WileyActa Medica Okayama1868-69742026Feasibility of Comprehensive Genomic Profiling for Biliary Tract Cancer Using Transpapillary Biopsy Samples: A Prospective StudyENKazuyaMiyamotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyukiMatsumotoDepartment of Endoscopy, Okayama University HospitalToshiakiOharaDepartment of Pathology and Experimental Medicine, Okayama University HospitalMasayoshiFujisawaDepartment of Pathology and Experimental Medicine, Okayama University HospitalHirohumiInoueDepartment of Medical Support, Okayama University HospitalRyosukeSatoDepartment of Gastroenterology and Hepatology, Okayama University HospitalAkihiroMatsumiDepartment of Endoscopy, Okayama University HospitalYukiFujiiDepartment of Endoscopy, Okayama University HospitalDaisukeUchidaDepartment of Gastroenterology and Hepatology, Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalBackground: Patients with biliary tract cancer (BTC) often have actionable mutations, and comprehensive genomic profiling (CGP) plays an important role. However, the feasibility of CGP using transpapillary biopsy (TPB) samples remains unclear.<br>
Methods: Thirty patients with suspected BTC based on radiographic imaging were enrolled. Pre-analytical criteria for CGP suitability were based on the OncoGuide NCC Oncopanel System (NCCOP) and FoundationOne CDx (F1CDx). Each patient underwent six biopsies using an endoscopic introducer: five biopsy samples were preserved as formalin-fixed paraffin-embedded (FFPE) samples and one as a fresh frozen (FF) sample. DNA quality indicators were compared between the two groups.<br>
Results: Malignancy was confirmed in 29 patients, and one had a benign biliary stricture. Suitability rate was 31% (9/29) for NCCOP and 3.4% (1/29) for F1CDx. Compared to FFPE samples, FF samples demonstrated significantly higher DNA concentration [ng/μL, interquartile range (IQR)], [0.34 (0.16–0.95) vs. 37.8 (11.6–67.6), p < 0.001] and DNA integrity number (IQR) [7.1 (6.8–7.3) vs. 8.9 (8.3–9), p = 0.021].<br>
Conclusions: Introducer-assisted multipass TPB may increase the rate of obtaining adequate CGP specimens, but its suitability remains limited and strongly panel dependent. Since FF samples have better DNA quality, establishing a system detailing their use is desirable.<br>
Trial Registration: ClinicalTrials.gov identifier: UMIN 000049826No potential conflict of interest relevant to this article was reported.岡山英文学会Acta Medica Okayama0389-7788532026奥付ENNo potential conflict of interest relevant to this article was reported.岡山英文学会Acta Medica Okayama0389-7788532026編集後記ENNo potential conflict of interest relevant to this article was reported.岡山英文学会Acta Medica Okayama0389-7788532026執筆者一覧ENNo potential conflict of interest relevant to this article was reported.岡山英文学会Acta Medica Okayama0389-7788532026人文学の重要性はいかに語られるのか―オックスフォード大学シュワルツマン・センターを手がかりに―4352ENNo potential conflict of interest relevant to this article was reported.岡山英文学会Acta Medica Okayama0389-7788532026『緋文字』におけるヘスターの適応戦略―進化心理学からの考察―2941ENNo potential conflict of interest relevant to this article was reported.岡山英文学会Acta Medica Okayama0389-7788532026『青と緑』から『波』への実験的手法の考察―色彩と語りの融合―1527ENNo potential conflict of interest relevant to this article was reported.岡山英文学会Acta Medica Okayama0389-7788532026Japanese Students’ Engagement with a Social Language Learning Space: Awareness, Anxiety, and Participation at L-café113ENJingzhouWangNo potential conflict of interest relevant to this article was reported.岡山英文学会Acta Medica Okayama0389-7788532026表紙・目次ENNo potential conflict of interest relevant to this article was reported.John Wiley & Sons LtdActa Medica Okayama1362-10173132026Early sedation intensity and psychological outcomes in critically ill adultse70500ENMikikoIwataniOkayama University Hospital; Graduate School of Health Sciences, Doctoral Program, Okayama UniversityMichikoMorimotoFaculty of Health Sciences, Okayama UniversityBackground: Long-term psychological impairment is a major concern for intensive care unit (ICU) survivors. Early deep sedation during mechanical ventilation has been associated with poor short-term outcomes and mortality after ICU discharge; however, its relationship with psychological outcomes remains unclear.<br>
Aim: To investigate sedation intensity during the first 24 h of mechanical ventilation and its association with psychological impairment 3 months after ICU discharge.<br>
Study Design: This retrospective ancillary analysis of a single-centre cohort study was conducted in two general ICUs at a university hospital in Japan. Eligible patients stayed in the ICU for more than 48 h and received mechanical ventilation for more than 8 h. Sedation intensity was quantified using the Sedation Index (SI) and Agitation Index (AI) derived from Richmond Agitation-Sedation Scale scores during the first 24 h. Psychological impairment 3 months post-ICU discharge was assessed based on symptoms of post-traumatic stress, anxiety and depression. Associations were examined using hierarchical logistic regression.<br>
Results: Among 130 participants, the median age was 64 years, and the median ventilation duration was 14 h. The median SI was 3.0; 47% had SI > 3, and 8.5% had AI > 0. Sedation intensity showed no significant association with psychological impairment (SI: adjusted odds ratio [OR] 0.87, 90% confidence interval [CI] 0.57–1.33, p = 0.59; AI: adjusted OR 0.21, 90% CI 0.01–3.08, p = 0.34). However, any agitation during the ICU stay was associated with psychological outcomes (adjusted OR 2.61, 90% CI 1.16–5.88, p = 0.05).<br>
Conclusions: This study did not identify a statistically significant association between early sedation intensity and psychological impairment 3 months after ICU discharge.<br>
Relevance to Clinical Practice: Critical care nurses should carefully titrate sedation from the initiation of mechanical ventilation to avoid unnecessary deep sedation, considering sedation intensity over time, while actively assessing agitation and its underlying causes.No potential conflict of interest relevant to this article was reported.Japan Poultry Science AssociationActa Medica Okayama1346-7395632026Supplementation of 5-Aminolevulinic Acid Suppressed Body Weight Loss and Reduced Disease Severity During Eimeria tenella Infection in Broiler Chickens2026010ENTaqi AhmadHanifLaboratory of Animal Physiology, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMakotoMatsubayashiDepartment of Veterinary Science, Graduate School of Veterinary Sciences, Osaka Metropolitan UniversityToshimitsuHatabuLaboratory of Animal Physiology, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityThis study aimed to evaluate the effects of 5-aminolevulinic acid (5-ALA) supplementation in broiler chickens infected with Eimeria tenella. To assess these effects, chickens supplemented with 20 ppm 5-ALA (5-ALA group) were compared with non-supplemented controls (control group). Sporulated E. tenella oocysts (2.0 × 103 oocysts per animal) were administered orally to 2-week-old broiler chickens. Body weight was measured weekly, and fecal samples were collected daily from 4 to 15 days post-infection (dpi). Fecal oocyst shedding was quantified using the sucrose flotation method. Cecal tissues were collected at 5 dpi for histopathological analysis and lesion scoring. The animals in the 5-ALA group exhibited significantly greater weight gain and milder clinical signs than those in the control group. Fecal oocyst shedding was highest at 7 dpi in both groups; however, the 5-ALA group exhibited significantly lower oocyst output than the control group. The total number of fecal oocysts shed during the acute infection period was significantly lower in the 5-ALA group than in the control group. Histopathological analysis revealed that although both groups exhibited epithelial hyperplasia and E. tenella schizonts in the cecal submucosa, inflammatory cell infiltration, cecal tissue damage, and histological lesion scores were significantly lower in the 5-ALA group than in the control group. These results suggest that 5-ALA supplementation may mitigate the clinical, parasitological, and histological effects of E. tenella infection in broiler chickens.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0341-81622692026Aeolian dust provenance across the Eurasian Asian steppe from grain-size dependent quartz δ18O in surface soils110109ENGeerTeniGraduate School of Science and Technology, University of TsukubaRyojiTanakaThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityMakiAsanoFaculty of Life and Environmental Sciences, University of TsukubaKenjiTamuraFaculty of Life and Environmental Sciences, University of TsukubaAeolian dust from the Eurasian interior significantly impacts climate, ecosystems, and soil formation, but the role of the Eurasian steppe as a dust source remains uncertain. We present grain-size-sorted quartz δ18O values in topsoil at 24 sites across the Eurasian steppe, from Ukraine and Kazakhstan to Xinjiang, Mongolia, and Inner Mongolia. Quartz fractions were separated from four fine soil classes (<2, 2–10, 10–20, 20–50 μm) at all sites, with additional coarse classes (50–200, 200–500, 500–2000 μm) at lithologically distinct locations. Coarse quartz grains in the Mongolian–Inner Mongolian Highlands show a relatively low and narrow δ18O range (7.6–9.0‰) over plutonic bedrocks and more variable higher values (8.9–17.8‰) over sedimentary bedrocks, indicating dependence on local lithology. In contrast, fine quartz grains (2–50 μm) exhibit a δ18O trend independent of bedrock lithology, indicating the values of regionally homogenized dust components. The δ18O values of the finest quartz fractions, exhibiting the highest at each site, decreased from the Western Steppe Plain (19.0 ± 0.8‰) through the Central Upland Steppe (18.0 ± 0.7‰) to the Mongolian–Inner Mongolian Highlands (13.8 ± 1.0‰), reflecting the distal dust input. Comparison with published quartz δ18O values for Mongolian and Northern China deserts and East Asian soils suggests that variable mixtures of these steppe end-members with Gobi and northern Chinese desert sources, along different atmospheric pathways of the East Asian winter monsoon, mid-latitude westerlies, and subtropical jets, can explain the aerosol-sized quartz in Japan and Korea.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8022026Revisiting Adrenal Crisis Triggered by Influenza Infection: Lessons from Two Fatal Cases153157ENYoshiyukiUedaDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTetsuyaYumotoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 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 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 UniversityKoseiHasegawaDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNatsukoFutagawaDepartment of Pediatrics, Okayama University HospitalHiromichiNaitoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAtsunoriNakaoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityCase Report10.18926/AMO/70458Adrenal crisis is a life-threatening endocrine emergency that can progress within hours despite a prior diagnosis and maintenance therapy. We describe a fatal influenza-triggered adrenal crisis in two patients: a child with panhypopituitarism and an adult with prior pituitary surgery, both presenting in cardiac arrest. Despite resuscitation and intravenous hydrocortisone, a fatal hypoxic-ischemic injury or multiorgan failure occurred. These cases highlight the fulminant course of an adrenal crisis and underscore the importance of early recognition, clinician awareness, prompt parenteral hydrocortisone administration, and reinforcement of education for patients, caregivers, and healthcare providers to improve preparedness and prevent avoidable deaths.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8022026Complete Transection of the Common Bile Duct Caused by Blunt Abdominal Trauma: A Rare Case Report147152ENShinyaSakamotoDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterMotoyasuTabuchiDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterAkiraHamadaDepartment of Intensive Care Medicine, Kochi Health Sciences CenterRikaYoshimatsuDepartment of Radiology, Kochi Health Sciences CenterYuichiSaisakaDepartment of Emergency and Critical Care Medicine, 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/70457Common bile duct (CBD) injury after blunt abdominal trauma is rare and difficult to diagnose. Delayed recognition leads to severe morbidity. A 70-year-old Japanese man was admitted after sustaining blunt abdominal trauma. Ultrasonography revealed intra-abdominal fluid, suggesting bleeding. Contrast-enhanced computed tomography revealed pancreatic head injury, intra-abdominal bleeding, and pseudoaneurysm of the anterior superior pancreatoduodenal artery (ASPDA). Bile duct injury was not evident. The application of transarterial embolization (TAE) controlled the bleeding. Canulation into the pancreatic or biliary duct was not possible during endoscopic retrograde cholangiopancreatography. An emergency laparotomy revealed severe pancreatic head and extrahepatic bile duct injuries. Pancreaticoduodenectomy/Child reconstruction was performed. Complete CBD transection was confirmed. The patient was ultimately discharged without complications. Early recognition, timely surgical management, and intensive care are essential for favorable outcomes in patients who have sustained abdominal trauma.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. 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J Med Microbiol (2020) 69: 233-238.Okayama University Medical SchoolActa Medica Okayama0386-300X8022026A Mixed-Methods Study on Changes in Interprofessional Education Attitudes and Fundamental Competencies: A Pre–Post Analysis of Clinical Training in Dietetic Students109117ENMikaSonoiDepartment of Foods and Human Nutrition, Faculty of Human Life Sciences, Notre Dame Seishin UniversityNorihiroSonoiCenter for Education in Medicine and Health Sciences, Okayama UniversityYokoKoyamaDepartment of Foods and Human Nutrition, Faculty of Human Life Sciences, Notre Dame Seishin UniversityOriginal Article10.18926/AMO/70453This study examined the effects of interprofessional education (IPE) on dietetics students during clinical training, focusing on changes in their attitudes toward IPE and their fundamental competencies. Eighty third-year female students (mean age, 21.0 years) at a Japanese women’s university participated. Self-administered surveys were conducted before and after clinical training to assess attitudes toward IPE using the Readiness for Interprofessional Learning Scale (RIPLS) and the Shakaijin Kisoryoku (SKL; Fundamental Competencies for Working Persons) scale. Quantitative data were analyzed using paired t-tests, chi-squared tests, and cluster analyses. Qualitative data from open-ended responses were analyzed thematically. RIPLS and SKL scores increased significantly, from 65.3 to 68.9, and from 28. 4 to 33. 2, respectively (p<0.001). All 12 SKL items showed significant improvement. In free responses, “initiative” (66 mentions), “communication” (10), and “execution” (8) were the most frequently cited as improved competencies. Cluster analysis identified three groups: increasing scores (n=25), high baseline (n=30), and minimal change (n=25). No significant correlation was found between changes in RIPLS and SKL scores (r=−0.108, p=0.355). 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New Dir Adult Contin Educ (1997) 1997: 5-12.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?. 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Rheumatol Int (2006) 26: 244-251.岡山大学算数・数学教育学会Acta Medica Okayama1341-3155312025奥付ENNo potential conflict of interest relevant to this article was reported.岡山大学算数・数学教育学会Acta Medica Okayama1341-3155312025岡山大学算数･数学教育学会誌規定6565ENNo potential conflict of interest relevant to this article was reported.岡山大学算数・数学教育学会Acta Medica Okayama1341-3155312025岡山大学算数･数学教育学会会則6364ENNo potential conflict of interest relevant to this article was reported.岡山大学算数・数学教育学会Acta Medica Okayama1341-3155312025学会だより6062ENNo potential conflict of interest relevant to this article was reported.岡山大学算数・数学教育学会Acta Medica Okayama1341-3155312025「数学的活動」の最適化5059EN 算数・数学教育では「数学的な見方・考え方を働かせ、数学的活動を通して、『数学的に考える』」という資質・能力を育成する方向が示されている(2017)。考える力の育成を叫ぶけれども、「個別最適な学び」「協働的な学び」という指導方法・授業スタイルに眼を奪われている。数学的活動は、「数学的に考える力」を育成する中心的な学習活動であるが、数学的な活動の在り方を分析・検討することには熱心でなく、教科書どおりのきまり切った活動をさせている。数学的活動には、外的活動と内的活動があり、どんな数学的活動にすれば最適化できるのかは容易ではない。外的な操作的活動は数理的なイメージを生み出す思考を促す。内的な数学的活動は直観的な数理的イメージを内面化し言語や記号と結びつけて､算数の概念や原理を形成する思考を生成する。外的及び内的な数学的活動は､相互に関連しつつ､シンクロしながら数理的思考を促進していくので、固定的に捉えないで､弾力的・機能的に捉えることが大切である。どのような活動にすれば、数学的に考える力は創発し、生成することができるのか、数学的活動の最適化を探究することは喫緊の課題である。No potential conflict of interest relevant to this article was reported.岡山大学算数・数学教育学会Acta Medica Okayama1341-3155312025「統合的・発展的に考える力」を育成する算数科の授業 ～６年「立体の体積」の学びを通して～4249EN VUCAの時代（※）を生き抜く子どもたちに必要な資質・能力の育成が喫緊の課題とされている。算数科では永年，「統合的・発展的に考える力」を育成すべき資質・能力の中核に置いてきた。この力はVUCAの時代にも通用する力であり，子どもが「自ら課題を見付け，自ら学び，自ら考える」（確かな学力、1996）原動力になる力であると考える。しかしながら，未だそれを十分達成することはできていない。それは，「統合的・発展的に考える力」を育成するシステムが示されておらず，プロセスが確立されていないからであると考える。<br>
3年後には新学習指導要領の告示が予想される今，改めて算数科で育成すべき資質・能力の中核である「統合的・発展的に考える力」の育成に焦点を当てる。６年「立体の体積」の学びを通して，「統合的・発展的に考える力」を育成するシステムを提案する。<br>
※「VUCAの時代」…Volatility（変動性），Uncertainty（不確実性），Complexity（複雑性），Ambiguity（曖昧性）のある時代。No potential conflict of interest relevant to this article was reported.岡山大学算数・数学教育学会Acta Medica Okayama1341-3155312025単元を貫く数学的活動で楽しい算数の授業 ―１年生「おおきいかず（４０までの数）」ー3441EN 本研究は、教具を体験する活動、教具を作る作業的活動、教具で説明する活動など様々な数学的活動を、同じ教具で単元をとおして行うことで、児童が意欲的に基礎的内容を理解するとともに、数学的な見方・考え方を働かせ、「１０といくつで１０いくつ」や「１０が何こで何十」「何十といくつで何十いくつ」の数の仕組みを理解できるようになっていく算数の授業実践研究である。No potential conflict of interest relevant to this article was reported.岡山大学算数・数学教育学会Acta Medica Okayama1341-3155312025算数科「部分に対する部分の割合に当たる大きさ」の問題解決のための足場がけ2433EN 小学５年生向けの一部の算数科教科書では，部分に対する部分の割合に当たる大きさを求める問題が扱われている．しかし，その問題解決は小学５年生には容易ではないと考えられる．そこで本稿は，どのような支援が部分に対する部分の割合に当たる大きさを求める問題解決に有効であるかを明らかにすることを目的とした．足場がけ (Scaffolding) を理論的枠組みとして，具体的な足場がけを構想し，授業を実践した．その結果，「学習者の頭の中で体験的にリアルな問題となるよう問題を工夫すること」，「児童にアイデアの一部 (どのような図的表現を用いたか) を紹介させること」，「図的表現を用いるよう促すこと」，「児童の必要感に応じて，ペアや小グループで互いの問題解決を見せ合うこと」，「児童が教室全体で自身の問題解決を発表すること」，「教師が問題文のどの情報に注目すべきかを指示すること」，「児童が他の児童に問題解決の達成を目指した説明をすること」が，有効な足場がけであることが示唆された．そして，それらの足場がけは，関わり合い機能させることが有効な場合もあることが示唆された．No potential conflict of interest relevant to this article was reported.岡山大学算数・数学教育学会Acta Medica Okayama1341-3155312025体系化を目指して割合の考えを深める比の授業1223EN〇本研究の目的は， 小学校算数科における比の授業実践を通して，児童自らが割合の考えを発展的・統合的に考察して深めることにある．第６学年「比とその利用」の学習までに学んだ既習の割合の考えと新規の比の考えを統合的・発展的に考察することで割合の考えは深まり，体系化する．しかし，割合と比を別々の概念として捉えてしまい，体系化が図られていない状況にある．比はＡ：Ｂ，割合はＡ／Ｂと表現方法は違うものの，両者は２つの数量の関係を表す場合，「一方を基準にして，もう一方はどんな大きさになるかを捉える」ことは本質に同じである．本実践を通して，児童自らが創造的数学力を発揮し，個の自立的な考えを集団での協働的な振り返り活動を通して割合と比を関連付け，統合的・発展的に考察することで，割合と比の概念は融合され，体系化が図られるという示唆を得た．No potential conflict of interest relevant to this article was reported.岡山大学算数・数学教育学会Acta Medica Okayama1341-3155312025小学校3年生のわり算の単元における二重に統合する場面の指導について ～かけ算，等分除，包含除の統合的把握におけるかけ算の意味理解の重要性～111EN 平成29年度告示の学習指導要領では，小学校算数科の目標を(1)知識及び技能，(2)思考力，判断力，表現力等，(3)学びに向かう力，人間性等の三本の柱に基づいて示している．特に(2)思考力，判断力，表現力等の内容として，「基本的な数量や図形の性質などを見出し統合的・発展的に考察する力」を養うと記述され，統合を通して子どもの考える力の向上が目指されている．<br>
本稿は，第 3 学年のわり算の等分除と包含除の問題を様々な視点から比較し，児童に統合する体験をさせることを目的としたものである．授業分析の結果，統合に関しては，等分除と包含除を統合するだけでなく，さらにかけ算とわり算を大きくかけ算とみて統合すること，つまり二重に統合する必要がある場合があり，かけ算の意味理解がこの場面の理解を助けるとともに，二重の統合に起因する学びの困難を指摘することができる．No potential conflict of interest relevant to this article was reported.岡山大学算数・数学教育学会Acta Medica Okayama1341-3155312025巻頭言ENNo potential conflict of interest relevant to this article was reported.岡山大学算数・数学教育学会Acta Medica Okayama1341-3155312025目次ENNo potential conflict of interest relevant to this article was reported.岡山大学算数・数学教育学会Acta Medica Okayama1341-3155312025表紙ENNo 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スクールカウンセラーは発達支持的生徒指導へいかに貢献できるか ―プランニングシートの活用を通した支援の拡充に向けた検討―253266ENNoriyukiHARARyoMISAWATazukoAOKI10.18926/CTED/70373 2022年に改訂された「生徒指導提要」では，すべての児童生徒の成長を支援する発達支持的生徒指導の重要性が明確に示されている。しかし，その定着には，教員の多忙化や組織的支援体制の不十分さなど，学校現場における多くの課題が指摘されている。さらに，スクールカウンセラー（SC）による支援も十分に展開されているとは言い難い。そこで本稿では，発達支持的生徒指導におけるSCの支援の拡充可能性を検討するため，現状と課題を整理した。また，プランニングシートを活用した実践事例（原他, 2024）の再分析を通して，SCと学校が教育目標を共有しながら協働的に支援を計画する枠組みの有用性を吟味した。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吹奏楽活動の地域展開における市民吹奏楽団の関わりに関する研究 ―市民吹奏楽団は地域展開の担い手になり得るか―123137ENKunihikoMAKINOCenter for Teacher Education and Development、Okayama University10.18926/CTED/70364 吹奏楽活動の地域展開（以下、地域展開）において、指導者や活動場所の不足は喫緊の課題である。本研究は、地域展開が進む中で、市民吹奏楽団が地域の子ども達の吹奏楽活動を支える担い手となり得るかを調査・検討した。岡山県内の市民吹奏楽団20 団体への聞き取り調査とテキストマイニング分析の結果、地域展開への意識には差がみられ、積極的な団体では子ども達の演奏指導や合同での活動を肯定的に捉える傾向が確認された。一方で、指導技術や時間的制約、責任負担への不安が障壁となっている可能性が示唆された。また、市民吹奏楽団が抱える活動場所や財政的な課題に対して公立学校施設の活用がその解決に寄与し得る可能性が示唆された。一方で、公立学校の施設開放については、実際の制度運用において自治体間の格差が存在することが明らかとなった。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凸レンズの像の左右理解に関する混乱の要因分析 教科書分析と教員アンケートによる探究的な学びへの提案3144ENKunihikoTANIMOTOFaculty of Education, Okayama UniversityYoshihikoINADAFaculty of Education, Okayama University10.18926/CTED/70358 本研究は、中学校理科の凸レンズ学習で生徒が像の向きに抱く混乱に着目した。その要因を、光源・スクリーン・観察場所といった実験条件が十分に意識されてこなかった点にあると考察し、学習指導要領と教科書の変遷分析、および現職教員へのアンケート調査を実施した。その結果、教科書の記述は観察場所を指定する方向へ変化しているものの、現場教員の指導法にはばらつきがあり、生徒の混乱を招く一因となっていることを明らかにした。これらの課題解決のため、観察視点を自然に固定できる3D プリンタ製教材を開発し、教員研修でその有効性を検討した。本教材は生徒の直感的理解を促し、探究的な学びを引き出す上で有効であることが示唆された。No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1432-08517532026A real-world comparison of nivolumab plus cabozantinib and pembrolizumab plus lenvatinib focusing on safety outcomes in metastatic renal cell carcinoma: results from the JK-FOOT consortium84ENTakafumiYanagisawaDepartment of Urology, The Jikei University School of MedicineKeiichiroMoriDepartment of Urology, The Jikei University School of MedicineTatsushiKawadaDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaSatoshiKatayamaDepartment of Urology, Comprehensive Cancer Center, Medical University of ViennaTakuyaTsujinoDepartment of Urology, Osaka Medical and Pharmaceutical UniversityRyoichiMaenosonoDepartment of Urology, Osaka Medical and Pharmaceutical UniversityShingoToyodaDepartment of Urology, Faculty of Medicine, Kindai UniversityTakuhisaNukayaDepartment of Urology, Fujita-Health University School of MedicineHirofumiMorinakaDepartment of Urology, Kawasaki Medical SchoolKeitaTamuraDepartment of Urology, Hamamatsu Medical UniversityWataruFukuokayaDepartment of Urology, The Jikei University School of MedicineFumihikoUrabeDepartment of Urology, The Jikei University School of MedicineMasayaMurakamiDepartment of Urology, The Jikei University School of MedicineKensukeBekkuDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKiyoshiTakaharaDepartment of Urology, Fujita-Health University School of MedicineKazutoshiFujitaDepartment of Urology, Faculty of Medicine, Kindai UniversityHaruhitoAzumaDepartment of Urology, Osaka Medical and Pharmaceutical UniversityMotooArakiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTeruoInamotoDepartment of Urology, Hamamatsu Medical UniversityKazumasaKomuraDepartment of Urology, Kawasaki Medical SchoolTakahiroKimuraDepartment of Urology, The Jikei University School of MedicinePurpose Immune checkpoint inhibitor (ICI)-based combination therapy is a standard first-line treatment for metastatic renal cell carcinoma (mRCC), with combinations such as nivolumab plus cabozantinib (Nivo + Cabo) and pembrolizumab plus lenvatinib (Pem + Len) demonstrating favorable oncologic outcomes. However, no direct comparisons between these two regimens have been conducted. This study aimed to compare the safety and oncologic outcomes of Nivo + Cabo and Pem + Len in patients with mRCC.<br>
Methods This retrospective study included 185 patients with mRCC treated with Nivo + Cabo (n = 81) or Pem + Len (n = 104) between January 2018 and June 2025 across multiple institutions. The primary outcome was a comparison of treatment-related adverse events (TrAEs). Oncologic outcomes, including objective response rate (ORR), progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS), were compared using one-to-one propensity score matching.<br>
Results Any-grade TrAEs occurred in 90% of patients in the Nivo + Cabo group and 92% in the Pem + Len group (p = 0.6). Severe TrAEs (grade ≥ 3) were more frequent in the Pem + Len group (44%) than in the Nivo + Cabo group (30%, p = 0.048). Tyrosine kinase inhibitor dose reduction and treatment discontinuation rates were similar between groups. In the matched cohort (Nivo + Cabo: n = 74; Pem + Len: n = 74), ORRs were comparable (66% vs. 71%, p = 0.6). With a median follow-up of 17 months, no significant differences were observed in PFS (p = 0.4), CSS (p = 0.9), or OS (p = 0.5).<br>
Conclusions Nivo + Cabo and Pem + Len demonstrated similar oncologic efficacy as first-line treatments for mRCC. However, Pem + Len was associated with more severe TrAEs. Careful toxicity management and shared decision-making are essential when selecting ICI-based combinations.No potential conflict of interest relevant to this article was reported.BON VIEW PUBLISHING PTEActa Medica Okayama2810-9503512025A Study on Zeek IDS Effectiveness for Cybersecurity in Agricultural IoT Networks133142ENSamsulHudaInterdisciplinary Education and Research Field, Okayama UniversityMuhammad BisriMusthafaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityS. M.ShamimGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYasuyukiNogamiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityAs agriculture moves toward Agriculture 4.0, which uses Internet of Things (IoT) devices to collect data in real time and monitor things from a distance, these networks are becoming increasingly vulnerable to cyberattacks. A common method used to protect against these kinds of threats is the use of intrusion detection systems (IDS). However, the agricultural environment is often changing and has limited resources, which makes cybersecurity challenging. Several available IDS tools are not designed to work properly in places with few resources, intermittent access, and unpredictable network conditions. This paper investigates the performance of Zeek, an open-source IDS, in identifying potential threats in agricultural IoT networks. We performed both offline and real-time experiments: offline analysis used pcap files from the Stratosphere Laboratory dataset, and real-time evaluation involved simulated live attack scenarios, focusing on unauthorized access attempts and distributed denial-of-service (DDoS) attacks. Zeek's performance was assessed based on CPU and memory utilization, as well as quality of service (QoS) metrics. From the experimental results, we found that Zeek was quite effective in protecting agricultural IoT networks against typical threats. Memory usage remained stable around 5% during offline analysis and under 20% during active attacks. However, CPU usage was more volatile, peaking at 120% during DDoS events. In terms of QoS, the system maintained a good throughput (1,375 kbits/s) with minimal packet loss (0.000186%). Among the attack types that we tested, brute force attacks, which represent attempts at unauthorized access, had the strongest effect on network performance, increasing delay to 2.159 ms and jitter to 0.793 ms. It seems clear that a heavier traffic load during such attacks can interfere with QoS. On the basis of our observation, we recommend practical deployment strategies for agricultural IoT systems that take these limitations into consideration, aiming to keep networks both secure and efficient under pressure.No potential conflict of interest relevant to this article was reported.岡山大学大学院ヘルスシステム統合科学研究科Acta Medica Okayama2436-322762026裏表紙・英文目次ENNo potential conflict of interest relevant to this article was reported.岡山大学大学院ヘルスシステム統合科学研究科Acta Medica Okayama2436-322762026投稿規程・奥付ENNo potential conflict of interest relevant to this article was reported.岡山大学大学院ヘルスシステム統合科学研究科Acta Medica Okayama2436-3227620262025 年度次世代医療機器開発人材育成プログラム BIZEN デバイスデザインコースの取り組み5968ENTsuneakiTSUZUKICenter for Innovative Clinical Medicine, Okayama University HospitalDaisukeUCHIDACenter for Innovative Clinical Medicine, Okayama University HospitalToshioKISHIMOTOOrganization for Research and Innovation Strategy, Okayama UniversityYoshinariSENGOKUCenter for Innovative Clinical Medicine, Okayama University HospitalToshioKORENAGAOrganization for Research and Innovation Strategy, Okayama UniversityYuHITOBECenter for Innovative Clinical Medicine, Okayama University HospitalYasuyukiYOSHIBAAcademic Field of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityJunSAKURAICenter for Innovative Clinical Medicine, Okayama University Hospital10.18926/interdisciplinary/70331No potential conflict of interest relevant to this article was reported.岡山大学大学院ヘルスシステム統合科学研究科Acta Medica Okayama2436-3227620262025 年度における「先進病院実習」の取り組み4957ENMizukiMORITAFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityMasakiMAGARIFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityJinWangFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityToyohikoWATANABEFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityMasatakaOITAFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityNahokoHARADAFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityKeisukeSHISHIDOFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama University10.18926/interdisciplinary/70330No potential conflict of interest relevant to this article was reported.岡山大学大学院ヘルスシステム統合科学研究科Acta Medica Okayama2436-322762026わが国のアドバンス・ケア・プランニングにおける地域住民への動機づけと評価についてのナラティブ・レビュー3947ENTakakoHASUIJapanese Red Cross Hokkaido College of NursingNaokoNAKAYAMAKanagawa University of Human Services10.18926/interdisciplinary/70329No potential conflict of interest relevant to this article was reported.岡山大学大学院ヘルスシステム統合科学研究科Acta Medica Okayama2436-322762026HIV 検査技術と日本における HIV 検査体制の変遷2737ENDechengWANGGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University10.18926/interdisciplinary/70328No potential conflict of interest relevant to this article was reported.岡山大学大学院ヘルスシステム統合科学研究科Acta Medica Okayama2436-322762026Shared Decision Making における患者参加の諸相と課題の考察1725ENMihoYOSHIDAGraduate School of Interdisciplinary Science and Engineering in Health Systems Okayama University10.18926/interdisciplinary/70327This paper traces the historical development of decision-making models in healthcare while exploring the meaning and practical significance of “patient participation” within the shared decision-making (SDM) framework. SDM is a recommended approach to clinical decision-making that emphasizes mutual information sharing and deliberation between physicians and patients. Traditional models often assume that patients can clearly articulate their values, preferences, and treatment goals. However, in actual clinical settings, particularly in cases of serious illness or life-threatening situations, patients frequently face emotional distress and psychological burdens, which can hinder their active participation in decision-making and the expression of their preferences. Based on SDM theory and practice reports, this study argues that SDM should not be viewed merely as a process that promotes patient choice. Even when patients choose not to actively participate and ultimately delegate decisions to healthcare providers or family members, such a choice can represent autonomous decision-making if it arises through meaningful communication and mutual understanding. This perspective calls for a more comprehensive and flexible interpretation of patient participation in SDM practice.No potential conflict of interest relevant to this article was reported.岡山大学大学院ヘルスシステム統合科学研究科Acta Medica Okayama2436-322762026介護技術論試論―高齢者介護を事例として―716ENYasuyukiYOSHIBAFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama University10.18926/interdisciplinary/70326In the first part of this paper, it was confirmed that the term “kaigo” (nursing care) was coined and its meaning defined during discussions on enacting social welfare legislation accompanying societal aging, as the care aspect was being “differentiated” from the “family’s health and welfare functions.” The paper also examined how the term “kaigo gijutsu”(nursing care technique) has been defined and used. In the latter part, based on the author’s own definition of “kaigo gijutsu”(nursing care technology), an attempt was made to analyze examples of technology utilization in nursing care settings, focusing on papers published in specialized welfare and nursing care technology journals. Through this preliminary study, it was shown that the author’s definition of “nursing care technology” clearly distinguishes between the means for care activities—such as welfare equipment—and the care recipients and caregivers who make use of them, and that this definition is useful for grasping the essence of challenges in nursing care settings.No potential conflict of interest relevant to this article was reported.岡山大学大学院ヘルスシステム統合科学研究科Acta Medica Okayama2436-322762026The effects of cold compresses on itching in patients with atopic dermatitis: A cross-over controlled pilot trial16ENYukiHIRAMIFormer Department of Nursing, Graduate School of Health Sciences, Okayama UniversityNahokoHARADADepartment of Nursing Science, Faculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityMihoONODepartment of Nursing, Faculty of Health, Kagawa Prefectural University of Health SciencesMasahideKODACo-learning Community Healthcare Re-innovation Office, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKiyokoFUKAIProfessor Emeritus, Okayama University, Graduate School of Nursing, The Jikei University School of Medicine10.18926/interdisciplinary/70325This cross-over controlled trial aimed to evaluate the effectiveness and safety of two types of cold compresses (towels and ice packs) in alleviating itching among patients with atopic dermatitis. The study recruited 19 participants diagnosed with atopic dermatitis and suffering from chronic itching for over 6 months. Each participant received both types of cold compress interventions. Itching sensations were assessed repeatedly using a visual analogue scale before and after the application of the cold compress. The mean and standard deviation of itching scores for the towel intervention were 16.9 ± 19.1 (baseline) and 11.4 ± 16.1 (post-application). For the ice pack intervention, the scores were 13.6 ± 14.7 (baseline) and 6.2 ± 9.8 (post-application). Although there was a reduction in mean itching scores following the application of cold compresses, the differences were not statistically significant for either intervention. Despite the lack of statistical significance, this study suggests that cold compresses, which are user-friendly and inexpensive, may safely reduce subjective itching in patients with atopic dermatitis without causing pain or discomfort. However, further research with a larger sample size is needed to confirm these findings.No potential conflict of interest relevant to this article was reported.岡山大学大学院ヘルスシステム統合科学研究科Acta Medica Okayama2436-322762026表紙・目次ENNo potential conflict of interest relevant to this article was reported.John Wiley & Sons Ltd.Acta Medica Okayama2314-613320252025Comparing the Activity of Peripheral Blood Mononuclear Cells Frozen Under Electromagnetic Field Freezing and Standard Slow-Freezing9884345ENTakehiroMatsubaraOkayama University Hospital BiobankMinaTakagiFaculty of Health Sciences, Okayama University Medical SchoolTakahiroUwaboDepartment of Biorepository Research and Networking, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunichiSohDepartment of Thoracic Surgery, Osaka Metropolitan University Graduate School of MedicineShinichiToyookaOkayama University Hospital BiobankMizukiMoritaOkayama University Hospital BiobankPeripheral blood mononuclear cells (PBMCs) are cells obtained from the blood that are used not only in clinical tests but also in various research applications. The slow-freezing (SLF) method, currently the standard for PBMC cryopreservation, involves extended storage at −80°C before transfer to liquid nitrogen. Delays in this transfer, such as overnight or weekend holds, risk a gradual decline in cell viability. Additionally, variability in freezing duration can lead to inconsistent cell quality, emphasizing the need for an alternative freezing method that allows for more timely transfer to liquid nitrogen. This study is aimed at clarifying whether the method of using a freezer with an applied electromagnetic field (EMF) is superior to the currently used standard SLF method for PBMC cryopreservation. A comparison of the number of viable cells, cell viability, and cell activity showed that the EMF method was equivalent to the SLF method. However, the shortest time required for freezing was significantly shorter with the EMF method than the SLF method (0.25 vs. 3 h), allowing for earlier transfer of PBMC to liquid nitrogen. This demonstrates that the EMF method offers an advantage in operational efficiency, particularly for facilities that routinely process and store PBMCs, such as biobanks and other storage-focused departments.No potential conflict of interest relevant to this article was reported.