Japan Medical AssociationActa Medica Okayama2433-3298912026Relationship between Maternal Body Composition during Pregnancy and Newborn Birth Weight in Japan189197ENErikoEtoDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasakazuKatoDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSatoeKirinoDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesChiakiKuriyamaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesShujiroSakataDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHikariNakatoDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSakurakoMishimaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAkikoOhiraDepartment 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 SciencesIntroduction: This study aimed to investigate the changes in maternal body composition during pregnancy in Japanese women and the relationship between maternal body composition and newborn birth weight using pre-pregnancy body mass index (BMI) in all trimesters.<br>
Methods: A total of 1,851 pregnant Japanese women were enrolled in this study. Body composition was measured using TANITA MC-190EM. The associations between newborn birth weight and maternal BMI, fat mass (FM), fat-free mass (FFM), total body water (TBW), muscle mass (MM), FM gain, FFM gain, and weight gain were evaluated.<br>
Results: The participants’ age and pre-pregnancy BMI were 34.1 years and 21.4 kg/m2, respectively. Among the patients, 13.4%, 73.0%, 10.3%, and 3.3% were underweight, average weight, overweight, and obese, respectively. The FM showed no significant change from the second to third trimesters in the underweight, overweight, and obese groups. Moreover, the FM in the overweight and obese groups did not change during any period. The FFM, TBW, and MM significantly increased from the first to second and second to third trimesters. In BMI-stratified multivariate regression analyses, FFM in the normal and overweight groups was positively associated with birth weight, whereas FM gain was negatively associated in the underweight and normal groups. No significant associations were observed in the obese group.<br>
Conclusions: Changes in maternal body composition during pregnancy in Japanese women varied by pre-pregnancy BMI. Associations with birth weight also differed by BMI group. Further prospective studies are needed to confirm these relationships and investigate the mechanisms.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ドイツ付近の夏の気候とシューベルトの歌曲《春に》 異質な他者との出会いを促す大学での学際的授業の報告7589ENKuranoshinKATOFaculty of Education, Okayama UniversityIsaoNAGAOKAFaculty of Education, Okayama UniversityHarukoKATOFaculty of Education, Gufu Shotoku Gakuen University (Former affiliation)10.18926/CTED/70361 「異質な他者」への出会いを促す授業例の更なる蓄積のため，ドイツ付近の「夏」の気候と季節感に注目した教科横断的な授業を大学で実践した。授業では，ドイツ付近の気候と季節サイクルの中での「夏」の特徴を把握すると共に，シューベルトの歌曲《春に》を鑑賞した。《春に》の3 番の「夏の間じゅう，ずっと」という歌詞で歌われている情景や情感が，ドイツ付近と日本付近を想定した場合にどう違い得るか，に関する受講生の記述を分析した。その結果，日本の夏の高温多湿な環境からは原詩の情感そのものが成立し難いと感じた学生もいるなど，本実践は，自分たちの「当たり前」とは異なる気候や季節感にも目を向ける機会になり得たといえる。一方，日本とはかなり違う気候背景の中でシューベルトが思い描いたであろう情景・心情に授業で深く迫るための，音楽表現自体への踏み込み方についても，今後検討する必要性が示唆された。No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0309-01672026Clinicopathological and transcriptomic profiles of 101 patients with diffuse large B-cell lymphoma/high-grade B-cell lymphoma with double-hit MYC and BCL2 or BCL6 and triple hitENMasashiMiyaokaDepartment of Pathology, School of Medicine, Tokai UniversityJoaquimCarrerasDepartment of Pathology, School of Medicine, Tokai UniversityYara YukieKikutiDepartment of Pathology, School of Medicine, Tokai UniversityHarukaIkomaDepartment of Pathology, School of Medicine, Tokai UniversityShunsukeNagaseDepartment of Pathology, School of Medicine, Tokai UniversityAtsushiItoDepartment of Pathology, School of Medicine Tokai University Isehara JapanMakotoOritaDepartment of Pathology, School of Medicine, Tokai UniversityHiroshiKawadaDepartment of Hematology, School of Medicine, Tokai UniversityRikaSakaiDepartment of Medical Oncology, Kanagawa Cancer CenterYasuharuSatoDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesMidori FilizNishimuraDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesKunihiroTsukasakiDepartment of Hematology, International Medical Center, Saitama Medical UniversityShujiMomoseDepartment of Pathology, Saitama Medical Center, Saitama Medical UniversityYoshihiroKameokaDepartment of Hematology, Nephrology and Rheumatology, Akita University Graduate School of MedicineMasahiroYoshidaDepartment of Hematology, Osaka City General HospitalAkiraSatouDepartment of Surgical Pathology, Aichi Medical University HospitalSeiichiKatoCenter for Clinical Pathology, Fujita Health University HospitalNaokiOishiDepartment of Pathology, University of YamanashiAkioSaitoDepartment of Hematology, NHO Shibukawa Medical CenterKenSadahiraDivision of Hematology, Kawasaki Municipal Kawasaki HospitalYoheiMasugiDepartment of Pathology, School of Medicine, Tokai UniversityNaoyaNakamuraDepartment of Pathology, School of Medicine, Tokai UniversityAims: Diffuse large B-cell lymphoma/high-grade B-cell lymphoma (DLBCL/HGBCL) with MYC and BCL2 rearrangements (double-hit lymphoma with BCL2, DHL-BCL2) is a mature aggressive B-cell lymphoma that also includes concurrent triple hit with BCL6 translocation (TH). DHL with MYC and BCL6 (DH-BCL6) can also occur. The differences among these three DLBCL/HGBCL subtypes have not yet been definitively determined.<br>
Methods and Results: This study characterized the clinicopathological features and transcriptomic profiles of a series of 101 cases of DLBCL/HGBCL that were subclassified according to MYC, BCL2 and BCL6 FISH data, including cell-of-origin (COO)-like, molecular high-grade (MHG)-like and double-hit/dark-zone (DHIT/DZsig)-like signatures. DLBCL/HGBCL-DH-BCL2 was characterized by higher HGBCL morphology, CD10 positivity, GCB Hans's, GCB COO and MHG molecular subtype. DLBCL/HGBCL-TH had higher LDH levels and worse overall survival. DLBCL/HGBCL-DH-BCL6 had higher MUM1 expression, non-GCB Hans', ABC/Unclassified COO, non-MHG and low DHIT/DZ signatures. Transcriptomic analysis showed that DLBCL/HGBCL-DH-BCL2 and DLBCL/HGBCL-TH were close but separated from DLBCL/HGBCL-DH-BCL6. Gene set enrichment analysis (GSEA) revealed different levels of enrichment between the subtypes.<br>
Conclusions: DLBCL/HGBCL-DH-BCL6 differs from the DLBCL/HGBCL-DH-BCL2, and the DLBCL/HGBCL-TH is associated with the worst survival. Analysis of all three genes of MYC, BCL2 and BCL6 is recommended in the context of DLBCL/HGBCL diagnosis.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 Okayama1340-741432120262018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.Springer Science and Business Media LLCActa Medica Okayama2045-23221612026Objective assessment of cesarean section suturing techniques using a uterine simulator7456ENHikariNakatoDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesJotaMakiDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesChiakiKuriyamaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesShujiroSakataDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKeiichiOishiDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAyanoSuemoriDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHikaruOobaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTomohiroMitomaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasakazuKatoDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSakurakoMishimaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAkikoOhiraDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSatoeKirinoDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesErikoEtoDepartment 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 SciencesCesarean wound healing is influenced by surgeon experience, suture type, and technique. This study utilized a simulation model to quantify these effects. Obstetricians–gynecologists and junior residents performed two-layer continuous suturing on uterine models, forming eight groups based on experience level (expert, novice), suture type (conventional, barbed), and technique (Albert–Lembert, layer-to-layer). The ideal wound condition was defined as that achieved by an expert using barbed sutures and the layer-to-layer technique. Wound characteristics were quantified and compared to this ideal. Experts using barbed sutures in Albert–Lembert suturing showed higher wound density but greater deformation and larger endometrial openings (both P < 0.01). Novices using barbed sutures in Albert–Lembert suturing showed similar wound density but significantly greater deformation and opening (both P < 0.01). Novices using conventional sutures in layer-to-layer suturing showed the lowest wound density and longest suturing time (both P < 0.01). Notably, novices using barbed sutures achieved wound characteristics comparable to experts using conventional sutures in Albert–Lembert suturing and results closer to the ideal in layer-to-layer suturing. These findings establish a quantifiable standard for cesarean suturing and suggest that optimizing suture types and techniques may help compensate for differences in surgical expertise.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0309-01678852025Claudin-18 expression in gastric type adenocarcinoma and HPV-associated adenocarcinoma of the uterine cervix10031015ENNobukoYasutakeDepartment of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu UniversityYukiYokawaDepartment of Pathology and Oncology, Graduate School of Medicine, Dentistry & Pharmaceutical Science, Okayama UniversityTakehiroTanakaDepartment of Pathology and Oncology, Graduate School of Medicine, Dentistry & Pharmaceutical Science, Okayama UniversityRiriMishimaDepartment of Pathology and Oncology, Graduate School of Medicine, Dentistry & Pharmaceutical Science, Okayama UniversityMisatoKomamizuDepartment of Gynecology and Obstetrics, Graduate School of Medical Sciences Kyushu University Fukuoka JapanRyosukeKugaDepartment of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu UniversityRinaJiromaruDepartment of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu UniversityShinichiroKawatokoDepartment of Medicine and Clinical Science, Kyushu University Beppu HospitalKenzoSonodaDepartment of Gynecology, Kyushu University Beppu HospitalHideakiYahataDepartment of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu UniversityKiyokoKatoDepartment of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu UniversityYoshinaoOdaDepartment of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu UniversityHidetakaYamamotoDepartment of Pathology and Oncology, Graduate School of Medicine, Dentistry & Pharmaceutical Science, Okayama UniversityAims: Claudin-18 (CLDN18) is both a marker for the gastric phenotype and a therapeutic target. However, little is known about its immunoexpression in endocervical adenocarcinomas (ECAs), particularly as detected using the clone 43-14A antibody, or about the gene expression of its isoforms in ECAs.<br>
Methods and results: We examined CLDN18, HIK1083, p16 and Rb expression by immunohistochemistry and high-risk human papillomavirus (HR-HPV) mRNA by in situ hybridization (ISH) in 121 ECAs, including 35 HPV-independent adenocarcinomas (gastric type [GAS], n = 24; non-GAS, n = 11) and 86 HPV-associated ECAs. We also analysed mRNA expression of the CLDN18.1 (lung type) and CLDN18.2 (gastric type) isoforms by quantitative polymerase chain reaction (qPCR) in selected cases. CLDN18 positivity was detected in 8/24 (33%) GASs, 0/11 (0%) non-GASs and 2/86 (2%) HPV-associated ECAs, with positivity defined as staining in ≥75% of tumour cells, as in gastric cancer. When a 5% cut-off was used, CLDN18 positivity was detected in 22/24 (92%) GASs, 0/11 (0%) non-GASs and 6/86 (7%) HPV-associated ECAs; CLDN18 expression was thus significantly associated with GAS histology (P < 0.0001). Among the 6 cases of HPV-associated ECAs with CLDN18 expression (ranging from 5% to 80%), the histological patterns included a mix of usual and mucinous features in 4 cases, pure usual type in 1 and villoglandular variant in 1. Otherwise features such as p16 overexpression and the Rb partial loss pattern were consistent with those of HPV-associated ECAs. Six of 22 (27%) CLDN18-positive GASs were also positive for p16, but their other features―such as CLDN18 expression and the Rb preserved pattern―were the same as in p16 negative GASs. Expression of CLDN18.2 mRNA but not CLDN18.1 mRNA was confirmed in both GASs and HPV-associated ECAs.<br>
Conclusions: CLDN18 (43-14A) emerged as a potential diagnostic and therapeutic marker for GAS. A minor subset of HPV-associated ECAs also can be immunoreactive for CLDN18 and express CLDN18.2 mRNA, suggesting divergent gastric phenotypic differentiation. The caution is that GAS and HPV-associated ECAs can share overlapping histological features and similar expression of CLDN18 and p16.No potential conflict of interest relevant to this article was reported.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.Frontiers Media SAActa Medica Okayama1664-462X162025Structural analysis of PSI-ACPI and PSII-ACPII supercomplexes from a cryptophyte alga Rhodomonas sp. NIES-23321716939ENWenyueZhangAdvanced Research Field, Research Institute for Interdisciplinary Science, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityNozomiYoneharaAdvanced Research Field, Research Institute for Interdisciplinary Science, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMizukiIshiiAdvanced Research Field, Research Institute for Interdisciplinary Science, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHaoweiJiangAdvanced Research Field, Research Institute for Interdisciplinary Science, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityRomainLa RoccaAdvanced Research Field, Research Institute for Interdisciplinary Science, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityPi-ChengTsaiAdvanced Research Field, Research Institute for Interdisciplinary Science, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHongjieLiAdvanced Research Field, Research Institute for Interdisciplinary Science, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKojiKatoAdvanced Research Field, Research Institute for Interdisciplinary Science, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityFusamichiAkitaAdvanced Research Field, Research Institute for Interdisciplinary Science, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityJian-RenShenAdvanced Research Field, Research Institute for Interdisciplinary Science, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityLight energy is converted to chemical energy by two photosystems (PSI and PSII) in complex with their light-harvesting complex proteins (LHCI and LHCII) in photosynthesis. Rhodomonas is a member of cryptophyte alga whose LHCs contain unique chlorophyll a/c proteins (ACPs) and phycobiliproteins. We purified PSI-ACPI and PSII-ACPII supercomplexes from a cryptophyte Rhodomonas sp. NIES-2332 and analyzed their structures at high resolutions of 2.08 Å and 2.17 Å, respectively, using cryo-electron microscopy. These structures are largely similar to those reported previously from two other species of cryptophytes, but exhibited some differences in both the pigment locations and subunit structures. A part of the antenna subunits of both photosystems is shifted compared with the previously reported structures from other species of cryptophytes, suggesting some differences in the energy transfer rates from the antenna to the PSI and PSII cores. Newly identified lipids are found to occupy the interfaces between the antennae and cores, which may be important for assembly and stabilization of the supercomplexes. Water molecules surrounding three iron-sulfur clusters of the PSI core are found in our high-resolution structure, some of which are conserved from cyanobacteria to higher plants but some are different. In addition, our structure of PSII-ACPII lacks the subunits of oxygen-evolving complex as well as the Mn4CaO5 cluster, suggesting that the cells are in the S-growth phase, yet the PSI-ACPI structure showed the binding of PsaQ, suggesting that it is in an L-phase. These results suggest that the S-phase and L-phase can co-exist in the cryptophytic cells. The high-resolution structures of both PSI-ACPIs and PSII-ACPIIs solved in this study provide a more solid structural basis for elucidating the energy transfer and quenching mechanisms in this group of the organisms.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1865-72571822025Microsatellite-high intrahepatic cholangiocarcinoma with favorable treatment outcome using pembrolizumab363368ENShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalHironariKatoDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyaMiyamotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalKosakuMorimotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalAkihiroMatsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalHiroyukiTerasawaDepartment of Gastroenterology and Hepatology, Okayama University HospitalYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalTakehiroTanakaDepartment of Pathology, Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalIntrahepatic cholangiocarcinoma has a poor prognosis. In unresectable cases, the survival period is short despite combination therapy with cytotoxic anticancer agents and immune checkpoint inhibitors. The usefulness of immune checkpoint inhibitors against malignant tumors with microsatellite instability-high (MSI-H) mutations was shown in the KEYNOTE158 study; however, data for intrahepatic cholangiocarcinoma are insufficient. In the present case, a 65-year-old man with intrahepatic cholangiocarcinoma and lymph node metastasis could not be treated with a combination of gemcitabine, CDDP, and S-1. A comprehensive cancer genomic profiling (CGP) test showed MLH1 pathogenic mutation and MSI-H. When pembrolizumab was administered, the tumor shrinkage effect was rapidly observed, which was sustained even after 30 months. No pathogenic mutations were observed in the germline test, and MSI-high was considered to be due to the MLH1 pathogenic mutation occurring sporadically in somatic cells. MSI-H intrahepatic cholangiocarcinoma is extremely rare. However, because pembrolizumab is expected to be effective, CGP testing should be actively performed.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841812026Saliva as a Reliable and Non-invasive Sample for Detecting Influenza A in Severe Acute Respiratory Infection Casese100872ENJunko STakeuchiDepartment of Academic-Industrial Partnerships Promotion, Center for Clinical Sciences, Japan Institute for Health SecurityNobuakiMatsunagaAntimicrobial Resistance (AMR) Clinical Reference Center, Japan Institute for Health SecurityAiTsukadaAntimicrobial Resistance (AMR) Clinical Reference Center, Japan Institute for Health SecurityNorikoIwamotoDisease Control and Prevention Center, Japan Institute for Health SecurityNorikoFuwaDisease Control and Prevention Center, Japan Institute for Health SecurityTakahiroIchikawaDepartment of Infectious Diseases, Sapporo City General HospitalYasuyukiKatoDepartment of Infectious Diseases, International University of Health and Welfare (IUHW) Narita HospitalYukaTomitaDepartment of Infectious Diseases, Japanese Red Cross Aichi Medical Center Nagoya Daini HospitalHirokiKitagawaDepartment of Infectious Diseases, Hiroshima University HospitalMasayaYamatoDepartment of General Internal Medicine and Infectious Diseases, Rinku General Medical CenterTetsujiAoyagiDepartment of Clinical Infectious Diseases, Tohoku University Graduate School of MedicineHideharuHagiyaDepartment of Infectious Diseases, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyotaHaseDepartment of Infectious Diseases, Japanese Red Cross Narita HospitalShujiHatakeyamaDivision of Infectious Diseases, Jichi Medical University HospitalTohruInabaDepartment of Infection Control and Laboratory Medicine, Kyoto Prefectural University of MedicineKoichiIzumikawaYoshioTakesueDepartment of Infectious Diseases, Nagasaki University Graduate School of Biomedical SciencesMotoKimuraDepartment of Academic-Industrial Partnerships Promotion, Center for Clinical Sciences, Japan Institute for Health SecurityNorioOhmagariDisease Control and Prevention Center, Japan Institute for Health SecurityBackground<br>
Nasopharyngeal swab sampling remains the gold standard for influenza diagnosis; however, it has several limitations, including dependence on medical staff, invasiveness, potential for nosocomial transmission, and occupational exposure risk. Non-invasive alternatives, such as saliva and nasal vestibular swabs, may improve patient comfort and participation in clinical studies. In addition, diagnosis with reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR) is often delayed because it requires trained laboratory technicians and facilities with appropriate laboratory settings. Although rapid diagnostic devices such as the GenPad® offer potential alternatives to RT-qPCR, their performance with non-invasive samples remains insufficiently explored. This study addresses the two key questions for influenza detection in severe acute respiratory infection (SARI) cases: (i) whether saliva or nasal vestibular swab samples serve as suitable alternatives to nasopharyngeal swab samples, and (ii) whether the GenPad® provides a reliable option for detecting influenza using saliva samples.<br>
Methodology<br>
A prospective observational study was conducted with 16 inpatients classified as having SARIs and diagnosed with influenza between December 2024 and March 2025 in Japan. Paired saliva and nasal vestibular swab samples were collected 1-9 (median = 3.5) days after symptom onset. RT-qPCR testing was performed according to the National Institute of Infectious Diseases protocol. Saliva samples were also tested using the GenPad® system. Comparisons between sample types and diagnostic methods were analyzed using the exact McNemar's test.<br>
Results<br>
Among the 16 influenza-positive patients, saliva samples demonstrated higher sensitivity (87.5%) than nasal vestibular swabs (31.3%) in RT-qPCR when compared with the diagnostic results obtained from nasopharyngeal swabs. A comparison of RT-qPCR results between saliva and nasal vestibular swabs revealed a total agreement of 43.8%, with exact McNemar's test showing a significant difference (p = 0.0039). While nasal vestibular swabs showed inconsistent results, saliva samples consistently tested positive, particularly within seven days of symptom onset (100% positive agreement). The GenPad®, a rapid diagnostic device, showed promising performance (92.9%) using saliva samples compared to RT-qPCR.<br>
Conclusions<br>
Saliva is a reliable non-invasive alternative to nasopharyngeal swabs for influenza detection in SARI cases, particularly within seven days of symptom onset, whereas nasal vestibular swabs show lower sensitivity. Additionally, the GenPad® provides comparable performance to RT-qPCR using saliva samples, offering a rapid, portable diagnostic option. These approaches may mitigate discomfort, minimize infection risk for healthcare workers, and improve testing capacity. However, the absence of influenza-negative controls and the small sample size (n = 16) substantially limit the assessment of diagnostic accuracy and specificity. As a result, the broader applicability of our findings should be interpreted with caution, and further studies are required to validate these observations.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8012026Effective Treatment of Advanced Hepatocellular Carcinoma with Extensive Peritoneal Dissemination Using Lenvatinib6974ENShinyaWakatsukiDepartment of Obstetrics and Gynecology, Kochi Health Sciences CenterShinyaSakamotoDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterAkikoUenoDepartment of Obstetrics and Gynecology, Kochi Health Sciences CenterTakaomiNambaDepartment of Obstetrics and Gynecology, Kochi Health Sciences CenterYoritoYamamotoDepartment of Obstetrics and Gynecology, Kochi Health Sciences CenterManabuMatsumotoDepartment of Diagnostic Pathology, Kochi Health Sciences CenterJunIwataDepartment of Diagnostic Pathology, Kochi Health Sciences CenterTakehiroOkabayashiDepartment of Gastroenterological Surgery, Kochi Health Sciences CenterCase Report10.18926/AMO/70075Patients with hepatocellular carcinoma (HCC) and extensive peritoneal dissemination generally have a poor prognosis and are often resistant to systemic therapy. We report the case of a 47-year-old woman with HCC and massive peritoneal dissemination who presented with malignant ascites requiring repeated cell-free and concentrated ascites reinfusion therapy and peritoneovenous shunt placement, as well as malignant pleural effusion requiring pleurodesis. Combined immunotherapy with durvalumab/tremelimumab was initiated;however, disease progression was observed after three treatment courses, prompting a switch to lenvatinib therapy. Two months after initiation of lenvatinib, CT imaging demonstrated complete disappearance of arterial enhancement in the primary hepatic lesion, along with reduction in the size of peritoneal dissemination nodules. Thirteen months after switching to lenvatinib (16 months after the initial diagnosis), the alpha-fetoprotein level continued to decrease, and the disease remained stable under treatment. Despite the extremely high tumor burden, lenvatinib achieved disease stabilization and symptomatic improvement.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8012026Development of a Stroke Discharge Support Evaluation Scale for Ward Nurses in Acute Care Hospitals1730ENHidekiYanoDepartment of Nursing, Faculty of Human Health Sciences, Niimi UniversityYokoTakahataGraduate School of Health Sciences, Okayama UniversityTakeshiYamaguchiFaculty of Nursing, Shikoku UniversityShinyaSaitoGraduate School of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/70069This study aimed to develop a scale enabling nurses to objectively evaluate their own stroke discharge support, as a basis for enhancing its overall effectiveness. A draft scale was created based on a literature review, and consisted of a 51-item, 5-point Likert-type questionnaire administered to ward nurses engaged in stroke discharge support at acute care hospitals. Factor analysis was performed to refine the scale. Construct validity was assessed using the known-groups method, and reliability was evaluated through internal consistency analysis. The resulting Stroke Discharge Support Evaluation Scale comprises 29 items across 5 factors, each rated on a 5-point Likert scale. Analysis of the data collected from 237 valid responses demonstrated good internal consistency and supported the scale’s construct validity. The Stroke Discharge Support Evaluation Scale is a reliable and valid tool enabling ward nurses in acute care hospitals to evaluate their own stroke discharge support.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2211-12474512026Immunopeptidomics combined with full-length transcriptomics uncovers diverse neoantigens116781ENTakamasaIshinoDepartment of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical SciencesTomofumiWatanabeDepartment of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical SciencesSerinaTokitaDivision of Cancer Immunology, Graduate School of Medical and Dental Sciences, Niigata UniversityYoukiUedaDepartment of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical SciencesKatsushigeKawaseDivision of Cell Therapy, Chiba Cancer Center Research InstituteYukaTakanoDepartment of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical SciencesYin MinThuDepartment of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical SciencesYutaSuzukiDepartment of Computational Biology and Medical Sciences, The University of TokyoChieOwaDepartment of Computational Biology and Medical Sciences, The University of TokyoTakashiInozumeDepartment of Dermatology, Chiba University Graduate School of MedicineWenhaoZhouDepartment of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical SciencesJojiNagasakiDepartment of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical SciencesVitalyKochinDepartment of Immunology, Nagoya University Graduate School of MedicineToshihideUenoDivision of Cellular Signaling, National Cancer Center Research InstituteShinyaKojimaDivision of Cellular Signaling, National Cancer Center Research InstituteAkikoHonobe-TabuchiDepartment of Dermatology, University of YamanashiTatsuyoshiKawamuraDepartment of Dermatology, University of YamanashiTakehiroOhnumaDepartment of Dermatology, Kumamoto Kenhoku HospitalTakamitsuMatsuzawaDepartment of Dermatology, Chiba University Graduate School of MedicineYuKawaharaDepartment of Dermatology, Chiba University Graduate School of MedicineKazuoYamashitaKOTAI Biotechnologies, IncJasonLinDivision of Cell Therapy, Chiba Cancer Center Research InstituteJunKosekiDivision of Systems Biology, Nagoya University Graduate School of MedicineHiroyoshiNishikawaDepartment of Immunology, Nagoya University Graduate School of MedicineMotooArakiDepartment of Urology, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical SciencesNaoyaKatoDepartment of Gastroenterology, Graduate School of Medicine, Chiba UniversityTeppeiShimamuraDivision of Systems Biology, Nagoya University Graduate School of MedicineShinichiMorishitaDepartment of Computational Biology and Medical Sciences, The University of TokyoYutakaSuzukiDepartment of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of TokyoHiroyukiManoDivision of Cellular Signaling, National Cancer Center Research InstituteToshihikoTorigoeTakayukiKanasekiDivision of Cancer Immunology, Graduate School of Medical and Dental Sciences, Niigata UniversityMasahitoKawazuDivision of Cell Therapy, Chiba Cancer Center Research InstituteYosukeTogashiDepartment of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical SciencesNeoantigens are crucial for antitumor immunity and immune checkpoint inhibitor (ICI) efficacy by triggering strong immune responses. However, conventional methods for identifying neoantigens, such as whole-exon sequencing and short-read RNA sequencing (RNA-seq), appear to be insufficient, and the tumor mutational burden cannot sufficiently predict ICI efficacy. In this study, we employed a proteogenomic approach using long-read RNA-seq with Pacific Biosciences Single-Molecule Real-Time Sequencing technology to analyze full-length transcripts in combination with the human leukocyte antigen ligandome. As a result, many neoantigen candidates were identified, which were unregistered in a comprehensive database, including those from non-coding regions. Additionally, we validated the responses of specific T cell receptors (TCRs) to these candidates and identified several pairs of TCRs and neoantigens. These findings highlight the presence of more diverse neoantigens than expected that cannot be identified by conventional methods.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.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.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.Japanese Society of BreedingActa Medica Okayama1344-76107532025Polyphyletic domestication and inter-lineage hybridization magnified genetic diversity of cultivated melon, Cucumis melo L.168178ENKatsunoriTanakaFaculty of Agriculture and Life Science, Hirosaki UniversityGentaroShigitaGraduate School of Environmental and Life Science, Okayama UniversityTran PhuongDungGraduate School of Environmental and Life Science, Okayama UniversityPhan Thi PhuongNhiUniversity of Agriculture and Forestry, Hue UniversityMamiTakahashiGraduate School of Environmental and Life Science, Okayama UniversityYukiMondenGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHidetakaNishidaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityRyujiIshikawaFaculty of Agriculture and Life Science, Hirosaki UniversityKenjiKatoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMelon accessions with diverse geographical origins were classified into large and small seed-types by length of seed at the boundary of 9 mm, and into five populations based on polymorphisms in the nuclear genome. They were further divided into three maternal lineages, Ia, Ib, and Ic, by polymorphisms in the chloroplast genome. By combining these three classifications, the Europe/US subsp. melo and the East Asian subsp. agrestis were characterized as [large seed, Ib, PopA1 or A2] and [small seed, Ia, PopB1 or B2], respectively, indicating nearly perfect divergence. In South Asia, in addition to the Europe/US and East Asian types, recombinant types between the two types were detected and accounted for 34.8% of South Asian melon. The finding of such an intermixed structure of genetic variation supported the Indian origin of Ia and Ib types. As to Momordica popular in South Asia, seed length was intermediate between the large and small seed-types, and chloroplast type was a mixture of Ia and Ib, suggesting its origin from the recombinant type. In Africa, three lineages of melon were distributed allopatrically and showed distinct divergence. Subsp. agrestis of the Ic type proved to be endemic to Africa, indicating its African origin.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1465-32492782025Clinical outcomes of Japanese patients treated with out-of-specification tisagenlecleucel in a phase 3b trial938943ENKojiKatoDepartment of Hematology, Oncology, and Cardiovascular Medicine, Kyushu University HospitalJunKatoDivision of Hematology, Department of Medicine, Keio University School of MedicineHidekiGotoDivision of Laboratory and Transfusion Medicine, Hokkaido University HospitalTakeshiKobayashiHematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalYoshiyukiTakahashiDepartment of Pediatrics, Nagoya University Graduate School of MedicineEmikoSakaidaDepartment of Hematology, Chiba University HospitalHidefumiHiramatsuDepartment of Pediatrics, Graduate School of Medicine, Kyoto UniversityMasahideYamamotoDepartment of Hematology, Institute of Science Tokyo HospitalSatoshiYoshiharaDepartment of Hematology, Hyogo Medical University HospitalJunAndoDepartment of Cell Therapy and Transfusion Medicine, Juntendo University Graduate School of MedicineKatsuyoshiKohDepartment of Hematology/Oncology, Saitama Children’s Medical CenterKentaroFukushimaDepartment of Hematology and Oncology, Osaka University Graduate School of MedicineFumikoIwamotoMedical Affairs, Novartis Pharma K.K.RanjanTiwariDevelopment Advance Quantitative Sciences, Novartis Healthcare Private LimitedNobuharuFujiiDepartment of Hematology and Oncology, Okayama University HospitalBackground: The final manufactured tisagenlecleucel product should meet the commercial product release specifications to ensure the quality in terms of safety, purity, identity, and potency. However, it may occasionally fail to meet these specifications due to the nature of patient-derived cells with variable properties as starting material and the complex manufacturing process. The final product that does not meet at least one of the commercial release specifications is referred to as “out-of-specification” (OOS). However, the benefit-risk profile of OOS tisagenlecleucel has not yet been fully elucidated.<br>
Aims: To evaluate the safety and efficacy of OOS tisagenlecleucel in Japanese patients with relapsed or refractory (r/r) diffuse large B-cell lymphoma (DLBCL) and B-cell acute lymphoblastic leukemia (B-ALL).<br>
Methods: This is a single-arm, open-label, multicenter phase 3b study (NCT04094311). Patients consistent with label indication were enrolled and followed-up for 3 months.<br>
Results: Of the 29 patients enrolled between December 2019 and May 2022 across 13 qualified sites in Japan, 28 received tisagenlecleucel, and of these, 23 had r/r DLBCL and 5 had r/r B-ALL. The primary reasons for OOS were low cell viability (15 of 24 batches) and low dose (8 of 23 batches) tisagenlecleucel in the r/r DLBCL group, and high dose (4 of 5 batches) in the r/r B-ALL group. In patients with r/r DLBCL, the grade 3 or 4 cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome occurred in 3 and 1 patients, respectively. Response assessments were performed for 15 of 23 patients with r/r DLBCL: 6 achieved a complete response, and 1 achieved a partial response as the best response within 3 months.<br>
Conclusions: Despite the limited patient sample size, our findings affirm that the infusion of OOS tisagenlecleucel is a viable option, with no observed increase in toxicity and outcomes comparable to those of in-specification products in clinical and real-world studies.No potential conflict of interest relevant to this article was reported.American Society for Clinical InvestigationActa Medica Okayama2379-370810242025Enhancement of drug delivery through fibroblast activation protein–targeted near-infrared photoimmunotherapye195776ENSeitaroNishimuraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceKazuhiroNomaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceTasukuMatsumotoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceYasushigeTakedaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceTatsuyaTakahashiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceHijiriMatsumotoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceKentoKawasakiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceHotakaKawaiDepartment of Oral Pathology and Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceTomoyoshiKunitomoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceMasaakiAkaiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceTerukiKobayashiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceNoriyukiNishiwakiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceHajimeKashimaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceTakuyaKatoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceSatoruKikuchiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceShunsukeTanabeDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceToshiakiOharaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceHiroshiTazawaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceYasuhiroShirakawaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencePeter L.ChoykeMolecular Imaging Branch, Center for Cancer Research, National Cancer Institute, NIHHisatakaKobayashiMolecular Imaging Branch, Center for Cancer Research, National Cancer Institute, NIHToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceThe tumor microenvironment plays a key role in cancer progression and therapy resistance, with cancer-associated fibroblasts (CAFs) contributing to desmoplasia, extracellular matrix (ECM) remodeling, and elevated interstitial fluid pressure, all of which hinder drug delivery. We investigated fibroblast activation protein–targeted (FAP-targeted) near-infrared photoimmunotherapy (NIR-PIT) as a strategy to improve drug penetration in CAF-rich tumors. In clinical esophageal cancer samples, FAP expression strongly correlated with increased collagen I, hyaluronic acid, and microvascular collapse. CAF-rich 3D spheroids demonstrated elevated ECM deposition and significantly impaired drug uptake compared with CAF-poor models. FAP-targeted NIR-PIT selectively reduced CAFs, reduced ECM components, and restored drug permeability. In vivo, FAP-targeted NIR-PIT enhanced the accumulation of panitumumab and Abraxane in CAF-rich tumors and improved antitumor efficacy when combined with chemotherapy. These findings highlight FAP-targeted NIR-PIT as a promising therapeutic approach to remodel the tumor stroma and overcome drug resistance in desmoplastic solid tumors.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.Okayama University Medical SchoolActa Medica Okayama0386-300X7962025Ileus Tube-Related Intussusception: A Case Report and Review of 80 Previously Reported Cases469474ENTeruyukiTsujiiDepartment of Surgery, Matsuda HospitalTatsuoMatsudaDepartment of Surgery, Matsuda HospitalYujiKimuraDepartment of Surgery, Matsuda HospitalRyoichiKatsubeDepartment of Surgery, Matsuda HospitalHironoriIwadouDepartment of Surgery, Matsuda HospitalSadamiFunabikiDepartment of Surgery, Matsuda HospitalYasuakiKamikawaDepartment of Surgery, Matsuda HospitalTadakazuMatsudaDepartment of Surgery, Matsuda HospitalCase Report10.18926/AMO/69851We report a rare case of ileus tube-related intussusception in an adult. A 56-year-old man with adhesive bowel obstruction was treated with a nasointestinal ileus tube. Although his condition initially improved, persistent abdominal pain led to the diagnosis of intussusception via CT imaging. Manual repositioning of the tube resolved the intussusception without the need for bowel resection. A review of 80 previously reported cases of ileus tube-associated intussusception (total 81 cases, 95 lesions) highlighted the timing of onset, treatment strategies, and precautions. Early detection and diagnosis are crucial to prevent severe complications and preserve bowel function.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2189-79482642025Video review by utilizing asynchronous video communication platform375378ENYukiOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEikoMitsudaKato & Namiki-dori HospitalYukichikaYamamotoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsushiKatoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesManoSoshiBonBon, IncMasayaHiguchiHarvard Medical SchoolMikakoObikaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTadayukiHashimotoDepartment of Emergency Medicine, Brigham and Women's HospitalBackground: Video review is widely recognized as an effective method for teaching communication; however, it can increase educators' workload and learners' stress.<br>
Methods: We utilized Tsucom, an online platform developed by BonBon, Inc., which enables asynchronous video communication instead of traditional styles. An 11-min and 42-s consultation video from a fifth-year resident was uploaded, and 10 physicians provided 30 text-based feedback.<br>
Results: In this pilot survey, the utility and ease of use were rated 4.4 and 4.1 out of 5, respectively.<br>
Conclusions: While asynchronous online video reviews provided flexibility and greater participation, challenges remain, and further trials and evaluations were deemed necessary.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.Springer Science and Business Media LLCActa Medica Okayama1341-96253082025Phase-Ib dose-finding and pharmacokinetic trial of metformin combined with nivolumab for refractory/recurrent solid tumors15371544ENToshioKuboDepartment of Allergy and Respiratory Medicine, Okayama University HospitalHironariKatoDepartment of Gastroenterology, Okayama University HospitalShigeruHoriguchiDepartment of Gastroenterology, Okayama University HospitalToshiyukiKozukiDepartment of Thoracic Oncology and Medicine, NHO Shikoku Cancer CenterAkinoriAsagiDepartment of Gastrointestinal Medical Oncology, NHO Shikoku Cancer CenterMichihiroYoshidaCenter for Innovative Clinical Medicine, Okayama University HospitalHeiichiroUdonoDepartment of Immunology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKatsuyukiKiuraDepartment of Allergy and Respiratory Medicine, Okayama University HospitalKatsuyukiHottaDepartment of Allergy and Respiratory Medicine, Okayama University HospitalBackground Our previous findings showed that the addition of metformin to nivolumab resulted in remarkable tumor regression and increased the number of tumor-infiltrating T cells in mouse models. Therefore, we conducted a phase Ib study using combination therapy with nivolumab and metformin in patients with refractory/recurrent solid tumors.<br>
Methods This study consisted of two parts: 1, evaluating the maximum tolerated dose (MTD), safety, pharmacokinetics in solid tumors, and 2, principally investigating the safety at the recommended dose limited to thoracic and pancreatic cancers. Metformin and nivolumab were administered orally at doses of 750–2,250 mg/day and biweekly at a fixed intravenous dose of 3 mg/kg, respectively. Dose-limiting toxicity was evaluated within the first 4 weeks. Both metformin and nivolumab were continued until disease progression or discontinued because of toxicity.<br>
Results In total, 17 and 24 patients were enrolled in parts 1 and 2, respectively. One patient experienced increased pancreatic enzyme levels (grade 4) and lactic acidosis (grade 3). No Grade 5 adverse events were observed. MTD was not reached up to 2,250 mg/day of metformin, 2,250 mg/day was selected for part 2. An objective response was observed in 4 of 41 patients. One-year progression-free and overall survival rates were 9.8% and 56.8%, respectively. Two patients remained alive without disease progression for more than three years.<br>
Conclusions Nivolumab and metformin combination therapy was well-tolerated and showed preliminary signals of efficacy in a subset of patients. Further verification of the underlying mechanism in cases where treatment is effective is required.<br>
Trial registration numbers UMIN registration number 000028405 https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000031915.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1433-785164132025Conduction Band and Defect Engineering for the Prominent Visible‐Light Responsive Photocatalystse202419624ENAkiraYamakataGraduate School of Natural Science and Technology, Okayama UniversityKosakuKatoGraduate School of Natural Science and Technology, Okayama UniversityTakafumiOgawaNanostructures Research Laboratory, Japan Fine Ceramics Center KantaOgawaDepartment of Energy and Hydrocarbon Chemistry Graduate School of Engineering, Kyoto UniversityMakotoOgawaDepartment of Energy and Hydrocarbon Chemistry Graduate School of Engineering, Kyoto UniversityDaichiKatoDepartment of Energy and Hydrocarbon Chemistry Graduate School of Engineering, Kyoto UniversityChengchaoZhongDepartment of Energy and Hydrocarbon Chemistry Graduate School of Engineering, Kyoto UniversityAkihideKuwabaraNanostructures Research Laboratory, Japan Fine Ceramics CenterRyuAbeDepartment of Energy and Hydrocarbon Chemistry Graduate School of Engineering, Kyoto UniversityHiroshiKageyamaDepartment of Energy and Hydrocarbon Chemistry Graduate School of Engineering, Kyoto UniversityControlling trap depth is crucial to improve photocatalytic activity, but designing such crystal structures has been challenging. In this study, we discovered that in 2D materials like BiOCl and Bi4NbO8Cl, composed of interleaved [Bi2O2]2+ and Cl- slabs, the trap depth can be controlled by manipulating the slab stacking structure. In BiOCl, oxygen vacancies (VO) create deep electron traps, while chlorine vacancies (VCl) produce shallow traps. The depth is determined by the coordination around anion vacancies: VO forms strong σ bonds with Bi-6p dangling bonds below the conduction band minimum (CBM), while those around Cl are parallel, forming weak π-bonding. The strong re-hybridization makes the trap depth deeper. In Bi4NbO8Cl, VCl also creates shallow traps, but VO does not produce deep traps although Bi-6p orbitals are also forming strong σ bonding. This difference is attributed to the difference of the energy level of CBM. In both cases, the CBM consists of Bi-6p orbitals extending into the Cl layers. However, these orbitals are isolated in BiOCl, but those in Bi4NbO8Cl are bonded with each other between neighboring [Bi2O2]2+ layers. This unique bonding-based CBM prevents the formation of deep electron traps, and significantly enhances H2 evolution activity by prolonging the lifetime of highly reactive free electrons.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1465-36215552025Multicenter, open-label, randomized, controlled study to test the utility of electronic patient-reported outcome monitoring in patients with unresectable advanced cancers or metastatic/recurrent solid tumors547555ENNarutoTairaDepartment of Breast and Thyroid Surgery, Kawasaki Medical SchoolNaomiKiyotaDepartment of Medical Oncology and Hematology, Cancer Center, Kobe University HospitalYuichiroKikawaDepartment of Breast Surgery, Kansai Medical UniversityEikiIchiharaCenter for Clinical Oncology, Okayama University HospitalKyokoKatoDepartment of Medical Oncology, National Hospital Organization Nagoya Medical Center KaoruKubotaDepartment of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical SchoolRyosukeTateishiDepartment of Gastroenterology, Graduate School of Medicine, The University of TokyoAkinobuNakataDepartment of Gastroenterology, Osaka Metropolitan University Graduate School of MedicineKeiichiroNakamuraDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiyaNaritaDepartment of Gastroenterology, Osaka Metropolitan University Graduate School of MedicineKatsuyukiHottaCenter for Innovative Clinical Medicine, Okayama University HospitalHirojiIwataDepartment of Advanced Clinical Research and Development, Nagoya City UniversityAkihikoGemmaDepartment of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical SchoolKojiroShimozumaDepartment of Biomed Sciences, College of Life Sciences, Ritsumeikan UniversityKeiMuroDepartment of Gastroenterology, Osaka Metropolitan University Graduate School of MedicineTetsuyaIwamotoCenter for Outcomes Research and Economic Evaluation for Health, National Institute of Public HealthYukiTakumotoCenter for Outcomes Research and Economic Evaluation for Health, National Institute of Public HealthTakeruShiroiwaCenter for Outcomes Research and Economic Evaluation for Health, National Institute of Public HealthTakashiFukudaCenter for Outcomes Research and Economic Evaluation for Health, National Institute of Public HealthTakuhiroYamaguchiDivision of Biostatistics, Tohoku University Graduate School of MedicineYasuhiroHagiwaraDepartment of Biostatistics, Division of Health Sciences and Nursing, The University of Tokyo Graduate School of MedicineHironobuMinamiDivision of Medical Oncology and Hematology, Department of Medicine, Kobe University Graduate School of MedicineElectronic patient-reported outcome (ePRO) monitoring for patients undergoing cancer chemotherapy may provide qualified and early detection of adverse events or disease-related symptoms, leading to improved patient care. The aim of this study is to examine whether addition of ePRO monitoring to routine medical care contributes to improved overall survival and quality of life of cancer patients undergoing chemotherapy. Patients with unresectable advanced cancers or metastatic/recurrent solid tumors receiving systemic chemotherapy will be randomized to an ePRO monitoring group and a usual care group. The ePRO group will conduct weekly symptom monitoring using an electronic device after study enrollment until the end of the study. Monitoring results will be returned to medical personnel and used as information for patient care. The primary endpoints are overall survival and health related quality of life. The initial target sample size for the study was 1500 patients. However, due to delays in enrollment, the target was readjusted to 500 patients. Enrollment has been completed, and the study is now in the follow-up phase.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.Acta Medica Okayama2025Changes of leucine-rich alpha 2 glycoprotein could be a marker of changes of endoscopic and histologic activity of ulcerative colitisENYukiAOYAMAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2040-11161662025Relation between obesity and health disorders as revealed by the J-ORBIT clinical information collection system directly linked to electronic medical records (J-ORBIT 1)11001111ENSeijiNishikageDivision of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of MedicineYushiHirotaDivision of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of MedicineYasushiNakagawaDivision of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of MedicineMasamichiIshiiCenter for Medical Informatics Intelligence, National Center for Global Health and MedicineMitsuruOhsugiDiabetes and Metabolism Information Center, Research Institute, National Center for Global Health and MedicineEiichiMaedaDivision of Medical Informatics, Department of Internal Medicine, Kobe University Graduate School of MedicineKaiYoshimuraDivision of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of MedicineAkaneYamamotoDivision of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of MedicineTomofumiTakayoshiDivision of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of MedicineTakehiroKatoDepartment of Diabetes, Endocrinology, and Metabolism and Department of Rheumatology and Clinical Immunology, Gifu University Graduate School of MedicineDaisukeYabeDepartment of Diabetes, Endocrinology, and Metabolism and Department of Rheumatology and Clinical Immunology, Gifu University Graduate School of MedicineMunehideMatsuhisaDiabetes Therapeutics and Research Center, Institute of Advanced Medical Sciences, Tokushima UniversityJunEguchiDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesJunWadaDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYukihiroFujitaDepartment of Medicine, Shiga University of Medical ScienceShinjiKumeDepartment of Medicine, Shiga University of Medical ScienceHiroshiMaegawaDepartment of Medicine, Shiga University of Medical ScienceKanaMiyakeDepartment of Diabetes and Metabolic Disease, The University of Tokyo Graduate School of MedicineNobuhiroShojimaDepartment of Diabetes and Metabolic Disease, The University of Tokyo Graduate School of MedicineToshimasaYamauchiDepartment of Diabetes and Metabolic Disease, The University of Tokyo Graduate School of MedicineKoutaroYokoteChiba UniversityKohjiroUekiDiabetes Research Center, Research Institute, National Center for Global Health and MedicineKengoMiyoCenter for Medical Informatics Intelligence, National Center for Global Health and MedicineWataruOgawaDivision of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of MedicineAims/Introduction: Obesity triggers various health disorders, but information on these disorders in real-world settings remains limited. To address this knowledge gap, we developed a database directly linked to electronic medical records (EMRs). We here present the baseline data for this database, designated Japan Obesity Research Based on electronIc healTh Records (J-ORBIT).<br>
