American Geophysical Union (AGU)Acta Medica Okayama2169-90971312026Lateral Variations in Lunar Crustal Thickness Inferred From Apollo Seismic and GRAIL Gravity Datae2025JE009453ENXiangZhangUniversité Paris Cité, Institut de physique du globe de Paris, CNRSTaichiKawamuraUniversité Paris Cité, Institut de physique du globe de Paris, CNRSMélanieDrilleauUniversité Paris Cité, Institut de physique du globe de Paris, CNRSPhilippeLognonnéUniversité Paris Cité, Institut de physique du globe de Paris, CNRSSamuelHenriUniversité Paris Cité, Institut de physique du globe de Paris, CNRSZongboXuUniversité Paris Cité, Institut de physique du globe de Paris, CNRSKeisukeOnoderaInstitute for Planetary Materials, Okayama UniversityThomasBodinInstituto de Ciencias del Mar (ICM)–CSICThe internal structure of the Moon is key to understanding its formation, evolution, and bulk composition. In particular, determining the structure of the crust–mantle interface (Moho), including its lateral variations, is of significant importance, but current knowledge is still insufficient to fully constrain it. To address this, we used seismic wave arrivals from impact events, which yield constraints on the crust at both the impact sites and the Apollo stations, to invert for local crustal thickness. Based on a series of assumed crust and mantle density models, we compared Moho depths inferred from global gravity recovery and interior laboratory gravity data with those from seismic observations. Although the gravity‐derived results broadly capture the overall Moho relief, local discrepancies remain, with differences reaching up to 10 km in the vicinity of the Apollo 17 Saturn IVB impact site. These results may reflect regional geological anomalies and highlight the importance of incorporating multiple seismically constrained crustal thickness estimates as anchors in gravity inversions. Using seven seismic anchor points and assuming an upper mantle velocity of Vp = 7.68 km/ s, an upper mantle density of 3,280 kg/m3, and a crustal density of 2,693 kg/m3, we obtain an average lunar crustal thickness of 43.6 ± 1.9 km. The findings also provide valuable guidance for future global 3D modeling of the Moon.No potential conflict of interest relevant to this article was reported.Ceramic Society of JapanActa Medica Okayama1348-653513442026Cation distribution and diffusion-path topologies of A-site-deficient perovskite LixLa(1−x)/3NbO3225231ENNaotoKitamuraDepartment of Pure and Applied Chemistry, Faculty of Science and Technology, Tokyo University of ScienceYizhongTangDepartment of Pure and Applied Chemistry, Faculty of Science and Technology, Tokyo University of ScienceKojiKimuraDepartment of Physical Science and Engineering, Nagoya Institute of TechnologyIppeiObayashiCenter for Artificial Intelligence and Mathematical Data Science, Okayama UniversityYoheiOnoderaCenter for Basic Research on Materials, National Institute for Materials ScienceKenNakashimaFaculty of Materials for Energy, Shimane UniversityChiakiIshibashiDepartment of Pure and Applied Chemistry, Faculty of Science and Technology, Tokyo University of ScienceYasushiIdemotoDepartment of Pure and Applied Chemistry, Faculty of Science and Technology, Tokyo University of ScienceKoichiHayashiDepartment of Physical Science and Engineering, Nagoya Institute of TechnologyLixLa(1−x)/3NbO3 with an A-site-deficient perovskite structure was investigated with a focus on the relationship between its atomic configuration and Li+ diffusion properties. To this end, total scattering (diffraction) measurements were performed, and then reverse Monte Carlo modeling using the data was employed to construct the atomic configuration. The results suggest that the partial occupancy of La in the La-poor layer facilitate Li+ diffusion across the layer owing to the volume contraction. Furthermore, topological analyses conducted via persistent homology using the constructed atomic configuration indicate that a large fourfold ring formed by Nb and O is one of the reasons for superior Li+ diffusion in LixLa(1−x)/3NbO3.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221612026Explainable analysis of the complex maze magnetic domain structure through extension of the Landau free energy model by adding an entropy feature12889ENK.MasuzawaDepartment of Material Science and Technology, Tokyo University of ScienceA. L.FoggiattoDepartment of Material Science and Technology, Tokyo University of ScienceS.KuniiDepartment of Material Science and Technology, Tokyo University of ScienceR.NagaokaDepartment of Material Science and Technology, Tokyo University of ScienceM.TaniwakiDepartment of Material Science and Technology, Tokyo University of ScienceT.YamazakiDepartment of Material Science and Technology, Tokyo University of ScienceC.MitsumataDepartment of Material Science and Technology, Tokyo University of ScienceI.ObayashiInterdisciplinary Education and Research Field, Okayama UniversityY.HiraokaKyoto University Institute for Advanced Study, Kyoto UniversityM.KotsugiDepartment of Material Science and Technology, Tokyo University of ScienceMaze magnetic domains exhibit complex, temperature-dependent behavior that impacts energy loss in soft magnets, yet their magnetization reversal mechanisms remain poorly understood due to current model limitations. To address this gap, we develop an entropy-extended Landau free energy model that incorporates thermal effects into the analysis of magnetic domain. We employ a data-driven pipeline combining persistent homology, energy decomposition, and principal component analysis to construct an interpretable model that quantifies structure–property relationships and enables causal analysis of magnetic pattern formation. Using this approach, we trace entropy increases to their origins in initial domain configurations and quantify energy transfer among entropic, demagnetization, and exchange contributions. We also find that domain wall lengthening tracks increasing structural complexity, yielding previously inaccessible insights into magnetization reversal mechanism and enabling automated visualization. Our entropy-augmented model provides an explainable framework to decipher magnetization processes and guide the design of magnetic materials to reduce energy loss.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8022026Necrotizing Fasciitis Caused by ESBL-Producing Raoultella ornithinolytica in an Immunocompromised Patient with VEXAS Syndrome141145ENMoeSakamoto-TokunagaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakayukiKatsuyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasakiMatobaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokazuTamuraDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNatsukiKubotaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuyaTerajimaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaShidaharaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeiHiroseDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuyaMatsumotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShoichiNawachiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakatoNakadoiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, 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 SciencesKeigoHayashiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiaMiyawakiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEriKatsuyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHarukiWatanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMarikoTakano-NarazakiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshinoriMatsumotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKen-EiSadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShumaTsujiDepartment of Medical Laboratory Science, Graduate School of Health Sciences, Okayama UniversityKazuyoshiGotohDepartment of Medical Laboratory Science, Graduate School of Health Sciences, Okayama UniversityShinnosukeFukushimaDepartment of Infectious Diseases, Okayama University HospitalHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/70456VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory somatic) syndrome has a poor prognosis, with infections being a major cause of death. Raoultella ornithinolytica is an environmental bacterium found predominantly in soil and water. Although R. ornithinolytica can cause various infections, necrotizing fasciitis due to this bacterium has not been reported. We describe the case of an 84-year-old Japanese male with VEXAS syndrome who developed septic shock and necrotizing fasciitis while he was under immunosuppressive therapy. The pathogen was initially misidentified as R. planticola by mass spectrometry but later confirmed by whole-genome sequencing as extended spectrum β-lactamase (ESBL) produced by R. ornithinolytica. Although a life-saving leg amputation was required, the patient recovered with appropriate antibiotic therapy. R. ornithinolytica is thus able to cause severe skin infections in immunocompromised individuals.No potential conflict of interest relevant to this article was reported.Beck DB, Ferrada MA, Sikora KA, Ombrello AK, Collins JC, Pei W, Balanda N, Ross DL, Ospina Cardona D, Wu Z, Patel B, Manthiram K, Groarke EM, Gutierrez-Rodrigues F, Hoffmann P, Rosenzweig S, Nakabo S, Dillon LW, Hourigan CS, Tsai WL, Gupta S, Carmona-Rivera C, Asmar AJ, Xu L, Oda H, Goodspeed W, Barron KS, Nehrebecky M, Jones A, Laird RS, Deuitch N, Rowczenio D, Rominger E, Wells KV, Lee CR, Wang W, Trick M, Mullikin J, Wigerblad G, Brooks S, DellʼOrso S, Deng Z, Chae JJ, Dulau-Florea A, Malicdan MCV, Novacic D, Colbert RA, Kaplan MJ, Gadina M, Savic S, Lachmann HJ, Abu-Asab M, Solomon BD, Retterer K, Gahl WA, Burgess SM, Aksentijevich I, Young NS, Calvo KR, Werner A, Kastner DL and Grayson PC: Somatic Mutations in UBA1 and Severe Adult-Onset Autoinflammatory Disease. N Engl J Med (2020) 383: 2628-2638.Georgin-Lavialle S, Terrier B, Guedon AF, Heiblig M, Comont T, Lazaro E, Lacombe V, Terriou L, Ardois S, Bouaziz JD, Mathian A, Le Guenno G, Aouba A, Outh R, Meyer A, Roux-Sauvat M, Ebbo M, Zhao LP, Bigot A, Jamilloux Y, Guillotin V, Flamarion E, Henneton P, Vial G, Jachiet V, Rossignol J, Vinzio S, Weitten T, Vinit J, Deligny C, Humbert S, Samson M, Magy-Bertrand N, Moulinet T, Bourguiba R, Hanslik T, Bachmeyer C, Sebert M, Kostine M, Bienvenu B, Biscay P, Liozon E, Sailler L, Chasset F, Audemard-Verger A, Duroyon E, Sarrabay G, Borlot F, Dieval C, Cluzeau T, Marianetti P, Lobbes H, Boursier G, Gerfaud-Valentin M, Jeannel J, Servettaz A, Audia S, Larue M, Henriot B, Faucher B, Graveleau J, de Sainte Marie B, Galland J, Bouillet L, Arnaud C, Ades L, Carrat F, Hirsch P, Fenaux P, Fain O, Sujobert P, Kosmider O and Mekinian A: Further characterization of clinical and laboratory features in VEXAS syndrome: large-scale analysis of a multicentre case series of 116 French patients. Br J Dermatol (2022) 186: 564-574.de Valence B, Delaune M, Nguyen Y, Jachiet V, Heiblig M, Jean A, Riescher Tuczkiewicz S, Henneton P, Guilpain P, Schleinitz N, Le Guenno G, Lobbes H, Lacombe V, Ardois S, Lazaro E, Langlois V, Outh R, Vinit J, Martellosio JP, Decker P, Moulinet T, Dieudonne Y, Bigot A, Terriou L, Vlakos A, de Maleprade B, Denis G, Broner J, Kostine M, Humbert S, Lifermann F, Samson M, Pechuzal S, Aouba A, Kosmider O, Dion J, Grosleron S, Bourguiba R, Terrier B, Georgin-Lavialle S, Fain O, Mekinian A, Morgand M, Comont T, Hadjadj J and French VG: Serious infections in patients with VEXAS syndrome: data from the French VEXAS registry. Ann Rheum Dis (2024) 83: 372-381.Drancourt M, Bollet C, Carta A and Rousselier P: Phylogenetic analyses of Klebsiella species delineate Klebsiella and Raoultella gen. nov., with description of Raoultella ornithinolytica comb. nov., Raoultella terrigena comb. nov. and Raoultella planticola comb. nov. Int J Syst Evol Microbiol (2001) 51: 925-932.Huang Q, Zhang J and Liao G: Abdominal abscess caused by Raoultella ornithinolytica secondary to postoperative gastric fistula: case report and review of literature. BMC Infect Dis (2024) 24: 363.Goodman DT, Murphy D and Dorairaj J: Case Study: Soft tissue infection with Raoultella ornithinolytica. JPRAS Open (2022) 33: 17-20.Shimizu T, Ide H, Tsuji Y, Koga T and Kawakami A: VEXAS syndrome complicated with severe infection. Rheumatology (Oxford) (2022) 61: e374-e376.Yoshida A, Ota T, Sasaoka S, Matsuura H, Fujimoto W and Morita Y; Necrotizing fasciitis in a patient with rheumatoid arthritis treated with tocilizumab: Mod Rheumatol (2012) 22: 317-318.van de Sande MG and van Slobbe-Bijlsma ER: Necrotizing fasciitis in a rheumatoid arthritis patient treated with tocilizumab. Rheumatology (Oxford) (2012) 51: 577-578.Seng P, Boushab BM, Romain F, Gouriet F, Bruder N, Martin C, Paganelli F, Bernit E, Le Treut YP, Thomas P, Papazian L, Raoult D and Stein A: Emerging role of Raoultella ornithinolytica in human infections: a series of cases and review of the literature. Int J Infect Dis (2016) 45: 65-71.Sekowska A, Dylewska K, Gospodarek E and Bogiel T: Catheter-related blood stream infection caused by Raoultella ornithinolytica. Folia Microbiol (Praha) (2015) 60: 493-495.Van Cleve JR, Boucher BA, Smith DV and Croce MA: Ventilator associated pneumonia caused by Raoultella ornithinolytica in two immunocompetent trauma patients. Respir Med Case Rep (2018) 24: 135-137.Wang S, Xu L, Chi X, Li Y, Kou Z, Hou P, Xie H, Bi Z and Zheng B: Emergence of NDM-1- and CTX-M-3-Producing Raoultella ornithinolytica in Human Gut Microbiota. Front Microbiol (2019) 10: 2678.Sekowska A, Bogiel T, Wozniak M and Gospodarek-Komkowska E: Raoultella spp. - reliable identification, susceptibility to antimicrobials and antibiotic resistance mechanisms. J Med Microbiol (2020) 69: 233-238.Okayama University Medical SchoolActa Medica Okayama0386-300X8022026Consistent Clinical Outcomes of Anteroinferior Minimally Invasive Plate Osteosynthesis for Midshaft Clavicle Fractures Across AO/OTA Fracture Types99107ENNguyen Trung ThanhDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoNakamichiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasunoriShimamuraDepartment of Orthopaedic Surgery, Kousei HospitalTaichiSaitoDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakeshiIshiharaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokiFurutaniDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHisakazuShitozawaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomoyukiNodaDepartment of Orthopaedic Surgery, Kawasaki Medical School General Medical CenterToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/70452Although the performance of minimally invasive plate osteosynthesis (MIPO) via the anteroinferior approach is increasingly adopted for midshaft clavicle fractures, the influence of fracture morphology on clinical outcomes under a standardized protocol is unclear. We retrospectively analyzed the cases of 54 patients who underwent anteroinferior MIPO for an acute midshaft clavicle fracture (AO/OTA types B1, B2, B3) performed by a single surgeon across three affiliated institutions (2009-2022). We evaluated the clinical outcomes, i.e., the surgical time, incision length, radiographic union, reduction accuracy, range of motion, pain (visual analog scale [VAS]), and complications and compared them among the three AO/OTA subtypes. The mean incision length (3.4 cm) and surgical time (71-79 min) were similar among the groups (both p>0.2). All fractures achieved radiographic union at a mean of 3.5 months. Postoperative alignment and clavicular length were maintained (length reduction −1.0±2.2 mm [B1], −0.5±2.0 mm [B2], −0.6±1.8 mm [B3]; p=0.825; angulation −0.8±3.4°, −1.1±3.1°, −0.3±3.3°; p=0.888). At 3 months, shoulder elevation and abduction were 169°-175° (p=0.079) and 164°-175° (p=0.324). Pain was minimal (100-mm VAS: ≤1 mm; p=0.782). One plate-fatigue failure occurred; no supraclavicular-nerve symptoms were recorded. Anteroinferior MIPO yielded consistent outcomes across AO/OTA types, with excellent union rates, functional recovery, and few complications, indicating that this technique is safe and reproducible for the surgical management of midshaft clavicle fractures.No potential conflict of interest relevant to this article was reported.Robinson CM: Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg Br (1998) 80: 476-484.Postacchini F, Gumina S, De Santis P and Albo F: Epidemiology of clavicle fractures. J Shoulder Elbow Surg (2002) 11: 452-456.Canadian Orthopaedic Trauma Society: Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am (2007) 89: 1-10.Ferran NA, Hodgson P, Vannet N, Williams R and Evans RO: Locked intramedullary fixation vs plating for displaced and shortened mid-shaft clavicle fractures: a randomized clinical trial. J Shoulder Elbow Surg (2010) 19: 783-789.Wijdicks FJ, Van der Meijden OA, Millett PJ, Verleisdonk EJ and Houwert RM: Systematic review of the complications of plate fixation of clavicle fractures. Arch Orthop Trauma Surg (2012) 132: 617-625.Havet E, Duparc F, Tobenas-Dujardin AC, Muller JM and Fréger P: Morphometric study of the shoulder and subclavicular innervation by the intermediate and lateral branches of supraclavicular nerves. Surg Radiol Anat (2007) 29: 605-610.Sands TT, Martin JB, Simms E, Henderson MM, Friedlander PL and Chiu ES: Supraclavicular artery island flap innervation: anatomical studies and clinical implications. J Plast Reconstr Aesthet Surg (2012) 65: 68-71.Sohn HS, Shin SJ and Kim BY: Minimally invasive plate osteosynthesis using anterior-inferior plating of clavicular midshaft fractures. Arch Orthop Trauma Surg (2012) 132: 239-244.Sohn HS, Shon MS, Lee KH and Song SJ: Clinical comparison of two different plating methods in minimally invasive plate osteosynthesis for clavicular midshaft fractures: A randomized controlled trial. Injury (2015) 46: 2230-2238.Jirangkul P, Kosiyatrakul A and Lorsuwannarat N: Minimally invasive plate osteosynthesis for displaced midshaft clavicle fractures: An indirect reduction using joystick technique. J Orthop Sci (2023) 28: 1365-1372.Ok S, Yoon SM and Choi S: Intuitive and Minimally Invasive Surgical Technique for Comminuted Mid-Shaft Clavicle Fractures: Fixation with an Anterior Mini Plate and Superior Locking Compression Plate. J Clin Med (2025) 14.Zhang Y, Xu J, Zhang C and Sun Y: Minimally invasive plate osteosynthesis for midshaft clavicular fractures using superior anatomic plating. J Shoulder Elbow Surg (2016) 25: e7-12.Kundangar RS, Mohanty SP and Bhat NS: Minimally invasive plate osteosynthesis (MIPO) in AO/OTA type B displaced clavicle fractures. Musculoskelet Surg (2019) 103: 191-197.Amaral FMD, Malavolta EA, Silva F, Altoé LS, Nunes CV and Pécora JR: MINIMALLY INVASIVE OSTEOSYNTHESIS FOR CLAVICULAR FRACTURE WITH LOCKED PLATE. Acta Ortop Bras (2023) 31: e263742.Meinberg EG, Agel J, Roberts CS, Karam MD and Kellam JF: Fracture and Dislocation Classification Compendium-2018. J Orthop Trauma (2018) 32 Suppl 1: S1-s170.Lee GB, Kim H, Jeon IH and Koh KH: Long-term outcomes of initially conservatively treated midshaft clavicle fractures. Clin Shoulder Elb (2021) 24: 9-14.Zhao B, Zhao W, Assan I and Bi R: Conoid tubercle angle: attention should be paid to supraclavicular plate fixation. J Orthop Surg Res (2022) 17: 105.Meeuwis MA, Pull Ter Gunne AF, Verhofstad MH and van der Heijden FH: Construct failure after open reduction and plate fixation of displaced midshaft clavicular fractures. Injury (2017) 48: 715-719.Zhuang Y, Zhang Y, Zhou L, Zhang J, Jiang G and Wu J: Management of comminuted mid-shaft clavicular fractures: Comparison between dual-plate fixation treatment and single-plate fixation. J Orthop Surg (Hong Kong) (2020) 28: 2309499020915797.Thorsmark AH, Muhareb Udby P, Ban I and Frich LH: Bone shortening of clavicular fractures: comparison of measurement methods. BMC Musculoskelet Disord (2017) 18: 537.Ribas GGO, Dau L, Gonçalves FF, Oliveira MHS, Marques NSH and Souza GAL: Measurement of Clavicular Symmetry in Healthy Subjects Using Tomographic Database of Public Hospitals. Rev Bras Ortop (Sao Paulo) (2023) 58: e617-e624.Zhang X, Tan J, Li N, Kelsang B, Han X, Cao R, Zhang Y and Jiang X: Measurement of clavicular symmetry: A hint for midshaft clavicle fracture management. Injury (2025) 56: 112023.Abdel Fatah EE, Shirley NR, Mahfouz MR and Auerbach BM: A three-dimensional analysis of bilateral directional asymmetry in the human clavicle. Am J Phys Anthropol (2012) 149: 547-559.Xu Y, Guo X, Peng H, Dai H, Huang Z and Zhao J: Different internal fixation methods for unstable distal clavicle fractures in adults: a systematic review and network meta-analysis. J Orthop Surg Res (2022) 17: 43.Marín Fermín T, Migliorini F, Papakostas E, Al-Khelaifi K, Maldonado DR, Hovsepian JM and Maffulli N: Concomitant glenohumeral injuries in patients with distal clavicle fractures undergoing arthroscopic-assisted surgery: a systematic review. J Orthop Surg Res (2022) 17: 31.Okayama University Medical SchoolActa Medica Okayama0386-300X8022026Effects of Nonsurgical Periodontal Treatment on Bacterial and Clinical Parameters in Down Syndrome Patients Based on 16S rRNA Gene Amplicon Sequencing8597ENTakahikoShibaDepartment of Periodontology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoMitsuhitoTakamoriDepartment of Oral Physiology, Graduate School of Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySayakaKatagiriDepartment of Oral Biology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoRyotaKobayashiDepartment of Periodontology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoAkiKawauchiDepartment of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoYujinOhsugiDepartment of Oral Biology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoPeiyaLinDepartment of Oral Biology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoDaisukeEkuniDepartment of Preventive Dentistry, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasahikoEgusaThe center for Special Needs Dentistry, Medical Development Field, Okayama UniversityTakanoriIwataDepartment of Periodontology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoShigeruMaedaDepartment of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoOriginal Article10.18926/AMO/70451Individuals with Down syndrome (DS) are more susceptible to periodontal disease; however, microbial changes following treatment remain insufficiently understood. This study evaluated the effects of nonsurgical periodontal therapy on clinical outcomes and oral microbiome dynamics in 6 patients with DS using 16S rRNA gene amplicon sequencing. Bacterial diversity, composition, network structure, and predicted functional pathways were analyzed using dental plaque samples. Bleeding on probing decreased significantly (p=0.047) after treatment, with a trend toward reduction in periodontal inflamed surface area (p=0.05). The abundance of Fusobacteria at the class level decreased significantly after treatment. The abundance of Mogibacterium timidum was higher in the pretreatment group than in the posttreatment group. M. timidum was positively correlated with Treponema denticola and associated with multiple bacterial taxa in the network during pretreatment. Predicted functional pathways related to aromatic compound degradation were more abundant in posttreatment samples than in pretreatment samples. An increase in the abundance of Fusobacterium and the positive correlation between T. denticola and M. timidum, together with their associations with other periodontal pathogens before treatment, may contribute to the development of periodontitis in individuals with DS. Nonsurgical periodontal therapy produces measurable clinical improvement and promotes microbial shifts in patients with DS.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8022026Involvement of ADAM12 in TGF-β1-Induced Proliferation of Rheumatoid Arthritis Synovial Fibroblasts7583ENDetingLinDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasahiroHoritaDepartment of Orthopaedic Surgery, Faculty of Medical Development Field, Okayama UniversityMasahitoWatanabeDepartment of Orthopaedic Surgery, Muscat Orthopaedic ClinicJoeHaseiMedical Information and Assistive Technology Development, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiOhtsukiMedical Technology, Graduate School of Health Sciences, Okayama UniversityNoriakiOtsukaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChinatsuIchikawaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNoriyukiShimizuDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuichiNaniwaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeiichiroNishidaDivision of Chronic Pain Medicine and Division of Comprehensive Rheumatology, Locomotive Pain Center, Faculty of Medical Development Field, Okayama UniversityOriginal Article10.18926/AMO/70450A disintegrin and metalloproteinase 12 (ADAM12) is known to be involved in chondrocyte proliferation and is upregulated in the synovial tissue of osteoarthritis (OA). However, the underlying mechanisms of ADAM12 on rheumatoid arthritis (RA) synovial cell proliferation remain unknown. Here, we investigated the role of ADAM12 in the proliferation of RA synovial fibroblasts (RASFs). The expression and localization of ADAM12 in RA synovial tissues were examined by immunohistochemistry and compared with OA and healthy control (HC) synovial tissues. The effect of inflammatory cytokines (TNF-α, TGF-β1, and PDGF-BB) on ADAM12 expression in RASFs from RA patients was examined by real-time RT-PCR. The effect of ADAM12 knock-down by ADAM12 siRNA and ADAM12 overexpression on cell proliferation of RASFs were examined by WST-1 assay. ADAM12 was identified predominantly in RA synovial tissue rather than OA and HC synovial tissues. Stimulation with TGF-β1 upregulated the expression of ADAM12 and cell proliferation of RASFs. ADAM12 siRNA suppressed TGF-β1-induced cell proliferation of RASFs, while ADAM12 overexpression promoted the cell proliferation of RASFs. These findings demonstrate that ADAM12 may have a key role in TGF-β1-induced cell proliferation of synovial fibroblasts in patients with RA.No potential conflict of interest relevant to this article was reported.Scott DL, Wolfe F and Huizinga TW: Rheumatoid arthritis. Lancet (2010) 24: 1094-1108.Scherer HU, Haupl T and Burmester GR: The etiology of rheumatoid arthritis. J Autoimmun (2020) 110: 102400.Cheon H, Yu SJ, Yoo DH, Chae IJ, Song GG and Sohn J: Increased expression of pro-inflammatory cytokines and metalloproteinase-1 by TGF-beta1 in synovial fibroblasts from rheumatoid arthritis and normal individuals. Clin Exp Immunol (2002) 127: 547-552.Rosengren S, Corr M and Boyle DL: Platelet-derived growth factor and transforming growth factor beta synergistically potentiate inflammatory mediator synthesis by fibroblast-like synoviocytes. Arthritis Res Ther (2010) 12: R65.Kveiborg M, Frohlich C, Albrechtsen R, Tischler V, Dietrich N, Holck P, Kronqvist P, Rank F, Mercurio AM and Wewer UM: Cancer Res (2005) 65: 4754-4761.Loechel F, Gilpin BJ, Engvall E, Albrechtsen R and Wewer UM: Human ADAM 12 (meltrin alpha) is an active metalloprotease. J Biol Chem (1998) 273: 16993-16997.Okada A, Mochizuki S, Yatabe T, Kimura T, Shiomi T, Fujita Y, Matsumoto H, Sehara-Fujisawa A, Iwamoto Y and Okada Y: ADAM-12 (meltrin alpha) is involved in chondrocyte proliferation via cleavage of insulin-like growth factor binding protein 5 in osteoarthritic cartilage. Arthritis Rheum (2008) 58: 778-789.Kerna I, Kisand K, Suutre S, Murde M, Tamm A, Kumm J and Tamm A: The ADAM12 is upregulated in synovitis and postinflammatory fibrosis of the synovial membrane in patients with early radiographic osteoarthritis. Joint Bone Spine (2014) 81: 51-56.Wang J, Zhang Z, Li R, Mao F, Sun W, Chen J, Zhang H, Bartsch JW, Shu K and Lei T: ADAM12 induces EMT and promotes cell migration, invasion and proliferation in pituitary adenomas via EGFR/ERK signaling pathway. Biomed Pharmacother (2018) 97: 1066-1077.Xu J, Wang Y, Jiang J, Yin C and Shi B: ADAM12 promotes clear cell renal cell carcinoma progression and triggers EMT via EGFR/ERK signaling pathway. J Transl Med (2023) 21: 56.Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH and Luthra HS: The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum (1988) 31: 315-324.Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd, Birnbaum NS, Burmester GR, Bykerk VP, Cohen MD, Combe B, Costenbader KH, Dougados M, Emery P, Ferraccioli G, Hazes JM, Hobbs K, Huizinga TW, Kavanaugh A, Kay J, Kvien TK, Laing T, Mease P, Menard HA, Moreland LW, Naden RL, Pincus T, Smolen JS, Stanislawska-Biernat E, Symmons D, Tak PP, Upchurch KS, Vencovsky J, Wolfe F and Hawker G: 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum (2010) 62: 2569-2581.de la Torre NG, Buley I, Wass JA and Turner HE: Angiogenesis and lymphangiogenesis in thyroid proliferative lesions: relationship to type and tumour behaviour. Endocr Relat Cancer (2006) 13: 931-944.Rao X, Huang X, Zhou Z and Lin X: An improvement of the 2ˆ(-delta delta CT) method for quantitative real-time polymerase chain reaction data analysis. Biostat Bioinforma Biomath (2013) 3: 71-85.Fröhlich C, Albrechtsen R, Dyrskjot L, Rudkjaer L, Orntoft TF and Wewer UM: Molecular profiling of ADAM12 in human bladder cancer. Clin Cancer Res (2006) 12: 7359-7368.Park YL, Park SY, Oh HH, Chung MW, Hong JY, Kim KH, Myung DS, Cho SB, Lee WS, Kim HS and Joo YE: A Disintegrin and Metalloprotease 12 Promotes Tumor Progression by Inhibiting Apoptosis in Human Colorectal Cancer. Cancers (Basel) (2021) 13: 1927.Zhu H, Jiang W, Zhu H, Hu J, Tang B, Zhou Z and He X: Elevation of ADAM12 facilitates tumor progression by enhancing metastasis and immune infiltration in gastric cancer. Int J Oncol (2022) 60: 51.Lv P, Zhang Y, Wu W, Jiang X and Xiang W: Pan-cancer analysis identifies ADAM12 as a prognostic biomarker and indicator of immune infiltration in glioma. Sci Rep (2025) 15: 6314.Evans CH, Ghivizzani SC and Robbins PD: Gene therapy for arthritis: what next?. Arthritis Rheum (2006) 54: 1714-1729.Kim YM, Kim J, Heo SC, Shin SH, Do EK, Suh DS, Kim KH, Yoon MS, Lee TG and Kim JH: Proteomic identification of ADAM12 as a regulator for TGF-beta1-induced differentiation of human mesenchymal stem cells to smooth muscle cells. PLoS One (2012) 7: e40820.Ruff M, Leyme A, Le Cann F, Bonnier D, Le Seyec J, Chesnel F, Fattet L, Rimokh R, Baffet G and Théret N: The Disintegrin and Metalloprotease ADAM12 Is Associated with TGF-β-Induced Epithelial to Mesenchymal Transition. PLoS One (2015) 25: e0139179.Ramdas V, McBride M, Denby L and Baker AH: Canonical transforming growth factor-beta signaling regulates disintegrin metalloprotease expression in experimental renal fibrosis via miR-29. Am J Pathol (2013) 183: 1885-1896.Blobe GC, Schiemann WP and Lodish HF: Role of transforming growth factor β in human disease. N Engl J Med (2000) 342: 1350-1358.Wang BH, Lu YH, Wu LF, Lu X, Guo W, Deng FY and Lei SF: Evaluation of plasma cytokine protein array profile: the highlighted PDGF-BB in rheumatoid arthritis. Clin Rheumatol (2020) 39: 3323-3330.Zhang L, Guo W, Chen Q, Fan X, Zhang Y and Duan E: Adam12 plays a role during uterine decidualization in mice. Cell Tissue Res (2009) 338: 413-421.Wang L, Tan Z, Zhang Y, Kady Keita N, Liu H and Zhang Y: ADAM12 silencing promotes cellular apoptosis by activating autophagy in choriocarcinoma cells. Int J Oncol (2020) 56: 1162-1174.Loechel F, Fox JW, Murphy G, Albrechtsen R and Wewer UM: ADAM 12-S cleaves IGFBP-3 and IGFBP-5 and is inhibited by TIMP-3. Biochem Biophys Res Commun (2000) 278: 511-515.Horita M, Nishida K, Hasei J, Furumatsu T, Sakurai M, Onodera Y, Fukuda K, Salter DM and Ozaki T: Involvement of ADAM12 in chondrocyte differentiation by regulation of TGF-β1‒induced IGF-1 and RUNX-2 expressions. Calcif Tissue Int (2019) 105: 97-106.Rosengren S, Boyle DL and Firestein GS: Acquisition, culture, and phenotyping of synovial fibroblasts. Methods Mol Med (2007) 135: 365-375.Seidel MF, Koch FW and Vetter H: Macrophage-like synoviocytes display phenotypic polymorphisms in a serum-free tissue-culture medium. Rheumatol Int (2006) 26: 244-251.Springer Science and Business Media LLCActa Medica Okayama2662-4435712026Stability and distribution of dense hydrous magnesium silicates in the mantle transition zone under low water activity conditions265ENYunkeSongKey Laboratory of High-temperature and High-pressure Study of the Earth’s Interior, Institute of Geochemistry, Chinese Academy of SciencesXinzhuanGuoState Key Laboratory of Critical Mineral Research and Exploration, Institute of Geochemistry, Chinese Academy of SciencesKuanZhaiKey Laboratory of High-temperature and High-pressure Study of the Earth’s Interior, Institute of Geochemistry, Chinese Academy of SciencesWeiGuoState Key Laboratory of Geomicrobiology and Environmental Changes, School of Earth Sciences, China University of Geosciences (Wuhan)TakashiYoshinoInstitute for Planetary Materials, Okayama UniversityWater plays a central role in controlling the physical and chemical properties of Earth’s deep interior. It remains uncertain how water is stored in subducting slabs within the mantle transition zone, between depths of about 410 and 660 kilometers, and whether dense hydrous magnesium silicates act as major water carriers to greater depths. Here we report high-pressure and high-temperature laboratory experiments on the Mg-Si-H system at pressures of 16 and 21.5 GPa and a temperature of 1400 K to evaluate hydrous phase stability under transition zone conditions. We find that when bulk water content is below 1.22 wt%, H2O is predominantly incorporated into wadsleyite and ringwoodite rather than forming dense hydrous magnesium silicates. Because estimated water contents in subducted oceanic slabs are typically lower than one weight percent, formation of these silicates is unlikely, suggesting that the mantle transition zone may restrict large scale water transport into the lower mantle.No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構 教師教育開発センターActa Medica Okayama2186-1323162026知的障害高等特別支援学校における SWPBS 第１層支援 ―キャンペーン方式の導入とその効果―205219ENHideakiTOKIMITSUGraduate School of Education (Professional Degree Course), Okayama UniversityYoshioMIYAZAKIFaculty of Education, Okayama UniversityMadokaKOYAMAKurashiki Kotoura Special Needs Seni or High School, Okayama Prefecture10.18926/CTED/70370 本研究は，軽度知的障害のある後期中等教育段階の公立知的障害高等特別支援学校において，SWPBS 第1層支援としてキャンペーン方式の支援を実施し，その効果検証を行った。方法としては，Ｘ学年生徒24名に対して挨拶行動の促進を狙ったキャンペーンを実施し，目標行動の生起数についてABフォローアップデザインを用いて検討した。また，Ｘ学年教員6名に対し，社会的妥当性を評価するアンケートを実施した。その結果，キャンペーンの介入直後に目標行動の生起数および目標行動に従事した生徒の割合の増加が見られ，キャンペーン終了後もベースラインと比較した増加が一定期間確認された。また，一定程度の社会的妥当性も確認できた。No potential conflict of interest relevant to this article was reported.一般社団法人粉体粉末冶金協会Acta Medica Okayama0532-87997332026熱間静水圧加圧法を用いたイットリア安定化ジルコニア緻密層の低温形成5559ENKyoheiMANABEOsaka Gas Co. Ltd.MitsuakiECHIGOOsaka Gas Co. Ltd.AkiraKISHIMOTOInstitute of Academic and Research, Faculty of Environmental, Life, Natural Science and Technology, Okayama UniversityThe sintering conditions using hot isostatic press (HIP) of yttria-stabilized zirconia (YSZ) were investigated to obtain a dense YSZ layer at low sintering temperature such as 1000°C for an electrolyte of metal-supported solid oxide fuel cell. It was found that a dense YSZ pellet with relative density of 93% could be obtained under a sintering condition of 1000°C-10 hours with HIP in 195 MPa. On the other hand, in X-ray diffraction analysis of the dense YSZ pellet, peaks of the monoclinic phase were slightly detected in addition to peaks of the cubic phase. From energy dispersive X-ray spectroscopy analysis, a small amount of boron was detected in the dense YSZ pellet. It is considered that the YSZ crystalline phase transformation of cubic to monoclinic phase was occurred by the boron diffusion from the diffusion barrier coating of metal foil capsule used for the HIP.No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama2470-13431192026Water-Resistant Antibacterial Coatings Using Cetylpyridinium Chloride - Graphene Oxide Composites1457014577ENKeisukeOkuboDepartment of Periodontics and Endodontics, Field of Medical Development, Okayama UniversityGenKanoGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasatoKomodaResearch Institute for Interdisciplinary Science, Okayama UniversityKazuhiroOmoriDepartment of Pathophysiology - Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYutaNishinaResearch Institute for Interdisciplinary Science, Okayama UniversityShogoTakashibaDepartment of Pathophysiology - Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHospital-acquired infections remain a persistent threat in healthcare settings, especially with the increasing number of elderly and immunocompromised patients. In situations where the use of disposable materials is difficult, durable antibacterial surface coatings are essential. In this study, we report the structural characterization of cetylpyridinium chloride-graphene oxide (CPC–GO) hybrid materials and the sustainability of their antibacterial effects, aiming at washable antibacterial coatings for medical applications. Graphene oxide (GO) has a large surface area and numerous functional groups, while cetylpyridinium chloride (CPC) is a quaternary ammonium compound with well-documented antibacterial activity. We hypothesized that the stable incorporation of CPC through the functional groups of GO could improve surface retention and provide long-term antibacterial performance. The structural properties of the CPC–GO composites were characterized by UV–vis spectroscopy, X-ray diffraction, thermogravimetric analysis, scanning electron microscopy, and atomic force microscopy. These analyses confirmed the formation of a complex through ionic bonds and the maintenance of a planar composite structure. The antibacterial performance of the CPC–GO coatings was examined using representative bacteria. Notably, the CPC–GO coatings maintained their antibacterial activity significantly better than the negative controls even after multiple washings. The excellent surface retention of the CPC–GO composite suggests its potential as a next-generation antibacterial coating for areas where disinfection and sterilization are impossible, such as the interior of complex medical devices. This study suggests a strategy to extend the efficacy of existing antibacterial agents through the application of nanomaterials. Future studies will focus on the controlled release, long-term stability, and biocompatibility of CPC to realize clinical applications.No potential conflict of interest relevant to this article was reported.岡山大学理学部地球科学科Acta Medica Okayama1340-74143212026寒風古窯跡群須恵器の岩石学的研究919ENTaijiANAMIDepartment of Earth Sciences, Okayama UniversityToshioNOZAKADepartment of Earth Sciences, Okayama UniversityOsamuKIMURADepartment of Archaeology, Osaka University10.18926/ESR/70295 The Sabukaze kiln site, a representative ancient tunnel-kiln site in the Kibi region, worked during the Asuka period (from early 7th century to early 8th century) to produce Sue ware including jars, cups, coffins, and ornamental tiles. To determine the provenance of the materials used for the Sue ware, we carried out petrological analyses of 13 Sue sherds, including optical microscopy, X-ray diffractometry, X-ray fluorescence spectroscopy, Raman spectroscopy, and electron-probe analysis. In spite of the difference of production time, all the Sue sherds show close similarities in modal proportion of mineral inclusions with dominant quartz and feldspar, and minor volcanic glass, in chemical compositions of feldspar and interstitial matrix, and in whole-sherd chemical composition. These similarities suggest that the paste materials of the Sabukaze Sue ware were commonly derived from weathered rhyolitic rocks and obtained from the same or neighboring mining site(s) located near the kiln site.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221612026Comparative efficacy of immune checkpoint inhibitor combination therapies by metastatic site in metastatic renal cell carcinoma3303ENShingoToyodaDepartment of Urology, Faculty of Medicine, Kindai UniversityLanInokiDepartment of Urology, Faculty of Medicine, Kindai UniversityMamoruHashimotoDepartment of Urology, Faculty of Medicine, Kindai UniversityWataruFukuokayaDepartment of Urology, The Jikei University School of MedicineKeiichiroMoriDepartment of Urology, The Jikei University School of MedicineShingoNishimuraDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineRyoichiMaenosonoDepartment of Urology, Osaka Medical and Pharmaceutical UniversityTakehiroIwataDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKensukeBekkuDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTakuhisaNukayaDepartment of Urology, Fujita-Health University School of MedicineTakafumiYanagisawaDepartment of Urology, The Jikei University School of MedicineTakuyaTsujinoDepartment of Urology, Osaka Medical and Pharmaceutical UniversityKazumasaKomuraDepartment of Urology, Kawasaki University School of MedicineKiyoshiTakaharaDepartment of Urology, Fujita-Health University School of MedicineTeruoInamotoDepartment of Urology, Hamamatsu University School of MedicineHaruhitoAzumaDepartment of Urology, Osaka Medical and Pharmaceutical UniversityKazutoshiFujitaDepartment of Urology, Faculty of Medicine, Kindai UniversityJK-FOOT study groupFew studies have investigated the efficacy of immuno-oncology (IO) combinations at different metastatic sites in renal cell carcinoma (RCC). We evaluated the differential efficacy of IO–IO and IO–tyrosine kinase inhibitor (TKI) combinations by metastatic site in metastatic RCC (mRCC). This retrospective multicenter study by the JK-FOOT Study Group included 579 patients with intermediate- or poor-risk mRCC (per International Metastatic RCC Database Consortium criteria) treated with first-line IO combinations between September 2018 and December 2024. Metastatic sites were lymph nodes, lungs, bones, liver, brain, and others. The primary endpoints were progression-free survival (PFS) and overall survival (OS); the secondary endpoint was objective response rate. Efficacy was compared between IO–IO and IO–TKI for each site. For lymph node (n = 36), lung (n = 132), or brain (n = 16) metastases, OS or PFS was not significantly different between IO–IO and IO–TKI. In bone metastases (n = 80), OS tended to favor IO–TKI (P = 0.053). In liver metastases (n = 22), OS was significantly longer with IO–TKI (P = 0.011). IO–TKI may be a more appropriate first-line option than IO–IO for mRCC with bone or liver metastases, while efficacy is similar for other sites.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2590-1397282025Flow diverter treatment for internal carotid artery aneurysm following management of distal cerebral aneurysms: Technical note100540ENYuichiHirataDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasafumiHiramatsuDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenjiSugiuDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFukikoBabaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJuntaroFujitaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYutaSotomeDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasatoKawakamiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyuKimuraDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiEbisudaniDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunHarumaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomohitoHishikawaDepartment of Neurosurgery, Kawasaki Medical SchoolShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground: In recent years, the effectiveness of flow diverters (FDs) for the treatment of intracranial aneurysms has been reported. While FDs are effective, their deployment involves advancing a delivery wire distally, which may pose a risk if a distal aneurysm exists within the same artery. In such cases, the delivery wire could potentially perforate the distal aneurysm. Here, we present two cases of tandem aneurysms in which an internal carotid artery (ICA) aneurysm was treated with an FD following the treatment of a distal cerebral aneurysm.<br>
Case description: A 44-year-old woman and a 67-year-old woman underwent magnetic resonance imaging for headache or abducens nerve palsy. In both cases, two aneurysms were revealed: one at the ICA and the other either at the middle cerebral artery or the top of the ICA. Due to the risk of perforation by the delivery wire during FD deployment, the distal aneurysms were treated first―either with surgical neck clipping or stent-assisted coil embolization. One month after the initial treatment, FD placement for the ICA aneurysm was performed as planned without complications in either case.<br>
Discussion: This is the first report where tandem aneurysms were successfully treated with treatment for distal cerebral aneurysms, followed by FDs for proximal ICA aneurysms. We emphasize the potential risk of perforation of the distal aneurysm by the delivery wire during FD placement.<br>
Conclusion: Treatment of distal cerebral aneurysms beforehand can help ensure the safe and effective use of FDs in patients with tandem aneurysms.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1999-49231812026Streamlined Radiosynthesis of [18F]Fluproxadine (AF78): An Unprotected Guanidine Precursor Enables Efficient One-Step, Automation-Ready Labeling for Clinical Use123ENXinyuChenNuclear Medicine, Faculty of Medicine, University of AugsburgKaitoOhtaFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiroyukiKimuraAgency for Health, Safety and Environment, Kyoto UniversityYusukeYagiFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakanoriSasakiFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNaokoNoseFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasaruAkehiFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomohikoYamaneDepartment of Molecular Imaging Research, Kobe City Medical Center General HospitalRudolf A.WernerDepartment of Nuclear Medicine, LMU Hospital, and German Cancer Consortium (DKTK), Partner Site Munich, Ludwig-Maximilians-University of MunichTakahiroHiguchiFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground/Objectives: [18F]Fluproxadine (formerly [18F]AF78) is a PET radiotracer targeting the norepinephrine transporter (NET) with potential applications in cardiac, neurological, and oncological imaging. Its guanidine moiety, while essential for NET binding, presents major radiosynthetic challenges due to high basicity and the harsh deprotection conditions required for protected precursors. Previous methods relied on multistep procedures, strong acids, and complex purification, limiting clinical translation. This study aimed to develop a practical one-step radiosynthesis suitable for routine and automated production. Methods: A direct SN2-type nucleophilic [18F]fluorination was performed using an unprotected guanidine precursor to eliminate deprotection steps. Reaction parameters, including the base system, solvent composition, precursor concentration, and temperature, were optimized under conventional and microwave heating. Radiochemical conversion (RCC) and operational robustness were evaluated, and purification strategies were assessed for automation compatibility. Results: Direct [18F]fluorination using the unprotected precursor reduced the total synthesis time to 60–70 min. Optimal conditions employed a tert-butanol/acetonitrile (4:1) solvent system with K2CO3/Kryptofix222, affording RCC up to 33% under conventional heating. Microwave irradiation further improved efficiency, achieving RCC of up to 64% within 1.5 min at 140 °C. The method showed broad tolerance to variations in the base molar ratio and precursor concentration and enabled isocratic HPLC purification. Conclusions: This one-step radiosynthesis overcomes longstanding challenges in [18F]fluproxadine production by eliminating harsh deprotection and enabling high-yield, automation-ready synthesis, thereby improving clinical feasibility.No potential conflict of interest relevant to this article was reported.American Geophysical Union (AGU)Acta Medica Okayama0094-82765352026Electrical Conductivity of Amorphous and Molten CaCO3 at High Pressures and Its Implications for Mantle Conductivity Anomaliese2025GL119568ENBinZhaoInstitute for Planetary Materials, Okayama UniversityTakashiYoshinoInstitute for Planetary Materials, Okayama UniversityQiChenCenter for Advanced Radiation Sources, The University of ChicagoTonyYuCenter for Advanced Radiation Sources, The University of ChicagoDongzhouZhangCenter for Advanced Radiation Sources, The University of ChicagoBinChenSchool of Ocean and Earth Science and Technology, University of Hawaii at ManoaYanbinWangCenter for Advanced Radiation Sources, The University of ChicagoImpedance spectrometry experiments have been conducted on CaCO3 up to 15 GPa and 2,100 K to identify its state under high pressure. The melting temperature of CaCO3 was also determined by the falling of a Re sphere observed via X-ray radiography. The phase transition from aragonite to the amorphous phase does not cause a leap in the Electrical conductivity (EC), while a drastic increase in the EC, by 1.5–2.0 log units, only occurs with the onset of melting. The EC of amorphous CaCO3 is comparable to other hydrous mantle minerals at similar pressure and temperature conditions. The required fraction of amorphous CaCO3 implies that it can be excluded from the potential origins responsible for the observed high EC anomalies in the upper mantle. If the conductivity anomalies are induced by the presence of carbonate, a low-degree melting of carbonate-bearing peridotite is anticipated.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1068-926532122025Mesenteric Route Superior Mesenteric Artery First Approach in Robot-Assisted Pancreatoduodenectomy89038905ENKoseiTakagiDepartment 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 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 SciencesTsubasaYanagiharaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground. The superior mesenteric artery (SMA) approach is crucial for the successful implementation of robot-assisted pancreatoduodenectomy (RPD). Herein, we present a novel technique, the mesenteric route SMA-first approach, for RPD.<br>
Patients and Methods. A 20-year-old woman with a 50 mm intraductal papillary mucinous neoplasm underwent RPD. As the tumor was large and located close to the mesenteric vessels, we developed the mesenteric route SMA-first approach.<br>
Results. Following the mesenteric Kocher maneuver, the mesenteric route SMA-first approach was applied. With appropriate retraction of the pancreatic head, dissection around the mesenteric vessels was performed and their branches were divided. The uncinate process dissection (PL, ph II) was performed via the mesenteric route. This approach facilitated dorsal dissection, particularly around the large tumor. After dissection of the hepatoduodenal ligament, the remaining pancreatic nerve plexus (PL ph I) was dissected. Finally, the pancreas was divided on the superior mesenteric vein, and the specimen was resected. Operative time was 390 min with minimal blood loss.<br>
Conclusions. The mesenteric route SMA-first approach enables uncinate process dissection via the mesenteric route. This technique may be a safe and feasible option for selected patients, such as nonobese individuals with a large pancreatic head tumor near major vessels.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1865-13801912026Association of Wet-Bulb Globe Temperature with heat-related illness hospitalizations in Japan: a time-stratified, case-crossover study11ENYukaYamamuraDepartment of Epidemiology, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical SciencesTakashiHongoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical SciencesTetsuyaYumotoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical SciencesFumiyaSasaiDepartment of Epidemiology, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical SciencesKoheiTokiokaDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical SciencesTakafumiObaraDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical SciencesTsuyoshiNojimaDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical SciencesJunKandaEmergency and Critical Care Medicine, Nippon Medical School Musashikosugi HospitalShojiYokoboriDepartment of Emergency and Critical Care Medicine, Nippon Medical SchoolHiromichiNaitoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical SciencesTakashiYorifujiDepartment of Epidemiology, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical SciencesAtsunoriNakaoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical SciencesBackground Heat-related illnesses are a serious public health concern and are exacerbated by global warming. Wet-Bulb Globe Temperature (WBGT) is widely used as a heat stress indicator, but its clinical impact remains unclear. This study aimed to investigate the association between hourly variations in WBGT and the incidence of hospitalizations for heat-related illness in Japan using a nationwide database. By incorporating individual-level clinical data and performing stratified analyses, we sought to provide a more granular understanding of how heat exposure affects the risk of heat-related illness requiring hospitalization.<br>
Methods We conducted a time-stratified, case-crossover study using data collected from July to September in 2020 and 2021 in the Heatstroke STUDY registry. The inclusion criteria were patients registered in the Heatstroke STUDY registry, specifically hospitalized patients with heat-related illness who were transported to participating hospitals during the study period. Hourly WBGT values were assigned based on the nearest monitoring station to each hospital. Conditional logistic regression and distributed lag models were used to estimate associations between WBGT and the risk of hospitalization.<br>
Results A total of 1,653 heat-related illness hospitalizations were analyzed. The mean patient age was 67.9 years; 67.6% were male. Each 1 °C increase in WBGT at onset (hospital arrival) was associated with a significantly increased risk of hospitalization (OR 1.10, 95% CI: 1.05–1.15). The cumulative effect over the prior six hours was also significant (OR 1.56, 95% CI: 1.50–1.62). Compared with WBGT < 25 °C, adjusted ORs were 3.39 (25–27 °C), 8.81 (28–30 °C), and 22.10 (≥ 31 °C). Stratified analyses suggested stronger associations among several subgroups; however, only patients with mental disorders showed statistically significant effect modification, whereas elevated WBGT posed a risk across all groups.<br>
