended to be shorter than those obtained with the BLS, but not significantly so. The NNS group tended to be in the extended position in the sagittal plane of the distal femur within 3 degrees, and the BLS group showed rather flexed deviation in the sagittal plane of the anterior femur. No potential conflict of interest relevant to this article was reported.

Public Library Science Acta Medica Okayama 1932-6203 8 3 2013 Cartilage-Specific Over-Expression of CCN Family Member 2/Connective Tissue Growth Factor (CCN2/CTGF) Stimulates Insulin-Like Growth Factor Expression and Bone Growth EN Nao Tomita Takako Hattori Shinsuke Itoh Eriko Aoyama Mayumi Yao Takashi Yamashiro Masaharu Takigawa Previously we showed that CCN family member 2/connective tissue growth factor (CCN2) promotes the proliferation, differentiation, and maturation of growth cartilage cells in vitro. To elucidate the specific role and molecular mechanism of CCN2 in cartilage development in vivo, in the present study we generated transgenic mice overexpressing CCN2 and analyzed them with respect to cartilage and bone development. Transgenic mice were generated expressing a ccn2/lacZ fusion gene in cartilage under the control of the 6 kb-Col2a1-enhancer/promoter. Changes in cartilage and bone development were analyzed histologically and immunohistologically and also by micro CT. Primary chondrocytes as well as limb bud mesenchymal cells were cultured and analyzed for changes in expression of cartilage-related genes, and non-transgenic chondrocytes were treated in culture with recombinant CCN2. Newborn transgenic mice showed extended length of their long bones, increased content of proteoglycans and collagen II accumulation. Micro-CT analysis of transgenic bones indicated increases in bone thickness and mineral density. Chondrocyte proliferation was enhanced in the transgenic cartilage. In in vitro short-term cultures of transgenic chondrocytes, the expression of col2a1, aggrecan and ccn2 genes was substantially enhanced; and in long-term cultures the expression levels of these genes were further enhanced. Also, in vitro chondrogenesis was strongly enhanced. IGF-I and IGF-II mRNA levels were elevated in transgenic chondrocytes, and treatment of non-transgenic chondrocytes with recombinant CCN2 stimulated the expression of these mRNA. The addition of CCN2 to non-transgenic chondrocytes induced the phosphorylation of IGFR, and ccn2-overexpressing chondrocytes showed enhanced phosphorylation of IGFR. Our data indicates that the observed effects of CCN2 may be mediated in part by CCN2-induced overexpression of IGF-I and IGF-II. These findings indicate that CCN2-overexpression in transgenic mice accelerated the endochondral ossification processes, resulting in increased length of their long bones. Our results also indicate the possible involvement of locally enhanced IGF-I or IGF-II in this extended bone growth. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 67 3 2013 Proximal Vertebral Body Fracture after 4-Level Fusion Using L1 as the Upper Instrumented Vertebra for Lumbar Degenerative Disease: Report of 2 Cases with Literature Review 197 202 EN Takao Yasuhara Yuichi Takahashi Shinji Kumamoto Masayuki Nakahara Kotaro Yoneda Tatsuomi Niimura Takashi Tanoue Akira Kusumegi Takashi Sennari Yasukazu Hijikata Hiroaki Manabe Yasuyuki Miyoshi Isao Date Koichi Ogawa Kenki Nishida Case Report 10.18926/AMO/50414 Some cases with lumbar degenerative diseases require multi-level fusion surgeries. At our institute, 27 and 4 procedures of 3- and 4-level fusion were performed out of a total 672 posterior lumbar interfusions (PLIFs) on patients with lumbar degenerative disease from 2005 to 2010. We present 2 osteoporotic patients who developed proximal vertebral body fracture after 4-level fusion. Both cases presented with gait disability for leg pain by degenerative lumbar scoliosis and canal stenosis at the levels of L1/2-4/5. After 4-level fusion using L1 as the upper instrumented vertebra, proximal vertebral body fractures were found along with the right pedicle fractures of L1 in both cases. One of these patients, aged 82 years, was treated as an outpatient using a hard corset for 24 months, but the fractures were exacerbated over time. In the other patient, posterolateral fusion was extended from Th10 to L5. Both patients can walk alone and have been thoroughly followed up. In both cases, the fracture of the right L1 pedicle might be related to the subsequent fractures and fusion failure. In consideration of multi-level fusion, L1 should be avoided as an upper instrumented vertebra to prevent junctional kyphosis, especially in cases with osteoporosis and flat back posture. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 67 3 2013 Development of Dysphagia and Trismus Developed after C1-2 Posterior Fusion in Extended Position 185 190 EN Haruo Misawa Masato Tanaka Yoshihisa Sugimoto Kouichiro Koshimune Toshifumi Ozaki Case Report 10.18926/AMO/50412 Cervical misalignment after upper cervical fusion including the occipital bone may cause trismus or dysphagia, because the occipito-atlanto joint is associated with most of the flex and extended motion of the cervical spine. There are no reports of dysphagia and trismus after C1-2 fusion. The purpose of this paper is to demonstrate the potential risk of dysphagia and trismus even after upper cervical short fusion without the occipital bone. The patient was a 69-year-old man with myelopathy caused by os odontoideum and Klippel-Feil syndrome, who developed dysphagia and trismus immediately after C1-2 fusion and C3-6 laminoplasty. Radiographs and CT revealed that his neck posture was extended, but his symptoms still existed a week after surgery. The fixation angle was hyperextended 12 days after the first surgery. His symptoms disappeared immediately after revision surgery. The fixation in the neck-flexed position is thought to be the main cause of the patientʼs post-operative dysphagia and trismus. Dysphagia and trismus may occur even after short upper cervical fusion without the occipital bone or cervical fusion in the neck-extended position. The pre-operative cervical alignment and range of motion of each segment should be thoroughly evaluated. No potential conflict of interest relevant to this article was reported.