Materials and Methods: Individuals with obesity disease diagnosed according to the criteria of the Japan Society for the Study of Obesity were registered in J-ORBIT from seven medical centers in Japan. We analyzed the relationship between body mass index (BMI), clinical characteristics, and the prevalence of obesity-related health disorders in this cohort.<br>
Results: Data were obtained from 1,169 individuals, with a mean (±SD) age of 56.9 ± 15.3 years and a BMI of 31.4 ± 6.1 kg/m2. The prevalence of health disorders varied substantially across BMI categories, with a higher BMI being associated with an increased prevalence of hyperuricemia or gout, obstructive sleep apnea syndrome or obesity hypoventilation syndrome, musculoskeletal disorders, and obesity-related kidney disease, as well as with a higher frequency of both a family history of obesity and of a history of childhood obesity. Among individuals with a BMI of ≥25 kg/m2, the prevalence of hypertension and dyslipidemia did not increase with BMI, whereas that of glucose intolerance decreased with increasing BMI.<br>
Conclusions: The J-ORBIT system, which collects clinical data in real time directly from EMRs, has the potential to provide insight into obesity and its associated health conditions, thereby contributing to improved care of affected individuals.No potential conflict of interest relevant to this article was reported.BMJActa Medica Okayama2044-60551562025Protocol for a multicentre, open-label, dose-escalation phase I/II study evaluating the tolerability, safety, efficacy and pharmacokinetics of repeated continuous intravenous PPMX-T003 in patients with aggressive natural killer cell leukaemiae098532ENNorikoFukuharaHematology, Tohoku University Graduate School of MedicineMakotoOnizukaDepartment of Hematology and Oncology, Tokai University School of Medicine Graduate School of MedicineJunyaKandaDepartment of Hematology, Graduate School of Medicine, Kyoto UniversityNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalKojiKatoDepartment of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu UniversityKiyoshiAndoDepartment of Hematology, Hiroshima UniversityIntroduction Aggressive natural killer cell leukaemia (ANKL) is a rare form of NK cell lymphoma with a very low incidence and poor prognosis. While multi-agent chemotherapy including L-asparaginase has been used to treat ANKL patients, they often cannot receive adequate chemotherapy at diagnosis due to liver dysfunction. PPMX-T003, a fully human monoclonal antibody targeting the transferrin receptor 1, shows promise in treating ANKL by helping patients recover from fulminant clinical conditions, potentially enabling a transition to chemotherapy. This study aimed to evaluate the tolerability, safety, efficacy, and pharmacokinetics of repeated continuous intravenous PPMX-T003 in patients with ANKL.<br>
Methods and analysis This multicentre, open-label, dose-escalation phase I/II study will be conducted at nine hospitals in Japan. Patients diagnosed with ANKL (whether as a primary or recurrent disease) and exhibiting abnormal liver function or hepatomegaly due to the primary disease will be included. The primary endpoint is the tolerability and safety of repeated continuous intravenous administration of PPMX-T003 in the first course, based on adverse events and dose-limiting toxicities. PPMX-T003 will be administered as a continuous intravenous infusion every 24 hours for five consecutive days, followed by a 2-day break. Pretreatment will be provided to minimise the risk of infusion-related reactions. Initial doses of PPMX-T003 will be 0.5, 1.0 or 2.0 mg/kg, with subsequent dose increases determined by the Data and Safety Monitoring Committee. The sample size is set at seven participants, with enrolment increased to up to 12 participants if dose-limiting toxicities occur, based on feasibility due to the rarity of ANKL. Descriptive statistics will summarise data according to initial dose, and pharmacokinetic analysis will be conducted based on administered dose.<br>
Ethics and dissemination This study was approved by the institutional review boards at participating hospitals. The results will be disseminated in peer-reviewed journals.<br>
Trial registration number jRCT2061230008 (jRCT); NCT05863234 (ClinicalTrials.gov).No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1092-9134812026The diagnostic utility and frequency of CD56 expression in plasma cell myeloma152587ENMidoriImaiDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesAsamiNishikoriDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesTomokaHaratakeDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesMidori FilizNishimuraDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesRioYamadaDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesSyomaKatoDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesMizuhaTabeDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesHiroyukiYanaiDepartment of Diagnostic Pathology, Okayama University HospitalHidetakaYamamotoDepartment of Pathology and Oncology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYasuharuSatoDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesPlasma cell myeloma (PCM) is a hematological malignancy characterized by systemic proliferation of neoplastic plasma cells within the bone marrow. Diagnosis requires clinical findings and immunohistochemical staining, including CD138, CD79a, cyclin D1, immunoglobulin κ (Igκ), and λ (Igλ). However, CD79a and cyclin D1 have limited sensitivity and specificity, and Igκ/Igλ assessment is often difficult due to overstaining. Therefore, more reliable antibodies are needed to accurately diagnose PCM. In this study, we examined the diagnostic utility of CD56 expression in PCM. We retrospectively performed immunostaining for CD138, CD56, CD79a, cyclin D1, Igκ, and Igλ in bone marrow samples from 116 patients with PCM.<br>
CD56 expression was observed in 85/116 cases (73.3 %), CD79a was downregulated in 46/116 cases (39.7 %), and cyclin D1 expression was observed in 42/116 cases (36.2 %). The expression of CD56 was significantly higher than that of CD79a and cyclin D1 (both p < 0.001). The combination of two antibodies resulted in the highest detection rate when combining CD56 and CD79a (105/116, 90.5 %), which was significantly higher than the detection rates of CD56 and cyclin D1 (93/116, 80.2 %) and CD79a and cyclin D1 (75/116, 64.7 %) (both p < 0.001). In contrast, lymphoplasmacytic lymphoma and marginal zone lymphoma lacked CD56 and cyclin D1 expression. Furthermore, in cases where light chain restriction was undetectable (11/116, 9.5 %), all could be diagnosed as PCM based on CD56, CD79a, and cyclin D1. Among these, CD56 showed the highest detection rate (8/11, 72.7 %).<br>
These findings highlight CD56 as a helpful marker for PCM diagnosis and support further clinical research.<br>No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0276-34782025DSOK-0011 Potentially Regulates Circadian Misalignment and Affects Gut Microbiota Composition in Activity-Based Anorexia ModelENHirokiKawaiDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNanamiWadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinjiSakamotoDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenjiMiyazakiSumitomo Pharma Co. LtdTaroKatoSumitomo Pharma Co. LtdYoshihiroHoriuchiSumitomo Pharma Co. LtdHiroshiKiriiDepartment of Animal Applied Microbiology, Okayama University Graduate School of Environmental, Life, Natural Science and TechnologyHoang DuyNguyenDepartment of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenjiHinotsuDepartment of Neuropsychiatry, Okayama University HospitalYoshioOhyaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakahiroAsadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkiyoshiYokodeDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukoOkahisaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHarukoMiyazakiDepartment of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshitakaOohashiDepartment of Molecular Biology and Biochemistry, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesManabuTakakiDepartment of Neuropsychiatry, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesObjective: Anorexia nervosa (AN) is a metabolic-psychiatric disorder characterized by severe weight loss, hypercortisolemia, and hypothalamic–pituitary–adrenal (HPA) axis activation. In this study, we investigated the effect of inhibiting cortisol regeneration via the enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) on the pathophysiology of AN.<br>
Method: Female C57BL/6J mice underwent a 7-day activity-based anorexia (ABA) paradigm, involving 3 h daily feeding and free access to wheels, until 25% body weight loss or experiment completion. Mice were orally treated once daily with a potent 11β-HSD1 inhibitor, DSOK-0011, or vehicle. Body weight, food intake, and activity transitions were recorded; plasma corticosterone and cholesterol levels were measured using a fluorometric assay; gut microbiota were analyzed using 16S rRNA sequencing; and hippocampal glial cells were analyzed using immunohistochemistry.<br>
Results: DSOK-0011-treated mice exhibited a modest but significant increase in postprandial wheel-running activity compared to baseline (4–5 p.m., p = 0.018; 5–6 p.m., p = 0.043), whereas vehicle-treated mice showed higher preprandial activity (9–10 a.m., p = 0.0229). Gut microbiota analysis revealed increased alpha diversity in ABA mice, with a specific enrichment of the Lachnospiraceae family in the DSOK-0011 group. However, DSOK-0011 did not significantly affect body weight, food intake, corticosterone, and lipid levels, or hippocampal glial cell populations.<br>
Conclusion: Inhibition of 11β-HSD1 by DSOK-0011 was associated with microbiota alterations and subtle shifts in activity timing under energy-deficient conditions. These findings suggest that peripheral glucocorticoid metabolism may influence microbial and behavioral responses in the ABA model, although its metabolic impact appears limited in the acute phase.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221512025The significance of adding posterior decompression to spine stabilization in metastatic spinal surgery: a multicenter prospective study27684ENHiroyukiTominagaDepartment of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima UniversityIchiroKawamuraDepartment of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima UniversityHirofumiShimadaDepartment of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima UniversityHiromiSasakiDepartment of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima UniversityNoboruTaniguchiDepartment of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima UniversityYukiShirataniDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba UniversityAkinobuSuzukiDepartment of Orthopaedic Surgery, Osaka Metropolitan UniversityHidetomiTeraiDepartment of Orthopaedic Surgery, Osaka Metropolitan UniversityTakakiShimizuDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityKenichiroKakutaniDepartment of Orthopaedic Surgery, Kobe University Graduate School of MedicineYutaroKandaDepartment of Orthopaedic Surgery, Kobe University Graduate School of MedicineMasayukiIshiharaDepartment of Orthopaedic Surgery, Kansai Medical University HospitalMasaakiPakuDepartment of Orthopaedic Surgery, Kansai Medical University HospitalYoheiTakahashiDepartment of Orthopaedic Surgery, Keio UniversityToruFunayamaDepartment of Orthopaedic Surgery, Institute of Medicine, University of TsukubaKouseiMiuraDepartment of Orthopaedic Surgery, Institute of Medicine, University of TsukubaEikiShirasawaDepartment of Orthopaedic Surgery, Kitasato University School of MedicineHirokazuInoueRehabilitation Center, Jichi Medical University HospitalAtsushiKimuraDepartment of Orthopaedics, Jichi Medical UniversityTakuyaIimuraDepartment of Orthopaedic Surgery, Dokkyo Medical UniversityHiroshiMoridairaDepartment of Orthopaedic Surgery, Dokkyo Medical UniversityHideakiNakajimaDepartment of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of FukuiShujiWatanabeDepartment of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of FukuiKojiAkedaDepartment of Orthopaedic Surgery, Mie University Graduate School of MedicineNorihikoTakegamiDepartment of Orthopaedic Surgery, Mie University Graduate School of MedicineKazuoNakanishiDepartment of Orthopaedic Surgery, Kawasaki Medical SchoolHirokatsuSawadaDepartment of Orthopaedic Surgery, Nihon University School of MedicineKojiMatsumotoDepartment of Orthopaedic Surgery, Nihon University School of MedicineMasahiroFunabaDepartment of Orthopaedics Surgery, Yamaguchi University Graduate school of MedicineHidenoriSuzukiDepartment of Orthopaedics Surgery, Yamaguchi University Graduate school of MedicineHarukiFunaoDepartment of Orthopaedic Surgery, International University of Health and Welfare Narita HospitalTsutomuOshigiriDepartment of Orthopaedic Surgery, Sapporo Medical University School of MedicineTakashiHiraiDepartment of Orthopedic Surgery, Institute of Science TokyoBungoOtsukiDepartment of Orthopaedic Surgery, Kyoto University HospitalKazuKobayakawaDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu UniversityKojiUotaniDepartment of Orthopaedic Surgery, Okayama University HospitalHiroakiManabeDepartment of Orthopedics, Tokushima UniversityShinjiTanishimaDivision of Orthopedic Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori UniversityKoHashimotoDepartment of Orthopaedic Surgery, Tohoku University Graduate School of MedicineChizuoIwaiDepartment of Orthopaedic Surgery, Gifu University HospitalDaisukeYamabeDepartment of Orthopaedic Surgery, Iwate Medical UniversityAkihikoHiyamaDepartment of Orthopaedic Surgery, Tokai University School of MedicineShojiSekiDepartment of Orthopaedic Surgery, University of ToyamaYutaGotoDepartment of Orthopaedic Surgery, Nagoya City UniversityMasashiMiyazakiDepartment of Orthopaedic Surgery, Faculty of Medicine, Oita UniversityKazuyukiWatanabeDepartment of Orthopaedic Surgery, Fukushima Medical University School of MedicineToshioNakamaeDepartment of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityTakashiKaitoDepartment of Orthopedic Surgery, Osaka University Graduate School of MedicineHiroakiNakashimaDepartment of Orthopaedic Surgery, Nagoya University Graduate School of MedicineNarihitoNagoshiDepartment of Orthopaedic Surgery, Keio UniversitySatoshiKatoDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityShiroImagamaDepartment of Orthopaedic Surgery, Nagoya University Graduate School of MedicineKotaWatanabeDepartment of Orthopaedic Surgery, Keio UniversityGenInoueDepartment of Orthopaedic Surgery, Kitasato University School of MedicineTakeoFuruyaDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba UniversityThe usefulness of spine stabilization for treating metastatic spinal tumors with tumor-induced instability has been reported. However, no reports have prospectively evaluated the effectiveness of adding posterior decompression to stabilization surgery for improving symptoms. This multicenter prospective study aimed to determine whether adding posterior decompression to spine stabilization surgery for metastatic spinal tumors affects postoperative outcomes and complications. A total of 263 patients who underwent spine stabilization with (n = 189) or without (n = 74) decompression were analyzed. Patient demographics, the Spinal Instability Neoplastic Score (SINS), and the Epidural Spinal Cord Compression (ESCC) score were recorded. The outcomes were assessed preoperatively and at 1 and 6 months postoperatively in terms of neurological status, the Barthel Index, the EQ-5D-5 L, and the visual analog scale (VAS). Decompression was primarily performed in patients with severe neurological deficits and high-grade ESCC. Both groups showed postoperative improvement. Propensity score matching was applied to adjust for baseline differences. After matching, there were no significant differences in functional improvement between the decompression and nondecompression groups, and the complication rates were comparable. In matched patients presenting primarily with spinal instability and pain, the addition of decompression did not appear to confer a significant functional benefit within 6 months postoperatively.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025Gastroduodenal Artery-Preserving Pancreatoduodenectomy after Esophagectomy with Gastric Conduit Reconstruction393398ENAkariMasunagaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoseiTakagiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuoNagaiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuyaYasuiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokazuFujiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMotohikoYamadaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakeyoshiNishiyamaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNoriyukiKanehiraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYumiSotaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/69441Pancreatoduodenectomy (PD) after esophagectomy with gastric conduit reconstruction is technically challenging. Preserving the blood supply of the gastric conduit is crucial in performing PD after esophagectomy. We report the case of a 66-year-old man who underwent gastroduodenal artery-preserving PD after esophagectomy with gastric conduit reconstruction for intraductal papillary mucinous neoplasm. The patient developed pseudoaneurysm rupture postoperatively, but was successfully treated with interventional radiology. Precise assessment is important in developing a surgical strategy depending on the patient’s specific anatomy and tumor characteristics. Moreover, special attention should be paid to avoid accidental injuries of the gastric conduit and gastric vessels during surgery.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025Blood 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 Okayama0386-300X7952025Inhibition of Air-Exposure Stress–Induced Autolysis in Clostridium perfringens by Zn2+345352ENNozomuMatsunagaDepartment of Life Science, Faculty of Science, Okayama University of ScienceSeiraEgusaDepartment of Life Science, Faculty of Science, Okayama University of ScienceRiyoAonoDepartment of Medical Technology, Kagawa Prefectural University of Health SciencesEijiTamaiDepartment of Infectious Disease, College of Pharmaceutical Science, Matsuyama UniversityYasuoHitusmotoDepartment of Life Science, Faculty of Science, Okayama University of ScienceSeiichiKatayamaDepartment of Life Science, Faculty of Science, Okayama University of ScienceOriginal Article10.18926/AMO/69435Clostridium perfringens is a pathogenic anaerobe that causes gas gangrene and food poisoning. Although autolysin-mediated reorganization of the bacterial cell wall is crucial for cell division, excessive autolysin activity induced by stressors can lead to cell lysis. In C. perfringens, air exposure is a significant stressor that causes cell lysis, and Acp (N-acetylglucosaminidase) is known to be a major autolysin. To further facilitate C. perfringens research, a technology to prevent air-induced cell lysis must be developed. This study investigated the role of Acp in air-induced autolysis and explored potential inhibitors that would prevent cell lysis during experimental procedures. Morphological analyses confirmed that Acp functions as an autolysin in C. perfringens, as acpdeficient strains exhibited filamentous growth. The mutants exhibited negligible autolysis under air-exposure stress, confirming the involvement of Acp in the autolytic process. We also evaluated the effects of various divalent cations on Acp activity in vitro and identified Zn2+ as a potent inhibitor. Brief treatment with a Zn2+- containing buffer induced dose-dependent cell elongation and autolysis inhibition in C. perfringens. These findings demonstrate that simple Zn2+ treatment before experiments stabilizes C. perfringens cells, reducing autolysis under aerobic conditions and facilitating various biological studies, except morphological analyses.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025A Review of the Endoscopic Treatment for Bile Leak Following Cholecystectomy and Hepatic Surgery321328ENTaisukeObataDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalReview10.18926/AMO/69432Bile leak occurs in 2-25% of liver transplant, 3-27% of hepatic resection, and 0.1-4% of cholecystectomy cases. The clinical course of bile leak varies depending on the type of surgery that caused the fistula, as well as the type, severity, and timing of bile duct injury. Although infections resulting from bile leak can be life-threatening, the introduction of endoscopic treatment has enabled some patients to avoid reoperation and has reduced the negative impact on quality of life associated with external fistulas for percutaneous drainage. Endoscopic interventions, such as sphincterotomy and stent placement, reduce the pressure gradient between the bile duct and duodenum, facilitating bile drainage through the papilla and promoting the closure of the leak. We reviewed the literature from 2004 to 2024 regarding bile leak following cholecystectomy and liver surgery, examining recommended techniques, timing, and treatment outcomes. In cases of bile leak following cholecystectomy, clinical success was achieved in 72-96% of cases, while success rates for bile leak following liver surgery ranged from 50% to 100%. Although endoscopic treatment is effective, it is not universally applicable, and its limitations must be carefully considered.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama0305-736413572025Molecular polymorphisms of the nuclear and chloroplast genomes among African melon germplasms reveal abundant and unique genetic diversity, especially in Sudan13291343ENOdirichi NnennayaImohGraduate School of Environmental and Life Science, Okayama UniversityGentaroShigitaGraduate School of Environmental and Life Science, Okayama UniversityMitsuhiroSugiyamaInstitute of Vegetable and Floriculture Science, National Agriculture and Food Research Organization (NARO)Tran PhuongDungGraduate School of Environmental and Life Science, Okayama UniversityKatsunoriTanakaFaculty of Agriculture and Life Science, Hirosaki UniversityMamiTakahashiGraduate School of Environmental and Life Science, Okayama UniversityKazusaNishimuraGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYukiMondenGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHidetakaNishidaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMashaerGodaPlant Genetic Resources Conservation and Research Center, Agricultural Research CorporationMichelPitratINRAE, UR1052, Génétique et amélioration des fruits et légumesKenjiKatoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityBackground and Aims Africa is rich in wild species of Cucumis and is considered one of the places of origin of melon. However, our knowledge of African melon is limited, and genetic studies using melon germplasms with wide geographical coverage are required. Here, we analysed the genetic structure of African melons, with emphasis on Sudan.<br>
Methods Ninety-seven accessions of African melon were examined along with 77 reference accessions representing Asian melon and major horticultural groups. Molecular polymorphisms in the nuclear and chloroplast genomes were investigated using 12 RAPD, 7 SSR and 3 SNP markers. Horticultural traits, including seed size, were measured for 46 accessions, mainly from Sudan.<br>
Key Results African melons were divided into large and small seed-types based on seed length: large seed-type from Northern Africa and small seed-type from Western and Southern Africa. Both seed types are common in Sudan. Molecular genetic diversity in these geographical populations was as high as in India, the Asian centre of melon domestication. Large seed-types from Northern Africa were assigned to Pop4 by structure analysis and had Ib cytoplasm in common with Cantalupensis, Inodorus and Flexuosus. Small seed-types were highly diversified and geographically differentiated; specifically, Pop1 with Ia cytoplasm in Southern Africa and South Asia, Pop2 with Ia in East Asia, including Conomon and Makuwa, and Pop3 with Ia or Ic in Africa. Sudanese small seed-types were grouped in Pop3, while their cytoplasm type was a mixture of Ia and Ic. Sudanese Tibish had Ic cytoplasm, which was unique in Africa, common in Western Africa and Sudan, and also found in wild or feral types.<br>
Conclusions Melon of Ic lineage, including Tibish, originated from wild melon in the ‘western Sudan region’, and independently of melon with Ia or Ib cytoplasm, which originated in Asia. This clearly indicates the polyphyletic origin of melon.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1422-006726192025Cardiac Myosin Inhibitors in Hypertrophic Cardiomyopathy: From Sarcomere to Clinic9347ENKazufumiNakamuraDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakahiroOkumuraDepartment of Advanced Cardiovascular Therapeutics, Nagoya University Graduate School of MedicineSeiyaKatoDivision of Pathology, Saiseikai Fukuoka General HospitalKenjiOnoueDepartment of Cardiovascular Medicine, Nara Medical UniversityToruKuboDepartment of Cardiology and Geriatrics, Kochi Medical School, Kochi UniversityHidemichiKouzuDepartment of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of MedicineToshiyukiYanoDepartment of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of MedicineTakayukiInomataDepartment of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental SciencesHypertrophic cardiomyopathy (HCM) is a primary myocardial disease characterized by unexplained left ventricular hypertrophy, often resulting from pathogenic variants of sarcomeric protein genes. Conventional treatments, such as the use of beta blockers or calcium channel blockers, focus on symptomatic control but do not address the underlying hypercontractility at the sarcomere level. Recent advances in molecular understanding have led to the development of cardiac myosin inhibitors that directly modulate sarcomeric function by reducing myosin–actin cross-bridge formation and adenosine triphosphatase (ATPase) activity. Mavacamten and aficamten have shown promising results in phase 2 and 3 clinical trials, improving symptoms, exercise capacity, and left ventricular outflow tract gradients in patients with obstructive HCM. This review summarizes the current understanding of HCM pathophysiology, diagnostic strategies, and conventional treatments with a focus on the mechanisms of action of myosin inhibitors, clinical evidence supporting their use, and future directions for improvement. We also discuss their potential applications in non-obstructive HCM and the importance of precision medicine guided by genetic profiling.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1367-22232812024Can online interactions reduce loneliness in young adults during university closures in Japan? The directed acyclic graphs approache12658ENKoheiKambaraDoshisha UniversityAkihiroToyaHiroshima UniversitySuminLeeHiroshima UniversityHarukaShimizuNishikyushu Univ. Junior CollegeKazuakiAbeHiroshima UniversityJunShigematsuToyama UniversityQingyuanZhangHiroshima UniversityNatsukiAbeHiroshima Bunkyo UniversityRyoHayaseChubu UniversityNobuhitoAbeKyoto UniversityRyusukeNakaiKyoto UniversityShuntaroAokiFukushima Medical UniversityKoheiAsanoKyoto UniversityRyosukeAsanoKurume UniversityMakotoFujimuraFukuoka Jo Gakuin UniversityKen’ichiroFukuiKwassui Women's UniversityYoshihiroFukumotoKansai Medical UniversityKaichiroFurutaniKansai UniversityKojiHasegawaKomazawa UniversityHirofumiHashimotoOsaka Metropolitan UniversityMikotoHashimotoChukyo Gakuin UniversityHirokiHosogoshiKansai UniversityHiroshiIkedaKyushu UniversityToshiyukiIshiokaKobe UniversityChiharuItoUniversity of Human EnvironmentsSuguruIwanoFukushima Medical UniversityMasafumiKamadaShujitsu Junior CollegeYoshihiroKanaiTohoku Gakuin UniversityTomonoriKaritaEhime UniversityYuKasagiRissho UniversityEmiko S.KashimaLa Trobe UniversityJuriKatoKanazawa Institute of TechnologyYousukeKawachiTohoku UniversityJun‐ichiroKawaharaHokkaido UniversityMasanoriKimuraGraduate School of Business Administration, Kobe UniversityYugoKiraKurume UniversityYukoKiyonaga (Sakoda)Kyushu Kyoritsu UniversityHiroshiKohguchiRyutsu Keizai UniversityAsukaKomiyaHiroshima UniversityKeitaMasuiOtemon Gakuin UniversityAkiraMidorikawaChuo UniversityNobuhiroMifuneKochi University of TechnologyAkimineMizukoshiAsahi UniversityKengoNawataFukuoka UniversityTakashiNishimuraHiroshima International UniversityDaisukeNogiwaSeikei UniversityKenjiOgawaHokkaido UniversityJunkoOkadaPrefectural University of HiroshimaAkiOkamotoOkayama UniversityReikoOkamotoOsaka UniversityKyokoSasakiKanagawa University of Human ServicesKosukeSatoKurume UniversityHiroshiShimizuKwansei Gakuin UniversityAtsushiSugimuraTokai UniversityYokoSugitaniSophia UniversityHitomiSugiuraKindai UniversityKyokoSumiokaOkayama UniversityBumpeiSunaguchiGraduate School of Business Administration, Kobe UniversityMasatakaTakebeOtsuma Women's UniversityHiroki C.TanabeNagoya UniversityAyumiTanakaDoshisha UniversityMasanoriTanakaHokkai‐Gakuen UniversityJunichiTaniguchiTezukayama UniversityNamijiTokunagaEhime Prefectural University of Health SciencesRyozoTomitaMusashino UniversityYumikoUedaAsahi UniversityTomomiYamashitaJumonji UniversityKazuhoYamauraRitsumeikan UniversityMasaoYogoDoshisha UniversityKenjiYokotaniTokushima UniversityAyanoYoshidaTohoku Fukushi UniversityHiroakiYoshidaShinshu UniversityKatsueYoshiharaFukuoka Institute of Technology Junior CollegeAyumiYoshikawaOsaka Dental University Faculty of NursingKuniakiYanagisawaKobe UniversityKen'ichiroNakashimaHiroshima UniversityAs a countermeasure to the increased loneliness induced by the COVID-19 pandemic-related university closures, universities provided students with online interaction opportunities. However, whether these opportunities contributed to reducing loneliness during the university closures remains unclear, as previous studies have produced contradictory findings. We conducted a nationwide cross-sectional survey. Data were collected on demographics, social environment, social support, interactions, health and loneliness from 4949 students from 60 universities across Japan. We used psychological network and Directed Acyclic Graphs (DAGs) to examine the effect of online interactions on loneliness during university closures during COVID-19. The results showed that the frequency of online interactions with friends did not exert a significant influence on loneliness during university closures. A comparative examination of the DAGs further illuminated that the social environment exhibited fewer pathways for interpersonal interactions and social support during these closure periods. The psychosocial pathways influencing young adults' loneliness show variations contingent on the university's closure status. Notably, the impact of heightened online interactions with friends on loneliness appears to be less pronounced among young adults in the context of university closure.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1475-28672512025Precise stratification of prognosis in pancreatic ductal adenocarcinoma patients based on pre- and postoperative genomic information305ENKokichiMiyamotoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesRyuichiYoshidaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuyaYasuiDepartment 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 SciencesKazuhiroYoshidaDepartment 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 SciencesKoseiTakagiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYuzoUmedaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceToshiakiTakahashiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuyaMoriwakeDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasashiKayanoDepartment 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 SciencesHidekiYamamotoDepartment of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHironariKatoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceHiroshiTazawaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMizukiMoritaDepartment of Biomedical Informatics, Okayama University Graduate School of Interdisciplinary Science and Engineering in Health SystemsMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground Pancreatic ductal adenocarcinoma (PDAC) has the highest mortality rate among all cancers; hence, multidisciplinary treatment is essential for patients with PDAC. Although the resectability status, tumour marker, KRAS circulating tumour DNA (mutKRAS-ctDNA) mutations, and GATA binding 6 (GATA6) expression status are promising prognostic biomarkers, their effective integration before and after surgery remains unclear.<br>
Methods In this retrospective cohort study, patients with PDAC who had undergone radical resection were enrolled, and pre- and postoperative independent factors associated with poor prognosis were identified using Cox hazard modelling. Risk stratification systems were developed using the identified prognostic factors and investigated for the ability to predict prognosis.<br>
Results A total of 91 patients with PDAC were included (median follow-up duration, 28 months). Borderline resectable or locally advanced cancer at diagnosis, elevated carbohydrate antigen 19–9 (CA19-9) level, and mutKRAS-ctDNA-positive status were identified as independent preoperative factors associated with poor prognosis. The postoperative factors significantly associated with shorter overall survival were low GATA6 expression, elevated CA19-9 level, and mutKRAS-ctDNA-positive status. Finally, the preoperative and postoperative risk scoring systems developed using Cox modelling hazard ratio values could significantly stratify prognosis after curative resection for PDAC.<br>
Conclusion A risk stratification system based on liquid biopsy, specialised for each phase (pre- and post-surgery), has been proven to be a useful, simple, and practical prognostic prediction clinical tool to determine the optimal multidisciplinary treatment protocol for PDAC.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2041-17231512024Neurotransmitter recognition by human vesicular monoamine transporter 27661ENDohyunImDepartment of Cell Biology, Graduate School of Medicine, Kyoto UniversityMikaJormakkaDepartment of Cell Biology, Graduate School of Medicine, Kyoto UniversityNarinobuJugeDepartment of Genomics and Proteomics, Advanced Science Research Center, Okayama UniversityJun-ichiKishikawaDepartment of Applied Biology, Kyoto Institute of TechnologyTakayukiKatoInstitute for Protein Research, Osaka UniversityYukihikoSugitaLaboratory of Ultrastructural Virology, Institute for Life and Medical Sciences, Kyoto UniversityTakeshiNodaLaboratory of Ultrastructural Virology, Institute for Life and Medical Sciences, Kyoto UniversityTomokoUemuraDepartment of Cell Biology, Graduate School of Medicine, Kyoto UniversityYukiShiimuraDepartment of Cell Biology, Graduate School of Medicine, Kyoto UniversityTakaakiMiyajiDepartment of Genomics and Proteomics, Advanced Science Research Center, Okayama UniversityHidetsuguAsadaDepartment of Cell Biology, Graduate School of Medicine, Kyoto UniversitySoIwataDepartment of Cell Biology, Graduate School of Medicine, Kyoto UniversityHuman vesicular monoamine transporter 2 (VMAT2), a member of the SLC18 family, plays a crucial role in regulating neurotransmitters in the brain by facilitating their uptake and storage within vesicles, preparing them for exocytotic release. Because of its central role in neurotransmitter signalling and neuroprotection, VMAT2 is a target for neurodegenerative diseases and movement disorders, with its inhibitor being used as therapeutics. Despite the importance of VMAT2 in pharmacophysiology, the molecular basis of VMAT2-mediated neurotransmitter transport and its inhibition remains unclear. Here we show the cryo-electron microscopy structure of VMAT2 in the substrate-free state, in complex with the neurotransmitter dopamine, and in complex with the inhibitor tetrabenazine. In addition to these structural determinations, monoamine uptake assays, mutational studies, and pKa value predictions were performed to characterize the dynamic changes in VMAT2 structure. These results provide a structural basis for understanding VMAT2-mediated vesicular transport of neurotransmitters and a platform for modulation of current inhibitor design.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2072-669417142025Definitions of, Advances in, and Treatment Strategies for Breast Cancer Oligometastasis2406ENTadahikoShienDepartment of Breast and Endocrine Surgery, Okayama University HospitalShogoNakamotoDepartment of Breast and Endocrine Surgery, Okayama University HospitalYukiFujiwaraDepartment of Breast and Endocrine Surgery, Okayama University HospitalMayaKosakaDepartment of Breast and Endocrine Surgery, Okayama University HospitalYukiNaraharaDepartment of Breast and Endocrine Surgery, Okayama University HospitalKentoFujiiDepartment of Breast and Endocrine Surgery, Okayama University HospitalReinaMaedaDepartment of Breast and Endocrine Surgery, Okayama University HospitalShutaroKatoDepartment of Breast and Endocrine Surgery, Okayama University HospitalAsukaMimataDepartment of Breast and Endocrine Surgery, Okayama University HospitalRyoYoshiokaDepartment of Breast and Endocrine Surgery, Okayama University HospitalChihiroKuwaharaDepartment of Breast and Endocrine Surgery, Okayama University HospitalTakahiroTsukiokiDepartment of Breast and Endocrine Surgery, Okayama University HospitalYukoTakahashiDepartment of Breast and Endocrine Surgery, Okayama University HospitalTsuguoIwataniDepartment of Breast and Endocrine Surgery, Okayama University HospitalMakiTaniokaDepartment of Breast and Endocrine Surgery, Okayama University HospitalOligometastasis represents a clinically relevant state of limited metastatic disease that could be amenable to selected local therapies in carefully chosen patients. Although initial trials such as SABR-COMET demonstrated a survival benefit with aggressive local treatment, breast cancer was underrepresented. Subsequent breast cancer-specific trials, including NRG-BR002, failed to show a clear survival benefit, highlighting uncertainties and the need for further refinement in patient selection and integration with systemic approaches. The definitions of oligometastasis continue to evolve, incorporating radiological, clinical, and biological features. Advances in imaging and molecular profiling suggest that oligometastatic breast cancer might represent a distinct biological subtype, with potential biomarkers including PIK3CA mutations and YAP/TAZ expression. Organ-specific strategies using stereotactic radiotherapy, surgery, and proton therapy have shown favorable local control in certain settings, though their impact on the overall survival remains under investigation. Emerging techniques, including circulating tumor DNA (ctDNA) analysis, are being explored to improve patient selection and disease monitoring. Ongoing trials may provide further insight into the role of local therapy, particularly in hormone receptor-positive or HER2-positive subtypes. Local and systemic strategies need to be carefully coordinated to optimize the outcomes. This review summarizes the current definitions of and evidence and therapeutic considerations for oligometastatic breast cancer and outlines potential future directions.No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama2691-3704522025Mechanistic Insights Into Oxidative Response of Heat Shock Factor 1 Condensates606617ENSoichiroKawagoeInstitute of Advanced Medical Sciences, Tokushima UniversityMotonoriMatsusakiInstitute of Advanced Medical Sciences, Tokushima UniversityTakuyaMabuchiFrontier Research Institute for Interdisciplinary Sciences, Tohoku UniversityYutoOgasawaraDepartment of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityKazunoriWatanabeDepartment of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityKoichiroIshimoriDepartment of Chemistry, Faculty of Science, Hokkaido UniversityTomohideSaioInstitute of Advanced Medical Sciences, Tokushima UniversityHeat shock factor 1 (Hsf1), a hub protein in the stress response and cell fate decisions, senses the strength, type, and duration of stress to balance cell survival and death through an unknown mechanism. Recently, changes in the physical property of Hsf1 condensates due to persistent stress have been suggested to trigger apoptosis, highlighting the importance of biological phase separation and transition in cell fate decisions. In this study, the mechanism underlying Hsf1 droplet formation and oxidative response was investigated through 3D refractive index imaging of the internal architecture, corroborated by molecular dynamics simulations and biophysical/biochemical experiments. We found that, in response to oxidative conditions, Hsf1 formed liquid condensates that suppressed its internal mobility. Furthermore, these conditions triggered the hyper-oligomerization of Hsf1, mediated by disulfide bonds and secondary structure stabilization, leading to the formation of dense core particles in the Hsf1 droplet. Collectively, these data demonstrate how the physical property of Hsf1 condensates undergoes an oxidative transition by sensing redox conditions to potentially drive cell fate decisions.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0094-24055282025Commissioning of respiratory‐gated 4D dynamic dose calculations for various gating widths without spot timestamp in proton pencil beam scanninge18026ENYukiTominagaDepartment 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 UniversityMasayaIchiharaMedical Physics Laboratory, Division of Health Science, Graduate School of Medicine, The University of OsakaKeisukeYasuiSchool of Medical Sciences, Fujita Health UniversityMotoharuSasakiGraduate 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 OsakaBackground: Proton pencil beam scanning (PBS) is susceptible to dose degradation because of interplay effects on moving targets. For cases of unacceptable motion, respiratory-gated (RG) irradiation is an effective alternative to free breathing (FB) irradiation. However, the introduction of RG irradiation with larger gate widths (GW) is hindered by interplay effects, which are analogous to those observed with FB irradiation. Accurate estimation of interplay effects can be performed by recording spot timestamps. However, our machine lacks this feature, making it imperative to find an alternative approach. Thus, we developed an RG 4-dimensional dynamic dose (RG-4DDD) system without spot timestamps.<br>
Purpose: This study aimed to investigate the accuracy of calculated doses from the RG-4DDD system for PBS plans with varying breathing curves, amplitudes, and periods for 10%–50% GW.<br>
Methods: RG-4DDDs were reconstructed using in-house developed software that assigned timestamps to individual spots, integrated start times for spills with breathing curves, and utilized deformable registrations for dose accumulation. Three cubic verification plans were created using a heterogeneous phantom. Additionally, typical liver and lung cases were employed for patient plan validation. Single- and multi-field-optimized (SFO and IMPT) plans (ten beams in total) were created for the liver and lung cases in a homogeneous phantom. Lateral profile measurements were obtained under both motion and no-motion conditions using a 2D ionization chamber array (2D-array) and EBT3 Gafchromic films on the CIRS dynamic platform. Breathing curves from the cubic plans were used to assess nine patterns of sine curves, with amplitudes of 5.0–10.0 mm (10.0–20.0 mm target motions) and periods of 3–6 sec. Patient field verifications were conducted using a representative patient curve with an average amplitude of 6.4 mm and period of 3.2 sec. Additional simulations were performed assuming a ± 10% change in assigned timestamps for the dose rate (DR), spot spill (0.08-s), and gate time delay (0.1-s) to evaluate the effect of parameter selection on our 4DDD models. The 4DDDs were compared with measured values using the 2D gamma index and absolute doses over that required for dosing 95% of the target.<br>
Results: The 2D-array measurements showed that average gamma scores for the reference (no motion) and 4DDD plans for all GWs were at least 99.9 ± 0.2% and 98.2 ± 2.4% at 3%/3 mm, respectively. The gamma scores of the 4DDDs in film measurements exceeded 95.4% and 92.9% at 2%/2 mm for the cubic and patient plans, respectively. The 4DDD calculations were acceptable under DR changes of ±10% and both spill and gate time delays of ±0.18 sec. For the 4DDD plan using all GWs for all measurement points, the absolute point differences for all validation plans were within ±5.0% for 99.1% of the points.<br>
Conclusions: The RG-4DDD calculations (less than 50% GW) of the heterogeneous and actual patient plans showed good agreement with measurements for various breathing curves in the amplitudes and periods described above. The proposed system allows us to evaluate actual RG irradiation without requiring the ability to record spot timestamps.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1472-68312512025A cross-sectional interventional study on the effects of periodontal treatment on periodontal inflamed surface area and masticatory efficiency values according to the 2018 periodontal status classification1094ENShinjiMatsudaDepartment of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityHiromichiYumotoDepartment of Periodontology and Endodontology, Institute of Biomedical Sciences, Tokushima University Graduate SchoolYasutakaKomatsuPeriodontal Clinic, Medical and Dental Hospital, Niigata UniversityNanaeDewakeDepartment of Operative Dentistry, Endodontology and Periodontology, School of Dentistry, Matsumoto Dental UniversityTakanoriIwataDepartment of Periodontology, Tokyo Medical and Dental UniversityTakatoshiNaganoDepartment of Periodontology, Tsurumi University School of Dental MedicineToshiyaMorozumiDepartment of Periodontology, Faculty of Dentistry, Kanagawa Dental UniversityRyomaGotoDepartment of Periodontology, School of Dentistry, Aichi Gakuin UniversitySatsukiKatoSchool of Dentistry, Division of Periodontology and Endodontology, Department of Oral Rehabilitation, Health Sciences University of HokkaidoMotozoYamashitaDepartment of Periodontology and Regenerative Dentistry, Osaka University Graduate School of DentistryJoichiroHayashiDivision of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, Meikai University School of DentistrySatoshiSekinoSchool of Life Dentistry Department of Periodontology, The Nippon Dental UniversityAkikoYamashitaSection of Periodontology, Division of Oral Rehabilitation Faculty of Dental Science, Kyushu UniversityKeikoYamashitaDepartment of Periodontology, Tokyo Dental CollegeAtsutoshiYoshimuraDepartment of Periodontology and Endodontology, Nagasaki University Graduate School of Biomedical SciencesTsutomuSugayaDepartment of Periodontology and Endodontology, Faculty of Dental Medicine, Hokkaido UniversityShogoTakashibaDepartment of Pathophysiology-Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoichiroTaguchiFaculty of Dentistry, Department of Periodontology, Osaka Dental UniversityEijiNemotoDepartment of Periodontology and Endodontology, Tohoku University Graduate School of DentistryTomoakiShintaniCenter of Oral Clinical Examination, Hiroshima University HospitalTsuyoshiMiyagawaClinical Research Center in Hiroshima, Hiroshima University HospitalHiromiNishiDepartment of General Dentistry, Hiroshima University Hospital,NoriyoshiMizunoDepartment of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityYukihiroNumabeDepartment of Periodontology, Tokyo Dental CollegeHiroyukiKawaguchiDepartment of General Dentistry, Hiroshima University Hospital,Background Periodontal inflamed surface area (PISA) and masticatory efficiency have been used to evaluate the relationship between systemic diseases and oral diseases. However, clear standards for PISA values and masticatory efficiency in relation to the severity of periodontitis are lacking. This study aims to evaluate PISA values and masticatory efficiency based on the 2018 periodontal status classification system.<br>
Methods In total, 153 healthy participants diagnosed with periodontitis were included in the study. The diagnosis was based on the 2018 periodontal status classification. PISA values and masticatory efficiency were measured at baseline and after initial periodontal therapy.<br>
Results PISA demonstrated a higher area under the curve for Stage III (0.815) and Grade B (0.85). At baseline, PISA was showed significant negative correlation with masticatory efficiency (B coefficient [95% CI]: -0.02 [-0.03, -0.006], p < 0.01). Following periodontal therapy, both PISA values and masticatory efficiency showed significant improvements, with median PISA values changing from 856 at baseline to 277.5 after treatment, and mean masticatory efficiency increasing from 153.3 to 166.9. After initial periodontal therapy, PISA values were significantly higher in patients classified as Stage IV and Grade C compared to those with other stages and grades. Age exhibited a significant negative correlation with changes in PISA (B coefficient [95%CI]: -11.8 [-20.3, -3.19]), and change in PISA value was significantly positively related to the increase in masticatory efficiency (B coefficient [95%CI], 0.02 [(0.0002, 0.03]). In patients with periodontitis, changes in periodontitis classification were associated with increased PISA values and decreased masticatory efficiency.<br>
