WileyActa Medica Okayama2090-6447202612026Carcinoma ex Pleomorphic Adenoma With an Epithelial‐Myoepithelial Carcinoma Component in the Submandibular Gland: A Case ReportENTomohiroYasuharaDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasanoriMasuiDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYukiKunisadaDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiroakiTakakuraDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityEijiIwataDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoichiKadoyaDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKokiUmemoriDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNorieYoshiokaDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKeisukeNakanoDepartment of Oral Pathology and Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySoichiroIbaragiDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground: Carcinoma ex pleomorphic adenoma (CXPA) is an uncommon malignant salivary gland tumor arising from pleomorphic adenoma, whereas epithelial-myoepithelial carcinoma (EMC) is a rare low-grade salivary gland malignancy. CXPA with an EMC component in the submandibular gland is uncommon.<br>
Case Report: A 65-year-old man presented with a painless, firm mass in the left submandibular region and weakness of the left lower lip. Computed tomography and magnetic resonance imaging demonstrated an irregular submandibular mass, and FDG-PET/CT showed increased uptake (maximum standardized uptake value, 9.2). Core biopsy suggested pleomorphic adenoma; however, the clinical and radiological findings strongly indicated malignancy. Incisional biopsy was therefore performed under general anesthesia, with a plan to proceed to definitive treatment if malignancy was confirmed. Intraoperative histopathological examination revealed a malignant salivary gland tumor, and tumor resection with neck dissection was completed during the same procedure. Histopathological examination showed invasive CXPA with an EMC component, accompanied by extracapsular invasion exceeding 6 mm, perineural invasion, and extension into adjacent muscle (pT3N0). Although surgical margins were negative, pulmonary metastases developed 12 months after surgery, followed by suspected pleural dissemination and spinal canal extension. The patient declined further aggressive treatment and died of the disease 48 months after surgery.<br>
Conclusion: This case highlights the importance of integrating clinical, radiological, and pathological findings for accurate diagnosis of salivary gland tumors, particularly when biopsy results are inconsistent with clinical suspicion.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0140-77912026Tripartite Interaction Between Penicillium pinophilum-Host Plants and CMV-Y: A Model for Endophyte-Mediated Viral BiocontrolENSarah R.IbiangGroup of Plant-Microbe Interactions, Institute of Plant Science and Resources, Okayama UniversityIvanGalisGroup of Plant-Insect Interactions, Institute of Plant Science and Resources, Okayama UniversityHidekiKondoGroup of Plant-Microbe Interactions, Institute of Plant Science and Resources, Okayama UniversityNobuhiroSuzukiGroup of Plant-Microbe Interactions, Institute of Plant Science and Resources, Okayama UniversityPlant-fungus-virus tripartite interactions represent complex ecological systems in which mutualistic endophytes can influence host physiology, yet the molecular basis of endophyte-mediated defence remains poorly understood. Here, we demonstrate that the endophytic fungus Penicillium pinophilum EU0013 suppresses the yellow strain of cucumber mosaic virus (CMV-Y) in Solanum lycopersicum and Nicotiana benthamiana. CMV-Y infection induced pronounced oxidative and hormonal perturbations, which were mitigated by P. pinophilum colonisation. Endophyte-associated plants exhibited early accumulation of jasmonate intermediates, consistent with the activation of jasmonate signalling. This response promoted the degradation of jasmonate-ZIM-domain proteins and release of core JA-responsive transcription factors. Virus-induced gene silencing identified MYC2 as a key regulator required for endophyte-mediated antiviral protection, with WRKY17 contributing to defence modulation. In parallel, transcriptome analysis revealed the upregulation of a Dicer-like gene, indicating enhanced engagement of RNA silencing, a primary antiviral mechanism targeting viral RNA. This coordinated activation occurred alongside significant induction of pathogenesis-related proteins, particularly PR9, and improved control of reactive oxygen species. Salicylic acid-responsive defences showed a host-modulated pattern, with PR1 induced by CMV and PR2/PR5 preferentially enhanced in endophyte-associated plants. Collectively, these findings demonstrate that P. pinophilum enhances antiviral immunity through coordinated defence integration pathways, providing a framework for endophyte-based viral disease management.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1639-44882026Triple Oxygen Isotope Compositions of Isotopic Reference Waters: Implications for VSMOW-Scale and VSMOW–SLAP-Scale Δ′17O CalibrationENRyojiTanakaThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityAndreasPackGeorg-August-Universität Göttingen, Geowissenschaftliches ZentrumTyler B.CoplenUS Geological SurveyTriple oxygen isotope ratios of waters are commonly reported on the VSMOW–SLAP scale, whereas comparison with theoretical calculations and assessment of instrumental scale distortion require accurate constraints on the measured isotopic compositions of the primary isotopic reference materials (iRMs) themselves. In particular, the measured δ17OVSMOW and Δ′17OVSMOW values for SLAP and its substitute, SLAP2, remain insufficiently constrained and reported values differ among laboratories. Here, we measured triple oxygen isotope ratios for two primary iRMs (VSMOW and SLAP) and twelve secondary iRMs (VSMOW2, SLAP2, GISP, GRESP, USGS45, USGS46, USGS46a, USGS47, USGS48, USGS49, USGS50 and USGS53) using BrF5 fluorination and dual-inlet isotope-ratio mass spectrometry. For SLAP, we obtained δ18OVSMOW = -55.50 ± 0.15‰ and δ17OVSMOW = -29.66 ± 0.08‰, giving Δ′17OVSMOW = 34 ± 6 per meg (all expanded uncertainties, k = 2). The corresponding values for SLAP2 agree within uncertainty. When expressed on the conventional VSMOW–SLAP scale, our Δ′17OVSMOW–SLAP values for all secondary iRMs with available literature values agree with previously published values within uncertainty, confirming interlaboratory comparability on that scale. In contrast, waters with low δ18O values, Δ′17OVSMOW values are systematically higher than the corresponding Δ′17OVSMOW–SLAP values. These results further suggest that accurate determination of the VSMOW-scale isotopic composition of SLAP and/or SLAP2 across laboratories is essential, particularly for low-δ18O samples, for which the difference between VSMOW-scale and VSMOW–SLAP-scale Δ′17O values becomes large, and for meaningful comparison between measured data and theoretical calculations.No potential conflict of interest relevant to this article was reported.公益社団法人 日本租税研究協会Acta Medica Okayama0288-07689212026組織再編成の適格要件の再検討－スピンオフの濫用防止を中心として－166193ENNo potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0721-832X2026Dissociation between globe shape-induced rectus muscle pulley displacement and abduction limitation in patients aged 40 years and older with high myopic strabismusENReikaKonoDepartment of Ophthalmology, Okayama University Graduate School of Medicine Dentistry, and Pharmaceutical SciencesIchiroHamasakiLino Eye ClinicFumikoKishimotoDivision of Ophthalmology, Ibara City HospitalKiyoShibataLino Eye ClinicShinMorisawaDepartment of Ophthalmology, Okayama University Graduate School of Medicine Dentistry, and Pharmaceutical SciencesYukiMorizaneDepartment of Ophthalmology, Okayama University Graduate School of Medicine Dentistry, and Pharmaceutical SciencesPurpose We hypothesized that high myopia (HM)-induced globe deformation displaces rectus muscle (RM) pulleys, contributing to mild ocular motility restriction. This study investigated the effects of globe shape on RM pulley positions in older Japanese patients with acquired strabismus (AS) and mild motility restriction—defined as the ability to abduct both eyes beyond the midline.<br>
Methods In this retrospective case series, 28 patients (mean age ± standard deviation: 61.2 ± 9.0 years) with adult-onset AS were included: 6 patients with (LAB group) and 22 patients without abduction limitation (NLAB group). In each subject, the eye with the longer axial length (AL ≥ 26 mm), measured using an AL measurement apparatus, was analyzed using magnetic resonance imaging (MRI). RM pulley positions relative to the globe center and equatorial diameter (ED) were measured; the ED-to-AL ratio (EAR) was calculated. We compared these parameters between groups and analyzed correlations of globe-shape factors (EAR, AL, and ED) with pulley positions and age.<br>
Results No significant differences in EAR, AL, ED, or pulley positions were detected between LAB and NLAB groups, possibly owing to the limited sample size and group imbalance, in the analyzed eyes. However, as EAR decreased (prolate deformation), the superior rectus (SR) pulley (r = 0.68, P < 0.01) and inferior rectus (IR) pulley (r = 0.40, P = 0.03) significantly displaced nasally. AL (r = -0.52, P < 0.01) correlated with the horizontal SR pulley position. Furthermore, age significantly correlated with AL (r = 0.45, P = 0.02) and decrease in EAR (r = -0.41, P = 0.03).<br>
Conclusions In older Japanese patients with HM and AS, prolate globe deformation was associated with age and significantly correlated with SR and IR pulley positions. While the direct relationship between these structural changes and the clinical degree of mild abduction limitation requires further investigation in larger cohorts, EAR sensitively reflected age-related morphological shifts; thus, when used in conjunction with AL, EAR may represent a readily measurable MRI-based parameter associated with restrictive motility tendencies in strabismus with high myopia.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2050-09041472026Custom‐Made Mouthpiece‐Assisted Oral Cryotherapy During Hematopoietic Stem Cell Transplantation in a Patient With Hemimaxillectomy‐Related Oroantral Communication: A Case Reporte73156ENKumikoMatsuzakiDivision of Hospital Dentistry, Okayama University HospitalFuminobuMiyazakiDental Laboratory Division, Okayama University HospitalYasujiMotoyamaDental Laboratory Division, Okayama University HospitalSeikoTakedaDepartment of Oral and Maxillofacial Reconstructive Surgery, Okayama University HospitalTakuoKubokiDental Laboratory Division, Okayama University HospitalYoshihikoSogaDivision of Hospital Dentistry, Okayama University HospitalA custom-made mouthpiece enabled safe oral cryotherapy in a patient with extensive oroantral communication after hemimaxillectomy and may also be applicable to other patients with communication between the oral cavity and the maxillary sinus or nasal cavity.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1078-81743262026Students’ perceptions of an electronic one-minute paper in a radiography training programme: An exploratory cross-sectional questionnaire study103486ENY.KomatsuDivision of Radiological Technology, Graduate School of Health Sciences, Okayama UniversityS.AbeDepartment of Radiological Technology, Faculty of Health Care Sciences, Jikei University of Health Care SciencesS.TsudouDepartment of Radiological Technology, Faculty of Health Care Sciences, Jikei University of Health Care SciencesY.YamamotoDivision of Radiological Technology, Graduate School of Health Sciences, Okayama UniversityY.TanabeFaculty of Health Sciences, Department of Radiological Technology, Okayama University Medical School, Okayama UniversityIntroduction: Formative assessment can support health professions education; however, reports on electronic 1-min papers as classroom feedback and engagement tools in radiography programmes remain limited. This study explored radiography students’ perceptions of an electronic 1-min paper, focusing on in-class reflection, ease of asking questions, and instructor feedback.<br>
Methods: An electronic 1-min paper was used in a radiotherapy course across 45 class sessions in the 2024 academic year for third-year students enrolled in a 4-year radiography programme. Each 90-min class comprised a 60-min lecture, 10-min completion of the paper, and 20-min instructor feedback. After the course, a de-identified online questionnaire was administered. Eleven 5-point Likert-scale items were analysed using descriptive statistics and Spearman's rank correlations. Free-text responses were analysed using inductive qualitative content analysis.<br>
Results: Of the 77 eligible students, 74 responded (96.1%). Ease of use received the highest rating (mean, 4.76; standard deviation [SD], 0.52), followed by ease of asking questions (mean, 4.32), question resolution (mean, 4.16), and usefulness of instructor feedback (mean, 4.08). Motivation to review after class was lowest (mean, 3.04; SD, 1.16). Active participation showed a strong positive association with in-class concentration (rs = 0.815; P < 0.001). Free-text responses indicated reflection and improved understanding, anonymous sharing of questions, active listening and concentration, and suggestions for improvement.<br>
Conclusion: The electronic 1-min paper was widely accepted and perceived to support in-class reflection, question expression, and immediate feedback. However, students’ perceptions of its influence on out-of-class review motivation were limited. The findings indicate perceived value and engagement rather than demonstrated educational effectiveness.<br>
Implications for practice: Electronic 1-min papers may help instructors identify students’ questions and respond during class, providing a practical approach to in-class feedback.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0016-23614292027Mechanism of Enhanced Heat Release in Spray Combustion of a Methanol–DME Blended Fuel140693ENYoshimitsuKobashiFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityShodaiMakinoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMasakuniNambaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityNobuyukiKawaharaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityKatsuyoshiAsakaTechnical Management Division, Carbon Neutral Technology Department, DAIHATSU INFINEARTH MFG. CO., LTD.KazuyukiKobayashiTechnical Management Division, Carbon Neutral Technology Department, DAIHATSU INFINEARTH MFG. CO., LTD.This paper investigates the spray combustion characteristics of a methanol–DME blended fuel with a DME mole fraction of 0.57 in a constant volume vessel. The rate of heat release (ROHR) was evaluated using pressure-based heat release analysis. The results show that the methanol–DME blended fuel requires a longer injection duration due to the lower LHV (lower heating value), but it exhibits a shorter combustion duration than conventional diesel fuel, together with a higher ROHR normalized by the injection LHV rate and a shorter afterburning duration. To elucidate the relationship between the spray combustion processes and the ROHR characteristics, the spray flame was visualized using schlieren and OH chemiluminescence imaging techniques. In addition, a one-dimensional simulation based on a diesel jet model was conducted to evaluate the distributions of the equivalence ratio. These analyses reveal that the lower theoretical air–fuel ratio, attributed to the oxygenated nature of the methanol–DME blended fuel, reduces the equivalence ratio within the spray, promoting earlier formation of near-stoichiometric mixtures. As a result, the ROHR reaches and sustains its maximum earlier during mixing-controlled combustion, and fuel consumption is enhanced during afterburning.No potential conflict of interest relevant to this article was reported.Ceramic Society of JapanActa Medica Okayama1348-653513472026Dielectric response modulation in relaxor (Sr,Ba)Nb2O6 via engineered defect455460ENRyuseiShiotaGraduate School of Natural Science and Technology, Okayama UniversityTakashiTeranishiGraduate School of Natural Science and Technology, Okayama UniversityShinyaKondoDepartment of Energy Engineering, Nagoya UniversityAkiraKishimotoGraduate School of Natural Science and Technology, Okayama UniversityDefect engineering provides an effective pathway to tune the dielectric response of relaxor ferroelectrics, yet the roles of individual defect species in tungsten bronze (TTB) systems remain unclear. Here, we investigated how engineered Ti–VO•• defect dipoles and native oxygen vacancies introduced through reduction annealing modify the dielectric properties of relaxor (Sr0.5,Ba0.5)Nb2O6 (0.5-SBN). Ti loading forms stable defect dipoles that generate smaller polar nanoregions (PNRs), suppress their overgrowth, and increase the number of dynamically active PNRs at room temperature, leading to enhanced permittivity ε′ while preserving DC-bias stability and breakdown strength (EB). Reduction annealing generates Nb4+-related local polarizations aligned with the external electric field, which strengthen dipole fluctuations and slightly increase ε′. Electron localization further relaxes the TTB-A2 site disorder–induced random fields, yielding a sharper dielectric peak and promoting more uniform PNR growth. Microwave dielectric spectroscopy combined with electromagnetic simulations revealed that the increases in ε′ for both Ti-loaded and reduced samples (0.5-SBNT and Reduced 0.5-SBN, respectively) originate predominantly from enhanced dipole polarization. Despite grain coarsening in 0.5-SBNT, the EB remained unchanged, indicating that defect dipoles act as pinning centers that inhibit field-induced PNR aggregation. In reduced 0.5-SBN, EB increased up to pO0 = 4.3 × 10−3 atm owing to relaxed random fields, whereas excessive reduction reduced EB through carrier-driven space-charge effects. These results demonstrate that precise control of defect species enables simultaneous optimization of ε′, DC-bias stability, and EB in TTB-type relaxor ferroelectrics.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2045-89401622026Recurrence of Pulmonary Hypertension After Unilateral Lung Transplantation: Histological Evidence of Vasoconstrictive Mechanisme70289ENSatoshiAkagiDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMegumiKondoDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoichiIchimuraDepartment of Pathology, Hiroshima City Hiroshima Citizens HospitalTakehiroTanakaDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeiichiroSugimotoDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalKentaroEjiriDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazufumiNakamuraCenter for Advanced Heart Failure, Okayama University HospitalShinsukeYuasaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesPulmonary hypertension (PH) is widely recognized as a disease driven by both vasoconstriction and vascular remodeling. Vasoconstriction is thought to play a predominant role in the early stages of PH, whereas the contribution of vascular remodeling increases as the disease progresses. However, clinical or histological evidence of this pathological progression has not been reported. We describe a case of recurrent PH after unilateral right lung transplantation, ultimately requiring bilateral transplantation 9 years later, and discuss the pathogenesis of PH based on histological findings in the transplanted normal lungs and changes in pulmonary blood flow observed by lung perfusion scintigraphy. Serial lung perfusion scintigraphy revealed a dynamic shift in pulmonary blood flow, initially favoring the transplanted lung, followed by a gradual decline. Histological examination demonstrated that the right lung of the second transplantation showed minimal vascular remodeling. These findings provide compelling evidence that vasoconstriction was the predominant contributor to PH after the first transplantation, offering unique insight into early PH pathobiology.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0941-43553482026Incidence and impact of odontogenic infection-related febrile episodes during perioperative doxorubicin-cyclophosphamide or docetaxel-cyclophosphamide chemotherapy for breast cancer747ENYoshihikoSogaDivision of Hospital Dentistry, Okayama University HospitalKumikoMatsuzakiDivision of Hospital Dentistry, Okayama University HospitalHirotakaKosakiDivision of Hospital Dentistry, Okayama University HospitalTomokoKishimotoDivision of Hospital Dentistry, Okayama University HospitalAikoYoshitomiDivision of Hospital Dentistry, Okayama University HospitalMakotoKajizonoDepartment of Pharmacy, Okayama University HospitalTakashiMakitaDepartment of Pharmacy, Okayama University HospitalYutaTanakaDepartment of Pharmacy, Okayama University HospitalYoshitoZamamiDepartment of Pharmacy, Okayama University HospitalTadahikoShienDepartment of Breast and Endocrine Surgery, Okayama University HospitalHiroyoshiDoiharaDepartment of Surgery, Kawasaki Medical School General Medical CenterBackground Doxorubicin-cyclophosphamide (AC) and docetaxel-cyclophosphamide (TC) are standard perioperative chemotherapy regimens for breast cancer. Febrile neutropenia (FN) is a common adverse event, and odontogenic infections may contribute to febrile episodes. This study was performed to investigate the incidence and impact of febrile episodes clinically associated with odontogenic infections during AC and TC chemotherapy.<br>
Methods A total of 408 patients with breast cancer receiving 4 cycles of AC (n = 285) or TC (n = 123) between 2015 and 2020 were included in this single-center retrospective study. Patients recorded daily axillary temperatures and oral symptoms. Dental evaluations were performed when oral infection was suspected. Febrile episodes (≥ 37.5 °C) were assessed, and their clinical association with odontogenic infections was determined based on dental records and the documented clinical course. Relative dose intensity (RDI) was calculated to assess chemotherapy delivery.<br>
Results Overall, 40.2% of patients experienced febrile episodes, and the frequency was higher in the TC group (48.8%) than the AC group (36.5%, P = 0.02). Febrile episodes associated with oral infections occurred in 9.1% of patients, of which 78.4% were clinically associated with odontogenic infections (7.1% of all patients). Most such episodes occurred during the first chemotherapy cycle (79.3%, P < 0.01). Chemotherapy RDI was reduced in three patients with febrile episodes clinically associated with odontogenic infection, but remained ≥ 85%.<br>
Conclusions Febrile episodes clinically associated with odontogenic infections occurred in approximately 7%–8% of patients with breast cancer receiving perioperative AC or TC chemotherapy, predominantly during the first cycle. Odontogenic infections should be considered one possible source of febrile episodes during treatment.No potential conflict of interest relevant to this article was reported.Frontiers Media SAActa Medica Okayama1664-462X172026Quantitative resistance to Rhizoctonia solani AG-4 develops independently in leaves and roots of Brachypodium distachyon1875734ENRoziFernandaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityNiranjanMahadevanGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityNatsukaKohnoSchool of Agriculture, Okayama UniversityReikoNagaoSchool of Agriculture, Okayama UniversityMegumiWatanabeGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityNanamiSakataGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHidenoriMatsuiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKazuhiroToyodaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYukiIchinoseGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYusukeKouzaiCrop Stress Management Group, Division of Plant Molecular Regulation Research, Institute of Agrobiological Sciences, National Agriculture and Food Research Organization (NARO)KeiichiMochidaRIKEN Center for Sustainable Resource ScienceYoshiteruNoutoshiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityRhizoctonia solani is a soil-borne phytopathogen with a broad host range, classified into multiple anastomosis groups (AGs). While the rice sheath blight pathogen AG-1 IA is well-studied, defense mechanisms against AG-4, which infects diverse monocots and dicots, remain unclear. Here, we screened 153 Brachypodium distachyon accessions for resistance to AG-4 HG-I+II using both leaf and soil inoculation assays. The accessions exhibited a quantitative resistance spectrum in both assays. Some accessions were resistant to both methods, while others showed resistance in only one, indicating that leaf and root defenses operate independently. Unlike the salicylic acid (SA)-dependent resistance observed in several accessions against AG-1 IA, AG-4 leaf resistance appears to be largely SA-independent. Among 22 resistant accessions, only eight induced the SA marker BdWRKY38, whereas twelve induced the jasmonic acid (JA) marker BdAOS. Additionally, resistance in Bd3–1 was unaffected by expression of the SA hydroxylase NahG. These results are consistent with previous findings that exogenous application of SA, JA, or ethylene fails to confer AG-4 resistance. Instead, most AG-4-resistant accessions showed common upregulation of cell wall biosynthesis-related genes following leaf infection, suggesting that cell wall fortification may contribute to defense against AG-4. These findings establish B. distachyon as a valuable model for dissecting resistance mechanisms against R. solani AG-4.No potential conflict of interest relevant to this article was reported.Japan Atherosclerosis SocietyActa Medica Okayama1340-34783322026A Case of Acquired LCAT Deficiency with the Discrepancy between Spontaneous Resolution of Proteinuria and Continually Low HDL Cholesterol Levels228236ENMikiMatsuoDepartment of Nephrology and Hypertension, National Cerebral and Cardiovascular CenterMasatsuneOguraDepartment of Clinical Laboratory Technology, Faculty of Medical Science, Juntendo UniversityMasayukiKurodaCenter for Advanced Medicine, Chiba University Hospital, Chiba UniversityTetsuyaArisatoDepartment of Nephrology and Hypertension, National Cerebral and Cardiovascular CenterMasatsuguKishidaDepartment of Nephrology and Hypertension, National Cerebral and Cardiovascular CenterMarikoHarada-ShibaCardiovascular Center, Osaka Medical and Pharmaceutical UniversityJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoutaroYokoteDepartment of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of MedicineFumikiYoshiharaDepartment of Nephrology and Hypertension, National Cerebral and Cardiovascular CenterA 79-year-old Chinese man was referred for nephrotic syndrome (proteinuria 4.4 g/day). In blood tests, serum high-density lipoprotein (HDL) cholesterol was undetectable, and the esterified cholesterol to total cholesterol ratio was very low. Lecithin: cholesterol acyltransferase (LCAT) activity was also undetectable. Since he had neither corneal opacity nor pathological mutations in the LCAT gene and anti-LCAT antibodies were detected in serum, a diagnosis of acquired LCAT deficiency was made. Renal biopsy revealed glomerulopathy associated with LCAT deficiency and membranous nephropathy (MN). Since the patient’s proteinuria did not improve despite prescribing an angiotensin II receptor blocker (ARB), we suggested the prescription of prednisolone, but he returned to China due to the expiration of his residence visa for Japan. One year after the initial visit, his proteinuria had improved to 0.9 g/day without immunosuppressive therapy. However, his HDL cholesterol level was still low at around 3 mg/dL, indicating a discrepancy between remission of nephrotic syndrome and lack of improvement in lipid levels.<br>
Of the 11 patients with acquired LCAT deficiency reported to date, 4 with undetectable LCAT activity and MN on renal biopsy required immunosuppressive therapy to alleviate proteinuria. The present patient was prescribed only an ARB according to his preference, which happened to be consistent with the MN treatment guideline that states, “Wait 6 months for spontaneous remission while using maximal antiproteinuric therapy.” The clinical course of acquired LCAT deficiency varies, and further case reports are needed to determine the necessity of immunosuppressive therapy.No potential conflict of interest relevant to this article was reported.Japan Atherosclerosis SocietyActa Medica Okayama1340-34783312026Safe Continuation of Apheresis during Pregnancy using the Double-Filtration Plasmapheresis Thermo Mode in a Pregnant Female with Familial Hypercholesterolemia: A Case Report109115ENYoshimasaSakurabuDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesHaruhito A.UchidaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesYukaOkuyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesErikoEtoDepartment of Obstetrics and Gynecology, Okayama University HospitalKanakoTakasugiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesTomohikoAsakawaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKatsuyoshiKatayamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesShugoOkamotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroOnishiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesNatsumiMatsuoka-UchiyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesChihiroFujiharaDepartment of Clinical Engineering Center, Okayama University HospitalKeikoTanakaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesHidemiTakeuchiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesRyokoUmebayashiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKatsuyukiTanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesFamilial hypercholesterolemia (FH) is an inherited disorder characterized by elevated LDL cholesterol levels and an increased risk of early-onset atherosclerotic cardiovascular disease. In pregnant female with FH, apheresis is the preferred treatment because standard therapeutic agents such as statins are contraindicated during pregnancy. LDL adsorption therapy is commonly used; however, after 27 weeks of gestation, it is often switched to dual filtration plasma exchange (DFPP) due to the significant drop in blood pressure caused by bradykinin production. However, DFPP has limited ability to adapt to the increase in circulating plasma volume associated with pregnancy. Here we discuss the case of a 32-year-old female with homozygous FH who underwent different apheresis strategies during her pregnancies. In her first pregnancy, she continued LDL adsorption therapy using DFPP but ultimately delivered a small-for-gestational-age infant via cesarean section. For her second pregnancy, double-filtration plasmapheresis thermo mode, DF-thermo, was introduced to mitigate the limitations of DFPP and LDL adsorption therapies, such as hypotension during apheresis and albumin loss. By minimizing these complications, DF-thermo allowed for a successful delivery without compromising fetal growth.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1323-89307532026Outcomes following the discontinuation of biologic therapy in patients with severe asthma400408ENTadaoNagasakiDepartment of Respiratory Medicine and Allergology, Kindai University Nara HospitalHisakoMatsumotoDepartment of Respiratory Medicine and Allergology, Kindai University Faculty of MedicineTakashiIwanagaDepartment of Respiratory Medicine and Allergology, Kindai University Faculty of MedicineKazutoMatsunagaDepartment of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi UniversityKiyoshiSekiyaClinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National HospitalTomoyaHaradaDepartment of Multidisciplinary Internal Medicine, Division of Respiratory Medicine and Rheumatology, Faculty of Medicine, Tottori UniversityShogoSakuraiDepartment of Respiratory Medicine, Shizuoka General HospitalNorihiroHaradaDepartment of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of MedicineToshiyukiKoyaDepartment of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental SciencesKoichiFukunagaDivision of Pulmonary Medicine, Department of Medicine, Keio University, School of MedicineTakeshiKanekoDepartment of Pulmonology, Yokohama City University Graduate School of MedicineKazuhisaAsaiDepartment of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan UniversityYukoKomaseDepartment of Respiratory Medicine, St.Marianna University School of Medicine, Yokohama Seibu HospitalYasuhiroGonDivision of Respiratory Medicine, Department of Internal Medicine, Nihon University School of MedicineAkihikoTanakaDepartment of Medicine, Division of Respiratory Medicine and Allergology, Showa Medical University, School of MedicineHironoriSagaraDepartment of Medicine, Division of Respiratory Medicine and Allergology, Showa Medical University, School of MedicineHironobuSunadomeDepartment of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto UniversityTatsuyaNaganoDivision of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of MedicineYoichiNakamuraMedical Center for Allergic and Immune Diseases, Yokohama City Minato Red Cross HospitalAkioNiimiDepartment of Respiratory Medicine, Allergy, and Clinical Immunology, Nagoya City University Graduate School of Medical SciencesNoboruHattoriDepartment of Molecular and Internal Medicine, Graduate School of Biomedical Sciences, Hiroshima UniversityTakashiHajiroDepartment of Respiratory Medicine, Tenri HospitalHajimeFujimotoDepartment of Pulmonary and Critical Care Medicine, Mie University Graduate School of MedicineMasayukiHojoDivision of Respiratory Medicine, National Center for Global Health and MedicineNobuakiMiyaharaDepartment of Medical Technology, Okayama University Graduate School of Health SciencesMasafumiYamaguchiDivision of Respiratory Medicine, Department of Internal Medicine, Shiga University of Medical ScienceKimikoTsujiDepartment of Respiratory Medicine and Allergology, Kochi Medical School, Kochi UniversityAkikoSanoDepartment of Respiratory Medicine and Allergology, Kindai University Faculty of MedicineRyutaHaraguchiDepartment of Respiratory Medicine and Allergology, Kindai University Faculty of MedicineHiroyukiSanoDepartment of Respiratory Medicine and Allergology, Kindai University Faculty of MedicineMasatoMurakiDepartment of Respiratory Medicine and Allergology, Kindai University Nara HospitalYujiTohdaDepartment of Respiratory Medicine and Allergology, Kindai University Faculty of MedicineBackground: Biologic therapies are pivotal in managing severe asthma. Despite their efficacy, some patients discontinue biologics, with varying outcomes. Predictors of successful versus unsuccessful discontinuation remain poorly defined. This study aimed to identify clinical factors associated with post-discontinuation outcomes in a real-world practice.<br>
Methods: This retrospective cohort included adults with severe asthma who had received biologics for at least 12 months and subsequently discontinued therapy for a minimum of three consecutive months. We assessed the effects of baseline blood eosinophilia (≥300 cells/μL), residual sputum symptoms during biologic therapy, treatment responsiveness, biologic class, and discontinuation reasons on post-discontinuation asthma exacerbation rates using multivariable Cox models.<br>
Results: A total of 118 patients were analyzed. The Kaplan–Meier analysis estimated a 65 % exacerbation-free probability at 12 months after discontinuation. Factors associated with successful discontinuation included a robust clinical response and absence of exacerbations before cessation. Conversely, baseline eosinophilia, residual sputum symptoms during biologics, and discontinuation due to inadequate therapeutic response or financial burden were associated with post-discontinuation exacerbations. In class-stratified restricted models, persistent sputum remained significantly associated with post-discontinuation exacerbations after stopping anti-IL-5 therapies, while baseline eosinophilia was associated with post-discontinuation exacerbations after stopping anti-IgE or anti-IL-4Rα. Among patients with sputum symptoms or poor-response discontinuation, the overall frequency of exacerbations declined after discontinuation.<br>
Conclusions: Baseline eosinophilia, persistent sputum during therapy, and discontinuation prompted by poor response or cost may serve as risk factors for post-discontinuation exacerbations; however, risk is phenotype- and class-dependent. Careful patient selection and monitoring are essential when considering the discontinuation of biologic treatment.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1745-62152712025Oral health care during pregnancy to prevent preterm birth and low birth weight: study protocol for a randomized controlled trial35ENJunkoYasuokaDivision of Global Health Sciences, Graduate School of Public Health, St. Luke’s International UniversityYoheiTakeshitaDepartment of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShunsukeOkadaDepartment of Oral and Maxillofacial Radiology, Medical Development Field, Okayama UniversityProdhan MD RubayetAlamDepartment of Orthodontics, Dental Unit, TMSS Medical College & Rafatullah Community HospitalAkiraShibanumaDepartment of Community and Global Health, Graduate School of Medicine, The University of TokyoKeikoNanishiOffice of International Academic Affairs, Graduate School of Medicine, The University of TokyoYokoSatoDepartment of Health Sciences, Graduate School of Medical Sciences, Kyushu UniversityMd. ZahidHossainDepartment of Periodontology and Oral Pathology, Holy Family Red Crescent Medical College HospitalMusfiqaAmanDepartment of Periodontology, Dental Unit, TMSS Medical College & Rafatullah Community HospitalFahmidaKarimDepartment of Obstetrics & Gynecology, Holy Family Red Crescent Medical College HospitalSultanaRaziaDepartment of Obstetrics & Gynecology, TMSS Medical College & Rafatullah Community HospitalRifatRezwanaDepartment of Molecular and Cellular Biochemistry, Division of Oral Health, Brain Health and Total Health, Faculty of Dental Science, Kyushu UniversityMd MahmudurRahmanGlobal Communication Center, Grameen CommunicationsNusratJahan KhanGlobal Communication Center, Grameen CommunicationsNaokiNakashimaDepartment of Medical Informatics, Graduate School of Medical Sciences, Kyushu UniversityRafiqulIslamDivision of Healthcare Digital Transformation, Kyushu UniversityKimiyoKikuchiDepartment of Research Promotion, Institute for Asian and Oceanian Studies, Kyushu UniversityBackground Periodontal disease during pregnancy has been associated with an increased risk of preterm birth (PTB) and low birth weight (LBW). However, most previous interventional studies have reported that scaling and root planing (SRP), a form of basic periodontal treatment, is insufficient to effectively prevent PTB and LBW. Recent systematic reviews and meta-analyses suggest that combining SRP with routine use of chlorhexidine gluconate (CHG) mouthwash may reduce the risk of these adverse birth outcomes by approximately half. This study will be among the first randomized controlled trials (RCTs) to evaluate the potential synergistic effects of this combined approach on improving birth outcomes.<br>
Methods This multi-center, three-arm RCT will be conducted at two hospitals in Dhaka and Bogura, Bangladesh, between April 2025 and September 2026. A total of 480 pregnant women less than 20 weeks’ gestation attending antenatal checkups will be recruited. Participants diagnosed with periodontal disease will be randomly assigned to either an intervention group or a positive control group. Participants without periodontal disease will be assigned to a negative control group. The intervention consists of SRP combined with continued use of CHG mouthwash throughout pregnancy. The primary outcome will be the rate of PTB. Secondary outcomes include the birth weight of the newborn baby, maternal periodontal status, and oral health-related quality of life (OHRQoL). Effectiveness will be assessed by comparing outcomes across the study groups.<br>
Discussion The oral health intervention is expected to improve both birth outcomes and maternal oral health. Demonstrating its effectiveness in a real-world setting may support the integration of oral health care into broader maternal, neonatal, and child health strategies, particularly in resource-limited settings.<br>
Trial registration UMIN Clinical Trials Registry. UMIN000057519. Registered on April 4, 2025. https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000065719.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0914-50878752026Cardio-ankle vascular index as a screening tool for coronary artery disease in patients with metabolic dysfunction-associated steatotic liver disease429433ENMitsutakaNakashimaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToruMiyoshiDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYutaUekiDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakahiroNishiharaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakashiMikiDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShoheiHaraDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeishiIchikawaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhiroOsawaDepartment of General Internal Medicine 3, Kawasaki Medical School General Medicine CentreShinsukeYuasaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common hepatic disorder that significantly increases cardiovascular risk. However, no established screening method exists for detecting subclinical coronary artery disease (CAD) in this high-risk population. The cardio-ankle vascular index (CAVI), a blood pressure–independent measure of arterial stiffness, may offer a non-invasive tool for early detection of coronary atherosclerosis.<br>
Methods: We retrospectively analyzed 295 patients with MASLD who underwent both CAVI measurement and coronary computed tomography angiography at a single center. Significant CAD was defined as ≥50 % luminal stenosis. Receiver operating characteristic (ROC) analysis was used to evaluate diagnostic performance. Multivariable logistic regression was performed to identify independent associations between elevated CAVI and CAD. The incremental predictive value of CAVI was assessed using net reclassification improvement (NRI).<br>
Results: Of the 295 patients, 110 (37.3 %) had significant CAD. Patients with CAD had significantly higher CAVI values (9.0 vs. 8.7, p = 0.007). The area under the ROC curve for CAVI predicting CAD was 0.614. A CAVI cut-off of 8.6 provided a sensitivity of 66.4 % and a specificity of 56.8 %. CAVI ≥8.0 was independently associated with CAD (OR 3.44, 95 % CI: 1.06–11.2, p = 0.040). Adding CAVI to a conventional risk model improved risk reclassification (NRI 0.4236, p < 0.001), although the C-statistic change was not significant (from 0.724 to 0.725, p = 0.835).<br>
Conclusions: CAVI is independently associated with significant coronary stenosis in MASLD patients and may serve as a non-invasive screening tool to enhance cardiovascular risk stratification. Its moderate diagnostic accuracy suggests utility as a component of a multifactorial risk assessment strategy.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1756-05001912025Plasma expression levels of microRNA-101 are downregulated in patients with Parkinson’s disease19ENTomohiroOmuraDepartment of Pharmacy, Kobe University HospitalHirokiNishiguchiDepartment of Pharmacy, Kobe University HospitalHarukaKanedaDepartment of Pharmacy, Kobe University HospitalYumiKitahiroDepartment of Pharmacy, Kobe University HospitalKotaroItoharaDepartment of Pharmacy, Kobe University HospitalKazuhiroYamamotoDepartment of Integrated Clinical and Basic Pharmaceutical Sciences, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshiyasuSakaneDepartment of Pharmaceutical Technology, Kobe Pharmaceutical UniversityIkukoYanoDepartment of Pharmacy, Kobe University HospitalObjective Parkinson’s disease (PD) is a neurodegenerative disorder characterized by the loss of dopaminergic neurons. Endoplasmic reticulum (ER) stress contributes to PD pathogenesis, with the ER-associated degradation (ERAD) system playing a protective role. HRD1, an ER-resident ubiquitin ligase, and its stabilizer SEL1L are involved in ERAD and neuronal survival. This study investigated alterations in the plasma levels of microRNA-101 (miR-101), which targets SEL1L, in patients with PD, and its potential role as a biomarker.<br>
Results Plasma miR-101 levels in patients with PD significantly decreased compared with those in healthy controls. Receiver operating characteristic curve analysis demonstrated that miR-101 could moderately discriminate patients with PD from healthy individuals (area under the curve = 0.781, 95% confidence interval = 0.547–1.00). The optimal cutoff, as determined by the Youden index, was 0.737 (expression ratio relative to that in the healthy control group), yielding a sensitivity of 50% and specificity of 100%. These results suggested that reduced plasma miR-101 expression may reflect the pathophysiological state of PD, and miR-101 has potential as minimally invasive biomarker for PD.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0289-07712026Sex differences and contest experience shape walking patterns in the broad-horned flour beetleENKentarouMatsumuraGraduate School of Arts and Sciences, The University of TokyoSoraHashiokaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityNaohisaNagayaFaculty of Information Science and Engineering, Kyoto Sangyo UniversityRyusukeFujisawaFaculty of Environmental Engineering, University of Kitakyushu,TakahisaMiyatakeGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityAnimal movement patterns vary widely across species, and sex differences are often expected because males typically need to encounter multiple females and acquire resources. In species where males engage in male–male combat using exaggerated weapons, variation in weapon size and contest outcomes is known to influence male reproductive strategies, and may therefore also affect movement behavior. However, sex-specific and male-specific differences in locomotor behavior, particularly in relation to weapon size and social interactions, remain poorly understood. Here, we investigated walking trajectories in the broad-horned flour beetle (Gnatocerus cornutus) to test for (1) sex differences, (2) associations between male weapon size and movement behavior, and (3) the effects of male–male combat. Males exhibited more tortuous and localized movement, whereas females showed straighter and more spatially extensive trajectories. Following contests, all males showed a reduction in activity regardless of contest outcome; however, winners and losers exhibited divergent changes in movement patterns, with winners showing straighter and more spatially extensive trajectories and losers showing more tortuous and localized trajectories. In contrast, body-size-corrected weapon size was not associated with any aspect of walking behavior. These results indicate that locomotor behavior in G. cornutus varies with sex and contest experience, and that variation in walking behavior is more closely associated with social experience than with weapon morphology.No potential conflict of interest relevant to this article was reported.American Geophysical Union (AGU)Acta Medica Okayama0094-827653142026Calcium Solubility of Bridgmanite in Subducted Basalt in Earth's Lower Mantlee2026GL121981ENChengweiZhangDepartment of Earth and Planetary Sciences, Jackson School of Geosciences The University of Texas at AustinTakashiYoshinoInstitute for Planetary Materials, Okayama UniversityEliasEl GhazaouiSchool of Earth and Environmental Sciences, Seoul National UniversityStellaCharitonCenter for Advanced Radiation Sources, The University of ChicagoVitali B.PrakapenkaCenter for Advanced Radiation Sources, The University of ChicagoLuoLiDepartment of Earth and Planetary Sciences, Jackson School of Geosciences The University of Texas at AustinYanyaoZhangEarth and Planetary Sciences, Stanford UniversityJung‐FuLinDepartment of Earth and Planetary Sciences, Jackson School of Geosciences The University of Texas at AustinThe calcium solubility in bridgmanite and the resulting abundance of davemaoite under lower-mantle pressure-temperature conditions have been under debate following a recent report of extensive calcium dissolution in bridgmanite. We experimentally investigated the calcium solubility in bridgmanite in a basaltic composition at pressures up to 125 GPa and temperatures up to 3,520 K. Our experimental data are modeled thermodynamically along the bridgmanite-davemaoite solvus to quantify the calcium solubility in bridgmanite and the davemaoite proportion in basaltic and pyrolitic assemblages along lower mantle geotherms. Our results indicate that bridgmanite hosts only 0.001–0.03 Ca cations per formula unit in the lower mantle, while davemaoite remains as an abundant mineral, accounting for 8 and 25 vol% of pyrolitic and basaltic mineralogical models, respectively, along representative lower-mantle geotherms. Our thermoelastic modeling further indicates that the effect of calcium dissolution on the density and bulk sound velocity of lower-mantle assemblages is negligible.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465812026裏表紙・英文目次ENNo potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-4146581202619世紀ザクセンの土地制度（６）4759ENNobushigeMatsuo10.18926/OER/70976No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465812026IAS41 と AASB1037 における生物の範囲設定に関する歴史的変遷3345ENKoheiYoshida10.18926/OER/70975No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465812026中国における経済学アカデミック・ジョブマーケットの現状と課題 ―クラウドソーシング・データに基づくインセンティブ構造の分析―2132ENRuitingWang10.18926/OER/70974No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465812026ライブラリ・スキーマによる大学図書館構造の可視化と知識創造 ―共有認知の形成に基づく研究枠組みの構築―119ENKensukeKobayashiSatoruMiyazaki10.18926/OER/70973 This study proposes a theoretical framework for understanding the relationship between the structural representation of university libraries and knowledge creation. In recent years, university libraries have experienced significant transformations due to the digitization of scholarly information, the expansion of research data management, and the increasing importance of learning support services. As their functions diversify, it has become increasingly difficult to comprehensively understand the structure and roles of university libraries.<br>
To address this issue, this study focuses on the concept of a library schema, which represents the structural relationships among the elements that constitute a library, including people, resources, services, and activities. While previous research has discussed methods for organizing library components, little attention has been paid to how structural understanding of libraries contributes to knowledge creation and service value.<br>
Drawing on schema theory, shared cognition in organizational studies, and the knowledge creation theory of Nonaka and Takeuchi, this study constructs a conceptual framework linking library schema visualization, shared cognition, interaction, knowledge creation processes, and library service value. The framework proposes that visualization of library structure through a library schema promotes shared cognition among librarians and users, which in turn facilitates interactions that activate knowledge creation processes. These processes ultimately contribute to the creation of library service value that supports learning and research activities.<br>
Furthermore, the framework introduces two moderating factors: schema representation methods and operational constraints of library management. Based on this framework, six research propositions are presented.<br>