Conclusions Higher WBGT levels were associated with an increased risk of heat-related hospitalization. Although the effect appeared greater in some subgroups, only patients with mental disorders demonstrated statistically significant effect modification, suggesting elevated WBGT confers risk broadly.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8012026Metastatic Intraocular Tumor Likely from Hepatocellular Carcinoma Mimicking Panuveitis6367ENEriTakasuDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusukeShiodeDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyaKindoDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuheiKimuraDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMioHosokawaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoMatobaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiKanzakiDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTetsuroMoritaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuyaAdachiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiMorizaneDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/70074A 77-year-old man undergoing treatment for hepatocellular carcinoma (HCC) presented with blurred vision in his right eye, persisting for 2 months. Slit-lamp microscopy and fundus examination revealed inflammatory cells in the anterior chamber, severe vitreous opacities, and retinal vasculitis in the right eye. The patient underwent vitreous surgery with biopsy, and vitreous cytology confirmed a metastatic intraocular tumor originating from the HCC. Radiotherapy was administered to the right eye, with no recurrence of intraocular inflammation observed at 10 months post-irradiation.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8012026Changes in Prescribing Patterns of Antiviral Drugs before and after Public Coverage Termination among Hospitalized COVID-19 Patients in Regional Hospitals in Japan: A Retrospective, Multicenter Study5562ENHidemasaAkazawaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,HideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalShinnosukeFukushimaDepartment of Infectious Diseases, Okayama University HospitalShoheiYamamotoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,YasuhiroNakanoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,FumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,Original Article10.18926/AMO/70073In Japan, antiviral agents for COVID-19 were freely available until September 2023 as part of national policy. This study evaluated changes in these agents’ prescribing patterns and the patient outcomes following the policy shift. We conducted a multicenter retrospective study at four hospitals in Japan’s Okayama and Kagawa prefectures from January 2022 to March 2024. The study period was divided into the public-expenditure phase (January 2022 to September 2023) and the post-expenditure phase (October 2023 to March 2024). We extracted the hospitalized patients’ clinical data from the electronic database. The study’s primary outcome was the antiviral prescription rate; the secondary outcome was in-hospital mortality. Among the 302 hospitalized patients (median age 85 years), 52.0% were classified as having a mild condition. Of the patients with mild conditions, 37.7% were diagnosed in outpatient settings prior to hospitalization. During the public-expenditure phase, 47.4% of the patients received antivirals as outpatients, mainly molnupiravir (80.9%). In the post-expenditure period, 80.0% of the patients were prescribed antivirals, mostly molnupiravir (91.7%). The antiviral prescription rate was significantly higher after the policy change. The overall in-hospital mortality was 15.8%, with no significant difference between the two periods (17.0% vs. 10.5%). Despite the termination of government funding, antiviral prescriptions remained frequent at community hospitals located in highly aging regions of western Japan such as Okayama and Kagawa prefectures. Mortality remains high among the elderly, highlighting the need for continued antiviral therapy and booster vaccinations.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8012026A Novel Nomogram that Predicts Chronic Hemodialysis Patients’ Survival Based on Their Sedentary Behavior916ENKentaroSugaharaDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityTakashiKondoInnoshima General HospitalNobuyukiMiyatakeDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityHiroyukiNishiInnoshima General HospitalKazuhiroUjikeInnoshima General HospitalKiichiKoumotoInnoshima General HospitalKeiichiNamioDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityShuheiHishiiDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityAkihikoKatayamaFaculty of Social Studies, Shikokugakuin UniversityHiromiSuzukiDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityYorimasaYamamotoInnoshima General HospitalOriginal Article10.18926/AMO/70068Appropriate treatments for chronic hemodialysis patients are a public health challenge in Japan. Sedentary behavior appears to be closely associated with these patients’ survival. We thus sought to develop a nomogram that predicts survival based on the duration of chronic hemodialysis patients’ sedentary behavior. One hundred twenty-four patients under chronic hemodialysis (73 men, 51 women, age 71.7±11.1 years) were enrolled in this cohort study. The patients wore a triaxial accelerometer that measured both their sedentary behavior, i.e., total sedentary behavior (minutes) and their maximum sedentary bouts (min) on non-hemodialysis days. We obtained the Kaplan-Meier curve and used the log-rank test and a Cox proportional hazards model to evaluate the relationship between the patients’ sedentary behavior and their survival. We also used a Cox proportional hazards model to develop a nomogram for the patients’ 5-year survival rate. Forty-six patients died during the follow-up period. When we stratified the patients by the medians of total sedentary behavior and maximum sedentary bouts, we observed significant between-group differences. After adjustment for confounding factors in a Cox proportional hazards model, total sedentary behavior and maximum sedentary bouts were identified as critical survival factors, and we generated a nomogram using an index of sedentary behavior. Our analysis results demonstrated that sedentary behavior on non-dialysis days was closely associated with the survival of the chronic hemodialysis patients, suggesting that a decrease in sedentary behavior would prolong their survival. The nomogram developed herein based on sedentary behavior may be useful for predicting the outcomes of chronic hemodialysis patients.No potential conflict of interest relevant to this article was reported.China Anti-cancer AssociationActa Medica Okayama2095-39412026SPRED2 suppresses the stemness of hepatocellular carcinoma through the p53/miR-506-3p/KLF4 pathwayENTongGaoDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySachioItoDepartment of Pathophysiology and Drug Discovery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAyeMoh-Moh-AungDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTianyiWangDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasayoshiFujisawaDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshiakiOharaDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTeizoYoshimuraDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAkihiroMatsukawaDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityObjective: We previously reported that endogenous Sprouty-related, EVH1 domain-containing protein 2 (SPRED2), an inhibitor of the Ras/Raf/ERK-MAPK pathway, controls hepatocellular carcinoma (HCC) cell stemness by downregulating the expression of pluripotency factors, such as Nanog, c-Myc, and KLF4, in an ERK-dependent fashion. However, the exact mechanisms by which SPRED2 regulates HCC cell stemness have not been established.<br>
Methods: Three human HCC cell lines [HepG2 (parental and SPRED2-deficient), HLE, and Hep3B] were used. Cells were transfected to downregulate or overexpress proteins. Western blot and RT-qPCR were used to evaluate the level of protein and mRNA expression. Co-immunoprecipitation and ChIP-qPCR were used to examine protein-protein interactions and the activation of gene transcription. Clinical HCC tissues were also used to validate in vitro data.<br>
Results: KLF4 was identified as the major pluripotency factor responsible for SPRED2-mediated downregulation of HCC cell stemness and KLF4 expression was regulated by miR-506-3p. SPRED2 formed a protein complex with the tumor suppressor (p53) and upregulated miR-506 gene transcription by binding to the promoter region, resulting in subsequent downregulation of KLF4 mRNA expression. There was a negative correlation between KLF4 expression and miR-506-3p and a positive correlation between miR-506-3p expression and SPRED2 in human HCC samples, highlighting the relevance of the study findings.<br>
Conclusions: The current study revealed a novel SPRED2/p53/miR-506-3p/KLF4 axis through which SPRED2 contributes to the suppression of HCC cell stemness and provides a potential new target to prevent HCC progression.No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama2694-2445562025Electronic Structure of the S1 State Manganese Cluster in Photosystem II Investigated Using Q-Band Selective Hole-Burning660671ENShinyaKosakiDepartment of Physics, Graduate School of Science, Nagoya UniversityNaohikoNakamuraDepartment of Physics, Graduate School of Science, Nagoya UniversityYoshikiNakajimaResearch Institute for Interdisciplinary Science, Advanced Research Field, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityJian-RenShenResearch Institute for Interdisciplinary Science, Advanced Research Field, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHiroyukiMinoDepartment of Physics, Graduate School of Science, Nagoya UniversityThe electronic structure of the S1 state of photosystem II (PSII) was investigated using selective hole burning of Q-band pulsed electron paramagnetic resonance. The free induction decay and spin–echo signals of the tyrosine radical YD• in the plant PSII oscillated because of the magnetic dipole–dipole interaction with the S1 state Mn cluster. The initial period was 410 ns (2.44 MHz) and was assigned to the S = 1 spin state. Based on the oscillation analysis, both Mn1 and Mn4 and both Mn2 and Mn3 were assigned as Mn(III) and Mn(IV), respectively, which is consistent with the quantum chemical calculations. The 410 ns period was accounted for in the simplified model using the isotropic spin density distribution ratio [1.6:–1.1:–1.1:1.6] for Mn1–4 ions. This oscillation was identical with that observed in the presence of methanol. The oscillation decreased in PsbP/Q- and PsbO/P/Q-depleted PSII. In Thermosynechococcus vulcanus, two periods, 390 ns (2.56 MHz) and 630 ns (1.59 MHz), were detected, indicating that the cyanobacterial S1 state includes two isomers, S = 1 and S ≥ 2 spins. The S ≥ 2 spin was not detected in PsbO/U/V-depleted PSII without polyethylene glycol. The S ≥ 2 state was consistent with the reported quantum chemical calculation using S = 3. A simplified model accounted for the S = 1 state as the spin density distribution [1.8:–1.3:–1.3:1.8] and for the S ≥ 2 state as the isotropic spin density distribution [−0.5:0.5:0.5:0.5] for Mn1–4 ions. In combination with quantum chemical calculations, the most probable protonated structure is W1 = H2O, W2 = H2O, O4 = O2–, and O5 = O2– for the S1 state. These results demonstrate that the selective hole burning method is a powerful tool to complement X-ray studies to determine the valence and protonation structure of manganese clusters, not only in the S1 state but also in higher S-states and general metal clusters, which would provide important insights into the water oxidation mechanism.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0925-571012252025Intravenous umbilical cord-derived mesenchymal stromal cell therapy may improve overall survival in Japanese patients with idiopathic pneumonia syndrome after hematopoietic stem cell transplantation: a multicenter, single-arm, phase II trial733743ENNorikoDokiHematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalNobuharuFujiiDepartment of Hematology and Oncology, Okayama University HospitalShinichiKakoDivision of Hematology, Jichi Medical University Saitama Medical CenterEmikoSakaidaDepartment of Hematology, Chiba University HospitalYoshinobuKandaDivision of Hematology, Department of Medicine, Jichi Medical UniversityIdiopathic pneumonia syndrome (IPS) is a serious complication of allogeneic hematopoietic stem cell transplantation (HSCT) and has a poor prognosis. Although IPS is often treated with steroids, the disease can become resistant to or dependent on steroid treatment, and there is no effective cure for patients with refractory or steroid-dependent IPS. This multicenter, open-label, single-arm, phase II clinical trial investigated the efficacy and safety of HLC-001 (allogeneic umbilical cord-derived mesenchymal stromal cells) in patients with progressive steroid-dependent or refractory IPS after HSCT. Seven male patients (all male; mean age: 43.3 years) received HLC-001 and three completed the trial. The survival rate at day 56 (primary endpoint) was 71.4% (5/7 patients; 95% confidence interval: 29.0%–96.3%) and was sustained at day 100, suggesting that HLC-001 was more effective than previously reported treatment. Three of the five patients with ≥ 100 days of follow-up died. Five patients experienced at least one adverse drug reaction, none of which were serious. These findings indicate that HLC-001 was potentially effective and generally well tolerated in Japanese patients with steroid-dependent or refractory IPS after HSCT. Given there is no effective cure for steroid-dependent or refractory IPS, HLC-001 may be a promising treatment option and further clinical evaluation is warranted.<br>
Trial registration: Japan Registry of Clinical Trials identifier: jRCT2063220014.No potential conflict of interest relevant to this article was reported.Ceramic Society of JapanActa Medica Okayama1348-653513412026Structural and spectroscopic characterization of keatite (SiO2)14ENMasamiKanzakiInstitute for Planetary Materials, Okayama UniversityXianyuXueInstitute for Planetary Materials, Okayama UniversityKeatite, a polymorph of silica rare in nature, was synthesized by hydrothermal treatment of silicon and water at 100 MPa and 600 °C. The crystal structure of keatite at 24 °C was refined by the Rietveld method using synchrotron X-ray diffraction data. The obtained structure is consistent with the results of previous studies in which some constraints were imposed during refinements. The 29Si MAS NMR spectrum of keatite shows two peaks at −113.9 and −114.3 ppm, which can be assigned to Si at the Si1 and Si2 sites, respectively. The Raman spectrum of keatite shows a prominent peak at 473 cm−1, which is attributable to the Si–O–Si bending mode of the 5-membered ring. These spectra, reported for the first time, are expected to be valuable for the identification of keatite in synthetic and natural samples.No potential conflict of interest relevant to this article was reported.Tech Science PressActa Medica Okayama1546-22268522025A Spectrum Allocation and Security-Sensitive Task Offloading Algorithm in MEC Using DVS34373455ENXianweiLiSchool of Computer and Information Engineering, Bengbu UniversityBoWeiFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityXiaoyingYangSchool of Information Engineering, Suzhou UniversityAmrTolbaComputer Science and Engineering Department, College of Applied Studies, King Saud UniversityZijianZengInstitute of Computer Science and Digital Innovation, UCSI UniversityOsamaAlfarrajComputer Science and Engineering Department, College of Applied Studies, King Saud UniversityWith the advancements of the next-generation communication networking and Internet of Things (IoT) technologies, a variety of computation-intensive applications (e.g., autonomous driving and face recognition) have emerged. The execution of these IoT applications demands a lot of computing resources. Nevertheless, terminal devices (TDs) usually do not have sufficient computing resources to process these applications. Offloading IoT applications to be processed by mobile edge computing (MEC) servers with more computing resources provides a promising way to address this issue. While a significant number of works have studied task offloading, only a few of them have considered the security issue. This study investigates the problem of spectrum allocation and security-sensitive task offloading in an MEC system. Dynamic voltage scaling (DVS) technology is applied by TDs to reduce energy consumption and computing time. To guarantee data security during task offloading, we use AES cryptographic technique. The studied problem is formulated as an optimization problem and solved by our proposed efficient offloading scheme. The simulation results show that the proposed scheme can reduce system cost while guaranteeing data security.No potential conflict of interest relevant to this article was reported.Ceramic Society of JapanActa Medica Okayama1348-653513412026Structure and acid resistance of fluoride-treated hydroxyapatite particles3137ENSatoshiHayakawaFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityKazukiAndoGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTomohikoYoshiokaFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTopical fluoride is used in clinical dentistry to prevent dental caries. The primary reaction product formed on the tooth surface after topical fluoride application is calcium fluoride (CaF2). In this study, we investigated the effect of deposited CaF2 on the acid resistance of fluoride-treated hydroxyapatite (HAp). Commercial HAp particles were treated with two types of fluoride-containing acetic acid-sodium acetate (Ac-AcNa) buffer solutions, with and without the addition of phosphate ions. X-ray diffraction (XRD) and nuclear magnetic resonance (NMR) analyses confirmed the formation of fluorine-substituted hydroxyapatite (F-HAp), along with a hydration layer containing calcium phosphate and CaF2. Phase composition analysis revealed that the presence of phosphate ions in the fluoride treatment solution reduced the amount of CaF2 deposited. Acid resistance evaluation and phase composition analysis indicated that the initial dissolution rate of the fluoride-treated HAp in Ac-AcNa buffer solutions decreased on surfaces densely covered with CaF2 particles.No potential conflict of interest relevant to this article was reported.Frontiers Media SAActa Medica Okayama1664-042X162025Activation of the pentose phosphate pathway by microcurrent stimulation mediates antioxidant effects in inflammation-stimulated macrophages1666999ENMikikoUemuraDepartment of Rehabilitation Science, Kobe University Graduate School of Health SciencesNoriakiMaeshigeDepartment of Rehabilitation Science, Kobe University Graduate School of Health SciencesAtomuYamaguchiDepartment of Rehabilitation Science, Kobe University Graduate School of Health SciencesXiaoqiMaDepartment of Rehabilitation Science, Kobe University Graduate School of Health SciencesYunfeiFuDepartment of Rehabilitation Science, Kobe University Graduate School of Health SciencesTaketoInoueAssisted Reproductive Technology Center, Okayama UniversityMamiMatsudaGraduate School of Science, Technology and Innovation, Kobe UniversityYuyaNishimuraGraduate School of Science, Technology and Innovation, Kobe UniversityTomohisaHasunumaGraduate School of Science, Technology and Innovation, Kobe UniversityJiWangDepartment of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical UniversityHiroyoKondoDepartment of Nutrition, Faculty of Health and Nutrition, Shubun UniversityHidemiFujinoDepartment of Rehabilitation Science, Kobe University Graduate School of Health SciencesIntroduction: Excessive inflammatory responses in macrophages lead to increased oxidative stress, and the excessive production of reactive oxygen species (ROS) causes tissue damage, contributing to the development of chronic diseases and tissue deterioration. Therefore, controlling the inflammatory response and ROS production is crucial for human health. Electrical stimulation (ES) has been shown to have antioxidant and anti-inflammatory effects on macrophages. However, the key pathway underlying these effects remains unclear.<br>
Methods: In this study, ES was applied to Lipopolysaccharide (LPS)-stimulated macrophages, and the production of ROS and 8–hydroxy–2′–deoxyguanosine (8-OHdG), inflammatory cytokine expression, and intracellular metabolites were analyzed in a glucose-6-phosphate dehydrogenase (G6PD) knockdown experiment, the rate-limiting enzyme of the Pentose Phosphate Pathway(PPP).<br>
Results: ES significantly increased sedoheptulose 7-phosphate (S7P), an intermediate metabolite in PPP, and reduced ROS and 8-OHdG production and the expression of inflammatory cytokines in LPS-stimulated macrophages. Meanwhile, ES did not exert antioxidant effects in G6PD-knockdown macrophages.<br>
Discussion: These findings indicate that the antioxidant effects of ES are mediated by PPP in LPS-stimulated macrophages.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0969-806X2372025Impact of different X-ray tube positions on actual dose measurements during CT examinations -An effect of patient physique-113001ENHiroakiHayashiCollege of Transdisciplinary Sciences for Innovation, Kanazawa UniversityTatsuyaMaedaGraduate School of Medical Sciences, Kanazawa UniversityKazukiTakegamiDepartment of Radiological Technology, Yamaguchi University HospitalSotaGotoFaculty of Health Sciences, Kobe Tokiwa UniversityTakashiAsaharaDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityNatsumiKimotoDepartment of Radiological Science, Faculty of Health Sciences, Junshin Gakuen UniversityRinaNishigamiGraduate School of Medical Sciences, Kanazawa UniversityDaikiKobayashiGraduate School of Medical Sciences, Kanazawa UniversityYukiKanazawaFaculty of Life Science, Kumamoto UniversityKazutaYamashitaDepartment of Orthopedics, School of Medicine, Tokushima UniversityTakeshiKonishiMEDITEC JAPAN Co., Ltd.MotochikaMakiMEDITEC JAPAN Co., Ltd.Dose management of patients is very important during X-ray Computed Tomography (CT) examinations, but because the patient's surface dose is inhomogeneous, it is difficult to measure the most probable value using a small passive-type dosimeter, lent to the patient. To solve this problem, our research group developed a precise dose analysis procedure in which a systematic uncertainty related to the X-ray incident direction (θin) is reduced. θin information was analyzed from CT images. However, the applicability of our procedure to actual patients with various physiques has not been examined. This study aims to propose a dose analysis procedure that can be applied to patients with various physiques, and to show its impact on dose measurement. Clinical data of 198 patients with Body Mass Index (BMI) values between 15 and 40 kg/m2 (mean value: 23.1 ± 3.8 kg/m2) who underwent chest CT scans were analyzed after dividing them into three groups based on BMI values. The absorbed dose was measured with a small-type Optically Stimulated Luminescence (OSL) dosimeter. To derive correction factors related to θin, the dependence of the actually-measured dose values of various patients on θin was analyzed. The correction coefficients were determined independently for the three groups classified by BMI values. By correcting the effect of θin, the systematic uncertainty element could be reduced, resulting in 30 % reduction of the uncertainty. Furthermore, it was found that our analysis procedure makes it possible to visualize outliers. In comparison with the expected dose values based on Computed Tomography Dose Index (CTDI) values, most of the data fell within the range of ±1.34 mGy (=1σ). However, 7 % of the data showed large deviations larger than 2σ. In conclusion, our research group has developed a procedure for measuring patient surface doses that can be applied to patients having various physiques, in which the effects of X-ray incident direction were accurately corrected. The procedure could be one solution to the problems with actual dose measurements during CT examinations, and will be useful for dose management based on the small-type dosimeter.No potential conflict of interest relevant to this article was reported.Microbiology SocietyActa Medica Okayama0022-1317106122025Thorough characterization of a new curvulavirid from a Japanese strain of Cryphonectria nitschkei002177ENSabitreeShahiInstitute of Plant Science and Resources, Okayama UniversitySakaeHisanoInstitute of Plant Science and Resources, Okayama UniversityWasiatusSa'diyahInstitute of Plant Science and Resources, Okayama UniversityYoshihiroTakakiInstitute for Extra-cutting-edge Science and Technology Avant-garde Research (X-star), Japan Agency for Marine-Earth Science and Technology (JAMSTEC)HidekiKondoInstitute of Plant Science and Resources, Okayama UniversityNobuhiroSuzukiInstitute of Plant Science and Resources, Okayama UniversityA new curvulavirid was isolated from a Japanese strain of the filamentous ascomycete Cryphonectria nitschkei and thoroughly characterized. The virus termed Cryphonectria nitschkei curvulavirus 1 (CnCvV1) has a bi-segmented dsRNA genome. CnCvV1 dsRNA1 encodes an RNA-dependent RNA polymerase (592 amino acids), while dsRNA2 possesses two ORFs, one that encodes a protein associated with the genomic dsRNA and the other that encodes a hypothetical protein of unknown function. CnCvV1 could be experimentally introduced into another virus-free strain of C. nitschkei and two strains of different fungal species within the genus Cryphonectria (Cryphonectria parasitica and Cryphonectria carpinicola). Based on phenotypic comparison, the virus caused asymptomatic infection in the three newly established fungal strains. However, there was a reduced colony growth rate and increased CnCvV1 accumulation in an RNA silencing-deficient mutant (Δdcl2), relative to the wt strain EP155 of a model virus host fungus (C. parasitica). These findings suggest that CnCvV1 is targeted by RNA silencing in C. parasitica. This study provides a foundation for further exploration of curvulavirids that have been biologically understudied.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2049-41731342025Identification of New Repeat Expansion Diseases244249ENHiroyukiIshiuraDepartment of Neurology, Okayama UniversityGraduate School of Medicine, Dentistry and Pharmaceutical SciencesThrough a genetic study of benign adult familial myoclonus epilepsy (BAFME) type 1, TTTCA and TTTTA repeat expansions have been identified in intron 4 of SAMD12. Lengths of expanded repeats inversely correlated with age at onset of epilepsy. Gain-of-toxic function mechanisms are suggested by the presence of UUUCA-repeat-containing RNA foci. From families with BAFME who did not have repeat expansions in SAMD12, we identified expanded TTTCA and TTTTA repeats in TNRC6A and RAPGEF2. These findings indicated a strong correlation between the repeat motif and the phenotype, leading to the identification of other types of BAFME. We then conducted genetic analysis of neuronal intranuclear inclusion disease (NIID), oculopharyngeal myopathy with leukoencephalopathy (OPML), and oculopharyngodistal myopathy (OPDM). From the observation that NIID, OPML, and OPDM, in addition to fragile X-associated tremor/ataxia syndrome, have shared clinical features, a direct search for CGG repeat expansions successfully led to the identification of the causative genes. Here, I review recent studies on repeat expansions.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7962025MRI Images of a Case of Adenocarcinoma, Human Papillomavirus-Independent, Mesonephric Type, of the Uterine Cervix463468ENYudaiAsanoDepartment of Radiology, Okayama University HospitalChikaNishiharaDepartment of Radiology, Okayama University HospitalTakahiroKitayamaDepartment of Radiology, Okayama University HospitalNanakoOkawaDepartment of Radiology, Okayama University HospitalSatokoMakimotoDepartment of Radiology, Okayama University HospitalFumiyoHigakiDepartment of Radiology, Okayama University HospitalKatsuhideKojimaDepartment of Radiology, Okayama University HospitalHanakoSugiharaDepartment of Obstetrics and Gynecology, Okayama University HospitalNaoyukiIdaDepartment of Obstetrics and Gynecology, Okayama University HospitalHiroyukiYanaiDepartment of Pathology, Okayama University HospitalTakaoHirakiDepartment of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityCase Report10.18926/AMO/69850We present a case of a woman in her 70s who was diagnosed with mesonephric adenocarcinoma of the uterine cervix, following biopsy and surgery. Preoperative MRI revealed a 7-cm, well-defined circumferential cervical mass with left lateral wall predominance, bulging into the uterine cavity and vagina. The lesion showed intermediate signal intensity on T2-weighted images, diffusion restriction, and early contrast enhancement weaker than that of the myometrium, followed by washout on contrast-enhanced imaging. The circumferential growth pattern with the lateral wall predominance and its imaging characteristics may suggest this rare entity be routinely included in the differential diagnosis of cervical cancers.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7962025Perioperative Team Management Was Beneficially Associated with Prolonged Postoperative Hospital Stays after Long Lower-Abdominal Surgeries445449ENJunyaMatsumiDepartment of Anesthesiology and Intensive Care Medicine, National Cancer Center HospitalOriginal Article10.18926/AMO/69847Our hospital began a PERIO program (perioperative patient management by a multi-disciplinary team from multiple departments) in 2016 to improve patient outcomes. We retrospectively analyzed the clinical effects of the PERIO program regarding the postoperative hospital stay (PHS) in the patients aged ≥ 18 years who underwent long lower-abdominal surgery at our hospital during the period April 2019 to March 2023. We excluded the cases of patients whose general anesthesia use was < 8 h, those for whom another surgery was performed simultaneously at another site, and emergency surgeries. The outcome was prolonged PHS, defined as exceeding the scheduled number of days specified in the patient’s clinical pathway. Among the 480 patients, prolonged PHS was observed for 270 patients (56.3%). In a multivariate logistic regression using advanced age, sex, high-risk general state, surgery requiring colon resection, serious adverse events (SAEs), and PERIO use, the following were associated with prolonged PHS: advance age (odds ratio [OR] 4.91, 95% confidence interval [CI]: 2.68-8.99, p=0.01), surgery requiring colon resection (OR 4.91, 95%CI: 2.68-8.99, p<0.001), SAE (OR 18.7, 95%CI: 7.22-48.2, p<0.001), and PERIO (OR 0.25, 95%CI: 0.13-0.47, p<0.001). The use of the PERIO program was thus beneficially associated with PHS after long lower-abdominal surgery.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7962025Effects of Thoron Inhalation and Cyclosporin A Treatment on Dextran Sulfate Sodium-Induced Oxidative Damage in Mice421429ENAyumiTanakaGraduate School of Health Sciences, Okayama UniversityShotaNaoeGraduate School of Health Sciences, Okayama UniversityReijuTakenakaGraduate School of Health Sciences, Okayama UniversityNorieKanzakiNingyo-toge Environmental Engineering Center, Japan Atomic Energy AgencyAkihiroSakodaNingyo-toge Environmental Engineering Center, Japan Atomic Energy AgencyKiyonoriYamaokaFaculty of Health Sciences, Okayama UniversityTakahiroKataokaFaculty of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/69844Radon (222Rn; Rn) and thoron (220Rn; Tn) inhalation have been reported to enhance antioxidant activity in various organs. However, the effects of Tn on the colon have not been investigated. This study aimed to clarify the effects of Tn inhalation, alone and in combination with cyclosporin A (CsA), on dextran sulfate sodium (DSS)-induced colitis, and the accompanying oxidative stress, in mice. Male BALB/c mice were subjected to continuous 8-day Tn inhalation (c-Tn, 533±128 Bq/m3) or alternate-day Tn inhalation over the same period (f-Tn, 577±63Bq/m3), followed by treatment with 3% DSS and either CsA or vehicle for 7 days. Although the disease activity index (DAI) decreased significantly by day 2 in the c-Tn group, scores remained significantly higher than those in the f-Tn group. In the c-Tn group, superoxide dismutase and catalase activity in the colon were significantly elevated compared with those in sham controls. Thus, DSS-induced damage was effectively inhibited in the earlier stages by the c-Tn mode of inhalation than by the f-Tn mode. These findings suggest that continuous Tn inhalation more effectively attenuated early colitis symptoms than alternate-day inhalation, potentially through upregulation of antioxidant defenses. Tn and CsA showed no combined effects.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7962025Real-World Outcomes of Anti-Vascular Endothelial Growth Factor Therapy for Neovascular Age-Related Macular Degeneration in Patients Aged 85 or Older405412ENChihiroOuchiDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMioMorizane HosokawaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuheiKimuraDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusukeShiodeDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoMatobaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTetsuroMoritaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiMorizaneDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/69842We investigated the treatment outcomes of patients aged ≥85 years with neovascular age-related macular degeneration (nAMD) who received anti-vascular endothelial growth factor (anti-VEGF) therapy using either treat-and-extend (TAE) or pro re nata (PRN) regimens for 1 year in real-world clinical practice. Eighty-five eyes from 85 patients were included. Among them, types 1, 2, and 3 macular neovascularization and polypoidal choroidal vasculopathy were present in 27.1%, 17.6%, 18.8%, and 36.5%, respectively. TAE and PRN regimens were used in 43.5% and 56.5% of patients, respectively. At baseline, the PRN group was older and had worse best-corrected visual acuity (BCVA), greater central retinal thickness, and more intraretinal fluid than the TAE group. In the TAE group, the mean number of injections was 7.6, BCVA improved significantly, and all retinal fluid rates decreased. In the PRN group, the mean number of injections was 3.9, BCVA remained unchanged, and the rates of macular fibrosis and atrophy increased. No serious adverse events were observed in either group. Anti-VEGF therapy was safe for patients aged ≥ 85 years with nAMD, and the TAE regimen effectively improved BCVA in this population. BCVA remained unchanged in the PRN-treated patients, with baseline disease severity and/or undertreatment potentially influencing the outcomes.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2304-676713122025Effects of miR-128-3p on Renal Inflammation in a Rat Periodontitis Model577ENMohammadNurhamimDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYixuanZhangDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMomokoNakaharaDepartment of Preventive Dentistry, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityDaikiFukuharaDepartment of Preventive Dentistry, Okayama University HospitalYoseiNagashimaDepartment of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakayukiMaruyamaDepartment of Preventive Dentistry, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityManabuMoritaDepartment of Oral Health, Takarazuka University of Medical and Health CareDaisukeEkuniDepartment of Preventive Dentistry, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityObjectives: The study aim was to investigate the effects of extracellular vesicles (EVs) derived miR-128-3p on renal inflammation using a rat periodontitis model. Methods: Ten-week-old male Wistar rats were divided into two groups: a control (n = 8) and a lipopolysaccharides (LPS) group (n = 8). The LPS group received LPS (Porphyromonas gingivalis) injection in the gingiva for 7 days. At the end of the experiment, plasma, gingival tissue, and kidney samples were collected. Hematoxylin and eosin staining was performed to evaluate the glomerular tissue injury score. Bioinformatic analysis was conducted to identify potential target genes of miR-128-3p. The reverse transcription-quantitative polymerase chain reaction was performed to evaluate miR-128-3p, inflammatory, pro-inflammatory cytokine, chemokine and predicting gene’s expression. The control and LPS groups were compared using Welch’s t-test. p-values < 0.05 were considered to indicate statistical significance. Results: The kidney glomerular tissue injury score was significantly higher in the LPS than in the control group. miR-128-3p expression in the LPS group was significantly higher in the gingival tissue and plasma. mRNAs (interleukin [IL]-1β, tumor necrosis factor [TNF]-α, C-X3-C motif chemokine ligand 1 [CX3CL1], and C-X-C motif chemokine ligand 7 [CXCL7]) expression was higher in the kidney of the LPS group. The potential target genes of activin A receptor type I (Acvr1), ribosomal protein S6 kinase B1 (Rps6kb1), and transforming growth factor beta receptor type 1 (Tgfbr1) were significantly lower in the kidneys of the LPS group. Conclusions: EVs-derived miR-128-3p in LPS induced periodontitis may cause kidney inflammation which may be mediated by, Rps6kb1, Tgfbr1, and Acvr1.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1350-44871912026Experimental approach of internal dose map visualization during helical CT examinations: importance of X-ray incident direction analysis and central internal dose estimation107586ENHiroakiHayashiCollege of Transdisciplinary Sciences for Innovation, Kanazawa UniversityKazukiTakegamiDepartment of Radiological Technology, Yamaguchi University HospitalRinaNishigamiGraduate School of Medical Sciences, Kanazawa UniversityDaikiKobayashiGraduate School of Medical Sciences, Kanazawa UniversitySotaGotoFaculty of Health Sciences, Kobe Tokiwa UniversityTakashiAsaharaDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityNatsumiKimotoDepartment of Radiological Science, Faculty of Health Sciences, Junshin Gakuen UniversityMasakiTakemitsuDepartment of Radiological Technology, Yamaguchi University HospitalRinIshiiCollege of Transdisciplinary Sciences for Innovation, Kanazawa UniversityShinichiMorimotoMeditec Japan Co., Ltd.MotochikaMakiMeditec Japan Co., Ltd.During computed tomography (CT) examination, radiation exposures should be appropriately managed taking into considering the effects of bowtie filter, the heel effect and over-beaming effect. Furthermore, the analysis of an X-ray incident direction is important. The purpose of this study is to develop a procedure to obtain two-dimensional (2D) internal dose distributions based on actual measurements of surface dose distribution and central internal dose data. Experiments were conducted using a clinical CT scanner and four cylindrical polyacetal resin (POM) phantoms having diameters of 15–30 cm. The entrance surface doses and the central internal dose were measured by placing the optically stimulated luminescence (OSL) dosimeters on the surface and inner part of the phantom, respectively, during helical CT scans. The X-ray incident direction at the slice containing the dosimeter was estimated based on the noise distribution analysis of the CT image. Then, circumferential surface dose distributions were determined as a function of the X-ray incident direction. Based on these experimental data, we succeeded in visualizing the 2D dose distributions. The obtained dose distribution was inhomogeneous, clearly reflecting the influence of factors such as the heel effect. The uncertainty due to our methodology was estimated to be from 4.3 % to 7.4 %. Our methodology needs central internal dose data, and the absence of this data introduced additional systematic uncertainties of +6.9 % to −11.4 %. In conclusion, correcting for the effect of the X-ray incident directions for entrance surface dose and adding the central inner dose data can improve the reliability of the internal dose distribution.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1350-44871912026A novel wearable dosimeter system that can analyze the incident direction of X-rays for medical dosimetry – Improvements to the detector arrangements and analysis algorithm –107592ENTakashiAsaharaDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityRinaNishigamiGraduate School of Medical Sciences, Kanazawa UniversityDaikiKobayashiGraduate School of Medical Sciences, Kanazawa UniversityNatsumiKimotoDepartment of Radiological Science, Faculty of Health Sciences, Junshin Gakuen UniversitySotaGotoFaculty of Health Science, Kobe Tokiwa UniversityKazukiTakegamiDepartment of Radiological Technology, Yamaguchi University HospitalRinIshiiCollege of Transdisciplinary Sciences for Innovation, Kanazawa UniversityManaMitaniDivision of Radiological Technology, Medical Support Department, Okayama University HospitalMitsugiHondaDivision of Radiological Technology, Medical Support Department, Okayama University HospitalToshihiroIguchiDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityHiroakiHayashiCollege of Transdisciplinary Sciences for Innovation, Kanazawa UniversityWhen performing real-time dosimetry using an active-type dosimeter during clinical fluoroscopic procedures, angular dependence of dosimeter response should be taken into account. Our research group addressed this issue and proposed a triple-type dosimeter that can determine the incident angle of scattered X-rays. The triple-type detector consists of three active dosimeters. The two side dosimeters have slope filters to enhance the angular dependence and are intentionally tilted. The central dosimeter faces forward. The incident angle of X-rays (θin) is estimated using the signal differences between the central dosimeter and the left and/or right dosimeters. Then, the absolute dose is determined by correcting the angular dependence of the central dosimeter based on the estimated θin. In order to verify the concept of the triple-type dosimeter, we conducted a proof-of-concept experiment using clinical X-ray fluoroscopic equipment. Scattered X-rays were generated by irradiating an elliptical cylindrical water phantom. The response of the triple-type dosimeter was evaluated by rotating it to vary the incident angle of scattered X-rays generated by the water phantom. The proposed dosimetry system could estimate the θin over an angular range of ±80° (with uncertainty of 1.35°), which is 30° wider than the previous version, and successfully determined the absolute doses after correction for the angular dependence of the dosimeter. Although the active-type dosimeter had a systematic uncertainty related to the angular dependence of ±15.2 %, our system succeeded in reducing the systematic uncertainty to ±3.2 %.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1078-81743222026Optimization of the reconstruction kernel for temporal bone imaging using photon-counting detector CT: A combined physical and visual evaluation103274ENS.NishiiGraduate School of Health Sciences, Okayama UniversityT.AsaharaDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityY.MorimitsuDivision of Radiological Technology, Medical Support Department, Okayama University HospitalS.KajisakiDivision of Radiological Technology, Medical Support Department, Okayama University HospitalN.AkagiDivision of Radiological Technology, Medical Support Department, Okayama University HospitalM.HondaDivision of Radiological Technology, Medical Support Department, Okayama University HospitalH.HayashiCollege of Transdisciplinary Sciences for Innovation, Kanazawa UniversityA.SugayaDepartment of Otolaryngology, Head & Neck Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityK.MunetomoDepartment of Radiology, Medical Development Field, Okayama UniversityF.HigakiDepartment of Radiology, Medical Development Field, Okayama UniversityT.HirakiDepartment of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityT.IguchiDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityIntroduction: Photon-counting detector CT (PCD-CT) offers superior spatial resolution and noise characteristics compared to conventional CT. However, optimal reconstruction parameters for temporal bone imaging, especially kernel selection, remain unclear. This study aimed to identify the optimal reconstruction kernel using both objective physical image quality metrics and subjective expert assessments.<br>
Methods: In phantom experiments, the system performance function (SPF) based on the task-based transfer function (TTF) and noise power spectrum (NPS) was calculated across 11 reconstruction kernels (Hr60–Hr98). Based on the results of the physical evaluation and clinical considerations from clinical practice, a subset of kernels was selected for visual assessment. For clinical images, two diagnostic radiologists evaluated three fine anatomical structures (i.e., stapes footplate, incudomalleolar joint, and cochlea) and overall image quality using both a ranking method and a 5-point Likert scale.<br>
Results: TTF analysis indicated that Hr96 had the highest spatial resolution, while Hr60 showed the lowest noise in the NPS. SPF analysis identified Hr72 as providing the optimal balance between resolution and noise. Visual assessment using four reconstruction kernels (Hr60, Hr72, Hr76, and Hr84) showed that Hr76 consistently received the highest preference for overall image quality and visualization of fine structures. Statistically significant differences were observed among the kernels, with Hr60 consistently rated the lowest (p < 0.05).<br>
Conclusion: The kernel Hr76 was found suitable for middle and inner ear diagnoses using PCD-CT, providing a good balance between spatial resolution and image noise. This finding provides a foundation for standardized reconstruction protocols in high-resolution temporal bone imaging.<br>