情報処理学会 Acta Medica Okayama 0919-6072 2012-NL-207 15 2012 述語の分析に基づく文書解析の考察 1 7 EN Koichi Takeuchi Nao Takeuchi Yasuhiro Ishihara 動詞間で共通する意味属性を考慮して,シソーラス上に整理した動詞項構造シソーラスを提案し,形容動詞まで拡張して分析を進めてきた.動詞項構造シソーラスの背景には語彙概念構造という状態変化を主に記述する形式を拡張してきたが,「必要だ」や「必ず〜する」といった主観的な内容を記述する場所が無く,意味記述の中に自然言語で埋めることになっている.本稿では述語の分析から必要となる意味構造の要件を明らかにする.その中でも可能世界意味論に関係している点を事例をもとに明確化し,文書解析のための意味構造について考察する.さらに,人工知能で議論されてきた様相論理,動的命題,設計学,オントロジー工学との関係について概観する. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 67 2 2013 Living Donor Liver Transplantation to a Survivor of LiverResection for Hepatocellular Carcinoma with Major Portal Vein Invasion 117 121 EN Hiroshi Sadamori Takahito Yagi Susumu Shinoura Yuzo Umeda Ryuichi Yoshida Daisuke Sato Daisuke Nobuoka Masashi Utsumi Toshiyoshi Fujiwara Case Report 10.18926/AMO/49671 We present a case of living donor liver transplantation to a 3-year disease-free survivor of liver resection for hepatocellular carcinoma (HCC) with major portal vein invasion. A 48-year-old man had HCC in the right lobe with a portal venous tumor thrombus extending into the left portal vein. An extended right lobectomy with thrombectomy was performed to remove the thrombus. Three years after liver resection, the patient experienced liver failure, with massive ascites and jaundice due to the formation of a thrombus in the main and left portal veins. During the 3 years after liver resection, no metastasis or recurrence of HCC had been detected, and tumor markers had been within normal ranges. The portal venous thrombus did not show any arterial enhancement under contrast-enhanced computed tomography, suggesting that the co-existence of any HCC component in the portal venous thrombus may have been negative. Based on these findings, living donor liver transplantation was performed using a right lobe graft from the patientʼs son. The patient is alive at 87 months after the transplantation, with no evidence of HCC recurrence. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 125 1 2013 免疫チェックポイント制御とがん免疫治療 13 18 EN Heiichiro Udono がんワクチンによる免疫治療では，如何にCD8T細胞を感作（プライミング）しその数を増やすか（免疫増強）という点に多大の努力が払われて来た．樹状細胞への抗原デリバリーと抗原プロセシング／提示，Toll様受容体などの刺激，即ち自然免疫系の活性化の併用などはそれに該当する．しかし十分に活性化されたＴ細胞をもってしても癌の拒絶は容易ではない．それには癌組織という特殊な環境が禍している．Ｔ細胞は癌塊内に入り込み莫大な数の癌細胞と遭遇する．癌組織内での繰り返す抗原認識の過程でＴ細胞は疲弊し，次第に本来あるべき機能を喪失していく．この疲弊（exhaustion）と呼ばれる現象は，Ｔ細胞に発現する複数の免疫抑制性分子―免疫チェックポイント分子―と腫瘍に発現するそのリガンドの結合によってもたらされる．代表的なチェックポイント分子の機能を抑制し，エフェクターＴ細胞が疲弊することなくその機能を長く維持できれば，これからのがん免疫治療に飛躍的な進展がみられるかもしれない． No potential conflict of interest relevant to this article was reported.

岡山大学国際センター, 岡山大学教育開発センター, 岡山大学言語教育センター, 岡山大学キャリア開発センター Acta Medica Okayama 1881-5952 8 2012 Reflections on Learning from a Study Leave: One Year Later 151 162 EN Ian Nakamura 10.18926/49297 Surviving, thriving, and evolving followed by further noticing, reflecting, and acting are some of the stages a teacher-researcher goes through before, during, and after the study leave experience. Having the opportunity to literally remove oneself from the daily concerns, routines, and habits entrenched in one’s local institutional context for an extended period of time（ e.g., six months） is an experience like no other. Blood donation campaigns call giving blood ‘a gift that keeps on giving’. While the majority of people in our profession do carry on with their work quite well without ever going on a study leave （or donating blood）, an important revelation that I have had is: a study leave is also ‘a gift that keeps on giving’. No potential conflict of interest relevant to this article was reported.

岡山大学理学部地球科学教室 Acta Medica Okayama 1340-7414 19 1 2012 地上梅雨前線の南方の九州における 線状降水帯の集団の維持について （2001年6月19日頃の事例解析） 39 50 EN Yasuhiro Goda Kuranoshin Kato Osamu Tsukamoto 10.18926/ESR/49212 A case study on persistent appearance of the ensemble of precipitation bands in the warm sector of the Baiu front in Kyushu District, the western part of Japan around 19 June 2001 was performed based on the operational observational data. Around 00UTC (09JST) 19 June when the Baiu front on the surface weather map was still located about a few 100kms to the north of Kyushu, the number and the total area of the meso-β or γ-scale line-shaped precipitation bands increased around Kyushu rapidly. These precipitation bands had been sustained there and gradually gathered each other to change into the Baiu frontal precipitation zone extending from the northern Kyushu to Seto-Naikai (Seto Inland Sea) around 09UTC (18JST) 19 June (the intense rainfall zone was still located in the warm sector of the Baiu front). Until ~09UTC (18JST) 19 June, the moist air flow with the latently unstable stratification had been sustained around Kyushu corresponding to the low-level southerly wind toward the surface Baiu front to the north of Kyushu. This large-scale situation would contribute greatly to the maintenance of the ensemble of the line-shaped precipitation bands in the warm sector of the Baiu front. No potential conflict of interest relevant to this article was reported.