By integrating concepts from library and information science with knowledge management theory, this study contributes to the theoretical understanding of university libraries as knowledge infrastructures and provides a foundation for future empirical research on knowledge creation in library environments.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465812026表紙・目次ENNo potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-29186582026Autopsy Case of a Disseminated Cytomegalovirus Infection with a Cutaneous Ulcer Mimicking Rheumatoid Vasculitis11721177ENKoheiOguniDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalYukichikaYamamotoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomoharuIshidaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokaOhkiDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesA 60-year-old woman with rheumatoid arthritis and an impaired consciousness was referred to our hospital. Prior to transfer, the patient underwent intensified immunosuppressive therapy under a diagnosis of rheumatoid vasculitis that had developed in her buttocks. Upon hospitalization, she developed severe multiorgan failure and hemophagocytic syndrome. Four days after admission, both blood cytomegalovirus (CMV) antigenemia and the DNA load were markedly elevated. Despite intensive care, the patient died. Later, a histopathological examination revealed that the cutaneous manifestation represented CMV disease, not rheumatoid vasculitis, as was initially suspected. Failure to identify CMV as the underlying cause may result in the inappropriate administration of immunosuppressive therapy, potentially worsening the patient's condition.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-29186572026Nasal Mucosal Manifestation of Behçet's Disease10691073ENHiroshiAkiyamaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoheiMasudaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiakiSoejimaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaNakamotoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuKatayamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkiSatoDepartment of Otolaryngology - Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBehçet's disease (BD) is a multisystem inflammatory condition that rarely affects the nasal mucosa. We report the case of a 25-year-old man presenting with prolonged fever, bilateral rhinalgia, and nasal obstruction, who was subsequently diagnosed with nasal ulcers associated with BD. These ulcers resolved along with the systemic symptoms following treatment with colchicine, apremilast, and prednisolone. Although there is no specific treatment strategy for nasal mucosal lesions in BD, standard systemic therapies may be effective. This case highlights nasal mucosal involvement as a rare but important manifestation of BD, emphasizing the importance of thorough evaluation and consideration of nasal symptoms for the diagnosis and treatment.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2666-63673242026Spatial Transcriptomics Analysis of Macrophage-to-Myofibroblast Transition in Bronchiolitis Obliterans Following Hematopoietic Stem Cell Transplantation454465ENAkiraYamamotoDepartment of Hematology and Oncology, Okayama University HospitalNobuharuFujiiDepartment of Hematology and Oncology, Okayama University HospitalKeisukeSeikeDepartment of Hematology and Oncology, Okayama University HospitalSeiichiroSugimotoDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalYusukeNaoiCenter for Comprehensive Genomic Medicine, Okayama University HospitalTomohiroNaganoDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSayaKubotaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuiKambaraDan L Duncan Comprehensive Cancer Center, Baylor College of MedicineKanakoFujiwaraDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshikiTeraoDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTadashiOyamaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMariKunihiroDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHirokiKobayashiDepartment of Hematology and Oncology, Okayama University HospitalTakumiKondoDepartment of Hematology and Oncology, Okayama University HospitalHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalDaisukeEnnishiDepartment of Hematology and Oncology, Okayama University HospitalKeikoFujiiDepartment of Hematology and Oncology, Okayama University HospitalShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalBronchiolitis obliterans (BO) is a severe, fibrotic manifestation of chronic graft-versus-host disease (GVHD) after hematopoietic stem cell transplantation (HSCT). Macrophage-derived TGF-β is linked to GVHD-related fibrosis; however, its role in BO remains unclear. Given emerging evidence of macrophage-to-myofibroblast transition (MMT) in fibrosis, this study aimed to investigate whether MMT contributes to BO development. We analyzed lung samples from 3 HSCT recipients with BO who underwent lung transplantation, with tissues from 2 patients with lung cancer as controls. Immunofluorescent staining for CD68, CD206, and α-SMA was used to identify cells undergoing MMT. Spatial transcriptomics was performed to profile gene expression in foamy macrophages across anatomical regions and histological stages, compared to control peribronchiolar regions. Immunostaining showed strong co-expression of CD68, CD206, and α-SMA in foamy macrophages within and surrounding bronchioles in BO samples, with minimal expression in controls, suggesting MMT involvement. In BO, spatial transcriptomics revealed upregulation of macrophage- and TGF-β signaling genes, with distinct stage- and region-specific gene expression patterns. Unsupervised clustering revealed a shift from inflammation to fibrosis. These findings indicate that MMT contributes to fibrosis in BO. Gene expression shifts from inflammation to fibrosis as the disease advances, underscoring the importance of early intervention.No potential conflict of interest relevant to this article was reported.Fuji Technology Press Ltd.Acta Medica Okayama1883-80302112026Developing and Implementing a Disaster Prevention Game to Enhance Local Understanding128135ENMiriShirokaneOkayama UniversityAiriYamadaOkayama UniversityRyoMisawaOkayama UniversityNobuhisaMattaOkayama UniversityThis study developed and implemented a local disaster prevention sugoroku-style game to address challenges in preserving and transmitting regional knowledge in areas with high population mobility. Many Japanese communities face both natural and social vulnerabilities, and effective disaster education requires linking hazard knowledge with local characteristics. Conducted at Sonan Junior High School in Okayama, the project combined lectures, workshops, and a community engagement event. Students learned about regional topography, land use, and disaster history and used this knowledge to design quizzes, rules, and disaster scenarios for the game. The final sugoroku set included a map-based board, thematic quiz areas, and preparedness item cards, enabling players to predict damage and consider appropriate actions. After creating the game, students shifted from identifying familiar landmarks to describing concrete disaster impacts such as liquefaction or infrastructure collapse. Interaction with local residents further enriched learning through shared experiences. The model proved feasible in terms of time and cost, and its structure is easily adaptable to other regions by incorporating local information. The findings suggest that this participatory, place-based approach enhances imagination, self-efficacy, and intergenerational knowledge transfer, contributing to community-wide disaster preparedness. Future studies will examine long-term educational impacts and broader regional applications.No potential conflict of interest relevant to this article was reported.Japan Neurosurgical SocietyActa Medica Okayama0470-81056632026Full-endoscopic Laminotomy Is Effective for Lumbar Spinal Stenosis with Low-grade Spondylolisthesis: A Comparative Cohort Study107115ENKyoheiKINDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesRyojiTOMINAGADepartment of Orthopaedics, Iwai Orthopaedic Medical HospitalKentoTAKEBAYASHIDepartment of Orthopaedics, Iwai Orthopaedic Medical HospitalHirokiIWAIDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHirohikoINANAMIDepartment of Orthopaedics, Iwai Orthopaedic Medical HospitalHisashiKOGADepartment of Orthopaedics, Iwai Orthopaedic Medical HospitalThe optimal management of lumbar spinal canal stenosis with spondylolisthesremains controversial, particularly when choosing between decompression alone or decompression with fusion. Current evidence is based on conventional open or endoscopy-assisted surgeries, with limited data on full-endoscopic decompression. This study aimed to assess the impact of spondylolisthesis on outcomes after full-endoscopic laminotomy by evaluating back pain-related disability scores in patients with lumbar spinal canal stenosis, with and without spondylolisthesis. A retrospective analysis was conducted at Iwai Orthopaedic Hospital, Japan. Patients with lumbar spinal canal stenosis who underwent full-endoscopic laminotomy between January 2021 and December 2022 were included and categorized into those without spondylolisthesis and those with spondylolisthesis. Postoperative Oswestry Disability Index scores at 2 years were compared in the groups using multivariable linear regression, adjusting for confounding factors. Exploratory analyses were also conducted to identify factors affecting the Oswestry Disability Index in the patients with lumbar spinal canal stenosis with spondylolisthesis group. Statistical significance was set at p < 0.05. The study included 80 patients, with 40 in each group. Both groups showed improved postoperative Oswestry Disability Index. There was no significant association between spondylolisthesis and postoperative Oswestry Disability Index. However, cauda equina redundancy negatively affected postoperative Oswestry Disability Index improvement in the patients with lumbar spinal canal stenosis with spondylolisthesis group. Full-endoscopic laminotomy is an effective surgical option for lumbar spinal canal stenosis, leading to significant alleviation of disability and improvements in quality of life, regardless of spondylolisthesis. Full-endoscopic laminotomy may offer similar functional improvements regardless of the presence of low-grade spondylolisthesis, supporting its role as a less invasive alternative to fusion.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama2329-69332352026Global trends in sarcoidosis-associated mortality, 2001–2023: insights from the World Health Organization mortality database823827ENKoHaradaBrookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount SinaiMarikoFujiiDepartment of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityNanamiSakoDepartment of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityQuynh ThiVuDepartment of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityYoshitoNishimuraDivision of Hematology and Oncology, Mayo ClinicKeith PardilladaBelangoyDepartment of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityHananeOuddoudDepartment of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTatsuakiTakedaDepartment of Education and Research Centre for Clinical Pharmacy, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityYoshitoZamamiDepartment of Pharmacy, Okayama University HospitalHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalToshihiroKoyamaDepartment of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.American Society of Tropical Medicine and HygieneActa Medica Okayama0002-963711432026A Case of Heavy Paragonimiasis Involving a Multi-Organ Presentation with Hypereosinophilia and Hepatic Migration486489ENHidemasaAkazawaDepartment of Infectious Diseases, Okayama University HospitalHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalShinnosukeFukushimaDepartment of Infectious Diseases, Okayama University HospitalKentaNakamotoDepartment of Infectious Diseases, Okayama University HospitalKoheiOguniDepartment of Infectious Diseases, Okayama University HospitalYoheiManabeDepartment of Pharmacy, Okayama University HospitalMioKokubo-TanakaDivision of Parasitology, Department of Infectious Diseases, Faculty of Medicine, University of MiyazakiHaruhikoMaruyamaDivision of Parasitology, Department of Infectious Diseases, Faculty of Medicine, University of MiyazakiFumioOtsukaDepartment of General Medicine, Okayama University HospitalParagonimiasis is a parasitic disease caused by the genus Paragonimus, typically transmitted through the ingestion of raw or undercooked freshwater crabs. Although pulmonary involvement is typical, ectopic migration to subcutaneous or hepatic sites is rare and poses diagnostic challenges. A case of paragonimiasis in a 29-year-old Cambodian woman residing in Japan who presented with painless subcutaneous nodules on the chest and abdomen is reported in the current study. She had consumed raw crab 4 months before presentation. Laboratory findings revealed marked eosinophilia (21,000/µL) and elevated immunoglobulin E (5,049 IU/mL). Computed tomography scans revealed pleural effusion, club-shaped pulmonary consolidation, funicular hypodense lesions in the liver, and subcutaneous lesions. Stool and sputum test results were negative for parasite eggs; however, a microplate ELISA indicated a Paragonimus westermani infection. The patient responded well to 3 consecutive days of praziquantel (75 mg/kg/day) and was discharged a week later. This case highlights the importance of considering paragonimiasis in patients with unexplained subcutaneous nodules and eosinophilia, especially when supported by dietary risk factors.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-291865112026Endotracheal and Endobronchial Metastases in Epidermal Growth Factor Receptor Exon 19 Deletion Lung Adenocarcinoma: A Case Successfully Managed with Bronchoscopic Therapy and Sequential Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors15201523ENMihoFujiwaraDepartment of Respiratory Medicine, Okayama University HospitalTakahiroBabaDepartment of Respiratory Medicine, Okayama University HospitalKotaroYamadaDepartment of Respiratory Medicine, Okayama University HospitalEriNakamuraDepartment of Respiratory Medicine, Okayama University HospitalTetsuyaTakeguchiDepartment of Respiratory Medicine, Okayama University HospitalYukiTakigawaDepartment of Respiratory Medicine, NHO Okayama Medical CenterAyakoMoritaCenter for Clinical Oncology, Okayama University HospitalNaofumiHaraDepartment of Respiratory Medicine, Okayama University HospitalHiromiWatanabeDepartment of Respiratory Medicine, NHO Okayama Medical CenterKiichiroNinomiyaCenter for Comprehensive Genomic Medicine, Okayama University HospitalKammeiRaiCenter for Innovative Clinical Medicine, Okayama University HospitalEikiIchiharaCenter for Clinical Oncology, Okayama University HospitalKadoakiOhashiDepartment of Respiratory Medicine, Okayama University HospitalKatsuyukiHottaCenter for Innovative Clinical Medicine, Okayama University HospitalKenSatoDepartment of Respiratory Medicine, NHO Okayama Medical CenterYoshinobuMaedaDepartment of Hematology, Oncology and Respiratory Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineYosukeTogashiDepartment of Respiratory Medicine, Okayama University HospitalGoMakimotoDepartment of Respiratory Medicine, Okayama University HospitalEndotracheal and endobronchial metastases from peripheral lung adenocarcinoma are rare, and optimal clinical management remains unclear. We herein report a 60-year-old woman with epidermal growth factor receptor (EGFR) exon 19 deletion-positive early-stage lung adenocarcinoma who underwent surgical resection followed by osimertinib treatment for recurrence. She later developed oligoprogressive disease with airway metastases. Bronchoscopic tumor removal was performed, and next-generation sequencing of the resected specimen revealed an acquired EGFR C797S mutation, along with exon 19 deletion. Gefitinib treatment was initiated, which led to a partial response. This case underscores the utility of repeated molecular profiling and local intervention in managing acquired resistance in EGFR-mutant non-small-cell lung cancer.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1572-1000582026Pathological features of residual head and neck cancer after near-infrared photoimmunotherapy: implications of an unfavorable tumor immune microenvironment105422ENTakumaMakinoDepartment of Otolaryngology - Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuharuSatoDepartment of Hematopathology, Okayama University Graduate School of Health SciencesAsamiNishikoriDepartment of Hematopathology, Okayama University Graduate School of Health SciencesYutoNaoiDepartment of Otolaryngology - Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMizuoAndoDepartment of Otolaryngology - Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesPurpose: Near-infrared photoimmunotherapy has been approved in Japan for unresectable locally advanced or recurrent head and neck cancer. While this therapy theoretically induces selective necrosis of epidermal growth factor receptor-expressing tumor cells following administration of cetuximab sarotalocan sodium and irradiation with 690-nm light, residual disease is not uncommon in clinical practice. The mechanisms underlying such persistence remain poorly understood.<br>
Methods: We examined two patients with head and neck squamous cell carcinoma who underwent salvage resection due to residual disease after four cycles of near-infrared photoimmunotherapy. Resected specimens were subjected to histopathological evaluation, including immunohistochemistry for epidermal growth factor receptor, cluster of differentiation 8, programmed cell death protein 1, and forkhead box P3 proteins.<br>
Results: In both cases, residual tumor cells were predominantly localized in the superficial mucosal layers, while deeper layers were replaced by fibrosis. All residual tumors retained expression of epidermal growth factor receptor. Lymphocytic infiltration was sparse, with scattered cluster of differentiation 8-positive cells but few programmed cell death protein 1-positive or forkhead box P3-positive lymphocytes. These findings suggest that the tumor microenvironment surrounding residual tumors may have been unfavorable for the induction of robust antitumor immune responses.<br>
Conclusion: Residual tumors after near-infrared photoimmunotherapy can occur despite adequate laser irradiation and epidermal growth factor receptor expression. Our observations imply that insufficient immune activation within the tumor microenvironment may contribute to treatment resistance. Further characterization of the post-photoimmunotherapy tumor microenvironment will be essential to better understand treatment mechanisms and to optimize therapeutic efficacy.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1877-056811232026Relationship between the Hounsfield Unit value of the greater trochanter and the risk of greater trochanteric fractures in anterolateral muscle-sparing minimally invasive total hip arthroplasty104642ENRyuichiroOkudaDepartment of Orthopaedic Surgery, Section of Medicine, Division of Medicine, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Okayama UniversityTomonoriTetsunagaDepartment of Musculoskeletal Health Promotion, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazukiYamadaDepartment of Orthopaedic Surgery, Faculty of Medical Development Field, Okayama UniversityTomokoTetsunagaDepartment of Sports Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomohiroInoueDepartment of Orthopaedic Surgery, Section of Medicine, Division of Medicine, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Okayama UniversityYasutakaMasadaDepartment of Orthopaedic Surgery, Section of Medicine, Division of Medicine, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Okayama UniversityTetsuyaYamamotoDepartment of Orthopaedic Surgery, Section of Medicine, Division of Medicine, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Okayama UniversityShinMatsumotoDepartment of Orthopaedic Surgery, Section of Medicine, Division of Medicine, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Okayama UniversityYukiOkazakiDepartment of Orthopaedic Surgery, Section of Medicine, Division of Medicine, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Okayama UniversityToshifumiOzakiDepartment of Orthopaedic Surgery, Section of Medicine, Division of Medicine, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Okayama UniversityBackground: No previous studies have investigated the association between the risk of greater trochanteric fractures and the Hounsfield Unit (HU) of the greater trochanter in muscle-sparing minimally invasive total hip arthroplasty (MIS-THA). This study aimed to investigate the risk factors for greater trochanteric fractures in anterolateral MIS-THA.<br>
Hypothesis: Lower HU values of the greater trochanter are associated with a higher risk of intraoperative and early postoperative greater trochanteric fractures.<br>
Patients and methods: This single-center retrospective observational study included 223 patients (257 hips) who underwent primary THA for osteoarthritis or osteonecrosis between January 2010 and August 2024 using a minimally invasive anterolateral approach in the lateral position. All surgeries were performed by four surgeons. Preoperative CT was used to reconstruct coronal sections including the femoral head center and proximal femoral axis, and cancellous HU values of the greater trochanter were measured. Postoperative CT (1 week) with metal artifact reduction was routinely performed; fractures were defined as cortical fracture lines on 3D-reconstructed CT and assessed by two independent orthopedic surgeons. Patients were divided into two groups according to the presence or absence of fractures.<br>
Results: The incidence of greater trochanteric fractures was 6.6% (17/257 hips). Twelve of these fractures (70.6%) were recognized intraoperatively or immediately postoperatively. Full hydroxyapatite (HA)-coated stems were associated with an increased fracture risk compared with other designs (relative risk [RR], 2.68; 95% CI, 1.07–6.68). Age, sex, BMI, ASA physical status, and diagnosis were not significantly associated with fractures. Multivariate analysis identified lower HU values (odds ratio [OR], 0.973; p < 0.0001) and full HA-coated stems (OR, 13.3; p = 0.04) as independent predictors. Receiver operating characteristic (ROC) analysis determined an optimal cut-off of 72.0 HU (sensitivity, 0.941; specificity, 0.742), with a value ≤72.0 HU demonstrating high predictive power (RR, 36.7; p < 0.0001).<br>
Conclusion: Preoperative measurement of HU values in the greater trochanter is a useful screening tool for identifying patients at increased risk of fractures in anterolateral MIS-THA. While an HU value of ≤ 72.0 necessitates careful intraoperative management and increased vigilance, it should be interpreted as an indicator of risk rather than a definitive predictor of fracture due to its moderate specificity.<br>
Level of evidence: IV; retrospective study.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0168-95254242026Medaka: a novel model for analyzing genome–environment interactions350361ENKiyoshiNaruseLaboratory of Bioresources, National Institute for Basic BiologyFelixLoosliInstitute of Biological and Chemical Systems, Biological Information Processing (IBCS-BIP), Karlsruhe Institute of TechnologySatoshiAnsaiUshimado Marine Institute, Okayama UniversityEwanBirneyEuropean Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI)JoachimWittbrodtCentre for Organismal Studies (COS), Heidelberg UniversityMedaka is an established vertebrate model system for biological and biomedical research. It possesses unique features that make it particularly suitable for studying genome–environment interactions. Endemic to habitats spanning from 4 to 40°C and varying salinities, it combines broad ecological adaptability with experimental tractability. Its exceptional tolerance to inbreeding enabled the creation of the Medaka Inbred Kiyosu-Karlsruhe panel—80 near-isogenic, fully sequenced lines derived from a single wild population. More than 100 wild-derived, fully sequenced strains, collected throughout East Asia for more than 40 years, show relatively low intra-strain variation (inbreeding coefficient of >0.75) but high inter-strain variability (SNP rates >4%). Advanced quantification methods facilitate genome-wide association studies and quantitative trait locus mapping. The system’s amenability to clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 editing and emerging epigenomic profiling enables causal validation and regulatory-mechanism discovery. Collectively, medaka offers an unparalleled vertebrate framework for integrating genetics, environment, and epigenetics—bridging evolutionary, biomedical, and population-level perspectives.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-291865112026Ocular Abscess Causing Remarkable Eyeball Deformity1578ENTomoyukiMiyaharaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinnosukeFukushimaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshihikoMatsuoDepartment of Ophthalmology, Okayama University HospitalHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalNo potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2041-17231712026Atomic imaging for hydrogen and boron aggregates in boron-doped diamond by spectro-photoelectron holography3482ENHirotoTomitaGraduate School of Science and Technology, Nara Institute of Science and TechnologyWataruHosodaResearch Institute for Interdisciplinary Science, Okayama UniversityTakumiTaniguchiResearch Institute for Interdisciplinary Science, Okayama UniversityHirokazuFujiwaraDepartment of Advanced Materials Science, Graduate School of Frontier Sciences, The University of TokyoNoriyukiKataokaResearch Institute for Interdisciplinary Science, Okayama UniversityTaisukeKageuraSensing Technology Research Institute, National Institute of Advanced Industrial Science and TechnologyYoshihikoTakanoResearch Center for Materials Nanoarchitectonics, National Institute for Materials ScienceHiroshiKawaradaFaculty of Science and Engineering, Waseda UniversityTamioOguchiCenter for Spintronics Research Network, The University of OsakaTakayoshiYokoyaResearch Institute for Interdisciplinary Science, Okayama UniversityTomohiroMatsushitaGraduate School of Science and Technology, Nara Institute of Science and TechnologyThe electrical properties of diamond are modulated by impurity doping. Isolated substitutional boron atoms introduce holes; however, the fraction of electrically inactive boron atoms increases at higher doping concentrations. This has been attributed to boron aggregation and hydrogen passivation, although their structural identification based on atomic arrangement has yet to be experimentally verified. Here we show the origin of multiple chemical states in homoepitaxially grown boron-doped diamond thin films by analyzing the atomic environment of boron using spectro-photoelectron holography. Our analysis identifies boron dimers and boron-hydrogen complexes, with hydrogen occupying different atomic sites that give rise to distinct chemical shifts. These results suggest that hydrogen incorporation during growth leads to passivation of boron acceptors. We demonstrate that photoelectron holography serves as a promising tool for imaging hydrogen as well as determining the atomic sites of dopants.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221612026Asthma-like bronchodilator responsiveness in patients with neuronal intranuclear inclusion disease16760ENDaisukeTaharaDepartment of Neuropathology, Institute for Medical Science of Aging, Aichi Medical UniversityNaoTaharaDepartment of Neuropathology, Institute for Medical Science of Aging, Aichi Medical UniversityChisatoTamaiDepartment of Neuropathology, Institute for Medical Science of Aging, Aichi Medical UniversityAkioAkagiDepartment of Neuropathology, Institute for Medical Science of Aging, Aichi Medical UniversityYuichiRikuDepartment of Neuropathology, Institute for Medical Science of Aging, Aichi Medical UniversityHiroakiMiyaharaDepartment of Neuropathology, Institute for Medical Science of Aging, Aichi Medical UniversityReiKobayashiDepartment of Neurology, NHO Nagoya Medical CenterHisashiOkadaDepartment of Neurology, NHO Nagoya Medical CenterMichiKawamotoDepartment of Neurology, Kobe City Medical Center General HospitalJunkoIshiiDepartment of Neurology, Kobe City Medical Center General HospitalHirokiYamazakiDepartment of Neurology, Tokushima University Graduate School of Biomedical ScienceTakashiKurashigeDepartment of Neurology, NHO Kure Medical Center and Chugoku Cancer CenterAtsuhikoSugiyamaDepartment of Neurology, Chiba UniversityAkikoNagaishiDepartment of Neurology, NHO Nagasaki Kawatana Medical CenterKatsuyaNishidaDepartment of Neurology, NHO Hyogo Chuo National HospitalKazumaSugieDepartment of Neurology, Nara Medical University HospitalTakayasuFukudomeDepartment of Neurology, NHO Nagasaki Kawatana Medical CenterKazukoHasegawaDepartment of Neurology, NHO Sagamihara National HospitalHiroyukiIshiuraDepartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHarukiKoikeDepartment of Neurology, Saga UniversityTakashiKasaiDepartment of Neurology, Kyoto Prefectural University of MedicineToshikiMizunoDepartment of Neurology, Kyoto Prefectural University of MedicineMasahiroAndoDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental SciencesYujiroHiguchiDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental SciencesFumiakiTanakaDepartment of Neurology and Stroke Medicine, Yokohama City University Graduate School of MedicineYuishinIzumiDepartment of Neurology, Tokushima University Graduate School of Biomedical ScienceGenSobueAichi Medical UniversityYasushiIwasakiDepartment of Neuropathology, Institute for Medical Science of Aging, Aichi Medical UniversitySatoruItoDivision of Respiratory Medicine and Allergology, Department of Internal Medicine, School of Medicine, Aichi Medical UniversityJunSoneDepartment of Neuropathology, Institute for Medical Science of Aging, Aichi Medical UniversityNeuronal intranuclear inclusion disease (NIID) is a neurodegenerative condition characterized by the presence of intranuclear inclusions in neuronal and visceral cells. Patients with NIID can present respiratory symptoms; however, data on pulmonary functions in NIID are lacking. This study investigated the respiratory conditions in NIID patients diagnosed with histopathological and genetic studies. We conducted two spirometries before and after administrating the bronchodilator in NIID patients with asthmatic histories or symptoms. We statistically compared pre- and post-measured values including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and peak expiratory flow (PEF). Before two spirometries, we also measured fractional concentration of exhaled nitric oxide (FeNO), if possible. Of the 51finally enrolled patients, 17 (33.3%, 95% CI 20.8% to 47.9%) patients had asthmatic histories or symptoms, and 14 patients received two spirometries. After administrating the bronchodilator, FEV1 and PEF significantly increased by 150 mL (6.01%, p = 0.002) and 260 mL/s (6.72%, p = 0.017), respectively. The median (interquartile range) of FeNO measured in nine patients was 15 (10–21) ppb. Patients with NIID have airflow reversibility like asthma. This condition appears to be less associated with airway inflammation and may be related to autonomic dysfunction.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2399-3642912026In vivo activities of E1 elements in the insulin promoter838ENHirofumiNoguchiDepartment of Regenerative Medicine, Graduate School of Medicine, University of the RyukyusChikaMiyagi-ShiohiraDepartment of Regenerative Medicine, Graduate School of Medicine, University of the RyukyusTakuyaSadahiraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasamiWatanabeDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesIsseiSaitohDepartment of Pediatric Dentistry, Asahi University School of DentistryIn this study, we evaluated the in vivo activity of the E1 element within the insulin promoter region. While we successfully obtained mice carrying a deletion exclusively in the E1 element of Ins2 (2E mice), we were unable to obtain mice with a deletion limited to the E1 element of Ins1. To assess the role of the E1 element in Ins1, we compared the mice carrying deletions in the GG2-GG1/A2-C1 elements with or without an additional E1 element deletion (1GC/1GCE mice). 1GCE2E mice developed diabetes. In contrast, 1GCE23 mice (without deletion in the E1 element of Ins2) did not develop diabetes, suggesting that the E1 element of Ins2 is critical for transcriptional regulation. Furthermore, 1GC2E mice (presence of the E1 element of Ins1) developed diabetes. However, the severity of the disease was milder in 1GC2E mice than in 1GCE2E mice, indicating that the E1 element of Ins1 also contributes to transcriptional regulation. These data suggest that the E1 elements in both Ins1/2 promoters are regulated for the in vivo transcription of insulin genes in mice.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1472-68312612026Differences in understanding of explanations and risk perception between dental staff and patients: a questionnaire study at a university hospital1050ENShihoOtomoSchool of Environment and Society, Institute of Science TokyoMaokoFujisakiSchool of Environment and Society, Institute of Science TokyoRisakoYanagaseSchool of Environment and Society, Institute of Science TokyoKanakoNoritakeInstitute of Science Tokyo Hospital, Institute of Science TokyoYoshinobuYanagiFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTaroSugiharaSchool of Environment and Society, Institute of Science TokyoBackground and purpose: Proper self-care necessitates behavioral changes, underpinned by correct knowledge. Oral health literacy (OHL) research constitutes a fundamental foundation for fostering effective self-care practices. However, the extent of the awareness gap between patients and dental staff regarding explanations provided during treatment remains unknown. This descriptive study was conducted to serve as an initial step in bridging this gap.<br>
Methods: Questionnaires were distributed to 92 dental staff members and 205 patients at university hospitals, with responses from 72 staff members and 157 patients.<br>
Results: In the category assessing understanding of explanations (patient vs. dental staff), patients’ self-assessed understanding exceeded the dental staff’s estimates in three aspects: disease name (p = 0.03, r = 0.17), treatment period (p = 0.01, r = 0.21), and pain relief (p = 0.01, r = 0.19). Regarding health self-awareness, the high-scoring group significantly outperformed the low-scoring group in explaining treatment risks (p = 0.03, r = 0.21) and understanding (p = 0.01, r = 0.23). Nevertheless, patients’ risk recognition was higher than that of dental staff in three aspects: root canal treatment (p < 0.01, r = 0.23), holes in the teeth (p < 0.01, r = 0.24), and bleeding during toothbrushing (p = 0.02, r = 0.17). Questions on “crack” (p = 0.02, r = 0.21) by sex, holes in one’s own teeth (p = 0.05, r = 0.03), and feeling one’s own teeth wobble (p < 0.01, r = 0.07) in the intergenerational comparison showed significant differences.<br>
Conclusion: Dental staff should not be satisfied merely with having "explained" something to the patient; they must engage in a confirmation process to verify the patient's correct understanding of the information or to identify excessive anxiety.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2090-6447202612026A Rare Case of Hyperplastic Dental Follicle Presenting With an Unusually Large Radiolucent Area2879891ENSatoshiOtsukiDepartment of Oral and Maxillofacial Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYukiKunisadaDepartment of Oral and Maxillofacial Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoichiKadoyaDepartment of Oral and Maxillofacial Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityChizuruKobayashiDepartment of Oral and Maxillofacial Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKeisukeNakanoDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshiyukiKawazuDepartment of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySoichiroIbaragiDepartment of Oral and Maxillofacial Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHyperplastic dental follicle (HDF) is a rare odontogenic hamartomatous lesion typically associated with unerupted teeth in children and adolescents and is often found incidentally on radiographic imaging. HDF usually presents as a pericoronal radiolucency of 2–3 mm in diameter and is commonly difficult to distinguish from dentigerous cysts on radiographs. We report an unusual case of HDF in an 11-year-old male who was referred for evaluation of delayed eruption of the left maxillary canine. Panoramic radiography and cone-beam computed tomography (CBCT) revealed a remarkably large radiolucent area, with a maximum dimension of 25.3 mm. The initial clinical diagnosis was a dentigerous cyst; however, incisional biopsy revealed solid tissue characteristics, and histopathological examination confirmed HDF, with no evidence of cystic lining, neoplastic transformation, or inflammation. Following the patient′s and parents′ preference for complete removal, resection of the lesion together with extraction of the impacted canine was performed under general anesthesia. At the 6-month follow-up, no recurrence was observed and bone regeneration was confirmed on radiographic examination. This case underscores the diagnostic challenge posed by atypical radiographic findings and highlights the necessity of histopathological confirmation. Given the exceptional size and potential for recurrence, long-term follow-up is warranted.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama0032-07812026NIMA-related kinases redundantly regulate vegetative and reproductive development in <i>Arabidopsis thaliana</i>pcag056ENShogoTakataniGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMaiKanazawaDepartment of Biology, Faculty of Science, Okayama UniversityKotaroSakamotoDepartment of Biology, Faculty of Science, Okayama UniversityYukiTomitaGraduate School of Biostudies, Division of Integrated Life Science, Kyoto UniversityNozomiKawamotoGraduate School of Biostudies, Division of Integrated Life Science, Kyoto UniversityTatsuyaSakaiGraduate School of Science and Technology, Niigata UniversityTakashiArakiGraduate School of Biostudies, Division of Integrated Life Science, Kyoto UniversityHiroyasuMotoseGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityNever-in-mitosis A-related kinases (NEKs) are conserved protein kinases in eukaryotes that regulate cell division and elongation. In Arabidopsis thaliana, NEK6 has been shown to control anisotropic growth through cortical microtubule depolymerization, but the functions of other NEK family members remain largely unknown. Here, we show that Arabidopsis NEKs redundantly regulate organ growth and flowering through phosphorylation-dependent mechanisms. Expression analyses revealed overlapping promoter activities of NEK genes in meristems, vascular tissues, and floral organs. While most single mutants showed no obvious phenotype, multiple mutants exhibited defects in root growth direction, leaf elongation, vascular formation, and floral transition. Biochemical analysis showed that NEK3 and NEK6 phosphorylate both β-tubulin and γ-tubulin, indicating a conserved role in microtubule regulation. In addition, several NEKs interacted with the florigen FLOWERING LOCUS T (FT), and NEK3 phosphorylated FT in vitro and inhibited the FT–FD interaction in transient assays, suggesting a role in flowering regulation. These findings show that Arabidopsis NEKs redundantly coordinate vegetative and reproductive development through phosphorylation-dependent regulation of microtubules and the flowering pathway.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2072-664318112026GLP-1 Receptor Agonists in the Rehabilitation of Patients with Heart Failure: Mechanisms, Clinical Evidence, and Future Perspectives1688ENLuh Oliva SaraswatiSuastikaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuko K.BandoDepartment of Molecular Physiology and Cardiovascular Biology, Mie University Graduate School of MedicineKeijiHoshinoDivision of Cardiology, Gunma Prefectural Cardiovascular CenterNorimichiKoitabashiDivision of Cardiology, Gunma Prefectural Cardiovascular CenterYukihiroSaitoDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinsukeYuasaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazufumiNakamuraDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHeart failure (HF) remains associated with high morbidity and mortality, with heart failure with preserved ejection fraction (HFpEF) becoming increasingly prevalent and therapeutically challenging despite advances in pharmacological and rehabilitative care. Beyond their glucose-lowering effects, glucagon-like peptide-1 receptor agonists (GLP-1RAs) confer cardiometabolic benefits and may serve as effective adjuncts to cardiac rehabilitation (CR), particularly in obese patients with HFpEF. Obesity plays a central role in the pathophysiology of HFpEF, and GLP-1RAs promote weight loss, reduce insulin resistance and leptin signaling, and improve hemodynamic and metabolic abnormalities associated with HFpEF. Accumulating evidence suggests that the benefits of GLP-1RAs are phenotype-specific and more pronounced in patients with HFpEF than in patients with HF with reduced ejection fraction. Current clinical guidelines recommend GLP-1RAs for patients who have type 2 diabetes mellitus and established cardiovascular (CV) disease or are at high CV risk, with recent updates recognizing their potential benefits in patients with HFpEF and obesity. Cardiac rehabilitation, delivered through multidisciplinary programs, remains a cornerstone of HF management. Although caloric restriction and aerobic exercise can be beneficial in patients with HFpEF and obesity, these interventions alone are often insufficient. Sarcopenia is common in older patients with HFpEF and contributes to adverse outcomes, underscoring the importance of incorporating resistance training into CR programs. The most frequent adverse effects of GLP-1RAs are gastrointestinal events, which are generally mild to moderate but may lead to treatment discontinuation in some patients. Future studies should investigate the potential synergistic effects of GLP-1RAs and CR, clarify their long-term safety and efficacy in HF populations, and define their role beyond obese HFpEF phenotypes.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1432-058410572026WT1 mRNA in peripheral blood enables early prognostic stratification in AML patients receiving venetoclax and azacitidine therapy105ENHiroyukiSugiuraDivision of Internal Medicine, Fukuyama City HospitalNoboruAsadaDepartment of Hematology, Oncology and Respiratory Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTakeruAsanoDepartment of Hematology and Oncology, Japanese Red Cross Society Himeji HospitalYasushiHiramatsuDepartment of Hematology and Oncology, Japanese Red Cross Society Himeji HospitalTomohiroUrataDepartment of Hematology and Blood Transfusion, Kochi Health Sciences CenterToshiImaiDepartment of Hematology and Blood Transfusion, Kochi Health Sciences CenterMakotoNakamuraDepartment of Hematology, Okayama City HospitalKazuhikoYamamotoDepartment of Hematology, Okayama City HospitalTatsunoriIshikawaDepartment of Hematology, Chugoku Central Hospital of Japan Mutual Aid Association of Public School TeachersMasanoriMakitaDepartment of Hematology, Chugoku Central Hospital of Japan Mutual Aid Association of Public School TeachersTakanoriYoshiokaDepartment of Hematology, NHO Okayama Medical CenterKazutakaSunamiDepartment of Hematology, NHO Okayama Medical CenterKyosukeSaekiDivision of Hematology, Ehime Prefectural Central HospitalYuichiroNawaDivision of Hematology, Ehime Prefectural Central HospitalMaikoKimuraDepartment of Hematology, Japanese Red Cross Okayama HospitalMakotoTakeuchiDepartment of Hematology, Japanese Red Cross Okayama HospitalMasayaAbeDepartment of Hematology, Oncology and Respiratory Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineShojiAsakuraDepartment of Internal Medicine, Okayama Rosai HospitalTomofumiYanoDepartment of Internal Medicine, Okayama Rosai HospitalYoshinobuMaedaDepartment of Hematology, Oncology and Respiratory Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineVenetoclax and azacitidine (VEN/AZA), which target BCL-2 and DNA methylation, have demonstrated substantial efficacy, particularly in older or unfit patients with acute myeloid leukemia (AML). Wilms’ Tumor-1 (WT1) mRNA, measurable in peripheral blood (PB), is an established biomarker for monitoring treatment response and predicting AML prognosis. We conducted a retrospective analysis of patients with AML treated with VEN/AZA within the Okayama Hematology Study Group (OHSG). Patients who showed a marked reduction in PB WT1 mRNA levels from baseline after the first or second treatment cycle had significantly improved overall survival (OS) and progression-free survival (PFS). Moreover, achieving PB WT1 mRNA negativity-regardless of whether this occurred early or later in the therapy།was consistently associated with superior OS and PFS. These findings suggest that PB WT1 mRNA is a sensitive and reliable biomarker for predicting treatment response and long-term outcomes in patients with AML receiving VEN/AZA.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0300-95722252026Decline in rescue breathing and its impact on outcomes in pediatric out-of-hospital cardiac arrest due to drowning: a nationwide study, 2012–2023111049ENTakafumiObaraDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTsuyoshiNojimaDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityNaomiMatsumotoDepartment of Epidemiology, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityKoheiTsukaharaDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTakashiHongoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTetsuyaYumotoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTakashiYorifujiDepartment of Epidemiology, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityAtsunoriNakaoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityHiromichiNaitoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityBackground: Rescue breathing is considered essential in pediatric out-of-hospital cardiac arrest (OHCA) due to drowning, a type of asphyxial arrest where hypoxia precedes circulatory collapse. However, the increasing promotion of compression-only CPR (CO-CPR) may have contributed to changes in bystander CPR practices, including a decline in rescue-breathing CPR (RB-CPR). Whether such temporal changes have influenced outcomes in pediatric drowning OHCA remains unclear.<br>
Methods: We analyzed nationwide data from the All-Japan Utstein Registry (2012–2023), including pediatric OHCA patients (≤17 years old) whose arrests were caused by drowning and received bystander CPR from laypersons. Patients were categorized into RB-CPR and CO-CPR groups. The primary outcome was 30-day mortality; secondary outcomes included prehospital absence of return of spontaneous circulation (ROSC) and 30-day unfavorable neurological survival, defined as Cerebral Performance Category score 3–5. We used multivariable Poisson regression to estimate adjusted risk ratio (aRR) and conducted analyses by age and witnessed status.<br>
Results: Among 740 eligible patients, 41.6% received RB-CPR and 58.4% received CO-CPR. The proportion of RB-CPR declined over the study period. CO-CPR was associated with higher 30-day mortality (aRR 1.38, 95% CI 1.14–1.67), higher prehospital absence of ROSC, and worse neurological outcomes compared with RB-CPR. The adverse association of CO-CPR was most pronounced in unwitnessed arrests, where ventilation may be particularly important.<br>
Conclusions: In pediatric drowning OHCA, CO-CPR was associated with worse survival and neurological outcomes than RB-CPR. These findings underscore the necessity for rescue breathing and the importance of ventilation-focused bystander CPR training in pediatric and drowning-related scenarios.No potential conflict of interest relevant to this article was reported.Ovid Technologies (Wolters Kluwer Health)Acta Medica Okayama2047-99801592026Insomnia and the Risk of Atrial Fibrillation: A Nationwide, Real‐World Cohort Studye045149ENTakuroMasudaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaroEjiriDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHidehiroKanekoDepartment of Cardiovascular Medicine, The University of TokyoYutaSuzukiDepartment of Advanced Cardiology, The University of TokyoToruMiyoshiDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiTayaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeiichiroIwasakiDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKojiNakagawaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuhiroNishiiDepartment of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroshiMoritaDepartment of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkiraOkadaDepartment of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of TokyoKatsuhitoFujiuDepartment of Cardiovascular Medicine, The University of TokyoNorifumiTakedaDepartment of Cardiovascular Medicine, The University of TokyoHiroyukiMoritaDepartment of Cardiovascular Medicine, The University of TokyoHideoYasunagaDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of TokyoNorihikoTakedaDepartment of Cardiovascular Medicine, The University of TokyoShinsukeYuasaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground: Insomnia is one of the most prevalent diseases observed in clinical practice, contributing to increased death and a range of chronic diseases. While numerous studies have explored the relationship between insomnia and cardiovascular disease, research on its association with atrial fibrillation (AF) remains limited. This study aimed to investigate the association between insomnia and incident AF in the general population by comprehensive, nationwide, real‐world data in Japan.<br>
Methods: A total of 1 780 764 individuals without prior cardiovascular disease including AF from the DeSC database were included between April 2014 and August 2023. Insomnia was defined by International Classification of Diseases, Tenth Revision (ICD‐10) codes (F510, G470) before the baseline health checkup. The primary outcome was incident AF (I480–I482 and I489). Cox proportional hazards models were used to estimate hazard ratios of AF according to present insomnia (versus absent).<br>
Results: Insomnia was observed in 216 919 individuals (12.2%), showing a significant association with incident AF after adjusting for potential confounding factors (adjusted hazard ratio, 1.14 [95% CI, 1.10–1.18]). Among subgroups, a similar pattern in the association between insomnia and incident AF was seen, while the association was stronger in younger individuals aged <65 years (versus ≥65 years) and women (versus men) (P for interaction=0.01 and 0.03, respectively).<br>
Conclusions: Insomnia was significantly associated with the risk of AF. It highlighted the importance of recognizing insomnia as a risk factor for AF, given its high prevalence in the general population and the substantial impact of AF on quality of life and prognosis.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1471-24312612026Sebastidae-specific food allergy causing anaphylaxis: a pediatric case report and fish allergen analysis628ENMitsuruTsugeDepartment of Pediatric Acute Diseases, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuhiroUdaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasanoriIkedaDepartment of Pediatrics, Okayama University HospitalHirokazuTsukaharaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground Fish allergy affects approximately 0–0.3% of the population. Parvalbumin is the major allergen in fish allergy, and patients with fish allergy sensitized to parvalbumin demonstrate allergic reactions to various fish species. However, a subset of patients exhibits allergic responses to only specific fish species. Fish of the Sebastidae family, widely consumed in Asian, North American, and European countries, has rarely been reported as an allergenic trigger.<br>
Case presentation A 14-year-old Japanese boy visited our clinic for evaluation of fish allergy after experiencing allergic reactions to Sebastes alutus (Alaskan rockfish). He developed respiratory symptoms, eyelid edema, and skin erythema after consuming a meal containing Sebastes alutus, suggesting anaphylaxis; however, he was able to consume many other fish species without any issues. Skin prick tests and basophil activation tests using fish species from the Sebastidae family showed positive reactions, whereas other fish species that the patient could tolerate showed negative reactions. Immunoblot analysis performed to identify the causative allergen revealed two IgE-binding bands (17 and 110 kDa) in Sebastidae, distinct from parvalbumin. Mass spectrometry identified these proteins as alpha-actinin-3b, ATPase sarcoplasmic/endoplasmic reticulum Ca2 + transporting 1, and several myosin-related proteins.<br>
Conclusions This case highlights the need for clinicians to recognize fish allergy specific to the Sebastidae family. Identifying the causative non-parvalbumin allergens would improve understanding of fish allergy diversity and individualized dietary management for patients. Additional cases and detailed analyses are necessary to identify the specific allergens involved in Sebastidae allergy.No potential conflict of interest relevant to this article was reported.SAGE PublicationsActa Medica Okayama1022-55363412026Similar functional outcomes but different remodeling patterns: A minimum 5-years radiographic comparison of short fit-and-fill stem and quadrangular taper stem110ENYasutakaMasadaDepartment of Orthopaedic Surgery, Section of Medicine, Division of Medicine, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomonoriTetsunagaDepartment of Musculoskeletal Health Promotion, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazuoFujiwaraDepartment of Orthopaedic Surgery, Okayama City General Medical Center, Okayama City HospitalKazukiYamadaDepartment of Orthopaedic Surgery, Okayama University HospitalTomohiroInoueDepartment of Orthopaedic Surgery, Section of Medicine, Division of Medicine, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRyuichiroOkudaDepartment of Orthopaedic Surgery, Section of Medicine, Division of Medicine, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomokoTetsunagaDepartment of Sports Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYukiOkazakiCenter for Education in Medicine and Health Sciences, Okayama UniversityToshifumiOzakiDepartment of Orthopaedic Surgery, Section of Medicine, Division of Medicine, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityPurpose: ACTIS and CORAIL are cementless titanium femoral stems with hydroxyapatite (HA) coating but differing macro-geometries: ACTIS features a variable triple-taper with a medial collar, whereas CORAIL is a straight double-tapered design available with or without a collar. We compared mid-term clinical and radiographic outcomes of these stems with a minimum 5-years follow-up.<br>
Methods: We retrospectively reviewed 114 primary total hip arthroplasties using ACTIS (63 hips) or CORAIL (51 hips). Clinical outcomes and standardized radiographic parameters were assessed and compared between groups.<br>
Results: The canal-fill ratio (CFR) was significantly greater at the proximal, middle, and distal levels in the ACTIS group. Spot-weld formation was more frequent with ACTIS than with CORAIL (58.7% vs 35.3%). In logistic regression, proximal CFR significantly predicted spot-weld formation for ACTIS, with an optimal cutoff of 66.2% (sensitivity 91.9%, specificity 72.0%). Rates of subsidence, radiolucent lines, and pedestal formation did not differ significantly between groups. No severe stress shielding was observed with ACTIS, whereas three CORAIL hips demonstrated severe stress shielding (0% vs 5.9%). Clinical scores improved significantly in both groups, with no significant between-group differences at final follow-up.<br>
Conclusions: Both stems yielded favorable radiographic and clinical mid-term outcomes. In ACTIS, greater proximal canal fill was associated with radiographic osseointegration, suggesting proximal CFR as a probabilistic radiographic marker of stem ingrowth.No potential conflict of interest relevant to this article was reported.American Society of HematologyActa Medica Okayama2473-952910132026Drivers of temporal improvement in CAR T-cell therapy for large B-cell lymphoma: a Japanese nationwide registry analysis44274438ENYuYagiDepartment of Medical Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalYusukeKanemasaDepartment of Medical Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalToshikiTerao2Department of Hematology, Okayama University Hospital, Okayama, JapanMotohiroKatoDepartment of Pediatrics, The University of TokyoTomoyasuJoDepartment of Hematology, Kyoto University HospitalTatsuShimoyamaDepartment of Medical Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalToshioKitawakiDepartment of Hematology, Kyoto University HospitalRyoHanajiriDepartment of Hematology and Oncology, Nagoya University Graduate School of MedicineNorikoDokiHematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalSatoshiYoshiharaDepartment of Hematology, Hyogo Medical University HospitalNobuharuFujiiDepartment of Hematology, Okayama University HospitalNorikoIwakiDepartment of Hematology, National Cancer Center HospitalGoYamamotoDepartment of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon HospitalMasatoshiSakuraiDivision of Hematology, Department of Medicine, Keio University School of MedicineToshihiroMatsukawaDepartment of Hematology, Hokkaido University HospitalEmikoSakaidaDepartment of Hematology, Chiba University HospitalYasuhiroNakashimaHematology and Hematopoietic Cell Transplantation, Osaka Metropolitan University HospitalAkiyoYoshidaDivision of Transfusion Medicine, Kanazawa University HospitalYoshihiroUmezawaDepartment of Hematology, Institute of Science Tokyo HospitalHaryoonKimDivision of Hematology, Department of Medicine, Keio University School of MedicineKeisukeKataokaDivision of Hematology, Department of Medicine, Keio University School of MedicineHidekiGoto11Department of Hematology, Hokkaido University Hospital, Sapporo, JapanYoshikoAtsutaJapanese Data Center for Hematopoietic Cell TransplantationKojiKatoDepartment of Hematology, Oncology, and Cardiovascular Medicine, Kyushu University HospitalReal-world CD19 chimeric antigen receptor (CAR) T-cell therapy for large B-cell lymphoma (LBCL) is characterized by expanded eligibility and evolving management practices. However, the prognostic impact of these changes remains inconsistent, and the specific drivers of outcomes remain unclear. This study analyzed 913 patients with relapsed/refractory (R/R) LBCL from a Japanese registry and compared the outcomes between 2 calendar periods (2019-2021 vs 2022-2024). The 2022-2024 cohort was older, had more adverse baseline features, and was less pretreated. Treatment patterns have shifted toward higher utilization of second-line therapy, a growing preference for axicabtagene ciloleucel (axi-cel) and lisocabtagene maraleucel (liso-cel), and improved disease control before infusion. Accordingly, the 2022-2024 cohort achieved a longer progression-free survival (PFS; 6-month PFS, 63.2% vs 55.2%; P = .005), which persisted after adjusting for baseline characteristics using propensity score matching. Multivariable analysis identified second-line therapy, improved preinfusion disease control, and a shift in product selection from tisagenlecleucel to axi-cel or liso-cel as the primary drivers of this improvement. This benefit was pronounced in high-risk populations, including patients with stable or progressive disease at infusion (6-month PFS, 54.6% vs 43.8%; P = .012) and those who were refractory to first-line therapy (6-month PFS, 51.7% vs 40.3%; P = .013). Despite broader use in higher-risk populations and greater axi-cel exposure, 6-month nonrelapse mortality remained low (2.1% vs 1.5%). Real-world outcomes of CD19 CAR T-cell therapy for R/R LBCL have improved, predominantly driven by second-line therapy, enhanced preinfusion disease control, and increased use of more potent CAR T products.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2041-17231712026The role of Pth1r in posterior cranium cartilage regulation and craniosynostosis5862ENKatsuhikoAmanoDepartment of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaisukeOkuzakiLaboratory of Human Immunology (Single Cell Genomics), WPI Immunology Frontier Research Center, University of OsakaYujiFujimotoLaboratory of Human Immunology (Single Cell Genomics), WPI Immunology Frontier Research Center, University of OsakaYu-ChenLiuLaboratory of Human Immunology (Single Cell Genomics), WPI Immunology Frontier Research Center, University of OsakaMikihikoKogoThe First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of DentistrySeijiIidaDepartment of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCraniosynostosis is a major craniofacial congenital disorder that causes developmental complications. During normal cranial development, intramembranous ossification forms the flat bones and sutures, while cartilage appears transiently in the posterior calvarial region. However, in craniosynostosis, premature suture fusion disturbs normal calvarial morphogenesis. To clarify the role of transient cartilage in this morphogenetic disruption, we investigated its molecular regulation and pathology in mice, focusing on parathyroid hormone 1 receptor (Pth1r) signaling. Conditional deletion of Pth1r in the cranial mesenchyme unexpectedly caused acrocephalic dysmorphology and craniosynostosis, with altered cartilage differentiation. Occipito–interparietal synostosis consistently occurred in Pth1r-ablated Gli1+ and Acan+ lineages, but not after adult Gli1-CreERT2 deletion, indicating a developmental role. Bulk and single-cell RNA-seq analysis revealed nine mesenchymal subsets, with mutant cells showing abnormal chondrocyte differentiation and upregulated Indian hedgehog (Ihh) signaling. These findings indicate that Pth1r maintains proper chondrogenic regulation during calvarial development, and its loss induces craniosynostosis through Ihh overactivation.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama0278-03724632026Estimating the distributional expansion of the invasive crayfish Procambarus clarkii (Girard, 1852) (Decapoda: Astacidea: Cambaridae) in South Korea using environmental DNA analysisruag033ENSeong-NamHamGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKaitoMoriuchiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMayukoHamadaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKazuyoshiNakataGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityThe red swamp crayfish Procambarus clarkii (Girard, 1852) is a globally invasive species that poses serious threats to native biodiversity and ecosystem functioning. In South Korea, established populations of P. clarkii have been documented from the Jiseokcheon River in the Yeongsangang River basin since 2018; however, information on its current nationwide distribution remains limited. We conducted environmental DNA (eDNA) surveys at 19 sites across 11 river systems in South Korea, including sites with no prior distributional records, to evaluate the current distribution and potential range expansion of P. clarkii. Water samples collected during July-August 2024 were analyzed using quantitative real-time PCR (qPCR) with two species-specific primer-probe sets targeting the mitochondrial COI gene. Procambarus clarkii eDNA was detected at three sites in the Yeongsangang River basin, whereas no eDNA was detected in the other surveyed river systems. Notably, P. clarkii eDNA was not detected at a site in the Mangyeonggang River system despite previous reports of individuals and eDNA data sampled there, indicating a possible local population decline or very low abundance. By contrast, detections within the Yeongsangang River basin, together with elevated eDNA concentrations at some sites, are consistent with localized upstream expansion and increased local abundance. The concordant results from the two primer-probe sets, together with Sterivex-based on-site filtration, support the reliability of the applied eDNA framework. These findings identify the Yeongsangang River basin as the current primary focus of the P. clarkii invasion in South Korea, with evidence consistent with localized upstream expansion and increasing abundance, and provide baseline data for early detection and long-term monitoring, as well as for developing management strategies.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1465-36212026Impact of pre-existing schizophrenia spectrum disorder on the receipt of invasive and systemic therapy for gastric cancer: a multicenter nationwide cohort study in Japanhyag102ENMyo MinKhantDepartment of Psychiatry, Faculty of Medicine, Shimane UniversityMasakiFujiwaraDepartment of Neuropsychiatry, Medical Development Field, Okayama UniversityYutoYamadaDivision of Survivorship Research, National Cancer Center Institute for Cancer Control, National Cancer CenterTaisukeIshiiDivision of Health Services Research, National Cancer Center Institute for Cancer Control, National Cancer CenterTomoneWatanabeDivision of Health Services Research, National Cancer Center Institute for Cancer Control, National Cancer CenterTakashiFukaoDepartment of Neuropsychiatry, Medical Development Field, Okayama UniversityMaikoFujimoriDivision of Survivorship Research, National Cancer Center Institute for Cancer Control, National Cancer CenterNaokiNakayaTohoku Medical Megabank Organization, Tohoku UniversityToshihikoKawamuraDepartment of Medical Informatics, Shimane University HospitalKojiOtsukiDepartment of Psychiatry, Faculty of Medicine, Shimane UniversityYoshihikoKakiuchiDepartment of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTaichiShimazuDivision of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer CenterShiroHinotsuDepartment of Biostatistics and Data Management, Sapporo Medical UniversityYosukeUchitomiDepartment of Cancer Survivorship and Digital Medicine, The Jikei University School of MedicineMasatoshiInagakiDepartment of Psychiatry, Faculty of Medicine, Shimane UniversityBackground: Patients with schizophrenia spectrum disorders (SSD) experience higher cancer mortality, partly because of later-stage diagnosis and lower rates of recommended treatments. While treatment disparities have been reported across several cancer types, no study has specifically examined stage-appropriate treatment for gastric cancer among patients with SSD.<br>
Methods: We conducted a retrospective cohort study using a nationwide Hospital-Based Cancer Registry linked to administrative data in Japan. Patients who received initial treatment for gastric cancer between 2018 and 2021 were included. Multivariable logistic regression models examined the association between SSD and the receipt of stage-appropriate cancer treatments, adjusting for age, sex, clinical stage, Charlson Comorbidity Index, and Barthel Index.<br>
Results: Among 189 447 patients from 709 hospitals, 1312 had SSD. Patients with SSD were more likely to be diagnosed at advanced stages. In crude analysis, SSD was associated with lower rates of surgical or endoscopic treatment; however, this association was not statistically significant after adjustment (adjusted odds ratio [aOR], 0.90; 95% confidence interval [CI], 0.75–1.08). In contrast, SSD was independently associated with lower rates of postoperative adjuvant chemotherapy for pathological stage II/III disease (aOR, 0.64; 95% CI, 0.45–0.91) and systemic therapy for stage IV disease (aOR, 0.36; 95% CI, 0.28–0.47).<br>