Implications for practice: These findings support the use of Hr76 as a standard kernel for high-resolution temporal bone imaging and may contribute to protocol optimization in clinical PCD-CT practice.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2073-43441522025Palladium-Catalyzed Decarbonylative Nucleophilic Halogenation of Acid Anhydrides191ENTianTianGraduate School of Natural Science and Technology, Okayama UniversityShuheiUeiDepartment of Chemistry, Faculty of Science, Okayama UniversityWeidanYanGraduate School of Natural Science and Technology, Okayama UniversityYasushiNishiharaResearch Institute for Interdisciplinary Science (RIIS), Okayama UniversityIn this study, we developed a palladium-catalyzed decarbonylative nucleophilic halogenation reaction using inexpensive and readily available acid anhydrides as substrates. This approach effectively circumvents the instability of acyl chlorides and the low reactivity of acyl fluorides. The Pd/Xantphos catalyst system exhibited excellent compatibility with the thermodynamically and kinetically challenging reductive elimination of C–X bonds (X = I, Br, and Cl) from Pd(II) intermediates. Notably, for electron-donating substrates, adopting an open system significantly improved the reaction efficiency. The positive effect of the open system may be due to the reversible nature of CO insertion and deinsertion, which helps direct the reaction toward the desired pathway by allowing the generated CO to exit the reaction system. Mechanistic studies suggest that the reaction proceeds through a highly reactive acyl halide intermediate, followed by a unimolecular fragment coupling (UFC) pathway via decarbonylation or an alternative pathway involving the formation of an activated anionic palladate complex in the presence of lithium halide.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025The X-ray induced quenching of the thorium-229 isomer states in a CaF2 crystal hostENMingGuanGraduate School of Natural Science and Technology, Okayama universityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Osteosarcoma cell–derived CCL2 facilitates lung metastasis via accumulation of tumor-associated macrophagesENHiroyaKONDOGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221512025Hypoglycemia and hyperinsulinemia induced by phenolic uremic toxins in CKD and DKD patients5762ENYoshiyasuTonguTohoku University School of MedicineTomokoKasaharaDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineYasutoshiAkiyamaLaboratory of Oncology, Pharmacy Practice and Sciences, Tohoku University Graduate School of Pharmaceutical SciencesTakehiroSuzukiDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineHsin-JungHoDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineYotaroMatsumotoLaboratory of Oncology, Pharmacy Practice and Sciences, Tohoku University Graduate School of Pharmaceutical SciencesRyotaKujiraiLaboratory of Oncology, Pharmacy Practice and Sciences, Tohoku University Graduate School of Pharmaceutical SciencesKoichiKikuchiDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineKojiNataDepartment of Medical Biochemistry, School of Pharmacy, Iwate Medical UniversityMakotoKanzakiDepartment of Biomedical Engineering, Tohoku UniversityKenshinSuzukiTohoku University School of MedicineShunWatanabeDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineChiharuKawabeDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineYuiMiyataDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineShunItaiDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineTakafumiToyoharaDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineChitoseSuzukiDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicineTetsuhiroTanakaDivision of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of MedicineJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshihisaTomiokaLaboratory of Oncology, Pharmacy Practice and Sciences, Tohoku University Graduate School of Pharmaceutical SciencesTakaakiAbeDepartment of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of MedicinePatients with end-stage renal disease have lower fasting plasma glucose and HbA1c levels, with significantly higher insulin levels. For a long time, it has been believed that this higher insulin level in renal failure is due to decreased insulin clearance caused by reduced renal function. However, here we reported that accumulation of the gut microbiota-derived uremic toxin, phenyl sulfate (PS) in the renal failure, increased insulin secretion from the pancreas by enhanced glucose-stimulated insulin secretion. Other endogenous sulfides compounds which accumulated as in the renal failure also increased glucose-stimulated insulin secretion from β-cell. With RNA-seq analyses and gene knock down, we demonstrated that insulin secretion evoked by PS was mediated by Ddah2. In addition, we also found that PS increased insulin resistance through lncRNA expression and Erk phosphorylation in the adipocytes. To confirm the relationship between PS and glucose metabolism in human, we recruited 2 clinical cohort studies (DKD and CKD) including 462 patients, and found that there was a weak negative correlation between PS and HbA1c. Because these trials did not measure fasting insulin level, we alternatively used the urinary C-peptide/creatinine ratio (UCPCR) as an indicator of insulin resistance. We found that PS may induce insulin resistance in patients with eGFR < 60 mL/min/1.73 m2. These data suggest that the accumulation of uremic toxins modulates glucose metabolism and induced insulin resistance in CKD and DKD patients. Considering HbA1c as a reflection of chronic hyperglycemia and UCPCR as a reflection of chronic hyperinsulinemia, our findings indicate that PS is negatively associated with hyperglycemia independent of CKD, and positively associated with hyperinsulinemia in DKD patients.No potential conflict of interest relevant to this article was reported.Ivyspring International PublisherActa Medica Okayama1837-966416142025CXCR4 Inhibition Induces Tumor Necrosis by Selectively Targeting the Proliferating Blood Vessels in Oral Squamous Cell Carcinoma40554070ENYaminSoeDepartment 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 UniversityHtoo ShweEainDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama UniversitySaoriYoshidaPreliminary Examination Room, Okayama University HospitalMay WathoneOoDepartment of Pathophysiology and Drug Discovery, 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 UniversityHitoshiNagatsukaDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama UniversityThe C-X-C chemokine receptor type 4 (CXCR4) is a G protein-coupled transmembrane receptor that contributes to tumor growth and angiogenesis. While prior studies have primarily focused on CXCR4 expression in cancer cells and its role in metastasis, a few have examined its involvement in tumor-associated vasculature. In this study, we reported for the first time that CXCR4 expression within the tumor vasculature is significantly associated with higher pathological grades of human oral squamous cell carcinoma (OSCC) (p<0.03). A previous study reported that inhibiting CXCR4 with AMD3100 induces tumor cell death and enhances the efficacy of the chemotherapeutic agent cisplatin. These findings suggest that CXCR4 is an important target for cancer treatment. However, the tumor vascular system is known to be heterogeneous within the tumor microenvironment (TME), which may influence the treatment outcomes. Therefore, this study aimed to explore the effect of CXCR4 antagonism on various blood vessels present within the oral squamous cell carcinoma (OSCC) tumor stroma. Although the efficiency of AMD3100 was not significant in MOC cancer cells, necrosis was induced in the TME when applied to a poorly differentiated OSCC model, highlighting the role of the TME. Notably, CXCR4 is found to be highly overlapped with CD105+ angiogenic tumor vessels among various vascular markers. Treatment with AMD3100 leads to a marked reduction in the CD105+ vessels and impairs the maturation of tumor micro-vessels, explaining the cause of observed necrosis. Thus, CXCR4 serves as a promising biomarker in OSCC, and its inhibition with AMD3100 offers the therapeutic potential, particularly in cases with advanced pathological grades.No potential conflict of interest relevant to this article was reported.Japan Institute of MetalsActa Medica Okayama0021-487689112025Ti-18Nb-xAl合金の構成相と材料特性に及ぼすAl添加量の影響337343ENYoshikazuMantaniDepartment of Materials Science and Engineering, National Institute of Technology (KOSEN), Suzuka CollegeYoshitoTakemotoFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityThe Ti-18mass%Nb alloy with a quenched α” martensitic structure exhibited a high damping capacity. However, there are issues such as lower strength than annealed α+β structure and decreasing damping capacity due to heating until 400 K. Therefore, in this study, to address these issues, we investigated the effect of Al addition on the constituent phases and material properties of Ti-18Nb-xAl alloys. The crystal structure was determined by examining the lattice constant and unit volume using X-ray diffraction, and optical microscopy was also performed. The material properties were investigated by Vickers hardness, Young’s modulus, internal friction, tensile tests, and DSC measurements. Vickers hardness and tensile strength increased with increasing Al content. This is thought to be due to the combined effects of the refinement of the microstructure and solid-solution strengthening due to Al addition. The Young’s modulus increased slightly from 0Al to 1Al, but increased significantly to 4Al. Internal friction was highest for 0Al and decreased for 4Al, whereas 7Al showed a higher value than 1Al. In the DSC heating curves, there was a decrease in the exothermic peak starting temperature and an increase in the phase-transformation heat with the addition of Al, except for 1Al. It was suggested that these changes in Ti-18Nb-xAl alloys were influenced by the structure of the quenched α” phase, texture, and pseudoelasticity or phase transformation by deformation.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0916-70052025Refinement of interval approximations for fully commutative quiversENYasuakiHiraokaKyoto UniversityKenNakashimaShimane UniversityIppeiObayashiOkayama UniversityChenguangXuKyoto UniversityA central challenge in the theory of multiparameter persistence modules lies in defining effective descriptors for representations of infinite or wild type. In this work, we propose a novel framework for analyzing interval approximations of fully commutative quivers, which offers a tunable trade-off between approximation resolution and computational complexity. Our approach is evaluated on commutative ladder modules of both finite and infinite type. For finite-type cases, we establish an efficient method for computing indecomposable decompositions using solely one-parameter persistent homology. For infinite-type cases, we introduce a new invariant that captures persistence in the second parameter by connecting standard persistence diagrams through interval approximations. Furthermore, we present several models for constructing commutative ladder filtrations, providing new insights into the behavior of random filtrations and demonstrating the utility of our framework in topological analysis of material structures.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025Epstein-Barr Virus-Associated Early Gastric Carcinoma with Lymphoid Stroma Mimicking a Submucosal Tumor: A Typical Case Diagnosed by Endoscopic Resection and Treated by Local Resection with Sentinel Node Navigation399404ENHiroshiIsozakiDepartment of Surgery, Oomoto HospitalSasauMatsumotoDepartment of Surgery, Oomoto HospitalTakehiroTakamaDepartment of Surgery, Oomoto HospitalYukaIsozakiDepartment of Surgery, Oomoto HospitalShigekiMurakamiDepartment of Surgery, Oomoto HospitalCase Report10.18926/AMO/69442Gastric cancer with lymphoid stroma (GCLS) accounts for 1%-7% of gastric cancers; ~80% are Epstein-Barr virus (EBV)-positive. The rate of lymph node metastasis is relatively low, even when an early GCLS has invaded the submucosa. We report an early GCLS with massive submucosal invasion mimicking a submucosal tumor (SMT), diagnosed by endoscopic submucosal resection (ESD) and treated with local resection and sentinel node navigation surgery (SNNS). The patient was a 40-year-old Japanese man. A protruding lesion on the greater curvature of the middle part of his stomach was detected by X-ray, and an endoscopic examination revealed a 2.5-cm protruding tumor covered with a normal mucosa and small ulcers at the apex. ESD was performed for a diagnosis. The pathological diagnosis was lymphoepithelioma-like gastric cancer (GCLS), pT1b(SM2), Ly0, V0, pHM1, pVM1. EBV infection in the cancer cells was confirmed pathologically by EBV-encoded RNA. The local resection was performed using SNNS. The patient has had no recurrence or post-gastrectomy syndrome 4 years postsurgery. EBV-associated early GCLS resembling an SMT is relatively rare, and clinicians need to be aware of this disease. Local resection using SNNS may be a surgical option for GCLS cases with a low rate of lymphatic metastasis.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025The Utility of a Preoperative 3D Imaging Analysis System for Trigonal Meningioma387392ENYusukeMoriDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshihiroOtaniDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoOmaeDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuichiroHiranoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJojiIshidaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaroFujiiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunHarumaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasafumiHiramatsuDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiMatsushitaDivision of Radiological Technology, Okayama University HospitalFumiyoHigakiDepartment of Radiology, Medical Development Field, Okayama UniversityKenjiSugiuDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/69440Trigonal meningiomas are rare and pose surgical challenges due to their deep location and proximity to critical neuroanatomical structures. We present the case of a 67-year-old woman with a growing trigonal meningioma successfully resected with guidance by a preoperative 3D imaging analysis system. Integration of CT and MRI including diffusion tensor imaging (DTI) enabled precise mapping of the optic radiation, guiding a middle temporal gyrus approach. Preoperative embolization reduced tumor vascularity, facilitating gross total resection with minimal blood loss. This case highlights the effectiveness of preoperative 3D imaging systems in optimizing surgical planning and improving outcomes in complex neurosurgical cases.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025Immunoglobulin G4-related Disease Mimicking Portal Vein Tumor Thrombus381385ENAtsunobuSakuraiDepartment of Radiology, NHO Iwakuni Clinical CenterTakayukiYabukiDepartment of Radiology, NHO Iwakuni Clinical CenterHidekiAokiDepartment of Gastroenterological Surgery, NHO Iwakuni Clinical CenterAkikoIsekiDepartment of Pathology, NHO Iwakuni Clinical CenterCase Report10.18926/AMO/69439We report the case of a 72-year-old Japanese man with an incidental portal vein mass that was surgically resected and diagnosed as immunoglobulin G4 (IgG4)-related disease. The mass was discovered during an atrial fibrillation examination. The patient had a history of gastric cancer and was also diagnosed with rectal cancer, raising concerns about metastasis. Due to technical challenges, a biopsy was not feasible. Imaging findings suggested portal vein tumor thrombosis, complicating the diagnosis. This case highlights a rare presentation of IgG4-related disease mimicking portal vein tumor thrombus.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025Blood Pressure and Heart Rate Patterns Identified by Unsupervised Machine Learning and Their Associations with Subclinical Cerebral and Renal Damage in a Japanese Community: The Masuda Study369379ENTakashiHisamatsuDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMinakoKinutaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSosukeMunetomoDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMariFukudaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKatsuhideKojimaDepartment of Radiology, Okayama University HospitalKaoriTaniguchiDepartment of Environmental Medicine and Public Health, Izumo, Shimane University Faculty of MedicineNorikoNakahataDepartment of Health and Nutrition, The University of Shimane Faculty of Nursing and NutritionHideyukiKandaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/69438We applied unsupervised machine learning to analyze blood pressure (BP) and resting heart rate (HR) patterns measured during a 1-year period to assess their cross-sectional relationships with subclinical cerebral and renal target damage. Dimension reduction via uniform manifold approximation and projection, followed by K-means++ clustering, was used to categorize 362 community-dwelling participants (mean age, 56.2 years; 54.9% women) into three groups: Low BP and Low HR (Lo-BP/Lo-HR), High BP and High HR (Hi-BP/Hi-HR), and Low BP and High HR (Lo-BP/Hi-HR). Cerebral vessel lesions were defined as the presence of at least one of the following magnetic resonance imaging findings: lacunar infarcts, white matter hyperintensities, cerebral microbleeds, or intracranial artery stenosis. A high urinary albumin-to-creatinine ratio (UACR) was defined as the top 10% (≥ 12 mg/g) of the mean value from ≥2 measurements. Poisson regression with robust error variance, adjusted for demographics, lifestyle, and medical history, showed that the Hi-BP/Hi-HR group had relative risks of 3.62 (95% confidence interval, 1.75-7.46) for cerebral vessel lesions and 3.58 (1.33-9.67) for high UACR, and the Lo-BP/Hi-HR group had a relative risk of 3.09 (1.12-8.57) for high UACR, compared with the Lo-BP/Lo-HR group. These findings demonstrate the utility of an unsupervised, data-driven approach for identifying physiological patterns associated with subclinical target organ damage.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025Comparison of Extraocular Muscles in Patients with Exotropia and Healthy Participants Using Anterior Segment Optical Coherence Tomography353358ENYukiChiharaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesIchiroHamasakiDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKiyoShibataDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinMorisawaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesReikaKonoDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeisukeKanenagaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiMorizaneDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/69436To analyze and characterize the medial and lateral rectus muscles in patients with exotropia using anterior segment optical coherence tomography (AS-OCT). This study included 24 patients with exotropia (48 eyes) and 25 healthy individuals (50 eyes). Anterior segment optical coherence tomography was used to construct the en face images. The anterior chamber angle to the extraocular muscle insertion distance, muscle width, and muscle fiber angle from the muscle insertion sites were compared between the exotropia and the control groups. The correlation between these parameters and age or angle of deviation was evaluated. The mean ages were 13.2±4.1 years for the exotropia group and 17.6±7.2 years for the control group. The lateral rectus angle was significantly more inwardly rotated in the exotropia group than in the control group (1.6±6.3°, −1.4±4.0°, p=0.014). With increasing angle of deviation, the width of the lateral rectus increased (p=0.002). Our results indicate that the lateral rectus angle is significantly more inwardly rotated in patients with exotropia. These findings should contribute to a deeper understanding of the extraocular muscles in patients with this condition.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025Inhibition of Air-Exposure Stress–Induced Autolysis in Clostridium perfringens by Zn2+345352ENNozomuMatsunagaDepartment of Life Science, Faculty of Science, Okayama University of ScienceSeiraEgusaDepartment of Life Science, Faculty of Science, Okayama University of ScienceRiyoAonoDepartment of Medical Technology, Kagawa Prefectural University of Health SciencesEijiTamaiDepartment of Infectious Disease, College of Pharmaceutical Science, Matsuyama UniversityYasuoHitusmotoDepartment of Life Science, Faculty of Science, Okayama University of ScienceSeiichiKatayamaDepartment of Life Science, Faculty of Science, Okayama University of ScienceOriginal Article10.18926/AMO/69435Clostridium perfringens is a pathogenic anaerobe that causes gas gangrene and food poisoning. Although autolysin-mediated reorganization of the bacterial cell wall is crucial for cell division, excessive autolysin activity induced by stressors can lead to cell lysis. In C. perfringens, air exposure is a significant stressor that causes cell lysis, and Acp (N-acetylglucosaminidase) is known to be a major autolysin. To further facilitate C. perfringens research, a technology to prevent air-induced cell lysis must be developed. This study investigated the role of Acp in air-induced autolysis and explored potential inhibitors that would prevent cell lysis during experimental procedures. Morphological analyses confirmed that Acp functions as an autolysin in C. perfringens, as acpdeficient strains exhibited filamentous growth. The mutants exhibited negligible autolysis under air-exposure stress, confirming the involvement of Acp in the autolytic process. We also evaluated the effects of various divalent cations on Acp activity in vitro and identified Zn2+ as a potent inhibitor. Brief treatment with a Zn2+- containing buffer induced dose-dependent cell elongation and autolysis inhibition in C. perfringens. These findings demonstrate that simple Zn2+ treatment before experiments stabilizes C. perfringens cells, reducing autolysis under aerobic conditions and facilitating various biological studies, except morphological analyses.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221512025Periodontitis associated with Porphyromonas gingivalis infection is a risk factor for infertility through uterine hypertrophy34964ENChiakiKamei-NagataDepartment of Pathophysiology-Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazuhiroOmoriDepartment of Pathophysiology-Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHidefumiSakoDepartment of Periodontics and Endodontics, Division of Dentistry, Okayama University HospitalKyosukeSakaidaDepartment of Periodontics and Endodontics, Division of Dentistry, Okayama University HospitalMasa-akiNakayamaDepartment of Oral Microbiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshiakiOharaDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHirokiMandaiDepartment of Pharmacy, Faculty of Pharmacy, Gifu University of Medical ScienceMoyukaKubota-TakamoriDepartment of Pathophysiology-Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityFumikoKiyamaDepartment of Pathophysiology-Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakayukiIshiiDepartment of Pathophysiology-Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKimitoHiraiDepartment of Pathophysiology-Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAtsushiIkedaDepartment of Periodontics and Endodontics, Division of Dentistry, Okayama University HospitalKazuTakeuchi-HatanakaDepartment of Periodontics and Endodontics, Division of Dentistry, Okayama University HospitalYukiShinoda-ItoDepartment of Pathophysiology-Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasakoTai-TokuzenDepartment of Periodontics and Endodontics, Division of Dentistry, Okayama University HospitalAiSakamotoCenter for Reproductive Medicine, Miyake ClinicMachikoKiyokawaCenter for Reproductive Medicine, Miyake ClinicTomomiYamanishiCenter for Reproductive Medicine, Miyake ClinicTakashiOdaCenter for Reproductive Medicine, Miyake ClinicMasayukiTakigawaMiyake Hello Dental Clinic, Pediatric Dentistry and OrthodonticsTadashiYamamotoThe Center for Graduate Medical Education (Dental Division), Okayama University HospitalTakahitoMiyakeCenter for Reproductive Medicine, Miyake ClinicShogoTakashibaDepartment of Pathophysiology-Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityPeriodontitis has recently been recognized as a potential risk factor for infertility due to its adverse effect on conception, although the underlying mechanisms remain unclear. This study investigated serum IgG antibody titers against periodontopathogenic bacteria in women with unexplained infertility and investigated how periodontal inflammation affects pregnancy and uterine function using a ligature-induced periodontitis mouse model infected with Porphyromonas gingivalis (Pg). IgG antibody titers against seven periodontopathogenic bacteria strains were measured by ELISA in 76 spontaneously pregnant women and 70 women undergoing infertility treatment. In the in vivo study, periodontitis mice were bred four weeks after periodontitis induction. Birth numbers, newborn weights, and gestation periods were assessed. To evaluate periodontal inflammation, alveolar bone, serum, and uterus was collected before mating. Uterine tissue was evaluated through histological and immunohistochemical staining. Women receiving infertility treatment were significantly older and had higher IgG titers against three Pg strains. Periodontitis mice had fewer births, lower newborn weights, and increased uterine cross-sectional areas. Additionally, elevated estrogen receptor α and progesterone receptor expression levels were observed in endometrial and stromal tissues. These results suggest that periodontitis may cause uterine hypertrophy and hormone receptor changes, potentially impairing pregnancy.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1618-12472025Establishment of a regenerative endodontic procedures model of mature mouse teeth and evaluation of the wound healing processENXiutingWangDepartment of Periodontology and Endodontology, Tohoku University Graduate School of DentistryShigekiSuzukiDepartment of Operative Dentistry, Okayama University Graduate School, Medicine, Dentistry and Pharmaceutical SciencesShin-HoTsaiDepartment of Operative Dentistry, Okayama University Graduate School, Medicine, Dentistry and Pharmaceutical SciencesKarinNagasakiDepartment of Periodontology and Endodontology, Tohoku University Graduate School of DentistryRahmad RifqiFahrezaDepartment of Periodontology and Endodontology, Tohoku University Graduate School of DentistryMasatoOmoriDepartment of Periodontology and Endodontology, Tohoku University Graduate School of DentistrySatoruYamadaDepartment of Periodontology and Endodontology, Tohoku University Graduate School of DentistryAs the pulp regeneration for non-vital teeth is one of the ultimate clinical achievements, regenerative endodontic procedures (REPs) have become the most explored treatment modality. In this technique, periodontal tissue is guided from the apical region into the root canal and pulp chamber to promote attachment. It is well established that immature teeth are effective targets for treatment. However, the indications for this treatment have not yet expanded sufficiently to encompass mature teeth with closed apical apex. In the present study, a mouse model of REPs in mature teeth was established, employing the maxillary first molar mesial root. μCT analyses disclosed that the distance from the occlusal surface to the physiological apex of the maxillary first molar mesial root in mice is 2.14 mm ± 0.08 mm, and the distance from the occlusal surface to the periapical alveolar bone is 2.46 mm ± 0.10 mm. Mesial root canal was treated with several sizes of k-files, and 15# k-file was identified as the most suitable k-file for use (P = 0.0007). During the regenerative process, spindle-shaped fibroblast-like cells, fibrous tissue formation, and mineralized tissue formation were identified on days 14 and 28. This study demonstrated that it is feasible to use the maxillary first molar mesial root as a REPs model for mature teeth and provided a detailed protocol and analysis of the healing process.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2072-664317182025Lacticaseibacillus rhamnosus Probio-M9 Alters the Gut Microbiota and Mitigates Pulmonary Hypertension in a Rat Model2927ENZhixinZhaoInner 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 UniversityGaopengLiDepartment of Cardiovascular Physiology, Faculty of Medicine, Kagawa UniversityKiyomiOhmichiDepartment of Diagnostic Pathology, Kagawa University HospitalXiaodongLiDepartment of Cardiovascular Physiology, Faculty of Medicine, Kagawa UniversityFeiyanZhaoInner 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 UniversityKaoriIshikawaDepartment of General Medicine, Kagawa University HospitalRyouIshikawaDepartment of Diagnostic Pathology, Kagawa University HospitalKazufumiNakamuraCenter for Advanced Heart Failure, Okayama University HospitalNaoyaYokotaDepartment of General Thoracic Surgery, Faculty of Medicine, Kagawa UniversityZhihongSunInner 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 UniversityBackground: Intestinal microbiota plays an important role in the progression of pulmonary hypertension (PH). Colostrum-derived Lacticaseibacillus rhamnosus Probio-M9 (Probio-M9) has shown protective effects against inflammation and remodeling. We investigated whether Probio-M9 supplementation could improve the pathology of PH. Methods: The monocrotaline (MCT)-induced PH model rats are created followed by Probio-M9 treatment. Microbiota and pathological analyses were performed to investigate the therapeutic effects of Probio-M9. Results: Probio-M9 significantly suppressed cardiovascular remodeling and reduced mortality in rats. Analysis of the fecal microbiota revealed that Probio-M9 significantly altered the gut microbiota of MCT model rats. Specifically, Alistipes sp009774895 and Duncaniella muris populations increased, whereas Limosilactobacillus reuteri_D, Ligilactobacillus apodeme and Monoglobus sp900542675 decreased compared to those in the MCT group. Focusing on the expression of GPNMB in macrophages and the localization of CD44, we found that the number of these cells increased in the MCT group but significantly decreased with Probio-M9 treatment. In lung tissue from PH patients, more GPNMB-positive macrophages were found than non-PH lungs, and an increase in CD44-positive cells was confirmed in the vicinity of GPNMB. Conclusions: Probio-M9 had a significant impact on the intestinal microbiota and GPNMB/CD44 positive cells in the lungs of PH rats.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221512025Pharmacokinetics and the effectiveness of pyrogen-free bioabsorbable wet adhesives20056ENRisaOshimaDepartment of Periodontology, Faculty of Dental Medicine, Hokkaido UniversityKumikoYoshiharaDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoNakanishiDepartment of Biomaterials and Bioengineering, Faculty of Dental Medicine, Hokkaido UniversityTsukasaAkasakaDepartment of Biomaterials and Bioengineering, Faculty of Dental Medicine, Hokkaido UniversityShinjiShimojiDepartment of Periodontology, Faculty of Dental Medicine, Hokkaido UniversityTeppeiNakamuraDepartment of Applied Veterinary Science, Faculty of Veterinary Medicine, Hokkaido UniversityTakumiOkiharaDivision of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama UniversityMarikoNakamuraDepartment of Clinical Psychology, School of Clinical Psychology, Kyushu University of Medical and ScienceAkihiroMatsukawaDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityIkkeiTamadaDepartment of Plastic and Reconstructive Surgery, Tokyo Metropolitan Children’s Medical CenterBartVan MeerbeekBIOMAT, Department of Oral Health Sciences, & UZ Leuven, Dentistry, KU LeuvenTsutomuSugayaDepartment of Periodontology, Faculty of Dental Medicine, Hokkaido UniversityYasuhiroYoshidaDepartment of Biomaterials and Bioengineering, Faculty of Dental Medicine, Hokkaido UniversityBioabsorbable materials are essential for advanced therapies, including surgical sealing, cell therapy, and drug delivery. Natural bioabsorbable materials, including collagen and hyaluronic acid, have better biocompatibility than synthetic bioabsorbable polymers; however, they are mainly derived from animals, presenting infection risks. Non-animal origin polymers have a lower molecular weight than those of animal origins. Their viscosity increases with increase in molecular weight, making endotoxin removal difficult. Here, using the phosphoryl chloride disposal method, we present a strategy for synthesizing pyrogen-free bioabsorbable adhesives with controlled molecular weight. Phosphopullulan, a polysaccharide derivative, had less than detectable endotoxin levels and controllable average molecular weight of approximately 300,000 to over 1,400,000. Furthermore, it is important to ensure the safety as well as efficacy of bio-implantable materials. We have evaluated the biosafety of polysaccharide derivatives we are developing, and have examined their cell phagocytosis and pharmacokinetics in vitro and in vivo, and have confirmed that they are safe. We have also evaluated their adhesion to wet tissue adhesions and confirmed that they leak less than existing materials.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2041-17231612025Fully-gapped superconductivity with rotational symmetry breaking in pressurized kagome metal CsV3Sb53643ENX. Y.FengInstitute of Physics, Chinese Academy of Sciences, and BeijingNational Laboratory for CondensedMatter PhysicsZ.ZhaoInstitute of Physics, Chinese Academy of Sciences, and BeijingNational Laboratory for CondensedMatter PhysicsJ.LuoInstitute of Physics, Chinese Academy of Sciences, and BeijingNational Laboratory for CondensedMatter PhysicsY. Z.ZhouInstitute of Physics, Chinese Academy of Sciences, and BeijingNational Laboratory for CondensedMatter PhysicsJ.YangInstitute of Physics, Chinese Academy of Sciences, and BeijingNational Laboratory for CondensedMatter PhysicsA. F.FangH. T.YangInstitute of Physics, Chinese Academy of Sciences, and BeijingNational Laboratory for CondensedMatter PhysicsH.-J.GaoInstitute of Physics, Chinese Academy of Sciences, and BeijingNational Laboratory for CondensedMatter PhysicsR.ZhouInstitute of Physics, Chinese Academy of Sciences, and BeijingNational Laboratory for CondensedMatter PhysicsGuo-qingZhengDepartment of Physics, Okayama UniversityThe discovery of the kagome metal CsV3Sb5 has generated significant interest in its complex physical properties, particularly its superconducting behavior under different pressures, though its nature remains debated. Here, we performed low-temperature, high-pressure 121/123Sb nuclear quadrupole resonance (NQR) measurements to explore the superconducting pairing symmetry in CsV3Sb5. At ambient pressure, we found that the spin-lattice relaxation rate 1/T1 exhibits a kink at T ~ 0.4 Tc within the superconducting state and follows a T3 variation as temperature further decreases. This suggests the presence of two superconducting gaps with line nodes in the smaller one. As pressure increases beyond Pc ~ 1.85 GPa, where the charge-density wave phase is completely suppressed, 1/T1 shows no Hebel-Slichter peak just below Tc, and decreases rapidly, even faster than T5, indicating that the gap is fully opened for pressures above Pc. In this high pressure region, the angular dependence of the in-plane upper critical magnetic field Hc2 breaks the C6 rotational symmetry. We propose the s + id pairing at P > Pc which explains both the 1/T1 and Hc2 behaviors. Our findings indicate that CsV3Sb5 is an unconventional superconductor and its superconducting state is even more exotic at high pressures.No potential conflict of interest relevant to this article was reported.Ceramic Society of JapanActa Medica Okayama1348-653513312025Comparative study of the effects of fluoride treatment with cyclic variations in pH on the structures of stoichiometric, calcium-deficient, and carbonated hydroxyapatites1524ENSatoshiHayakawaFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityYuOkadaGraduate School of Natural Science and Technology, Okayama UniversityTomohikoYoshiokaFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityThe primary objective of this study was to analyze the effects of fluoride treatment with cyclic variations in pH on the structure of stoichiometric hydroxyapatite (HAp), calcium-deficient HAp (CDHAp), and carbonated HAp (CHAp) powders. The structures of HAp, CDHAp, and CHAp before and after fluoride treatment were investigated using X-ray diffraction, Fourier-transform infrared, Raman, and nuclear magnetic resonance spectroscopic analyses. The fluoride treatment with cyclic variations in pH increased the calcium deficiency in HAp and CHAp but decreased in CDHAp. During fluoride treatment, fluoridated CDHAp or fluoridated calcium-deficient CHAp was formed on the surface of the HAp samples via dissolution and crystal growth, accompanied by the selective elution of component ions and partial substitution of OH− groups in the HAp hexagonal lattice with F− ions. No evidence of the formation of Ca(OH)2 and OH− groups outside the HAp crystal lattice was obtained. A new perspective on the formation of structured water at the surface termination of the OH columns (disordered region), with possible interactions with adsorbed water molecules or nonspecifically adsorbed F− ions was provided. The top surface of the fluoridated CDHAp consisted of an amorphous fluoride-rich hydrated layer, which included calcium phosphate and CaF2.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2673-6497532024Synthesis and Crystal Structure of Ilmenite-Type Silicate with Pyrope Composition394403ENTakayukiIshiiInstitute for Planetary Materials, Okayama UniversityRyosukeSinmyoDepartment of Physics, School of Science and Technology, Meiji UniversityTomooKatsuraBavarian Research Institute of Experimental Geochemistry and Geophysics, University of BayreuthAkimotoite, ilmenite-type MgSiO3 high-pressure polymorph can be stable in the lower-mantle transition zone along average mantle and subducting slab geotherms. Significant amounts of Al2O3 can be incorporated into the structure, having the pyrope (Mg3Al2Si3O12) composition. Previous studies have investigated the effect of Al2O3 on its crystal structure at nearly endmember compositions. In this study, we synthesized high-quality ilmenite-type Mg3Al2Si3O12 phase at 27 GPa and 1073 K by means of a Kawai-type multi-anvil press and refined the crystal structure at ambient conditions using a synchrotron X-ray diffraction data via the Rietveld method to examine the effect of Al2O3. The unit-cell lattice parameters were determined to be a = 4.7553(7) Å, c = 13.310(2) Å, and V = 260.66(6) Å3, with Z = 6 (hexagonal, R3̲
). The volume of the present phase was placed on the akimotoite-corundum endmember join. However, the refined structure showed a strong nonlinear behavior of the a- and c-axes, which can be explained by Al incorporation into the MgO6 and SiO6 octahedral sites, which are distinctly different each other. Ilmenite-type Mg3Al2Si3O12 phase may be found in shocked meteorites and can be a good indicator for shock conditions at relatively low temperatures of 1027–1127 K.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1751-73621812024Cyanorhodopsin-II represents a yellow-absorbing proton-pumping rhodopsin clade within cyanobacteriawrae175ENMasumiHasegawa-TakanoAtmosphere and Ocean Research Institute, The University of TokyoToshiakiHosakaLaboratory for Protein Functional and Structural Biology, RIKEN Center for Biosystems Dynamics ResearchKeiichiKojimaFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYosukeNishimuraAtmosphere and Ocean Research Institute, The University of TokyoMarieKuriharaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYuNakajimaAtmosphere and Ocean Research Institute, The University of TokyoYoshikoIshizuka-KatsuraLaboratory for Protein Functional and Structural Biology, RIKEN Center for Biosystems Dynamics ResearchTomomiKimura-SomeyaLaboratory for Protein Functional and Structural Biology, RIKEN Center for Biosystems Dynamics ResearchMikakoShirouzuLaboratory for Protein Functional and Structural Biology, RIKEN Center for Biosystems Dynamics ResearchYukiSudoFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySusumuYoshizawaAtmosphere and Ocean Research Institute, The University of TokyoMicrobial rhodopsins are prevalent in many cyanobacterial groups as a light-energy-harvesting system in addition to the photosynthetic system. It has been suggested that this dual system allows efficient capture of sunlight energy using complementary ranges of absorption wavelengths. However, the diversity of cyanobacterial rhodopsins, particularly in accumulated metagenomic data, remains underexplored. Here, we used a metagenomic mining approach, which led to the identification of a novel rhodopsin clade unique to cyanobacteria, cyanorhodopsin-II (CyR-II). CyR-IIs function as light-driven outward H+ pumps. CyR-IIs, together with previously identified cyanorhodopsins (CyRs) and cyanobacterial halorhodopsins (CyHRs), constitute cyanobacterial ion-pumping rhodopsins (CyipRs), a phylogenetically distinct family of rhodopsins. The CyR-II clade is further divided into two subclades, YCyR-II and GCyR-II, based on their specific absorption wavelength. YCyR-II absorbed yellow light (λmax = 570 nm), whereas GCyR-II absorbed green light (λmax = 550 nm). X-ray crystallography and mutational analysis revealed that the difference in absorption wavelengths is attributable to slight changes in the side chain structure near the retinal chromophore. The evolutionary trajectory of cyanobacterial rhodopsins suggests that the function and light-absorbing range of these rhodopsins have been adapted to a wide range of habitats with variable light and environmental conditions. Collectively, these findings shed light on the importance of rhodopsins in the evolution and environmental adaptation of cyanobacteria.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1071-26902025S100A8/A9-MCAM signaling promotes gastric cancer cell progression via ERK-c-Jun activationENYouyiChenDepartment of Breast Surgery, The First Affiliated Hospital, Zhejiang University School of MedicineXuYangDepartment of Pathology, The First Affiliated Hospital, Zhejiang University School of MedicineRieKinoshitaDepartment of Cell Biology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNahokoTomonobuDepartment of Cell Biology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBoPanThe First Affiliated Hospital, Zhejiang University School of MedicineFangpingWuSchool of Pharmaceutical Sciences, Zhejiang Chinese Medical UniversityXuZhangDepartment of Urology, The First Affiliated Hospital, Zhejiang University School of MedicineKazumiSagayamaFaculties of Educational and Research Management Field, Okayama UniversityBeiSunDepartment of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical UniversityMasakiyoSakaguchiDepartment of Cell Biology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesS100 protein family members S100A8 and S100A9 function primarily as a heterodimer complex (S100A8/A9) in vivo. This complex has been implicated in various cancers, including gastric cancer (GC). Recent studies suggest that these proteins play significant roles in tumor progression, inflammation, and metastasis. However, the exact mechanisms by which S100A8/A9 contributes to GC pathogenesis remain unclear. This study investigates the role of S100A8/A9 and its receptor in GC. Immunohistochemical analysis was performed on GC tissue samples to assess the expression of the S100A8/A9 receptor melanoma cell adhesion molecule (MCAM). In vitro transwell migration and invasion assays were used to evaluate the motility and invasiveness of GC cells. Cell proliferation was assessed using a growth assay, and Western blotting (WB) was employed to examine downstream signaling pathways, including ERK and the transcription factor c-Jun, in response to S100A8/A9–MCAM interaction. S100A8/A9 stimulation enhanced both proliferation and migration through MCAM binding in GC cell lines. These cellular events were accompanied by ERK activation and c-Jun induction. Downregulation of MCAM suppressed both ERK phosphorylation and c-Jun expression, highlighting the importance of the S100A8/A9‒MCAM‒ERK‒c-Jun axis in promoting GC progression. These findings indicate that S100A8/A9 contributes to GC progression via MCAM, which activates the ERK‒c-Jun pathway. The S100A8/A9‒signaling axis may represent a novel therapeutic target in GC.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2073-440914172025Discovery and Functional Characterization of Novel Aquaporins in Tomato (Solanum lycopersicum): Implications for Ion Transport and Salinity Tolerance1305ENNewton ChandraPaulInstitute of Plant Science and Resources, Okayama UniversityShahinImranInstitute of Plant Science and Resources, Okayama UniversityAnriMitsumotoInstitute of Plant Science and Resources, Okayama UniversityIzumi C.MoriInstitute of Plant Science and Resources, Okayama UniversityMakiKatsuharaInstitute of Plant Science and Resources, Okayama UniversityAquaporins (AQPs) are membrane proteins that facilitate the transport of water and solutes. Among AQPs, plasma membrane intrinsic proteins (PIPs) play a critical role in maintaining water balance between the internal and external cell environments. This study focuses on the tomato due to its economic importance and cultivation under moderate salinity conditions in Japan. A swelling assay using X. laevis oocyte confirmed that all five examined tomato SlPIP2 isoforms showed water transport activity. Among them, two-electrode voltage clamp (TEVC) experiments showed that only SlPIP2;1, SlPIP2;4, and SlPIP2;8 transport Na+ and K+, with no transport activity for Cs+, Rb+, Li+, or Cl−. CaCl2 (1.8 mM) reduced ionic currents by approximately 45% compared to 30 µM free-Ca2+. These isoforms function as very low-affinity Na+ and K+ transporters. Expression analysis showed that SlPIP2;4 and SlPIP2;8 had low, stable expression, while SlPIP2;1 was strongly upregulated in roots NaCl treatment (200 mM, 17days), suggesting distinct physiological roles for these ion-conducting AQPs (icAQPs). These data hypothesized that tomato icAQPs play a critical role in ion homeostasis, particularly under salinity stress. In conclusion, the first icAQPs have been identified in the dicotyledonous crop. These icAQPs are essential for plant resilience under salt stress.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0969-806X2392026Helical X-ray tube trajectory estimation via image noise analysis for enhanced CT dosimetry113260ENTatsuyaMaedaGraduate School of Medical Sciences, Kanazawa UniversityKazukiTakegamiDepartment of Radiological Technology, Yamaguchi University HospitalSotaGotoFaculty of Health Sciences, Kobe Tokiwa UniversityTakashiAsaharaDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityDaikiKobayashiGraduate School of Medical Sciences, Kanazawa UniversityRinaNishigamiGraduate School of Medical Sciences, Kanazawa UniversityNatsumiKimotoDepartment of Radiological Science, Faculty of Health Sciences, Junshin Gakuen UniversityKazutaYamashitaDepartment of Orthopedics, School of Medicine, Tokushima UniversityKosakuHigashinoShikoku Medical Center for Children and AdultsShinichiMorimotoMEDITEC JAPAN Co., Ltd., Yamaguchi Kosan Bld.TakeshiKonishiMEDITEC JAPAN Co., Ltd., Yamaguchi Kosan Bld.MotochikaMakiMEDITEC JAPAN Co., Ltd., Yamaguchi Kosan Bld.HiroakiHayashiCollege of Transdisciplinary Sciences for Innovation, Kanazawa UniversityInformation on the helical trajectory of the X-ray tube is necessary for accurate dose evaluation during computed tomography (CT). We aimed to propose a methodology for analyzing the trajectory of the X-ray tube. The novelty of this paper is that the incident direction of X-rays is estimated from the standard deviation (SD) distribution. The X-ray incident direction for each slice was analyzed using a distribution function of SD values, in which the analysis regions were placed in the air region. Then, the helical trajectory of the CT scan was estimated by fitting a three-dimensional helical function to the analyzed data. The robustness of our algorithm was verified through phantom studies: the analyzed X-ray incident directions were compared with instrumental log data, in which cylindrical polyoxymethylene resin phantoms and a whole-body phantom were scanned. Chest CT scanning was mimicked, in which the field of view (FOV) was set at the lung region. The procedure for analyzing the X-ray incident direction was applicable to cylindrical phantoms regardless of the phantom size. In contrast, in the case of the whole-body phantom, although it was possible to apply our procedure to the chest and abdomen regions, the shoulder slices were inappropriate to analyze. Therefore, the helical trajectory was determined based on chest and abdominal CT images. The accuracy in X-ray incident direction analysis was evaluated to be 7.5°. In conclusion, we have developed an algorithm to estimate a three-dimensional helical trajectory that can be used for dose measurements and simulations.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221512025Lactose fermenting enteroinvasive Escherichia coli from diarrhoeal cases confers enhanced virulence24040ENDebjaniGhoshDivision of Bacteriology, ICMR-National Institute for Research in Bacterial Infections (ICMR-NIRBI)ProlayHalderDivision of Bacteriology, ICMR-National Institute for Research in Bacterial Infections (ICMR-NIRBI)ProsenjitSamantaDivision of Bacteriology, ICMR-National Institute for Research in Bacterial Infections (ICMR-NIRBI)GoutamChowdhuryCollaborative Research Centre of Okayama University for Infectious Diseases, ICMR-National Institute for Research in Bacterial InfectionsSreejaShawDivision of Bacteriology, ICMR-National Institute for Research in Bacterial Infections (ICMR-NIRBI)PujaBoseDivision of Bacteriology, ICMR-National Institute for Research in Bacterial Infections (ICMR-NIRBI)DeboleenaRoyDivision of Bacteriology, ICMR-National Institute for Research in Bacterial Infections (ICMR-NIRBI)NiveditaRoyDivision of Bacteriology, ICMR-National Institute for Research in Bacterial Infections (ICMR-NIRBI)KeiKitaharaCollaborative Research Centre of Okayama University for Infectious Diseases, ICMR-National Institute for Research in Bacterial InfectionsThandavarayanRamamurthyDivision of Bacteriology, ICMR-National Institute for Research in Bacterial Infections (ICMR-NIRBI)HemantaKoleyDivision of Bacteriology, ICMR-National Institute for Research in Bacterial Infections (ICMR-NIRBI)Shin-ichiMiyoshiGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShantaDuttaDivision of Bacteriology, ICMR-National Institute for Research in Bacterial Infections (ICMR-NIRBI)Asish KumarMukhopadhyayDivision of Bacteriology, ICMR-National Institute for Research in Bacterial Infections (ICMR-NIRBI)Enteroinvasive Escherichia coli (EIEC), known for causing bacillary dysentery akin to Shigella species, comprises both lactose-fermenting (LF) and non-lactose-fermenting (NLF) isolates. While NLF-EIEC is a well-established pathogen associated with acute dysentery and harbours classical Shigella-like virulence factors, the role of LF-EIEC in human disease remains underexplored. In this study, we sought to characterize LF-EIEC clinical isolates and assessed their pathogenic potential in comparison to NLF-EIEC. Among 13,682 diarrhoeal stool specimens, six LF and nine NLF-EIEC were isolated, predominantly belonging to serogroups O28ac, O125, O136, and O152. Unlike other E. coli, all the EIEC isolates were non-motile. Both the types of EIEC had multiple plasmids harbouring several virulence encoding genes (ipaBCD, ial, virF, sig, sepA and ipaH). Resistance to recent generation antibiotics were mostly confined to NLF-EIEC but some of the LF-EIEC were resistant only to ceftriaxone. Higher invasion ability and significant increase in the expression of virulence encoding genes by the LF-EIEC (p < 0.05) were noted during infection to Int407 cell-line. Additionally, LF-EIEC exhibited extensive colonization of the mouse intestine and expressed severe keratoconjunctivitis in guinea pigs. Together, our findings highlight LF-EIEC as an emerging pathogenic variant warranting heightened surveillance and comprehensive investigation to better understand its epidemiological and clinical significance.No potential conflict of interest relevant to this article was reported.International Union of Crystallography (IUCr)Acta Medica Okayama1600-57753252025X-ray fluorescence holography under high-pressure conditions13021309ENXinhuiZhanGraduate School of Advanced Science and Engineering, Hiroshima UniversityNaokiIshimatsuGeodynamics Research Center, PIAS, Ehime UniversityKojiKimuraDepartment of Physical Science and Engineering, Nagoya Institute of TechnologyNaohisaHappoGraduate School of Information Sciences, Hiroshima City UniversityHalubaiSekharInstitute of Industrial Nanomaterials, Kumamoto UniversityTomokoSatoInstitute of Materials Structure Science, High Energy Accelerator Research Organization, KEKNobuoNakajimaGraduate School of Advanced Science and Engineering, Hiroshima UniversityNaomiKawamuraJapan Synchrotron Radiation Research Institute, SPring-8KotaroHigashiJapan Synchrotron Radiation Research Institute, SPring-8OkiSekizawaJapan Synchrotron Radiation Research Institute, SPring-8HirokazuKadobayashiJapan Synchrotron Radiation Research Institute, SPring-8RitsukoEguchiGraduate School of Science, University of HyogoYoshihiroKubozonoResearch Institute for Interdisciplinary Science, Okayama UniversityHirooTajiriJapan Synchrotron Radiation Research Institute, SPring-8ShinyaHosokawaFaculty of Materials for Energy, Shimane UniversityTomohiroMatsushitaGraduate School of Science and Technology, Nara Institute of Science and TechnologyToruShinmeiGeodynamics Research Center, PIAS, Ehime UniversityTetsuoIrifuneGeodynamics Research Center, PIAS, Ehime UniversityKoichiHayashiDepartment of Physical Science and Engineering, Nagoya Institute of TechnologyThis study reports the first application of X-ray fluorescence holography (XFH) under high-pressure conditions. We integrated XFH with a diamond anvil cell to investigate the local structure around Sr atoms in single-crystal SrTiO3 under high pressure. By utilizing nano-polycrystalline diamond anvils and a yttrium filter, we effectively eliminated significant background noise from both the anvils and the gasket. This optimized experimental configuration enabled the measurement of Sr Kα holograms of the SrTiO3 sample at pressures up to 13.3 GPa. The variation of lattice constants with pressure was calculated by the shifts of Kossel lines, and real-space images of the atomic structures were reconstructed from the Sr Kα holograms at different pressures. This work successfully demonstrates the feasibility of employing XFH under high-pressure conditions as a novel method for visualizing pressure-induced changes in the three-dimensional local structure around the specified element.No potential conflict of interest relevant to this article was reported.The Royal SocietyActa Medica Okayama1744-957X2172025Animal–chlorophyte photosymbioses: evolutionary origins and ecological diversityENIsabel Jiah-YihLiaoBiodiversity Research Center, Academia SinicaTosukeSakagamiBiodiversity Research Center, Academia SinicaThomas D.LewinBiodiversity Research Center, Academia SinicaXavierBaillyLaboratoire des Modèles Marins Multicellulaires, Station Biologique de RoscoffMayukoHamadaUshimado Marine Institute, Okayama UniversityYi-JyunLuoBiodiversity Research Center, Academia SinicaPhotosynthetic symbiosis occurs across diverse animal lineages, including Porifera, Cnidaria, Xenacoelomorpha and Mollusca. These associations between animal hosts and photosynthetic algae often involve the exchange of essential macronutrients, supporting adaptation to a wide range of aquatic environments. A small yet taxonomically widespread subset of animals host photosymbionts from the core chlorophytes, a phylogenetically expansive clade of green algae. These rare instances of ‘plant-like’ animals have arisen independently across distantly related lineages, resulting in striking ecological and physiological diversity. Although such associations provide valuable insights into the evolution of symbiosis and adaptation to novel ecological niches, animal–chlorophyte photosymbioses remain relatively understudied. Here, we present an overview of photosymbioses between animals and chlorophytes, highlighting their independent evolutionary origins, ecological diversity and emerging genomic resources. Focusing on Porifera, Cnidaria and Xenacoelomorpha, we review shared and lineage-specific adaptations underlying these associations. We also contrast them with dinoflagellate-based systems to demonstrate their distinct ecological and cellular features. Our work sets the stage for elucidating the molecular mechanisms underlying these associations, enhancing our understanding of how interspecies interactions drive adaptation to unique ecological niches through animal–chlorophyte symbiosis.No potential conflict of interest relevant to this article was reported.International Union of Crystallography (IUCr)Acta Medica Okayama2052-25251252025Illuminating DNA repair in action: structural insights into a photocaged glycosylase complex513514ENMichihiroSugaResearch Institute for Interdisciplinary Science, Okayama UniversityNo potential conflict of interest relevant to this article was reported.American Physiological SocietyActa Medica Okayama1040-060532912025Activated factor X inhibition ameliorates NF-κB-IL-6-mediated perivascular inflammation and pulmonary hypertensionL183L196ENSatomiImakiireDepartment of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu UniversityKeijiKimuroDepartment of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu UniversityKeimeiYoshidaDepartment of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu UniversityKoheiMasakiDepartment of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu UniversityRyoIzumiDepartment of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu UniversityMisakiImabayashiDepartment of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu UniversityTakanoriWatanabeDepartment of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu UniversityTomohitoIshikawaDepartment of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu UniversityKazuyaHosokawaDepartment of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu UniversityShoujiMatsushimaDepartment of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu UniversityToruHashimotoDepartment of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu UniversityKeisukeShinoharaDepartment of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu UniversityShunsukeKatsukiDepartment of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu UniversityTetsuyaMatobaDepartment of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu UniversityKazufumiNakamuraDepartment of Cardiovascular Medicine, Okayama UniversityKatsuyaHiranoDepartment of Cardiovascular Physiology, Faculty of Medicine, Kagawa UniversityHiroyukiTsutsuiDepartment of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu UniversityKohtaroAbeDepartment of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu UniversityActivated factor X (FXa) induces inflammatory response and cell proliferation in various cell types via activation of proteinase-activated receptor-1 (PAR1) and/or PAR2. We thus aimed to investigate the impact of FXa on the development of pulmonary arterial hypertension (PAH) and the mechanisms involved. The effects of edoxaban, a selective FXa inhibitor, on hemodynamic, right ventricular (RV) hypertrophy, and vascular remodeling were evaluated in a monocrotaline (MCT)-exposed pulmonary hypertension (PH) rat model. At 21 days after a single subcutaneous injection of MCT of 60 mg/kg, right ventricular systolic pressure (RVSP) and total pulmonary vascular resistance index (TPRI) were elevated concomitant with the increased plasma FXa and lung interleukin-6 (IL-6) mRNA. Daily administration of edoxaban (10 mg/kg/day, by gavage) starting from the day of MCT injection for 21 days ameliorated RVSP, TPRI, RV hypertrophy, pulmonary vascular remodeling, and macrophage accumulation. Edoxaban reduced nuclear factor-kappa B (NF-κB) activity and IL-6 mRNA level in the lungs of MCT-exposed rats. mRNA levels of FXa, PAR1, and PAR2 in cultured pulmonary arterial smooth muscle cells (PASMCs) isolated from patients with PAH were higher than those seen in normal PASMCs. FXa stimulation increased cell proliferation and mRNA level of IL-6 in normal PASMCs, both of which were blunted by edoxaban and PAR1 antagonist. Moreover, FXa stimulation activated extracellularly regulated kinases 1/2 in a PAR1-dependent manner. Inhibition of FXa ameliorates NF-κB-IL-6-mediated perivascular inflammation, pulmonary vascular remodeling, and the development of PH in MCT-exposed rats, suggesting that FXa may be a potential target for the treatment of PAH.<br>