岡山大学教育学部国語研究会Acta Medica Okayama2189-5414402026奥付ENNo potential conflict of interest relevant to this article was reported.岡山大学教育学部国語研究会Acta Medica Okayama2189-5414402026「ぼっけえ」と「でえれえ」―同義的類義語の意味用法の分析―(48)(60)ENNo potential conflict of interest relevant to this article was reported.岡山大学教育学部国語研究会Acta Medica Okayama2189-5414402026枡野浩一『石川くん』に学ぶ韻文の書き換え ―文法と語彙の選択がもたらす表現の対照性―(37)(47)ENNo potential conflict of interest relevant to this article was reported.岡山大学教育学部国語研究会Acta Medica Okayama2189-5414402026昭和初期における郷土国語読本の検討 ―芦田恵之助と繋がりの深い宇和島和霊尋常小学校における読本編纂―(23)(36)ENNo potential conflict of interest relevant to this article was reported.岡山大学教育学部国語研究会Acta Medica Okayama2189-5414402026専検国語科の試験問題 ―統一問題にみる中学校国語科の教科内容―(13)(22)ENNo potential conflict of interest relevant to this article was reported.岡山大学教育学部国語研究会Acta Medica Okayama2189-5414402026訓読漢詩の音読について ―音読台本のすすめ―(1)(12)ENNo potential conflict of interest relevant to this article was reported.岡山大学教育学部国語研究会Acta Medica Okayama2189-5414402026《私の国語教室》 「即座の表現力」の育成4245ENNo potential conflict of interest relevant to this article was reported.岡山大学教育学部国語研究会Acta Medica Okayama2189-5414402026生成ＡＩの「もっともらしさ」を問い直す ―出典に立ち返る学習を通じて―3541ENNo potential conflict of interest relevant to this article was reported.岡山大学教育学部国語研究会Acta Medica Okayama2189-5414402026大津皇子と石川郎女の贈答歌 ―入門教材としての古典和歌―1834ENNo potential conflict of interest relevant to this article was reported.岡山大学教育学部国語研究会Acta Medica Okayama2189-5414402026魯迅「故郷」論 ―〈高い壁〉の中の「私」―117ENNo potential conflict of interest relevant to this article was reported.岡山大学教育学部国語研究会Acta Medica Okayama2189-5414402026表紙ENNo potential conflict of interest relevant to this article was reported.Japan Society of Mechanical EngineersActa Medica Okayama1880-55582012025Numerical analysis validating the standard k-epsilon model for the kinetic energy of turbulence subjected to weak but long-lasting wind tunnel blockage accelerationJFST0004ENAkiraONOGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHirokiSUZUKIGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityToshinoriKOUCHIGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKentoTANAKAGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityThe aim of this study is to investigate the effect of weak but prolonged mean flow accelerations, such as those observed in wind tunnel blockage acceleration, on free-stream turbulence. Specifically, this research aims to validate a model previously developed based on the k-epsilon model. To test this model, the study focuses on scenarios where the turbulence under acceleration is steady and isotropic, since the model suggests that this type of acceleration has no effect on the turbulent kinetic energy. To examine this suggestion, the turbulence within a periodic box was analyzed using large-eddy simulation (LES) based on the conventional Smagorinsky model framework. The numerical analysis is based on a method that conserves velocity fluctuation intensities. The results show that while high rate of acceleration deviates turbulent kinetic energy, low rate acceleration has hardly any effect on turbulent kinetic energy, enstrophy, pressure fluctuation, relative pressure fluctuation intensity, and higher-order statistics of a velocity fluctuation. These results validate the accuracy of the model proposed in the previous studies. These results were obtained by focusing on differences in Reynolds numbers and the spatial scale of the forcing.No potential conflict of interest relevant to this article was reported.Universitas Islam Negeri Alauddin MakassarActa Medica Okayama2548-53341722025Trend of adjusted antenatal care visits on pregnant women and neonatal during the COVID-19 pandemic: Findings from a three districts survey in 2021110118ENJulianiIbrahimDepartement of Public Health, Faculty of Medicine and Health Science, Universitas Muhammadiyah MakassarYokoTakahataNursing of Department, Graduate School of Health Science, Okayama UniversitySukaeniIbrahimFaculty of Medicine, Bosowa UniversitySustainable health development efforts amid infectious disease outbreaks such as Coronavirus disease 2019 (COVID-19) require a resilient maternal health system. With cases rising globally and across Asia, Indonesia faces significant disruptions in essential services. A critical research gap exist in utilizing adjusted time-series analysis to isolated pandemic impact from seasonal variation in urban Indonesia. This study evaluates trends in antenatal care (ANC) visits (January 2019–December 2020) at three Community Health Centres in Makassar: Bara-Baraya, Jongaya and Batua using Interrupted Time Series (ITS) analysis. Findings reveal a significant decline in visits during the second and third quarters of 2020, primarily due to transmission fears. We suggest integration of telemedicine and home visits to maintain continuity of care. Although focused on urban Makassar, these results are an important reference for health and offer applicable solutions for other developing countries facing resource constraints. This study emphasizes the need for inclusive prevention strategies to protect maternal health in urban and rural areas in low- to middle-income countries during systemic health crises.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裏表紙・目次ENNo 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岡山大学地球科学研究報告 投稿規定（約款）ENNo potential conflict of interest relevant to this article was reported.岡山大学理学部地球科学科Acta Medica Okayama1340-741432120262018年7月5日〜7日の西日本豪雨における広域降水特性3344ENKuranoshinKATOFaculty of Education, Okayama UniversityKengoMATSUMOTOOkayama Gakugeikan High SchoolKazuoOTANITV Setouchi Broadcasting Co., LTD.10.18926/ESR/70297 Large-scale rainfall characteristics at the heavy rainfall event around the western Japan for 5–7 July 2018 were analyzed with use of the 10-mimute precipitation data at the surface meteorological observation stations of the Japan Meteorological Agency, and so on. In this case, the area with 3 days total precipitation of near or more than 300 mm was distributed widely from northern Kyushu to Shiga and Fukui Prefectures. As in the many heavy rainfall events around Kyushu District in the mature stage of the Baiu season, contribution of the intense rainfall with more than 4 mm/10-minute (24 mm/h) attained about one third of the areal mean total precipitation. However, it is noted that the "not so intense rain" with less than 2 mm/10-minute (12 mm/h) also contributed to about one third of the huge total precipitation in the wide area. In short, this case could be characterized by the mixture of the western Japan type heavy rainfall event and the eastern Japan type one.No potential conflict of interest relevant to this article was reported.岡山大学理学部地球科学科Acta Medica Okayama1340-7414321202610分間降水量から大雨の特徴の多様性を捉える大学での授業の試み（防災気象リテラシー育成へ向けて）2131ENKuranoshinKATOFaculty of Education, Okayama University10.18926/ESR/70296 In the disaster prevention education on the heavy rainfall around Japan, it is also important to promote the meteorological literacy on the seasonal and regional differences of their rainfall characteristics such as the convective rain or stratiform rain, together with their total amount of precipitation and their occurrence frequency. As the first step toward the above purpose, the present study made a lesson practice for the university students by utilizing the 10-minute precipitation data for the four heavy rainfall events, in which the types of the heavy rainfall (although all the cases examined in the lesson are relating to the deep convective clouds) are rather different from each other, such as the differences of the rainfall intensity at the peak time, short-period variation of the rainfall intensity and the persistency of the rainfall including the "not so intense rainfall". The reports by the students seem to perceive the different features among these events briefly, but the students' attention to how long the intense rainfall with short-period variation or "not so intense rainfall" lasted was not so sufficient.No potential conflict of interest relevant to this article was reported.岡山大学理学部地球科学科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.岡山大学理学部地球科学科Acta Medica Okayama1340-74143212026岡山平野児島湾岸部での微動アレイ探査17ENNobuyukiYAMADAFaculty of Science and Technology, Kochi UniversityHiroshiTAKENAKADepartment of Earth Sciences, Okayama University10.18926/ESR/70294 This report describes microtremor array observations conducted at two sites for deep exploration and three sites for shallow exploration around Kojima Bay area in the southern Okayama Plain. Based on these records, the ground velocity structures were estimated. The results yielded solutions indicating the depth of the top of the seismic base layer (equivalent to 3 km/s layer) ranges from 140 to 300 m, while the depth of the top of the engineering basement layer (equivalent to 0.6 km/s layer) is approximately about 13–14 m. The shallow exploration results also suggested the possible presence of an inversion layer. These estimated velocity structure models provided a reasonable explanation for the observed phase velocities.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 Okayama1340-74143212026Title PageENNo 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表紙・英文目次ENNo potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671612026『論語集注』訳注（子罕第九 （二））(1)(20)ENLuyiSUN10.18926/70285No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671612026「国郡志御編集ニ付下調べ書出し帳」にみる広島藩の歌謡田植 ― 大田植の分布と種類に対する一つのアプローチ ―6584ENHiroshiTAKANO10.18926/70278No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671612026南オーストラリア州（アデレード）のリプロダクティブ・ヘルス＆ライツをめぐる現状と課題3146ENKeisukeSAITOSetsukoSUGANO10.18926/70276No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671612026多文化共修のためのグループワークから学生は何を感じたのか？ ― GIS ソフトを使用した地域研究授業からの一考察 ―120ENTakaoINAMORI10.18926/70274No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2055-02941212026Association between the incidence of infusion-related reactions by obinutuzumab and the dose of corticosteroid as premedication: a multicenter retrospective cohort study27ENTatsuyaOhtsuboDepartment of Pharmacy, Japanese Red Cross Kyoto Daini HospitalKazuhiroYamamotoDepartment of Integrated Clinical and Basic Pharmaceutical Sciences, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySaoriMatumotoDepartment of Pharmacy, Japanese Red Cross Osaka HospitalKaoriItoFaculty of Pharmacy, Meijo UniversityYuzukaSasaDepartment of Pharmacy, Kindai University HospitalKosukeTomishimaDepartment of Pharmacy, Japanese Red Cross Kyoto Daiichi HospitalSatoshiDoteDepartment of Pharmacy, Kyoto-Katsura HospitalKatuyaMakiharaDepartment of Pharmacy, Yodogawa Christian HospitalYoshinoriWakasugiDepartment of Pharmacy, Shiga University of Medical Science HospitalTsutomuMitsuieDepartment of Pharmacy, Japanese Red Cross Otsu HospitalKouheiYamagiwaDepartment of Pharmacy, Saiseikai Shiga HospitalKazuoSatoDepartment of Pharmacy, Japan Baptist HospitalHirokiHasegawaDepartment of Pharmacy, Rakuwakai Otowa HospitalNobuhikoUoshimaDepartment of Hematology, Japanese Red Cross Kyoto Daini HospitalYumiKitahiroDepartment of Pharmacy, Kobe University HospitalKanjiTomoganeDepartment of Pharmacy, Japanese Red Cross Kyoto Daini HospitalBackground Premedication with corticosteroids is recommended for prophylaxis against infusion-related reactions (IRRs) caused by obinutuzumab despite a lack of solid evidence regarding the dose of corticosteroids.<br>
Methods The incidence rates of IRR in the high-dose and low-dose corticosteroid groups were investigated and compared using Student’s t-test.Univariable and multivariable logistic regression analyses were performed on patients to explore the risk of developing IRRs with obinutuzumab.<br>
Results The incidence of IRRs in the high-dose and low-dose corticosteroid groups at the initial administration of obinutuzumab was 27.0% (41/152) and 48.4% (31/64), respectively, indicating that the high-dose group had a lower incidence of IRRs (p = 0.002). The incidence of IRRs at the initial administration of obinutuzumab was significantly associated with the administration of first-generation histamine 1 receptor antagonist (OR = 3.31, 95% CI: 1.16–9.47; reference: second-generation histamine 1 receptor antagonist), hydrocortisone (OR = 7.21, 95% CI: 1.57–33.15; reference: dexamethasone), and methylprednisolone (OR = 3.99, 95% CI :1.13–14.10; reference: dexamethasone), although no association was found with the lower dose of corticosteroids.<br>
Conclusions Although no association was found between corticosteroid dosage and IRR when considering multiple factors, dexamethasone may be a better option than hydrocortisone or methylprednisolone for preventing IRR. Additionally, second-generation H1-receptor antagonists may be a better option than first-generation drugs. Certain combinations of premedications may influence infusion reaction incidence.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2076-34171652026Concentration-Dependent Synergistic Interfacial Interactions Between Multifunctional Acrylate and Silane Coupling Agents in an Organic–Inorganic Nanohybrid Material2339ENYukinoriMaruoDepartment of Prosthodontics, Okayama UniversityKumikoYoshiharaHealth Research Institute, National Institute of Advanced Industrial Science and TechnologyMasaoIrieDepartment of Biomaterials, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNoriyukiNagaokaAdvanced Research Center for Oral and Craniofacial Sciences, Dental School, Okayama UniversityNaokiKodamaDepartment of Prosthodontics, Okayama UniversityMaiYoshizaneDepartment of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKentaroAkiyamaDepartment of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySynergistic effects of a multifunctional acrylate and a long-chain silane coupling agent were investigated in an organic–inorganic nanohybrid material. We tested the bond strength of nanohybrid composites treated with experimental primers containing silane coupling agents—3-methacryloxypropyl trimethoxysilane (γ-MPTS) or 8-methacryloxyoctyl trimethoxysilane (8-MOTS)—with or without multifunctional acrylates—trimethylolpropane triacrylate (A-TMPT) or dipentaerythritol hexaacrylate (A-DPH). Shear bond strength was evaluated after 24 h of water storage at 37 °C. Untreated control and silane-only groups exhibited low shear bond strengths (e.g., control: 2.4 ± 2.0 MPa) and failed exclusively at the adhesive interface. While addition of A-TMPT did not significantly improve bond strength, addition of A-DPH produced significantly higher shear bond strengths. Highest strength was achieved with 30% 8-MOTS and A-DPH (22.4 ± 6.1 MPa), followed by 20% γ-MPTS and A-DPH (19.0 ± 7.0 MPa), and A-DPH groups produced cohesive failures. Regardless of the silane used (γ-MPTS or 8-MOTS), incorporating A-DPH in the primer consistently yielded superior bond strengths, indicating a promising strategy for improved adhesion for such nanohybrid systems. These findings provide new insights into optimizing resin–filler interfacial interactions and may contribute to the development of restorative materials with improved long-term clinical durability.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama2752-4191562025Sex differences in the progression of cardiovascular–kidney–metabolic syndromeoeaf162ENSatoshiTayaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaroEjiriDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHidehiroKanekoDepartment of Cardiovascular Medicine, The University of TokyoYutaSuzukiDepartment of Advanced Cardiology, The University of TokyoToruMiyoshiDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsushiMizunoDepartment of Cardiology, Medical Quality Management Office, QI Center, St. Luke's International HospitalToshiyukiKoDepartment of Cardiovascular Medicine, The University of TokyoTakahiroJimbaDepartment of Cardiovascular Medicine, The University of TokyoTatsuhikoAzegamiDivision of Nephrology, Endocrinology, and Metabolism, Department of Internal Medicine, Keio University School of MedicineAkiraOkadaDepartment of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of TokyoKatsuhitoFujiuDepartment of Cardiovascular Medicine, The University of TokyoNorifumiTakedaDepartment of Cardiovascular Medicine, The University of TokyoHiroyukiMoritaDepartment of Cardiovascular Medicine, The University of TokyoKaoriHayashiDivision of Nephrology, Endocrinology, and Metabolism, Department of Internal Medicine, Keio University School of MedicineKoichiNodeDepartment of Cardiovascular Medicine, Saga UniversityMasaomiNangakuDivision of Nephrology and Endocrinology, The University of Tokyo Graduate School of MedicineHideoYasunagaDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of TokyoNorihikoTakedaDepartment of Cardiovascular Medicine, The University of TokyoShinsukeYuasaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAims Cardiovascular–kidney–metabolic (CKM) syndrome is a novel disease concept; however, sex differences in its progression remain uncertain. This study aimed to quantify the risk of cardiovascular disease (CVD) events across CKM stages and to explore sex differences in this association.<br>
Methods and results We included 1 332 436 individuals (581 423 males and 751 013 females) from the DeSC database between 2014 and 2023 who had no prior CVD (i.e. CKM Stage 4). CKM stages were categorized as follows: Stage 0 (no CKM risk factors); Stage 1 (excess or dysfunctional adiposity); Stage 2 [metabolic risk factors and chronic kidney diseases (CKD)], and Stage 3 (subclinical CVD). We used Cox models to examine the association of CKM stages with the risk of CVD events (newly developed CKM Stage 4), including myocardial infarction, stroke, heart failure, atrial fibrillation, and peripheral artery disease. The progression from CKM Stages 0 to 3 showed a dose-dependent increase in adjusted hazard ratios (HR) for developing CVD events, with the highest risk at Stage 3 [1.85 (95% CI: 1.80–1.90)]. A similar pattern was observed in both males and females. However, the magnitude of associations for CKM stages 1–3 differed between the sexes: HR by Stage 1, 1.12 (1.04–1.21) vs. 1.12 (1.07–1.16); by Stage 2, 1.78 (1.69–1.88) vs. 1.43 (1.39–1.48); by Stage 3, 1.99 (1.89–2.10) vs. 1.82 (1.76–1.88); and P-for-interaction values were 0.87, < 0.001, and 0.005, respectively.<br>
Conclusion In this large nationwide cohort, CKM stage progression was associated with higher CVD risk in both sexes, with modest sex-specific differences. These findings highlight the value of CKM staging for early risk assessment, regardless of sex.No potential conflict of interest relevant to this article was reported.岡山大学文学部学芸員課程Acta Medica Okayama202025学芸員課程 Newsletter 第20号EN10.18926/70233No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1471-22612512025Prognostic value of right atrial strain in patients with chronic heart failure908ENRieNakayamaDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Science, Okayama University Graduate School of MedicineYoichiTakayaDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Science, Okayama University Graduate School of MedicineMitsutakaNakashimaDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Science, Okayama University Graduate School of MedicineTakahiroNishiharaDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Science, Okayama University Graduate School of MedicineNorihisaTohDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Science, Okayama University Graduate School of MedicineMiyoshiToruDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Science, Okayama University Graduate School of MedicineKazufumiNakamuraDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Science, Okayama University Graduate School of MedicineShinsukeYuasaDepartment of Cardiovascular Medicine, Dentistry and Pharmaceutical Science, Okayama University Graduate School of MedicineAims Right ventricular dysfunction is a well-established prognostic marker in patients with heart failure (HF). However, the prognostic significance of right atrial (RA) function remains unclear. Given its sensitivity to systemic congestion, RA function may provide additional insights into HF disease progression and management. This study aimed to investigate whether RA reservoir function serves as an independent prognostic indicator in patients with chronic HF.<br>
Methods A total of 613 patients with chronic HF and a left ventricular (LV) ejection fraction of less than 50% who underwent echocardiographic assessment at Okayama University Hospital between January 2018 and March 2023 were included (median age: 68 (58–76) years; 69% male). RA reservoir function was quantified using two-dimensional speckle-tracking echocardiography. The primary endpoint was cardiovascular death or HF-related hospitalization. Kaplan–Meier survival analysis was performed to examine the association between RA reservoir function and clinical outcomes.<br>
Results During a median follow-up period of 41 months (range: 12–91 months), 119 patients experienced cardiac events. Compared with event-free patients, those with cardiac events exhibited a significantly larger RA maximum volume index (38 mL/m2 vs. 31 mL/m2, P < 0.001) and a significantly lower RA reservoir longitudinal strain (RASr) (17% vs. 22%, P < 0.001). Kaplan–Meier analysis demonstrated that patients with RASr ≤ 20% had significantly poorer event-free survival than those with RASr > 20%, even without RA volume enlargement (log-rank test, P < 0.001). Multivariate Cox regression analysis identified RASr as an independent predictor of cardiac events (hazard ratio: 0.95, 95% confidence interval: 0.93 to 0.97, P < 0.001).<br>
Conclusions In patients who experienced adverse cardiac events, a reduced RASr and an increased RA maximum volume were observed. Furthermore, a reduced RASr was independently associated with an increased risk of cardiovascular death and HF-related hospitalization in patients with chronic HF and LV dysfunction. These findings indicate that RASr may serve as a valuable prognostic marker for the risk stratification and management of chronic HF.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1613-681021502025Collagen Signaling via DDR1 Exacerbates Barriers to Macromolecular Drug Delivery in a 3D Model of Pancreatic Cancer Fibrosise06926ENMayuOhiraDepartment of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMoeKitamuraDepartment of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiroyoIwasakiDepartment of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHarukoOhta‐OkanoDepartment of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiyoriTsujiiDepartment of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityReikaNakamuraDepartment of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakuyaNakazawaDepartment of Pharmaceutical Biomedicine, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityAkihiroNishiguchiBiomaterials Field, Research Center for Macromolecules and Biomaterials, National Institute for Materials ScienceMasayaYamamotoDepartment of Materials Processing, Graduate School of Engineering, Tohoku UniversityKensukeOsadaDepartment of Molecular Imaging and Theranostics, Institute for Quantum Medical Science, National Institutes for Quantum Sciences and Technology (QST)ShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHoracioCabralDepartment of Bioengineering, Graduate School of Engineering, The University of TokyoAtsushiMasamuneDivision of Gastroenterology, Graduate School of Medicine, Tohoku UniversityMitsunobu R.KanoDepartment of Pharmaceutical Biomedicine, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityHiroyoshi Y.TanakaDepartment of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityFibrosis is a significant barrier to drug delivery in pancreatic ductal adenocarcinoma (PDAC) and contributes to its dismal prognosis. Pancreatic stellate cells (PSCs) drive fibrosis by excessively secreting extracellular matrix proteins such as collagen I. Collagen I is thought to physically obstruct the delivery of macromolecules, such as albumin, antibodies, and nanomedicines. Apart from its structural role, collagen signals through dedicated cell surface receptors, such as the discoidin domain receptors (DDR) 1/2. However, whether and how collagen signaling contributes to fibrotic barrier generation remains uncharacterized. Here, a 3D culture model of PDAC fibrosis constructed from patient PSCs is used to assess the contribution of DDR1/2-mediated collagen signaling. DDR1/2 inhibition diminishes collagen I expression in PSCs to enhance macromolecular delivery. Moreover, MEK inhibitors exacerbate the fibrotic barrier by up-regulating collagen I, an effect reversed by inhibiting DDR1/2. Through isoform-specific targeting, inhibiting DDR1, but not DDR2, is shown to be effective. Downstream of DDR, the involvement of the PI3K/AKT/mTOR pathway is demonstrated, particularly alternative mTOR complexes involving MEAK7 and GIT1. Altogether, the results show in vitro that DDR1-mediated collagen signaling exacerbates the fibrotic barrier and may be targeted to enhance macromolecular drug delivery in PDAC.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1546-00962312025Comparison of clinical practices during the transitional and young adult phases between patients with oligoarticular/polyarticular juvenile idiopathic arthritis and those with rheumatoid arthritis in Japan120ENShoMoriDivision of Rheumatology and Allergology, Department of Internal Medicine, St. Marianna University School of MedicineKosukeShabanaDepartment of Pediatrics, Osaka Medical and Pharmaceutical UniversityToshihiroMatsuiDepartment of Rheumatology Research, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National HospitalTomoNozawaDepartment of Pediatrics, Graduate School of Medicine, Yokohama City UniversityYukoSugitaDepartment of Pediatrics, Osaka Medical and Pharmaceutical UniversityMinakoTomiitaDepartment of Allergy and Rheumatology, Chiba Children’s HospitalYasuoNakagishiDepartment of Pediatric Rheumatology, Hyogo Prefectural Kobe Children’s HospitalYuichiYamasakiDepartment of Pediatrics, Kagoshima University HospitalHiroakiUmebayashiDepartment of General Pediatrics, Miyagi Children’s HospitalMasatoYashiroDepartment of Pediatrics, Okayama University HospitalNaomiIwataDepartment of Infection and Immunology, Allergy and Immunology Center, Aichi Children’s Health and Medical CenterJunkoYasumuraDepartment of Pediatrics, Hiroshima University Graduate School of Biomedical and Health SciencesHiroyukiWakiguchiDepartment of Pediatrics, Yamaguchi University Graduate School of MedicineTakeshiYamamotoDepartment of Pediatrics, Chiba University Graduate School of MedicineShunichiroTakezakiDepartment of Pediatrics, Faculty of Medicinea and Graduate School of Medicine, Hokkaido UniversityYukaOkuraCenter for Pediatric Allergy and Rheumatology, KKR Sapporo Medical CenterTadafumiYokoyamaDepartment of Pediatrics, Kanazawa UniversityMasakiShimizuDepartment of Pediatrics, Perinatal and Maternal Medicine, Graduate School of Medical and Dental Sciences, Institute of Science TokyoMasahiroHirayamaDepartment of Pediatrics, Mie University Graduate School of MedicineShigetoTohmaDepartment of Rheumatology, National Hospital Organization Tokyo National HospitalNamiOkamotoDepartment of Pediatrics, Osaka Medical and Pharmaceutical UniversityMasaakiMoriDivision of Rheumatology and Allergology, Department of Internal Medicine, St. Marianna University School of MedicineBackground Juvenile idiopathic arthritis (JIA) is a chronic inflammatory condition that frequently persists into adulthood, posing long-term challenges in disease control and quality of life. However, clinical management during the transitional and young adult phases remains insufficiently characterized, especially in comparison with adult-onset rheumatoid arthritis (RA). This study aimed to compare disease activity, medication use, and treatment practices between patients with oligoarticular/polyarticular JIA and those with RA, focusing on individuals aged 16–30 years.<br>
Methods Data were derived from two nationwide multicenter databases in Japan—NinJa (National Database of Rheumatic Diseases in Japan) for RA and CoNinJa (a pediatric counterpart of NinJa) for JIA. A total of 176 JIA and 152 RA patients, all aged 16–30 years, were analyzed. Clinical parameters, disease activity indices, and medication profiles were compared using the Mann–Whitney U test and Fisher’s exact test.<br>
Results Compared to RA patients, JIA patients demonstrated significantly lower disease activity (median SDAI 0.6 vs. 2.4) and higher remission rates, particularly Boolean remission (70% vs. 44%) (p < 0.001). MTX usage was less frequent in JIA (49% vs. 68%, p < 0.001), whereas biologic use was notably more common (69% vs. 38%, p < 0.001), with 31% involving off-label prescriptions. Among patients in CDAI remission, biologic monotherapy was observed more frequently in JIA (29% vs. 7%, p < 0.001). Discontinuation of MTX was most commonly attributed to disease improvement (58%) or gastrointestinal intolerance (nausea, 29%). Subcutaneous tocilizumab, though unapproved for JIA in Japan, had the lowest discontinuation rate (4%), suggesting favorable tolerability.<br>
Conclusions Despite an overlap in age, patients with JIA and RA exhibit distinct disease characteristics and therapeutic patterns. These differences underscore the need to expand approved treatment options for JIA, promote equitable access to biologics, and strengthen transitional care frameworks. Further research is warranted to explore long-term outcomes, reproductive health considerations, and socioeconomic barriers that influence treatment continuity in young adults with childhood-onset arthritis.No potential conflict of interest relevant to this article was reported.American Medical Association (AMA)Acta Medica Okayama2574-38058112025Trastuzumab Deruxtecan for ERBB2-Mutant Metastatic Non–Small Cell Lung Cancer With or Without Brain Metastases: A Secondary Analysis of Randomized Clinical Trialse2543107ENPasi A.JänneLowe Center for Thoracic Oncology, Dana-Farber Cancer InstituteDavidPlanchardDepartment of Medical Oncology, Thoracic Cancer Group, Gustave Roussy, Medical OncologyKoichiGotoDepartment of Thoracic Oncology, Nation Cancer Center Hospital EastEgbert F.SmitDepartment of Pulmonary Diseases, Leiden University Medical CenterAdrianus Johannesde LangenDepartment of Thoracic Oncology, Netherlands Cancer InstituteYasushiGotoDepartment of Thoracic Oncology, National Cancer Center HospitalKiichiroNinomiyaCenter for Comprehensive Genomic Medicine, Okayama University HospitalToshioKuboCenter for Clinical Oncology, Okayama University HospitalMauricePérolDepartment of Medical Oncology, Centre Léon BérardEnriquetaFelipDepartment of Medical Oncology, Vall d’Hebron University and Vall d’Hebron Institute of OncologyHidetoshiHayashiDepartment of Medical Oncology, Kindai University Faculty of MedicineKazuhikoNakagawaDepartment of Medical Oncology, Kindai University Faculty of MedicineJunichiShimizuDepartment of Thoracic Oncology, Aichi Cancer CenterMisakoNagasakaDivision of Hematology-Oncology, Department of Medicine, University of California IrvineKalinePereiraDaiichi Sankyo IncAyumiTaguchiDaiichi Sankyo Co LtdAhmedAliDaiichi Sankyo Europe GmbHMahaKarnoubDaiichi Sankyo IncRieYonemochiDaiichi Sankyo IncDavidLeungDaiichi Sankyo IncBob T.LiThoracic Oncology and Early Drug Development Service, Global Research Program, Memorial Sloan Kettering Cancer CenterImportance Brain metastases reduce overall survival rates of patients with non–small cell lung cancer (NSCLC); patients with epidermal growth factor receptor 2 (ERBB2 [formerly HER2])–mutant NSCLC are more likely to have baseline brain metastases. Trastuzumab deruxtecan (T-DXd) is an approved ERBB2-directed treatment for previously treated unresectable or metastatic ERBB2-mutant NSCLC.<br>
Objective To assess the clinical effectiveness and safety of T-DXd 5.4 mg/kg and 6.4 mg/kg doses in patients with previously treated ERBB2-mutant metastatic NSCLC with or without untreated or previously treated stable brain metastases.<br>
Design, Setting, and Participants This post hoc secondary analysis pooled patients from the DESTINY-Lung01 (data cutoff date: December 3, 2021) and DESTINY-Lung02 (data cutoff date: December 23, 2022) clinical trials by T-DXd dose (5.4 mg/kg and 6.4 mg/kg). DESTINY-Lung01 was a multicenter, open-label, 2-cohort, nonrandomized phase 2 study, while DESTINY-Lung02 was a dose-blinded, multicenter, 2-cohort, randomized phase 2 study. Participants had a previously treated ERBB2-mutant metastatic NSCLC with or without untreated or previously treated stable brain metastases at baseline. All statistical analyses were performed from April 2023 to October 2024.<br>
Intervention Patients received a T-DXd dose of either 5.4 mg/kg or 6.4 mg/kg intravenously every 3 weeks.<br>
Main Outcome and Measure Systemic and intracranial effectiveness by blinded independent central review using RECIST (Response Evaluation Criteria in Solid Tumors) version 1.1, sites of progression, and safety.<br>
Results This analysis included 102 patients in the T-DXd 5.4-mg/kg dose group (65 females [64%]; median [range] age, 57.5 [37.0-83.0] years and 59.5 [30.0-79.0] years in patients with and without brain metastases, respectively) and 141 patients in the T-DXd 6.4-mg/kg dose group (94 females [67%]; median [range] age, 62.5 [29.0-88.0] years and 59.0 [27.0-83.0] years in patients with and without brain metastases, respectively). In each group, 31% (32 of 102) and 38% (54 of 141) of patients, respectively, had baseline brain metastases and 53% (17 of 32) and 44% (24 of 54), respectively, received prior brain metastasis treatment. In patients with and without brain metastases, systemic confirmed objective response rates (ORRs) were 47% (15 of 32; 95% CI, 29%-65%) and 50% (35 of 70; 95% CI, 38%-62%), respectively, with the T-DXd 5.4-mg/kg dose, and 50% (27 of 54; 95% CI, 36%-64%) and 59% (51 of 87; 95% CI, 48%-69%) with the T-DXd 6.4-mg/kg dose. Median progression-free survival was 7.1 (95% CI, 5.5-9.7) months in the T-DXd 5.4-mg/kg dose group and 7.1 (95% CI, 4.5-9.6) months in the T-DXd 6.4-mg/kg dose group of patients with baseline brain metastases. Among patients with measurable baseline brain metastases, intracranial confirmed ORRs were 50% (7 of 14; 95% CI, 23%-77%) with the T-DXd 5.4-mg/kg dose and 30% (9 of 30; 95% CI, 15%-49%) with the T-DXd 6.4-mg/kg dose. At both doses, the safety profile of T-DXd was generally manageable, regardless of baseline brain metastases, favoring the T-DXd 5.4 mg/kg dose.<br>
Conclusions and Relevance In this secondary analysis, T-DXd at the approved dose of 5.4 mg/kg showed antitumor activity in patients with previously treated ERBB2-mutant metastatic NSCLC with or without brain metastases. This finding supports T-DXd 5.4 mg/kg use in this population.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1556-086420122025Final Analysis Results and Patient-Reported Outcomes From DESTINY-Lung02—A Dose-Blinded, Randomized, Phase 2 Study of Trastuzumab Deruxtecan in Patients With HER2-Mutant Metastatic NSCLC18141828ENPasi A.JänneLowe Center for Thoracic Oncology, Dana-Farber Cancer InstituteYasushiGotoDepartment of Thoracic Oncology, National Cancer Central HospitalToshioKuboCenter for Clinical Oncology, Okayama University HospitalKiichiroNinomiyaCenter for Comprehensive Genomic Medicine, Okayama University HospitalSang-WeKimOncology Department, Asan Medical Center, Seoul, and University of Ulsan College of Medicine, UlsanDavidPlanchardDepartment of Medical Oncology, Thoracic Cancer Group, Gustave Roussy, and Faculty of Medicine, Paris-Saclay UniversityMyung-JuAhnDepartment of Hematology and Oncology, Samsung Medical Center Sungkyunkwan, and University School of MedicineEgbertSmitDepartment of Pulmonary Diseases, Leiden University Medical CenterAdrianusJohannes de LangenDepartment of Thoracic Oncology, Netherlands Cancer InstituteMauricePérolDepartment of Medical Oncology, Léon Berard CentreElvirePons-TostivintCentre Hospitalier Universitaire Nantes, Nantes UniversitySilviaNovelloDepartment of Oncology, University of Turin, Turin, and Azienda Ospedaliero-Universitaria San Luigi GonzagaHidetoshiHayashiDepartment of Medical Oncology, Kindai University HospitalJunichiShimizuDepartment of Thoracic Oncology, Aichi Cancer Center HospitalDong-WanKimDepartment of Internal Medicine, Seoul National University College of Medicine and Seoul National University HospitalKalinePereiraDaiichi SankyoFu-ChihChengDaiichi SankyoAyumiTaguchiDaiichi SankyoYingkaiChengDaiichi SankyoKyleDuntonDaiichi Sankyo UKAhmedAliDaiichi Sankyo Europe GmbHKoichiGotoDepartment of Thoracic Oncology, National Cancer Center Hospital EastIntroduction: Trastuzumab deruxtecan (T-DXd) demonstrated strong and durable responses in patients with previously treated HER2 (ERBB2) mutant (HER2m) metastatic NSCLC (mNSCLC) in the DESTINY-Lung02 primary analysis (December 23, 2022, data cutoff). This final analysis evaluated T-DXd efficacy and safety after 8 additional months of follow-up, including clinically relevant subgroups and patient-reported outcomes.<br>