Conclusion Periodontal therapy improved PISA and masticatory efficiency values. However, the extent of improvement was less pronounced in patients with higher stages and grades of periodontitis. It is essential to consider the interplay between increased PISA and decreased masticatory efficiency when treating patients with severe periodontitis.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Pulmonary Calcium Phosphate Cement Embolism After Percutaneous Vertebroplasty for Thoracic Vertebrae Fractures299303ENRuibinFengDepartment of Orthopedics, the Ninth Affiliated Hospital of Guangxi Medical UniversityBikangZhuDepartment of Orthopedics, the Ninth Affiliated Hospital of Guangxi Medical UniversityDanyunWeiDepartment of Orthopedics, the Ninth Affiliated Hospital of Guangxi Medical UniversityDingjiaoZhuDepartment of Radiology, the Ninth Affiliated Hospital of Guangxi Medical UniversityCairuChenDepartment of Orthopedics, the Ninth Affiliated Hospital of Guangxi Medical UniversityCase Report10.18926/AMO/69157Pulmonary cement embolism (PCE) is a rare but severe complication following percutaneous vertebroplasty (PVP). Calcium phosphate cement (CPC) has emerged as an alternative to traditional materials for vertebral augmentation. There appear to be no established guidelines for managing symptomatic PCE, and there is scarce literature on CPC embolisms. This is a first report of a case of pulmonary CPC embolism following PVP. The patient, a 63-year-old Chinese female, was administered anticoagulant treatment and achieved a satisfactory outcome. Her case highlights the severe potential morbidity associated with CPC leakage and emphasizes the efficacy of anticoagulant treatment for managing pulmonary CPC embolisms.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Outcome of Decompression Surgery Following Rapid Neurological Deterioration in Patients with Spinal Cord Injury Without Radiographic Evidence of Trauma (SCIWORET)261267ENYuichiHirataDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChiakiSugaharaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSusumuSasadaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHayatoMiyakeDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakayukiNagaseDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakaoYasuharaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/69151Cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) increase the likelihood of spinal cord injury without radiographic evidence of trauma (SCIWORET). Opinions regarding the optimal timing for surgery in such cases vary, however. We retrospectively investigated the demographics and outcomes of patients with SCIWORET who underwent surgery shortly after experiencing rapid neurological deterioration, and we matched patients who underwent standby surgery for CSM or OPLL. Although the optimal timing of surgery for SCIWORET remains unclear, our findings suggest that early stage surgery for SCIWORET may yield favorable neurological improvements.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Organ Donation after Extracorporeal Cardiopulmonary Resuscitation: Clinical and Ethical Perspectives221229ENTetsuyaYumotoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiromichiNaitoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiHongoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakafumiObaraDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshinoriKosakiDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoheiAgetaDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTsuyoshiNojimaDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoheiTsukaharaDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAtsunoriNakaoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityReview10.18926/AMO/69147Extracorporeal cardiopulmonary resuscitation (ECPR) has evolved into a life-saving therapy for select cardiac arrest patients, yet a growing body of evidence suggests it also holds promise as a bridge to organ donation in non-survivors. This review explores the clinical outcomes, ethical complexities, and evolving policies surrounding organ donation after ECPR. We summarize recent international and Japanese data demonstrating favorable graft function from ECPR donors, with the exception of lung transplantation. The ethical challenges ― particularly those involving brain death determination on extracorporeal membrane oxygenation and adherence to the dead donor rule ― are discussed in the context of Japan’s recent regulatory reforms. Additionally, we highlight the importance of structured end-of-life communication through multidisciplinary team meetings in facilitating ethically sound transitions from rescue efforts to donation pathways. Moving forward, improvements in donor management, standardized legal frameworks, and public and professional education are essential to optimizing the life-saving and life-giving potential of ECPR.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0028-083663880492025Immune evasion through mitochondrial transfer in the tumour microenvironment225236ENHidekiIkedaDivision of Cell Therapy, Chiba Cancer Center Research InstituteKatsushigeKawaseDivision of Cell Therapy, Chiba Cancer Center Research InstituteTatsuyaNishiDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomofumiWatanabeDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKeizoTakenagaDivision of Innovative Cancer Therapeutics, Chiba Cancer Center Research InstituteTakashiInozumeDivision of Cell Therapy, Chiba Cancer Center Research InstituteTakamasaIshinoDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShoAkiDivision of Nutriomics and Oncology, RCAST, The University of TokyoJasonLinDivision of Cell Therapy, Chiba Cancer Center Research InstituteShusukeKawashimaDivision of Cell Therapy, Chiba Cancer Center Research Institute, Chiba, Japan Department of Dermatology, Graduate School of Medicine, Chiba UniversityJojiNagasakiDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoukiUedaDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShinichiroSuzukiDepartment of Medical Oncology, Kindai University Faculty of MedicineHidekiMakinoshimaTsuruoka Metabolomics Laboratory, National Cancer CenterMakikoItamiDepartment of Surgical Pathology, Chiba Cancer CenterYukiNakamuraDivision of Cell Therapy, Chiba Cancer Center Research InstituteYasutoshiTatsumiDivision of Cell Therapy, Chiba Cancer Center Research InstituteYusukeSuenagaLaboratory of Evolutionary Oncology, Chiba Cancer Center Research InstituteTakaoMorinagaDivision of Cell Therapy, Chiba Cancer Center Research InstituteAkikoHonobe-TabuchiDepartment of Dermatology, Faculty of Medicine, University of YamanashiTakehiroOhnumaDepartment of Dermatology, Faculty of Medicine, University of YamanashiTatsuyoshiKawamuraDepartment of Dermatology, Faculty of Medicine, University of YamanashiYoshiyasuUmedaDepartment of Skin Oncology/Dermatology, Saitama Medical University International Medical CenterYasuhiroNakamuraDepartment of Skin Oncology/Dermatology, Saitama Medical University International Medical CenterYukikoKiniwaDepartment of Dermatology, Shinshu University School of MedicineEikiIchiharaDepartment of Allergy and Respiratory Medicine, Okayama University HospitalHidetoshiHayashiDepartment of Medical Oncology, Kindai University Faculty of MedicineJun-ichiroIkedaDepartment of Diagnostic Pathology, Graduate School of Medicine, Chiba UniversityToyoyukiHanazawaDepartment of Otorhinolaryngology/Head and Neck Surgery, Chiba University Graduate School of MedicineShinichiToyookaDepartment of General Thoracic Surgery and Endocrinological Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiroyukiManoDivision of Cellular Signalling, National Cancer Center Research InstituteTakujiSuzukiDepartment of Respirology, Graduate School of Medicine, Chiba UniversityTsuyoshiOsawaDivision of Nutriomics and Oncology, RCAST, The University of TokyoMasahitoKawazuDivision of Cell Therapy, Chiba Cancer Center Research InstituteYosukeTogashiDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityCancer cells in the tumour microenvironment use various mechanisms to evade the immune system, particularly T cell attack1. For example, metabolic reprogramming in the tumour microenvironment and mitochondrial dysfunction in tumour-infiltrating lymphocytes (TILs) impair antitumour immune responses2,3,4. However, detailed mechanisms of such processes remain unclear. Here we analyse clinical specimens and identify mitochondrial DNA (mtDNA) mutations in TILs that are shared with cancer cells. Moreover, mitochondria with mtDNA mutations from cancer cells are able to transfer to TILs. Typically, mitochondria in TILs readily undergo mitophagy through reactive oxygen species. However, mitochondria transferred from cancer cells do not undergo mitophagy, which we find is due to mitophagy-inhibitory molecules. These molecules attach to mitochondria and together are transferred to TILs, which results in homoplasmic replacement. T cells that acquire mtDNA mutations from cancer cells exhibit metabolic abnormalities and senescence, with defects in effector functions and memory formation. This in turn leads to impaired antitumour immunity both in vitro and in vivo. Accordingly, the presence of an mtDNA mutation in tumour tissue is a poor prognostic factor for immune checkpoint inhibitors in patients with melanoma or non-small-cell lung cancer. These findings reveal a previously unknown mechanism of cancer immune evasion through mitochondrial transfer and can contribute to the development of future cancer immunotherapies.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2040-11162025Relationship between maternal body composition changes and heavy for date infants in pregnant women with diabetesENErikoEtoDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasakazuKatoDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoeKirinoChiakiKuriyamaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSyujiroSakataDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHikariNakatoDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSakurakoMishimaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkikoOhiraDepartment 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 SciencesAims/Introduction: Maternal hyperglycemia is associated with heavy for date (HFD) infants. Considering the association between body composition and hyperglycemia, we investigated the changes in maternal body composition and their relationship with HFD infants in pregnant women with diabetes.<br>
Materials and Methods: Body composition was measured during pregnancy using a bioelectrical impedance analysis system. This retrospective study included 151 pregnant women; 27 women had type 1 diabetes mellitus (DM), 21 had type 2 DM, 101 were diagnosed with gestational DM, and 2 had overt DM. The number of HFD infants was 40.<br>
Results: In the non-type 1 DM group, change in fat mass (ΔFM) (P < 0.01) and pre-pregnancy BMI (P < 0.05) were risk factors for HFD. In the insulin group, ΔFM, pre-pregnancy BMI, and age (all P < 0.05) were risk factors for HFD. The area under the curve was 0.813 for the predictive model combined with ΔFM and pre-pregnancy BMI in the non-type 1 DM group and 0.818 for the model combined with ΔFM, pre-pregnancy BMI, and age in the insulin group.<br>
Conclusions: The combination of body composition parameters and clinical data may predict HFD in pregnant women with diabetes.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2077-038314102025Experience of High Tibial Osteotomy for Patients with Rheumatoid Arthritis Treated with Recent Medication: A Case Series3332ENYasuhiroTakaharaDepartment of Orthopedic Surgery, Nippon Kokan Fukuyama HospitalHirotakaNakashimaDepartment of Orthopedic Surgery, Nippon Kokan Fukuyama HospitalKeiichiroNishidaDepartment of Orthopedic Surgery, Okayama University HospitalYoichiroUchidaDepartment of Orthopedic Surgery, Nippon Kokan Fukuyama HospitalHisayoshiKatoDepartment of Orthopedic Surgery, Nippon Kokan Fukuyama HospitalSatoruItaniDepartment of Orthopedic Surgery, Nippon Kokan Fukuyama HospitalYuichiIwasakiDepartment of Orthopedic Surgery, Nippon Kokan Fukuyama HospitalBackground: High tibial osteotomy (HTO) was generally not indicated in patients with rheumatoid arthritis (RA) because synovial inflammation may exacerbate joint damage postoperatively. Recently, joint destruction in RA has dramatically changed with the introduction of methotrexate (MTX) and biological disease-modifying antirheumatic drugs (bDMARDs). This study aimed to investigate the clinical outcomes of HTO for patients with RA treated with recent medication. Methods: In this study, patients with RA who underwent HTO between 2016 and 2020 were retrospectively reviewed. Patients whose follow-up period was <2 years and those whose onset of RA occurred after HTO were excluded. Clinical outcomes were investigated using the Japanese orthopedic Association (JOA) and visual analog scale (VAS) scores. Results: Seven patients (two males and five females, mean age 72.0 ± 6.2 years, mean body mass index 24.0 ± 2.9 kg/m2) were included in this study. The mean follow-up period was 62.1 ± 21.4 months. Open-wedge and hybrid closed-wedge HTO were performed in two and five cases, respectively. MTX was used for all cases. The bDMARDs were used in six cases (golimumab and tocilizumab in four and two cases, respectively). JOA scores significantly improved from 63.6 ± 10.7 preoperatively to 90.7 ± 5.3 postoperatively (p = 0.0167 Wilcoxon rank test). VAS scores significantly decreased from 48.6 ± 12.2 preoperatively to 11.4 ± 6.9 postoperatively (p = 0.017 Wilcoxon rank test). None of the patients underwent total knee arthroplasty. Conclusions: This study showed seven RA patients who underwent HTO treated with recent medication. The prognosis of RA, including joint destruction, has dramatically improved with induction of MTX and bDMARDs. HTO may be one of effective joint preservation surgeries even for patients with RA. To achieve the favorable outcomes, surgeons should pay attention to timing and indication of surgery.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0169-50021992025Real-world status of multimodal treatment of Stage IIIA-N2 non-small cell lung cancer in Japan: Results from the SOLUTION study, a non-interventional, multicenter cohort study108027ENHidehitoHorinouchiDepartment of Thoracic Oncology, National Cancer Center HospitalHaruyasuMurakamiDepartment of Thoracic Oncology, Shizuoka Cancer CenterHideyukiHaradaDivision of Radiation Therapy, Shizuoka Cancer CenterTomotakaSobueDivision of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka UniversityTomohiroKatoDepartment of Respiratory Medicine, National Hospital Organization Himeji Medical CenteShinjiAtagiDepartment of Thoracic Oncology, National Hospital Organization Kinki-Chuo Chest Medical CenterToshiyukiKozukiDepartment of Thoracic Oncology and Medicine, National Hospital Organization Shikoku Cancer CenterTakaakiTokitoDivision of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University HospitalSatoshiOizumiDepartment of Respiratory Medicine, National Hospital Organization Hokkaido Cancer CenterMasahiroSeikeDepartment of Pulmonary Medicine and Oncology, Nippon Medical School HospitalKadoakiOhashiDepartment of Respiratory Medicine, Okayama University HospitalTadashiMioDepartment of Respiratory Medicine, National Hospital Organization Kyoto Medical CenterTakashiSoneDepartment of Respiratory Medicine, Kanazawa University HospitalChikakoIwaoDepartment of Medical, AstraZeneca K.K.TakeshiIwaneDepartment of Medical, AstraZeneca K.K.RyoKotoDepartment of Medical, AstraZeneca K.K.MasahiroTsuboiDepartment of Thoracic Surgery, National Cancer Center Hospital EastObjectives: There is limited consensus on resectability criteria for Stage IIIA-N2 non-small cell lung cancer (NSCLC). We examined the patient characteristics, N2 status, treatment decisions, and clinical outcomes according to the treatment modality for Stage IIIA-N2 NSCLC in Japan.<br>
Materials and methods: Patients with Stage IIIA-N2 NSCLC in Japan were consecutively registered in the SOLUTION study between 2013 and 2014. Patients were divided according to treatment (chemoradiotherapy [CRT], surgery + perioperative therapy [neoadjuvant and/or adjuvant therapy], surgery alone). Demographic characteristics, N2 status (number and morphological features), pathological information, and treatments were analyzed descriptively. Overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) were estimated using the Kaplan–Meier method.<br>
Results: Of 227 patients registered, 133 underwent CRT, 56 underwent surgery + perioperative therapy, and 38 underwent surgery alone. The physicians reported the following reasons for unresectability for 116 of 133 CRT patients: large number of metastatic lymph nodes (70.7 %), extranodal infiltration (25.0 %), poor surgical tolerance (19.0 %), or other reasons (18.1 %). CRT was more frequently performed in patients whose lymph nodes had an infiltrative appearance (64.3 %) and was the predominant treatment in patients with multiple involved stations (discrete: 60.0 %; infiltrative: 80.4 %). Distant metastasis with/without local progression was found in 50.4 %, 50.0 %, and 36.8 % of patients in the CRT, surgery + perioperative therapy, and surgery alone groups, respectively. The respective 3-year OS and DFS/PFS rates (median values) were as follows: surgery + perioperative therapy―61.9 % (not reached) and 37.1 % (22.4 months; DFS); CRT group―42.2 % (31.9 months) and 26.8 % (12.0 months; PFS); surgery alone group―37.7 % (26.5 months) and 28.7 % (12.6 months; DFS).<br>
Conclusion: This study has illuminated the real-world decision rules for choosing between surgical and non-surgical approaches in patients with Stage IIIA-N2 NSCLC. Our landmark data could support treatment decision making for using immune checkpoint inhibitors and targeted therapy for driver oncogenes in the perioperative therapy era.
No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221512025Survival days of patients with metastatic spinal tumors of lung cancer requiring surgery: a prospective multicenter study24117ENTakuyaTakahashiDepartment of Orthopedic Surgery, Institute of Science TokyoTakashiHiraiDepartment of Orthopedic Surgery, Institute of Science TokyoYukiShirataniDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba UniversityAkinobuSuzukiDepartment of Orthopaedic Surgery, Osaka Metropolitan UniversityKenichiroKakutaniDepartment of Orthopaedic Surgery, Kobe University Graduate School of MedicineSatoshiKatoDepartment of Orthopaedic Surgery Graduate School of Medical Sciences, Kanazawa UniversityHiroyukiTominagaDepartment of Orthopedic Surgery Graduate School of Medical and Dental Sciences, Kagoshima UniversityHirokazuInoueRehabilitation Center, Jichi Medical University HospitalHirokatsuSawadaDepartment of Orthopaedic Surgery, Nihon University School of MedicineNorihikoTakegamiDepartment of Orthopaedic Surgery, Mie University Graduate School of MedicineKazuoNakanishiDepartment of Orthopaedic Surgery, Kawasaki Medical SchoolHideakiNakajimaDepartment of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of FukuiMasayukiIshiharaDepartment of Orthopaedic surgery, Kansai Medical University HospitalTsutomuOshigiriDepartment of Orthopaedic Surgery, Sapporo Medical University School of MedicineToruFunayamaDepartment of Orthopaedic Surgery Institute of Medicine, University of TsukubaTakuyaIimuraDepartment of Orthopaedic Surgery, Dokkyo Medical UniversityShinjiTanishimaDivision of Orthopedic Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori UniversityHiroakiNakashimaDepartment of Orthopaedic Surgery, Nagoya University Graduate School of MedicineDaisukeYamabeDepartment of Orthopaedic Surgery, Iwate Medical UniversityKoHashimotoDepartment of Orthopaedic Surgery, Tohoku University Graduate School of MedicineKojiUotaniDepartment of Orthopaedic Surgery, Okayama University HospitalMasahiroFunabaDepartment of Orthopaedics Surgery, Yamaguchi University Graduate school of MedicineNarihitoNagoshiDepartment of Orthopaedic Surgery, Keio UniversityKazuKobayakawaDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu UniversityToshitakaYoshiiDepartment of Orthopedic Surgery, Institute of Science TokyoKazuyukiWatanabeDepartment of Orthopaedic Surgery, Fukushima Medical University School of MedicineToshioNakamaeDepartment of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityTakashiKaitoDepartment of Orthopedic Surgery, Osaka University Graduate School of MedicineGenInoueDepartment of Orthopaedic Surgery, Kitasato University School of MedicineShiroImagamaDepartment of Orthopaedic Surgery, Nagoya University Graduate School of MedicineKotaWatanabeDepartment of Orthopaedic Surgery, Keio UniversityTakeoFuruyaDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba UniversitySurgery for metastatic spinal tumors has improved postoperative activities of daily living. A few studies reported on prognostic factors assessed in large multicenter prospective studies for metastatic spinal tumors of lung cancer origin. This study aimed to determine preoperative prognostic factors in patients undergoing surgery for metastatic spinal tumors associated with lung cancer. This prospective registry study included 74 patients diagnosed and operated with metastatic spine tumors derived from lung cancer in 39 high-volume cancer centers. We examined the postoperative survival period and the preoperative factors related to postoperative survival time. We conducted univariate and multivariate Cox regression analyses to determine preoperative prognostic factors. The mean postoperative survival period was 343 days. Multivariate Cox regression analysis revealed a higher feeding score of vitality index, indications for molecularly targeted therapy, and a higher mobility score of Barthel index as independent factors associated with postoperative survival time in metastatic spinal tumors derived from lung cancer. Patients with indications for molecular-targeted therapy and good vitality exhibited longer survival. These results may help in surgical selection for patients with metastatic spinal tumors derived from lung cancer.No potential conflict of interest relevant to this article was reported.SAGE PublicationsActa Medica Okayama2192-56821542024Effects of Palliative Surgical Treatment for Spinal Metastases on the Patient’s Quality of Life With a Focus on the Segment of the Metastasis: A Prospective Multicenter Study22862299ENNaokiSegiDepartment of Orthopaedic Surgery, Nagoya University Graduate School of MedicineHiroakiNakashimaDepartment of Orthopaedic Surgery, Nagoya University Graduate School of MedicineSadayukiItoDepartment of Orthopaedic Surgery, Nagoya University Graduate School of MedicineJunOuchidaDepartment of Orthopaedic Surgery, Nagoya University Graduate School of MedicineYukiShirataniDepartment of Orthopaedic Surgery, Chiba University HospitalTakakiShimizuDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityAkinobuSuzukiDepartment of Orthopaedic Surgery, Osaka Metropolitan UniversityHidetomiTeraiDepartment of Orthopaedic Surgery, Osaka Metropolitan UniversityKenichiroKakutaniDepartment of Orthopaedic Surgery, Kobe University Graduate School of MedicineYutaroKandaDepartment of Orthopaedic Surgery, Kobe University Graduate School of MedicineHiroyukiTominagaDepartment of Orthopedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima UniversityIchiroKawamuraDepartment of Orthopedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima UniversityMasayukiIshiharaDepartment of Orthopaedic Surgery, Kansai Medial University HospitalMasaakiPakuDepartment of Orthopaedic Surgery, Kansai Medial University HospitalYoheiTakahashiDepartment of Orthopaedic Surgery, Keio UniversityMasahiroFunabaDepartment of Orthopaedics Surgery, Yamaguchi University Graduate school of MedicineToruFunayamaDepartment of Orthopaedic Surgery, Institute of Medicine, University of TsukubaHideakiNakajimaDepartment of Orthopaedics and Rehabilitation Medicine, University of Fukui Faculty of Medical SciencesKojiAkedaDepartment of Orthopaedic Surgery, Mie University Graduate School of MedicineTakashiHiraiDepartment of Orthopedic Surgery, Tokyo Medical and Dental UniversityHirokazuInoueRehabilitation Center, Jichi Medical University HospitalKazuoNakanishiDepartment of Orthopaedic Surgery, Kawasaki Medical SchoolHarukiFunaoDepartment of Orthopaedic Surgery, International University of Health and Welfare Narita HospitalTsutomuOshigiriDepartment of Orthopaedic Surgery, Sapporo Medical University School of MedicineBungoOtsukiDepartment of Orthopaedic Surgery, Kyoto University HospitalKazuKobayakawaDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu UniversityShinjiTanishimaDivision of Orthopedic Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori UniversityKoHashimotoDepartment of Orthopaedic Surgery, Tohoku University Graduate School of MedicineTakuyaIimuraDepartment of Orthopaedic Surgery, Dokkyo Medical UniversityHirokatsuSawadaDepartment of Orthopaedic Surgery, Nihon University School of MedicineKojiUotaniDepartment of Orthopaedic Surgery, Okayama University HospitalHiroakiManabeDepartment of Orthopedics, Tokushima UniversityChizuoIwaiDepartment of Orthopaedic Surgery, Gifu University HospitalDaisukeYamabeDepartment of Orthopaedic Surgery, Iwate Medical UniversityAkihikoHiyamaDepartment of Orthopaedic Surgery, Tokai University School of MedicineShojiSekiDepartment of Orthopaedic Surgery, University of ToyamaYutaGotoDepartment of Orthopaedic Surgery, Nagoya City UniversityMasashiMiyazakiDepartment of Orthopaedic Surgery, Faculty of Medicine, Oita UniversityKazuyukiWatanabeDepartment of Orthopaedic Surgery, Fukushima Medical University School of MedicineToshioNakamaeDepartment of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityTakashiKaitoDepartment of Orthopaedic Surgery, Osaka University Graduate School of MedicineNarihitoNagoshiDepartment of Orthopaedic Surgery, Keio UniversitySatoshiKatoDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityKotaWatanabeDepartment of Orthopaedic Surgery, Keio UniversityShiroImagamaDepartment of Orthopaedic Surgery, Nagoya University Graduate School of MedicineGenInoueDepartment of Orthopaedic Surgery, Kitasato University School of MedicineTakeoFuruyaDepartment of Orthopaedic Surgery, Chiba University HospitalStudy Design: Prospective multicenter study.<br>
Objectives: Palliative surgery is crucial for maintaining the quality of life (QOL) in patients with spinal metastases. This study aimed to compare the short-term outcomes of QOL after palliative surgery between patients with metastatic spinal tumors at different segments.<br>
Methods: We prospectively compared the data of 203 patients with spinal metastases at 2-3 consecutive segments who were divided into the following three groups: cervical, patients with cervical spine lesions; thoracic, patients with upper–middle thoracic spine lesions; and TL/L/S, patients with lesions at the thoracolumbar junction and lumbar and sacral regions. Preoperative and postoperative EuroQol 5-dimension (EQ5D) 5-level were compared.<br>
Results: All groups exhibited improvement in the Frankel grade, performance status, pain, Barthel index, EQ5D health state utility value (HSUV), and EQ5D visual analog scale (VAS) postoperatively. Although preoperative EQ5D HSUVs did not significantly differ between the groups (cervical, 0.461 ± 0.291; thoracic, 0.321 ± 0.292; and TL/L/S, 0.376 ± 0.272), the thoracic group exhibited significantly lower postoperative EQ5D HSUVs than the other two groups (cervical, 0.653 ± 0.233; thoracic, 0.513 ± 0.252; and TL/L/S, 0.624 ± 0.232). However, postoperative EQ5D VAS was not significantly different between the groups (cervical, 63.4 ± 25.8; thoracic, 54.7 ± 24.5; and TL/L/S, 61.7 ± 21.9).<br>
Conclusions: Palliative surgery for metastatic spinal tumors provided comparable QOL improvement, irrespective of the spinal segment involved. Patients with upper and middle thoracic spinal metastases had poorer QOL outcomes than those with metastases in other segments; however, sufficient QOL improvement was achieved.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1099-51292722025SCN5A variant type-dependent risk prediction in Brugada syndromeeuaf024ENTakanoriAizawaDepartment of Cardiovascular Medicine, Kyoto University Graduate School of MedicineTakeruMakiyamaDepartment of Cardiovascular Medicine, Kyoto University Graduate School of MedicineHaiHuangDepartment of Cardiovascular Medicine, Kyoto University Graduate School of Medicine , 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507 ,TomohikoImamuraDepartment of Cardiovascular Medicine, Kyoto University Graduate School of MedicineMegumiFukuyamaDepartment of Cardiovascular Medicine, Shiga University of Medical ScienceKeikoSonodaMedical Genome Center, National Cerebral and Cardiovascular CenterKoichiKatoDepartment of Cardiovascular Medicine, Shiga University of Medical ScienceTakashiHisamatsuDepartment of Public Health, Dentistry and Pharmaceutical Science, Okayama University Graduate School of MedicineYukoNakamuraDepartment of Pediatrics, Tsuchiura Kyodo General HospitalKenjiHoshinoDepartment of Cardiology, Saitama Children’s Medical CenterJunichiOzawaDepartment of Pediatrics, Niigata University Graduate School of Medical and Dental SciencesHiroshiSuzukiUonuma Institute of Community Medicine, Niigata University Medical and Dental HospitalKazushiYasudaDepartment of Pediatric Cardiology, Aichi Children’s Health and Medical CenterHisaakiAokiDepartment of Pediatric Cardiology, Osaka Women’s and Children’s HospitalTakashiKuritaDivision of Cardiovascular Center, Kindai University School of MedicineYokoYoshidaDivision of Pediatric Cardiology and Electrophysiology, Osaka City General HospitalTsugutoshiSuzukiDivision of Pediatric Cardiology and Electrophysiology, Osaka City General HospitalYoshihideNakamuraDivision of Pediatric Cardiology and Electrophysiology, Osaka City General HospitalYoshiharuOgawaDivision of Cardiology, Hyogo Prefectural Kobe Children’s HospitalShintaroYamagamiDepartment of Cardiology, Tenri HospitalHiroshiMoritaDepartment of Cardiovascular Therapeutics, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShinsukeYuasaDepartment of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical SciencesMasakazuFukudaDivision of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of MedicineMakotoOnoDivision of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of MedicineHidekazuKondoDepartment of Cardiology and Clinical Examination, Faculty of Medicine, Oita UniversityNaohikoTakahashiDepartment of Cardiology and Clinical Examination, Faculty of Medicine, Oita UniversitySeikoOhnoMedical Genome Center, National Cerebral and Cardiovascular CenterYoshihisaNakagawaDepartment of Cardiovascular Medicine, Shiga University of Medical ScienceKohOnoDepartment of Cardiovascular Medicine, Kyoto University Graduate School of MedicineMinoruHorieDepartment of Cardiovascular Medicine, Shiga University of Medical ScienceAims The variant in SCN5A with the loss of function (LOF) effect in the cardiac Na+ channel (Nav1.5) is the definitive cause for Brugada syndrome (BrS), and the functional analysis data revealed that LOF variants are associated with poor prognosis. However, which variant types (e.g. missense or non-missense) affect the prognoses of those variant carriers remain unelucidated.<br>
Methods and results We defined SCN5A LOF variants as all non-missense and missense variants that produce peak INa < 65% of wild-type previously confirmed by patch-clamp studies. The study population consisted of 76 Japanese BrS patients (74% patients were male and the median age [IQR] at diagnosis was 28 [14–45] years) with LOF type of SCN5A variants: 40 with missense and 36 with non-missense variants. Non-missense variant carriers presented significantly more severe cardiac conduction disorder compared to the missense variant carriers. During follow-up periods of 9.0 [5.0–14.0] years, compared to missense variants, non-missense variants were significant risk factors of lifetime lethal arrhythmia events (LAEs) (P = 0.023). When focusing only on the missense variants that produce no peak INa, these missense variant carriers exhibited the same clinical outcomes as those with non-missense (log-rank P = 0.325). After diagnosis, however, both variant types were comparable in risk of LAEs (P = 0.155).<br>
Conclusion We identified, for the first time, that SCN5A non-missense variants were associated with higher probability of LAE than missense variants in BrS patients though it did not change significantly after diagnosis.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1550-41313722025Maternal circadian rhythms during pregnancy dictate metabolic plasticity in offspring395412.e6ENNaYaoDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineKenichiroKinouchiDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineManamiKatohDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of TokyoKousha ChangiziAshtianiDepartment of Computer Science, University of CaliforniaSherifAbdelkarimDepartment of Computer Science, University of CaliforniaHiroyukiMorimotoDepartment of Integrative Anatomy, Nagoya City University Graduate School of Medical SciencesTakutoTorimitsuDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineTakahideKozumaDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineAkihideIwaharaDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineShotaroKosugiDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineJinKomuroDepartment of Cardiology, Keio University School of MedicineKyosukeKatoDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineShunTonomuraDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineToshifumiNakamuraDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineArataItohDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineShintaroYamaguchiDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineJunYoshinoDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineJunichiroIrieDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineHisayukiHashimotoDepartment of Cardiology, Keio University School of MedicineShinsukeYuasaDepartment of Cardiovascular Medicine, Academic Field, Dentistry and Pharmaceutical Sciences, Okayama UniversityAkikoSatohDepartment of Integrative Physiology, Institute of Development, Aging and Cancer, Tohoku UniversityYoheiMikamiDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of MedicineShusakuUchidaDepartment of Integrative Anatomy, Nagoya City University Graduate School of Medical SciencesTakatoshiUekiDepartment of Integrative Anatomy, Nagoya City University Graduate School of Medical SciencesSeitaroNomuraDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of TokyoPierreBaldiDepartment of Computer Science, University of CaliforniaKaoriHayashiDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineHiroshiItohDivision of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of MedicineTissue-level oscillation is achieved by tissue-intrinsic clocks along with network-dependent signals originating from distal organs and organismal behavior. Yet, it remains unexplored whether maternal circadian rhythms during pregnancy influence fetal rhythms and impact long-term susceptibility to dietary challenges in offspring. Here, we demonstrate that circadian disruption during pregnancy decreased placental and neonatal weight yet retained transcriptional and structural maturation. Intriguingly, diet-induced obesity was exacerbated in parallel with arrhythmic feeding behavior, hypothalamic leptin resistance, and hepatic circadian reprogramming in offspring of chronodisrupted mothers. In utero circadian desynchrony altered the phase-relationship between the mother and fetus and impacted placental efficiency. Temporal feeding restriction in offspring failed to fully prevent obesity, whereas the circadian alignment of caloric restriction with the onset of the active phase virtually ameliorated the phenotype. Thus, maternal circadian rhythms during pregnancy confer adaptive properties to metabolic functions in offspring and provide insights into the developmental origins of health and disease.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2662-47292025Impact of differences in computed tomography value-electron density/physical density conversion tables on calculate dose in low-density areasENMiaNomuraFaculty of Health Sciences, Department of Radiological Technology, Okayama University Medical School, Okayama UniversityShunsukeGotoGraduate School of Health Sciences, Department of Radiological Technology, Okayama UniversityMizukiYoshiokaFaculty of Health Sciences, Department of Radiological Technology, Okayama University Medical School, Okayama UniversityYuikoKatoFaculty of Health Sciences, Department of Radiological Technology, Okayama University Medical School, Okayama UniversityAyakaTsunodaFaculty of Health Sciences, Department of Radiological Technology, Okayama University Medical School, Okayama UniversityKunioNishiokaDepartment of Radiology, Tokuyama Central HospitalYoshinoriTanabeFaculty of Medicine, Graduate School of Health Sciences, Okayama UniversityIn radiotherapy treatment planning, the extrapolation of computed tomography (CT) values for low-density areas without known materials may differ between CT scanners, resulting in different calculated doses. We evaluated the differences in the percentage depth dose (PDD) calculated using eight CT scanners. Heterogeneous virtual phantoms were created using LN-300 lung and − 900 HU. For the two types of virtual phantoms, the PDD on the central axis was calculated using five energies, two irradiation field sizes, and two calculation algorithms (the anisotropic analytical algorithm and Acuros XB). For the LN-300 lung, the maximum CT value difference between the eight CT scanners was 51 HU for an electron density (ED) of 0.29 and 8.8 HU for an extrapolated ED of 0.05. The LN-300 lung CT values showed little variation in the CT-ED/physical density data among CT scanners. The difference in the point depth for the PDD in the LN-300 lung between the CT scanners was < 0.5% for all energies and calculation algorithms. Using Acuros XB, the PDD at − 900 HU had a maximum difference between facilities of > 5%, and the dose difference corresponding to an LN-300 lung CT value difference of > 20 HU was > 1% at a field size of 2 × 2 cm2. The study findings suggest that the calculated dose of low-density regions without known materials in the CT-ED conversion table introduces a risk of dose differences between facilities because of the calibration of the CT values, even when the same CT-ED phantom radiation treatment planning and treatment devices are used.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0028-083663780462025Centrophilic retrotransposon integration via CENH3 chromatin in Arabidopsis744748ENSayuriTsukaharaDepartment of Biological Sciences, The University of TokyoAlexandrosBousiosSchool of Life Sciences, University of SussexEstelaPerez-RomanSchool of Life Sciences, University of SussexSotaYamaguchiDepartment of Biological Sciences, The University of TokyoBasileLeduqueInstitute of Plant Sciences Paris‐Saclay (IPS2), Centre National de la Recherche Scientifique, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, Université Evry, Université ParisAimiNakanoDepartment of Biological Sciences, The University of TokyoMatthewNaishDepartment of Plant Sciences, University of CambridgeAkihisaOsakabeDepartment of Biological Sciences, The University of TokyoAtsushiToyodaCenter for Genetic Resource Information, National Institute of GeneticsHidetakaItoFaculty of Science, Hokkaido UniversityAlejandroEderaInstitute of Plant Sciences Paris‐Saclay (IPS2), Centre National de la Recherche Scientifique, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, Université Evry, Université ParisSayakaTominagaDepartment of Biological Sciences, The University of TokyoJuliarniDepartment of Biological Sciences, The University of TokyoKaeKatoDepartment of Integrated Genetics, National Institute of GeneticsShokoOdaDepartment of Biological Sciences, The University of TokyoSoichiInagakiDepartment of Biological Sciences, The University of TokyoZdravkoLorkovićGregor Mendel Institute (GMI), Austrian Academy of Sciences, Vienna BioCenter (VBC)KiyotakaNagakiInstitute of Plant Science and Resources, Okayama UniversityFrédéricBergerGregor Mendel Institute (GMI), Austrian Academy of Sciences, Vienna BioCenter (VBC)AkiraKawabeFaculty of Life Sciences, Kyoto Sangyo UniversityLeandroQuadranaInstitute of Plant Sciences Paris‐Saclay (IPS2), Centre National de la Recherche Scientifique, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, Université Evry, Université ParisIanHendersonDepartment of Plant Sciences, University of CambridgeTetsujiKakutaniDepartment of Biological Sciences, The University of TokyoIn organisms ranging from vertebrates to plants, major components of centromeres are rapidly evolving repeat sequences, such as tandem repeats (TRs) and transposable elements (TEs), which harbour centromere-specific histone H3 (CENH3)1,2. Complete centromere structures recently determined in human and Arabidopsis suggest frequent integration and purging of retrotransposons within the TR regions of centromeres3,4,5. Despite the high impact of ‘centrophilic’ retrotransposons on the paradox of rapid centromere evolution, the mechanisms involved in centromere targeting remain poorly understood in any organism. Here we show that both Ty3 and Ty1 long terminal repeat retrotransposons rapidly turnover within the centromeric TRs of Arabidopsis species. We demonstrate that the Ty1/Copia element Tal1 (Transposon of Arabidopsis lyrata 1) integrates de novo into regions occupied by CENH3 in Arabidopsis thaliana, and that ectopic expansion of the CENH3 region results in spread of Tal1 integration regions. The integration spectra of chimeric TEs reveal the key structural variations responsible for contrasting chromatin-targeting specificities to centromeres versus gene-rich regions, which have recurrently converted during the evolution of these TEs. Our findings show the impact of centromeric chromatin on TE-mediated rapid centromere evolution, with relevance across eukaryotic genomes.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2056-306X1112025Effect of temperature cycles on the sleep-like state in Hydra vulgaris2ENAyaSatoFaculty of Arts and Science, Kyushu UniversityManabuSekiguchiGraduate School of Natural Science and Technology, Okayama UniversityKogaNakadaGraduate School of Systems Life Sciences, Kyushu UniversityTaishiYoshiiGraduate School of Natural Science and Technology, Okayama UniversityTaichi Q.ItohFaculty of Arts and Science, Kyushu UniversityBackground Sleep is a conserved physiological phenomenon across species. It is mainly controlled by two processes: a circadian clock that regulates the timing of sleep and a homeostat that regulates the sleep drive. Even cnidarians, such as Hydra and jellyfish, which lack a brain, display sleep-like states. However, the manner in which environmental cues affect sleep-like states in these organisms remains unknown. In the present study, we investigated the effects of light and temperature cycles on the sleep-like state in Hydra vulgaris.<br>
Results Our findings indicate that Hydra responds to temperature cycles with a difference of up to 5° C, resulting in decreased sleep duration under light conditions and increased sleep duration in dark conditions. Furthermore, our results reveal that Hydra prioritizes temperature changes over light as an environmental cue. Additionally, our body resection experiments show tissue-specific responsiveness in the generation ofthe sleep-like state under different environmental cues. Specifically, the upper body can generate the sleep-like state in response to a single environmental cue. In contrast, the lower body did not respond to 12-h light–dark cycles at a constant temperature.<br>
Conclusions These findings indicate that both light and temperature influence the regulation of the sleep-like state in Hydra. Moreover, these observations highlight the existence of distinct regulatory mechanisms that govern patterns of the sleep-like state in brainless organisms, suggesting the potential involvement of specific regions for responsiveness of environmental cues for regulation of the sleep-like state.No potential conflict of interest relevant to this article was reported.eLife Sciences Publications, LtdActa Medica Okayama2050-084X132024Structural basis for molecular assembly of fucoxanthin chlorophyll a/c-binding proteins in a diatom photosystem I supercomplexRP99858ENKojiKatoResearch Institute for Interdisciplinary Science and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYoshikiNakajimaResearch Institute for Interdisciplinary Science and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityJianXingGraduate School of Agriculture, Kyoto UniversityMinoruKumazawaGraduate School of Agriculture, Kyoto UniversityHaruyaOgawaResearch Institute for Interdisciplinary Science and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityJian-RenShenResearch Institute for Interdisciplinary Science and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKentaroIfukuGraduate School of Agriculture, Kyoto UniversityRyoNagaoFaculty of Agriculture, Shizuoka UniversityPhotosynthetic organisms exhibit remarkable diversity in their light-harvesting complexes (LHCs). LHCs are associated with photosystem I (PSI), forming a PSI-LHCI supercomplex. The number of LHCI subunits, along with their protein sequences and pigment compositions, has been found to differ greatly among the PSI-LHCI structures. However, the mechanisms by which LHCIs recognize their specific binding sites within the PSI core remain unclear. In this study, we determined the cryo-electron microscopy structure of a PSI supercomplex incorporating fucoxanthin chlorophyll a/c-binding proteins (FCPs), designated as PSI-FCPI, isolated from the diatom Thalassiosira pseudonana CCMP1335. Structural analysis of PSI-FCPI revealed five FCPI subunits associated with a PSI monomer; these subunits were identified as RedCAP, Lhcr3, Lhcq10, Lhcf10, and Lhcq8. Through structural and sequence analyses, we identified specific protein–protein interactions at the interfaces between FCPI and PSI subunits, as well as among FCPI subunits themselves. Comparative structural analyses of PSI-FCPI supercomplexes, combined with phylogenetic analysis of FCPs from T. pseudonana and the diatom Chaetoceros gracilis, underscore the evolutionary conservation of protein motifs crucial for the selective binding of individual FCPI subunits. These findings provide significant insights into the molecular mechanisms underlying the assembly and selective binding of FCPIs in diatoms.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2025Rates and risk factors of bleeding after gastric endoscopic submucosal dissection with continuous warfarin or 1-day withdrawal of direct oral anticoagulantsENShoichiroHIRATAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.American Association for the Advancement of ScienceActa Medica Okayama2375-254811202025Structure of a photosystem I supercomplex from Galdieria sulphuraria close to an ancestral red algaeadv7488ENKojiKatoResearch institute for interdisciplinary Science and Graduate School of environ-mental, life, natural Science and technology, Okayama UniversityMinoruKumazawaGraduate School of Agriculture, Kyoto UniversityYoshikiNakajimaResearch institute for interdisciplinary Science and Graduate School of environ-mental, life, natural Science and technology, Okayama UniversityTakehiroSuzukiBiomolecular characterization Unit, RiKen center for Sustainable Resource ScienceNaoshiDohmaeBiomolecular characterization Unit, RiKen center for Sustainable Resource ScienceJian-RenShenResearch institute for interdisciplinary Science and Graduate School of environ-mental, life, natural Science and technology, Okayama UniversityKentaroIfukuGraduate School of Agriculture, Kyoto UniversityRyoNagaoFaculty of Agriculture, Shizuoka UniversityRed algae exhibit unique photosynthetic adaptations, characterized by photosystem I (PSI) supercomplexes containing light-harvesting complexes (LHCs), forming PSI-LHCI supercomplexes. In this study, we solved the PSI-LHCI structure of Galdieria sulphuraria NIES-3638 at 2.19-angstrom resolution using cryo-electron microscopy, revealing a PSI monomer core associated with seven LHCI subunits. Structural analysis uncovered the absence of phylloquinones, the common secondary electron acceptor in PSI of photosynthetic organisms, suggesting adaptation to a benzoquinone-like molecule. Phylogenetic analysis suggests that G. sulphuraria retains traits characteristic of an ancestral red alga, including distinctive LHCI binding and interaction patterns. Variations in LHCI composition and interactions across red algae, particularly in red-lineage chlorophyll a/b-binding-like protein and red algal LHCs, highlight evolutionary divergence and specialization. These findings not only deepen our understanding of red algal PSI-LHCI diversification but also enable us to predict features of an ancestral red algal PSI-LHCI supercomplex, providing a framework to explore evolutionary adaptations from an ancestral red alga.No potential conflict of interest relevant to this article was reported.Nature PortfolioActa Medica Okayama2041-17231612025Structure of a photosystem II-FCPII supercomplex from a haptophyte reveals a distinct antenna organization4175ENRomainLa RoccaResearch Institute for Interdisciplinary Science, and Advanced Research Field, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKojiKatoResearch Institute for Interdisciplinary Science, and Advanced Research Field, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityPi-ChengTsaiResearch Institute for Interdisciplinary Science, and Advanced Research Field, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYoshikiNakajimaResearch Institute for Interdisciplinary Science, and Advanced Research Field, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityFusamichiAkitaResearch Institute for Interdisciplinary Science, and Advanced Research Field, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityJian-RenShenResearch Institute for Interdisciplinary Science, and Advanced Research Field, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHaptophytes are unicellular algae that produce 30 to 50% of biomass in oceans. Among haptophytes, a subset named coccolithophores is characterized by calcified scales. Despite the importance of coccolithophores in global carbon fixation and CaCO3 production, their energy conversion system is still poorly known. Here we report a cryo-electron microscopic structure of photosystem II (PSII)-fucoxanthin chlorophyll c-binding protein (FCPII) supercomplex from Chyrostila roscoffensis, a representative of coccolithophores. This complex has two sets of six dimeric and monomeric FCPIIs, with distinct orientations. Interfaces of both FCPII/FCPII and FCPII/core differ from previously reported. We also determine the sequence of Psb36, a subunit previously found in diatoms and red algae. The principal excitation energy transfer (EET) pathways involve mainly 5 FCPIIs, where one FCPII monomer mediates EET to CP47. Our findings provide a solid structural basis for EET and energy dissipation pathways occurring in coccolithophores.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7932025Investigation of Cup Placement Position in Total Hip Arthroplasty with Cup-side Implant Placement in Computed Tomography Horizontal Sections177184ENShuroFuruichiDepartment of Bone and Joint Surgery, Kawasaki Medical SchoolShigeruMitaniDepartment of Bone and Joint Surgery, Kawasaki Medical SchoolHirosukeEndoDepartment of Bone and Joint Surgery, Kawasaki Medical SchoolYoshifumiNambaDepartment of Bone and Joint Surgery, Kawasaki Medical SchoolToyohiroKawamotoDepartment of Bone and Joint Surgery, Kawasaki Medical SchoolOriginal Article10.18926/AMO/68725The position attained in total hip arthroplasty (THA) is ideally in the center of the horizontal plane of the acetabulum. However, central placement is not always possible. We hypothesized that differences in approach result in individual differences in cup positioning; thus, we investigated the cup positions of 217 hips that underwent THA. The acetabulum’s anteroposterior diameter was measured, and the cups placed within 2 mm of the line perpendicular to the center as a central placement (central). Of the 217 hips, 68, 114, and 35 hips were anterior, central, and posterior, respectively. In 21 hips, anteroposterior deviation was noted. Among patients operated using the anterolateral approach, 48, 93, and 30 hips were anterior, central, and posterior, respectively. Among those operated using the posterolateral approach, 16, 20, and 4 hips were anterior, central, and posterior, respectively. The cup position shifted either anteriorly or posteriorly to the acetabulum in approximately half of all hips operated using both approaches and tended to shift anteriorly in the hips operated using the posterolateral approach. During THA surgery, it is important to operate with awareness of the center of the acetabulum.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7932025Promising Effectiveness of Combined Chemotherapy and Immunotherapy in Patients with Advanced Non-small Cell Lung Cancer: A Real-World Prospective Observational Study (CS-Lung-003)167176ENNobuhiroKanajiDepartment of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa UniversityKazuyaNishiiDepartment of Respiratory Medicine, National Hospital Organization Iwakuni Clinical CenterYukariTsubataDepartment of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of MedicineMikaNakaoDepartment of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of MedicineTakaeOkunoDepartment of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of MedicineSachiOkawaDepartment of Allergy and Respiratory Medicine, Okayama University HospitalKenjiTakataDepartment of Allergy and Respiratory Medicine, Okayama University HospitalMasahiroKodaniDivision of Medical Oncology and Molecular Respirology, Faculty of Medicine, Tottori UniversityMasahiroYamasakiDepartment of Respiratory Disease, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors HospitalKazunoriFujitakaDepartment of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityTetsuyaKubotaDepartment of Respiratory Medicine and Allergology, Kochi UniversityMasaakiInoueDepartment of Chest Surgery, Shimonoseki City HospitalNaokiWatanabeDepartment of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa UniversityKatsuyukiHottaCenter for Innovative Clinical Medicine, Okayama University HospitalCS-Lung-003 InvestigatorOriginal Article10.18926/AMO/68724This prospective observational study investigated the clinical status of patients with advanced non-small cell lung cancer (NSCLC) treated with cytotoxic chemotherapy+an immune checkpoint inhibitor (chemo + IO) as first-line treatment in a real-world setting. The cases of 98 patients treated with chemo + IO were prospectively collected and analyzed for effectiveness and safety. The response rate to chemo + IO was 46.9%, and the disease control rate was 76.5%. The median progression-free survival and overall survival (OS) in the total population were 5.2 and 22.3 months, respectively. The patients positive for PD-L1 (≥ 1%) showed significantly longer OS than the negative group (<1%) (median 26.7 vs. 18.7 months, p=0.04). Pre-existing interstitial lung disease (ILD) was associated with shorter OS than the absence of ILD (median 9.0 vs. 22.6 months, p<0.01). Immunerelated adverse events (irAEs) were observed in 28 patients (28.6%). The most frequent irAE was ILD (n=11); Grade 1 (n=1 patient), G2 (n=5), G3 (n=4), and only a single patient with a G5 irAE. In this CS-Lung-003 study, first-line chemo + IO in a real-world setting showed good effectiveness, comparable to that observed in international clinical trials. In real-world practice, chemo + IO is a promising and steadfast strategy.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1828-04472052025Iatrogenic fever of unknown origin16171618ENShinnosukeFukushimaDepartment of General Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalKeijiYunokiDepartment of Cardiovascular Surgery, Okayama University HospitalGentaroKatoDepartment of Cardiovascular Surgery, Okayama University HospitalShinichiMukaiDepartment of General Medicine, Okayama City HospitalNo potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7922025Calcified Amorphous Tumor of the Left Ventricle with Paroxysmal Atrial Fibrillation135138ENYasufumiFujitaDepartment of Cardiovascular Surgery, Kure Kyosai HospitalShujiShimizuDepartment of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMakotoMohriDepartment of Cardiovascular Surgery, Japanese Red Cross Society Himeji HospitalCase Report10.18926/AMO/68653Cardiac calcified amorphous tumor (CAT) is a rare, benign non-neoplastic mass of the heart that is sometimes found due to embolic events. Most cases of CAT are treated with surgical removal to prevent future embolic events. However, the treatment strategy for CAT complicated by atrial fibrillation has remained to be determined. Here we report a case of left ventricular CAT complicated by paroxysmal atrial fibrillation (PAF) that was successfully treated with surgical removal and pulmonary vein isolation. Pulmonary vein isolation can be a simple and effective procedure for PAF, even during surgical removal of CAT.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7922025Relationship between Personality Traits and Postpartum Depressive Symptoms in Women who Became Pregnant via Infertility Treatment109116ENKyokoAwaiGraduate School of Health Sciences, Okayama UniversityMikiyaNakatsukaFaculty of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/68649The status of postpartum depression was elucidated herein with the use of the Edinburgh Postnatal Depression Scale (EPDS) in women in Shikoku, Japan who became pregnant and gave birth after undergoing infertility treatment, including assisted reproductive technology (ART). The assessment was performed during their children’s 4-month health examination. The relationships between postpartum depression and the mothers’ background factors and scores on the Big Five personality traits scale were also examined. Of the Big Five personality traits, the scores for neuroticism were significantly higher in the ART group (n=71) than in the general infertility treatment (n=118) and natural pregnancy (n=872) groups. No significant differences in EPDS scores were seen among these three groups. A logistic regression analysis showed that neuroticism was associated with an EPDS score ≧9 points, (which is suggestive of postpartum depression, ) in all groups. Moreover, although a long-standing marriage had an inhibitory effect on postpartum depression in the natural pregnancy group, no such trend was seen in the ART group, which included many women with long-standing marriages. Particularly for women who become pregnant by ART, an individualized response that pays close attention to the woman’s personality traits is needed.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7922025Lower Work Engagement Is Associated with Insomnia, Psychological Distress, and Neck Pain among Junior and Senior High School Teachers in Japan93100ENRinaTsuchieDepartment 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 SciencesHidekiTsumuraDepartment of Psychology, Graduate School of Technology, Industrial and Social Sciences, Tokushima UniversityMinakoKinutaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakashiHisamatsuDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideyukiKandaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/68647School teachers are subject to both physical and mental health problems. We examined cross-sectional relationships between work engagement and major health outcomes among junior and senior high school teachers in Japan via a nationwide survey in 2019-2020. A total of 3,160 respondents were included in the analyses (19.9% response rate). Work engagement was assessed with the Utrecht Work Engagement Scale-9 (UWES-9), and we thus divided the teachers into quartiles according to their UWES-9 scores. Based on validated questionnaires, we assessed insomnia, psychological distress, and neck pain as health outcomes. A binomial logistic regression adjusted for age, gender, school type, teacher’s roles, involvement in club activities, division of duties, employment status, and whether they lived with family demonstrated that the teachers with lower UWES-9 scores had higher burdens of insomnia, psychological distress, and neck pain (odds ratios [95% confidence intervals] in 4th vs. 1st quartile, 2.92 (2.34-3.65), 3.70 (2.81-4.88), and 2.12 (1.68-2.68), respectively; all trend p<0.001). There were no significant differences in these associations between full-time and part-time teachers. Our findings indicate that low work engagement may contribute to physical and mental health issues among junior and senior high school teachers, thus providing insights for preventing health problems in this profession.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7922025Association between the Pretreatment Body Mass Index and Anamorelin’s Efficacy in Patients with Cancer Cachexia: A Retrospective Cohort Study6573ENMasatoshiMakiDepartment of Hospital Pharmacy, NHO Fukuyama Medical CenterRyoTakadaDepartment of Hospital Pharmacy, NHO Fukuyama Medical CenterTomoyukiIshigoDepartment of Pharmacy, Sapporo Medical University HospitalMikiFujiwaraDepartment of Hospital Pharmacy, NHO Fukuyama Medical CenterYokoTakahashiDepartment of Hospital Pharmacy, NHO Fukuyama Medical CenterShinyaOtsukaDepartment of Surgery, NHO Fukuyama Medical CenterKojiTamuraDepartment of Hospital Pharmacy, NHO Fukuyama Medical CenterTerutakaHamaokaDepartment of Hospital Pharmacy, NHO Fukuyama Medical CenterOriginal Article10.18926/AMO/68644Anamorelin (ANAM) is used to treat cancer-associated cachexia, a syndrome involving muscle loss and anorexia. The timing of the initiation of ANAM treatment is crucial to its efficacy. Although the body mass index (BMI) is a diagnostic criterion for cancer cachexia, no studies have explored its association with ANAM efficacy. We conducted a single-center, retrospective cohort study to investigate the association between the pre-treatment BMI and ANAM efficacy in patients with cancer-associated cachexia (n=47). The ANAM treatment was considered effective if the patient’s appetite improved within 30 days of treatment initiation. We calculated a BMI cutoff value (19.5 kg/m2) and used it to divide the patients into high- and low-BMI groups. Their background, clinical laboratory values, cancer types, and treatment lines were investigated. Twenty (42.6%) had a high BMI (≥ 19.5 kg/m2) and 27 (57.4%) had a low BMI (< 19.5 kg/m2). High BMI was significantly associated with ANAM effectiveness (odds ratio 7.86, 95% confidence interval 1.99-31.00, p=0.003). Together these results indicate that it is beneficial to initiate ANAM treatment before a patient’s BMI drops below 19.5 kg/m2. Our findings will help advance cancer cachexia treatment and serve as a reference for clinicians to predict ANAM’s efficacy.No potential conflict of interest relevant to this article was reported.SAGE PublicationsActa Medica Okayama1756-2848182025Clipping closure length is a crucial factor for delayed bleeding after endoscopic papillectomy: a retrospective multicenter cohort studyENYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalKiyoakiOchiDepartment of Gastroenterology, Fukuyama City HospitalHitomiHimeiDepartment of Gastroenterology, Hiroshima City Hiroshima Citizens HospitalIchiroSakakiharaDepartment of Gastroenterology, Kagawa Prefectural Central HospitalEijiroUetaDepartment of Gastroenterology, National Hospital Organization, Iwakuni Clinical CenterTatsuyaToyokawaDepartment of Gastroenterology, National Hospital Organization, Fukuyama Medical CenterRyoHaradaDepartment of Gastroenterology, Japanese Red Cross Okayama HospitalTaijiOgawaDepartment of Gastroenterology, Tsuyama Chuo HospitalTakeshiTomodaDepartment of Gastroenterology, Okayama City HospitalHironariKatoDepartment of Gastroenterology, Okayama City HospitalRyosukeSatoDepartment of Gastroenterology and Hepatology, Okayama University HospitalTaisukeObataDepartment of Gastroenterology and Hepatology, Okayama University HospitalAkihiroMatsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyaMiyamotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalDaisukeUchidaDepartment of Gastroenterology and Hepatology, Okayama University HospitalShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKoichiroTsutsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalBackground: Bleeding is a serious and frequent adverse event that occurs during and after endoscopic papillectomy (EP). Previous studies have highlighted the effectiveness of preventive clipping closure of the resection site in preventing post-EP bleeding. However, the optimal length of closure remained unclear. <br>