Department of Mathematics, Faculty of Science, Okayama University Acta Medica Okayama 0030-1566 55 1 2013 UNIFORM STABILITY AND BOUNDEDNESS OF SOLUTIONS OF NONLINEAR DELAY DIFFERENTIAL EQUATIONS OF THE THIRD ORDER 157 166 EN Ademora Adeleke Timothy Arawamo Peter Olutola 10.18926/mjou/49103 In this paper, a complete Lyapunov functional was con- structed and used to obtain criteria (when p = 0) for uniform asymptotic stability of the zero solution of the nonlinear delay differential equation (1.1). When p ≠ 0, sufficient conditions are also established for uni- form boundedness and uniform ultimate boundedness of solutions of this equation. Our results improve and extend some well known results in the literature. No potential conflict of interest relevant to this article was reported.

Department of Mathematics, Faculty of Science, Okayama University Acta Medica Okayama 0030-1566 55 1 2013 ON MONO-INJECTIVE MODULES AND MONO-OJECTIVE MODULES 117 129 EN Derya Keskin Tütüncü Yosuke Kuratomi 10.18926/mjou/49099 In [5] and [6], we have introduced a couple of relative generalized epi-projectivities and given several properties of these projectivities. In this paper, we consider relative generalized injectivities that are dual to these relative projectivities and apply them to the study of direct sums of extending modules. Firstly we prove that for an extending module N, a module M is N-injective if and only if M is mono-Ninjective and essentially N-injective. Then we define a mono-ojectivity that plays an important role in the study of direct sums of extending modules. The structure of (mono-)ojectivity is complicated and hence it is difficult to determine whether these injectivities are inherited by finite direct sums and direct summands even in the case where each module is quasi-continuous. Finally we give several characterizations of these injectivities and find necessary and sufficient conditions for the direct sums of extending modules to be extending. 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 Okayama 1883-2423 151 2012 ドイツにおける後期中等教育段階の物理教育の変遷 ― 旧東ドイツ地区・ザクセン邦ギムナジウム上級段階物理と東ドイツ拡大オーベル シューレ物理との比較考察 ― 81 91 EN Kenji Tanaka 10.18926/bgeou/49020 ドイツ・ザクセン邦のギムナジウム上級段階と東ドイツの拡大オーベルシューレとに焦点 を当て，ほぼ30年を経た，いわば新旧指導要領などの比較考察から，後期中等教育段階の物 理教育の変遷を明らかにした。この新物理に至り，必修でなく選択教科や分野の設定，可能 な履修時間幅の拡大があり，目標も変容し，現代物理学の重視という変化もあり，生徒の興 味関心・教師の自由裁量を考慮・許容してきている。結局，イデオロギーの変化や科学技術 の発展に加えて，対象生徒数の増大に対応してきたといえるだろう。 No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 124 2 2012 ボツリヌスＡ型菌変異株が産生するHA複合体の構造に関する研究 137 143 EN Shaobo Ma Clostridium botulinum produces seven neurotoxin (NTX) serotypes, classified from as A to G. In culture, NTX forms protein complexes by association with non-toxic components, such as nontoxic-nonhemagglutinin (NTNH) and hemagglutinins (HA1, HA2, HA3). C. botulinum serotype A produces three types of toxin complexes, M-toxin (NTX and NTNH), L-toxin (M-toxin and HAs) and LL-toxin (dimer of L-toxin). In this study, I found three HA complexes in the culture of a nontoxigenic mutant serotype A lacking ntx and ntnh expression. The HA complexes displayed similar banding patterns on SDS-PAGE, but the staining intensities of the HA1 and HA2 bands were different. In addition, their native-PAGE banding profiles exhibited different behaviors. The large-molecular-size HA complex showed the highest activity, similar to that of an L-toxin. Based on the combined results of the PAGE and gel-filtration profiles, the differences in molecular size among the three HA complexes were thought to be caused by different numbers of HA1 and HA2 molecules. This paper reports for the first time the purification and characterization of a native HA complex of serotype A, and suggests that the HA can form complex structures without NTX and NTNH. This may help in understanding the toxin complex assembly pathway. No potential conflict of interest relevant to this article was reported.

Zoological Society of Japan Acta Medica Okayama 0289-0003 24 6 2007 Effects of Unilateral Compound-Eye Removal on the Photoperiodic Responses of Nymphal Development in the Cricket Modicogryllus siamensis 604 610 EN Tomoaki Sakamoto Kenji Tomioka The cricket, Modicogryllus siamensis, shows clear photoperiodic responses at 25 degrees C in nymphal development. Under long-day conditions (LD16:8), nymphs became adults about 50 days after hatching, while under short-day conditions (LD8:16) the duration of nymphal stage extended to more than 130 days. Under constant dark conditions, two developmental patterns were observed: about 60% of crickets became adults slightly slower than under the long-day conditions, and the rest at later than 100 days after hatching, like those under the short-day conditions. When the compound eye was unilaterally removed on the 2nd day of hatching, an increase of molting and an extension of the nymphal period were observed under the long-day conditions, while under the short-day conditions, some crickets developed faster and others slower than intact crickets. These results suggest that this cricket receives photoperiodic information through the compound eye, that a pair of the compound eyes is required for a complete photoperiodic response, and that interaction between bilateral circadian clocks may be also involved in the response. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 40 12 1928 脾臟ト甲状腺トノ交互作用ニ關スル研究 第4囘報告 脾動靜脉ノ白血球,血色素,網状赤血球等血液成分竝ニ造血臟器ノ組織像ニ就テ 2465 2475 EN Yoshito Tsunashima Having studied, as mentioned in the previous report, the changes of blood-platelets in the splenic arteries and veins, I extended my investigation into white corpuscles, hemoglobin and reticulated red cells: and with the object of ascertainning what their changes mean, I carried out an histological research of the spleen, the liver and the bonemarrow in the above-stated procedures and came to the following conclusions. 1) In the case of a normal rabbit, the number of the white corpuscles especially the lymphocytes in the splenic veins exceeds that in the splenic arteries. 2) After thyroidectomy and the injection of phenylhydrazin the white corpuscles in splenic veins increase more remarkably than those in splenic arteries, the lymphocytes and monocytes also showing a remarkable augmentation. 3) When adrenalin or silver-elecroid is injected, the white corpuscles in splenic veins outnumber exceedingly those in splenic arteries. When adrenalin is injected, the lymphocytes and monocytes increase especially. When silver-elecroid is injected, the augmentation of the lymphocytes is not comparatively remarkable, while on the other hand, the pseudoeosinophile-leucocytes increase. 4) In the case of a normal rabbit, as well as in that where the thyroidectomy is performed, a greater quantity of hemoglobin is found in the splenic veins than in the splenic arteries, and it is especially so when phenylhydrazin is injected. But the continuous injection of silver-elecroid does not cause any remarkable change of the contents of splenic veins and arteries. The quantity of the hemoglobin fluctuates almost in the same way as the number of the red blood corpuscles does. 5) No remarkable change of the reticulated red cells occurs in splenic arteries and veins. 6) After thyroidectomy and the injection of phenylhydrazin, the appearance of the megacaryocytes in the spleen is demonstrable, but no remarkable change occurs in the liver. 7) Thyroidectomy gives rise to the atrophy of the bone-marrow, the proliferation of adipose tissue and the decrease of megacaryocytes. A similar tendency is recognizable when phenylhydrazin is injected. 8) From these above-stated blood pictures of the splenic arteries and veins, as well as the histological researches of the blood-making organs, it may be inferred that from thyroidectomical causes, the spleen regains, in a compensatory sense, its blood-making function outside the bone-marrow. No potential conflict of interest relevant to this article was reported.