NEW & NOTEWORTHY This study demonstrated that chronic treatment with activated factor X (FXa) inhibitor ameliorated NF-κB-IL-6-mediated perivascular inflammation in a rat model with pulmonary arterial hypertension, which is associated with elevated FXa activity. FXa may act on pulmonary arterial smooth muscle cells, inducing cell proliferation and inflammatory response via upregulated PAR1, thereby contributing to pulmonary vascular remodeling. Understanding the patient-specific pathophysiology is a prerequisite for applying FXa-targeted therapy to the treatment of pulmonary arterial hypertension.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1068-92653222024Hemodynamic Assessment Using SPY Laser Fluorescence Imaging During Pancreatoduodenectomy with Common Hepatic Artery Resection13341336ENTomokazuFujiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKoseiTakagiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuyaYasuiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakeyoshiNishiyamaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMotohikoYamadaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYasuoNagaiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNoriyukiKanehiraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground. Pancreatectomies combined with arterial resection can be indicated for pancreatic cancer. In a pancreatectomy with arterial resection, intraoperative confirmation of blood flow through reconstructed vessels is crucial. This study highlights the usefulness of SPY laser fluorescence imaging during a pancreatoduodenectomy with common hepatic artery resection (PD-CHAR).<br>
Patient and Methods. A 55-year-old man with borderline resectable pancreatic head cancer underwent a PD-CHAR. After confirming tumor resectability, reconstruction of the CHA to the proper hepatic artery was performed. Subsequently, the superior mesenteric vein was reconstructed.<br>
Results. SPY laser fluorescence imaging demonstrated arterial blood perfusion to the liver through the reconstructed hepatic artery, followed by perfusion from the portal vein. The operation lasted 493 min, with an estimated blood loss of 400 mL. The postoperative course was uneventful with good arterial blood flow.<br>
Conclusion. The SPY Portable Handheld Imager could be valuable for visualizing blood flow in reconstructed vessels and assessing tissue perfusion during a pancreatectomy combined with vascular reconstruction.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1598-23512025Hydrogen Embrittlement Characteristics of Austenitic Stainless Steels After Punching ProcessENMitsuhiroOkayasuDepartment of Mechanical and Systems Engineering, Okayama UniversityXichangLiDepartment of Mechanical and Systems Engineering, Okayama UniversityTomohisaKawakamiSHOYO SANGYO Co., Ltd.This study investigates the influence of microstructural characteristics on the hydrogen embrittlement of SUS304 austenitic stainless steel. The investigation utilized SUS304 sheets with a thickness of 1.5 mm, which were processed by punching with an 8 mm diameter to make specimens. Severe plastic deformation was localized near the punching edge, with the extent of deformation determined by the punching speed. Slower punching speeds induced more pronounced plastic strain, which was closely associated with work hardening and strain-induced martensitic (SIM) transformation. The SIM phase was predominantly observed within a depth of approximately 0.1 mm from the punched edge when processed at a punching speed of 0.25 mm/s, corresponding to roughly 10% of the cross-sectional area of the sample. These microstructural changes led to a significant reduction in tensile and fatigue strength, thereby exacerbating susceptibility to severe hydrogen embrittlement, despite the limited extent of microstructural alteration. Based on these findings, a modified Goodman diagram for SUS304 austenitic stainless steel, incorporating mechanical properties and hydrogen embrittlement behavior, was proposed.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0969-806X2382026Bone-enhanced high contrast X-ray images derived from attenuation estimation related to ultra-low energy X-rays – An application of an energy-resolving photon-counting detector (ERPCD)113243ENRinaNishigamiGraduate School of Medical Sciences, Kanazawa UniversityNatsumiKimotoDepartment of Radiological Science, Faculty of Health Sciences, Junshin Gakuen UniversityTakashiAsaharaFaculty of Health Sciences, Okayama UniversityTatsuyaMaedaGraduate School of Medical Sciences, Kanazawa UniversityDaikiKobayashiGraduate School of Medical Sciences, Kanazawa UniversitySotaGotoFaculty of Health Sciences, Kobe Tokiwa UniversityTomonobuHabaFaculty of Radiological Technology, School of Medical Science, Fujita Health UniversityYukiKanazawaFaculty of Life Science, Kumamoto UniversityShuichiroYamamotoJOB CORPORATIONHiroakiHayashiCollege of Transdisciplinary Sciences for Innovation, Kanazawa UniversityPurpose: X-ray diagnosis in medicine is often used for bone diagnosis based on qualitative observation analysis. However, there are often cases where the contrast of bones is reduced because of the existence of soft-tissues, making it difficult to accurately diagnose the bone conditions. Although the algorithm for bone extraction images was proposed using an energy-resolving photon-counting detector (ERPCD), this algorithm can depict “one” bone material (such as hydroxyapatite under the assumption), and it is difficult to adequately depict other components. The purpose of this study is to develop an algorithm for bone-enhanced high-contrast images that can be virtually represented by the attenuation of extremely low-energy X-rays without making any special assumptions.<br>
Methods: High-contrast images were virtually generated based on the attenuation rate of ultra-low energy X-rays. It was determined by fitting the mass attenuation coefficient (μ/ρ) curve to the X-ray attenuation values (μt values) measured at middle (30–40 keV) and high (40–60 keV) energy windows, and extrapolating the μt values to those for the low energy region (E = 5–20 keV). When performing the extrapolation, the effective atomic number (Zeff ) of the object was taken into consideration. The methodology was validated by simulating X-ray projections using a digital human body phantom. The frequency of correspondence between the pixel values in the high-contrast image and the Zeff image was analyzed for each pixel.<br>
Results: We succeeded in creating virtual high-contrast X-ray images that reflect the image contrast of monochromatic X-rays of 5–20 keV. It was confirmed that the pixel values in the high-contrast image corresponding to an Zeff = 7.5 (soft-tissue) were completely separated from those corresponding to an Zeff = 9 (bone). The optimization of the energy related to the high contrast images was performed based on the contrast-to-noise ratio (CNR) analysis. The high contrast image with 10 keV showed a good CNR value.<br>
Conclusions: Based on the analysis of the attenuation information of middle and high-energy X-rays measured by ERPCDs, we succeeded in creating a novel algorithm that can generate a virtual monochromatic image with high contrast.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0969-806X2392026Counting-loss correction procedure of X-ray imaging detectors with consideration for the effective atomic number of biological objects113237ENNatsumiKimotoDepartment of Radiological Science, Faculty of Health Sciences, Junshin Gakuen UniversityRinaNishigamiGraduate School of Medical Sciences, Kanazawa UniversityDaikiKobayashiGraduate School of Medical Sciences, Kanazawa UniversityTatsuyaMaedaGraduate School of Medical Sciences, Kanazawa UniversityTakashiAsaharaDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversitySotaGotoFaculty of Health Science, Kobe Tokiwa UniversityYukiKanazawaFaculty of Life Science, Kumamoto UniversityAkitoshiKatsumataOral Radiology and Artificial Intelligence, Asahi UniversityShuichiroYamamotoJOB CORPORATIONHiroakiHayashiCollege of Transdisciplinary Sciences for Innovation, Kanazawa UniversityIt is necessary to correct counting loss caused by the pulse pile-up effect and dead time when using energy-resolving photon-counting detectors (ERPCDs) under “high-counting-rate” conditions in medical and/or industrial settings. We aimed to develop a novel counting-loss correction procedure in which biological objects having effective atomic numbers (Zeff values) of 6.5–13.0 are measured with polychromatic X-rays. To correct for counting loss, such a procedure must theoretically estimate the count value of an ideal X-ray spectrum without counting loss. In this study, we estimated the ideal X-ray spectrum by focusing on the following two points: (1) the X-ray attenuation in an object (Zeff values of 6.5–13.0) and (2) the detector response. Virtual materials having intermediate atomic numbers between 6.5 and 13.0 were generated by using a mixture of polymethylmethacrylate (PMMA, Zeff = 6.5) and aluminum (Al, Zeff = 13.0). We then constructed an algorithm that can perform the counting-loss correction based on the object’s true Zeff value. To demonstrate the applicability of our procedure, we analyzed investigational objects consisting of PMMA and Al using a prototype ERPCD system. A fresh fish sample was also analyzed. The Zeff values agree with the theoretical values within an accuracy of Zeff ±1. In conclusion, we have developed a highly accurate procedure for correcting counting losses for the quantitative X-ray imaging of biological objects.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Mimicking Contralateral Pneumothorax during Thoracoscopic Bullectomy Associated with Intraoperative Hyperinflation of a Large Bulla in an Obese Patient311315ENKeiMatsubaraDepartment of Thoracic Surgery, Hiroshima City Hiroshima Citizens HospitalKeiMatsubaraDepartment of Thoracic Surgery, Hiroshima City Hiroshima Citizens HospitalYutakaHiranoDepartment of Thoracic Surgery, Hiroshima City Hiroshima Citizens HospitalToshiyaFujiwaraDepartment of Thoracic Surgery, Hiroshima City Hiroshima Citizens HospitalCase Report10.18926/AMO/69159A 55-year-old obese Japanese male with left pneumothorax presented to our hospital. Bilateral pulmonary emphysema was confirmed. Persistent air leakage was observed, and a thoracoscopic bullectomy was performed. Although the thoracoscopic bullectomy was completed uneventfully, pre-extubation chest X-ray imaging indicated hyper-lucency occupying the right upper part of the thoracic cavity, suggesting right-sided pneumothorax. CT imaging indicated a right-upper-lobe expanded bulla. Extubation was performed, and the hyperinflated bulla gradually deflated. Careful management of bulla expansion and respiratory status may be necessary for patients with obesity and large bullae, especially in one-lung ventilation cases.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025A Rare Presentation of Pneumonic-Type Adenocarcinoma Hidden behind Empyema305309ENSatoruSenooDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterEitoNimanDepartment of General Thoracic Surgery, National Hospital Organization Fukuyama Medical CenterRyokoTsujiDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterKoheiTakataDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterShunsukeMatsumoriDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterFumikaMuranoDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterYukaSugisakiDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterHirokiOmoriDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterAkihikoTaniguchiDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterRikaOmoteDepartment of Diagnostic Pathology, National Hospital Organization Fukuyama Medical CenterEikiIchiharaDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterKenjiTakahashiDepartment of General Thoracic Surgery, National Hospital Organization Fukuyama Medical CenterToshiakiOkadaDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterCase Report10.18926/AMO/69158Pneumonic-type adenocarcinoma (P-ADC) can closely mimic pneumonia. We report a P-ADC initially diagnosed as pneumonia which developed into a pulmonary abscess and empyema. A 50-year-old Japanese male diagnosed with pneumonia, pulmonary abscess, and empyema was administered antibiotics and a chest tube for drainage, which improved his symptoms and blood test results. However, chest computed tomography showed an enlarged infiltrative shadow. The patient underwent bronchoscopy and was diagnosed with an adenocarcinoma. This case highlights the importance of considering P-ADC in differential diagnoses when a pneumonia-like shadow enlarges post-empyema treatment. Diagnostic and clinical tests, e.g., bronchoscopy, should be performed in such cases.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Pulmonary Calcium Phosphate Cement Embolism After Percutaneous Vertebroplasty for Thoracic Vertebrae Fractures299303ENRuibinFengDepartment of Orthopedics, the Ninth Affiliated Hospital of Guangxi Medical UniversityBikangZhuDepartment of Orthopedics, the Ninth Affiliated Hospital of Guangxi Medical UniversityDanyunWeiDepartment of Orthopedics, the Ninth Affiliated Hospital of Guangxi Medical UniversityDingjiaoZhuDepartment of Radiology, the Ninth Affiliated Hospital of Guangxi Medical UniversityCairuChenDepartment of Orthopedics, the Ninth Affiliated Hospital of Guangxi Medical UniversityCase Report10.18926/AMO/69157Pulmonary cement embolism (PCE) is a rare but severe complication following percutaneous vertebroplasty (PVP). Calcium phosphate cement (CPC) has emerged as an alternative to traditional materials for vertebral augmentation. There appear to be no established guidelines for managing symptomatic PCE, and there is scarce literature on CPC embolisms. This is a first report of a case of pulmonary CPC embolism following PVP. The patient, a 63-year-old Chinese female, was administered anticoagulant treatment and achieved a satisfactory outcome. Her case highlights the severe potential morbidity associated with CPC leakage and emphasizes the efficacy of anticoagulant treatment for managing pulmonary CPC embolisms.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Anterior Uveitis Secondary to an Infected Postoperative Maxillary Cyst283286ENYutaImamuraDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusukeShiodeDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuheiKimuraDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMioHosokawaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoMatobaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiKanzakiDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyaKindoDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTetsuroMoritaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAyaMuraiDepartment 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 SciencesYukiMorizaneDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/69154A 76-year-old man presented with right eyelid swelling and deteriorated vision. Examination revealed anterior uveitis with hypopyon and a visual acuity of 20/2,000 in the right eye, with no abnormalities in the left. Computed tomography revealed enlargement of the right maxillary sinus and internal fluid accumulation, suggesting a postoperative maxillary cyst (POMC). Nasal endoscopic surgery drained the pus by opening the lower wall of the maxillary cyst. Following the procedure, intraocular inflammation resolved, and visual acuity in the right eye improved to 24/20. This is the first reported case of uveitis secondary to POMC.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Femoral and Global Femoral Offset, but not Anteroposterior Offset, to Improve Postoperative Outcomes Following Total Hip Arthroplasty: Considerations Independent of the Contralateral Side269278ENNorioImaiDivision of Comprehensive Musculoskeletal Medicine, Niigata University Graduate School of Medical and Dental SciencesYukiHiranoDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesDaisukeHommaDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesYukiEndoDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesYojiHorigomeDivision of Comprehensive Musculoskeletal Medicine, Niigata University Graduate School of Medical and Dental SciencesHayatoSuzukiDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesHiroyukiKawashimaDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesOriginal Article10.18926/AMO/69152The global femoral offset (the sum of the acetabular and femoral offsets) influences outcomes after total hip arthroplasty (THA). The optimal offset using plain radiographs has been reported, but internal and external rotations of the hip affect the offset value, producing unclear results when the nonsurgical side is not intact. We investigated the relationship between a functional hip score, i.e., the Harris Hip Score (HHS) and its effect on the post-THA anteroposterior and lateral offsets, and we sought to identify the optimal offset value. The cases of 158 patients with hemilateral hip osteoarthritis who underwent THA at a single center were retrospectively analyzed in this cross-sectional study. Three-dimensional pelvic and femoral models generated from computed tomography were used to examine several parameters, and the results revealed a significant binomial correlation among the modified HHS and femoral and global femoral offsets, with maximum values of 21.3 mm and 40 mm/100 cm body height, respectively. Pelvic and femoral parameters were measured and evaluated via alignment with a specific coordinate system. Our findings indicate that preoperative planning using these parameters may improve postoperative hip function, even when the nonoperative side is unsuitable for use as a reference, as in bilateral hip osteoarthritis cases.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Bloodstream Infections Caused by Gram-Negative Bacteria in Geriatric Patients: Epidemiology, Antimicrobial Resistance and The Factors Affecting Mortality231242ENM Enes KardanDepartment of Infectious Diseases, Faculty of Medicine, Namik Kemal UniversityIlknurErdemDepartment of Infectious Diseases, Faculty of Medicine, Namik Kemal UniversityEmreYildizDepartment of Infectious Diseases, Faculty of Medicine, Namik Kemal UniversityNuriKirazDepartment of Medical Microbiology, Faculty of Medicine, Namik Kemal UniversityAliyeÇelikkolDepartment of Biochemistry, Faculty of Medicine, Namik Kemal UniversityOriginal Article10.18926/AMO/69148Bloodstream infections (BSIs) are an important cause of morbidity and mortality in geriatric patients. We retrospectively analyzed the cases of geriatric patients who developed BSIs due to gram-negative bacteria in order to evaluate the epidemiology, antimicrobial resistance, and the factors affecting mortality. The cases of 110 patients aged ≥ 65 years admitted to our hospital between January 1, 2017, and December 31, 2022 were assessed; 70 (63.6%) of the BSIs were healthcare-associated BSIs. The urinary system was the most common detectable source of infection at 43.6%. The most frequently isolated bacteria were Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae, in that order. Carbapenem resistance was detected in 17 patients (15.5%), and extended-spectrum beta-lactamase (ESBL) production from Enterobacterales family members was detected in 37 (51.4%) patients. Multivariate analysis revealed that (i) the probability of mortality in the patients with total bilirubin was increased by approx. sixfold and (ii) the likelihood of mortality for those with a Pitt bacteremia score (PBS) ≥ 4 points was approx. 17 times higher. PBS and simplified qPitt scores can help predict mortality and manage geriatric patients. There is a significant increase in mortality among patients with procalcitonin (PCT) levels at ≥ 2 nm/ml.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Organ Donation after Extracorporeal Cardiopulmonary Resuscitation: Clinical and Ethical Perspectives221229ENTetsuyaYumotoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiromichiNaitoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiHongoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakafumiObaraDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshinoriKosakiDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoheiAgetaDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTsuyoshiNojimaDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoheiTsukaharaDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAtsunoriNakaoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityReview10.18926/AMO/69147Extracorporeal cardiopulmonary resuscitation (ECPR) has evolved into a life-saving therapy for select cardiac arrest patients, yet a growing body of evidence suggests it also holds promise as a bridge to organ donation in non-survivors. This review explores the clinical outcomes, ethical complexities, and evolving policies surrounding organ donation after ECPR. We summarize recent international and Japanese data demonstrating favorable graft function from ECPR donors, with the exception of lung transplantation. The ethical challenges ― particularly those involving brain death determination on extracorporeal membrane oxygenation and adherence to the dead donor rule ― are discussed in the context of Japan’s recent regulatory reforms. Additionally, we highlight the importance of structured end-of-life communication through multidisciplinary team meetings in facilitating ethically sound transitions from rescue efforts to donation pathways. Moving forward, improvements in donor management, standardized legal frameworks, and public and professional education are essential to optimizing the life-saving and life-giving potential of ECPR.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1341-96252025Advances in liquid biopsy for bone and soft-tissue sarcomasENYilangWangDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTomohiroFujiwaraDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakanaoKurozumiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTeruhikoAndoDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakahikoIshimaruDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHiroyaKondoDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesEijiNakataDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshiyukiKunisadaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBone and soft-tissue sarcomas are a heterogeneous group of malignant tumors originating from mesenchymal tissues, accounting for approximately 1% of adult solid malignancies and 20% of pediatric solid malignancies. While blood-based tumor markers are available in major types of cancers, evidence demonstrating useful circulating biomarkers is limited in bone and soft-tissue sarcomas. Despite the development of combined modality treatments, a significant proportion of sarcoma patients respond poorly to chemotherapy or radiotherapy, leading to local relapse or distant metastasis. However, imaging methods, such as X-ray, computed tomography, positron emission tomography, magnetic resonance imaging, and scintigraphy, are mostly used to detect or monitor tumor development. Liquid biopsy is an emerging minimally invasive diagnostic technique that detects tumor-derived molecules in body fluids, including circulating tumor cells, circulating tumor DNA (ctDNA), circulating tumor RNA (ctRNA), and circulating extracellular vesicles. This method offers new possibilities for early tumor detection, prognostic evaluation, and therapeutic monitoring and may serve as a benchmark for treatment modification. This review focuses on the current technological advances in liquid biopsy for bone and soft-tissue sarcoma and explores its potential role in guiding personalized treatments. If these modalities could determine resistance to ongoing therapy or the presence of minimal residual disease at the end of the treatment protocol, the obtained data would be important for determining whether to change treatment approaches or add adjuvant therapies.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2304-676712112024Coronal Cementum and Reduced Enamel Epithelium on Occlusal Surface of Impacted Wisdom Tooth in a Human348ENNaohiroHorieDivision of Reconstructive Surgery for Oral and Maxillofacial Region, School of Dentistry, Health Sciences University of HokkaidoMasaruMurataDivision of Regenerative Medicine, School of Dentistry, Health Sciences University of HokkaidoYasuhitoMinamidaDivision of Oral and Maxillofacial Surgery, School of Dentistry, Health Sciences University of HokkaidoHirokiNagayasuDivision of Oral and Maxillofacial Surgery, School of Dentistry, Health Sciences University of HokkaidoTsuyoshiShimoDivision of Reconstructive Surgery for Oral and Maxillofacial Region, School of Dentistry, Health Sciences University of HokkaidoToshiyukiAkazawaIndustrial Technology and Environment Research Development, Hokkaido Research OrganizationHidetsuguTsujigiwaDepartment of Life Science, Faculty of Science, Okayama University of ScienceYoussefHaikelDepartment of Biomaterials and Bioengineering, Institut National de la Santé et de la Recherche médicale Unité Mixte de Recherche (INSERM UMR) _S 1121, University of StrasbourgHitoshiNagatsukaDepartment of Oral Pathology and Medicine Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground: There is only limited research on the coronal cementum of a tooth, and the mechanisms of its forming process are not well-defined. This report presents a coronal cementum on the occlusal surfaces of enamel in an impacted wisdom tooth in a human, which is not nearly the cervical portion. Materials and Methods: The tooth (Tooth #1) was derived from a 46-year-old female. Histological analysis, including hematoxylin and eosin (HE) and toluidine blue (TB) staining, and Scanning Electron Microscopy and Energy Dispersive X-ray Spectrometer (SEM-EDS) analysis of the extracted tooth were conducted. Radiographic examination showed that Tooth #1 was horizontally impacted in the maxilla and had the apex of a single root placed between the buccal and palatal roots of Tooth #2. Results: Coronal cementum was distributed widely on the enamel, and reduced enamel epithelium was also found with enamel matrix proteins histologically. The formation of acellular cementum was observed to be more predominant than that of the cellular cementum in Tooth #1. SEM showed that the occlusal cementum connected directly with enamel. Calcium mapping revealed an almost similar occlusal cementum and enamel. In addition, the spectrum of elements in coronal cementum resembled the primary cementum according to SEM-EDS. Discussion: Thus, coronal cementogenesis in impacted human teeth might be related to the existence of reduced enamel epithelium.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2076-341715112025Top-Down Stereolithography-Based System for Additive Manufacturing of Zirconia for Dental Applications6155ENKumikoYoshiharaNational Institute of Advanced Industrial Science and Technology (AIST), Health and Medical Research InstituteNoriyukiNagaokaAdvanced Research Center for Oral and Craniofacial Sciences, Okayama University Dental SchoolFionaSpirrettJoining and Welding Research Institute, Osaka UniversityYukinoriMaruoDepartment of Prosthodontics, Okayama UniversityYasuhiroYoshidaDepartment of Biomaterials and Bioengineering, Faculty of Dental Medicine, Hokkaido UniversityBartVan MeerbeekBIOMAT, Department of Oral Health Sciences, KU LeuvenSoshuKiriharaJoining and Welding Research Institute, Osaka UniversityThis study investigated the feasibility and effectiveness of a commercial top-down stereolithography (SLA)-based system for the additive manufacturing of zirconia dental prostheses. Yttria-stabilized zirconia–resin slurries were prepared, and zirconia objects were fabricated using a top-down SLA system. Thermogravimetric–differential thermal analysis was used to examine the resin, while X-ray fluorescence spectroscopy and X-ray diffraction were used to analyze the printed samples. The microstructures of additively manufactured and subtractively manufactured zirconia were compared using field emission scanning electron microscopy (FE-SEM) before and after sintering. Biaxial flexural strength tests were also conducted to evaluate mechanical properties. The green bodies obtained via additive manufacturing exhibited uniform layering with strong interlayer adhesion. After sintering, the structures were dense with minimal porosity. However, compared to subtractively manufactured zirconia, the additively manufactured specimens showed slightly higher porosity and lower biaxial flexural strength. The results demonstrate the potential of SLA-based additive manufacturing for dental zirconia applications while also highlighting its current mechanical limitations. The study also showed that using a blade to evenly spread viscous slurry layers in a top-down SLA system can effectively reduce oxygen inhibition at the surface and relieve internal stresses during the layer-by-layer printing process, offering a promising direction for clinical adaptation.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2075-44181552025Review Article: Diagnostic Paradigm Shift in Spine Surgery594ENAras EfeLeventDepartment of Orthopedic Surgery, Okayama Rosai HospitalMasatoTanakaDepartment of Orthopedic Surgery, Okayama Rosai HospitalChetanKumawatDepartment of Orthopedic Surgery, Okayama Rosai HospitalChristianHengDepartment of Orthopedic Surgery, Okayama Rosai HospitalSalamalikisNikolaosDepartment of Orthopedic Surgery, Okayama Rosai HospitalKajetanLatkaDepartment of Orthopedic Surgery, Okayama Rosai HospitalAkiyoshiMiyamotoDepartment of Orthopedic Surgery, Okayama Rosai HospitalTadashiKomatsubaraDepartment of Orthopedic Surgery, Okayama Rosai HospitalShinyaAratakiDepartment of Orthopedic Surgery, Okayama Rosai HospitalYoshiakiOdaDepartment of Orthopedic Surgery, Okayama University HospitalKensukeShinoharaDepartment of Orthopedic Surgery, Okayama University HospitalKojiUotaniDepartment of Orthopedic Surgery, Okayama University HospitalMeticulous clinical examination is essential for spinal disorders to utilize the diagnostic methods and technologies that strongly support physicians and enhance clinical practice. A significant change in the approach to diagnosing spinal disorders has occurred in the last three decades, which has enhanced a more nuanced understanding of spine pathology. Traditional radiographic methods such as conventional and functional X-rays and CT scans are still the first line in the diagnosis of spinal disorders due to their low cost and accessibility. As more advanced imaging technologies become increasingly available worldwide, there is a constantly increasing trend in MRI scans for detecting spinal pathologies and making treatment decisions. Not only do MRI scans have superior diagnostic capabilities, but they also assist surgeons in performing meticulous preoperative planning, making them currently the most widely used diagnostic tool for spinal disorders. Positron Emission Tomography (PET) can help detect inflammatory lesions, infections, and tumors. Other advanced diagnostic tools such as CT/MRI fusion image, Functional Magnetic Resonance Imaging (fMRI), Upright and Kinetic MRI, magnetic resonance spectroscopy (MRS), diffusion-weighted imaging (DWI), and diffusion tensor imaging (DTI) could play an important role when it comes to detecting more special pathologies. However, some technical difficulties in the daily praxis and their high costs act as obstacles to their further spread. Integrating artificial intelligence and advancements in data analytics and virtual reality promises to enhance spinal procedures’ precision, safety, and efficacy. As these technologies continue to develop, they will play a critical role in transforming spinal surgery. This paradigm shift emphasizes the importance of continuous innovation and adaptability in improving the diagnosis and treatment of spinal disorders.No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama1554-892919122024Discovery of a Compound That Inhibits IRE1α S-Nitrosylation and Preserves the Endoplasmic Reticulum Stress Response under Nitrosative Stress24292437ENHarunaKurogiDepartment of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNobumasaTakasugiDepartment of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShoKubotaDepartment of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAshutoshKumarLaboratory for Structural Bioinformatics, Center for Biosystems Dynamics Research, RIKENTakehiroSuzukiBiomolecular Characterization Unit, Technology Platform Division, RIKEN Center for Sustainable Resource ScienceNaoshiDohmaeBiomolecular Characterization Unit, Technology Platform Division, RIKEN Center for Sustainable Resource ScienceDaisukeSawadaDepartment of Fine Organic Synthesis, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKam Y.J.ZhangLaboratory for Structural Bioinformatics, Center for Biosystems Dynamics Research, RIKENTakashiUeharaDepartment of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityInositol-requiring enzyme 1α (IRE1α) is a sensor of endoplasmic reticulum (ER) stress and drives ER stress response pathways. Activated IRE1α exhibits RNase activity and cleaves mRNA encoding X-box binding protein 1, a transcription factor that induces the expression of genes that maintain ER proteostasis for cell survival. Previously, we showed that IRE1α undergoes S-nitrosylation, a post-translational modification induced by nitric oxide (NO), resulting in reduced RNase activity. Therefore, S-nitrosylation of IRE1α compromises the response to ER stress, making cells more vulnerable. We conducted virtual screening and cell-based validation experiments to identify compounds that inhibit the S-nitrosylation of IRE1α by targeting nitrosylated cysteine residues. We ultimately identified a compound (1ACTA) that selectively inhibits the S-nitrosylation of IRE1α and prevents the NO-induced reduction of RNase activity. Furthermore, 1ACTA reduces the rate of NO-induced cell death. Our research identified S-nitrosylation as a novel target for drug development for IRE1α and provides a suitable screening strategy.No potential conflict of interest relevant to this article was reported.American Geophysical Union (AGU)Acta Medica Okayama0094-827652142025Unraveling the Complex Features of the Seismic Scatterers in the Mid‐Lower Mantle Through Phase Transition of (Al, H)‐Bearing Stishovitee2024GL114146ENYingxinYuDeep Space Exploration Laboratory, School of Earth and Space Sciences, University of Science and Technology of ChinaYouyueZhangInstitute for Planetary Materials, Okayama UniversityLuoLiDeep Space Exploration Laboratory, School of Earth and Space Sciences, University of Science and Technology of ChinaXinyueZhangDeep Space Exploration Laboratory, School of Earth and Space Sciences, University of Science and Technology of ChinaDengleiWangDeep Space Exploration Laboratory, School of Earth and Space Sciences, University of Science and Technology of ChinaZhuMaoDeep Space Exploration Laboratory, School of Earth and Space Sciences, University of Science and Technology of ChinaNingyuSunDeep Space Exploration Laboratory, School of Earth and Space Sciences, University of Science and Technology of ChinaYanyaoZhangEarth and Planetary Sciences, Stanford UniversityXinyangLiState Key Laboratory of High Pressure and Superhard Materials, College of Physics, Jilin UniversityWancaiLiCAS Key Laboratory of Crust‐Mantle Materials and Environments, School of Earth and Space Sciences, University of Science and Technology of ChinaSergioSpezialeGFZ German Research Centre for GeosciencesDongzhouZhangGeoSoilEnviroCARS, University of ChicagoJung‐FuLinDepartment of Earth and Planetary Sciences, Jackson School of Geosciences, The University of Texas at AustinTakashiYoshinoInstitute for Planetary Materials, Okayama UniversitySmall-scale scatterers observed in the mid-lower mantle beneath the subduction zones are thought to result from the phase transition of stishovite within subducted oceanic crusts. Here we investigate the phase transition of (Al, H)-bearing stishovite with four compositions at simultaneously high P-T conditions combining Raman spectroscopy and X-ray diffraction. These experimental results reveal that the incorporation of 0.01 a.p.f.u Al into stishovite with H/Al ratio of ∼1/3 lowers the transition pressure by 6.7(3) GPa. However, the Clapeyron slope of this transition is nearly unaffected by changes in the Al content and has a value of 12.2–12.5(3) MPa/K. According to our results, Al content variation ranging from 0 to 0.07 a.p.f.u in SiO2 can reasonably explain the depth distribution from 800 to 1,900 km of the seismic scatterers observed in the circum-Pacific region. These results deepen our understanding on the complex features of mid-lower mantle seismic scatterers and corresponding dynamic processes.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1999-49231772025Development of an Antimicrobial Coating Film for Denture Lining Materials902ENKumikoYoshiharaNational Institute of Advanced Industrial Science and Technology (AIST), Health and Medical Research InstituteTakeruKameyamaGraduate School of Natural Science and Technology, Okayama UniversityNoriyukiNagaokaDental School, Advanced Research Center for Oral and Craniofacial Science, Okayama UniversityYukinoriMaruoDepartment of Prosthodontics, Okayama UniversityYasuhiroYoshidaDepartment of Biomaterials and Bioengineering, Faculty of Dental Medicine, Hokkaido UniversityBartVan MeerbeekBIOMAT, Department of Oral Health Sciences, KU LeuvemTakumiOkiharaGraduate School of Natural Science and Technology, Okayama UniversityBackground/Objectives: Denture hygiene is essential for the prevention of oral candidiasis, a condition frequently associated with Candida albicans colonization on denture surfaces. Cetylpyridinium chloride (CPC)-loaded montmorillonite (CPC-Mont) has demonstrated antimicrobial efficacy in tissue conditioners and demonstrates potential for use in antimicrobial coatings. In this study, we aimed to develop and characterize CPC-Mont-containing coating films for dentures, focusing on their physicochemical behaviors and antifungal efficacies. Methods: CPC was intercalated into sodium-type montmorillonite to prepare CPC-Mont; thereafter, films containing CPC-Mont were fabricated using emulsions of different polymer types (nonionic, cationic, and anionic). CPC loading, release, and recharging behaviors were assessed at various temperatures, and activation energies were calculated using Arrhenius plots. Antimicrobial efficacy against Candida albicans was evaluated for each film using standard microbial assays. Results: X-ray diffraction analysis confirmed the expansion of montmorillonite interlayer spacing by approximately 3 nm upon CPC loading. CPC-Mont showed temperature-dependent release and recharging behavior, with higher temperatures enhancing its performance. The activation energy for CPC release was 38 kJ/mol, while that for recharging was 26 kJ/mol. Nonionic emulsions supported uniform CPC-Mont dispersion and successful film formation, while cationic and anionic emulsions did not. CPC-Mont-containing coatings maintained antimicrobial activity against Candida albicans on dentures. Conclusions: CPC-Mont can be effectively incorporated into nonionic emulsion-based films to create antimicrobial coatings for denture applications. The films exhibited temperature-responsive, reversible CPC release and recharging behaviors, while maintaining antifungal efficacy, findings which suggest the potential utility of CPC-Mont-containing films as a practical strategy to prevent denture-related candidiasis.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221512025Trends in the incidence of severe fever with thrombocytopenia syndrome in Japan: an observational study from 2013 to 202220715ENShinnosukeFukushimaDepartment of General Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineHidemasaAkazawaDepartment of General Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineToshihiroKoyamaDepartment of Health Data Science, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalWe aimed to determine the 10-year trend in the incidence of Severe fever with thrombocytopenia syndrome (SFTS) in Japan. This retrospective observational study used a publicly available national database. Trends in the incidence of SFTS with annual percent changes (APC) were examined using Joinpoint regression analysis with stratification by patient age, season, and region. The association between disease incidence and environmental factors was investigated using Spearman’s rank correlation. Between 2013 and 2022, there were 803 notified cases (397 males and 406 females) of SFTS, with 79.5% aged ≥ 65 years. The annual incidence rate increased continuously with an APC of 9.6%. The incidence peaked between May and June, with 80.8% of cases observed between May and October. The incidence was predominantly higher in western Japan, and the mean annual incidence rate was the highest in Miyazaki prefecture, with 0.89 per 100,000 people. Correlations between the SFTS incidence rates and environmental factors were observed in western Japan, with forest area (correlation coefficient, 0.80), followed by agricultural population rate (0.70). SFTS incidence is continuously increasing in Japan, especially among the elderly population. Environmental factors such as broader forest areas and increased agricultural population were possibly associated with the incidence.No potential conflict of interest relevant to this article was reported.Royal Society of Chemistry (RSC)Acta Medica Okayama2050-748813232025A meta-linked isomer of ITIC: influence of aggregation patterns on open-circuit voltage in organic solar cells17720ENKaiWangThe Institute of Scientific and Industrial Research (SANKEN), The University of OsakaSeihouJinnaiThe Institute of Scientific and Industrial Research (SANKEN), The University of OsakaKaitoUesakaGraduate School of Natural Science & Technology, Okayama UniversityAkiraYamakataGraduate School of Natural Science & Technology, Okayama UniversityYutakaIeThe Institute of Scientific and Industrial Research (SANKEN), The University of OsakaImproving the open-circuit voltage (VOC) of organic solar cells (OSCs) remains an important challenge. While it is known that the energy levels at the donor/acceptor (D/A) interface affect the VOC, the impact of aggregation patterns on the energy levels at the D/A interface has not been fully elucidated. Herein, we focus on ITIC, a widely used acceptor in OSCs, and designed a meta-linked isomer of ITIC (referred to as im-ITIC) to alter molecular symmetry and modify substitution arrangements. Concentration-dependent 1H NMR spectra revealed that im-ITIC shows stronger aggregation behavior in solution. Single-crystal X-ray analysis showed that im-ITIC forms both tail-to-tail (J-aggregation) and face-to-face (H-aggregation) stacking modes, whereas ITIC exclusively forms tail-to-tail stacking. OSCs based on PBDB-T:im-ITIC showed a high VOC value of 1.02 V, which is 0.12 V higher than that of those based on PBDB-T:ITIC. Time-resolved infrared measurements revealed the lifetime of free electrons for the pristine and blend films. The energy levels of the charge transfer state (ECT) for PBDB-T:im-ITIC- and PBDB-T:ITIC OSCs were determined to be 1.57 and 1.39 eV, respectively, correlating with the VOC values. Theoretical calculations indicated that pronounced H-aggregation in im-ITIC increases the ECT compared with J-aggregation, contributing to the improved VOC. This study underscores the critical impact of molecular aggregation patterns on energy alignment and VOC enhancement, offering insights into molecular design for achieving high VOC in OSCs.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1068-92652025Tumor Microvessels with Specific Morphology as a Prognostic Factor in Esophageal Squamous Cell CarcinomaENHnin ThidaTunDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasayoshiFujisawaDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshiakiOharaDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySeitaroNishimuraDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomoyoshiKunitomoDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazuhiroNomaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAkihiroMatsukawaDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground Angiogenesis is essential for tumor progression. Microvessel density (MVD) is a widely used histological method to assess angiogenesis using immunostained sections, but its prognostic significance in esophageal cancer remains controversial. Recently, the evaluation of microvascular architecture has gained importance as a method to assess tumor aggressiveness. The present study aimed to identify the histological characteristics of tumor microvessels that are associated with the aggressiveness of esophageal squamous cell carcinoma.<br>
Patients and Methods A total of 108 esophageal squamous cell carcinoma tissues were immunohistochemically stained with blood vessel markers and angiogenesis-related markers, including CD31, alpha smooth muscle actin, vascular endothelial growth factor A (VEGF-A), CD206, and D2-40. MVD, microvessel pericyte coverage index (MPI), and tumor vascular morphology were evaluated by microscopy.<br>
Results MVD was significantly associated with patient outcomes, whereas neither MPI nor VEGF-A expression throughout the tumor showed a significant correlation. In addition, the presence of blood vessels encircling clusters of tumor cells, termed C-shaped microvessels, and excessively branching microvessels, termed X-shaped microvessels, was significantly associated with poor prognosis. These vessel types were also correlated with clinicopathological parameters, including deeper invasion of the primary tumor, presence of lymph node metastasis, advanced pathological stage, and distant metastasis. Focal VEGF-A immunoexpression in tumor cells was higher in areas containing C-shaped or X-shaped microvessels compared with areas lacking these vessel morphologies.<br>
Conclusions The data suggest that tumor microvessels with specific morphologies (C-shaped and X-shaped microvessels) may serve as a promising prognostic factor in esophageal squamous cell carcinoma.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2198-384412182025Cryo-EM Analysis of a Tri-Heme Cytochrome-Associated RC-LH1 Complex from the Marine Photoheterotrophic Bacterium Dinoroseobacter Shibae2413456ENWeiweiWangCollege of Life Sciences, Zhejiang UniversityYantingLiuState Key Laboratory of Marine Environmental Science, College of Ocean and Earth Sciences, Xiamen UniversityJiayiGuCollege of Life Sciences, Zhejiang UniversityShaoyaAnDepartment of Pathology of Sir Run Run Shaw Hospital, Department of Biophysics, Zhejiang University School of MedicineChengMaDepartment of Pathology of Sir Run Run Shaw Hospital, Department of Biophysics, Zhejiang University School of MedicineHaichunGaoCollege of Life Sciences, Zhejiang UniversityNianzhiJiaoState Key Laboratory of Marine Environmental Science, College of Ocean and Earth Sciences, Xiamen UniversityJian‐RenShenResearch Institute for Interdisciplinary Science, and Graduate School of Natural Science and Technology, Okayama UniversityJohn ThomasBeattyDepartment of Microbiology & Immunology, University of British ColumbiaMichalKoblížekLaboratory of Anoxygenic Phototrophs, Institute of Microbiology, Czech Academy of ScienceXingZhangDepartment of Pathology of Sir Run Run Shaw Hospital, Department of Biophysics, Zhejiang University School of MedicineQiangZhengState Key Laboratory of Marine Environmental Science, College of Ocean and Earth Sciences, Xiamen UniversityJing‐HuaChenCollege of Life Sciences, Zhejiang UniversityThe reaction center-light harvesting 1 (RC-LH1) complex converts solar energy into electrical energy, driving the initiation of photosynthesis. The authors present a cryo-electron microscopy structure of the RC-LH1 isolated from a marine photoheterotrophic bacterium Dinoroseobacter shibae. The RC comprises four subunits, including a three-heme cytochrome (Cyt) c protein, and is surrounded by a closed LH ring composed of 17 pairs of antenna subunits. Notably, a novel subunit with an N-terminal “helix-turn-helix” motif embedded in the gap between the RC and the LH ring is identified. The purified RC-LH1 complex exhibits high stability in solutions containing Mg2+ or Ca2+. The periplasmic Cyt c2 is predicted to bind at the junction between the Cyt subunit and the membrane plane, enabling electron transfer from Cyt c2 to the proximal heme of the tri-heme Cyt, and subsequently to the special pair of bacteriochlorophylls. These findings provide structural insights into the efficient energy and electron transfer processes within a distinct type of RC-LH1, and shed light on evolutionary adaptations of photosynthesis.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1340-68683242025Japanese translation of the Functional Assessment of Cancer Therapy-Breast + 4 (FACT-B + 4) following international guidelines: a verification of linguistic validity773782ENTakahiroTsukiokiDepartment of Breast and Endocrine Surgery, Okayama University HospitalNozomuTakataSimpson Querrey Biomedical Research Center, Northwestern UniversitySaya R.DennisDepartment of Preventive Medicine Feinberg School of Medicine, Northwestern UniversityKaoriTerataDepartment of Breast and Endocrine Surgery, Akita University HospitalYasuakiSagaraDepartment of Breast Surgical Oncology, Social Medical Corporation Hakuaikai Sagara HospitalTakehikoSakaiDepartment of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of JFCRShinTakayamaDepartment of Breast Surgery, National Cancer Center HospitalDaiKitagawaDepartment of Breast Surgical Oncology, National Center for Global Health and MedicineYuichiroKikawaDepartment of Breast Surgery, Kansai Medical University HospitalYukoTakahashiDepartment of Breast and Endocrine Surgery, Okayama University HospitalTsuguoIwataniDepartment of Breast and Endocrine Surgery, Okayama University HospitalFumikataHaraDepartment of Breast Oncology, Aichi Cancer Center HospitalTomomiFujisawaDepartment of Breast Cancer, Gunma Prefectural Cancer CenterTadahikoShienDepartment of Breast and Endocrine Surgery, Okayama University HospitalBackground For breast cancer patients, postoperative lymphedema and upper limb movement disorders are serious complications that absolutely reduce their quality of life (QOL). To evaluate this serious complication, we used “Quick Dash” or “FACT-B”, which can assess a patient's physical, social, emotional, and functional health status. To evaluate their breast cancer surgery-related dysfunction correctly, “FACT-B + 4” was created by adding four questions about “arm swelling'' and “tenderness”. We have translated it into Japanese according to international translation guidelines.<br>
Methods At the beginning, we contacted FACT headquarters that we would like to create a Japanese version of FACT-B + 4. They formed the FACIT Trans Team (FACIT) following international translation procedures, and then, we began translating according to them. The steps are 1: perform “Forward and Reverse translations” to create a “Preliminary Japanese version”, 2: request the cooperation of 5 breast cancer patients and “conduct a pilot study” and “questionnaire survey”, and 3: amendments and final approval based on pilot study results and clinical perspectives.<br>
Result In Step1, FACIT requested faithful translation of the words, verbs, and nouns from the original text. In Step2, patients reported that they felt uncomfortable with the Japanese version words such as “numb'' and “stiffness'' and felt that it might be difficult to describe their symptoms accurately. In Step3, we readjusted the translation to be more concise and closer to common Japanese language, and performed “Step1” again to ensure that the translation definitely retained the meaning of the original.<br>