Objectives: We aimed to clarify the optimal clipping length at the post-EP resection site to prevent delayed bleeding. <br>
Design: This study was a multicenter retrospective cohort study. <br>]
Methods: We retrospectively analyzed patients who were consecutively admitted to nine high-volume centers for EP between November 2003 and October 2023. The primary outcome was the frequency of delayed bleeding based on the closure length. The optimal closure length rate of the resected site to prevent delayed bleeding was determined using a receiver operating characteristic curve. Secondary outcomes were the incidence, treatment outcomes, and risk factors for post-EP delayed bleeding. <br>
Results: A total of 130 patients who underwent EP were analyzed. Delayed bleeding was observed in 22 (17%) patients, occurring more frequently in cases without clipping closure than in those with clipping closure (28% (13/47) vs 11% (9/83); p = 0.014). Among 83 patients who underwent clipping closure, delayed bleeding occurred more frequently with a closure length rate <65% than in those with a closure rate >= 65% (25% (5/20) vs 6% (4/63); p = 0.019). Multivariate analysis showed that a closure rate <65% was the risk factor for delayed bleeding (odds ratio, 6.3; 95% confidence interval, 1.2-33; p = 0.030) in cases with clipping. <br>
Conclusion: Clipping closure was effective in preventing delayed bleeding, and closure length rate >= 65% of the resected site significantly reduced post-EP delayed bleeding.No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323152025ドイツ付近の春・５月の気候と歌（その２）：異質な他者への出会いを促す大学での学際的授業の実践163177ENKuranoshinKATOFaculty of Education, Okayama UniversityIsaoNAGAOKAFaculty of Education, Okayama UniversityHarukoKATOFaculty of Education, Gifu Shotoku Gakuen University (Former affiliation)KazuoOTANITV Setouchi Broadcasting Co., LTD.10.18926/CTED/68489 ドイツ付近の「春・5月」の気候と歌の表現の学際的学習を通して「異質な他者」への出会いを促す教科横断的授業を大学で行った。授業では，ドイツ付近における「春・5月」の季節感の2つの側面，すなわち「厳しい冬を経て巡り来る特別な喜び」や「すぐに過ぎ去る至福の瞬間の儚さ」に関連した気候の特徴を講義すると共に，それらの季節感が表現されたドイツ歌曲や映画《会議は踊る》の主題歌〈ただ一度だけ〉等の鑑賞を行い，作品の背景にある気候と音楽表現の関りにアプローチした。その結果，作品の歌詞を主な手がかりに，気候や季節感と音楽表現の関りを概ね捉えることができた。従って，本実践が「異質な他者」の存在を実感する機会になり得たといえる。一方，「5月」という一語に凝縮されたドイツ付近ならではの深い内容を「我が事」としてより強く実感するためには，歌詞はもとより音楽的表現との絡みを意識した捉え方，提示の必要性が示唆された。No potential conflict of interest relevant to this article was reported.Nature PortfolioActa Medica Okayama2045-23221512025Changes of leucine-rich alpha 2 glycoprotein could be a marker of changes of endoscopic and histologic activity of ulcerative colitis5248ENYukiAoyamaDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySakikoHiraokaDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityErikoYasutomiDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshihiroInokuchiDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakehiroTanakaDepartment of Pathology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKensukeTakeiDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShokoIgawaDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKeikoTakeuchiDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasahiroTakaharaDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJunkiToyosawaDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYasushiYamasakiDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHideakiKinugasaDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJunKatoDepartment of Gastroenterology, Graduate School of Medicine, Chiba UniversityHiroyukiOkadaDepartment of Gastroenterology, Japanese Red Cross Society Himeji HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityLeucine-rich alpha 2 glycoprotein (LRG) is one of the serum biomarkers for disease activity of ulcerative colitis (UC). We focused on the correlation between the changes of LRG and the changes of endoscopic and histologic activity of UC, in comparison to the changes of fecal calprotectin (Fcal), fecal immunochemical test (FIT), and C-reactive protein (CRP). Seventy-nine patients with two or more colonoscopies were enrolled, and 123 paired colonoscopies and 121 paired biopsies were examined. With regard to the change of endoscopic/histologic activity between the preceding and subsequent colonoscopy, there was improvement (n = 29/45), unchanging (n = 63/36), and worsening (n = 31/40). The correlations between the changes of marker levels and endoscopic/histologic activity were Fcal; r = 0.50/0.39 and FIT; r = 0.41/0.40, LRG; r = 0.42/0.40 and CRP; r = 0.22/0.17. Furthermore, when the correlation between the changes of LRG levels and the changes of endoscopic/histological activity was compared with those of other markers, the correlation of LRG tended to be superior to those of CRP (CRP vs. LRG; p = 0.08/0.01). LRG is equivalent to fecal markers and superior to CRP, when inferring changes in disease activity of UC based on changes in its level.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0278-69151972025Fraglide-1 from traditional Chinese aromatic vinegar: A natural AhR antagonist for atopic dermatitis115301ENKosukeKatoGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityMikiAkamatsuGraduate School of Environmental and Life Science, Okayama UniversitySayaKakimaruGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityMayukoKoreishiGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityMasahiroTakagiSchool of Materials Science, Japan Advanced Institute of Science and TechnologyMasahiroMiyashitaGraduate School of Agriculture, Kyoto UniversityYoshiyukiMurataGraduate School of Environmental and Life Science, Okayama UniversityYoshimasaNakamuraGraduate School of Environmental and Life Science, Okayama UniversityAyanoSatohGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityYoshioTsujinoGraduate School of Science, Technology and Innovation, Kobe UniversityTraditional Chinese Zhenjiang aromatic vinegar (Kozu) contains Fraglide-1 (FG1), a bioactive lactone with demonstrated peroxisome proliferator-activated receptor gamma (PPARγ) agonist and antioxidant activities. This study explored FG1's novel ability to antagonize the aryl hydrocarbon receptor (AhR) signaling pathway, which regulates artemin expression and contributes to itching and inflammation in atopic dermatitis. Through molecular docking simulations and cell-based assays in human keratinocytes, we demonstrated FG1's potent antagonistic activity against AhR signaling. FG1 effectively suppressed FICZ-induced inflammatory responses, including artemin expression, with potency (half maximal inhibitory concentration, IC50 = 5.1 μM) comparable to the synthetic antagonist StemRegenin 1 (SR1) while demonstrating a superior safety profile (median lethal concentration, LC50 > 100 μM vs. 27.5 μM for SR1). These findings expand our understanding of bioactive compounds from traditional fermented foods and their regulatory effects on AhR signaling, providing a foundation for future studies on FG1's role in modulating skin inflammation.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7912025Endothelial Cell Polarity in Health and Disease17ENMoeThihaDepartment of Pathophysiology and Drug Discovery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakaoHikitaDepartment of Pathophysiology and Drug Discovery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasanoriNakayamaDepartment of Pathophysiology and Drug Discovery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesReview10.18926/AMO/68353Endothelial cell polarity is fundamental to the organization and function of blood vessels, influencing processes such as angiogenesis, vascular stability, and response to shear stress. This review elaborates on the molecular mechanisms that regulate endothelial cell polarity, focusing on key players like the PAR polarity complex and Rho family GTPases. These pathways coordinate the front–rear, apical–basal and planar polarity of endothelial cells, which are essential for the proper formation and maintenance of vascular structures. In health, endothelial polarity ensures not only the orderly development of blood vessels, with tip cells adopting distinct polarities during angiogenesis, but also ensures proper vascular integrity and function. In disease states, however, disruptions in polarity contribute to pathologies such as coronary artery disease, where altered planar polarity exacerbates atherosclerosis, and cancer, where disrupted polarity in tumor vasculature leads to abnormal vessel growth and function. Understanding cell polarity and its disruption is fundamental not only to comprehending how cells interact with their microenvironment and organize themselves into complex, organ-specific tissues but also to developing novel, targeted, and therapeutic strategies for a range of diseases, from cardiovascular disorders to malignancies, ultimately improving patient outcomes.No potential conflict of interest relevant to this article was reported.eLife Sciences PublicationsActa Medica Okayama2050-084X132024Structural basis for molecular assembly of fucoxanthin chlorophyll a/c-binding proteins in a diatom photosystem I supercomplexRP99858ENKojiKatoResearch Institute for Interdisciplinary Science and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYoshikiNakajimaResearch Institute for Interdisciplinary Science and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityJianXingGraduate School of Agriculture, Kyoto UniversityMinoruKumazawaGraduate School of Agriculture, Kyoto UniversityHaruyaOgawaResearch Institute for Interdisciplinary Science and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityJian-RenShenResearch Institute for Interdisciplinary Science and Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKentaroIfukuGraduate School of Agriculture, Kyoto UniversityRyoNagaoFaculty of Agriculture, Shizuoka UniversityPhotosynthetic organisms exhibit remarkable diversity in their light-harvesting complexes (LHCs). LHCs are associated with photosystem I (PSI), forming a PSI-LHCI supercomplex. The number of LHCI subunits, along with their protein sequences and pigment compositions, has been found to differ greatly among the PSI-LHCI structures. However, the mechanisms by which LHCIs recognize their specific binding sites within the PSI core remain unclear. In this study, we determined the cryo-electron microscopy structure of a PSI supercomplex incorporating fucoxanthin chlorophyll a/c-binding proteins (FCPs), designated as PSI-FCPI, isolated from the diatom Thalassiosira pseudonana CCMP1335. Structural analysis of PSI-FCPI revealed five FCPI subunits associated with a PSI monomer; these subunits were identified as RedCAP, Lhcr3, Lhcq10, Lhcf10, and Lhcq8. Through structural and sequence analyses, we identified specific protein-protein interactions at the interfaces between FCPI and PSI subunits, as well as among FCPI subunits themselves. Comparative structural analyses of PSI-FCPI supercomplexes, combined with phylogenetic analysis of FCPs from T. pseudonana and the diatom Chaetoceros gracilis, underscore the evolutionary conservation of protein motifs crucial for the selective binding of individual FCPI subunits. These findings provide significant insights into the molecular mechanisms underlying the assembly and selective binding of FCPIs in diatoms.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2692-4609512025Efficacy and safety of endoscopic ultrasonography-guided radiofrequency ablation of small pancreatic neuroendocrine neoplasms: A prospective, pilot studye70073ENKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalDaisukeUchidaDepartment of Gastroenterology and Hepatology, Okayama University HospitalYasutoTakeuchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalHironariKatoDepartment of Gastroenterology and Hepatology, Okayama University HospitalYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKeiHaradaDepartment of Gastroenterology and Hepatology, Okayama University HospitalNaoHattoriDepartment of Gastroenterology and Hepatology, Okayama University HospitalRyosukeSatoDepartment of Gastroenterology and Hepatology, Okayama University HospitalTaisukeObataDepartment of Gastroenterology and Hepatology, Okayama University HospitalAkihiroMatsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyaMiyamotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKoichiroTsutsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyaYasuiDepartment of Gastroenterological Surgery, Transplant and Surgical Oncology, Okayama University HospitalRyoHaradaDepartment of Gastroenterology, Japanese Red Cross Okayama HospitalMasakuniFujiiDepartment of Internal Medicine, Okayama Saiseikai General HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalObjectives: Endoscopic ultrasonography (EUS)-guided radiofrequency ablation has recently been introduced as one of the management strategies for small pancreatic neuroendocrine neoplasms (PNENs). However, prospective data on its safety and efficacy remain limited.<br>
Methods: This prospective pilot study was conducted at Okayama University Hospital from May 2023 to December 2024. Patients with grade 1 PNENs <= 15 mm, confirmed by EUS-guided fine-needle aspiration, were included. The primary endpoint was safety (adverse events [AEs] evaluated according to the 2010 guidelines of the American Society for Gastrointestinal Endoscopy. Severe AEs were defined as moderate or higher in American Society for Gastrointestinal Endoscopy grading and grade >= 3. Secondary endpoints included efficacy (complete response on contrast-enhanced computed tomography at 1 and 6 months), treatment details, device failure, diabetes mellitus exacerbation, and overall survival at 6 months.<br>
Results: Five patients with non-functional PNENs (median age: 64 years; median tumor size: 10 mm) were treated. AEs occurred in two patients (40%, 2/5), although none was severe. Both patients developed asymptomatic pseudocysts, one experienced mild pancreatitis, and both resolved with conservative treatment. The complete response rates on contrast-enhanced computed tomography at one and 6 months were 100%. The median procedure time was 16 min without any device failure, and the median hospitalization was 5 days. None of the patients developed new-onset or worsening diabetes mellitus. The 6-month overall survival rate was 100%.<br>
Conclusion: EUS-guided radiofrequency ablation demonstrated a high complete response rate with no severe AEs in this pilot study, suggesting a minimally invasive option for small, low-grade PNENs (jRCTs062230014).No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0008-62232342025Reversible chemical modifications of graphene oxide for enhanced viral capture and release in water120015ENPilarFerré-PujolResearch Institute for Interdisciplinary Science, Okayama UniversitySeijiObataResearch Institute for Interdisciplinary Science, Okayama UniversityJésusRayaInstitut de Chimie, UMR 7177 CNRS, Université de StrasbourgAlbertoBiancoResearch Institute for Interdisciplinary Science, Okayama UniversityHiroyukiKatayamaDepartment of Urban Engineering, School of Engineering, The University of TokyoTakashiKatoResearch Center for Water Environment Technology, School of Engineering, The University of TokyoYutaNishinaResearch Institute for Interdisciplinary Science, Okayama UniversityDetecting low concentrations of viruses in sewage water is crucial for monitoring the spread of emerging viral diseases. However, current detection methods, which involve concentrating viruses using traditional materials such as gauze or cotton, have limitations in effectively accomplishing this task. This study demonstrates that graphene oxide (GO), a two-dimensional carbon material, possesses strong viral adsorption capabilities. However, it lacks efficiency for effective viral release. Therefore, we designed a series of new GO-based materials, which exhibited a viral adsorption similar to pristine GO, while significantly enhancing their release performance by attaching alkyl chains and hydrophilic functional groups. Among the synthesized materials, 1,8-aminooctanol grafted to GO (GO-NH2C8OH) has emerged as the most promising candidate, achieving a viral release rate higher than 50 %. This superior performance can be attributed to the synergistic effect of the alkyl chain and the terminal OH group, which enhances both its affinity for viruses and water dispersibility. Furthermore, we have successfully applied GO-NH2C8OH in a new protocol for concentrating viruses from sewage wastewater. This approach has demonstrated a 200-fold increase in virus concentration, allowing PCR detection of this type of pathogens present in wastewater below the detection limit by direct analysis, underscoring its significant potential for virus surveillance.No potential conflict of interest relevant to this article was reported.ElsevierActa Medica Okayama1341-321X3112025Cryptococcal prostatitis in an immunocompromised patient with tocilizumab and glucocorticoid therapy: A case report102494ENKoheiOguniDepartment 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 SciencesTakehiroIwataDepartment of Urology, 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 SciencesSawakoOnoDepartment of Pathology and Oncology, 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 SciencesCryptococcus prostatitis is an uncommon manifestation of cryptococcal infection that occurs mostly in immunocompromised patients. Tocilizumab, an anti-interleukin-6 receptor monoclonal antibody, has been associated with an increased risk of cryptococcal infections. However, there have been no documented cases of cryptococcal prostatitis in patients receiving tocilizumab therapy. We report a case of cryptococcal prostatitis in a 72-year-old man treated with glucocorticoids and tocilizumab for giant cell arteritis and granulomatosis with polyangiitis. The patient presented dysuria and his serum level of prostate-specific antigen was elevated. Magnetic resonance imaging revealed a prostate mass, and a prostate biopsy was performed, leading to a pathologic diagnosis of cryptococcal prostatitis. Fungal cultures for blood and urine were negative, while the cryptococcal antigen for both serum and urine showed positive results. There were no particular findings in the pulmonary and central nervous systems. The patient was successfully treated with oral fluconazole (400 mg/day) and was discharged. Although cryptococcal prostatitis is a rare entity, clinicians should note that an immunosuppressed patient may develop such a difficult-to-diagnose disease.
No potential conflict of interest relevant to this article was reported.Society for Hard Tissue Regenerative BiologyActa Medica Okayama1341-76493342024β-catenin Binds to Gsk-3β in Liquid-Liquid Phase Separation Compartment in HEK293 Cells213218ENMariKatoDepartment of Oral Morphology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAiriTanaiDepartment of Oral Morphology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYokoFukuharaDepartment of Oral Morphology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityXinyuZhengDepartment of Oral Morphology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHeriatiSitosariDepartment of Oral Morphology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTadashiYamamotoThe Center for Graduate Medical Education (Dental Division), Okayama University HospitalMikaIkegameDepartment of Oral Morphology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHirohikoOkamuraDepartment of Oral Morphology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityLiquid-liquid phase separation (LLPS) has emerged as a significant mechanism for cellular organization, impacting various biological processes, including Wnt/β-catenin signaling. This study investigates the role of LLPS in the regulation of β-catenin in HEK293 cells, particularly in response to Wnt3a signaling. Our findings demonstrate that β-catenin is regulated by LLPS, forming spherical droplets indicative of this phenomenon. Fluorescence recovery after photobleaching (FRAP) assays revealed that these droplets exhibit reversible dynamics, further confirming their phase-separated nature. Importantly, treatment with Wnt3a led to an increase in β-catenin levels, while simultaneously reducing the recovery of fluorescence intensity in FRAP experiments, suggesting that enhanced Wnt signaling may stimulate the release of β-catenin from LLPS. Immunoprecipitation studies indicated that β-catenin binds to glycogen synthase kinase 3β (Gsk-3β) within the LLPS state, highlighting a potential regulatory mechanism whereby LLPS facilitates the phosphorylation and subsequent degradation of β-catenin. The addition of 1,6-hexanediol disrupted the β-catenin/Gsk-3β interaction, reinforcing the idea that LLPS plays a critical role in modulating these biochemical interactions. The findings presented in this study suggest that LLPS is not only crucial for the spatial organization of β-catenin but also serves as a regulatory mechanism for its signaling functions in the Wnt pathway. Given the association of aberrant Wnt signaling with various diseases, including cancer and neurodegenerative disorders, understanding the role of LLPS in this context may provide new insights into therapeutic strategies targeting these pathological conditions.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813632024令和５年度岡山医学会賞 がん研究奨励賞（林原賞・山田賞）9496ENTaisukeObataDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7862024Closure of Ventricular Septal Rupture through a Left Thoracotomy in a Patient with a History of Esophageal Reconstruction449452ENGentaroKatoDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalTatsuyaOgawaDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalTomohiroHayashidaDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalShujiShimizuDepartment of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University HospitalShuYamamotoDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalTakeshiShichijoDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalCase Report10.18926/AMO/67870A 73-year-old man who had undergone esophagectomy and retrosternal gastric tube reconstruction for esophageal cancer 8 years prior was transferred to our hospital for the treatment of an acute myocardial infarction. Emergent percutaneous coronary intervention for the left anterior descending artery (#7) was successfully performed. However, echocardiography revealed a ventricular septal rupture (25×27 mm). Seventeen days after admission, the rupture was successfully treated with a double-patch closure via a left anterolateral thoracotomy to avoid a surgical injury to his retrosternal gastric tube. Determining the best surgical approach to the heart is important for safe cardiac surgery in patients after esophageal reconstruction.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7862024Risk Factors for Gangrenous Cholecystitis and the Outcomes of Early Cholecystectomy: A Retrospective Study of a Single-Center City General Hospital439447ENMampeiYamashitaDepartment of Surgery, Sasebo City General HospitalTakayukiTanakaDepartment of Surgery, Sasebo City General HospitalYorihisaSumidaDepartment of Surgery, Sasebo City General HospitalShotoYamazakiDepartment of Surgery, Sasebo City General HospitalYukiHaraDepartment of Surgery, Sasebo City General HospitalAkikoFukudaDepartment of Surgery, Sasebo City General HospitalMakotoHisanagaDepartment of Surgery, Sasebo City General HospitalKokiWakataDepartment of Surgery, Sasebo City General HospitalMasatoArakiDepartment of Surgery, Sasebo City General HospitalSusumuEguchiDepartment of Surgery, Nagasaki University Graduate School of Biomedical ScienceOriginal Article10.18926/AMO/67869Gangrenous cholecystitis (GC) is classified as moderate acute cholecystitis according to the Tokyo Guidelines from 2018 (TG18). We evaluated the risk factors for GC and the outcomes of early cholecystectomy. A total of 136 patients who underwent emergency cholecystectomy for acute cholecystitis were retrospectively analyzed; 58 of these patients (42.6%) were diagnosed with GC (GC group) based on our retrospective pathologic diagnosis. We comparatively evaluated the patient backgrounds and surgical outcomes between the GC group and non-GC group. The GC group was significantly older and included more hypertensive patients than the non-GC group. The GC group was prescribed more antibiotics as initial treatment than the non-GC group, and they had more days between onset and surgery. The preoperative white blood cell count and C-reactive protein values were significantly higher in the GC group than in the non-GC group, and these values were predictive factors for GC. Cholecystectomy required a longer operation time and caused greater blood loss in the GC group. The GC group also had longer hospitalization times than the non-GC group; however, no significant differences were observed in terms of postoperative complications. In conclusion, gangrenous changes should be assessed when diagnosing cholecystitis, and appropriate treatment, such as surgery or drainage, should be undertaken.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2054-345X1112024Genotypes and phenotypes of neurofibromatosis type 1 patients in Japan: A Hereditary Tumor Cohort Study42ENMashuFutagawaDepartment of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTetsuyaOkazakiDepartment of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEijiNakataDepartment of Orthopedic Surgery, Okayama University HospitalChikaFukanoDepartment of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRisaOsumiDepartment of Clinical Genetics and Genomic Medicine, Okayama University HospitalFuminoKatoDepartment of Clinical Genetics and Genomic Medicine, Okayama University HospitalYusakuUrakawaDepartment of Genetic Medicine, School of Medicine, Fujita Health UniversityHidekiYamamotoDepartment of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopedic Surgery, Okayama University HospitalAkiraHirasawaDepartment of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNeurofibromatosis type 1 (NF1) presents with a broad spectrum of clinical manifestations, including an increased risk of tumor development and hypertension. Comprehensive data on genotype‒phenotype correlations in patients with NF1 are limited. Therefore, in this study, we aimed to elucidate the detailed genetic and clinical characteristics of NF1 in a hereditary tumor cohort. We performed sequencing and copy number assays in a clinical laboratory and analyzed the clinical data of 44 patients with suspected NF1. Germline pathogenic variants were detected in 36 patients (81.8%), and 20.7% of the variants were novel. Notably, 40.0% of adult patients presented with malignancies; female breast cancer occurred in 20.0% of patients, which was a higher rate than that previously reported. Hypertension was observed in 30.6% of the adult patients, with one patient experiencing sudden death and another developing pheochromocytoma. Three patients with large deletions in NF1 exhibited prominent cutaneous, skeletal, and neurological manifestations. These results highlight the importance of regular surveillance, particularly for patients with malignancies and hypertension. Our findings provide valuable insights for genetic counseling and clinical management, highlighting the multiple health risks associated with NF1 and the need for comprehensive and multidisciplinary care.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2024MicroRNA-451a inhibits gemcitabine-refractory biliary tract cancer progression by suppressing the MIF-mediated PI3K/AKT pathwayENTaisukeOBATAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2024MicroRNA-34a-5p: A pivotal therapeutic target in gallbladder cancerENTakashiODAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2024Fibroblast activation protein-targeted near-infrared photoimmunotherapy depletes immunosuppressive cancer-associated fibroblasts and remodels local tumor immunityENMasaakiAKAIGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2024Near-infrared Photoimmunotherapy Targeting Cancer-Associated Fibroblasts in Patient-Derived Xenografts Using a Humanized Anti-Fibroblast Activation Protein AntibodyENTerukiKOBAYASHIGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.SpringerActa Medica Okayama2198-77931012024Gastro-tracheal fistula following esophageal cancer surgery through the retrosternal route: a case report252ENSeitaroNishimuraDepartment of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKazuhiroNomaDepartment of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKentoKawasakiDepartment of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineMasashiHashimotoDepartment of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTakuyaKatoDepartment of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineNaoakiMaedaDepartment of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineShunsukeTanabeDepartment of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineYasuhiroShirakawaDepartment of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineBackground Gastro-tracheal fistula is a rare but serious complication after esophageal surgery, often requiring long-term treatment and invasive procedures. Gastro-tracheal fistula usually occurs through the posterior mediastinal route and rarely through the retrosternal route. No previous reports have described gastro-tracheal fistula after retrosternal route reconstruction was cured by conservative treatment.<br>
Case presentation A 70-year-old man with lower thoracic esophageal cancer underwent thoracoscopic esophagectomy in the prone position and gastric tube reconstruction through the retrosternal route with neck anastomosis after neoadjuvant chemotherapy. Despite anastomotic leakage on postoperative day 10, his general condition was stable, and he was managed conservatively with antibiotics and gastric tube decompression. On day 29, he presented with high fever and a gastro-tracheal fistula was observed by esophagography. Conservative management was continued because the patient remained stable. On day 48, esophagography showed that the fistula was undetectable. The patient was able to take fluids orally. He progressed well on an oral diet and was transferred to a different hospital.<br>
Conclusions A gastro-tracheal fistula, although rare, can occur after retrosternal route reconstruction. When a patient is stable, gastro-tracheal fistula after retrosternal route reconstruction may be cured by conservative treatment.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7852024Occult Nesidioblastosis Detected by 111In-Pentetreotide Single-Photon Emission Computed Tomography423428ENShinyaSakamotoDepartment of Gastroenteorlogical Surgery, Kochi Health Sciences CenterMotoyasuTabuchiDepartment of Gastroenteorlogical Surgery, Kochi Health Sciences CenterRikaYoshimatsuDepartment of Radiology, Kochi Health Sciences CenterAiHishidaDepartment of Endocrinology and Metabolism, Kochi Health Sciences CenterManabuMatsumotoDepartment of Diagnostic Pathology, Kochi Health Sciences CenterJunIwataDepartment of Diagnostic Pathology, Kochi Health Sciences CenterTakehiroOkabayashiDepartment of Gastroenteorlogical Surgery, Kochi Health Sciences CenterCase Report10.18926/AMO/67667Nesidioblastosis, also known as persistent hyperinsulinemic hypoglycemia, is usually observed in children and infants, although more recently adult-onset nesidioblastosis has also been described. We present a case of nesidioblastosis in a 78-year-old man that was detected by 111In-pentetreotide single photon emission computed tomography (SPECT/CT). The patient was transferred to our hospital’s emergency department in a hypoglycemic coma. Dynamic enhanced CT could detect no lesion in the pancreas, but an 111In-pentetreotide SPECT/CT scan performed after a similar episode four weeks later showed increased focal uptake at the head of the pancreas. The results of a selective arterial calcium injection test were negative. After careful consideration and discussion among colleagues, surgical intervention was selected, and a pancreaticoduodenectomy was performed. On histology, there were elevated numbers of Langerhans islets in the pancreatic head, and the islets themselves appeared enlarged. Hypertrophic β-cells comprised the majority, but α-cells, δ-cells and pancreatic polypeptide were also detected in the islets. Based on the histopathological results and repeated hyperinsulinemic hypoglycemic crises, the patient was finally diagnosed with adult-onset nesidioblastosis. He had no hypoglycemic symptoms during outpatient follow-up examination. Since 111In-pentetreotide SPECT/CT may be able to detect nesidioblastosis, clinicians should consider this relatively new-modality examination when encountering such cases.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7852024Pediatric Severe Febrile Thrombocytopenia Syndrome: A Case Report and Literature Review401405ENYusukeToyotaDepartment of Pediatrics, NHO Iwakuni Clinical CenterKazuhiroUdaDepartment of Pediatrics, NHO Iwakuni Clinical CenterKomeiShirabeYamaguchi Prefectural Institute of Public Health and EnvironmentTadashiMoriwakeDepartment of Pediatrics, NHO Iwakuni Clinical CenterCase Report10.18926/AMO/67664Severe febrile thrombocytopenia syndrome (SFTS) is a tick-borne infectious disease that is endemic in parts of eastern Asia. Few pediatric cases have been reported. We describe a case of SFTS in a seven-year-old girl who presented with prolonged fever and gastrointestinal symptoms. Leukopenia and thrombocytopenia on hematology, and a history of outdoor activity led us to diagnose SFTS, although the patient had no tick bite marks. We also review the literature and discuss the characteristics of pediatric SFTS. Physicians should consider SFTS in the differential diagnosis of fever with thrombocytopenia in children living in endemic areas.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7852024Phenotypic and Genetic Characteristics of Carbapenemase-Producing Enterobacterales Isolates at Okayama University Hospital371376ENKazuyoshiGotohDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMakotoMiyoshiDepartment of Medical Laboratory Science, Graduate School of Health Sciences, Okayama UniversityI Putu Bayu MayuraDepartment of Clinical Microbiology, Faculty of Medicine, Udayana UniversityShumaTsujiDepartment of Medical Laboratory Science, Graduate School of Health Sciences, Okayama UniversityKojiIioMicrobiology Division, Clinical Laboratory, Okayama University HospitalShinnosukeFukushimaDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOsamuMatsushitaDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalOriginal Article10.18926/AMO/67657Spread of carbapenemase-producing Enterobacterales (CPE) is an ongoing public health issue worldwide, including in Japan. In this study, we investigated the phenotypic and genetic characteristics of CPE isolates at Okayama University Hospital over the 5 years (2013-2018) prior to the outbreak of the 2019 coronavirus pandemic. Of 24 carbapenem-resistant Enterobacterales isolated during the study period, we identified 8 CPE isolates harboring blaIMP-1 (5 isolates) and blaIMP-6 genes (3 isolates). Bacterial species and carbapenem susceptibility patterns exhibited diversity. Minimum inhibitory concentrations (MICs) of meropenem were generally higher than those of imipenem and biapenem. Results of pulsed-field gel electrophoresis demonstrated that neither clonal nor plasmid-mediated outbreaks of blaIMP-harboring CPE isolates have developed at our hospital. One Klebsiella oxytoca isolate showed a high MIC (128 μg/mL) of meropenem, which could be explained by the high plasmid copy number. Subsequent analysis of this isolate may elucidate the intricacies of carbapenem resistance profiles among CPE isolates. Collectively, our findings underscore the necessity for ongoing genetic surveillance of CPE, complemented by tailored approaches for infection prevention and control.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7852024Small-for-Gestational-Age Status and the Risk of Kawasaki Disease: A Nationwide Birth Cohort in Japan363370ENSatoeTakanagaDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaomiMatsumotoDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomokaKadowakiDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSoshiTakaoDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiYorifujiDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityOriginal Article10.18926/AMO/67656Kawasaki disease (KD) is a pediatric disease of unknown etiology that commonly affects infants in East Asia. Infants born small for gestational age (SGA) have weaker immune systems and are more susceptible to infection. Using data from a nationwide Japanese birth cohort study conducted in 2010 (n=34,579), we investigated whether SGA increases the risk of KD. SGA was defined as birth weight below the 10th percentile for gestational age. The outcome was hospitalization for KD between 6 and 30 months of age. The association between SGA and hospitalization for KD, adjusted for child and maternal factors, was examined using logistic regression. Of the 231 children hospitalized for KD, 9.5% were SGA. Further statistical analysis showed that SGA did not increase the odds ratio (OR) of hospitalization for KD (adjusted OR 1.12, 95% confidence interval 0.71-1.75). This result was not changed with stratification by early daycare attendance and preterm status. Reasons for the lack of association may include the multifactorial pathogenesis of KD; in addition, the types of infections to which SGA infants are predisposed may differ from those triggering KD. Overall, our large nationwide study found no association between SGA and KD.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7852024Factors Affecting Dynamic Postural Control Ability in Adolescent Idiopathic Scoliosis357362ENRyokoYamawakiDivision of Physical Medicine and Rehabilitation, Okayama UniversityYoshiakiOdaDepartment of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShuheiYamaneDivision of Physical Medicine and Rehabilitation, Okayama UniversityKojiUotaniDepartment of Orthopaedic Surgery, Okayama UniversityHaruoMisawaRyusoh Orthopaedic HospitalYoshimiKatayamaDivision of Physical Medicine and Rehabilitation, Okayama UniversityMasanoriHamadaDivision of Physical Medicine and Rehabilitation, Okayama UniversityToshifumiOzakiDivision of Physical Medicine and Rehabilitation, Okayama UniversityOriginal Article10.18926/AMO/67655Research on postural control in patients with adolescent idiopathic scoliosis (AIS) has focused on static postural control, with few studies assessing dynamic postural control. We aimed to identify factors affecting index of postural stability (IPS), a dynamic postural control parameter, in patients with AIS. The participants comprised 50 female patients with AIS. We measured the IPS using stabilometry to evaluate dynamic postural control ability. We investigated age of the participants, major curve position (thoracic or thoracolumbar/lumbar), Cobb angle, and coronal balance. We then assessed the relationships between stabilometry parameters and other variables. IPS was analyzed with a linear regression model. Coronal balance, major curve position, and age each correlated with dynamic postural control ability. The Cobb angle showed no correlation with any of the parameters. Our results offer new insights into the assessment of postural control in patients with AIS.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0815-931939122024Rates and risk factors of bleeding after gastric endoscopic submucosal dissection with continuous warfarin or 1‐day withdrawal of direct oral anticoagulants27602766ENShoichiroHirataDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaHamadaDepartment of Practical Gastrointestinal Endoscopy, Okayama UniversityMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHirokazuMouriDepartment of Gastroenterology and Hepatology, Kurashiki Central HospitalKojiMiyaharaDepartment of Internal Medicine, Hiroshima City HospitalTakaoTsuzukiDepartment of Gastroenterology, Japanese Red Cross Society Himeji HospitalKenjiYamauchiDepartment of Gastroenterology, Mitoyo General HospitalSayoKobayashiDepartment of Internal Medicine, Fukuyama City HospitalSakumaTakahashiDepartment of Gastroenterology, Kagawa Prefectural Central HospitalRyutaTakenakaDepartment of Internal Medicine, Tsuyama Chuo HospitalShinichiroHoriDepartment of Gastroenterology, Japanese Red Cross Society Himeji HospitalMasafumiInoueDepartment of Gastroenterology, Japanese Red Cross Okayama HospitalTatsuyaToyokawaDepartment of Gastroenterology, National Hospital Organization Fukuyama Medical CenterMamoruNishimuraDepartment of Internal Medicine, Okayama City HospitalShuheiIshiyamaDepartment of Internal Medicine, Okayama Saiseikai General HospitalJiroMiyaikeDepartment of Internal Medicine, Saiseikai Imabari HospitalRyoKatoDepartment of Gastroenterology, National Hospital Organization Iwakuni Clinical CenterMinoruMatsubaraDepartment of Internal Medicine, Sumitomo Besshi HospitalNaokoYunokiDepartment of Internal Medicine, Akaiwa Medical Association HospitalHiromitsuKanzakiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiroKawaharaDepartment of Practical Gastrointestinal Endoscopy, Okayama UniversityHiroyukiOkadaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHidekiIshikawaDepartment of Molecular-Targeting Prevention, Kyoto Prefectural University of MedicineMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayama Gut Study GroupBackground and Aim: The 2017 Japanese guidelines recommend continuing warfarin therapy during the perioperative period or discontinuing direct oral anticoagulants (DOACs) only on the day of endoscopic submucosal dissection for early gastric cancer. However, their safety has not been sufficiently explored. This study aimed to validate this management method.<br>
Methods: This retrospective, multicenter study analyzed the characteristics and outcomes of patients who underwent gastric endoscopic submucosal dissection between July 2017 and June 2019. The patients were categorized according to the use of warfarin or DOACs.<br>
Results: Among the 62 eligible patients, 53 (85%) were male (median age, 76 years). Warfarin was used in 10 patients (16%) and DOACs in 52 patients (84%). Fourteen patients taking DOACs (27%) used concomitant antiplatelet agents, with seven patients (13%) continuing treatment at the time of the endoscopic procedure. No postprocedural bleeding occurred in patients receiving warfarin (0%), whereas 10 cases (19%) of bleeding occurred in patients receiving DOACs: rivaroxaban, 0% (0/22); dabigatran, 0% (0/2); edoxaban, 43% (6/14); and apixaban, 29% (4/14). The type of anticoagulant (P < 0.01) and continuation of antiplatelet therapy (P = 0.02) were risk factors for postprocedural bleeding in patients receiving DOACs. Intraprocedural bleeding requiring transfusion or symptomatic thromboembolic events were not reported.<br>
Conclusions: Continuous warfarin therapy is preferred. DOAC withdrawal 1 day before a procedure is associated with a high bleeding rate, which may differ for different types of anticoagulants. The continuation of antiplatelet medications in patients receiving DOACs carries a high risk of bleeding and is a future challenge.No potential conflict of interest relevant to this article was reported.Nature PortfolioActa Medica Okayama2045-23221412024Effectiveness of data-augmentation on deep learning in evaluating rapid on-site cytopathology at endoscopic ultrasound-guided fine needle aspiration22441ENYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceDaisukeUchidaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceRyosukeSatoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceTaisukeObataDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceMatsumiAkihiroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceKazuyaMiyamotoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceKosakuMorimotoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceHiroyukiTerasawaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceTatsuhiroYamazakiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceKoichiroTsutsumiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceHironariKatoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceHirofumiInoueDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceTenChoBusiness Strategy Division, Ryobi Systems Co., Ltd.TakayoshiTanimotoBusiness Strategy Division, Ryobi Systems Co., Ltd.AkimitsuOhtoBusiness Strategy Division, Ryobi Systems Co., Ltd.YoshiroKawaharaDepartment of Practical Gastrointestinal Endoscopy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceRapid on-site cytopathology evaluation (ROSE) has been considered an effective method to increase the diagnostic ability of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA); however, ROSE is unavailable in most institutes worldwide due to the shortage of cytopathologists. To overcome this situation, we created an artificial intelligence (AI)-based system (the ROSE-AI system), which was trained with the augmented data to evaluate the slide images acquired by EUS-FNA. This study aimed to clarify the effects of such data-augmentation on establishing an effective ROSE-AI system by comparing the efficacy of various data-augmentation techniques. The ROSE-AI system was trained with increased data obtained by the various data-augmentation techniques, including geometric transformation, color space transformation, and kernel filtering. By performing five-fold cross-validation, we compared the efficacy of each data-augmentation technique on the increasing diagnostic abilities of the ROSE-AI system. We collected 4059 divided EUS-FNA slide images from 36 patients with pancreatic cancer and nine patients with non-pancreatic cancer. The diagnostic ability of the ROSE-AI system without data augmentation had a sensitivity, specificity, and accuracy of 87.5%, 79.7%, and 83.7%, respectively. While, some data-augmentation techniques decreased diagnostic ability, the ROSE-AI system trained only with the augmented data using the geometric transformation technique had the highest diagnostic accuracy (88.2%). We successfully developed a prototype ROSE-AI system with high diagnostic ability. Each data-augmentation technique may have various compatibilities with AI-mediated diagnostics, and the geometric transformation was the most effective for the ROSE-AI system.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2212-53456252024A randomized, open-label phase II study on the preventive effect of goshajinkigan against peripheral neuropathy induced by paclitaxel-containing chemotherapy: The OLCSG2101 study protocol897900ENNaokiNakamuraDepartment of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesGoMakimotoDepartment of Allergy and Respiratory Medicine, Okayama University HospitalTakaakiTanakaDepartment of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukaKatoCenter of Innovative Clinical Medicine, Okayama University HospitalIsaoOzeDivision of Cancer Epidemiology and Prevention, Aichi Cancer Center Research InstituteToshiyukiKozukiDepartment of Respiratory Medicine, Shikoku Cancer CenterToshihideYokoyamaDepartment of Respiratory Medicine, Kurashiki Central HospitalHirohisaIchikawaDepartment of Respiratory Medicine, KKR Takamatsu HospitalShoichiKuyamaDepartment of Respiratory Medicine, Iwakuni Clinical CenterNaofumiHaraDepartment of Respiratory Medicine, Okayama Rosai HospitalYoshinobuMaedaDepartment of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKatsuyukiHottaCenter of Innovative Clinical Medicine, Okayama University HospitalBackground: Paclitaxel (PTX) is an essential cytotoxic anticancer agent and a standard treatment regimen component for various malignant tumors, including advanced unresectable non-small cell lung cancer, thymic cancer, and primary unknown cancers. However, chemotherapy-induced peripheral neuropathy (CIPN) caused by PTX is a significant adverse event that may lead to chemotherapy discontinuation and deterioration of the quality of life (QOL). Although treatment modalities such as goshajinkigan (GJG), pregabalin, and duloxetine are empirically utilized for CIPN, there is no established evidence for an agent as a preventive measure. We designed a randomized phase II trial (OLCSG2101) to investigate whether prophylactic GJG administration can prevent the onset of CIPN induced by PTX.<br>