Faculty of Engineering, Okayama University Acta Medica Okayama 0475-0071 36 2 2002 Experimental Verification of Common-Mode Excitation Model for PCB Having Partially Narrow Return Path 83 89 EN Tetsushi Watanabe Osami Wada Ryuji Koga Yoshitaka Toyota Takuya Miyashita 10.18926/47029 Suppression of common-mode current is important to achieve electromagnetic compatibility of high-speed and high-density electronic circuits. The authors have focused on the common mode current flowing on a printed circuit board (PCB) to explain the excitation mechanism. A narrow ground pattern in microstrip structure excites common-mode current. In the previous paper, the authors explained the mechanism of common mode generation by means of "current division factor" for simple PCBs. The estimated radiation from a simple PCB agreed well with measured one. In this paper, the authors extend the theory to be applied to generalize ground structure. The validity of the theory is confirmed by comparing the measured radiation and the estimated value using the common-mode model for a test PCB. The estimated radiation agrees well with the measured one within 3 dB up to 900 MHz. No potential conflict of interest relevant to this article was reported.

Faculty of Engineering, Okayama University Acta Medica Okayama 0475-0071 36 2 2002 Application of Transfer Matrix Method with Signal Flow-Chart to Analyze Optical Multi-Path Ring-Resonator 73 82 EN Iip Syarif Hidayat Yoshitaka Toyota Osamu Torigoe Osami Wada Ryuji Koga 10.18926/47028 A multi-path ring-resonator (MPRR) was proposed to extend FSR of ring resonator. However, it is complicated to analyze the MPRR by using well-known analysis techniques such as scattering matrix or other numerical methods. This paper describes procedure for deriving transfer matrix by means of signal flow-chart to analyze the MPRR. We do not need complicated calculation for steady state analysis because transfer matrix elements are formulated clearly. As a result, The calcultaion time in this method can be reduced 1/3 to 1/20 times compared with using scattering matirx method. Furthermore, a transmittance characteristics of the MPRR at FSR extension-factor of 10 will also be shown. This suggests that analysis of other types of the MPRR by using this method can be performed simply and take a shorter time. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 65 5 2011 Factors That Influence Primary Cilium Length 279 285 EN Ko Miyoshi Kyosuke Kasahara Ikuko Miyazaki Masato Asanuma Review 10.18926/AMO/47009 Almost all mammalian cells carry one primary cilium that functions as a biosensor for chemical and mechanical stimuli. Genetic damages that compromise cilia formation or function cause a spectrum of disorders referred to as ciliapathies. Recent studies have demonstrated that some pharmacological agents and extracellular environmental changes can alter primary cilium length. Renal injury is a well-known example of an environmental insult that triggers cilia length modification. Lithium treatment causes primary cilia to extend in several cell types including neuronal cells;this phenomenon is likely independent of glycogen synthase kinase-3β inhibition. In renal epithelial cell lines, deflection of the primary cilia by fluid shear shortens them by reducing the intracellular cyclic AMP level, leading to a subsequent decrease in mechanosensitivity to fluid shear. Primary cilium length is also influenced by the dynamics of actin filaments and microtubules through the levels of soluble tubulin in the cytosol available for primary cilia extension. Thus, mammalian cells can adapt to the extracellular environment by modulating the primary cilium length, and this feedback system utilizing primary cilia might exist throughout the mammalian body. Further investigation is required concerning the precise molecular mechanisms underlying the control of primary cilium length in response to environmental factors. No potential conflict of interest relevant to this article was reported.