Conclusion A Japanese version of FACT has existed until now, but there was no Japanese version of FACT-B + 4, which adds four additional items to evaluate swelling and pain in the upper limbs. This time, we have created a Japanese version that has been approved by FACT.No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama0743-746341212025Unraveling the Molecular Mechanism of Transient Multilamellar Formation in Ethanol-Modified Vesicle Solutions1337213380ENKanaShibataDepartment of Materials Chemistry, Nagoya UniversityMasatoshiMaekiDivision of Applied Chemistry, Faculty of Engineering, Hokkaido UniversityManabuTokeshiDivision of Applied Chemistry, Faculty of Engineering, Hokkaido UniversityWataruShinodaResearch Institute for Interdisciplinary Science, Okayama UniversityA recent microfluidic-based small-angle X-ray scattering (SAXS) measurement intriguingly suggested the transient formation of multilamellar structures during the mixing of unilamellar vesicles with ethanol in an aqueous solution. This study explores a possible molecular mechanism underlying this phenomenon, primarily through coarse-grained molecular dynamics (CG-MD) simulations. We first examined lipid aggregate morphology as a function of ethanol concentration in an aqueous solution. Even though vesicles were observed in pure aqueous solution, increasing ethanol concentrations led to more frequent pore formation in vesicular membranes. At ethanol concentrations above 52%, vesicles destabilized and transformed into worm-like micelles. We hypothesized that the transient multilamellar structures might arise from vesicle stacking due to variations in the effective interactions between vesicles. However, a series of potential of mean force (PMF) calculations consistently showed repulsive interactions between vesicles, regardless of ethanol concentration, ruling out this possibility. In contrast, once lipid aggregates transformed into worm-like micelles, the PMF barrier between them dropped (∼5kBT), promoting fusion. Our CG-MD simulations further demonstrated that lipid aggregates (micelles) readily fused and grew in high ethanol concentrations. Upon subsequent exposure to lower ethanol levels, these enlarged aggregates reorganized into vesicles with internal lamellar structure─multilamellar vesicles. These findings suggest that the heterogeneous mixing of unilamellar vesicular solutions with ethanol in a microfluidic device plays a key role in the emergence of transient multilamellar structures.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0021-925830172025A repertoire of visible light–sensitive opsins in the deep-sea hydrothermal vent shrimp Rimicaris hybisae110291ENYuyaNagataGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNorioMiyamotoInstitute for Extra-Cutting-Edge Science and Technology Avant-Garde Research (X-Star), Japan Agency for Marine-Earth Science and Technology (JAMSTEC)KeitaSatoFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYosukeNishimuraResearch Center for Bioscience and Nanoscience (CeBN), Research Institute for Marine Resources Utilization, Japan Agency for Marine-Earth Science and Technology (JAMSTEC)YukiTaniokaSchool of Pharmaceutical Sciences, Okayama UniversityYujiYamanakaSchool of Pharmaceutical Sciences, Okayama UniversitySusumuYoshizawaAtmosphere and Ocean Research Institute, The University of TokyoKutoTakahashiGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoheiObayashiDepartment of Biology, Graduate School of Science, Kobe UniversityHisaoTsukamotoDepartment of Biology, Graduate School of Science, Kobe UniversityKenTakaiInstitute for Extra-Cutting-Edge Science and Technology Avant-Garde Research (X-Star), Japan Agency for Marine-Earth Science and Technology (JAMSTEC)HideyoOhuchiFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakahiroYamashitaDepartment of Biophysics, Graduate School of Science, Kyoto UniversityYukiSudoFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKeiichiKojimaFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityUnlike terrestrial environments, where humans reside, there is no sunlight in the deep sea. Instead, dim visible light from black-body radiation and bioluminescence illuminates hydrothermal vent areas in the deep sea. A deep-sea hydrothermal vent shrimp, Rimicaris hybisae, is thought to detect this dim light using its enlarged dorsal eye; however, the molecular basis of its photoreception remains unexplored. Here, we characterized the molecular properties of opsins, universal photoreceptive proteins in animals, found in R. hybisae. Transcriptomic analysis identified six opsins: three Gq-coupled opsins, one Opn3, one Opn5, and one peropsin. Functional analysis revealed that five of these opsins exhibited light-dependent G protein activity, whereas peropsin exhibited the ability to convert all-trans-retinal to 11-cis-retinal like photoisomerases. Notably, all the R. hybisae opsins, including Opn5, convergently show visible light sensitivity (around 457–517 nm), whereas most opsins categorized as Opn5 have been demonstrated to be UV sensitive. Mutational analysis revealed that the unique visible light sensitivity of R. hybisae Opn5 is achieved through the stabilization of a protonated Schiff base by a counterion residue at position 83 (Asp83), which differs from the position identified in other opsins. These findings suggest that the vent shrimp R. hybisae has adapted its photoreceptive devices to dim deep-sea hydrothermal light by selectively maintaining a repertoire of visible light–sensitive opsins, including the uniquely tuned Opn5.No potential conflict of interest relevant to this article was reported.SAGE PublicationsActa Medica Okayama2214-35992025Recent progress in oculopharyngodistal myopathy research from clinical and genetic viewpointsENHiroyukiIshiuraDepartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityOculopharyngodistal myopathy (OPDM) is a rare muscular disorder characterized by ocular symptoms, pharyngeal symptoms, facial weakness, and distal predominant limb muscle weakness. The cause of the disease was unknown for a long time. Recently, however, it has been reported that expansions of CGG or CCG repeats in LRP12, LOC642361/NUTM2B-AS1, GIPC1, NOTCH2NLC, RILPL1, and ABCD3 are the causes of the disease. Cases sometimes present with neurological symptoms, and the clinical spectrum of diseases caused by expansions of CGG or CCG repeats has been proposed to be called FNOP-spectrum disorder after the names of fragile X-associated tremor/ataxia syndrome, neuronal intranuclear inclusion disease, oculopharyngeal myopathy with leukoencephalopathy, and OPDM. In this article, the recent progress in the field of OPDM is reviewed, and remaining issues in OPDM are discussed.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2197-42841212025Stability and water solubility of calcium ferrite-type aluminum-rich phase: implications for deep water cycle caused by subducting basaltic crusts32ENXinyueZhangDeep Space Exploration Laboratory/School of Earth and Space Sciences, University of Science and Technology of ChinaIzumiMashinoInstitute for Planetary Materials, Okayama UniversityTakayukiIshiiInstitute for Planetary Materials, Okayama UniversityThe subducting crustal materials serve as a crucial channel for transporting water to the lower mantle. Recent experimental studies suggest that crustal materials such as basaltic crust can be a main water carrier and reservoir playing an important role on water cycling in the lower mantle. Despite being a primary mineral in crustal materials, the water solubility of calcium ferrite-type (CF) phase and its stability are unclear yet. A recent phase relation study of hydrous basalts showed Na-depletion in lower-mantle minerals, suggesting the presence of fluid possibly with high Na concentration and the absence of CF phase along the low-temperature slab geotherms, where Al-rich hydrous phase H and ferropericlase appear instead. These phases could consequently produce Na-depleted CF phase when reaching the dehydration temperature of Al-rich hydrous phase H. In this study, we investigated the stability and water solubility of CF-type MgAl2O4, which is a main CF component in a hydrous basalt, in water-bearing systems at 26–32 GPa and 1200–1900 °C using a Kawai-type multi-anvil press. Our results indicate that the stability of the CF phase is strongly influenced by water content in the system. Water contents of recovered CF phases estimated by Fourier-transform infrared spectroscopy show a limited variation between 73 and 87 ppm wt at a pressure of 26 GPa and temperatures of 1500–1900 °C. We suggest that CF phase could not be a primary water carrier at lower mantle depths. This emphasizes contributions of hydrous aluminous silica minerals to Earth’s deep water cycling and heterogeneous structures in the lower mantle due to the strong water partitioning to this phase compared with other constituent minerals.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2054-345X1212025In-frame deletion variant of ABCD1 in a sporadic case of adrenoleukodystrophy5ENTakashiMatsukawaDepartment of Neurology, Graduate School of Medicine, The University of TokyoAtsushiSudoDepartment of Neurology, Graduate School of Medicine, The University of TokyoToshiyukiKakumotoDepartment of Neurology, Graduate School of Medicine, The University of TokyoAkihitoHaoDepartment of Neurology, Graduate School of Medicine, The University of TokyoMitsuhiroKainagaDepartment of Neurology, Graduate School of Medicine, The University of TokyoHyangriChangDepartment of Neurology, Graduate School of Medicine, The University of TokyoTatsuoManoDepartment of Neurology, Graduate School of Medicine, The University of TokyoHiroyukiIshiuraDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunMitsuiDepartment of Precision Medicine Neurology, Graduate School of Medicine, The University of TokyoToshihiroHayashiDepartment of Neurology, Graduate School of Medicine, The University of TokyoShinichiMorishitaDepartment of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of TokyoShojiTsujiDepartment of Neurology, Graduate School of Medicine, The University of TokyoTatsushiTodaDepartment of Neurology, Graduate School of Medicine, The University of TokyoAdrenoleukodystrophy (ALD), an X-linked leukodystrophy caused by pathogenic variants in ABCD1, exhibits a broad range of phenotypes from childhood-onset cerebral forms to adult-onset adrenomyeloneuropathy (AMN). We report a rare in-frame ABCD1 deletion c.1469_71delTGG (p.Val490del) in a man with AMN. Although this variant has been interpreted as ‘uncertain significance’ in ClinVar, biochemical analysis along with clinical evaluation confirmed the pathogenicity of this variant, underscoring the importance of functional assessment of in-frame deletions.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1526-99142662025Quantitative quality control of 3D water tank using image analysise70119ENYukiTanimotoDepartment of Radiology, NHO Kure Medical Center and Chugoku Cancer CenterKoheiSugimotoDepartment of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical WelfareKazunobuKoshiDepartment of Radiology, NHO Fukuyama Medical CenterAkiraHiroshigeDepartment of Radiology, NHO Shikoku Cancer CenterShoheiYoshidaDepartment of Radiology, NHO Shikoku Cancer CenterYoshikiFujitaDepartment of Radiology, NHO Shikoku Cancer CenterAtsukiNakahiraDepartment of Radiology, NHO Shikoku Cancer CenterDaikiNakanishiDivision of Radiology, Department of Medical Technology, Kyushu University HospitalHirofumiHondaDepartment of Radiological Technology, Ehime University HospitalMasatakaOitaDepartment of Healthcare Science, Faculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityBackground and objective: Accurate beam data acquisition using three-dimensional (3D) water tanks is essential for beam commissioning and quality control (QC) in clinical radiation therapy. This study introduces a novel method for quantitative QC of the system, utilizing MV images and webcam videos. The stability of the motor drive speed and the positional accuracy of the fixture were evaluated under two measurement modes: “continuous mode” and “step-by-step mode.”<br>
Methods: A TRUFIX mounting system (PTW Freiburg Inc., Germany) was used to attach the center of the steel ball to its top, ensuring alignment with the water surface of the tank. To assess deviations from the radiation isocenter, MV images were acquired and compared with digitally reconstructed radiographs (DRRs). These evaluations were performed at different speed settings (slow, medium, and fast) using ET CT Body Marker (BRAINLAB Inc., USA) mounted on the drive unit. A webcam was utilized to capture the images, and custom-developed tracking software was employed to analyze deviations in driving speed and positional errors.<br>
Results: The mean error of the radiation isocenter was 0.37 ± 0.09 mm. As the motor drive speed increased, the discrepancy between the set speed and the actual speed observed in the analysis also became larger. In “continuous mode,” the deviation from the displayed value was greater than that observed in “step-by-step mode.”<br>
Conclusion: It is demonstrated that the proposed analysis method can quantitatively evaluate radiation isocenter misalignment, tank setup position deviation, and both the indicated drive speed values and their stability. At higher drive speeds, the “step-by-step mode” showed smaller deviations from the indicated values.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025The role of GABA in modulation of taste signaling within the taste budENAyakaMIKAMIGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Real-World Comparative Analysis of Trastuzumab Originator and Biosimilars: Safety, Efficacy, and Cost EffectivenessENTomokaMAMORIGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Human heart‑on‑a‑chip microphysiological system comprising endothelial cells, fibroblasts, and iPSC‑derived cardiomyocytesENYUNLIUGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Neuroprotective effect of, a flavonoid, sudachitin in mice stroke modelENOTA ELLIOTT RICARDO SATOSHIGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.BMCActa Medica Okayama1472-68312512025Exploring the relationship between posture-dependent airway assessment in orthodontics: insights from kinetic MRI, cephalometric data, and three-dimensional MRI analysis745ENNaokiOkaDepartment of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJanvierHabumugishaDepartment of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasahiroNakamuraDepartment of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomokiKataokaDivision of Oral and Maxillofacial Surgery, Tottori UniversityAtsuroFujisawaDepartment of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNoriakiKawanabeDepartment of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiIzawaDepartment of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiroshiKamiokaDepartment of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground Previous studies have assessed the upper airway using various examination methods, such as cephalometric imaging and magnetic resonance imaging (MRI). However, there is a significant gap in the research regarding the relationship between these different imaging modalities. This study compares airway assessments using kinetic MRI and cephalometric scans, examining their correlation with three dimensional (3D) MRI data.<br>
Materials and methods Kinetic MRI, cephalometric scans, and 3D MRI of forty-seven participants were used in the present study. Airway areas and widths were measured at the retropalatal, retroglossal, and hypopharyngeal levels in both kinetic MRI and cephalometric scans. Airway volumes were calculated from 3D MRI data. Statistical analyses, including the Wilcoxon Signed Rank test, Spearman correlation, and multiple linear regression, were performed to evaluate the data and identify significant differences, correlations, and prediction models, respectively.<br>
Results Significant differences were found between kinetic MRI and cephalometric scans. Cephalometric data showed larger airway areas and widths compared to kinetic MRI measurements. Although both cephalometric and kinetic MRI showed a correlation with 3D MRI, kinetic MRI demonstrated stronger correlations with 3D MRI airway volumes than cephalometric scans. According to our linear regression model equations, RPA-Max (maximum retropalatal airway area) and RPA (retropalatal airway area) can elucidate variations in RPV (retropalatal airway volume). RGA-Med (median retroglossal airway area) and RGA-Min (minimum retroglossal airway area) can explain variations in RGV (retroglossal airway volume). HPA (hypopharyngeal airway area) and ULHPAW-Max (maximum upper limit hypopharyngeal airway width) account for variations in HPV (hypopharyngeal airway volume). Additionally, TA-Max (maximum total airway area) can account for variations in TPV (total pharyngeal airway volume).ConclusionBoth cephalometric data and kinetic MRI data showed correlations with 3D MRI data. The shared posture of kinetic MRI and 3D MRI led to stronger correlations between these two modalities. Although cephalometric data had fewer correlations with 3D MRI and predictors for 3D airway volume, they were still significant. Our study highlights the complementary nature of kinetic MRI and cephalometric imaging, as both provide valuable information for airway assessment and exhibit significant correlations with 3D MRI data.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7932025Emotional Changes among Young Patients with Breast Cancer to Foster Relationship-Building with Their Partners: A Qualitative Study185195ENAyumiYoshikawaFaculty of Nursing, Osaka Dental UniversityNarutoTairaKawasaki Medical School, Department of Breast and Thyroid SurgeryMayumiOkanagaGifu College of Nursing, Nursing of Children and Child-Rearing FamiliesShinyaSaitoGraduate School of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/68726We investigated the emotional changes that young patients with breast cancer need to undergo in order to foster relationship-building with their partners by conducting a qualitative descriptive study (March 1 to Nov. 26, 2021) and semi-structured interviews with eight postoperative patients (age 20-40 years) with breast cancer. The data were analyzed using the modified grounded theory approach (M-GTA), yielding five categories: (i) Awareness of being a breast cancer patient, (ii) Being at a loss, (iii) Support from significant others, (iv) The struggle to transition from being a patient with cancer to becoming “the person I want to be”, and (v) Reaching the “me” I want to be who can face building a relationship with a partner. These findings suggest that young breast cancer patients must feel that they can lead a normal life through activities such as work or acquiring qualifications before building relationships with their partners, and that getting closer to their desired selves is important. Nurses can provide information to young patients with breast cancer to assist them in building a solid relationship with their partners. We believe that this support may enhance the patients’ quality of life and help them achieve stronger relationships with their partners.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7932025Promising Effectiveness of Combined Chemotherapy and Immunotherapy in Patients with Advanced Non-small Cell Lung Cancer: A Real-World Prospective Observational Study (CS-Lung-003)167176ENNobuhiroKanajiDepartment of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa UniversityKazuyaNishiiDepartment of Respiratory Medicine, National Hospital Organization Iwakuni Clinical CenterYukariTsubataDepartment of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of MedicineMikaNakaoDepartment of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of MedicineTakaeOkunoDepartment of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of MedicineSachiOkawaDepartment of Allergy and Respiratory Medicine, Okayama University HospitalKenjiTakataDepartment of Allergy and Respiratory Medicine, Okayama University HospitalMasahiroKodaniDivision of Medical Oncology and Molecular Respirology, Faculty of Medicine, Tottori UniversityMasahiroYamasakiDepartment of Respiratory Disease, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors HospitalKazunoriFujitakaDepartment of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityTetsuyaKubotaDepartment of Respiratory Medicine and Allergology, Kochi UniversityMasaakiInoueDepartment of Chest Surgery, Shimonoseki City HospitalNaokiWatanabeDepartment of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa UniversityKatsuyukiHottaCenter for Innovative Clinical Medicine, Okayama University HospitalCS-Lung-003 InvestigatorOriginal Article10.18926/AMO/68724This prospective observational study investigated the clinical status of patients with advanced non-small cell lung cancer (NSCLC) treated with cytotoxic chemotherapy+an immune checkpoint inhibitor (chemo + IO) as first-line treatment in a real-world setting. The cases of 98 patients treated with chemo + IO were prospectively collected and analyzed for effectiveness and safety. The response rate to chemo + IO was 46.9%, and the disease control rate was 76.5%. The median progression-free survival and overall survival (OS) in the total population were 5.2 and 22.3 months, respectively. The patients positive for PD-L1 (≥ 1%) showed significantly longer OS than the negative group (<1%) (median 26.7 vs. 18.7 months, p=0.04). Pre-existing interstitial lung disease (ILD) was associated with shorter OS than the absence of ILD (median 9.0 vs. 22.6 months, p<0.01). Immunerelated adverse events (irAEs) were observed in 28 patients (28.6%). The most frequent irAE was ILD (n=11); Grade 1 (n=1 patient), G2 (n=5), G3 (n=4), and only a single patient with a G5 irAE. In this CS-Lung-003 study, first-line chemo + IO in a real-world setting showed good effectiveness, comparable to that observed in international clinical trials. In real-world practice, chemo + IO is a promising and steadfast strategy.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7932025Continuous Stimulation with Glycolaldehyde-derived Advanced Glycation End Product Reduces Aggrecan and COL2A1 Production via RAGE in Human OUMS-27 Chondrosarcoma Cells157166ENOmer FarukHatipogluDepartment of Pharmacology, Faculty of Medicine, Kindai UniversityTakashiNishinakaDepartment of Pharmacology, Faculty of Medicine, Kindai UniversityKursat OguzYaykasliDepartment of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum ErlangenShujiMoriDepartment of Pharmacology, School of Pharmacy, Shujitsu UniversityMasahiroWatanabeDepartment of Pharmacology, School of Pharmacy, Shujitsu UniversityTakaoToyomuraDepartment of Pharmacology, School of Pharmacy, Shujitsu UniversityMasahiroNishiboriDepartment of Translational Research & Dug Development, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiHirohataDepartment of Medical Technology, Graduate School of Health Sciences, Okayama UniversityHideoTakahashiDepartment of Pharmacology, Faculty of Medicine, Kindai UniversityHidenoriWakeDepartment of Pharmacology, Faculty of Medicine, Kindai UniversityOriginal Article10.18926/AMO/68723Chondrocytes are responsible for the production of extracellular matrix (ECM) components such as collagen type II alpha-1 (COL2A1) and aggrecan, which are loosely distributed in articular cartilage. Chondrocyte dysfunction has been implicated in the pathogenesis of rheumatic diseases such as osteoarthritis (OA) and rheumatoid arthritis (RA). With age, advanced glycation end products (AGEs) accumulate in all tissues and body fluids, including cartilage and synovial fluid, causing and accelerating pathological changes associated with chronic diseases such as OA. Glycolaldehyde-derived AGE (AGE3), which is toxic to a variety of cell types, have a stronger effect on cartilage compared with other AGEs. To understand the long-term effects of AGE3 on cartilage, we stimulated a human chondrosarcoma cell line (OUMS-27), which exhibits a chondrocytic phenotype, with 10 μg/ml AGE3 for 4 weeks. As a result, the expressions of COL2A1 and aggrecan were significantly downregulated in the OUMS-27 cells without inducing cell death, but the expressions of proteases that play an important role in cartilage destruction were not affected. Inhibition of the receptor for advanced glycation end products (RAGE) suppressed the AGE3-induced reduction in cartilage component production, suggesting the involvement of RAGE in the action of AGE3.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7932025Immunometabolic Regulation of Innate Immunity in Systemic Lupus Erythematosus147155ENHarukiWatanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesYoshinoriMatsumotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesReview10.18926/AMO/68722Pathogens or their components can induce long-lasting changes in the behavior of innate immune cells, a process analogous to “training” for future threats or environmental adaptation. However, such training can sometimes have unintended consequences, such as the development of autoimmunity. Systemic lupus erythematosus (SLE) is a chronic and heterogeneous autoimmune disease characterized by the production of autoantibodies and progressive organ damage. Innate immunity plays a central role in its pathogenesis, contributing through impaired clearance of apoptotic cells, excessive type I interferon production, and dysregulated formation of neutrophil extracellular traps. Recent studies have revealed that metabolites and nucleic acids derived from mitochondria, a crucial energy production site, directly regulate type I interferon and anti-inflammatory cytokine production. These insights have fueled interest in targeting metabolic pathways as a novel therapeutic approach for SLE, offering promise for improving long-term patient outcomes.No potential conflict of interest relevant to this article was reported.SpringerActa Medica Okayama0340-70047472025Osteosarcoma cell-derived CCL2 facilitates lung metastasis via accumulation of tumor-associated macrophages193ENHiroyaKondoDepartments of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroshiTazawaDepartments of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomohiroFujiwaraDepartments of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkiYoshidaDepartments of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMihoKureDepartments of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKojiDemiyaDepartments of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuhikoKanayaDepartments of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiakiHataDepartments of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKojiUotaniDepartments of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJoeHaseiDepartments of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiyukiKunisadaDepartments of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShunsukeKagawaDepartments of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusukeYoshiokaDepartment of Molecular and Cellular Medicine, Tokyo Medical UniversityToshifumiOzakiDepartments of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiyoshiFujiwaraDepartments of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOsteosarcoma (OS) is the most common malignant tumor of bone in children and adolescents. Although lung metastasis is a major obstacle to improving the prognosis of OS patients, the underlying mechanism of lung metastasis of OS is poorly understood. Tumor-associated macrophages (TAMs) with M2-like characteristics are reportedly associated with lung metastasis and poor prognosis in OS patients. In this study, we investigated the metastasis-associated tumor microenvironment (TME) in orthotopic OS tumor models with non-metastatic and metastatic OS cells. Non-metastatic and metastatic tumor cells derived from mouse OS (Dunn and LM8) and human OS (HOS and 143B) were used to analyze the TME associated with lung metastasis in orthotopic OS tumor models. OS cell-derived secretion factors were identified by cytokine array and enzyme-linked immunosorbent assay (ELISA). Orthotopic tumor models with metastatic LM8 and 143B cells were analyzed to evaluate the therapeutic potential of a neutralizing antibody in the development of primary and metastatic tumors. Metastatic OS cells developed metastatic tumors with infiltration of M2-like TAMs in the lungs. Cytokine array and ELISA demonstrated that metastatic mouse and human OS cells commonly secreted CCL2, which was partially encapsulated in extracellular vesicles. In vivo experiments demonstrated that while primary tumor growth was unaffected, administration of CCL2-neutralizing antibody led to a significant suppression of lung metastasis and infiltration of M2-like TAMs in the lung tissue. Our results suggest that CCL2 plays a crucial role in promoting the lung metastasis of OS cells via accumulation of M2-like TAMs.No potential conflict of interest relevant to this article was reported.IOP PublishingActa Medica Okayama1367-26302742025Characterization of the thorium-229 defect structure in CaF2 crystals043024ENS.TakatoriResearch Institute for Interdisciplinary Science (RIIS), Okayama UniversityM.PimonFaculty of Physics, TU WienS.PollittFaculty of Physics, TU WienM.BartokosFaculty of Physics, TU WienK.BeeksFaculty of Physics, TU WienA.GrueneisFaculty of Physics, TU WienT.HirakiResearch Institute for Interdisciplinary Science (RIIS), Okayama UniversityT.HonmaJapan Synchrotron Radiation Research InstituteN.HosseiniFaculty of Physics, TU WienA.LeitnerFaculty of Physics, TU WienT.MasudaResearch Institute for Interdisciplinary Science (RIIS), Okayama UniversityIMorawetzFaculty of Physics, TU WienK.NittaJapan Synchrotron Radiation Research InstituteK.OkaiResearch Institute for Interdisciplinary Science (RIIS), Okayama UniversityT.RiebnerFaculty of Physics, TU WienF.SchadenFaculty of Physics, TU WienT.SchummFaculty of Physics, TU WienO.SekizawaJapan Synchrotron Radiation Research InstituteT.SikorskyFaculty of Physics, TU WienY.TakahashiDepartment of Earth and Planetary Science, The University of TokyoCol, L. ToscaniDe ColFaculty of Physics, TU WienR.YamamotoResearch Institute for Interdisciplinary Science (RIIS), Okayama UniversityT.YomogidaDepartment of Earth and Planetary Science, The University of TokyoA.YoshimiResearch Institute for Interdisciplinary Science (RIIS), Okayama UniversityK.YoshimuraResearch Institute for Interdisciplinary Science (RIIS), Okayama UniversityRecent advancements in laser excitation of the low-energy thorium-229 (229Th) nuclear isomeric state in calcium fluoride (CaF2) single crystals render this system a promising candidate for a solid-state nuclear clock. Nonetheless, the precise experimental determination of the microscopic ion configuration surrounding the doped 229Th and its electronic charge state remains a critical challenge. Such characterization is essential for precisely controlling the clock transition and evaluating the performance of this solid-state nuclear clock system. In this study, we use x-ray absorption fine structure spectroscopy of 229Th:CaF2 to investigate the charge state and coordination environment of doped 229Th. The results indicate that 229Th displays a 4+ oxidation state at the substitutional site of a Ca2+ ion, with charge compensated provided by two F− ions positioned at interstitial sites adjacent to 229Th.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7922025A Case of Retinitis Pigmentosa Diagnosed with Severe Anterior Capsule Contraction after Cataract Surgery129134ENAkihiroTsujiDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusukeShiodeDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuheiKimuraDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMioHosokawaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoMatobaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTetsuroMoritaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKosukeTakahashiFukuyama City Hospital, Fukuyama CityYukiMorizaneDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/68652A 66-year-old woman presented with significant anterior capsule contraction and intraocular lens dislocation in both eyes 4 months after cataract surgery. Postoperative examinations such as fluorescein angiography, Goldmann perimetry, and electroretinography revealed retinitis pigmentosa (RP). Patients with significant anterior capsule contraction after cataract surgery should be closely examined because RP may be a contributing factor.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7922025Macular Hole Formation Six Months after Hemorrhage Displacement for Submacular and Henle Fiber Layer Hemorrhage due to Retinal Arterial Macroaneurysm Rupture123127ENRikuAkatsukaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuheiKimuraDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoMatobaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMioMorizane HosokawaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusukeShiodeDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTetsuroMoritaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinichiroDoiDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiMorizaneDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/68651A 78-year-old woman presented with sudden vision loss and central scotoma. Visual acuity in the right eye was 20/222, with submacular hemorrhage (SMH) and Henle fiber layer hemorrhage (HFLh) due to retinal arterial macroaneurysm (RAM) rupture. She underwent SMH displacement, including cataract surgery, vitrectomy, intravitreal injection of tissue-plasminogen activator, and air tamponade. Three months postoperatively the SMH and HFLh had disappeared and visual acuity had improved to 20/200. Six months postoperatively, a macular hole had developed. We performed an inverted internal limiting membrane flap and gas tamponade. Ten months later, the hole had closed and visual acuity had improved to 20/100.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7922025Relationship between Personality Traits and Postpartum Depressive Symptoms in Women who Became Pregnant via Infertility Treatment109116ENKyokoAwaiGraduate School of Health Sciences, Okayama UniversityMikiyaNakatsukaFaculty of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/68649The status of postpartum depression was elucidated herein with the use of the Edinburgh Postnatal Depression Scale (EPDS) in women in Shikoku, Japan who became pregnant and gave birth after undergoing infertility treatment, including assisted reproductive technology (ART). The assessment was performed during their children’s 4-month health examination. The relationships between postpartum depression and the mothers’ background factors and scores on the Big Five personality traits scale were also examined. Of the Big Five personality traits, the scores for neuroticism were significantly higher in the ART group (n=71) than in the general infertility treatment (n=118) and natural pregnancy (n=872) groups. No significant differences in EPDS scores were seen among these three groups. A logistic regression analysis showed that neuroticism was associated with an EPDS score ≧9 points, (which is suggestive of postpartum depression, ) in all groups. Moreover, although a long-standing marriage had an inhibitory effect on postpartum depression in the natural pregnancy group, no such trend was seen in the ART group, which included many women with long-standing marriages. Particularly for women who become pregnant by ART, an individualized response that pays close attention to the woman’s personality traits is needed.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7922025Association between the Pretreatment Body Mass Index and Anamorelin’s Efficacy in Patients with Cancer Cachexia: A Retrospective Cohort Study6573ENMasatoshiMakiDepartment of Hospital Pharmacy, NHO Fukuyama Medical CenterRyoTakadaDepartment of Hospital Pharmacy, NHO Fukuyama Medical CenterTomoyukiIshigoDepartment of Pharmacy, Sapporo Medical University HospitalMikiFujiwaraDepartment of Hospital Pharmacy, NHO Fukuyama Medical CenterYokoTakahashiDepartment of Hospital Pharmacy, NHO Fukuyama Medical CenterShinyaOtsukaDepartment of Surgery, NHO Fukuyama Medical CenterKojiTamuraDepartment of Hospital Pharmacy, NHO Fukuyama Medical CenterTerutakaHamaokaDepartment of Hospital Pharmacy, NHO Fukuyama Medical CenterOriginal Article10.18926/AMO/68644Anamorelin (ANAM) is used to treat cancer-associated cachexia, a syndrome involving muscle loss and anorexia. The timing of the initiation of ANAM treatment is crucial to its efficacy. Although the body mass index (BMI) is a diagnostic criterion for cancer cachexia, no studies have explored its association with ANAM efficacy. We conducted a single-center, retrospective cohort study to investigate the association between the pre-treatment BMI and ANAM efficacy in patients with cancer-associated cachexia (n=47). The ANAM treatment was considered effective if the patient’s appetite improved within 30 days of treatment initiation. We calculated a BMI cutoff value (19.5 kg/m2) and used it to divide the patients into high- and low-BMI groups. Their background, clinical laboratory values, cancer types, and treatment lines were investigated. Twenty (42.6%) had a high BMI (≥ 19.5 kg/m2) and 27 (57.4%) had a low BMI (< 19.5 kg/m2). High BMI was significantly associated with ANAM effectiveness (odds ratio 7.86, 95% confidence interval 1.99-31.00, p=0.003). Together these results indicate that it is beneficial to initiate ANAM treatment before a patient’s BMI drops below 19.5 kg/m2. Our findings will help advance cancer cachexia treatment and serve as a reference for clinicians to predict ANAM’s efficacy.No potential conflict of interest relevant to this article was reported.Japanese Society for Pediatric EndocrinologyActa Medica Okayama0918-57393422025Effect of calcium supplementation on bone deformity and histopathological findings of skin papules in a pediatric patient with vitamin D–dependent rickets type 2A: A case report131136ENKoseiHasegawaDepartment of Pediatrics, Okayama University HospitalTomokoMiyakeDepartment of Dermatology, Okayama University HospitalMinaKobashiDepartment of Dermatology, Okayama University HospitalTomonoriTetsunagaDepartment of Dermatology, Okayama University HospitalYukoAgoDepartment of Pediatrics, Okayama University HospitalNatsukoFutagawaDepartment of Pediatrics, Okayama University HospitalHiroyukiMiyaharaDepartment of Pediatrics, Okayama University HospitalYousukeHiguchiDepartment of Pediatrics, Okayama University HospitalShinMorizaneDepartment of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHirokazuTsukaharaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesVitamin D–dependent rickets type 2A (VDDR2A) is an autosomal recessive disease caused by pathogenic variants of the vitamin D receptor (VDR) gene. VDDR2A rickets are usually resistant to native or active vitamin D treatment because of impaired active calcium absorption against the calcium concentration gradient, which is a ligand-dependent VDR action in the small intestine. Alopecia due to an impaired skin follicular cycle is occasionally observed in patients with VDDR2A. Among the pathogenic VDR variants, most in the DNA-binding domain and some in the ligand-binding domain, which affect the dimerization of VDR with the retinoic X receptor, are associated with alopecia. Herein, we report a case of VDDR2A caused by compound heterozygous pathogenic variants of the DNA-binding domain of VDR. Active vitamin D treatment did not ameliorate genu varum, rachitic changes in the roentgenogram, or abnormal laboratory findings. However, oral administration of calcium lactate dramatically improved these findings. The patient also experienced hair loss at two months of age and multiple papules on the skin at two yr of age, which did not improve with vitamin D or calcium supplementation. We also report the histopathological findings of skin papules in this patient.No potential conflict of interest relevant to this article was reported.Department of Mathematics, Faculty of Science, Okayama UniversityActa Medica Okayama0030-15666712025The irreducibility and monogenicity of power-compositional trinomials5365ENJoshuaHarringtonDepartment of Mathematics, Cedar Crest CollegeLennyJonesDepartment of Mathematics, Shippensburg UniversityA polynomial f(x) ∈ Z[x] of degree N is called monogenic if f(x) is irreducible over Q and {1, θ, θ2, . . . , θN−1} is a basis for the ring of integers of Q(θ), where f(θ) = 0. Define F(x) := xm+Axm−1+B. In this article, we determine sets of conditions on m, A, and B, such that
the power-compositional trinomial F(xpn) is monogenic for all integers n ≥ 0 and a given prime p. Furthermore, we prove the actual existence of infinite families of such trinomials F(x).No potential conflict of interest relevant to this article was reported.AIP PublishingActa Medica Okayama0034-67489632025Development of density measurement at high pressure and high temperature using the x-ray absorption method combined with laser-heated diamond anvil cell033907ENHidenoriTerasakiDepartment of Earth Sciences, Okayama UniversityHiroyukiKaminaDepartment of Earth Sciences, Okayama UniversitySaori I.KawaguchiJapan Synchrotron Radiation Research Institute, SPring-8TadashiKondoDepartment of Earth and Space Science, Osaka UniversityKoMoriokaDepartment of Earth Sciences, Okayama UniversityRyoTsuruokaDepartment of Earth and Space Science, Osaka UniversityMoeSakuraiDepartment of Earth Sciences, Okayama UniversityAkiraYonedaDepartment of Earth and Space Science, Osaka UniversitySeijiKamadaAD Science IncorporationNaohisaHiraoJapan Synchrotron Radiation Research Institute, SPring-8The densities of liquid materials at high pressures and high temperatures are important information to understand the elastic behavior of liquids at extreme conditions, which is closely related to the formation and evolution processes of the Earth and planetary interiors. The x-ray absorption method is an effective method to measure the density of non-crystalline materials at high pressures. However, the temperature condition of the x-ray absorption method using a diamond anvil cell (DAC) has been limited to 720 K to date. To significantly expand the measurable temperature condition of this method, in this study, we developed a density measurement technique using the x-ray absorption method in combination with a laser-heated DAC. The density of solid Ni was measured up to 26 GPa and 1800 K using the x-ray absorption method and evaluated by comparison with the density obtained from the x-ray diffraction. The density of solid Ni with a thickness >17 μm was determined with an accuracy of 0.01%–2.2% (0.001–0.20 g/cm3) and a precision of 0.8%–1.8% (0.07–0.16 g/cm3) in the x-ray absorption method. The density of liquid Ni was also determined to be 8.70 ± 0.15–8.98 ± 0.38 g/cm3 at 16–23 GPa and 2230–2480 K. Consequently, the temperature limit of the x-ray absorption method can be expanded from 720 to 2480 K by combining it with a laser-heated DAC in this study.No potential conflict of interest relevant to this article was reported.Medknow PublicationsActa Medica Okayama0971-62034942024Backside Irradiation of Ultraviolet-A for Correcting Nonuniformity Error of Gafchromic XR-QA2 Films563567ENNobuyoshiTankiDepartment of Radiological Technology, Graduate School of Health Sciences, Okayama UniversitySachikoGotoDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityToshizoKatsudaDepartment of Medical Radiation Technology, Shizuoka College of Medicalcare ScienceRumiGotandaDepartment of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical WelfareTatsuhiroGotandaDepartment of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical WelfareTadaoKuwanoDepartment of Radiology, Osaka Center for Cancer and Cardiovascular Diseases PreventionPurpose: Radiochromic film is used for quality assurance and quality control of X-ray equipment in the diagnostic radiology. In addition, three-dimensional dose distribution of computed tomography (CT) is measured. To correct the nonuniformity and uncertainty of radiochromic films for dose measurement of CT, the films are preirradiated ultraviolet (UV)-A rays. There is a difference in the UV protection strength of radiochromic films. A concern exists about the effects of the UV-A irradiation intensity. We thus irradiated with UV-A rays from the backsides of the films to assess if backside irradiation was possible. Materials and Methods: Gafchromic XR-QA2 and RTQA2 were used in this study. The UV-A rays were simultaneously irradiated on the front and backsides of each film for 12 h. The yellow layer of each film was scanned and imaged. The average pixel values ± standard deviations (SDs) were compared. In the statistical analysis, a paired t-test was performed. To compare, the active-layer densities engendered by the UV-A rays. Calibration curve was created with 48 h of preirradiation of UV-A. Results: The mean pixel values ± SD for Gafchromic XR-QA2 on the front and backsides were 130.776 ± 0.812 and 81.015 ± 1.128, respectively. On the other hand, the mean pixel values ± SD for Gafchromic RTQA2 on the front and backsides were 62.299 ± 1.077 and 133.761 ± 1.365, respectively. The statistical results of the paired t-test were significantly different (P < 0.01) between both films. Fitting equation of the calibration curve is shown below. y = -390.47 ± 200 + (443.45 ± 10x80).5068 ± 0.0434. Conclusion: Based on the relationship between the sensitivity of the active layer to UV-A rays and the strength of UV protection on the surface, we concluded that backside irradiation is recommended for Gafchromic XR-QA2, and frontside irradiation is recommended for Gafchromic RTQA2.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1383-57691062025The antimalarial activity of transdermal N-89 mediated by inhibiting ERC gene expression in P. Berghei-infected mice103026ENHiroakiMatsumoriDivision of International Infectious Diseases Control, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityThi QuyenDinhDivision of International Infectious Diseases Control, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShin-ichiMiyoshiResearch Center for Intestinal Health Science, Okayama UniversityMasayukiMoritaDepartment of Anatomy, Kawasaki Medical SchoolHye-SookKimDivision of International Infectious Diseases Control, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityThrough studies of new antimalarial drugs, we identified 1,2,6,7-tetraoxaspiro[7.11]nonadecane (N-89) as a potential drug candidate. Here, we analyzed the antimalarial action of a transdermal formulation (td) of N-89, designed for easy use by children, using Plasmodium berghei-infected mice as a model for malaria patients. The td N-89 or artemisinin (ART) formulation was transdermally administered to P. berghei-infected mice with 0.2–0.4 % parasitemia, twice daily for four days, at an effective dose of 90 % for malaria. Parasitemia was decreased in td N-89 and td ART groups during the drug treatment; then, three of the eight mice in td N-89 group were completely cured without relapse. Additionally, abnormal trophozoites in td N-89 group were observed 8 h after administration and increased up to 24 h. To study the change in endoplasmic reticulum-resident calcium-binding protein (ERC) gene expression with td N-89, we investigated the gene expression of P. berghei ERC (PbERC) after td N-89 treatment. PbERC gene expression was increased time-dependently in control group, and was statistically decreased at 4 and 8 h and then increased similar to that of control group at 12 h in td ART group. In contrast, the expression in td N-89 group was almost steady starting from 0 h. We also studied parasite egress-related genes expression after td N-89 treatment, plasmepsin X, subtilisin-like protease 1 and merozoite surface protein 1, were suppressed at 12 h compared to control group. These results suggest that N-89 affects function of endoplasmic reticulum via regulating gene suppression and subsequently parasite growth is inhibited.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7912025A Rare Case of Compression Neuritis due to Intraorbital Arteriovenous Fistula (IOAVF) Mimicking Retrobulbar Optic Neuritis5964ENShunMinakawaDepartment of Ophthalmology, Japanese Red Cross Society Himeji HospitalMasayukiHiranoDepartment of Ophthalmology, Japanese Red Cross Society Himeji HospitalKazuyaTakahashiDepartment of Neurosurgery, Japanese Red Cross Society Himeji HospitalYutaImamuraDepartment of Ophthalmology, Japanese Red Cross Society Himeji HospitalTakashiWatanabeDepartment of Ophthalmology, Japanese Red Cross Society Himeji HospitalCase Report10.18926/AMO/68363Intraorbital arteriovenous fistulas (IOAVFs) are rare vascular abnormalities. We describe a case of an IOAVF featuring a direct shunt between the accessory meningeal artery and the superior ophthalmic artery. A 55-year-old woman presented with a 1-month history of visual impairment in her right eye, and magnetic resonance imaging (MRI) revealed optic neuritis-like findings. Steroid pulse therapy temporarily resolved visual impairment. However, 1 month later, she experienced decreased visual acuity, ocular conjunctival hyperemia, edema, and a pulsatile murmur. Contrast-enhanced MRI and digital subtraction angiography revealed compression optic neuropathy due to an IOAVF. Following successful treatment with transarterial embolization, her symptoms disappeared.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7912025Photoinitiators Induce Histamine Production in Human Mast Cells5158ENTaroMiuraDepartment of Clinical Pharmacy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoichiKawasakiLaboratory of Clinical Pharmacology and Therapeutics, Kagawa School of Pharmaceutical Sciences, Tokushima Bunri UniversityHirofumiHamanoDepartment of Clinical Pharmacy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshitoZamamiDepartment of Clinical Pharmacy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiakiSendoDepartment of Clinical Pharmacy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/68362Photoinitiators are used in the manufacture of many daily products, and may produce harmful effects due to their cytotoxicity. They have also been detected in human serum. Here, we investigated the histamine-producing effects in HMC-1 cells and the inflammatory cytokine release effects in RAW264 cells for four photoinitiators: 1-hydroxycyclohexyl phenyl ketone; 2-isopropylthioxanthone; methyl 2-benzoylbenzoate; and 2-methyl-4´-(methylthio)-2-morpholinopropiophenone. All four promoted histamine production in HMC-1 cells; however, they did not significantly affect the release of inflammatory cytokines in RAW264 cells. These findings suggest that these four photoinitiators induce inflammatory cytokine-independent histamine production, potentially contributing to histamine-mediated chronic inflammation in vitro.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7912025Could the Trabecular Bone Score Be a Complementary Tool for Evaluating Degenerative Lumbar Vertebrae?3945ENShinichiroTakaoDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKojiUotaniDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHaruoMisawaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokoTetsunagaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKensukeShinoharaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaroYamaneDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiakiOdaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHironoriTsujiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuyaKajikiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/68360Evaluating vertebral bone mass and quality in the elderly poses challenges due to degenerative changes. This study aims to elucidate the usefulness of the trabecular bone score (TBS) by examining the relationship between bone mineral density (BMD), TBS, and Hounsfield unit (HU) values. A retrospective analysis of 599 vertebrae from 152 patients (mean age 69.0 years; range 44-89; 74 males and 78 females) undergoing dual-energy X-ray absorptiometry (DXA) and CT scans was conducted. Vertebrae were categorized into three grades based on the degree of degeneration. The TBS was calculated from DXA images, and the HU value was measured by placing a region of interest on an axial image of the vertebral mid-body. One-way analysis of variance and Pearson’s correlation tests were employed to investigate the relationship between BMD and TBS or HU values. While lumbar BMD significantly increased (p<0.01) with degenerative changes, TBS and HU values showed no significant differences. The correlations between lumbar BMD and TBS values, and between BMD and HU values, were stronger without degenerative changes than with degenerative changes. Significantly different HU values were observed between the right and left sides of severely degenerated vertebrae. Severe degenerative changes, particularly those associated with sclerosis, may impact HU values. TBS exhibits greater potential than HU values as a complementary tool.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7912025Prediction of Prostate Cancer Grades Using Radiomic Features2130ENYasuhiroYamamotoDepartment of Radiology, Houshasen Daiichi HospitalTakafumiHaraguchiDepartment of Advanced Biomedical Imaging and Informatics, St. Marianna University School of MedicineKaoriMatsudaDepartment of Radiology, Houshasen Daiichi HospitalYoshioOkazakiDepartment of Radiology, Houshasen Daiichi HospitalShinKimotoDepartment of Radiology, Houshasen Daiichi HospitalNozomuTanjiDepartment of Urology, Houshasen Daiichi HospitalAtsushiMatsumotoDepartment of Urology, Houshasen Daiichi HospitalYasuyukiKobayashiDepartment of Medical Information and Communication Technology Research, St. Marianna University School of MedicineHidefumiMimuraDepartment of Radiology, St. Marianna University School of MedicineTakaoHirakiDepartment of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/68355We developed a machine learning model for predicting prostate cancer (PCa) grades using radiomic features of magnetic resonance imaging. 112 patients diagnosed with PCa based on prostate biopsy between January 2014 and December 2021 were evaluated. Logistic regression was used to construct two prediction models, one using radiomic features and prostate-specific antigen (PSA) values (Radiomics model) and the other Prostate Imaging-Reporting and Data System (PI-RADS) scores and PSA values (PI-RADS model), to differentiate high-grade (Gleason score [GS] ≥ 8) from intermediate or low-grade (GS < 8) PCa. Five imaging features were selected for the Radiomics model using the Gini coefficient. Model performance was evaluated using AUC, sensitivity, and specificity. The models were compared by leave-one-out cross-validation with Ridge regularization. Furthermore, the Radiomics model was evaluated using the holdout method and represented by a nomogram. The AUC of the Radiomics and PI-RADS models differed significantly (0.799, 95% CI: 0.712-0.869; and 0.710, 95% CI: 0.617-0.792, respectively). Using holdout method, the Radiomics model yielded AUC of 0.778 (95% CI: 0.552-0.925), sensitivity of 0.769, and specificity of 0.778. It outperformed the PI-RADS model and could be useful in predicting PCa grades, potentially aiding in determining appropriate treatment approaches in PCa patients.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7912025Gastrectomy Causes an Imbalance in the Trunk Muscles919ENNanamiIkeyaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsushiOkitaDepartment of Surgery, Okayama City HospitalShinsukeHashidaDepartment of Surgery, Okayama City HospitalSumiharuYamamotoDepartment of Surgery, Okayama City HospitalHirokuniIkedaDepartment of Surgery, Okayama City HospitalKazunoriTsukudaDepartment of Surgery, Okayama City HospitalShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/68354Muscle loss negatively affects gastrectomy prognosis. However, muscle loss is recognized as a systemic change, and individual muscle function is often overlooked. We investigated changes in the muscle volume of individual muscles after gastrectomy to identify clues for prognostic factors and optimal rehabilitation programs. Patients who underwent R0 gastrectomy for Stage I gastric cancer at our hospital from 2015 to 2021 were retrospectively selected to minimize the effects of malignancy and chemotherapy. Trunk muscle volume was measured by computed tomography to analyze body composition changes. Statistical analysis was performed to identify risk factors related to body composition changes. We compared the preoperative and 6-month postoperative conditions of 59 patients after gastrectomy. There was no difference in the psoas major muscle, a conventional surrogate marker of sarcopenia. There were significant decreases in the erector spinae (p=0.01) and lateral abdominal (p=0.01) muscles, and a significant increase in the rectus abdominis muscle (p=0.02). No significant correlation was found between these muscle changes and nutritional status. Body composition imbalance may serve as a new indicator of the general condition of patients after gastrectomy. Rehabilitation to correct this imbalance may improve prognosis after gastrectomy.