Conclusions: Among patients with gastric cancer, SSD was associated with reduced receipt of systemic therapy but not surgical or endoscopic treatment. Efforts to improve early detection among patients with SSD may be important for reducing treatment disparities, alongside strengthened support for systemic therapy to ensure equitable access to guideline-recommended gastric cancer care.No potential conflict of interest relevant to this article was reported.American Geophysical Union (AGU)Acta Medica Okayama2169-909713172026Surface Geology and Evolution of Asteroid Ryugu: Insights From Hayabusa2 Global Mappinge2025JE009578ENLisa M.VincentDepartment of Earth Sciences, Utrecht UniversityTrishitRujInstitute for Planetary Materials, Okayama UniversityGoroKomatsuInternational Research School of Planetary Sciences, Università G. d'AnnunzioAdityaRayDepartment of Geology, Presidency UniversityHiroshiKikuchiGakushuin UniversityRyodoHemmiInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencyHideakiMiyamotoDepartment of Systems Innovation School of Engineering, The University of TokyoSeijiSugitaPlanetary Exploration Research Center, Chiba Institute of Technologythe Hayabusa2 ONC science teamRubble-pile asteroids, characterized by loose aggregates of debris held together by gravity, represent both a significant planetary hazard and a key to understanding planetesimal formation. Geologic mapping of these bodies provides essential insights into their origins, evolution, and surface processes. This knowledge is crucial for advancing space mission capabilities, from precise navigation and safe sampling to assessing the feasibility of future asteroid mining. Here, we present the most comprehensive geologic map of Ryugu in comparison to previous early-stage and single-feature maps, integrating Optical Navigation Camera (ONC) mosaics, LIDAR-derived topography, Mobile Asteroid Surface Scout (MASCOT) descent images, and spectral slope data. The analysis includes reclassification of previously identified features and newly identified features from global to local scales. The geologic mapping technique followed United States Geological Survey (USGS) planetary cartography standards using the ArcGIS Pro platform. This global framework provides an essential geologic context for interpreting returned samples and constraining rubble-pile evolution. We identified geomorphological, structural, and surface texture units on Ryugu's unconsolidated rubble-pile surface using 0.2–0.7 m/pixel image mosaics. Elongated troughs at the poles and mirrored, oblique lineaments near the equatorial ridge are consistent with rotational strain. Compared with another rubble-pile asteroid Bennu, Ryugu shows a more uniform boulder distribution, and its immensely prominent equatorial ridge indicates a more intense period of rotational deformation. However, the western bulge deviates from this trend; its fewer boulders, underdeveloped ridges, and older degraded craters suggest selective resurfacing. These features show evidence of catastrophic disruption, rotational reshaping, and ongoing surface movement.No potential conflict of interest relevant to this article was reported.Institute of Electrical and Electronics Engineers (IEEE)Acta Medica Okayama2187-01361412025Study of Signal Separation and Demodulation Techniques Considering IQ Imbalance by Stored Data Batch Signal Processing3033ENYudaiMitaGraduate School of Natural Science and Technology, Okayama UniversityYutaHiraokaGraduate School of Natural Science and Technology, Okayama UniversityTomofumiHikasaGraduate School of Natural Science and Technology, Okayama UniversityShigeruTomisatoGraduate School of Natural Science and Technology, Okayama UniversitySatoshiDennoGraduate School of Natural Science and Technology, Okayama UniversityKazuhiroUeharaGraduate School of Natural Science and Technology, Okayama UniversityWith the arrival of the IoT era, the problem of interference has become even more serious, and the challenge is to establish techniques for separating and demodulating collide signals. To achieve this, we are conducting research on stored data batch signal processing technology using short-time Fourier transform (STFT). In this paper, we used a feature quantity demodulation method proposed as a method for stored data batch signal processing to evaluate the effect of IQ imbalance, which is a factor in signal degradation in the transmitter, on signal separation and demodulation performance. Furthermore, we proposed a receiver configuration that estimates the amount of degradation due to IQ imbalance from the extracted feature quantities and compensates for the signal degradation. Computer simulation results confirmed that the proposed compensation method can improve signal separation and demodulation performance when degraded by IQ imbalance.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1478-63622712025Performance of the modified 2022 ACR/EULAR giant cell arteritis classification criteria without age restriction for discriminating from Takayasu arteritis19ENTakahikoSugiharaDepartment of Rheumatology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoMasayoshiHarigaiDivision of Rheumatology, Department of Internal Medicine, Tokyo Women’s Medical University School of MedicineHaruhito A.UchidaDepartment of Chronic Kidney Disease and Cardiovascular Disease, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineHajimeYoshifujiDepartment of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto UniversityYasuhiroMaejimaDepartment of Cardiovascular Medicine, Graduate School of Medical and Dental Sciences, Institute of Science TokyoJunIshizakiDepartment of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of MedicineYoshikoWatanabeDepartment of General Medicine, Kawasaki Medical SchoolHiroakiDobashiDivision of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa UniversityYoshinoriKomagataDepartment of Nephrology and Rheumatology, Kyorin University School of MedicineNaotoTamuraDepartment of Internal Medicine and Rheumatology, Juntendo University School of MedicineYoshikazuNakaokaDepartment of Vascular Physiology, National Cerebral and Cardiovascular Center Research InstituteJapan Research Committee of the Ministry of Health, Labour, and Welfare for Intractable Vasculitis (JPVAS)Objective To evaluate the ability to discriminate giant cell arteritis (GCA) from Takayasu arteritis (TAK) according to the modified 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology (ACR/EULAR) GCA classification criteria.<br>
Methods Patients enrolled in the Japanese nationwide retrospective registry were evaluated using the criteria with partial modification; wall thickening of descending thoracic-abdominal aorta were mainly diagnosed by contrast-enhanced computed tomography (CT) or magnetic resonance imaging instead of evaluating with positron emission tomography (PET)-CT. The discriminability of the criteria was evaluated using C-statistic (> 0.7: good ability).<br>
Results Newly diagnosed patients with GCA (n = 139) and TAK (n = 129) were assessed, and 23.3% of TAK were aged 50 years or older at onset. The sensitivity of the modified 2022 ACR/EULAR GCA classification criteria with a score ≥ 6 was 82.0%, 68.5%, and 32.1% in all GCA, GCA with large-vessel involvement, and GCA without cranial arteritis, respectively. The specificity of the modified criteria was 96.1% for the 129 TAK as controls. Five patients with late-onset TAK met the modified criteria, and four had cranial signs and symptoms, two had bilateral axillary artery involvement, and four had descending thoracic-abdominal aorta involvement. The discriminability of the criteria was good (C-statistic: 0.986, 95% confidence interval [CI]: 0.976–0.996) and remained good after excluding age (C-statistic: 0.927, 95% CI: 0.894–0.961). The discriminability of a set of large-vessel lesions (bilateral axillary artery and descending thoracic-abdominal aorta) and inflammatory markers was markedly decreased with poor C-statistic value (C-statistic: 0.598, 95% CI: 0.530–0.667). Discriminability was improved after adding polymyalgia rheumatica (PMR) (C-statistic: 0.757, 95% CI: 0.700–0.813) or age (C-statistic: 0.913, 95%CI: 0.874–0.951) to the set of large-vessel lesions. In GCA patients with a score ≤ 5, 52% had bilateral subclavian and/or axillary artery involvement.<br>
Conclusion The modified 2022 ACR/EULAR GCA classification criteria well performed in classifying GCA and TAK without PET-CT in routine clinical practice. A set of items included in the modified GCA classification criteria had good discriminative ability for GCA and TAK, even when age was excluded. However, age restriction or PMR was required to distinguish GCA without cranial lesions from TAK.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1433-785164222025Efficient Nickel Precatalysts for Suzuki-Miyaura Cross-Coupling of Aryl Chlorides and Arylboronic Acids Under Mild Conditionse202504108ENMorgan E.JohnSchool of Molecular Sciences, The University of Western Australia (M310)Michael J.NuttSchool of Molecular Sciences, The University of Western Australia (M310)Josephine E.OfferSchool of Molecular Sciences, The University of Western Australia (M310)Jeremy A.DuczynskiSchool of Molecular Sciences, The University of Western Australia (M310)KenYamazakiDivision of Applied Chemistry, Okayama UniversityTomoyaMiuraDivision of Applied Chemistry, Okayama UniversityStephen A.MoggachSchool of Molecular Sciences, The University of Western Australia (M310)George A.KoutsantonisSchool of Molecular Sciences, The University of Western Australia (M310)RetoDortaSchool of Molecular Sciences, The University of Western Australia (M310)Scott G.StewartSchool of Molecular Sciences, The University of Western Australia (M310)The synthesis and catalytic properties of Ni(II) complexes with the general formula Ni(NHC)[P(OR)3](Ar)Cl are described. These complexes are air-stable and extremely effective precatalysts in the Suzuki-Miyaura cross-coupling reaction. The reaction protocols described allow for the cross-coupling of aryl chlorides and arylboronic acids, employing low catalytic loading, to deliver a large variety of functionalized biaryl compounds. For the coupling of aryl chlorides with N-heterocyclic boronic acids, TBAF was used as an additive to afford nitrogen-containing biaryl products. Overall, these reaction protocols operate at room or mild temperatures and can be applied to a variety of electronically and sterically differentiated coupling partners. Fundamental insights into the mechanism of this reaction, including the proposed formation of the catalytically active Ni(NHC)[P(Oi-Pr)3] and resting state species, are also reported.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama2050-3911202512025Saddle-Point Approximation to the False-Vacuum Decay at Finite Temperature in 1D Quantum Mechanics013A01ENKojiHaradaFaculty of Arts and Science, Kyushu UniversityShuichiroTaoInstitute of Promotion of Education and Campus Life, Okayama UniversityQiangYinGraduate School of Science, Kyushu UniversityWe calculate the false-vacuum decay rate in 1D quantum mechanics on the basis of the saddle-point approximation in the Euclidean path integral at finite temperature. The saddle points are the finite-T and shifted bounce solutions, which are finite-period analogs of the (zero-temperature) bounce solution, and the shot solutions. We reexamine the zero-temperature result by Callan and Coleman and compare it with the zero-temperature limit of our results. We also perform some numerical calculations to illustrate the temperature dependence of the decay rate and compare it with the result by Affleck.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221612026Nitric oxide induces p53-mediated cell death in human nasal epithelial cells10055ENShizukiKamiuezonoDepartment of Medicinal Pharmacology, Faculty of Pharmaceutical Sciences, Okayama UniversityShoKubotaDepartment of Medicinal Pharmacology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTomokiTsuchidaDepartment of Medicinal Pharmacology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityNobumasaTakasugiDepartment of Medicinal Pharmacology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTakashiUeharaDepartment of Medicinal Pharmacology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityNitric oxide (NO) is a key signaling molecule that plays a vital role in maintaining homeostasis of physiological processes such as immune responses and neurotransmission. However, excessive NO production during inflammatory responses to infection can lead to cytotoxicity and tissue damage. The nasal epithelial barrier is a crucial first line of immunological defense against viral infections, and it is likely exposed to excessive NO levels during chronic inflammation. Therefore, clarifying the effects of NO on this barrier is thus critical. In this study, we investigated the biological effects of sustained NO exposure on RPMI2650 human nasal epithelial cells. Post-NO exposure transcriptomic analyses revealed significant upregulation of genes involved in the p53 signaling pathway. RT-qPCR analyses confirmed the temporal upregulation of p53 target genes associated with apoptosis and cell cycle regulation. These gene expression changes downregulated cell proliferation and induced cell death. Our findings suggest that excessive NO exposure induces nasal epithelial cell death via the p53 pathway, which over the long term can result in tissue damage and dysfunction under inflammatory conditions. These results provide new insights into how prolonged NO exposure affects the nasal epithelial cells and may contribute to the progression of chronic infectious diseases.No potential conflict of interest relevant to this article was reported.American Society for Clinical InvestigationActa Medica Okayama1558-8238136102026Spatial single-cell proteotyping reveals immunotherapy-resistant features within the complex tumor microenvironment of metastatic NSCLCe195021ENKohsukeIsomotoDepartment of Medical Oncology, Kindai University Faculty of MedicineKojiHarataniDepartment of Medical Oncology, Kindai University Faculty of MedicineTakahiroTsujikawaDepartment of Otolaryngology–Head and Neck Surgery, Kyoto Prefectural University of MedicineShutaTomidaCenter for Comprehensive Genomic Medicine, Okayama University HospitalYusukeMakutaniDepartment of Surgery, Kindai University Faculty of MedicineMasayukiTakedaDepartment of Medical Oncology, Kindai University Faculty of MedicineKimioYonesakaDepartment of Medical Oncology, Kindai University Faculty of MedicineKaoruTanakaDepartment of Medical Oncology, Kindai University Faculty of MedicineTsutomuIwasaDepartment of Medical Oncology, Kindai University Faculty of MedicineKazukoSakaiDepartment of Genome Biology, Kindai University Faculty of MedicineKazutoNishioDepartment of Genome Biology, Kindai University Faculty of MedicineAkihikoItoDepartment of Pathology, Kindai University Faculty of MedicineKazuhikoNakagawaDepartment of Medical Oncology, Kindai University Faculty of MedicineHidetoshiHayashiDepartment of Medical Oncology, Kindai University Faculty of MedicineBACKGROUND. Immune checkpoint inhibitors (ICIs) targeting the programmed cell death 1 axis have revolutionized metastatic non–small cell lung cancer (mNSCLC) treatment. However, disease progression remains a concern, and the role of the complex tumor microenvironment (TME) in treatment failure is not fully understood.<br>
METHODS. In this biomarker study involving 103 patients with mNSCLC, including 81 patients who received ICI treatment, we evaluated the association between heterogeneous immune cell subsets and ICI efficacy through single-cell spatial profiling of pretreatment tumor tissue, using a 29-marker multiplex IHC platform built for in-depth dissection of the TME.<br>
RESULTS. Among various types of intratumoral lymphocytes, including Th1, Treg, and NK cells, only CD8+ T cells (tumor-infiltrating lymphocytes [TILs]) were associated with ICI efficacy. Computational tissue segmentation underscored the importance of direct physical interactions between CD8+ TILs and cancer cells for ICI efficacy. TIL phenotyping identified CD39/CD103/Ki-67 positivity as a hallmark of exhausted yet functional tumor-reactive CD8+ TILs. Immunosuppressive tumor-associated macrophages (TAMs) and cancer-associated fibroblasts were independent unfavorable adversaries. High CD73 expression on cancer cells was suggested to confer tolerance to ICI in EGFR/ALK-oncogene+ NSCLC, potentially through M2-TAM accumulation and aberrant angiogenesis.<br>
CONCLUSION. Our study delineates the clinical relevance of heterogeneous immune cell subsets in ICI-treated mNSCLC, aiding the development of targeted therapeutic strategies.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2041-17231712026Bacterial collagenase harnesses collagen geometry for processive cleavage5485ENHiroyaOkiDepartment of Infection Metagenomics, Genome Information Research Center, Research Institute for Microbial Diseases, The University of OsakaKatsukiTakebeDepartment of Dental Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAdjoaBonsuDepartment of Chemistry and Biochemistry, University of ArkansasKazunoriFujiiDepartment of Chemistry and Biochemistry, School of Advanced Science and Engineering, Waseda UniversityRyoMasudaWaseda Research Institute for Science and Engineering, Waseda UniversityNicholasHendersonDepartment of Chemistry and Biochemistry, University of ArkansasTakehikoMimaDepartment of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health SciencesTakakiKoideDepartment of Chemistry and Biochemistry, School of Advanced Science and Engineering, Waseda UniversityMahmoudMoradiDepartment of Chemistry and Biochemistry, University of ArkansasOsamuMatsushitaDepartment of Bacteriology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJoshuaSakonDepartment of Chemistry and Biochemistry, University of ArkansasKazukiKawaharaGraduate School of Pharmaceutical Sciences, The University of OsakaCollagen, the major structural protein in the animal extracellular matrix, forms a triple helix that resists proteolysis and requires specialised enzymes for degradation. Flesh-eating bacteria secrete collagenases that unwind the collagen triple helix and processively trim Gly–X–Y triplet repeats, yet the molecular basis of this process has remained obscure. Here, cryo-electron microscopy reveals how Hathewaya histolytica collagenase ColH engages its substrate and exploits the helix’s architecture for catalysis. ColH encircles a single collagen triple helix in a closed-ring conformation and, through dynamic domain motions, dehydrates and destabilises it. The enzyme undergoes substrate-assisted twisting to adopt a rigid ratcheted conformation, in which one chain is bent into a tripeptide-long ‘bight’ and threaded into the active site for cleavage, while two uncut strands are partitioned to non-catalytic sites. Release of the bight appears to reset the enzyme, with the uncut strands serving as guiding tracks. Repeated cycling between dynamic and rigid states likely enables triplet-by-triplet translocation, allowing ColH to harness collagen’s geometry for processive degradation. These findings reveal a bacterial strategy for collagen unwinding and cleavage distinct from that of mammalian collagenases, highlighting divergent evolutionary solutions for degrading one of nature’s most intractable substrates.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221612026Dual-calibration RT-qPCR reveals distinct dnaK1/2/3 and groEL1/2 expression dynamics under heat and acid stress in the sinefungin producer Streptomyces incarnatus19282ENZhaoXiao-HuiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMaoKuboGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHarukaYamagataGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYurikoNakashimaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTomohisaHasunumaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTadayoshiKanaoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTakashiTamuraGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityStreptomyces incarnatus NRRL8089 produces sinefungin, a nucleoside antibiotic whose yield is enhanced under defined environmental stresses. Here, dual-calibration RT-qPCR was used to resolve paralogue-specific expression dynamics of the dnaK and groE chaperone systems under heat and acid stress conditions that increase sinefungin titres. The canonical dnaK1–dnaJ1 and groES–groEL1 operons exhibited moderate induction, whereas monocistronic paralogues (dnaK2, dnaK3 and groEL2) showed markedly higher inducibility, with up to ~ 125-fold increases relative to baseline expression. Promoter analyses revealed conserved inverted repeats and differences in predicted secondary-structure stability, suggesting that promoter architecture contributes to paralogue-specific responsiveness. Structural modelling indicated divergence among DnaK paralogues in regions associated with substrate interaction, whereas GroEL paralogues retained a conserved overall scaffold, consistent with kinetic rather than structural differentiation. Together, these findings indicate that duplicated paralogues are not functionally redundant but are differentially regulated to partition proteostasis capacity under stress. This paralogue-specific regulation may provide a framework linking environmental perturbation to secondary-metabolite production in actinomycetes.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221612026Metastatic promoting role of mesenchymal stem cells in oral squamous cell carcinoma revealed by an improved bone marrow chimeric model20445ENHtoo ShweEainDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama UniversityHotakaKawaiDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama UniversityShoSanouDepartment of Oral and Maxillofacial Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama UniversityYaminSoeDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama UniversityMay WathoneOoDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama UniversityTianyanPiaoDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama UniversityZin ZinMinDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama UniversityKiyofumiTakabatakeDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama UniversityKeisukeNakanoDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama UniversitySoichiroIbaragiDepartment of Oral and Maxillofacial Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama UniversityHitoshiNagatsukaDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama UniversityMesenchymal stem cells (MSCs) are essential stromal regulators that coordinate tissue repair, angiogenesis, and immune balance. Within tumours, MSCs remodel the microenvironment and influence disease progression, yet their systemic contribution remains unclear due to the limited recovery of functional MSCs in conventional bone marrow transplantation models. Here, we developed an improved bone marrow collection (iBMC) method using enzymatic digestion, which markedly increases MSC yield while preserving their native phenotype. GFP bone marrow chimeric mice generated by iBMC and conventional transplantation displayed comparable hematopoietic reconstitution but differed in MSC abundance, enabling direct analysis of MSC-specific effects under physiological conditions. In mouse models of oral squamous cell carcinoma (OSCC), MSCs profoundly affected tumour development. MSC-deficient tumours exhibited necrosis and infiltration of immature myeloid-derived suppressor cells (MDSCs), whereas MSC-rich tumours showed enhanced vascularisation, adaptive immune infiltration, and stromal remodelling. Notably, lung metastasis occurred only in MSC-rich mice, accompanied by bone marrow–derived endothelial activation and TNF-α–driven inflammation. Pharmacological inhibition of LepR signalling using SHU9119 unexpectedly increased metastasis, underscoring the dual, context-dependent functions of MSCs. These findings establish iBMC as a reproducible and physiologically relevant model to study MSC-mediated regulation of tumour immunity, angiogenesis, and metastasis.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama2977-0548232026Truncation by death in the sufficient-cause frameworkuuag021ENBronner PGonçalvesFaculty of Health and Medical Sciences, University of SurreyEijiYamamotoOkayama University of ScienceEtsujiSuzukiDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityThe sufficient-cause framework has been used for decades to improve our understanding of both basic and complex causal concepts in epidemiology, such as mediation and interaction. Here, we make use of this framework to provide a description of truncation by death, in which the outcome of interest is undefined for individuals who die before the assessment time at the end of follow-up. We explain the noncausal nature of the crude estimand that compares outcomes by treatment levels conditional on observed survival by showing that it corresponds to a comparison of distinct risk-status types, which are defined based on their susceptibility to sufficient causes. Further, expressions for the crude estimand and for the survivor average causal effect (SACE)—a causal estimand defined under the principal stratification approach—are provided in terms of population-level joint frequencies of the background factors of sufficient causes. Finally, we also describe conditions, based on background factors of sufficient causes, under which the SACE is null. Our description of this problem, which studies truncation by death from a new perspective, might encourage further analyses of principal stratification-based estimands using sufficient causes.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama0002-92622026Causal diagrams integrating counterfactuals and sufficient causeskwag046ENEtsujiSuzukiDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityEijiYamamotoOkayama University of ScienceNo potential conflict of interest relevant to this article was reported.American Society for MicrobiologyActa Medica Okayama0066-48046912025Genomic epidemiology and genetic characteristics of clinical Campylobacter species cocirculating in West Bengal, India, 2019, using whole genome analysise01108-24ENDaichiMoritaDepartment of Microbiology, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityAsish KumarMukhopadhyayDivision of Bacteriology, ICMR - National Institute of Cholera and Enteric DiseasesGoutamChowdhuryDivision of Bacteriology, ICMR - National Institute of Cholera and Enteric DiseasesFumitoMaruyamaSection of Microbial Genomics and Ecology, The IDEC Institute, Hiroshima UniversityMiyukiKandaDepartment of Cellular and Molecular Biology, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityYukiYamamotoDepartment of Cellular and Molecular Biology, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityHidetoshiTaharaDepartment of Cellular and Molecular Biology, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityPiyaliMukherjeeDivision of Bacteriology, ICMR - National Institute of Cholera and Enteric DiseasesMainakBardhanDivision of Bacteriology, ICMR - National Institute of Cholera and Enteric DiseasesTakanoriKumagaiDepartment of Microbiology, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityKeiKitaharaCollaborative Research Centre of Okayama University for Infectious Diseases at ICMR-NICEDShin-IchiMiyoshiCollaborative Research Centre of Okayama University for Infectious Diseases at ICMR-NICEDShantaDuttaDivision of Bacteriology, ICMR - National Institute of Cholera and Enteric DiseasesTeruoKurodaDepartment of Microbiology, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityCampylobacter species are the most common pathogens responsible for foodborne gastroenteritis worldwide. India is a region with frequent diarrheal infections and a high level of Campylobacter infection incidence, but the detailed genomic information is limited. This study aimed to characterize 112 isolates of Campylobacter from diarrhea patients at two hospitals in Kolkata, West Bengal, by whole genome analysis. The Campylobacter isolates consisted of 90 C. jejuni, 20 C. coli, and 2 C. lari isolates. Multilocus sequence typing analysis revealed that the largest sequence type (ST) populations were ST-2131 in C. jejuni and ST-830 in C. coli and seven novel STs were found in C. jejuni and one in C. coli. Notably, ST-2131, which is rarely seen elsewhere, was positive for a sialylated LOS-related gene (wlaN +neuA + cstIII) associated with Guillain-Barré syndrome. Antibiotic resistance factors predicted from the genome sequence included blaOXA variants (58.9%), tet(O) (54.5%), tet(W) (0.9%), ant(6)-Ia (0.9%), mutation in GyrA (T86I, T86I+D90N, T86I+P104S, T86I+D90N+P104S) (79.5%), and mutation in 23S rRNA (A2075G) (12.5%). In addition to the high drug resistance of Campylobacter in Kolkata, Campylobacter pathogens were circulating that may be associated with Guillain-Barré syndrome. This study indicates the importance of genomic analysis in the surveillance of pathogens, which provides genomic information on genetic diversity, virulence mechanisms, and determinants of antimicrobial resistance.No potential conflict of interest relevant to this article was reported.American Society for MicrobiologyActa Medica Okayama0019-95679312025A newly developed oral infection mouse model of shigellosis for immunogenicity and protective efficacy studies of a candidate vaccinee00346-2ENRishaHaldarDivision of Clinical Medicine, ICMR-National Institute of Cholera and Enteric DiseasesProlayHalderDivision of Bacteriology, ICMR-National Institute of Cholera and Enteric DiseasesHemantaKoleyDivision of Bacteriology, ICMR-National Institute of Cholera and Enteric DiseasesShin-ichiMiyoshiDivision of Medicine, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySantasabujDasDivision of Clinical Medicine, ICMR-National Institute of Cholera and Enteric DiseasesShigella infection poses a significant public health challenge in the developing world. However, lack of a widely available mouse model that replicates human shigellosis creates a major bottleneck to better understanding of disease pathogenesis and development of newer drugs and vaccines. BALB/c mice pre-treated with streptomycin and iron (FeCl3) plus desferrioxamine intraperitoneally followed by oral infection with virulent Shigella flexneri 2a resulted in diarrhea, loss of body weight, bacterial colonization and progressive colitis characterized by disruption of epithelial lining, loss of crypt architecture with goblet cell depletion, increased polymorphonuclear infiltration into the mucosa, submucosal swelling (edema), and raised proinflammatory cytokines and chemokines in the large intestine. To evaluate the usefulness of the model for vaccine efficacy studies, mice were immunized intranasally with a recombinant protein vaccine containing Shigella invasion protein invasion plasmid antigen B (IpaB). Vaccinated mice conferred protection against Shigella, indicating that the model is suitable for testing of vaccine candidates. To protect both Shigella and Salmonella, a chimeric recombinant vaccine (rIpaB–T2544) was developed by fusing IpaB with Salmonella outer membrane protein T2544. Vaccinated mice developed antigen-specific serum IgG and IgA antibodies and a balanced Th1/Th2 response and were protected against oral challenge with Shigella (S. flexneri 2a, Shigella dysenteriae, and Shigella sonnei) using our present mouse model and Salmonella (Salmonella Typhi and Paratyphi) using an iron overload mouse model. We describe here the development of an oral Shigella infection model in wild-type mouse. This model was successfully used to demonstrate the immunogenicity and protective efficacy of a candidate protein subunit vaccine against Shigella.No potential conflict of interest relevant to this article was reported.Japanese Society of Veterinary ScienceActa Medica Okayama0916-72508762025Effects of heat stress on gene expression associated with antioxidant capacity of bovine early antral follicles680684ENKoheiKAWANOLaboratory of Reproductive Physiology, Faculty of Environmental, Life, Natural Science and Technology, Okayama UniversityKenichiroSAKAGUCHILaboratory of Veterinary Theriogenology, Joint Department of Veterinary Medicine, Faculty of Applied Biological Sciences, Gifu UniversityEriFURUKAWANational Institute of Animal Health, National Agriculture and Food Research OrganizationNattapongNINPETCHDepartment of Animal Science, Faculty of Agriculture at Kamphaeng Saen, Kasetsart UniversityYojiroYANAGAWALaboratory of Theriogenology, Department of Clinical Sciences, Division of Veterinary Medicine, Faculty of Veterinary Medicine, Hokkaido UniversitySeijiKATAGIRILaboratory of Theriogenology, Department of Clinical Sciences, Division of Veterinary Medicine, Faculty of Veterinary Medicine, Hokkaido UniversityHeat exposure at the physiological level of oocyte-cumulus-granulosa cell complexes (OCGCs) during in vitro growth (IVG) culture decreases the reduced glutathione (GSH) level of oocytes, an antioxidant, but its mechanism has been unclear. We subjected OCGCs to IVG for 4, 8, or 12 days and investigated the effects of heat exposure on the gene expression of cumulus-granulosa cells associated with antioxidant capacity. Heat exposure did not alter the expression of genes related to GSH synthesis or reuse. Conversely, heat exposure increased mRNA expression of superoxide dismutase 2 and decreased that of glutathione peroxidase 1, which are antioxidant enzymes. Ultimately, heat exposure alters the gene expression of antioxidant enzymes in growing follicles, which may indirectly decrease the GSH level of oocytes.No potential conflict of interest relevant to this article was reported.Pharmaceutical Society of JapanActa Medica Okayama0918-615847122024Staphylococcus aureus δ-Toxin Induces Ca2+ Influx-Independent Degranulation of Murine Cultured Mast Cells20582064ENKangLiuLaboratory of Pharmacology, Division of Pathological Sciences, Kyoto Pharmaceutical UniversityTomoakiKatayamaDivision of Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHitomiSatoDivision of Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYuhoHamaoka-TamuraLaboratory of Pharmacology, Division of Pathological Sciences, Kyoto Pharmaceutical UniversityMichikoSaitoBioscience Research Center, Kyoto Pharmaceutical UniversityKazuyukiFurutaDivision of Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSatoshiTanakaLaboratory of Pharmacology, Division of Pathological Sciences, Kyoto Pharmaceutical UniversityCutaneous colonization with Staphylococcus aureus (SA) is frequently observed in patients with atopic dermatitis. SA produces a wide variety of bacterial toxins, among which δ-toxin was found to induce degranulation of mast cells. Degranulation of mast cells could enhance bacterial clearance and protection from future SA infection but lead to exacerbation of atopic dermatitis. Because it remains to be determined how δ-toxin triggers degranulation, we investigated δ-toxin-induced changes in murine bone marrow-derived cultured mast cells in this study. We found that δ-toxin-induced degranulation could be classified into two phases, an early Ca2+-independent and a late Ca2+-dependent phase. Recent studies suggest that NOD-like receptor family, pyrin domain containing 3 is involved in the degranulation of mast cells, raising a possibility that leakage of K+ induced by δ-toxin is involved in the Ca2+-independent phase. However, Ca2+-independent degranulation remains unchanged although Ca2+-influx and degranulation induced by δ-toxin were significantly suppressed in the presence of high concentrations of K+. Because actin depolymerization was reported to induce degranulation in the absence of Ca2+ in the permeabilized rat peritoneal mast cells, a slow but steady decrease in the amount of filamentous actin observed here may be involved in Ca2+-independent degranulation induced by δ-toxin. Although Mas-related G protein-coupled receptor (MRGPR) X2 in humans and Mrgprb2 in mice are regarded as the receptors responsible for immunoglobulin E-independent degranulation, δ-toxin-induced degranulation remained unchanged in Mrgprb2−/− mast cells. Our findings pave the way for identification of the target receptors of δ-toxin.No potential conflict of interest relevant to this article was reported.American Physical Society (APS)Acta Medica Okayama2470-001011352026Analytical study of birefringent cavities for axionlike dark matter search055009ENTadashiKuramotoResearch Institute for Interdisciplinary Science, Okayama UniversityYasutakaImaiResearch Institute for Interdisciplinary Science, Okayama UniversityTakahikoMasudaResearch Institute for Interdisciplinary Science, Okayama UniversityYutakaShikanoInstitute of Systems and Information Engineering, University of TsukubaSayuriTakatoriResearch Institute for Interdisciplinary Science, Okayama UniversitySatoshiUetakeResearch Institute for Interdisciplinary Science, Okayama UniversityLight polarization plays a crucial role in optical-cavity experiments; however, mirror birefringence presents a significant challenge that must be addressed carefully. In this study, a rigorous, nonperturbative framework is developed to quantify birefringence effects by incorporating variations in reflectance and polarization misalignment. We analyze the impact of this framework on the sensitivity of axionlike particle (ALP) dark matter searches. The results show that both birefringence and misalignment contribute to sensitivity degradation in the low-mass regime; however, the adverse effects of misalignment can be mitigated by selecting a postselection angle greater than the misalignment angle. Furthermore, birefringence produces an additional resonance peak in the high-mass region, which remains largely unaffected by misalignment and postselection variations. This rigorous framework underscores the importance of considering birefringence in high-precision optical-cavity experiments for ALP detection.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0385-56006922024RpoB H481Y Rifampicin Resistance Mutation-Associated Oxidative Stress Sensitivity Reduces the Virulence of Staphylococcus aureus128131ENTomonoriKanoGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazuyaIshikawaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityLinaImaiGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazuyukiFurutaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityChikaraKaitoGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityIn this study, we have established a Staphylococcus aureus RpoB H481Y mutant strain and demonstrated that it is sensitive to menadione or hydrogen peroxide-induced oxidative stress and exhibits reduced virulence against a silkworm infection model. Furthermore, the reduced virulence of the RpoB H481Y mutant was abrogated in the presence of N-acetylcysteine, a reactive oxygen species scavenger. These results suggest that oxidative stress sensitivity caused by the RpoB H481Y rifampicin resistance mutation attenuates the virulence of S. aureus.No potential conflict of interest relevant to this article was reported.American Society for MicrobiologyActa Medica Okayama0021-9193206102024Overexpression of diglucosyldiacylglycerol synthase leads to daptomycin resistance in Bacillus subtilise00307-24ENRyogoYamamotoGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazuyaIshikawaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYusukeMiyoshiGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazuyukiFurutaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShin-IchiMiyoshiGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityChikaraKaitoGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityThe lipopeptide antibiotic daptomycin exhibits bactericidal activity against Gram-positive bacteria by forming a complex with phosphatidylglycerol (PG) and lipid II in the cell membrane, causing membrane perforation. With the emergence of daptomycin-resistant bacteria, understanding the mechanisms of bacterial resistance to daptomycin has gained great importance. In this study, we aimed to identify the genetic factors contributing to daptomycin resistance in Bacillus subtilis, a model Gram-positive bacterium. Our findings demonstrated that overexpression of ugtP, which encodes diglucosyldiacylglycerol synthase, induces daptomycin resistance in B. subtilis. Specifically, overexpression of ugtP resulted in increased levels of diglucosyldiacylglycerol (Glc2DAG) and decreased levels of acidic phospholipids cardiolipin and PG, as well as the basic phospholipid lysylphosphatidylglycerol. However, ugtP overexpression did not alter the cell surface charge and the susceptibility to the cationic antimicrobial peptide nisin or the cationic surfactant hexadecyltrimethylammonium bromide. Furthermore, by serial passaging in the presence of daptomycin, we obtained daptomycin-resistant mutants carrying ugtP mutations. These mutants showed increased levels of Glc2DAG and a >4-fold increase in the minimum inhibitory concentration of daptomycin. These results suggest that increased Glc2DAG levels, driven by ugtP overexpression, modify the phospholipid composition and confer daptomycin resistance in B. subtilis without altering the cell surface charge of the bacteria.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0304-860817112025Novel Escherichia coli phages representing a distinct genus within the subfamily Stephanstirmvirinae: genome and host range characteristics18ENTomoyoshiKanekoDepartment of Life Science and Medical Bioscience, Waseda UniversityJumpeiUchiyamaDepartment of Bacteriology, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama UniversityToshifumiOsakaDepartment of Microbiology and Immunology, Tokyo Women’s Medical UniversitySatoshiTsunedaDepartment of Life Science and Medical Bioscience, Waseda UniversityBacteriophages play crucial roles in microbial ecosystems and have potential for biotechnological applications. However, our understanding of culturable phages remains limited. In this study, we characterized six novel Escherichia coli phages isolated from pig farm wastewater and urban sewage, using comprehensive genomic, morphological, and host-range analysis. Using multiple comparative approaches, including gene-sharing network analysis, average nucleotide identity (ANI), and nucleotide intergenomic similarity (NIS), we demonstrated that five of these phages form a distinct group within the subfamily Stephanstirmvirinae, potentially representing a novel genus, for which we propose the name "Wecvirus”. We further propose that these phages, each of which exhibits a unique host range pattern, should be classified in two distinct species within the proposed genus. This host specificity is reflected in differences in the amino acid sequences of tail fibers, which are crucial for infection. The remaining phage, which was not classified as a wecvirus, exhibited characteristics that challenged the current classification criteria, highlighting the need for more-flexible taxonomic approaches. These findings expand our understanding of phage diversity within the subfamily Stephanstirmvirinae and contribute to the evolving phage taxonomy framework.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0012-16065202025Tunicate-specific protein Epi-1 is essential for conferring hydrophilicity to the larval tunic in the ascidian Ciona4152ENKazuKuroiwaShimoda Marine Research Center, University of TsukubaKaoruMita-YoshidaShimoda Marine Research Center, University of TsukubaMayukoHamadaUshimado Marine Institute, Okayama UniversityAkikoHozumiShimoda Marine Research Center, University of TsukubaAtsuo S.NishinoDepartment of Biology, Faculty of Agriculture and Life Science, Hirosaki UniversityYasunoriSasakuraShimoda Marine Research Center, University of TsukubaAnimals must avoid adhesion to objects in the environment to maintain their mobility and independence. The marine invertebrate chordate ascidians are characterized by an acellular matrix tunic enveloping their entire body for protection and swimming. The tunic of ascidian larvae consists of a surface cuticle layer and inner matrix layer. Hydrophilic substances coat the cuticle; this modification is thought to be for preventing adhesion. However, the molecule responsible for regulating this modification has not been clarified. We here found that the tunicate-specific protein Epi-1 is responsible for preventing adhesiveness of the tunic in the ascidian Ciona intestinalis Type A. Ciona mutants with homozygous knockouts of Epi-1 exhibited adhesion to plastic plates and to other individuals. The cuticle of the Epi-1 mutants was fragile, and it lost the glycosaminoglycans supplied by test cells, the accessory cells that normally attach to the tunic surface. Although it has an apparent signal peptide for membrane trafficking, we showed that the Epi-1 protein is localized to the cytosol of the epidermal cells. Our study suggests that the emergence of the tunicate-specific protein Epi-1 made the tunic less adhesive, providing a selective advantage for the last common tunicate ancestor.No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama0743-746340522024Formation of Nonspherical Cellulose Acetate Microparticles under Microflow2731427322ENKurumiMoriDepartment of Applied Chemistry, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTakaichiWatanabeDepartment of Applied Chemistry, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTsutomuOnoDepartment of Applied Chemistry, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityNonspherical particles have gained significant interest owing to their unique shapes and large specific surface areas, making them suitable for a wide range of applications, such as drug delivery, catalysis, and adsorption. However, conventional methods for preparing nonspherical particles face certain limitations. In this study, we propose a simple method for fabricating nonspherical cellulose acetate (CA) microparticles using a microfluidic device in which droplets undergo rapid diffusion in a continuous aqueous phase. The influence of variations in the flow rate ratio and continuous phase composition on the dimensionless Péclet number (Pe) within the droplet and shape of the resultant particles is investigated. Pe is critical, because it indicates the balance between polymer diffusion and droplet shrinkage dynamics. Our findings reveal that increasing the flow rate ratio and reducing the methyl acetate concentration in the continuous phase lead to faster droplet shrinkage and an increased Pe. A high Pe (>100) suggests that the reduction of the droplet interface predominates over polymer diffusion, resulting in the formation of a viscous layer near the droplet surface, which subsequently leads to nonspherical particle shapes (such as bowl-like or biconcave structures). In situ time-lapse observations of droplets from the top and side of a microchannel reveal that the formation of a viscous layer near the droplet surface and the deformation of the droplet, influenced by the z-axis location of the droplets during particle formation, ultimately determine the final particle shape. Based on these observations, a linear correlation between the initial conditions, i.e., the Pe and z-axis location at which the viscous layer formed, is established, enabling the prediction of the particle structure. In summary, the present study enhances the understanding of shape control in microfluidic particle formation and offers a novel guideline for the fabrication of spherical and nonspherical particles.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1347-694788102024Evaluation of quercetin as a potential cytoprotector against acetaldehyde using the cultured hepatocyte model with aldehyde dehydrogenase isozyme deficiency11991202ENYuhangXuGraduate School of Environmental and Life Science, Okayama UniversityTakeshiSawamotoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityRuitongSunGraduate School of Environmental and Life Science, Okayama UniversityAkiIshikuraGraduate School of Environmental and Life Science, Okayama UniversityShintaroMunemasaGraduate School of Environmental and Life Science, Okayama UniversityYoshiyukiMurataGraduate School of Environmental and Life Science, Okayama UniversityAyanoSatohGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityAkikoMatsumotoDepartment of Social and Environmental Medicine, Saga UniversityToshiyukiNakamuraGraduate School of Environmental and Life Science, Okayama UniversityYoshimasaNakamuraGraduate School of Environmental and Life Science, Okayama UniversityProtective effect of quercetin against acetaldehyde was evaluated using the cultured hepatocyte models with aldehyde dehydrogenase (ALDH) isozyme deficiency (aldh2-kd and aldh1a1-kd). The quercetin-induced cytoprotection against acetaldehyde in the ALDH1A1-deficient mutant (aldh1a1-kd) was weaker than that in the wild type. Furthermore, quercetin did not enhance the ALDH activity in aldh1a1-kd cells, suggesting that ALDH1A1 is involved in quercetin-induced cytoprotection.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1347-69478882024Negative regulation of chitosan-induced stomatal closure by glutathione in Arabidopsis thaliana918922ENIsratJahanGraduate School of Environmental and Life Science, Okayama UniversityShintaroMunemasaGraduate School of Environmental and Life Science, Okayama UniversityToshiyukiNakamuraGraduate School of Environmental and Life Science, Okayama UniversityYoshimasaNakamuraGraduate School of Environmental and Life Science, Okayama UniversityYoshiyukiMurataGraduate School of Environmental and Life Science, Okayama UniversityChitosan (CHT) is a deacylated derivative of chitin and improves growth and yield performance, activates defensive genes, and also induces stomatal closure in plants. Glutathione (GSH) has significant functions in the growth, development, defense systems, signaling, and gene expression. GSH negatively regulates abscisic acid-, methyl jasmonate-, and salicylic acid-induced stomatal closure. However, the negative regulation by GSH of CHT-induced stomatal closure is still unknown. Regulation of CHT-induced stomatal closure by GSH in guard cells was investigated using two GSH-deficient mutants, cad2-1 and chlorina 1-1 (ch1-1), and a GSH-decreasing chemical, 1-chloro-2,4-dinitrobenzene (CDNB). The cad2-1 and ch1-1 mutations and CDNB treatment enhanced CHT-induced stomatal closure. Treatment with glutathione monoethyl ester restored the GSH level in the guard cells of cad2-1 and ch1-1 and complemented the stomatal phenotype of the mutants. These results indicate that GSH negatively regulates CHT-induced stomatal closure in Arabidopsis thaliana.No potential conflict of interest relevant to this article was reported.Royal Society of Chemistry (RSC)Acta Medica Okayama2050-748813112025Enhanced capacity of aluminum-ion batteries by adjusting the average pore size of the porous carbon cathode80528058ENYifengChenGraduate School of Environmental, Life, Natural Science, and Technology, Okayama UniversityHirooSuzukiGraduate School of Environmental, Life, Natural Science, and Technology, Okayama UniversityShuFukumotoGraduate School of Environmental, Life, Natural Science, and Technology, Okayama UniversityChiyuNakanoDepartment of Comprehensive Technical Solutions, Okayama UniversityTakeshiNishikawaGraduate School of Environmental, Life, Natural Science, and Technology, Okayama UniversityShigeyukiUmezawaSeiwa Electric Mfg. Co., LtdYasuhikoHayashiGraduate School of Environmental, Life, Natural Science, and Technology, Okayama UniversityLithium-ion batteries (LIBs) are widely used but with the increasing scarcity and uneven distribution of global lithium resources, there is a need to explore alternative battery technologies. Due to its abundance, low cost, and high theoretical capacity, aluminum is a strong candidate for metal anodes, making aluminum-ion batteries (AIBs) an area of considerable interest. Current mainstream research focuses on ionic liquid electrolytes, which offer a wide electrochemical window and high ionic conductivity. Carbon materials are ideal cathode candidates due to their low cost, abundance, and high voltage platform. AIBs using carbon materials typically exhibit low discharge capacity. This study addressed the challenge of improving the discharge capacity of carbon-based cathodes in AIBs. By using porous carbon (PC) materials with varying specific surface areas, average pore sizes, and total pore volumes as cathodes, average pore size was found to impact capacity. This contradicts the contention that larger specific surface areas result in higher capacities. There is a key difference in ion behavior: whereas aluminum chloride ions intercalate into layered graphite structures, they do not intercalate into PC materials but are adsorbed to the surface. By adjusting the average pore size, it is possible to increase the discharge capacity of AIBs, challenging the traditional emphasis on specific surface area. This research does not fully solve the problem of low discharge capacity in carbon-based cathodes, but provides a new perspective on the role of pore size in enhancing battery performance, offering valuable insights for future electrode design.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0803-525311422024Outdoor playing during preschool was associated with a reduced risk of school-age obesity in Japan303309ENTakahiroTsugeDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNaomiMatsumotoDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySoshiTakaoDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiYorifujiDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAim: This study investigated the association between outdoor play habits during preschool and school-age obesity.<br>
Methods: We conducted a longitudinal cohort study of all children born in Japan during 2 weeks in January and July 2001. We defined outdoor play habits at age 2.5 years (third survey) as exposure, while parent-reported height and weight at age 7 years (seventh survey) were defined as overweight and obesity status using the WHO reference. Logistic regression models were used to estimate odds ratios (ORs) for associations between preschool outdoor play habits and school-age obesity, adjusting for parental and child factors.<br>
Results: Of 53 575 children born, 42 812 had data on outdoor play habits at age 2.5 years, with 91% (38 970) having such habits. At age 7 years, 31 743/42 812 (74%) children had height and weight data, with 3249/31 743 (10%) classified as overweight or obesity (BMI SD score ≥1.0). Outdoor play habits were negatively associated with obesity (adjusted OR 0.85, 95% confidence interval (CI): 0.74–0.97).<br>
Conclusion: Outdoor play habits in early preschool years are associated with a reduced risk of school-age obesity. Parents and caregivers may consider encouraging their children to outdoor play habits at an early age to help prevent obesity later in life.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1433-785164112025Stereoselective Preparation and Palladium-Catalyzed Suzuki–Miyaura Cross-Coupling of Alkenyl Sulfoximinese202420949ENKosukeYasuiDepartment of Applied Chemistry Graduate School of Engineering, Osaka UniversityYuichiroTomishimaDepartment of Applied Chemistry Graduate School of Engineering, Osaka UniversityTomoyaMiuraDivision of Applied Chemistry, Okayama UniversityKenYamazakiDivision of Applied Chemistry, Okayama UniversityKojiHiranoDepartment of Applied Chemistry Graduate School of Engineering, Osaka UniversityAlthough numerous transition-metal catalyzed cross-coupling reactions of alkenyl electrophiles with a sulfur(VI) leaving group, mainly alkenyl sulfones, have been developed, most rely heavily on highly nucleophilic Grignard reagents, and the use of organoboron reagents remains challenging. We report herein facile preparation and the following Pd-catalyzed Suzuki–Miyaura cross-coupling reaction of alkenyl sulfoximine, a monoaza analog of sulfone. The condensation of alkyl sulfoximine with aldehydes, developed in this study, makes alkenyl sulfoximines more readily available. The resulting alkenes undergo an unprecedented oxidative addition of the C−S bond to the Pd center. This cross-coupling proceeds with retention of its original stereochemistry and provided alkenes bearing three different functionalities in a stereoselective fashion. DFT calculations highlight the critical role of boronic acid and in situ-generated boroxines in facilitating this transformation.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841872026Reappraisal of the Entity of Pediatric Uveitis: Bilateral Iridocyclitis With Retinal Capillaritis (BIRC) in Juveniles in 18 Additional Casese112232ENToshihikoMatsuoOphthalmology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityObjectives: Bilateral iridocyclitis with retinal capillaritis (BIRC) in juveniles is a newly recognized entity of juvenile chronic uveitis with no systemic involvement. In this study, 18 additional consecutive patients with BIRC were reported to show that the entity would be useful in the differential diagnosis.<br>
Methods: Clinical features were retrospectively reviewed in 18 consecutive patients diagnosed with BIRC in juveniles at Okayama University Hospital, Okayama, Japan, between 1996 and 2025.<br>
Results: The 18 patients comprised 6 males and 12 females, with an age at onset ranging from 9 to 16 years (median, 13 years). All patients presented with aqueous cells and mutton-fat keratic precipitates in both eyes, and fluorescein angiography revealed varying degrees of optic disc leakage and retinal capillary leakage in the midperipheral to peripheral fundus of both eyes. None had systemic symptoms, including skin rashes, joint pain, or fever, and no abnormalities were detected on blood examinations, urinalysis, or plain chest x-rays. Oral prednisolone, tapered from 30 mg daily, together with topical 0.1% betamethasone four times daily, was administered to five patients: two with optic disc edema and three with macular edema in both eyes or the unilateral eye. The remaining 13 patients were treated with topical 0.1% betamethasone eye drops alone. In patients who developed elevated intraocular pressure, often due to a steroid response, the instillation of topical 0.1% betamethasone was reduced to twice daily, or intraocular pressure-lowering eye drops were used in combination. In two patients who showed relapse of unilateral macular edema after oral prednisolone was tapered or discontinued, oral colchicine (1 mg daily) was introduced, resulting in the subsidence of macular edema. Bilateral uveitis in all 18 patients subsided within 6 months to a few years until 19 years of age, and all topical medications were discontinued, with relapse occurring in only one patient.<br>