Methods: This study was designed as a two-arm, prospective, randomized, multicenter phase II trial. The patients will be randomly assigned to either the GJG prophylaxis arm (Arm A) or the GJG non-prophylaxis arm (Arm B), using cancer type (lung cancer or not) and age (<70 years or not) as adjustment factors. A total of 66 patients (33 in each arm) will be enrolled.<br>
Discussion: The results of this study may contribute to better management of CIPN, which can enable the continuation of chemotherapy and maintenance of the patient's QOL.<br>
Ethics and dissemination: Ethical approval was obtained from the certified review board of Okayama University (approval no. CRB21-005) on September 28, 2021. Results will be published in peer-reviewed journals and presented at national and international conferences.<br>
Trial registration: Japan Registry of Clinical Trials (registration number jRCTs061210047).No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813622024令和５年度岡山医学会賞 がん研究奨励賞（林原賞・山田賞）4547ENTakamasaIshinoDepartment of Tumor Microenvironment, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7842024Surgical Treatment of an Abdominal Aortic Aneurysm in a Patient with a Liver Abscess345347ENGentaroKatoDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalYutoNarumiyaDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalMichihiroOkuyamaDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalShujiShimizuDepartment of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University HospitalKenjiSangawaDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalShuYamamotoDepartment of Cardiovascular Surgery, Kagawa Prefectural Central HospitalCase Report10.18926/AMO/67553The presence of an intraperitoneal source of infection, e.g., a liver abscess, can be an obstacle to performing an abdominal aortic surgery with a midline laparotomy because graft infection is one of the most critical complications of aortic surgery. We report the successful Y-grafting of a pararenal abdominal aortic aneurysm through a retroperitoneal approach in a 67-year-old male undergoing liver abscess drainage. The retroperitoneal approach to the abdominal aorta may be useful for abdominal aortic surgery in patients with a localized intraperitoneal infection.No potential conflict of interest relevant to this article was reported.Nature PortfolioActa Medica Okayama2045-23221412024Clinical and endocrine features of orthostatic intolerance detected in patients with long COVID17025ENAtsushiKatoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazukiTokumasuDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoichiroYamamotoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroNakanoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiHondaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaruhikoSunadaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasueSakuradaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuiMatsudaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToruHasegawaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyosukeTakaseDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeigoUedaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOrthostatic intolerance (OI) is a key symptom of long COVID; however, the pathophysiology remains unknown. Among 688 long COVID patients who visited our clinic during the period from February 2021 to April 2023, 86 patients who were suspected of having OI and who underwent an active standing test (ST) were investigated to elucidate the clinical characteristics of OI in patients with long COVID. Of the 86 patients, 33 patients (38%) were ST-positive. Nausea and tachycardia in daily life were frequent complaints in the ST-positive group. The increase in heart rate (HR) during the ST was significantly greater during a 10-min period after standing in the ST-positive group (+ 30 bpm) than in the ST-negative group (+ 16 bpm). The initial increase in diastolic blood pressure (DBP) just after standing was significantly greater in the ST-positive group (+ 14 mmHg) than in the ST-negative group (+ 9 mmHg). Serum cortisol levels in the ST-positive patients aged over 20 years were higher and growth hormone levels in the patients under 20 years of age were lower than those in the ST-negative group. Autonomous nervous symptoms, transient DBP rise with increasing HR after standing, and endocrine dysfunctions are helpful for detecting OI related to long COVID.No potential conflict of interest relevant to this article was reported.Royal Society of ChemistryActa Medica Okayama2041-652015322024Boosting charge separation in organic photovoltaics: unveiling dipole moment variations in excited non-fullerene acceptor layers1268612694ENAkiraYamakataGraduate School of Natural Science and Technology, Okayama UniversityKosakuKatoGraduate School of Natural Science and Technology, Okayama UniversityTakumiUrakamiDepartment of Molecular Engineering, Graduate School of Engineering, Kyoto UniversitySotaTsujimuraDepartment of Chemistry, Graduate School of Science, Kobe UniversityKasumiMurayamaDepartment of Chemistry, Graduate School of Science, Kobe UniversityMasahiroHigashiDepartment of Complex Systems Science, Graduate School of Informatics, Nagoya UniversityHirofumiSatoDepartment of Molecular Engineering, Graduate School of Engineering, Kyoto UniversityYasuhiroKoboriDepartment of Chemistry, Graduate School of Science, Kobe UniversityTomokazuUmeyamaDepartment of Applied Chemistry, Graduate School of Engineering, University of HyogoHiroshiImahoriDepartment of Molecular Engineering, Graduate School of Engineering, Kyoto UniversityThe power conversion efficiency (PCE) of organic photovoltaics (OPVs) has reached more than 19% due to the rapid development of non-fullerene acceptors (NFAs). To compete with the PCEs (26%) of commercialized silicon-based inorganic photovoltaics, the drawback of OPVs should be minimized. This drawback is the intrinsic large loss of open-circuit voltage; however, a general approach to this issue remains elusive. Here, we report a discovery regarding highly efficient NFAs, specifically ITIC. We found that charge-transfer (CT) and charge dissociation (CD) can occur even in a neat ITIC film without the donor layer. This is surprising, as these processes were previously believed to take place exclusively at donor/acceptor heterojunctions. Femtosecond time-resolved visible to mid-infrared measurements revealed that in the neat ITIC layers, the intermolecular CT immediately proceeds after photoirradiation (<0.1 ps) to form weakly-bound excitons with a binding energy of 0.3 eV, which are further dissociated into free electrons and holes with a time-constant of 56 ps. Theoretical calculations indicate that stacking faults in ITIC (i.e., V-type molecular stacking) induce instantaneous intermolecular CT and CD in the neat ITIC layer. In contrast, J-type stacking does not support such CT and CD. This previously unknown pathway is triggered by the larger dipole moment change on the excited state generated at the lower symmetric V-type molecular stacking of ITIC. This is in sharp contrast with the need of sufficient energy offset for CT and CD at the donor-acceptor heterojunction, leading to the significant voltage loss in conventional OPVs. These results demonstrate that the rational molecular design of NFAs can increase the local dipole moment change on the excited state within the NFA layer. This finding paves the way for a groundbreaking route toward the commercialization of OPVs.No potential conflict of interest relevant to this article was reported.ElsevierActa Medica Okayama0016-510710052024Virtual indigo carmine chromoendoscopy images: A novel modality for peroral cholangioscopy using artificial intelligence technology (with video)938946.e1ENRyosukeSatoDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalHideakiKinugasaDepartment of Gastroenterology and Hepatology, Okayama University HospitalMasahiroTomiyaBusiness Strategy Division, Ryobi Systems Co, LtdTakayoshiTanimotoBusiness Strategy Division, Ryobi Systems Co, LtdAkimitsuOhtoBusiness Strategy Division, Ryobi Systems Co, LtdKeiHaradaDepartment of Gastroenterology and Hepatology, Okayama University HospitalNaoHattoriDepartment of Gastroenterology and Hepatology, Okayama University HospitalTaisukeObataDepartment of Gastroenterology and Hepatology, Okayama University HospitalAkihiroMatsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyaMiyamotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalKosakuMorimotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalHiroyukiTerasawaDepartment of Gastroenterology and Hepatology, Okayama University HospitalYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University HospitalDaisukeUchidaDepartment of Gastroenterology and Hepatology, Okayama University HospitalKoichiroTsutsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalHironariKatoDepartment of Gastroenterology and Hepatology, Okayama University HospitalYoshiroKawaharaDepartment of Gastroenterology and Hepatology, Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalBackground and Aims: Accurately diagnosing biliary strictures is crucial for surgical decisions, and although peroral cholangioscopy (POCS) aids in visual diagnosis, diagnosing malignancies or determining lesion margins via this route remains challenging. Indigo carmine is commonly used to evaluate lesions during GI endoscopy. We aimed to establish the utility of virtual indigo carmine chromoendoscopy (VICI) converted from POCS images using artificial intelligence.<br>
Methods: This single-center, retrospective study analyzed 40 patients with biliary strictures who underwent POCS using white-light imaging (WLI) and narrow-band imaging (NBI). A cycle-consistent adversarial network was used to convert the WLI into VICI of POCS images. Three experienced endoscopists evaluated WLI, NBI, and VICI via POCS in all patients. The primary outcome was the visualization quality of surface structures, surface microvessels, and lesion margins. The secondary outcome was diagnostic accuracy.<br>
Results: VICI showed superior visualization of the surface structures and lesion margins compared with WLI (P < .001) and NBI (P < .001). The diagnostic accuracies were 72.5%, 87.5%, and 90.0% in WLI alone, WLI and VICI simultaneously, and WLI and NBI simultaneously, respectively. WLI and VICI simultaneously tended to result in higher accuracy than WLI alone (P = .083), and the results were not significantly different from WLI and NBI simultaneously (P = .65).<br>
Conclusions: VICI in POCS proved valuable for visualizing surface structures and lesion margins and contributed to higher diagnostic accuracy comparable to NBI. In addition to NBI, VICI may be a novel supportive modality for POCS.No potential conflict of interest relevant to this article was reported.American Physical Society (APS)Acta Medica Okayama2469-9950109172024Time-dependent Ginzburg-Landau theory of the vortex spin Hall effect174503ENHirotoAdachiResearch Institute for Interdisciplinary Science, Okayama UniversityYusukeKatoDepartment of Basic Science, University of TokyoJun-ichiroOheDepartment of Physics, Toho UniversityMasanoriIchiokaResearch Institute for Interdisciplinary Science, Okayama UniversityWe develop a time-dependent Ginzburg-Landau theory of the vortex spin Hall effect, i.e., a spin Hall effect that is driven by the motion of superconducting vortices. For the direct vortex spin Hall effect in which an input charge current drives the transverse spin current accompanying the vortex motion, we start from the well-known Schmid-Caroli-Maki solution for the time-dependent Ginzburg-Landau equation under the applied electric field, and find out the expression of the induced spin current. For the inverse vortex spin Hall effect in which an input spin current drives the longitudinal vortex motion and produces the transverse charge current, we microscopically construct the time-dependent Ginzburg-Landau equation under the applied spin accumulation gradient, and calculate the induced transverse charge current as well as the open circuit voltage. The time-dependent Ginzburg-Landau equation and its analytical solution developed here can be a basis for more quantitative numerical simulations of the vortex spin Hall effect.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7832024Assessment of a New Elbow Joint Positioning Method Using Area Detector Computed Tomography215225ENTakuyaAkagawaDepartment of Radiological Technology, Tokushima Red Cross HospitalRyoheiFukuiDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityKatsuhiroKidaDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityRyutaroMatsuuraDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityMakotoShimadaDepartment of Radiology, Osaka International Cancer InstituteMitsuhiroKinoshitaDepartment of Radiology, Tokushima Red Cross HospitalYokoAkagawaDepartment of Radiology, Tokushima Red Cross HospitalSachikoGotoDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/67196We propose a sitting position that achieves both high image quality and a reduced radiation dose in elbow joint imaging by area detector computed tomography (ADCT), and we compared it with the ‘superman’ and supine positions. The volumetric CT dose index (CTDIvol) for the sitting, superman, and supine positions were 2.7, 8.0, and 20.0 mGy and the dose length products (DLPs) were 43.4, 204.7, and 584.8 mGy • cm, respectively. In the task-based transfer function (TTF), the highest value was obtained for the sitting position in both bone and soft tissue images. The noise power spectrum (NPS) of bone images showed that the superman position had the lowest value up to approx. 1.1 cycles/mm or lower, whereas the sitting position had the lowest value when the NPS was greater than approx. 1.1 cycles/mm. The overall image quality in an observer study resulted in the following median Likert scores for Readers 1 and 2: 5.0 and 5.0 for the sitting position, 4.0 and 3.5 for the superman position, and 4.0 and 2.0 for the supine position. These results indicate that our proposed sitting position with ADCT of the elbow joint can provide superior image quality and allow lower radiation doses compared to the superman and supine positions.No potential conflict of interest relevant to this article was reported.SpringerActa Medica Okayama2198-77931012024Subtotal esophagectomy and concurrent reconstruction with free jejunal flap for primary esophageal cancer after pancreatoduodenectomy128ENKazuyaMoriwakeDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhiroNomaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentoKawasakiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTasukuMatsumotoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasashiHashimotoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuyaKatoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaoakiMaedaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShunsukeTanabeDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroShirakawaDepartment 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 Pancreatoduodenectomy and subtotal esophagectomy are widely considered the most invasive and difficult surgical procedures in gastrointestinal surgery. Subtotal esophagectomy after pancreatoduodenectomy is expected to be extremely difficult due to complicated anatomical changes, and selecting an appropriate intestinal reconstruction method will also be a difficult task. Therefore, perhaps because the method is considered impossible, there have been few reports of subtotal esophagectomy after pancreatoduodenectomy.<br>
Case presentation A 73-year-old man with a history of pancreatoduodenectomy was diagnosed with superficial thoracic esophageal squamous cell carcinoma. Definitive chemoradiation therapy was recommended at another hospital; however, he visited our department to undergo surgery. We performed the robot-assisted thoracoscopic subtotal esophagectomy. There were some difficulties with the reconstruction: the gastric tube could not be used, the reconstruction was long, and the organs reconstructed in the previous surgery had to be preserved. However, the concurrent reconstruction was achieved with the help of a free jejunal flap and vascular reconstruction. All reconstructions from the previous surgery, including the remnant stomach, were preserved via regional abdominal lymph node dissection. After reconstruction, intravenous indocyanine green showed that circulation in the reconstructed intestines was preserved. On postoperative day 1, no recurrent nerve paralysis was observed during laryngoscopy. The patient could start oral intake smoothly 2 weeks after surgery and did not exhibit any postoperative complications related to the reconstruction. The patient was transferred to another hospital on postoperative day 21.<br>
Conclusions Owing to the free jejunal flap interposition method, we safely performed one stage subtotal esophagectomy and concurrent reconstruction, preservation of the remnant stomach, and pancreaticobiliary reconstruction in patients with a history of pancreatoduodenectomy. We believe that this method is acceptable and useful for patients undergoing complicated reconstruction.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2024現代日本語形容詞の活用と派生−形容詞ク形の副詞化をめぐって−ENKazumiKATOGraduate School of Humanities and Social Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2024咬合支持を欠如したラットにおける記憶保持の低下と脳内アドレナリン量の変化ENTomokaKATOGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2024Expression and function of CCN2-derived circRNAs in chondrocytesENSomaKATOGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2024Promising Gene Therapy Using an Adenovirus Vector Carrying REIC/Dkk-3 Gene for the Treatment of Biliary CancerENEmiTANAKAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2024Endocrinological Changes after Anamorelin Administration in Patients with Gastrointestinal CancerENSakikoKURAOKAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2024PD‑L1‑expressing cancer‑associated fibroblasts induce tumor immunosuppression and contribute to poor clinical outcome in esophageal cancerENKentoKAWASAKIGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0340-700472112023PD-L1-expressing cancer-associated fibroblasts induce tumor immunosuppression and contribute to poor clinical outcome in esophageal cancer37873802ENKentoKawasakiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhiroNomaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuyaKatoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiakiOharaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShunsukeTanabeDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasushigeTakedaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHijiriMatsumotoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeitaroNishimuraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomoyoshiKunitomoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasaakiAkaiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTerukiKobayashiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNoriyukiNishiwakiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHajimeKashimaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaoakiMaedaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoruKikuchiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroshiTazawaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroShirakawaDepartment 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 SciencesThe programmed cell death 1 protein (PD-1)/programmed cell death ligand 1 (PD-L1) axis plays a crucial role in tumor immunosuppression, while the cancer-associated fibroblasts (CAFs) have various tumor-promoting functions. To determine the advantage of immunotherapy, the relationship between the cancer cells and the CAFs was evaluated in terms of the PD-1/PD-L1 axis. Overall, 140 cases of esophageal cancer underwent an immunohistochemical analysis of the PD-L1 expression and its association with the expression of the α smooth muscle actin, fibroblast activation protein, CD8, and forkhead box P3 (FoxP3) positive cells. The relationship between the cancer cells and the CAFs was evaluated in vitro, and the effect of the anti-PD-L1 antibody was evaluated using a syngeneic mouse model. A survival analysis showed that the PD-L1+ CAF group had worse survival than the PD-L1- group. In vitro and in vivo, direct interaction between the cancer cells and the CAFs showed a mutually upregulated PD-L1 expression. In vivo, the anti-PD-L1 antibody increased the number of dead CAFs and cancer cells, resulting in increased CD8+ T cells and decreased FoxP3+ regulatory T cells. We demonstrated that the PD-L1-expressing CAFs lead to poor outcomes in patients with esophageal cancer. The cancer cells and the CAFs mutually enhanced the PD-L1 expression and induced tumor immunosuppression. Therefore, the PD-L1-expressing CAFs may be good targets for cancer therapy, inhibiting tumor progression and improving host tumor immunity.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1341-96252862023Neoadjuvant chemotherapy followed by interval debulking surgery for advanced epithelial ovarian cancer: GOTIC-019 study804815ENShojiNagaoDepartment of Obstetrics and Gynecology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJunTamuraDepartment of Biostatistics, Yokohama City University School of MedicineTakashiShibutaniDepartment of Gynecologic Oncology, Hyogo Cancer CenterMaikoMiwaDepartment of Gynecologic Oncology, Saitama Medical University International Medical CenterTomoyasuKatoDepartment of Gynecologic Oncology, National Cancer Center HospitalAyumiShikamaDepartment of Obstetrics and Gynecology, Graduate School of Comprehensive Human Sciences, University of TsukubaYujiTakeiDepartment of Obstetrics and Gynecology, Jichi Medical UniversityNatsukoKamiyaDepartment of Obstetrics and Gynecology, Yokohama City University School of MedicineNaokiInoueDepartment of Obstetrics and Gynecology, Gunma UniversityKazutoNakamuraDepartment of Gynecologic Oncology, Gunma Prefectural Cancer CenterAyaInoueDepartment of Obstetrics and Gynecology, Ehime University School of MedicineKojiYamamotoDepartment of Biostatistics, Yokohama City University School of MedicineKeiichiFujiwaraDepartment of Gynecologic Oncology, Saitama Medical University International Medical CenterMitsuakiSuzukiDepartment of Obstetrics and Gynecology, Shin-Yurigaoka General HospitalIntroduction Three randomized controlled trials have resulted in extremely extensive application of the strategy of using neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS) for patients with advanced epithelial ovarian cancer in Japan. This study aimed to evaluate the status and effectiveness of treatment strategies using NAC followed by IDS in Japanese clinical practice.<br>
Patients and methods We conducted a multi-institutional observational study of 940 women with Federation of Gynecology and Obstetrics (FIGO) stages III–IV epithelial ovarian cancer treated at one of nine centers between 2010 and 2015. Progression-free survival (PFS) and overall survival (OS) were compared between 486 propensity-score matched participants who underwent NAC followed by IDS and primary debulking surgery (PDS) followed by adjuvant chemotherapy.<br>
Results Patients with FIGO stage IIIC receiving NAC had a shorter OS (median OS: 48.1 vs. 68.2 months, hazard ratio [HR]: 1.34; 95% confidence interval [CI] 0.99–1.82, p = 0.06) but not PFS (median PFS: 19.7 vs. 19.4 months, HR: 1.02; 95% CI: 0.80–1.31, p = 0.88). However, patients with FIGO stage IV receiving NAC and PDS had comparable PFS (median PFS: 16.6 vs. 14.7 months, HR: 1.07 95% CI: 0.74–1.53, p = 0.73) and OS (median PFS: 45.2 vs. 35.7 months, HR: 0.98; 95% CI: 0.65–1.47, p = 0.93).<br>
Conclusions NAC followed by IDS did not improve survival. In patients with FIGO stage IIIC, NAC may be associated with a shorter OS.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7822024Reduced Immunogenicity of COVID-19 Vaccine in Obese Patients with Type 2 Diabetes: A Cross-Sectional Study185191ENHirokoTakahashiDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunEguchiDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMayuWatanabeDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasanoriNakayamaOffice of Innovative Medicine, Organization for Research Strategy and Development, Okayama UniversityJunWadaDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/66927The global pandemic of coronavirus infection 2019 (COVID-19) was an unprecedented public health emergency. Several clinical studies reported that heart disease, lung disease, diabetes, hypertension, dyslipidemia, and obesity are critical risk factors for increased severity of and hospitalization for COVID-19. This is largely because patients with these underlying medical conditions can show poor immune responses to the COVID-19 vaccinations. Diabetes is one of the underlying conditions most highly associated with COVID-19 susceptibility and is considered a predictor of poor prognosis of COVID-19. We therefore investigated factors that influence the anti-SARS-CoV-2 spike IgG antibody titer after three doses of vaccination in patients with type 2 diabetes. We found that obesity was associated with low anti-SARS-CoV-2 spike IgG antibody titers following three-dose vaccination in type 2 diabetics. Obese patients with type 2 diabetes may have attenuated vaccine efficacy and require additional vaccination; continuous infection control should be considered in such patients.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7822024The Relationships among Internalized Stigma, Sense of Coherence, and Personal Recovery of Persons with Schizophrenia Living in the Community171184ENAyaKuramotoGraduate School of Health Sciences, Okayama UniversityShinyaSaitoGraduate School of Health Sciences, Okayama UniversityKumiWatanabeSchool of Nursing, Faculty of Medicine, Kagawa UniversityOriginal Article10.18926/AMO/66926We investigated (i) the relationships among internalized stigma (IS), sense of coherence (SOC), and the personal recovery (PR) of persons with schizophrenia living in the community, and (ii) how to improve the support for these individuals. A questionnaire survey on IS, SOC, and PR was sent by mail to 270 persons with schizophrenia living in the community who were using psychiatric daycare services, of whom 149 responded and 140 were included in the analysis. We established a hypothetical model in which IS influences PR, and SOC influences IS and PR, and we used structural equation modeling to examine the relationships among these concepts. The goodness of fit was acceptable. Our findings suggest that rather than directly promoting PR, SOC promotes PR by mitigating the impact of IS. It is important for nurses/supporters to support individuals with schizophrenia living in the community so that they have opportunities to reflect on their own experiences through their activities and to share their experiences with peers. Nurses/supporters themselves should also reflect on their own support needs. Our findings suggest that this will lead to a reduction of IS and the improvement of SOC, which will in turn promote personal recovery.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7822024Impact of Travel Distance on Surgical Outcomes of Patients Surgically Treated for Non-Small Cell Lung Cancer: A Single-Center Study in Ehime, Japan143149ENHisayukiShigematsuDepartment of Thoracic Surgery, NHO Shikoku Cancer CenterNatsumiYamashitaClinical Research Center, NHO Shikoku Cancer CenterHiroshiSuehisaDepartment of Thoracic Surgery, NHO Shikoku Cancer CenterTsuyoshiUenoDepartment of Thoracic Surgery, NHO Shikoku Cancer CenterTsuyoshiRyukoDepartment of Thoracic Surgery, NHO Shikoku Cancer CenterTakahitoSugiharaDepartment of Thoracic Surgery, NHO Shikoku Cancer CenterShoheiNakashimaDepartment of Thoracic Surgery, NHO Shikoku Cancer CenterYoshifumiSanoDepartment of Cardiovascular and Thoracic Surgery, Ehime University Graduate School of MedicineMotohiroYamashitaDepartment of Thoracic Surgery, NHO Shikoku Cancer CenterOriginal Article10.18926/AMO/66923Travel burden is a poor prognostic factor for many cancers worldwide because it hinders optimal diagnosis and treatment planning. Currently, the impact of travel burden on survival after surgery for non-small cell lung cancer (NSCLC) in Japan is largely unexplored. We examined the impact of travel distance on the postoperative outcomes of patients with NSCLC in Ehime Prefecture, Japan. The data of 1212 patients who underwent surgical resection for NSCLC were retrospectively reviewed. Patients were divided into quartiles based on the travel distance from their home to the hospital (≤ 13 km, 13-40 km, 40-57 km, and > 57 km) in Ehime Prefecture. We found no significant differences among the quartiles in baseline clinicopathological characteristics, including sex, smoking status, histology, surgical procedure, clinical stage, and pathological stage. Overall survival (OS) and relapse-free survival (RFS) also were not significantly different among the travel distance quartiles. We conclude that travel distance did not impact OS or RFS among patients with NSCLC who underwent surgical resection at our institution.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7822024The Roles of Neuropeptide Y in Respiratory Disease Pathogenesis via the Airway Immune Response95106ENJunkoItanoDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKatsuyukiKiuraDepartment of Allergy and Respiratory Medicine, Okayama University HospitalYoshinobuMaedaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuakiMiyaharaDepartment of Allergy and Respiratory Medicine, Okayama University HospitalReview10.18926/AMO/66912The lungs are very complex organs, and the respiratory system performs the dual roles of repairing tissue while protecting against infection from various environmental stimuli. Persistent external irritation disrupts the immune responses of tissues and cells in the respiratory system, ultimately leading to respiratory disease. Neuropeptide Y (NPY) is a 36-amino-acid polypeptide and a neurotransmitter that regulates homeostasis. The NPY receptor is a seven-transmembrane-domain G-protein-coupled receptor with six subtypes (Y1, Y2, Y3, Y4, Y5, and Y6). Of these receptors, Y1, Y2, Y4, and Y5 are functional in humans, and Y1 plays important roles in the immune responses of many organs, including the respiratory system. NPY and the Y1 receptor have critical roles in the pathogenesis of asthma, chronic obstructive pulmonary disease, and idiopathic pulmonary fibrosis. The effects of NPY on the airway immune response and pathogenesis differ among respiratory diseases. This review focuses on the involvement of NPY in the airway immune response and pathogenesis of various respiratory diseases.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0028-083662679992024Oxygen-evolving photosystem II structures during S1–S2–S3 transitions670677ENHongjieLiResearch Institute for Interdisciplinary Science, Graduate School of Natural Science and Technology, Okayama UniversityYoshikiNakajimaResearch Institute for Interdisciplinary Science, Graduate School of Natural Science and Technology, Okayama UniversityErikoNangoInstitute of Multidisciplinary Research for Advanced Materials, Tohoku UniversityShigekiOwadaJapan Synchrotron Radiation Research InstituteDaichiYamadaDepartment of Picobiology, Graduate School of Life Science, University of HyogoKanaHashimotoResearch Institute for Interdisciplinary Science, Graduate School of Natural Science and Technology, Okayama UniversityFangjiaLuoJapan Synchrotron Radiation Research InstituteRieTanakaRIKEN SPring-8 CenterFusamichiAkitaResearch Institute for Interdisciplinary Science, Graduate School of Natural Science and Technology, Okayama UniversityKojiKatoResearch Institute for Interdisciplinary Science, Graduate School of Natural Science and Technology, Okayama UniversityJungminKangRIKEN SPring-8 CenterYasunoriSaitohResearch Institute for Interdisciplinary Science, Graduate School of Natural Science and Technology, Okayama UniversityShunpeiKishiResearch Institute for Interdisciplinary Science, Graduate School of Natural Science and Technology, Okayama UniversityHuaxinYuResearch Institute for Interdisciplinary Science, Graduate School of Natural Science and Technology, Okayama UniversityNaokiMatsubaraResearch Institute for Interdisciplinary Science, Graduate School of Natural Science and Technology, Okayama UniversityHajimeFujiiResearch Institute for Interdisciplinary Science, Graduate School of Natural Science and Technology, Okayama UniversityMichihiroSugaharaJapan Synchrotron Radiation Research InstituteMamoruSuzukiInstitute for Protein Research, Osaka UniversityTetsuyaMasudaDivision of Food and Nutrition, Faculty of Agriculture, Ryukoku UniversityTetsunariKimuraDepartment of Chemistry, Graduate School of Science, Kobe UniversityTran NguyenThaoResearch Institute for Interdisciplinary Science, Graduate School of Natural Science and Technology, Okayama UniversityShinichiroYonekuraResearch Institute for Interdisciplinary Science, Graduate School of Natural Science and Technology, Okayama UniversityLong-JiangYuResearch Institute for Interdisciplinary Science, Graduate School of Natural Science and Technology, Okayama UniversityTakehikoToshaRIKEN SPring-8 CenterKensukeTonoJapan Synchrotron Radiation Research InstituteYasumasaJotiJapan Synchrotron Radiation Research InstituteTakakiHatsuiJapan Synchrotron Radiation Research InstituteMakinaYabashiJapan Synchrotron Radiation Research InstituteMinoruKuboDepartment of Picobiology, Graduate School of Life Science, University of HyogoSoIwataRIKEN SPring-8 CenterHiroshiIsobeResearch Institute for Interdisciplinary Science, Graduate School of Natural Science and Technology, Okayama UniversityKizashiYamaguchiCenter for Quantum Information and Quantum Biology, Osaka UniversityMichihiroSugaResearch Institute for Interdisciplinary Science, Graduate School of Natural Science and Technology, Okayama UniversityJian-RenShenResearch Institute for Interdisciplinary Science, Graduate School of Natural Science and Technology, Okayama UniversityPhotosystem II (PSII) catalyses the oxidation of water through a four-step cycle of Si states (i = 0–4) at the Mn4CaO5 cluster1,2,3, during which an extra oxygen (O6) is incorporated at the S3 state to form a possible dioxygen4,5,6,7. Structural changes of the metal cluster and its environment during the S-state transitions have been studied on the microsecond timescale. Here we use pump-probe serial femtosecond crystallography to reveal the structural dynamics of PSII from nanoseconds to milliseconds after illumination with one flash (1F) or two flashes (2F). YZ, a tyrosine residue that connects the reaction centre P680 and the Mn4CaO5 cluster, showed structural changes on a nanosecond timescale, as did its surrounding amino acid residues and water molecules, reflecting the fast transfer of electrons and protons after flash illumination. Notably, one water molecule emerged in the vicinity of Glu189 of the D1 subunit of PSII (D1-E189), and was bound to the Ca2+ ion on a sub-microsecond timescale after 2F illumination. This water molecule disappeared later with the concomitant increase of O6, suggesting that it is the origin of O6. We also observed concerted movements of water molecules in the O1, O4 and Cl-1 channels and their surrounding amino acid residues to complete the sequence of electron transfer, proton release and substrate water delivery. These results provide crucial insights into the structural dynamics of PSII during S-state transitions as well as O–O bond formation.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0309-01678472024Immunohistochemical p16 overexpression and Rb loss correlate with high‐risk human papillomavirus infection in endocervical adenocarcinomas11781191ENNobukoYasutakeDepartment of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu UniversityHidetakaYamamotoDepartment of Pathology, Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama UniversityRyosukeKugaDepartment of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu UniversityRinaJiromaruDepartment of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu UniversityTakahiroHongoDepartment of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu UniversityYoshihiroKatayamaDepartment of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu UniversityKenzoSonodaDepartment of Gynecology and Obstetrics, National Kyushu Cancer CenterHideakiYahataDepartment of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu UniversityKiyokoKatoDepartment of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu UniversityYoshinaoOdaDepartment of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu UniversityAims: p16 is a sensitive surrogate marker for transcriptionally active high-risk human papillomavirus (HR-HPV) infection in endocervical adenocarcinoma (ECA); however, its specificity is not perfect.<br>
Methods and results: We examined p16 and Rb expressions by immunohistochemistry (IHC) and the transcriptionally active HR-HPV infection by mRNA in-situ hybridisation (ISH) with histological review in 108 ECA cases. Thirteen adenocarcinomas of endometrial or equivocal origin (six endometrioid and seven serous carcinomas) were compared as the control group. HR-HPV was detected in 83 of 108 ECA cases (77%), including five HPV-associated adenocarcinomas in situ and 78 invasive HPV-associated adenocarcinomas. All 83 HPV-positive cases showed consistent morphology, p16 positivity and partial loss pattern of Rb. Among the 25 cases of HPV-independent adenocarcinoma, four (16%) were positive for p16, and of these four cases, three of 14 (21%) were gastric type adenocarcinomas and one of 10 (10%) was a clear cell type adenocarcinoma. All 25 HPV-independent adenocarcinomas showed preserved expression of Rb irrespective of the p16 status. Similarly, all 13 cases of the control group were negative for HR-HPV with preserved expression of Rb, even though six of 13 (46%) cases were positive for p16. Compared with p16 alone, the combination of p16 overexpression and Rb partial loss pattern showed equally excellent sensitivity (each 100%) and improved specificity (100 versus 73.6%) and positive predictive values (100 versus 89.2%) in the ECA and control groups. Furthermore, HR-HPV infection correlated with better prognosis among invasive ECAs.<br>
Conclusions: The results suggest that the combined use of p16 and Rb IHC could be a reliable method to predict HR-HPV infection in primary ECAs and mimics. This finding may contribute to prognostic prediction and therapeutic strategy.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 Okayama1881-1671572024形容詞修飾語用法の不規則性について―規定語・述語用法との比較から―89109ENKazumiKATO10.18926/66830No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323142024人間関係力を育む保育者養成教育の実践 ―心理教育“サクセスフル・セルフ”保育者養成版の作成，実施と評価2―253264ENYumiKATODepartment of Early Childhood Care and Education, Niimi UniversityMikayoANDOFaculty of Humanities and Social Sciences, Okayama University10.18926/CTED/66785 保育者養成大学の学生が保育現場の実情を知り，職務上の人間関係のあり方について実践的に学ぶことができるようにするため，四年制の保育者養成課程4年生45名対象として心理教育プログラム“サクセスフル・セルフ保育者養成版”の後半5レッスンを実施し，その内容や実施方法，効果について検討した。学生の記述内容から，本プログラムは分かりやすく役立つ内容になっていることが示唆され，学生のコミュニケーション能力や問題解決力等の向上に繋がり，ストレスマネジメントについて考える機会となったことが窺えた。なお，プログラム実施前後の心理社会的要因に関する評価指標には有意な差は見られなかったことから，プログラムの効果については，今後さらに詳細な検討が必要だと考えられる。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323142024音楽の視点を取り入れた教科等横断型理科授業の開発 ―《早春賦》を接点とした気象に対する意識の涵養―5770ENKenichiMATSUOOkayamajoto High SchoolKengoMATSUMOTOOkayamagakugeikan High SchoolKuranoshinKATOFaculty of Education, Okayama University10.18926/CTED/66772 季節の遷移期に注目した気象と音楽とを連携させた教科等横断型のアクティブ・ラーニング型の理科授業を考案し，その学習効果を検討した。唱歌《早春賦》を接点として，「芸術作品に表現される自然や季節を感覚的な視点で捉えることから気象の理解のきっかけとする」と同時に，「自然や季節を科学的な視点で捉えることで芸術作品の成立や表現したいことの背景の理解を深める」といった気象（科学的視点）と芸術（感覚的視点）とを連携させた双方向からのアプローチにより，生徒の興味・関心を高め，多面的な視点から考察できるような授業デザインとした。模擬授業後のアンケート分析により，本授業の狙いが伝わったような記述が多く見受けられ，相応の学習効果が認められた。また，本研究は，教科等横断型授業としても意義のある新たな提案の1つと考える。No potential conflict of interest relevant to this article was reported.Public Library of ScienceActa Medica Okayama1932-62031912024Aromatic oil from lavender as an atopic dermatitis suppressante0296408ENHarunaSatoGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityKosukeKatoGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityMayukoKoreishiGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityYoshimasaNakamuraGraduate School of Environmental and Life Science, Okayama UniversityYoshioTsujinoGraduate School of Science, Technology, and Innovation, Kobe UniversityAyanoSatohGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityIn atopic dermatitis (AD), nerves are abnormally stretched near the surface of the skin, making it sensitive to itching. Expression of neurotrophic factor Artemin (ARTN) involved in such nerve stretching is induced by the xenobiotic response (XRE) to air pollutants and UV radiation products. Therefore, AD can be monitored by the XRE response. Previously, we established a human keratinocyte cell line stably expressing a NanoLuc reporter gene downstream of XRE. We found that 6-formylindolo[3,2-b]carbazole (FICZ), a tryptophan metabolite and known inducer of the XRE, increased reporter and Artemin mRNA expression, indicating that FICZ-treated cells could be a model for AD. Lavender essential oil has been used in folk medicine to treat AD, but the scientific basis for its use is unclear. In the present study, we investigated the efficacy of lavender essential oil and its major components, linalyl acetate and linalool, to suppress AD and sensitize skin using the established AD model cell line, and keratinocyte and dendritic cell activation assays. Our results indicated that lavender essential oil from L. angustifolia and linalyl acetate exerted a strong AD inhibitory effect and almost no skin sensitization. Our model is useful in that it can circumvent the practice of using animal studies to evaluate AD medicines.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7812024A Case of Idiopathic Peptic Ulcer Disease Treated Effectively with Trimebutine Maleat8588ENKeisukeMiyakePost graduate clinical education center, Kawasaki Medical School General Medical CenterTomohiroTanikawaDepartment of General Internal Medicine 2, Kawasaki Medical SchoolKenHarumaDepartment of General Internal Medicine 2, Kawasaki Medical SchoolMayukoKawadaDepartment of General Internal Medicine 2, Kawasaki Medical SchoolKatsunoriIshiiDepartment of General Internal Medicine 2, Kawasaki Medical SchoolNoriyoUrataDepartment of General Internal Medicine 2, Kawasaki Medical SchoolKenNishinoDepartment of General Internal Medicine 2, Kawasaki Medical SchoolMitsuhikoSuehiroDepartment of General Internal Medicine 2, Kawasaki Medical SchoolMiwaKawanakaDepartment of General Internal Medicine 2, Kawasaki Medical SchoolNoriakiManabeDivision of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical SchoolHirofumiKawamotoDepartment of General Internal Medicine 2, Kawasaki Medical SchoolCase Report10.18926/AMO/66675A 30-year-old man with idiopathic peptic ulcer disease (IPUD) experienced repeated recurrence of ulcerative bleeding despite treatment with lansoprazole and then vonoprazan. Further evaluation suggested that the cause of the ulcer was strong contractile movements of the antrum. This prompted the co-administration of trimebutine maleate (TM) and vonoprazan to relieve the stomach contractions. TM was effective in preventing the recurrence of ulcerative bleeding, and the patient has remained in remission for 4 years. This case highlights the potential efficacy of TM in treating IPUD and the importance of considering hypercontractility as the underlying cause in cases of IPUD.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7812024Utility of Combined Use of Transabdominal Ultrasonography and Fecal Immunochemical Test Examinations in Ulcerative Colitis7983ENMasahiroTakaharaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSakikoHiraokaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasayasuOhmoriDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeikoTakeuchiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKensukeTakeiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiAoyamaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesErikoYasutomiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShokoIgawaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshihiroInokuchiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunkiToyosawaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasushiYamasakiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideakiKinugasaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeitaHaradaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHidekiOnishiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiOkadaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShort Communication10.18926/AMO/66674This study examined the utility of the combined use of transabdominal ultrasonography (TUS) and fecal immunochemical testing (FIT) to detect mucosal inflammation, vis-a-vis the Mayo endoscopic subscore (MES), in ulcerative colitis (UC). Sixty-three UC patients who underwent TUS and FIT were retrospectively enrolled. For TUS, the colon was divided into five segments, and the bowel wall thickness was measured and evaluated. The accuracy of FIT (> 100 ng/ml) in detecting mucosal inflammation (MES>0) was 0.93, whereas that of TUS (BWT>2 mm) in each segment was 0.84-0.97. The combined use of TUS and FIT may be helpful in noninvasive treatment strategies.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7812024Long-Term Follow-up Data of a Multi-Institutional Phase-2 Study of S-1/oxaliplatin and Bevacizumab Therapy in Patients with Advanced Colorectal Cancer: The HiSCO-02 Study4752ENManabuShimomuraDepartment of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityKatsunoriShinozakiDivision of Clinical Oncology, Hiroshima Prefectural HospitalTakuyaYanoDepartment of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityShintaroAkabaneDepartment of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityHidekiOhdanDepartment of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityHiroshima Surgical study group of Clinical Oncology (HiSCO)Original Article10.18926/AMO/66670Oral fluoropyrimidines (FUs) have certain advantages over intravenous FUs, such as longer intervals between outpatient visits, no requirement for central venous port (CVP) implantation, and lower incidence of neutropenia. We previously reported the efficacy of S-1/oxaliplatin (SOX) with bevacizumab therapy as a first-line treatment for advanced colorectal cancer (CRC) in a prospective phase-II multi-institutional clinical trial (HiSCO-02 study). However, our prognostic data at the time lacked a sufficient observation period. Herein, we analyze the longer-term follow-up data, focusing on the status of eventual CVP implantation via an open-label, non-randomized, multicenter study. This study enrolled 55 patients (mean age, 64 years), of whom 43 died (41 of primary cancer). The median overall survival was 22.7 months (95% CI: 20.1-34.7 months). Post-treatment regimens after failure of first-line treatment were initiated in 43 patients; CPT11-based regimens were selected in most cases, and other oral FU combinations in nine. CVP was implanted in 35 patients prior to first-line treatment; eleven of the remaining 20 patients did not require CVP implantation. In conclusion, we report here the final prognostic update of the Phase II clinical trial examining the efficacy of SOX plus bevacizumab therapy, the results of which confirm the clinical efficacy of this regimen.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7812024Regression of Necrotic Lesions after Methotrexate Withdrawal in Patients with Methotrexate-Associated Lymphoproliferative Disorders: A Retrospective CT Study2936ENTakahiroKitayamaDepartment of Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiTanakaDepartment of Radiology, Okayama City HospitalYuichiroKanieDepartment of Radiology, Okayama University HospitalYoheiMarukawaDepartment of Radiology, Okayama Saiseikai General HospitalKatsuhideKojimaDepartment of Radiology, Okayama University HospitalTakehiroTanakaDepartment of Pathology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySoshiTakaoDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakaoHirakiDepartment of Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityOriginal Article10.18926/AMO/66668This retrospective study investigated whether necrotic lesions detected on a computed tomography (CT) scan are more regressive than non-necrotic lesions after methotrexate withdrawal in patients pathologically diagnosed with methotrexate-associated lymphoproliferative disorders (MTX-LPD). In total, 89 lesions extracted from 24 patients on CT scans were included in the analysis. All patients had been evaluated for the presence of necrosis within lesions via CT scan upon first suspicion of MTX-LPD (baseline CT scan). The percentage lesion size reduction between the baseline and initial follow-up CT scan was calculated. The association between necrosis within lesions and size changes was estimated via linear regression analyses using both crude and adjusted models. Necrosis was significantly more common in extranodal lesions (27 out of 30 lesions, 90%) than in nodal lesions (9 out of 59 lesions, 15%, p<0.001). In the crude model, the regression of necrotic lesions was 58.5% greater than that of non-necrotic lesions; the difference was statistically significant (p<0.001). Additionally, the longest diameter of necrotic lesions at the baseline CT scan was significantly greater than that of non-necrotic lesions (p<0.001). Based on the adjusted model, necrotic lesions showed 49.3% greater regression than non-necrotic lesions (p=0.017). Necrosis detected on a CT scan was found to be an independent predictor of regression after MTX withdrawal in patients with MTX-LPD.No potential conflict of interest relevant to this article was reported.Cell PressActa Medica Okayama2162-2531342023MicroRNA-451a inhibits gemcitabine-refractory biliary tract cancer progression by suppressing the MIF-mediated PI3K/AKT pathway102054ENTaisukeObataDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceKoichiroTsutsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalEijiroUetaDepartment of Gastroenterology and Hepatology, Okayama University HospitalTakashiOdaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceTatsuyaKikuchiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceSoichiroAkoDepartment of Gastroenterology and Hepatology, Okayama University HospitalYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University HospitalTatsuhiroYamazakiDepartment of Gastroenterology and Hepatology, Okayama University HospitalDaisukeUchidaDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalHironariKatoDepartment of Gastroenterology and Hepatology, Okayama University HospitalHiroyukiOkadaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical ScienceGemcitabine is an effective chemotherapeutic agent for biliary tract cancers (BTCs), including gallbladder cancer (GBC) and cholangiocarcinoma (CCA). However, few other effective agents are currently available, particularly for GEM-refractory BTCs. We previously identified microRNA-451a (miR-451a) as a potential therapeutic target in GBC. To elucidate the antineoplastic effects of miR-451a and its underlying mechanisms, we transfected miR-451a into GBC, gemcitabine-resistant GBC (GR-GBC), and gemcitabine-resistant CCA (GR-CCA) cell lines. Furthermore, mimicking in vivo conditions, tumorigenic GBC organoids and three-dimensional (3D) cell culture systems were employed to investigate the anti-proliferative effects of miR-451a on BTCs, and its effect on stem cell properties. We found that miR-451a significantly inhibited cell proliferation, induced apoptosis, and reduced chemoresistant phenotypes, such as epithelial-mesenchymal transition, in both GBC and GR-GBC. The principal mechanism is probably the negative regulation of the phosphatidylinositol 3-kinase/AKT pathway, partially accomplished by directly downregulating macrophage migration inhibitory factor. The Gene Expression Omnibus database revealed that miR-451a was the most significantly downregulated microRNA in CCA tissues. The introduction of miR-451a resulted in similar antineoplastic effects in GR-CCA. Furthermore, miR-451a reduced cell viability in 3D spheroid models and tumorigenic GBC organoids. These findings suggest that the supplementation of miR-451a is a potential treatment strategy for GEM-refractory BTCs.No potential conflict of interest relevant to this article was reported.eLife Sciences PublicationsActa Medica Okayama2050-084X122023Characterization of tryptophan oxidation affecting D1 degradation by FtsH in the photosystem II quality control of chloroplastsRP88822ENYusukeKatoInstitute of Plant Science and Resources (IPSR), Okayama UniversityHiroshiKurodaResearch Institute for Interdisciplinary Science, Okayama UniversityShin-IchiroOzawaInstitute of Plant Science and Resources (IPSR), Okayama UniversityKeisukeSaitoResearch Center for Advanced Science and Technology, The University of TokyoVivekDograShanghai Center for Plant Stress Biology, Center for Excellence in Molecular Plant Sciences, Chinese Academy of SciencesMartinScholzInstitute of Plant Biology and Biotechnology, University of MünsterGuoxianZhangInstitute of Plant Science and Resources (IPSR), Okayama UniversityCatherinede VitryInstitut de Biologie Physico-Chimique, Unité Mixte de Recherche 7141, Centre National de la Recherche Scientifique and Sorbonne Université Pierre et Marie CurieHiroshiIshikitaResearch Center for Advanced Science and Technology, The University of TokyoChanhongKimShanghai Center for Plant Stress Biology, Center for Excellence in Molecular Plant Sciences, Chinese Academy of SciencesMichaelHipplerInstitute of Plant Science and Resources (IPSR), Okayama UniversityYuichiroTakahashiResearch Institute for Interdisciplinary Science, Okayama UniversityWataruSakamotoInstitute of Plant Science and Resources (IPSR), Okayama UniversityPhotosynthesis is one of the most important reactions for sustaining our environment. Photosystem II (PSII) is the initial site of photosynthetic electron transfer by water oxidation. Light in excess, however, causes the simultaneous production of reactive oxygen species (ROS), leading to photo-oxidative damage in PSII. To maintain photosynthetic activity, the PSII reaction center protein D1, which is the primary target of unavoidable photo-oxidative damage, is efficiently degraded by FtsH protease. In PSII subunits, photo-oxidative modifications of several amino acids such as Trp have been indeed documented, whereas the linkage between such modifications and D1 degradation remains elusive. Here, we show that an oxidative post-translational modification of Trp residue at the N-terminal tail of D1 is correlated with D1 degradation by FtsH during high-light stress. We revealed that Arabidopsis mutant lacking FtsH2 had increased levels of oxidative Trp residues in D1, among which an N-terminal Trp-14 was distinctively localized in the stromal side. Further characterization of Trp-14 using chloroplast transformation in Chlamydomonas indicated that substitution of D1 Trp-14 to Phe, mimicking Trp oxidation enhanced FtsH-mediated D1 degradation under high light, although the substitution did not affect protein stability and PSII activity. Molecular dynamics simulation of PSII implies that both Trp-14 oxidation and Phe substitution cause fluctuation of D1 N-terminal tail. Furthermore, Trp-14 to Phe modification appeared to have an additive effect in the interaction between FtsH and PSII core in vivo. Together, our results suggest that the Trp oxidation at its N-terminus of D1 may be one of the key oxidations in the PSII repair, leading to processive degradation by FtsH.No potential conflict of interest relevant to this article was reported.ElsevierActa Medica Okayama2666-36434102023Immunologic Significance of CD80/CD86 or Major Histocompatibility Complex-II Expression in Thymic Epithelial Tumors100573ENHidekiIkedaChiba Cancer Center, Research InstituteJojiNagasakiChiba Cancer Center, Research InstituteDaikiShimizuDivision of Thoracic Surgery, Chiba Cancer CenterYukiKatsuyaDepartment of Experimental Therapeutics, National Cancer Center HospitalHidehitoHorinouchiDepartment of Thoracic Oncology, National Cancer Center HospitalYukioHosomiDepartment of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalEtsukoTanjiChiba Cancer Center, Research InstituteTakekazuIwataDivision of Thoracic Surgery, Chiba Cancer CenterMakikoItamiDepartment of Surgical Pathology, Chiba Cancer CenterMasahitoKawazuChiba Cancer Center, Research InstituteYuichiroOheDepartment of Thoracic Oncology, National Cancer Center HospitalTakujiSuzukiDepartment of Respirology, Graduate School of Medicine, Chiba UniversityYosukeTogashiDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityIntroduction: Unresectable or recurrent thymic epithelial tumors (TETs) have a poor prognosis, and treatment options are limited. This study aimed to investigate the immunologic significance of CD80/CD86 or major histocompatibility complex class II (MHC-II) expression in TETs, as potential predictive biomarkers for immune checkpoint inhibitors (ICIs).<br>