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7912025Endothelial Cell Polarity in Health and Disease17ENMoeThihaDepartment of Pathophysiology and Drug Discovery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakaoHikitaDepartment of Pathophysiology and Drug Discovery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasanoriNakayamaDepartment of Pathophysiology and Drug Discovery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesReview10.18926/AMO/68353Endothelial cell polarity is fundamental to the organization and function of blood vessels, influencing processes such as angiogenesis, vascular stability, and response to shear stress. This review elaborates on the molecular mechanisms that regulate endothelial cell polarity, focusing on key players like the PAR polarity complex and Rho family GTPases. These pathways coordinate the front–rear, apical–basal and planar polarity of endothelial cells, which are essential for the proper formation and maintenance of vascular structures. In health, endothelial polarity ensures not only the orderly development of blood vessels, with tip cells adopting distinct polarities during angiogenesis, but also ensures proper vascular integrity and function. In disease states, however, disruptions in polarity contribute to pathologies such as coronary artery disease, where altered planar polarity exacerbates atherosclerosis, and cancer, where disrupted polarity in tumor vasculature leads to abnormal vessel growth and function. Understanding cell polarity and its disruption is fundamental not only to comprehending how cells interact with their microenvironment and organize themselves into complex, organ-specific tissues but also to developing novel, targeted, and therapeutic strategies for a range of diseases, from cardiovascular disorders to malignancies, ultimately improving patient outcomes.No potential conflict of interest relevant to this article was reported.Nature PortfolioActa Medica Okayama2045-23221512025Nomogram models for predicting outcomes in thyroid cancer patients with distant metastasis receiving 131iodine therapy2486ENShuiJinDepartment of Nuclear Medicine, Zhejiang Cancer HospitalXuemeiYeDepartment of Nuclear Medicine, Zhejiang Cancer HospitalTingYeDepartment of Nuclear Medicine, Zhejiang Cancer HospitalXinyuChenNuclear Medicine, Faculty of Medicine, University of AugsburgJianfengJiDepartment of Nuclear Medicine, Zhejiang Cancer HospitalJinyuWangMedical records and statistics office, Zhejiang Cancer HospitalXinZhuKey Laboratory of Head and Neck Cancer Translational Research of Zhejiang Province, Zhejiang Cancer HospitalXiaochunMaoDepartment of Thyroid Surgery, Zhejiang Cancer HospitalTakahiroHiguchiFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHeqingYiDepartment of Nuclear Medicine, Zhejiang Cancer HospitalThis study aimed to establish and validate prognostic nomogram models for patients who underwent I-131 therapy for thyroid cancer with distant metastases. The cohort was divided into training (70%) and validation (30%) sets for nomogram development. Univariate and multivariate Cox regression analyses were used to identify independent predictors for overall survival (OS) and progression-free survival (PFS). Nomograms were developed based on these predictors, and Kaplan-Meier curves were constructed for validation. Among 451 patients who were screened, 412 met the inclusion criteria and were followed-up for a median duration of 65.2 months. The training and validation sets included 288 and 124 patients, respectively. Pathological type, first I-131 administrated activity, and lesion I-131 uptake in lesions were independent predictors for PFS. For OS, predictors included gender, age, metastasis site, first I-131 administrated activity, I-131 uptake, pulmonary lesion size, and stimulated thyroglobulin levels. These predictors were used to construct nomograms for predicting PFS and OS. Low-risk patients had significantly longer PFS and OS compared to high-risk patients, with 10-year PFS rates of 81.1% vs. 51.9% and 10-year OS rates of 86.2% vs. 37.4%. These may aid individualized prognostic assessment and clinical decision-making, especially in determining the prescribed activity for the first I-131 treatment.No potential conflict of interest relevant to this article was reported.Frontiers MediaActa Medica Okayama1664-1078152024Visual dominance of the congruency sequence effect in a cross-modal context1504068ENXiaoyuTangSchool of Psychology, Liaoning Collaborative Innovation Center of Children and Adolescents Healthy Personality Assessment and Cultivation, Liaoning Normal UniversityXiZhangSchool of Psychology, Liaoning Collaborative Innovation Center of Children and Adolescents Healthy Personality Assessment and Cultivation, Liaoning Normal UniversityTingtingWangDepartment of Psychology, Soochow UniversityHongtaoYuSchool of Psychology, Liaoning Collaborative Innovation Center of Children and Adolescents Healthy Personality Assessment and Cultivation, Liaoning Normal UniversityAijunWangDepartment of Psychology, Soochow UniversityMingZhangFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityThe congruency sequence effect (CSE) refers to the reduction in the congruency effect in the current trial after an incongruent trial compared with a congruent trial. Although previous studies widely suggested that CSE was observed only in the modality repeat condition, few studies have reported that CSE could also appear in the modality switch condition. However, it remains unclear whether these conflicting findings were caused by partial repetition effects under modality transition conditions. To address this issue, Experiment 1 controlled for partial repetition effects by ensuring that the modality relationships in both the repetition and switch conditions were either fully congruent or incongruent. The results revealed significant CSE only under the modality repetition condition. In particular, a larger CSE was observed in visual-auditory (VA) repetition than in auditory-visual (AV) repetition, indicating that modality asymmetry might affect the CSE by inducing the priming effect. Thus, Experiment 2 concurrently presented visual and auditory stimuli to eliminate priming effects and further validated CSE differences between auditory and visual modalities. The results revealed that the CSE was significantly greater under the VA condition than under the AV condition and confirmed that the visual modality played a dominant role in the CSE, as visual information is prioritized in processing and ultimately reduces the congruency effect in the next trial. Overall, the present study provides evidence for the specificity of CSE under modality repetition conditions by excluding partial repetition effects and further underscores the critical role of visual dominance in cross-modal CSE.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0300-78395142023Does International Environmental Certification Change Local Production and Trade Practices? A Case Study of Shrimp Farming in Southern Vietnam781794ENHirokiWatanabeGraduate School of Environmental and Life Science, Okayama UniversityFumikazuUbukataInstitute of Academic and Research, Okayama UniversityStudies on international environmental certification (IEC) have primarily focused on how certification can sustainably “upgrade” local production and trading practices. However, not many studies view this market-based governance process from the perspective of local practices and location-specific factors. This study therefore examines how the upstream of the local supply chain influenced global interventions through the case of certification for shrimp farming in the mangroves of southern Vietnam. To clarify various aspects of these interactions, semi-structured interviews were conducted with the provincial government, NGOs, a trading company, shrimp farmers, and middlemen. The results revealed that IEC did not affect local production practices and only partially influenced trade practices. The implementation of IEC was thus at the mercy of the robustness of local society, which was attributed to unique agroecology, production systems, and upstream customary economic practices.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama2072-66941712024The Three-Class Annotation Method Improves the AI Detection of Early-Stage Osteosarcoma on Plain Radiographs: A Novel Approach for Rare Cancer Diagnosis29ENJoeHaseiDepartment of Medical Information and Assistive Technology Development, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRyuichiNakaharaScience of Functional Recovery and Reconstruction, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYujiroOtsukaDepartment of Radiology, Juntendo University School of MedicineYusukeNakamuraPlusman LCCKunihiroIkutaDepartment of Orthopedic Surgery, Graduate School of Medicine, Nagoya UniversityShuheiOsakiDepartment of Musculoskeletal Oncology and Rehabilitation, National Cancer Center HospitalTamiyaHironariDepartment of Musculoskeletal Oncology Service, Osaka International Cancer InstituteShinjiMiwaDepartment of Orthopedic Surgery, Kanazawa University Graduate School of Medical SciencesShusaOhshikaDepartment of Orthopaedic Surgery, Hirosaki University Graduate School of MedicineShunjiNishimuraDepartment of Orthopaedic Surgery, Kindai University HospitalNaoakiKaharaDepartment of Orthopedic Surgery, Mizushima Central HospitalAkiYoshidaScience of Functional Recovery and Reconstruction, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomohiroFujiwaraScience of Functional Recovery and Reconstruction, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityEijiNakataScience of Functional Recovery and Reconstruction, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshiyukiKunisadaScience of Functional Recovery and Reconstruction, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshifumiOzakiScience of Functional Recovery and Reconstruction, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground/Objectives: Developing high-performance artificial intelligence (AI) models for rare diseases is challenging owing to limited data availability. This study aimed to evaluate whether a novel three-class annotation method for preparing training data could enhance AI model performance in detecting osteosarcoma on plain radiographs compared to conventional single-class annotation. Methods: We developed two annotation methods for the same dataset of 468 osteosarcoma X-rays and 378 normal radiographs: a conventional single-class annotation (1C model) and a novel three-class annotation method (3C model) that separately labeled intramedullary, cortical, and extramedullary tumor components. Both models used identical U-Net-based architectures, differing only in their annotation approaches. Performance was evaluated using an independent validation dataset. Results: Although both models achieved high diagnostic accuracy (AUC: 0.99 vs. 0.98), the 3C model demonstrated superior operational characteristics. At a standardized cutoff value of 0.2, the 3C model maintained balanced performance (sensitivity: 93.28%, specificity: 92.21%), whereas the 1C model showed compromised specificity (83.58%) despite high sensitivity (98.88%). Notably, at the 25th percentile threshold, both models showed identical false-negative rates despite significantly different cutoff values (3C: 0.661 vs. 1C: 0.985), indicating the ability of the 3C model to maintain diagnostic accuracy at substantially lower thresholds. Conclusions: This study demonstrated that anatomically informed three-class annotation can enhance AI model performance for rare disease detection without requiring additional training data. The improved stability at lower thresholds suggests that thoughtful annotation strategies can optimize the AI model training, particularly in contexts where training data are limited.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1880-70624512023Mutation and apoptosis are well-coordinated for protecting against DNA damage-inducing toxicity in Drosophila11ENMegumiToyoshima-SasataniGraduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityFumikaImuraGraduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityYukoHamatakeGraduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityAkihiroFukunagaSchool of Nursing, Osaka City UniversityTomoeNegishiGraduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityBackground Apoptotic cell death is an important survival system for multicellular organisms because it removes damaged cells. Mutation is also a survival method for dealing with damaged cells in multicellular and also unicellular organisms, when DNA lesions are not removed. However, to the best of our knowledge, no reports have comprehensively explored the direct relationship between apoptosis and somatic cell mutations induced by various mutagenic factors.<br>
Results Mutation was examined by the wing-spot test, which is used to detect somatic cell mutations, including chromosomal recombination. Apoptosis was observed in the wing discs by acridine orange staining in situ. After treatment with chemical mutagens, ultraviolet light (UV), and X-ray, both the apoptotic frequency and mutagenic activity increased in a dose-dependent manner at non-toxic doses. When we used DNA repair-deficient Drosophila strains, the correlation coefficient of the relationship between apoptosis and mutagenicity, differed from that of the wild-type. To explore how apoptosis affects the behavior of mutated cells, we determined the spot size, i.e., the number of mutated cells in a spot. In parallel with an increase in apoptosis, the spot size increased with MNU or X-ray treatment dose-dependently; however, this increase was not seen with UV irradiation. In addition, BrdU incorporation, an indicator of cell proliferation, in the wing discs was suppressed at 6 h, with peak at 12 h post-treatment with X-ray, and that it started to increase again at 24 h; however, this was not seen with UV irradiation.<br>
Conclusion Damage-induced apoptosis and mutation might be coordinated with each other, and the frequency of apoptosis and mutagenicity are balanced depending on the type of DNA damage. From the data of the spot size and BrdU incorporation, it is possible that mutated cells replace apoptotic cells due to their high frequency of cell division, resulting in enlargement of the spot size after MNU or X-ray treatment. We consider that the induction of mutation, apoptosis, and/or cell growth varies in multi-cellular organisms depending on the type of the mutagens, and that their balance and coordination have an important function to counter DNA damage for the survival of the organism.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama0009-267397112024Refined surface area determination of graphene oxide using methylene blue as a probe molecule: a comparative approachuoae118ENIsraelOrtiz-AnayaGraduate School of Natural Sciences and Technology, Okayama UniversityYutaNishinaResearch Institute for Interdisciplinary Science, Okayama UniversityIn this research, we explored the effectiveness of the methylene blue adsorption method as an alternative approach for determining the specific surface area of graphene oxide. Initially, through a comparative analysis with reference activated carbon, we identified the limitations of utilizing N2 physisorption for specific surface area determination of graphene oxide. Our findings revealed that the standard pretreatment process (heating under vacuum) before N2 physisorption led to damage to the surface oxygen groups on graphene oxide, and the measured surface areas (43 m2/g) do not accurately represent the entire surface area. To optimize methylene blue coverage on graphene oxide, we conducted adsorption equilibrium experiments, focusing on controlling temperature and pH. The pH was significantly important in regulating the coverage of methylene blue. Under the optimized methylene blue adsorption conditions, the specific surface area of graphene oxide was 1,555 m2/g. Our assumptions regarding specific surface area calculations were supported by structural characterization of samples with varying methylene blue uptakes. The results confirmed a uniform coverage of methylene blue on graphene oxide by scanning electron microscopy and energy dispersive X-ray, X-ray diffraction, and atomic force microscopy.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama2071-105016232024Assessing CO2 Reduction Effects Through Decarbonization Scenarios in the Residential and Transportation Sectors: Challenges and Solutions for Japan's Hilly and Mountainous Areas10342ENXiyueHaoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityChuyueYanDepartment of Socio-Environmental Energy Science, Graduate School of Energy Science, Kyoto UniversityDaisukeNarumiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityDepopulation, aging, and regional decline are becoming increasingly serious issues in Japan's hilly and mountainous areas. Focusing on mitigating environmental damage and envisioning a sustainable future for these regions, this study examines the potential for reducing CO2 emissions in the residential and transportation sectors by 2050. Bottom-up simulations were used to estimate CO2 emissions. Subsequently, six decarbonization scenarios were formulated, considering various measures from the perspectives of population distribution and technological progress. Based on these scenarios, this study analyzes changes in future population, energy consumption, and CO2 emissions by 2050. The results of this study show the following. (1) Depopulation and aging problems in these regions are expected to become more severe in the future. It is necessary to take action to promote sustainable regional development. (2) Pursuing decarbonization has a positive impact on enhancing regional sustainability; however, maintaining the intensity of measures at the current level could lead to a reduction of only 40% in CO2 emissions per capita by 2050 compared with 2020. (3) Scenarios that strengthen decarbonization measures could achieve a reduction of over 95% by 2050, indicating that carbon neutrality is attainable. However, this will require implementing measures at a higher intensity, especially in the transportation sector.No potential conflict of interest relevant to this article was reported.Frontiers MediaActa Medica Okayama2296-2360122024Trabecular bone scores in children with osteogenesis imperfecta respond differently to bisphosphonate treatment depending on disease severity1500023ENNatsukoFutagawaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoseiHasegawaDepartment of Pediatrics, Okayama University HospitalHiroyukiMiyaharaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiTanakaDepartment of Pediatrics, Okayama Saiseikai General HospitalHirokazuTsukaharaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesIntroduction: Osteogenesis imperfecta (OI) is a congenital skeletal disorder characterized by bone fragility. Bisphosphonates (BISs) have become the mainstream treatment in children with OI. However, an optimal treatment protocol has not yet been established, while BIS treatment tends to be administered to normalize bone mineral density (BMD). Bone quality is an important component of bone strength. The trabecular bone score (TBS) is a quantitative measure of the microstructure that affects bone quality. This study investigated the TBS during BIS treatment in children with OI. Materials and methods: Twenty-nine children with OI were enrolled and classified into two groups: mild (type 1) and moderate to severe (types 3 and 4). Dual-energy x-ray absorptiometry images were retrospectively analyzed for TBS calculation. The relationship between the areal BMD (aBMD), its Z-score, height-adjusted BMD (BMDHAZ) Z-score, TBS, and TBS Z-score with the treatment duration was assessed for each group. Results: In the mild group, the aBMD, its Z-score, and BMDHAZ Z-score showed a significant positive correlation with treatment duration (r = 0.68, 0.68, 0.72, respectively, p < 0.01). The TBS Z-score tended to increase with treatment duration, albeit without reaching significance. In the moderate to severe group, the TBS Z-score showed a significant positive correlation with treatment duration (r = 0.48, p < 0.01), in contrast to the aBMD Z-score, which did not increase. Finally, the BMDHAZ Z-score only showed a weak positive correlation with treatment duration (r = 0.37, p < 0.01). Conclusion: Because BIS affect the BMD and TBS differently based on the severity of OI, treatment goals may need to be stratified by disease severity.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7862024C-arm Free Unilateral Biportal Endoscopic Discectomy: A Technical Note475483ENHongfeiXiangDepartment of Orthopaedic Surgery, Okayama Rosai HospitalKajetanLatkaDepartment of Orthopaedic Surgery, Okayama Rosai HospitalPrafulMasteDepartment of Orthopaedic Surgery, Okayama Rosai HospitalMasatoTanakaDepartment of Orthopaedic Surgery, Okayama Rosai HospitalChetanKumawatDepartment of Orthopaedic Surgery, Okayama Rosai HospitalShinyaAratakiDepartment of Orthopaedic Surgery, Okayama Rosai HospitalYoshihiroFujiwaraDepartment of Orthopaedic Surgery, Okayama Rosai HospitalTakuyaTaokaDepartment of Orthopaedic Surgery, Okayama Rosai HospitalAkiyoshiMiyamotoDepartment of Orthopaedic Surgery, Okayama Rosai HospitalCase Report10.18926/AMO/67878This report presents a new unilateral biportal endoscopic (UBE) technique for lumbar disc herniation without C-arm guidance. Lumbar disc herniation requires surgical intervention when conservative methods fail. Shifts towards minimally invasive percutaneous endoscopic lumbar discectomy, including uniportal and biportal approaches, have been hindered by challenges such as steep learning curves and reliance on radiation-intensive C-arm guidance. We here describe the use of standard intraoperative navigation in UBE to reduce radiation exposure and increase surgical accuracy. A 24-year-old man with low back and bilateral leg pain with gait disturbance was referred to our hospital. He had had conservative treatment for 12 months in another hospital before admission, but this proved unsuccessful. On admission he had low back pain (VAS 4/10) and bilateral leg pain (VAS 8/10), muscle weakness of the bilateral legs (manual muscle testing (MMT) grade of the extensor hallucis longus: 4/4), and numbness of the bilateral lower legs. Preoperative lumbar MRI showed L4/5 large central disc herniation. He underwent C-arm free UBE discectomy under the guidance of O-arm navigation. The surgery was successful, with postoperative lumbar MRI showing good decompression of the dural sac and bilateral L5 nerve roots. The MMT grade and sensory function of both legs had recovered fully on final follow-up at one year. The new UBE technique under navigation guidance was shown to be useful for lumbar disc herniation. This innovative technique was safe and accurate for the treatment of lumbar intervertebral disc herniation, and minimized radiation exposure to surgeons.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7862024Treatment of Tenosynovial Giant Cell Tumor of the Cervical Spine with Postoperative Anti-RANKL Antibody (Denosumab) Administration469474ENYuichiHirataDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakayukiNagaseDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSusumuSasadaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiyukiAyadaDepartment of Pathology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHayatoMiyakeDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChiakiSugaharaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHidetakaYamamotoDepartment of Pathology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshinaoOdaDepartment of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu UniversityTakaoYasuharaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/67877Tenosynovial giant cell tumor (TGCT) is a fibrous histiocytic tumor originating in the synovial membrane. While cervical TGCT may not be considered a common diagnosis preoperatively because it is relatively rare, it has a high recurrence rate and should be considered. Total resection is preferable, but it can be challenging due to the risk of damaging the vertebral artery. Denosumab has shown effectiveness as a postoperative treatment for osteolytic bone lesion. Denosumab administration coupled with close follow-up might offer an effective postoperative treatment option for unresectable TGCT with bone invasion.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7862024Traumatic Neuroma Arising from Surgical Trauma during Conversion from Laparoscopic to Open Cholecystectomy459464ENShinyaSakamotoDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterMotoyasuTabuchiDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterRikaYoshimatsuDepartment of Radiology, Kochi Health Sciences CenterManabuMatsumotoDepartment of Diagnostic Pathology, Kochi Health Sciences CenterJunIwataDepartment of Diagnostic Pathology, Kochi Health Sciences CenterTakehiroOkabayashiDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterCase Report10.18926/AMO/67872Traumatic neuroma is an abnormal proliferation of injured nerves resulting from trauma or surgery. We present a case of traumatic neuroma arising in the cystic duct after cholecystectomy. A 66-year-old man was referred to our department due to a biliary tumor. He had undergone cholecystectomy 20 years prior. Cholangioscopy showed an elevated lesion covered with smooth mucosa. Histological examination revealed normal bile duct mucosa. Although benign disease was suspected, the possibilities of malignant disease could not be excluded. Extrahepatic bile duct resection was planned to include intraoperative rapid-freezing of a biopsy specimen followed by histopathological examination. These intraoperative histology results showed proliferation of nerve and fibrous tissue only, resulting in the diagnosis of traumatic neuroma, so no lymph nodes were removed. To avoid excessive surgical intervention, histopathological examination of an intraoperative rapid-frozen biopsy specimen may be important for diagnosing traumatic neuroma.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7862024Case of Radiation-Induced Angiosarcoma after Breast-Conserving Surgery with Hypofractionated Radiotherapy in a Japanese Patient453458ENYujiroKawataDepartment of Radiology, Kawasaki Medical SchoolKentaWatanabeDepartment of Radiology, Kawasaki Medical SchoolRyojiTokiyaDepartment of Radiology, Kawasaki Medical SchoolTakeshiMatsunoDepartment of Pathology, Kawasaki Medical SchoolRyoTanakaDepartment of Dermatology, Kawasaki Medical SchoolNarutoTairaDepartment of Breast and Thyroid Surgery, Kawasaki Medical SchoolKuniakiKatsuiDepartment of Radiology, Kawasaki Medical SchoolCase Report10.18926/AMO/67871Radiation-induced angiosarcoma (RIAS) is a rare, late adverse event of radiotherapy comprising approximately half of all radiation-induced sarcomas. It has a relatively short latency period and generally unfavorable prognosis. This study presents a case of RIAS that developed 5 years and 11 months after the completion of hypofractionated radiotherapy (42.56 Gy/16 fractions) following partial mastectomy. The patient was diagnosed with RIAS 10 months after the onset of skin redness. She underwent skin tumor resection, followed by paclitaxel, then pazopanib administration, but no radiotherapy. At 6 years and 2 months after surgery, no RIAS recurrence has been detected.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7862024Risk Factors for Gangrenous Cholecystitis and the Outcomes of Early Cholecystectomy: A Retrospective Study of a Single-Center City General Hospital439447ENMampeiYamashitaDepartment of Surgery, Sasebo City General HospitalTakayukiTanakaDepartment of Surgery, Sasebo City General HospitalYorihisaSumidaDepartment of Surgery, Sasebo City General HospitalShotoYamazakiDepartment of Surgery, Sasebo City General HospitalYukiHaraDepartment of Surgery, Sasebo City General HospitalAkikoFukudaDepartment of Surgery, Sasebo City General HospitalMakotoHisanagaDepartment of Surgery, Sasebo City General HospitalKokiWakataDepartment of Surgery, Sasebo City General HospitalMasatoArakiDepartment of Surgery, Sasebo City General HospitalSusumuEguchiDepartment of Surgery, Nagasaki University Graduate School of Biomedical ScienceOriginal Article10.18926/AMO/67869Gangrenous cholecystitis (GC) is classified as moderate acute cholecystitis according to the Tokyo Guidelines from 2018 (TG18). We evaluated the risk factors for GC and the outcomes of early cholecystectomy. A total of 136 patients who underwent emergency cholecystectomy for acute cholecystitis were retrospectively analyzed; 58 of these patients (42.6%) were diagnosed with GC (GC group) based on our retrospective pathologic diagnosis. We comparatively evaluated the patient backgrounds and surgical outcomes between the GC group and non-GC group. The GC group was significantly older and included more hypertensive patients than the non-GC group. The GC group was prescribed more antibiotics as initial treatment than the non-GC group, and they had more days between onset and surgery. The preoperative white blood cell count and C-reactive protein values were significantly higher in the GC group than in the non-GC group, and these values were predictive factors for GC. Cholecystectomy required a longer operation time and caused greater blood loss in the GC group. The GC group also had longer hospitalization times than the non-GC group; however, no significant differences were observed in terms of postoperative complications. In conclusion, gangrenous changes should be assessed when diagnosing cholecystitis, and appropriate treatment, such as surgery or drainage, should be undertaken.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7862024Partial versus Radical Nephrectomy for Small Renal Cancer: Comparative Propensity Score-Matching Analysis of Cardiovascular Event Risk429437ENRisaKubotaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKensukeBekkuDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiKatayamaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakehiroIwataDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShingoNishimuraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiEdamuraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokoKobayashiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuyukiKobayashiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMotooArakiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/67868Although partial nephrectomy (PN) is preferred over radical nephrectomy (RN) for preserving renal function in patients with cT1 renal cancer, its impact on cardiovascular events (CVe) remains controversial. This study aimed to compare PN and RN in regard to the occurrence of CVe, including cerebrovascular events and exacerbation of hypertension (HT). We retrospectively analyzed 418 consecutive patients who underwent PN or RN for cT1 renal cancer. Propensity score-matching analysis was used to adjust for imbalances between patients who underwent PN and RN, leaving 102 patients in each group. The 5-year probability of cumulative CVe incidence was 6% in the PN group and 12% in the RN group (p=0.03), with a median follow-up of 73.5 months. The statistical significance was retained after propensity score matching for patients without preoperative proteinuria (p=0.03). For all CVe including cerebrovascular events and exacerbation of HT analyzed, PN provided a lower probability of occurrence than RN in patients with small renal cancers.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama1424-822024222024Microdetection of Nucleocapsid Proteins via Terahertz Chemical Microscope Using Aptamers7382ENXueDingGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityManaMurakamiGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityJinWangGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityHirofumiInoueGraduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University HospitalToshihikoKiwaGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityIn the detection of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), several methods have been employed, including the detection of viral ribonucleic acid (RNA), nucleocapsid (N) proteins, spike proteins, and antibodies. RNA detection, primarily through polymerase chain reaction tests, targets the viral genetic material, whereas antigen tests detect N and spike proteins to identify active infections. In addition, antibody tests are performed to measure the immune response, indicating previous exposure or vaccination. Here, we used the developed terahertz chemical microscope (TCM) to detect different concentrations of N protein in solution by immobilizing aptamers on a semiconductor substrate (sensing plate) and demonstrated that the terahertz amplitude varies as the concentration of N proteins increases, exhibiting a highly linear relationship with a coefficient of determination (R2 = 0.9881), indicating that a quantitative measurement of N proteins is achieved. By optimizing the reaction conditions, we confirmed that the amplitude of the terahertz wave was independent of the solution volume. Consequently, trace amounts (0.5 μL) of the N protein were successfully detected, and the detection process only took 10 min. Therefore, this study is expected to develop a rapid and sensitive method for the detection and observation of the SARS-CoV-2 virus at a microdetection level. It is anticipated that this research will significantly contribute to reducing the spread of novel infectious diseases in the future.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2024The concept of X-Ray CT dose evaluation method using radiochromic film and film-folding phantomENNobuyoshiTANKIGraduate School of Health Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2024Neuroprotective effects of carnosine in a mice stroke model concerning oxidative stress and inflammatory responseENXINRANHUGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2024Exploring the Regulators of Keratinization: Role of BMP-2 in Oral MucosaENXINDIMUGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama1661-659625222024Efficient Production of Chondrocyte Particles from Human iPSC-Derived Chondroprogenitors Using a Plate-Based Cell Self-Aggregation Technique12063ENShojiroHanakiDepartment of Regenerative Science, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineDaisukeYamadaDepartment of Regenerative Science, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTomokaTakaoDepartment of Regenerative Science, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineRyosukeIwaiInstitute of Frontier Science and Technology, Okayama University of ScienceTakeshiTakaradaDepartment of Regenerative Science, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineThe limited capacity of articular cartilage for self-repair is a critical challenge in orthopedic medicine. Here, we aimed to develop a simplified method of generating chondrocyte particles from human-induced pluripotent stem cell-derived expandable limb-bud mesenchymal cells (ExpLBM) using a cell self-aggregation technique (CAT). ExpLBM cells were induced to form chondrocyte particles through a stepwise differentiation protocol performed on a CAT plate (prevelex-CAT (R)), which enables efficient and consistent production of an arbitrary number of uniformly sized particles. Histological and immunohistochemical analyses confirmed that the generated chondrocyte particles expressed key cartilage markers, such as type II collagen and aggrecan, but not hypertrophic markers, such as type X collagen. Additionally, when these particles were transplanted into osteochondral defects in rats with X-linked severe combined immunodeficiency, they demonstrated successful engraftment and extracellular matrix production, as evidenced by Safranin O and Toluidine Blue staining. These data suggest that the plate-based CAT system offers a robust and scalable approach to produce a large number of chondrocyte particles in a simplified and efficient manner, with potential application to cartilage regeneration. Future studies will focus on refining the system and exploring its clinical applications to the treatment of cartilage defects.No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama0743-746340432024Nanoscale Structures of Tough Microparticle-Based Films Investigated by Synchrotron X-Ray Scattering and All-Atom Molecular-Dynamics Simulation2261422626ENKeitaNambaDepartment of Frontier Materials Chemistry, Graduate School of Science and Technology, Hirosaki UniversityYumaSasakiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYutoKawamuraGraduate School of Textile Science &Technology, Shinshu UniversityShotaroYoshidaDepartment of Materials Chemistry, Nagoya UniversityYoshikiHiedaDepartment of Chemistry and Materials Engineering, Faculty of Chemistry, Materials and Bioengineering, Kansai UniversityKazushiFujimotoDepartment of Chemistry and Materials Engineering, Faculty of Chemistry, Materials and Bioengineering, Kansai UniversityNatsukiWatanabeDepartment of Physics, Nagoya UniversityYuichiroNishizawaDepartment of Physics, Nagoya UniversityTakayukiUchihashiDepartment of Physics, Nagoya UniversityDaisukeSuzukiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTakumaKurehaDepartment of Frontier Materials Chemistry, Graduate School of Science and Technology, Hirosaki UniversityIn this study, the nanoscale structures of microparticle-based films are revealed by synchrotron small-angle X-ray scattering (SAXS) and all-atom molecular-dynamics (AA-MD) simulations. The microparticle-based films consisting of the simplest acrylate polymer microparticles are applied as a model because the films are formed without additives and organic solvents and exhibit high toughness properties. The characteristic interfacial thickness (tinter) obtained from the SAXS analysis reflects the mixing degree of polymer chains on the microparticle surface in the film. The cross-linking density of inner microparticles is found to be strongly correlated to not only several properties of individual microparticles, such as swelling ratio and radius of gyration, but also the tinter and toughness of the corresponding films. Therefore, the tinter and toughness values follow a linear relationship because the cross-linking restricts the mixing of polymer chains between their surfaces in the film, which is a unique feature of microparticle-based films. This characteristic also affects their deformation behavior observed by in situ SAXS during tensile testing and their density profiles calculated by AA-MD simulations. This work provides a general strategy for material design to control the physical properties and structures of their films for advanced applications, including volatile organic compound-free sustainable coatings and adhesives.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2352-409X602024Petrological characterization for material provenance of haniwa earthenware from mounded tombs in the Kibi region, Japan104813ENToshioNozakaDepartment of Earth Sciences, Okayama UniversityNaoyaOhbayashiDepartment of Earth Sciences, Okayama UniversityYukiTodaDepartment of Earth Sciences, Okayama UniversityKanakoSugiuraDepartment of Archaeology, Okayama UniversityTakahiroNozakiResearch Institute for the Dynamics of Civilizations, Okayama UniversityOsamuKimuraResearch Institute for the Dynamics of Civilizations, Okayama UniversityNaokoMatsumotoResearch Institute for the Dynamics of Civilizations, Okayama UniversityAkiraSeikeDepartment of Archaeology, Okayama UniversityTo determine the provenance of the materials used in the production of haniwa earthenware unearthed from mounded tombs (kofun) in the Kibi region (modern Okayama Prefecture) during the Kofun period (late 3rd – 6th century CE) of Japan, we carried out petrological analyses of haniwa sherds, including optical microscopy, X-ray diffractometry, X-ray fluorescence spectroscopy, and electron-probe analysis. The 25 haniwa sherds analyzed from 12 representative mounded tombs are composed of mineral and rock inclusions with variable grain size set in a clay matrix. The dominant inclusions are quartz, K-feldspar, and plagioclase, associated with minor amounts of amphibole, volcanic glass, and granitic rocks in all the haniwa sherds, and small amounts of hornfels, quartz rock, and accessory minerals, including mica, ilmenite, and chromite, in some of the sherds. Amphibole and plagioclase have compositional variations indicative of the mixing of tephra and granitic components. The compositions of volcanic glass inclusions are similar to those of the Aira-Tanzawa and Kikai-Akahoya tephras widely distributed in southwestern Japan. Bulk chemical compositions show magmatic differentiation trends, which are variable between individual tombs. From these results, it is concluded that the paste materials of haniwa in the Kibi region were commonly derived from weathered granitic rocks mixed with minor amounts of three widespread tephras. The variations of chemical and mineralogical compositions are probably the reflection of local geologic settings, suggesting the presence of specific mining sites of paste materials around each tomb. The mining sites could be located at the bases of hills of granitic rocks covered by widespread tephras and in some cases, near the flood plain of big river systems.No potential conflict of interest relevant to this article was reported.Royal Society of ChemistryActa Medica Okayama2633-54095222024Enhanced piezo-response of mixed-cation copper perovskites with Cl/Br halide engineering89538960ENAmrElattarGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityChristopherMunozIndustrial & Manufacturing Engineering, FAMU-FSU College of EngineeringLiborKoberaInstitute of Macromolecular Chemistry of the Czech Academy of SciencesAndriiMahunInstitute of Macromolecular Chemistry of the Czech Academy of SciencesJiriBrusInstitute of Macromolecular Chemistry of the Czech Academy of SciencesMohammed JasimUddinPhotonics and Energy Research Laboratory (PERL), Department of Mechanical Engineering, The University of TexasYasuhikoHayashiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityOkenwaOkoliIndustrial & Manufacturing Engineering, FAMU-FSU College of EngineeringTarikDickensIndustrial & Manufacturing Engineering, FAMU-FSU College of EngineeringHalide and cation engineering of organic-inorganic hybrid perovskites has shown a great potential for structural modulation of perovskites and enhancing their optoelectronic properties. Here, we studied the impact of Cl/Br halide engineering on the structural and piezoelectric properties of MA/Cs mixed-cation Cu-perovskite crystals. X-ray diffraction, Raman spectroscopy, and 133Cs solid-state NMR were utilized to find out the nature of the perovskite crystal structure formation. Three distinct crystal structures were obtained depending on the Cl/Br content. High Cl content resulted in the formation of Br-doped (Cs/MA)CuCl3 perovskite with the presence of paramagnetic Cu2+ ions. High Br content led to the formation of Cl-doped (MA/Cs)2CuBr4 perovskite with the presence of diamagnetic Cu+ ions. Equimolar Cl/Br perovskite content gave a novel crystal structure with the formation of well-dispersed diamagnetic domains. Compared to the high Cl/Br containing perovskites, the equimolar Cl/Br perovskite revealed the highest potential for piezoelectric applications with a maximum recordable piezoelectric output voltage of 5.0 V. The results provide an insight into the importance of mixed-halide and mixed-cation engineering for tailoring the perovskite structural properties towards a wide range of efficient optoelectronics.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1173-88043912024Real-World Comparative Analysis of Trastuzumab Originator and Biosimilars: Safety, Efficacy, and Cost Effectiveness131142ENTomokaMamoriDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityMakiTaniokaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityKenjiTakadaMedical AI Project, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityHirofumiHamanoDepartment of Pharmacy, Okayama University HospitalTakahiroTsukiokiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityYukoTakahashiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTsuguoIwataniDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTadahikoShienDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityBackground Despite the global use of trastuzumab biosimilars, concerns remain regarding their efficacy and safety. In particular, when used concurrently with pertuzumab, trastuzumab biosimilars lack extensive real-world data and safety information. Additionally, as cancer drug expenditures continue to rise worldwide, cost savings from biosimilars have become increasingly important.<br>
Objective This study aims to assess the safety, efficacy, and cost effectiveness of trastuzumab originators and their biosimilars in real-world clinical settings, focusing on a large patient population.<br>
Methods The analysis included 31,661 patients with HER2-positive breast cancer from the Medical Data Vision Co., Ltd. database in Japan. Additionally, adverse event reports for the trastuzumab originator and its biosimilars were obtained for 58,799 patients from the World Health Organization’s VigiBase, the global adverse event reporting database.<br>
Results No significant differences were observed in heart failure hospitalizations, liver dysfunction, or infusion reaction rates in both the Medical Data Vision Co., Ltd. database and the World Health Organization’s VigiBase. In the Medical Data Vision Co., Ltd. database, the addition of pertuzumab did not significantly influence the incidence of adverse events, and the use of biosimilars significantly reduced medical costs, with no significant difference in breast cancer recurrence rates.<br>
Conclusions By analyzing two large and diverse datasets from multiple perspectives, we obtained reliable results that the trastuzumab originator and its biosimilars have similar safety profiles. The concurrent use of pertuzumab was also found to be safe. The use of biosimilars can lead to cost savings. These findings provide crucial insights for the evaluation and adoption of biosimilars in clinical practice.No potential conflict of interest relevant to this article was reported.Institute of Electrical and Electronics EngineersActa Medica Okayama2169-3536122024MUSIC Spectrum Based Interference Detection, Localization, and Interference Arrival Prediction for mmWave IRS-MIMO System142592142605ENYafeiHouFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityKazutoYanoWave Engineering Laboratories, Advanced Telecommunications Research Institute InternationalNorisatoSugaWave Engineering Laboratories, Advanced Telecommunications Research Institute InternationalJulianWebberWave Engineering Laboratories, Advanced Telecommunications Research Institute InternationalSatoshiDennoFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityToshikazuSakanoWave Engineering Laboratories, Advanced Telecommunications Research Institute InternationalFor a millimeter wave (mmWave) intelligent re-configurable surface (IRS)-MIMO system, if it can correctly detect the interference occurrence and their locations, the patterns of interference signal can be collected and learned using machine learning for the prediction of interference arrival. With the information of interference location and activity pattern, the capacity of the system can be largely improved using many techniques such as beamforming, interference cancellation, and transmission scheduling. This paper aims to detect interference occurrence using a low-complexity MUSIC (MUSIC: multiple signal classification) spectrum-based method, and then localize their sources for mmWave IRS-MIMO system. The MUSIC spectrum of wireless system can be regarded as somehow the 'signature' related to the signals transmitted from different users or interference. We utilize such property to detect the occurrence of interference, and then localize their sources in a low-complexity way. Finally, the pattern of interference occurrence can be learned to predict the interference arrival from the collected data. This paper also proposed an efficient probabilistic neural network (PNN)-based predictor for the interference arrival prediction and showed its prediction accuracy. From simulated results, our proposed method can achieve the correct results with the accuracy near to 100% when the fingerprint samples is over 10. In addition, the localization error can be within 1 m with more than 65% and 43% for Y-axis and X-axis, respectively. Finally, based on the results of the interference occurrence, the proposed PNN-based predictor for the interference arrival prediction can capture correctly the similar distribution function of the coming continuous idle status.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7852024Pediatric Severe Febrile Thrombocytopenia Syndrome: A Case Report and Literature Review401405ENYusukeToyotaDepartment of Pediatrics, NHO Iwakuni Clinical CenterKazuhiroUdaDepartment of Pediatrics, NHO Iwakuni Clinical CenterKomeiShirabeYamaguchi Prefectural Institute of Public Health and EnvironmentTadashiMoriwakeDepartment of Pediatrics, NHO Iwakuni Clinical CenterCase Report10.18926/AMO/67664Severe febrile thrombocytopenia syndrome (SFTS) is a tick-borne infectious disease that is endemic in parts of eastern Asia. Few pediatric cases have been reported. We describe a case of SFTS in a seven-year-old girl who presented with prolonged fever and gastrointestinal symptoms. Leukopenia and thrombocytopenia on hematology, and a history of outdoor activity led us to diagnose SFTS, although the patient had no tick bite marks. We also review the literature and discuss the characteristics of pediatric SFTS. Physicians should consider SFTS in the differential diagnosis of fever with thrombocytopenia in children living in endemic areas.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7852024Effect of Radon Inhalation on Murine Brain Proteins: Investigation Using Proteomic and Multivariate Analyses387399ENShotaNaoeGraduate School of Health Sciences, Okayama UniversityAyumiTanakaGraduate School of Health Sciences, Okayama UniversityNorieKanzakiNingyo-toge Environmental Engineering Center, Japan Atomic Energy AgencyReijuTakenakaGraduate School of Health Sciences, Okayama UniversityAkihiroSakodaNingyo-toge Environmental Engineering Center, Japan Atomic Energy AgencyTakaakiMiyajiAdvanced Science Research Center, Okayama UniversityKiyonoriYamaokaFaculty of Health Sciences, Okayama UniversityTakahiroKataokaFaculty of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/67663Radon is a known risk factor for lung cancer; however, it can be used beneficially, such as in radon therapy. We have previously reported the enhancement of antioxidant effects associated with trace amounts of oxidative stress as one of the positive biological effects of radon inhalation. However, the biological effects of radon inhalation are incompletely understood, and more detailed and comprehensive studies are required. Although several studies have used proteomics to investigate the effects of radon inhalation on body proteins, none has focused on brain proteins. In this study, we evaluated the expression status of proteins in murine brains using proteomic and multivariate analyses to identify those whose expressions changed following two days of radon inhalation at a concentration of 1,500 Bq/m3. We found associations of radon inhalation with the expressions of seven proteins related to neurotransmission and heat shock. These proteins may be proposed as biomarkers indicative of radon inhalation. Although further studies are required to obtain the detailed biological significance of these protein alterations, this study contributes to the elucidation of the biological effects of radon