Conclusions: BIRC in juveniles should be included in the differential diagnosis for school-age children and young adolescents. BIRC follows a chronic course of a few years and subsides completely with a good prognosis. In cases of macular edema or optic disc edema that affects vision, oral corticosteroid treatment is recommended, whereas patients with no sight-threatening signs can be treated with topical corticosteroid eye drops alone. The entity of BIRC may be distinct from juvenile chronic iridocyclitis in young girls with onset at preschool age, which shares common features with juvenile idiopathic arthritis-associated uveitis.No potential conflict of interest relevant to this article was reported.Georg Thieme Verlag KGActa Medica Okayama0013-726X57042024Efficacy and safety of endoscopic ultrasonography-guided ethanol injections of small pancreatic neuroendocrine neoplasms: a prospective multicenter study321329ENKazuyukiMatsumotoGastroenterology and Hepatology, Okayama University HospitalHironariKatoGastroenterology and Hepatology, Okayama University HospitalTakaoItoiGastroenterology and Hepatology, Tokyo Medical UniversityMasayukiKitanoSecond Department of Internal Medicine, Wakayama Medical UniversityKazuoHaraGastroenterology, Aichi Cancer Center HospitalMasakiKuwataniGastroenterology and Hepatology, Hokkaido University HospitalMamoruTakenakaGastroenterology and Hepatology, Kindai University Faculty of Medicine Graduate School of Medical SciencesReikoAshidaSecond Department of Internal Medicine, Wakayama Medical UniversityShuntaroMukaiGastroenterology and Hepatology, Tokyo Medical UniversityNozomiOkunoGastroenterology, Aichi Cancer Center HospitalKazumichiKawakuboGastroenterology and Hepatology, Hokkaido University HospitalTatsuhiroYamazakiGastroenterology and Hepatology, Okayama University HospitalJunSakuraiCenter for Innovative Clinical Medicine, Okayama University HospitalYukiNakatsukaCenter for Innovative Clinical Medicine, Okayama University HospitalMichihiroYoshidaCenter for Innovative Clinical Medicine, Okayama University HospitalMotoyukiOtsukaGastroenterology and Hepatology, Okayama University HospitalBackground Endoscopic ultrasonography (EUS)-guided ethanol injection (EI) has recently been introduced as one of the management strategies for pancreatic neuroendocrine neoplasms (PNENs); however, its role as a surgical alternative is unclear. We evaluated the efficacy and safety of EUS-EI in treating small PNENs through a prospective multicenter study.<bR>
Methods Patients with grade 1 tumors of ≤15 mm confirmed by pathology were included. The primary end point assessed efficacy and safety, measuring complete ablation using computed tomography at 1 and 6 months, prevention of adverse events (AEs) within 1 month, severe pancreatic fistula at 1 month, and incidence/worsening of diabetes mellitus (DM) at 6 months. The composite end point of EUS-EI was compared with that of historical results of a study based on surgical treatment.<br>
Results 25 patients with PNENs, with a median tumor size of 10.1 mm, were treated using EUS-EI. The composite primary end point was achieved by 76.0% of patients (19/25; 95%CI 54.9%–90.6%), a proportion significantly higher than that of surgical treatment (P = 0.008). Regarding efficacy, 88.0% (22/25) of patients achieved complete ablation at 1 and 6 months (95%CI 68.8%–97.5%). Regarding safety, 96.0% (24/25) of patients had no severe AEs within 1 month (95%CI 79.7%–99.9%). No patients had severe pancreatic fistulas at 1 month, and 84.0% (21/25) had no incidence or exacerbation, or both, of DM at 6 months (95%CI 63.9%–95.5%).<br>
Conclusion EUS-EI is safe and could be a potent treatment option for patients with small PNENs.No potential conflict of interest relevant to this article was reported.American Society of Clinical Oncology (ASCO)Acta Medica Okayama0732-183X43162025Methotrexate, Doxorubicin, and Cisplatin Versus Methotrexate, Doxorubicin, and Cisplatin + Ifosfamide in Poor Responders to Preoperative Chemotherapy for Newly Diagnosed High-Grade Osteosarcoma (JCOG0905): A Multicenter, Open-Label, Randomized Trial18861897ENHiroakiHiragaMusculoskeletal Oncology, NHO Hokkaido Cancer CenterRyunosukeMachidaJapan Clinical Oncology Group Data Center/Operations Office, National Cancer Center HospitalAkiraKawaiMusculoskeletal Oncology, National Cancer Center HospitalToshiyukiKunisadaOrthopaedic Surgery, Faculty of Medicine, Okayama UniversityTsukasaYonemotoOrthopaedic Surgery, Chiba Cancer CenterMakotoEndoOrthopaedic Surgery, Graduate School of Medical Sciences, Kyushu UniversityYoshihiroNishidaDepartment of Rehabilitation Medicine, Nagoya University HospitalAkihitoNaganoOrthopaedic Surgery, Gifu University School of MedicineKeisukeAeOrthopaedic Surgery, Cancer Institute HospitalShinichirouYoshidaOrthopaedic Surgery, Tohoku University Graduate School of MedicineKunihiroAsanumaOrthopaedic Surgery, Mie UniversityJunyaToguchidaDepartment of Tissue Regeneration, Center for Induced Pluripotent Stem Cell Research and Application, Institute for Frontier Medical Sciences, Kyoto UniversityTaisukeFurutaOrthopaedic Surgery, Hiroshima UniversityRobertNakayamaDepartment of Orthopaedic Surgery, Keio University School of MedicineToshihiroAkisueOrthopaedic Surgery, Kobe UniversityToruHirumaBone and Soft Tissue Tumour Surgery, Kanagawa Cancer CenterTakeshiMoriiOrthopaedic Surgery, Kyorin UniversityHidekiNishimuraOrthopaedic Surgery, Kagawa University HospitalKojiHiraokaOrthopaedic Surgery, Kurume University HospitalMasanobuTakeyamaOrthopaedic Surgery, Yokohama City University HospitalMakotoEmoriOrthopaedic Surgery, Sapporo Medical University HospitalSatoshiTsukushiOrthopaedic Surgery, Aichi Cancer CenterHiroshiHatanoMusculoskeletal Oncology, Niigata Cancer Center HospitalHiroyukiKawashimaOrthopaedic Surgery, Niigata University Medical & Dental HospitalKazuoIsuOrthopaedic Surgery, Higashi Sapporo HospitalKazuhiroTanakaAdvanced Medical Sciences, Oita University Faculty of MedicineTomokoKataokaJapan Clinical Oncology Group Data Center/Operations Office, National Cancer Center HospitalHaruhikoFukudaJapan Clinical Oncology Group Data Center/Operations Office, National Cancer Center HospitalYukihideIwamotoOrthopaedic Surgery, Kyushu Rosai HospitalToshifumiOzakiOrthopaedic Surgery, Faculty of Medicine, Okayama UniversityPurpose Our previous NECO phase II studies on high-grade osteosarcoma suggested that administering ifosfamide (IF; 16 g/m2 [4g/m2 once on day 1, then 2g/m2 once on days 2-7] × six) to patients showing a poor response (PrRsp) to preoperative chemotherapy with methotrexate, doxorubicin, and cisplatin (MAP) improves their prognoses. In this Japan Clinical Oncology Group (JCOG) study, JCOG0905, we aimed to investigate the efficacy and safety of IF in patients with PrRsp.<br>
Methods JCOG0905 is a multicenter, open-label, multi-institutional, randomized trial. Eligible patients (50 years and younger) had resectable, high-grade osteosarcoma (stage II or III, Union for International Cancer Control TNM) of the extremities, limb girdles, and thoracic wall. After two MAP cycles and tumor resection, patients with PrRsp were randomly assigned to either the MAP or MAP plus 15 g/m2 (3g/m2 once daily on days 1-5) × six IF (MAP + IF [MAPIF]) group. The primary end point was disease-free survival (DFS); secondary end points were overall survival (OS) and safety. The planned sample size was 100 patients with a one-sided α of .1 and a power of 0.7, assuming a 3-year DFS of 50% and 65% for MAP and MAPIF, respectively. This trial is registered with the Japan Registry of Clinical Trials (jRCT; jRCTs031180126).<br>
Results Of the 287 patients registered between February 2010 and August 2020, 51 and 52 patients with PrRsp were assigned to the MAP and MAPIF groups, respectively. As of March 2022, DFS did not differ between groups (hazard ratio [HR], 1.05 [95% CI, 0.55 to 1.98]) and OS was numerically inferior in the MAPIF group (HR, 1.48 [95% CI, 0.68 to 3.22]). Nine and zero patients in the MAPIF and MAP groups discontinued treatment because of adverse events, respectively.<br>
Conclusion Evidence from JCOG0905 does not support the addition of IF for patients with PrRsp.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0022-05312262025Costly subjective learning105997ENYouichiroHigashiFaculty of Economics, Okayama UniversityKazuyaHyogoFaculty of Economics, Ryukoku UniversityNorioTakeokaDepartment of Economics, Hitotsubashi UniversityWe examine the behavioral foundation of rational inattention within a menu-choice framework. Unlike previous studies, our approach enables the unique identification of nonadditive information costs. The nonadditivity of information costs makes the effective cost inherently dependent on benefits of information. In contrast to additive cost models, this feature may lead to a violation of the preference for early resolution of menu uncertainty. Early resolution is typically preferable as it allows the agent to fine-tune information for relevant menus. However, if the effective cost function is convex in benefits of information, late resolution may reduce the effective information costs. The violation occurs when this cost-reduction effect outweighs the benefits of early resolution.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0025-583139212025Global well-posedness and scattering in weighted space for nonlinear Schrödinger equations below the Strauss exponent without gauge-invariance10511097ENMasakiKawamotoResearch Institute for Interdisciplinary Science, Okayama UniversitySatoshiMasakiDepartment of Mathematics, Hokkaido UniversityHayatoMiyazakiTeacher Training Courses, Faculty of Education, Kagawa UniversityIn this paper, we consider the nonlinear Schrödinger equation (NLS) with a general homogeneous nonlinearity in dimensions up to three. We assume that the degree (i.e., power) of the nonlinearity is such that the equation is mass-subcritical and short-range. We establish global well-posedness (GWP) and scattering for small data in the standard weighted space for a class of homogeneous nonlinearities, including non-gauge-invariant ones. Additionally, we include the case where the degree is less than or equal to the Strauss exponent. When the nonlinearity is not gauge-invariant, the standard Duhamel formulation fails to work effectively in the weighted Sobolev space; for instance, the Duhamel term may not be well-defined as a Bochner integral. To address this issue, we introduce an alternative formulation that allows us to establish GWP and scattering, even in the presence of poor time continuity of the Duhamel term.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0911-60284042024Central dentinogenic ghost cell tumor of the maxilla: a case report with new imaging findings and review of the literature561568ENSuzukaYoshidaDepartment of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoheiTakeshitaDepartment of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshiyukiKawazuDepartment of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMikiHisatomiDepartment of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShunsukeOkadaDepartment of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMamikoFujikuraDepartment of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKyoichiObataDepartment of Oral and Maxillofacial Surgery, Okayama University HospitalKiyofumiTakabatakeDepartment of Oral Pathology and Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySaoriYoshidaPreliminary Examination Room, Okayama University HospitalJunichiAsaumiDepartment of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesA dentinogenic ghost cell tumor (DGCT) is a rare benign odontogenic tumor that commonly shows characteristics of solid proliferation and has a relatively high risk of recurrence after surgical treatment. We herein report a case of a central DGCT that occurred in the maxilla and resulted in bone expansion. This study highlights new imaging findings (particularly magnetic resonance imaging) along with histopathological observations. In addition, we conducted a review of the existing literature on this rare tumor. A 37-year-old man developed swelling around the right cheek. A benign odontogenic tumor such as ameloblastoma was suspected based on the imaging examination findings (including bone expansion and the internal characteristics of the tumor) on panoramic imaging, computed tomography, and magnetic resonance imaging. The lesion was surgically excised from the right maxilla. Postoperative histopathological examination led to a definitive diagnosis of central DGCT. The tumor comprised epithelial neoplastic islands, resembling ameloblastoma, inside tight fibroconnective tissue; masses of ghost cells and formation of dentin were also observed. We had suspected that the minute high-density region around the molars on the imaging examinations represented alveolar bone change; however, it represented dentin formation. This led to difficulty diagnosing the lesion. Although DGCT may present characteristic findings on imaging examinations, its occurrence is infrequent, and in some cases, the findings may include the presence or absence of an impacted tooth without obvious calcification. The present case suggests that we should consider the possibility of an odontogenic tumor with calcification when high-density structures are observed inside the lesion.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1279-851746102024Radiological assessment of the dissection area in supraomohyoid neck dissection16431652ENYoheiTakeshitaDepartment of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJoeIwanagaClinical Anatomy Research Association in Oral and Maxillofacial SurgeryYoshioOhyamaClinical Anatomy Research Association in Oral and Maxillofacial SurgerySoichiroIbaragiDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYukiMatsushitaClinical Anatomy Research Association in Oral and Maxillofacial SurgeryR. ShaneTubbsClinical Anatomy Research Association in Oral and Maxillofacial SurgeryNorioKitagawaClinical Anatomy Research Association in Oral and Maxillofacial SurgeryToshiyukiKawazuMikiHisatomiDepartment of Oral and Maxillofacial Radiology, Okayama University HospitalShunsukeOkadaDepartment of Oral and Maxillofacial Radiology, Okayama University HospitalMamikoFujikuraDepartment of Oral and Maxillofacial Radiology, Okayama University HospitalJunichiAsaumiDepartment of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityPurpose The current supraomohyoid neck dissection (SOHND) is performed above the omohyoid muscle to dissect levels I, II, and III in the levels of cervical lymph nodes. However, the anatomical boundary between levels III and IV is the inferior border of the cricoid cartilage. We investigated the anatomical relationship between the omohyoid muscle and cricoid cartilage using contrast-enhanced CT (CE-CT) images to assess the validity of the current SOHND.<br>
Methods CE-CT images of the head and neck regions in patients were reviewed. The patients were divided into two groups: “malignant tumors” and “others”. The vertebral levels corresponding to the positions of anatomical structures such as the intersection of the omohyoid muscle and internal jugular vein (OM-IJ), and the inferior border of the cricoid cartilage (CC), were recorded.<br>
Results The OM-IJ was located around the seventh cervical to the first thoracic vertebra. There was a significant difference between the malignant tumor and others groups in females (p = 0.036). The CC was located around the sixth to seventh cervical vertebrae. There was a significant sex difference in each group (malignant tumor: p < 0.0001; others: p = 0.008). Both sexes tended to have lower OM-IJ than CC, and females had significantly lower OM-IJ than males.<br>
Conclusion This study provides clear anatomical evidence showing the difference between the SOHND dissection area and levels I, II, and III. It could be considered that in most cases SOHND invades level IV, not just levels I, II, and III, especially in female patients.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama0366-70225452025Highly emissive and robust diarylethene fluorophore incorporating imide-fused phenanthryl moietiesupaf091ENKeitoNoseDepartment of Chemistry, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMinoruYamajiProgram of Applied Chemistry, Cluster of Materials and Environment, Gunma UniversityTadashiMoriResearch Center for Environmental Preservation and Graduate School of Engineering, The University of OsakaFumitoTaniInstitute for Materials Chemistry and Engineering, Kyushu UniversityKentaGotoInstitute for Materials Chemistry and Engineering, Kyushu UniversityHidekiOkamotoDepartment of Chemistry, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityThe fluorescence properties and photostabilities of (E)-diarylethenes (DPEs), featuring two 3-phenanthryl moieties, were investigated. Pristine (E)-di-1,2-(3-phenanthryl)ethene and its ester derivative, respectively referred to as DPE-H and DPE-E, exhibited blue fluorescence. However, they underwent a two-step photoreaction sequence that yielded [7]helicenes, resulting in a gradual reduction of the fluorescence intensity. In contrast, the imide-fused derivative DPE-I displayed intense green fluorescence and it was unexpectedly photostable in solution, maintaining its highly efficient fluorescent nature even after prolonged light exposure. DPE-I, thus, provides a new type of highly efficient and robust diarylethene fluorophore.No potential conflict of interest relevant to this article was reported.Royal Society of Chemistry (RSC)Acta Medica Okayama1477-052022462024A direct oxidative esterification of aldehydes with alcohols mediated by photochemical C–H bromination90329035ENHaruAndoDepartment of Chemistry, Graduate School of Natural Science and Technology, Okayama UniversitySakuraKodakiDepartment of Chemistry, Graduate School of Natural Science and Technology, Okayama UniversityHiroyoshiTakamuraDepartment of Chemistry, Graduate School of Natural Science and Technology, Okayama UniversityIsaoKadotaDepartment of Chemistry, Graduate School of Natural Science and Technology, Okayama UniversityKentaTanakaResearch Institute for Interdisciplinary Science, Okayama UniversityThe photochemical direct esterification of aldehydes with alcohols via in situ-generated acyl-bromides presented in this report is an attractive complementary addition to hitherto reported methods, as these are usually carried out in a two-step, one-pot procedure in order to avoid side reactions such as the oxidation of alcohols by halogen sources.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0361-860910012024Different impacts of granulocyte colony‐stimulating factor administration on allogeneic hematopoietic cell transplant outcomes for adult acute myeloid leukemia according to graft type6677ENTakaakiKonumaDepartment of Hematology/Oncology, The Institute of Medical Science, The University of TokyoKazuakiKamedaDivision of Hematology, Jichi Medical University Saitama Medical CenterKaoruMoritaDivision of Hematology, Jichi Medical UniversityTadakazuKondoDepartment of Hematology, Kobe City Medical Center General HospitalFumihikoKimuraDivision of Hematology, Department of Internal Medicine, National Defense Medical CollegeHidekiNakasoneDivision of Hematology, Jichi Medical University Saitama Medical CenterFumihikoOuchiHematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalNaoyukiUchidaDepartment of Hematology, Toranomon HospitalMasatsuguTanakaDepartment of Hematology, Kanagawa Cancer CenterTetsuyaNishidaDepartment of Hematology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi HospitalTakahiroFukudaDepartment of Hematopoietic Stem Cell Transplantation, National Cancer Center HospitalYutaHasegawaDepartment of Hematology, Hokkaido University HospitalMamikoSakata‐YanagimotoDepartment of Hematology, University of Tsukuba HospitalMakotoOnizukaDepartment of Hematology and Oncology, Tokai University School of MedicineMasashiSawaDepartment of Hematology and Oncology, Anjo Kosei HospitalShuichiOtaDepartment of Hematology, Sapporo Hokuyu HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalShin‐IchiroFujiwaraDivision of Hematology, Jichi Medical UniversitySatoshiYoshiharaDepartment of Hematology, Hyogo Medical University HospitalFumihikoIshimaruTechnical Department, Japanese Red Cross Society Blood Service HeadquartersMakotoYoshimitsuDepartment of Hematology and Rheumatology, Kagoshima University HospitalYoshinobuKandaDivision of Hematology, Jichi Medical UniversityMarieOhbikiJapanese Data Center for Hematopoietic Cell TransplantationYoshikoAtsutaJapanese Data Center for Hematopoietic Cell TransplantationMasamitsuYanadaDepartment of Hematology and Oncology, Nagoya City University East Medical CenterWe retrospectively evaluated the impacts of using granulocyte colony-stimulating factor (G-CSF) and its timing on posttransplant outcomes for 9766 adults with acute myeloid leukemia (AML) between 2013 and 2022 using a Japanese database. We separately evaluated three distinct cohorts based on graft type: 3248 received bone marrow transplantation (BMT), 3066 received peripheral blood stem cell transplantation (PBSCT), and 3452 received single-unit cord blood transplantation (CBT). Multivariate analysis showed that G-CSF administration significantly accelerated neutrophil recovery after BMT, PBSCT, and CBT. However, it was associated with a higher risk of grades II–IV acute graft-versus-host disease (GVHD) across all graft types. Moreover, an increased incidence of overall chronic GVHD was observed with G-CSF administration in BMT and CBT patients, but not in PBSCT patients. G-CSF administration significantly improved overall survival (OS) and leukemia-free survival (LFS) only following CBT. Regarding the timing of G-CSF, in comparison with late initiation of G-CSF (Days 5–10), early initiation (Days 0–4) did not provide benefits for hematopoietic recovery regardless of graft type. In contrast, late initiation was significantly associated with a lower risk of grades II–IV acute GVHD and better OS and LFS in CBT patients. These data demonstrated that G-CSF administration accelerated neutrophil recovery and increased the risk of grades II–IV acute GVHD across all graft types, but significantly improved survival outcomes but only following CBT. Therefore, routine use of G-CSF should be considered for CBT in adult patients with AML.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0342-17915222025The effect of Fe incorporation on the single-crystal elasticity of δ-AlOOH18ENNiccolòSattaInstitut für Mineralogie, Universität MünsterGiacomoCrinitiBayerisches Geoinstitut, Universität BayreuthTizianaBoffa BallaranBayerisches Geoinstitut, Universität BayreuthAlexanderKurnosovBayerisches Geoinstitut, Universität BayreuthTakayukiIshiiInstitute for Planetary Materials, Okayama UniversityJohannesBuchenBayerisches Geoinstitut, Universität BayreuthHaukeMarquardtDepartment of Earth Sciences, University of OxfordThe seismic mapping of hydrous materials in the Earth’s deep interior requires experimental constraints on the elastic anisotropy of hydrous minerals and phases. Oxyhydroxides like δ-(Al,Fe)OOH are arguably the main hosts of water in the lower mantle. Therefore, constraints on the single-crystal elastic tensor of δ-(Al,Fe)OOH solid solutions are crucial to quantify the elastic anisotropy of this material, and advance the current understanding of the recycling of water into the lower mantle. Yet, experimental data for intermediate compositions are scarce, limiting the understanding of how Fe incorporation affects the single-crystal elastic properties of δ-AlOOH. In this study, we provide experimental constraints on the single-crystal elasticity of two δ-(Al,Fe)OOH solid solutions, with Fe/(Al + Fe) of 0.06(1) and 0.133(3). Large single-crystal samples of δ-(Al,Fe)OOH were synthetized at high pressures and temperatures using a multi-anvil press, and the full elastic stiffness tensors were determined at ambient conditions by combining X-ray diffraction and Brillouin scattering measurements. We show that replacing Al3+ with Fe3+ in δ-(Al,Fe)OOH lowers the magnitude of most coefficients of the elastic stiffness tensor (cij), which translates into a substantial reduction of aggregate moduli and acoustic wave velocities. We further show that, at ambient conditions, the acoustic anisotropy of δ-(Al,Fe)OOH displays no sensitivity to Fe–Al substitution.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0031-92013612025Effect of chemistry on the compressibility and high-pressure structural evolution of the CaFe2O4-type aluminous silicate phase107331ENGiacomoCrinitiBayerisches Geoinstitut, University of BayreuthTizianaBoffa BallaranBayerisches Geoinstitut, University of BayreuthAlexanderKurnosovBayerisches Geoinstitut, University of BayreuthTakayukiIshiiInstitute for Planetary Materials, Okayama UniversityElena-MarieRogmannBayerisches Geoinstitut, University of BayreuthKonstantinGlazyrinDeutsches Elektronen-Synchrotron DESYTimofeyFedotenkoDeutsches Elektronen-Synchrotron DESYDaniel J.FrostBayerisches Geoinstitut, University of BayreuthApproximately 22–26 vol% of a basaltic phase assemblage at lower mantle conditions is comprised of a (Na,Mg,Fe2+)(Al,Si,Fe3+)2O4 phase with CaFe2O4-type (CF-type) structure. Previous experimental studies attempted to determine the equation of state of the CF-type phase but reported contrasting compressibility values, even for samples with the same composition. Therefore, the elastic properties of the CF-type phase remain, to date, largely unconstrained. Here, we conducted single-crystal X-ray diffraction (SCXRD) measurements in the diamond anvil cell (DAC) at high pressure and room temperature on three samples of CF-type phase with compositions Na0.90(1)Al1.03(2)Si1.00(2)O4 (NaCF), Na0.66(4)Mg0.28(4)Al1.22(3)Si0.78(3)O4 (MgCF) and Na0.62(2)Mg0.19(1)Fe2+0.17(1)Fe3+0.080(4)Al1.20(3)Si0.70(1)O4 (FeCF). A multi-sample loading approach was employed for most DAC runs, where two samples were loaded in the same sample chamber to reduce possible systematic deviations between datasets, thus enhancing internal consistency and corroborating data reproducibility. Experiments on the NaCF and MgCF samples were conducted up to ∼50 GPa, while the FeCF sample was compressed to ∼72 GPa to better characterize the effect of the spin crossover of octahedrally coordinated Fe3+. We found the isothermal bulk modulus (KT0) to increase with decreasing NaAlSiO4 content, accompanied by only a slight decrease in its pressure derivative (K'T0). Analysis of the crystal structures of the three samples at high pressure allowed compositional trends to be determined also for the interatomic bonds and polyhedral compressibility, as well as the distortion indices. These suggest an overall stiffening of the A site with increasing Mg2+ and Fe2+ content, as well of the two B sites with increasing Al3+ and Fe3+ content. Enhanced compressibility of the unit cell and octahedral B sites was observed between ∼26–42 GPa in the FeCF sample, suggesting a pressure-induced spin crossover of Fe3+, in agreement with some previous observations. Finally, trends in the elastic properties from experimental studies conducted along the NaAlSiO4-MgAl2O4 join are discussed and used as a proxy to evaluate the reliability of end-member properties for the CF-type phase employed in most recent mineral physical and thermodynamic databases. Our analysis suggests current mineral physical models might underestimate densities and overestimate bulk sound velocities of NaAlSiO4-rich CF-type phases with basaltic composition.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1086-937959122024Radial transport and nebular thermal processing of millimeter‐sized solids in the Solar protoplanetary disk inferred from Cr‐Ti‐O isotope systematics of chondrules32823304ENKoheiFukudaWiscSIMS, Department of Geoscience, University of Wisconsin-MadisonYukiHibiyaResearch Center for Advanced Science and Technology, Graduate School of Science, The University of TokyoCraig R.KastelleNational Oceanic and Atmospheric AdministrationKatsuhikoSuzukiSubmarine Resources Research Center, Japan Agency for Marine-Earth Science TechnologyTsuyoshiIizukaDepartment of Earth and Planetary Science, Graduate School of Science, The University of TokyoKatsuyukiYamashitaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityThomas E.HelserNational Oceanic and Atmospheric AdministrationNoriko T.KitaWiscSIMS, Department of Geoscience, University of Wisconsin-MadisonUnderstanding the material transport and mixing processes in the Solar protoplanetary disk provides important constraints on the origin of chemical and isotopic diversities of our planets. The limited extent of radial transport and mixing between the inner and outer Solar System has been suggested based on a fundamental isotopic dichotomy between non-carbonaceous (NC) and carbonaceous (CC) meteorite groups. The limited transport and mixing could be further tested by tracing the formation regions of individual meteoritic components, such as Ca-Al-rich inclusions (CAIs) and chondrules. Here, we show further evidence for the outward transport of CAIs and chondrules from the inner and subsequent thermal processing in the outer region of the protoplanetary disk based on the petrography and combined Cr-Ti-O isotope systematics of chondrules from the Vigarano-like (CV) carbonaceous chondrite Allende. One chondrule studied consists of an olivine core that exhibits NC-like Ti and O, but CC-like Cr isotopic signatures, which is enclosed by a pyroxene igneous rim with CC-like O isotope ratios. These observations indicate that the olivine core formed in the inner Solar System. The olivine core then migrated into the outer Solar System and experienced nebular thermal processing that generated the pyroxene igneous rim. The nebular thermal processing would result in Cr isotope exchange between the olivine core and CC-like materials, but secondary alteration effects on the parent body are also responsible for the CC-like Cr isotope signature. By combining previously reported Cr-Ti-O isotope systematics of CV chondrules, we show that some CV chondrules larger than ~1 mm would have formed in the inner Solar System. The accretion of the millimeter-sized, inner Solar System solids onto the CV carbonaceous chondrite parent body would require their very early migration into the outer Solar System within the first 1 million years after the Solar System formation.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1341-96253032025Five-year outcomes with gefitinib induction and chemoradiotherapy in EGFR-mutant stage III non-small-cell lung cancer: LOGIK0902/OLCSG0905 phase II study497503ENKatsuyukiHottaCenter for Innovative Clinical Medicine, Okayama University HospitalShoSaekiDepartment of Respiratory Medicine, Kumamoto University HospitalShinyaSakataDepartment of Respiratory Medicine, Kumamoto University HospitalMasafumiYamaguchiDepartment of Thoracic Oncology, NHO Kyushu Cancer CenterDaijiroHaradaDepartment of Thoracic Oncology, National Hospital Organization Shikoku Cancer CenterAkihiroBesshoDepartment of Respiratory Medicine, Japanese Red Cross Okayama HospitalKentaroTanakaDepartment of Respiratory Medicine, Kyushu University HospitalKojiInoueDepartment of Respiratory Medicine, Kitakyushu Municipal Medical CenterKojiInoueDepartment of Respiratory Medicine, Ehime Prefectural Central HospitalKenichiGembaDepartment of Respiratory Medicine, Chugoku Central HospitalToshioKuboDepartment of Respiratory Medicine, Okayama University HospitalAkikoSatoDepartment of Respiratory Medicine, Okayama University HospitalEikiIchiharaCenter for Clinical Oncology, Okayama University HospitalHiromiWatanabeDepartment of Respiratory Medicine, Okayama University HospitalJunjiKishimotoDepartment of Research and Development of Next Generation Medicine, Faculty of Medical Sciences, Kyushu UniversityYoshiyukiShioyamaRadiation Oncology, Ion Beam Therapy Center, SAGA HIMAT FoundationKuniakiKatsuiDepartment of Radiology, Kawasaki Medical SchoolKenjiSugioDivision of Radiation Oncology, Department of Thoracic and Breast Surgery, Oita UniversityKatsuyukiKiuraDepartment of Respiratory Medicine, Okayama University HospitalBackground We previously showed the 2-year OS rate, the primary endpoint, of 90% in a phase II trial of gefitinib induction followed by chemoradiotherapy (CRT) in unresectable, stage III, EGFR-mutant, non-small-cell lung cancer (NSCLC). However, neither long-term survival data nor late-phase adverse event profiles have been presented.<br>
Patients and methods Patients with unresectable, EGFR-mutant, stage III NSCLC were administered gefitinib monotherapy for 8 weeks. After confirming no disease progression during induction therapy, cisplatin and docetaxel on days 1, 8, 29, and 36 with concurrent radiotherapy at a total dose of 60 Gy were subsequently administered.<br>
Results In the enrolled twenty patients, the 5-year OS rate and median survival time were 70.0% [95% confidence interval: 45.1–85.3] and 5.5 years [4.91-NE], respectively, whereas 5-year PFS rate and median PFS time were 15.0% (3.7–33.5) and 1.4 years [0.69–2.29], respectively. Efficacy did not seem influenced even if radiation field was re-planed in response to the effect of gefitinib induction. As for late adverse events, pulmonary fibrosis occurred in 7 patients (35%). The median time from completion of CRT to the occurrence of the event was 245 days. All were grade 1, and there was no evidence of cavitation of the lesions or chronic infections such as Aspergillus infection during the course of the disease. One case of small cell lung cancer occurred during the period.<br>
Conclusions With longer follow-up time, we demonstrated favorable efficacy with tolerable toxicity profiles in the EGFR-TKI induction followed by standard CRT in EGFR-mutant, stage III, NSCLC.<br>
Trial registration numbers UMIN00005086. https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&recptno=R000006047&type=summary&language=EjRCTs071180036. https://jrct.niph.go.jp/latest-detail/jRCTs071180036No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1444-15862582025Efficacy of human–robot interaction on local residents11521153ENHiroshiKuroishiGraduate School of Health, Okayama UniversitySakuraKikuchiBizDev, CMIC TrustKanaKazawaDepartment of Nursing Faculty of Health Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama1948-718516232025Ultrafast Protein Dynamics Prior to Retinal Photoisomerization in Microbial Rhodopsins57325738ENShinyaTaharaMolecular Spectroscopy Laboratory, RIKENRikaKuriharaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKeiichiKojimaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHikaruKuramochiMolecular Spectroscopy Laboratory, RIKENSatoshiTakeuchiMolecular Spectroscopy Laboratory, RIKENYukiSudoGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTaheiTaharaMolecular Spectroscopy Laboratory, RIKENRhodopsins, an important group of photoreceptor proteins, possess a retinal chromophore. It has long been believed that the photoisomerization of the chromophore is the initial event triggering its photocycle. However, we recently reported that protein structural changes around the chromophore precede photoisomerization in bacteriorhodopsin (BR). In this study, we performed deep-ultraviolet femtosecond stimulated Raman measurements for H+-pump rhodopsin (RxR) and photosensor rhodopsin (NpSRII) to investigate whether these ultrafast protein dynamics are common among rhodopsins. We observed that the protein structural changes occur within 0.2 ps after photoexcitation and precede the chromophore photoisomerization, similar to the case for BR. This strongly indicates that the protein structural change precedes the photoisomerization in rhodopsins, regardless of the difference in their origins and functions. Furthermore, we found that only limited protein changes occur on the time scale of the photoisomerization, suggesting that the protein environment is already optimized for the structural change of the chromophore. These observations raise the possibility that the ultrafast protein change arranges the environment around the chromophore to facilitate the photoisomerization.No potential conflict of interest relevant to this article was reported.Geological Society of AmericaActa Medica Okayama0091-761353112025Long-term and multi-stage ice accumulation in the martian mid-latitudes during the Amazonian945950ENTrishitRujInstitute for Planetary Materials, Okayama UniversityHanayaOkudaKochi Institute for Core Sample Research (X-star), JAMSTECGoroKomatsuInternational Research School of Planetary Sciences, Università d’AnnunzioHitoshiHasegawaDepartment of Global Environment and Disaster Prevention, Faculty of Science and Technology, Kochi UniversityJames W.HeadDepartment of Earth, Environmental and Planetary Sciences, Brown UniversityTomohiroUsuiInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencyShunMihiraInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencyMakitoKobayashiDepartment of Systems Innovation, School of Engineering, University of TokyoSubsurface ice in the mid-latitudes of Mars represents one of the largest present-day water ice reservoirs. While atmospheric models predict Late Amazonian (during the past hundreds of millions of years) obliquity-driven ice accumulation, its long-term variations, and the factors influencing accumulation remain unclear. Using geomorphological evidence and numerical modeling, we reveal a southwestern depositional trend within northern mid-latitudinal crater walls and floors. Detailed crater-fill deposit analyses indicate multiple glaciation stages, including an earlier, high-intensity stage followed by a later, lower-intensity stage, both exhibiting this southwestern trend (ca. 640–98 Ma). We conclude that persistent multiple-stage Amazonian glaciations were governed by atmospheric water availability and obliquity-driven climate cycles.No potential conflict of interest relevant to this article was reported.American Physical Society (APS)Acta Medica Okayama0031-9007134242025Acceleration of Positive Muons by a Radio-Frequency Cavity245001ENS.AritomeGraduate School of Science, University of TokyoK.FutatsukawaHigh Energy Accelerator Research OrganizationH.HaraResearch Institute for Interdisciplinary Science, Okayama UniversityK.HayasakaInstitute of Science and Technology, Niigata UniversityY.IbarakiGraduate School of Science, Nagoya UniversityT.IchikawaGraduate School of Science, Nagoya UniversityT.IijimaGraduate School of Science, Nagoya UniversityH.IinumaGraduate School of Science and Engineering, Ibaraki UniversityY.IkedoHigh Energy Accelerator Research OrganizationY.ImaiResearch Institute for Interdisciplinary Science, Okayama UniversityK.InamiGraduate School of Science, Nagoya UniversityK.IshidaHigh Energy Accelerator Research OrganizationS.KamalDepartment of Chemistry, Laboratory for Advanced Spectroscopy and Imaging Research (LASIR), University of British ColumbiaS.KamiokaHigh Energy Accelerator Research OrganizationN.KawamuraHigh Energy Accelerator Research OrganizationM.KimuraHigh Energy Accelerator Research OrganizationA.KodaHigh Energy Accelerator Research OrganizationS.KojiGraduate School of Science, Nagoya UniversityK.KojimaKobayashi-Maskawa Institute for the Origin of Particles and the Universe, Nagoya UniversityA.KondoGraduate School of Science, Nagoya UniversityY.KondoJapan Atomic Energy Agency (JAEA)M.KuzubaGraduate School of Science and Engineering, Ibaraki UniversityR.MatsushitaGraduate School of Science, University of TokyoT.MibeHigh Energy Accelerator Research OrganizationY.MiyamotoResearch Institute for Interdisciplinary Science, Okayama UniversityJ. G.NakamuraHigh Energy Accelerator Research OrganizationY.NakazawaGraduate School of Science and Engineering, Ibaraki UniversityS.OgawaResearch Center of Advanced Particle Physics, Kyushu UniversityY.OkazakiHigh Energy Accelerator Research OrganizationA.OlinDepartment of Physics and Astronomy, University of VictoriaM.OtaniHigh Energy Accelerator Research OrganizationS.OyamaGraduate School of Science, University of TokyoN.SaitoHigh Energy Accelerator Research OrganizationH.SatoGraduate School of Science and Engineering, Ibaraki UniversityT.SatoGraduate School of Science, University of TokyoY.SatoInstitute of Science and Technology, Niigata UniversityK.ShimomuraHigh Energy Accelerator Research OrganizationZ.ShioyaFaculty of Science, Kyushu UniversityP.StrasserHigh Energy Accelerator Research OrganizationS.SugiyamaGraduate School of Science, Nagoya UniversityK.SumiGraduate School of Science, Nagoya UniversityK.SuzukiKobayashi-Maskawa Institute for the Origin of Particles and the Universe, Nagoya UniversityY.TakeuchiFaculty of Science, Kyushu UniversityM.TanidaFaculty of Science, Kyushu UniversityJ.TojoFaculty of Science, Kyushu UniversityK.UedaGraduate School of Science, Nagoya University, NagoyaS.UetakeResearch Institute for Interdisciplinary Science, Okayama UniversityX. H.XieSchool of Physics, Peking UniversityM.YamadaFaculty of Science, Kyushu UniversityS.YamamotoResearch Institute for Interdisciplinary Science, Okayama UniversityT.YamazakiHigh Energy Accelerator Research OrganizationK.YamuraInstitute of Science and Technology, Niigata UniversityM.YoshidaHigh Energy Accelerator Research OrganizationT.YoshiokaResearch Center of Advanced Particle Physics, Kyushu UniversityM.YotsuzukaGraduate School of Science, Nagoya UniversityAcceleration of positive muons from thermal energy to 100 keV has been demonstrated. Thermal muons were generated by resonant multiphoton ionization of muonium atoms emitted from a sheet of laser-ablated aerogel. The thermal muons were first electrostatically accelerated to 5.7 keV, followed by further acceleration to 100 keV using a radio-frequency quadrupole with an intensity of 2×10−3 𝜇+/pulse. The transverse normalized rms emittance of the accelerated muons in the horizontal and vertical planes were 0.85±0.25(stat)+0.22−0.13(syst) 𝜋 mm mrad and 0.32±0.03(stat)+0.05−0.02(syst) 𝜋 mm mrad, respectively. The measured emittance values demonstrated phase-space reduction by a factor of 2.0 ×102 (horizontal) and 4.1 ×102 (vertical) allowing good acceleration efficiency. These results pave the way to realize the first-ever muon accelerator for a variety of applications in particle physics, material science, and other fields.No potential conflict of interest relevant to this article was reported.Department of Mathematics, Faculty of Science, Okayama UniversityActa Medica Okayama0030-15666812026On the stratification of combinatorial spectra183204ENRyoHoriuchiIn this note, we investigate a mixture of combinatorial spectra and stratified simplicial sets, which would be thought of as a model of the spectrum objects of (∞,∞)-categories.No potential conflict of interest relevant to this article was reported.Department of Mathematics, Faculty of Science, Okayama UniversityActa Medica Okayama0030-15666812026Local cohomology of ideals and the Rn condition of Serre175181ENTony J. PuthenpurakalDepartment of Mathematics, IIT BombayLet R be a regular ring of dimension d containing a field K of characteristic zero. If E is an R-module let Assi E = {Q ∈ AssE | heightQ = i}. Let P be a prime ideal in R of height g. We show that if R/P satisfies Serre’s condition Ri then Assg+i+1 Hg+1P(R) is a finite set. As an application of our techniques we prove that if P is a prime ideal in R such that (R/P)q is regular for any non-maximal prime ideal q then HiP(R) has finitely many associate primes for all i.No potential conflict of interest relevant to this article was reported.Department of Mathematics, Faculty of Science, Okayama UniversityActa Medica Okayama0030-15666812026Wronskian theory revisited from a linear algebraic and null space viewpoint147174ENTomomichiHagiwaraDepartment of Electrical Engineering Graduate School of Engineering Kyoto UniversityThis paper aims at providing a new fundamental framework for the Wronskian theory by paying attention to the null space of the Wronski matrix. It is first shown that identical vanishing of the Wronskian leads to two different representations of vector-valued functions that lie in the null space of the Wronski matrix. It is further shown that they are algebraically linearly dependent, by which we are immediately led to a key identity in the Wronskian theory, derived only through very simple linear algebraic arguments. Most fundamental results on the Wronskian theory available in the literature can thus be obtained in a quite straightforward fashion with a very clear perspective, and hence the relevant arguments are believed to be of pedagogical value, too. Some further issues relevant to the null space viewpoint are also discussed, where some other results available in the literature are derived through the null space viewpoint in a somewhat strengthened form.No potential conflict of interest relevant to this article was reported.Department of Mathematics, Faculty of Science, Okayama UniversityActa Medica Okayama0030-15666812026Matijevic-Roberts type theorems, Rees rings and associated graded rings139146ENJunHoriuchiDepartment of Mathematics, Nippon Institute of TechnologyKazumaShimomotoDepartment of Mathematics, Institute of Science TokyoThe aim of this article is to investigate interrelated structures lying among three notable problems in commutative algebra. These are Lifting problem, Ascent/descent along associated graded rings, and Matijevic-Roberts type problem.No potential conflict of interest relevant to this article was reported.Department of Mathematics, Faculty of Science, Okayama UniversityActa Medica Okayama0030-15666812026Resolution theorem of the algebraic K-theory and its applications113137ENMarikoOharaCenter for Liberal Arts and Sciences Faculty of Engineering Toyama Prefectural UniversityThe main objective is showing a variant of resolution theorem of connective Waldhausen K-theory in suitable situations. We construct two sequences of subcategories, one is consisting of finitely generated symmetric module spectra which satisfy the condition of the resolution theorem and the other is consisting of the corresponding ∞-subcategories of certain finitely generated module spectra. As an application, we construct a sequence of subcategories consisting of certain DG-modules satisfying the condition of a resolution theorem.No potential conflict of interest relevant to this article was reported.Department of Mathematics, Faculty of Science, Okayama UniversityActa Medica Okayama0030-15666812026Retract problem and a subset admitting complete Boolean algebra structure of monoidally distributive posets89111ENRyoKatoDepartment of Core Studies, Kochi University of TechnologyIn [3], Hovey and Palmieri proved many interesing results around the Bousfield lattice of the stable homotopy caregory of spectra. In [4], the author, Shimomura and Tatehara defined monoidally distributive posets as a generalization of the Bousfield lattice. In this paper, we consider the retract problem and a subset admitting complete Boolean algebra structure of monoidally distributive posets. In the last section, we see that some results in [3] are given by our results in this paper.No potential conflict of interest relevant to this article was reported.Department of Mathematics, Faculty of Science, Okayama UniversityActa Medica Okayama0030-15666812026On groups of units of commutative finite rings7787ENChiteng’a JohnChikunjiDepartment of Biometry and Mathematics, Botswana University of Agriculture and Natural ResourcesLet R be a commutative completely primary finite ring with unique maximal ideal J such that J3 = {0} and J2 ̸= {0}. In this paper, we investigate and determine the structure of the group of units U(R) of the ring R of characteristic p3 without giving any conditions on the generators for the maximal ideal J or on the invariants of the ring R.No potential conflict of interest relevant to this article was reported.Department of Mathematics, Faculty of Science, Okayama UniversityActa Medica Okayama0030-15666812026The Dijkgraaf-Witten invariants from second Chern classes6375ENTakefumiNosakaDepartment of Mathematics, Tokyo Institute of TechnologyGiven a 3-cocycle ψ in the cohomology of a finite group G, we can define the Dijkgraaf-Witten invariant of closed 3-manifolds. In this paper, we focus on the case where ψ is a 3-cocycle systematically transferred from the second Chern class of a complex representation of G, and show some procedures for computing the invariant, and clarify its topological interpretation under some conditions.No potential conflict of interest relevant to this article was reported.Department of Mathematics, Faculty of Science, Okayama UniversityActa Medica Okayama0030-15666812026Natural homotopy of multipointed d-spaces1362ENPhilippeGaucherUniversité Paris Cité, CNRS, IRIFWe identify Grandis’ directed spaces as a full reflective subcategory of the category of multipointed d-spaces. When the multipointed d-space realizes a precubical set, its reflection coincides with the standard realization of the precubical set as a directed space. The reflection enables us to extend the construction of the natural system of topological spaces in Baues-Wirsching’s sense from directed spaces to multipointed d-spaces. In the case of a cellular multipointed d-space, there is a discrete version of this natural system which is proved to be bisimilar up to homotopy. We also prove that these constructions are invariant up to homotopy under globular subdivision. These results are the globular analogue of Dubut’s results. Finally, we point the apparent incompatibility between the notion of bisimilar natural systems and the q-model structure of multipointed d-spaces and we give some suggestions for future works.No potential conflict of interest relevant to this article was reported.Department of Mathematics, Faculty of Science, Okayama UniversityActa Medica Okayama0030-15666812026Generator of the quadratic subextension of an odd dihedral extension112ENToruKomatsuDepartment of Mathematics Faculty of Science and Technology Tokyo University of ScienceIn this paper we present an algorithm to make a generator of the quadratic subextension of an odd dihedral extension. As an application we solve the Galois group problem for the quintic polynomials given by Kishi and Yamada.No potential conflict of interest relevant to this article was reported.John Wiley & Sons LtdActa Medica Okayama0364-23132026Indicators for Monitoring Recovery From Surgery to Discharge Using Accelerometer in Patients With Esophageal Cancer14ENTakahiroYamaneDepartment of Biomedical Informatics, Okayama University Graduate School of Interdisciplinary Science and Engineering in Health SystemsYoshikazuKimuraDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesManamiTetsutaniFaculty of Health Sciences, Okayama University Medical SchoolShotaYamamuraFaculty of Health Sciences, Okayama University Medical SchoolAiruItoFaculty of Health Sciences, Okayama University Medical SchoolMoeTanumaFaculty of Health Sciences, Okayama University Medical SchoolMinaHonjohFaculty of Health Sciences, Okayama University Medical SchoolYoshikoMoriwakiDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuhiroNomaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShunsukeTanabeDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaoakiMaedaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshikazuMatsuokaDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMizukiMoritaDepartment of Biomedical Informatics, Okayama University Graduate School of Interdisciplinary Science and Engineering in Health SystemsHiroshiMorimatsuDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesEsophageal cancer is a highly invasive malignancy necessitating esophagectomy, which is associated with considerable postoperative morbidity and prolonged hospitalization. Enhanced Recovery After Surgery (ERAS) protocols recommend early mobilization to facilitate recovery; however, objectively assessing physical activity during hospitalization remains challenging. Traditional methods, such as the 6-min walk test or patient-reported questionnaires can be burdensome, or may not accurately reflect recovery. Accelerometer-based measurement provides a low-burden, objective approach, but previous studies focused on the immediate postoperative period or long after discharge, leaving the recovery trajectory from surgery to discharge underexplored.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-291865102026Mycobacterium intracellulare Infection in a Japanese Patient with Signal Transducer and Activator of Transcription-3 Gain-of-function Syndrome14211430ENHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalYoshiakiSoejimaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazukiTokumasuDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYojiHiraiDepartment of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMarinaKawaguchiDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinnosukeFukushimaDepartment of Infectious Diseases, Okayama University HospitalKentaNakamotoDepartment of Infectious Diseases, Okayama University HospitalKoheiOguniDepartment of Infectious Diseases, Okayama University HospitalYusukeShiodeDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhiroUdaDepartment of Pediatrics, Okayama University HospitalMasatoYashiroDepartment of Pediatrics, Okayama University HospitalKouseiHasegawaDepartment of Pediatrics, Okayama University HospitalKojiIioMicrobiology Division, Clinical Laboratory, Okayama University HospitalFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSignal transducer and activator of transcription-3 (STAT3) gain-of-function (GOF) syndrome predisposes patients to autoimmunity diseases. Yet, nontuberculous mycobacterial (NTM) infections have rarely been described. We herein report a teenage Japanese patient with genetically confirmed STAT3-GOF syndrome who developed Mycobacterium intracellulare disease. Combination antimycobacterial chemotherapy reduced the bacterial burden; however, the refractory NTM infection relapsed after initiation of adjunctive tofacitinib therapy. The present case demonstrates that host-directed therapy must be combined with prolonged antimycobacterial regimens to control drug-resistant NTM in patients with inborn errors of immunity.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-29186552026Cervical Clue in Spontaneous Pneumomediastinum762763ENTsuyoshiNojimaDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences Okayama UniversityTakafumiObaraDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences Okayama UniversityTakashiHongoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences Okayama UniversityAtsunoriNakaoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences Okayama UniversityNo potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0960-98223652026Compound starch granule formation in grass seeds is associated with distinct temporal patterns of gene expression11421155.e6ENAlexanderWatson-LazowskiJohn Innes Centre, Norwich Research ParkDoreenFeikeJohn Innes Centre, Norwich Research ParkQi YangNgaiJohn Innes Centre, Norwich Research ParkLaraEschJohn Innes Centre, Norwich Research ParkNaokoFujitaDepartment of Biological Production, Akita Prefectural UniversityRyoMatsushimaInstitute of Plant Science and Resources, Okayama UniversityAlison M.SmithJohn Innes Centre, Norwich Research ParkDavidSeungJohn Innes Centre, Norwich Research ParkThere is extensive interspecies variation in starch granule morphology in the endosperm of grass species, but the factors underpinning this variation are poorly understood. The two major granule morphology types among species are simple and compound granules, where simple granules arise from a single initiation per amyloplast, and compound granules form from multiple granule initiations. Here, we carried out an extensive survey of seed starch morphology, examining specimens from 105 species within the Pooideae using electron microscopy. This not only expanded our current knowledge of the diversity of starch granule types but also confirmed the homoplasy of simple and compound starch granules. We then selected species representing independent origins of simple (Brachyelytrum japonicum, Phaenosperma globosa, and Brachypodium distachyon) and compound granules (Nardus stricta, Melica altissima, and Calamagrostis brachytricha) for analysis of starch structure and gene expression. There were no clear patterns in starch content, amylopectin structure, or amylose content that could distinguish the two granule types. However, comparative transcriptomics over seed development revealed gene expression patterns associated with granule type, most notably increasing expression of STARCH SYNTHASE 3a (SS3a), STARCH BRANCHING ENZYME 1 (SBE1), and limit dextrinases (LDAs) between 3 and 9 days post anthesis in species with compound granules. Mutation of these genes in rice, which natively produces compound granules, resulted in altered granule shape and/or size. Our work highlights differences in gene expression that could contribute to natural variation in granule morphology within the Pooideae while providing important new starch phenotype and gene expression datasets that can be widely used to study endosperm development.No potential conflict of interest relevant to this article was reported.American Society for MicrobiologyActa Medica Okayama0021-919320852026Knockout of tusA confers cationic antimicrobial resistance via fur and omp genes in Escherichia colie00103-26ENKazuyaIshikawaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKihoNakataGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoichiroYamadaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMioUnemeGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazuyukiFurutaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityChikaraKaitoGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitytRNA 2-thiouridine synthesizing protein A (TusA), a sulfur-carrier protein, plays a crucial role in tRNA sulfur modification. Several studies have reported that tusA deficiency affects iron–sulfur (Fe–S) homeostasis in addition to tRNA sulfur modification, resulting in pleiotropic phenotypes. In this study, we analyzed the phenotype of tusA-deficient Escherichia coli and its underlying mechanisms. Although the Keio tusA knockout strain showed increased swimming motility and flagellar biosynthesis, these phenotypes were not restored by tusA complementation. Genome resequencing of the original Keio tusA knockout strain identified an unintended secondary mutation in lrhA, a transcriptional regulator of flagellar and chemotaxis genes. This secondary mutation impaired lrhA function, contributing to enhanced flagellar synthesis and swimming motility, as well as altered global gene expression. A tusA knockout strain in which the secondary mutation was corrected (ΔtusA) exhibited reduced swimming motility compared with the wild-type strain, despite showing no abnormalities in flagellar formation. Furthermore, ΔtusA displayed increased resistance to cationic antibacterial agents, including cetyltrimethylammonium bromide, cetylpyridinium chloride, and protamine sulfate. The reduced motility caused by tusA deletion was observed independently of Fur, a global regulator of iron homeostasis, whereas resistance to cationic antibacterial agents was abolished in the fur knockout background. In addition, altered expression of outer membrane protein (omp) genes was observed in ΔtusA, and deletion of these omp genes abolished resistance to cationic antibacterial agents. Together, these results indicate that, by disentangling the phenotypic effects of tusA deletion from those of the unintended secondary mutation, loss of tusA confers resistance to cationic antibacterial agents through a Fur-dependent and Omp-dependent mechanism.No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama2637-61058112026Solution Structure and Counterion Condensation of Carboxymethyl Cellulose in Organic Solvents81838197ENAnishGulatiInstitute of Physical Chemistry, RWTH Aachen UniversityLingziMengMaterials Science and Engineering Department, The Pennsylvania State UniversityCanHouInstitute of Physical Chemistry, RWTH Aachen UniversityTakaichiWatanabeDepartment of Applied Chemistry, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityCarlos G.LopezMaterials Science and Engineering Department, The Pennsylvania State UniversityWe report scattering (SANS and SAXS) and electrical conductivity data for aqueous and organic solutions of carboxymethyl cellulose with tetrabutylammonium counterions. For SANS in deuterated solvents, the contrast is heavily dominated by the hydrogen-rich counterions, while for SAXS the polymer backbone has a more significant contribution to the scattering signal. The correlation length calculated from the SAXS measurements follows a scaling law of ξ ∝ c–1/2, while that measured by SANS displays a weaker exponent at higher concentrations for solvents of high dielectric constants. These results indicate a decoupling in the characteristic length scales of fluctuations of the polymer backbone and counterions at high polyelectrolyte concentrations. The stretching parameter calculated from the correlation length indicates a highly stretched local conformation for TBACMC in water and several high dielectric constant solvents, consistent with the semiflexible nature of the cellulose backbone. In solvents of lower dielectric permittivity, the chains display a higher degree of local coiling. Combining electrical conductivity and scattering data, we find that the fraction of monomers bearing a dissociated charge is nearly independent of concentration and approximately proportional to the reciprocal of the Bjerrum length of the solvent, as expected by the Oosawa-Manning model.No potential conflict of interest relevant to this article was reported.Society for Human Environmental StudiesActa Medica Okayama1348-52532412026Relationships between awareness of age-related change, subjective well-being, and psychological stress6977ENNatsueShiraishiGraduate School of Social and Cultural Sciences, Okayama UniversityAllysonBrothersHuman Development and Family Studies, Colorado State UniversityYasuhiroYamamotoFaculty of Education, Okayama UniversityTakeshiNakagawaGraduate School of Human Sciences, University of OsakaTakashiHoriuchiFaculty of Humanities and Social Sciences, Okayama University本研究は、加齢に伴う変化の認識（Awareness of Age-Related Change: AARC）、主観的幸福感（Subjective Well-Being:SWB）、および心理的ストレスの縦断的関係の検討を行った。