Methods: We analyzed CD80, CD86, MHC class I (MHC-I), and MHC-II expression in TETs using immunohistochemistry and investigated their association with T-cell infiltration or ICI efficacy. In addition, we generated CD80- or MHC-II–expressing mouse tumors, evaluated the effects of ICIs, and analyzed tumor-infiltrating lymphocytes. We also performed tumor-rechallenge experiments in vivo.<br>
Results: We found that approximately 50% and 30% of TETs had high expression of CD80/CD86 and MHC-II in tumor cells, respectively, and that this expression was related to T-cell infiltration in clinical samples. In mouse models, both CD80 and MHC-II increase the effects of ICIs. In addition, senescent T cells and long-lived memory precursor effector T cells were significantly decreased and increased, respectively, in tumor-infiltrating lymphocytes from CD80-expressing tumors, and rechallenged tumors were completely rejected after the initial eradication of CD80-expressing tumors by programmed cell death protein 1 blockade. Indeed, patients with CD80-high thymic carcinoma had longer progression-free survival with anti–programmed cell death protein 1 monoclonal antibody.<br>
Conclusions: Half of the TETs had high expression of CD80/CD86 or MHC-II with high T-cell infiltration. These molecules could potentially increase the effects of ICIs, particularly inducing a durable response. CD80/CD86 and MHC-II can be predictive biomarkers of ICIs in TETs, promoting the development of drugs for such TETs.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813532023令和４年度岡山医学会賞 がん研究奨励賞（林原賞・山田賞）109112ENKazuyaNishiiDepartment of Hematology, Oncology Allergy and Respitatory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.BMCActa Medica Okayama1472-68312312023Ligneous periodontitis exacerbated by Behçet’s disease in a patient with plasminogen deficiency and a stop-gained variant PLG c.1468C > T: a case report843ENYukiShinoda-ItoDepartment of Pathophysiology‑Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAnnaHiraiDepartment of Periodontics and Endodontics, Division of Dentistry, Okayama University HospitalKazuhiroOmoriDepartment of Pathophysiology‑Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHidetakaIdeguchiDepartment of Periodontics and Endodontics, Division of Dentistry, Okayama University HospitalHidekiYamamotoDepartment of Clinical Genomic Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityFuminoKatoDepartment of Clinical Genomic Medicine, Okayama University HospitalKyoichiObataDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTatsuoOgawaDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKeisukeNakanoDepartment of Oral Pathology and Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakatoNakadoiThe Center for Graduate Medical Education (Dental Division), Okayama University HospitalEriKatsuyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySoichiroIbaragiDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTadashiYamamotoThe Center for Graduate Medical Education (Dental Division), Okayama University HospitalHitoshiNagatsukaDepartment of Oral Pathology and Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAkiraHirasawaDepartment of Clinical Genomic Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShogoTakashibaDepartment of Pathophysiology‑Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground Plasminogen serves as the precursor to plasmin, an essential element in the fibrinolytic process, and is synthesized primarily in the liver. Plasminogen activation occurs through the action of plasminogen activator, converting it into plasmin. This conversion greatly enhances the fibrinolytic system within tissues and blood vessels, facilitating the dissolution of fibrin clots. Consequently, congenital deficiency of plasminogen results in impaired fibrin degradation. Patients with plasminogen deficiency typically exhibit fibrin deposits in various mucosal sites throughout the body, including the oral cavity, eyes, vagina, and digestive organs. Behcet's disease is a chronic recurrent systemic inflammatory disease with four main symptoms: aphthous ulcers of the oral mucosa, vulvar ulcers, skin symptoms, and eye symptoms, and has been reported worldwide. This disease is highly prevalent around the Silk Road from the Mediterranean to East Asia.<br>
We report a case of periodontitis in a patient with these two rare diseases that worsened quickly, leading to alveolar bone destruction. Genetic testing revealed a novel variant characterized by a stop-gain mutation, which may be a previously unidentified etiologic gene associated with decreased plasminogen activity.<br>
Case presentation This case report depicts a patient diagnosed with ligneous gingivitis during childhood, originating from plasminogen deficiency and progressing to periodontitis. Genetic testing revealed a suspected association with the PLG c.1468C > T (p.Arg490*) stop-gain mutation. The patient's periodontal condition remained stable with brief intervals of supportive periodontal therapy. However, the emergence of Behçet's disease induced acute systemic inflammation, necessitating hospitalization and treatment with steroids. During hospitalization, the dental approach focused on maintaining oral hygiene and alleviating contact-related pain. The patient's overall health improved with inpatient care and the periodontal tissues deteriorated.<br>
Conclusions Collaborative efforts between medical and dental professionals are paramount in comprehensively evaluating and treating patients with intricate complications from rare diseases. Furthermore, the PLG c.1468C > T (p.Arg490*) stop-gain mutation could contribute to the association between plasminogen deficiency and related conditions.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7762023A Case of Migration of a Hydrogel Spacer for Radiotherapy into the Pulmonary Artery647650ENKatsuhideKojimaDepartment of Radiology, Okayama University HospitalYukaTakahashiDepartment of Radiology, Okayama University HospitalSoichiSugiyamaDepartment of Proton Beam Therapy, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYudaiAsanoDepartment of Radiology, Okayama University HospitalNanakoOkawaDepartment of Radiology, Okayama University HospitalSatokoMakimotoDepartment of Radiology, Okayama University HospitalFumiyoHigakiDepartment of Radiology, Okayama University HospitalToshihiroIguchiDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityTakaoHirakiDepartment of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityCase Report10.18926/AMO/66157A 67-year-old man was referred to our hospital for the diagnosis and treatment of prostate cancer. Multidisciplinary discussion led to intensity-modulated radiotherapy preceded by hormone therapy. Before radiotherapy, a biodegradable hydrogel spacer (HS) was placed between the prostate and rectum to reduce radiation injury risk. Three weeks postplacement, pelvic magnetic resonance imaging revealed HS migration into the pelvic vein. Subsequent whole-body contrast-enhanced computed tomography (CECT) revealed HS migration into the pulmonary artery. The patient showed no symptoms or clinical signs. Radiotherapy was completed uneventfully. Complete absorption of the migrated HS was confirmed using CECT images 5 months postplacement.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7762023Concomitant Use of Multiple Nephrotoxins including Renal Hypoperfusion Medications Causes Vancomycin-Associated Nephrotoxicity: Combined Retrospective Analyses of Two Real-World Databases595605ENTakashiBandoDepartment of Pharmacy, Tokushima University HospitalMasayukiChumaClinical Research Center for Developmental Therapeutics, Tokushima University HospitalHirofumiHamanoDepartment of Clinical Pharmacology and Therapeutics, Tokushima University Graduate School of Biomedical SciencesTakahiroNiimuraClinical Research Center for Developmental Therapeutics, Tokushima University HospitalNaotoOkadaDepartment of Pharmacy, Tokushima University HospitalMasateruKondoDepartment of Pharmacy, Tokushima University HospitalYukiIzumiDepartment of Pharmacy, Tokushima University HospitalShunsukeIshidaDepartment of Pharmacy, Tokushima University HospitalToshihikoYoshiokaDepartment of Pharmacy, Tokushima University HospitalMizuhoAsadaDepartment of Medical Molecular Informatics, Meiji Pharmaceutical UniversityYoshitoZamamiDepartment of Clinical Pharmacology and Therapeutics, Tokushima University Graduate School of Biomedical SciencesKenshiTakechiDepartment of Drug Information Analysis, College of Pharmaceutical Sciences, Matsuyama UniversityMitsuhiroGodaDepartment of Pharmacy, Tokushima University HospitalKojiMiyataDepartment of Clinical Pharmacology and Therapeutics, Tokushima University Graduate School of Biomedical SciencesKentaYagiClinical Research Center for Developmental Therapeutics, Tokushima University HospitalYukiIzawa-IshizawaDepartment of Pharmacology, Tokushima University Graduate School of Biomedical SciencesMomoyoAzumaDepartment of Infection Control and Prevention, Tokushima University HospitalHiroakiYanagawaDepartment of Nursing, Faculty of Health and Welfare, Tokushima Bunri UniversityYoshikazuTasakiDepartment of Hospital Pharmacy and Pharmacology, Asahikawa Medical UniversityKeisukeIshizawaDepartment of Pharmacy, Tokushima University HospitalOriginal Article10.18926/AMO/66151There is a growing concern about the relationship between vancomycin-associated nephrotoxicity (VAN) and concomitant use of nephrotoxins. We examined this relationship by combined retrospective analyses of two real-world databases. Initially, the FDA Adverse Event Reporting System (FAERS) was analyzed for the effects of concomitant use of one or more nephrotoxins on VAN and the types of combinations of nephrotoxins that exacerbate VAN. Next, electronic medical records (EMRs) of patients who received vancomycin (VCM) at Tokushima University Hospital between January 2006 and March 2019 were examined to confirm the FAERS analysis. An elevated reporting odds ratio (ROR) was observed with increases in the number of nephrotoxins administered (VCM + one nephrotoxin, adjusted ROR (95% confidence interval [CI]) 1.67 [1.51-1.85]; VCM + ≥2 nephrotoxins, adjusted ROR [95% CI] 1.54 [1.37-1.73]) in FAERS. EMRs analysis showed that the number of nephrotoxins was associated with higher incidences of VAN [odds ratio: 1.99; 95% CI: 1.42-2.78]. Overall, concomitant use of nephrotoxins was associated with an increased incidence of VAN, especially when at least one of those nephrotoxins was a renal hypoperfusion medication (furosemide, non-steroidal anti-inflammatory drugs, and vasopressors). The concomitant use of multiple nephrotoxins, especially including renal hypoperfusion medication, should be avoided to prevent VAN.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7762023Japanese Nursing Staff’s Knowledge and Attitude toward Bereavement Care for Couples with Miscarriage/Stillbirth and Its Associated Factors577587ENSiyuLiuGraduate School of Health Sciences, Okayama UniversityRukmaliAthurupanaGraduate School of Health Sciences, Okayama UniversityHongmeiHanGraduate School of Health Sciences, Okayama UniversityTitiYangGraduate School of Medicine, Density and Pharmaceutical Sciences, Okayama UniversityMikiyaNakatsukaGraduate School of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/66149Bereavement care is conducted to meet the emotional needs of grieving couples who are devastated by the experience of a miscarriage or stillbirth. From January to April 2022, we distributed a questionnaire that assessed the knowledge and attitudes of Japanese nursing staff (nurses and midwives) in Japan’s Chugoku-Shikoku region toward bereavement care for couples with miscarriage/stillbirth. The 370 survey respondents’ answers revealed that the nursing staff’s knowledge regarding recurrent pregnancy loss and subsequent bereavement care was insufficient. About 41.1% and 64.1% of the respondents had received school and on-the-job education in bereavement care, respectively, and 79.2% expressed willingness to provide such care. Our analyses revealed that the following factors were associated with the nursing staff’s knowledge level: parent status, age, reproductive history, midwifery license, work experience and environment, and on-the-job education. The following were correlated with the staff’s willingness to provide bereavement care: work environment, midwifery license, bereavement care knowledge, and on-the-job education. Together our findings indicate that education plays a significant role in equipping caregivers to provide effective bereavement care for couples who have experienced a miscarriage or stillbirth.No potential conflict of interest relevant to this article was reported.Japanese Society of BreedingActa Medica Okayama1344-76107352023Genomic traces of Japanese malting barley breeding in two modern high-quality cultivars, ‘Sukai Golden’ and ‘Sachiho Golden’435444ENShinTaketaInstitute of Plant Science and Resources, Okayama UniversityJune-SikKimInstitute of Plant Science and Resources, Okayama UniversityHidekazuTakahashiFaculty of Food and Agricultural Sciences, Fukushima UniversityShunsukeYajimaNODAI Genome Research Center, Tokyo University of AgricultureYuichiKoshiishiNODAI Genome Research Center, Tokyo University of AgricultureToshinoriSotomeTochigi Prefectural Agricultural Experiment StationTsuneoKatoTochigi Prefectural Agricultural Experiment StationKeiichiMochidaBioproductivity Informatics Research Team, RIKEN Center for Sustainable Resource ScienceTwo modern high-quality Japanese malting barley cultivars, ‘Sukai Golden’ and ‘Sachiho Golden’, were subjected to RNA-sequencing of transcripts extracted from 20-day-old immature seeds. Despite their close relation, 2,419 Sukai Golden-specific and 3,058 Sachiho Golden-specific SNPs were detected in comparison to the genome sequences of two reference cultivars: ‘Morex’ and ‘Haruna Nijo’. Two single nucleotide polymorphism (SNP) clusters respectively showing the incorporation of (1) the barley yellow mosaic virus (BaYMV) resistance gene rym5 from six-row non-malting Chinese landrace Mokusekko 3 on the long arm of 3H, and (2) the anthocyanin-less ant2 gene from a two-row Dutch cultivar on the long arm of 2H were detected specifically in ‘Sukai Golden’. Using 221 recombinant inbred lines of a cross between ‘Ishukushirazu’ and ‘Nishinochikara’, another BaYMV resistance rym3 gene derived from six-row non-malting Japanese cultivar ‘Haganemugi’ was mapped to a 0.4-cM interval on the proximal region of 5H. Haplotype analysis of progenitor accessions of the two modern malting cultivars revealed that rym3 of ‘Haganemugi’ was independently introduced into ‘Sukai Golden’ and ‘Sachiho Golden’. Residual chromosome 5H segments of ‘Haganemugi’ surrounding rym3 were larger in ‘Sukai Golden’. Available results suggest possibilities for malting quality improvement by minimizing residual segments surrounding rym3.No potential conflict of interest relevant to this article was reported.SAGE PublicationsActa Medica Okayama1756-283X162023Optimal liver drainage rate for survival in patients with unresectable malignant hilar biliary obstruction using 3D-image volume analyzerENKosakuMorimotoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTaisukeObataDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakashiOdaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuyaMiyamotoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkihiroMatsumiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiTerasawaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTatsuhiroYamazakiDepartment 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 SciencesKoichiroTsutsumiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHironariKatoDepartment 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 SciencesBackground: Drainage exceeding 50% of total liver volume is a beneficial prognostic factor in patients with unresectable malignant hilar biliary obstruction (UMHBO). However, it is unclear what threshold percentage of total liver volume drained ('liver drainage rate') significantly improves survival in patients with UMHBO who received systemic chemotherapy.<br>
Objectives: We aimed to assess the optimal liver drainage rate that improves survival in patients with UMHBO receiving chemotherapy using a three-dimensional (3D)-image volume analyzer.<br>
Design: This study was a single-center retrospective cohort study.<br>
Methods: Data from 90 patients with UMHBO who received chemotherapy after endoscopic biliary drainage using metal stents at Okayama University Hospital from January 2003 to December 2020 were reviewed. The liver drainage rate was calculated by dividing the drained liver volume by the total liver volume using a 3D-image volume analyzer. The primary endpoint was overall survival by liver drainage rate. The secondary endpoints were time to recurrent biliary obstruction (TRBO) and prognostic factors.<br>
Results: The median total liver volume was 1172 (range: 673-2032) mL, and the median liver drainage rate was 83% (range: 50-100). Overall survival was 376 (95% CI: 271-450) days, and patients with >80% drainage (n = 67) had significantly longer survival than those with <80% drainage (n = 23) (450 days versus 224 days, p = 0.0033, log-rank test). TRBO was 201 (95% CI: 155-327) days and did not differ significantly by liver drainage rate. Multivariate Cox proportional hazards regression analysis revealed >80% liver drainage [hazard ratio (HR): 0.35, 95% CI: 0.20-0.62, p = 0.0003] and hilar cholangiocarcinoma (HR: 0.30, 95% CI: 0.17-0.50, p < 0.0001) as significant prognostic factors.<br>
Conclusion: In patients with UMHBO scheduled for chemotherapy, >80% drainage is associated with improved survival. Further prospective multicenter studies are needed to verify the results of this study.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2023Conventional Cancer Therapies Can Accelerate Malignant Potential of Cancer Cells by Activating Cancer-Associated Fibroblasts in Esophageal Cancer ModelsENSatoshiKOMOTOGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.ElsevierActa Medica Okayama2213-0071382022Massive hemoptysis in a post-operative patient with recurrent lung cancer successfully treated by the combination therapy of Endobronchial Watanabe Spigot and bronchial artery embolization101669ENMasatakaTaokaDepartment of Allergy and Respiratory Medicine, Okayama University HospitalGoMakimotoDepartment of Allergy and Respiratory Medicine, Okayama University HospitalNoriyukiUmakoshiDepartment of Radiology, Okayama University HospitalKiichiroNinomiyaDepartment of Allergy and Respiratory Medicine, Okayama University HospitalHisaoHigoDepartment of Allergy and Respiratory Medicine, Okayama University HospitalYukaKatoCenter for Innovative Clinical Medicine, Okayama University HospitalMasanoriFujiiDepartment of Allergy and Respiratory Medicine, Okayama University HospitalToshioKuboCenter for Clinical Oncology, Okayama University HospitalEikiIchiharaDepartment of Allergy and Respiratory Medicine, Okayama University HospitalKadoakiOhashiDepartment of Allergy and Respiratory Medicine, Okayama University HospitalKatsuyukiHottaCenter for Innovative Clinical Medicine, Okayama University HospitalMasahiroTabataCenter for Clinical Oncology, Okayama University HospitalYoshinobuMaedaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKatsuyukiKiuraDepartment of Allergy and Respiratory Medicine, Okayama University HospitalA 76-year-old woman who was treated with lorlatinib for postoperative recurrent anaplastic lymphoma kinase-positive lung adenocarcinoma visited our hospital with massive hemoptysis. Chest computed tomography showed massive bleeding from the right upper lobe; however, the cause of bleeding was unclear. After bronchial artery embolization (BAE), bronchial occlusion was performed using an Endobronchial Watanabe Spigot (EWS) that was easily placed because BAE had reduced the bleeding volume. Treatment with BAE alone was inadequate; however, additional therapy with EWS after BAE successfully controlled the massive hemoptysis, especially in this patient who underwent lobectomy to prevent respiratory dysfunction.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1742-464X29162023Hepatitis C virus NS5B triggers an MDA5-mediated innate immune response by producing dsRNA without the replication of viral genomes11191130ENHiromichiDansakoDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasanoriIkedaDivision of Biological Information Technology, Joint Research Center for Human Retrovirus Infection, Kagoshima UniversityYasuoAriumiManagement Department of Biosafety, Laboratory Animal, and Pathogen Bank, National Institute of Infectious DiseasesYosukeTogashiDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNobuyukiKatoDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityDuring the replication of viral genomes, RNA viruses produce double-stranded RNA (dsRNA), through the activity of their RNA-dependent RNA polymerases (RdRps) as viral replication intermediates. Recognition of viral dsRNA by host pattern recognition receptors – such as retinoic acid-induced gene-I (RIG-I)-like receptors and Toll-like receptor 3 – triggers the production of interferon (IFN)-β via the activation of IFN regulatory factor (IRF)-3. It has been proposed that, during the replication of viral genomes, each of RIG-I and melanoma differentiation-associated gene 5 (MDA5) form homodimers for the efficient activation of a downstream signalling pathway in host cells. We previously reported that, in the non-neoplastic human hepatocyte line PH5CH8, the RdRp NS5B derived from hepatitis C virus (HCV) could induce IFN-β expression by its RdRp activity without the actual replication of viral genomes. However, the exact mechanism by which HCV NS5B produced IFN-β remained unknown. In the present study, we first showed that NS5B derived from another Flaviviridae family member, GB virus B (GBV-B), also possessed the ability to induce IFN-β in PH5CH8 cells. Similarly, HCV NS5B, but not its G317V mutant, which lacks RdRp activity, induced the dimerization of MDA5 and subsequently the activation of IRF-3. Interestingly, immunofluorescence analysis showed that HCV NS5B produced dsRNA. Like HCV NS5B, GBV-B NS5B also triggered the production of dsRNA and subsequently the dimerization of MDA5. Taken together, our results show that HCV NS5B triggers an MDA5-mediated innate immune response by producing dsRNA without the replication of viral genomes in human hepatocytes.No potential conflict of interest relevant to this article was reported.Royal Society of ChemistryActa Medica Okayama2041-652014422023An emissive charge-transfer excited-state at the well-defined hetero-nanostructure interface of an organic conjugated molecule and two-dimensional inorganic nanosheet1191411923ENTomokazuUmeyamaDepartment of Applied Chemistry, Graduate School of Engineering, University of HyogoDaizuMizutaniDepartment of Molecular Engineering, Graduate School of Engineering, Kyoto UniversityYukiIkedaDepartment of Molecular Engineering, Graduate School of Engineering, Kyoto UniversityW. RyanOsterlohDepartment of Molecular Engineering, Graduate School of Engineering, Kyoto UniversityFutaYamamotoDepartment of Applied Chemistry, Graduate School of Engineering, University of HyogoKosakuKatoGraduate School of Natural Science and Technology, Okayama UniversityAkiraYamakataGraduate School of Natural Science and Technology, Okayama UniversityMasahiroHigashiDepartment of Molecular Engineering, Graduate School of Engineering, Kyoto UniversityTakumiUrakamiDepartment of Molecular Engineering, Graduate School of Engineering, Kyoto UniversityHirofumiSatoDepartment of Molecular Engineering, Graduate School of Engineering, Kyoto UniversityHiroshiImahoriDepartment of Molecular Engineering, Graduate School of Engineering, Kyoto UniversityPrecise engineering of excited-state interactions between an organic conjugated molecule and a two-dimensional semiconducting inorganic nanosheet, specifically the manipulation of charge-transfer excited (CTE) states, still remains a challenge for state-of-the-art photochemistry. Herein, we report a long-lived, highly emissive CTE state at structurally well-defined hetero-nanostructure interfaces of photoactive pyrene and two-dimensional MoS2 nanosheets via an N-benzylsuccinimide bridge (Py-Bn-MoS2). Spectroscopic measurements reveal that no charge-transfer state is formed in the ground state, but the locally-excited (LE) state of pyrene in Py-Bn-MoS2 efficiently generates an unusual emissive CTE state. Theoretical studies elucidate the interaction of MoS2 vacant orbitals with the pyrene LE state to form a CTE state that shows a distinct solvent dependence of the emission energy. This is the first example of organic-inorganic 2D hetero-nanostructures displaying mixed luminescence properties by an accurate design of the bridge structure, and therefore represents an important step in their applications for energy conversion and optoelectronic devices and sensors.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7752023Endoscopic Manifestations and Clinical Characteristics of Localized Gastric Light-Chain Amyloidosis545552ENMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShouichiTanakaDepartment of Gastroenterology, National Hospital Organization Iwakuni Clinical CenterTatsuyaToyokawaDepartment of Gastroenterology, National Hospital Organization Fukuyama Medical CenterMamoruNishimuraDepartment of Internal Medicine, Okayama City HospitalTakaoTsuzukiDepartment of Internal Medicine, Japanese Red Cross Society Himeji HospitalKojiMiyaharaDepartment of Internal Medicine, Hiroshima City Hiroshima Citizens HospitalShinNegishiDepartment of Gastroenterology, Kagawa Prefectural Central HospitalShogenOhyaKawaguchi Medical ClinicTakehiroTanakaDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/65978To determine the endoscopic and clinical features of localized gastric amyloid light-chain (AL) amyloidosis, we retrospectively examined the characteristics of nine patients (eight men and one woman) encountered by the hospitals in our network. Lesions were predominantly flat and depressed with surface vascular dilatation (n=5); others were characterized by subepithelial lesions (n=2), mucosal color change (n=1), and a mass-like morphology with swollen mucosal folds (n=1). Colonoscopy (n=7), video capsule enteroscopy (n=2), serum (n=5) and urine immunoelectrophoresis (n=4), and bone marrow examination (n=3) were performed to exclude involvement of organs other than the stomach. As treatment for gastric lesions of AL amyloidosis, one patient each underwent endoscopic submucosal dissection (n=1) and argon plasma coagulation (n=1), while the remaining seven patients underwent no specific treatment. During a mean follow-up of 4.2 years, one patient died 3.2 years after diagnosis, but the cause of death, which occurred in another hospital, was unknown. The remaining eight patients were alive at the last visit. In conclusion, although localized gastric AL amyloidosis can show various macroscopic features on esophagogastroduodenoscopy, flat, depressed lesions with vascular dilatation on the surface are predominant.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7752023Association between BRCA Gene Variants and the Response to Modified FOLFIRINOX in Patients with Unresectable Pancreatic Cancer517525ENShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalKosakuMorimotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalAkihiroMatsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalHiroyukiTerasawaDepartment of Gastroenterology and Hepatology, Okayama University HospitalYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University HospitalTatsuhiroYamazakiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKoichiroTsutsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalHironariKatoDepartment of Gastroenterology and Hepatology, Okayama University HospitalOriginal Article10.18926/AMO/65974We investigated the effect of modified FOLFIRINOX (mFFX) in unresectable pancreatic cancer by retrospectively analyzing the cases of 43 patients who underwent BRCA testing (germline, n=11; somatic, n=26; both germline and somatic, n=6). The association between BRCA mutations and therapeutic effect was clarified. Six patients tested positive for germline pathogenic variants. Familial pancreatic cancer (33% vs. 3%, p=0.006) and peritoneal disseminated lesions (66% vs. 8%, p<0.001) were significantly more common in patients with germline pathogenic variants. The partial response (PR) rate was 100% in the germline BRCA-positive patients, and 27% in the germline BRCA-negative patients (p<0.001). The median progression-free survival (PFS) was not reached for any germline BRCA-positive patients but was 9.0 months for the germline BRCA-negative patients (p=0.042). Patients with stage IV BRCA-associated pancreatic cancer had better overall survival than those with non-BRCA-associated pancreatic cancer, although the difference was nonsignificant (not reached vs. 655 days, p=0.061). Our results demonstrate that a PR and prolonged PFS can be expected in germline BRCA-positive patients after treatment with mFFX. Our findings also suggest that germline BRCA pathogenic variants may be useful as biomarkers for the therapeutic effect of mFFX in patients with pancreatic cancer.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7752023Associations among Preoperative Malnutrition, Muscle Loss, and Postoperative Walking Ability in Intertrochanteric Fractures: A Retrospective Study511516ENKoheiSatoDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHironoriTsujiDepartment of Orthopedic Surgery, Japanese Red Cross Okayama HospitalMasanoriYorimitsuDepartment of Orthopedic Surgery, Okayama University HospitalTakenoriUeharaDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiOkazakiDepartment of Orthopedic Surgery, Tsuyama Chuo HospitalShinichiroTakaoDepartment of Orthopedic Surgery, Okayama Medical CenterToshiakiHataDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShiroFukuokaDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomoyukiNodaDepartment of Orthopedic Surgery, Kawasaki Medical School, General Medical CenterHideyukiKandaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/65973Sarcopenia and malnutrition are increasing in older adults and are reported risk factors for functional impairment after hip fracture surgery. This study aimed to investigate the associations between skeletal muscle mass loss, malnutrition, and postoperative walking ability in patients with hip fracture. We retrospectively reviewed patients who underwent intertrochanteric fracture surgery at our institute. The psoas muscle index, controlling nutritional status score, and functional ambulation category (FAC) were used to evaluate skeletal muscle mass, nutritional status, and walking ability, respectively. Six months after surgery, walking ability was assessed as either “gait disturbance” or “independent gait”. Multivariate binomial logistic regression analysis, with skeletal muscle mass, nutritional status, and other factors, was used to predict the risk of being assigned to the gait disturbance group. This study included 95 patients (mean age, 85.2 years; 70 women). Sixty-six patients had low skeletal muscle mass, 35 suffered from malnutrition, and 28 had both. Malnutrition and low skeletal muscle mass were significantly associated with postoperative gait disturbance (FAC < 3). Preoperative low skeletal muscle mass and malnutrition were risk factors for postoperative poor walking ability. Further preventive interventions focusing on skeletal muscle mass and nutritional status are required.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7752023Childcare and Child Development in Japan479490ENAkikoMurataDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaomiMatsumotoFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityChikaraMiyajiDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSoshiTakaoFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiYorifujiFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityOriginal Article10.18926/AMO/65970For decades, the notion has persisted in developed countries that exclusive care by the mothers is best for the development of children up to 3 years of age. To examine the veracity of this “myth of the first three years” in Japan, we examined the effects of childcare facility use for children younger than 3 years on their development using the cohorts of the Longitudinal Survey of Newborns in the 21st Century conducted in Japan. Of the 47,015 respondents to the survey, we studied the children of 5,508 mothers with university/professional education to evaluate the relationships between primary early (< 2.5 years) childcare providers during weekday daytime hours and specific development indices for the ages of 2.5, 5.5, and 8 years. At the age of 2.5 and 5.5 years, children attending childcare facilities were judged as having more advanced developmental behaviors by their parents, such as being able to compose a two-word sentence (adjusted odds ratio [aOR]: 0.22) or to express emotions (aOR: 0.81), compared with those cared for by mothers. However, at the age of 8 years, children who attended childcare facilities as infants < 2.5 years showed more aggressive behavior in interrupting people (aOR: 1.20) and causing disturbances in public (aOR: 1.26) than those cared for by mothers (after adjustment for numerous child and parental factors). Although these results are generally consistent with previous studies, issues potentially involved with problem behavior such as quality of childcare require further investigation, as does the case of children of mothers with more modest educational attainment.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7752023Low Patient Weight and Long Intubation Time Are Key Factors for Pain during Colonoscopy471478ENShoheiOkaDepartments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeitaHaradaDepartments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShumpeiYamamotoDepartments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesErikoYasutomiDepartments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShokoIgawaDepartments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasayasuOhmoriDepartments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMamiHiraiDepartments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasushiYamasakiDepartments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshihiroInokuchiDepartments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideakiKinugasaDepartments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasahiroTakaharaDepartments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSakikoHiraokaDepartments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiOkadaDepartments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/65969Although the clinical usefulness of colonoscopy has been established, the procedure remains painful for many patients. This study was designed to clarify the factors predicting colonoscopy-related pain. We evaluated 283 consecutive patients who completed a first-ever, total colonoscopy without sedatives or analgesics. The severity of pain symptoms was evaluated by a numeric rating scale (NRS) in a questionnaire immediately after the colonoscopy. Patient backgrounds and endoscopic findings were analyzed to evaluate their association with pain. Out of 283 patients, 53 scored their pain 0-1 on the NRS while 48 scored it 6-10. We defined the colonoscopies of the former and latter patients as painless and painful, respectively, and compared the two. Multivariate analyses revealed that low body weight (OR 4.95, 95%CI 1.89-12.99) and longer intubation time (OR 3.63, 95%CI 1.46-9.03) were significant risk factors for painful colonoscopy. To identify factors contributing to the increased intubation time, we divided subjects into short- and long-intubation-time groups based on a median insertion time of 7 min. Older age (OR 2.28, 95%CI 1.31-3.98), previous abdominal surgery (OR 1.93, 95%CI 1.13-3.32) and findings of invasive cancer (OR 10.90, 95%CI 1.34-88.90) were significant factors for longer intubation time.No potential conflict of interest relevant to this article was reported.American Association for the Advancement of Science (AAAS)Acta Medica Okayama2375-25488122022Structure and dynamics of Odinarchaeota tubulin and the implications for eukaryotic microtubule evolutioneabm2225ENCanerAkılResearch Institute for Interdisciplinary Science, Okayama UniversitySamsonAliResearch Institute for Interdisciplinary Science, Okayama UniversityLinh T.TranResearch Institute for Interdisciplinary Science, Okayama UniversityJérémieGaillardUniversity of Grenoble-Alpes, CEA, CNRS, INRA, Interdisciplinary Research Institute of Grenoble, Laboratoire de Physiologie Cellulaire & Végétale, CytoMorpho LabWenfeiLiNational Laboratory of Solid State Microstructure, Department of Physics, Collaborative Innovation Center of Advanced Microstructures, Nanjing UniversityKenichiHayashidaCellular and Structural Physiology Institute (CeSPI), Nagoya UniversityMikaHiroseInstitute for Protein Research, Osaka UniversityTakayukiKatoInstitute for Protein Research, Osaka UniversityAtsunoriOshimaCellular and Structural Physiology Institute (CeSPI), Nagoya UniversityKosukeFujishimaTokyo Institute of Technology, Earth-Life Science Institute (ELSI)LaurentBlanchoinUniversity of Grenoble-Alpes, CEA, CNRS, INRA, Interdisciplinary Research Institute of Grenoble, Laboratoire de Physiologie Cellulaire & Végétale, CytoMorpho LabAkihiroNaritaDivision of Biological Science, Graduate School of Science, Nagoya UniversityRobert C.RobinsonResearch Institute for Interdisciplinary Science, Okayama UniversityTubulins are critical for the internal organization of eukaryotic cells, and understanding their emergence is an important question in eukaryogenesis. Asgard archaea are the closest known prokaryotic relatives to eukaryotes. Here, we elucidated the apo and nucleotide-bound x-ray structures of an Asgard tubulin from hydrothermal living Odinarchaeota (OdinTubulin). The guanosine 5′-triphosphate (GTP)–bound structure resembles a microtubule protofilament, with GTP bound between subunits, coordinating the “+” end subunit through a network of water molecules and unexpectedly by two cations. A water molecule is located suitable for GTP hydrolysis. Time course crystallography and electron microscopy revealed conformational changes on GTP hydrolysis. OdinTubulin forms tubules at high temperatures, with short curved protofilaments coiling around the tubule circumference, more similar to FtsZ, rather than running parallel to its length, as in microtubules. Thus, OdinTubulin represents an evolutionary stage intermediate between prokaryotic FtsZ and eukaryotic microtubule-forming tubulins.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1873-96011742023Expression and function of CCN2-derived circRNAs in chondrocytes15011515ENSomaKatoDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazumiKawataDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakashiNishidaDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomomiMizukawaDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasaharuTakigawaAdvanced Research Center for Oral and Craniofacial Sciences, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesSeijiIidaDepartment of Oral Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiKubotaDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCellular communication network factor 2 (CCN2) molecules promote endochondral ossification and articular cartilage regeneration, and circular RNAs (circRNAs), which arise from various genes and regulate gene expression by adsorbing miRNAs, are known to be synthesized from CCN2 in human vascular endothelial cells and other types of cells. However, in chondrocytes, not only the function but also the presence of CCN2-derived circRNA remains completely unknown. In the present study, we investigated the expression and function of CCN2-derived circRNAs in chondrocytes. Amplicons smaller than those from known CCN2-derived circRNAs were observed using RT-PCR analysis that could specifically amplify CCN2-derived circRNAs in human chondrocytic HCS-2/8 cells. The nucleotide sequences of the PCR products indicated novel circRNAs in the HCS-2/8 cells that were different from known CCN2-derived circRNAs. Moreover, the expression of several Ccn2-derived circRNAs in murine chondroblastic ATDC5 cells was confirmed and observed to change alongside chondrocytic differentiation. Next, one of these circRNAs was knocked down in HCS-2/8 cells to investigate the function of the human CCN2-derived circRNA. As a result, CCN2-derived circRNA knockdown significantly reduced the expression of aggrecan mRNA and proteoglycan synthesis. Our data suggest that CCN2-derived circRNAs are expressed in chondrocytes and play a role in chondrogenic differentiation.No potential conflict of interest relevant to this article was reported.BMCActa Medica Okayama1471-230X2312023The efficacy of non-anesthesiologist-administered propofol sedation with a target-controlled infusion system during double-balloon endoscopic retrograde cholangiopancreatography296ENKazuyaMiyamotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyukiMatsumotoDepartment 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 HospitalKosakuMorimotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalTaijiOgawaDepartment of Gastroenterology and Hepatology, Okayama University HospitalHiroyukiTerasawaDepartment of Gastroenterology and Hepatology, Okayama University HospitalYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University HospitalTatsuhiroYamazakiDepartment of Gastroenterology and Hepatology, Okayama University HospitalDaisukeUchidaDepartment of Gastroenterology and Hepatology, Okayama University HospitalShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKoichiroTsutsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalHironariKatoDepartment of Gastroenterology and Hepatology, Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalBackground The sedation method used during double-balloon endoscopic retrograde cholangiopancreatography (DB-ERCP) differs among countries and/or facilities, and there is no established method. This study aimed to evaluate the efficacy of non-anesthesiologist-administered propofol (NAAP) sedation using a target-controlled infusion (TCI) system during DB-ERCP.<br>
Methods This retrospective study was conducted between May 2017 and December 2020 at an academic center. One hundred and fifty-six consecutive patients who underwent DB-ERCP were sedated by gastroenterologists using diazepam (n = 77) or propofol with a TCI system (n = 79), depending on the period. The primary endpoint was a comparison of poor sedation rates between the two groups. Poor sedation was defined as a condition requiring the use of other sedative agents or discontinuation of the procedure. Secondary endpoints were sedation-related adverse events and risk factors for poor sedation.<br>
Results Poor sedation occurred significantly more often in the diazepam sedation group (diazepam sedation, n = 12 [16%] vs. propofol sedation, n = 1 [1%]; P = 0.001). Vigorous body movements (3 or 4) (diazepam sedation, n = 40 [52%] vs. propofol sedation, n = 28 [35%]; P = 0.038) and hypoxemia (< 85%) (diazepam sedation, n = 7 [9%] vs. propofol sedation, n = 1 [1%]; P = 0.027) occurred significantly more often in the diazepam sedation group. In the multivariate analysis, age < 70 years old (OR, 10.26; 95% CI, 1.57-66.98; P = 0.015), BMI = 25 kg/m2 (OR, 11.96; 95% CI, 1.67-85.69; P = 0.014), and propofol sedation (OR, 0.06; 95% CI, 0.01-0.58; P = 0.015) were associated factors for poor sedation.<br>
Conclusions NAAP sedation with the TCI system during DB-ERCP was safer and more effective than diazepam sedation.No potential conflict of interest relevant to this article was reported.The Editorial Office of Gut and LiverActa Medica Okayama1976-22831712022Comparison of Bilateral and Trisegment Drainage in Patients with High-Grade Hilar Malignant Biliary Obstruction: A Multicenter Retrospective Study170178ENKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalHironariKatoDepartment of Gastroenterology and Hepatology, Okayama University HospitalKosakuMorimotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyaMiyamotoDepartment of Gastroenterology, Tsuyama Central HospitalYosukeSaragaiDepartment of Gastroenterology, Iwakuni Medical CenterHirofumiKawamotoDepartment of General Internal Medicine 2, Kawasaki Medical SchoolHiroyukiOkadaDepartment of Gastroenterology and Hepatology, Okayama University HospitalBackground/Aims: Bilateral endoscopic drainage with self-expanding metallic stent (SEMS) can be used to effectively manage hilar malignant biliary obstruction. However, the benefits of using a trisegment drainage method remain unknown.<br>
Methods: This study retrospectively reviewed the data of 125 patients with Bismuth type IIIa or IV unresectable malignant strictures who underwent bilateral endoscopic drainage using SEMSs at four tertiary centers. The patients were divided into the bilateral and trisegment drainage groups for comparison. The primary endpoint was stent patency and the secondary endpoints were technical success, technical and clinical success of reintervention, and overall survival.<br>
Results: The technical success rates of the bilateral and trisegment drainage groups were 95% (34/36) and 90% (80/89) (p=0.41), respectively, with median stent patency durations of 226 and 170 days (p=0.26), respectively. Although the technical success of reintervention was not significantly different between the two groups (p=0.51), the clinical success rate of reintrvention was significantly higher in the trisegment drainage group (73% [11/15] vs 96% [47/49], p=0.009). The median survival times were 324 and 323 days in the bilateral and trisegment drainage groups, respectively (p=0.72). Multivariate Cox hazards model revealed no stent patency-associated factor; however, chemotherapy was associated with longer survival.<br>
Conclusions: Although no significant difference was noted with respect to stent patency, significantly higher clinical success rates were achieved with reintervention using the trisegment drainage method than using the bilateral drainage method alone.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1091-255X2662022Diagnostic Utility of the PD-L1 Immunostaining in Biopsy Specimens of Patients with Biliary Tract Neoplasms12131223ENKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshiakiOharaDepartment of Pathology and Experimental Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasayoshiFujisawaDepartment of Pathology and Experimental Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAkinobuTakakiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasahiroTakaharaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHironariKatoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesRyuichiYoshidaDepartment of Gastroenterological Surgery, Transplant and Surgical Oncology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYuzoUmedaDepartment of Gastroenterological Surgery, Transplant and Surgical Oncology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakahitoYagiDepartment of Gastroenterological Surgery, Transplant and Surgical Oncology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAkihiroMatsukawaDepartment of Pathology and Experimental Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHiroyukiOkadaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground Anti-programmed death 1/programmed death ligand 1 (PD1/PD-L1) antibodies have been successfully used as treatment agents for several solid tumors; however, it is difficult to predict their effectiveness. We evaluated whether biopsy specimens could predict the positive status of PD-L1 in surgically resected tissue.<br>
Methods Among 91 patients who underwent tissue sampling with endoscopic or liver biopsy before surgery for biliary tract neoplasms in an academic center, 45 (49%) patients were selected for retrospective analysis because the quality and quantity of their biopsy specimens were adequate for histologic evaluation. We performed immunohistochemical staining to investigate the PD-L1 expression in both resected and biopsy specimens. The percentage of the positively stained cells was calculated for subsequent use in the correlation investigation.<br>
Results The biopsy methods were endoscopic retrograde cholangiopancreatography (ERCP) in 28 cases, percutaneous liver biopsy in 10 cases, and endoscopic ultrasound fine-needle aspiration in 7 cases. Among the 45 patients, when patients with > 10% positive tumor cells in surgically resected tissues were regarded as truly positive PD-L1, the positive and negative concordance rates between surgically resected tissues and biopsy samples were 56% (5/9) and 100% (36/36), respectively. With regard to the use of preoperative biopsy as a diagnostic tool, all (5/5) PD-L1-positive patients had a positive resected specimen. The accuracy of each biopsy method was as follows: ERCP, 89% (25/28); fine-needle aspiration, 86% (6/7); and liver biopsy, 100% (10/10).<br>