inhalation as a low-dose radiation.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7852024Phenotypic and Genetic Characteristics of Carbapenemase-Producing Enterobacterales Isolates at Okayama University Hospital371376ENKazuyoshiGotohDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMakotoMiyoshiDepartment of Medical Laboratory Science, Graduate School of Health Sciences, Okayama UniversityI Putu Bayu MayuraDepartment of Clinical Microbiology, Faculty of Medicine, Udayana UniversityShumaTsujiDepartment of Medical Laboratory Science, Graduate School of Health Sciences, Okayama UniversityKojiIioMicrobiology Division, Clinical Laboratory, Okayama University HospitalShinnosukeFukushimaDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOsamuMatsushitaDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalOriginal Article10.18926/AMO/67657Spread of carbapenemase-producing Enterobacterales (CPE) is an ongoing public health issue worldwide, including in Japan. In this study, we investigated the phenotypic and genetic characteristics of CPE isolates at Okayama University Hospital over the 5 years (2013-2018) prior to the outbreak of the 2019 coronavirus pandemic. Of 24 carbapenem-resistant Enterobacterales isolated during the study period, we identified 8 CPE isolates harboring blaIMP-1 (5 isolates) and blaIMP-6 genes (3 isolates). Bacterial species and carbapenem susceptibility patterns exhibited diversity. Minimum inhibitory concentrations (MICs) of meropenem were generally higher than those of imipenem and biapenem. Results of pulsed-field gel electrophoresis demonstrated that neither clonal nor plasmid-mediated outbreaks of blaIMP-harboring CPE isolates have developed at our hospital. One Klebsiella oxytoca isolate showed a high MIC (128 μg/mL) of meropenem, which could be explained by the high plasmid copy number. Subsequent analysis of this isolate may elucidate the intricacies of carbapenem resistance profiles among CPE isolates. Collectively, our findings underscore the necessity for ongoing genetic surveillance of CPE, complemented by tailored approaches for infection prevention and control.No potential conflict of interest relevant to this article was reported.Nature PortfolioActa Medica Okayama2399-3642712024Contribution of collagen-binding protein Cnm of Streptococcus mutans to induced IgA nephropathy-like nephritis in rats1141ENShuheiNakaDepartment of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaikiMatsuokaDepartment of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTaroMisakiDivision of Nephrology, Seirei Hamamatsu General HospitalYasuyukiNagasawaDepartment of General Internal Medicine, Hyogo College of MedicineSeigoItoDepartment of Internal Medicine, Japan Self-Defense Force Iruma HospitalRyotaNomuraDepartment of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityKazuhikoNakanoDepartment of Pediatric Dentistry, Graduate School of Dentistry, The University of OsakaMichiyoMatsumoto-NakanoDepartment of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesIgA nephropathy (IgAN), the most common primary glomerulonephritis, is considered an intractable disease with unknown pathogenic factors. In our previous study, Streptococcus mutans, the major causative bacteria of dental caries, which expresses Cnm, was related to the induction of IgAN-like nephritis. In the present study, the Cnm-positive S. mutans parental strain, a Cnm-defective isogenic mutant strain, its complementation strain, and recombinant Cnm (rCnm) protein were administered intravenously to Sprague Dawley rats, and the condition of their kidneys was evaluated focusing on the pathogenicity of Cnm. Rats treated with parental and complement bacterial strains and rCnm protein developed IgAN-like nephritis with mesangial proliferation and IgA and C3 mesangial deposition. Scanning immunoelectron microscopy revealed that rCnm was present in the electron-dense deposition area of the mesangial region in the rCnm protein group. These results demonstrated that the Cnm protein itself is an important factor in the induction of IgAN in rats.No potential conflict of interest relevant to this article was reported.Nature PortfolioActa Medica Okayama2045-23221412024Suppression of PTBP1 in hippocampal astrocytes promotes neurogenesis and ameliorates recognition memory in mice with cerebral ischemia20521ENYusukeFukuiDepartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRyutaMoriharaDepartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityXinranHuDepartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYumikoNakanoDepartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTaijunYunokiDepartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMamiTakemotoDepartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKojiAbeDepartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToruYamashitaDepartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityThe therapeutic potential of suppressing polypyrimidine tract-binding protein 1 (Ptbp1) messenger RNA by viral transduction in a post-stroke dementia mouse model has not yet been examined. In this study, 3 days after cerebral ischemia, we injected a viral vector cocktail containing adeno-associated virus (AAV)-pGFAP-mCherry and AAV-pGFAP-CasRx (control vector) or a cocktail of AAV-pGFAP-mCherry and AAV-pGFAP-CasRx-SgRNA-(Ptbp1) (1:5, 1.0 x 1011 viral genomes) into post-stroke mice via the tail vein. We observed new mCherry/NeuN double-positive neuron-like cells in the hippocampus 56 days after cerebral ischemia. A portion of mCherry/GFAP double-positive astrocyte-like glia could have been converted into new mCherry/NeuN double-positive neuron-like cells with morphological changes. The new neuronal cells integrated into the dentate gyrus and recognition memory was significantly ameliorated. These results demonstrated that the in vivo conversion of hippocampal astrocyte-like glia into functional new neurons by the suppression of Ptbp1 might be a therapeutic strategy for post-stroke dementia.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama2073-89941682024An Enhanced Active Access-Point Configuration Algorithm Using the Throughput Request Satisfaction Method for an Energy-Efficient Wireless Local-Area Network1005ENBinWuGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityNobuoFunabikiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityDezhengKongGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityXuanWangGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTaishiroSetoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYu-ChengFanDepartment of Electronic Engineering, National Taipei University of TechnologyWireless Local-Area Networks (WLANs), as a popular internet access solution, are widely used in numerous places, including enterprises, campuses, and public venues. As the number of devices increases, large-scale deployments will cause the problem of dense wireless networks, including a lot of energy consumption. Thus, the optimization of energy-efficient wireless AP devices has become a focal point of attention. To reduce energy consumption, we have proposed the active access-point (AP) configuration algorithm for WLANs using APs with a dual interface. This uses the greedy algorithm combined with the local search optimization method to find the minimum number of activated APs while satisfying the minimum throughput constraint. However, the previous algorithm basically satisfies only the average throughput among the multiple hosts associated with one AP, wherein some hosts may not reach the required one. In this paper, to overcome this limitation, we propose an enhanced active AP configuration algorithm by incorporating the throughput request satisfaction method that controls the actual throughput at the target value (target throughput) for every host by applying traffic shaping. The target throughput is calculated from the single and concurrent communicating throughput of each host based on channel occupancy time. The minimum throughput constraint will be iteratively adjusted to obtain the required target throughput and achieve the fair throughput allocation. For evaluations, we conducted simulations using the WIMNET simulator and experiments using the testbed system with a Raspberry Pi 4B for APs in four topology cases with five APs and ten hosts. The results show that the proposed method always achieved the required minimum throughput in simulations as well as in experiments, while minimizing the number of active APs. Thus, the validity and effectiveness of our proposal were confirmed.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0031-6768476112024The role of GABA in modulation of taste signaling within the taste bud17611775ENAyakaMikamiDepartment of Oral Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHaiHuangDepartment of Oral Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAikoHyodoDepartment of Oral Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKengoHorieDepartment of Oral Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKeikoYasumatsuTokyo Dental Junior CollegeYuzoNinomiyaDepartment of Oral Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshihiroMitohDepartment of Oral Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySeijiIidaDepartment of Oral and Maxillofacial Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRyusukeYoshidaDepartment of Oral Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTaste buds contain 2 types of GABA-producing cells: sour-responsive Type III cells and glial-like Type I cells. The physiological role of GABA, released by Type III cells is not fully understood. Here, we investigated the role of GABA released from Type III cells using transgenic mice lacking the expression of GAD67 in taste bud cells (Gad67-cKO mice). Immunohistochemical experiments confirmed the absence of GAD67 in Type III cells of Gad67-cKO mice. Furthermore, no difference was observed in the expression and localization of cell type markers, ectonucleoside triphosphate diphosphohydrolase 2 (ENTPD2), gustducin, and carbonic anhydrase 4 (CA4) in taste buds between wild-type (WT) and Gad67-cKO mice. Short-term lick tests demonstrated that both WT and Gad67-cKO mice exhibited normal licking behaviors to each of the five basic tastants. Gustatory nerve recordings from the chorda tympani nerve demonstrated that both WT and Gad67-cKO mice similarly responded to five basic tastants when they were applied individually. However, gustatory nerve responses to sweet–sour mixtures were significantly smaller than the sum of responses to each tastant in WT mice but not in Gad67-cKO mice. In summary, elimination of GABA signalling by sour-responsive Type III taste cells eliminates the inhibitory cell–cell interactions seen with application of sour–sweet mixtures.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1347-9032115112024High-quality expert annotations enhance artificial intelligence model accuracy for osteosarcoma X-ray diagnosis36953704ENJoeHaseiDepartment of Medical Information and Assistive Technology Development, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyuichiNakaharaDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYujiroOtsukaDepartment of Radiology, Juntendo University School of MedicineYusukeNakamuraDepartment of Radiology, Juntendo University School of MedicineTamiyaHironariDepartment of Musculoskeletal Oncology Service, Osaka International Cancer InstituteNaoakiKaharaDepartment of Orthopedic Surgery, Mizushima Central HospitalShinjiMiwa Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical SciencesShusaOhshikaDepartment of Orthopedic Surgery, Hirosaki University Graduate School of MedicineShunjiNishimuraDepartment of Orthopedic Surgery, Kindai University HospitalKunihiroIkutaDepartment of Orthopedic Surgery, Nagoya University Graduate School of MedicineShuheiOsakiDepartment of Musculoskeletal Oncology, National Cancer Center HospitalAkiYoshidaDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomohiroFujiwaraDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEijiNakataDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiyukiKunisadaDepartment 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 SciencesPrimary malignant bone tumors, such as osteosarcoma, significantly affect the pediatric and young adult populations, necessitating early diagnosis for effective treatment. This study developed a high-performance artificial intelligence (AI) model to detect osteosarcoma from X-ray images using highly accurate annotated data to improve diagnostic accuracy at initial consultations. Traditional models trained on unannotated data have shown limited success, with sensitivities of approximately 60%–70%. In contrast, our model used a data-centric approach with annotations from an experienced oncologist, achieving a sensitivity of 95.52%, specificity of 96.21%, and an area under the curve of 0.989. The model was trained using 468 X-ray images from 31 osteosarcoma cases and 378 normal knee images with a strategy to maximize diversity in the training and validation sets. It was evaluated using an independent dataset of 268 osteosarcoma and 554 normal knee images to ensure generalizability. By applying the U-net architecture and advanced image processing techniques such as renormalization and affine transformations, our AI model outperforms existing models, reducing missed diagnoses and enhancing patient outcomes by facilitating earlier treatment. This study highlights the importance of high-quality training data and advocates a shift towards data-centric AI development in medical imaging. These insights can be extended to other rare cancers and diseases, underscoring the potential of AI in transforming diagnostic processes in oncology. The integration of this AI model into clinical workflows could support physicians in early osteosarcoma detection, thereby improving diagnostic accuracy and patient care.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0029-85492061-22024Does a coexisting congener of a mixed mating species affect the genetic structure and selfing rate via reproductive interference?3745ENKoki R.KatsuharaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityAtushiUshimaruGraduate School of Human Development and Environment, Kobe UniversityYukoMiyazakiFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityReproductive interference is defined as an interspecific interaction that reduces fitness via mating processes. Although its ecological and evolutionary consequences have attracted much attention, how reproductive interference affects the population genetic structures of interacting species is still unclear. In flowering plants, recent studies found that self-pollination can mitigate the negative effects of reproductive interference. Selfing-biased seed production is expected to increase population-level inbreeding and the selfing rate, and limits gene flow via pollinator outcrossing among populations. We examined the population genetics of the mixed-mating annual herb Commelina communis f. ciliata, focusing on reproductive interference by the sympatric competing congener C. communis using microsatellite markers. First, we found that almost all C. c. f. ciliata populations had relatively high inbreeding coefficients. Then, comparing sympatric and allopatric populations, we found evidence that reproductive interference from a competing congener increased the inbreeding coefficient and selfing rate. Allopatric populations exhibit varied selfing rates while almost all sympatric populations exhibit extremely high selfing rates, suggesting that population selfing rates were also influenced by unexamined factors, such as pollinator limitation. Besides, our findings revealed that reproductive interference from a competing congener did not limit gene flow among populations. We present the first report on how reproductive interference affects the genetic aspects of populations. Our results suggested that the high selfing rate of C. c. f. ciliata promotes its sympatric distribution with C. communis, even in the presence of reproductive interference, although it is not clear whether reproductive interference directly causes the high selfing rate.No potential conflict of interest relevant to this article was reported.Nature PortfolioActa Medica Okayama2045-23221412024Human heart-on-a-chip microphysiological system comprising endothelial cells, fibroblasts, and iPSC-derived cardiomyocytes18063ENYunLiuDepartment of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRumaisaKamranDepartment of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityXiaoxiaHanDepartment of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMengxueWangDepartment of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityQiangLiDepartment of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityDaoyueLaiDepartment of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKeijiNaruseDepartment of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKenTakahashiDepartment of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityIn recent years, research on organ-on-a-chip technology has been flourishing, particularly for drug screening and disease model development. Fibroblasts and vascular endothelial cells engage in crosstalk through paracrine signaling and direct cell-cell contact, which is essential for the normal development and function of the heart. Therefore, to faithfully recapitulate cardiac function, it is imperative to incorporate fibroblasts and vascular endothelial cells into a heart-on-a-chip model. Here, we report the development of a human heart-on-a-chip composed of induced pluripotent stem cell (iPSC)-derived cardiomyocytes, fibroblasts, and vascular endothelial cells. Vascular endothelial cells cultured on microfluidic channels responded to the flow of culture medium mimicking blood flow by orienting themselves parallel to the flow direction, akin to in vivo vascular alignment in response to blood flow. Furthermore, the flow of culture medium promoted integrity among vascular endothelial cells, as evidenced by CD31 staining and lower apparent permeability. The tri-culture condition of iPSC-derived cardiomyocytes, fibroblasts, and vascular endothelial cells resulted in higher expression of the ventricular cardiomyocyte marker IRX4 and increased contractility compared to the bi-culture condition with iPSC-derived cardiomyocytes and fibroblasts alone. Such tri-culture-derived cardiac tissues exhibited cardiac responses similar to in vivo hearts, including an increase in heart rate upon noradrenaline administration. In summary, we have achieved the development of a heart-on-a-chip composed of cardiomyocytes, fibroblasts, and vascular endothelial cells that mimics in vivo cardiac behavior.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7842024Surgical Treatment of an Abdominal Aortic Aneurysm in a Patient with a Liver Abscess345347ENGentaroKatoDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalYutoNarumiyaDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalMichihiroOkuyamaDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalShujiShimizuDepartment of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University HospitalKenjiSangawaDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalShuYamamotoDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalCase Report10.18926/AMO/67553The presence of an intraperitoneal source of infection, e.g., a liver abscess, can be an obstacle to performing an abdominal aortic surgery with a midline laparotomy because graft infection is one of the most critical complications of aortic surgery. We report the successful Y-grafting of a pararenal abdominal aortic aneurysm through a retroperitoneal approach in a 67-year-old male undergoing liver abscess drainage. The retroperitoneal approach to the abdominal aorta may be useful for abdominal aortic surgery in patients with a localized intraperitoneal infection.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7842024A Rare Subglottic Pleomorphic Adenoma: Magnetic Resonance Findings331335ENChiekoFurukawaDepartment of Otolaryngology Head and Neck Surgery, Japanese Red Cross Society Himeji HospitalTomoyasuTachibanaDepartment of Otolaryngology Head and Neck Surgery, Japanese Red Cross Society Himeji HospitalTetsujiNobuhisaDepartment of Surgery, Japanese Red Cross Society Himeji HospitalYuichiroKanieDepartment of Radiology, Japanese Red Cross Society Himeji HospitalYojiWaniDepartment of Pathology, Japanese Red Cross Society Himeji HospitalJun-YaMatsumotoDepartment of Otolaryngology Head and Neck Surgery, Japanese Red Cross Society Himeji HospitalAkifumiKariyaDepartment of Otolaryngology Head and Neck Surgery, Japanese Red Cross Society Himeji HospitalAsukaSatoDepartment of Otolaryngology Head and Neck Surgery, Japanese Red Cross Society Himeji HospitalIichiroIshikawaDepartment of Surgery, Japanese Red Cross Society Himeji HospitalYutoNaoiDepartment 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 SciencesCase Report10.18926/AMO/67549No previous study has published magnetic resonance imaging (MRI) findings for a subglottic pleomorphic adenoma. Here, we describe the case of a 62-year-old man with a subglottic pleomorphic adenoma. Endoscopic findings revealed a smooth-surfaced tumor arising from the subglottic posterior wall. MRI revealed the lesion as an isointense region on T1-weighted images, which was homogeneously enhanced. This lesion showed a heterogeneously hyperintense region on T2-weighted images. Diffusion-weighted imaging (DWI) showed slightly high intensity in the same area, with a normal or only slightly high apparent diffusion coefficient (ADC). Laryngomicrosurgery was performed for transoral excision of the subglottic tumor, resulting in a postsurgical diagnosis of pleomorphic adenoma.No potential conflict of interest relevant to this article was reported.BMCActa Medica Okayama2051-59601212024Pure argyrophilic grain disease revisited: independent effects on limbic, neocortical, and striato-pallido-nigral degeneration and the development of dementia in a series with a low to moderate Braak stage121ENOsamuYokotaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokoMikiDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHanaeNakashima-YasudaOkayama University Medical School HidekiIshizuOkayama University Medical School TakashiHaraguchiDepartment of Neurology, National Hospital Organization Minami Okayama Medical CenterChikakoIkedaOkayama University Medical School MasatoHasegawaDementia Research Project, Tokyo Metropolitan Institute of Medical ScienceAkinoriMiyashitaDepartment of Molecular Genetics, Brain Research Institute, Niigata UniversityTakeshiIkeuchiDepartment of Molecular Genetics, Brain Research Institute, Niigata UniversityNaotoNishikawaDepartment of Neuropsychiatry, Okayama University HospitalShintaroTakenoshitaDepartment of Neuropsychiatry, Okayama University HospitalKoichiroSudoDepartment of Psychiatry, Tosa HospitalSeishiTeradaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesManabuTakakiDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAgyrophilic grains (AGs) are age-related limbic-predominant lesions in which four-repeat tau is selectively accumulated. Because previous methodologically heterogeneous studies have demonstrated inconsistent findings on the relationship between AGs and dementia, whether AGs affect cognitive function remains unclear. To address this question, we first comprehensively evaluated the distribution and quantity of Gallyas-positive AGs and the severity of neuronal loss in the limbic, neocortical, and subcortical regions in 30 cases of pure argyrophilic grain disease (pAGD) in Braak stages I-IV and without other degenerative diseases, and 34 control cases that had only neurofibrillary tangles with Braak stages I-IV and no or minimal A beta deposits. Then, we examined whether AGs have independent effects on neuronal loss and dementia by employing multivariate ordered logistic regression and binomial logistic regression. Of 30 pAGD cases, three were classified in diffuse form pAGD, which had evident neuronal loss not only in the limbic region but also in the neocortex and subcortical nuclei. In all 30 pAGD cases, neuronal loss developed first in the amygdala, followed by temporo-frontal cortex, hippocampal CA1, substantia nigra, and finally, the striatum and globus pallidus with the progression of Saito AG stage. In multivariate analyses of 30 pAGD and 34 control cases, the Saito AG stage affected neuronal loss in the amygdala, hippocampal CA1, temporo-frontal cortex, striatum, globus pallidus, and substantia nigra independent of the age, Braak stage, and limbic-predominant age-related TDP-43 encephalopathy (LATE-NC) stage. In multivariate analyses of 23 pAGD and 28 control cases that lacked two or more lacunae and/or one or more large infarctions, 100 or more AGs per x 400 visual field in the amygdala (OR 10.02, 95% CI 1.12-89.43) and hippocampal CA1 (OR 12.22, 95% CI 1.70-87.81), and the presence of AGs in the inferior temporal cortex (OR 8.18, 95% CI 1.03-65.13) affected dementia independent of age, moderate Braak stages (III-IV), and LATE-NC. Given these findings, the high density of limbic AGs and the increase of AGs in the inferior temporal gyrus may contribute to the occurrence of dementia through neuronal loss, at least in cases in a low to moderate Braak stage.No potential conflict of interest relevant to this article was reported.Nature PortfolioActa Medica Okayama2041-17231512024Controlling 229Th isomeric state population in a VUV transparent crystal5536ENTakahiroHirakiResearch Institute for Interdisciplinary Science, Okayama UniversityKoichiOkaiResearch Institute for Interdisciplinary Science, Okayama UniversityMichaelBartokosInstitute for Atomic and Subatomic Physics, TU WienKjeldBeeksInstitute for Atomic and Subatomic Physics, TU WienHiroyukiFujimotoNational Institute of Advanced Industrial Science and Technology (AIST)YutaFukunagaResearch Institute for Interdisciplinary Science, Okayama UniversityHiromitsuHabaRIKENYoshitakaKasamatsuGraduate School of Science, Osaka UniversityShinjiKitaoInstitute for Integrated Radiation and Nuclear Science, Kyoto UniversityAdrianLeitnerInstitute for Atomic and Subatomic Physics, TU WienTakahikoMasudaResearch Institute for Interdisciplinary Science, Okayama UniversityMingGuanResearch Institute for Interdisciplinary Science, Okayama UniversityNobumotoNagasawaJapan Synchrotron Radiation Research InstituteRyoichiroOgakeResearch Institute for Interdisciplinary Science, Okayama UniversityMartinPimonInstitute for Atomic and Subatomic Physics, TU WienMartinPresslerInstitute for Atomic and Subatomic Physics, TU WienNoboruSasaoResearch Institute for Interdisciplinary Science, Okayama UniversityFabianSchadenInstitute for Atomic and Subatomic Physics, TU WienThorstenSchummInstitute for Atomic and Subatomic Physics, TU WienMakotoSetoInstitute for Integrated Radiation and Nuclear Science, Kyoto UniversityYudaiShigekawaRIKENKotaroShimizuResearch Institute for Interdisciplinary Science, Okayama UniversityTomasSikorskyInstitute for Atomic and Subatomic Physics, TU WienKenjiTamasakuRIKEN SPring-8 CenterSayuriTakatoriResearch Institute for Interdisciplinary Science, Okayama UniversityTsukasaWatanabeNational Institute of Advanced Industrial Science and Technology (AIST)AtsushiYamaguchiRIKENYoshitakaYodaJapan Synchrotron Radiation Research InstituteAkihiroYoshimiResearch Institute for Interdisciplinary Science, Okayama UniversityKojiYoshimuraResearch Institute for Interdisciplinary Science, Okayama UniversityThe radioisotope thorium-229 (Th-229) is renowned for its extraordinarily low-energy, long-lived nuclear first-excited state. This isomeric state can be excited by vacuum ultraviolet (VUV) lasers and Th-229 has been proposed as a reference transition for ultra-precise nuclear clocks. To assess the feasibility and performance of the nuclear clock concept, time-controlled excitation and depopulation of the Th-229 isomer are imperative. Here we report the population of the Th-229 isomeric state through resonant X-ray pumping and detection of the radiative decay in a VUV transparent Th-229-doped CaF2 crystal. The decay half-life is measured to 447(25) s, with a transition wavelength of 148.18(42) nm and a radiative decay fraction consistent with unity. Furthermore, we report a new "X-ray quenching" effect which allows to de-populate the isomer on demand and effectively reduce the half-life. Such controlled quenching can be used to significantly speed up the interrogation cycle in future nuclear clock schemes.No potential conflict of interest relevant to this article was reported.Royal Society of ChemistryActa Medica Okayama2046-206914322024Lead-free iron-doped Cs3Bi2Br9 perovskite with tunable properties2317723183ENThiriHtunGraduate School of Natural Science and Technology, Okayama UniversityAmrElattarDepartment of Chemistry, Faculty of Science, Ain Shams UniversityHythamElbohyPhysics Department, Faculty of Science, Damietta UniversityKoseiTsutsumiGraduate School of Natural Science and Technology, Okayama UniversityKazumasaHoriganeResearch Institute for Interdisciplinary Science, Okayama UniversityChiyuNakanoAdvanced Science Research Center, Okayama UniversityXiaoyuGuGuangdong University Key Laboratory for Advanced Quantum Dot Displays and Lighting and Department of Electronic & Electrical Engineering, Southern University of Science and TechnologyHirooSuzukiGraduate School of Natural Science and Technology, Okayama UniversityTakeshiNishikawaGraduate School of Natural Science and Technology, Okayama UniversityAung Ko KoKyawGuangdong University Key Laboratory for Advanced Quantum Dot Displays and Lighting and Department of Electronic & Electrical Engineering, Southern University of Science and TechnologyYasuhikoHayashiGraduate School of Natural Science and Technology, Okayama UniversityPerovskite based on cesium bismuth bromide offers a compelling, non-toxic alternative to lead-containing counterparts in optoelectronic applications. However, its widespread usage is hindered by its wide bandgap. This study investigates a significant bandgap tunability achieved by introducing Fe doping into the inorganic, lead-free, non-toxic, and stable Cs3Bi2Br9 perovskite at varying concentrations. The materials were synthesized using a facile method, with the aim of tuning the optoelectronic properties of the perovskite materials. Characterization through techniques such as X-ray diffraction, Raman spectroscopy, X-ray photoelectron spectroscopy, energy dispersive spectroscopy (EDS), and UV-vis spectroscopy was conducted to elucidate the transformation mechanism of the doping materials. The substitution process results in a significant change in the bandgap energy, transforming from the pristine Cs3Bi2Br9 with a bandgap of 2.54 eV to 1.78 eV upon 70% Fe doping. The addition of 50% Fe in Cs3Bi2Br9 leads to the formation of the orthorhombic structure in Cs2(Bi,Fe)Br5 perovskite, while complete Fe alloying at 100% results in the phase formation of CsFeBr4 perovskite. Our findings on regulation of bandgap energy and crystal structure through B site substitution hold significant promise for applications in optoelectronics.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1474-905X2382024Intramolecular [π4s + π4s] photocycloaddition of carbon- and nitrogen-bridged [32](1,4)naphthalenophanes15091519ENYukikoOgumaDivision of Earth, Life, and Molecular Sciences, Graduate School of Natural Science and Technology, Okayama UniversityMasanoriYamamotoDivision of Earth, Life, and Molecular Sciences, Graduate School of Natural Science and Technology, Okayama UniversityYukinariSunatsukiDivision of Earth, Life, and Molecular Sciences, Graduate School of Natural Science and Technology, Okayama UniversityHiromiOtaDepartment of Instrumental Analysis, Advanced Science Research Center, Okayama UniversityMinoruYamajiDivision of Molecular Science, Graduate School of Science and Engineering, Gunma UniversityHidekiOkamotoDivision of Earth, Life, and Molecular Sciences, Graduate School of Natural Science and Technology, Okayama University[32](1,4)Naphthalenophanes, bearing carbon-bridge chains (syn- and anti-NPs) and nitrogen-bridge chains (syn- and anti-ANPs), were synthesized, and their X-ray structures and photoreactions were investigated. The intramolecular separation distance between the naphthalene cores for ANPs was shorter than that for NPs, suggesting that intramolecular interactions between the naphthalene rings were more efficient for ANPs compared to NPs. Upon photoirradiation at 300 nm, anti-NP, syn-ANP and anti-ANP produced the corresponding intramolecular [π4s + π4s] cycloadducts, whereas syn-NP gave an unidentified complex product mixture. Quantum yields for the photo-consumption (ΦPC) of NPs and ANPs were evaluated to quantitatively compare their photoreactivity. The ΦPC values of ANPs were approximately two-fold higher than those of ANPs.Noteworthily, the ΦPC value of syn-ANP was estimated to be unity. Based on these results we discuss the effects of the alignments of the naphthalene cores (anti vs. syn) and the bridging elements (C-bridge vs. N-bridge) on the photoreaction efficiencies of [32](1,4)naphthalenophanes.No potential conflict of interest relevant to this article was reported.Oxford University PressActa Medica Okayama0449-30606542024Comparison of mutation spectra induced by gamma-rays and carbon ion beams491499ENYukaTokuyamaAnalytical Research Center for Experimental Science, Saga UniversityKanaeMoriAnalytical Research Center for Experimental Science, Saga UniversityMidoriIsobeAdvanced Science Research Center, Okayama UniversityHiroakiTeratoAdvanced Science Research Center, Okayama UniversityThe ionizing radiation with high linear energy transfer (LET), such as a heavy ion beam, induces more serious biological effects than low LET ones, such as gamma- and X-rays. This indicates a difference in the DNA damage produced by low and high LET radiations and their biological effects. We have been studying the differences in DNA damage produced by gamma-rays and carbon ion beams. Therefore, we analyze mutations induced by both ionizing radiations to discuss the differences in their biological effects in this study. pUC19 plasmid DNA was irradiated by carbon ion beams in the solution containing 1M dimethyl sulfoxide to mimic a cellular condition. The irradiated DNA was cloned in competent cells of Escherichia coli. The clones harboring some mutations in the region of lacZ alpha were selected, and the sequence alterations were analyzed. A one-deletion mutation is significant in the carbon-irradiated DNA, and the C:G <-> T:A transition is minor. On the other hand, the gamma-irradiated DNA shows mainly G:C <-> T:A transversion. These results suggest that carbon ion beams produce complex DNA damage, and gamma-rays are prone to single oxidative base damage, such as 8-oxoguanine. Carbon ion beams can also introduce oxidative base damage, and the damage species is 5-hydroxycytosine. This was consistent with our previous results of DNA damage caused by heavy ion beams. We confirmed the causal DNA damage by mass spectrometry for these mutations.No potential conflict of interest relevant to this article was reported.Zoological Society of JapanActa Medica Okayama0289-00034132024Volume X-Ray Micro-Computed Tomography Analysis of the Early Cephalized Central Nervous System in a Marine Flatworm, Stylochoplana pusilla281289ENTakanoriIkenagaGraduate School of Science and Engineering, Kagoshima UniversityAoshiKobayashiUshimado Marine Institute (UMI), Faculty of Environmental, Life, Natural Science and Technology, Okayama UniversityAkihisaTakeuchiJapan Synchrotron Radiation Research Institute/SPring-8KentaroUesugiJapan Synchrotron Radiation Research Institute/SPring-8TakanobuMaezawaDepartment of Integrated Science and Technology, National Institute of Technology, Tsuyama CollegeNoritoShibataDepartment of Integrated Science and Technology, National Institute of Technology, Tsuyama CollegeTatsuyaSakamotoUshimado Marine Institute (UMI), Faculty of Environmental, Life, Natural Science and Technology, Okayama UniversityHirotakaSakamotoUshimado Marine Institute (UMI), Faculty of Environmental, Life, Natural Science and Technology, Okayama UniversityPlatyhelminthes are a phylum of simple bilaterian invertebrates with prototypic body systems. Compared with non-bilaterians such as cnidarians, the bilaterians are likely to exhibit integrated free-moving behaviors, which require a concentrated nervous system “brain” rather than the distributed nervous system of radiatans. Marine flatworms have an early cephalized ‘central’ nervous system compared not only with non-bilaterians but also with parasitic flatworms or freshwater planarians. In this study, we used the marine flatworm Stylochoplana pusilla as an excellent model organism in Platyhelminthes because of the early cephalized central nervous system. Here, we investigated the three-dimensional structures of the flatworm central nervous system by the use of X-ray micro-computed tomography (micro-CT) in a synchrotron radiation facility. We found that the obtained tomographic images were sufficient to discriminate some characteristic structures of the nervous system, including nerve cords around the cephalic ganglion, mushroom body-like structures, and putative optic nerves forming an optic commissure-like structure. Through the micro-CT imaging, we could obtain undistorted serial section images, permitting us to visualize precise spatial relationships of neuronal subpopulations and nerve tracts. 3-D micro-CT is very effective in the volume analysis of the nervous system at the cellular level; the methodology is straightforward and could be applied to many other non-model organisms.No potential conflict of interest relevant to this article was reported.Frontiers MediaActa Medica Okayama2296-858X112024Late-onset renal variant Fabry disease with R112H mutation and mild increase in plasma globotriaosylsphingosine: a case report1383309ENKeikoTanakaFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama UniversityHitoshiSugiyamaFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama UniversityHiroshiMorinagaFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama UniversityAkifumiOnishiDepartment of Nephrology, Fukuyama City HospitalKatsuyukiTanabeFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama UniversityHaruhito A.UchidaFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama UniversityHirokiMaruyamaDepartment of Clinical Nephroscience, Niigata University Graduate School of Medical and Dental SciencesJunWadaFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama UniversityFabry disease (FD) is an X-linked disorder resulting in a deficiency of alpha-galactosidase A (GLA) activity. The R112H mutation of GLA is relatively common in Japanese FD patients, characterized by a late-onset phenotype, almost normal to mild lyso-Gb3 elevation, and mild clinical symptoms, despite low GLA activity. This is due to the structural features of the R112H GLA protein. We herein report the case of a 42-year-old male patient with late-onset FD with a R112H mutation. The patient exhibited only renal involvement with no other organ damage and was successfully treated with galactosidase beta and subsequent migalastat for approximately 10 years. Especially, migalastat was clinically effective in normalizing plasma lyso-Gb3 levels and inhibiting the progression of renal damage associated with FD. Therefore, the use of migalastat in the FD patients with R112H mutation is highly recommended based on this case report.No potential conflict of interest relevant to this article was reported.Nature PortfolioActa Medica Okayama2041-17231512024Strain-induced long-range charge-density wave order in the optimally doped Bi2Sr2-x Lax CuO6 superconductor5082ENShinjiKawasakiDepartment of Physics, Okayama UniversityNaoTsukudaDepartment of Physics, Okayama UniversityChengtianLinMax-Planck-Institut fur FestkorperforschungGuo-QingZhengDepartment of Physics, Okayama UniversityThe mechanism of high-temperature superconductivity in copper oxides (cuprate) remains elusive, with the pseudogap phase considered a potential factor. Recent attention has focused on a long-range symmetry-broken charge-density wave (CDW) order in the underdoped regime, induced by strong magnetic fields. Here by Cu-63,Cu-65-nuclear magnetic resonance, we report the discovery of a long-range CDW order in the optimally doped Bi2Sr2-xLaxCuO6 superconductor, induced by in-plane strain exceeding divided by epsilon divided by = 0.15 %, which deliberately breaks the crystal symmetry of the CuO2 plane. We find that compressive/tensile strains reduce superconductivity but enhance CDW, leaving superconductivity to coexist with CDW. The findings show that a long-range CDW order is an underlying hidden order in the pseudogap state, not limited to the underdoped regime, becoming apparent under strain. Our result sheds light on the intertwining of various orders in the cuprates.No potential conflict of interest relevant to this article was reported.Nature PortfolioActa Medica Okayama2045-23221412024Palaeoproteomic investigation of an ancient human skeleton with abnormal deposition of dental calculus5938ENYokoUchida-FukuharaDepartment of Oral Morphology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShigeruShimamuraInstitute for Extra-Cutting-Edge Science and Technology Avant-Garde Research (X-STAR), Japan Agency for Marine-Earth Science and Technology (JAMSTEC)RikaiSawafujiResearch Center for Integrative Evolutionary Science, The Graduate University for Advanced Studies (SOKENDAI)TakumiNishiuchiResearch Center for Experimental Modeling of Human Disease, Kanazawa UniversityMinoruYonedaThe University Museum, The University of TokyoHajimeIshidaDepartment of Human Biology and Anatomy, Graduate School of Medicine, University of the RyukyusHirofumiMatsumuraSchool of Health Sciences, Sapporo Medical UniversityTakumiTsutayaResearch Center for Integrative Evolutionary Science, The Graduate University for Advanced Studies (SOKENDAI)Detailed investigation of extremely severe pathological conditions in ancient human skeletons is important as it could shed light on the breadth of potential interactions between humans and disease etiologies in the past. Here, we applied palaeoproteomics to investigate an ancient human skeletal individual with severe oral pathology, focusing our research on bacterial pathogenic factors and host defense response. This female skeleton, from the Okhotsk period (i.e., fifth to thirteenth century) of Northern Japan, poses relevant amounts of abnormal dental calculus deposition and exhibits oral dysfunction due to severe periodontal disease. A shotgun mass-spectrometry analysis identified 81 human proteins and 15 bacterial proteins from the calculus of the subject. We identified two pathogenic or bioinvasive proteins originating from two of the three "red complex" bacteria, the core species associated with severe periodontal disease in modern humans, as well as two additional bioinvasive proteins of periodontal-associated bacteria. Moreover, we discovered defense response system-associated human proteins, although their proportion was mostly similar to those reported in ancient and modern human individuals with lower calculus deposition. These results suggest that the bacterial etiology was similar and the host defense response was not necessarily more intense in ancient individuals with significant amounts of abnormal dental calculus deposition.No potential conflict of interest relevant to this article was reported.Nature PortfolioActa Medica Okayama2045-23221412024Absolute lymphocyte count and neutrophil-to-lymphocyte ratio as predictors of CDK 4/6 inhibitor efficacy in advanced breast cancer9869ENShogoNakamotoDepartment of Breast and Endocrine Surgery, Okayama University HospitalTadahikoShienDepartment of Breast and Endocrine Surgery, Okayama University HospitalTakayukiIwamotoDepartment of Breast and Endocrine Surgery, Okayama University HospitalShinichiroKuboDepartment of Breast and Thyroid Surgery, Fukuyama City HospitalMariYamamotoDepartment of Breast and Thyroid Surgery, Fukuyama City HospitalTetsumasaYamashitaDepartment of Breast and Thyroid Surgery, Fukuyama City HospitalChihiroKuwaharaDepartment of Breast and Thyroid Surgery, Fukuyama City HospitalMasahikoIkedaDepartment of Breast and Thyroid Surgery, Fukuyama City HospitalCyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) are the standard agents for treating patients with estrogen receptor-positive and human epidermal growth factor receptor 2-negative advanced breast cancer (ER + HER2 - ABC). However, markers predicting the outcomes of CDK4/6i treatment have yet to be identified. This study was a single-center retrospective cohort study. We retrospectively evaluated 101 patients with ER + HER2 - ABC receiving CDK4/6i in combination with endocrine therapy at Fukuyama City Hospital between November 2017 and July 2021. We investigated the clinical outcomes and the safety of CDK4/6i treatment, and the absolute lymphocyte count (ALC) and neutrophil-to-lymphocyte ratio (NLR) as predictive markers for CDK4/6i. We defined the cut-off values as 1000/mu L for ALC and 3 for NLR, and divided into "low" and "high" groups, respectively. We evaluated 43 and 58 patients who received abemaciclib and palbociclib, respectively. Patients with high ALC and low NLR had significantly longer overall survival than those with low ALC and high NLR (high vs. low; ALC: HR 0.29; 95% CI 0.12-0.70; NLR: HR 2.94; 95% CI 1.21-7.13). There was no significant difference in efficacy between abemaciclib and palbociclib and both had good safety profiles. We demonstrated that ALC and NLR might predict the outcomes of CDK4/6i treatment in patients with ER + HER2 - ABC.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7832024Palliative Gamma Knife Radiosurgery for a Small Part of a Large Vestibular Schwannoma in an Elderly Patient301306ENKiyoshiNakazakiDepartment of Neurosurgery, Brain Attack Center Ota Memorial HospitalSatoshiHiraiDepartment of Neurosurgery, Kawasaki Medical SchoolTomohitoHishikawaDepartment of Neurosurgery, Kawasaki Medical SchoolCase Report10.18926/AMO/67207We report a case of a large vestibular schwannoma in an 80-year-old female patient that shrank after palliative Gamma Knife radiosurgery (GKS). Neurological symptoms included hearing deterioration and facial palsy. The tumor volume was 21.9 mL. Craniotomy was considered high-risk, and conventional GKS was risky, owing to the risk of transient enlargement. Therefore, GKS was performed on only a portion of the tumor. The marginal dose (12 Gy) volume was 3.8 mL (17.4%). The tumor began to shrink after transient enlargement. Sixty months later, the tumor volume was only 3.1 mL, and the patient was able to maintain independent activities of daily living without salvage treatment.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7832024Calcification of a Hydrophilic Acrylic Intraocular Lens after Glaucoma Surgery295300ENSaraOkamotoDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusukeShiodeDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuheiKimuraDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMioHosokawaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoMatobaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiKanzakiDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyaKindoDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTetsuroMoritaDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkihiroTsujiFukuyama City HospitalKosukeTakahashiFukuyama City HospitalYukiMorizaneDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/67206A Japanese woman in her 70s was referred to our hospital for the evaluation and treatment of high intraocular pressure (IOP) in her right eye. She had undergone bilateral cataract surgeries and the insertion of hydrophilic acrylic intraocular lenses (IOLs). We performed trabeculotomy and trabeculectomy to lower her right IOP; thereafter, a circular opacity was observed on the right eye’s IOL surface. We removed the right IOL because that eye’s vision had decreased due to IOL opacification. The analysis of the removed IOL revealed that the main opacity component was calcium phosphate. This is the first post-glaucoma-surgery IOL calcification case report.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7832024Effect of Humidified High-Flow Nasal Cannula Oxygen Therapy with a Pulmonary Infection Control Window as a Ventilation Switching Indication in Combination with Atomizing Inhalation of Terbutaline on the Lung Function of Patients with Acute Exacerbation of COPD271279ENMengjiaoYeDepartment of Respiratory and Critical Care Medicine, Tiantai Hospital of Traditional Chinese MedicineRenweiZhangDepartment of Respiratory and Critical Care Medicine, Tiantai Hospital of Traditional Chinese MedicineOriginal Article10.18926/AMO/67202We investigated how humidified high-flow nasal cannula oxygen therapy (HFNC) with a pulmonary infection control (PIC) window as a ventilation switching indication in combination with atomizing inhalation of terbutaline affects the lung function of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). We examined 140 hospitalized AECOPD patients randomized to control and observation groups. Conventional supportive therapy and invasive mechanical ventilation with tracheal intubation were conducted in both groups, with a PIC window as the indication for ventilation switching. Noninvasive positive pressure ventilation (NIPPV) plus atomizing inhalation of terbutaline was used in the control group. In the observation group, HFNC combined with atomizing inhalation of terbutaline was used. Compared to the control group, after 48-hr treatment and treatment completion, the observation group had significantly increased levels of lung function indicators (maximal voluntary ventilation [MVV] plus forced vital capacity [FVC], p<0.05) and oxygen metabolism indicators (arterial oxygen partial pressure [PaO2], arterial oxygen content [CaO2], and oxygenation index, p<0.05). The comparison of the groups revealed that the levels of airway remodeling indicators (matrix metalloproteinase-2 [MMP-2], tissue inhibitor of metalloproteinase 2 [TIMP-2] plus MMP-9) and inflammatory indicators (interferon gamma [IFN-γ] together with interleukin-17 [IL-17], IL-10 and IL-4) were significantly lower after 48 h of treatment as well as after treatment completion (both p<0.05). These results demonstrate that HFNC with a PIC window as the indication for ventilation switching combined with atomizing inhalation of terbutaline can relieve the disorder of oxygen metabolism and correct airway hyper-reactivity.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7832024The Role of the Lipid Profile and Oxidative Stress in Fatigue, Sleep Disorders and Cognitive Impairment in Patients with Multiple Sclerosis259270ENGonulVuralDepartment of Neurology, Faculty of Medicine, Ankara Yildirim Beyazit UniversityEsraDemirDepartment of Neurology, Ankara City HospitalSadiyeGumusyaylaDepartment of Neurology, Faculty of Medicine, Ankara Yildirim Beyazit UniversityFundaErenDepartment of Clinical Biochemistry, Ankara City HospitalSerdarBarakliDepartment of Neurology, Ankara City HospitalSalimNeseliogluDepartment of Clinical Biochemistry, Ankara City HospitalOzcanErelDepartment of Clinical Biochemistry, Ankara City HospitalOriginal Article10.18926/AMO/67201The aim of this study is to investigate the relationship of the lipid profile, dysfunctional high-density lipoprotein, ischaemia-modified albumin and thiol–disulfide homeostasis with cognitive impairment, fatigue and sleep disorders in patients with multiple sclerosis. The cognitive functions of patients were evaluated with the Brief International Cognitive Assessment for Multiple Sclerosis battery. Fatigue was evaluated with the Fatigue Severity Scale and the Fatigue Impact Scale. The Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale were used to assess patients’ sleep disturbance. Peripheral blood samples were collected, and lipid levels and myeloperoxidase and paraoxonase activity were measured. The myeloperoxidase/paraoxonase ratio, which indicates dysfunctional high-density lipoprotein, was calculated. Thiol–disulfide homeostasis and ischaemia-modified albumin were measured.<br>