Faculty of Engineering, Okayama University Acta Medica Okayama 0475-0071 37 2 2003 Estimation of Ground Resisitivity Distribution Using 3D DRM Charge Simulation Modelling 45 60 EN Wei Xu Y. Zhao T. Horikane T. Hayata H. Tosuji Y. Kagawa 10.18926/46979 Resistivity distribution sounding of the non-homogeneous earth is important for electrical ground system design, geophysical prospecting and survey or monitoring the groundwater flow level. The previous paper presented that the direct inversion of the electric resistivity distribution in a domain is possible from the impedance data measured over the domain boundary using the dual reciprocity boundary element modelling in two-dimentional field [1]. The proposed inversion technique is extended to the distribution in three-dimensional space [2]. This technique is capable of inversion without iteration and meshing of the domain. Electric field with spatially varying conductivity is governed by Laplace equation, which is transformed into a Poisson-type expression with an inhomogeneous term involving the conductivity difference as a source term. Dual reciprocity method (DRM) is a technique for transforming the domain integral associated with the inhomogeneous term in Poisson equation into the boundary integral expression. The resistivity distribution in the field can thus be identified from the data observed over its boundary, for which some examples are demonstrated [2]. In this paper, the examination is extended to the case where only the data measured over the single surface is used for the inversion. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 41 1 1929 生物發光ニ關スル研究（其ノ1） 153 187 EN Kanae Hayasi Misao Okuyama The bioluminescence is especially interesting for physiologists in the sense that the end of the intracellular mechanism of the light producing cells is revealed by the light. Whole energy liberated by the process is represented by the light only, unmixed by other energies e. g. movement or heat. This special fact simplifies the experiment enormously, because the light intensity can be measured accurately and conveniently. Photometries used for these studies were following two, according for the purpose. a) Photographic method comparing either of the intensity grade or the diameter of the dark spot on the negative plate or film. b) Comparison method of the brightness of the light with the aid of the adjustable dark glasses (double frame detached from the Hess' differential pupilloscope). The results obtained on the Japanese firefly (Genzi-hotaru and Heike-hotaru) were summariesed as follows. 1) The light producing organ kept in exsicator could be brought to emitt light again by moisting with water, even after two years. 2) The spectrum of the light of the Japanese firefly extends continuously from the reddish orange (660μμ) to the bluish green (480μμ). 3) The intensity of the light increases by the stimulation of the light producing organ with the faradic current or by the chemicals which affect only muscle but not nerve. This phenomenon does not suggest the excitability of the organ or the presence of the exciting nerve for the organ, but can be explained by the increased supply of air by the contraction of the tracheal muscle. 4) The light extinguishes at temperature 0°--7°C., it reappears again dy warming. At the temperature over 40°C. the light becomes gradually reddish and extinguishes at 48°C-54°C. It does not reappear by cooling. The temperature coefficient for intervals 10°C. of the light intensity is 1.2-1.3. The same for the velocity of decay of light is 1.9-2.1. 5) Oxygen is indispensable to the light production of the light producing substance of firefly, which does not emit light under 1/40 atomospheric pressure of oxygen. The intensity of the light increases propotional to the oxygen pressure in the extent of 1/40 to I atomospheric pressure; over that pressure the light intensity approaches asymptotic to the maximum. Further increase of pressure beyond the maximum, also until 4-5 atomospheric pressure or even to 15 atm. pr. does not show any tendency to decrease the light intensity. 6) The light emission from the minced light producing organ of the firefly is not affected by carbon monoxide. It shows that the oxidizable substance does not combine with CO more forcible than with oxygen as haemoglobin does. 7) The light is given out, when the hot water extract from the light producing organ or the non-luminous part of the firefly or from certain animals like cocoonworm (Kaikono-Mayu) which have no light producing organ, is added to the cold water extract from the light producing organ of the firefly. 8) HCN-gas has no influence upon light production of the light producing organ or the mixture of cold water and hot water extracts from the light producing organ, the oxidation concerned with the light production by the firefly would refer to other than the oxidation connected with iron. 9) The authers measured the CO(2) production from the isolated light producing part and non-luminous part of the firefly with Osterhout's indicater method applied for the CO(2) -gas measurement of nerve fibre by Parker and came to the conclusion that the oxidation reaction does not accompany with CO(2) production, for the light producing part did not give out more CO(2)-gas than the non-luminous part. 10) The decay curve of the light emitted from the mixture of the hot water extract from non-luminous part of the firefly or from the larva of the Dendrolimus pini (Matu-Kemusi) and the cold water extract from the light producing part of the firefly indicates that the luminescent reaction in the firefly belongs to a monomolecular reaction, provided, the light intensity at any instant is assumed to be proportional to reaction velocity at that instant. 11) The velocity of the decay of the light intensity which emits from the mixture of cold and hot extract quickens by the increase of the quantity of the cold water extract of the light producing part of firefly. From this fact it seems that the cold water extract contains an enzymlike substance which hastens the luminescent reaction. On the contrary, when the quantity of the hot water extract from luminous part or non-luminous part of the firefly or from non-luminous animals increases, the light of the mixture decays slowly and lasts longer. This fact is explained by an assumption that the hot water extract lets the photogenic substance active (e. g. it sets the inactive photogenic substance combined with protein free.) and at the same time enzymlike substance becomes correspondingly inactive (e. g. by the adsorption). At the addition of the cold water extract into the cold and hot water mixture, it sometimes brightens the emitted light and sometimes lessons it. This initial flash is accounted for granting that the hot water extract acts at bravest at an optimal concentration which is proved especially in case of that from non-luminous part of the firefly. 12) The extinguished but still active cold water extract emits the light by the addition of alkali instead of the hot water extract. On the contrary, we could not let shine the hot water extract by any means. 13) Potassium bromide or erytrosin inhibits luminescence of the light mixture, but Potassium cyanide does not. 14) The active hot water extract is formed by heat from the firefly or certain non- luminous animals; i.e. by the convertion of the precursor into its efficacious form and by the destruction of material preventing the action of the active substance. Required temparature and time for this purpose is about over 3 min. at 50℃. or 15-16 min. at 100℃.. On the contrary, the active cold water extract loses its power by warming at 42°-43°C. over 3 min. 15) The active hot water extract in solution does not degenerate in half a day, and is efficacious even after a day, but the active cold water extract diminishes in power remarkably in 1-2 hours at room temperature. 16) The active component in the hot water extract passes easily through filterpaper, Chamberand filter and collodium membrane, but the active substance in the cold water extract does not filter through collodium membrane. 17) Charcoal adsorbs the active part both in hot and cold water extracts, but the latter is less adsorbed than the former. 18) Such an efficacious component as that in the active hot or cold water extract can not be extracted by alkohol or ether. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 46 10 1934 肺臓原基ノ形態學的發生ニ就テ（鳥類殊ニ十姉妹ニ於ケル檢索） 2587 2608 EN Hideo Kaneoka Though many experiments concerning the development of the avian lung anlage have been performed, our knowlegde is still inadequate and defective with regard to the state of the development of air-sacs, parabronchi and recurrent bronchi. The author investigated to the development of the lung anlage of Uroloncha domestica Flower, comparing his results with those of Rösler, Shikinami, Murayama and Yakushiji, and in connection with this, further observed the state of the dovelopment of air-sacs, parabronchi and bronchial circuits. Most of the embryos were fixed in Zenker's fluid, and stained with borax-carmine. After subsequent treatment in the usual manner, these specimens were embedded in paraffin and trimmed and cut in transverse serial sections with a thickness of 10 microns. A number of models were prepared according to Born-Peter's method of wax-plate reconstruction. From the results obtained the following may be concluded. 1) The lung anlage of Uroloncha domestica Flower develops in pairs as in the case of the mammals and other birds. 2) In an embryo of 28 somites and 4.0mm in length, the first appearance of the lung anlage comes in as an enlargement of each side of the foregut caudal to the third gill-pouch. 3) In an embryo of 3.5mm length and of 31 somites, the lung anlage appears as a hernious enlargement on each side of the foregut. The distal end of the anlage foreshadows the bronchus anlage. 4) In an embryo of 4.5mm in length, the bronchus anlage is clearly distinguished and its distal portion is divided into the right and left mesobronchi. Each of the mesobronchi, markedly extending in the caudal direction, shows in the central portion of the dorsal surface the first division of the bronchus, i.e. Ent. 1., as a papillar bud-like enlargement. 5) In an embryo of 5.0-6.5mm length, each mesobronchus, divided from the bronchus, shows irregular spindle-shaped enlargement which forms the embryonic vestibulum. In an embryo of 7.0mm length, the embryonic vestibulum, surrounded by the mesobronchus, does not show any clear outline. 6) In an embryo of 5.0mm in length, the mesobronchus shows not only the Ent. 1. and 2., and at the caudo-medial portion Ent. 3. and 4., but also Ect. 1. and 2., which developed from the dorsal surface of the embryonic vestibulum. The four entobronchi enumerated in Uroloncha domestica Flower and these are in front of the embryonic vestibulum. 7) In an embryo of 5.5mm length, not only do each of the Ent. 1., 2., 3. and 4. show enlargement and proliferation, but the Ect. 1., 2. and 3. develop from the dorsal surface of the embryonic vestibulum, and the Lat. 2. is foreshadowed at the lateral wall of the embryonic vestibulum. 