Conclusions Biopsy samples could be a surrogate material for the assessment of the PD-L1 expression with substantial positive and high negative concordance rates.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2692-4609212021Endoscopic removal of proximally migrated stents using a double-balloon enteroscope in patients with bowel reconstruction (with video)e32ENTakashiOdaDepartment of Gastroenterology, Okayama University HospitalKazuyukiMatsumotoDepartment of Gastroenterology, Okayama University HospitalEijiroUetaDepartment of Gastroenterology, Okayama University HospitalHitomiHimeiDepartment of Gastroenterology, Okayama University HospitalTaijiOgawaDepartment of Gastroenterology, Okayama University HospitalHiroyukiTerasawaDepartment of Gastroenterology, Okayama University HospitalYukiFujiiDepartment of Gastroenterology, Okayama University HospitalTatsuhiroYamazakiDepartment of Gastroenterology, Okayama University HospitalShigeruHoriguchiDepartment of Gastroenterology, Okayama University HospitalKoichiroTsutsumiDepartment of Gastroenterology, Okayama University HospitalHironariKatoDepartment of Gastroenterology, Okayama University HospitalHiroyukiOkadaDepartment of Gastroenterology, Okayama University HospitalEndoscopic migrated stent removal using a balloon-assisted enteroscope is technically difficult in patients with bowel reconstruction. We report the treatment outcomes and endoscopic removal methods for migrated stents using a double-balloon enteroscope (DBE). We retrospectively studied 12 patients with stent migration into the main pancreatic duct (MPD) or bile duct who underwent bowel reconstruction between January 2012 and June 2020. The successful removal rates in the MPD (n = 3) and the bile duct (n = 9) were 66.7% (2/3) and 88.9% (8/9), respectively. The removal techniques included the indirect method (n = 3), the direct method (n = 4), and a combination of indirect and direct methods (n = 3). The removal devices included an extraction balloon catheter (n = 7), basket catheter (n = 5), biopsy forceps (n = 3), and snare (n = 2). Stent removal using a DBE was feasible and useful as the first treatment for patients with bowel reconstruction. The choice of the direct and/or indirect method according to the situation of the migrated stent is important.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2692-4609212021Recent advances regarding endoscopic biliary drainage for unresectable malignant hilar biliary obstructione33ENHironariKatoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHiroyukiOkadaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBiliary drainage for unresectable malignant hilar biliary obstruction (UMHBO) is still associated with a number of controversies to be resolved. The superiority of bilateral drainage in comparison to unilateral drainage has not been proven obviously yet. However, bilateral drainage is necessary to treat obstructive jaundice in some UMHBO patients, and this may be connected with preservation of the functional liver volume. The partial stent-in-stent (SIS) method and side-by-side (SBS) method developed as bilateral drainage methods. There is no significant difference in the technical or clinical success rates of the SIS and SBS methods. In addition, these methods are comparable in terms of adverse events, patency period, and survival period. On the other hand, reintervention for recurrent biliary obstruction (RBO) after the SBS method seems to be easier in comparison to cases with RBO after the SIS method; however, there is no remarkable difference in the clinical results of these procedures. Endoscopic ultrasound (EUS)-guided biliary drainage also has become an option for patients with UMHBO. Left hepatic drainage using EUS-guided hepaticogastrostomy (EUS-HGS) has become common; however, few studies have reported the results of bridging drainage for the right lobe using the EUS-HGS route or EUS-guided hepaticojejunostomy. A few studies addressed the results of newly designed stents, such as the 6-mm braided metal stent and inside stent. The development of various drainage methods and new devices is necessary for the further advancement of endoscopic biliary drainage for patients with UMHBO, further studies to evaluate those methods and devices are warranted.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813522023令和４年度岡山医学会賞 がん研究奨励賞（林原賞・山田賞）5860ENYasuhiroShirakawaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.Royal Society of Chemistry (RSC)Acta Medica Okayama2050-748810372022Effects of the rigid and sterically bulky structure of non-fused nonfullerene acceptors on transient photon-to-current dynamics2003520047ENSeihouJinnaiThe Institute of Scientific and Industrial Research (SANKEN), Osaka UniversityKasumiMurayamaDepartment of Chemistry, Graduate School of Science, Kobe UniversityKeisukeNagaiThe Institute of Scientific and Industrial Research (SANKEN), Osaka UniversityMegumiMineshitaDepartment of Mathematics, Physics and Computer Science, Japan Women's UniversityKosakuKatoGraduate School of Natural Science & Technology, Okayama UniversityAzusaMuraokaDepartment of Mathematics, Physics and Computer Science, Japan Women's UniversityAkiraYamakataGraduate School of Natural Science & Technology, Okayama UniversityAkinoriSaekiDepartment of Applied Chemistry, Graduate School of Engineering, Osaka UniversityYasuhiroKoboriDepartment of Chemistry, Graduate School of Science, Kobe UniversityYutakaIeThe Institute of Scientific and Industrial Research (SANKEN), Osaka UniversityNon-fused electron-accepting π-conjugated compounds have been investigated recently for application to nonfullerene acceptors (NFAs) in organic solar cells (OSCs). However, the establishment of rational molecular design for non-fused NFAs is still lagging because the influence of flexible non-fused structures on the dynamics of electron–hole pairs in OSCs is not entirely understood. In this study, we utilized cyclopentene-annelated thiophene with spiro-substituted 2,7-bis(2-ethylhexyl)fluorene (FT) as a rigid and sterically bulky linker unit and developed a non-fused NFA (TT–FT–DCI) containing FT units. Photophysical measurements indicated that the introduction of the FT unit leads to the formation of rigid molecular structure. OSCs based on donor polymer (PBDB-T) and TT–FT–DCI showed an improved power conversion efficiency of 7.13% due to the increase in the short-circuit current density and fill factor. Time-resolved optical and microwave spectroscopies showed that the FT unit contributes to the long lifetimes of excited state and charge-separated state in the PBDBT:TT–FT–DCI blend films. Time-resolved electron paramagnetic resonance measurements showed that the distant charge-separated states of the face-to-face PBDB-T:TT–FT–DCI structure, which is derived by avoiding over-crystallization by the steric bulkiness of TT–FT–DCI, can interact with the cathodes for preferential electron injection following charge generations. This study highlights that by using the rigid π-conjugated framework and suppressed self-aggregation of the non-fused acceptor, effective molecular design for the appropriate dynamics of photocurrent generation is possible.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7742023Acute Coronary Spasm Following Pelvic Fracture, Bleeding, and Shock in a Trauma Patient423427ENYasuakiYamakawaEmergency and Critical Care Center, Kochi Health Sciences CenterKoheiMiyashitaEmergency and Critical Care Center, Kochi Health Sciences CenterAtsushiMorizaneEmergency and Critical Care Center, Kochi Health Sciences CenterMasatoTakeuchiDepartment of Cardiology, Kochi Health Sciences CenterYutaKawashimaDepartment of Radiology, Kochi Health Sciences CenterTomokoSugimuraEmergency and Critical Care Center, Kochi Health Sciences CenterYuichiSaisakaEmergency and Critical Care Center, Kochi Health Sciences CenterCase Report10.18926/AMO/65753We report a case of a patient with severe pelvic fracture who showed concurrent ST elevation on electrocardiogram. A 70-year-old man incurred an unstable pelvic fracture from a motorcycle accident. On admission, he was hemodynamically unstable, and massive transfusion and noradrenaline were administered immediately. Although ST elevation was present in leads II, III, aVF, V5, and V6, cardiac function was preserved; thus, trans-arterial embolization and external fixation for pelvic fracture were given priority. Four days after the injury, he suffered a cardiac arrest, and coronary angiography revealed that the cause of ST elevation and cardiac arrest was coronary vasospasm. Physicians should be aware that pain-related stress and platelet activation as well as use of noradrenaline in severe trauma cases can induce coronary vasospasm.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7742023Association of Tumor Necrosis Factor-Alpha with Psychopathology in Patients with Schizophrenia395405ENMarkoPavlovicUniversity Hospital Center Mostar, University of MostarDraganBabicUniversity Hospital Center Mostar, University of MostarPejanaRastovicUniversity Hospital Center Mostar, University of MostarJuricaArapovicUniversity Hospital Center Mostar, University of MostarMarkoMartinacHealth Care Center Mostar, University of MostarSanjaJakovacUniversity Hospital Center Mostar, University of MostarRomanaBarbaricUniversity Hospital Center Mostar, University of MostarOriginal Article10.18926/AMO/65750We investigated the relationship between serum tumor necrosis factor-alpha (TNF-α) levels and psychopathological symptoms, clinical and socio-demographic characteristics and antipsychotic therapy in individuals with schizophrenia. TNF-α levels were measured in 90 patients with schizophrenia and 90 healthy controls matched by age, gender, smoking status, and body mass index. The Positive and Negative Syndrome Scale (PANSS) was used to assess the severity of psychopathology in patients. No significant differences in TNF-α levels were detected between the patients and controls (p=0.736). TNF-α levels were not correlated with total, positive, negative, general, or composite PANSS scores (all p>0.05). A significant negative correlation was observed between TNF-α levels and the PANSS cognitive factor (ρ=−0.222, p=0.035). A hierarchical regression analysis identified the cognitive factor as a significant predictor of the TNF-α level (beta=−0.258, t=−2.257, p=0.027). There were no significant differences in TNF-α levels among patients treated with different types of antipsychotics (p=0.596). TNF-α levels correlated positively with the age of onset (ρ=0.233, p=0.027) and negatively with illness duration (ρ=−0.247, p=0.019) and antipsychotic treatment duration (ρ=−0.256, p=0.015). These results indicate that TNF-α may be involved in cognitive impairment in schizophrenia, and would be a potential clinical-state marker in schizophrenia.No potential conflict of interest relevant to this article was reported.American Association for Cancer Research (AACR)Acta Medica Okayama2326-60661172023High Expression of MHC Class I Overcomes Cancer Immunotherapy Resistance Due to IFNγ Signaling Pathway Defects895908ENKatsushigeKawaseDivision of Cell Therapy, Chiba Cancer Center Research InstituteShusukeKawashimaDivision of Cell Therapy, Chiba Cancer Center Research InstituteJojiNagasakiDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiInozumeDivision of Cell Therapy, Chiba Cancer Center Research InstituteEtsukoTanjiDivision of Cell Therapy, Chiba Cancer Center Research InstituteMasahitoKawazuDivision of Cell Therapy, Chiba Cancer Center Research InstituteToyoyukiHanazawaDepartment of Otorhinolaryngology/Head & Neck Surgery, Graduate School of Medicine, Chiba UniversityYosukeTogashiDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityIFNγ signaling pathway defects are well-known mechanisms of resistance to immune checkpoint inhibitors. However, conflicting data have been reported, and the detailed mechanisms remain unclear. In this study, we have demonstrated that resistance to immune checkpoint inhibitors owing to IFNγ signaling pathway defects may be primarily caused by reduced MHC-I expression rather than by the loss of inhibitory effects on cellular proliferation or decreased chemokine production. In particular, we found that chemokines that recruit effector T cells were mainly produced by immune cells rather than cancer cells in the tumor microenvironment of a mouse model, with defects in IFNγ signaling pathways. Furthermore, we found a response to immune checkpoint inhibitors in a patient with JAK-negative head and neck squamous cell carcinoma whose HLA-I expression level was maintained. In addition, CRISPR screening to identify molecules associated with elevated MHC-I expression independent of IFNγ signaling pathways demonstrated that guanine nucleotide-binding protein subunit gamma 4 (GNG4) maintained MHC-I expression via the NF-κB signaling pathway. Our results indicate that patients with IFNγ signaling pathway defects are not always resistant to immune checkpoint inhibitors and highlight the importance of MHC-I expression among the pathways and the possibility of NF-κB–targeted therapies to overcome such resistance.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0925-98647132023Analysis of genetic diversity and population structure in Cambodian melon landraces using molecular markers10671083ENPervin MstNazninGraduate School of Environmental and Life Science, Okayama UniversityOdirichi NnennayaImohGraduate School of Environmental and Life Science, Okayama UniversityKatsunoriTanakaFaculty of Agriculture and Life Science, Hirosaki UniversityOuchSreynechCambodian Agricultural Research and Development InstituteGentaroShigitaDepartment of Life Science Systems, Technical University of MunichYonSopheaCambodian Agricultural Research and Development InstituteSakhanSophanyCambodian Agricultural Research and Development InstituteOukMakaraPlant Breeder, Retired Director of the Cambodian Agricultural Research and Development InstituteNorihikoTomookaResearch Center of Genetic Resources, National Agriculture and Food Research Organization (NARO)YukiMondenGraduate School of Environmental and Life Science, Okayama UniversityHidetakaNishidaGraduate School of Environmental and Life Science, Okayama UniversityKenjiKatoGraduate School of Environmental and Life Science, Okayama UniversityGenetic diversity of Cambodian melons was evaluated by the analysis of 12 random amplified polymorphic DNA (RAPD) and 7 simple sequence repeat (SSR) markers using 62 accessions of melon landraces and compared with 231 accessions from other areas for genetic characterization of Cambodian melons. Among 62 accessions, 56 accessions were morphologically classified as small-seed type with seed lengths shorter than 9 mm, as in the horticultural groups Conomon and Makuwa. Gene diversity of Cambodian melons was 0.228, which was equivalent to those of the groups Conomon and Makuwa and smaller than those of Vietnamese and Central Asian landraces. A phylogenetic tree constructed from a genetic distance matrix classified 293 accessions into three major clusters. Small-seed type accessions from East and Southeast Asia formed clusters I and II, which were distantly related with cluster III consisting of large-seed type melon from other areas. All Cambodian melons belonged to cluster I (except three accessions) along with those from Thailand, Myanmar, Yunnan (China), and Vietnam (“Dua thom” in the northwest), thus indicating genetic similarity in these areas. In addition, the Cambodian melons were not differentiated among geographical populations. Conomon and Makuwa were classified into cluster II, together with melon groups from the plains of Vietnam. The presence of two groups of melons in Southeast Asia was also indicated by population structure and principal coordinate analysis. These results indicated a close genetic relationship between Cambodia and the neighboring countries, thus suggesting that Cambodian melons are not directly related to the establishment of Conomon and Makuwa.No potential conflict of interest relevant to this article was reported.SpringerActa Medica Okayama2198-7793912023Adenocarcinoma arising from widespread heterotopic gastric mucosa in the cervicothoracic esophagus: a case report132ENShoheiNogiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhiroNomaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasashiHashimotoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuyaKatoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaoakiMaedaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShunsukeTanabeDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroShirakawaDepartment of Surgery, Hiroshima City Hiroshima Citizens HospitalToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground In Japan, about 6% of esophageal cancers are adenocarcinomas, although most of them arise from Barrett's epithelium. Adenocarcinoma arising from heterotopic gastric mucosa (HGM) is very rare. Due to its rarity, there is no unified view on its treatment strategy and prognosis.<br>
Case presentation A 57-year-old man presented with a protruding lesion in the cervicothoracic esophagus that was detected by an upper gastrointestinal series at a medical checkup. Esophagoscopy revealed a 30 mm Type 1 tumor circumferentially surrounded by widespread HGM. Computed tomography (CT) and fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT showed no metastasis or invasion of the surrounding organs. We diagnosed the lesion as cT2N0M0 cStageIIB [Union for International Cancer Control (UICC) 8th Ed] cancer and performed subtotal esophagectomy with three-field lymph node dissection. The tumor was determined to be a well-differentiated adenocarcinoma arising from HGM, with deep invasion of the submucosa. The patient underwent no adjuvant therapy and has currently survived without any evidence of recurrence for 15 months.<br>
Conclusions Although the treatment for adenocarcinoma arising from HGM is basically the same as that for squamous cell carcinoma (SCC) of the esophagus, it is important to determine the treatment strategy based on the characteristics of the adenocarcinoma arising from HGM.No potential conflict of interest relevant to this article was reported.Japanese Society of BreedingActa Medica Okayama1344-76107332023Elucidation of genetic variation and population structure of melon genetic resources in the NARO Genebank, and construction of the World Melon Core Collection269277ENGentaroShigitaGraduate School of Environmental and Life Science, Okayama UniversityTran PhuongDungGraduate School of Environmental and Life Science, Okayama UniversityMst. NazninPervinGraduate School of Environmental and Life Science, Okayama UniversityThanh-ThuyDuongGraduate School of Environmental and Life Science, Okayama UniversityOdirich NnennayaImohGraduate School of Environmental and Life Science, Okayama UniversityYukiMondenGraduate School of Environmental and Life Science, Okayama UniversityHidetakaNishidaGraduate School of Environmental and Life Science, Okayama UniversityKatsunoriTanakaFaculty of Agriculture and Life Science, Hirosaki UniversityMitsuhiroSugiyamaInstitute of Vegetable and Floriculture Science, National Agriculture and Food Research Organization (NARO)YoichiKawazuInstitute of Vegetable and Floriculture Science, National Agriculture and Food Research Organization (NARO)NorihikoTomookaResearch Center of Genetic Resources, National Agriculture and Food Research Organization (NARO)KenjiKatoGraduate School of Environmental and Life Science, Okayama UniversityNumerous genetic resources of major crops have been introduced from around the world and deposited in Japanese National Agriculture and Food Research Organization (NARO) Genebank. Understanding their genetic variation and selecting a representative subset (“core collection”) are essential for optimal management and efficient use of genetic resources. In this study, we conducted genotyping-by-sequencing (GBS) to characterize the genetic relationships and population structure in 755 accessions of melon genetic resources. The GBS identified 39,324 single-nucleotide polymorphisms (SNPs) that are distributed throughout the melon genome with high density (one SNP/10.6 kb). The phylogenetic relationships and population structure inferred using this SNP dataset are highly associated with the cytoplasm type and geographical origin. Our results strongly support the recent hypothesis that cultivated melon was established in Africa and India through multiple independent domestication events. Finally, we constructed a World Melon Core Collection that covers at least 82% of the genetic diversity and has a wide range of geographical origins and fruit morphology. The genome-wide SNP dataset, phylogenetic relationships, population structure, and the core collection provided in this study should largely contribute to genetic research, breeding, and genetic resource preservation in melon.No potential conflict of interest relevant to this article was reported.SpringerActa Medica Okayama2198-7793912023Safe and curative modified two-stage operation for T4 esophageal cancer after definitive chemoradiotherapy: a case report119ENTasukuMatsumotoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhiroNomaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaoakiMaedaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuyaKatoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuyaMoriwakeDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentoKawasakiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasashiHashimotoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShunsukeTanabeDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroShirakawaDepartment 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 prognosis of esophageal cancer (EC) with organ invasion is extremely poor. In these cases, definitive chemoradiotherapy (CRT) followed by salvage surgery can be planned; however, the issue of high morbidity and mortality rates persists. Herein, we report the long-term survival of a patient with EC and T4 invasion who underwent a modified two-stage operation after definitive CRT.<br>
Case presentation A 60-year-old male presented with type 2 upper thoracic EC with tracheal invasion. First, definitive CRT was performed, which resulted in tumor shrinkage and improvement in the tracheal invasion. However, an esophagotracheal fistula subsequently developed, and the patient was treated with fasting and antibiotics. Although the fistula recovered, severe esophageal stenoses made oral intake impossible. To improve quality of life and cure the EC, a modified two-stage operation was planned. In the first surgery, an esophageal bypass was performed using a gastric tube with cervical and abdominal lymph node dissections. After confirming improved nutritional status and absence of distant metastasis, the second surgery was performed with subtotal esophagectomy, mediastinal lymph node dissection, and tracheobronchial coverage of the fistula. The patient discharged without major complications after radical resection and has been recurrence-free for 5 years since the start of treatment.<br>
Conclusion A standard curative strategy could be difficult for EC with T4 invasion due to differences in the invaded organs, presence of complications, and patient condition. Therefore, patient-tailored treatment plans are needed, including a modified two-stage operation.No potential conflict of interest relevant to this article was reported.Nature PortfolioActa Medica Okayama2041-17231412023Structure of a monomeric photosystem I core associated with iron-stress-induced-A proteins from Anabaena sp. PCC 7120920ENRyoNagaoResearch Institute for Interdisciplinary Science and Graduate School of Natural Science and Technology, Okayama UniversityKojiKatoResearch Institute for Interdisciplinary Science and Graduate School of Natural Science and Technology, Okayama UniversityTasukuHamaguchiBiostructural Mechanism Laboratory, RIKEN SPring-8 CenterYoshifumiUenoGraduate School of Science, Kobe UniversityNaokiTsuboshitaResearch Institute for Interdisciplinary Science and Graduate School of Natural Science and Technology, Okayama UniversityShotaShimizuResearch Institute for Interdisciplinary Science and Graduate School of Natural Science and Technology, Okayama UniversityMiyuFurutaniGraduate School of Science, Kobe UniversityShigekiEhiraDepartment of Biological Sciences, Graduate School of Science, Tokyo Metropolitan UniversityYoshikiNakajimaResearch Institute for Interdisciplinary Science and Graduate School of Natural Science and Technology, Okayama UniversityKeisukeKawakamiBiostructural Mechanism Laboratory, RIKEN SPring-8 CenterTakehiroSuzukiBiomolecular Characterization Unit, RIKEN Center for Sustainable Resource ScienceNaoshiDohmaeBiomolecular Characterization Unit, RIKEN Center for Sustainable Resource ScienceSeijiAkimotoGraduate School of Science, Kobe UniversityKojiYonekura Biostructural Mechanism Laboratory, RIKEN SPring-8 CenterJian-RenShenResearch Institute for Interdisciplinary Science and Graduate School of Natural Science and Technology, Okayama UniversityIron-stress-induced-A proteins (IsiAs) are expressed in cyanobacteria under iron-deficient conditions. The cyanobacterium Anabaena sp. PCC 7120 has four isiA genes; however, their binding property and functional roles in PSI are still missing. We analyzed a cryo-electron microscopy structure of a PSI-IsiA supercomplex isolated from Anabaena grown under an iron-deficient condition. The PSI-IsiA structure contains six IsiA subunits associated with the PsaA side of a PSI core monomer. Three of the six IsiA subunits were identified as IsiA1 and IsiA2. The PSI-IsiA structure lacks a PsaL subunit; instead, a C-terminal domain of IsiA2 occupies the position of PsaL, which inhibits the oligomerization of PSI, leading to the formation of a PSI monomer. Furthermore, excitation-energy transfer from IsiAs to PSI appeared with a time constant of 55 ps. These findings provide insights into both the molecular assembly of the Anabaena IsiA family and the functional roles of IsiAs.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama2072-669415112023Conventional Cancer Therapies Can Accelerate Malignant Potential of Cancer Cells by Activating Cancer-Associated Fibroblasts in Esophageal Cancer Models2971ENSatoshiKomotoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuhiroNomaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakuyaKatoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTerukiKobayashiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNoriyukiNishiwakiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToruNarusakaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHiroakiSatoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYukiKatsuraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHajimeKashimaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSatoruKikuchiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshiakiOharaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHiroshiTazawaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesEsophageal cancer is one of the most aggressive tumors, and the outcome remains poor. One contributing factor is the presence of tumors that are less responsive or have increased malignancy when treated with conventional chemotherapy, radiotherapy, or a combination of these. Cancer-associated fibroblasts (CAFs) play an important role in the tumor microenvironment. Focusing on conventional cancer therapies, we investigated how CAFs acquire therapeutic resistance and how they affect tumor malignancy. In this study, low-dose chemotherapy or radiotherapy-induced normal fibroblasts showed enhanced activation of CAFs markers, fibroblast activation protein, and α-smooth muscle actin, indicating the acquisition of malignancy in fibroblasts. Furthermore, CAFs activated by radiotherapy induce phenotypic changes in cancer cells, increasing their proliferation, migration, and invasion abilities. In in vivo peritoneal dissemination models, the total number of tumor nodules in the abdominal cavity was significantly increased in the co-inoculation group of cancer cells and resistant fibroblasts compared to that in the co-inoculation group of cancer cells and normal fibroblasts. In conclusion, we demonstrated that conventional cancer therapy causes anti-therapeutic effects via the activation of fibroblasts, resulting in CAFs. It is important to select or combine modalities of esophageal cancer treatment, recognizing that inappropriate radiotherapy and chemotherapy can lead to resistance in CAF-rich tumors.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7732023Associations between Comorbidities and Acute Exacerbation of Interstitial Lung Disease after Primary Lung Cancer Surgery301309ENTakahideKatoDepartment of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of MedicineSeigoMiyoshiDepartment of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of MedicineChizuruHamadaDepartment of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of MedicineYoshifumiSanoDepartment of Cardiovascular and Thoracic Surgery, Ehime University Graduate School of MedicineNaoyukiNogamiDepartment of Community Medicine, Pulmonology and Cardiology, Ehime University Graduate School of MedicineOsamuYamaguchiDepartment of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of MedicineNaohikoHamaguchiDepartment of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of MedicineOriginal Article10.18926/AMO/65495Acute exacerbation (AE) of interstitial lung disease (ILD) is a severe complication of lung resection in lung cancer patients with ILD (LC-ILD). This study aimed to assess the predictive value of comorbidities other than ILD for postoperative AE in patients with LC-ILD. We retrospectively evaluated 68 patients with LC-ILD who had undergone lung resection. We classified them into two groups: those who had developed postoperative AE within 30 days after resection and those who had not. We analyzed patient characteristics, high-resolution computed tomography findings, clinical data, pulmonary function, and intraoperative data. The incidence of postoperative AEs was 11.8%. In univariate analysis, performance status (PS), honeycombing, forced vital capacity (FVC), and high hemoglobin A1c (HbA1c) levels without comorbidities were significantly associated with postoperative AE. Patients were divided into two groups according to cutoff levels of those four variables as determined by receiver operating characteristic curves, revealing that the rates of patients without postoperative AE differed significantly between groups. The present results suggested that preoperative comorbidities other than ILD were not risk factors for postoperative AE in patients with LC-ILD. However, a high preoperative HbA1c level, poor PS, low FVC, and honeycombing may be associated with postoperative AE of LC-ILD.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7732023A Comparison of the Efficacy of Plastic Stent Placement Above and Across the Sphincter of Oddi for Benign Biliary Hilar Stricture291299ENHitomiHimeiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHironariKatoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYosukeSaragaiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTatsuhiroYamazakiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaisukeUchidaDepartment of Gastroenterology and Hepatology, 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 SciencesKoichiroTsutsumiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiOkadaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/65494We investigated the efficacy and safety of endoscopic plastic stent (PS) placement for hilar benign biliary strictures (BBSs) and compared cases with PS placement above (inside stent, IS) and across (usual stent, US) the sphincter of Oddi. Patients who underwent initial endoscopic PS placement for hilar BBSs between August 2012 and December 2021 were retrospectively analyzed. Hilar BBSs in 88 patients were investigated. Clinical success was achieved in 81 of these cases (92.0%), including 38 patients in the IS group and 43 patients in the US group. Unexpected stent exchange (uSE) before the first scheduled PS exchange occurred in 18 cases (22.2%). The median time from first stent placement to uSE was 35 days. There was no significant difference in the rate and median time to uSE between the two groups. The rates of adverse events such as pancreatitis or cholangitis in the two groups did not significantly differ. However, the rate of difficult stent removal in the IS group (15.8%) was significantly higher than that in the US group (0%) (p=0.0019). US placement is preferable to IS placement for scheduled stent exchange, as it offers the same effectiveness and risk of adverse events with easier stent removal.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7732023Endocrinological Changes after Anamorelin Administration in Patients with Gastrointestinal Cancer235241ENSakikoKuraokaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuyaSatomiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTatsuhiroYamazakiDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaHamadaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiyasuKonoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiromitsuKanzakiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHironariKatoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiOkadaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/65488Changes in hormone levels in patients with cancer cachexia after anamorelin administration have not been fully investigated. This study aimed to determine how anamorelin affects the endocrine system in patients with gastrointestinal cancer and cachexia. We prospectively enrolled 13 patients and comprehensively investigated their body weight and levels of serum albumin, hemoglobin A1c (HbA1c), and hormones before (week 0) and 3 and 12 weeks after anamorelin administration. The variables were evaluated at week 3 in 9 patients and at week 12 in 5 patients. At week 3, anamorelin administration resulted in body weight gain and increased the levels of growth hormone and HbA1c, as well as insulin-like growth factor-1 standard deviation scores (IGF-1 SD scores). At the same time, negative correlations were observed between ΔIGF-1 SD score and Δthyroidstimulating hormone (TSH) and between ΔIGF-1 SD score and Δfree testosterone. ΔBody weight and ΔIGF-1 SD score correlated positively at week 12. These results suggest that TSH and free testosterone levels can be affected 3 weeks after anamorelin administration; however, those variables tend to return to a state of equilibrium, and anabolic effects of anamorelin appear in long-term (≥ 12 weeks) users.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 Okayama1340-74142912023気候・文化理解教育の学際的ESD学習プラン開発へ向けた取り組み（日本とヨーロッパの季節サイクルや季節感に注目して）2948ENKuranoshinKATOFaculty of Education, Okayama UniversityHarukoKATOFaculty of Education, Gufu Shotoku Gakuen University (Former Affiliation)RikakoAKAGIFaculty of Education, Okayama University10.18926/ESR/65480We have continued the interdisciplinary integration of the knowledge on climate and music and have developed the crosscutting study plans on the climate and cultural understanding education. A part of these results had been summarized in a Japanese book titled “Climate and music (Cultural understanding and ESD spreading from the “Doors of Song”)” (Kato and Kato 2019), building mainly our papers written in Japanese. This article will re-integrate our above study results, mainly for the climate and songs/traditional seasonal events around Germany, Northern Europe and Japan, with special attention to (A) asymmetric seasonal progression from autumn to next spring around Japan, (B) winter climate around Germany in association with the seasonal feeling on the traditional events “Fasnacht” for driving winter away and (C) climate around Northern Europe in association with the seasonal feeling on the summer solstice festival “Juhannus” with comparison to the summer climate around Japan.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1438-49572542023Sequential flotation of 4 components in silicon-based waste solar cells24072416ENMamiMizukawaDepartment of Material and Energy Science, Graduate School of Environmental and Life Science, Okayama UniversityNorikoNishimuraDepartment of Material and Energy Science, Graduate School of Environmental and Life Science, Okayama UniversityMd. AzharUddinDepartment of Material and Energy Science, Graduate School of Environmental and Life Science, Okayama UniversityYoshieiKatoDepartment of Material and Energy Science, Graduate School of Environmental and Life Science, Okayama UniversityYu-ichiUchidaDepartment of Applied Chemistry, Faculty of Fundamental Engineering, Nippon Institute of TechnologySi, Al, Cu, and Ag particles’ mixture which mainly composes pulverized silicon-based waste solar cells were individually separated by the batch flotation experiments with high recovery and content, and then a general flow chart of the sequential flotation procedure of n-component was postulated including 2-, 3-, and 4-components. The n-component mixture was separated to 1: n-1 or i: j (i + j = n) by a flotation procedure and n-1 times operation was necessary to divide into the individual component. The first flotation process to separate Al into the froth layer was carried out with a collector of SDS solution after dipping Si, Al, Cu, and Ag mixture into the SDS solution. Si was separated in the froth by the second flotation with a collector of a commercial neutral detergent after Al etching by HCl, and Si, Cu and Ag mixture dipped in the detergent. The Cu and Ag mixture was calcinated at 673 or 773 K and dipped into the detergent, and the third flotation with the collector of the detergent led to Cu in the froth and Ag in the sediment. The 4-component mixture was successfully separated into each component by the 3-consecutive flotation processes.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2023A Comparison of the Efficacy of Plastic Stent Placement Above and Across the Sphincter of Oddi for Benign Biliary Hilar StrictureENHitomiHIMEIGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2023CD8+ T-cell Responses Are Boosted by Dual PD-1/VEGFR2 Blockade after EGFR Inhibition in Egfr-Mutant Lung CancerENKazuyaNISHIIGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Japanese Society of BreedingActa Medica Okayama1344-76107322023Melon diversity on the Silk Road by molecular phylogenetic analysis in Kazakhstan melons219229ENKatsunoriTanakaFaculty of Agriculture and Life Science, Hirosaki UniversityMitsuhiroSugiyamaInstitute of Vegetable and Floriculture Science, National Agriculture and Food Research Organization (NARO)GentaroShigitaGraduate School of Environmental and Life Science, Okayama UniversityRyomaMurakamiFaculty of Agriculture and Life Science, Hirosaki UniversityThanh-ThuyDuongFaculty of Agronomy, University of Agriculture and Forestry, Hue UniversityYashengAierkenCenter for Hami Melon, Xinjiang Academy of Agricultural SciencesAnna MArtemyevaAll-Russian Institute of Plant Genetic Resources on the name of N.I.Vavilov (VIR)ZharasMamypbelovKazakhstan Research Institute of Potato and Vegetable Growing LLCRyujiIshikawaFaculty of Agriculture and Life Science, Hirosaki UniversityHidetakaNishidaGraduate School of Environmental and Life Science, Okayama UniversityKenjiKatoGraduate School of Environmental and Life Science, Okayama UniversityTo uncover population structure, phylogenetic relationship, and diversity in melons along the famous Silk Road, a seed size measurement and a phylogenetic analysis using five chloroplast genome markers, 17 RAPD markers and 11 SSR markers were conducted for 87 Kazakh melon accessions with reference accessions. Kazakh melon accessions had large seed with exception of two accessions of weedy melon, Group Agrestis, and consisted of three cytoplasm types, of which Ib-1/-2 and Ib-3 were dominant in Kazakhstan and nearby areas such as northwestern China, Central Asia and Russia. Molecular phylogeny showed that two unique genetic groups, STIa-2 with Ib-1/-2 cytoplasm and STIa-1 with Ib-3 cytoplasm, and one admixed group, STIAD combined with STIa and STIb, were prevalent across all Kazakh melon groups. STIAD melons that phylogenetically overlapped with STIa-1 and STIa-2 melons were frequent in the eastern Silk Road region, including Kazakhstan. Evidently, a small population contributed to melon development and variation in the eastern Silk Road. Conscious preservation of fruit traits specific to Kazakh melon groups is thought to play a role in the conservation of Kazakh melon genetic variation during melon production, where hybrid progenies were generated through open pollination.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1438-49572522022Flotation kinetics of aluminum powders derived from waste crystalline silicon solar cells and its comparison between batch, continuous and column flotation practices826834ENYoshieiKatoDepartment of Material and Energy Science, Graduate School of Environmental and Life Science, Okayama UniversityShoHaradaDepartment of Material and Energy Science, Graduate School of Environmental and Life Science, Okayama UniversityNorikoNishimuraDepartment of Material and Energy Science, Graduate School of Environmental and Life Science, Okayama UniversityMd. AzharUddinDepartment of Material and Energy Science, Graduate School of Environmental and Life Science, Okayama UniversityYu-ichiUchidaDepartment of Applied Chemistry, Faculty of Fundamental Engineering, Nippon Institute of TechnologyIn this study, floatability rate of aluminum (Al) powders was analyzed for the purpose of separating valuable resources from residual materials in waste photovoltaic (PV) solar cells, and equations for flotation recovery were developed for various flotation types according to the rate-determining steps of the gas flowrate and feed rate. The flotation rate became a zero-order reaction at the rate-determining step of the gas flow rate and had the same form between a batch and continuous typed practices by substituting residence time with real time. Under the rate-determining step of the feed rate, the flotation rate was expressed by the linear combination of the first-order reaction of an even group material. The flotation recovery rate of Al powders was analyzed by the data of a batch floatability experiment and indicated by the linear expression of the first-order reaction of two groups due to the rate-determining step of the feed rate. The calculated separation recovery of n-cell type device increased as the number of cells increased and approached that of the batch and column types.No potential conflict of interest relevant to this article was reported.Iron and Steel Institute of JapanActa Medica Okayama0915-15596162021Effect of Impeller and Gas Stirring on Agglomeration Behavior of Polydisperse Fine Particles in Liquid17751783ENAkitoYamaguchiDepartment of Material and Energy Science, Graduate School of Environmental and Life Science, Okayama UniversityHitoshiOkanoDepartment of Material and Energy Science, Graduate School of Environmental ScienceSyunsukeSumitomoDepartment of Material and Energy Science, Graduate School of Environmental and Life Science, Okayama UniversityMd. AzharUddinDepartment of Material and Energy Science, Graduate School of Environmental and Life Science, Okayama UniversityYoshieiKatoDepartment of Material and Energy Science, Graduate School of Environmental and Life Science, Okayama UniversityAgglomeration, coalescence and flotation of non-metallic inclusions in steel melt are effective for obtaining “clean steel.” In this study, the agglomeration and breakup behaviors of particles with a primary particle size distribution (hereinafter, polydisperse particles) in a liquid under impeller and gas stirring were compared by numerical calculations and model experiments. The particle-size-grouping (PSG) method in the numerical agglomeration model of particles was combined with a breakup term of agglomeration due to bubble bursting at the free surface. Polydisperse and monodisperse polymethylmethacrylate (PMMA) particles were used in the agglomeration experiments. The agglomeration rate of the polydisperse particles under impeller stirring was increased by an increasing energy input rate, whereas the agglomeration rate under gas stirring decreased under this condition due to the larger contribution of the breakup of agglomerated particles during bubble bursting in gas stirring. At the same energy input rate, agglomeration of polydisperse particles was larger under impeller stirring than under gas stirring. The agglomeration rate of polydisperse particles was larger than that of monodisperse particles under both impeller and gas stirring at the same energy input rate. The computational temporal changes in the total number of particles were in good agreement with the experimental results. This means that the difference in the agglomeration behaviors observed in impeller and gas stirring can be explained by the turbulent coagulation and subsequent agglomerated particle breakup in gas stirring. The computational temporal change in the number of each group approximately agreed with the experimental change in both impeller and gas stirring.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7722023Withdrawal from Hemodialysis in a Patient with IgD Type Multiple Myeloma: A Case-based Review221225ENHirokiIriyoshiDepartment of Internal Medicine, Kochi Prefectural Hata-Kenmin HospitalKen-eiSadaDepartment of Internal Medicine, Kochi Prefectural Hata-Kenmin HospitalAtsushiMiyauchiDepartment of Internal Medicine, Kochi Prefectural Hata-Kenmin HospitalHirotakaYamamotoDepartment of Internal Medicine, Kochi Prefectural Hata-Kenmin HospitalDaisukeHashimotoDepartment of Internal Medicine, Kochi Prefectural Hata-Kenmin HospitalShigeruNojimaDepartment of Internal Medicine, Kochi Prefectural Hata-Kenmin HospitalShingoYamanakaDepartment of Internal Medicine, Kochi Prefectural Hata-Kenmin HospitalMasafumiKawamuraDepartment of Internal Medicine, Kochi Prefectural Hata-Kenmin HospitalSatoshiOkaDepartment of Internal Medicine, Kochi Prefectural Hata-Kenmin HospitalCase Report10.18926/AMO/65154Several previous case reports have shown that patients with immunoglobulin D (IgD) multiple myeloma (MM) can be withdrawn from hemodialysis, however, the characteristics that can predict withdrawal in these patients have not yet been elucidated. A 57-year-old Japanese woman required hemodialysis because of renal dysfunction due to IgD-λ and Bence Jones protein-λ MM. Bortezomib-based chemotherapy nine days after admission led to her withdrawal from hemodialysis on Day 50. In our case-based review, younger age and early initiation of bortezomib-based chemotherapy emerged as possible predictors of successful hemodialysis withdrawal.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7722023Three Cases of Down Syndrome with Transient Abnormal Myelopoiesis who Underwent Liver Biopsy before Induction of Low-Dose Cytarabine215220ENKanaWashioDepartment of Pediatrics, Okayama University HospitalKosukeTamefusaDepartment of Pediatrics, Okayama University HospitalMotoharuOchiDepartment of Pediatrics, Okayama University HospitalKiichiroKanamitsuDepartment of Pediatrics, National Hospital Organization Okayama Medical CenterHisashiIshidaDepartment of Pediatrics, Okayama University HospitalKaoriFujiwaraDepartment of Pediatrics, Okayama University HospitalKenjiNishidaDepartment of Pathology, Okayama University HospitalKeiTamaiDepartment of Neonatology, National Hospital Organization Okayama Medical CenterYosukeWashioDepartment of Pediatrics, Okayama University HospitalJunkoYoshimotoDepartment of Pediatrics, Okayama University HospitalTakuoNodaDepartment of Pediatric Surgery, Okayama University HospitalHirokazuTsukaharaDepartment of Pediatrics, Okayama University HospitalCase Report10.18926/AMO/65153Among patients with transient abnormal myelopoiesis (TAM) associated with Down syndrome, approximately 20% die within 6 months from multiorgan failure, especially liver fibrosis. We experienced three children with TAM who had low white blood cell counts but increased bilirubin levels. Here, we discuss the detailed clinical courses of these patients, including the pathological findings of liver biopsies. Our cases, together with previous literature, suggest that liver biopsy can be performed safely and provides useful information, especially regarding disease activities, and that low-dose cytarabine is a reasonable option to prevent early death in TAM patients with liver dysfunction.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7722023Evaluating the Coping Behavior of Children with Psychosomatic Disorders under Frustrating Situations Simulated Using the Rosenzweig Picture-Frustration Study185192ENAkikoSugiharaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAyumiOkadaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMakikoHoriuchiClinical Psychology section, Department of Medical Support, Okayama University Hospital Department of Medical SupportMayumiYabeClinical Psychology section, Department of Medical Support, Okayama University Hospital Department of Medical SupportYoshieShigeyasuDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChikakoFujiiDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChieTanakaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakashiYorifujiDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHirokazuTsukaharaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/65148Psychosomatic disorders are influenced by psychosocial factors such as interpersonal relationships. Coping behaviors, especially in frustrating situations, reflect a patient’s ability to cope with stress, and it is important to assess these behaviors for the treatment of psychosomatic diseases. This study aimed to clarify the interpersonal relationships and coping behaviors of pediatric patients with psychosomatic diseases during frustrating situations simulated using the Rosenzweig Picture-Frustration study. This retrospective study included 126 patients (41 male, 85 female) with an average age of 12.9 (6-16) years who were consulted at the Department of Pediatric Psychosomatic Medicine at Okayama University Hospital from 2013 to 2018 and underwent the P-F study. Each score was compared with a standardization sample. The mean group conformity rating did not differ significantly between the participants and healthy children. Compared with healthy children, those with psychosomatic diseases were less likely to explain their perspective. The children with psychosomatic disorders responded to frustrating situations in a sensible and age-appropriate manner. However, they were less likely to respond by explaining their perspective to protect themselves.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7722023Predictive Factors for Recovery from Alcoholic Liver Failure169177ENKanaeInoueDepartment of Gastroenterology, Okayama City HospitalRioFujitaDepartment of Gastroenterology, Okayama City HospitalTakatoshiNagaharaDepartment of Gastroenterology, Okayama City HospitalShihoMurakamiDepartment of Gastroenterology, Okayama City HospitalYutaNagaiDepartment of Gastroenterology, Okayama City HospitalRinaMoriwakeDepartment of Gastroenterology, Okayama City HospitalNozomiMiyakeDepartment of Gastroenterology, Okayama City HospitalAkikoWakutaDepartment of Gastroenterology, Okayama City HospitalKazuyaKariyamaDepartment of Gastroenterology, Okayama City HospitalMamoruNishimuraDepartment of Gastroenterology, Okayama City HospitalKazuhiroNousoDepartment of Gastroenterology, Okayama City HospitalOriginal Article10.18926/AMO/65146Alcoholic liver disease is a risk factor for non-virus-related hepatocellular carcinoma (HCC), which is increasing in prevalence. This study aimed to identify the factors for recovery from alcoholic liver failure. Sixty-two consecutive patients hospitalized for alcoholic liver failure at Okayama City Hospital were enrolled. The characteristics of patients who survived to the 1-month follow-up and whose liver function improved to Child–Pugh A at 3 months (CPA3) and 12 months (CPA12) were compared with the rest of the patients. The survivors at 1 month (50 patients) were significantly younger than the deceased patients and had better liver and renal function with higher levels of γ-glutamyl transferase (GGT). The same factors, except renal function, were correlated with achieving CPA3. High AST, ALT, and GGT levels as well as short spleen length, total abstinence, and good Child–Pugh scores at admission were identified as factors for achieving CPA12. The extent of alcohol intake before admission was not identified as a risk factor in any analysis. In conclusion, baseline liver function is crucial for survival and achieving CPA3, whereas high transaminase and γ-GTP levels, the absence of splenomegaly, and total abstinence are significant factors for achieving CPA12.No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323132023ドイツ付近の春・５月の気候と歌：異質な他者の発見を促すESD 教師教育の学際的アプローチ175189ENKuranoshinKatoFaculty of Education, Okayama UniversityIsaoNagaokaFaculty of Education, Okayama UniversityHarukoKatoFaculty of Education, Gufu Shotoku Gakuen University (Former affiliation)KazuoOtaniTV Setouchi Broadcasting Co., LTD.10.18926/CTED/65072ドイツ付近の「春・5 月」の気候と歌の表現に関する学際的テーマを例に，5 月の位置づけに関する新たな気候学的解析と再体系化を行うとともに，「異質な他者」への出会いを促す大学での授業構築へ向けた検討を行った。授業は，教育学部の「教科横断的思考・表現法」に関する専門科目での実践を念頭に置いた。「夏の入り口としての春」というドイツ付近の季節感に関連して，5 月には「極端な低温日」の頻出する冬は終了しており，ドイツの「夏」に普通に出現する平均気温15〜20℃の日の頻度も急増する。このような気候の背景も踏まえて，ドイツ歌曲に見られる「春・5 月」の表現について，教材化の観点から分析・考察した。更に，ドイツと日本の歌曲について，季節の共通事象に注目して表現や気候背景の捉え方を吟味し，異質な他者への出会いを促す授業構築のための検討・提案を行った。No potential conflict of interest relevant to this article was reported.Elsevier B.V.Acta Medica Okayama23523204212022Development of hydroxyapatite-coated nonwovens for efficient isolation of somatic stem cells from adipose tissues5261ENRyotaChijimatsuOkayama University Hospital, Center for Comprehensive Genomic MedicineTaigaTakedaThe University of Tokyo, Bone and Cartilage Regenerative Medicine, Graduate School of MedicineShinsakuTsujiCPC CorporationKoheiSasakiJapan Vilene Company, Ltd., Central Research LaboratoryKoichiKatoJapan Vilene Company, Ltd., Central Research LaboratoryRieKojimaJapan Vilene Company, Ltd., Central Research LaboratoryNorikoMichihataJapan Vilene Company, Ltd., Central Research LaboratoryToshiyaTsubakiThe University of Tokyo, Sensory and Motor System Medicine, Graduate School of MedicineAyaMatuiCPC CorporationMiharuWatanabeCPC CorporationSakaeTanakaThe University of Tokyo, Sensory and Motor System Medicine, Graduate School of MedicineTakuSaitoThe University of Tokyo, Sensory and Motor System Medicine, Graduate School of MedicineAdipose-derived stem cells (ASCs) are an attractive cell source for cell therapy. Despite the increasing number of clinical applications, the methodology for ASC isolation is not optimized for every individual. In this study, we developed an effective material to stabilize explant cultures from small-fragment adipose tissues.<br>
Methods: Polypropylene/polyethylene nonwoven sheets were coated with hydroxyapatite (HA) particles. Adipose fragments were then placed on these sheets, and their ability to trap tissue was monitored during explant culture. The yield and properties of the cells were compared to those of cells isolated by conventional collagenase digestion.<br>
Results: Hydroxyapatite-coated nonwovens immediately trapped adipose fragments when placed on the sheets. The adhesion was stable even in culture media, leading to cell migration and proliferation from the tissue along with the nonwoven fibers. A higher fiber density further enhanced cell growth. Although cells on nonwoven explants could not be fully collected with cell dissociation enzymes, the cell yield was significantly higher than that of conventional monolayer culture without impacting stem cell properties.<br>
Conclusions: Hydroxyapatite-coated nonwovens are useful for the effective primary explant culture of connective tissues without enzymatic cell dissociation.