We did not identify any relationship between dysfunctional high-density lipoprotein and the physical disability, cognitive decline, fatigue and sleep problems of multiple sclerosis. Thiol–disulfide homeostasis was associated with cognitive scores. The shift of the balance towards disulfide was accompanied by a decrease in cognitive scores. On the other hand, we did not detect any relationship between fatigue and sleep disorders and thiol–disulfide homeostasis. Our findings revealed a possible correlation between cognitive dysfunction and thiol–disulfide homeostasis in multiple sclerosis patients.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7832024The Impact of Reduced Skeletal Muscle Mass on Patients with Knee Osteoarthritis245250ENManabuAkagawaDepartment of Orthopedic Surgery, Omagari Kousei Medical CenterHidetomoSaitoDepartment of Orthopedic Surgery, Akita University Graduate School of MedicineYasuhiroTakahashiDepartment of Orthopedic Surgery, Omagari Kousei Medical CenterYosukeIwamotoDepartment of Orthopedic Surgery, Omagari Kousei Medical CenterJunpeiIidaDepartment of Orthopedic Surgery, Omagari Kousei Medical CenterTakayukiYoshikawaDepartment of Orthopedic Surgery, Omagari Kousei Medical CenterToshikiAbeDepartment of Orthopedic Surgery, Omagari Kousei Medical CenterKimioSaitoDepartment of Orthopedic Surgery, Akita University Graduate School of MedicineHiroakiKijimaDepartment of Orthopedic Surgery, Akita University Graduate School of MedicineYujiKasukawaDepartment of Orthopedic Surgery, Akita University Graduate School of MedicineMichioHongoDepartment of Orthopedic Surgery, Akita University Graduate School of MedicineNaohisaMiyakoshiDepartment of Orthopedic Surgery, Akita University Graduate School of MedicineOriginal Article10.18926/AMO/67199Although several studies have suggested a possible association between sarcopenia and knee osteoarthritis (OA) in the elderly, there remains no definitive evidence. Recently, however, the serum creatinine/cystatin C ratio (sarcopenia index: SI) was reported to correlate with skeletal muscle mass. The present retrospective study therefore investigated the impact of reduced skeletal muscle mass on advanced knee OA using SI. In 55 individuals scheduled for knee osteotomy or knee arthroplasty, correlations between SI and patient-reported outcomes such as the Knee Society Score (KSS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Oxford Knee Score (OKS) were explored. Significant associations were found between SI and the KSS functional activity score (β=0.37; p=0.022), KOOS subscale for activities of daily living (β=0.42; p=0.0096), and OKS (β=0.42; p=0.0095). This study underscores the role of reduced muscle mass in functional outcomes and introduces SI as a valuable marker for assessing muscle loss in knee OA patients.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7832024Effect of Lipopolysaccharide on the Duration of Zolpidem-Induced Loss of Righting Reflex in Mice227235ENYudaiWadaDepartment of Clinical Pharmacy, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSoichiroUshioDepartment of Pharmacy, Okayama University HospitalYoshihisaKitamuraDepartment of Clinical Pharmacy, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshitoZamamiDepartment of Clinical Pharmacy, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiakiSendoDepartment of Clinical Pharmacy, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/67197Zolpidem, a non-benzodiazepine hypnotic, is primarily used to treat insomnia. In a previous study, pior treatment with non-benzodiazepine receptor agonists was associated with inflammation. The present study aimed to clarify the association between the effects of zolpidem and inflammation in mice treated with lipopolysaccharide (LPS), a known model of inflammation. We assessed the zolpidem-induced loss of righting reflex (LORR) duration 24 h after LPS treatment in mice. Additionally, the expressions of γ-aminobutyric acid (GABA)A receptor subunit and K+-Cl− cotransporter isoform 2 (KCC2) mRNA in the hippocampus and frontal cortex were examined in LPS-treated mice. Pretreatment with LPS was associated with significantly prolonged duration of zolpidem-induced LORR compared to control mice. This effect was significantly attenuated by administering bicuculline, a GABAA receptor antagonist, or flumazenil, a benzodiazepine receptor antagonist, in LPS-treated mice. Compared to controls, LPS-treated mice showed no significant change in the expression of GABAA receptor subunits in the hippocampus or frontal cortex. Bumetanide, an Na+-K+-2Cl− cotransporter isoform 1 blocker, attenuated the extended duration of zolpidem-induced LORR observed in LPS-treated mice. LPS significantly decreased Kcc2 mRNA expression in the hippocampus and the frontal cortex. These findings suggest that inflammation increases zolpidem-induced LORR, possibly through a reduction in KCC2 expression.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7832024Assessment of a New Elbow Joint Positioning Method Using Area Detector Computed Tomography215225ENTakuyaAkagawaDepartment of Radiological Technology, Tokushima Red Cross HospitalRyoheiFukuiDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityKatsuhiroKidaDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityRyutaroMatsuuraDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityMakotoShimadaDepartment of Radiology, Osaka International Cancer InstituteMitsuhiroKinoshitaDepartment of Radiology, Tokushima Red Cross HospitalYokoAkagawaDepartment of Radiology, Tokushima Red Cross HospitalSachikoGotoDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/67196We propose a sitting position that achieves both high image quality and a reduced radiation dose in elbow joint imaging by area detector computed tomography (ADCT), and we compared it with the ‘superman’ and supine positions. The volumetric CT dose index (CTDIvol) for the sitting, superman, and supine positions were 2.7, 8.0, and 20.0 mGy and the dose length products (DLPs) were 43.4, 204.7, and 584.8 mGy • cm, respectively. In the task-based transfer function (TTF), the highest value was obtained for the sitting position in both bone and soft tissue images. The noise power spectrum (NPS) of bone images showed that the superman position had the lowest value up to approx. 1.1 cycles/mm or lower, whereas the sitting position had the lowest value when the NPS was greater than approx. 1.1 cycles/mm. The overall image quality in an observer study resulted in the following median Likert scores for Readers 1 and 2: 5.0 and 5.0 for the sitting position, 4.0 and 3.5 for the superman position, and 4.0 and 2.0 for the supine position. These results indicate that our proposed sitting position with ADCT of the elbow joint can provide superior image quality and allow lower radiation doses compared to the superman and supine positions.No potential conflict of interest relevant to this article was reported.Nature PortfolioActa Medica Okayama2041-17231512024Structure and distinct supramolecular organization of a PSII-ACPII dimer from a cryptophyte alga Chroomonas placoidea4535ENZhiyuanMaoPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesXingyueLiPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesZhenhuaLiPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesLiangliangShenPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesXiaoyiLiPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesYanyanYangPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesWendaWangPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesTingyunKuangPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesJian-RenShenInstitute for Interdisciplinary Science, and Graduate School of Natural Science and Technology, Okayama UniversityGuangyeHanPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesCryptophyte algae are an evolutionarily distinct and ecologically important group of photosynthetic unicellular eukaryotes. Photosystem II (PSII) of cryptophyte algae associates with alloxanthin chlorophyll a/c-binding proteins (ACPs) to act as the peripheral light-harvesting system, whose supramolecular organization is unknown. Here, we purify the PSII-ACPII supercomplex from a cryptophyte alga Chroomonas placoidea (C. placoidea), and analyze its structure at a resolution of 2.47 & Aring; using cryo-electron microscopy. This structure reveals a dimeric organization of PSII-ACPII containing two PSII core monomers flanked by six symmetrically arranged ACPII subunits. The PSII core is conserved whereas the organization of ACPII subunits exhibits a distinct pattern, different from those observed so far in PSII of other algae and higher plants. Furthermore, we find a Chl a-binding antenna subunit, CCPII-S, which mediates interaction of ACPII with the PSII core. These results provide a structural basis for the assembly of antennas within the supercomplex and possible excitation energy transfer pathways in cryptophyte algal PSII, shedding light on the diversity of supramolecular organization of photosynthetic machinery.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama2073-440913102024Exploring the Regulators of Keratinization: Role of BMP-2 in Oral Mucosa807ENXindiMuDepartment of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMitsuakiOnoDepartment of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHa Thi ThuNguyenDepartment 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 SciencesKunZhaoDepartment of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTaishiKomoriTomokoYonezawaDepartment of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuoKubokiDepartment of Oral Rehabilitation and Implantology, Okayama University HospitalToshitakaOohashiDepartment of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesThe oral mucosa functions as a physico-chemical and immune barrier to external stimuli, and an adequate width of the keratinized mucosa around the teeth or implants is crucial to maintaining them in a healthy and stable condition. In this study, for the first time, bulk RNA-seq analysis was performed to explore the gene expression of laser microdissected epithelium and lamina propria from mice, aiming to investigate the differences between keratinized and non-keratinized oral mucosa. Based on the differentially expressed genes (DEGs) and Gene Ontology (GO) Enrichment Analysis, bone morphogenetic protein 2 (BMP-2) was identified to be a potential regulator of oral mucosal keratinization. Monoculture and epithelial-mesenchymal cell co-culture models in the air-liquid interface (ALI) indicated that BMP-2 has direct and positive effects on epithelial keratinization and proliferation. We further performed bulk RNA-seq of the ALI monoculture stimulated with BMP-2 in an attempt to identify the downstream factors promoting epithelial keratinization and proliferation. Analysis of the DEGs identified, among others, IGF2, ID1, LTBP1, LOX, SERPINE1, IL24, and MMP1 as key factors. In summary, these results revealed the involvement of a well-known growth factor responsible for bone development, BMP-2, in the mechanism of oral mucosal keratinization and proliferation, and pointed out the possible downstream genes involved in this mechanism.No potential conflict of interest relevant to this article was reported.American Chemical SocietyActa Medica Okayama2470-13439192024Superstructure of Fe5–xGeTe2 Determined by Te K-Edge Extended X-ray Absorption Fine Structure and Te Kα X-ray Fluorescence Holography2128721297ENRitsukoEguchiResearch Institute for Interdisciplinary Science, Okayama UniversityHalubaiSekharDepartment of Physical Science and Technology, Nagoya Institute of TechnologyKojiKimuraDepartment of Physical Science and Technology, Nagoya Institute of TechnologyHirokazuMasaiDepartment of Materials and Chemistry, National Institute of Advanced Industrial Science and Technology (AIST)NaohisaHappoGraduate School of Information Sciences, Hiroshima City UniversityMitsukiIkedaResearch Institute for Interdisciplinary Science, Okayama UniversityYukiYamamotoResearch Institute for Interdisciplinary Science, Okayama UniversityMasakiUtsumiResearch Institute for Interdisciplinary Science, Okayama UniversityHidenoriGotoResearch Institute for Interdisciplinary Science, Okayama UniversityYasuhiroTakabayashiDepartment of Physical Science and Technology, Nagoya Institute of TechnologyHirooTajiriJapan Synchrotron Radiation Research Institute (JASRI)KoichiHayashiDepartment of Physical Science and Technology, Nagoya Institute of TechnologyYoshihiroKubozonoResearch Institute for Interdisciplinary Science, Okayama UniversityThe local structure of the two-dimensional van der Waals material, Fe5–xGeTe2, which exhibits unique structural/magnetic phase transitions, was investigated by Te K-edge extended X-ray absorption fine structure (EXAFS) and Te Kα X-ray fluorescence holography (XFH) over a wide temperature range. The formation of a trimer of Te atoms at low temperatures has been fully explored using these methods. An increase in the Te–Fe distance at approximately 150 K was suggested by EXAFS and presumably indicates the formation of a Te trimer. Moreover, XFH displayed clear atomic images of Te atoms. Additionally, the distance between the Te atoms shortened, as confirmed from the atomic images reconstructed from XFH, indicating the formation of a trimer of Te atoms, i.e., a charge-ordered (3⎯⎯√×3⎯⎯√)𝑅30◦ superstructure. Furthermore, Te Kα XFH provided unambiguous atomic images of Fe atoms occupying the Fe1 site; the images were not clearly observed in the Ge Kα XFH that was previously reported because of the low occupancy of Fe and Ge atoms. In this study, EXAFS and XFH clearly showed the local structure around the Te atom; in particular, the formation of Te trimers caused by charge-ordered phase transitions was clearly confirmed. The charge-ordered phase transition is fully discussed based on the structural variation at low temperatures, as established from EXAFS and XFH.No potential conflict of interest relevant to this article was reported.PeerJActa Medica Okayama2167-8359122024Heterogeneity of the effect of the COVID-19 pandemic on the incidence of Metabolic Syndrome onset at a Japanese campuse17013ENToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Okayama University HospitalBackground. The coronavirus disease 2019 (COVID-19) outbreak began in China in December 2019, with the World Health Organization declaring a state of emergency in January 2020. Worldwide implementation of lockdown measures to slow the spread of the virus led to reduced physical activity, disrupted eating habits, mental health issues, and sleep disturbances, which increased the risk of lifestyle -related diseases such as metabolic syndrome (MetS). During the COVID-19 pandemic, healthcare workers, especially intensive care workers, experienced longer working hours and burnout, which further increased the risk of lifestyle -related diseases. Accordingly, it is important to identify individuals at a risk of new -onset MetS during a pandemic, which could direct preventive interventions. This study aimed to assess the heterogeneous impact of the COVID-19 pandemic on the incidence of new -onset MetS based on the conditional average treatment effect (CATE) and to identify at -risk populations. <br>
Methods. This study analyzed health checkup data obtained from Okayama University Shikata Campus workers using paired baseline and follow-up years. Baseline data encompassed 2017 to 2019, with respective follow-up data from 2018 to 2020. Furthermore, as the COVID-19 pandemic in Japan began in January 2020, workers who underwent follow-up health checkups in 2018 to 2019 and 2020 were considered as "unexposed"and "exposed,"respectively. As the Shikata campus has several departments, comparisons among departments were made. The primary outcome was new -onset MetS at follow-up. Predictor variables included baseline health checkup results, sex, age, and department (administrative, research, medical, or intensive care department). X -learner was used to calculate the CATE. <br>
Results. This study included 3,572 eligible individuals (unexposed, n = 2,181; exposed, n = 1,391). Among them, 1,544 (70.8%) and 866 (62.3%) participants in the unexposed and exposed groups, respectively, were females. The mean age (+/- standard deviation) of the unexposed and exposed groups was 48.2 +/- 8.2 and 47.8 +/- 8.3 years, respectively. The COVID-19 pandemic increased the average probability of new -onset MetS by 4.4% in the overall population. According to the department, the intensive care department showed the highest CATE, with a 15.4% increase. Moreover, there was large heterogeneity according to the department. The high-CATE group was characterized by older age, urinary protein, elevated liver enzymes, higher triglyceride levels, and a history of hyperlipidemia treatment. <br>
Conclusions. This study demonstrated that the COVID-19 pandemic increased the incidence of new -onset MetS, with this effect showing heterogeneity at a single Japanese campus. Regarding specific populations, workers in the intensive care department showed an increased risk of new -onset MetS. At -risk populations require specific preventive interventions in case the current COVID-19 pandemic persists or a new pandemic occurs.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0340-54437772023Latitudinal cline in reproductive traits in the red flour beetle Tribolium castaneum85ENKentarouMatsumuraGraduate School of Environmental, Life Science and Technology, Okayama UniversityKyosukeWakabayashiGraduate School of Environmental, Life Science and Technology, Okayama UniversityRenyaKawakamiFaculty of Agriculture, Kagawa UniversityTakahisaMiyatakeGraduate School of Environmental, Life Science and Technology, Okayama UniversitySeveral previous studies have reported geographic variation and/or latitudinal clines of morphological sexual characteristics, but there are few studies that consider reproductive traits that are not morphological. Here, we measured the proportion of females fertilized by males, frequency of reproductive failure in males, and number of female copulations of the red flour beetle Tribolium castaneum collected from fields in Japan to investigate the relationship between reproductive traits and latitude. Our results show substantial differences in the reproductive traits of both sexes among field populations. We identified latitudinal clines for reproductive traits in males, but not females. Moreover, female, but not male, reproductive traits were correlated with body size. Our study suggests that selection for male reproductive traits varies with latitude in T. castaneum.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0302-8933205102023Flavobacterium okayamense sp. nov. isolated from surface seawater346ENKeiKitaharaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBasilua AndreMuzemboGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShoMorohoshiTechnoSuruga Laboratory Co., LtdTadaoKunihiroTechnoSuruga Laboratory Co., LtdNozomiTazatoTechnoSuruga Laboratory Co., LtdAyumuOhnoGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazumaUesakaGraduate School of Bioagricultural Sciences, Nagoya UniversityMakotoTaniguchiOral Microbiome Center, Taniguchi Dental ClinicShin-ichiMiyoshiGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityStrain KK2020170T, a Gram-stain negative, yellow colony-forming bacterium, was isolated from surface seawater sampled in Kojima Bay, Okayama, Japan. Phylogenetic analysis based on the 16S rRNA gene revealed that strain KK2020170T belongs to the genus Flavobacterium, with Flavobacterium haoranii LQY-7T (98.1% similarity) being its closest relative, followed by Flavobacterium sediminis MEBiC07310T (96.9%) and Flavobacterium urocaniciphilum YIT 12746T (96.0%). Whole-genome shotgun sequencing showed that strain KK2020170T, when paralleled with F. haoranii LQY-7 T, had 81.3% average nucleotide identity, and 24.6% in silico DNA–DNA hybridization values, respectively. The DNA G + C content of strain KK2020170T was 31.1 mol%. The most abundant fatty acids (> 10%) of strain KK2020170T were iso-C15: 0, iso-C17: 0 3-OH and iso-C15: 1 G. The dominant respiratory quinone of the strain was menaquinone MK-6. Based on the phylogenetic and phenotypic analysis results, we propose that strain KK2020170T represents a novel species, for which the name Flavobacterium okayamense sp. nov. has been proposed. The type strain is KK2020170T (= ATCC TSD-280 T = NBRC 115344 T).No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1434-51616832023Recent advances in CGG repeat diseases and a proposal of fragile X-associated tremor/ataxia syndrome, neuronal intranuclear inclusion disease, and oculophryngodistal myopathy (FNOP) spectrum disorder169174ENHiroyukiIshiuraDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShojiTsujiDepartment of Neurology, Graduate School of Medicine, The University of TokyoTatsushiTodaDepartment of Neurology, Graduate School of Medicine, The University of TokyoWhile whole genome sequencing and long-read sequencing have become widely available, more and more focuses are on noncoding expanded repeats. Indeed, more than half of noncoding repeat expansions related to diseases have been identified in the five years. An exciting aspect of the progress in this field is an identification of a phenomenon called repeat motif–phenotype correlation. Repeat motif–phenotype correlation in noncoding repeat expansion diseases is first found in benign adult familial myoclonus epilepsy. The concept is extended in the research of CGG repeat expansion diseases. In this review, we focus on newly identified CGG repeat expansion diseases, update the concept of repeat motif–phenotype correlation in CGG repeat expansion diseases, and propose a clinical concept of FNOP (fragile X-associated tremor/ataxia syndrome, neuronal intranuclear inclusion disease, and oculopharyngodistal myopathy)-spectrum disorder, which shares clinical features and thus probably share some common disease pathophysiology, to further facilitate discussion and progress in this field.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1867-10714232023Prospective evaluation of core number of biopsy for renal tumor: are multiple cores preferable?319325ENToshihiroIguchiDepartment of Radiology, Okayama University HospitalYusukeMatsuiDepartment of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomohiroTojiDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesJunSakuraiCenter for Innovative Clinical Medicine, Okayama University HospitalKojiTomitaDepartment of Radiology, Okayama University HospitalMayuUkaDepartment of Radiology, Okayama University HospitalNoriyukiUmakoshiDepartment of Radiology, Okayama University HospitalTakahiroKawabataDepartment of Radiology, Okayama University HospitalKazuakiMunetomoDepartment of Radiology, Okayama University HospitalToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Okayama University HospitalTakaoHirakiDepartment of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityPurpose This single-center, single-arm, prospective, open-label study was conducted to evaluate the optimal number of cores (single or multiple) in renal tumor biopsy.<br>
Materials and methods Forty-four biopsies of 44 tumors (mean diameter, 2.7 ± 1.0 cm; range, 1.6–5.0 cm) were included. Biopsy was performed under ultrasound or computed tomography fluoroscopy guidance using an 18-gauge cutting needle and the co-axial method. Two or more specimens were obtained, which were divided into first and subsequent specimens. “First specimen” and “all specimens” were histologically evaluated (i.e., appropriateness of specimen, histological diagnosis, subtype, and Fuhrman grade of renal cell carcinoma [RCC]) blindly and independently by two board-certified pathologists.<br>
Results Multiple specimens were successfully and safely obtained in all the biopsies. All tumors were histologically diagnosed; 40 malignancies included 39 RCCs and 1 solitary fibrous tumor, and 4 benign lesions included 2 angiomyolipomas, 1 oncocytoma, and 1 capillary hemangioma. In all RCCs, the subtype could be determined (32 clear cell RCCs, 4 chromophobe RCCs, and 3 papillary RCCs), and the Furman grade was determined in 38 RCCs. When only the first specimen was evaluated, 22.7% of the specimens were inappropriate for diagnosis, and 34 (77.3%) were histologically diagnosed. The diagnostic yield was significantly lower than that of all specimens (P = 0.0044). Univariate analysis revealed that smaller lesions were a significant predictor of diagnostic failure (P = 0.020).<br>
Conclusion Biopsy with multiple cores significantly improved diagnostic yield. Thus, operators should obtain multiple cores during renal tumor biopsy.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7822024A Case of Gallbladder Cancer with Trousseau Syndrome Successfully Treated Using Radical Resection201204ENAkariMasunagaDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterMotoyasuTabuchiDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterShinyaSakamotoDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterRikaYoshimatsuDepartment of Radiology, Kochi Health Sciences CenterManabuMatsumotoDepartment of Radiology, Kochi Health Sciences CenterJunIwataDepartment of Diagnostic Pathology, Kochi Health Sciences CenterTakehiroOkabayashiDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterCase Report10.18926/AMO/66931Trousseau syndrome is characterized by cancer-associated systemic thrombosis. We describe the first case of a successfully treated gallbladder adenocarcinoma accompanied by Trousseau syndrome. A 66-year-old woman presented with right hemiplegia. Magnetic resonance imaging identified multiple cerebral infarctions. Her serum carbohydrate antigen 19-9 and D-dimer levels were markedly elevated, and a gallbladder tumor was detected via abdominal computed tomography. Venous ultrasonography of the lower limbs revealed a deep venous thrombus in the right peroneal vein. These findings suggested that the brain infarctions were likely caused by Trousseau syndrome associated with her gallbladder cancer. Radical resection of the gallbladder tumor was performed. The resected gallbladder was filled with mucus and was pathologically diagnosed as an adenocarcinoma. Her postoperative course was uneventful, and she received a one-year course of adjuvant therapy with oral S-1. No cancer recurrence or thrombosis was noted 26 months postoperatively. Despite concurrent Trousseau syndrome, a radical cure of the primary tumor and thrombosis could be achieved with the appropriate treatment.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7822024Reduced Immunogenicity of COVID-19 Vaccine in Obese Patients with Type 2 Diabetes: A Cross-Sectional Study185191ENHirokoTakahashiDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunEguchiDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMayuWatanabeDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasanoriNakayamaOffice of Innovative Medicine, Organization for Research Strategy and Development, Okayama UniversityJunWadaDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/66927The global pandemic of coronavirus infection 2019 (COVID-19) was an unprecedented public health emergency. Several clinical studies reported that heart disease, lung disease, diabetes, hypertension, dyslipidemia, and obesity are critical risk factors for increased severity of and hospitalization for COVID-19. This is largely because patients with these underlying medical conditions can show poor immune responses to the COVID-19 vaccinations. Diabetes is one of the underlying conditions most highly associated with COVID-19 susceptibility and is considered a predictor of poor prognosis of COVID-19. We therefore investigated factors that influence the anti-SARS-CoV-2 spike IgG antibody titer after three doses of vaccination in patients with type 2 diabetes. We found that obesity was associated with low anti-SARS-CoV-2 spike IgG antibody titers following three-dose vaccination in type 2 diabetics. Obese patients with type 2 diabetes may have attenuated vaccine efficacy and require additional vaccination; continuous infection control should be considered in such patients.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7822024p53-Armed Oncolytic Virotherapy Improves Radiosensitivity in Soft-Tissue Sarcoma by Suppressing BCL-xL Expression151161ENTadashiKomatsubaraDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroshiTazawaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJoeHaseiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshinoriOmoriDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhisaSugiuDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusukeMochizukiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKojiDemiyaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkiYoshidaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomohiroFujiwaraDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiyukiKunisadaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuoUrataOncolys BioPharma, Inc.ShunsukeKagawaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/66924Soft-tissue sarcoma (STS) is a heterogeneous group of rare tumors originating predominantly from the embryonic mesoderm. Despite the development of combined modalities including radiotherapy, STSs are often refractory to antitumor modalities, and novel strategies that improve the prognosis of STS patients are needed. We previously demonstrated the therapeutic potential of two telomerase-specific replication-competent oncolytic adenoviruses, OBP-301 and tumor suppressor p53-armed OBP-702, in human STS cells. Here, we demonstrate in vitro and in vivo antitumor effects of OBP-702 in combination with ionizing radiation against human STS cells (HT1080, NMS-2, SYO-1). OBP-702 synergistically promoted the antitumor effect of ionizing radiation in the STS cells by suppressing the expression of B-cell lymphoma-X large (BCL-xL) and enhancing ionizing radiation-induced apoptosis. The in vivo experiments demonstrated that this combination therapy significantly suppressed STS tumors’ growth. Our results suggest that OBP-702 is a promising antitumor reagent for promoting the radiosensitivity of STS tumors.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7822024Photon-Counting Detector CT: Potential for 75% Reduction in Contrast Medium Amount: A Phantom Study135142ENFumiyoHigakiDepartment of Radiology, Okayama University HospitalYusukeMorimitsuDepartment of Radiological Technology, Okayama University HospitalToshihiroIguchiDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityHayatoSaitoDepartment of Radiological Technology, Okayama University Medical SchoolHaruhikoTakakiDepartment of Radiological Technology, Okayama University Medical SchoolAyakoNakagoshiDepartment of Radiological Technology, Okayama University Medical SchoolMakiWadaDepartment of Radiological Technology, Okayama University Medical SchoolMayuUkaDepartment of Radiology, Okayama University HospitalNoriakiAkagiDepartment of Radiological Technology, Okayama University HospitalToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Okayama University HospitalYusukeMatsuiDepartment of Radiology, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesTakaoHirakiDepartment of Radiology, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/66916This study aimed to evaluate the potential reduction in contrast medium utilization using photon-counting detector computed tomography (PCD-CT). One PCD-CT scan (CT1) and three conventional (non-PCD-CT) CT scans (CT2-CT4) were performed using a multi-energy CT phantom that contained eight rods with different iodine concentrations (0.2, 0.5, 1, 2, 5, 10, 15, and 20 mg/ml). The CT values of the seven groups (CT1 for 40, 50, 60, and 70 keV; and CT2-4) were measured. Noise and contrast-to-noise ratio (CNR) were assessed for the eight rods at various iodine concentrations. CT2 and CT1 (40 keV) respectively required 20 mg/ml and 5 mg/ml of iodine, indicating that a comparable contrast effect could be obtained with approximately one-fourth of the contrast medium amount. The standard deviation values increased at lower energy levels irrespective of the iodine concentration. The CNR exhibited a decreasing trend with lower iodine concentrations, while it remained relatively stable across all iodine levels (40-70 keV). This study demonstrated that virtual monochromatic 40 keV images offer a similar contrast effect with a reduced contrast medium amount when compared to conventional CT systems at 120 kV.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7822024Sigle Agent of Posttransplant Cyclophosphamide Without Calcineurin Inhibitor Controls Severity of Experimental Chronic GVHD123134ENKyosukeSaekiDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University HospitalKeisukeSeikeDepartment of Hematology and Oncology, Okayama University HospitalTaigaKuroiDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHisakazuNishimoriDepartment of Hematology and Oncology, Okayama University HospitalTakehiroTanakaDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKen-ichiMatsuokaDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuharuFujiiDivision of Transfusion, Okayama University HospitalYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/66915Chronic graft-versus-host disease (GVHD) is a major cause of late death and morbidity following allogeneic hematopoietic cell transplantation (HCT), but its pathogenesis remains unclear. Recently, haplo-identical HCT with post-transplant cyclophosphamide (Haplo-HCT with PTCY) was found to achieve a low incidence rate of acute GVHD and chronic GVHD. However, while the pathogenesis of acute GVHD following Haplo-HCT with PTCY has been well investigated, that of chronic GVHD remains to be elucidated, especially in HLA-matched HCT with PTCY. Based on its safety profile, PTCY is currently applied for the human leucocyte antigen (HLA)-matched HCT setting. Here, we investigated the mechanisms of chronic GVHD following HLA-matched HCT with PTCY using a well-defined mouse chronic GVHD model. PTCY attenuated clinical and pathological chronic GVHD by suppressing effector T-cells and preserving regulatory T-cells compared with a control group. Additionally, we demonstrated that cyclosporine A (CsA) did not show any additional positive effects on attenuation of GVHD in PTCY-treated recipients. These results suggest that monotherapy with PTCY without CsA could be a promising strategy for the prevention of chronic GVHD following HLA-matched HCT.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7822024Evaluation of the Efficacy and Safety of Tenofovir Disoproxil Fumarate in Intercepting Mother-to-Child Transmission of Hepatitis B Virus107113ENDongxiangHanDepartment of Obstetrics, Shijiazhuang Maternity & Child Healthcare HospitalJianxiuDuDepartment of Laboratory Medicine, Shijiazhuang Maternity & Child Healthcare HospitalWeiWangDepartment of Obstetrics, Shijiazhuang Maternity & Child Healthcare HospitalCuiWangDepartment of Functional, Shijiazhuang Maternity & Child Healthcare HospitalOriginal Article10.18926/AMO/66913Vertical transmission of hepatitis B virus (HBV), especially in Asia, is a key target in the global elimination of HBV. This study assessed the effects of tenofovir disoproxil fumarate (TDF) in pregnant women for mother-to-infant transmission of HBV. A total of 122 pregnant women at our hospital met the inclusion criteria for high HBV DNA viral loads. They were randomly divided into TDF-treatment (n=70) and placebo (n=52) groups. Maternal liver function and serum HBV DNA load were tested before and after treatment. Clinical and laboratory data of infants were assayed at delivery and 7-months post-partum visit and compared between the two groups. There was no difference in clinical characteristics of participants between the two groups. There were no significant differences in liver function markers, including alanine aminotransferase, total bilirubin, blood creatinine, and blood urea nitrogen levels before and after TDF treatment. The serum HBV DNA viral load of the TDF-treated group became significantly lower than those of the control group and their own pre-medication levels. Infants showed no significant difference in body growth, including weight, height, head size, and five-min Apgar score. At 7 months after birth, 94.29% of infants in the TDF group and 86.54% of control-group infants had protective HBsAb levels ≥ 10 mIU/ml (p>0.05). The HBV infection rate of infants in the TDF-treated group was lower than that in the non-treated group. In high-HBV-DNA-load pregnant women, TDF administered from 28 weeks gestational age to delivery was associated with a lower risk of mother-to-infant transmission of HBV.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7822024The Roles of Neuropeptide Y in Respiratory Disease Pathogenesis via the Airway Immune Response95106ENJunkoItanoDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKatsuyukiKiuraDepartment of Allergy and Respiratory Medicine, Okayama University HospitalYoshinobuMaedaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuakiMiyaharaDepartment of Allergy and Respiratory Medicine, Okayama University HospitalReview10.18926/AMO/66912The lungs are very complex organs, and the respiratory system performs the dual roles of repairing tissue while protecting against infection from various environmental stimuli. Persistent external irritation disrupts the immune responses of tissues and cells in the respiratory system, ultimately leading to respiratory disease. Neuropeptide Y (NPY) is a 36-amino-acid polypeptide and a neurotransmitter that regulates homeostasis. The NPY receptor is a seven-transmembrane-domain G-protein-coupled receptor with six subtypes (Y1, Y2, Y3, Y4, Y5, and Y6). Of these receptors, Y1, Y2, Y4, and Y5 are functional in humans, and Y1 plays important roles in the immune responses of many organs, including the respiratory system. NPY and the Y1 receptor have critical roles in the pathogenesis of asthma, chronic obstructive pulmonary disease, and idiopathic pulmonary fibrosis. The effects of NPY on the airway immune response and pathogenesis differ among respiratory diseases. This review focuses on the involvement of NPY in the airway immune response and pathogenesis of various respiratory diseases.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1867-10714222023Evaluation of the ear ossicles with photon-counting detector CT158164ENYukaTakahashiDepartment of Radiology, Okayama University HospitalFumiyoHigakiDepartment of Radiology, Okayama University HospitalAkikoSugayaDepartment of Otolaryngology‑Head and Neck Surgery, Okayama University HospitalYudaiAsanoDepartment of Radiology, Okayama University HospitalKatsuhideKojimaDepartment of Radiology, Okayama University HospitalYusukeMorimitsuDepartment of Radiological Technology, Okayama University HospitalNoriakiAkagiDepartment of Radiological Technology, Okayama University HospitalToshihideItohDepartment of CT‑Research and Collaboration, Siemens HealthineersYusukeMatsuiDepartment of Radiology, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical SciencesTakaoHirakiDepartment of Radiology, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical SciencesRecently, computed tomography with photon-counting detector (PCD-CT) has been developed to enable high-resolution imaging at a lower radiation dose. PCD-CT employs a photon-counting detector that can measure the number of incident X-ray photons and their energy. The newly released PCD-CT (NAEOTOM Alpha, Siemens Healthineers, Forchheim, Germany) has been in clinical use at our institution since December 2022. The PCD-CT offers several advantages over current state-of-the-art energy-integrating detector CT (EID-CT). The PCD-CT does not require septa to create a detector channel, while EID-CT does. Therefore, downsizing the anode to achieve higher resolution does not affect the dose efficiency of the PCD-CT. CT is an indispensable modality for evaluating ear ossicles. The ear ossicles and joints are clearly depicted by PCD-CT. In particular, the anterior and posterior legs of the stapes, which are sometimes unclear on conventional CT scans, can be clearly visualized. We present cases of congenital anomalies of the ossicular chain, ossicular chain dislocation, tympanosclerosis, and cholesteatoma in which PCD-CT was useful. This short article reports the usefulness of PCD-CT in the 3D visualization of the ear ossicles.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1465-362153112023Advances in treatment of alveolar soft part sarcoma: an updated review10091018ENTomohiroFujiwaraDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshiyukiKunisadaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesEijiNakataDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKenjiNishidaDepartment of Pathology, Okayama University HospitalHiroyukiYanaiDepartment of Pathology, Okayama University HospitalTomokiNakamuraDepartment of Orthopaedic Surgery, Mie UniversityKazuhiroTanakaDepartment of Advanced Medical Sciences, Oita UniversityToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAlveolar soft part sarcoma is a rare neoplasm of uncertain histogenesis that belongs to a newly defined category of ultra-rare sarcomas. The neoplasm is characterized by a specific chromosomal translocation, der (17) t(X; 17)(p11.2;q25), that results in ASPSCR1–TFE3 gene fusion. The natural history of alveolar soft part sarcoma describes indolent behaviour with slow progression in deep soft tissues of the extremities, trunk and head/neck in adolescents and young adults. A high rate of detection of distant metastasis at presentation has been reported, and the most common metastatic sites in decreasing order of frequency are the lung, bone and brain. Complete surgical resection remains the standard treatment strategy, whereas radiotherapy is indicated for patients with inadequate surgical margins or unresectable tumours. Although alveolar soft part sarcoma is refractory to conventional doxorubicin-based chemotherapy, monotherapy or combination therapy using tyrosine kinase inhibitors and immune checkpoint inhibitors have provided antitumor activity and emerged as new treatment strategies. This article provides an overview of the current understanding of this ultra-rare sarcoma and recent advancements in treatments according to the clinical stage of alveolar soft part sarcoma.No potential conflict of interest relevant to this article was reported.ElsevierActa Medica Okayama2666-831992024Radiation evaluation assay using a human three-dimensional oral cancer model for clinical radiation therapy.100297ENLucieSercombeBiomedical Engineering Department, Grenoble Institute of TechnologyKazuyoIgawaNeutron Therapy Research Center, Okayama UniversityKenjiIzumiDivision of Biomimetics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata UniversityWith the development of various radiation -based cancer therapies, radiobiological evaluation methods instead of traditional clonogenic assays with monolayer single cell culture are required to bridge gaps in clinical data. Heterogeneity within cancer tissues is the reason for bridging the gap between basic and clinical research in cancer radiotherapy. To solve this problem, we investigated an evaluation assay using a three-dimensional (3D) model of cancer tissue. In this study, a 3D model consisting of tumor and stromal layers was used to compare and verify radiobiological effects with conventional two-dimensional (2D) methods. A significant difference in the response to radiation was observed between the 2D and 3D models. The relative number of cancer cells decreased with X-ray dose escalations in the 2D and 3D models. In contrast, the relative number of normal cells was quite different between the 2D and 3D models. Considering the ability of cells to recover from radiation-induced damage, the histological results of the 3D model were reflected in the clinical data. Histopathological analysis using a 3D model is a potential method for evaluating radiobiological effects on the tumor and tumor margins.No potential conflict of interest relevant to this article was reported.ElsevierActa Medica Okayama0022-22756532024Nuclear SphK2/S1P signaling is a key regulator of ApoE production and Aβ uptake in astrocytes100510ENMasatoKomaiDepartment of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYukaNodaDepartment of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAtsuyaIkedaDepartment of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNanakaKaneshiroDepartment of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYujiKamikuboDepartment of Cellular and Molecular Pharmacology, Juntendo University Graduate School of MedicineTakashiSakuraiDepartment of Cellular and Molecular Pharmacology, Juntendo University Graduate School of MedicineTakashiUeharaDepartment 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 UniversityThe link between changes in astrocyte function and the pathological progression of Alzheimer's disease (AD) has attracted considerable attention. Interestingly, activated astrocytes in AD show abnormalities in their lipid content and metabolism. In particular, the expression of apolipoprotein E (ApoE), a lipid transporter, is decreased. Because ApoE has anti-inflammatory and amyloid β (Aβ)-metabolizing effects, the nuclear receptors, retinoid X receptor (RXR) and LXR, which are involved in ApoE expression, are considered promising therapeutic targets for AD. However, the therapeutic effects of agents targeting these receptors are limited or vary considerably among groups, indicating the involvement of an unknown pathological factor that modifies astrocyte and ApoE function. Here, we focused on the signaling lipid, sphingosine-1-phosphate (S1P), which is mainly produced by sphingosine kinase 2 (SphK2) in the brain. Using astrocyte models, we found that upregulation of SphK2/S1P signaling suppressed ApoE induction by both RXR and LXR agonists. We also found that SphK2 activation reduced RXR binding to the APOE promoter region in the nucleus, suggesting the nuclear function of SphK2/S1P. Intriguingly, suppression of SphK2 activity by RNA knockdown or specific inhibitors upregulated lipidated ApoE induction. Furthermore, the induced ApoE facilitates Aβ uptake in astrocytes. Together with our previous findings that SphK2 activity is upregulated in AD brain and promotes Aβ production in neurons, these results indicate that SphK2/S1P signaling is a promising multifunctional therapeutic target for AD that can modulate astrocyte function by stabilizing the effects of RXR and LXR agonists, and simultaneously regulate neuronal pathogenesis.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0020-16935642024Synthesis and characterization of iron(II) complex with unsymmetrical heterocyclic (2-pyridyl)(4-imidazolyl)azine121937ENKennedy MawunyaHayiborYukinariSunatsukiTakayoshiSuzukiA new iron(II) complex bearing unsymmetrical azine, [Fe(HLH)2](PF6)2·H2O·MeCN (HLH = 2-pyridylmethylidenehydrazono(4-imidazolyl)methane), was synthesized exclusively by a reaction of 2-pyridine carboxaldehyde, 1H-imidazole-4-carboxaldehyde, hydrazine monohydrate and FeCl2·4H2O (in a molar ratio of 2:2:2:1) in methanol, followed by the addition of an aqueous NH4PF6 solution. It was characterized using spectroscopic techniques, elemental analysis, magnetic measurement, and cyclic voltammetry. The molecular and crystal structure of the compound was revealed by X-ray analysis, where an iron(II) ion was surrounded by two HLH azines with a planar E(py),Z(im) conformation, and tridentate κ3N,N’,N” coordination mode, forming a monomeric six-coordinated and diamagnetic complex. The complex cations were linked by water molecules via intermolecular hydrogen-bonding interactions between the imidazole N−H and the neighboring uncoordinated azine-N atom, forming a 1D chain structure. The selective formation of this unsymmetrical azine (HLH) from a stoichiometric mixture of the components would result from the steric preference of the five- and six-membered chelate rings by the 2-pyridyl and 4-imidazolyl azine moieties, respectively, with the E(py),Z(im) configuration.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama3005-073124512024Experimental apparatus for detection of radiative decay of 229Th isomer from Th-doped CaF214ENTakahiroHirakiResearch Institute for Interdisciplinary Science, Okayama UniversityAmong all the nuclei, Thorium-229 has the lowest excited level at approximately 8.3 eV. This level is an isomeric state with a long radiative lifetime. Therefore, 229Th can be excited to the isomeric state using a vacuum ultraviolet laser and is expected to have applications such as in frequency standards. Our group has been conducting experiments to excite 229Th to the isomeric state via the second excited state using the high-intensity X-ray beam available at the SPring-8 facility. To detect vacuum ultraviolet photons from the isomeric state of 229Th, a dedicated apparatus was constructed. We employed 229Th-doped CaF2 crystals as the irradiation target. Because these targets emit numerous scintillation photons due to nuclear decay and X-ray beam irradiation, detectors are required to significantly reduce these background events. To achieve this, we adopted dichroic mirrors and a photomultiplier tube for detecting scintillation photons by nuclear decay, in addition to a solar-blind photomultiplier tube for detecting decay photons from the isomeric state of 229Th. In this proceedings paper, we describe the experimental apparatus used in the beamtime in 2023.No potential conflict of interest relevant to this article was reported.BMCActa Medica Okayama1471-23182412024Long-term, patient-centered, frailty-based outcomes of older critical illness survivors from the emergency department: a post hoc analysis of the LIFE Study257ENTakashiHongoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTetsuyaYumotoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityMototakaInabaDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityShunsukeTaitoDepartment of Clinical Practice and Support, Hiroshima University HospitalTakashiYorifujiDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAtsunoriNakaoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityHiromichiNaitoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama Universitythe LIFE Study InvestigatorsDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityBackground Evidence indicates frailty before intensive care unit (ICU) admission leads to poor outcomes. However, it is unclear whether quality of life (QOL) and activities of daily living (ADL) for survivors of critical illness admitted to the ICU via the emergency department remain consistent or deteriorate in the long-term compared to baseline. This study aimed to evaluate long-term QOL/ADL outcomes in these patients, categorized by the presence or absence of frailty according to Clinical Frailty Scale (CFS) score, as well as explore factors that influence these outcomes.<br>
Methods This was a post-hoc analysis of a prospective, multicenter, observational study conducted across Japan. It included survivors aged 65 years or older who were admitted to the ICU through the emergency department. Based on CFS scores, participants were categorized into either the not frail group or the frail group, using a threshold CFS score of < 4. Our primary outcome was patient-centered outcomes (QOL/ADL) measured by the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) and the Barthel Index six months post-ICU admission, comparing results from baseline. Secondary outcomes included exploration of factors associated with QOL/ADL six months post-ICU admission using multiple linear regression analyses.<br>
Results Of 514 candidates, 390 participants responded to the EQ-5D-5L questionnaire, while 237 responded to the Barthel Index. At six months post-admission, mean EQ-5D-5L values declined in both the not frail and frail groups (0.80 to 0.73, p = 0.003 and 0.58 to 0.50, p = 0.002, respectively); Barthel Index scores also declined in both groups (98 to 83, p < 0.001 and 79 to 61, p < 0.001, respectively). Multiple linear regression analysis revealed that baseline frailty (β coefficient, -0.15; 95% CI, − 0.23 to − 0.07; p < 0.001) and pre-admission EQ-5D-5L scores (β coefficient, 0.14; 95% CI, 0.02 to 0.26; p = 0.016) affected EQ-5D-5L scores at six months. Similarly, baseline frailty (β coefficient, -12.3; 95% CI, − 23.9 to − 0.80; p = 0.036) and Barthel Index scores (β coefficient, 0.54; 95% CI, 0.30 to 0.79; p < 0.001) influenced the Barthel Index score at six months.<br>
Conclusions Regardless of frailty, older ICU survivors from the emergency department were more likely to experience reduced QOL and ADL six months after ICU admission compared to baseline.No potential conflict of interest relevant to this article was reported.Nature PortfolioActa Medica Okayama2041-17231412023Structural insights into photosystem II supercomplex and trimeric FCP antennae of a centric diatom Cyclotella meneghiniana8164ENSonghaoZhaoPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesLiliShenPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesXiaoyiLiPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesQiushuangTaoPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesZhenhuaLiPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesCaizheXuPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesCuicuiZhouPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesYanyanYangPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesMinSangChina National Botanical GardenGuangyeHanPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesLong-JiangYuPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesTingyunKuangPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesJian-RenShenResearch Institute for Interdisciplinary Science, Graduate School of Natural Science and Technology, Okayama UniversityWendaWangPhotosynthesis Research Center, Key Laboratory of Photobiology, Institute of Botany, Chinese Academy of SciencesDiatoms are dominant marine algae and contribute around a quarter of global primary productivity, the success of which is largely attributed to their photosynthetic capacity aided by specific fucoxanthin chlorophyll-binding proteins (FCPs) to enhance the blue-green light absorption under water. We purified a photosystem II (PSII)-FCPII supercomplex and a trimeric FCP from Cyclotella meneghiniana (Cm) and solved their structures by cryo-electron microscopy (cryo-EM). The structures reveal detailed organizations of monomeric, dimeric and trimeric FCP antennae, as well as distinct assemblies of Lhcx6_1 and dimeric FCPII-H in PSII core. Each Cm-PSII-FCPII monomer contains an Lhcx6_1, an FCP heterodimer and other three FCP monomers, which form an efficient pigment network for harvesting energy. More diadinoxanthins and diatoxanthins are found in FCPs, which may function to quench excess energy. The trimeric FCP contains more chlorophylls c and fucoxanthins. These diversified FCPs and PSII-FCPII provide a structural basis for efficient light energy harvesting, transfer, and dissipation in C. meneghiniana.No potential conflict of interest relevant to this article was reported.BMCActa Medica Okayama1471-24742512024The first presentation of a case of nail-patella syndrome newly diagnosed at the onset of rheumatoid arthritis: a case report139ENKazuyaMatsumotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshinoriMatsumotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShoichiNawachiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYosukeAsanoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYuKatayamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshiaMiyawakiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakayukiKatsuyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityEriKatsuyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshihisaNasuDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKen-EiSadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground Nail-patella syndrome (NPS) is a rare autosomal dominant disorder that is characterized by dysplasia of the nails, hypoplasia and/or dislocation of the patella and the presence of iliac horns. Using the CARE guidelines, we present the first reported case of NPS that was newly diagnosed at the onset of rheumatoid arthritis (RA).<br>
Case presentation A 74-year-old man was admitted to our hospital due to an 8-month history of arthralgia in bilateral wrists, elbows and fingers. He had a past history of glaucoma and left patella dislocation that had been operatively recentered at the age of 15 years. Laboratory data showed elevated levels of serum C-reactive protein and rheumatoid factor and an elevated titer of anti-SS-A antibodies, while estimated glomerular filtration rate (eGFR), titers of other antibodies and the results of a urinary test were normal. An X-ray showed deformity of bilateral radial heads and the right elbow, and magnetic resonance imaging (MRI) of his hands showed synovitis and erosion in the multiple swollen joints of the wrists and fingers. In addition to these typical features of RA, he had bilateral thumb nail dysplasia with mild hypoplasia of bilateral patellae and iliac horns as shown by the X-ray. He was diagnosed as having autosomal dominant disorder NPS co-existing with RA and he was treated with methotrexate in combination with an oral Janus kinase (JAK) inhibitor, leading to induction of remission.<br>
Conclusions We have presented a rare case of NPS that was newly diagnosed at the onset of RA. Clinical and radiographic findings of NPS are highlighted in this case report for diagnosing NPS on the basis of typical manifestations. No potential conflict of interest relevant to this article was reported.