8) In an embryo of 6.0mm length, three branches from Ent. 1., extending towards cranial, transverse and medial, two branches from Ent. 2. towards ventro-lateral and dorso-lateral, two branches from Ent. 3. towards cranial and ventral, develop in connection with the enlargement of Ent. 4. The outlines of Ect. 1., 2., 3., 4., and Lat. 1., 2., 3. are clearly seem. 9) In an embryo of 6.5mm length, the first appearance of the air-sacs and parabronchi, which are proper to the bird's embryo, is observed. It arises from the Ent. 1., cranial the cervical air-sac, transversal the lateral moiety of the interclavicular airsac: from the Ent. 3., cranial the medial moiety of the interclavicular air-sac, ventral the anterior intermediate air-sac: from the Lat. 3., the posterior intermediate air-sac: from the Ent. 1. and 2., respectively 3. and 2. parabronchi: from the Ent. 3., each two parabronchi of the ventral and dorsal walls, and from Ent. 4. none. Further the ectobronchi develops 4 on the right side and 5 on the left. Ect. 1. divides in cranial and dorsal branches, from each of which two parabronchi develop. 3 parabronchi rise from Ect. 3.,4 . from Ect. 3.,a nd 2., from Ect. 4. At this time, Lat. 1., 2.,a nd 3. begin to appear and one parabronchus develops from Lat . 2. 10) In an embryo of 7.0mm length, each bronchial tree shows not only more enlargement and ramification, but each branch arising from the bronchial tree also shows marked development and grape-like appearance where they come in contact with each other. Ent. 1., and 2. from the ventral portion of the upper region of the lung. The tree-like parabronchi arising from Ent. 1., and 2., come in contact at the lateral surface of the upper region of the lung with the parabronchi from Ect. 1., 2. and Lat. 1., 2., which extend in a cranial direction. Ent. 3., and 4. from the ventral portion of the caudal lung region, and the parabronchi arising from these come into contact at the lateral and medial sides of the dorsal surface of the lung with those from the Ect. 2., 3., and 4. In this way, the parabronchi which come in contact with each other, combine together and from the bronchial circuits. And the anterior-intermediate-air-sac of the Ent. 3., as mentioned in the embryo of 6.5mm length, extending towards ventral, forms a rod-like prominence and develops the medial moiety that extends from cranial to ventral direction. At this stage, the first appearance of the recurrent bronchi is observed at the cranial extremity of the posterior-intermediate-air-sac, rising from Lat. 3. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 47 10 1935 無尾兩棲類腦下垂體ノ發生ニ就テ（特ニ青蛙Rhacophorus schlegeliiニ於ケル檢索） 2631 2654 EN Takeshi Kôchi Although the literature dealing with the development of the hypophysis is voluminous, there is still a great deal of confusion concerning the cradle of the anlage of the epithelial lobe of the hypophysis. An endless chain of discussion has been evoked by the question as to whether the epithelial hypophysis is derived from the entoderm or from the ectoderm, or whether it is compounded of elements derived from both of these germ layers. On account of these discrepancis, the auther investigated the development of the hypophysis of the Anura, especially on Rhacophorus schlegelii, in comparison with previous results. Most of the materials were fixed in formalin-alcohol fluid, and stained with borax-carmine. After subsequent treatment in the usual manner, the specimens were embeded in paraffin, trimmed and cut in transverse serial sections and longitudinal serial sections of 10.0 and 20.0 microns' thickness. Some sections were stained with eosin-hämatoxyliu. A number of models were prepared according to Born-Peter's method of waxplate reconstruction. From the results of my experiments, the following summary and conclusions were made: 1) The hypophysis of Rhacophorus schlegelii consists of three epithelial lobes and a neural lobe. The epithelial hypophysis is derived from the ectoderm and consists of the pars anterior, the pars intermedia, and the pars tuberalis. 2) The pars anterior developer from the main central portion of the solid epithelial anlage. It is a flatish elliptical shape except in the case of the early stages, and lies caudal and ventral to the other lobes of the hypohysis. It moves caudally at an early stage, in the adult it connects with the infundibulum indirectly through the pars intermedia and the pars neuralis. 3) The pars intermedia is derived from the dorso-caudal region of the solid epithelial anlage. It has a long axis extending from side to side, and lies between the pars anterior and the pars neuralis. 4) The pars tuberalis arises from the pars lateralis which developes from the pars anterior. In the early stages it connects with the pars anterior but later on becomes detached, forming two epithelial disks lying close under the ventral wall of the infundibulum. 5) The pars anterior is the largest of three epithelial lobes, the pars intermedia the next smaller and the pars tuberalis the smallest. 6) The pars neuralis devolopes from the caudal tip of the infundibulum. It has a long axis extending from side to side and connects with the crauio-dorsal region of the pars intermedia. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 65 1 2011 Regulation of Mitochondrial Dynamics and Neurodegenerative Diseases 1 10 EN Xiao-Jian Han Kazuhito Tomizawa Atsushi Fujimura Iori Ohmori Tei-ichi Nishiki Masayuki Matsushita Hideki Matsui Review 10.18926/AMO/43824 Mitochondria are important cellular organelles in most metabolic processes and have a highly dynamic nature, undergoing frequent fission and fusion. The dynamic balance between fission and fusion plays critical roles in mitochondrial functions. In recent studies, several large GTPases have been identified as key molecular factors in mitochondrial fission and fusion. Moreover, the posttranslational modifications of these large GTPases, including phosphorylation, ubiquitination and SUMOylation, have been shown to be involved in the regulation of mitochondrial dynamics. Neurons are particularly sensitive and vulnerable to any abnormalities in mitochondrial dynamics, due to their large energy demand and long extended processes. Emerging evidences have thus indicated a strong linkage between mitochondria and neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease and Huntington's disease. In this review, we will describe the regulation of mitochondrial dynamics and its role in neurodegenerative diseases. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 66 12 1954 流行性肝炎の疫学研究 第1報 赤磐地区における流行性肝炎の疫学観察（其の一） 2349 2355 EN Kiyowo Kosaka Keitaro Seto Gosuke Horio Chihiro Masaoka Kaichi Morimoto Teruyuki Namba Kiyoshi Imai Mitsugu Matsuba Kiyoshi Nishimura Norihiro Tanimizu Mitsuo Sato Akira Onari Masashi Terao Masao Iwahara Masuo Hino Since August 1951 to Feb. 1953, there was a great epidemic of serious infectious hepatitis over the area including Toyota, Onoda, Kama villages in Akaiwa County, as well as Kumayama village in wake County; observing its state, the following results were obtained. 1. Death toll has amounted to 13, out of 93 patients: its mortality rate, 13.98%; in number of the patients, Kama at the top, next, Toyoda, Onoda and Kumayama village, in literal order. 2. The epidemic took the direction, from the south extending to the north in a slow march, taking a hamlet as unit, showed a lack of specific seasonal occurence. 3. As to age, it has ranged roughly from 10 to 60, amid which 21-30 figured out as top years; below 10, only 4 cases; above 70, 5 cases. As to sex, almost similar in number. 4. As to profession, principally, farming people; as one can suppose from its locality. In making investigations into the cause of disease. certain consideration must be taken on the great responsibility imposed on farmers' wives. 5. The infection for this disease was classified as village infection or familiary infection; among 22 cases (23.4% of total patients) of familary infection, there were 4 families, each yielding even 3 sickened members; 5 families whose two members taken infection; in total, amnunted to 9 families. Among these tribal infection, report has been submitted about 1 family whose infection tract was clearly traced, as well as a family in which, if man did not expose certain inapparent infections, all cases have proved utterly whimsical. 6. The incubation period for this disease may probably be estimated to be about 24-27 days, if it may be supposed from these infectious state, and would be considered perorale infection. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 67 1 1955 腎結核における腎機能に関する研究 第1編 偏側性腎結核の腎機能（特に水試験と色素排泄試験成績について） 289 305 EN Yoshio Kosokabe I have made a study on the renal function in 163 cases of unilateral renal tuberculosis by examining the fluid test, indigocarmin and phenolsulfonphthalein excretion test and obtained the following results: (1) Concerning the fluid test, 46 cases (29.6%) out of 155 cases had insufficiency in excretion ability, 91 cases (58.7%) had insufficiency in concentration ability, and 46 cases (29.6%) had insufficiency both in excretion and concentration abilities. Moreover, 61 cases with insufficiency in concentration ability showed normal excretion ability, and 16 cases (10.3%) with insufficiency in excretion ability showed normal concentration ability. (2) The renal dysfuntcion in renal tuberculosis appears first in concentration then second in excretion ability. (3) In indigocarmin excretion test, 24 cases (25.8%) out of 93 cases showed disturbance in left side, 35 cases (37.6%) in right side, and 24 cases (25.8%) in both sides. (4) In phenolsulfonphthalein test, only 7 cases (8.8%) showed disturbance of excretion, i.e., excretion less than 45% in an hour, and 72 cases showed normal value, i.e., 26 cases (32.9%) with excretion over 71% and 46 cases (52.8%) with excretion between 70% and 46% in an hour. (5) The results of the previous 3 tests did not always completly coincide with each other, so the summarised dicision of the results of various examinations must be made in order to learn the renal function distinctly. (6) No difference could be found between the male and female, or the side of affection, In the research of the age of patients, the patients from 21 to 40 years old were affected more frequently but the extend of the insufficiency of renal function was rather slight. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 69 9 1957 子宮頸癌骨盤内淋巴節転移と予後との関係並びに再発々生部位 2345 2350 EN Kenji Kawada Shogo Tachibana Kazuo Yamaguchi We have examined histopathologically the removed lymph-nodes of 334 cases of carcinoma of the uterine cervix which were submitted to Okabayashi's abdominal extendive radical operation. We checked the lymph-node metastasis in every case and made a review on the interrelationship between the pelvic lymph-nodes metastasis and 5 year survival rate, and also the sites where recurrence of carcinoma happened. Results were summarized as follows: 1) In the group with positive lymph-nodes metastases 5 year suvival rate was 26.1 per cent (17 out of 65 cases). 2) In the group where no pelvic lymph-nodes metastases were found, 5-year survival rate was 71 per cent (194 out of 269 cases). 3) The prognosis is far better in the group in which no metastasis was present. 4) Recurrence was frequently found within the pelvic cavity, especially quite often at the vaginal stump or the parametrial region. With regard to recurrence, no specific difference was found between the group with metastasis and without it. No potential conflict of interest relevant to this article was reported.