Methods: DESTINY-Lung02 was a randomized, dose-blinded, multicenter, phase 2 trial. Patients with previously treated HER2m mNSCLC were randomized 2:1 to receive T-DXd 5.4 or 6.4 mg/kg once every 3 weeks. Primary end point was confirmed objective response rate by blinded independent central review.<br>
Results: As of August 25, 2023, 102 and 50 patients had received T-DXd 5.4 or 6.4 mg/kg, respectively. Median follow-up (Q1–Q3) was 15.8 (8.2–20.7) months and 16.5 (9.4–20.8) months, respectively. Confirmed objective response rate (95% confidence interval) was 50.0% (51/102; 39.9%–60.1%) and 56.0% (28/50; 41.3%–70.0%), respectively. Safety profile was acceptable and generally manageable. Accordingly, median treatment duration (Q1–Q3) was 7.7 (3.7–14.4) months and 8.3 (2.8–13.1) months; drug-related grade 3 or higher treatment-emergent adverse events occurred in 39.6% (40/101) and 60.0% (30/50), with nausea most common (67.3% [68/101], 82.0% [41/50]). Adjudicated drug-related interstitial lung disease occurred in 14.9% (15/101) and 32.0% (16/50), mostly grade 1 or 2 with one grade 5 in each arm. Health-related quality of life was preserved for the duration of T-DXd treatment while sample size was sufficient for analysis, with no adverse effects on health-related quality of life observed at either dose.<br>
Conclusions: T-DXd demonstrated strong and durable responses at both doses, with no clinically significant changes in toxicity. The approved 5.4-mg/kg dose demonstrated a more favorable benefit-risk profile, including lower adjudicated drug-related interstitial lung disease incidence.<br>
ClinicalTrials.gov identifier: NCT04644237No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231912026裏表紙・英文目次ENNo potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231912026中山間地域に住む高齢女性の子どもとの同居意向の変化とその要因 ― 岡山県の山村を対象とした分析 ―101110ENMasaoNOBEFaculty of Education, Okayama University10.18926/bgeou/70199 筆者は1997‒98年と2016‒17年に、岡山県の中山間地域にある同一の山村で65歳以上80歳未満の女性を対象に調査を実施した。本稿では、そのデータを用いて、①子ども（夫婦）との同居の有無、②将来における子ども（夫婦）との同居希望、③将来希望する居住場所、が約20年間でどのように変化したのかを明らかにする。データの分析から、次のことを明らかにした。子ども（夫婦）と同居していなかったり、将来にわたって子ども（夫婦）との同居を望まなかったりする高齢女性が増えていた。とくに、別居する子どもが岡山県内に居住している場合、同居を望まない傾向が顕著であった。また、子どもとの同居を希望する高齢女性であっても、高梁市の現住所を離れることには抵抗感を示していた。No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231912026自己変容を通してみたマインドワンダリングの創造性について ― 自己嫌悪場面での４つの内言に着目した検討 ―3145ENTazukoAOKIFaculty of Education, Okayama UniversityMakotoHAGIWARAa public employeeKazuhiroYASUNAGAFaculty of Education, Okayama University10.18926/bgeou/70194 マインドワンダリング(以下MW)は心が自己内の複数の領域をさまようことで, 新たな気づきや発想
が生まれる土壌になるとされる。本稿では，この創造性を検討するため，水間(2003)を参考に，自己嫌悪
場面で生起する4 つの反応についての研究モデルを用いてこの創造性を検討した。その際，MW とその
他の類似の内省を区別するため，自己嫌悪場面で生起する内言として自己注目(省察・反芻), 自己への没
入(MW・空想)の4 つを想定した。またその内言が自己の成長にとって意味のある内言か否かを判断する
指標として本来感を用いた。分析の結果, 本来感高群において, MW による集中力の欠如が人の思考を
多領域にさまよわせ, 内的な個性の創造と内的な個人の成長を促すことが示された。また低群において
省察は自分らしさを求め変容を目指す意識が促進されることが示された。他方, 反芻と空想はいずれの
反応様式にも関わっていないことがわかった。No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-2423191202620 世紀初頭のイギリス教員から見たヘルバルト学派 ―『ヘルバルト教授法にかんする授業ノート』の分析 ―1730ENYoshitsuguHIRATAFaculty of Education, Okayama University10.18926/bgeou/70193 本論は，ジャーマン・インパクトを視座として，19-20 世紀にかけて教員養成改革がいかに展開されてきたのかを解明する研究の一部をなすものである。ここでは20 世紀初頭のイギリス教員がどのようにヘルバルト学派の教育思想を受容したのかを明らかにすることを目的とし，『ヘルバルト教授法にかんする授業ノート』の分析を行った。その結果，以下の共通点と相違点が明らかとなった。授業冒頭において目的を明らかにし，授業で学ばれる内容へと子どもの意識を集中させ，新しい知識を教授するという流れは，ヘルバルト学派の五段階教授法と共通していた。だが，第四および第五段階については大胆な変更が施されていた。20 世紀初頭のイギリス教員がヘルバルト学派の教育思想を正確に受容するよりも選択的に受容した可能性があることを解明した。No potential conflict of interest relevant to this article was reported.American Association for Cancer Research (AACR)Acta Medica Okayama2767-9764622026Clinical Characteristics and Spatial Transcriptome Analysis of Non–Small Cell Lung Cancers Exhibiting Early Alectinib Resistance: A Retrospective OLCSG Study284293ENTadahiroKuribayashiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesGoMakimotoDepartment of Respiratory Medicine, Okayama University HospitalKadoakiOhashiDepartment of Respiratory Medicine, Okayama University HospitalShutaTomidaCenter for Comprehensive Genomic Medicine, Okayama University HospitalHirofumiInoueCenter for Comprehensive Genomic Medicine, Okayama University HospitalToshihideYokoyamaDepartment of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central HospitalShoichiKuyamaDepartment of Respiratory Medicine, NHO Iwakuni Clinical CenterYukaKatoDepartment of Thoracic Oncology and Medicine, National Hospital Organization, Shikoku Cancer CenterKenichiroKudoDepartment of Respiratory Medicine, National Hospital Organization Okayama Medical CenterNaokatsuHoritaDepartment of Respiratory Medicine, Kure Kyosai HospitalHiroeKayataniDepartment of Respiratory Medicine, Japanese Red Cross Okayama HospitalMasaakiInoueDepartment of Chest Surgery, Shimonoseki City HospitalKeisukeSugimotoDepartment of Respiratory Medicine, Japanese Red Cross Kobe HospitalKiichiroNinomiyaCenter for Comprehensive Genomic Medicine, Okayama University HospitalYoshinobuMaedaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYosukeTogashiDepartment of Respiratory Medicine, Okayama University HospitalKatsuyukiHottaCenter for Innovative Clinical Medicine, Okayama University HospitalSome anaplastic lymphoma kinase (ALK) gene rearrangement–positive lung cancers show early resistance, within 3 months, to alectinib. This study investigated the clinical and molecular characteristics of these patients. We analyzed patients with unresectable stage III/IV disease without indications for radical radiotherapy and recurrent ALK-positive lung cancer who received alectinib as the primary ALK tyrosine kinase inhibitor between 2013 and 2021 at nine hospitals. In total, 103 patients were included. The median age was 65 years; 44 were male and 22 had brain metastases. The median progression-free survival and overall survival (OS) were 28.7 and 80.6 months. Nineteen patients treated for ≤3 months and 84 treated for >3 months were categorized into the early resistance and responder groups, respectively. The early resistance group had significantly shorter OS (8.4 months vs. not estimable, P < 0.001) and was significantly more likely to have brain metastases (42% vs. 17%, P = 0.027). They also showed elevated inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR). Univariate analysis identified brain metastases and high NLR as significant predictors of early resistance. Spatial transcriptome analysis and immunohistochemical staining revealed upregulation of annexin A1 (ANXA1), a calcium-dependent phospholipid-binding protein involved in inflammation and cancer progression, in the early resistance group. Interleukin 6 stimulation, prompted by elevated inflammatory markers, increased ANXA1 expression and reduced alectinib sensitivity. Knockdown of ANXA1 improved alectinib sensitivity in alectinib-resistant cells. In conclusion, brain metastases and high NLR are associated with early resistance. ANXA1 may play an important role in mediating early resistance. New treatment options for the early resistance group are required.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0956-71351832026Monitoring postharvest water loss in eggplants (Solanum melongena L.) using UV-induced fluorescence imaging and multivariate analysis111902ENVincentRotichLaboratory of Biosensing Engineering, Graduate School of Agriculture, Kyoto UniversityTianqiGaoLaboratory of Biosensing Engineering, Graduate School of Agriculture, Kyoto UniversityPanintornPrempreeLaboratory of Biosensing Engineering, Graduate School of Agriculture, Kyoto UniversityTakahiroHayashiLaboratory of Biosensing Engineering, Graduate School of Agriculture, Kyoto UniversityKazuhikoNambaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityMitsujiMontaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityMotomiNishimotoTechnology and Innovation Center, Daikin Industries, Ltd.NaoshiKondoLaboratory of Biosensing Engineering, Graduate School of Agriculture, Kyoto UniversityEggplant (Solanum melongena L.) is susceptible to significant postharvest losses primarily due to water loss during storage, which affects market quality by causing texture and glossiness degradation. We investigated whether UV-induced fluorescence imaging and EEM (Excitation-Emission Matrix) fluorescence spectroscopy can non-destructively monitor WL under four storage regimes (10 °C/95 % RH, 20 °C/95 % RH, 20 °C/75 % RH, 10 °C/75 % RH). EEMs exhibited three regions; a 365/420 nm blue emission increased most under warm, low-humidity storage and is consistent with phenolic/lignin-related fluorescence. Side-view fluorescence (FL) images showed progressive blue-white emission and surface textural changes that tracked gravimetric water loss (WL). A PLSR model using combined color and texture features from FL and reflectance (CL) images achieved R2CV = 0.88 (RMSECV = 3.47 %) with only six features. To test a minimal predictor, we fit an Analysis of Covariance (ANCOVA) using Day-1 FL MeanBlue as a covariate and storage category as a factor with Leave One Out Cross-validation (LOOCV); this forecasted cumulative WL with R2LOOCV = 0.92 and MAE = 1.88 %. Importantly, this ANCOVA model using Day-1 blue-band fluorescence as a covariate was predictive only under 20 °C/75 % RH; under the other conditions, its contribution was weak. Linear Discriminant Analysis (LDA) and Support Vector Machine (SVM) models achieved accuracies of 94.4 % and 85.2 %, respectively, in differentiating storage conditions. These results support low-cost FL imaging as a practical tool to monitor WL and storage stress.No potential conflict of interest relevant to this article was reported.American Society for Horticultural ScienceActa Medica Okayama0018-53456122026Interactive Effects of Maximum Daytime and Minimum Nighttime Temperatures on Spinach Growth and Physiological Characteristics444451ENNethoneSambaFaculty of Food and Agricultural Sciences, Fukushima UniversityHisaoAkasakaThe United Graduate School of Agricultural Sciences, Iwate University, Iwate, 020-8550, Japan; and Iwate Agricultural Research Center, Kenpoku Agricultural Research InstituteKen-ichiroYasubaGraduate School of Environmental and Life Science, Okayama UniversityTanjuroGotoGraduate School of Environmental and Life Science, Okayama UniversityMinoriHikawa-EndoGraduate School of Environmental and Life Science, Okayama UniversityYokoMiyamaFaculty of Food and Agricultural Sciences, Fukushima University, Fukushima, 960-1296, Japan; and The United Graduate School of Agricultural Sciences, Iwate UniversityHigh temperatures restrict spinach growth, and the plant’s growth and physiological responses to heat remain poorly understood. It remains unclear whether high daytime or elevated nighttime temperatures have a more negative impact on spinach growth. In addition, the interaction effect of maximum daytime and minimum nighttime temperatures on spinach growth remains unknown. This study was conducted to address these issues. Spinach was grown in controlled environments under four temperature treatments: 30 and 20 °C (T30/20), 30 and 25 °C (T30/25), 35 and 20 °C (T35/20), and 35 and 25 °C (T35/25). These treatments represent the maximum daytime temperature and minimum nighttime temperature, respectively, and were maintained for 45 days. Plant growth characteristics were monitored, and the physiological responses to temperature regimes were assessed. The results show that compared with T30/20, dry matter production decreased by 15.4% with increased nighttime temperature (T30/25), decreased by 42.3% with increased daytime temperature (T35/20), and decreased by 57.7% when both daytime and nighttime temperatures were increased (T35/25). However, there was no statistically significant interaction effect (P > 0.05) between daytime maximum and nighttime minimum temperatures on plant biomass production variables. In comparison with T30/20, the T35/25 treatment increased significantly plant stomatal conductance, stomatal apertures, transpiration rate, and leaf temperature during heat waves. The T35/25 treatment also decreased the quantum efficiency in light compared with the other treatments. Plant biomass production did not improve with the T35/20 and T35/25 treatments, likely as a result of a decoupling of photosynthesis and stomatal conductance during heat waves. Overall, these results reveal that maximum daytime and minimum nighttime temperatures exert additive effects on spinach growth.No potential conflict of interest relevant to this article was reported.Japanese Society for Horticultural ScienceActa Medica Okayama2189-01029512026Comparison of Fruit Development, Ripening, and Transcriptome Dynamics in Taiwanese and Japanese Cultivars of Japanese Apricot (Prunus mume Sieb. et Zucc.)1020ENTomoakiKashiwamotoGraduate School of Environmental and Life Science, Okayama UniversityTakashiKawaiGraduate School of Environmental and Life Science, Okayama UniversityTakaakiOeJapanese Apricot Laboratory, Wakayama Fruit Tree Experiment StationKojiNumaguchiJapanese Apricot Laboratory, Wakayama Fruit Tree Experiment StationYutoKitamuraFaculty of Agriculture, Setsunan UniversityYasutakaKuboGraduate School of Environmental and Life Science, Okayama UniversityFumioFukudaGraduate School of Environmental and Life Science, Okayama UniversityKoichiroUshijimaGraduate School of Environmental and Life Science, Okayama UniversityIn this study, we compared changes in traits associated with fruit development and ripening in Taiwanese and Japanese cultivars of Japanese apricot (Prunus mume Sieb. et Zucc.). We also analyzed transcriptome profiles to comprehensively examine different fruit development and ripening patterns between the two groups in terms of fruit characteristics and gene expression. Early fruit development in Taiwanese cultivars ‘ST’ and ‘Ellching’ and the Japanese cultivar ‘Hakuo’ was ahead of that in other three Japanese cultivars (P1). From late April to early May, around the stone-hardening stage, the developmental differences decreased to the same level. Thereafter, Japanese cultivars showed rapid growth, whereas Taiwanese cultivars showed slower growth, reversing the developmental differences between these lines (P2). Ethylene production was not detected until the full ripening stage and was detected for the first time at this stage in five cultivars, except for ‘Ellching’ (P3). In contrast, no ethylene production was observed during the entire duration of fruit development in ‘Ellching’. A multidimensional scaling plot showed that the overall transcriptome profile changed according to the three stages (P1–P3) of fruit development and ripening. At P1, gene ontologies (GOs) related to cell division, such as the cell cycle and regulation of cyclin-dependent protein serine/threonine kinase activity, were enriched for differentially expressed genes downregulated in Taiwanese cultivars as compared with their expression in Japanese cultivars. At P2, GOs related to fruit development were not enriched, but some genes related to phytohormones, such as auxin, abscisic acid, and cytokinin, which are associated with fruit development and ripening, were differentially expressed. At P3, the expression of genes such as ACS, ACO, and PG, which are involved in ethylene biosynthesis, increased in response to increased ethylene production, but not in ‘Ellching’, which showed no ethylene production. Expression analysis of 115 NAC (NAM-ATAF1/2-CUC2) family genes, which are related to fruit ripening and ripening date in other fruit species, in the ‘Ellching’ genome revealed changes in expression of NAC056 and NAC073 corresponding to fruit development and ripening in Taiwanese and Japanese cultivars. We discuss the differences in fruit development and ripening behaviors between Taiwanese and Japanese cultivars in terms of physiological and transcriptome changes.No potential conflict of interest relevant to this article was reported.Institute of Electrical and Electronics Engineers (IEEE)Acta Medica Okayama2169-3536142026FEM-Based Design and Characterization of a Millimeter-Scale Piezoelectric Resonance Force Sensor1796017970ENAotoYamazakiDepartment of Mechanical Engineering, Toyohashi University of TechnologyTakumaAkidukiDepartment of Mechanical Engineering, Toyohashi University of TechnologyAtsuoHonnaRiccoh Company Ltd.MichiteruKitazakiDepartment of Computer Science and Engineering, Toyohashi University of TechnologyTomoakiMashimoGraduate School of Natural Science and Technology, Okayama UniversityThis paper presents a millimeter-scale piezoelectric effect-based force sensor that uses the change in its resonant frequency as the detection principle for high sensitivity and a wide measurement range. Such characteristics are suited for robot hand applications that not only detect small forces but also handle large payloads. We develop a methodology to estimate the relationship between applied force and resonant frequency shift by combining classical contact theory and finite element method (FEM) analysis. Although this relationship is non-linear, the designability of sensitivity and measurement range is demonstrated by the simulation. The simulation results based on the method are verified, showing good agreement with the experimental results. The static characteristics, including sensitivity, standard deviation, and resolution, are evaluated using prototype sensors with characteristic lengths ranging from 1 mm to 4 mm. The 4-mm model has a measurement range of 77 mN to 300 N, and the smallest model, which is one of the smallest force sensors suitable for practical implementation, has a measurement range of 9 mN to 20 N.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2475-0328962025Surgery for Older Cancer Patients: Cross‐Organ Review and Good Practice Statement by the Japanese Geriatric Oncology Guideline Committee11281136ENChieTanakaDepartment of Gastroenterological Surgery, Nagoya University Graduate School of MedicineTakashiOfuchiDepartment of Surgery, Kyushu University Beppu HospitalKiichiroNinomiyaCenter for Comprehensive Genomic Medicine, Okayama University HospitalDaisukeInoueDepartment of Obstetrics and Gynecology, University of FukuiKenSugimotoDepartment of General Geriatric Medicine, Kawasaki Medical SchoolKeikoMurofushiDivision of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalToruOkuyamaDepartment of Psychiatry/Palliative Care Center, Nagoya City University West Medical CenterShigeakiWatanukiNational Center for Global Health and Medicine, National College of NursingChiyoImamuraAdvanced Cancer Translational Research Institute, Showa UniversityDaisukeSakaiDepartment of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of MedicineNaomiSakuraiCancer Solutions Co. LtdKiyotakaWatanabeDivision of Medical Oncology, Department of Medicine, School of Medicine, Teikyo UniversityKazuoTamuraNPO Clinical Hematology/Oncology Treatment Study GroupToshiakiSaekiBreast Oncology Service, Saitama Medical University International Medical CenterHiroshiIshiguroBreast Oncology Service, Saitama Medical University International Medical CenterBackground: Although the number of older people is increasing, there is a lack of evidence and insufficient consensus regarding postoperative complications and survival in older cancer patients. In this study, we conducted a literature search and systematic review focusing on the outcomes after surgery for older cancer patients.<br>
Methods: Literature focusing on surgical treatment for older cancer patients was extracted from Japanese clinical practice guidelines for gastric cancer, lung cancer, colorectal cancer, liver cancer, and gynecological cancers (uterine body, uterine cervix, ovary, and external genitalia and vagina). Outcomes were reviewed, and committee members determined the strength of evidence on a four-point scale (A to D), with A being the highest and D being the lowest.<br>
Results: Older cancer patients tend to have a higher incidence of postoperative complications and postoperative syndromes, and their expected survival is generally shorter compared to non-older patients. When extensive surgeries such as para-aortic lymph node dissection and/or resection with other organs are performed for older cancer patients, the postoperative mortality rates tend to increase compared to non-older patients.<br>
Conclusion: Surgical treatments for older cancer patients tend to result in higher morbidity even when the patients are in good health status. Nevertheless, there is still a possibility that a certain fraction of the patients achieve treatment outcomes comparable to those of non-older patients. Therefore, surgical indication and procedure for older cancer patients should be carefully determined based on surgical invasiveness and patient tolerability.No potential conflict of interest relevant to this article was reported.Informa UK LimitedActa Medica Okayama1350-46222026Towards place-responsive climate change education: Mongolian primary teachers’ pedagogical judgement across urban and rural contextsENShinetsetsegGerelkhuuGraduate School of Humanities and Social Sciences, Okayama UniversityKhalifatullohFiel’ardhGraduate School of Education, Okayama UniversityHirokiFujiiGraduate School of Education, Okayama UniversityBatchuluunYembuuGeography Department, Mongolian National University of EducationUuriintuyaDembereldorjLifelong Learning and Distance Education Department, Mongolian National University of EducationClimate change education (CCE) in primary schools is increasingly recognised as essential, yet how teachers interpret and enact CCE across diverse local contexts remains underexplored. This study examines how Mongolian primary school teachers working with students aged 6–11 in urban and rural contexts interpret and teach climate change, with particular attention to the role of place. Drawing on semi-structured interviews with 20 teachers across contrasting contexts, the study explores how environmental, cultural, and institutional conditions shape teachers’ pedagogical interpretations and classroom practices. Data were analysed using reflexive thematic analysis, informed by conceptual frameworks that position place as an active mediator of teaching and learning. Findings show that rural teachers frequently integrated traditional ecological knowledge and lived environmental experience to connect global climate processes with locally observable ecological change, emphasising livelihood impacts and intergenerational ecological memory. Urban teachers, by contrast, framed climate change through anthropogenic pressures such as air pollution, waste, and infrastructure constraints, foregrounding feasible individual actions within everyday school contexts. Across both settings, teachers exercised place-responsive pedagogical judgement by selectively adapting climate content to local realities while navigating curriculum constraints and workload pressures. The study contributes a place-responsive account of teachers’ pedagogical judgement in CCE, demonstrating how place functions not only as context but as a condition shaping pedagogical feasibility.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.岡山大学教育推進機構Acta Medica Okayama1881-595232026裏表紙・英文目次ENNo potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026奥付ENNo potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026Teaching and Learning：Japanese and International Student Collaboration in the Classroom209226ENAlexisPUSINAJunkoOTOSHI10.18926/70122This practical report introduces three intercultural collaborative trial classes designed to integrate Japanese and international students in first-year EFL classes. Using a CLIL-informed approach, the classes promoted intercultural understanding through culturally grounded activities and small-group communication tasks. Reflection surveys from both Japanese and international participants revealed overall positive experiences, with international students expressing strong enjoyment and Japanese students highlighting both linguistic gains and communication challenges. Analysis indicates that interaction across diverse cultural and linguistic backgrounds fostered intercultural awareness while motivating Japanese learners to further develop their speaking skills. The findings support the value of collaborative, content-based activities for enhancing intercultural understanding.No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026世界観光倫理憲章を踏まえたアクセシブルアウトドアツーリズムの検討 ―世界自然遺産地域でのアウトドア型車椅子を用いた実践を通じて―195208ENKosukeIKETANIGeneral Education and Global Studies Field, Okayama UniversityShinHARADAGeneral Education and Global Studies Field, Okayama UniversityKeitaKUSUNOKIInstitute of Student Support, Bukkyo University10.18926/70121アクセシブルアウトドアツーリズムを進めていくためには，「保全・保護」と「開発」の両立が非常に重要な観点となる。そこで本実践では，一人でも多くの人がアウトドア活動に参加できることを目指し，世界自然遺産地域においてアウトドア型車椅子を用いたツアーが実現できるかどうかを検討することとした。「誰ひとり取り残さない観光」とは，世界観光倫理憲章でも標榜された目標であるが，このことを実現するためには，今回検討を行ったような一つ一つの実践を積み重ねることによって，少しずつであってもアクセシブルアウトドアツーリズムの可能範囲を広げていくことが，最も確実な取り組みなのではないかと考えている。No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026ピア・AI・教員の三者協働フィードバックによるライティング授業の再設計 ―AI利用の実践報告－174194ENMarikoUzukaInstitute for Promotion of Education and Campus Life10.18926/70120本稿は、アカデミック・ライティング授業におけるピア・AI・教員のそれぞれの役割と利用順序（自分→ピア→AI→（省察）→教員）を組み込んだ三者協働モデルを設計し、2024～2025年度に実践した内容を報告する。授業後の学生アンケートでは、AIの即時性・精緻化が評価される一方、依存や有効性の限界に関する懸念も表明された。成績分布においては、AI導入後に下位層が縮小し、学習成果の底上げが示唆された。また、AI誤用や濫用を防ぐには、教室内で建設的な利用法の具体的な指導（例：例文より診断的フィードバックを重視、AI提案の採否理由のメタ記述）が効果的であった。これらの結果から、AIの利点を活かしつつ、学生の判断を中心に据えるライティング授業設計の有効性と課題を提示する。No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026大学における中国語多読の試み155173ENTomomiISHIIInstitute for Promotion of Education and Campus Life, Okayama University10.18926/70119 This study examines the implementation of the instruction for extensive reading in Chinese among 19 learners who completed one year of beginner-level Chinese studies comprising two 100-minute sessions per week. Regarding survey methods, a questionnaire using a five-point Likert scale and open-ended responses was utilized. The findings revealed that learners recognized extensive reading as an effective strategy for improving their reading comprehension and vocabulary. However, some challenges exist, including the lack of suitable books for extensive reading practices and difficulties in sustaining extensive reading habits.No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026「知の探研」× 多文化共修 ―オンライン授業再構築の試み―145154ENYumikoYAMAMOTOFaculty of General and Global Studies (GDP), Okayama UniversityKha ManhNGUYENDiscovery Program for Global Learners, Okayama University10.18926/70118岡山大学では2025年4月入学生から新カリキュラムがスタートした。学士課程改革の一環として導入されたのが全学共通・課題探究科目「知の探研」である。本稿では，新入生対象科目である「知の探研」を，海外生を含むグローバル・ディスカバリー・プログラム生向けに英語で “Inquiries of Knowledge” として開講した初年度の取り組みを報告する。とりわけオンデマンド型オンライン授業を, 本学が推進する多文化共修の視点で再構築するにあたり，教材を単に英訳するのではなく, オンライン環境においても協働学習を実現する工夫や，言語的・文化的配慮の統合が不可欠であることを明らかにする。No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026学部別インタビューによる学習者ナラティブとオリエンテーション実践 ―大学入学時における外国語学習動機づけ促進の試み―129144ENAzumiYOSHIDAInstitute for Promotion of Education and Campus Life, Okayama UniversityMasakoTERANISHIInstitute for Promotion of Education and Campus Life, Okayama University10.18926/70117岡山大学では新学習指導要領実施に合わせ、「学習者中心の学び」の実現を目指すTarget2025と呼ばれる方針のもと英語カリキュラムの改革を進めてきた。この改革では、英語系教員と各部局とが密に連携しながら、学士課程全体を通した英語学習を全学的に展開していくことに焦点を当てている。その取り組みの一環として、各部局から推薦を受けたロールモデルとの学部別インタビューを実施し、英語学習についての詳細を聴き取った。また、新入生への激励のメッセージ動画を作成し、英語授業オリエンテーションで上映した。本稿では、インタビューで得られたナラティブやオリエンテーション実施の経緯、また、オリエンテーション後に実施したアンケート結果について報告する。No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026From The Odyssey to The Zahir：The Evolution of Penelopeia Across Time and Tradition120128ENSaidaKHALMIRZAEVAFaculty of General Education and Global Studies, Okayama University10.18926/70116The story of a man who leaves home and strives to return has become one of the most enduring narrative patterns in world literature and folklore. Across centuries and cultures, it has been retold in myths, epics, folktales, and modern fiction—the story of the homecoming hero who, after long absence and peril, finds his way back to the place and the person he once called his own. This study explores the persistence and transformation of this universal motif through a comparative reading of Homer’s The Odyssey and Paulo Coelho’s The Zahir. It examines the evolving image of the waiting wife—from Homer’s Penelopeia, emblem of chastity and endurance, to Coelho’s Esther, a modern woman of independence and choice. Despite differences in setting, voice, and moral vision, both works embody the same human longing: to return, to be recognized, and to rediscover love that endures time and change. Beneath their differences lies the same truth—the heart to which every journey, whether physical or spiritual, must ultimately return.No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026Developing a Short-form Scale to Assess Learner Beliefs Regarding English Learning Strategies100119ENHiroshiMORITANIInstitute for Promotion of Education and Campus Life, Okayama UniversityAlexisPUSINAInstitute for Promotion of Education and Campus Life, Okayama University10.18926/70115Questionnaire surveys are a prevalent method in applied linguistics for investigating complex constructs, such as learner beliefs. However, their complex nature often creates overly lengthy instruments, making them impractical for classroom use or for obtaining timely educational insights. This study aimed to develop a simplified, yet robust version of an existing learner belief scale to address these challenges. The authors carefully selected 24 belief-specific items from an initial pool of 78 items from a previous study for use in an online survey, which was completed by 246 participants. The data were subject to exploratory factor analysis. This process resulted in a concise 12-item scale, could offer a more practical tool for language educators.No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026発達障害を有する高校生の保護者による障害学生支援の認知度9199ENShinHARADAGeneral Education and Global Studies Field, Okayama UniversityKosukeIketaniGeneral Education and Global Studies Field, Okayama UniversityMegumiMATSUIGeneral Education and Global Studies Field, Okayama UniversityNaotoMOCHIZUKIHealth and Counseling Center, The University of Osaka10.18926/70114 本研究では，発達障害を有する高校生の保護者が，「大学等における障害学生支援や学生相談をどの程度知っているか」，「大学等における障害学生支援や学生相談の情報をどのように入手したか」，「大学等における障害学生支援や学生相談の情報収集をする上で，大学等にどのような情報発信を期待するか」について調査を行った。その結果，まだ保護者に対し，十分に大学の学生支援の情報が行き届いていないこと，学生支援に関する情報発信を行う説明会や相談会を行うことが保護者から期待されていること，発達障害を有する高校生の高大移行を促進するために，高校の先生方に対する情報発信も精力的に行ったり，高大連携の取り組みをより行う必要があること等が見出された。No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026近代韓国の読本教科書『初等小学』の底本に関する再考7490ENAnkooLEEInstitute for Promotion of Education and Campus Life, Okayama University10.18926/70113 本稿では、近代韓国の読本教科書『初等小学』（1906）の編纂において参照されたと思われる日本の明治期読本教科書について比較・考察を行った。まず、文部省編纂の検定『尋常小学読本』（1887）と第1期国定『尋常小学読本』（1903）、さらに金港堂出版の『尋常国語読本』（1900）及び『高等国語読本』（1900）との関連性について、先行研究の議論を再検討した。そのうえで、新たに金港堂の『新体読本 尋常小学用』（1894）と普及舎の『尋常小学新読本』（1893）の2種を底本として確認することができた。『初等小学』において最も多く参照された明治期読本教科書は金港堂の『尋常国語読本』（1900）であり、『初等小学』は、金港堂と文部省の比較的新しい尋常小学用読本教科書を優先的に参照したと思われる。No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026留学生受け入れにおける教員の判断基準 ―多くの留学生を受け入れている教員の視点から―5773ENTakaoINAMORIFaculty of General and Global Studies, Okayama University10.18926/70112 少子化は国内大学の定員充足率に深刻な影響を与えることから、留学生の受入増に期待が寄せられている。しかし、大学院教育において留学生受入に前向きな教員と、消極的な教員が見受けられる。本研究では、より多くの留学生を受け入れている教員が、どのような判断基準で受け入れを決定しているのかを、半構造化インタビューを通じて明らかにすることを試みた。その結果、判断基準に関しては、教員により表現は異なるが「人物」と「能力」を確認していることが分かった。また、受け入れを前向きに考える教員は、留学・在外研究員経験や、初めて受け入れた留学生指導を通じて良い経験をしたこと等が、留学生に対するプラスの印象をつくり、積極的な受け入れにつながっていることが明らかになった。No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026自閉スペクトラム症特性と精神的健康の関連：自己理解による媒介効果の検討4156ENHirokiNISHIMURAInstitute for Promotion of Education and Campus Life, Okayama UniversityAkihiroUCHIDAOkayama Psychiatric Medical Center10.18926/70111 本研究は、自閉スペクトラム症特性と精神的健康の関連において、自己理解がどのような役割を果たすかを明らかにすることを目的とした。日本の成人604名のデータを利用した二次分析の結果、自閉スペクトラム症特性の高さと精神的健康の悪化との間には関連が認められた。この関連は、自己理解の肯定的側面によって部分的に媒介されることが示された。特にこの自己理解の保護的な効果は、男性よりも女性においてより強い可能性が示唆された。一方で、自己理解の否定的側面は媒介効果を示さなかった。これらの結果から、自閉スペクトラム症特性を持つ人々への支援において、肯定的な自己理解を促進することが重要であり、性差を考慮したアプローチの必要性が示唆された。No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026オンラインによるボランティア日本語教室における参加者間のインターアクションの分析 ―地域型日本語教育の実現に向けて―3140ENMiwaSUESHIGEInstitute for Promotion of Education and Campus Life, Okayama University10.18926/70110 本研究では，地域型日本語教育のモデル構築に向け，地域型の特徴を有する教室内での支援者および参加者の発話や教授行動の傾向を明らかにすべく，外国語相互作用分析システムを用い，オンラインによるボランティア教室におけるインターアクションの分析を行った。分析の結果，（1）支援者の平均発話数が学習者より多いこと，（2）支援者の発話における間接的行動の割合が直接的行動よりもやや高いことが示された。「おしゃべり型の教育」では，学習者が伝えたいことを言語化していくプロセスの中で，間接的行動の下位分類の「質問」「学習者の意図の利用」「学習者の回答の繰り返し」等を支援者が積極的に使用し支援していることが分かった。No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026心理臨床家同士のグループ体験における反省的実践1230ENRyosukeKOBASHIInstitute for Promotion of Education and Campus Life, Okayama UniversityMasashiTANAKATokai UniversityRinMURASEGraduate School of Education and Human Development, Nagoya University10.18926/70109 心理臨床家にとって反省的実践は重要であり，多様な形態のグループに参加をすることによって反省的実践を行っている。本研究では，全般的な心理臨床家同士のグループにおける体験（研究1）および継続的なグループにおける体験（研究2）を探索することを目的として，数名の心理臨床家による話し合いをKJ法を援用して分析した。その結果，心理臨床家同士のグループ体験における反省的実践には，【グループ体験が内省につながるかどうか】などの4つ側面が重要であることが示された。また，継続的なグループにおける体験では，《本来の人としての感覚や欲求》や《自分を不自由にしている要因》などの【会における気づき】が得られることが反省的実践として有意義であることが明らかになった。No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026セクシュアリティのゆらぎと発達障害のADHDとの関連111ENMegumiMATSUIInstitute for Promotion of Education and Campus Life, Okayama University10.18926/70108 セクシュアリティのゆらぎと発達障害のADHDとの関連を明らかにするため，WEBによる縦断調査を行った。18歳以上の成人を対象とし，第1回目の調査は11,018人，1年後の第2回目の調査では5,474人から回答を得た。性自認，性的指向，性表現の様々なセクシュアリティについて，2回の調査での該当・非該当で4群に分け，ADHD得点について1要因の被験者間分散分析を行った。「デミロマンティック」「デミセクシュアル」以外で群の主効果が有意であり，「異性愛」「ゲイ」を除くセクシュアリティで，2回とも「非該当」群よりも「該当→非該当」群のADHD得点が有意に高かった。これによりセクシュアリティのゆらぎとADHDとの関連が示唆された。No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026表紙・目次ENNo potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama2050-3911202622026Feedback-Controlled Beam Pattern Measurement Method Using a Power-Variable Calibration Source for Cosmic Microwave Background Telescopes023F01ENHaruakiHiroseDepartment of Physics, Graduate School of Engineering Science, Yokohama National UniversityMasayaHasegawaInstitute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK)DaisukeKanekoInternational Center for Quantum-field Measurement Systems for Studies of the Universe and Particles (WPI-QUP), High Energy Accelerator Research Organization (KEK)TaketoNagasakiAccelerator Laboratory (ACCL), High Energy Accelerator Research Organization (KEK)RyotaTakakuGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTijmende HaanInstitute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK)SatoruTakakuraDepartment of Physics, Faculty of Science, The University of TokyoTakuroFujinoInternational Center for Quantum-field Measurement Systems for Studies of the Universe and Particles (WPI-QUP), High Energy Accelerator Research Organization (KEK)We demonstrate a novel beam pattern measurement method for the side lobe characterization of cosmic microwave background telescopes. The method employs a power-variable artificial microwave source under feedback control from the detector under test on the telescope. It enables us to extend the dynamic range of the beam pattern measurement without introducing nonlinearity effects from the detector. We conducted a laboratory-based proof-of-concept experiment, measuring the H-plane beam pattern of a horn antenna coupled to a diode detector at 81 GHz. We gained an additional dynamic range of 60.3 dB attributed to the feedback control. In addition, we verified the measurement by comparing it with other reference measurements obtained using conventional methods. The method is also applicable to general optical measurements requiring a high dynamic range to detect subtle nonidealities in the characteristics of optical devices.No potential conflict of interest relevant to this article was reported.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.Springer Science and Business Media LLCActa Medica Okayama2168-818417112025Association of Carboxyhemoglobin With Severity and Outcomes in Hypothermic Patients: A Retrospective Cohort Studye97962ENYuyaMiyoshiDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTetsuyaYumotoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 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 UniversityTsuyoshiNojimaDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityHiromichiNaitoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityAtsunoriNakaoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityIntroduction<br>
Carboxyhemoglobin (COHb), an endogenous marker of carbon monoxide production mediated by heme oxygenase-1, may reflect physiological stress responses in critically ill patients. However, its clinical relevance in accidental hypothermia remains unclear.<br>