AARC は、ライフスパン発達理論に基づき、心理的適応に重要な役割を果たすとされる。先行研究ではAARC と幸福感の関連が報告されているが、多くは横断研究であり、時間的方向性を考慮した検討は不十分である。そこで本研究では、日本の40 歳以上の成人585 名を対象に、AARC 短縮版（AARC-10 SF）、人生満足度尺度（SWLS）、心理的ストレス尺度（K6）を用いて、2 時点（2022 年7 月、2023 年10 月）でオンライン調査を実施した。交差遅延効果モデルの分析の結果、AARC-gains とSWLS の間に双方向の関連が認められ、AARC-gains が高い人ほど後の主観的幸福感が高く、その逆も成立することが示された。一方、心理的ストレスはAARC-losses に対して一方向の関連が確認され、ストレスが高い人ほど後のAARC-losses が高いことが示された。これらの結果は、ライフスパン発達理論の枠組みと整合し、加齢に伴う適応過程の理解を深めるものである。介入においては、AARC-gains を促進し幸福感を高めることが高齢者のサクセスフル・エイジングに寄与する可能性がある。No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2075-47011522025A Review on the Magnetovolume Effect of the Full Heusler Alloys Ni2MnZ (Z = In, Sn, Sb)215ENTakeshiKanomataResearch Institute for Engineering and Technology, Tohoku Gakuin UniversityXiaoXuDepartment of Materials Science, Graduate School of Engineering, Tohoku UniversityTakuoSakonFaculty of Advanced Science and Technology, Ryukoku UniversityYukiNagataFaculty of Advanced Science and Technology, Ryukoku UniversityShinImadaCollege of Science and Engineering, Ritsumeikan UniversityToshihiroOmoriDepartment of Materials Science, Graduate School of Engineering, Tohoku UniversityRyosukeKainumaDepartment of Materials Science, Graduate School of Engineering, Tohoku UniversityTetsujiroEtoKurume Institute of TechnologyYoshiyaAdachiGraduate School of Science and Technology, Yamagata UniversityTakumiKiharaResearch Institute for Interdisciplinary Science, Okayama UniversityYasushiAmakoFaculty of Science, Shinshu UniversityMasaakiDoiResearch Institute for Engineering and Technology, Tohoku Gakuin UniversityYoshiyaUwatokoInstitute for Solid State Physics, The University of TokyoThe full Heusler alloys Ni2MnZ (Z = In, Sn, Sb) exhibit ferromagnetic properties with a Curie temperature (TC) above room temperature. The magnetic properties of Ni2MnZ (Z = In, Sn, Sb) were studied through a combination of experiments and band calculations under ambient and elevated pressures. The main results of this study open up further prospects for controlling the magnetic properties of the multifunctional Heusler alloys Ni2Mn1+xZ1−x (Z = In, Sn, Sb) and their practical application.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2041-17231612025Grain boundary diffusion cannot explain the W isotope heterogeneities of the deep mantle1866ENYihangPengDepartment of Geosciences, Princeton UniversityTakashiYoshinoInstitute for Planetary Materials, Okayama UniversityJieDengDepartment of Geosciences, Princeton UniversityThe low 182W/184W and high 3He/4He in some ocean island basalts compared to the bulk mantle values may derive from the Earth’s core through long-term core-mantle interactions. It has been proposed that the grain boundary diffusion of siderophile elements is an efficient mechanism for core-mantle interaction and may effectively modify the W isotopic compositions of the plume-source mantle. In this study, we perform large-scale molecular dynamics simulations driven by machine learning potentials of ab initio quality to investigate the diffusion of W along ferropericlase grain boundaries and in (Mg,Fe)O liquid. Here we show that the diffusion of W is sluggish under core-mantle boundary conditions, and thus is unlikely to have observable impacts on the W isotopic compositions of terrestrial igneous rocks.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama2056-3426122025Optimizing β-TCP with E-rhBMP-2-infused fibrin for vertical bone regeneration in a mouse calvarium modelrbae144ENKunZhaoDepartment of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMitsuakiOnoDepartment of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesXindiMuDepartment of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesZiyiWangDepartment of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShichaoXieDepartment of Biomaterials, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokoYonezawaDepartment of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasahiroOkadaDivision of Dental Biomaterials, Tohoku University Graduate School of DentistryTakuyaMatsumotoDepartment of Biomaterials, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuoKubokiDepartment of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshitakaOohashiDepartment of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEffective reconstruction of large bone defects, particularly in thickness, remains one of the major challenges in orthopedic and dental fields. We previously produced an Escherichia coli-based industrial-scale GMP-grade recombinant human bone morphogenetic protein-2 (E-rhBMP-2) and showed that the combination of E-rhBMP-2 with beta-tricalcium phosphate (β-TCP/E-rhBMP-2) can effectively promote bone reconstruction. However, the limited mechanical strength and poor morphology retention of β-TCP granules are key points that need optimization to obtain more effective grafts and further expand its clinical applications. Therefore, we combined β-TCP/E-rhBMP-2 with fibrin gel to enhance its mechanical properties and usability for vertical bone regeneration. We investigated the mechanical properties and vertical bone regeneration effects of the materials applied, with or without fibrin containing E-rhBMP-2, in a calvarial defect model in mice. Compression tests were conducted to assess the initial stability of the materials. Scanning electron microscopy and Fourier transform infrared spectroscopy were conducted to characterize the presence of fibrin on the scaffold. After 4 and 12 weeks of implantation, micro-computed tomography and histological and immunofluorescent analyses were performed to assess the morphology and volume of the newly formed bone. The fibrin-containing groups had significantly higher initial mechanical strength and higher ability to maintain their morphology in vivo compared to the counterparts without fibrin. However, fibrin gel alone suppressed the bone formation ability of β-TCP/E-rhBMP-2 whereas the presence of high doses of E-rhBMP-2 in fibrin gel resulted in material resorption and enhanced new bone formation. In conclusion, fibrin gel significantly improved the mechanical strength and surgical manageability of the β-TCP/E-rhBMP-2 scaffold, and the addition of E-rhBMP-2 to the fibrin gel further enhanced the vertical bone regeneration and initial structural integrity of the scaffold.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2673-8937512025The Early Response After Radiation Therapy on Three-Dimensional Oral Cancer Model Using Patient-Derived Cancer-Associated Fibroblasts12ENIzumiYamamotoNeutron Therapy Research Center, Okayama UniversityKazuyoIgawaNeutron Therapy Research Center, Okayama UniversityNatsukoKondoParticle Radiation Oncology Center, Institute for Integrated Radiation and Nuclear Science, Kyoto UniversityYoshinoriSakuraiParticle Radiation Oncology Center, Institute for Integrated Radiation and Nuclear Science, Kyoto UniversityAtsushiFujimuraDepartment of Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKiyofumiTakabatakeDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityPengHuangNeutron Therapy Research Center, Okayama UniversityHiroyukiMichiueNeutron Therapy Research Center, Okayama UniversitySoichiroIbaragiDepartment of Oral and Maxillofacial Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKenjiIzumiDivision of Biomimetics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityBackground/Objectives: Cancer-associated fibroblasts (CAFs), which are an important component of the tumor microenvironment, have been reported to have an adverse effect on conventional radiotherapy. This study aims to elucidate the effects of CAFs in boron neutron capture therapy (BNCT) using a three-dimensional (3D) oral cancer model. Methods: Three-dimensional cancer models were fabricated using patient-derived CAFs or patient-derived normal oral fibroblasts (NOFs) and a human oral squamous cell carcinoma cell line. Each 3D cancer model was performed with either a conventional X-ray treatment or BNCT and additionally analyzed histomorphologically. Results: The 3D oral cancer-CAFs model demonstrated a greater depth of cancer cell invasion than the 3D oral cancer-NOFs model. Radiation therapy for the 3D oral cancer models indicated a trend for decreasing cancer cell invasion and cell number with dose dependence in both X-ray and BNCT. In comparison with X-rays, BNCT showed a consistent increase in the number of NOFs and a significant reduction in the number of CAFs. Conclusions: BNCT for the 3D oral cancer model was shown to be effective against cancer cells and CAFs but not against NOFs, indicating its usefulness as a minimally invasive treatment for advanced cancer. Furthermore, it is indicated that the 3D oral cancer-CAFs model is a valuable tool to evaluate cancer treatment and research, particularly in high-grade malignant tumors with invasion.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2041-17231612025Low melt viscosity enables melt doublets above the 410-km discontinuity3239ENLongjianXieCenter for High Pressure Science & Technology Advanced ResearchDenisAndraultUniversité Clermont Auvergne, CNRS, IRD, OPGC, Laboratoire Magmas et VolcansTakashiYoshinoInstitute for Planetary Materials, Okayama UniversityCunruiHanSchool of Natural Sciences, Birkbeck, University of LondonJames O. S.HammondSchool of Natural Sciences, Birkbeck, University of LondonFangXuSchool of Earth Sciences, Zhejiang UniversityBinZhaoInstitute for Planetary Materials, Okayama UniversityOliver T.LordSchool of Earth Sciences, University of BristolYingweiFeiEarth & Planets Laboratory, Carnegie Institution for ScienceSimonFalvardUniversité Clermont Auvergne, CNRS, IRD, OPGC, Laboratoire Magmas et VolcansShoKakizawaJapan Synchrotron Radiation Research InstituteNoriyoshiTsujinoJapan Synchrotron Radiation Research InstituteYujiHigoJapan Synchrotron Radiation Research InstituteLauraHenrySynchrotron SOLEILNicolasGuignotSynchrotron SOLEILDavid P.DobsonDepartment of Earth Sciences, University College LondonSeismic and magnetotelluric studies suggest hydrous silicate melts atop the 410 km discontinuity form 30–100 km thick layers. Importantly, in some regions, two layers are observed. These stagnant layers are related to their comparable density to the surrounding mantle, but their formation mechanisms and detailed structures remain unclear. Here we report a large decrease of silicate melt viscosity at ~14 GPa, from 96(5) to 11.7(6) mPa⋅s, as water content increases from 15.5 to 31.8 mol% H₂O. Such low viscosities facilitate rapid segregation of melt, which would typically prevent thick layer accumulation. Our 1D finite element simulations show that continuous dehydration melting of upwelling mantle material produces a primary melt layer above 410 km and a secondary layer at the depth of equal mantle-melt densities. These layers can merge into a single thick layer under low density contrasts or high upwelling rates, explaining both melt doublets and thick single layers.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1471-24072512025Long-term outcomes of salvage high-dose-rate brachytherapy for localized recurrence of prostate cancer following definitive radiation therapy: a retrospective analysis524ENKentaWatanabeDepartment of Radiology, Okayama University HospitalNobuhikoKamitaniDepartment of Radiology, Kawasaki Medical SchoolNaokiIkedaDepartment of Radiology, Kawasaki Medical SchoolYujiroKawataDepartment of Radiology, Kawasaki Medical SchoolRyojiTokiyaDepartment of Radiology, Kawasaki Medical SchoolTakafumiHayashiDepartment of Radiology, Kawasaki Medical SchoolYoshiyukiMiyajiDepartment of Urology, Kawasaki Medical SchoolTsutomuTamadaDepartment of Radiology, Kawasaki Medical SchoolKuniakiKatsuiDepartment of Radiology, Kawasaki Medical SchoolBackground Salvage high-dose-rate brachytherapy (HDR-BT) is a potential treatment for localized recurrence of prostate cancer following definitive radiation therapy. This study aimed to evaluate the long-term safety and efficacy of HDR-BT alone, without androgen deprivation therapy (ADT), in this patient population.<br>
Methods We conducted a retrospective analysis of patients with prostate cancer who developed pathologically confirmed local recurrence after definitive radiation therapy and were treated with salvage HDR-BT alone at Kawasaki Medical School Hospital between 2007 and 2021. The prescribed HDR-BT dose was 22 Gy in 2 fractions. Biochemical relapse-free survival (bRFS), cause-specific survival (CSS), and overall survival (OS) were assessed using the Kaplan–Meier method. Adverse events were evaluated based on the Common Terminology Criteria for Adverse Events.<br>
Results Thirty-five patients were included, with a median follow-up of 66.0 months (range, 8.1–169.1). The 5-year bRFS, CSS, and OS rates were 29.7%, 100%, and 89.3%, respectively. Biochemical recurrence occurred in 21 patients (60.0%). Grade 2 adverse events were reported in eight patients (22.9%), while two (5.7%) experienced grade 3 adverse events. All grade 3 adverse events occurred in patients who had HDR-BT as their initial definitive radiation therapy.<br>
Conclusions Salvage HDR-BT without ADT is a safe and effective treatment option for localized prostate cancer recurrence after definitive radiation therapy. It provides excellent CSS rates with acceptable toxicity while potentially reducing the need for ADT. Further prospective studies are warranted to confirm these findings.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1718-77293262025Global Incidence Trend of Early-Onset Obesity-Related and Non-Obesity-Related Cancers324ENMiyuTerashimaOkayama University Medical SchoolKotaNakayamaOkayama University Medical SchoolSatokoUgaiDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USAHwa-YoungLeeGraduate School of Public Health and Healthcare Management, The Catholic University of KoreaYutaTsukumoDepartment of Epidemiology, Harvard T.H. Chan School of Public HealthEtsujiSuzukiDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHirokiMizunoDepartment of Epidemiology, Harvard T.H. Chan School of Public HealthMinkyoSongLaboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of HealthNaokoSasamotoPublic Health Sciences Division, Fred Hutchinson Cancer CenterIchiroKawachiDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public HealthTomotakaUgaiDepartment of Epidemiology, Harvard T.H. Chan School of Public HealthThe global rise in obesity prevalence and the incidence of early-onset cancer (diagnosed between 20 and 49 years of age) is a serious public health concern. We, therefore, evaluated the recent global trends in the incidence of early-onset obesity-related cancers and compared them to those of non-obesity-related cancers. We obtained age-standardized incidence rates of early-onset cancers diagnosed between 2000 and 2012 in 44 countries from the Cancer Incidence in Five Continents database. Using joinpoint regression models, we calculated the average annual percentage changes (AAPCs) and their corresponding 95% confidence intervals (95% CIs) for combined and individual categories of obesity-related cancers (11 and 9 cancer types in females and males, respectively) and non-obesity-related cancers (12 cancer types in both females and males). Differences in the AAPC were assessed by comparing 95% CIs, where nonoverlapping 95% CIs were considered statistically significantly different. We observed statistically significant positive AAPCs for early-onset obesity-related cancers in all available countries combined among females (global AAPC, 4.3%; 95% CI, 4.1–4.6%) and males (global AAPC, 1.4%; 95% CI, 1.2–1.7%). When analyzed by countries, we observed statistically significant positive AAPCs in 26 countries among females and 11 countries among males. AAPCs for early-onset obesity-related cancers were statistically significantly higher than those of non-obesity-related cancers in several regions, especially North America and Oceania. In conclusion, this study indicates that the incidence of early-onset obesity-related cancers exhibited a more pronounced increasing trend than non-obesity-related cancers among both sexes in many countries and regions.No potential conflict of interest relevant to this article was reported.Microbiology SocietyActa Medica Okayama2057-58581142025Whole-genome-based characterization of Escherichia albertii strains isolated from paediatric diarrhoeal cases in Kolkata, India001363ENGoutamChowdhuryCollaborative Research Centre of Okayama University for Infectious Diseases, ICMR-National Institute of Cholera and Enteric DiseasesYukiHoshikoDivision of Microbiology, Department of Infectious Medicine, School of Medicine, Kurume UniversityMikiOkunoDivision of Microbiology, Department of Infectious Medicine, School of Medicine, Kurume UniversityKeiKitaharaCollaborative Research Centre of Okayama University for Infectious Diseases, ICMR-National Institute of Cholera and Enteric DiseasesM JohnAlbertDepartment of Microbiology, College of Medicine, Kuwait UniversityShin-ichiMiyoshiGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshitoshiOguraDivision of Microbiology, Department of Infectious Medicine, School of Medicine, Kurume UniversityShantaDuttaDivision of Bacteriology, ICMR-National Institute of Cholera and Enteric DiseasesThandavarayanRamamurthyDivision of Bacteriology, ICMR-National Institute of Cholera and Enteric DiseasesAsish K.MukhopadhyayDivision of Bacteriology, ICMR-National Institute of Cholera and Enteric DiseasesEscherichia albertii is a Gram-negative facultative anaerobic bacterium that causes diarrhoea in humans. This study shows the isolation of E. albertii from hospitalized paediatric diarrhoeal cases and genome-based characteristics with putative virulence factors and antimicrobial resistance. E. albertii isolates were identified by species-specific PCR, targeting the gene encoding cytolethal distending toxin (Ea-cdt). The genome of E. albertii was sequenced to identify (i) genes encoding virulence factors (ii) antibiotic resistance-encoding genes, including the mobile genetic elements and (iii) core gene-based phylogenetic relationships and pan-genome features. A total of 10 (1.2%) E. albertii isolates were isolated from 854 faecal samples, of which 6 (60%) were found as the sole pathogen and the remaining 4 (40%) were identified along with other pathogens, such as enteroaggregative Escherichia coli, rotavirus and adenovirus. Patients from whom E. albertii was isolated presented cholera-like diarrhoea, i.e. with watery stool (60%) with moderate dehydration (100%), fever (20%) and abdominal pain (20%). The antimicrobial susceptibility testing of E. albertii showed that most of the isolates were susceptible or reduced susceptible to most of the antibiotics except resistance to erythromycin (80%), tetracycline (50%), nalidixic acid (40%), ampicillin (40%), doxycycline (30%) and ceftriaxone (20%). In the whole-genome sequence, E. albertii isolates revealed several virulence-encoding genes, namely the intimin (eae, E. coli attaching and effacing), the cytolethal distending toxin type II subunit A (cdt-IIA), adhesion (paa, porcine attaching- and effacing-associated), non-LEE (locus of enterocyte effacement) encoded effector A (nleA) and antimicrobial resistance genes (ARGs) conferring resistance to tetracycline (tetA, tetR), sulphonamides (sul2), fluoroquinolones (qnrS) and beta-lactamases (blaCTX-M, blaTEM). The SNP-based phylogenetic analysis of 647 whole genomes of E. albertii isolates from the National Center for Biotechnology Information databases did not reveal any comparable clustering pattern based on the biological source and place of isolation. The genome of some of the E. albertii was closely related to those of the isolates from China and the United Kingdom. The PFGE patterns revealed that most of the E. albertii isolates were distinct clones. This study reports on the extensive genome analysis of diarrhoea-associated E. albertii harbouring multiple virulence and ARGs.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1880-59817812026Electrical conductivity measurements of rhyolitic glass at high pressure and high temperature57ENYusukeHaraguchiGraduate School of Engineering, The University of OsakaKiyoshiFuji-TaGraduate School of Engineering, The University of OsakaTakashiYoshinoInstitute for Planetary Materials, Okayama UniversityMasashiNakamotoGraduate School of Engineering, The University of OsakaMasanoriSuzukiGraduate School of Engineering, The University of OsakaToshihiroTanakaGraduate School of Engineering, The University of OsakaWe performed electrical conductivity measurements of rhyolite glasses across the glass transition temperature at 1 GPa. Our experimental data show that, in the Arrhenius plot, the conductivity of rhyolite with 0.2 wt% H2O has an inflection point between around 760 K, while for rhyolite with 4.9 wt% H2O the gradient changes between 685 and 825 K. These inflection points correlate with the glass transition temperature, and are compared with results of previous experiments. The degree of welding of clastic and hydrous rock can be constrained by estimating glass transition temperatures of volcanic rocks combined with measurements of electrical conductivity structures obtained from electromagnetic soundings beneath volcanic bodies. This, in turn, can be used to aid predictions of volcanic eruption.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0021-925830132025Taste receptor type 1 member 3 in osteoclasts regulates osteoclastogenesis via detection of glucose108273ENAnnaYoshimuraDivision of Molecular Signaling and Biochemistry, Kyushu Dental UniversityTakumaMatsubaraDivision of Molecular Signaling and Biochemistry, Kyushu Dental UniversityNaoKodamaDivision of Molecular Signaling and Biochemistry, Kyushu Dental UniversityYoshimitsuKakutaLaboratory of Structural Biology, Graduate School of Systems Life Sciences, Kyushu UniversityKazumaYasudaDivision of Molecular Signaling and Biochemistry, Kyushu Dental UniversityRyusukeYoshidaDepartment of Oral Physiology, Graduate School of Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityOsamuKaminumaDepartment of Disease Model, Research Institute of Radiation Biology and Medicine, Hiroshima UniversityShuheiHosomiDepartment of Gastroenterology, Graduate School of Medicine, Osaka Metropolitan UniversityHirojiShinkawaDepartment of Hepatobiliary-Pancreatic Surgery, Graduate School of Medicine, Osaka Metropolitan UniversityQuanYuanState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan UniversityTatsuoKawamotoDivision of Orofacial Functions and Orthodontics, Kyushu Dental UniversityShoichiroKokabuDivision of Molecular Signaling and Biochemistry, Kyushu Dental UniversityThe taste system extends beyond the oral cavity, with various taste receptors found in extraoral organs. Mice deficient in the taste receptor type 1 (TAS1R) family member, TAS1R3, and fed a high-fat, high-sugar diet showed high bone mass without altering food consumption. However, the underlying mechanisms, including the cell types responsible for TAS1R3 expression, remain unclear. Here, we demonstrate the expression and function of TAS1R3 in osteoclasts, which are responsible for bone resorption. The expression of Tas1r3, but not Tas1r1 or Tas1r2, is evoked during osteoclast differentiation. Osteoclastogenesis-related genes were downregulated in TAS1R3-deficient mice, whereas the opposite phenotypes were elicited by TAS1R3 overexpression. Contrary to the common heterodimerization with TAS1R1 or TAS1R2, TAS1R3 formed a homodimer that functioned to detect glucose, enhance p38 phosphorylation, and induce osteoclastogenesis. These results provide novel insights into the role of TAS1R3 in bone metabolism and suggest that TAS1R3 may be a viable target for therapeutic agents in bone metabolic diseases.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1756-46461262025Proteome analysis reveals the molecular mechanisms of fucoxanthin-induced apoptosis in glial cells PC12 after nanoencapsulation106710ENChunyanWangSchool of Food Science, Henan Institute of Science and TechnologyXinxinMaSchool of Food Science, Henan Institute of Science and TechnologyYoshimasaNakamuraGraduate School of Environmental and Life Science, Okayama UniversityHangQiSKL of Marine Food Processing & Safety Control, National Engineering Research Center of Seafood, Collaborative Innovation Center of Seafood Deep Processing, School of Food Science and Technology, Dalian Polytechnic UniversityFucoxanthin (FX) is a natural pigment belonging to the xanthophyll carotenoid, which has been proven to have inhibitory effects on glioblastoma. In our previous study, nano-FX was fabricated through whey protein and flaxseed gum co-encapsulated for improved stability and glial cell (PC12) inhibitory activity of FX. To investigate the molecular mechanisms of FX-induced apoptosis in PC12 after nanoencapsulation, proteomics analysis based on TMT technology was performed. Protein profiles in PC12 were determined after 0 (Control), 8 (L_Treat), and 24 (H_Treat) μg/mL nano-FX intervention. Results indicated 78 differential abundant proteins (DAPs) linked to the cytotoxicity of nano-FX could be potential biomarkers. GO and KEGG analysis revealed altered proteasome and NF-kappa B/MAPK/TNF. Proteins involved in cell proliferation were downregulated, while proteins response to autophagy and apoptosis were upregulated. The multiple mechanisms involved in the anti-tumor activity of nano-FX will provide a reference for the development of FX high value-added functional foods.No potential conflict of interest relevant to this article was reported.Ferrata Storti Foundation (Haematologica)Acta Medica Okayama1592-872111152025Distinct interleukin-6 production in IPL and TAFRO subtypes of idiopathic multicentric Castleman disease17051715ENAsamiNishikoriDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesMidori FilizNishimuraDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesYoshitoNishimuraDivision of Hematology/Oncology, Mayo ClinicRioYamadaDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesTomokaHaratakeDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesDaisukeEnnishiCenter for Comprehensive Genomic Medicine, Okayama University Hospital, Okayama, Japan; Department of Hematology and Oncology, Okayama University HospitalRyotaChijimatsuCenter for Comprehensive Genomic Medicine, Okayama University Hospital, Okayama, Japan; Department of Hematology and Oncology, Okayama University HospitalToshihiroItoDepartment of Immunology, Nara Medical UniversityTomohiroKogaDepartment of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical SciencesSayakaOchiDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesYuriKawaharaDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesHimawariUetaDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesYudaiTakedaDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesMichael V.GonzalezCenter for Cytokine Storm Treatment and Laboratory, Department of Medicine, Perelman School of Medicine, University of PennsylvaniaDavid C.FajgenbaumCenter for Cytokine Storm Treatment and Laboratory, Department of Medicine, Perelman School of Medicine, University of PennsylvaniaFritsVan RheeUniversity of Arkansas for Medical SciencesShujiMomoseDepartment of Pathology, Saitama Medical Center, Saitama Medical UniversityYasuharuSatoDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesIdiopathic multicentric Castleman disease (iMCD) is a rare lymphoproliferative disorder characterized by systemic inflammation and lymphadenopathy. Two major clinical subtypes, idiopathic plasmacytic lymphadenopathy (iMCD-IPL) and iMCD with thrombocytopenia, anasarca, fever, renal dysfunction/reticulin fibrosis, and organomegaly (iMCD-TAFRO), have distinct pathophysiological mechanisms. While interleukin-6 (IL-6) is known to be elevated in iMCD, differences in the sources of IL-6 production between subtypes remain unclear. We examined the source of IL-6 production and its transcriptional regulation across iMCD subtypes using immunohistochemistry, in situ hybridization, and gene expression profiling. Immunohistochemistry and in situ hybridization revealed that plasma cells were the predominant IL-6-expressing cells in iMCD-IPL, whereas vascular endothelial cells expressed IL-6 in iMCD-TAFRO. Plasma cells exhibited stronger IL-6 protein expression in iMCD-IPL than in iMCD-TAFRO. Gene expression analysis revealed upregulation of XBP1, MZB1, DERL3, SSR4, FKBP11, FKBP2, PIM2, RABAC1, and SDF2L1 in iMCD-IPL, implicating endoplasmic reticulum stress and plasma cell differentiation in IL-6 dysregulation. Our findings suggest that XBP1-mediated IL-6 production may contribute to the pathogenesis of iMCD-IPL, potentially explaining its favorable responses to IL-6 blockade therapy. In contrast, IL-6 production in iMCD-TAFRO may be predominantly from vascular endothelial cells, suggesting that elevated serum IL-6 is a secondary phenomenon of the cytokine storm in this subtype. Future studies should clarify how proteomics and gene expression profiling could inform subtype-specific therapeutic strategies in iMCD.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221612026Boulder populations and orientation trends on asteroid Ryugu: implications for rubble-pile surface processes14404ENAdityaRayInstitute for Planetary Materials, Okayama UniversityTrishitRujInstitute for Planetary Materials, Okayama UniversityGoroKomatsuInternational Research School of Planetary Sciences, Università G. d‘AnnunzioLisa M.VincentDepartment of Earth Sciences, Utrecht UniversityHiroshiKikuchiGakushuin UniversityRyodoHemmiInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencyJensOrmöCentro de Astrobiología (CAB), CSIC-INTAAsteroid (162173) Ryugu is a spinning-top shaped, rubble-pile C-type asteroid with a surface dominated by boulders spanning a broad size-range. Using Hayabusa2 ONC-T mosaics for mapping, we present the most extensive global boulder dataset to date, representing an eleven-fold increase over the earliest survey and greater completeness than later AI-based estimates. Crucially, this work provides the first global boulder orientation dataset. The cumulative size-frequency distribution follows a power-law slope of − 2.665 ± 0.066 (boulders ≥ 3 m), indicating its fragmented nature. Boulder density is lower along the equatorial ridge, consistent with regolith accumulation during earlier YORP-driven spin-up and poleward migration of blocks during the present spin-down phase. Orientation analyses reveal systematic hemispheric trends in what we define as slope-breaker zones (i.e., regions of high slope differentials), with NW–SE alignment in the northern hemisphere and NE–SW in the southern hemisphere, but absent at the equatorial ridge and poles. We interpret these as reorientations that developed during downslope boulder migration, as despite ongoing spin-down, the current spin rate remains high enough to drive such motion. In addition, fresh craters exhibit locally heightened boulder densities, recording ongoing resurfacing by impact events that exhume buried subsurface boulders and segregate them from finer regolith via seismic shaking induced granular convection. Together, these results yield new insights into rubble-pile surface evolution, rotational dynamics, and impact-driven resurfacing, with boulder orientations providing critical evidence of spin-related downslope transport and establish a framework for comparative asteroid studies.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0883-29272072026Effects of secondary hydrothermal fluids on gallium distribution and coordination in hot springs silica using Ga K-edge XANES106961ENM.C.RoweSchool of Environment, University of AucklandK.A.CampbellSchool of Environment, University of AucklandD.A.StallardSchool of Environment, University of AucklandB.LyonSchool of Environment, University of AucklandA.LangendamAustralian Synchrotron Facility (Ansto)E.KalininaThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityM.YamanakaThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityR.TanakaThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityT.ChristopherSchool of Chemical Sciences, University of AucklandS.W.RuffArizona State University, School of Earth And Space ExplorationE.NersezovaSchool of Environment, University of AucklandT.OtaThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityA.HamiltonSchool of Environment, University of AucklandGallium (Ga), a critical element in the electronics industry, is enriched in hot spring silica deposits (sinter) at concentrations comparable to, and in some cases greater than, bauxite, coal, and sphalerite deposits from which it is currently extracted. Focusing on well characterized Holocene and Pleistocene New Zealand sinters, we utilize synchrotron-X-ray fluorescence (sXRF) and Ga K-edge X-ray absorption near edge structure (XANES) spectroscopy to examine the spatial distribution of Ga as well as its changing coordination number. Ga+3 is the only observed oxidation state in the analyzed sinters. Gallium is predominantly found in tetrahedral coordination in sinter deposited from alkali chloride fluids, with analyses best matching Ga-aluminosilicate standards. However, Ga coordination is octahedral in sinter samples that have undergone alteration by acidic fluids/gases, associated with a change in hydrology from alkali-chloride to acid-sulfate fluid conditions. High Ga concentrations are found associated with both these coordination environments, with a heterogeneous distribution. Octahedral Ga is observed both as particles and in larger regions affected by Fe-rich fluid overprinting. The combined use of sXRF and XANES demonstrates an ability to fingerprint diagenesis and alteration in these complex geothermal settings where tetrahedral and octahedral Ga co-exist. The transition from tetrahedral to octahedral Ga also appears to mimic the inferred natural process forming lateritic bauxite deposits, where remobilized tetrahedral Ga is reconcentrated and adsorbed to oxides. A similar process may occur for sinter Ga enrichment, whereby introduced Ga in acidic conditions is adsorbed to oxide phases as the Fe-rich secondary fluids infiltrate porous sinter material.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0969-80432362026An algorithm to calculate physical density of biomedical objects having 3 ≤ Zeff ≤ 20: an application study using clinical photon-counting computed tomography equipment112768ENHiroakiHayashiCollege of Transdisciplinary Sciences for Innovation, Kanazawa UniversityRinaNishigamiGraduate School of Medical Sciences, Kanazawa UniversityTakashiAsaharaDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityNatsumiKimotoDepartment of Radiological Science, Faculty of Health Sciences, Junshin Gakuen UniversityDaikiKobayashiGraduate School of Medical Sciences, Kanazawa UniversityManaMitaniDivision of Radiological Technology, Medical Support Department, Okayama University HospitalNoriakiAkagiDivision of Radiological Technology, Medical Support Department, Okayama University HospitalFumiyoHigakiDepartment of Radiology, Medical Development Field, Okayama UniversityToshihiroIguchiDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityRecently, photon-counting computed tomography (PC-CT) devices have become clinically available for X-ray diagnosis, and developments of analysis algorithms to generate various quantitative images have focused attention. This study proposes an algorithm to calculate the effective physical density (ρeff) of biological objects having an effective atomic number (Zeff) of 3–20. In our procedure, ρeff was determined when fitting the interaction cross sections (σs) to the measured linear attenuation coefficients (μs), which were determined from virtual monochromatic images (VMIs). In this process, the Zeff was analyzed in advance, and this information was fed back to the ρeff analysis. A key feature of our procedure is that it does not require calibration processes based on specific substances, which allow us to analyze any substance without making assumptions.<br>
To validate the availability of the proposed algorithm, we conducted an experiment using a clinical PC-CT scanner. A multi-energy CT phantom, a water phantom, an in-house low-density phantom, food samples, and a chest phantom were scanned. The results showed that our procedure can calculate ρeff of water with an uncertainty of 4.5%. The academic significance of the present research results lies in demonstrating that the factors contributing to contrast, previously obtained from CT values, can be physically interpreted using information from Zeff and ρeff. This analysis cannot be performed with conventional single-energy CT scanners and is possible with PC-CT and dual-energy CT scanners. Our novel procedure is expected to provide useful additional information in X-ray diagnosis.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1931-52442952026A novel spontaneous rat model of chronic kidney disease with mitochondrial dysfunction driven by thioredoxin insufficiency5164ENIori K.OhmoriSection of Developmental Physiology and Pathology, Faculty of Education, Okayama UniversityMamoruOuchidaDepartment of Molecular Oncology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshikoHadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHaruhito A.UchidaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShinyaToyokuniDepartment of Pathology and Biological Responses, Nagoya University Graduate School of MedicineTomojiMashimoDivision of Animal Genetics, Laboratory Animal Research Center, Institute of Medical Science, The University of TokyoBackground: Chronic kidney disease (CKD) is a global health burden with high prevalence and poor prognosis. Although oxidative stress and mitochondrial dysfunction have been implicated in its pathogenesis, in vivo causal evidence remains limited. Thioredoxin (Trx), encoded by Txn1, is a redox-active protein that plays a central role in controlling oxidative stress and maintaining intracellular redox homeostasis.<br>
Methods: To address this gap, we investigated the lifelong phenotypes of Txn1-F54L mutant rats harboring approximately one-third of the normal Trx activity. These rats were generated via N-ethyl-N-nitrosourea mutagenesis and validated by clustered regularly interspaced palindromic repeat (CRISPR)/CRISPR-associated protein 9 genome editing. Comprehensive analyses included biochemical testing, histopathology, immunohistochemistry, transmission electron microscopy, RNA-sequencing, western blotting, and cytokine profiling.<br>
Results: Txn1-F54L mutant rats spontaneously developed progressive CKD, with median survival times of 110–119 days for homozygotes and 303–346 days for heterozygotes. Their clinical features—elevated blood urea nitrogen, hypoalbuminemia, hypercholesterolemia, hypertension, and arterial medial sclerosis—closely resembled those of human CKD. Histopathological evaluation revealed extensive tubular injury, interstitial fibrosis, and glomerulosclerosis. Transcriptomic profiling identified 3,418 differentially expressed genes significantly enriched in immune activation and fibrosis pathways. Mitochondrial dysfunction was prominent in proximal tubules, accompanied by oxidative stress accumulation and concurrent activation of regulated cell death pathways (apoptosis, necroptosis, and pyroptosis). Elevated serum levels of interleukin-1β, interleukin-6, and interferon-γ indicated systemic inflammation.<br>
Conclusions: Our findings demonstrate that lifelong Trx deficiency induces oxidative stress–mediated mitochondrial dysfunction and regulated cell death, leading to inflammation and progressive CKD. This study establishes the Txn1 mutant rat as a valuable spontaneous CKD model, providing translational insights and a platform for developing therapeutic strategies targeting oxidative stress–induced pathways.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama3042-6081222026Interfacial Bond Strength of Resin Cement to Polyetheretherketone (PEEK) Using Experimental Primers Doping Multifunctional Methacrylate and Acrylate Monomers12ENYukinoriMaruoDepartment of Prosthodontics, Okayama UniversityKumikoYoshiharaHealth Research Institute, National Institute of Advanced Industrial Science and TechnologyMasaoIrieOkayama University Dental SchoolNoriyukiNagaokaAdvanced Research Center for Oral and Craniofacial Sciences, Okayama University Dental SchoolNaokiKodamaDepartment of Prosthodontics, Okayama UniversityYukiTanakaDepartment of Occlusal and Oral Functional Rehabilitation, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMihoKuwaharaDepartment of Occlusal and Oral Functional Rehabilitation, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaroAkiyamaDepartment of Occlusal and Oral Functional Rehabilitation, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesPolyetheretherketone (PEEK) is a high-performance thermoplastic polymer with low surface energy, chemical inertness, and a highly crystalline structure, which limit durable adhesion to resin-based materials and require improved bonding strategies. This in vitro study evaluated the effect of incorporating multifunctional methacrylate (TMPTMA) and acrylate monomers (A-TMPT and A-DPH) into an experimental primer on the 24 h shear bond strength (SBS) of resin cement to PEEK (n = 6 per group). Experimental primers were prepared by adding varying amounts (100–500 µL) of each multifunctional monomer to a UDMA/MMA-based primer, and SBS was measured after cementation with a dual-cure resin cement. TMPTMA-containing primers produced median SBS values of approximately 10–12 MPa, while acrylate-based primers showed slightly higher values, particularly at higher concentrations, reaching up to ~15.8 MPa; however, no statistically significant improvement over the control group was observed (p > 0.05). Failure modes were predominantly mixed across all conditions. These findings indicate that multifunctional monomers, despite their potential to enhance cross-link density and wetting, do not substantially overcome the intrinsic adhesion-resistant nature of polished PEEK. The results underscore that monomer modification alone is insufficient and that effective adhesion to PEEK likely requires integrated strategies combining chemical activation with mechanical surface conditioning.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2075-17291662026Disease-Suppressive Activity of Lecithin Against Foliar Infection by Rhizoctonia solani Isolates in Cabbage, Rice, and Brachypodium distachyon998ENTran XuanCuongGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMisakiAsanoSchool of Agriculture, Okayama UniversityDaikiHonmaSchool of Agriculture, Okayama UniversityMoekoSoedaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMegumiWatanabeGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityNanamiSakataGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHidenoriMatsuiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKazuhiroToyodaGraduate School of Environmental, Life, Natural Science and Technology, Okayama University, Okayama 700-8530, JapanYukiIchinoseGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKentaroIkedaFaculty of Bioscience and Applied Chemistry, Hosei UniversityYoshiteruNoutoshiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityRhizoctonia solani is a necrotrophic phytopathogenic fungus that causes disease in various crops. In agriculture, many crops suffer from root or seedling rot caused by this soil-borne pathogen, whereas cabbage and rice develop lesion-like symptoms on aboveground tissues. Diseases caused by R. solani are generally controlled using chemical fungicides; however, environmentally friendly alternatives are needed for sustainable agriculture. In this study, we evaluated the efficacy of lecithin, a mixture of phospholipids previously registered in Japan as an agrochemical for controlling cucumber powdery mildew, against Rhizoctonia diseases. In cabbage, foliar spraying of 0.2–1.0% soybean lecithin effectively suppressed leaf symptoms caused by R. solani isolate RhiCa-2, which was identified as AG-1 IB. In rice and Brachypodium distachyon, 0.2–1.0% lecithin significantly suppressed leaf symptoms induced by R. solani AG-1 IA. Hyphal staining of inoculated leaves revealed reduced hyphal density on lecithin-treated leaves. Consistently, hyphal growth of R. solani on cellophane placed on water agar was retarded by lecithin treatment. However, 5.0% lecithin induced phytotoxicity in B. distachyon. Egg yolk-derived lecithin also exhibited disease-suppressive activity in cabbage and B. distachyon, with efficacy comparable to that of soybean lecithin under the conditions tested. These results suggest that lecithin suppresses foliar infection by R. solani, at least in part, through direct inhibitory effects on fungal hyphae, and may serve as a potential alternative material for disease control in sustainable crop production.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2075-17291662026UGT76B1 and 41 Additional Arabidopsis UDP-Glycosyltransferases Show No Detectable In Vitro Glycosylation Activity Toward N-Hydroxypipecolic Acid992ENJiyuanBaoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTaigaUchiyamaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKazukiKusunokiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYukaShinoharaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYurikaTanigawaSchool of Agriculture, Okayama UniversityMegumiWatanabeGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityNanamiSakataGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHidenoriMatsuiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKazuhiroToyodaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYukiIchinoseGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYoshiteruNoutoshiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityN-hydroxypipecolic acid (NHP) is a key mobile signal in systemic acquired resistance in plants, and its glycosylation has been proposed to regulate immune signaling. Previous studies have demonstrated that the UDP-glycosyltransferase UGT76B1, known as an SA glycosyltransferase in Arabidopsis thaliana, also catalyzes NHP glycosylation. In this study, we re-evaluated NHP glycosylation activity of UGT76B1 using an in vitro enzyme-coupled fluorescence assay that quantitatively detects UDP released during UDP-sugar-dependent glycosylation. Unexpectedly, our biochemical analyses demonstrated that UGT76B1 lacks genuine glycosylation activity toward NHP under the in vitro assay conditions tested, although this system clearly detected UGT76B1 activity toward salicylic acid (SA), as well as the activities of UGT74F1 and UGT72B1 toward SA and hydroquinone, respectively. To explore potential UGTs responsible for NHP glycosylation, we evaluated the enzymatic activities of 41 UGT candidates successfully expressed in Escherichia coli, which are selected based on transcriptomic responses to tenoxicam treatment, molecular docking simulations using AlphaFold3/AutoDock Vina, phylogenetic criteria, and previous reports. Within this selected and successfully expressed UGT panel, none exhibited authentic NHP glycosylation activity, although this does not preclude the possibility that other members of the Arabidopsis UGT family possess NHP glycosyltransferase activity. Our findings challenge the prevailing view that UGT76B1 is the primary glycosyltransferase for NHP in A. thaliana and indicate that NHP metabolism may rely on undiscovered non-canonical enzymes or distinct metabolic pathways that warrant further investigation.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221612026Variations in the perceived value of anti-SARS-CoV-2 therapeutics based on physicians’ clinical backgrounds5705ENAkihikoHagiwaraRespiratory Medicine and Infectious Diseases, Oita University Faculty of MedicineKosakuKomiyaRespiratory Medicine and Infectious Diseases, Oita University Faculty of MedicineYuichiroShindoDepartment of Respiratory Medicine, Nagoya University Graduate School of MedicineKazufumiTakamatsuDepartment of Respiratory Medicine and Allergology, Kochi Medical School, Kochi UniversityNaokiNishimuraDepartment of Respiratory Medicine, National Center for Global Health and MedicineYukakoTakechiIki-iki ClinicEikiIchiharaCenter for Clinical Oncology, Okayama University HospitalTakahiroTakazonoDepartment of Respiratory Medicine, Nagasaki University Graduate School of Biomedical SciencesShinyuIzumiDepartment of Respiratory Medicine, National Center for Global Health and MedicineShimpeiGotohDepartment of Clinical Application, Center for iPS Cell, Research and Application, Kyoto UniversitySeiichiroSakaoDepartment of Pulmonary Medicine, School of Medicine, International University of Health and WelfareTakehiroIzumoDepartment of Respiratory Medicine, Japanese Red Cross Medical CenterKazukoYamamotoDivision of Infectious, Respiratory, and Digestive Medicine, First Department of Internal Medicine, University of the Ryukyus Graduate School of MedicineKazuhiroYateraDepartment of Respiratory Medicine, School of Medicine, University of Occupational and Environmental HealthHiroshiKakeyaDepartment of Infection Control Science, Osaka Metropolitan University Graduate School of MedicineYokoShibataDepartment of Pulmonary Medicine, Fukushima Medical University School of MedicineKeisukeTomiiDepartment of Respiratory Medicine, Kobe City Medical Center General HospitalHironoriSagaraDepartment of Medicine, Division of Respiratory Medicine and Allergology, Showa Medical University School of MedicineYukaSasakiCenter for Pulmonary Disease, National Hospital Organization Tokyo National HospitalToyohiroHiraiDepartment of Respiratory Medicine, Graduate School of Medicine, Kyoto UniversityAkihitoYokoyamaDepartment of Respiratory Medicine and Allergology, Kochi Medical School, Kochi UniversityHiroshiMukaeDepartment of Respiratory Medicine, Nagasaki University Graduate School of Biomedical SciencesTakashiOguraDepartment of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory CenterAlthough the global emergency phase of the coronavirus disease 2019 (COVID-19) pandemic has ended, antiviral therapy remains crucial for patients at high risk of severe illness. In Japan, the out-of-pocket costs for antiviral drugs shifted from full public coverage to partial patient payment in April 2024. However, the impact of physicians’ background characteristics on antiviral cost perceptions and prescribing behavior remains underexplored. This study involved a secondary analysis of a nationwide, web-based interventional survey of 1,500 physicians treating COVID-19. Participants reported whether they avoided prescribing antivirals owing to drug costs and identified what they considered an appropriate cost per treatment course. Associations between physicians’ characteristics and their cost perceptions were analyzed. Among 1,500 physicians surveyed, 1,193 (79.5%) reported avoiding antiviral prescriptions owing to drug costs. The most commonly selected appropriate cost was ≤ 33 USD (65.0%). Generalists, pulmonologists, ear, nose, and throat specialists, and clinic-based physicians were more likely to refrain from prescribing antivirals and favor lower treatment costs compared with physicians in other specialties or hospital settings. A multivariate analysis revealed workplace setting as the only factor independently associated with cost-related prescribing behavior. High antiviral drug costs in Japan may contribute to underprescription, particularly among clinic-based physicians, and this underprescription could hypothetically lead to delays in treatment, which might increase the risk of severe outcomes in high-risk patients. As high-risk patients with mild COVID-19 often first seek care in clinics, promoting appropriate antiviral use in these settings is essential. Strengthening communication and sharing clinical experiences between hospitals and clinics may help reduce prescribing disparities driven by drug costs.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1999-59031862026A Batch-Based VNF Deployment Mechanism for Privacy-Preserving Multi-Domain SFC Deployment Using Deep Reinforcement Learning312ENArif IndraIrawanGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYukinobuFukushimaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityFuture 6G networks require higher performance and wider service coverage. Multi-domain Service Function Chain (SFC) deployment enables service provisioning across multiple network domains to meet these demands. However, when collaboration occurs among different network operators, privacy-preserving mechanisms are required to protect sensitive information such as internal topology and resource availability. Existing SIRM-based mechanisms, such as the Privacy-Preserving Deployment Mechanism (PPDM), address this challenge but suffer from structural limitations: PPDM performs whole-chain feasibility evaluation with extensive virtual occupation. This paper proposes a ℬ-Batch Sequential Deployment mechanism for privacy-preserving multi-domain SFC deployment. Instead of evaluating whole-chain feasibility at once, the proposed ℬ-Batch mechanism partitions each incoming SFC into fixed-size VNF batches and constructs a batch-level SIRM. This design confines virtual occupation to the current batch and reduces both its magnitude and duration while remaining fully compatible with the SIRM privacy model and the hierarchical multi-domain control architecture. A Deep Q-Network (DQN) is employed to learn substrate node selection policies based solely on SIRM-based state information, without exposing domain-internal topology or resource details. Simulation results on a three-domain AARNET substrate topology demonstrate that the proposed mechanism consistently improves deployment robustness under varying traffic intensities and SFC lengths, including short (3–6 VNFs), medium (6–9 VNFs), and long (9–12 VNFs) service chains. Compared with PPDM, the proposed ℬ-Batch mechanism achieves higher acceptance ratios under moderate-to-heavy traffic while reducing end-to-end delay and improving average substrate resource utilization. Node selection analysis further shows that smaller batch sizes preserve feasibility through compact node reuse, whereas larger batch sizes encourage broader substrate exploration. Overall, the proposed ℬ-Batch mechanism enhances feasibility preservation and deployment robustness in privacy-preserving multi-domain SFC orchestration.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8032026Determination of the Side Responsible for Bilateral Pneumothorax due to Pleural Communication225228ENKenSuzawaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHaruchikaYamamotoDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKumiNakajimaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinTanakaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHidejiroTorigoeDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhikoShienDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentarohMiyoshiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMikioOkazakiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeiichiroSugimotoDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/70859Simultaneous bilateral spontaneous pneumothorax associated with pleuro-pleural communication is a rare but potentially life-threatening condition, most commonly occurring after major thoracic surgery. We report the case of an 81-year-old man with severe emphysema and a history of esophagectomy who presented with sudden-onset dyspnea. Chest computed tomography revealed bilateral pneumothorax with pleuro-pleural communication. Although bilateral chest tube drainage was performed, the primary side of air leakage could not be identified preoperatively. After induction of general anesthesia, a double-lumen endotracheal tube clamping test identified the right pleural cavity as the source of air leakage, thereby enabling appropriate thoracoscopic surgery.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8032026Common Bile Duct Stone Formed Around an Ingested Fish Bone219223ENKaitaroHigashiDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterMotoyasuTabuchiDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterShinyaSakamotoDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterShutaTamuraDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterSunaoUemuraDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterTeppeiTokumaruDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterTakehiroOkabayashiDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterCase Report10.18926/AMO/70858An 86-year-old man presented with epigastric pain. He had previously undergone distal gastrectomy with Roux-en-Y reconstruction. Computed tomography (CT) revealed a 32×17 mm common bile duct (CBD) stone with an internal 20 mm linear hyperdense component. Endoscopic removal was unsuccessful due to the size and impaction of the stone. Open choledochotomy retrieved multiple stones and a calcified fish bone, which was confirmed by infrared spectroscopy using the potassium bromide (KBr) wafer method. Although fish bone ingestion is relatively common, this case highlights that such foreign bodies can occasionally serve as a nidus for CBD stone formation, leading to unexpected and clinically significant pathologies. When CT demonstrates a linear high-attenuation intraductal structure, clinicians should suspect a bone fragment and follow a stepwise approach, considering early surgical intervention when endoscopic extraction is unsuccessful or likely to be challenging.