岡山大学理学部地球科学教室 Acta Medica Okayama 1340-7414 17 1 2010 1993，1994，1995年における東アジアの秋雨前線帯付近の雲分布や大気場の総観的特徴の比較 7 19 EN Shigeko Fukuda Kuranoshin Kato 10.18926/ESR/42458 In order to examine year-to-year variability of the Akisame (autumn rainfall) frontal zone in East Asia, large-scale cloud distribution and atmospheric fields around the frontal zone were compared among 1993, 1994 and 1995, when their characteristics were rather different among each other. While the Akisame frontal zone extended zonally and the deep convective clouds tended to appear in that frontal zone near the southern coast of the Japan Islands in 1993, the frontal zone extends from southwest to northeast and the large amount of precipitation was brought mainly in the northern Japan. In 1995, although the surface front on the weather maps appeared frequently also around the southern coast of the Japan Islands, the rainfall amount there was not so large. The area with frequent appearance of the deep convective clouds in the Akisame frontal zone was seen only to the east of the Japan Islands. As such, it is noted that the active area of the Akisame frontal zone shows rather large year-to-year variability also in the zonal direction. It is also suggested that such great variability of the Akisame frontal zone in the zonal direction seems to correspond to the variations of the subtropical high and the ITCZ in the western Pacific region around September. No potential conflict of interest relevant to this article was reported.