<br>
Methods<br>
We conducted a single-center retrospective cohort study of adult patients admitted to the emergency ICU with accidental hypothermia between January 1, 2019, and March 31, 2025. Patients were categorized into low- and high-COHb groups based on median COHb levels upon emergency department arrival. Associations between COHb levels, disease severity (Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores), and 28-day mortality were analyzed using regression models adjusted for clinical confounders.<br>
<br>
Results<br>
Among the 88 patients, who had a median admission temperature of 28.7°C, 45 were classified into the low-COHb group and 43 into the high-COHb group, based on a median COHb level of 0.3%. Lower COHb levels on admission were significantly associated with higher APACHE II scores (β = −4.20; 95% CI, −7.56 to −0.85), but not with SOFA scores. Admission and minimum COHb levels were not associated with 28-day mortality. However, higher maximum COHb levels within the first 24 hours were independently associated with lower 28-day mortality (adjusted OR, 0.17; 95% CI, 0.023 to 0.93).<br>
<br>
Conclusions<br>
Lower COHb levels were associated with greater disease severity, and higher maximum COHb levels were associated with lower 28-day mortality. COHb may reflect systemic stress in accidental hypothermia, but its prognostic value appears limited.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8012026Kinesiophobia Is Associated with Disability, Poor Quality of Life, Psychological Morbidity, and Surgery Dissatisfaction in Patients with Lumbar Microdiscetomy: A Cross-Sectional Controlled Study3946ENNihalTezelDepartment of Physical and Rehabilitation Medicine, Health Sciences UniversityAslı GençayCanDepartment of Physical and Rehabilitation Medicine, Faculty of Medicine, Ankara Yıldırım Beyazıt UniversityOriginal Article10.18926/AMO/70071The study aimed to determine the prevalence of kinesiophobia in patients who had undergone lumbar microdiscectomy and to examine its associations with pain intensity, disability, quality of life, depression, anxiety, and satisfaction with surgery. Forty-eight patients with microdiscectomy and 48 healthy controls were enrolled. The Tampa Scale for Kinesiophobia (TSK), Roland-Morris Disability Index (RMDI), Hospital Anxiety and Depression Scale (HADS-A and HADS-D, respectively), and Short Form-36 Health Survey (SF-36) were administered to both groups. The scores of TSK, RMDI, HADS-A, and HADS-D were significantly higher and SF-36 scores were significantly lower in the microdiscectomy than the control group (p<0.001 for all). In the microdiscectomy group, median (min-max) RMDI, HADS-A, and HADS-D scores were 19 (4-34), 10 (0-18), and 9 (0-18), respectively, in kinesiophobic patients, and were significantly higher than 6 (2-20), 3 (0-11), 2.5 (0-11) in non-kinesiophobic patients (all p<0.001). The median (min-max) SF-36 PCS, SF-36 MCS, and VAS scores for surgery satisfaction were 36.5 (8.7-75), 52.1 (11-95), 5, 5 (0-10), respectively, in kinesiophobic patients and were significantly lower than 71 (28-95), 85.5 (9-93), 8.5 (3-10) in non-kinesiophobic patients (all p<0.05). TSK scores were significantly correlated with RMDI, HADS-A, HADS-D, SF-36, and surgery satisfaction scores (all p<0.05). Kinesiophobic patients with lumbar microdiscectomy therefore showed greater disability and psychological morbidity, poorer quality of life, and lower satisfaction with surgery.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8012026The Preoperative Anterior Pelvic Plane Angle Predicts Cup Anteversion Changes at 1 Year after Total Hip Arthroplasty3137ENKyotaIshibashiDepartment of Orthopedic Surgery, Hachinohe City HospitalHirotakaOishiDepartment of Orthopedic Surgery, Hachinohe City HospitalRyoArakiDepartment of Orthopedic Surgery, Hachinohe City HospitalKosukeKawamuraDepartment of Orthopedic Surgery, Hachinohe City HospitalIsamuSasakiDepartment of Orthopedic Surgery, Hachinohe City HospitalEijiSasakiDepartment of Orthopedic Surgery, Hirosaki University Graduate School of MedicineHikaruKamadaDepartment of Orthopedic Surgery, Hachinohe City HospitalMasakazuKogawaDepartment of Orthopedic Surgery, Hachinohe City HospitalSunaoTanakaDepartment of Orthopedic Surgery, Hachinohe City HospitalTakuyaNumasawaDepartment of Orthopedic Surgery, Hachinohe City HospitalYasuyukiIshibashiDepartment of Orthopedic Surgery, Hirosaki University Graduate School of MedicineOriginal Article10.18926/AMO/70070We investigated global alignment changes following total hip arthroplasty (THA) and predictive alignment parameters for increased cup anteversion (CA) by retrospectively analyzing the primary THA data of 75 patients treated at our hospital (49 women, 26 men; age 65.1±5.7 years, BMI 28.3±3.4 kg/m2). Global alignment parameters, i.e., the anterior pelvic plane angle (APPa) and proximal femoral shaft angle (PFSa) and other alignment parameters were measured. CA was evaluated based on the patients’ standing coronal radiographs. ΔCA was defined as the difference in CA from 2 weeks before to 1 year after each THA. We classified the cases as stable (S) (CA < 10°; n=63) and pelvic retroversion (R) (CA ≥ 10°; n=12) groups. Associations between ΔCA and alignment parameters were evaluated by linear regression and a receiver operating characteristic (ROC) analysis. A significant decrease in the PFSa occurred between the 2-week and 1-year post-THA timepoints (7.8±4.3° vs. 4.2±3.6°, p<0.001), with no notable change in other alignment parameters. At 1-year post-THA, the CA of 12 (16%) patients had increased to 4.5±4.4°. Only the preoperative APPa was positively associated with ΔCA (β=0.165, p=0.020). The ROC analysis revealed that the optimal cut-off value for increased CA in the APPa is 2.1° (area under the curve, 0.700; p=0.020; odds ratio, 4.80). The APPa change predicted increased CA, which emphasizes the importance of the use of preoperative standing radiography for identifying the optimal cup positioning for post-THA changes in CA.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8012026A Novel Nomogram that Predicts Chronic Hemodialysis Patients’ Survival Based on Their Sedentary Behavior916ENKentaroSugaharaDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityTakashiKondoInnoshima General HospitalNobuyukiMiyatakeDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityHiroyukiNishiInnoshima General HospitalKazuhiroUjikeInnoshima General HospitalKiichiKoumotoInnoshima General HospitalKeiichiNamioDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityShuheiHishiiDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityAkihikoKatayamaFaculty of Social Studies, Shikokugakuin UniversityHiromiSuzukiDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityYorimasaYamamotoInnoshima General HospitalOriginal Article10.18926/AMO/70068Appropriate treatments for chronic hemodialysis patients are a public health challenge in Japan. Sedentary behavior appears to be closely associated with these patients’ survival. We thus sought to develop a nomogram that predicts survival based on the duration of chronic hemodialysis patients’ sedentary behavior. One hundred twenty-four patients under chronic hemodialysis (73 men, 51 women, age 71.7±11.1 years) were enrolled in this cohort study. The patients wore a triaxial accelerometer that measured both their sedentary behavior, i.e., total sedentary behavior (minutes) and their maximum sedentary bouts (min) on non-hemodialysis days. We obtained the Kaplan-Meier curve and used the log-rank test and a Cox proportional hazards model to evaluate the relationship between the patients’ sedentary behavior and their survival. We also used a Cox proportional hazards model to develop a nomogram for the patients’ 5-year survival rate. Forty-six patients died during the follow-up period. When we stratified the patients by the medians of total sedentary behavior and maximum sedentary bouts, we observed significant between-group differences. After adjustment for confounding factors in a Cox proportional hazards model, total sedentary behavior and maximum sedentary bouts were identified as critical survival factors, and we generated a nomogram using an index of sedentary behavior. Our analysis results demonstrated that sedentary behavior on non-dialysis days was closely associated with the survival of the chronic hemodialysis patients, suggesting that a decrease in sedentary behavior would prolong their survival. The nomogram developed herein based on sedentary behavior may be useful for predicting the outcomes of chronic hemodialysis patients.No potential conflict of interest relevant to this article was reported.岡山大学文明動態学研究所Acta Medica Okayama2436-832652026島根県猪目洞窟遺跡出土人骨の年代・食性・遺伝的特徴2039ENHideakiKANZAWA-KIRIYAMADivision of Human Evolution, Paleontology and Anthropology, National Museum of Nature and Science, Tsukuba City, Ibaraki PrefectureMaiTAKIGAMIDivision of Human Evolution, Paleontology and Anthropology, National Museum of Nature and Science, Tsukuba City, Ibaraki PrefectureTsuneoKAKUDADepartment of Legal Medicine, Interdisciplinary Graduate School of Medicine and Engineering, University of YamanashiLeoSPEIDELCenter for Interdisciplinary Theoretical and Mathematical Sciences, RIKENGarrettHELLENTHALDepartment of Genetics, Evolution and Environment, University College London Genetics Institute (UGI), University College LondonNancyBIRDDepartment of Genetics, Evolution and Environment, University College London Genetics Institute (UGI), University College LondonYousukeKAWAIGenome Medical Science Project, National Institute of Global Health and Medicine, National Institute for Health SecurityNCBN Controls WGS ConsortiumMinoruSAKAMOTONational Museum of Japanese HistoryYuichiKAMEDADivision of Human Evolution, Paleontology and Anthropology, National Museum of Nature and Science, Tsukuba City, Ibaraki PrefectureNoboruADACHIDepartment of Legal Medicine, Interdisciplinary Graduate School of Medicine and Engineering, University of YamanashiKen-ichiSHINODANational Museum of Nature and ScienceNaruyaSAITOUNational Institute of GeneticsTatsuhikoHAMADAResearch Institute for the Dynamics of Civilizations, Okayama University論文 (Research article)10.18926/70052This paper reports on the integrative research findings of the human bones excavated from the Inome Cave Site in Shimane Prefecture, based on dietary estimation using carbon and nitrogen isotope analysis, radiocarbon dating, and whole genome analysis. The dates of the analyzed human bones span a wide range, from the Middle to Late Kofun period, the Nara period to the Early Heian period, and the Middle to Late Heian period, indicating that the Inome Cave Site was continuously used as a burial place. Dietary habits were a mixture of C3 resources (C3 plants and terrestrial animals that consumed C3 plants) and marine resources, with individual variations in the intake of marine and terrestrial resources. A correlation was observed between differences in dietary habits and individual variations in the Jomon ratio in the nuclear genome, with individuals who consumed higher amounts of marine resources tending to have a higher Jomon ratio. This suggests that individuals with different backgrounds were buried in the same site due to interactions with surrounding settlements.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1996-19441932026Effect of Surface Morphology Formed by Additive Manufacturing on the Adhesion of Dental Cements to Zirconia563ENKumikoYoshiharaNational Institute of Advanced Industrial Science and Technology (AIST), Health and Medical Research InstituteNoriyukiNagaokaAdvanced Research Center for Oral and Craniofacial Sciences, Okayama University Dental SchoolSunghoLeeNational Institute of Advanced Industrial Science and Technology (AIST)YukinoriMaruoDepartment of Prosthodontics, Okayama UniversityFionaSpirrettJoining and Welding Research Institute, Osaka UniversitySoshuKiriharaJoining and Welding Research Institute, Osaka UniversityYasuhiroYoshidaDepartment of Biomaterials and Bioengineering, Faculty of Dental Medicine, Hokkaido UniversityBartVan MeerbeekDepartment of Oral Health Sciences, BIOMAT, KU LeuvenBackground: Durable bonding to zirconia remains difficult because its chemically inert surface resists acid etching. Additive manufacturing (AM) enables controlled surface morphology, which may enhance micromechanical retention without additional treatments. Methods: Zirconia specimens with three AM-derived surface designs—(1) concave–convex hemispherical patterns, (2) concave hemispherical patterns, and (3) as-printed surfaces—were fabricated using a slurry-based 3D printing system and sintered at 1500 °C. Zirconia specimens fabricated by subtractive manufacturing using CAD/CAM systems, polished with 15 µm diamond lapping film and with or without subsequent alumina sandblasting, served as controls. Surface morphology was analyzed by FE-SEM, and shear bond strength (SBS) was tested after cementation with a resin-based luting agent. Results: SEM revealed regular layered textures and designed hemispherical structures (~300 µm) in AM specimens, along with step-like irregularities (~40 µm) at layer boundaries. The concave–convex AM group showed significantly higher SBS than both sandblasted and polished subtractive-manufactured zirconia (p < 0.05). Vertically printed specimens demonstrated greater bonding strength than those printed parallel to the bonding surface, indicating that build orientation affects resin infiltration and interlocking. Conclusion: AM-derived zirconia surfaces can provide superior and reproducible micromechanical retention compared with conventional treatments. Further optimization of printing parameters and evaluation of long-term durability are needed for clinical application.No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025奥付ENNo potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025『論語集注』訳注（子罕第九 （一））(1)(20)ENLuyiSUN10.18926/70032No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671602025ライプニッツの「人間学」―『定義集』の叙述を中心に―3150ENTsuyoshiMATSUDA10.18926/70019No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0041-11322026Pediatric autologous peripheral blood stem cell collection without heparin using a highly concentrated sodium citrate anticoagulant: A retrospective comparison with standard ACD-AENKeikoFujiiDepartment of Hematology, Okayama University HospitalWataruKitamuraDepartment of Hematology, Okayama University HospitalKanaWashioDepartment of Pediatrics, Okayama University HospitalKazuhiroIkeuchiDepartment of Hematology, Okayama University HospitalJojiShimonoDepartment of Hematology, Okayama University HospitalHiroyukiMurakamiDepartment of Hematology, Okayama University HospitalFumioOtsukaDivision of Clinical Laboratory, Okayama University HospitalYoshinobuMaedaDepartment of Hematology, Okayama University HospitalNobuharuFujiiDepartment of Hematology, Okayama University HospitalBackground: Heparin combined with sodium citrate has been used in leukocytapheresis for pediatric patients. Since 2022, we have performed leukocytapheresis using a highly concentrated sodium citrate solution (HSC, 5.32%) instead of acid citrate dextrose solution A (ACD-A). We conducted this study to determine whether HSC use reduces run time and the total amount of anticoagulant solution in children.<br>
Study Design and Methods: We retrospectively analyzed data from consecutive autologous peripheral blood stem cell harvests (auto-PBSCHs) between June 2012 and May 2025, including patient characteristics, mobilization methods, protocol used, anticoagulant type, run time, total anticoagulant solution volume, and collection efficiency.<br>
Results: Auto-PBSCH was performed using the mononuclear cell collection (MNC) protocol in 28 procedures and the continuous MNC protocol in 20 procedures. ACD-A was used in 35 procedures and HSC in 13. The run time was significantly shorter (204 [range, 117–302] vs. 157 min [range, 103–227], p = .02) in the HSC group and also confirmed in multivariable regression analysis (coefficient, −55.6; 95% confidence interval, −106.2 to −5.04; p = .03). In a subgroup analysis of cMNC procedures, CD34+ collection efficiency showed a strong negative correlation with the proportion of run time devoted to establishing the initial interface (r = −.73, p = .0003).<br>
Conclusion: Delays in establishing the initial interface can reduce the duration of the effective MNC collection phase and may negatively affect collection efficiency. Careful attention to the initial interface phase is therefore warranted when using HSC.No potential conflict of interest relevant to this article was reported.SAGE PublicationsActa Medica Okayama1756-2848192026Clinical efficacy and safety of endoscopic ultrasound-guided ablation therapies for pancreatic neuroendocrine tumors: a systematic review and meta-analysisENKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University HospitalDaisukeUchidaDepartment of Gastroenterology and Hepatology, Okayama University HospitalYasutoTakeuchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalBackground: Pancreatic neuroendocrine tumors (pNETs) are rare; however, they are increasingly being detected. Although surgical resection remains the standard treatment, its invasiveness has prompted interest in less invasive alternatives, particularly for small non-functional pNETs (NF-pNETs) and insulinomas.<br>
Objectives: To evaluate the clinical efficacy and safety of endoscopic ultrasound-guided ethanol injection (EUS-EI) and radiofrequency ablation (EUS-RFA) for pNETs.<br>
Design: A systematic review and meta-analysis.<br>
Data sources and methods: A literature search of PubMed, MEDLINE, and Google Scholar was conducted (April 2005–April 2025). Studies were eligible if they reported clinical outcomes of EUS-EI or EUS-RFA in adult patients with insulinomas or NF-pNETs. The primary endpoints were clinical success (short-term symptom resolution or radiological response) and adverse event (AE) rates. Data were pooled using a random-effects model.<br>
Results: Twenty-six studies were included in the meta-analysis. For insulinomas, the pooled clinical success rate was 77% (95% confidence interval (CI), 59–88) for EUS-EI and 95% (95% CI, 89–97) for EUS-RFA. The pooled incidence of total AEs was 32% (95% CI, 17–51) for EUS-EI and 25% (95% CI, 15–39) for EUS-RFA. For NF-pNETs, the pooled clinical success rates were 76% (95% CI, 54–90) for EUS-EI and 85% (95% CI, 74–92) for EUS-RFA, and the pooled incidence of total AEs was 27% (95% CI, 20–35) and 26% (95% CI, 17–38), respectively. The most common moderate or severe AEs were pancreatitis in 12 patients (7.6%) after EUS-EI, and pancreatic fluid collection in 4 patients (1.9%) and pancreatic duct stricture in 3 patients (1.4%) after EUS-RFA. One fatal case occurred in a 97-year-old patient following EUS-RFA.<br>
Conclusion: Both EUS-EI and EUS-RFA are effective, relatively safe, and minimally invasive treatment options for pNETs. However, severe AE can occur, and careful patient selection and treatment indication are essential.<br>
Trial registration: Not registered.No potential conflict of interest relevant to this article was reported.Japanese Society of TribologistsActa Medica Okayama1881-21982042025Tribological Properties of Amorphous-SiC-Based Coatings on Al2O3 Substrates in Normal Saline212219ENTadashiShiotaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityDaikiTaniyaGraduate School of Natural Science and Technology, Okayama UniversityKazumaShimazakiGraduate School of Natural Science and Technology, Okayama UniversityChiyuNakanoDepartment of Comprehensive Technical Solutions, Okayama UniversityYuyaOmiyaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityMasahiroFujiiFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityAmorphous SiC (a-SiC)-based coatings containing not only Si–C bonds but also C–Si–O, C–C, and Si–O2 bonds were deposited on Al2O3 substrates via pulsed laser deposition. Sliding tests using SiC ceramic balls in normal saline revealed that the coating exhibited a low friction coefficient of 0.05-0.06 at a shorter running-in process than SiC bulk ceramic plates. The specific wear rate of the coating was also lower than that of the SiC plate. Reactive molecular dynamics simulations revealed that the C–Si–O bonds in the coating facilitated the generation of Si–O units, which contained Si–O bonds but no Si-C bonds, through tribochemical reactions with water, resulting in superior tribological properties in normal saline compared to those of SiC plates. These findings demonstrate that a-SiC-based coatings containing C–Si–O bonds are promising as low-friction and low-wear coatings for biomedical implants such as ceramic joint prostheses.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.The Japanese Society of Interventional RadiologyActa Medica Okayama2432-0935102025Is Saline Sealing of Needle Tract Effective to Prevent Pneumothorax after Computed Tomography-guided Lung Biopsy?e2025-0068ENSoichiroOkamotoDepartment of Radiology, Okayama University HospitalYusukeMatsuiDepartment of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKojiTomitaDepartment of Radiology, Okayama University HospitalKazuakiMunetomoDepartment of Radiology, Okayama University HospitalNoriyukiUmakoshiDepartment of Radiology, Okayama University HospitalToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Medical Development Field, Okayama UniversityToshihiroIguchiDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityTakaoHirakiDepartment of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityPurpose: To evaluate the efficacy of needle tract sealing using normal saline instillation for decreasing the risk of pneumothorax after computed tomography-guided lung biopsy.<br>
Material and Methods: This retrospective, single-institution study included 391 computed tomography-guided lung biopsies performed by 12 operators between January 2022 and October 2024. After exclusion, 298 biopsies were analyzed by comparing the saline seal (n = 138) and control (n = 160) groups. A 17/18-gauge or 19/20-gauge coaxial biopsy system was used, and tract sealing was performed by instilling 1-5 mL of normal saline during the withdrawal of the introducer needle in the saline seal group; tract sealing was not performed in the control group. After 1:1 propensity score matching was performed to balance baseline characteristics, the incidences of pneumothorax and chest tube placement were compared between the two groups using Fisher's exact test.<br>
Results: After propensity score matching, 108 pairs (mean lesion size: 17 mm) were well balanced. The incidence of pneumothorax did not differ significantly between the control and saline seal groups (50.0% vs. 60.2%, respectively; p = 0.171). Similarly, the incidence of chest tube placement was not significantly different between the two groups (7.4% vs. 13.0%, respectively; p = 0.260).<br>
Conclusions: According to the propensity score-matched analysis, normal saline instillation for tract sealing did not significantly reduce the incidence of pneumothorax or chest tube placement. In our cohort, which had a high prevalence of small lesions, saline sealing alone may be insufficient to reduce post-biopsy pneumothorax risk. Hence, combined strategies require further investigation.No potential conflict of interest relevant to this article was reported.American Geophysical Union (AGU)Acta Medica Okayama2169-931313112026Electrical Conductivity of Carbonatite Melts to 20 GPa: Constraints on Partial Melting Atop the 410‐km Discontinuity and in the Lower Mantle Transition Zonee2025JB033390ENBinZhaoInstitute for Planetary Materials, Okayama UniversityJintaoZhuInstitute for Planetary Materials, Okayama UniversityQiChenCenter for Advanced Radiation Sources, University of ChicagoTakashiYoshinoInstitute for Planetary Materials, Okayama UniversityDeep-origin carbonatite melts are considered to be the products of partial-melting of the oceanic crust in the subduction zones. In this study, we conducted electrical conductivity (EC) measurements on two samples, the composition of which resemble the partial-melting products atop the 410-km discontinuity and in the lower part of the transition zone. The EC of carbonatite melts was investigated using impedance spectroscopy combined with a multi-anvil press up to 20 GPa. Pressure has a great effect on the EC of the carbonatite melts. While the EC dropped overall by 0.6 log unit from 3 to 20 GPa for varying compositions, the pressure effect becomes weaker above 10 GPa. The Hashin-Shtrikman mixing model indicates that melt fraction of 0–0.3 vol% is necessary to account for the EC atop the 410-km discontinuity beneath NE China, north Philippine Sea, north Pacific, and Australian craton. However, this value soars to 1–4.5 vol% for the lower part of the transition zone in the same regions, and further increases to 3.7–7.3 vol% for cold subduction regions if the slab surface temperature is 300 K lower. The difference in the needed melt fraction at different depths implies that the magnitude of partial melting is much larger in the lower part of the mantle transition zone, and it is thus likely to be the main barrier to the recycled carbonates towards the deep interior.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1341-321X3172025Impact of full-time equivalent allocation on the effectiveness of antimicrobial stewardship activities: A multicenter study in Okayama, Japan102730ENShihoKajitaAntimicrobial Stewardship Team, Okayama City HospitalHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalAtsushiOkitaDepartment of Surgery, Setouchi City HospitalYutoHarukiDepartment of Pharmacy, Tsuyama Chuo HospitalHarutoYamadaAntimicrobial Stewardship Team, Okayama City HospitalYasurouInoueAntimicrobial Stewardship Team, Okayama City HospitalTsukasaHigashionnaDepartment of Pharmacy, Okayama University HospitalKanaSatouDivision of Pharmacy, Kurashiki Central HospitalFumihiroTorigoeDivision of Pharmacy, Kurashiki Central HospitalShinobuIwamotoDivision of Pharmacy, Okayama Kyoritsu HospitalMikaYoshidaInfection Control Team, National Hospital Organization Minami-Okayama Medical CenterYumikoYamaneInfection Control Team, National Hospital Organization Minami-Okayama Medical CenterHirokiKenmotsuDivision of Pharmacy, Okayama Saiseikai HospitalSatoruSugimuraDepartment of Internal Medicine, Okayama Kyoritsu HospitalYutakaFujiwaraInfection Control Team, National Hospital Organization Minami-Okayama Medical CenterFusaoIkedaDepartment of Hepatology, Okayama Saiseikai HospitalToshihiroKoyamaDepartment of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityChikamasaYoshidaInfection Control Team, Okayama City HospitalShinichirouAndouInfection Control Team, Okayama City HospitalToshimitsuSuwakiInfection Control Team, Okayama City HospitalBackground: Optimized administration of antimicrobial agents is critical for mitigating the emergence of antimicrobial resistance. This study aimed to elucidate the relationship between antimicrobial stewardship (AS) activities and antimicrobial prescription trends and patterns.<br>
Methods: This retrospective, multicenter, longitudinal study was conducted between April 2014 and March 2023 (9-year fiscal period). A structured, questionnaire survey, regarding institutional infrastructure and environmental parameters, service modalities provided by AS activities, resource allocation and systemic support, and data on the use of broad-spectrum antimicrobial agents, was distributed to co-investigators working at seven hospitals in Okayama, Japan. Full-time equivalent (FTE) allocation for each healthcare facility were calculated and subsequently compared among the hospitals. Temporal variations in the proportional distribution of broad-spectrum antimicrobial agents were statistically evaluated using joinpoint regression analysis.<br>
Results: Two hospitals where pharmacists were exclusively dedicated to AS activities and met the recommended FTE allocation showed a statistically significant reduction in the proportion of broad-spectrum antibiotic administration, with average annual percentage changes of −8.0 % (95 % confidence interval [CI]: −10.5 to −5.8) and −3.1 % (95 % CI: −5.5 to −0.7), respectively. In contrast, two other hospitals with full-time AS members but insufficient FTE allocation exhibited inconsistent and statistically nonuniform trends. The remaining three healthcare institutions with poorly resourced AS teams demonstrated no statistically significant trends in their broad-spectrum antimicrobial prescriptions.<br>
Conclusion: Our findings uncovered that hospitals with adequate FTE staffing metrics for AS activities exhibited statistically significant downward trends in the consumption of broad-spectrum antimicrobial agents.No potential conflict of interest relevant to this article was reported.American Society for MicrobiologyActa Medica Okayama0099-22402025Efficient resuscitation of early-stage viable but non-culturable cells of Vibrio cholerae using treatment with proteolytic enzymesENShin-ichiMiyoshiGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMonaOgasawaraGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShihoNiwakiGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRenaSugiharaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBasilua AndreMuzemboResearch Institute of Nursing Care for People and Community, University of HyogoDaisukeImamuraResearch Center for Intestinal Health Science, Okayama UniversityVibrio cholerae, the etiological agent of cholera, is ubiquitous in environmental brackish waters. Exposure to low water temperatures induces the bacterium to enter a viable but non-culturable (VBNC) state. In this study, a stepwise decrease in water temperature to 4°C was found to delay the transition to the non-culturable state compared to an abrupt temperature drop, suggesting that V. cholerae cells partially adapt to low temperatures. V. cholerae VBNC cells maintained at 4°C gradually lost their ability to revert to a culturable state. However, VBNC cells in the early stage of dormancy were efficiently resuscitated following treatment with proteolytic enzymes, including proteinase K. The abundance of culturable V. cholerae cells in brackish estuarine waters was quantified using the most probable number (MPN)–quantitative polymerase chain reaction (qPCR) method. Although culturable cells were undetectable in samples treated with bovine serum albumin, they were estimated at 93 and 1,500 MPN/mL in two water samples collected on different days and pre-incubated with proteinase K. Similarly, the abundance of Vibrio species increased markedly following treatment with this enzyme. Additionally, cells of Vibrio species were enumerated by the plating method using CHROMagar Vibrio plates. Consistent with the results of the MPN–qPCR method, treatment with proteinase K resulted in over a 100-fold increase in colony formation. Collectively, these findings suggest that treatment with proteinase K is effective for resuscitating and quantifying V. cholerae VBNC cells in environmental water samples.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1341-321X31122025Whole-genome sequencing and in vitro characterization of a disseminated ST398 Staphylococcus aureus infection: A case report102845ENYosukeSazumiDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinnosukeFukushimaDepartment of Bacteriology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalAtsushiKatoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsuhitoSuyamaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiOguniDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuyoshiGotohDepartment of Medical Laboratory Science, Okayama University Graduate School of Health SciencesShokoKutsunoAntimicrobial Resistance Research Center, National Institute of Infectious Diseases, Japan Institute for Health SecurityJunzoHisatsuneAntimicrobial Resistance Research Center, National Institute of Infectious Diseases, Japan Institute for Health SecurityMotoyukiSugaiAntimicrobial Resistance Research Center, National Institute of Infectious Diseases, Japan Institute for Health SecurityShumaTsujiDepartment of Bacteriology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKojiIioMicrobiology Division, Clinical Laboratory, Okayama University HospitalFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesStaphylococcus aureus potentially causes systemic infections such as disseminated abscesses and bloodstream infections, leading to high mortality rates. We herein describe a case of disseminated muscle abscesses caused by sequence type (ST) 398 methicillin-sensitive S. aureus (MSSA), along with in vitro investigation results for potential pathogenic factors. A 67-year-old healthy woman was admitted to our hospital with complaints of systemic body pain. Blood cultures identified MSSA and contrast-enhanced computed tomography revealed multiple muscle abscesses extending from her neck to her soles. She received antibiotic treatment with intravenous cephazolin and underwent repeated surgical drainage, and was finally discharged. Notably, the MSSA strain exclusively affected her muscle tissues, prompting us to perform genetic analysis to uncover the underlying reason. Short-read genome analysis revealed the isolate to be ST398, harboring chp and scn genes known for immune evasion from human immunity. However, no other known pathogenic factors were identified despite rigorous assays for biofilm formation, surface and cell wall proteins, protease production, and hyaluronidase activity. ST398 S. aureus is commonly isolated from livestock, and her prior experience of being flooded could be related to the disease onset. The present case underscores the possibility of severe ST398 MSSA infections in humans, even in the absence of direct animal exposure.