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8032026A Novel Flap Design to Reduce Urethral Complications in Anterolateral Thigh Phalloplasty: The Pipe Flap Technique213217ENToshiroImaiDepartment of Plastic and Reconstructive Surgery, Tohoku University Graduate School of MedicineToshiyukiWatanabeDepartment of Plastic and Reconstructive Surgery, Okayama University HospitalShihoWatanabeDepartment of Plastic and Reconstructive Surgery, National Hospital Organization Tokyo Medical CenterMasanobuHayashiDepartment of Plastic and Reconstructive Surgery, Tohoku University Graduate School of MedicineYusukeTominagaDepartment of Urology, Okayama University HospitalYuzaburoNambaGender Center, Okayama University HospitalCase Report10.18926/AMO/70857Phalloplasty is one of the most challenging procedures in gender-affirming surgery, and urethral complications remain common despite numerous preventive efforts. No definitive solution has been established, and many patients still require subsequent corrective procedures. We designed a novel anterolateral thigh flap that creates a planned external fistula at the penile base to mitigate urethral complications. The fistula was closed in a second-stage procedure one year later, and the postoperative course was uneventful. We report a case of a transgender man treated with this two-stage “pipe flap” technique, resulting in satisfactory urinary function. This approach may offer a safe and less invasive option for mitigating urethral complications in phalloplasty.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8032026Evaluation of Bone Mineral Density and Bone Structure in the Cervical and Thoracic Spine203212ENShingoAoyamaDepartment of Orthopedic Surgery, Kindai University HospitalTerumasaIkedaDepartment of Orthopedic Surgery, Kindai University HospitalNobuhitoNangoRatoc System Engineering Co., Ltd.KojiGotoDepartment of Orthopedic Surgery, Kindai University HospitalOriginal Article10.18926/AMO/70856Dropped head syndrome, which has been increasingly reported in recent years, requires correction of cervical kyphosis and may require long-range fixation extending from the cervical to the thoracic spine. Assessing vertebral bone structure may be important for preventing instrumentation failure in the upper thoracic spine, which is a potential complication of surgery. In this study, we evaluated volumetric bone mineral density, trabecular bone porosity, and cortical calcification in the cervical and upper thoracic spine using three-dimensional (3D) trabecular structure measurement software. The study included 79 patients with cervical spine disorders who underwent various surgical procedures and preoperative imaging, including dual-energy X-ray absorptiometry and computed tomography (CT) scans from C3 to Th3. Quantitative analysis using specialized software assessed volumetric bone mineral density and trabecular and cortical bone parameters, and statistical analyses were performed to examine correlations between imaging metrics and indicators of bone fragility. Two-dimensional CT evaluation revealed different trends between cancellous and cortical bone in the cervical and thoracic spine, suggesting that detailed 3D evaluation may also be important.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8032026HIP COMPASS®: A Mechanical Intraoperative Navigation Guide Associated with Improved Revision-Free Implant Survivorship after Ceramic-on-Ceramic Total Hip Arthroplasty at Minimum 10-Year Follow-up195202ENYoshiakiTeiDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesNorioImaiDivision of Comprehensive Musculoskeletal Medicine, Niigata University Graduate School of Medical and Dental SciencesKeishiKimuraDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesYukiHiranoDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesYojiHorigomeDivision of Comprehensive Musculoskeletal Medicine, Niigata University Graduate School of Medical and Dental SciencesKenSudaDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesHiroyukiKawashimaDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesOriginal Article10.18926/AMO/70855HIP COMPASS® has demonstrated improved accuracy in intraoperative support for the acetabular component insertion angle. We assessed long-term revision-free implant survivorship following total hip arthroplasty (THA) using HIP COMPASS, with ≥10 years of follow-up. We retrospectively analyzed 210 hips of 186 patients who underwent cementless THA with ceramic-on-ceramic bearing couples, with or without HIP COMPASS. The mean follow-up duration was 10.8 years in the HIp COMPASS group and 12.7 years in the control group. Overall, 86.0% and 78.2% of cups were placed within Lewinnek’s safe zone with and without HIP COMPASS, respectively. Variability in radiographic inclination and anteversion was greater in the control group than in the HIP COMPASS group. Dislocation rates were 3.2% in the control group and 1.2% in the HIP COMPASS group, with no significant difference between groups. The control group had a significantly higher revision rate than the HIP COMPASS group (7.3% vs. 1.2%). Use of HIP COMPASS was associated with improved long-term revision-free implant survivorship over ≥ 10 years and more consistent acetabular component positioning at an appropriate insertion angle, which may contribute to stable initial fixation.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8032026Reducing Hesitation in Resuscitation: Educational Effects of a Female-Appearing Simulator in Basic Life Support Training185193ENTakuyaKuboDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoheiTsukaharaDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiHongoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakafumiObaraDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshinoriKosakiDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTsuyoshiNojimaDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTetsuyaYumotoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiromichiNaitoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAtsunoriNakaoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityOriginal Article10.18926/AMO/70854Women are less likely than men to receive timely defibrillation during out-of-hospital cardiac arrest. We investigated whether using a simulator that is visually modified to resemble a female affects learners’ attitudes, knowledge, and performance in basic life support (BLS) training. In a BLS simulation training, first-year medical students (n=220) used a standard gender-neutral simulator (control group) or a modified simulator with a female-like appearance (intervention group). Pre- and post-training questionnaires concerning attitudes and knowledge plus a post-training skills evaluation assessed the students’ training outcomes. The intervention group initiated chest compressions significantly faster than the control group (33.1 vs. 39.8 sec, p<0.01) and achieved a significantly higher rate of correct AED pad placement (64.2% vs. 38.5%, p<0.01). While performing the resuscitation on the female-appearing manikin, the intervention group showed significantly greater increases in self-efficacy (p<0.01) and larger decreases in discomfort about removing the patient’s clothes (p<0.01). They were also significantly more likely to recognize that chest compressions can be performed (p=0.016) and AED pads can be applied (p=0.015) without removing the patient’s underwear. Using a female-appearing simulator in BLS training was thus associated with faster chest compression initiation, more accurate AED pad placement, and improved gender-sensitive attitudes and knowledge.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8032026Oral Eicosapentaenoic Acid and Paclitaxel-Associated Peripheral Neuropathy: A Retrospective Study at Okayama University Hospital179184ENAyakoMoritaCenter for Clinical Oncology, Okayama University HospitalHidekiKatayamaCenter for Clinical Oncology, Okayama University HospitalEikiIchiharaCenter for Clinical Oncology, Okayama University HospitalYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalOriginal Article10.18926/AMO/70853This retrospective study investigated whether eicosapentaenoic acid (EPA) reduces paclitaxel-associated chemotherapy-induced peripheral neuropathy (CIPN) and acute neuropathic pain in dyslipidemic cancer patients. The medical records of cancer patients treated with paclitaxel or nab-paclitaxel at Okayama University Hospital between January 2018 and December 2022 were reviewed. Patients receiving concomitant therapy for dyslipidemia were categorized as EPA users or non-EPA users. Numbness and pain severity were extracted from medical records. The primary endpoint was the change from baseline in Common Terminology Criteria for Adverse Events (CTCAE) grade for peripheral neuropathy and pain; groups were analyzed using the Mann–Whitney U test. Of 184 eligible patients, 18 received EPA. Bleeding events were more frequent in the EPA group; however, changes in numbness and pain did not differ significantly between groups at any time point. Overall, EPA did not show a preventive effect on paclitaxel-associated CIPN or acute neuropathic pain. Future studies should evaluate EPA in combination with other neuroprotective agents to better define its potential role in CIPN prevention.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8032026Peripheral Blood T-Cell Receptor Repertoire and Host Immune Background in Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy169178ENYukiNakamuraDepartment of Breast and Thyroid Surgery, Kawasaki Medical School HospitalTakayukiIwamotoDepartment of Breast and Thyroid Surgery, Kawasaki Medical School HospitalYukikoKajiwaraDepartment of Breast Surgery, Hiroshima City Hiroshima Citizens HospitalAkiraHidaDepartment of Pathology, Matsuyama Shimin HospitalShogoNakamotoDepartment of Breast and Endocrine Surgery, Okayama University HospitalYuichiroMiyoshiDepartment of Breast Endocrine Surgery, Kagawa Prefectural Center HospitalTadahikoShienDepartment of Breast and Endocrine Surgery, Okayama University HospitalMasahikoIkedaDepartment of Breast and Thyroid Surgery, Fukuyama City HospitalHiroyoshiDoiharaDepartment of General Surgery, Kawasaki Medical School General Medical CenterRyoheiOgataDepartment of Breast and Thyroid Surgery, Kawasaki Medical School HospitalYoshikazuKoikeDepartment of Breast and Thyroid Surgery, Kawasaki Medical School HospitalTsunehisaNomuraDepartment of Breast and Thyroid Surgery, Kawasaki Medical School HospitalKatsuhiroTanakaDepartment of Breast and Thyroid Surgery, Kawasaki Medical School HospitalKazutakaNakashimaDepartment of General Surgery, Kawasaki Medical School General Medical CenterTomokiYamatsujiDepartment of General Surgery, Kawasaki Medical School General Medical CenterNarutoTairaDepartment of Breast and Thyroid Surgery, Kawasaki Medical School HospitalOriginal Article10.18926/AMO/70852The association between peripheral blood T-cell receptor (TCR) repertoire and chemotherapy response remains unclear. We evaluated peripheral blood TCR repertoire and gut microbiota in 21 breast cancer patients receiving neoadjuvant chemotherapy (NAC) who were enrolled in the SBP-14 prospective cohort study between October 2019 and March 2022. We analyzed stool samples obtained pre-NAC and peripheral blood samples obtained pre- and post-NAC. The primary endpoint was the association between baseline peripheral blood TCR repertoire and treatment response. Eleven patients (52%) had hormone receptor-positive breast cancer. All patients received anthracyclines and taxanes, with anti-HER2 therapy for HER2-positive disease. TCR diversity (TCR alpha chain [TRA], p=0.095; TCR beta chain [TRB], p=0.051) and clonality (TRA, p=0.271; TRB, p=0.500) were not significantly associated with treatment response. Gut microbiota diversity was not correlated with TCR diversity (TRA: ρ=0.046, p=0.845; TRB: ρ=0.021, p=0.929); however, three bacterial orders (Erysipelotrichales, Bacillales, and Pasteurellales) were significantly associated with TCR repertoire. Baseline TCR repertoire was not associated with treatment response in this cohort of breast cancer patients.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8032026Self-Reported Adolescent Menstrual Symptoms and Delayed Gynecologic Consultation among Japanese Women with Endometriosis159168ENTomokoIkedaFaculty of Health Sciences, Okayama UniversityMikiyaNakatsukaFaculty of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/70851Endometriosis symptoms often first appear during adolescence, yet delays in seeking gynecologic consultation remain a persistent challenge worldwide. Despite growing international evidence, the specific patterns of symptom recognition and consultation delay among Japanese women — particularly in relation to self-monitoring behaviors and cultural barriers — remain poorly understood. This study aimed to provide foundational data to guide menstrual education and preconception care strategies by conducting a cross-sectional online survey with retrospective recall among women with endometriosis to assess menstrual characteristics and symptom patterns from adolescence to initial care seeking. The survey was conducted in Japan in January 2024 and enrolled 166 women with endometriosis and 200 controls. Participants reported current and adolescent menstrual characteristics, symptom recognition, analgesic and low-dose estrogen–progestin use, school/work impact, and age at first gynecologic consultation for menstrual problems. Women with endometriosis reported heavier bleeding, stronger pain, and greater school/work absence than controls, both currently and retrospectively. The median age at first recognition of heavy bleeding or school/work absence was 16 years, whereas consultation occurred at approximately 21-23 years, indicating a consultation delay of 5-6 years. Notably, while self-monitoring of symptoms was more frequent among women with endometriosis, it only modestly shortened consultation delays. This study provides evidence from Japan that consultation delay persists despite active self-monitoring of symptoms, highlighting the influence of educational and cultural barriers on health-seeking behavior. These findings underscore the importance of integrating menstrual education with clinical guidance to promote timely gynecologic consultation.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0721-832X2026Age-related changes in the orbital pulley array of older Japanese adults with acquired exotropiaENReikaKonoDepartment of Ophthalmology,, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesIchiroHamasakiLino Eye ClinicFumikoKishimotoDivision of Ophthalmology, Ibara City HospitalKiyoShibataLino Eye ClinicShinMorisawaDepartment of Ophthalmology,, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYukiMorizaneDepartment of Ophthalmology,, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesPurpose: To evaluate age-related changes in the orbital pulley array using magnetic resonance imaging (MRI) in older Japanese adults with acquired exotropia (XT) compared with young healthy participants (YHP).<br>
Methods: In this retrospective cross-sectional case series, MRI images of 30 eyes from fifteen patients (age ≥ 60 years) with distance XT and no high myopia were compared with those of 14 eyes from seven YHP. Rectus muscle (RM) pulley positions relative to the globe center were assessed. The lateral rectus muscle–superior rectus (LR–SR) band was evaluated for rupture.<br>
Results: Mean age of patients with XT was 73.7 ± 5.5 years. Compared with YHP, patients with XT showed significant inferior displacement of the lateral rectus (LR) pulley (–3.6 ± 1.2 mm vs. − 2.0 ± 1.1 mm, p < 0.01) and temporal displacement of the superior rectus (SR) pulley (–0.4 ± 1.2 mm vs. − 1.6 ± 0.8 mm, p < 0.01). No significant differences were observed in medial rectus or inferior rectus pulley positions. Inferior LR pulley displacement correlated with inferior SR pulley displacement (r = 0.41, p = 0.03), whereas no significant relationship was observed between LR pulley position and MR or IR pulley position. Rupture of the LR–SR band was observed in 24 orbits (80.0%).<br>
Conclusion: Older Japanese adults with XT exhibit localized pulley displacement and LR–SR band rupture. These structural changes differ from the global sagging observed in sagging eye syndrome and may contribute to the pathogenesis of acquired exotropia in older adults.No potential conflict of interest relevant to this article was reported.American Physiological SocietyActa Medica Okayama0022-307713542026Characteristics of cross-modal negative BOLD responses in the human sensory subcortex and cortex747759ENToshikazuMiyataDivision of Sensory and Cognitive Brain Mapping, Department of System Neuroscience, National Institute for Physiological SciencesMasakiFukunagaSection of Brain Function Information, National Institute for Physiological SciencesJunxiangLuoDivision of Sensory and Cognitive Brain Mapping, Department of System Neuroscience, National Institute for Physiological SciencesIsaoYokoiNational Institute for Physiological SciencesTetsuyaYamamotoSection of Brain Function Information, National Institute for Physiological SciencesAyumiYoshiokaSection of Brain Function Information, National Institute for Physiological SciencesJiajiaYangGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTomoyoMoritaCenter for Information and Neural Networks (CiNet), Advanced ICT Research Institute, National Institute of Information and Communications Technology (NICT)HiromasaTakemuraDivision of Sensory and Cognitive Brain Mapping, Department of System Neuroscience, National Institute for Physiological SciencesFunctional magnetic resonance imaging (fMRI) is a noninvasive method for measuring human brain activity based on blood oxygenation level-dependent (BOLD) responses. Although many studies have reported positive BOLD responses evoked by sensory stimuli, others have reported negative BOLD responses (NBRs) in the sensory cortex when stimuli from different sensory modalities are presented (i.e., cross-modal NBRs). We conducted an fMRI experiment to better understand the characteristics of cross-modal NBRs in subcortical and cortical regions. Auditory and visual stimuli were presented unilaterally to one ear and to either the left or right visual field, respectively. The lateral geniculate nucleus and medial geniculate nucleus did not show a significant cross-modal NBR. In contrast, the primary auditory cortex showed a significant cross-modal NBR when visual stimuli were presented in either the contralateral or ipsilateral visual fields. Finally, we found that the cross-modal NBR in the early visual cortex was highly variable across subjects and did not exhibit consistent trends. However, each subject’s data exhibited considerable split-half reliability. Our results suggest that cross-modal NBR in the auditory cortex likely reflects mechanisms such as interhemispheric suppression, rather than those coordinated within the same hemisphere.<br>
NEW & NOTEWORTHY This study demonstrated that the human primary auditory cortex showed a significant cross-modal negative BOLD response bilaterally, regardless of the visual field in which the visual stimuli were presented. This result suggests that the cross-modal negative BOLD response is not an epiphenomenon of visual cortex activation predominantly observed in the contralateral hemisphere, but is more likely to reflect interhemispheric suppression mechanisms.No potential conflict of interest relevant to this article was reported.American Physiological SocietyActa Medica Okayama1040-060533052026The role of S100A8/A9 in the pathogenesis of acute exacerbations of pulmonary fibrosisL593L609ENNaokiNakamuraDepartment of Hematology, Oncology, Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHisaoHigoDepartment of Allergy and Respiratory Medicine, Okayama University HospitalSatoruSenooDepartment of Hematology, Oncology, Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAkihikoTaniguchiDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterTaichiOzekiDepartment of Hematology, Oncology, Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesRyotaSunamiDepartment of Hematology, Oncology, Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYumiInukaiDepartment of Hematology, Oncology, Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesShuseiYamamotoDepartment of Medical Laboratory Science, Okayama University Faculty of Health SciencesJunkoItanoDepartment of Hematology, Oncology, Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAyakaTanakaDepartment of Respiratory Medicine, Kurashiki Central HospitalNahokoTomonobuDepartment of Cell Biology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesRieKinoshitaDepartment of Cell Biology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasakiyoSakaguchiDepartment of Cell Biology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYoshinobuMaedaDepartment of Hematology, Oncology, Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNobuakiMiyaharaDepartment of Allergy and Respiratory Medicine, Okayama University HospitalAcute exacerbation of idiopathic pulmonary fibrosis is a life-threatening condition characterized by neutrophilic inflammation. S100A8/A9, an alarmin released by activated neutrophils and monocytes/macrophages, plays a pivotal role in regulating inflammatory responses. However, its specific involvement in acute exacerbations of pulmonary fibrosis remains unclear. This study evaluated the role of S100A8/A9 in the pathogenesis of acute exacerbations of pulmonary fibrosis. S100A8/A9 levels were measured in bronchoalveolar lavage fluid and serum from patients with idiopathic interstitial pneumonia, with and without acute exacerbations. To model acute exacerbations of pulmonary fibrosis, mice were intratracheally administered bleomycin followed by lipopolysaccharide. Subsequently, inflammatory cell infiltration, cytokine levels, morphological changes, and fibrosis marker levels in lung tissue and airways were analyzed. S100A8/A9 levels were significantly higher in the bronchoalveolar lavage fluid and serum of patients with idiopathic interstitial pneumonia experiencing acute exacerbations relative to those without; these levels were correlated with patient prognosis. In an experimental mouse model, intratracheal administration of bleomycin followed by lipopolysaccharide resulted in a significant increase in airway S100A8/A9 levels compared with bleomycin alone and control mice. Anti-S100A8/A9 neutralizing antibody Ab45 mitigated airway inflammation and lung fibrosis in mice with acute exacerbations of pulmonary fibrosis, reducing S100A8/A9 levels and neutrophil extracellular traps. In vitro, recombinant S100A8/A9 or lipopolysaccharide and neutrophils activated and differentiated fibroblasts; these effects were inhibited by anti-S100A8/A9 neutralizing antibody Ab45 and the humanized form of Ab45 (HuAb45). These findings highlight S100A8/A9 as a potential prognostic biomarker and therapeutic target for acute exacerbations of pulmonary fibrosis.No potential conflict of interest relevant to this article was reported.American Society for MicrobiologyActa Medica Okayama2576-098X1542026Draft genome sequence of blaIMP-1-carrying Phytobacter ursingii OUH-01, isolated from the feces of an acute lymphoblastic leukemia patiente0087625ENShumaTsujiDepartment of Medical Laboratory Science, Okayama University Graduate School of Health SciencesHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalShinnosukeFukushimaDepartment of Infectious Diseases, Okayama University HospitalIoriUrakamiDepartment of Medical Laboratory Science, Okayama University Graduate School of Health SciencesKazuyoshiGotohDepartment of Medical Laboratory Science, Okayama University Graduate School of Health SciencesWe report the 5.7 Mbp draft genome of carbapenem-resistant Phytobacter ursingii strain OUH-01, recovered from the feces of a patient with acute lymphoblastic leukemia. The genome comprises a chromosome (G+C content of 53.5%), three plasmids, and four linear contigs, including the 222 kb plasmid pOUH-phyto-IMP-01 carrying blaIMP-1. Nanopore/Illumina sequencing achieved 235× coverage.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1574-78912026Stimulator of interferon genes agonist augmented antitumor immunity of osimertinib in <i>Egfr</i> ‐mutated lung cancerENJunNishimuraDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTadahiroKuribayashiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJohannesBrägelmannDepartment of Translational Genomics Faculty of Medicine and University Hospital Cologne, University of Cologne GermanySachiOkawaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasatakaTaokaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuntaMoriDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokaNishimuraDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakaakiTanakaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesGoMakimotoDepartment of Respiratory Medicine, Okayama University HospitalKiichiroNinomiyaCenter for Comprehensive Genomic Medicine, Okayama University HospitalKammeiRaiCenter for Innovative Clinical Medicine, Okayama University HospitalEikiIchiharaCenter for Clinical Oncology, Okayama University HospitalRyoheiKatayamaDivision of Experimental Chemotherapy, Cancer Chemotherapy Centre, Japanese Foundation for Cancer ResearchKatsuyukiHottaCenter for Innovative Clinical Medicine, Okayama University HospitalMasahiroTabataCenter for Clinical Oncology, Okayama University HospitalYosukeTogashiDepartment of Respiratory Medicine, Okayama University HospitalYoshinobuMaedaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMartin L.SosDepartment of Translational Genomics Faculty of Medicine and University Hospital Cologne, University of Cologne GermanyKatsuyukiKiuraDepartment of Respiratory Medicine, Okayama University HospitalKadoakiOhashiDepartment of Respiratory Medicine, Okayama University HospitalEpidermal growth factor receptor (EGFR)-mutant non-small-cell lung cancers (NSCLCs) lack effective immunotherapy due to a noninflamed tumor microenvironment (TME). We previously reported that EGFR tyrosine-kinase-inhibitor (TKI) induced CD8+ T-cell immunity, which was insufficient for tumor eradication. We evaluated the potential of combining EGFR-TKI with stimulator of interferon genes (STING) agonists in activating a systemic antitumor response. Using a syngeneic mouse model of genetically engineered Egfr-mutant NSCLC, we evaluated the antitumor effects of STING agonist ADU-S100, alone and combined with osimertinib. Immunohistochemistry and flow cytometry were used to assess the TME. Osimertinib alone enhanced CD8+ T-cell infiltration but not Natural Killer (NK) cell infiltration. ADU-S100 injection alone modestly suppressed tumor growth with increasing CD8+/NK cell infiltration in the TME, but lacked an abscopal effect. Combining ADU-S100 with osimertinib significantly enhanced the antitumor effects and CD8+/NK cell infiltration. Depletion of either CD8+ or NK cells reduced the combination effect. Crucially, the combination induced an abscopal effect accompanied by PD-1+/CD8+ cell infiltration. Combining osimertinib with a STING agonist augmented innate and adaptive immunity, inducing systemic antitumor responses in EGFR-mutant NSCLC.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0950-923245182026Trisomy 8 alters chromatin conformations and activates Y chromosome genes in stem cells to drive a pre-leukemic state16751687ENJieBaiLaboratory of Transcriptional Regulation in Leukemogenesis, International Research Center for Medical Sciences, Kumamoto UniversityKimiArakiInstitute of Resource Development and Analysis, Kumamoto UniversityDaisukeKurotakiLaboratory of Chromatin Organization in Immune Cell Development, International Research Center for Medical Sciences, Kumamoto UniversityEerdundulengLaboratory of Transcriptional Regulation in Leukemogenesis, International Research Center for Medical Sciences, Kumamoto UniversitySupannikaSorinLaboratory of Transcriptional Regulation in Leukemogenesis, International Research Center for Medical Sciences, Kumamoto UniversityKeiHiramatsuDepartment of Chromosome Biomedical Engineering, Integrated Medical Sciences, Graduate School of Medical Sciences, Tottori UniversityNarumiUnoLaboratory of Bioengineering, School of Life Sciences, Tokyo University of Pharmacy and Life SciencesAiHamashimaLaboratory of Transcriptional Regulation in Leukemogenesis, International Research Center for Medical Sciences, Kumamoto UniversityMihokoIimoriLaboratory of Transcriptional Regulation in Leukemogenesis, International Research Center for Medical Sciences, Kumamoto UniversityKentaKikuchiLaboratory of Chromatin Organization in Immune Cell Development, International Research Center for Medical Sciences, Kumamoto UniversityMinoruTerashimaLaboratory of Transcriptional Regulation in Leukemogenesis, International Research Center for Medical Sciences, Kumamoto UniversityShoKubotaDepartment of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKensakuKohrogiDepartment of Pediatrics, Graduate School of Medical Sciences, Kumamoto UniversityGangHuangDepartment of Cell Systems & Anatomy, Department of Pathology & Laboratory Medicine, UT Health San Antonio, Joe R. and Teresa Lozano Long School of Medicine, Mays Cancer Center at UT Health San AntonioMinetaroOgawaDepartment of Cell Differentiation, Institute of Molecular Embryology and Genetics, Kumamoto UniversityMitsuoOshimuraChromosome Engineering Research Center, Tottori UniversityYasuhiroKazukiDepartment of Chromosome Biomedical Engineering, Integrated Medical Sciences, Graduate School of Medical Sciences, Tottori UniversityGoroSashidaLaboratory of Transcriptional Regulation in Leukemogenesis, International Research Center for Medical Sciences, Kumamoto UniversityThe mechanistic role of trisomy 8 in the development of myelodysplastic syndrome (MDS) remains poorly defined. Here, we generated a trisomy 8 mouse model by transferring a human chromosome 8 into murine embryonic stem cells and prospectively examined the effects on hematopoietic stem cells (HSC) by trisomy 8. The expression of inflammatory genes was enhanced, and hematopoietic programs mediated by transcription factors and polycomb repressive complex 2 (PRC2) were dysregulated in trisomy 8 HSC, which impaired their self-renewal and balanced differentiation. Trisomy 8 HSC altered the chromatin accessibility and conformations and activated Y chromosome genes, such as Uty/Kdm6c epigenetic modifier, which is known to demethylate histone H3K27me3 modification. The Uty gene facilitated the activation of PRC2-target and Runx1-target genes in leukemogenesis and drove the proliferation of human trisomy 8 leukemic cells. Since the RUNX1 gene is frequently mutated in patients with trisomy 8 MDS, its deletion attenuated the enhanced expression of inflammatory genes and mitigated the impaired self-renewal of trisomy 8 HSC in mice. Our findings reveal that trisomy 8 altered the transcriptional programs and chromatin conformations in HSC and drove a pre-malignant state through activating the expression of Uty, suggesting a route for the development of trisomy 8 MDS.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0951-64335232026VGLL3 Regulates DAPK2-Mediated Autophagy During Osteoblast Differentiatione70104ENYuhanHeDepartment of Oral Morphology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityZiyiWangDepartment of Molecular Biology and Biochemistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYaoWengDepartment of Oral Morphology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHeriatiSitosariDepartment of Oral Biology, Faculty of Dentistry, Universitas Gadjah MadaYilinZhengDepartment of Oral Morphology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYaxinQuDepartment of Dental Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMikaIkegameDepartment of Oral Morphology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHirohikoOkamuraDepartment of Oral Morphology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityVestigial-like family member 3 (VGLL3), a transcriptional cofactor of the TEA domain family, has been previously identified as a regulator of osteoblast differentiation. Building upon our previous findings, we investigated VGLL3 function in MC3T3-E1 osteoblasts using an integrated approach combining transcriptomic analysis and functional assays to identify its downstream effectors and explore associated autophagy mechanisms. RNA-seq analysis of Vgll3-knockdown (shVgll3) cells identified death-associated protein kinase 2 (DAPK2), a regulator of autophagy, as a downstream effector. Autophagic activity was examined using transmission electron microscopy and western blot analysis of LC3-II and p62 proteins. The effects of Dapk2 knockdown (shDapk2) on osteoblast differentiation were evaluated using qPCR, western blotting, alkaline phosphatase staining, and Alizarin Red staining. Rapamycin treatment was used to determine whether pharmacologic activation of autophagy could restore osteoblast function. Vgll3 knockdown significantly suppressed autophagic flux, as evidenced by fewer autophagic vacuoles, decreased LC3-II accumulation, and increased p62 expression. A comparable reduction in autophagic activity was observed in shDapk2 cells and was accompanied by impaired osteoblast differentiation. Rapamycin treatment partially restored autophagy and osteogenic differentiation in Vgll3-deficient cells. Finally, overexpression of DAPK2 partially rescued autophagic activity and osteogenic differentiation in shVgll3 cells, supporting its role as a key downstream functional effector. FOXM1 was further implicated as a potential transcriptional regulator contributing to DAPK2 expression. Collectively, our findings suggest that VGLL3 may influence osteogenic differentiation in osteoblasts, potentially involving DAPK2-associated autophagy.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2197-11531312026Association between discoid lateral meniscus and medial meniscus posterior root tear: A retrospective cohort studye70666ENRyosukeYamashitaDepartment of Orthopaedic Surgery, Okayama University HospitalYukiOkazakiDepartment of Orthopaedic Surgery, Okayama University HospitalKeisukeKintakaDepartment of Orthopaedic Surgery, Kochi Health Sciences CenterKokiKawadaDepartment of Orthopaedic Surgery, Okayama University HospitalToshikiKoharaDepartment of Orthopaedic Surgery, Okayama University HospitalTakayukiFurumatsuDepartment of Orthopaedic Surgery, Japanese Red Cross Okayama HospitalPurpose: Medial meniscus (MM) posterior root tear (PRT) has gained increasing attention because of its biomechanical impact and rapid progression to osteoarthritis. Identifying the risk factors for MMPRT is essential for early diagnosis. Although the discoid lateral meniscus (DLM) is a common congenital variant, no studies have reported on the relationship between MMPRT and DLM. This study aimed to examine the relationship between MMPRT and DLM.<br>
Methods: This retrospective cohort study included 94 matched knees that underwent arthroscopic surgery between 2015 and 2021 (58 with MMPRT and 36 with other MM injuries). The matching was performed according to age and sex. Morphological analysis of the lateral meniscus (LM) was performed using coronal magnetic resonance imaging (MRI). DLM was defined as an LM ratio (LM width/tibial width) > 0.20. LM width, LM ratio and DLM prevalence were compared between the two groups. In the MMPRT group, subgroup analysis compared the preoperative and 1-year postoperative clinical outcomes between patients with and without DLM.<br>
Results: The PRT group showed significantly greater LM width (12.6 ± 3.1 mm vs. 11.1 ± 2.2 mm; p = 0.03) and LM ratio (0.18 ± 0.04 vs. 0.16 ± 0.03; p = 0.01) compared with the other group. The incidence of DLM was also significantly higher in the PRT group (29.3% vs. 8.3%; p = 0.02). No significant differences in clinical scores were observed between the two subgroups either preoperatively or 1 year postoperatively. However, both groups demonstrated significant improvement in all clinical outcomes 1 year postoperatively (p < 0.01).<br>
Conclusions: DLM was significantly more prevalent in patients with MMPRT than in those with other MM injuries. Favourable clinical outcomes were achieved following pullout repair in MMPRT knees regardless of the presence of DLM.<br>
Level of Evidence: Level III, retrospective cohort study.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2041-17231712026Structural insights into YheS-mediated release of SecM-arrested ribosome4963ENKaishiIsoDepartment of Biological Sciences, Graduate School of Science, The University of TokyoTomaIkedaSchool of Life Science and Technology, Institute of Science TokyoKoheiYamasakiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYushinAndoDepartment of Biological Sciences, Graduate School of Science, The University of TokyoFumiya K.SanoDepartment of Biological Sciences, Graduate School of Science, The University of TokyoTadaomiFurutaSchool of Life Science and Technology, Institute of Science TokyoHidekiTaguchiSchool of Life Science and Technology, Institute of Science TokyoOsamuNurekiDepartment of Biological Sciences, Graduate School of Science, The University of TokyoYuheiChadaniFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityYuzuruItohDepartment of Biological Sciences, Graduate School of Science, The University of TokyoATP-binding cassette subfamily F (ABCF) proteins interact with the ribosome to resolve translation defects near the peptidyl transferase center (PTC). In Escherichia coli, four ABCF proteins (EttA, Uup, YbiT, and YheS) selectively promote translation of distinct problematic nascent peptide sequences, but their molecular mechanisms remain unclear. Here, we present a 2.8 Å cryo-EM structure of the ribosome in complex with an ATPase-deficient mutant of YheS and investigate how it releases ribosomes arrested by the SecM nascent chain. YheS binds to the ribosomal E-site via the L1 stalk, and its P-site tRNA-interaction motif (PtIM) extends toward the PTC, displacing the CCA end of the P-site tRNA. Notably, the cryo-EM density corresponding to the SecM nascent chain within the exit tunnel is largely lost upon YheS binding. These observations suggest that YheS relieves peptide sequence-dependent stalling by perturbing nascent chain-tunnel interactions through P-site tRNA relocation. Steered molecular dynamics simulations provide qualitative support for this model. Together, our findings provide mechanistic insight into a mode of arrest release distinct from the translocon-mediated release mechanism.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1755-43301862026Two-dimensional metal–organic frameworks offer all-in-one cocatalysts for photocatalytic overall water splitting10531061ENJingyanGuanDepartment of Energy and Hydrocarbon Chemistry, Graduate School of Engineering, Kyoto UniversityHajimeSuzukiDepartment of Energy and Hydrocarbon Chemistry, Graduate School of Engineering, Kyoto UniversityKazuhideKamiyaResearch Center for Solar Energy Chemistry, Graduate School of Engineering Science, The University of OsakaTakashiHaradaResearch Center for Solar Energy Chemistry, Graduate School of Engineering Science, The University of OsakaRintaroAdachiGraduate School of Natural Science and Technology, Okayama UniversityOsamuTomitaDepartment of Energy and Hydrocarbon Chemistry, Graduate School of Engineering, Kyoto UniversityHirofumiKurokawaInstitute of Multidisciplinary Research for Advanced Materials, Tohoku UniversityDaisukeUnabaraInstitute of Multidisciplinary Research for Advanced Materials, Tohoku UniversityKojiYonekuraInstitute of Multidisciplinary Research for Advanced Materials, Tohoku UniversityNaoyaFukuiResearch Institute for Science and Technology, Tokyo University of ScienceHiroakiMaedaResearch Institute for Science and Technology, Tokyo University of ScienceKunihisaSugimotoDepartment of Chemistry, Kindai UniversityYuichiYamaguchiDepartment of Applied Chemistry, Faculty of Science, Tokyo University of ScienceAkinoriSaekiInnovative Catalysis Science Division, Institute for Open and Transdisciplinary Research Initiatives, The University of OsakaAkiraYamakataGraduate School of Natural Science and Technology, Okayama UniversityAkihikoKudoDepartment of Applied Chemistry, Faculty of Science, Tokyo University of ScienceRyuAbeDepartment of Energy and Hydrocarbon Chemistry, Graduate School of Engineering, Kyoto UniversityRyotaSakamotoDepartment of Chemistry, Graduate School of Science, Tohoku UniversityPhotocatalytic overall water splitting holds great promise for sustainable hydrogen production. For overall water splitting performed by one-step excitation, both the hydrogen evolution and oxygen evolution reactions are hindered kinetically; hence, it is necessary to employ site-selective modification of photocatalysts with hydrogen-evolving and oxygen-evolving cocatalysts. However, critical challenges remain, including the need for cumbersome, multi-step photodeposition processes and durable blocking layers to inhibit the reverse reactions. Here we find a conductive, two-dimensional metal–organic framework to serve as a simple, multifunctional cocatalyst. We loaded this framework on SrTiO3:Al, an overall water-splitting photocatalyst, using a one-step self-assembly method. The framework cocatalyst promoted steady photocatalysis with an apparent quantum efficiency of 31.5% at 350 nm, free from the reverse reaction even without blocking layers. We proposed the operational principles for the cocatalyst activity using spectroscopic, electrochemical and theoretical analyses. This two-dimensional metal–organic framework offers an all-in-one approach for designing efficient and practical one-step excitation overall water-splitting systems.No potential conflict of interest relevant to this article was reported.International Institute of Anticancer ResearchActa Medica Okayama2732-7787632026Predictors for Recurrences Within One Year Following Radical Nephrectomy for Non-metastatic Renal Cell Carcinomas419427ENKENSUKEBEKKUDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTOMOAKIYAMANOIDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTATSUSHIKAWADADepartment of Urology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYUSUKETOMINAGADepartment of Urology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTAKUYASADAHIRADepartment of Urology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSATOSHIKATAYAMADepartment of Urology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTAKEHIROIWATADepartment of Urology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSHINGONISHIMURADepartment of Urology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMOTOOARAKIDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground/Aim: This study aimed to identify predictors of rapid recurrence following radical nephrectomy for non-metastatic renal cell carcinomas.<br>
Patients and Methods: Patients with non-metastatic renal cell carcinoma who underwent radical nephrectomy between 2014 and 2024 at Okayama University Hospital were included. Rapid recurrence was defined as local or distant metastasis occurring within one year after radical nephrectomy, whereas recurrences occurring beyond one year were classified as non-rapid.<br>
Results: Among a total of 194 patients, 37 (19%) experienced recurrence during a median follow-up of 37 months, with 16 (43%) being classified as experiencing rapid recurrence. The multivariate Cox hazard model revealed that microscopic venous invasion and a size of 60 mm or larger were predictors of rapid recurrence (hazard ratio=4.1, 95% confidence interval=1.5-11.4, p=0.006, and hazard ratio=8.0, 95% confidence interval=2.6-25.0, p<0.001, respectively). Dividing the entire cohort into four groups based on the presence of the two risk factors (0, 1: venous invasion, 1: tumor size, and 2), the median PFS was not estimable, 87, 67, and 7 months, respectively (p<0.001).<br>
Conclusion: Microscopic venous invasion and tumor size of 60 mm or larger were identified as independent predictors of rapid recurrence following radical nephrectomy for non-metastatic renal cell carcinoma.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1347-90322026Afatinib Overcomes Osimertinib Resistance via Egfr V804F Mutation in a Syngeneic Egfr-Mutant Lung Cancer Mouse Model117ENTakaakiTanakaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasatoFujitaniDivision of Experimental Chemotherapy, Cancer Chemotherapy Center, Japanese Foundation for Cancer ResearchMasatakaTaokaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesIwaoShimomuraDivision of Experimental Chemotherapy, Cancer Chemotherapy Center, Japanese Foundation for Cancer ResearchSachiOkawaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuntaMoriDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTadahiroKuribayashiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunNishimuraDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokaNishimuraDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAyakoMoritaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama UniversityNaofumiHaraDepartment of Hematology, Oncology and Respiratory Medicine, Okayama UniversityKiichiroNinomiyaCenter for Comprehensive Genomic Medicine, Okayama University HospitalGoMakimotoDepartment of Hematology, Oncology and Respiratory Medicine, Okayama UniversityHisaoHigoDepartment of Hematology, Oncology and Respiratory Medicine, Okayama UniversityKammeiRaiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama UniversityEikiIchiharaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama UniversityShutaTomidaCenter for Comprehensive Genomic Medicine, Okayama University HospitalKatsuyukiHottaCenter for Innovative Clinical Medicine, Okayama University HospitalYosukeTogashiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama UniversityYoshinobuMaedaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKatsuyukiKiuraDepartment of Hematology, Oncology and Respiratory Medicine, Okayama UniversityRyoheiKatayamaDivision of Experimental Chemotherapy, Cancer Chemotherapy Center, Japanese Foundation for Cancer ResearchKadoakiOhashiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama UniversityOsimertinib is the standard first-line treatment for advanced EGFR-mutant non-small cell lung cancer. However, acquired resistance invariably develops, and identifying novel resistance pathways is clinically important as a substantial portion remains undefined. We used an immunocompetent syngeneic lung cancer mouse model harboring an Egfr exon 19 deletion (mDEL tumors) to establish acquired resistance. Osimertinib-resistant tumors were generated in vivo using a drug-holiday/re-challenge protocol. The resistance mechanism was identified using Sanger sequencing, receptor tyrosine kinase arrays, and western blotting. Egfr V804F knock-in cells were generated using CRISPR/Cas9, and their sensitivity to osimertinib and afatinib was assessed in vitro and in vivo. We established two distinct osimertinib-resistant tumor lines in a syngeneic lung cancer mouse model (mDEL OsiR #1/#3). The analysis revealed an on-target secondary Egfr V804F mutation (corresponding to human EGFR V802F) in both tumor lines. Importantly, Egfr V804F knock-in cells demonstrated significant osimertinib resistance, with a 5.7–10.5-fold increase in in vitro IC50 (mean, 8.2-fold), but remained highly sensitive to afatinib. Furthermore, afatinib effectively overcame osimertinib resistance in the V804F knock-in cell-derived mouse model. Consistently, afatinib treatment resulted in marked tumor shrinkage and suppression of EGFR signaling in the established mDEL OsiR #1/#3 in vivo. These findings establish secondary Egfr V804F/EGFR V802F as an on-target osimertinib resistance mechanism, providing a preclinical rationale for evaluating afatinib in biomarker-selected patients harboring this alteration.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama2753-670X4152026Lung Segmental Perfusion Defect Is Associated With Airway Complications After Living-Donor Lobar Lung Transplantationivag139ENKentaroImanishiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeiichiroSugimotoDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTsuyoshiRyukoDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuakiTomiokaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinTanakaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenSuzawaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhikoShienDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentarohMiyoshiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMikioOkazakiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesPURPOSE: Airway complications (ACs) are potentially fatal after lung transplantation (LT). Although bronchial blood flow to the graft is supplied mainly from the pulmonary circulation after LT, lung segmental perfusion defects (LSPDs) are occasionally identified on lung perfusion scintigraphy (Q-scinti) after living-donor lobar LT (LDLLT). Lung segmental perfusion defects may impair bronchial healing and contribute to the development of ACs. This study aimed to evaluate the relationship between LSPD and AC after LDLLT.<br>
METHODS: We retrospectively reviewed 86 recipients who underwent LDLLT and 163 living donors at our institution from October 1998 to December 2023. Transplanted lungs that developed AC were classified as the AC group, whereas those without AC were classified as the non-AC group. Blood flow in the transplanted lungs was evaluated using Q-scinti after LDLLT.<br>
RESULTS: AC developed in 8 (4.9%) of 163 transplanted lungs after LDLLT. Although there were no significant differences in recipient-related variables between the 2 groups, LSPD was detected significantly more frequently in the AC group (n = 8) than in the non-AC group (n = 155) (50.0% vs 6.5%, P = .002). Furthermore, transplanted lungs showing LSPD were associated with significantly higher grades of the pulmonary interlobar fissures at the time of living-donor lobectomy (P = .025). Overall survival did not differ between patients with and without AC after LDLLT.<br>
CONCLUSIONS: LSPD on Q-scinti, which may develop in grafts with incomplete interlobar fissures during living-donor lobectomy, is associated with the development of AC after LDLLT.<br>
CLINICAL REGISTRATION NUMBER: This study was approved by the Institutional Review Board of Okayama University Hospital (approval date: August 23, 2024; 2409-027).No potential conflict of interest relevant to this article was reported.Public Library of Science (PLoS)Acta Medica Okayama1553-74042222026Octopamine signaling from clock neurons plays dual roles in Drosophila long-term memorye1012045ENYutoKurataDepartment of Biological Sciences, Tokyo Metropolitan UniversityTaishiYoshiiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTakaomiSakaiDepartment of Biological Sciences, Tokyo Metropolitan UniversityCircadian clock genes are best known for regulating circadian rhythms, but they also play crucial roles in memory processes. This suggests that memory is modulated by neural networks containing clock neurons, although the underlying mechanisms remain unclear. In Drosophila melanogaster, approximately 240 clock neurons are grouped into at least eight distinct clusters. Among them, the dorsal–lateral neurons (LNds) are required for maintaining long-term memory (LTM). In contrast, the neuropeptide Pigment-dispersing factor (Pdf), expressed in both small and large ventral–lateral neurons (s-LNvs and l-LNvs, respectively), functions as a circadian output signal and is also essential for maintaining LTM. In addition, Pdf-expressing neurons (hereafter, Pdf neurons) release neurotransmitters other than Pdf, which are involved in LTM consolidation. However, the specific transmitters used by LNds and Pdf neurons in LTM processing have remained unknown. Here, we show that octopamine signaling from LNds is essential for LTM maintenance, whereas octopamine in Pdf neurons is essential for LTM consolidation. Temporally restricted knockdown of Tyramine β hydroxylase (Tbh), the gene encoding the enzyme required for octopamine synthesis, disrupted LTM maintenance when targeted in LNds, whereas it impaired LTM consolidation when targeted in Pdf neurons. Notably, Tbh knockdown in LNds or Pdf neurons had minimal effects on circadian behavioral rhythms or sleep. These findings reveal that octopamine released from specific subtypes of clock neurons independently regulates distinct phases of LTM in Drosophila.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1422-006727112026Rice Genotype-Dependent Phyllosphere Microbiome Assembly and Isolation of Antagonistic Burkholderia for Sheath Blight Biocontrol4879ENAndrewsDanso OforiState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityZohrehNasimiState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityMuhammad IrfanAhmedState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityYaotingYanState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityWangLiState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityAbdul GhaniKandroState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityKazunoriOkadaAgro-Biotechnology Research Center, The University of TokyoKeiichiMochidaBioproductivity Informatics Research Team, RIKEN Center for Sustainable Resource ScienceYoshiteruNoutoshiGraduate School of Environmental and Life Science, Okayama UniversityAipingZhengState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityRice sheath blight (RSB), caused by Rhizoctonia solani, causes 10–50% yield losses globally. Using 16S rRNA sequencing of 100 rice cultivars, we found that resistant varieties harbor significantly more diverse bacterial communities (3230 OTUs; 2064 unique) than susceptible cultivars (599 OTUs; 36 unique). Resistant varieties were enriched in beneficial Burkholderiaceae, Bacillaceae, and Pseudomonadaceae, while Sphingobacteriaceae and Enterobacteriaceae were predominant in the susceptible rice varieties. From the 260 bacterial isolates, Burkholderia vietnamiensis J14EPLEAF2 presented potent antifungal activity (77% inhibition), suppressed lesion development, and abolished sclerotia formation. This strain displayed multiple plant growth-promoting traits, enhanced seed germination, and primed defense responses by upregulating PR5 and PR10. Hypersensitive response assays confirmed B. vietnamiensis as non-pathogenic, unlike B. gladioli and B. cepacia. This study identifies B. vietnamiensis J14EPLEAF2 as a promising, safe biocontrol agent for sustainable rice disease management.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1422-006727112026Genomic Basis of Lifestyle Divergence in Rice-Associated Burkholderia: From Pathogenesis to Plant Growth Promotion4730ENAndrews DansoOforiState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityZohrehNasimiState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityFrank KwekucherAckahDepartment of Crop Science, School of Agriculture and Natural Sciences, University of Cape CoastMuhammad IrfanAhmedState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityYaotingYanState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityWangLiState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityAbdul GhaniKandroState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityKazunoriOkadaAgro-Biotechnology Research Center, The University of TokyoKeiichiMochidaBioproductivity Informatics Research Team, RIKEN Center for Sustainable Resource ScienceYoshiteruNoutoshiGraduate School of Environmental and Life Science, Okayama UniversityAipingZhengState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityThe genus Burkholderia encompasses both plant pathogenic and beneficial species, yet the genomic determinants underlying this lifestyle divergence remain poorly understood. Using 16S rRNA sequencing of 100 rice cultivars, our companion study demonstrated that resistant varieties are enriched in beneficial Burkholderiaceae, leading to the isolation of three phenotypically contrasting strains. Here, we present comparative genomic analyses of non-pathogenic biocontrol strain Burkholderia vietnamiensis J14EpLeaf2 and pathogenic strains Burkholderia gladioli A1EpSeed5 and Burkholderia cepacia J14Eple. Pathogenic strains possess significantly larger genomes (8.36–8.46 Mb) enriched in mobile genetic elements compared to the streamlined 6.95 Mb genome of B. vietnamiensis. CAZyme analysis revealed broader repertoires of glycoside hydrolases and polysaccharide lyases in pathogens, consistent with enhanced plant cell wall degradation. B. gladioli possesses a complete T3SS and expanded T6SS with 301 predicted effectors, while B. cepacia lacks structural T3SS genes but harbors 271 candidate effectors predicted to be secreted via alternative secretion pathways, compared to 180 in B. vietnamiensis. Notably, B. cepacia harbors cystic fibrosis-associated markers (cable pili, ZmpA/ZmpB), raising significant biosafety concerns that preclude its agricultural application. LC-MS validated IAA, ornibactin, and AHL production in B. vietnamiensis, supporting its plant growth-promoting and biocontrol functions. Computational PPI networks predicted distinct interaction landscapes requiring experimental validation. This study provides a genomic framework for distinguishing pathogenic from beneficial Burkholderia and supports B. vietnamiensis as a safe biocontrol agent while cautioning against B. cepacia J14Eple.No potential conflict of interest relevant to this article was reported.Frontiers Media SAActa Medica Okayama1664-2392172026Behavior of serum thyroglobulin in relation to thyroid function under low-thyrotropin conditions in general practice17568631756863ENYosukeSazumiDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiakiSoejimaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroNakanoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoichiroYamamotoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsuhitoSuyamaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyosukeTakaseDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiOguniDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMihoYasudaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasanoriFurukawaDepartment of Laboratory Medicine, Okayama University HospitalFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesIntroduction: Serum thyroglobulin (Tg) and thyroid hormones are essential biomarkers in the diagnosis and management of thyroid diseases. Although Tg is routinely measured as a marker for thyroid neoplasia and an adjunct in the diagnosis of thyrotoxicosis due to destructive thyroiditis, its clinical significance under conditions of abnormal thyroid function remains unclear.<br>Methods: We investigated the association between serum Tg levels and thyroid function in 292 patients who underwent simultaneous evaluation of serum Tg, free thyroxine (FT4), and free triiodothyronine (FT3) levels in routine clinical practice. Based on thyroid-stimulating hormone (TSH) levels, participants were classified into three groups: high-TSH (> 4.23 μIU/mL; n = 38), normal-TSH (0.61–4.23 μIU/mL; n = 191), and low-TSH (< 0.61 μIU/mL; n = 63).<br>Results: The low-TSH group exhibited significantly higher serum Tg levels (118.66 ± 32.13 ng/mL) than the normal-TSH (70.20 ± 23.48 ng/mL) and high-TSH (34.70 ± 13.62 ng/mL) groups. Among patients positive for TSH-receptor antibodies (TRAb) or thyroid-stimulating antibodies (TSAb), elevated Tg levels were observed exclusively in the low-TSH group. Correlation analyses revealed that Tg levels were positively correlated with the FT3/FT4 ratio in the low-TSH group (rho = 0.62, p < 0.01), and this association was more evident in patients positive for both TRAb and TSAb (rho = 0.71, p < 0.01). These associations remained significant after multivariable adjustment and were supported by correlations between Tg and SPINA-GD, a model-based index of thyroid function reflecting deiodinase activity, with similar findings observed in patients with autoimmune hyperthyroidism.<br>Conclusion: These findings suggest that serum Tg levels may reflect biochemical features consistent with T3 predominance in autoimmune hyperthyroidism and have potential clinical utility in characterizing disease pathophysiology.