No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0007-09202023Somatic mutations can induce a noninflamed tumour microenvironment via their original gene functions, despite deriving neoantigensENTakamasaIshinoDepartment of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical SciencesShusukeKawashimaDivision of Cell Therapy, Chiba Cancer Center Research InstituteEtsukoTanjiDivision of Cell Therapy, Chiba Cancer Center Research InstituteToshihideUenoDivision of Cellular Signaling, National Cancer Center Research InstituteYoukiUedaDepartment of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical SciencesSadahisaOgasawaraDepartment of Gastroenterology, Graduate School of Medicine, Chiba UniversityKazuhitoSatoDepartment of Surgical Oncology, Graduate School of Medicine, The University of TokyoHiroyukiManoDivision of Cellular Signaling, National Cancer Center Research InstituteSoichiroIshiharaDepartment of Surgical Oncology, Graduate School of Medicine, The University of TokyoNaoyaKatoDepartment of Gastroenterology, Graduate School of Medicine, Chiba UniversityMasahitoKawazuDivision of Cell Therapy, Chiba Cancer Center Research InstituteYosukeTogashiDepartment of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical SciencesBackground<br>
Identifying biomarkers to predict immune checkpoint inhibitor (ICI) efficacy is warranted. Considering that somatic mutation-derived neoantigens induce strong immune responses, patients with a high tumour mutational burden reportedly tend to respond to ICIs. However, there are several conflicting data. Therefore, we focused on the original function of neoantigenic mutations and their impact on the tumour microenvironment (TME).<br>
<br>
Methods<br>
We evaluated 88 high-frequency microsatellite instability (MSI-H) colorectal cancers and analysed the function of the identified neoantigenic mutations and their influence on programmed cell death 1 (PD-1) blockade efficacy. The results were validated using The Cancer Genome Atlas (TCGA) datasets.<br>
<br>
Results<br>
We identified frameshift mutations in RNF43 as a common neoantigenic gene mutation in MSI-H tumours. However, loss-of-function RNF43 mutations induced noninflamed TME by activating the WNT/β-catenin signalling pathway. In addition, loss of RNF43 function induced resistance to PD-1 blockade even in neoantigen-rich tumours. TCGA dataset analyses demonstrated that passenger rather than driver gene mutations were related to the inflamed TME in diverse cancer types.<br>
<br>
Conclusions<br>
We propose a novel concept of “paradoxical neoantigenic mutations” that can induce noninflamed TME through their original gene functions, despite deriving neoantigens, suggesting the significance of qualities as well as quantities in neoantigenic mutations.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7712023Scattered Tiny Whitish Protrusions in the Stomach Are a Clue to the Diagnosis of Autoimmune Gastritis7580ENMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakehiroTanakaDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaHamadaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiyasuKonoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiromitsuKanzakiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeijiKawanoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiroKawaharaDepartment of Practical Gastrointestinal Endoscopy, Okayama University HospitalHiroyukiOkadaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/64365Herein, we report two patients with autoimmune gastritis who had undergone multiple esophagogastroduodenoscopy procedures for 17 and 9 years, respectively, before their diagnosis. Instead, they had been diagnosed with and treated for Helicobacter pylori-associated gastritis. The correct diagnosis was made when scatterings of tiny whitish protrusions in the gastric mucosa were detected on esophagogastroduodenoscopy. Our findings suggest that scattered tiny whitish bumps may be a clue to the diagnosis of autoimmune gastritis.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7712023Increased Glycine-conjugated and Unconjugated Bile Acid Levels Associated with Aggravation of Nonalcoholic Steatohepatitis and Cardiovascular Disease in SHRSP5/Dmcr Rat2936ENShuseiYamamotoAcademic Field of Health Sciences, Okayama UniversityIkumiSatoDepartment of Medical Technology, Graduate School of Health Sciences, Okayama UniversityMoeFujiiDepartment of Medical Technology, Graduate School of Health Sciences, Okayama UniversityMaiKakimotoDepartment of Medical Technology, Graduate School of Health Sciences, Okayama UniversityKokiHonmaDepartment of Medical Technology, Graduate School of Health Sciences, Okayama UniversityNatsumiAkiyamaDepartment of Medical Technology, Faculty of Health Sciences, Okayama UniversityMikuSakaiDepartment of Medical Technology, Faculty of Health Sciences, Okayama UniversityNatsukiFukuhamaDepartment of Medical Technology, Faculty of Health Sciences, Okayama UniversityShotaKumazakiDepartment of Medical Technology, Graduate School of Health Sciences, Okayama UniversitySatoshiHirohataAcademic Field of Health Sciences, Okayama UniversityKazuyaKitamoriCollege of Human Life and Environment, Kinjo Gakuin UniversityYukioYamoriInstitute for World Health Development, Mukogawa Women's UniversityShogoWatanabeAcademic Field of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/64358The SHRSP5/Dmcr is a useful animal model for the development of nonalcoholic steatohepatitis (NASH) pathology when fed a high-fat, high-cholesterol diet, and further drug interventions can lead to concomitant cardiovascular disease. While SHRSP5/Dmcr rats have been used for basic research related to NASH, details of their bile acid metabolism in this condition are unknown. In this study, we aimed to clarify the changes in the serum bile acid (BA) fractions associated with NASH and found that glycine-conjugated and unconjugated bile acid increased with worsening NASH and cardiovascular disease while taurine-conjugated BA relatively decreased.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0915-56353542022Endoscopic ablation therapy for the pancreatic neoplasms430442ENKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalHironariKatoDepartment of Gastroenterology and Hepatology, Okayama University HospitalRecently, endoscopic ultrasound (EUS)-guided ablation therapy has been reported as a less invasive therapy for patients with pancreatic neoplasms. Some ablation techniques, including injective ablation (using ethanol or other ablative agents), radiofrequency ablation (RFA), photodynamic therapy, and laser ablation, have been described in the literature. Among these, injective ablation and RFA are more frequently used for treating pancreatic neoplasms. Few studies have evaluated the effectiveness of EUS-guided ethanol ablation (EUS-EA) for potentially malignant solid neoplasms (neuroendocrine neoplasms or solid pseudopapillary neoplasms) and have reported a complete response (CR) rate of 60-80%. In addition, the CR rate after EUS-RFA for these lesions has been reported to be 55-100%, with no additional procedure-related adverse events (AEs). Regarding the amelioration of the symptoms of an insulinoma, the success rates of both the therapies were found to be excellent. Regarding complete tumor ablation, EUS-RFA appeared to be superior to EUS-EA. Although EUS-RFA has been reported as a safe treatment for pancreatic cancers, its effectiveness remains inadequate. Some studies have examined the effectiveness of EUS-guided injection ablation therapy for pancreatic cystic neoplasms (PCNs) and have reported CR rates that range from 35% to 79%. Alcohol-free chemotherapeutic agent ablation appears to be effective, with a low risk of AEs. However, studies on the effectiveness of EUS-RFA for PCNs are limited. In the future, EUS-guided ablation therapy could become a more widely used approach for potentially malignant and malignant pancreatic lesions.No potential conflict of interest relevant to this article was reported.LIPPINCOTT WILLIAMS & WILKINSActa Medica Okayama0025-7974101482022Endoscopic treatment for duodenal perforation due to biliary stent dislocation: A case report and brief review of the literaturee31868ENYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceKazuyaMiyamotoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceAkihiroMatsumiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceKosakuMorimotoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceHiroyukiTerasawaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceTatsuhiroYamazakiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceKoichiroTsutsumiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceHironariKatoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceRationale:Duodenal wall perforation by a dislocated biliary stent placed for biliary structure is rare but can be life-threatening. There are few reports on the management of stent-related duodenal perforation. Patient concerns:Three cases included in this study had undergone endoscopic retrograde cholangiopancreatography with placement of a plastic stent for biliary stricture. Two cases had symptoms (fever or abdominal pain), while other case showed no symptom after biliary stent placement. Diagnoses:Dislocation of plastic stents was revealed on computed tomography or endoscopic images. Two patients were diagnosed with duodenal perforation due to distal migration of long stents with a straight shape on the distal side. One patient was diagnosed with fistula formation between the intrahepatic bile duct and duodenum due to perforation of a pigtail stent. Interventions:All cases could successfully be managed endoscopically with closure by hemoclips or stent replacement. Outcomes:All 3 cases were improved after endoscopic treatment without any subsequent intervention. Lessons:Longer stents with a straight distal side are associated with a higher risk of duodenal perforation. Endoscopic management is appropriate as a first-line approach for a clinically stable patient. At the time of stent placement, we should pay attention to the length and type of stent.No potential conflict of interest relevant to this article was reported.Sage Publications Ltd.Acta Medica Okayama1179-5549162022Study Protocol for a Trial: A Single-Arm, Open-Labeled Study Evaluating Transcatheter Arterial Embolization Plus Everolimus Combination Therapy for Patients With Liver Metastasis of Gastroenteropancreatic Neuroendocrine Tumors15ENYasutoTakeuchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalHironariKatoDepartment of Gastroenterology and Hepatology, Okayama University HospitalShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalAtsushiOyamaDepartment of Gastroenterology and Hepatology, Okayama University HospitalTakuyaAdachiDepartment of Gastroenterology and Hepatology, Okayama University HospitalNozomuWadaDepartment of Gastroenterology and Hepatology, Okayama University HospitalHidekiOnishiDepartment of Gastroenterology and Hepatology, Okayama University HospitalHidenoriShirahaDepartment of Gastroenterology and Hepatology, Okayama University HospitalAkinobuTakakiDepartment of Gastroenterology and Hepatology, Okayama University HospitalBackground: The number of patients with non-functional neuroendocrine tumors (NETs) has increased recently, and the rate of liver metastasis of NETs is about 20% in patients at the first diagnosis. Transcatheter arterial embolization (TAE) and everolimus are therapies with reported efficacy, but few reports have described their combined treatment. We therefore aim to evaluate the efficacy and safety of combination therapy with everolimus and TAE in patients with liver metastasis of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) in a prospective study. Methods: We design a single-arm, open-label, prospective study to evaluate the efficacy and safety of combination therapy with everolimus and TAE in patients with liver metastases of GEP-NETs. The study started in June 2021 at Okayama University Hospital and is expected to enroll 18 patients over a 2-year period. Discussion: This study is a prospective study investigating a new treatment method for a rare disease called GEP-NETs. We may obtain useful information that contributes to the treatment guidelines in this study. However, NET is a rare disease, and although the number of cases is statistically established, it may not be possible to accurately assess causality.No potential conflict of interest relevant to this article was reported.Nature PortfolioActa Medica Okayama2045-23221212022Dual-targeted near-infrared photoimmunotherapy for esophageal cancer and cancer-associated fibroblasts in the tumor microenvironment20152ENHiroakiSatoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhiroNomaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiakiOharaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentoKawasakiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasaakiAkaiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTerukiKobayashiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNoriyukiNishiwakiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToruNarusakaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiKomotoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHajimeKashimaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiKatsuraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuyaKatoDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoruKikuchiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroshiTazawaDepartment 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 SciencesYasuhiroShirakawaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHisatakaKobayashiMolecular Imaging Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, BethesdaToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCancer-associated fibroblasts (CAFs) play a significant role in tumor progression within the tumor microenvironment. Previously, we used near-infrared photoimmunotherapy (NIR-PIT), a next-generation cancer cell-targeted phototherapy, to establish CAF-targeted NIR-PIT. In this study, we investigated whether dual-targeted NIR-PIT, targeting cancer cells and CAFs, could be a therapeutic strategy. A total of 132 cases of esophageal cancer were analyzed for epidermal growth factor receptor (EGFR), human epidermal growth factor 2 (HER2), and fibroblast activation protein (FAP) expression using immunohistochemistry. Human esophageal cancer cells and CAFs were co-cultured and treated with single- or dual-targeted NIR-PIT in vitro. These cells were co-inoculated into BALB/c-nu/nu mice and the tumors were treated with single-targeted NIR-PIT or dual-targeted NIR-PIT in vivo. Survival analysis showed FAP- or EGFR-high patients had worse survival than patients with low expression of FAP or EGFR (log-rank, P < 0.001 and P = 0.074, respectively), while no difference was observed in HER2 status. In vitro, dual (EGFR/FAP)-targeted NIR-PIT induced specific therapeutic effects in cancer cells and CAFs along with suppressing tumor growth in vivo, whereas single-targeted NIR-PIT did not show any significance. Moreover, these experiments demonstrated that dual-targeted NIR-PIT could treat cancer cells and CAFs simultaneously with a single NIR light irradiation. We demonstrated the relationship between EGFR/FAP expression and prognosis of patients with esophageal cancer and the stronger therapeutic effect of dual-targeted NIR-PIT than single-targeted NIR-PIT in experimental models. Thus, dual-targeted NIR-PIT might be a promising therapeutic strategy for cancer treatment.No potential conflict of interest relevant to this article was reported.Baishideng Publishing Group Inc.Acta Medica Okayama2307-896010312022Gastric linitis plastica with autoimmune pancreatitis diagnosed by an endoscopic ultrasonography-guided fine-needle biopsy: A case report1160711616ENRyosukeSatoKazuyukiMatsumotoGastroenterology and Hepatology, Okayama University HospitalHiromitsuKanzakiGastroenterology and Hepatology, Okayama University HospitalAkihiroMatsumiGastroenterology and Hepatology, Okayama University HospitalKazuyaMiyamotoGastroenterology and Hepatology, Okayama University HospitalKosakuMorimotoGastroenterology and Hepatology, Okayama University HospitalHiroyukiTerasawaGastroenterology and Hepatology, Okayama University HospitalYukiFujiiGastroenterology and Hepatology, Okayama University HospitalTatsuhiroYamazakiGastroenterology and Hepatology, Okayama University HospitalDaisukeUchidaGastroenterology and Hepatology, Okayama University HospitalKoichiroTsutsumiGastroenterology and Hepatology, Okayama University HospitalShigeruHoriguchiHironariKatoGastroenterology and Hepatology, Okayama University HospitalBACKGROUND<br>
Gastric linitis plastica (GLP) is a subset of gastric cancer with a poor prognosis. It is difficult to obtain a definitive diagnosis by endoscopic mucosal biopsies, and the usefulness of an endoscopic ultrasonography-guided fine-needle biopsy (EUS-FNB) for GLP has been recently reported. Meanwhile, autoimmune diseases are occasionally known to coexist with malignant tumors as paraneoplastic syndrome. We herein report the usefulness of an EUS-FNB for detecting GLP and the possibility of paraneoplastic syndrome coexisting with GLP.<br>
<br>
CASE SUMMARY<br>
An 81-year-old man was admitted to our hospital for a 1-mo history of epigastric pain that increased after eating. His laboratory data revealed high levels of serum carbohydrate antigen 19-9 and immunoglobulin-G4. Endoscopic examinations showed giant gastric folds and reddish mucosa; however, no epithelial changes were observed. The gastric lumen was not distensible by air inflation, suggesting GLP. Computed tomography showed the thickened gastric wall, the diffuse enlargement of the pancreas, and the peripancreatic rim, which suggested autoimmune pancreatitis (AIP) coexisting with GLP. Because the pathological findings of the endoscopic biopsy showed no malignancy, he underwent an EUS-FNB and was diagnosed with GLP. He received chemotherapy for unresectable gastric cancer due to peritoneal metastasis, after which both the gastric wall thickening and diffuse enlargement of the pancreas were improved.<br>
<br>
CONCLUSION<br>
An EUS-FNB for GLP with a negative endoscopic biopsy is useful, and AIP may develop as a paraneoplastic syndrome.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7662022Posterolateral Floating Technique for the Thoracic Ossification of the Posterior Longitudinal Ligament with Navigation: A Technical Note743748ENMasatoTanakaDepartment of Orthopaedic Surgery, Okayama Rosai HospitalHardikSutharDepartment of Orthopaedic Surgery, Okayama Rosai HospitalDhvanitDesaiDepartment of Orthopaedic Surgery, Okayama Rosai HospitalTaroYamauchiDepartment of Orthopaedic Surgery, Okayama Rosai HospitalShinyaAratakiDepartment of Orthopaedic Surgery, Okayama Rosai HospitalYoshihiroFujiwaraDepartment of Orthopaedic Surgery, Okayama Rosai HospitalKojiUotaniDepartment of Orthopaedic Surgery, Okayama Rosai HospitalYoshiakiOdaDepartment of Orthopaedic Surgery, Okayama Rosai HospitalHaruoMisawaDepartment of Orthopaedic Surgery, Okayama University HospitalCase Report10.18926/AMO/64126We describe a floating technique via a posterolateral approach with intraoperative O-arm navigation to facilitate decompression of the spinal cord in thoracic myelopathy due to severe ossification of the posterior longitudinal ligament (OPLL). A 62-year-old man with myelopathy due to thoracic OPLL had left-leg muscle weakness, urinary disturbance, and spastic gait. Bilateral leg pain and gait disturbance had persisted for 2 years. He was successfully treated by the posterolateral OPLL floating procedure and posterior pedicle fixation under O-arm navigation. At a 2-year follow-up, manual muscle testing results and sensory function of the left leg had recovered fully. His cervical Japanese Orthopedic Association score had improved from 5/12 to 11/12. The novel intraoperative O-arm navigation-guided posterolateral floating procedure for thoracic OPLL is effective for achieving precise decompression and strong fixation with a posterior approach only and can provide an excellent result for severe thoracic OPLL without the risk of adverse events from intraoperative radiation.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7662022A Rare Case of Idiopathic Spinal Cord Herniation Treated by DuraGen® Collagen Matrix Graft731736ENMahoKamamuraDepartment of Radiology, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesFumiyoHigakiDepartment of Radiology, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesSusumuSasadaDepartment of Neurological Surgery, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesToshiMatsushitaDivision of Radiological Technology, Okayama University HospitalTakaoYasuharaDepartment of Neurological Surgery, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesIsaoDateDepartment of Neurological Surgery, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesTakaoHirakiDepartment of Radiology, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/64124We report a rare case of idiopathic spinal cord herniation (ISCH) with a history of cerebrospinal fluid (CSF) leakage. ISCH is a protrusion of the spinal cord through a dural defect. Thin constructive interference in steady-state (CISS) images clearly demonstrated the herniated cord in the present case. The myelopathy worsened and the patient underwent surgery for reduction of herniated spinal cord; the dural defect was filled by placing collagen matrix graft (DuraGen<sup>®</sup>) between the inner and outer dural layers. The patient’s symptoms have improved without relapse for 8 months since surgery. This method may be a good surgical option for cases of spinal cord herniation.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7662022The Impact of Tofogliflozin on Physiological and Hormonal Function, Serum Electrolytes, and Cardiac Diastolic Function in Elderly Japanese Patients with Type 2 Diabetes Mellitus705713ENToshihiroHigashikawaKanazawa Medical University Himi Municipal HospitalTomohikoItoKanazawa Medical University Himi Municipal HospitalTakurouMizunoKanazawa Medical University Himi Municipal HospitalKeiichiroIshigamiKanazawa Medical University Himi Municipal HospitalKengoKurokiKanazawa Medical University Himi Municipal HospitalNaotoMaekawaKanazawa Medical University Himi Municipal HospitalDaisukeUsudaKanazawa Medical University Himi Municipal HospitalToshihideIzumidaKanazawa Medical University Himi Municipal HospitalShinyaYamadaKanazawa Medical University Himi Municipal HospitalRyushoSangenKanazawa Medical University Himi Municipal HospitalKazuHamadaKanazawa Medical University Himi Municipal HospitalJunKiyosawaKanazawa Medical University Himi Municipal HospitalAtsushiSaitoKanazawa Medical University Himi Municipal HospitalMasaharuIguchiKanazawa Medical University Himi Municipal HospitalYujiKasamakiKanazawa Medical University Himi Municipal HospitalTakeshiNakahashiKanazawa Medical University Himi Municipal HospitalAkihiroFukudaKanazawa Medical University Himi Municipal HospitalHitoshiSaitoKanazawa Medical University Himi Municipal HospitalTsugiyasuKandaKanazawa Medical University Himi Municipal HospitalMasashiOkuroDepartment of Geriatric Medicine, Kanazawa Medical UniversityOriginal Article10.18926/AMO/64121The sodium glucose transporter 2 (SGLT2) inhibitor tofogliflozin is a glucose-lowering drug that causes the excretion of surplus glucose by inhibiting SGLT2. Because of tofogliflozin’s osmotic diuresis mechanism, patients’ serum electrolytes, body fluid levels, and cardiac function must be monitored. We retrospectively analyzed the cases of 64 elderly Japanese patients with type 2 diabetes mellitus (T2DM) who received tofogliflozin for 3 months. Their HbA1c, serum electrolytes (sodium, potassium, chloride), hematocrit, brain natriuretic peptide (cardiac volume load marker) and renin and aldosterone (RAA; an index of regulatory hormones involved in body fluid retention) were continuously monitored during the investigation period. Renal function and cardiac function (by echocardiography) were assessed throughout the period. HbA1c significantly decreased (β1=−0.341, p<0.0001, linear regression analysis [LRA]). Most of the hormonal, electrolyte, and physiological parameters were maintained throughout the study period. In these circumstances, E/e’ tended to decrease (β1=−0.382, p=0.13, LRA). Compared to the baseline, E/e’ was significantly decreased at 1 and 3 months (p<0.01, p<0.05). In the higher E/e’ group (E/e’≥10, n=34), E/e’ decreased significantly (β1=−0.63, p<0.05, LRA). ΔE/e’ was correlated with body-weight change during treatment (r=0.64, p<0.01). The 3-month tofogliflozin treatment improved glycemic control and diastolic function represented by E/e’ in T2DM patients, without affecting serum electrolytes, renal function, or RAA. No negative impacts on the patients were observed. Three-month tofogliflozin treatment lowered glucose and improved cardiac diastolic function.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7662022History of Transcatheter Arterial Chemoembolization Predicts the Efficacy of Hepatic Arterial Infusion Chemotherapy in Hepatocellular Carcinoma Patients695703ENHidekiOnishiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhiroNousoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkinobuTakakiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsushiOyamaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuyaAdachiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNozomuWadaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasutoTakeuchiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHidenoriShirahaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiOkadaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/64120This study sought to identify factors that are predictive of a therapeutic response to hepatic arterial infusion chemotherapy (HAIC) by focusing on the number of prior transcatheter arterial chemoembolization (TACE) sessions. To determine the parameters predicting a good response to HAIC, we retrospectively analyzed 170 patients with hepatocellular carcinoma (HCC) who received HAIC regimens comprising low-dose cisplatin combined with 5-fluorouracil (LFP) or cisplatin (CDDP) for the first time. In both the LFP and CDDP regimens, the response rates were significantly lower in patients with three or more prior TACE sessions than in those with two or fewer prior TACE sessions (LFP 57% versus 28%; p=0.01, CDDP 27% versus 6%; p=0.01). Multivariable logistic regression analysis revealed that the number of prior TACE sessions (≥ 3) was significantly associated with non-responder status (odds ratio 4.17, 95% Confidence Interval (CI) 1.76-9.86) in addition to the HAIC regimen. Multivariable analysis using the Cox proportional hazards model revealed that a larger number of prior TACE sessions (≥ 3) was a significant risk factor for survival (hazard ratio 1.60, 95% CI 1.12-2.29) in addition to Child-Pugh class, serum alpha-fetoprotein concentration, and maximum diameter of HCC. HCC patients who receive fewer prior TACE sessions (≤ 2) were found to be better responders to HAIC.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7662022An Evaluation of the Efficacy of Compression Therapy Using Sleeves and Stockings to Prevent Docetaxel-induced Peripheral Neuropathy in Breast Cancer Patients689694ENKoshoYamanouchiDepartment of Surgery, Nagasaki University Graduate School of Biomedical ScienceSayakaKubaDepartment of Surgery, Nagasaki University Graduate School of Biomedical ScienceMegumiMatsumotoDepartment of Surgical Oncology, Nagasaki University Graduate School of Biomedical ScienceHiroshiYanoDepartment of Surgical Oncology, Nagasaki University Graduate School of Biomedical ScienceMichiMoritaDepartment of Surgery, Nagasaki University Graduate School of Biomedical ScienceChikaSakimuraDepartment of Surgery, Nagasaki University Graduate School of Biomedical ScienceRyotaOtsuboDepartment of Surgical Oncology, Nagasaki University Graduate School of Biomedical ScienceMasaakiHidakaDepartment of Surgery, Nagasaki University Graduate School of Biomedical ScienceTakeshiNagayasuDepartment of Surgical Oncology, Nagasaki University Graduate School of Biomedical ScienceSusumuEguchiDepartment of Surgery, Nagasaki University Graduate School of Biomedical ScienceOriginal Article10.18926/AMO/64119Taxanes are key drugs for patients with breast cancer. A major adverse effect of taxanes is peripheral neuropathy (PN). To investigate the ability of compression therapy using sleeves and stockings to prevent PN due to the taxane docetaxel, we conducted a single-center historical control trial. Patients receiving docetaxel at 75 mg/m2 every 3 weeks for 4 cycles as first-line chemotherapy for breast cancer were eligible. PN was evaluated using the common terminology criteria for adverse events version 4.0. The primary endpoint was the incidence of allgrade PN until 3 weeks after the fourth docetaxel administration. We evaluated 26 patients in the intervention group and compared their data to those collected retrospectively from 52 patients treated with docetaxel without compression. Neither the incidence of all-grade PN until 3 weeks after the fourth docetaxel administration (63.5% in the control group vs. 76.9% in the intervention group, p=0.31) nor that of PN grade ≥ 2 (13.5% vs. 15.4%, p=0.99) differed between the groups. In this study, the efficacy of compression therapy using sleeves and stockings to prevent PN induced by docetaxel was not demonstrated. Further clinical studies including medications or intervention are needed to reduce the incidence and severity of PN induced by chemotherapy.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7662022Handling of Germline Findings in Clinical Comprehensive Cancer Genomic Profiling673678ENMikaOkazawa-SakaiDepartment of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasukoYamamotoDepartment of Cancer Genomic Medicine, National Hospital Organization Shikoku Cancer CenterMashuFutagawaDepartment of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMikiOkamuraDepartment of Hereditary Tumors, National Hospital Organization Shikoku Cancer CenterSatokoMiyawakiDepartment of Cancer Genomic Medicine, National Hospital Organization Shikoku Cancer CenterTomohiroNishinaDepartment of Cancer Genomic Medicine, National Hospital Organization Shikoku Cancer CenterKazuhiroTakeharaDepartment of Gynecologic Oncology, National Hospital Organization Shikoku Cancer CenterToshiyukiKozukiDepartment of Clinical Research Center, National Hospital Organization Shikoku Cancer CenterShutaTomidaCenter for Comprehensive Genomic Medicine, Okayama University HospitalIchinosukeHyodoDepartment of Cancer Genomic Medicine, National Hospital Organization Shikoku Cancer CenterShozoOhsumiDepartment of Hereditary Tumors, National Hospital Organization Shikoku Cancer CenterAkiraHirasawaDepartment of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/64117Patients found to have presumed germline pathogenic variants (PGPVs) during comprehensive genomic profiling (CGP) require genetic counseling (GC) referrals. We retrospectively investigated the outcomes of patients with PGPVs. Among 159 patients who underwent CGP, we recommended GC for the 16 patients with PGPVs (3 with [FG group] and 13 without [G Group] a family/personal history of hereditary cancer) as well as for the 8 patients with no PGPVs, but a history (F group); 2 (67%), 5 (38%), and 3 (38%) patients received GC in the FG, G, and F groups, respectively. Germline testing results were positive in 1 and 2 patients of the FG and G groups, respectively. Among the patients recommended for GC, 58% did not receive GC due to lack of interest, poor performance status, or death. CGP contributes to the identification of germline variants in patients without a history of hereditary cancer. However, the proportion of patients who undergo GC should be improved.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7662022Association of Genetic Polymorphism with Taxane-induced Peripheral Neuropathy: Sub-analysis of a Randomized Phase II Study to Determine the Optimal Dose of 3-week Cycle Nab-Paclitaxel in Metastatic Breast Cancer Patients661671ENYukoAbeDepartment of Thoracic, Breast, and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNarutoTairaDepartment of Breast and Endocrine surgery, Kawasaki Medical School HospitalKosukeKashiwabaraClinical Research Promotion Center, University of Tokyo HospitalJunjiTsurutaniAdvanced Cancer Translational Research Institute, Showa UniversityMasahiroKitadaBreast Disease Center, Asahikawa Medical University HospitalMasatoTakahashiDepartment of Breast Surgery, National Hospital Organization Hokkaido Cancer CenterHiroakiKatoDepartment of Breast Surgery, Teine Keijinkai HospitalYuichiroKikawaDepartment of Breast Surgery, Kansai Medical University HospitalEikoSakataDepartment of Breast Surgery, Niigata City General HospitalYoichiNaitoDepartment of Medical Oncology, National Cancer Center Hospital EastYoshieHasegawaDepartment of Breast Surgery, Hachinohe City HospitalTsuyoshiSaitoDepartment of Breast Surgery, Japanese Red Cross Saitama HospitalTsutomuIwasaDepartment of Medical Oncology, Kindai University Faculty of MedicineTsutomuTakashimaDepartment of Breast and Endocrine Surgery, Osaka City University Graduate School of MedicineTomohikoAiharaBreast Center, Aihara HospitalHirofumiMukaiDepartment of Medical Oncology, National Cancer Center Hospital EastFumikataHaraBreast Oncology Center, Cancer Institute Hospital of Japanese Foundation for Cancer ResearchTadahikoShienDepartment of Breast and Endocrine surgery, Okayama University HospitalHiroyoshiDoiharaDepartment of Breast surgery, Kawasaki Medical School General Medical CenterShinichiToyookaDepartment of Thoracic, Breast, and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/64116Chemotherapy-induced peripheral neuropathy (CIPN) is an important clinical challenge that threatens patients’ quality of life. This sub-study of the ABROAD trial investigated the influence of single nucleotide polymorphisms (SNPs) on CIPN, using genotype data from a randomized study to determine the optimal dose of a 3-week-cycle regimen of nab-paclitaxel (q3w nab-PTX) in patients with metastatic breast cancer (MBC). Patients with HER2-negative MBC were randomly assigned to three doses of q3w nab-PTX (SD: 260 mg/m2 vs. MD: 220 mg/m2 vs. LD: 180 mg/m2). Five SNPs (EPHA4-rs17348202, EPHA5-rs7349683, EPHA6-rs301927, LIMK2-rs5749248, and XKR4-rs4737264) were analyzed based on the results of a previous genome-wide association study. Per-allele SNP associations were assessed by a Cox regression to model the cumulative dose of nab-PTX up to the onset of severe or worsening sensory neuropathy. A total of 141 patients were enrolled in the parent study; 91(65%) were included in this sub-study. Worsening of CIPN was significantly greater in the cases with XKR4 AC compared to those with a homozygote AA (HR 1.86, 95%CI: 1.00001−3.46, p=0.049). There was no significant correlation of CIPN with any other SNP. A multivariate analysis showed that the cumulative dose of nab-PTX was most strongly correlated with CIPN (p<0.01).No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2022Accuracy of Endoscopic Transpapillary Gallbladder Drainage with Liquid-Based Cytology for Gallbladder DiseaseENSoichiroKAWAHARAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2022Regulatory T cells induce a suppressive immune milieu and promote lymph node metastasis in intrahepatic cholangiocarcinomaENDaisukeKONISHIGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2022Association of Genetic Polymorphism with Taxane-induced Peripheral Neuropathy: a Sub-analysis of a Randomized Phase II Study to Determine the Optimal Dose of 3-week Cycle Nab-Paclitaxel in Metastatic Breast Cancer PatientsENYukoABEGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.