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1341-321X31122025Clinical and molecular characteristics of urinary catheter-associated Pseudomonas aeruginosa prostatic infection: A case series of four postoperative nosocomial infections102853ENShinnosukeFukushimaDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakayukiSanoLaboratory of Veterinary Public Health, School of Veterinary Medicine and Animal Sciences, Kitasato UniversityTakashigeKashimotoLaboratory of Veterinary Public Health, School of Veterinary Medicine and Animal Sciences, Kitasato UniversityHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalPseudomonas aeruginosa is a causative pathogen of nosocomial catheter-associated urinary tract infections (CAUTI), but prostate involvement, including prostatitis and prostatic abscess, is rare. The clinical characteristics of P. aeruginosa-associated CAUTI with prostatic lesions, as well as the contribution of genetic backgrounds remain unclear. We describe four cases of urinary catheter-associated prostatic infection caused by P. aeruginosa following postoperative catheterization. All patients developed fever within 10 days after surgery, and three of the four patients developed bacteremia. Three patients were diagnosed with prostatic abscess by contrast-enhanced computed tomography or magnetic resonance imaging, while one case presented with prostatitis without abscess formation. Prostate-specific antigen levels were elevated over 20 ng/mL in all three measured cases. All patients were treated successfully with prolonged antibiotic therapy (28–39 days) without surgical drainage. Notably, all three abscess cases were successfully managed with fluoroquinolone-based combination therapy, highlighting its potential role in the management of prostatic abscesses. Three of four isolates were submitted for molecular investigations. All isolates harbored exoT and exoY, whereas exoU was absent. Biofilm-associated genes were detected in two cases, but not in the remaining case. Our findings suggested that P. aeruginosa strains carrying T3SS genes (exoT and exoY) potentially develop prostatic infections, independent of biofilm-associated genes. Host and iatrogenic factors, such as catheter manipulation, may play more critical roles in the development of prostatic pathology than strain-specific determinants. Assessment of prostate-specific antigen levels and early imaging may facilitate appropriate diagnosis and effective management when P. aeruginosa is detected as a cause of CAUTI.No potential conflict of interest relevant to this article was reported.American Association for the Advancement of Science (AAAS)Acta Medica Okayama2375-254811442025Structural insights into the divergent evolution of a photosystem I supercomplex in Euglena graciliseaea6241ENKojiKatoResearch Institute for Interdisciplinary Science, Advanced Research Field, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYoshikiNakajimaResearch Institute for Interdisciplinary Science, Advanced Research Field, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityRunaSakamotoResearch Institute for Interdisciplinary Science, Advanced Research Field, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMinoruKumazawaInstitute of Low Temperature Science, Hokkaido UniversityKentaroIfukuGraduate School of Agriculture, Kyoto UniversityTakahiroIshikawaInstitute of Agricultural and Life Sciences, Academic Assembly, Shimane UniversityJian-RenShenResearch Institute for Interdisciplinary Science, Advanced Research Field, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityAtsushiTakabayashiInstitute of Low Temperature Science, Hokkaido UniversityRyoNagaoFaculty of Agriculture, Shizuoka UniversityPhotosystem I (PSI) forms supercomplexes with light-harvesting complexes (LHCs) to perform oxygenic photosynthesis. Here, we report a 2.82-angstrom cryo–electron microscopy structure of the PSI-LHCI supercomplex from Euglena gracilis, a eukaryotic alga with secondary green alga-derived plastids. The structure reveals a PSI monomer core with eight subunits and 13 asymmetrically arranged LHCI proteins. Euglena LHCIs bind diadinoxanthin, which is one of the carotenoids typically associated with red-lineage LHCs and is not present in the canonical LHCI belt found in green-lineage PSI-LHCI structures. Phylogenetic analysis shows that the Euglena LHCIs originated from LHCII-related clades rather than from the green-lineage LHCI group and that the nuclear-encoded PSI subunit PsaD likely originated from cyanobacteria via horizontal gene transfer. These observations indicate a mosaic origin of the Euglena PSI-LHCI. Our findings uncover a noncanonical light-harvesting architecture and highlight the structural and evolutionary plasticity of photosynthetic systems, illustrating how endosymbiotic acquisition and lineage-specific adaptation shape divergent light-harvesting strategies.No potential conflict of interest relevant to this article was reported.BMJActa Medica Okayama0143-005X8022025Exposure-induced mediator–outcome confounders in causal mediation: implications and visualisation129130ENEtsujiSuzukiDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomohiroShinozakiInterfaculty Initiative in Information Studies, the University of TokyoEijiYamamotoOkayama University of ScienceNo potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1347-90322025Genotype–Phenotype Correlations of Li–Fraumeni Syndrome in Japan Children's Cancer Group LFS20 Study CohortENFumitoYamazakiDepartment of Pediatrics, Keio University School of MedicineYoshikoNakanoDepartment of Genetic Medicine and Services, National Cancer Center HospitalMasashiSanadaDepartment of Advanced Diagnosis, Clinical Research Center, NHO Nagoya Medical CenterHirokiKurahashiDivision of Molecular Genetics, Center for Medical Science, Fujita Health UniversityShunsukeMiyaiDivision of Molecular Genetics, Center for Medical Science, Fujita Health UniversityArisaUekiDepartment of Clinical Genetic Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer ResearchYukoWatanabeDepartment of Pediatric Oncology, National Cancer Center HospitalDaisukeHasegawaDepartment of Pediatrics, St. Luke's International HospitalShuheiKarakawaDepartment of Pediatrics, Hiroshima University HospitalToshifumiOzakiDepartment of Orthopaedic Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityAkiraHirasawaDepartment of Clinical Genomic Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAkiko M.SaitoClinical Research Center, NHO Nagoya Medical CenterEisukeInoueShowa Medical University Research Administration Center, Showa Medical UniversityMotohiroKatoDepartment of Pediatrics, The University of TokyoHiroyoshiHattoriDepartment of Clinical Genetics, NHO Nagoya Medical CenterLi–Fraumeni syndrome (LFS) is a cancer predisposition syndrome caused by germline pathogenic variants in the TP53 gene. With the increasing use of multi-gene panel testing, TP53 variants have been identified in individuals who do not meet established TP53 testing criteria, such as the Chompret criteria. The term “attenuated LFS” has been proposed for some of these cases, particularly those with adult-onset cancer. We analyzed participants of the Japanese nationwide prospective clinical trial of the cancer surveillance program (Japan Children's Cancer Group LFS-20), along with clinical information including their family histories, to better understand their genotypic and phenotypic characteristics. We identified 32 distinct TP53 variants from 41 families (45 participants), including four missense variants with conflicting classifications of pathogenicity in ClinVar. Among these families, 36 (88%) met the LFS criteria (hereafter referred to as “LFS” in contrast to attenuated LFS), while 5 (12%) were classified as attenuated LFS. Including 30 additional family members carrying the same variant, we analyzed 75 individuals with TP53 variants. Of these, 40 with LFS and 6 with attenuated LFS had cancer. Multiple primary cancers occurred in 22 individuals (21 LFS, 1 attenuated LFS). LFS-core tumors accounted for 66% (58/88) of cancers in the LFS group and 63% (5/8) in the attenuated LFS group; of note, all core tumors in the attenuated group were limited to breast cancer. Hotspot missense variants were detected in 11 of 36 LFS families and in none of 5 attenuated LFS families, and non-hotspot null variants were found in 14 and 1, respectively. Our study revealed genotype–phenotype correlations in several respects. UMIN-CTR: UMIN000045855.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1347-90322025Atezolizumab + Chemotherapy for Advanced Non-Small Cell Lung Cancer in Japanese Clinical Practice (J-TAIL-2)ENHiroshigeYoshiokaDepartment of Thoracic Oncology, Kansai Medical UniversityMakotoNishioDepartment of Thoracic Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer ResearchKadoakiOhashiDepartment of Respiratory Medicine, Okayama University HospitalAtsushiOsoegawaDepartment of Thoracic and Breast Surgery, Oita University Faculty of MedicineEikiKikuchiDepartment of Respiratory Medicine, Faculty of Medicine, Hokkaido UniversityHideharuKimuraDepartment of Respiratory Medicine, Kanazawa University HospitalYasushiGotoDepartment of Thoracic Oncology, National Cancer Center HospitalJunichiShimizuDepartment of Thoracic Oncology, Aichi Cancer Center HospitalEisakuMiyauchiDepartment of Respiratory Medicine, Tohoku University HospitalIchiroYoshinoInternational University of Health and Welfare, Narita HospitalToshihiroMisumiDepartment of Data Science, National Cancer Center Hospital EastYasutakaWatanabeDepartment of Thoracic Oncology, Saitama Cancer CenterAkitoHataDivision of Thoracic Oncology, Kobe Minimally Invasive Cancer CenterAkiraKisoharaDepartment of Respiratory Medicine, Kasukabe Medical CenterShoichiKuyamaDepartment of Respiratory Medicine, NHO Iwakuni Clinical CenterMasafumiYamaguchiDepartment of Thoracic Oncology, NHO Kyushu Cancer CenterAsakoMiwaChugai Pharmaceutical Co., Ltd.ShunichiroIwasawaChugai Pharmaceutical Co., Ltd.MisaTanakaChugai Pharmaceutical Co., Ltd.AkihikoGemmaNippon Medical SchoolFirst-line atezolizumab combination therapies were approved for the treatment of metastatic non-small cell lung cancer (NSCLC) based on results from the global phase 3 trials IMpower130, IMpower132, and IMpower150. These trials reported 12-month overall survival (OS) rates of 60%–67% with atezolizumab combination therapy. J-TAIL-2 (NCT04501497), a prospective, multicenter, observational study, evaluated atezolizumab combination therapy in routine clinical practice in Japan. Patients ≥ 20 years old with NSCLC received atezolizumab plus carboplatin and nab-paclitaxel (atezo + CnP), atezolizumab plus carboplatin or cisplatin plus pemetrexed (atezo + PP), or atezolizumab plus bevacizumab plus carboplatin and paclitaxel (atezo + bev + CP) in clinical practice. The primary endpoint was the 12-month OS rate. Secondary endpoints included OS, progression-free survival, and subgroup analyses, including IMpower-unlike (did not meet the main eligibility criteria of each IMpower trial) and IMpower-like patients. In total, 814 patients were enrolled (atezo + CnP, n = 217; atezo + PP, n = 211; atezo + bev + CP, n = 386). The IMpower-unlike group included patients with Eastern Cooperative Oncology Group performance status ≥ 2, autoimmune disease, or interstitial lung disease. Twelve-month OS rates (95% confidence interval [CI]) were 62.9% (55.8–69.2), 72.1% (65.2–77.9), and 68.3% (63.2–72.9) with atezo + CnP, atezo + PP, and atezo + bev + CP, respectively. OS hazard ratios (95% CI) in the IMpower-unlike vs. -like subgroups were 1.36 (0.91–2.05), 1.08 (0.70–1.68), and 1.49 (1.09–2.06), respectively. No new safety signals were observed. Real-world efficacy and safety for each atezolizumab combination were comparable to those in the relevant IMpower trials.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0732-889311342025Time to positivity for differentiating blood culture contamination: A 20-hour cutoff for major contaminants117030ENYoheiManabeDepartment of Pharmacy, Okayama University HospitalHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalShinnosukeFukushimaDepartment of Infectious Diseases, Okayama University HospitalKentaNakamotoDepartment of Infectious Diseases, Okayama University HospitalKoheiOguniDepartment of Infectious Diseases, Okayama University HospitalHidemasaAkazawaDepartment of Infectious Diseases, Okayama University HospitalYasushiFujitaDepartment of Nursing, Okayama University HospitalTakashiKiguchiDepartment of Nursing, Okayama University HospitalKojiIioMicrobiology Division, Clinical Laboratory, Okayama University HospitalBackground: Blood culture remains the gold standard for diagnosing bacteremia; however, contamination inevitably occurs in 2-3% of cases, requiring differentiation between true bacteremia and contamination. Although time to positivity (TTP) aids in this clinical decision, with detection after 24 hours generally indicating contamination, technological advances in blood culture systems may have shortened this threshold interval.<br>
Methods: This study retrospectively analyzed blood culture data in our hospital from April 2023 to January 2025 to determine the optimal TTP cutoff. Patients with positive blood cultures for major contaminating bacteria were included. Cases were classified as true bacteremia or contamination based on a comprehensive chart review conducted by the antimicrobial stewardship audit, and TTP was compared between the groups. Sensitivity, specificity, and Youden index at various TTP cutoffs were utilized to determine the optimal threshold using the receiver operating characteristic curve analysis.<br>
Results: Seventy-one patients were enrolled, with 34 cases classified as true bacteremia and 37 as contamination. Identified bacteria included coagulase-negative staphylococci (70.4%), viridans group streptococci (18.3%), and others (11.3%). The median TTP was significantly shorter in the true bacteremia group compared with the contamination group (18.6 vs.25.8 hours, p < 0.001). In the contamination group, 43.2% of the cases demonstrated positive growth within 24 hours. Based on sensitivity, specificity, and Youden index, the optimal threshold was estimated to be 20 hours. A subgroup analysis of the CNS-only cohort yielded concordant results.<br>
Conclusion: This study suggests that a 20-hour TTP threshold could help effectively differentiate true bacteremia from contamination in current clinical settings.No potential conflict of interest relevant to this article was reported.Public Library of Science (PLoS)Acta Medica Okayama1932-62032092025Impact of COVID-19 on the awareness and interest in infectious disease specialization among Japanese medical studentse0329451ENNarutoKamadaFaculty of Medicine, Wakayama Medical UniversityHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalSatoshiKutsunaDepartment of Infection Control and Prevention, Graduate School of Medicine, Osaka UniversityBackground<br>
The SARS-CoV-2 pandemic has highlighted the critical deficiency of infectious disease (ID) specialists, a subspecialty that remains underrepresented among Japanese medical students.<br>
Methods<br>
This nationwide cross-sectional survey was administered between April and August 2024 via an online questionnaire distributed to medical students throughout Japan. The survey assessed awareness of and interest in ID specialization, categorizing students by academic year: lower (first- and second-year students), middle (third- and fourth-year students), and upper grades (fifth- and sixth-year students).<br>
Results<br>
Of 502 respondents, data for 492 medical students were eligible, of whom 69.7% demonstrated awareness of ID specialists, with recognition rates increasing proportionally with academic progression. Regarding career aspirations, 9.8% of respondents expressed interest in pursuing ID specialization, with the highest proportion observed among upper-grade students (19.4%). Male students (14.8%) expressed greater interest in ID specialization than female students (5.2%). The pandemic positively influenced 5.5% of students to consider ID specialization as a future career, whereas only 0.6% reported a negative impact.<br>
Conclusions<br>
These findings underscore the necessity of enhanced educational initiatives to promote ID specialization among medical students, addressing current shortages and future infectious disease preparedness.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2077-03831512026Oral Health-Related Quality of Life and Self-Reported Oral Health Status Are Associated with Change in Self-Reported Depression Status: A Cohort Study376ENNorikoTakeuchiDepartment of Preventive Dentistry, Division of Dentistry, Medical Development Field, Okayama UniversityTakayukiMaruyamaDepartment of Preventive Dentistry, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNaokiToyamaDepartment of Preventive Dentistry, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYuzukiKatsubeDental School, Okayama UniversityTakahiroTabuchiDivision of Epidemiology, School of Public Health, Tohoku University Graduate School of MedicineDaisukeEkuniDepartment of Preventive Dentistry, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground/Objectives: Oral health-related quality of life (OHRQoL) may influence mental health outcomes, yet longitudinal evidence on its association with depression remains limited. This study aimed to examine whether oral health status and OHRQoL are associated with a change in self-reported depression status among adults in Japan. Methods: We analyzed data from the Japan COVID-19 and Society Internet Survey (JACSIS), conducted in 2022 and 2023. A total of 15,068 participants aged ≥20 years without depression at baseline were included. Depression status was identified by self-reported measures between the two survey waves. Logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) for change in self-reported depression status in relation to OHRQoL and oral health status, adjusting for sociodemographic and behavioral factors. Results: During follow-up, 218 participants (1.45%) reported a change in self-reported depression status. Poorer OHRQoL was significantly associated with a change in self-reported depression status (OR: 1.018; 95% CI: 1.001–1.036; p = 0.039). Additional risk factors included younger age (OR: 0.974; 95% CI: 0.964–0.985), participation in hobbies and cultural activities (OR: 2.224; 95% CI: 1.498–3.302), habitual use of sleeping pills or anxiolytics (current use OR: 3.512; 95% CI: 2.267–5.442), increased loneliness (OR: 1.217; 95% CI: 1.140–1.299), lower life satisfaction (OR: 0.900; 95% CI: 0.836–0.969), and poor self-rated health (OR: 2.921; 95% CI: 1.810–4.715). Conclusions: Impaired OHRQoL was associated with a change in self-reported depression status, potentially through psychosocial mechanisms. These findings suggest that oral health and OHRQoL may be relevant factors to consider in integrated oral and mental health approaches in clinical practice.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0040-8166932025Detection of the nuclear translocation of androgen receptor using quantitative and automatic cell imaging analysis102631ENLanlanBaiGraduate School of Science and Engineering, Iwate UniversityTaoWuGraduate School of Science and Engineering, Iwate UniversityMizukiFukasawaNeuro-AI Integration Science Laboratory, Faculty of Environmental, Life, Natural Science and Technology, Okayama UniversitySayoKashiwagiRohto Pharmaceutical Co., Ltd., Basic Research Development DivisionHarukaTateGraduate School of Science and Engineering, Iwate UniversityTakuOzakiGraduate School of Science and Engineering, Iwate UniversityErikoSuganoGraduate School of Science and Engineering, Iwate UniversityHiroshiTomitaGraduate School of Science and Engineering, Iwate UniversityTsuyoshiIshiiRohto Pharmaceutical Co., Ltd., Basic Research Development DivisionTakuyaAkashiNeuro-AI Integration Science Laboratory, Faculty of Environmental, Life, Natural Science and Technology, Okayama UniversityTomokazuFukudaGraduate School of Science and Engineering, Iwate UniversityTestosterone signaling mediates diseases such as androgenetic alopecia and prostate cancer and is controlled by the activation of the androgen receptor (AR) and nuclear translocation of the ligand-receptor complex. This study established an immortalized dermal papilla cell line that stably expresses the AR labeled with a monomeric green fluorescence marker. The cells expressed the histone H2B protein as visualized using a red fluorescence marker, enabling the Detection of nuclear translocation under live cell conditions using image analysis. The AR was observed to be translocated from the cytoplasm to the nucleus of cells after stimulation with dihydrotestosterone (DHT). The signal intensity of the nuclear/cytoplasm ratio was analyzed using automatic image analysis and a newly developed algorithm. The quantitation method to detect nuclear translocation revealed that the AR nuclear signal plateaued approximately 20 min after DHT exposure. Our developed method has the potential to save human labor by the automatic process of the image.No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama0006-296064202025Characterization of Autonomous and Ca2+/Calmodulin-Dependent Activities of CaMKK Isoforms In Vitro and in Mouse Tissues43094317ENSatomiOhtsukaApplied Cell Biology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityYerunChenApplied Cell Biology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityMasakiMagariApplied Cell Biology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTeruhikoIshikawaDepartment of Science Education, Graduate School of Education, Okayama UniversityHiroyukiSakagamiDepartment of Anatomy, Kitasato University School of MedicineFutoshiSuizuClinical Examination Department, Kagawa Prefectural University of Health SciencesHiroshiTokumitsuApplied Cell Biology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityCa2+/CaM-dependent protein kinase kinase (CaMKK) phosphorylates and activates downstream kinases, including CaMKI, CaMKIV, PKB, and AMPK, regulating various cellular functions such as neuronal morphogenesis, metabolic control, and pathophysiological pathways, such as cancer progression. CaMKKα/1 is tightly regulated by an autoinhibitory mechanism. CaMKKβ/2 activity is highly Ca2+/CaM-independent (autonomous activity) in vitro and Ca2+/CaM-dependent in cultured cells. Whether these two activity states of CaMKKβ/2 exist in vivo and the detailed regulatory mechanisms for the transition of both activity states remain unclear due to the difficulty in distinguishing the two activity states. In this study, we detected Ca2+-dependent and autonomous CaMKK activity in HeLa cells and successfully separated both activity states of CaMKKβ/2 in mouse brain and testis extracts using a recently developed CaMKK inhibitor (TIM-063)-coupled sepharose, which binds to the catalytic domain in the active state but not in the autoinhibited state. Furthermore, lambda protein phosphatase treatment converted the Ca2+/CaM-dependent form to the autonomous form of CaMKKβ/2, which was not affected by Ala mutation of Ser128, Ser132, and Ser136. The two activity forms of CaMKKβ/2 had equivalent Ca2+/CaM-binding ability. The findings demonstrate the presence of autonomous and Ca2+/CaM-dependent forms of CaMKKβ/2 independently in mouse tissues and cultured cells. The transition of these states of CaMKKβ/2 may be dynamically regulated by the phosphorylation/dephosphorylation of serine residues in the N-terminal regulatory domain.No potential conflict of interest relevant to this article was reported.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.International Institute of Anticancer ResearchActa Medica Okayama0250-70054612025P53-Armed Oncolytic Virotherapy Promotes the Efficacy of PD1 Blockade in Murine Osteosarcoma Tumors6984ENMIHOKUREDepartment 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 SciencesKOJIDEMIYADepartment 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 SciencesYUSUKEMOCHIZUKIDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTADASHIKOMATSUBARADepartment 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 SciencesKOJIUOTANIDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJOEHASEIDepartment 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 SciencesYASUOURATADepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSHUNSUKEKAGAWADepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical 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 SciencesBackground/Aim: Osteosarcoma (OS) is refractory to immune checkpoint inhibitors targeting programmed cell death 1 (PD1)/PD ligand 1 (PD-L1) due to poor immune response. We previously developed telomerase-specific, replication-competent oncolytic adenoviruses non-armed OBP-301 and P53-armed OBP-702 that exert antitumor efficacy against human OS cells. Recently, we demonstrated that P53-armed OBP-702 induces more profound immunogenic cell death and antitumor immune response against human and murine OS cells than does non-armed OBP-301. In the present study, we assessed the combined efficacy of PD1 blockade and P53-armed OBP-702 against murine OS cells.<br>
Materials and Methods: Three murine OS cell lines (K7M2, NHOS, NHOS-LM4) were used to assess the cytopathic effect of non-armed OBP-301 and P53-armed OBP-702 by XTT assay. Virus-induced immunogenic cell death was assessed by analyzing the levels of extracellular adenosine triphosphate and high-mobility group box protein B1. The expression of PD-L1 and PD-L2 was analyzed by flow cytometry. The malignant potential of NHOS-LM4 cells was analyzed by a migration and invasion assay. An orthotopic NHOS-LM4 tumor model was used to evaluate the antitumor efficacy of combination therapy with P53-armed OBP-702 and anti-PD1.<br>
Results: P53-armed OBP-702 exhibited antitumor potential for the induction of immunogenic cell death, apoptosis, autophagy, and PD-L1/2 upregulation in K7M2 and NHOS cells. NHOS-LM4 cells showed increased migratory and invasive ability compared to NHOS cells. P53-armed OBP-702 significantly suppressed the malignant potential of NHOS-LM4 cells. Combination dosing showed that P53-armed OBP-702 significantly promoted the antitumor effect of PD1 blockade against NHOS-LM4 tumors.<br>
Conclusion: Our results suggest that P53-armed OBP-702 is a promising agent for improving the antitumor effect of PD1 blockade in treating invasive OS.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1347-90322025Genomic Profiling of Pediatric Solid Tumors With a Dual DNA/RNA Panel: JCCG-TOP2 StudyENKayokoTaoDepartment of Pediatrics, National Cancer Center HospitalTakakoYoshiokaDepartment of Pathology, National Center for Child Health and DevelopmentMihoKatoDepartment of Childhood Cancer Data Management, National Center for Child Health and DevelopmentKazuyukiKomatsuDepartment of Pediatrics, Hamamatsu University School of MedicineShinichiTsujimotoDepartment of Pediatrics, Yokohama City UniversityKenichiSakamotoDepartment of Pediatrics, Shinshu University School of MedicineKazukiTanimuraDepartment of Pediatrics, National Cancer Center HospitalMinakoSugiyamaDepartment of Pediatrics, National Cancer Center HospitalMasahiroSekiguchiDepartment of Pediatrics, The University of TokyoYoshikoNakanoDepartment of Pediatrics, The University of TokyoYoshihiroOtaniDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasushiYatabeDepartment of Diagnostic Pathology, National Cancer Center HospitalAkihikoYoshidaDepartment of Diagnostic Pathology, National Cancer Center HospitalHajimeOkitaDepartment of Pathology, Keio University School of MedicineJunkoHiratoDepartment of Pathology, Public Tomioka General HospitalKenichiKohashiDepartment of Pathology, Graduate School of Medicine, Osaka Metropolitan UniversityYukichiTanakaDepartment of Pathology, Kanagawa Children's Medical CenterShinjiKohsakaDivision of Cellular Signaling, National Cancer Center Research InstituteTakashiKuboDepartment of Clinical Genomics, National Cancer Center Research InstituteKunikoSunamiDepartment of Laboratory Medicine, National Cancer Center HospitalMakotoHirataDepartment of Genetic Medicine and Services, National Cancer Center HospitalShuichiTsutsumiGenome Science & Medicine Division, Research Center of Advanced Science and Technology, The University of TokyoHiroyukiAburataniGenome Science & Medicine Division, Research Center of Advanced Science and Technology, The University of TokyoKatsuyoshiKohDepartment of Hematology and Oncology, Saitama Children's Medical CenterMasahiroHirayamaDepartment of Pediatrics, Mie University Graduate School of MedicineShuheiKarakawaDepartment of Pediatrics, Hiroshima University HospitalYukayoTerashitaDepartment of Pediatrics, Hokkaido University HospitalHiroyukiFujisakiDepartment of Pediatric Hematology and Oncology, Osaka City General HospitalTakeshiYagiOkinawa Prefectural Nanbu Medical Center & Children's Medical CenterAkihiroYonedaDepartment of Pediatric Surgery, National Center for Child Health and DevelopmentShinjiMochizukiDepartment of Pediatrics, National Center for Global Health and Medicine, Japan Institute for Health SecurityHiroyukiShichinoDepartment of Pediatrics, National Center for Global Health and Medicine, Japan Institute for Health SecurityTatsuyaSuzukiDepartment of Hematology, National Cancer Center HospitalTetsuyaTakimotoDepartment of Childhood Cancer Data Management, National Center for Child Health and DevelopmentKoichiIchimuraDepartment of Pathology, Kyorin University Faculty of MedicineChitoseOgawaDepartment of Pediatrics, National Cancer Center HospitalKimikazuMatsumotoChildren's Cancer Center National Center for Child Health and DevelopmentHitoshiIchikawaDepartment of Clinical Genomics, National Cancer Center Research InstituteMotohiroKatoDepartment of Pediatrics, The University of TokyoTo develop an optimized genomic medicine platform for pediatric cancers, a nationwide cancer genome profiling project was conducted from January 2022 to February 2023 in collaboration with the Japan Children's Cancer Group. This prospective observational study analyzed matched blood and FFPE tumor samples from patients aged 0–29 years with solid tumors. Genomic analysis used the TOP2 hybrid capture–enrichment system, targeting 737 and 455 genes in the DNA and RNA panels, along with allele-specific genome copy number alterations. A total of 210 patients from 50 institutions were enrolled across Japan (median age, 8 years; range, 0–25). Of these, 154 (77%) were enrolled at diagnosis or during/after initial treatment and 56 (27%) at disease progression or relapse. The TOP2 findings had great benefits in clarifying the diagnosis of pediatric solid tumors. Among the 204 patients with genomic results, 147 (72%) had potentially actionable findings, including diagnostic, prognostic, and therapeutic findings in 111 (54%), 61 (30%), and 64 (31%), respectively. Oncogenic fusions were noted in 45 (23%) patients. A copy number alteration was identified in at least one genomic region in 170 (83%) patients. Two patients exhibited a high tumor mutation burden. Seventeen (8%) patients harbored a germline pathogenic/likely pathogenic variant in cancer-predisposing genes. This study highlighted the feasibility of implementing a nationwide precision medicine platform and the clinical utility of the TOP2 system for pediatric cancers. The results support the integration of genomic data into the standard clinical care of pediatric patients with cancer, both at diagnosis and at relapse.No potential conflict of interest relevant to this article was reported.Japanese Society for Horticultural ScienceActa Medica Okayama2189-01029432025Effect of Storage Temperature and a Sugar-ester Edible Coating on Postharvest Quality and Storage Life of ‘Fuyu’ Persimmon (Diospyros kaki Thunb.)401407ENMaqsoodMuqadasGraduate School of Environmental, Life Science, Natural Science and Technology Okayama UniversityOscar W.MitaloFaculty of Life and Environmental Sciences, University of TsukubaKyoheiOhashiGraduate School of Environmental, Life Science, Natural Science and Technology Okayama UniversityTakumiOtsukiGraduate School of Environmental, Life Science, Natural Science and Technology Okayama UniversityChikaraYanoGraduate School of Environmental, Life Science, Natural Science and Technology Okayama UniversityZiaurrahmanHejaziGraduate School of Agriculture, University of MiyazakiNatsukiHiraShiga R&D Center, Mitsubishi Chemical CorporationKoichiroUshijimaGraduate School of Environmental, Life Science, Natural Science and Technology Okayama UniversityYasutakaKuboGraduate School of Environmental, Life Science, Natural Science and Technology Okayama UniversityIn ‘Fuyu’ persimmons (Diospyros kaki Thunb.), crunchiness is a preferred postharvest attribute among both distributors and consumers. The present study first examined softening characteristics during storage at 0, 5, 10, 15, 20, and 25°C. Fruit stored at 0°C remained firm for 84 d, while that stored at 5°C had a 100% softening rate within 35 d. At 10 and 15°C, over 70% of fruit softened within 49 d and 63 d, respectively. The softening rate was relatively slower at 20 and 25°C, with only 27% softened fruit after 56 d at 25°C. The potential of a newly developed sugar-ester (SE) edible coating to delay fruit softening and maintain postharvest quality was then assessed during storage at 0 and 25°C. Uncoated fruit stored at 0°C for 56 d developed chilling injury (CI) symptoms (rapid fruit softening and peel browning) within 2 d of rewarming at 20°C. These CI symptoms were notably mitigated in SE-coated fruit. At 25°C, SE coating also delayed fruit softening and peel color change in addition to reducing fruit shrinkage. In conclusion, in ‘Fuyu’ persimmons ambient temperature (20–25°C) storage in combination with an edible SE coating is recommended for the high demand Christmas and new year seasons and 0°C storage with an edible SE coating is suitable for longer storage and distribution.No potential conflict of interest relevant to this article was reported.Fuji Technology Press Ltd.Acta Medica Okayama1883-80493762025Directed Poisoning Attacks on FRIT in Adaptive Cruise Control13921399ENTaichiIkezakiFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityKenjiSawadaGraduate school of Mechanical Engineering, The University of OsakaOsamuKanekoGraduate School of Informatics and Engineering, The University of Electro-CommunicationsRecent advances in connected-vehicle technologies have enabled the large-scale collection of driving data, facilitating the deployment of data-driven control schemes. Although these methods offer advantages by eliminating the need for explicit modeling, they also introduce vulnerabilities due to their reliance on stored data. This study investigates a class of targeted data poisoning attacks on fictitious reference iterative tuning, a widely used data-driven controller tuning approach. We present a method that allows an adversary to influence closed-loop dynamics by manipulating the training data so that the resulting controller behavior matches a maliciously defined reference response. This strategy differs from conventional poisoning attacks, which aim only to the degrade control performance. Instead, it enables deliberate alteration of control characteristics such as overshoot and convergence time. The proposed attack is formulated as a constrained optimization problem under bounded tampering signals. Through a numerical study involving adaptive cruise control with stop functionality, we show that minor data modifications, indistinguishable from sensor noise, can cause significant degradation in control behavior. These findings highlight the need for robust security mechanisms in data-driven control implementation.No potential conflict of interest relevant to this article was reported.Japan Society of Mechanical EngineersActa Medica Okayama1880-55662022025DNS analysis on the correlation between local burning velocity and flame displacement speed of turbulent premixed flames25-00212ENKazuyaTSUBOIFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityThe local burning velocity and flame displacement speed are the major properties of premixed flames. The local burning velocity, which is the instantaneous quantity based on the local consumption rate of the unburnt mixture, is considered to be the most appropriate burning velocity in terms of the definition. The local burning velocity can be evaluated theoretically and numerically; however, it is almost impossible to obtain it experimentally using the current technology of measurement. The flame displacement speed can be evaluated more easily than the local burning velocity and compared with the flame displacement speed obtained from experiments. However, the local burning velocity and flame displacement speed have been discussed separately in turbulent premixed flames. In this study, to clarify the relation between the local burning velocity and the flame displacement speed, numerical analyses were performed using the DNS database of statistically steady and fully developed turbulent premixed flames with different density ratios of the unburnt mixture to the burnt product and with different Lewis numbers. It was found that for different density ratios, the local burning velocity was little sensitive to the flame displacement speed in any case under the unity Lewis number. This means the correlation between the local burning velocity and the flame displacement speed is little affected by the dilation of a flame. For different Lewis numbers, the correlation between the local burning velocity and the flame displacement speed was negative in Le = 0.8, and positive in Le = 1.2. This can be explained by the effect of the Lewis number on the local burning velocity, and the flame displacement speed was little affected by the Lewis number in the correlation between the local burning velocity and the flame displacement speed.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7962025Exacerbation of Proteinuria in a Patient with Behçet’s Disease and IgA Nephropathy Following Colchicine Discontinuation457461ENTomohikoAsakawaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesHaruhito A.UchidaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesYuKatayamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesYoshimasaSakurabuDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKatsuyoshiKatayamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroOnishiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesNatsumiMatsuoka-UchiyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesHidemiTakeuchiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKeikoTanakaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKenjiTsujiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesRyokoUmebayashiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesRikaTakemotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/69849This case involves a 23-year-old male who was diagnosed with Behçet’s disease 5 years ago and managed with colchicine. Two months ago, he underwent renal biopsy due to abnormal urinalysis and kidney dysfunction, leading to a diagnosis of IgA nephropathy. He subsequently underwent tonsillectomy followed by glucocorticoid pulse therapy. However, after the tonsillectomy, discontinuing colchicine led to increased proteinuria, despite the glucocorticoid pulse therapy. Upon reintroducing colchicine, urinary protein excretion decreased, achieving incomplete remission. These findings suggest that colchicine may be effective in decreasing proteinuria in patients with Behçet’s disease complicated by IgA nephropathy.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7962025Recurrence of FVIII Inhibitor during Surgery in a Patient with Severe Hemophilia A Receiving Emicizumab Prophylaxis451455ENMoeHagiharaDepartment of Hematology and Oncology, Okayama University HospitalKeisukeSeikeDepartment of Hematology and Oncology, Okayama University HospitalKentaHayashinoDepartment of Hematology and Oncology, Okayama University HospitalTakaoYasuharaDepartment of Neurological Surgery, Okayama University HospitalKyoheiKinDepartment of Neurological Surgery, Okayama University HospitalYuichiHirataDepartment of Neurological Surgery, Okayama University HospitalHirokiKobayashiDepartment of Hematology and Oncology, Okayama University HospitalWataruKitamuraDepartment of Hematology and Oncology, Okayama University HospitalHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalNobuharuFujiiDivision of Transfusion and Cell Therapy, Okayama University HospitalYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalCase Report10.18926/AMO/69848Emicizumab, a bispecific monoclonal antibody, benefits patients with severe hemophilia A. It alters laboratory assessments of coagulation activity, requiring anti-idiotype monoclonal antibodies for accurate monitoring. A 64-year-old man, receiving emicizumab regularly, was admitted for laminoplasty. We planned to use FVIII replacement during the perioperative period after confirming the disappearance of inhibitors, monitoring coagulation activity with anti-idiotype monoclonal antibodies. Activated partial thromboplastin time was prolonged on postoperative day 2, prompting an immediate switch to eptacog alfa. The patient recovered without bleeding. This case underscores the necessity of anti-idiotype monoclonal antibodies for accurate monitoring.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1120-17971402025Improvements of lateral penumbra at various depth regions in proton pencil beam scanning with a multileaf collimator: Dose verifications and plan comparisons105684ENYukiTominagaDepartment of Radiotherapy, Medical Co. Hakuhokai, Osaka Proton Therapy ClinicYushiWakisakaDepartment of Radiotherapy, Medical Co. Hakuhokai, Osaka Proton Therapy ClinicTakahiroKatoDepartment of Radiological Sciences, School of Health Sciences, Fukushima Medical UniversityKeisukeYasuiSchool of Medical Sciences, Fujita Health UniversityRyoheiKatoDepartment of Radiation Physics and Technology, Southern Tohoku Proton Therapy CenterMasayaIchiharaMedical Physics Laboratory, Division of Health Science, Graduate School of Medicine, The University of OsakaMasashiTomidaDepartment of Proton Beam Technology Room, Narita Memorial Proton CenterMotoharuSasakiGraduate School of Biomedical Sciences, Tokushima UniversityMasatakaOitaFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTeijiNishioMedical Physics Laboratory, Division of Health Science, Graduate School of Medicine, The University of OsakaPurpose: In scanned proton therapy, the current consensus is that the effective range of the collimator’s contribution to lateral penumbra improvement is up to approximately 150 mm depth. We characterized the penumbra variations for scanned proton beams with or without a new type of multileaf collimator (MLC) under various air gaps, depth, and with or without range shifter (RS).<br>