No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1877-959X1732026Epidemiological and molecular characteristics of human-biting ticks in areas endemic to Japanese spotted fever: a prospective study102635ENShinnosukeFukushimaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroshiSunamiSumiyoshi Fujii HospitalYasuhiroNakanoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaNakamotoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHidemasaAkazawaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshimiHidaniNumakuma HospitalKoujiKidaOkayama Prefectural Institute for Environmental Science and Public HealthGoTsurumiOkayama Prefectural Institute for Environmental Science and Public HealthHideharuHagiyaTick-borne diseases (TBDs) have become a great health concern worldwide. This study aimed to clarify the pathogenic and potentially pathogenic microorganisms carried by ticks that bite humans and to assess the risk of acquiring tick-borne infections in regions endemic for Japanese spotted fever. Tick specimens were prospectively collected from patients who presented with tick bites at 10 medical institutions in the Hiroshima, Okayama, and Kagawa prefectures, Japan between May 2023 and December 2024. The evaluated parameters included the estimated bite location, date of bite, patient age, tick species identification, and presence of TBD-associated pathogens in the collected ticks. Overall, 191 ticks were collected from 181 patients. Among patients with known sex, females were slightly more prevalent than males, and 45.9% of the patients were aged ≥ 70 years. Seasonal distribution demonstrated a peak incidence from April to July, with the highest number of cases observed in June (29.3%). Amblyomma testudinarium was the predominant species, accounting for 152 (79.6%) ticks, followed by Haemaphysalis hystricis (7.3%) and Haemaphysalis longicornis (6.8%). Nymphs represented the majority (83.8%), whereas adults and larvae accounted for 14.6% and 1.0%, respectively. A total of 27 ticks (14.1%) carried Rickettsia species, including two identified species (Rickettsia tamurae and Rickettsia monacensis) and one unclassified Rickettsia species. However, molecular analysis did not detect any known human pathogenic organisms, including Ehrlichia and Anaplasma species, Francisella tularensis, or Rickettsia japonica. Further epidemiological data regarding the abundance of tick-borne pathogens will provide valuable surveillance information with significant clinical utility for disease diagnosis and management.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1068-92653352026Novel Arterial Reconstruction of the Left Gastric Artery Supplying the Replaced Left Hepatic Artery in Distal Pancreatectomy with Celiac Axis Resection41184121ENKoseiTakagiDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineAteneItoDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTomokazuFujiDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKazuyaYasuiDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTakeyoshiNishiyamaDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineYasuoNagaiDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineShoheiYokoyamaDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineBackground. Distal pancreatectomy with celiac axis resection (DP-CAR) with reconstruction of the left gastric artery (LGA) is a technically challenging procedure. The middle colic artery is commonly used for LGA reconstruction. This study highlights our novel arterial reconstruction of the LGA using the common hepatic artery (CHA) supplying the replaced left hepatic artery (rLHA) during DP-CAR.<br>
Patient and Methods. A 65-year-old man diagnosed with locally advanced unresectable pancreatic body cancer underwent DP-CAR following systemic chemotherapy. As a rLHA arising from the LGA was present, arterial reconstruction was necessary.<br>
Results. After confirming resectability, the CHA and LGA were encircled. Following division of the pancreas and radical lymphadenectomy, the origin of the celiac axis (CA) was divided. Subsequently, the CHA and LGA were transected and anastomosed. An indocyanine green fluorescence system was used to confirm adequate arterial blood supply and satisfactory tissue perfusion. Operative time was 215 min, with an estimated blood loss of 35 mL.<br>
Conclusions. This study demonstrated a novel arterial reconstruction of the LGA supplying the rLHA during DP-CAR. The CHA may be a candidate for the reconstruction of the LGA in DP-CAR.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1432-12624112026Navigating long-term patient-reported outcomes after colorectal cancer surgery in older adults: ostomy, nutritional status, and living conditions as determinants in a prospective cohort study97ENFuminoriTeraishiDepartment of Gastroenterological Surgery, Okayama University HospitalShioriItagakiPerioperative Management Center, Okayama University HospitalToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Medical Development Field, Okayama UniversityRieTamuraPerioperative Management Center, Okayama University HospitalYoshikazuMatsuokaPerioperative Management Center, Okayama University HospitalRyoheiShojiDepartment of Gastroenterological Surgery, Okayama University HospitalNobuhikoKanayaDepartment of Gastroenterological Surgery, Okayama University HospitalYukiMatsumiDepartment of Gastroenterological Surgery, Okayama University HospitalYoshitakaKondoDepartment of Gastroenterological Surgery, Okayama University HospitalKunitoshiShigeyasuDepartment of Gastroenterological Surgery, Okayama University HospitalToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University HospitalPurpose To elucidate determinants of long-term patient-reported outcomes (PROs) following colorectal cancer (CRC) surgery in older adults, focusing on the impact of ostomy creation, nutritional status, and living conditions on functional independence and quality of life (QoL).<br>
Methods This single-center, prospective observational study included patients aged ≥ 75 years who underwent elective CRC resection between July 2020 and December 2023. Comprehensive geriatric assessments were performed preoperatively, and PROs—including Instrumental Activities of Daily Living (IADL), EQ-5D, and EQ-VAS—were reassessed more than one year postoperatively. The primary outcomes were postoperative changes in IADL and QoL. Modified Poisson regression identified independent determinants of long-term decline in each PRO domain.<br>
Results Sixty patients (median age 79 years; 60% female) completed one-year follow-up. IADL declined in 35.6% of patients, EQ-5D in 26.6%, and EQ-VAS in 43.3%. Multivariate analysis revealed that stoma formation was independently associated with IADL decline (adjusted RR = 3.37, 95% CI 1.50–7.54, p = 0.003), whereas living alone postoperatively correlated with preserved IADL (adjusted RR = 0.14, 95% CI 0.02–0.87, p = 0.035). Low preoperative BMI (< 20 kg/m2) was significantly associated with EQ-5D deterioration (adjusted RR = 5.25, 95% CI 1.20–22.94, p = 0.027). No significant predictors were identified for EQ-VAS decline.<br>
Conclusion Among older CRC patients, stoma creation predicts long-term functional decline, while low BMI predicts QoL deterioration. Conversely, independent living appears protective for functional maintenance. Integrating PROs into perioperative assessment and tailoring surgical, nutritional, and social interventions may enhance survivorship outcomes in this aging population.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2072-66941872026Predictive Nomogram for Recurrence After Upfront Surgery for Resectable Pancreatic Ductal Adenocarcinoma: A Multicenter Study (OS-HBP-2)1181ENRyuichiYoshidaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKoseiTakagiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuyaYasuiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasayoshiHiokiDepartment of Surgery, Fukuyama City HospitalTakehiroOkabayashiDepartment of Surgery, Kochi Health Sciences CenterToruKojimaDepartment of Surgery, Okayama Saiseikai General HospitalYoshikatsuEndoDepartment of Surgery, Himeji Red Cross HospitalDaisukeNobuokaDepartment of Surgery, Fukuyama City HospitalKentaSuiDepartment of Surgery, Kagawa Prefectural HospitalMasaruInagakiDepartment of Surgery, National Hospital Organization Fukuyama Medical CenterSusumuShinouraDepartment of Surgery, Tsuyama Chuo HospitalMasashiKimuraDepartment of Surgery, Matsuyama Shimin HospitalTatsuoMatsudaDepartment of Surgery, Tenwakai Matsuda HospitalHidekiAokiDepartment of Surgery, National Hospital Organization Iwakuni Clinical CenterToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground/Objectives: Postoperative recurrence is a critical issue in the treatment of resectable pancreatic ductal adenocarcinoma (rPDAC). Moreover, the prognosis after early recurrence is extremely poor. This study aimed to develop a recurrence prediction model and to define early recurrence after upfront surgery (UFS) for rPDAC. Methods: This multicenter retrospective study included patients who underwent UFS for anatomically rPDAC between January 2013 and December 2017. Multivariate analyses were conducted to identify the risk factors for recurrence-free survival and to construct a recurrence prediction model. Subsequently, a minimum p value approach was used to determine the optimal cutoff values for early and late recurrence. Results: The cohort included 603 patients (325 men and 278 women). During the median follow-up period of 25 months (interquartile range, 15–38 months), 381 patients (63.2%) experienced a recurrence. Multivariate analyses revealed carbohydrate antigen 19-9 ≥37 U/mL (hazard ratio [HR], 1.58; p < 0.001), tumor size ≥ 2.2 cm (HR, 1.59; p < 0.001), lymph node metastasis (HR, 1.86; p < 0.001), R1 resection (HR, 1.56; p = 0.002), and no adjuvant chemotherapy (HR, 1.54; p < 0.001) as independent predictors. The recurrence prediction model demonstrated an area under the curve of 0.72–0.75. The optimal threshold for early and late recurrences was a recurrence-free interval of five months. Carbohydrate antigen 19-9 ≥ 156 U/mL was a significant predictor of early recurrence (OR, 3.28; p < 0.001). Conclusions: This study identified the prognostic risk factors for recurrence and developed a recurrence prediction model for patients undergoing UFS for rPDAC. Moreover, a recurrence-free interval of five months was identified as the optimal threshold for distinguishing between early and late recurrences.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2072-66941842026Outcomes After Robot-Assisted Versus Open Pancreatoduodenectomy: A Propensity Score-Matching Analysis in a High-Volume Center (TAKUMI-7)602ENKoseiTakagiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTomokazuFujiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuyaYasuiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYuzoUmedaDepartment of Hepatobiliary Pancreatic Surgery, Ehime University Graduate School of MedicineRyuichiYoshidaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMotohikoYamadaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakeyoshiNishiyamaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYasuoNagaiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAteneItoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNaohiroOkadaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesShoheiYokoyamaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground/Objectives: Although the safety and feasibility of robot-assisted pancreatoduodenectomy (RPD) compared to open pancreatoduodenectomy (OPD) have been reported, studies investigating the advantages of RPD remain limited. Moreover, only a few studies have investigated the effects of robotic surgery on textbook outcomes (TO). Methods: This single-center retrospective study included 400 patients who underwent RPD and OPD at our institution between January 2017 and December 2025. Outcomes were compared between the RPD (n = 162) and OPD (n = 238) groups using propensity score-matching (PSM) analysis. The factors associated with TO were examined. Results: Before PSM, significant differences were observed between the groups. PSM yielded RPD (n = 117) and OPD (n = 117) with equal preoperative factors. The RPD group demonstrated a significantly shorter operative time (402 vs. 444 min, p < 0.001), lesser blood loss (75 vs. 270 mL, p < 0.001), shorter postoperative hospital stays (13 vs. 22 days, p < 0.001), and fewer major complications (17.1 vs. 44.4%, p < 0.001), resulting in a higher TO achievement rate (76.9 vs. 52.1%, p = 0.001). Adjusted multivariate analyses identified robotic surgery (odds ratio 3.04, p < 0.001) as an independent predictor of TO. Conclusions: This study demonstrated that RPD was potentially superior to OPD in terms of short-term outcomes. Robotic surgery was significantly associated with TO after pancreatoduodenectomy at the expert’s hand.No potential conflict of interest relevant to this article was reported.International Institute of Anticancer ResearchActa Medica Okayama0258-851X4012026Modified Subtraction Technique for the Middle Hepatic Vein Tributary and Glissonean Pedicle in Right Lobe Graft Procurement349354ENKOSEITAKAGIDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTOMOKAZUFUJIDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKAZUYAYASUIDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTAKEYOSHINISHIYAMADepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYASUONAGAIDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSHOHEIYOKOYAMADepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYUZOUMEDADepartment of Hepatobiliary Pancreatic Surgery, Ehime University Graduate School of MedicineTOSHIYOSHIFUJIWARADepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground/Aim: The procurement of right lobe grafts while preserving the middle hepatic vein (MHV) tributaries (V5 and V8) just before graft retrieval is technically challenging. Moreover, the safe isolation of the hepatic duct from the Glissonean pedicle is essential in living donor hepatectomy. To date, few studies have reported surgical techniques for preserving the MHV tributaries during right lobe graft procurement.<br>
Patients and Methods: This report presents our modified subtraction technique for managing the MHV tributaries and Glissonean pedicle during right lobe graft procurement. First, a subtraction technique for the MHV tributaries was initiated by isolating the right Glissonean pedicle. The lower tip of the tape was placed behind the caudate lobe and passed behind the right hepatic vein. Each end of the tape was then passed behind V5 and V8, followed by dissection of the remaining liver parenchyma between them. Subsequently, a subtraction technique for the Glissonean pedicle was applied to safely isolate the right hepatic duct and hilar plate.<br>
Results: Between September 2011 and May 2025, seven donors underwent right lobe graft procurement using the subtraction technique for the middle hepatic vein tributaries. The mean operative time was 381 min with an estimated blood loss of 217 ml. Using the subtraction technique, all middle hepatic vein tributaries were preserved just before graft retrieval.<br>
Conclusion: This study presents subtraction techniques used during living donor hepatectomy. The technique may facilitate liver parenchyma dissection while preserving MHV tributaries just before graft retrieval and isolating the Glissonean pedicle.No potential conflict of interest relevant to this article was reported.International Institute of Anticancer ResearchActa Medica Okayama0258-851X4032026Impact of Donor Cirrhosis Outcome Risk Estimator (CORE) Score on Recipient Outcomes Following Living-donor Liver Transplantation15701576ENKOSEITAKAGIDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTOMOKAZUFUJIDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKAZUYAYASUIDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTAKEYOSHINISHIYAMADepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYASUONAGAIDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNAOHIROOKADADepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSHOHEIYOKOYAMADepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTOSHIYOSHIFUJIWARADepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground/Aim: Several studies have investigated predictive factors for outcomes of living-donor liver transplantation (LDLT). However, few have examined the clinical significance of the Cirrhosis Outcome Risk Estimator (CORE) score on prognosis following LDLT. This study aimed to investigate the impact of donor CORE scores in predicting the outcomes of patients undergoing LDLT.<br>
Patients and Methods: This single-center retrospective study included 362 adult LDLT recipients at our Institution between January 1998 and December 2024. Patient and graft survival rates were compared between the groups with low (≤0.05) and high (>0.05) CORE scores. Subsequently, multivariate analyses were performed to investigate prognostic factors for survival, including the CORE score.<br>
Results: Patients in the group with a low CORE score had significantly better survival (p=0.001; 5-year, 85.3% vs. 76.2%) and graft survival (p=0.001; 5-year, 84.1% vs. 74.6%) than those with a high CORE score. Multivariate analyses identified the CORE score (>0.05) as an independent predictor of patient survival (hazard ratio=1.70, 95% confidence interval=1.01-2.62, p=0.018) and graft survival (hazard ratio=1.66, 95% confidence interval=1.07-2.57, p=0.024).<br>
Conclusion: This study demonstrated the clinical significance of donor CORE scores in recipient outcomes after LDLT. Assessment of the donor CORE score may be useful for evaluating the quality of liver grafts and estimating recipient outcomes.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2072-669417222025Prognosis Prediction Model After Upfront Surgery for Resectable Pancreatic Ductal Adenocarcinoma: A Multicenter Study (OS-HBP-2)3694ENKoseiTakagiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityRyuichiYoshidaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityKazuyaYasuiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityMasayoshiHiokiDepartment of Surgery, Fukuyama City HospitalTakehiroOkabayashiDepartment of Surgery, Kochi Health Sciences CenterToruKojimaDepartment of Surgery, Okayama Saiseikai General HospitalYoshikatsuEndoDepartment of Surgery, Himeji Red Cross HospitalDaisukeNobuokaDepartment of Surgery, Fukuyama City HospitalKentaSuiDepartment of Surgery, Kagawa Prefectural HospitalMasaruInagakiDepartment of Surgery, National Hospital Organization Fukuyama Medical CenterSusumuShinouraDepartment of Surgery, Tsuyama Chuo HospitalMasashiKimuraDepartment of Surgery, Matsuyama Shimin HospitalTatsuoMatsudaDepartment of Surgery, Tenwakai Matsuda HospitalHidekiAokiDepartment of Surgery, National Hospital Organization Iwakuni Clinical CenterToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityBackground/Objectives: Upfront surgery (UFS) remains the standard treatment for patients with resectable pancreatic ductal adenocarcinoma (PDAC). We aimed to investigate the prognostic factors for survival after UFS in patients with resectable PDAC and to develop a prognostic prediction model. Methods: This multicenter, retrospective study included 603 patients who underwent UFS for resectable PDAC between January 2013 and December 2017. Univariate and multivariate analyses were performed to identify prognostic factors for overall survival (OS). We constructed a prognostic prediction model for OS after UFS. An internal validation was performed to evaluate the discriminative performance of the model. Results: The 1-, 3-, and 5-year OS rates were 83.7%, 48.2%, and 37.5%, respectively. The Cox proportional hazards model showed that tumor size > 2 cm (hazard ratio [HR] 1.50, p = 0.001); tumor contact with the portal and superior mesenteric veins of ≤180° (HR 1.47, p = 0.003); carbohydrate antigen 19-9 levels of 40 to 500 U/mL (HR 1.59, p = 0.002) and ≥500 U/mL (HR 2.16, p < 0.001); and a modified Glasgow Prognostic Score of two (HR 1.56, p = 0.038) were predictors associated with OS. The prognostic prediction model for 5-year OS demonstrated an area under the curve of 0.68. The calibration plots indicate a concordance index of 0.63. Conclusions: We identified the preoperative prognostic factors for OS and developed a prognostic prediction model to estimate OS in patients undergoing UFS for resectable PDAC. Our model may be useful and internally validated for predicting OS.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1868-697432112025Risk Factors and Strategies for Failure to Rescue Following Hepatectomy: A Review801809ENJiroKimuraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKoseiTakagiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTomokazuFujiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuyaYasuiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakeyoshiNishiyamaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesFailure to rescue (FTR), defined as mortality after major postoperative complications, is a crucial indicator of surgical quality. Although mortality rates after hepatectomy have declined owing to improved surgical techniques and perioperative care, FTR remains a major concern. This review synthesizes the current evidence on the risk factors contributing to FTR after hepatectomy and explores multidisciplinary strategies to reduce its rate. Post-hepatectomy liver failure, hemorrhage, bile leakage, and sepsis commonly precede FTR. Risk factors for FTR are multifactorial and include patient-, procedure-, and system-related factors. Higher procedural volumes are associated with lower FTR rates, likely due to better infrastructure, experienced personnel, and access to rapid interventions. Strategies to reduce the FTR rate include preoperative optimization, intraoperative precision, and vigilant postoperative surveillance. System-level approaches, such as multidisciplinary rounds, standardized escalation protocols, and a robust institutional safety culture, are also pivotal. Future innovations, such as predictive analytics, artificial intelligence, and wearable monitoring devices, offer considerable potential for the early detection of complications. Centralization of complex liver surgeries to high-volume centers is recommended to enhance team preparedness. This review emphasizes the importance of adopting a comprehensive, proactive, and technologically integrated approach to reduce the FTR rate after hepatectomy and improve patient survival.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2072-669417182025Outcomes of Robotic Pancreatectomy in the Octogenarian: A Multicenter Retrospective Cohort Study3038ENKoseiTakagi Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityYuichiroUchida Department of Surgery, Fujita Health UniversityTomokazuFuji Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTakeshiTakahara Department of Surgery, Fujita Health UniversityKazuyaYasui Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTakeyoshiNishiyama Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityIchiroUyama Department of Advanced Laparoscopic and Robotic Surgery, Fujita Health UniversityKoichiSuda Department of Surgery, Fujita Health UniversityToshiyoshiFujiwara Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityBackground/Objectives: Due to the increasing incidence of pancreatic and periampullary cancers with advancing age, coupled with the growing evidence supporting minimally invasive pancreatectomy, the demand for such procedures is rising. However, data on the feasibility of robotic pancreatectomy in octogenarian patients remain scant. This study aimed to investigate overall outcomes of robotic pancreatectomy and evaluate its safety and feasibility in octogenarian patients. Methods: A multicenter, retrospective study was conducted, including 380 patients who underwent robotic pancreatectomy at two high-volume centers in Japan from April 2020 to December 2024. Using prospectively collected data, we compared outcomes between younger patients (<80 years) and octogenarian patients (≥80 years). Multivariable logistic regression analyses were performed to assess the impact of age on postoperative outcomes. Results: Among the 380 patients, with a median age of 72 (interquartile range: 61–77) years, 213 underwent robotic pancreatoduodenectomy (RPD), and 167 underwent robotic distal pancreatectomy (RDP). Octogenarian patients were found to have more comorbidities and a higher incidence of malignant diseases. Octogenarians experienced significantly longer hospital stays post-RPD (22 [octogenarian; n = 36] vs. 14 [younger; n = 177] days, p < 0.001) and post-RDP (14 [n = 23] vs. 10.5 [n = 144] days, p = 0.02), yet their perioperative outcomes were comparable. Multivariable analyses indicated that age (≥80 years) was not a significant risk factor for major complications following robotic pancreatectomy (odds ratio, 1.33; 95% confidence interval, 0.59–2.84; p = 0.479). Conclusions: This multicenter study conducted at high-volume centers suggests that robotic pancreatectomy can be safely performed in carefully selected octogenarian patients.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1068-92653372026Association of Preoperative Inspiratory Muscle Weakness and Respiratory Sarcopenia with Postoperative Pneumonia Following Esophagectomy: A Multicenter Retrospective Cohort Study62966305ENKazukiOkuraDepartment of Rehabilitation Medicine, Akita University HospitalTomohiroIkedaDepartment of Rehabilitation Medicine, Okayama University HospitalHirokiSatoDepartment of Rehabilitation, Kawasaki University of Medical WelfareShoKatayamaDepartment of Rehabilitation Medicine, Okayama University HospitalYusukeTakahashiDepartment of Rehabilitation Medicine, Akita University HospitalYushiNagakiDepartment of Esophageal Surgery, Akita University HospitalAkiyukiWakitaDepartment of Esophageal Surgery, Akita University HospitalNaoakiMaedaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShunsukeTanabeDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshinoriFujiwaraDepartment of Digestive Surgery, Kawasaki Medical SchoolKazuhiroNomaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYusukeSatoDepartment of Esophageal Surgery, Akita University HospitalYujiKasukawaDepartment of Rehabilitation Medicine, Akita University HospitalNaohisaMiyakoshiDepartment of Rehabilitation Medicine, Akita University HospitalBackground Esophagectomy is associated with a high rate of postoperative pneumonia, which significantly impacts patient outcomes, including survival and quality of life. While some modifiable risk factors have been identified, the specific role of preoperative respiratory muscle function remains to be fully elucidated. Therefore, this study was designed to investigate the association of preoperative inspiratory muscle weakness (IMW) and respiratory sarcopenia (RS) with postoperative pneumonia in patients with esophageal cancer who underwent esophagectomy.<br>
Methods Patients with esophageal cancer who underwent esophagectomy between July 2021 and June 2023 were enrolled in this multicenter, retrospective, cohort study. The primary outcome was postoperative pneumonia, while preoperative IMW and RS were the main exposures. Respiratory sarcopenia was defined as the presence of both IMW and low skeletal muscle mass, which is assessed by using bioelectrical impedance analysis. Associations were analyzed by using G-computation within a Bayesian framework.<br>
Results A total of 213 patients were enrolled in this study. Postoperative pneumonia occurred in 42 patients (19.7%). Preoperative IMW was strongly associated with an increased risk of pneumonia, with a mean risk difference (RD) of 18.1% (95% credible interval [CrI] 5–33.6). The posterior probability that the RD exceeds 5% was > 98%. Respiratory sarcopenia also showed a potential association, although with greater uncertainty (mean RD, 11.2%; 95% CrI − 3.8 to 27.9). The posterior probability that the RD exceeds 5% was 76.7%.<br>
Conclusions Preoperative IMW is a notable risk factor for postoperative pneumonia following esophagectomy. While a potential link with RS was found, its role remains uncertain and requires further investigation.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1347-90322026Atezolizumab + Chemotherapy in Older Patients With Lung Cancer in Japan113ENJunichiShimizuDepartment of Thoracic Oncology, Aichi Cancer Center HospitalMakotoNishioDepartment of Thoracic Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer ResearchKadoakiOhashiDepartment of Respiratory Medicine, Okayama University HospitalAtsushiOsoegawaDepartment of Thoracic and Breast Surgery, Oita University Faculty of MedicineEikiKikuchiDepartment of Respiratory Medicine, Faculty of Medicine, Hokkaido UniversityHideharuKimuraDepartment of Respiratory Medicine, Kanazawa University HospitalYasushiGotoDepartment of Thoracic Oncology, National Cancer Center HospitalEisakuMiyauchiDepartment of Respiratory Medicine, Tohoku University HospitalHiroshigeYoshiokaDepartment of Thoracic Oncology, Kansai Medical UniversityIchiroYoshinoInternational University of Health and Welfare Narita HospitalToshihiroMisumiDepartment of Data Science, National Cancer Center Hospital EastKozoYoshimoriDepartment of Clinical Oncology, Japan Anti‐Tuberculosis Association, Fukujuji HospitalKazuhikoShibataDepartment of Medical Oncology, Kouseiren Takaoka HospitalTakeshiTsudaDivision of Respiratory Medicine, Toyama Prefectural Central HospitalMasahiroSeikeDepartment of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical SchoolTakahiroOtaDepartment of Respiratory Medicine, Kyoto City HospitalKoichiSamataChugai Pharmaceutical Co., Ltd. YukiKobayashiChugai Pharmaceutical Co., Ltd.MisaTanakaChugai Pharmaceutical Co., Ltd. AkihikoGemmaNippon Medical SchoolPivotal phase 3 trials leading to the approvals of atezolizumab─chemotherapy combinations for non-small cell and extensive-stage small cell lung cancer (NSCLC and ES-SCLC) had strict eligibility criteria. J-TAIL-2 was a prospective, observational study in Japan that evaluated atezolizumab regimens for advanced NSCLC/ES-SCLC, including patients ineligible for global trials. The primary endpoint was 12-month overall survival (OS); safety and efficacy in subgroups defined by age, ECOG PS and/or G8 score, and creatinine clearance were key secondary endpoints. As of February 3, 2023, 1217 patients were treated in clinical practice based on Japanese labeling/treatment guidelines. Patients received atezolizumab with either carboplatin and nab-paclitaxel (atezo + CnP), carboplatin/cisplatin and pemetrexed (atezo + PP), or bevacizumab and carboplatin and paclitaxel (atezo + bev + CP) in the NSCLC cohort (n = 814) or with carboplatin and etoposide (atezo + CE) in the ES-SCLC cohort (n = 403). Overall, 53.5% were ≥ 70 years old, and 11.8% had ECOG PS ≥ 2; median G8 scores were 13 (NSCLC cohort) and 12 (ES-SCLC). Patients < 70 and ≥ 70 years had similar median (m)OS and progression-free survival (mPFS) across treatment regimens. Patients with ECOG PS < 2 and G8 score ≥ median had the highest mOS/PFS vs. patients with ECOG PS ≥ 2 and G8 score<median. Patients ≥ 70 years had higher incidence of Grade ≥ 3 adverse events with atezo + CnP and atezo + PP than patients < 70 years; incidences were similar between groups for other regimens. Older vs. younger patients also had higher incidence of interstitial lung disease. Overall, these results suggest that atezolizumab-containing regimens remain effective in older patients, with no new safety signals.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1347-90322026Plasma Protein Analysis for Biomarker Discovery in Lung Cancer Treated With Atezolizumab Combination Therapy in J-TAIL-2113ENYasushiGotoDepartment of Thoracic Oncology, National Cancer Center HospitalMakotoNishioDepartment of Thoracic Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer ResearchKadoakiOhashiDepartment of Respiratory Medicine, Okayama University HospitalAtsushiOsoegawaDepartment of Thoracic and Breast Surgery, Oita University Faculty of MedicineEikiKikuchiDepartment of Respiratory Medicine, Faculty of Medicine, Hokkaido UniversityHideharuKimuraDepartment of Respiratory Medicine, Kanazawa University HospitalJunichiShimizuDepartment of Thoracic Oncology, Aichi Cancer Center HospitalEisakuMiyauchiDepartment of Respiratory Medicine, Tohoku University HospitalHiroshigeYoshiokaDepartment of Thoracic Oncology, Kansai Medical UniversityIchiroYoshinoDepartment of Thoracic Surgery, International University of Health and Welfare Narita HospitalToshihiroMisumiDepartment of Data Science, National Cancer Center Hospital EastYasutakaWatanabeDepartment of Thoracic Oncology, Saitama Cancer CenterNobuyukiKatakamiDepartment of Pulmonary Medicine and Medical Oncology Takarazuka City Hospital Takarazuka JapanAkiraKisoharaDepartment of Respiratory Medicine, Kasukabe Medical CenterMasafumiYamaguchiDepartment of Thoracic Oncology, NHO Kyushu Cancer CenterHirotakaKurokiChugai Pharmaceutical Co., Ltd.MasamichiSugimotoChugai Pharmaceutical Co., Ltd.HisaoAshimuraChugai Pharmaceutical Co., Ltd.MisaTanakaChugai Pharmaceutical Co., Ltd.AkihikoGemmaNippon Medical SchoolJ-TAIL-2 evaluated the efficacy and safety of atezolizumab, an anti–programmed death-ligand 1 (PD-L1), plus chemotherapy in patients with non-small cell lung cancer (NSCLC) and extensive-stage small cell lung cancer (ES-SCLC) in Japanese clinical practice, demonstrating comparable outcomes to those in the corresponding Phase 3 trials. Although PD-L1 expression is predictive of atezolizumab efficacy in some settings, additional minimally invasive, blood-based biomarkers are needed. This exploratory biomarker study included 359 J-TAIL-2 patients. The NSCLC cohort received atezolizumab combined with carboplatin and nab-paclitaxel (CnP, n = 42), cisplatin/carboplatin and pemetrexed (n = 72), or bevacizumab plus carboplatin and paclitaxel (bev + CP, n = 135). The ES-SCLC cohort received atezolizumab plus carboplatin and etoposide (n = 100). Approximately 560 cancer- or immune-related proteins were evaluated using the Proximity Extension Assay from blood plasma collected at three timepoints: baseline, before the second atezolizumab dose, and at the onset of immune-related adverse events (irAEs). Protein-wise comparisons were made to evaluate significant changes (P < 0.05 and > 0.5 log2 fold change) and linked to clinical outcomes reported in J-TAIL-2. IL-6, MUC-16, and KRT-19 were associated with shorter progression-free survival across multiple regimens. Granzyme A and B, immune activation markers, were elevated in responders who received atezolizumab + CnP and atezolizumab + bev + CP. High levels of baseline immune stimulation proteins were associated with irAEs across regimens. Protein expression changes were varied and regimen-dependent in subgroup analyses including older patients and those with EGFR-mutant tumors. These data warrant further investigation across different cancer types and atezolizumab-containing regimens to determine their relevance to efficacy and irAE occurrence of atezolizumab combination therapy.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0012-1592684-52026Computer‐Aided Sperm Analysis Protocol for Evaluating Sperm Motility in Japanese Medakae70061ENMiwaKuroyanagiDepartment of Advanced Aquaculture Science, Faculty of Marine Bioscience and Technology, Fukui Prefectural UniversitySatoshiAnsaiUshimado Marine Institute, Faculty of Science, Okayama UniversityKeigoOkamotoLaboratory of Aquatic Molecular Developmental Biology, Graduate School of Bioresource and Bioenvironmental Sciences, Kyushu UniversityAiKatoInteruniversity Bio-Backup Project Center, National Institute for Basic Biology (NIBB)ToukoYamazakiLaboratory of Bioresources, National Institutes of Natural SciencesYasuhiroKameiOptics and Bioimaging Facility, NIBBEijiWatanabeBasic Biology Program, Graduate University for Advanced Studies (SOKENDAI)KiyoshiNaruseLaboratory of Bioresources, National Institutes of Natural SciencesYukikoOginoLaboratory of Aquatic Molecular Developmental Biology, Graduate School of Bioresource and Bioenvironmental Sciences, Kyushu UniversityChanges in sperm motility can serve as an early indicator of reproductive effects caused by environmental chemicals or genetic perturbations. However, sperm motility is highly sensitive to external factors such as osmolarity, ionic composition, and the timing of measurement after activation, making it challenging to obtain consistent and reproducible measurements. Here, we present a standardized protocol for assessing sperm motility in Japanese medaka (Oryzias latipes) using a sperm motility analysis system (SMAS), an application for computer-aided sperm motility analysis (CASA). This protocol details the procedures for sperm collection, activation, and quantitative motility assessment, with particular focus on changes in the percentage of motile sperm post activation and the effects of sperm cryopreservation. We demonstrate time-dependent declines in sperm motility and velocity, and highlight the importance of early post-activation measurements to accurately capture peak motility. Notably, cryopreservation significantly accelerated the decline in sperm motility rate without affecting the initial proportion of motile sperm. To enable reliable comparisons among experimental groups, we recommend standardizing the initiation time after sperm activation by using CASA, and show that measurements should be initiated within 1 min after activation to obtain consistent and reliable data. This standardized SMAS-based protocol provides a robust and reproducible framework for sperm motility analysis in medaka and will be valuable not only for studies in reproductive biology, toxicology, and environmental risk assessment but also for applied research, such as breeding of aquacultural fishes.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2050-09041462026CPPD-Induced Iliopsoas Bursitis Mimicking Pyomyositise72814ENHirokiOkunobuDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinnosukeFukushimaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCalcium pyrophosphate deposition disease may mimic an iliopsoas abscess on imaging. The combined use of polarized light microscopy and 16S rRNA gene analysis can help distinguish crystal-induced inflammation from infection, thereby preventing unnecessary antimicrobial therapy.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2077-038315102026Exploratory Analysis of Serum IGF-I Levels and Symptom Trajectories in Long COVID During the Omicron Period3702ENAtsuhitoSuyamaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroNakanoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazukiTokumasuDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasueSakuradaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuiMatsudaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiHondaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiakiSoejimaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToruHasegawaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyosukeTakaseDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaisukeOmuraDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiOguniDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeigoUedaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground: Although several risk factors have been reported for long COVID (LC), reliable biomarkers for this illness remain lacking. Insulin-like growth factor (IGF)-I, a major mediator of growth hormones, plays an important role in metabolism, neuroprotection, and systemic homeostasis, and therefore may be useful in predicting the severity and prognosis of LC. Methods: This study included patients who visited a specialized clinic for long COVID between 2022 and 2025 during the Omicron period and had serum IGF-I measurements taken. IGF-I levels were expressed as age- and sex-adjusted standard deviation scores (IGF-I SD), and patients were classified into low (SD < −1.0), normal (−1.0 ≤ SD < 1.0), and high (SD ≥ 1.0) groups. Clinical characteristics, patient-reported outcomes, laboratory data, and follow-up duration were analyzed. Results: A total of 811 patients were included (median 42 years; 52.5% female). Compared with the normal group, the low-IGF-I group exhibited higher fatigue (FAS: 37.0 vs. 34.0; p < 0.05) and depressive (SDS: 50.0 vs. 49.0; p < 0.05) status. Multivariable linear regression analyses identified lower IGF-I SD as independently associated with higher scores of both FAS and SDS. IGF-I SD values showed negative correlations with ferritin (ρ = −0.125, p < 0.05) and TSH (ρ = −0.202, p < 0.01) and positive correlations with albumin (ρ = 0.227, p < 0.01) and FT4 (ρ = 0.165, p < 0.01). Among the 237 patients who completed follow-up, the median duration from the initial visit to recovery tended to be longer in the low-IGF-I group (221 days) compared with the normal (191 days) and high (109 days) groups, although these differences were not statistically significant overall. In patients aged < 50 years, the low-IGF-I group showed a relatively longer follow-up duration (p < 0.05). Furthermore, the low-IGF-I group had a longer time to recovery compared to the high-IGF-I group (p < 0.05), and this difference was more pronounced in patients under 50 years of age, with significant differences observed among the three IGF-I groups. Conclusions: Lower IGF-I levels in LC may be associated with greater fatigue and depressive symptoms and longer recovery time, particularly in younger patients. Further studies are needed to clarify the clinical significance of these findings.No potential conflict of interest relevant to this article was reported.Frontiers Media SAActa Medica Okayama1663-9812172026Hochuekkito attenuates anxiety-like behavior associated with pulmonary inflammation induced by intratracheal lipopolysaccharides in mice1774957ENYasuhisaIzushiDepartment of Pharmacotherapy, Graduate School of Pharmacy, Shujitsu UniversitySoichiroUshioDepartment of Pharmaceutical Sciences for Health Crisis Management, Faculty of Pharmaceutical Sciences, Fukuoka UniversityTeppeiUedaDepartment of Pharmacotherapy, Graduate School of Pharmacy, Shujitsu UniversityYuichiTasakaLaboratory of Clinical Pharmacy, School of Pharmacy, Shujitsu UniversityIkukoMiyazakiDepartment of Medical Neurobiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasatoAsanumaDepartment of Medical Neurobiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshihisaKitamuraDepartment of Pharmacotherapy, Graduate School of Pharmacy, Shujitsu UniversityIntroduction: We have previously demonstrated that intratracheal lipopolysaccharide (LPS) injection induces significant pulmonary inflammation accompanied by hippocampal microglial activation, indicative of neuroinflammation. Hochuekkito (HET) is a traditional Japanese herbal medicine used to treat various conditions, including mental disorders and physical weakness. We have previously reported that HET ameliorates anxiety-like behaviors induced by intraperitoneal LPS injections in mice. However, its anxiolytic effects on anxiety-like behaviors due to pulmonary inflammation remain poorly understood. Therefore, in the present study, we aimed to investigate the effects of HET on anxiety-like behaviors induced by intratracheal LPS injection in mice.<br>
Methods: Mice received HET (1.0 g/kg) once daily for 2 weeks through oral gavage prior to LPS treatment. The light-dark box test was conducted 24 h following LPS injection to assess anxiety-like behaviors. Diazepam, a clinically used anxiolytic, served as a positive control. The lung wet-to-dry weight ratio was determined, and the concentrations of interleukin-6 (IL-6) in the lungs and serum were assessed.<br>
Results: Repeated administration of HET prevented the development of anxiety-like behaviors and reduced serum IL-6 concentrations and hippocampal Il6 mRNA expression levels in LPS-treated mice. Diazepam failed to exert significant effects in LPS-treated mice, whereas HET remained effective under inflammatory conditions. Moreover, LPS injections significantly increased the number of Iba-1-immunoreactive microglial cells in the CA1 region of the hippocampus, whereas this effect was suppressed by treatment with HET. In the bronchoalveolar lavage fluid (BALF), the LPS-induced increase in white blood cell count was significantly reduced by treatment with HET. Furthermore, HET alleviated LPS-induced pulmonary inflammation, as evidenced by decreased lung wet-to-dry weight ratios.<br>
Conclusion: This study suggests that inflammation induced by intratracheal LPS injection contributes to anxiety-like behaviors in mice and that IL-6 may play a key role in linking peripheral inflammation to neuroinflammatory responses. The anxiolytic effects of HET appear to be associated, at least in part, with the suppression of IL-6 elevation in both the periphery and the hippocampus, along with attenuation of microglial activation. Our findings suggest that HET may serve as a potential therapeutic agent for anxiety-like behaviors associated with pulmonary inflammation.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0039-60601952026Biliverdin supplementation in perfusate and preservation solution attenuates ischemia-reperfusion injury in a rat donation-after-circulatory-death heart transplantation model110231ENKoheiTokiokaDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTsuyoshiNojimaDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakahiroHirayamaDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakashiHongoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakafumiObaraDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiAgetaDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuroIgawaDepartment of Pathology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiyukiAokageBiological Process of Aging, Tokyo Metropolitan Institute for Geriatrics and GerontologyKoheiTsukaharaDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTetsuyaYumotoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiromichiNaitoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsunoriNakaoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground: Heart transplantation faces a persistent donor shortage; therefore, hearts from donation after circulatory death have become a feasible option despite unavoidable warm ischemia and subsequent ischemia-reperfusion injury. Biliverdin, an endogenous bile pigment with strong antioxidant and anti-inflammatory properties, has shown protective effects against ischemia-reperfusion injury in several organ transplantation models. Whether biliverdin attenuates warm ischemic injury in donation after circulatory death heart transplantation remains unclear. This study evaluated biliverdin supplementation in the perfusate and preservation solution in a rat donation after circulatory death model.<br>
Methods: Circulatory death was induced under deep anesthesia, and warm ischemia was maintained for 18 minutes, including the mandatory 5-minute stand-off period. Donor hearts were then flushed and subsequently cold-stored in the same biliverdin-supplemented extracellular-type trehalose–containing Kyoto solution, whereas control grafts received extracellular-type trehalose–containing Kyoto without biliverdin at both stages before heterotopic transplantation. Grafts were assessed at 3 and 24 hours after reperfusion (n = 6 per group). Evaluations included early graft recovery, myocardial injury markers, histological and ultrastructural changes, and inflammatory and stress-response gene expression.<br>
Results: Biliverdin significantly improved early graft recovery, shortening reanimation time and increasing left ventricular fractional shortening at 24 hours. Serum troponin I levels were lower in biliverdin-treated grafts. Biliverdin also reduced histological injury and inflammatory cell infiltration. Ultrastructural analysis showed preserved mitochondrial architecture and ultrastructural integrity. Early proinflammatory gene expression was suppressed.<br>
Conclusion: Biliverdin supplementation in the perfusate and preservation solution attenuates ischemia-reperfusion injury in the experimental rat donation after circulatory death heart transplantation model. These findings provide proof of concept for further mechanistic and translational evaluation of biliverdin for myocardial protection in donation after circulatory death.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0721-832X2026Classification of hypotony maculopathy based on optical coherence tomography findings and risk factors for visual outcomesENYukiKanzakiDepartment of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMiyukiFujiwaraDepartment of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRieFujiwaraDepartment of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySaraOkamotoDepartment of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNarukaMitsuiDepartment of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYusukeShiodeDepartment of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMio MorizaneHosokawaDepartment of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRyoMatobaDepartment of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTetsuroMoritaDepartment of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJunkoHayashiDepartment of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYukiMasudaDepartment of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRikuAkatsukaDepartment of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAkihiroTsujiDepartment of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYukiMorizaneDepartment of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityPurpose To classify hypotony maculopathy (HM) using optical coherence tomography (OCT) findings and to investigate the associations among morphological types, clinical factors, and visual outcomes.<br>