岡山大学経済学会 Acta Medica Okayama 0386-3069 29 3 1997 Global Comparative Statics for Models with Hicksian Imperfect Stability 79 85 EN Takao Fujimoto 10.18926/OER/41600 This note is to provide a bridge between traditional local analysis for comparative statics and its global counterpart. Many economists vaguely believe that it is possible to obtain a global result by applying consecutively a series of local results. This belief is not well founded in models where parameters enter in a not-so-simple way. An example is given to show that local analysis is after all local. In the proof of the first main theorem, a consecutive use of a well known local result is employed. Some necessary assumptions are explicitly stated. Then this theorem is applied to establish another main theorem in which a simple repetitive application of local analysis may break down because some required properties cease to hold. This two-stage approach seems to be useful in tackling with other types of equations. As an application of our theorems, a general equilibrium model with Hicksian imperfect stability is taken up. A comparative statics result due to Hicks is extended to the case of global changes. An interesting point to note is that when dealing with global comparative statics, the old system plays no explicit role. Only the new system matters together with the new and old equilibrium values. Understanding this point is important when we come to consider such real situations as involve technical changes in which new processes as well as new commodities turn up. No potential conflict of interest relevant to this article was reported.

岡山大学経済学会 Acta Medica Okayama 0386-3069 30 3 1999 Univalence of Nonlinear Mappings : A Qualitative Approach 345 351 EN Takao Fujimoto 10.18926/OER/41559 This note is a sequel to the previous one published in this journal (Vol. 30, No.1). In that article, we used one of mean value theorems to prove the univalence of a nonlinear mapping based on the qualitative regularity ofthe Jacobian matrix. The qualitative regularity is a property of a matrix whose regularity is shown to be valid by using only the sign patterns of mappings involved. In this note, we extend the result into a vector space over an integral domain. The vectors themselves are of n-tuples of elements in the integral domain. This integral domain is totally ordered, and some natural properties are assumed concerning this order. First two lennnata are given, and the first one is in fact a sort of mean value theorem for mappings from a direct product of discrete spaces into a discrete space, and utilizes mathematical induction. The second lemma depends on the fact that theory of matrices and determinants can be constructed also on a ring except for inverse matrix. Finally, our main proposition derives from the very integrity of a given domain. Another merit of the result is that the domain of a mapping need not be convex, and can be even a set oflattice points. No potential conflict of interest relevant to this article was reported.

岡山大学経済学会 Acta Medica Okayama 0386-3069 31 4 2000 A Univalence Theorem for Nonlinear Mappings: An Elementary Approach 277 283 EN Takao Fujimoto Carmen Herrero 10.18926/OER/41521 This note is to extend a well-known theorem due to Gale and Nikaido on the univalence of nonlinear mappings. Our approach is based on a simple elimination method of variables, and the key proposition used is the implicit function theorem. In terms of the condition on signs of principal minors, our result is more general than that of Gale and Nikaido since the sign of a minor can be positive or negative. Besides we require the sign condition only for the leading principal minors. On the other hand, the domain of mappings we can deal with has to be unbounded for all but one variable. In addition, the value of each principal minor must be in a finite range. Some remarks are given in the final section. No potential conflict of interest relevant to this article was reported.

岡山大学経済学会 Acta Medica Okayama 0386-3069 32 2 2000 所得分布と高齢化社会における税制改革 59 98 EN Akira Okamoto 10.18926/OER/41467 This paper examines the effects of changes in the variance of income distribution on both capital accumulation and social welfare in Japan, the society with an aging population. To analyze the problem, we adopt a simulation approach for an extended life-cycle general equilibrium model of overlapping generations with continuous income distribution. The simulation results indicate that the changes in the variance affect economic variables under a progressive tax scheme but they do not under a proportional tax scheme. The results also show that social welfare greatly increases as the variance shrinks. Therefore, the recent shift in Japan, where the taxation system has tended in effect to become flat, may cause a significant damage to social welfare. No potential conflict of interest relevant to this article was reported.