Methods: Eighty-six uniform dose plans were created (38 RS-negative and 48 RS-positive plans) for nine box targets of 60 × 60 × 54 mm3 at 0–280 mm depths in water. They were created with or without MLC, with 50–300 mm air gaps. The penumbra and average doses of MLC-positive and MLC-negative plans at the organs at risk (OAR) region of each box plan were compared. Besides, several plan doses were validated by measurements with penumbra (with an average of 80–20 % dose point widths for both side profiles) differences and 2D gamma analysis.<br>
Results: The MLC-positive plans reduced the penumbra and mean OAR doses by 1.0–5.1 mm and 3.3–13.5 %, respectively, compared to MLC-negative plans even at >150 mm depths. The penumbra differences in measurements were <±1.5 mm for all plans. The mean gamma scores at 2 %/2 mm were 97.9 ± 2.3 % and 97.4 ± 3.1 % for the MLC-negative and MLC-positive plans, respectively.<br>
Conclusions: The MLC-positive beams improved the penumbra and reduced the OAR dose in every depth region and air gap. We have shown that PBS with MLCs can be useful at more than 150 mm regions, depending on the machine.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2468-2942452025Neoadjuvant FOLFOXIRI for locally advanced rectal cancer: A retrospective analysis focusing on long-term anal preservation101049ENRyoheiShojiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFuminoriTeraishiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiMatsumiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusukeYoshidaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuhikoKanayaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKunitoshiShigeyasuDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshitakaKondoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshikoMoriDepartment of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical UniversityShunsukeKagawaDepartment 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 SciencesTo investigate the safety and efficacy of FOLFOXIRI as neoadjuvant chemotherapy (NAC) for locally advanced rectal cancer (LARC). The outcomes of preoperative and perioperative treatments, as well as long-term outcomes, were retrospectively compared between 26 patients who underwent FOLFOXIRI as NAC for LARC with cT3–4 and/or N+ at our institute between 2015 and 2022, and 31 patients with LARC who underwent neoadjuvant chemoradiotherapy (CAPOX-RT) at our institute between 2011 and 2022. Grade 3 or higher adverse events due to neoadjuvant treatment were significantly more common in the FOLFOXIRI group (11 cases, 42.3 %) than in the CAPOX-RT group (3 cases, 9.7 %), and most of these were neutropenia. Based on the postoperative pathological findings, the complete response rate was significantly lower in the FOLFOXIRI group (1 case, 3.8 %) than in the CAPOX-RT group (7 cases, 22.6 %), but there were no significant differences in the R0 resection rate, survival rate, or relapse-free survival rate. In the CAPOX-RT group, 17 patients (54.8 %) had anal preservation, and during the observation period, 4 patients required stoma construction due to loss of anal function in the late stage. In contrast, in the FOLFOXIRI group, there were no cases of loss of anal function among the 20 patients (76.9 %) who had anal preservation. FOLFOXIRI as NAC requires caution regarding hematological toxicity, but it can be an effective treatment option for patients with LARC who wish to preserve their anus.No potential conflict of interest relevant to this article was reported.British Editorial Society of Bone & Joint SurgeryActa Medica Okayama2633-1462682025Long-term functional and quality of life outcomes after cementless minimally invasive extendable endoprosthesis replacement in skeletally immature patients with bone sarcomas at the lower limb a Japanese Musculoskeletal Oncology Group (JMOG) study954963ENYusukeTsudaDepartment of Orthopaedic Surgery, The University of Tokyo HospitalYoshihiroNishidaDepartment of Rehabilitation, Nagoya University HospitalAkioSakamotoDepartment of Orthopaedic Surgery, Graduate School of Medicine, Kyoto UniversityKoichiOguraDepartment of Musculoskeletal Oncology and Rehabilitation, National Cancer Center HospitalTomohiroFujiwaraDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTetsuyaSekitaDepartment of Musculoskeletal Oncology and Rehabilitation, National Cancer Center HospitalHirotakaKawanoDepartment of Orthopaedic Surgery, Teikyo University School of MedicineHiroshiKobayashiDepartment of Orthopaedic Surgery, The University of Tokyo HospitalAims<br>
Extendable endoprostheses are utilized to reconstruct segmental defects following resection of bone sarcomas in skeletally immature children. However, there remains a paucity of data regarding long-term functional and quality of life outcomes.<br>
Methods<br>
We conducted a retrospective, multicentre study and reviewed 45 children who underwent cementless minimally invasive extendable endoprosthetic replacement. Anatomical sites included the distal femur (n = 29), proximal femur (n = 4), proximal tibia (n = 11), and total femur (n = 1). The mean follow-up period was 12 years. The mean age at extendable endoprosthetic replacement was ten years (5 to 15). Most patients (96%, 43/45) had reached skeletal maturity at the final follow-up.<br>
Results<br>
The ten-year endoprosthetic failure-free survival rate was 60%. Of the 45 patients, 25 (56%) had 42 complications which were frequently related to structural failure (45%, 19/42), with extension mechanism jamming being the most common (n = 7, 17%). Excluding lengthening procedures, 20 patients (44%) underwent additional surgery with a mean of two surgeries per patient. The mean limb-length discrepancy at the final follow-up was 2.3 cm. Limb salvage was achieved in 44 (98%) patients. The mean Musculoskeletal Tumor Society (MSTS) scores, Toronto Extremity Salvage Score (TESS), and EuroQol five-dimension five-level questionnaire (EQ-5D-5L) were 78%, 92%, and 92% at the last follow-up, respectively. Multiple additional surgeries (≥ 2 times) for complications were associated with worse MSTS scores compared with those without multiple additional surgeries (p = 0.009). Moreover, limb-length discrepancy > 3 cm showed significantly worse MSTS scores compared with those ≤ 3 cm (p = 0.019).<br>
Conclusion<br>
Extendable endoprostheses were associated with a high complication rate and need for additional surgeries over time, especially for structural-related complications. Despite this, successful limb salvage with reasonable function/quality of life and small limb-length discrepancy were achievable in the long term. Patients’ function in the long term depended on the experience of postoperative complications and limb-length discrepancy.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0915-56352025EUS-Guided Versus Percutaneous Transhepatic Drainage of Liver Abscesses: A Multicenter Endohepatology Study in Western Japan (EPIC-LA Study)ENTakeshiOguraPancreatobiliary Advanced Medical Center, Osaka Medical and Pharmaceutical University HospitalTairaKurodaGastroenterology Center, Ehime Prefectural HospitalTakanoriMatsuuraDivision of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of MedicineJunKitadaiDivision of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of MedicineKohKitagawaDepartment of Gastroenterology, Nara Medical UniversityMasahiroItonagaSecond Department of Internal Medicine, Wakayama Medical UniversityKotaroTakeshitaDepartment of Gastroenterology, Tane General HospitalTomoakiMatsumoriDepartment of Gastroenterology and Hepatology, Kyoto University Graduate School of MedicineTomoyaEmoriDepartment of Gastroenterology, Wakayama Rosai HospitalMamoruTakenakaDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine Graduate School of Medical SciencesHajimeImaiDepartment of Gastroenterology, Okanami General HospitalKoichiroMandaiDepartment of Gastroenterology, Kyoto Second Red Cross HospitalShuheiShintaniDepartment of Gastroenterology, Shiga University of Medical ScienceNaoFujimoriDepartment of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu UniversityHideyukiShiomiDivision of Hepatobiliary and Pancreatic Diseases, Department of Gastroenterology, Hyogo Medical UniversityMasanoriAsadaDepartment of Gastroenterology and Hepatology, Japanese Red Cross Osaka HospitalRyotaSagamiDepartment of Gastroenterology, Faculty of Medicine, Oita UniversityHirotsuguMaruyamaDepartment of Gastroenterology, Graduate School of Medicine, Osaka Metropolitan UniversityTsukasaIkeuraDivision of Gastroenterology and Hepatology, Kansai Medical University HospitalMasaakiShimataniDepartment of Gastroenterology and Hepatology, Kansai Medical University Medical CenterHidefumiNishikioriDepartment of Gastroenterology, Oita San-ai Medical CenterKazuyukiMatsumotoDepartment of Endoscopy, Okayama University HospitalMasahitoKokubuDepartment of Gastroenterology and Metabology, Ehime University Graduate School of MedicineHidekiKamadaDepartment of Gastroenterology and Neurology, Faculty of Medicine, Kagawa UniversityYusukeIshidaDepartment of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka UniversityAkitoshiHakoda2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical UniversityMasayukiKitanoSecond Department of Internal Medicine, Wakayama Medical UniversityObjective: Percutaneous transhepatic liver abscess drainage (PTAD) and endoscopic ultrasound-guided liver abscess drainage (EUS-LAD) have several limitations. Recently, because of technical improvements in echoendoscope maneuvers, EUS-guided access for the right hepatic lobe has been reported. The aim of this multicenter, retrospective study was to compare clinical outcomes of PTAD and EUS-LAD including the right hepatic lobe in West Japan.<br>
Method: This retrospective, multicenter study included consecutive patients with liver abscesses between January 2019 and November 2024. The primary outcome in this study was the clinical success rate compared between EUS-LAD and PTAD.<br>
Results: During the study period, 1012 consecutive patients developed liver abscesses. Of them, 734 patients were excluded, 43 underwent EUS-LAD and 235 patients underwent PTAD. After propensity score-matched analysis, the clinical success rate was significantly higher in the EUS-LAD group (97.7%, 42/43) than in the PTAD group (79.1%, 34/43) (p = 0.007). After a propensity score-matched analysis, 25 patients were included in each group. The clinical success rate was significantly higher in the EUS-LAD group (100%, 25/25) than in the PTAD group (84%, 21/25) (p = 0.037). Adverse events were also significantly higher in the PTAD group (16%, 5/25) than in the EUS-LAD group (p = 0.025). In addition, the median length of hospital stay was significantly shorter in the EUS-LAD group (15 days) than in the PTAD group (22 days) (p = 0.005).<br>
Conclusions: EUS-LAD using a metal stent might be one of the options, but further randomized, controlled trials are needed.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1424-39032572025Efficacy of diagnosing intraductal papillary mucinous neoplasm with mural nodules by contrast-enhanced endoscopic ultrasound using time–intensity curve analysis with a new support program: A multicenter retrospective study (with video)11031108ENKazuyaMiyamotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalDaisukeUchidaDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalYosukeSaragaiDepartment of Internal Medicine, Fukuyama City HospitalTsuneyoshiOgawaDepartment of Internal Medicine, Fukuyama City HospitalToruUekiDepartment of Internal Medicine, Fukuyama City HospitalKeiHaradaDepartment of Gastroenterology and Hepatology, Okayama University HospitalNaoHattoriDepartment of Gastroenterology and Hepatology, Okayama University HospitalTaisukeObataDepartment of Gastroenterology and Hepatology, Okayama University HospitalRyosukeSatoDepartment of Gastroenterology and Hepatology, Okayama University HospitalAkihiroMatsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalHiroyukiTerasawaDepartment of Gastroenterology and Hepatology, Okayama University HospitalYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University HospitalShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKoichiroTsutsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalSoichiroUemotoBusiness Strategy Division, Ryobi Systems Co., Ltd.TakayoshiTanimotoBusiness Strategy Division, Ryobi Systems Co., Ltd.AkimitsuOhtoBusiness Strategy Division, Ryobi Systems Co., Ltd.MotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalBackground/objectives: Preoperative diagnosis of the pathological grade of intraductal papillary mucinous neoplasms (IPMN) is challenging. This study aimed to evaluate the accuracy of contrast-enhanced endoscopic ultrasound (CE-EUS) using time–intensity curve (TIC) analysis with a newly developed support program to differentiate between low-grade dysplasia (LGD) and high-grade dysplasia (HGD)/invasive carcinoma (IC) in IPMN.<br>
Methods: This study retrospectively analyzed 32 patients who underwent CE-EUS using the support program for TIC analysis and IPMN resection (LGD: 17, HGD/IC: 15) at two medical centers. The TIC parameters of mural nodules (MN) were compared between the LGD and HGD/IC groups, and the diagnostic accuracies of the TIC parameters were evaluated.<br>
Results: The MN/pancreatic parenchyma contrast ratio was significantly higher in the HGD/IC group than in the LGD group (1.53 vs. 0.99; P < 0.0001), and the diagnostic abilities of the contrast ratio were as follows: sensitivity, 67 %; specificity, 100 %; and accuracy, 84 %. There were no differences in the echo intensity reduction rate of the MNs between the two groups (HGD/IC, 61.6 vs. 61.2, 0.99; P = 0.421), and the diagnostic abilities of the reduction rate were as follows: sensitivity, 93 %; specificity, 41 %; and accuracy, 66 %.<br>
Conclusions: The contrast ratio calculated using TIC analysis with the support program is potentially useful for differentiating between IPMNs with LGD and those with HGD/IC.No potential conflict of interest relevant to this article was reported.American Society of Clinical Oncology (ASCO)Acta Medica Okayama0732-183X2025Amivantamab Plus Lazertinib in Atypical EGFR-Mutated Advanced Non–Small Cell Lung Cancer: Results From CHRYSALIS-2JCO-24-02835ENPascaleTomasiniAix Marseille University - CNRS, INSERM, CRCM; CEPCM - AP-HM Hôpital de La TimoneYongshengWangDivision of Thoracic Tumor Multimodality Treatment, Cancer Center and Clinical Trial Center, West China Hospital, Sichuan UniversityYongshengLiChongqing University Cancer HospitalEnriquetaFelipMedical Oncology Service, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de BarcelonaLinWuDepartment of Thoracic Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South UniversityJiuweiCuiThe First Hospital of Jilin UniversityBenjaminBesseParis-Saclay University, Institut Gustave RoussyAlexander I.SpiraVirginia Cancer SpecialistsJoel W.NealStanford Cancer Institute, Stanford UniversityKoichiGotoNational Cancer Center Hospital EastChristina S.BaikUniversity of Washington Fred Hutchinson Cancer Research CenterMelina E.MarmarelisPerelman School of Medicine, University of PennsylvaniaEikiIchiharaCenter for Clinical Oncology, Okayama University HospitalYipingZhangZhejiang Cancer HospitalJong-SeokLeeSeoul National University College of Medicine and Seoul National University HospitalSe-HoonLeeSamsung Medical Center, Sungkyunkwan University School of MedicineJames Chih-HsinYangNational Taiwan University Cancer CenterSebastianMichelsDepartment I for Internal Medicine, Faculty of Medicine and University Hospital Cologne, Lung Cancer Group Cologne, Center for Integrated Oncology Aachen Köln Bonn Düsseldorf, University of CologneZachariasAnastasiouJohnson & JohnsonJoshua C.CurtinJohnson & JohnsonXuesongLyuJohnson & JohnsonJanineMahoneyJohnson & JohnsonLevonDemirdjianJohnson & JohnsonCraig S.MeyerJohnson & JohnsonYouyiZhangJohnson & JohnsonIsabelleLeconteJohnson & JohnsonPatriciaLorenziniJohnson & JohnsonRoland E.KnoblauchJohnson & JohnsonLeonardoTraniJohnson & JohnsonMahadiBaigJohnson & JohnsonJoshua M.BaumlJohnson & JohnsonByoung ChulChoDivision of Medical Oncology, Yonsei Cancer Center, Yonsei University College of MedicinePurpose For patients with advanced non–small cell lung cancer (NSCLC) harboring atypical epidermal growth factor receptor (EGFR) mutations (eg, S768I, L861Q, G719X), efficacy of current treatment options is limited.<br>
Patients and Methods CHRYSALIS-2 Cohort C enrolled participants with NSCLC harboring atypical EGFR mutations (G719X, S768I, L861Q, etc) and ≤2 previous lines of therapy. Participants were treatment-naïve or previously received first- or second-generation EGFR tyrosine kinase inhibitors. Coexisting exon 20 insertions, exon 19 deletions, or exon 21 L858R mutations were exclusionary. Participants received 1,050 mg (1,400 mg if ≥80 kg) intravenous amivantamab once weekly for the first 4 weeks and then once every 2 weeks plus 240 mg oral lazertinib once daily. The primary end point was investigator-assessed objective response rate (ORR).<br>
Results As of January 12, 2024, 105 participants received amivantamab-lazertinib. Most common atypical mutations were G719X (56%), L861X (26%), and S768I (23%), including single and compound mutations. In the overall population (median follow-up: 16.1 months), the ORR was 52% (95% CI, 42 to 62). The median duration of response (mDoR) was 14.1 months (95% CI, 9.5 to 26.2). The median progression-free survival (mPFS) was 11.1 months (95% CI, 7.8 to 17.8); median overall survival (mOS) was not estimable (NE; 95% CI, 22.8 to NE). Adverse events were consistent with previous studies and primarily grade 1 and 2. Among treatment-naïve participants, the ORR was 57% (95% CI, 42 to 71). The mPFS was 19.5 months (95% CI, 11.2 to NE), the mDoR was 20.7 months (95% CI, 9.9 to NE), and mOS was NE (95% CI, 26.3 to NE). Solitary or compound EGFR mutations had no major impact on ORR. The ORR in participants with P-loop and αC-helix compressing, classical-like, and T790M-like mutations was 45% (n = 38), 64% (n = 14), and 67% (n = 3), respectively.<br>
Conclusion In participants with atypical EGFR-mutated advanced NSCLC, amivantamab-lazertinib demonstrated clinically meaningful antitumor activity with no new safety signals.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1556-08642052025Amivantamab Plus Lazertinib in Patients With EGFR-Mutant NSCLC After Progression on Osimertinib and Platinum-Based Chemotherapy: Results From CHRYSALIS-2 Cohort A651664ENBenjaminBesseParis-Saclay University, Institut Gustave RoussyKoichiGotoNational Cancer Center Hospital EastYongshengWangInstitute of Clinical Trial Center and Cancer Center, West China Hospital, Sichuan UniversitySe-HoonLeeSamsung Medical Center, Sungkyunkwan University School of MedicineMelina E.MarmarelisUniversity of Pennsylvania, Perelman School of MedicineYuichiroOheNational Cancer Center HospitalReyesBernabe CaroHospital Universitario Virgen Del RocioDong-WanKimSeoul National University College of Medicine and Seoul National University HospitalJong-SeokLeeSeoul National University College of Medicine and Seoul National University HospitalSophieCousinInstitut BergoniéEikiIchiharaCenter for Clinical Oncology, Okayama University HospitalYongshengLiChongqing University Cancer HospitalLuisPaz-AresHospital Universitario 12 de OctubreAkiraOnoShizuoka Cancer CenterRachel E.SanbornEarle A. Chiles Research Institute, Providence Cancer InstituteNaohiroWatanabeDepartment of Thoracic Oncology, Aichi Cancer Center HospitalMaria Josede MiguelSTART Madrid-CIOCC, Hospital HM SanchinarroCaroleHelisseyClinical Research unit, Military Hospital BeginCatherine A.ShuColumbia University Medical CenterAlexander I.SpiraVirginia Cancer SpecialistsPascaleTomasiniAix Marseille University - CNRS, INSERM, CRCM; CEPCM - AP-HM Hopital de La TimoneJames Chih-HsinYangNational Taiwan University Cancer CenterYipingZhangZhejiang Cancer HospitalEnriquetaFelipMedical Oncology Service, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron University Hospital Campus, Universitat Autonoma de BarcelonaFrankGriesingerPius-Hospital, University Medicine of OldenburgSaiama N.WaqarDivision of Oncology, Washington University School of MedicineAntonioCallesHospital General Universitario Gregorio MarañónJoel W.NealStanford University Medical CenterChristina S.BaikUniversity of Washington, Fred Hutchinson Cancer CenterPasi A.JänneLowe Center for Thoracic Oncology, Dana Farber Cancer InstituteS. MartinShreeveJohnson & JohnsonJoshua C.CurtinJohnson & JohnsonBharvinPatelJohnson & JohnsonMichaelGormleyJohnson & JohnsonXuesongLyuJohnson & JohnsonJunChenJohnson & JohnsonPei-LingChuJohnson & JohnsonJanineMahoneyJohnson & JohnsonLeonardoTraniJohnson & JohnsonJoshua M.BaumlJohnson & JohnsonMeenaThayuJohnson & JohnsonRoland E.KnoblauchJohnson & JohnsonByoung ChulChoDivision of Medical Oncology, Yonsei Cancer Center, Yonsei University College of MedicineIntroduction: Treatment options for patients with EGFR-mutated NSCLC with disease progression on or after osimertinib and platinum-based chemotherapy are limited.<br>
Methods: CHRYSALIS-2 cohort A evaluated amivantamab plus lazertinib in patients with EGFR exon 19 deletion- or L858R-mutated NSCLC with disease progression on or after osimertinib and platinum-based chemotherapy. Primary end point was investigator-assessed objective response rate (ORR). The patients received 1050 mg of intravenous amivantamab (1400 mg if ≥ 80 kg) plus 240 mg of oral lazertinib.<br>
Results: In cohort A (N = 162), the investigator-assessed ORR was 28% (95% confidence interval [CI]: 22–36). The blinded independent central review–assessed ORR was 35% (95% CI: 27–42), with a median duration of response of 8.3 months (95% CI: 6.7–10.9) and a clinical benefit rate of 58% (95% CI: 50–66). At a median follow-up of 12 months, 32 of 56 responders (57%) achieved a duration of response of more than or equal to 6 months. Median progression-free survival by blinded independent central review was 4.5 months (95% CI: 4.1–5.8); median overall survival was 14.8 months (95% CI: 12.2–18.0). Preliminary evidence of central nervous system antitumor activity was reported in seven patients with baseline brain lesions and no previous brain radiation or surgery. Exploratory biomarker analyses using next-generation sequencing of circulating tumor DNA revealed responses in patients with and without EGFR- or MET-dependent resistance. The most frequent adverse events were rash (grouped term; 81%), infusion-related reaction (68%), and paronychia (52%). The most common grade greater than or equal to 3 treatment-related adverse events were rash (grouped term; 10%), infusion-related reaction (9%), and hypoalbuminemia (6%).<br>
Conclusions: For patients with limited treatment options, amivantamab plus lazertinib demonstrated an antitumor activity with a safety profile characterized by EGFR- or MET-related adverse events, which were generally manageable.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1341-807651112025The Short‐Term Impacts of Japan's 2024 Physician Working‐Hour Limits on Labor Conditions, Self‐Directed Professional Development, and Happiness Among Obstetrician‐Gynecologistse70112ENYutoMaedaDepartment of Public Health, Institute of Science TokyoSatoruNakagawaDepartment of Obstetrics and Gynecology, Osaka UniversityKentaroNakanishiDepartment of Obstetrics and Gynecology, Asahikawa Medical UniversityEriInoueAiiku Maternal and Child Health Center, Aiiku HospitalDaisukeInoueDepartment of Obstetrics and Gynecology, University of FukuiSakiKidoDepartment of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu UniversityMichikoKidoDepartment of Obstetrics and Gynecology, Japanese Red Cross Medical CenterKaoriKogaDepartment of Obstetrics and Gynecology, Reproductive Medicine Chiba UniversityShunjiSuzukiDepartment of Obstetrics and Gynecology, Nippon Medical SchoolYukioSuzukiDepartment of Gynecology, Kanagawa Cancer CenterJunkoHaragaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHisashiMasuyamaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEikoYamamotoDepartment of Healthcare Administration, Nagoya University Graduate School of MedicineTakeshiUmazumeDepartment of Obstetrics and Gynecology, Hokkaido UniversityYoshihitoYokoyamaDepartment of Obstetrics and Gynecology, Hirosaki University Graduate School of MedicineAkiraIwaseDepartment of Obstetrics and Gynecology, Gunma University Graduate School of MedicineTomoakiIkedaSaiseikai Matsusaka General HospitalYoshioYoshidaDepartment of Obstetrics and Gynecology, University of FukuiYoshikiKudoDepartment of Obstetrics and Gynecology, Hiroshima UniversityTakashiSugiyamaDepartment of Obstetrics and Gynecology, Ehime University Graduate School of MedicineKiyonoriMiuraDepartment of Obstetrics and Gynecology, Nagasaki UniversityHideakiYahataDepartment of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu UniversityNobuyaUnnoCenter for Perinatal Medicine, JCHO Sagamino HospitalKentaroKurasawaDepartment of Obstetrics and Gynecology, Yokohama City University Graduate School of MedicineTakahideMaenakaDepartment of Obstetrics and Gynecology, Higashiosaka City Medical CenterEtsukoMiyagiDepartment of Obstetrics and Gynecology, Yokohama City University Graduate School of MedicineKiyokoKatoDepartment of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu UniversityYasuhitoKatoDepartment of Obstetrics and Gynecology, Asahikawa Medical UniversityObjective: To examine the short-term impacts of Japan's newly implemented physician working-hour limits (April 2024) on working conditions, self-directed professional development (SDPD), defined as activities undertaken outside working hours to enhance one's professional skills, and work-related happiness among obstetrician-gynecologists (OB-GYNs).<br>
Methods: An online survey was conducted between July 8 and July 31, 2024, targeting 867 Japan Society of Obstetrics and Gynecology members. Five hundred and fourteen full-time practitioners who had not changed workplaces around April 2024 and had no missing data were analyzed. Participants were stratified by regulation levels (A, B, C, discretionary labor system, those who don't know their own level), and their working hours, anticipated income, SDPD satisfaction, and happiness (0–10 scale) were assessed. We used multivariate linear regression to evaluate the influence of labor condition changes on happiness and explored interactions involving unpaid overtime, income changes, and SDPD satisfaction.<br>
Results: Compared with level A (up to 960 h of overtime per year), participants at levels B and C (up to 1860 h of overtime per year) reported significantly lower happiness (p < 0.001). Most respondents observed no major shifts in working conditions since March 2024, yet about 40% did not record SDPD hours that meet the working hour requirement as official work time. Adjusted analyses revealed that decreased income and unsatisfactory SDPD significantly lowered happiness, whereas higher SDPD satisfaction increased it (β: −0.64 [−1.07, −0.21], −0.98 [−1.46, −0.50], and 0.90 [0.44, 1.35], respectively). Subgroup analysis indicated that rising unpaid overtime further reduced happiness among those dissatisfied with SDPD (−1.43 [−2.41, −0.45]).<br>
Conclusions: The new working-hour limits had minimal impact on labor conditions in the short run. However, satisfaction with SDPD was positively associated with happiness, whereas anticipated decreases in income were correlated with lower happiness.No potential conflict of interest relevant to this article was reported.AIP PublishingActa Medica Okayama0021-9606163192025Interplay of coil–globule transitions and aggregation in homopolymer aqueous solutions: Simulation and topological insights191101ENJunichiKomatsuDepartment of Chemistry, Faculty of Science, Okayama UniversityKenichiroKogaDepartment of Chemistry, Faculty of Science, Okayama UniversityJonasBerxNiels Bohr International Academy, Niels Bohr Institute, University of CopenhagenWe investigate the structural and topological properties of hydrophobic homopolymer chains in aqueous solutions using molecular dynamics simulations and circuit topology (CT) analysis. By combining geometric observables, such as the radius of gyration and the degree of aggregation, with CT data, we capture the relationship between coil–globule and aggregation transitions, resolving the system’s structural changes with temperature. Our results reveal a temperature-driven collective transition from isolated coiled chains to globular aggregates. At a characteristic transition temperature Tc, each chain in multichain systems undergoes a rapid coil–globule collapse, coinciding with aggregation, in contrast to the gradual collapse observed in single-chain systems at infinite dilution. This collective transition is reflected in geometric descriptors and a reorganization of CT motifs, shifting from intrachain-dominated motifs at low temperatures to a diverse ensemble of multichain motifs at higher temperatures. CT motif enumeration provides contact statistics while offering a topologically detailed view of polymer organization. These findings highlight CT’s utility as a structural descriptor for polymer systems and suggest applications for biopolymer aggregation and folding.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2078-248916102025A Comparative Study of Authoring Performances Between In-Situ Mobile and Desktop Tools for Outdoor Location-Based Augmented Reality908ENKomang CandraBrataDepartment of Information and Communication Systems, Okayama UniversityNobuoFunabikiDepartment of Information and Communication Systems, Okayama UniversityHtoo HtooSandi KyawDepartment of Information and Communication Systems, Okayama UniversityPrismahardi AjiRiyantokoDepartment of Information and Communication Systems, Okayama UniversityNopriantoDepartment of Information and Communication Systems, Okayama UniversityMustikaMentariDepartment of Information and Communication Systems, Okayama UniversityIn recent years, Location-Based Augmented Reality (LAR) systems have been increasingly implemented in various applications for tourism, navigation, education, and entertainment. Unfortunately, the LAR content creation using conventional desktop-based authoring tools has become a bottleneck, as it requires time-consuming and skilled work. Previously, we proposed an in-situ mobile authoring tool as an efficient solution to this problem by offering direct authoring interactions in real-world environments using a smartphone. Currently, the evaluation through the comparison between the proposal and conventional ones is not sufficient to show superiority, particularly in terms of interaction, authoring performance, and cognitive workload, where our tool uses 6DoF device movement for spatial input, while desktop ones rely on mouse-pointing. In this paper, we present a comparative study of authoring performances between the tools across three authoring phases: (1) Point of Interest (POI) location acquisition, (2) AR object creation, and (3) AR object registration. For the conventional tool, we adopt Unity and ARCore SDK. As a real-world application, we target the LAR content creation for pedestrian landmark annotation across campus environments at Okayama University, Japan, and Brawijaya University, Indonesia, and identify task-level bottlenecks in both tools. In our experiments, we asked 20 participants aged 22 to 35 with different LAR development experiences to complete equivalent authoring tasks in an outdoor campus environment, creating various LAR contents. We measured task completion time, phase-wise contribution, and cognitive workload using NASA-TLX. The results show that our tool made faster creations with 60% lower cognitive loads, where the desktop tool required higher mental efforts with manual data input and object verifications.