Methods We retrospectively reviewed 60 eyes that developed HM after trabeculectomy. HM was classified according to the distribution and configuration of chorioretinal undulations on OCT B-scans. Between-group comparisons were performed, and factors associated with the morphological classification and logMAR best-corrected visual acuity (BCVA) at 3 months after HM onset (3-month BCVA) were determined.<br>
Results HM was classified into three OCT-based types by categorizing chorioretinal undulations as folds (U-shaped troughs) or spikes (V-shaped troughs): Type 1, folds only on vertical scans; Type 2, folds on both vertical and horizontal scans; Type 3, folds on both scans, with spikes. Axial length in Type 3 was significantly longer than that in Type 2 (P = 0.034). Subfoveal choroidal thickness was significantly thinner in Type 3 than in Types 1 and 2 (both P < 0.001). Minimum intraocular pressure (IOP) was significantly higher in Type 1 than in Types 2 and 3 (P < 0.001 and P = 0.003, respectively), with no difference between Types 2 and 3. In multivariable analysis using Type 1 as the reference group, minimum IOP was significantly associated with Type 2 (P = 0.001). For Type 3, both minimum IOP (P = 0.03) and subfoveal choroidal thickness (P = 0.02) showed significant associations. The 3-month BCVA was significantly worse in Type 3 than in Types 1 and 2 (P < 0.001 and P = 0.007, respectively). Chorioretinal spikes and preoperative BCVA were significantly associated with 3-month BCVA (both P < 0.001). Exploratory receiver operating characteristic analysis assessed the discriminative ability of subfoveal choroidal thickness for the presence of chorioretinal spikes (AUC = 0.876). A thickness of 195.0 μm was identified as a candidate cutoff value (sensitivity 92.3% and specificity 72.3%).<br>
Conclusions In HM following TLE, chorioretinal spikes and preoperative BCVA are significantly associated with the 3-month BCVA. In HM, a thin subfoveal choroid (< 195.0 μm), may be associated with chorioretinal spikes, suggesting the need for careful postoperative IOP and OCT monitoring.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0196-07094732026Predictors of therapeutic response and pain after near-infrared photoimmunotherapy in head and neck cancer104848ENJunyaMatsumotoDepartment of Otolaryngology - Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakumaMakinoDepartment of Otolaryngology - Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYutoNaoiDepartment of Otolaryngology - Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShoheiFujimotoDepartment of Otolaryngology - Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMizuoAndoDepartment of Otolaryngology - Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesObjective: Near-infrared photoimmunotherapy (NIR-PIT) has been approved by the Japanese national health insurance for approximately five years, and clinical experience has steadily accumulated. However, reports analyzing treatment outcomes and pain-related factors remain limited. This study aimed to identify predictors of therapeutic response and pain following NIR-PIT.<br>
Methods: This retrospective cohort study included 25 patients who underwent NIR-PIT for head and neck cancer between January 2021 and June 2025. Lesion diameter and thickness were evaluated in relation to complete response (CR), and the frequency and predictors of post-treatment pain were assessed.<br>
Results: Among 22 evaluable patients, eight achieved CR. Lesions with a shorter longest diameter and thinner thickness were significantly associated with higher CR rates (p = 0.011 and p = 0.024). Moderate-to-severe pain (Numerical Rating Scale ≥4) occurred in 18 of 48 treatment cycles (37.5%) but was significantly less frequent in patients with a history of reconstructive surgery (p = 0.017).<br>
Conclusions: NIR-PIT demonstrated particularly favorable efficacy for short, thin lesions, suggesting that early introduction of treatment may be associated with improved therapeutic outcomes. A history of reconstructive surgery was associated with reduced post-treatment pain, highlighting the importance of individualized treatment and pain management strategies in head and neck cancer patients undergoing NIR-PIT.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0919-81723352026Comparative Efficacy of First-Line Immune Checkpoint Inhibitor-Based Combination Therapies in Patients With Sarcomatoid Renal Cell Carcinoma: A Japanese Multicenter Cohort Studye70494ENKeitaTamuraDepartment of Urology, Hamamatsu University School of MedicineYutoMatsushitaDepartment of Urology, Hamamatsu University School of MedicineHiromitsuWatanabeDepartment of Urology, Hamamatsu University School of MedicineTakafumiYanagisawaDepartment of Urology, Jikei University School of MedicineKeiichiroMoriDepartment of Urology, Jikei University School of MedicineHirofumiMorinakaDepartment of Urology, Kawasaki Medical SchoolKensukeBekkuDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesShingoToyodaDepartment of Urology, Kindai University Faculty of MedicineTakuhisaNukayaDepartment of Urology, Fujita-Health University School of MedicineRyoichiMaenosonoDepartment of Urology, Osaka Medical and Pharmaceutical UniversityKazumasaKomuraDepartment of Urology, Kawasaki Medical SchoolMotooArakiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazutoshiFujitaDepartment of Urology, Kindai University Faculty of MedicineKiyoshiTakaharaDepartment of Urology, Fujita-Health University School of MedicineHaruhitoAzumaDepartment of Urology, Osaka Medical and Pharmaceutical UniversityTeruoInamotoDepartment of Urology, Hamamatsu University School of MedicineObjectives: Sarcomatoid renal cell carcinoma (sRCC) is an aggressive histological variant associated with a poor prognosis. While immune checkpoint inhibitor (ICI)-based combinations have become the standard of care, the optimal first-line regimen, specifically dual immunotherapy (IO-IO) vs. IO plus tyrosine kinase inhibitor (IO-TKI), remains controversial. We herein examined the real-world clinical outcomes of Japanese patients with sRCC.<br>
Methods: We conducted a retrospective multicenter study on 46 patients with advanced or metastatic sRCC receiving first-line ICI-based combination therapy between January 2018 and December 2024 (IO-IO: n = 18; IO-TKI: n = 28). In a comparative survival analysis, three favorable-risk patients in the IO-TKI group were excluded to align risk profiles, focusing on intermediate/poor-risk groups (n = 43). The primary endpoint was overall survival (OS).<br>
Results: In the entire cohort (n = 46), the objective response rate was numerically higher in the IO-TKI group (64.3%) than in the IO-IO group (50.0%) (p = 0.37). In the comparative analysis of intermediate/poor-risk patients (n = 43), progression-free survival (PFS) was slightly longer (p = 0.071), and OS was significantly longer (p = 0.016) in the IO-TKI group than in the IO-IO group. A multivariable analysis adjusted for IMDC risk categories showed favorable survival with the IO-TKI regimen (HR 0.37, p = 0.061).<br>
Conclusions: The present study indicates that first-line IO-TKI combination therapy represents a promising treatment option with a potential survival advantage over IO-IO therapy for Japanese patients with sRCC. However, due to the retrospective design and small sample size, reliably determining the comparative efficacy of these regimens remains challenging, and further validation is warranted.No potential conflict of interest relevant to this article was reported.Portland Press Ltd.Acta Medica Okayama0144-84634662026Tubulogenesis of bovine uterine glands by epidermal growth factor and collagen I in 3D culture systemsBSR20260010ENYosukeSuginoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityReiIchikawaGraduate School of Bioagricultural Sciences, Nagoya UniversityShuichiMatsuyamaGraduate School of Bioagricultural Sciences, Nagoya UniversityYukiYamamotoDepartment of Veterinary Medicine, Tokyo University of Agriculture and TechnologyKoheiKawanoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKojiKimuraGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityUterine glands are endometrial exocrine epithelia that support early embryo development. Their secretions are particularly essential for conceptus elongation in cattle. Uterine glands develop from the luminal epithelium and elongate into the stromal layer toward the myometrium. This process is regulated by growth factors, WNT proteins, and the surrounding extracellular matrix (ECM); however, the precise mechanisms that govern bovine uterine gland morphogenesis remain unclear. In this study, we determined how these signaling factors and ECM components affect the tubular formation of bovine uterine gland fragments in 3D culture systems. Uterine gland fragments were enzymatically isolated from bovine endometria and 3D-cultured in Matrigel with or without growth factors (EGF, FGF1, FGF2, FGF7, FGF10, and IGF-1) and WNT (WNT3A, WNT5A, and WNT7A) proteins. Of these, only EGF stimulated the elongation of uterine gland fragments and eventually induced the formation of uterine gland-like structures. EGF-induced tubulogenesis was accompanied by a rapid increase in cell proliferation and alterations in cell–ECM interactions. The supplementation of collagen I with Matrigel further promoted the elongation of the tubular structures. Although the addition of collagen I did not alter the gene expression profiles of the uterine gland-like structures, the integrin-ROCK pathway contributed to the collagen-induced enhancement of elongation. Our findings clarified that EGF and collagen I, but not FGFs, IGF-1, or WNTs, are key regulators for the tubular formation of 3D-cultured bovine uterine gland fragments. This 3D culture system provides a new platform to examine the cellular and molecular mechanisms underlying bovine uterine gland morphogenesis.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0897-38062026What Is the Pterygomandibular Raphe? A Confluence of Fasciae Rather Than a Discrete Structure19ENJoeIwanagaDepartment of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of MedicineShionHamaSection of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu UniversityKeikoFukinoDepartment of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental UniversityShogoKikutaDental and Oral Medical Center, Kurume University School of MedicineMi‐SunHurDepartment of Anatomy, Daegu Catholic University School of MedicineMaria Cristina ManzanaresCespedesHuman Anatomy and Embryology Unit. Experimental Pathology and Therapeutics Department, Faculty of Medicine and Health Sciences, University of BarcelonaYoshioOhyamaOral and Maxillofacial Surgery, Shizuoka City Shizuoka HospitalMasayaAkashiDepartment of Oral and Maxillofacial Surgery, Kobe University Graduate School of MedicineNoritakaKomuneDepartment of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu UniversityHideakiKamochiDepartment of Maxillofacial Surgery, Institute of Science TokyoSoichiroIbaragiDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityThe pterygomandibular raphe (PMR) has traditionally been described as a fibrous or tendinous band connecting the bucinator (BM) and superior pharyngeal constrictor (SPCM) muscles. However, recent evidence has questioned its existence. This study aimed to reevaluate the anatomy of the pterygomandibular region by preserving fascial continuity and examining the relationships among adjacent muscles and connective tissues. Twenty-five sides from formalin-fixed cadaveric heads were examined. Twenty sides underwent macroscopic dissection under a surgical microscope, and five sides were sectioned axially and analyzed histologically using Masson's trichrome staining to assess muscle–fascia continuity. The buccopharyngeal fascia (BpF) adhered tightly to the posterolateral surface of the BM. A ligament-like bundle observed between the BM and medial pterygoid muscle corresponded to an artificial continuation of the BpF created by dissection. Axial sections revealed that the BpF, masseteric, and temporalis fasciae converged anteriorly on the lateral surface of the BM, while posteriorly, the BpF and temporalis fascia also merged, forming a confluence of fasciae. No discrete tendinous or ligamentous PMR was identified. The so-called PMR represents a dissection artifact rather than a true anatomical structure. These findings emphasize the importance of preserving fascial relationships and using precise terminology in anatomical and clinical contexts.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2090-67492026Arthroscopically Confirmed Complete Healing of Anterior Cruciate Ligament Avulsion Fracture Following Four‐Corner Pullout Repair Using Ultrahigh‐Molecular‐Weight Polyethylene Tapes: A Case Report5671446ENToshikiKoharaDepartment of Orthopedic Surgery , Okayama University Graduate School of Medicine , Dentistry , and Pharmaceutical SciencesYukiOkazakiDepartment of Orthopedic Surgery , Okayama University Graduate School of Medicine , Dentistry , and Pharmaceutical SciencesShinichiMiyazawaDepartment of Orthopedic Surgery , NHO Fukuyama Medical CenterTakayukiFurumatsuDepartment of Orthopedic Surgery , Japanese Red Cross Okayama HospitalYusukeYokoyamaDepartment of Orthopedic Surgery , Okayama University Graduate School of Medicine , Dentistry , and Pharmaceutical SciencesMasanoriTamuraDepartment of Orthopedic Surgery , Okayama University Graduate School of Medicine , Dentistry , and Pharmaceutical SciencesKokiKawadaDepartment of Orthopedic Surgery , Okayama University Graduate School of Medicine , Dentistry , and Pharmaceutical SciencesTsubasaHasegawaDepartment of Orthopedic Surgery , Okayama University Graduate School of Medicine , Dentistry , and Pharmaceutical SciencesTomonoriTetsunagaDepartment of Orthopedic Surgery , Okayama University Graduate School of Medicine , Dentistry , and Pharmaceutical SciencesKazukiYamadaDepartment of Orthopedic Surgery , Okayama University Graduate School of Medicine , Dentistry , and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopedic Surgery , Okayama University Graduate School of Medicine , Dentistry , and Pharmaceutical SciencesWe report a case of tibial insertion avulsion fracture of the anterior cruciate ligament (ACL). A 10-year-old boy who fell from a skateboard was diagnosed with a tibial insertion avulsion fracture of the ACL and was treated arthroscopically. The avulsed fragment was provisionally fixed with guide pins inserted into its four corners, and the lateral view was checked to avoid penetration of the growth plate. Two ultrahigh-molecular-weight polyethylene tapes were passed through the ACL just above its tibial insertion, pulled through the four-corner bone tunnels in an X-shaped configuration, and tightened. The patient was immobilized for 3 weeks, and partial weight bearing was initiated at 4 weeks. Bone union was confirmed at 6 months using plain radiographs, and second-look arthroscopy and implant removal were performed 8 months postoperatively. During arthroscopy, complete union with smooth continuity of the articular cartilage at the fracture site and a stable ACL were observed. The patient had a full knee range of motion and no pain at the final follow-up.No potential conflict of interest relevant to this article was reported.Institute of Electrical and Electronics Engineers (IEEE)Acta Medica Okayama2169-3536142026Construction of a Lightweight Simulation Environment Based on Topological Mapping73466 73478ENYukinagaKatoGraduate School of Environmental, Life, Natural Science, and Technology, Okayama UniversityYuichiroTodaFaculty of Environmental, Life, Natural Science, and Technology, Okayama UniversityTakayukiMatsunoFaculty of Environmental, Life, Natural Science, and Technology, Okayama UniversityAutonomous mobile robots require safe and efficient environmental representations for traversability-aware navigation and learning. In particular, self-learning of traversability from real-world driving experience can require robots to operate near the limits of their mobility, which introduces physical risks such as falls, malfunctions, or hardware damage. To provide a safer complementary environment for such validation and future learning, this paper proposes ATC-Mesh. This framework constructs a lightweight, simulation-ready mesh environment from the topological map produced by Adaptive Resonance Theory-based Topological Clustering with Different Topologies (ATC-DT) using high-density LiDAR point clouds. Unlike standard mesh reconstruction methods that directly process dense point clouds, ATC-Mesh generates a compact mesh from the node–edge structure of the topological map while preserving traversability attributes associated with the topological map. Experiments using two real-world LiDAR datasets show that ATC-Mesh achieves competitive mesh-construction quality compared with standard baseline methods while reducing construction time and mesh size. Gazebo experiments further show that the generated meshes can support waypoint-based navigation with a low simulation load.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0753-33221942026Elucidation of mechanisms underlying the therapeutic effects of cordycepin on pulmonary hypertension, with a focus on cell senescence and gut microbiota118923ENGaopengLiDepartment of Cardiovascular Physiology, Faculty of Medicine, Kagawa UniversityZhixinZhaoInner Mongolia Key Laboratory of Dairy Biotechnology and Engineering, Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs, Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural UniversityMitsuhiroMachitaniDivision of Cancer Stem Cell, National Cancer Center Research InstituteRyouIshikawaDepartment of Diagnostic Pathology, Kagawa University HospitalKaoriIshikawaDepartment of General Medicine, Kagawa University HospitalNaoyaYokotaDepartment of General Thoracic Surgery, Faculty of Medicine, Kagawa UniversityReijiHabaDepartment of Diagnostic Pathology, Kagawa University HospitalKazufumiNakamuraCenter for Advanced Heart Failure, Okayama University HospitalZhihongSunInner Mongolia Key Laboratory of Dairy Biotechnology and Engineering, Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs, Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural UniversityLin-HaiKuraharaDepartment of Cardiovascular Physiology, Faculty of Medicine, Kagawa UniversityKatsuyaHiranoDepartment of Cardiovascular Physiology, Faculty of Medicine, Kagawa UniversityIntroduction: Pulmonary hypertension (PH) is a progressive cardiopulmonary disorder characterized by excessive pulmonary vascular remodeling and aberrant proliferation of pulmonary artery smooth muscle cells (PASMCs). Emerging evidence suggests that gut microbiota dysbiosis contributes to PH development. Cordycepin, a natural adenosine analogue derived from Cordyceps militaris, has demonstrated antiproliferative and microbiota-modulating properties; however, its mechanism of action in PH remains unclear.<br>
Objective: Elucidate the mechanisms underlying the therapeutic effects of cordycepin on PH, focusing on cellular senescence and gut microbiota.<br>
Methods: The effects of cordycepin on PH pathology were investigated by transcriptome analysis of PASMCs from patients, and metagenomic analysis of rodent PH models. Cellular senescence was analyzed in lung tissue from p16Ink4a-CreERT2 reporter mice and in rat bone marrow-derived macrophages (BMDMs).<br>
Results: RNA sequencing analysis revealed activation of p53 signaling by cordycepin in PASMCs. Cordycepin suppressed CDK1 expression and TERT phosphorylation at threonine 249. It ameliorated vascular and cardiac remodeling in PH rat and mouse models. Cordycepin induced M1-like macrophage senescence in p16 Ink4a reporter mice lungs and rat BMDMs. Cordycepin significantly reshaped the gut microbiota, increasing beneficial genera (e.g. Alistipes and Acetatifactor) and reducing proinflammatory taxa (e.g., Ruminococcus), with modulating key metabolic pathways, including short-chain fatty acid, tryptophan, and vitamin K2 metabolism.<br>
Conclusion: Cordycepin exerts multi-target therapeutic effects in PH by inhibiting PASMC proliferation via the p53–CDK1/pTERT axis, modulating gut microbiota-linked immunometabolism and induces proinflammatory macrophage senescence. These findings support cordycepin as a promising candidate for PH therapies targeting the vascular, immune, and gut–lung axes.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0040-40391832026Photochemical oxidative synthesis of carboxylic acids from aldehydes or alcohols with water via CH bromination156163ENMohamed R.El-kholanyGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityAtsuyaMiyamotoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMorganeFalconeGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHiroyoshiTakamuraGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityIsaoKadotaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKentaTanakaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityThe photoinduced oxidation of aldehydes or alcohols with water to give the corresponding carboxylic acids is described. This photochemical carboxylation proceeds via the in-situ generation of acyl-bromide intermediates upon irradiation with purple or UV LED light; these intermediates subsequently react with water to give the desired carboxylic acids. This mild photochemical reaction affords diverse carboxylic acids without peroxide generation or the need to use transition-metal catalysts and a stoichiometric amount of base, highlighting its potential utility for the synthesis of natural products and bioactive compounds.No potential conflict of interest relevant to this article was reported.Royal Society of Chemistry (RSC)Acta Medica Okayama1359-73452026Switchable photoluminescence of europium(iii) complexes with chromonylhydrazonesENAsahiKameiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityDaisukeSaitoGraduate School of Science, Hokkaido UniversityKazumaTakaharaGraduate School of Science, University of HyogoKeitoNoseGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHidekiOkamotoDepartment of Chemistry, Faculty of Environmental, Life, Natural Science and Technology, Okayama UniversityMasakiYoshidaGraduate School of Science, The University of OsakaMasakoKatoSchool of Biological and Environmental Sciences, Kwansei Gakuin UniversityTakayoshiSuzukiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityEuropium(III) complexes bearing 4-hydroxy- or 4-methyl-N′-((6-methyl-4-oxo-4H-chromen-3-yl)methylene)benzohydrazide (HL1 or HL2) showed characteristic EuIII 5D0 → 7FJ (J = 0–4) luminescence both in acetonitrile and in solid states with relatively high Φtot values. The luminescence was quenched not only by adding triethylamine in acetonitrile, but also by heating the solid sample, and recovered by adding perchloric acid in solution or by diffusion of HCl vapor to the resulting solid sample.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1349-00796812026Roles of the aryl hydrocarbon receptor and its ligands in osteoclast differentiation and temporomandibular joint osteoarthritis100726ENTakashiIzawaDepartment of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityIslamy RahmaHutamiDepartment of Orthodontics, Universitas Islam Sultan AgungYuriYoshikawaDepartment of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityGohjiKozakiDepartment of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYusakuHamadaDepartment of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYukiNambaDepartment of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMisaTaguchiDepartment of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJiaminChenDepartment of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJanvierHabumugishaDepartment of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiroshiKamiokaDepartment of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground: The aryl hydrocarbon receptor (AhR) is a ligand-activated transcription factor that plays an essential role in skeletal homeostasis. Increasing evidence indicates that AhR critically regulates osteoclast differentiation and activity, thereby influencing bone mass, bone resorption, and susceptibility to skeletal diseases. Although AhR has also been implicated in osteoblast-lineage cells, its regulatory roles in osteoclasts and immune cells are less well understood but are increasingly recognized as central to bone remodeling. In particular, AhR signaling modulates immune cell subsets relevant to bone metabolism and governs the differentiation of bone marrow-derived macrophages into osteoclasts.<br>
Highlight: This review summarizes the recent findings regarding the regulation of osteoclast differentiation by AhR and its ligands under both physiological and pathological conditions. Special emphasis is placed on the interaction between AhR and the RANKL signaling axis in osteoclasts, as well as on how exogenous and endogenous ligands, including benzo[a]pyrene (B[a]P) and 6-formylindolo[3,2-b]carbazole (FICZ), modulate bone resorption and subchondral bone remodeling in temporomandibular joint osteoarthritis. Furthermore, the role of macrophages as osteoclast progenitors and immunomodulators has been highlighted, positioning AhR as a critical intermediary that links environmental exposure, inflammation, and skeletal metabolism.<br>
Conclusion: In this review, we outlined the diverse functions of AhR signaling and its ligands in oral and temporomandibular joint osteoarthritis. AhR plays a central role in bone remodeling. The harmful exogenous ligand B[a]P generally promotes bone loss, whereas the endogenous ligand FICZ exerts protective actions. These insights highlight AhR as a key regulatory switch linking the skeletal and immune systems and as a promising therapeutic target for bone-destructive disorders.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1865-72571932026Successful management and 10-year survival of a rectal neuroendocrine tumor with rare systemic metastases via a non-portal venous pathway491498ENShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyaMiyamotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalAkihiroMatsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalHiroyukiTerasawaDepartment of Gastroenterology and Hepatology, Okayama University HospitalYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKoseiTakagiDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTakashiKuiseDepartment of Gastroenterological Surgery, Okayama Red Cross HospitalTakehiroTanakaDepartment of Pathology, Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalMetastatic neuroendocrine tumors (NETs) typically involve the liver and lymph nodes. Metastases in the orbit, heart, and ovary are rare and present unique clinical challenges. We report a woman who was 70 years old at the time of initial presentation with liver metastases from a rectal neuroendocrine tumor. Following a right hepatectomy for liver metastases, she remained free of hepatic recurrence for 10 years. Notably, four years after the right hepatectomy, she developed new metastases in the left orbit, right ventricle, and left ovary, with diplopia as the sole clinical symptom. This clinical course suggests a distinct metastatic pathway associated with the lower rectum that bypasses the portal circulation, consistent with the dual drainage system of the rectal region. Management involved a strategic multimodal approach that includes systemic therapy with everolimus and lanreotide as well as targeted surgical resectioning of the cardiac and ovarian lesions. The orbital lesion achieved a complete response through systemic therapy alone, preserving visual function. Currently, 10 years after the initial treatment, the patient maintains an excellent performance status (ECOG PS 0) while receiving peptide receptor radionuclide therapy (PRRT). This case demonstrates that recognizing atypical metastatic pathways and employing strategic multimodal therapies can achieve long-term survival and functional preservation in rectal NETs.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2090-6528202612026Selective ARID1A Loss Restricted to the Undifferentiated Component of a Mismatch Repair‐Deficient Gastric Carcinoma: A Case Report8863202ENRikaOmoteDepartment of Diagnostic Pathology, NHO Fukuyama Medical CenterRyosukeHamanoDepartment of Surgery, NHO Fukuyama Medical CenterShinyaOtsukaDepartment of Surgery, NHO Fukuyama Medical CenterTakehiroTanakaDepartment of Pathology, Okayama University HospitalHiroyukiYanaiDepartment of Pathology, Okayama University HospitalMismatch repair-deficient (dMMR) gastric carcinomas often harbor ARID1A alteration, but a sharply demarcated undifferentiated/rhabdoid component with selective ARID1A loss is uncommon and may create a diagnostic dilemma. An 80-year-old man underwent esophagogastroduodenoscopy for anemia, which revealed a circumferential Borrmann Type 3 lesion in the gastric body, and distal gastrectomy was performed. Histologically, the tumor was composed predominantly of undifferentiated carcinoma with focal rhabdoid features and a minute well-differentiated adenocarcinoma component, with an abrupt transition between the two. Immunohistochemistry showed loss of nuclear MLH1 and PMS2 in both components, whereas loss of ARID1A expression was confined to the undifferentiated component; SMARCB1 (INI1), SMARCA2 (BRM), and SMARCA4 (BRG1) were retained. EBER in situ hybridization was negative. Because gene-level testing, MSI testing, and MLH1 promoter methylation analysis were not performed, the molecular basis of the dMMR phenotype and ARID1A loss could not be determined. The restricted scope of molecular testing limits the ability to draw broad or generalizable conclusions and to fully establish clinicopathological correlations. The value of this report is, therefore, not mechanistic proof but recognition of a practical morphologic-immunophenotypic observation: When a gastric carcinoma shows a sharply demarcated shift from differentiated to undifferentiated/rhabdoid morphology, dMMR should be considered, and selective ARID1A loss in the undifferentiated component may be associated with dedifferentiation. These findings should be interpreted with caution as preliminary, hypothesis-generating observations that require validation in larger studies with more extensive molecular profiling.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1340-68683342026Differences in drug efficacy and prognosis between primary and metastatic sites for de novo stage IV breast cancer: an exploratory analysis of a phase III trial, JCOG1017829838ENKiyoTanakaDepartment of Breast Surgery, Toranomon HospitalAkihikoShimomuraDepartment of Breast and Medical Oncology, National Center for Global Health and MedicineMakotoIshitobiDepartment of Breast Surgery, Osaka Habikino Medical CenterTakashiYamanakaDepartment of Breast Surgery, Kanagawa Cancer CenterTakahiroTsukiokiDepartment of Breast and Endocrine Surgery, Okayama University HospitalHirojiIwataDepartment of Advanced Clinical Research and Development, Nagoya City University Graduate School of Medical SciencesFumikataHaraDepartment of Breast Oncology, Aichi Cancer CenterTomomiFujisawaDepartment of Breast Oncology, Gunma Prefectural Cancer CenterKeitaSasakiClinical Oncology Group Data Center/Operations Office, National Cancer Center HospitalRyoSadachiClinical Oncology Group Data Center/Operations Office, National Cancer Center HospitalRikuKajikawaClinical Oncology Group Data Center/Operations Office, National Cancer Center HospitalTakehikoSakaiDepartment of Breast Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer ResearchYasuakiSagaraDepartment of Breast Surgery, Sagara HospitalHideoShigematsuDepartment of Breast Surgery, Hiroshima University HospitalYukinoriOzakiDepartment of Breast Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer ResearchKazukiNozawaDepartment of Advanced Clinical Research and Development, Nagoya City University Graduate School of Medical SciencesKazukiSudoDepartment of Medical Oncology, National Cancer Center HospitalYoichiNaitoDepartment of General Internal Medicine, National Cancer Center Hospital EastKaoriTerataDepartment of Breast and Endocrine Surgery, Akita University HospitalToshiyukiIshibaDepartment of Breast Surgery, Institute of Science Tokyo HospitalHaruhikoFukudaClinical Oncology Group Data Center/Operations Office, National Cancer Center HospitalTadahikoShienDepartment of Breast and Endocrine Surgery, Okayama University HospitalBackground Breast cancer is a highly heterogeneous disease, with biological factors like estrogen receptor, progesterone receptor, and HER2 receptor differing between primary and metastatic sites, potentially affecting treatment response.<br>
This exploratory analysis aims to differentiate drug efficacy and long-term prognosis between these sites in stage IV breast cancer.<br>
Methods Patients from JCOG1017, a phase III trial evaluating the role of primary tumor resection, who received primary systemic therapy (PST) were evaluated at three months. In this analysis, treatment response was assessed separately in primary and metastatic sites. Patients were categorized into four groups: discordant I (primary non-PD, metastatic PD), concordant I (both PD), discordant II (primary PD, metastatic non-PD), and concordant II (both non-PD).<br>
Results Among 271 patients, overall discordance proportion of treatment response between primary and metastatic sites was 25.1%. Group distribution was 24.7% (discordant I), 9.6% (concordant I), 0.4% (discordant II), and 65.3% (concordant II). Discordance was more frequent in luminal (28.9%), triple-negative (25.0%), and luminal-HER2 (22.0%) subtypes than in HER2-enriched (11.1%). Survival analysis showed prognostic differences: concordant II, with both sites non-PD, demonstrated the most favorable outcome compared with discordant I (HR 0.556; 95% confidence interval, 0.396–0.782).<br>
Conclusions One-fourth of patients exhibited discordant responses between primary and metastatic sites in early treatment phases. These discrepancies were associated with survival differences, emphasizing the importance of evaluating both primary and metastatic lesions when assessing efficacy and determining treatment strategies in de novo stage IV breast cancer.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1341-96253132026Clinical complete response and predictive factors in HER2-positive early breast cancer treated with neoadjuvant chemotherapy aimed at omission of surgery: an exploratory analysis of the JCOG1806 trial528536ENHideoShigematsuDepartment of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University HospitalTomomiFujisawaGunma Prefectural Cancer CenterFumikataHaraAichi Cancer CenterHirojiIwataGraduate School of Medical Sciences, Nagoya City UniversityToshiyukiIshibaInstitute of Science Tokyo HospitalYukinoriOzakiCancer Institute Hospital of the Japanese Foundation for Cancer ResearchTakehikoSakaiCancer Institute Hospital of the Japanese Foundation for Cancer ResearchYasuakiSagaraHakuaikai Sagara HospitalAkihikoShimomuraNational Center for Global Health and MedicineKazukiSudoNational Cancer Center HospitalKaoriTerataAkita University HospitalYoichiNaitoNational Cancer Center Hospital EastKazukiNozawaGraduate School of Medical Sciences, Nagoya City UniversityKeitaSasakiJapan Clinical Oncology Group Data Center/Operations Office, National Cancer Center HospitalNorikoMitomeJapan Clinical Oncology Group Data Center/Operations Office, National Cancer Center HospitalRyoSadachiJapan Clinical Oncology Group Data Center/Operations Office, National Cancer Center HospitalTaroShibataJapan Clinical Oncology Group Data Center/Operations Office, National Cancer Center HospitalTadahikoShienOkayama University HospitalPurpose The JCOG1806 trial (jRCTs031190129) is underway to evaluate the omission of surgery in patients with human epidermal growth factor receptor (HER2)-positive early breast cancer who have a clinical complete response (cCR) after primary systemic therapy (PST). We aimed to assess the cCR rate in this trial and identify predictive factors.<br>
Methods HER2-positivity was defined as an immunohistochemistry (IHC) score of 3 + or in situ hybridization-positivity. A cCR was defined as the absence of detectable lesions upon palpation, contrast-enhanced magnetic resonance imaging, and ultrasonography; biopsy-based confirmation was optional in hormone receptor (HR)-negative cases and mandatory in HR-positive cases. Multivariate logistic regression analyses were used to identify predictors of a cCR.<br>
Results The cCR rate was 57.6% (196/340 patients; 95% confidence interval [CI]: 52.2–63.0%). Strongly estrogen-receptor (ER)-positive tumors (≥ 10%) were significantly less likely to have a cCR than ER-negative tumors (odds ratio [OR], 0.41; 95% CI: 0.20–0.81). IHC 3 + tumors had higher cCR rates than IHC 1 + or 2 + tumors (OR, 2.19; 95% CI: 1.01–4.74). Compared with histological grade I tumors, cCR odds were higher in grade II (OR: 2.92; 95% CI: 1.07–7.93) and III (OR: 4.90; 95% CI: 1.76–13.7) tumors. Among patients without a cCR patients undergoing surgery, 22.2% were diagnosed with ypT0 tumors upon analysis of surgical specimens.<br>
Conclusion ER-negativity, an IHC score of 3 + , and a higher histological grade were independent predictors of a cCR. Identifying these features may improve the feasibility and safety of surgery omission for patients with HER2-positive early breast cancer.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0007-104820862026Decreased renal function predicts severe cytokine release syndrome after CAR-T-cell therapy for large B-cell lymphoma21242133ENYasuyukiAraiDepartment of Hematology, Graduate School of Medicine, Kyoto UniversityTomoyasuJoDepartment of Hematology, Graduate School of Medicine, Kyoto UniversityTakayukiSatoDepartment of Hematology and Oncology, Kurashiki Central HospitalMasatoshiSakuraiDivision of Hematology, Department of Medicine, Keio University School of MedicineDaisukeKajiDepartment of Hematology, Toranomon HospitalToshioKitawakiDepartment of Hematology, Graduate School of Medicine, Kyoto UniversityKazuyukiShimadaDepartment of Hematology and Oncology, Nagoya University Graduate School of MedicineTatsuShimoyamaDivision of Clinical Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalSatoshiYoshiharaDepartment of Hematology, Hyogo Medical University HospitalShinichiMakitaDepartment of Hematology, National Cancer Center HospitalNobuharuFujiiDepartment of Hematology and Oncology, Okayama University HospitalGoYamamotoDepartment of Hematology, Toranomon HospitalKeisukeKataokaDivision of Hematology, Department of Medicine, Keio University School of MedicineEmikoSakaidaDepartment of Hematology, Chiba University HospitalHidekiGotoDepartment of Hematology, Hokkaido University HospitalYasuhiroNakashimaDepartment of Hematology, Osaka Metropolitan University HospitalAkiyoYoshidaDepartment of Hematology, Kanazawa University HospitalYoshihiroUmezawaDepartment of Hematology, Institute of Science Tokyo HospitalHaryoonKimDivision of Hematology, Department of Medicine, Keio University School of MedicineMotohiroKatoDepartment of Pediatrics, The University of TokyoYoshikoAtsutaJapanese Data Center for Hematopoietic Cell TransplantationKojiKatoHematology, Oncology and Cardiovascular Medicine, Kyushu University HospitalCytokine release syndrome (CRS) remains a major toxicity of chimeric antigen receptor (CAR) T-cell therapy in large B-cell lymphoma (LBCL), and robust pre-infusion predictors are needed for risk-adapted management. We retrospectively analysed LBCL patients in the Japanese nationwide registry who underwent CD19 CAR-T-cell therapy between 2019 and 2024. Among 900 patients (median age 62 years), cumulative incidences of CRS within 30 days after infusion were 75.0% for any grade, 20.8% for grade ≥ 2 and 14.0% for grade ≥ 3. In multivariable analysis, lower estimated glomerular filtration rate (eGFR) (adjusted hazard ratio [aHR] 1.108 per 10 mL/min per 1.73 m2 decrease; 95% confidence interval [CI] 1.015–1.209; p = 0.022), higher ferritin (aHR 1.006 per 100 ng/mL; 95% CI 1.001–1.010; p = 0.016), C-reactive protein (CRP) (aHR 1.142 per mg/dL; 95% CI 1.091–1.195; p < 0.001) and lactate dehydrogenase (LDH) (aHR 1.073 per 100 U/L; 95% CI 1.008–1.142; p = 0.028) independently predicted grade ≥ 2 CRS. We then built a four-factor CRS pre-infusion risk evaluation model, cytokine release syndrome-pre-infusion risk evaluation (CRS-PRE), that stratified grade ≥ 2 CRS risk into low, intermediate and high groups with incidences of 2.8%, 26.0% and 50.0% respectively. Decreased eGFR, a surrogate of host renal reserve, with elevated ferritin, CRP and LDH emerged as predictors of high-grade CRS. The CRS-PRE may facilitate risk-adapted monitoring and intervention in clinical practice.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2667-2421202026Behavioral effects of a chronic envy-like stress paradigm in mice using an adjacent cage model148159ENHiroshiUenoDepartment of Medical Technology, Kawasaki University of Medical WelfareYoshihiroTanakaDepartment of Psychiatry, Kawasaki Medical SchoolErikoKitanoDepartment of Psychiatry, Kawasaki Medical SchoolYuTakahashiDepartment of Psychiatry, Kawasaki Medical SchoolSachikoMoriDepartment of Psychiatry, Kawasaki Medical SchoolShinjiMurakamiDepartment of Psychiatry, Kawasaki Medical SchoolKentaWaniDepartment of Psychiatry, Kawasaki Medical SchoolYosukeMatsumotoDepartment of Neuropsychiatry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMotoiOkamotoDepartment of Medical Technology, Graduate School of Health Sciences, Okayama UniversityTakeshiIshiharaDepartment of Psychiatry, Kawasaki Medical SchoolBackground: Social comparison and envy are significant psychosocial stressors in humans and are known to be involved in the onset and persistence of psychiatric disorders. However, animal models capable of experimentally reproducing the effects of indirect social comparison without physical contact are limited. In this study, we used a newly developed "adjacent-cage paradigm" to investigate whether chronic vicarious exposure to conspecifics in different environments induces envy-like stress in mice.<br>
Methods: Male C57BL/6 N mice served as observers, while demonstrator mice were assigned to one of four conditions: (1) an environment enriched with objects, (2) an igloo, (3) a tube, or (4) social isolation. Observers were continuously exposed to these adjacent cages for 21 days. Subsequently, a comprehensive battery of behavioral tests was conducted to assess general health, anxiety-like behavior, spatial memory, social behavior, and depression-like behavior.<br>
Results: In the objects condition, a decrease in time spent in the light compartment of the light/dark box indicated an increase in anxiety-like behavior. In the isolation condition, the mean duration per social interaction was shortened, suggesting a qualitative change in social behavior. The igloo condition resulted in reduced immobility time in the forced swim test, suggesting a possible alteration in stress coping behavior. Furthermore, increased nociceptive sensitivity was observed in the hot plate test under both the objects and isolation conditions.<br>
Conclusion: Although the envy-like stress paradigm did not affect many behavioral indices, it did cause condition-dependent and limited behavioral changes. This suggests that the paradigm may serve as a novel model for capturing psychological and context-dependent social stress, which differs from conventional physical stress models. Elucidating the neural basis of this paradigm is expected to contribute to the understanding of how social comparison affects mental health in modern society.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221612026Adolescent envy-like social comparison stress induces HPA axis hypoactivity and anxiety in female mice: implications for somatic symptom disorder15771ENHiroshiUenoDepartment of Medical Technology, Kawasaki University of Medical WelfareYoshihiroTanakaDepartment of Psychiatry, Kawasaki Medical SchoolErikoKitanoDepartment of Psychiatry, Kawasaki Medical SchoolYuTakahashiDepartment of Psychiatry, Kawasaki Medical SchoolSachikoMoriDepartment of Psychiatry, Kawasaki Medical SchoolShinjiMurakamiDepartment of Psychiatry, Kawasaki Medical SchoolKentaWaniDepartment of Psychiatry, Kawasaki Medical SchoolYosukeMatsumotoDepartment of Neuropsychiatry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMotoiOkamotoDepartment of Medical Technology, Graduate School of Health Sciences, Okayama UniversityTakeshiIshiharaDepartment of Psychiatry, Kawasaki Medical SchoolAdolescence is a critical developmental window marked by heightened neuroplasticity and maturation of the stress response system, conferring vulnerability to psychosocial stress. Chronic stress during this period increases the risk of anxiety and depressive disorders and may contribute to somatic symptom disorder (SSD), which is characterized by medically unexplained physical complaints and shows a striking female predominance. The impact of envy-like stress arising from social comparison, a pervasive psychosocial factor in modern society, remains poorly understood. Male and female C57BL/6N mice were exposed to chronic envy-like stress from postnatal day (P)21 to P52 by housing them adjacent to enriched cages, while control mice were housed without such exposure. From P52 onward, mice underwent behavioral testing of anxiety-like behavior, exploratory activity, social interaction, spatial working memory, motor coordination, nociception, and depression-like behavior. Serum corticosterone and adrenocorticotropic hormone (ACTH) concentrations were measured to assess hypothalamic–pituitary–adrenal (HPA) axis function. Envy-like stress induced sex-specific phenotypes. Male mice exhibited hyperactivity, reduced social interaction, and impaired spatial working memory. In contrast, female mice displayed robust increases in anxiety-like behavior, impaired motor coordination, and significant reductions in basal corticosterone and ACTH levels. Chronic envy-like stress during adolescence elicits distinct, sex-dependent behavioral and endocrine alterations. The phenotype observed in female mice—characterized by heightened anxiety and lower basal HPA axis hormone levels—shares some biological features with clinical observations in SSD. This model may serve as a starting point for elucidating the mechanisms linking psychosocial stress and somatic symptoms in a sex-dependent manner.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221512025Post-weaning maternal presence exerts a protective effect against social isolation-induced behavioural alterations in mice44248ENHiroshiUenoDepartment of Medical Technology, Kawasaki University of Medical WelfareErikoKitanoDepartment of Psychiatry, Kawasaki Medical SchoolYuTakahashiDepartment of Psychiatry, Kawasaki Medical SchoolSachikoMoriDepartment of Psychiatry, Kawasaki Medical SchoolShinjiMurakamiDepartment of Psychiatry, Kawasaki Medical SchoolKentaWaniDepartment of Psychiatry, Kawasaki Medical SchoolYosukeMatsumotoDepartment of Neuropsychiatry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMotoiOkamotoDepartment of Medical Technology, Graduate School of Health Sciences, Okayama UniversityTakeshiIshiharaDepartment of Psychiatry, Kawasaki Medical SchoolParental “watchful presence” is considered an important factor influencing behavioural and emotional development in offspring across mammalian species, including humans. However, the effects of such parental presence remain insufficiently understood, even in human studies. In laboratory mice, offspring are typically weaned at approximately three weeks of age, leaving the impact of post-weaning maternal presence on behavioural development largely unexplored. This study aimed to investigate whether maternal presence in an adjacent cage after weaning can attenuate behavioural effects of social isolation stress in mice. Furthermore, we sought to assess whether this experimental paradigm could serve as a novel animal model for studying the effects of parental watchful presence, with potential relevance to human parent–child relationship research. Mouse pups were weaned at postnatal day 21 and housed either adjacent to their mother (maternal presence group) or without maternal presence (control group). The pups were subsequently housed either in groups with littermates or individually until eight weeks of age. After maturation, behavioural tests were conducted to assess locomotor activity, anxiety-like behaviour, social behaviour, and depression-like behaviour. In group-housed mice, maternal presence did not influence behavioural outcomes. However, in individually housed mice, maternal presence partially attenuated social isolation-induced behavioural alterations, suggesting a subtle protective effect, including hyperlocomotion, reduced anxiety-like behaviour, and abnormal social interactions. Our findings demonstrate that maternal presence during the post-weaning period can offer a protective effect against certain behavioural abnormalities induced by social isolation stress in mice. This simple adjacent-cage paradigm provides a novel and practical model for elucidating the impact of parental watchful presence on behavioural and emotional development, offering insights relevant to the understanding of parent–child relationships in humans.No potential conflict of interest relevant to this article was reported.