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1616-301X2025A Biologically-Architected Wear and Damage-Resistant Nanoparticle Coating From the Radular Teeth of Cryptochiton stellerie21664ENTaifengWangDepartment of Materials Science and Engineering, University of CaliforniaYuChenLyles School of Civil and Construction Engineering, Purdue UniversityEzraSarmientoDepartment of Materials Science and Engineering, University of CaliforniaTaigeHaoMaterials and Manufacturing Technologies Program, University of CaliforniaAtsushiArakakiDivision of Biotechnology and Life Science, Institute of Engineering, Tokyo University of Agriculture and Technology MichikoNemotoGraduate School of Environmental and Life Science, Okayama UniversityPabloZavattieriLyles School of Civil and Construction Engineering, Purdue UniversityDavidKisailusDepartment of Materials Science and Engineering, University of CaliforniaNature utilizes simple building blocks to construct mechanically robust materials that demonstrate superior performance under extreme conditions. These exquisite structures result from the controlled synthesis and hierarchical assembly of nanoscale organic and mineral components that have provided critical evolutionary advantages to ensure survival. One such example is the ultrahard radular teeth found in mollusks, which are used to scrape against rock to feed on algae. Here, it is reported that the leading edges of these teeth consist of a wear-resistant coating that is comprised of densely packed ≈65 nm magnetic nanoparticles integrated within an organic matrix of chitin and protein. These mesocrystalline magnetite-based structures are assembled from smaller, highly aligned nanocrystals with inter/intracrystalline organics introduced during the crystallization process. Nanomechanical testing reveals that this multi-scale, nano-architected coating has a combination of increased hardness and a slight decrease in modulus versus geologic magnetite provides the surface of the chiton tooth with superior abrasion resistance. The mesocrystalline structures fracture at primary domain interfaces, corroborated by computational models, providing significant toughening to the tooth under extreme contact stresses. The design features revealed provide insight for the design and fabrication of next-generation advanced wear- and impact-resistant coatings for tooling, machinery, wind turbines, armor, etc.No potential conflict of interest relevant to this article was reported.Public Library of ScienceActa Medica Okayama1932-62032082025Risk stratification for the prediction of skeletal-related events in patients with castration-resistant prostate cancer with bone metastasese0328792ENMasanoriHamadaEijiNakataRyuichiNakaharaShinsukeSugiharaHaruyoshiKatayamaTakutoItanoTomohiroInoueShotaTakihiraYoshiteruAkezakiToshifumiOzakiSkeletal-related events (SREs) are common in patients with bone metastases from castration-resistant prostate cancer (CRPC). Despite advances in prostate cancer treatment, clinically validated predictive models for SREs in CRPC patients with bone metastases remain elusive. This gap in prognostic tools hinders optimal patient management and treatment planning for this high-risk population. This study aimed to develop a prediction model for SRE by investigating potential risk factors and classifying them into different groups. This model can be used to identify patients at high risk of SREs who need close follow-up. Between 2004 and 2013, 68 male patients with bone metastases from CRPC who were treated at our institute were evaluated for survival without SREs and survival without SREs of the spinal cord. The study analyzed clinical data at enrollment to identify risk factors for initial and spinal SREs. Multivariate analysis revealed that a high count of metastatic vertebrae, along with visceral or lymph node metastases, were significant risk factors. Patients were categorized into four subgroups based on the number of vertebral metastases and presence of visceral or lymph node metastases: 1) extensive vertebral and both types of metastases, 2) extensive vertebral without additional metastases, 3) some vertebral with other metastases, 4) some vertebral without additional metastases. The first SRE and spinal SRE occurred significantly sooner in the first subgroup compared to others. Incidence rates at 12 months for the first SRE were 56%, 40%, 27%, and 5%, and for the first spinal SRE were 47%, 40%, 27%, and 0% respectively. Patients with extensive vertebral and additional metastases require vigilant monitoring to mitigate SREs.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-818417102025Risk Stratification for the Prediction of Skeletal-Related Events in Patients With Bone Metastases From Non-small Cell Lung Cancere95808ENYoshihiroSakamotoDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEijiNakataDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasanoriHamadaDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshimiKatayamaDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinsukeSugiharaDepartment of Orthopedic Surgery, Shikoku Cancer CenterToshifumiOzakiDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSkeletal-related events (SREs) frequently occur in patients with bone metastases from non-small cell lung cancer (NSCLC). This study aimed to identify risk factors for SREs in patients with NSCLC. Based on these factors, we also aimed to stratify patients into subgroups to facilitate the assessment of SRE risk. This retrospective analysis used medical records of 139 patients with NSCLC bone metastases who received treatment at our institution between 2011 and 2014. The incidence of SREs was assessed, and SRE-free survival was analyzed using the Kaplan-Meier method. Clinical information collected at registration was assessed to identify factors associated with the onset of SREs within six months. Univariate analysis was performed using Fisher’s exact test, and multivariate analysis was performed using Cox regression. Of the 139 patients, 36 (26%) developed SREs after registration. The SRE-free survival rates were 80% and 64% at 6 and 12 months, respectively. The univariate and multivariate analyses revealed that the absence of epidermal growth factor receptor (EGFR) mutations or anaplastic lymphoma kinase (ALK) rearrangement (hazard ratio (HR): 4.51, 95% confidence interval (CI): 1.32-15.7, p = 0.017) and a lactate dehydrogenase (LDH) level ≥400 U/L (HR: 8.08, 95% CI: 1.78-36.6, p = 0.0067) were risk factors for SRE presentation within six months. Patients were classified into the following three subgroups: with EGFR mutation or ALK rearrangement and LDH level <400 U/L; without EGFR mutation or ALK rearrangement and LDH level <400 U/L; with/without EGFR mutation or ALK rearrangement and LDH level ≥400 U/L. The corresponding six-month SRE-free survival rates were 92%, 69%, and 34%, respectively, showing significant differences (p < 0.001). Close monitoring is recommended for patients with LDH levels ≥400 U/L in daily clinical practice, particularly with the help of the proficiency of orthopedic and radiological experts, to prevent complications such as pathological fractures and paraplegia.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841762025Clinical Outcomes and Biomechanical Evaluation of the Cement-Catching Screw Technique for Osteoporotic Vertebral Fracturese85955ENHisakazuShitozawaDepartment of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHaruoMisawaDepartment of Orthopaedic Surgery, Ryusou Orthopaedic HospitalYoshiakiOdaDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRyojiJokoDepartment of Orthopaedic Surgery, Japanese Red Cross Okayama HospitalMasayaTakahashiDepartment of Orthopaedic Surgery, Japanese Red Cross Okayama HospitalKojiUotaniDepartment of Orthopaedic Surgery, Okayama University HospitalYasuyukiShiozakiDepartment of Orthopaedic surgery, Mitoyo General HospitalTomokoTetsunagaDepartment of Orthopaedic Surgery, Okayama University HospitalKensukeShinoharaDepartment of Sports Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRyoNakamichiDepartment of Orthopaedic Surgery, Okayama University HospitalMasatakaUedaDepartment of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyoTakatoriDepartment of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazutakaYamashitaDepartment of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityObjectives: We developed a cement-catching screw (CCS) technique for pedicle screw insertion into hardened cement, connecting anterior and posterior vertebral elements during balloon kyphoplasty (BKP) for osteoporotic vertebral fractures (OVFs). This study reports the CCS technique, clinical outcomes, and biomechanical properties.<br>
Methods: This retrospective study included 59 patients (20 men, 39 women; mean age, 77.4 ± 8.7 years) who underwent BKP with one-above-one-below posterior fixation for OVFs between 2020 and 2023. Patients were divided into CCS (−) (without intermediate screws, n = 28) and CCS (+) (with intermediate CCSs, n = 31) groups. Clinical and radiographic outcomes, including activities of daily living, vertebral wedge angle (VWA), surgical level Cobb angle (CA), anterior vertebral body height (AVBH), screw loosening, pullout, and adjacent vertebral fractures, were evaluated preoperatively, postoperatively, and at the final follow-up (≥6 months). Biomechanical pullout strength was assessed at different insertion depths (5, 10, and 15 mm) using polymethylmethacrylate cement.<br>
Results: No significant differences were observed between groups in age, sex, follow-up duration, or blood loss; however, the operation time was significantly longer in the CCS (+) group than in the CCS (−) group (P < 0.0001). Radiographic outcomes showed no significant differences in the VWA, CA, AVBH, adjacent vertebral fracture rates, and reoperation rates. However, the incidence of adjacent pedicle screws loosening and pullout was significantly higher in the CCS (−) group than in the CCS (+) group (P = 0.046 and 0.0084, respectively). The correction loss of the CA was significantly lower in the CCS (+) group (CCS (−), 5.6° ± 4.8°; CCS (+), 3.5° ± 4.8°, P = 0.023). The biomechanical test revealed pullout strengths of 683 ± 164, 2231 ± 208, and 3477 ± 393 N for insertion depths of 5, 10, and 15 mm, respectively, with significant increases by depth (P = 0.003 and 0.009).<br>
Conclusions: The CCS technique improves anterior-posterior vertebral body stability, enhances fixation strength, and contributes to better surgical outcomes in OVFs treatment.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841712025Mid-term Clinical and Radiographic Outcomes of the Actis Total Hip System: A Retrospective Studye77632ENYasutakaMasadaDepartment of Medical Materials for Musculoskeletal Reconstruction, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomonoriTetsunagaDepartment of Musculoskeletal Health Promotion, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazukiYamadaDepartment of Medical Materials for Musculoskeletal Reconstruction, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiKouraDepartment of Medical Materials for Musculoskeletal Reconstruction, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomohiroInoueDepartment of Medical Materials for Musculoskeletal Reconstruction, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRyuichiroOkudaDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomokoTetsunagaDepartment of Orthopaedic Surgery, Okayama University HospitalYusukeYokoyamaDepartment of Orthopaedic Surgery, Okayama University HospitalYukiOkazakiDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshifumiOzakiDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityIntroduction<br>
Implant technology for total hip arthroplasty (THA) was developed to improve hip function and patient satisfaction. Actis (DePuy Synthes, Warsaw, IN, USA) is a short fit-and-fill titanium stem, with a medial-collared and triple-taper (MCTT) geometry, that is fully coated with hydroxyapatite (HA). We evaluated the radiographic and clinical outcomes of the Actis Total Hip System during a mean follow-up of five years.<br>
Patients and methods<br>
We retrospectively analyzed data from 80 patients (14 male and 66 female, mean age: 65 ± 8.4 years) who underwent primary THA using Actis stems (anterolateral approach, 60 hips; posterior approach, 20 hips). Radiographs were obtained postoperatively and at the time of the final examination. Radiographic assessments included the alignment of the femoral stem, spot welds, stress shielding, cortical hypertrophy, subsidence (>2 mm), radiolucent line, pedestal formation, Dorr type, canal fill ratio (CFR), and stem fixation. Clinical evaluation included the Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ) and Harris Hip Score (HHS).<br>
Results<br>
The mean follow-up period was 64.0 ± 6.0 months. No significant differences were observed in the alignment of the femoral components between approaches. Of the 80 hips, 53 (66.3%) showed radiographic signs of stem osseointegration, predominantly in the mid-distal region of the stem at the final follow-up. Multiple logistic regression analysis revealed that younger age and a higher CFR (20 mm proximal to the lesser trochanter) were associated with the presence of spot welds. Mild stress shielding occurred in 25 hips (31.3%), and no patient experienced severe stress shielding. All stems were fixed by bone on growth. The JHEQ and HHS significantly improved at the final assessment.<br>
Conclusion<br>
At the five-year follow-up, patients who received the Actis Total Hip System during THA had good radiographic and clinical outcomes.<br>No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0020-13835682025Risk factors for extensor pollicis longus tendon rupture following non-displaced distal radius fractures112454ENTaichiSaitoDepartment 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 SciencesRyoNakamichiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesRyuichiNakaharaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHidenoriKondoDepartment of Orthopaedic Surgery, Kagawa Rosai HospitalYasunoriShimamuraDepartment of Orthopaedic Surgery, Kousei HospitalJunyaImataniDepartment of Orthopaedic Surgery, Saiseikai General HospitalToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesIntroduction: Distal radius fractures (DRFs) are common, with an increasing incidence, particularly among the elderly. Rupture of the extensor pollicis longus (EPL) tendon, essential for thumb extension, is a notable complication, especially in non-displaced DRFs. Several mechanisms, such as local adhesion, ischemic atrophy, and tendon laceration, are associated with EPL tendon rupture. This multicenter retrospective study aims to identify risk factors for EPL tendon rupture in non-displaced DRFs.<br>
Materials and methods: The study reviewed 20 cases of EPL tendon rupture and 52 control cases from 2005 to 2022, excluding those who underwent surgery or had incomplete computed tomography (CT) data. We investigated age, sex, location of fracture line, and the morphology of Lister’s tubercle as variables. Logistic regression and decision tree analyses were employed to determine the risk factors for EPL tendon rupture based on these variables.<br>
Results: Fracture lines distal to Lister’s tubercle and specific shapes of Lister’s tubercle, characterized by shallow peak height and a higher radial peak than the ulnar peak, increased the risk of EPL tendon rupture. Decision tree analysis confirmed them as major risk factors. There was a significant difference in the predicted probability rate of tendon rupture between the case with these factors and those without them (P < 0.001). Conversely, the location and size of Lister’s tubercle did not affect the incidence of EPL tendon rupture.<br>
Conclusion: The location of fracture line and the shape of Lister’s tubercle are key factors influencing EPL tendon rupture in non-displaced DRFs. Understanding these factors can help orthopedic surgeons predict and prevent EPL tendon ruptures, improving patient outcomes following these fractures.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Accuracy of deep learning-based attenuation correction in 99mTc-GSA SPECT/CT hepatic imagingENMasahiroMIYAIGraduate School of Health Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1869-695316122025A Multicenter, Prospective, Observational, and Single-Arm Interventional Study of Mirogabalin in Diabetic Peripheral Neuropathic Pain: Rationale and Design of Dia-NeP23512363ENHidekiKamiyaDivision of Diabetes, Department of Internal Medicine, Aichi Medical University School of MedicineRyoSuzukiDepartment of Diabetes, Metabolism and Endocrinology, Tokyo Medical UniversityJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama UniversityTakahisaDeguchiDepartment of Diabetes, Metabolism and Endocrinology, Kagoshima University Graduate School of Medical and Dental SciencesTatsuhitoHimenoDivision of Diabetes, Department of Internal Medicine, Aichi Medical University School of MedicineShuheiYamamotoData Intelligence Department, Daiichi Sankyo Co., Ltd.TaikiToyamaPrimary Medical Science Department, Daiichi Sankyo Co., Ltd.JiroNakamuraDivision of Diabetes, Department of Internal Medicine, Aichi Medical University School of MedicineBackground/Objectives: The exact prevalence of and recent changes in diabetic polyneuropathy (DPN) and diabetic peripheral neuropathic pain (DPNP) in Japan are unclear. The oral gabapentinoid, mirogabalin besylate (mirogabalin), is effective with a good safety profile for DPNP with moderate-to-severe pain (numerical rating scale [NRS] scores ≥ 4). However, clinical evidence for mild pain (NRS scores ≤ 3) is unclear. The Dia-NeP study aims to examine: (1) the prevalences of DPN and DPNP and background factors in patients with type 2 diabetes mellitus (T2DM); and (2) the efficacy and safety of mirogabalin in patients with DPNP, including those with mild pain.<br>
Methods: The Dia-NeP study is a multicenter, prospective study consisting of two parts, a baseline survey and an interventional study, to be conducted from March 2025 to August 2026 in patients with T2DM in Japan. The baseline survey is the observational study investigating the epidemiology of DPN and DPNP, and the interventional study is an exploratory, single-arm, open-label study of 12-week mirogabalin treatment. Of patients with T2DM enrolled in the baseline survey, those diagnosed with DPNP who have an NRS score for pain ≥ 1 will be included in the interventional study. The target sample size is 1000 to 3000 patients for the baseline survey and 100 for the interventional study.<br>
Planned Outcomes: The primary endpoint is the change from baseline in the NRS score at week 12 in the interventional study. The safety endpoint is adverse events. This study will not only show the latest prevalence of DPN and DPNP in Japan, but is also the first study to investigate the efficacy and safety of mirogabalin in patients with DPNP having mild pain, as well as moderate-to-severe pain, and is expected to provide useful evidence for future DPN and DPNP treatment.<br>
Trial Registration: Japan Registry of Clinical Trials (jRCTs031240623, registered 20/January/2025, https://jrct.mhlw.go.jp/en-latest-detail/jRCTs031240623).No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231902025中山間地域における人口移動の動向 ― 岡山県苫田郡鏡野町の事例 ―95108ENMasaoNOBEFaculty of Education, Okayama University10.18926/bgeou/69614 本稿の目的は，2006 年以降の岡山県鏡野町の人口動態を明らかにすることである。分析によって，次の4 点を明らかにした。(1) 鏡野町の人口は2006 年以降一貫して減少しているが，近年はその減少幅が拡大している。2006 年以降は自然減が続き，2010 年代後半からは社会減も拡大した。両効果が働いたために，2010 年代後半から人口減少が加速した。(2) 2006 年以降，鏡野町の人口移動はおおむね安定した傾向が見られた。そして，その人口移動は，津山圏との間における集中的かつ均衡した人口移動，近畿地方・岡山圏・関東地方への転出超過，真庭圏・阿新圏からの小規模な転入超過と特徴づけることができる。(3) 2010 年代後半から，鏡野町は岡山圏への転出超過が顕著となり，近畿地方および関東地方への転出もそれに続いた。その結果，鏡野町は社会減が大きくなった。農林業・製造業・商業の停滞や都市部との賃金格差が若年層の流出を促進し，社会減の拡大に繋がった。(4) 人口移動の中心は一貫して20 歳代と30 歳代であった。No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231902025帝政ロシアの総合大学における教員養成の法制 ― 1804 年帝国大学令の制定と中等学校教員の目的養成 ―1331ENAtsushiTAKASEFaculty of Education, Okayama University10.18926/bgeou/69608 1804 年に公布された帝国大学令は，各教育管区の諸学校を管理・指導する総合大学にギムナジア等の中等学校教員を目的養成する附属教育大学の設置を定めていた。モスクワ帝国大学，カザン帝国大学及びハリコフ帝国大学に設置された附属教育大学は，高等教育機関を卒業した学士を対象に3 年間の教員養成教育を提供する機関であり，修了後に3 年間以上のギムナジアの上級教員を勤めた者については，定数外の助教授として総合大学に任官できる場合があるとされた。これに対して，サンクトペテルブルク教育管区では，ギムナジア等を卒業した者を対象とする教育大学が帝国大学に先行して設けられ，その後，独立した高等教育レベルの教員養成機関である中央教育大学に改編された。No potential conflict of interest relevant to this article was reported.Japan Medical AssociationActa Medica Okayama2433-3298822025Successful Transplantation of Multiple Organs from Donor after Helium Asphyxiation: First Case Report in Japan650653ENShuntaJinnoDepartment 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 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 UniversityTetsuyaYumotoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityHiromichiNaitoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityAtsunoriNakaoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityHelium inhalation has increased, but most cases are either minor injuries or deaths; there have not yet been any reported cases of brain death leading to organ donation. We report a patient who attempted helium inhalation and was declared brain dead and became an organ donor without complications. To the best of our knowledge, this is the first reported case of deceased organ donation following helium asphyxiation in Japan. The patient in cardiac arrest was found with a helium-filled vinyl bag sealed around the neck. During emergency medical transport to the hospital, a spontaneous return of circulation was obtained after 31 minutes of cardiopulmonary resuscitation. Upon hospital arrival, the physical examination revealed dilated pupils with no response to light. Electrocardiography showed widespread ST-segment depression and ST-segment elevation in augmented Vector Right, as well as elevated cardiac enzymes and decreased myocardial contractility. Head computed tomography revealed diffuse cerebral edema and loss of the gray-white matter boundary without signs of air embolism in the cerebral and coronary arteries. Despite comprehensive post-cardiac arrest care with recovery of organ function, brain death was confirmed on day 4 after hospitalization. The family consented to organ donation on the 11th day of hospitalization. The heart, lungs, liver, and two kidneys were successfully transplanted and all organs functioned. All organ grafts were functioning well at the 3-month follow-up. Our case demonstrates that brain death caused by helium inhalation is not a contraindication to organ donation.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0007-10482025Efficacy of ciclosporin monotherapy in non-severe aplastic anaemia not requiring transfusions: Results from a multicentre phase II studyENKenIshiyamaDepartment of Hematology, Kanazawa University HospitalMasahideYamazakiDepartment of Internal Medicine, Keiju Medical CenterHiroyukiMaruyamaDepartment of Hematology, Kanazawa University HospitalNaokoHosonoDepartment of Hematology and Oncology, University of Fukui HospitalHirokiYamaguchiDepartment of Hematology, Nippon Medical SchoolNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalKazukiTanimotoDepartment of Hematology and Oncology, Japanese Red Cross Fukuoka HospitalHiroyukiSugiuraDepartment of Hematology, Chugoku Central Hospital of Japan Mutual Aid Association of Public School TeachersKensukeUsukiDepartment of Hematology, NTT Medical Center TokyoKenichiYoshimuraDepartment of Biostatistics and Health Data Science, Graduate School of Medical Science, Nagoya City UniversitySeishiOgawaDepartment of Pathology and Tumor Biology, Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto UniversityYuzuruKanakuraSumitomo HospitalItaruMatsumuraDepartment of Hematology and Rheumatology, Kindai University Faculty of MedicineKoichiAkashiDepartment of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical SciencesShinjiNakaoDepartment of Hematology, Kanazawa University HospitalThe efficacy of ciclosporin (CsA) to treat transfusion-independent non-severe aplastic anaemia (TI-NSAA) has not yet been systematically evaluated. We conducted a prospective trial in patients with TI-NSAA treated with CsA monotherapy. CsA (3.5 mg/kg/day) was administered to patients with TI-NSAA aged ≥16. The CsA dose was adjusted to maintain a blood CsA level of ≥600 ng/mL at 2 h post-administration. Blood cell counts were assessed after 8, 16 and 52 weeks of therapy. Thirty-two evaluable patients from 21 institutions were enrolled. The median age was 63.5 (range: 16–83) years. At 8 weeks, haematological improvement, with increases in haemoglobin (Hb) ≥1.5 g/dL (haematological improvement in erythrocytes [HI-E]) and platelet count ≥30 × 109/L (haematological improvement in platelets [HI-P]), was observed in 0/25 (0%) and 6/32 (19%) evaluable cases respectively. HI-E and HI-P occurred in 1/25 (4%) and 10/32 (31%) patients at 16 weeks, respectively, and at 52 weeks in 5/25 (20%) and 16/32 (50%) patients respectively. Nine grade 3 adverse events (AEs) occurred in six patients, but there were no grade ≥4 AEs. Ten of the 32 patients experienced grade 2 renal toxicity. Low-dose CsA is effective in TI-NSAA patients and demonstrates minimal renal toxicity. However, at least 16 weeks are necessary to adequately evaluate its efficacy.No potential conflict of interest relevant to this article was reported.Japanese Society of TribologistsActa Medica Okayama1881-21982032025Water Lubrication of Polysiloxane-Containing Polyimide Coatings on Stainless Steel Substrates124129ENYuelinFanGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTadashiShiotaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityYuyaOmiyaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityMasahiroFujiiFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityThis study investigated the water-lubricated tribological properties of coatings made of a novel polysiloxane-containing polyimide (si-PI) material that was recently developed for the aerospace industry and can be diluted with the harmless and environmentally friendly ethanol or water. The si-PI coatings were deposited on stainless steel (JIS SUS304) substrates at curing temperatures ranging from 160°C to 275°C. Their water lubrication properties were measured by rubbing the coatings against each other in water at room temperature. The coatings exhibited lower friction than conventional polyimide materials, with a minimum friction coefficient of 0.04, which was lower than that of polytetrafluoroethylene (PTFE) measured under the same sliding conditions. Unlike the conventional polyimide, the coatings did not exhibit any obvious wear or damage. The results demonstrate that the si-PI coating is a promising low-friction and highly durable coating for water lubrication.No potential conflict of interest relevant to this article was reported.The Japanese Society of Interventional RadiologyActa Medica Okayama2432-0935102025Optimal Virtual-target Definition for Detecting Feeding Arteries of Renal Cell Carcinoma Using Automated Feeder-detection Softwaree2025-0034ENSoichiroOkamotoDepartment of Radiology, Medical Development Field, Okayama UniversityYusukeMatsuiDepartment of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakahiroKawabataDepartment of Radiology, Tsuyama Chuo HospitalKojiTomitaDepartment of Radiology, Medical Development Field, Okayama UniversityKazuakiMunetomoDepartment of Radiology, Medical Development Field, Okayama UniversityNoriyukiUmakoshiDepartment of Radiology, Medical Development Field, Okayama UniversityFumiyoHigakiDepartment of Radiology, Medical Development Field, Okayama UniversityToshihiroIguchiDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityTakaoHirakiDepartment of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityPurpose: To determine the optimal virtual-target definition for detecting renal cell carcinoma feeders using transarterial computed tomography angiography with automated feeder-detection software.<br>
Material and Methods: This retrospective study included 17 patients with 17 renal cell carcinomas who underwent transarterial ethiodized-oil marking before cryoablation. Tumor feeders were automatically detected on transarterial renal computed tomography angiography images using the automated feeder-detection software with three virtual-target definitions: small (ellipsoidal area maximized within the tumor contour), medium (ellipsoidal area covering the entire tumor with a minimal peripheral margin), and large (ellipsoidal area including the tumor and a 5-mm peripheral margin). The detected feeders were classified as true or false positives according to the findings of selective renal arteriography, by consensus of two interventional radiologists. Feeder-detection sensitivity and the mean number of false-positive feeders per tumor were calculated for each virtual-target definition.<br>
Results: For 17 tumors, 25 feeding arteries were identified on the arteriography. The feeder-detection sensitivity of the software was 80.0% (20/25), 88.0% (22/25), and 48.0% (12/25) for small, medium, and large virtual targets, respectively. The mean ± standard deviation number of false-positive feeders per tumor was 0.82 ± 1.3, 1.41 ± 1.1, and 2.82 ± 1.6 when using small, medium, and large virtual-target definitions, respectively.<br>
Conclusions: The detection rate of renal cell carcinoma feeders with the automated feeder-detection software varies according to the virtual-target definition. Using a medium virtual target, covering the entire tumor with a minimal peripheral margin, may provide the highest sensitivity and an acceptable number of false-positive feeders.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465722025金銭債権の譲渡による損益が雑所得に区分される理由―金利に該当するからなのか，それとも貸倒損失処理に伴う問題への対処なのか―3147ENYoshiyukiNakagawa10.18926/OER/69552 金銭債権の譲渡による損益は，所得税基本通達33-1により譲渡所得の基因となる資産から除外される。この理由について課税当局は50年もの長きにわたり，①「金銭債権の譲渡による利益は金利に該当するからである」，との説明と，②「金銭債権の譲渡による損失を貸倒処理して税制上の恩典を受けることから生ずる不合理に対処するためである」，とする2つの異なる説明を行ってきている。<br>
本稿は課税当局によるこの2つの説明の比較検討を行い，②の「金銭債権の譲渡による損失を貸倒処理して税制上の恩典を受けることから生ずる不合理に対処するためである」，との説明の方がより優れていることを明らかにするものである。<br>
また「金銭債権の譲渡による利益は金利に該当する」との説明に根本的な疑問を感じたことから，この点について深い検討を行い，この説明は適切でないことを明らかにするものである。No potential conflict of interest relevant to this article was reported.Spandidos PublicationsActa Medica Okayama1791-29973312025Protective impact of landiolol against acute lung injury following hemorrhagic shock and resuscitation in rats22ENRisaSakamotoDepartment of Anesthesiology and Resuscitology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHirokoShimizuDepartment of Anesthesiology and Resuscitology, Okayama University Medical SchoolRyuNakamuraDepartment of Anesthesiology and Resuscitology, Okayama University Medical SchoolYifuLuDepartment of Human Anatomy, Shantou University Medical CollegeYaqiangLiDepartment of Anesthesiology and Resuscitology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEmikoOmoriDepartment of Anesthesiology and Resuscitology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToruTakahashiDepartment of Anesthesiology, Okayama Saidaiji HospitalHiroshiMorimatsuDepartment of Anesthesiology and Resuscitology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHemorrhagic shock and resuscitation (HSR) induces pulmonary inflammation, leading to acute lung injury (ALI). Notably, blocking β1 receptors can lead to organ protection through anti‑inflammatory and anti‑apoptotic effects. Additionally, although the β1 receptor pathway is blocked by the β1 blocker, the β2 receptor pathway may be preserved and activate the 5' adenosine monophosphate‑activated protein kinase (AMPK) pathway. The present study aimed to examine whether administration of the β1 blocker landiolol could achieve lung protection in a model of HSR‑ALI, alongside improvements in inflammation and apoptosis. Male Sprague‑Dawley rats underwent hemorrhage keeping their mean arterial pressure at 30 mmHg for 1 h. Resuscitation by reinfusion was initiated to restore blood pressure to pre‑hemorrhage levels for >15 min, followed by a 45‑min stabilization period to create the HSR‑ALI model. Landiolol (100 mg/kg/min) or saline was continuously administered after resuscitation. The lung tissues, which were collected for assessing inflammation and apoptosis‑related damage, underwent analyses, including histological examination, neutrophil count, assessment of lung wet/dry weight ratio, detection of the mRNA levels of tumor necrosis factor‑α (TNF‑α) and inducible nitric oxide synthase (iNOS), identification of terminal deoxynucleotidyl transferase dUTP nick‑end labeling (TUNEL)‑positive cells, and evaluation of caspase‑3 expression. In addition, phosphorylated AMPKα (pAMPKα) expression was tested via western blotting. Compared with the HSR/saline group, the HSR/landiolol group demonstrated a reduction in lung tissue damage score, and significant reductions in neutrophil count, lung wet/dry weight ratio, lung TNF‑α and iNOS mRNA levels, TUNEL‑positive cells and cleaved caspase‑3 expression. Furthermore, landiolol administration following HSR treatment increased pAMPKα expression. No significant hypotension occurred between the HSR/landiolol and HSR/saline groups; and blood loss did not differ significantly between the groups. In conclusion, landiolol administration after HSR reduced lung inflammation and apoptosis, suggesting a potential improvement in tissue damage. Furthermore, pAMPKα activation in the HSR/landiolol group may be the mechanism underlying the pulmonary protective effects of landiolol.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0913-86683922025T2 high-signal-intensity zone of the spinal cord dorsal horn in patients treated with spinal cord stimulation for herpes zoster-associated pain: a retrospective case–control study273281ENKyosukeArakawaDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasayukiNakagawaDepartment of Pain Management Clinic, NTT Medical Center TokyoYoichiroAbeDepartment of Pain Management Clinic, NTT Medical Center TokyoHiroshiMorimatsuDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesPurpose In patients with herpes zoster-associated pain (ZAP), magnetic resonance imaging (MRI) has revealed T2 high-signal intensity zones (MRI T2 HIZ) in the dorsal horn of the spinal cord, associated with postherpetic neuralgia (PHN). We retrospectively analyzed the relationship between PHN and MRI T2 HIZ in patients with refractory ZAP in the subacute phase who underwent temporary spinal cord stimulation therapy (tSCS).<br>
Methods This single-center, case–control study included patients who underwent tSCS for refractory ZAP between 2010 and 2018. MRIs were re-assessed for the presence of T2 HIZ in the dorsal horn of the spinal cord. Patients were divided into T2 HIZ( +) and T2 HIZ(−) groups. Patients with a numerical rating score (NRS) ≥ 3 at the last visit were defined as PHN. The NRS values and the incidence rate of PHN were compared between the two groups.<br>
Results Of the 67 cases extracted, 38 were included in the analysis: 22 in T2 HIZ( +) group and 16 in T2 HIZ(−) group. No significant differences were observed in background factors between the two groups. However, the T2 HIZ( +) group had a significantly higher NRS at the final visit (T2 HIZ( +):3.8 ± 2.1, T2 HIZ(−):1.4 ± 1.5; P < 0.05) and had significantly more patients with PHN than the T2 HIZ(−) group (T2 HIZ( +) vs. T2 HIZ(−), 15/22 (68%) vs. 3/16 (19%); odds ratio = 8.67; 95% confidence interval, 1.7–63.3).<br>
Conclusion T2HIZ is detected in more than half of refractory ZAP, and pain is more likely to remain after tSCS treatment in the T2HIZ( +) group.No potential conflict of interest relevant to this article was reported.The Korean Society of AnesthesiologistsActa Medica Okayama2005-64197752024Utilization of the pericapsular nerve group block in preoperative rehabilitation of patients with femoral neck fractures -a case series-565569ENZhuanJinDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaisukeSugiyamaDepartment of Anesthesiology, Kameda Medical CenterFumiyaHigoDepartment of Rehabilitation, Kameda Medical CenterTakahiroHirataDepartment of Rehabilitation, Kameda Medical CenterOsamuKobayashiDepartment of Anesthesiology, Kameda Medical CenterHiroshiMorimatsuDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenichiUedaDepartment of Anesthesiology, Kameda Medical CenterBackground: Elderly patients with femoral neck fractures, particularly those with severe comorbidities or living in regions with limited medical resources, may experience delays in surgical treatment. Although the benefits of preoperative rehabilitation (prehabilitation) in hip arthroplasty have been reported, pain management remains a challenge. The pericapsular nerve group (PENG) block, known for its exceptional analgesic effect and motor function preservation, may be a promising intervention during prehabilitation in these patients.<br>
Case: We enrolled ten patients with Garden classification 3–4 femoral neck fractures scheduled for hip arthroplasty. After receiving a PENG block with 20 ml of 0.375% ropivacaine, all patients underwent initial prehabilitation sessions comprising 9 mobility levels, ranging from bed-sitting to walking. One patient was excluded due to experiencing high blood pressure during prehabilitation. Six of the nine remaining patients (66.7%) were successfully transferred from bed to wheelchair.<br>
Conclusions: The PENG block enhanced prehabilitation for patients with femoral neck fractures undergoing hip arthroplasty.No potential conflict of interest relevant to this article was reported.Public Library of Science (PLoS)Acta Medica Okayama1932-620320102025Relationship between obesity indices and cognitive function in Japanese men: A cross-sectional studye0332595ENSatoshiMatsunoDepartment of Psychiatry, Shiga University of Medical ScienceYujiOzekiDepartment of Psychiatry, Shiga University of Medical ScienceSayakaKadowakiNCD Epidemiology Research Center, Shiga University of Medical ScienceSayukiToriiNCD Epidemiology Research Center, Shiga University of Medical ScienceKeikoKondoNCD Epidemiology Research Center, Shiga University of Medical ScienceNaokoMiyagawaDepartment of Preventive Medicine and Public Health, Keio University School of MedicineAzusaShimaDepartment of Clinical Nursing, Shiga University of Medical ScienceMizukiOhashiNCD Epidemiology Research Center, Shiga University of Medical ScienceItsukoMiyazawaDepartment of Medicine, Shiga University of Medical ScienceHiroyoshiSegawaNCD Epidemiology Research Center, Shiga University of Medical ScienceTakashiHisamatsuDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAyaKadotaNCD Epidemiology Research Center, Shiga University of Medical ScienceKatsuyukiMiuraNCD Epidemiology Research Center, Shiga University of Medical ScienceWe aimed to investigate the associations among various obesity indices, including visceral (VAT) and subcutaneous adipose tissue (SAT), and cognitive function in community-dwelling Japanese men. This population-based cross-sectional study used data of 853 men who participated in the follow-up examinations of the Shiga Epidemiological Study of Subclinical Atherosclerosis. Among them, we analyzed data of 776 men who completed the Cognitive Abilities Screening Instrument (CASI) and had abdominal VAT and SAT areas measured using computed tomography. The VAT-to-SAT ratio (VSR) was calculated; participants were categorized into VSR quartiles. Using analysis of covariance, we computed crude and adjusted means of the CASI total and domain scores across VSR quartiles, adjusting for potential confounders. No significant differences were observed in total CASI scores among body mass index, VAT, or SAT quartiles. However, in the multivariable-adjusted model, participants in the lowest VSR quartile (Q1) had significantly lower CASI total scores than those in the third quartile (Q3) (Q1: 89.5, Q3: 90.9). Low VSR was independently associated with lower cognitive function in a community-based sample of middle-aged and older Japanese men. In summary, VSR may be associated with cognitive function in Japanese men, highlighting the importance of fat distribution in cognitive health and highlighting VSR as a useful indicator.No potential conflict of interest relevant to this article was reported.Japan Neurosurgical SocietyActa Medica Okayama2188-4226122025Endovascular Thrombectomy for Large Vessel Occlusion in a Patient on Venoarterial Extracorporeal Membrane Oxygenation: A Case Report445451ENYukiEBISUDANIDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasafumiHIRAMATSUDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeiichiroIWASAKIDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenjiSUGIUDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunHARUMADepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyuKIMURADepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasatoKAWAKAMIDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYutaSOTOMEDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakahiroNISHIHARADepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinsukeYUASADepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShotaTANAKADepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesExtracorporeal membrane oxygenation is utilized in the treatment of severe acute cardiac failure and respiratory failure. While it provides the advantage of oxygenating blood through extracorporeal circulation, it also carries risks of intracranial ischemic and hemorrhagic complications due to the continuous presence of artificial materials within the body. We encountered a case in which venoarterial extracorporeal membrane oxygenation was initiated for fulminant myocarditis, and the patient subsequently developed a large vessel occlusion. The diagnosis was confirmed using perfusion computed tomography. A visible thrombus was observed on the arterial cannula of the extracorporeal membrane oxygenation circuit, and the large vessel occlusion was determined to have been caused by thromboembolism. An immediate extracorporeal membrane oxygenation circuit exchange was performed, followed by endovascular thrombectomy. The patient experienced no perioperative complications and achieved a favorable neurological outcome. Endovascular thrombectomy in extracorporeal membrane oxygenation patients requires careful perioperative management and should be promptly performed in eligible cases of thromboembolic events. Furthermore, because patients on extracorporeal membrane oxygenation are often sedated and under intensive systemic management, regular neurological assessments and intracranial monitoring are essential for the early detection of intracranial pathologies.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2072-669417202025Tertiary Lymphoid Structures Are Associated with Favorable Clinical Outcomes and Negatively Correlated with Cancer-Associated Fibroblasts in Esophageal Cancer3351ENTomoyoshiKunitomoDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazuhiroNomaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNoriyukiNishiwakiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySeitaroNishimuraDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYasushigeTakedaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHijiriMatsumotoDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTatsuyaTakahashiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKentoKawasakiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasaakiAkaiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNaoakiMaedaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySatoruKikuchiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShunsukeTanabeDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshiakiOharaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiroshiTazawaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYasuhiroShirakawaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground: Esophageal cancer remains a highly aggressive malignant tumor with poor prognosis, despite advances in combination therapies and novel immunotherapies. Tertiary lymphoid structures (TLSs), characterized by densely packed CD20+ B cells in a germinal-center-like structure, have recently been recognized as immune-stimulating components within the tumor microenvironment. In contrast, cancer-associated fibroblasts (CAFs) are stromal cells expressing fibroblast-activating protein (FAP) involved in immunosuppression. Methods: In this retrospective study, 124 clinical samples from patients who underwent radical surgery for esophageal cancer at our institute were analyzed. We investigated whether TLSs could serve as a prognostic factor and examined their association with tumor microenvironment factors. Results: The presence of TLSs was an independent prognostic factor for overall and progression-free survival in multivariate analyses. A high level of TLS formation correlated with better nutritional status, fewer M2 macrophages, and greater plasma cell infiltration. Additionally, little TLS formation was observed in areas with abundant CAFs, and quantitative analyses revealed a significant negative correlation between TLSs and CAFs. Conclusions: TLSs enhance antitumor immunity via macrophages and plasma cells and can be a valuable prognostic indicator in patients undergoing surgery for esophageal cancer. Targeting CAFs may prove to be a promising therapeutic strategy to enhance tumor-immunity-related TLSs.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1439-01082025Coupling effects of biochar and sediment microbial fuel cells on CH4 and CO2 emissions from straw-amended paddy soilENAdhena TesfauBekeleGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMorihiroMaedaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityNozomiNakaharaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityAyumiHashiguchiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHiroakiSomuraGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversitySatoshiAkaoFaculty of Science and Engineering, Doshisha UniversityChiyuNakanoDepartment of Comprehensive Technical Solutions, Okayama UniversityYutaNishinaResearch Institute for Interdisciplinary Science, Okayama UniversityPurpose The independent incorporation of biochar and sediment microbial fuel cells (SMFCs) into paddy soil has been shown to reduce methane (CH4) emissions. However, the application of rice straw into paddy soil enhances the availability of labile carbon that stimulates methanogen growth, counteracting the mitigation effects of both methods. This study, therefore, aimed to investigate the effect of coupling biochar and SMFC on CH4 and CO2 emissions from straw-amended paddy soil.<br>
Materials and methods Single chamber SMFC setups constructed using acrylic columns (height, 25 cm; inner diameter, 9 cm) with six treatments were established using soil amended with 0% (0BC), 1% (1BC), and 2% (2BC) biochar: with and without SMFC conditions. Stainless steel mesh (15 × 3 cm) and graphite felt (6 × 5 cm) were used as anode and cathode materials, respectively.<br>
Results Cumulative emission of CH4 in the 0BC treatment with SMFC was 39% less than in that without SMFC. Biochar addition and SMFC operation together further reduced CH4 emission by 57% and 60% in 1BC and 2BC treatments, respectively, compared to that in the 0BC treatment without SMFC operation. The relative abundance of microbial communities indicated methane-oxidizing bacteria were enriched in the presence of biochar and hydrogenotrophic Methanoregula were suppressed by SMFC operation. This suggested that SMFC mainly inhibited CH4 production by outcompeting hydrogenotrophic archaea.<br>
Conclusion The use of biochar made from leftover rice straw has an interactive effect on SMFC operation and both methods can be used to reduce CH4 emission from straw-amended paddy soil.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841772025Prevalence of Locomotive Syndrome in Perioperative Patients With Localized Cancere88699ENYoshimiKatayamaDepartment of Rehabilitation Medicine, Okayama University HospitalEijiNakataDepartment of Orthopaedic Surgery, Okayama University HospitalTakutoItanoDepartment of Orthopaedic Surgery, Okayama University HospitalYoshiteruAkezakiDivision of Physical Therapy, Kochi Professional University of RehabilitationMasanoriHamadaDepartment of Rehabilitation Medicine, Okayama University HospitalToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University HospitalIntroduction<br>
Many patients with cancer experience reduced activities of daily living due to muscle weakness and fatigue caused by underlying symptoms and treatment side effects. However, the incidence of locomotive syndrome, which may reduce mobility due to motor dysfunction in patients with cancer, has not been sufficiently explored. Therefore, we aimed to investigate the incidence of locomotive syndrome and identify its risk factors in perioperative patients with cancer.<br>
<br>
Methods<br>
We included 636 perioperative patients with localized cancer who were treated between 2020 and 2023. The severity of locomotive syndrome was classified into stages 1, 2, and 3.<br>
<br>
Results<br>
The overall locomotive syndrome rate was 88.1%, with distribution across stages: stage 1 (56.8%), stage 2 (17.5%), and stage 3 (13.8%). Among men, the overall incidence was 86.5%, with stage 1 (60.3%), stage 2 (15.5%), and stage 3 (10.7%). Among women, the overall incidence was 90.6%, with stage 1 (50.6%), stage 2 (20.9%), and stage 3 (19.1%). Half of patients in their 20s and two-thirds in their 30s had locomotive syndrome. The rates were 58.6%, 80.4%, 81.8%, 93.2%, and 97.8% in the 40s, 50s, 60s, 70s, and 80s age groups, respectively. Individuals in their 40s had significantly lower rates than those in older groups. Age, grip strength, and percent vital capacity were identified as risk factors.<br>
<br>
Conclusion<br>
A high prevalence of locomotive syndrome was observed among patients with localized cancer. Age, reduced grip strength, and lower respiratory capacity were identified as associated factors. While the findings suggest possible implications for postoperative recovery, further validation through longitudinal studies is required.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0022-510X4782025Two Japanese families with adult-onset leukoencephalopathy caused by pathogenic variants in CST3123708ENKentaOrimoDepartment of Precision Medicine Neurology, Graduate School of Medicine, The University of TokyoTakashiMatsukawaDepartment of Neurology, Graduate School of Medicine, The University of TokyoKazutakaShiomiDivision of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of MiyazakiRyojiGotoDepartment of Neurology, Graduate School of Medicine, The University of TokyoAkihikoMitsutakeDepartment of Neurology, Graduate School of Medicine, The University of TokyoYumikoKuromiDepartment of Neurology, Fukushima Medical UniversityNozomuMatsudaDepartment of Neurology, Fukushima Medical UniversityKazuakiKanaiDepartment of Neurology, Fukushima Medical UniversityRyoKurokawaDepartment of Radiology, Graduate School of Medicine, The University of TokyoHiroyukiIshiuraDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunMitsuiDepartment of Precision Medicine Neurology, Graduate School of Medicine, The University of TokyoJunkoNomotoInstitute of Medical Genomics, International University of Health and WelfareMasakiTanakaInstitute of Medical Genomics, International University of Health and WelfareYosukeOmaeGenome Medical Science Project, National Institute of Global Health and MedicineYosukeKawaiGenome Medical Science Project, National Institute of Global Health and MedicineKatsushiTokunagaGenome Medical Science Project, National Institute of Global Health and MedicineShojiTsujiDepartment of Neurology, Graduate School of Medicine, The University of TokyoTatsushiTodaDepartment of Neurology, Graduate School of Medicine, The University of TokyoCST3 (NM_000099.4) encodes cystatin C, whose C-terminal truncating variants in this gene have recently been reported to cause adult-onset leukoencephalopathy, characterized by headaches, transient neurological symptoms, and distinct imaging findings. We present four patients from two Japanese families, including one with a novel variant (c.358-2_395del). Three patients from one family developed chronic headaches around the age of 20, whereas the patient from the other family remained asymptomatic until his fifties. mRNA analysis of the patient with c.358-2_395del revealed a splicing alteration leading to an in-frame deletion (p.Lys120_Gln133del), representing the first CST3 variant that does not result in a truncated protein. These findings broaden our understanding of the clinical and genetic spectra of CST3-related leukoencephalopathy (114 words).No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841782025Subacute Progression of Gait Disturbance and Consciousness Impairment Due to Communicating Hydrocephalus Associated With Vestibular Schwannomae89880ENSatokaYanoDepartment of Neurology, The University of Tokyo Graduate School of Medicine and Faculty of MedicineAkatsukiKubotaDepartment of Neurology, The University of Tokyo Graduate School of Medicine and Faculty of MedicineMizuhoKawaiDepartment of Neurology, The University of Tokyo Graduate School of Medicine and Faculty of MedicineDaikiYashitaDepartment of Neurology, The University of Tokyo Graduate School of Medicine and Faculty of MedicineHiroyukiIshiuraDepartment of Neurology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesWataruSatakeDepartment of Neurology, The University of Tokyo Graduate School of Medicine and Faculty of MedicineKaoruYamadaDepartment of Neuropathology, The University of Tokyo Graduate School of Medicine and Faculty of MedicineYukiShinyaDepartment of Neurosurgery, The University of Tokyo Graduate School of Medicine and Faculty of MedicineSatoruMiyawakiDepartment of Neurosurgery, The University of Tokyo Graduate School of Medicine and Faculty of MedicineTakeshiIwatsuboDepartment of Neuropathology, The University of Tokyo Graduate School of Medicine and Faculty of MedicineTatsushiTodaDepartment of Neurology, The University of Tokyo Graduate School of Medicine and Faculty of MedicinePatients with vestibular schwannomas (VSs) present with vestibulocochlear nerve dysfunction such as vertigo and tinnitus. VSs occasionally develop communicating hydrocephalus as a complication, which is typically characterized by an insidious progression of symptoms. We report a case of an 84-year-old female patient with a VS who developed gait disturbance and consciousness impairment over a three-week period, ultimately resulting in an inability to walk and communicate. A thorough evaluation ruled out encephalitis and other differential diagnoses. Imaging studies demonstrated findings consistent with communicating hydrocephalus, and a tap test temporarily improved her consciousness disturbances. The patient underwent ventriculoperitoneal shunting and stereotactic radiosurgery (SRS), after which both consciousness and gait disturbances dramatically improved 10 days postoperatively. The subacute development of symptoms due to normal pressure hydrocephalus associated with VSs is rare. Furthermore, to the best of our knowledge, this is the first reported case of severe gait impairment and disturbance of consciousness progressing within a short period. This case highlights the importance of considering communicating hydrocephalus associated with VSs as a differential diagnosis, even in cases of subacute consciousness disturbance. We also discuss the pathophysiology of hydrocephalus in relation to cerebrospinal fluid (CSF) clearance into the extracranial space. No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2196-29951212025Natural Effects and Separable Effects: Insights into Mediation Analysis20ENEtsujiSuzukiDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomohiroShinozakiInterfaculty Initiative in Information Studies, the University of TokyoEijiYamamotoOkayama University of SciencePurpose of Review We compare natural effects and separable effects under nonparametric structural equation models with independent errors, highlighting their similarities and differences. By examining their required properties and sufficient conditions for identification, we aim to provide deeper insights into mediation analysis.<br>
Recent Findings If certain assumptions about confounding, positivity, and consistency are met, we can identify natural direct and indirect effects under nonparametric structural equation models with independent errors. However, these effects have been criticized because they rely on a specific cross-world quantity, and the so-called cross-world independence assumption cannot be empirically verified. Furthermore, interventions on the mediator may sometimes be challenging to even conceive. As an alternative approach, separable effects have recently been proposed and applied in mediation analysis, often under finest fully randomized causally interpretable structured tree graph models. These effects are defined without relying on any cross-world quantities and are claimed to be identifiable under assumptions that are testable in principle, thereby addressing some of the challenges associated with natural direct and indirect effects.<br>
Summary To conduct meaningful mediation analysis, it is crucial to clearly define the research question of interest, and the choice of methods should align with the nature of the question and the assumptions researchers are willing to make. Examining the underlying philosophical perspectives on causation and manipulation can provide valuable insights.No potential conflict of interest relevant to this article was reported.岡山大学環境管理センターActa Medica Okayama0917-1533472025岡山大学環境管理センター報 第47号ENNo potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1422-006726202025Neurofibromin Encoded by the Neurofibromatosis Type 1 (NF1) Gene Promotes the Membrane Translocation of SPRED2, Thereby Inhibiting the ERK Pathway in Breast Cancer Cells10072ENNang TheeSu PwintDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityChunningLiDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTongGaoDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYuzeWangDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasayoshiFujisawaDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshiakiOharaDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasakiyoSakaguchiDepartment of Cell Biology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTeizoYoshimuraDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAkihiroMatsukawaDepartment of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNeurofibromin (NF) inhibits the RAS/RAF/ERK pathway through its interaction with SPRED1 (Sprouty-related EVH1 domain-containing protein 1). Here, we investigated the functional relationship between NF and SPRED2 in breast cancer (BC). Human BC cell lines were transfected to downregulate or overexpress NF and SPRED2 and subsequently subjected to functional assays. Protein and mRNA levels were analyzed by Western blotting and RT-qPCR, respectively. Protein–protein interactions were examined by immunoprecipitation. Database analyses and immunohistochemistry (IHC) of BC tissues were performed to validate the in vitro findings. Downregulating NF or SPRED2 expression in BC cells enhanced cell proliferation, migration and invasion accompanied by RAF/ERK activation, whereas overexpression produced opposite effects. NF formed a protein complex with SPRED2 and facilitated its translocation to the plasma membrane. By IHC, SPRED2 membrane localization was absent in NF-negative luminal A and triple-negative BC (TNBC) but present in a subset of luminal A BC. By database analyses, both NF1 and SPRED2 mRNA levels were reduced in BC tissues, and luminal A BC patients with high expression of both NF1 and SPRED2 mRNA exhibited improved relapse-free survival. These results suggest a critical role for the NF–SPRED2 axis in BC progression and highlight it as a potential therapeutic target.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2072-669417202025Impact of Neoadjuvant Chemotherapy with Gemcitabine Plus S-1 in Patients with Resectable Pancreatic Ductal Adenocarcinoma3287ENKazuyaYasuiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoseiTakagiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokazuFujiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakeyoshiNishiyamaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuoNagaiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,YukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground/Objectives: Although neoadjuvant chemotherapy (NAC) is not universally recommended for resectable pancreatic ductal adenocarcinoma (PDAC), NAC with gemcitabine plus S-1 (NAC-GS) has become a commonly used regimen for resectable PDAC in Japan. Furthermore, the impact of achieving textbook outcomes (TO) in patients receiving NAC-GS remains unclear. Methods: This retrospective study included 265 patients who were diagnosed with resectable PDAC at our institution between January 2009 and December 2023. Patients were categorized into two groups: the NAC-GS group (n = 81; 2019–2023) and the upfront surgery (UFS) group (n = 164; 2009–2018). After comparing the clinical outcomes between groups, multivariate analyses for survival were performed. Additionally, outcomes stratified by the achievement of the modified TO were analyzed in the NAC-GS group. Results: The completion rate of NAC-GS was 90.1%. Patients in the NAC-GS group exhibited significantly longer survival than those in the UFS group (2-year recurrence-free survival: 61.4% vs. 37.9%, p < 0.01; 2-year overall survival: 83.2% vs. 61.2%, p < 0.01). Multivariate analyses identified lymph node metastasis, NAC-GS induction, and completion of adjuvant chemotherapy as factors significantly associated with improved survival. Moreover, among patients who received NAC-GS, those who achieved modified TO demonstrated significantly longer survival than those who did not. Conclusions: This study demonstrated the clinical efficacy of NAC-GS in patients with resectable PDAC. Induction of NAC-GS was significantly associated with improved long-term outcomes. In multidisciplinary treatment strategies for PDAC, achieving a modified TO may lead to improved survival of patients undergoing NAC-GS.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1752-19471912025The safety and efficacy of finasteride for transgender men with androgenetic alopecia: a case series468ENYusukeTominagaDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTomokoKobayashiDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineYukoMatsumotoDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTomokoSakoDepartment of Urology, Hiroshima City Hiroshima Citizens HospitalTakatoshiMoriwakeDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineSatoshiHoriiDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTakuyaSadahiraDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineSatoshiKatayamaDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTakehiroIwataDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineShingoNishimuraDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKensukeBekkuDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKoheiEdamuraDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineMasamiWatanabeCenter for Innovative Clinical Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineMotooArakiDepartment of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineBackground Testosterone replacement therapy is commonly used in transgender men for masculinization. One of the most common adverse effects of testosterone replacement therapy is androgenetic alopecia. In Japan, finasteride is approved exclusively for cisgender men and is not indicated for transgender men. The aim of this clinical trial was to evaluate the safety and efficacy of finasteride in transgender men with androgenetic alopecia.<br>
Case presentation This study included three transgender men (assigned female at birth, identifying as male), aged 44, 43, and 29 years. All participants were of Asian ethnicity. A clinical trial was conducted from October 2021 to December 2023. Transgender men aged 20–60 years who had not undergone hysterectomy, were undergoing testosterone replacement therapy, and who had been diagnosed with stage ≥ II androgenetic alopecia on the basis of the Norwood–Hamilton scale were recruited. The participants initiated treatment with 0.2 mg of finasteride per day for 3 months (phase 1). If no adverse events above grade 2 occurred, the dose was increased to 1.0 mg per day for an additional 3 months (phase 2). The primary endpoints were the incidence of treatment-related adverse events at 1 week, 1 month, and 3 months, as well as the rate of participants continuing treatment at 3 months. None of the patients experienced serious adverse events at 3 months, and all the patients extended their treatment to a total of 6 months. Improvements of at least one stage on the N–H scale were observed, but two participants experienced resumption of menstruation.<br>
Conclusion Finasteride appears to be a safe and effective treatment for androgenetic alopecia in transgender men undergoing testosterone replacement therapy. However, its potential for reducing some of the effects of testosterone replacement therapy warrants further investigation. Trial registration: jRCT, jRCTs061210040, registered 7 October 2021, https://jrct.mhlw.go.jp/latest-detail/jRCTs061210040.No potential conflict of interest relevant to this article was reported.Okayama University Medical 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 Okayama0386-300X7952025Advantages of Single-Position Surgery over Posterior Fusion for Single-Level Degenerative Lumbar Diseases359368ENTomohikoHiroseDepartment of Orthopedic Surgery, Kagawa Prefectural Central HospitalHisanoriIkumaDepartment of Orthopedic Surgery, Kagawa Prefectural Central HospitalKazutoshiOtsukaOtsuka Orthopedic ClinicKeisukeKawasakiDepartment of Orthopedic Surgery, Kagawa Prefectural Central HospitalOriginal Article10.18926/AMO/69437Single-position surgery with lateral lumbar interbody fusion (LLIF) and percutaneous pedicle screws (PPSs) is gaining attention for its reduced invasiveness. We developed SPAPS, a technique allowing two surgeons to perform anterior LLIF and posterior PPS insertion simultaneously in a single lateral decubitus position. This retrospective study compared SPAPS (SPAPS-LLIF, Group SL) and minimally invasive posterior/transforaminal lumbar interbody fusion (MIS-PLIF/TLIF, Group PT) in patients treated between 2016 and 2019 with a two-year follow-up. Operative time, estimated blood loss (EBL), length of hospital stay (LOS), JOABPEQ and VAS scores, segmental lordotic angle, lumbar lordotic angle, segmental Cobb’s angle, PPS misplacement, PPS loosening, fusion status, and muscle cross-sectional areas were compared. Fifty-two patients were analyzed (Group SL: 25; Group PT: 27). SPAPS significantly reduced operative time (118.0 vs. 165.3 min, p <0.01) and estimated blood loss (8.6 vs. 164.1 mL, p<0.01). While clinical outcomes and hospital stay were comparable, Group SL had significantly lower PPS loosening (0% vs. 13%, p<0.01) and non-union rates (0% vs. 22.2%, p=0.02). Multifidus muscle atrophy was also less in Group SL (−14.3 vs. −121.5 mm2, p<0.01). SPAPS demonstrated advantages in reducing surgical invasiveness without compromising clinical efficacy, offering a promising alternative to conventional posterior fusion surgery.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025Comparison 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 Okayama0386-300X7952025Evaluation of Scleral Adjustment Method: A Novel Adjustable Suture Technique in Strabismus Surgery339343ENIchiroHamasakiLino Eye ClinicKiyoShibataLino Eye ClinicOriginal Article10.18926/AMO/69434To determine whether passing a pole suture through the sclera at two points provides fixation comparable to that of a sliding noose, we measured the tensile strength of the suture‒sclera interface during simulated traction. In this in vitro study, three suture patterns were evaluated in porcine eyeballs, using 6-0 polyglycolic acid sutures. Patterns A (control), B (second suture pass perpendicular), and C (second suture pass in the same direction) were compared. The tensile strength of each pattern was measured 20 times using a KANON TK300CN, and the results were analyzed using the Kruskal‒Wallis test. Pattern A showed a tensile strength of 2±4 gram-force (gf) (range: 0-12). Pattern B showed 112±38 gf (range: 61-184). Pattern C showed 139±31 gf (range: 97-204). Patterns B and C had significantly higher tensile strengths than Pattern A (p<0.001). Although Pattern C was not significantly different from Pattern B (p=0.363), it exhibited the highest tensile strength. Lifting the suture between the first and second suture passes allows for an adjustable suture length, suggesting that adjustability can be achieved using only the sclera. This scleral adjustment method with a second suture pass offers a durable means of securing extraocular muscles and may represent a valuable addition to adjustable suturing techniques.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025Current Status of Extracorporeal Membrane Oxygenation as a Treatment Strategy for Primary Graft Dysfunction after Lung Transplantation329337ENKeiMatsubaraDepartment of Thoracic Surgery, Hiroshima City Hiroshima Citizens HospitalKentarohMiyoshiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesReview10.18926/AMO/69433Primary graft dysfunction (PGD) is one of the major risk factors affecting patients’ short- and long-term survival after lung transplantation. No particular management strategy has been established for PGD; supportive care is the mainstay of PGD treatment. When a supportive strategy fails, the patient may require the introduction of extracorporeal membrane oxygenation (ECMO) as the last-resort measure for severe PGD. A variety of study of ECMO as a PGD treatment was reported and the management of PGD patients developed so far. Early recognition of a patient’s need for ECMO and its prompt initiation are critical to improved outcomes. The use of venovenous-ECMO became the preferred procedure for PGD rather than venoarterial-ECMO. However, the current ECMO strategy has limitations, and using ECMO to manage patients with PGD is not sufficiently effective. Further studies are required to develop this promising technology.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025A Review of the Endoscopic Treatment for Bile Leak Following Cholecystectomy and Hepatic Surgery321328ENTaisukeObataDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalReview10.18926/AMO/69432Bile leak occurs in 2-25% of liver transplant, 3-27% of hepatic resection, and 0.1-4% of cholecystectomy cases. The clinical course of bile leak varies depending on the type of surgery that caused the fistula, as well as the type, severity, and timing of bile duct injury. Although infections resulting from bile leak can be life-threatening, the introduction of endoscopic treatment has enabled some patients to avoid reoperation and has reduced the negative impact on quality of life associated with external fistulas for percutaneous drainage. Endoscopic interventions, such as sphincterotomy and stent placement, reduce the pressure gradient between the bile duct and duodenum, facilitating bile drainage through the papilla and promoting the closure of the leak. We reviewed the literature from 2004 to 2024 regarding bile leak following cholecystectomy and liver surgery, examining recommended techniques, timing, and treatment outcomes. In cases of bile leak following cholecystectomy, clinical success was achieved in 72-96% of cases, while success rates for bile leak following liver surgery ranged from 50% to 100%. Although endoscopic treatment is effective, it is not universally applicable, and its limitations must be carefully considered.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2077-038314172025Risk Factors for Perioperative Urinary Tract Infection After Living Donor Kidney Transplantation Characterized by High Prevalence of Desensitization Therapy: A Single-Center Analysis6102ENShingoNishimuraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShotaInoueDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakanoriSekitoDepartment of Inflammation and Immunity, Lerner Research Institute, Cleveland ClinicIchiroTsuboiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMotoTokunagaDepartment of Urology, NHO Okayama Medical CenterKasumiYoshinagaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiMaruyamaDepartment of Inflammation and Immunity, Lerner Research Institute, Cleveland ClinicYosukeMitsuiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomoakiYamanoiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTatsushiKawadaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRisaKubotaDepartment of Urology, NHO Okayama Medical CenterTakuyaSadahiraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusukeTominagaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakehiroIwataDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiKatayamaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKensukeBekkuDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiEdamuraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoichiroWadaDepartment of Urology, Shimane University Faculty of MedicineYasuyukiKobayashiDepartment of Urology, Hiroshima City Hiroshima Citizens HospitalMotooArakiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground/Objectives: Limited research exists on risk factors for urinary tract infections (UTIs) in kidney transplant recipients, particularly in high-risk groups such as ABO-incompatible or donor-specific antibody (DSA)-positive cases. Early UTIs, especially within the first month post-transplant, impact on acute rejection and long-term graft outcomes, highlighting the need for risk factor identification and management. Methods: Among 157 living donor kidney transplant cases performed at our institution between 2009 and 2024, 128 patients were included after excluding cases with >72 h of perioperative prophylactic antibiotics or urological complications. UTI was defined as the presence of pyuria and a positive urine culture, accompanied by clinical symptoms requiring antibiotic treatment, occurring within one month post-transplantation. Results: The median onset of UTI was postoperative day 8 (interquartile range, IQR: 6.8–9.3). No subsequent acute rejection episodes were observed. The median serum creatinine at 1 month postoperatively was 1.3 mg/dL (IQR: 1.1–1.7), and this was not significantly different from those who did not develop UTI. In univariate analysis, low or high BMI (<20 or >25), longer dialysis duration (>2.5 years), desensitization therapy (plasmapheresis + rituximab), elevated preoperative neutrophil-to-lymphocyte ratio (NLR) (≥3), and longer warm ischemic time (WIT) (≥7.8 min) were significantly associated with an increased infection risk of UTI (p = 0.010, 0.036, 0.028, 0.015, and 0.038, respectively). Multivariate analyses revealed that abnormal BMI, longer dialysis duration, desensitization therapy, and longer WIT were independent risk factors for UTI (p = 0.012, 0.031, 0.008, and 0.033, respectively). The incidence of UTI increased with the number of risk factors: 0% (0/16) for zero, 10% (5/48) for one, 31% (16/51) for two, 45% (5/11) for three, and 100% (2/2) for four risk factors. Conclusions: Desensitization therapy, BMI, dialysis duration, and WIT were identified as independent risk factors for perioperative UTI. In patients with risk factors, additional preventive strategies should be considered, with extended antibiotic prophylaxis being one potential option.No potential conflict of interest relevant to this article was reported.