40 results on '"Nagashima, Y."'
Search Results
2. Improved multi-food allergen analysis of processed foods using HRAM-LC-MS/MS with an ELISA-validated extraction solution and MS sample prep kit.
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Oyama Y, Hamasaka T, Okada H, Nagashima Y, and Morita M
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Food allergens in processed foods are affected by heating, processing, and the food matrix. To conduct highly reliable tests, extracting allergens into test solutions is necessary for appropriate detection. In addition to the commonly used enzyme-linked immunosorbent assay (ELISA), liquid chromatography-mass spectrometry (LC-MS), which has the advantage of simultaneously detecting multiple allergens in foods, is being increasingly used. When managing food allergens at food manufacturing sites, obtaining the same measured values is desirable, regardless of the analytical method used. Therefore, in this study, we focused on the importance of pretreatment steps for LC-MS when examining food allergens in processed foods, which can be difficult to analyze. The ELISA method uses food extracts optimized for analyzing allergens in processed foods. We developed a high-resolution accurate mass spectrometry (HRAM)-LC-MS/MS method using the same food extract used in the ELISA method and an MS sample preparation kit. Multiple food allergen analysis was performed using 1, 5, 10, and 20 ppm of allergen-incurred processed foods. Overall, a strong correlation was observed between the measured values of HRAM-LC-MS/MS and ELISA, demonstrating the applicability of multi-allergen analysis using LC-MS., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.)
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- 2024
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3. Renal cell carcinoma preceded by a rheumatoid‑like paraneoplastic syndrome: A case report.
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Yoshimura Y, Suwabe T, Miki K, Yokoyama T, Kono K, Kinowaki K, Kato I, Nagashima Y, Nishikori A, Sato Y, Kurihara S, Oba Y, Mizuno H, Sekine A, Yamanouchi M, Kamiyama M, Ishii Y, Nakamura Y, Ubara Y, and Sawa N
- Abstract
A man with polycystic kidney disease and a history of renal transplantation at the age of 55 years developed seronegative rheumatoid arthritis (RA) at the age of 68 years. Treatment with a biological derivative led to remission; however, the patient relapsed 2 years later. After being switched to baricitinib, the patient again achieved remission. After 2 years, when the patient was aged 72 years, RA recurred, and the right native kidney became enlarged due to the presence of a large tumor. Surgical nephrectomy was performed, and the tumor was classified as renal cell carcinoma (RCC), not otherwise specified. The cancer tissue comprised sarcomatoid and rhabdoid cells with marked neutrophil infiltration, and the tumor cells were positive for interleukin-6. The patient, aged 73 years, experienced a resolution of joint pain following surgical intervention; however, they died because of systemic metastases ~10 weeks post-operation. Based on the clinical course, the RA-like lesions and subsequent RCC were considered to represent a paraneoplastic syndrome., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2024, Spandidos Publications.)
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- 2024
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4. Dose Comparison of Flowable Gelatin Hemostatic Matrix for Bleeding Loss in Primary Total Knee Arthroplasty.
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Matsuda S, Miyazaki M, Hirakawa M, Nagashima Y, Akase H, and Kaku N
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Introduction Intraoperative and postoperative bleeding in total knee arthroplasty (TKA) affects postoperative outcomes. Although the hemostatic effect of a flowable gelatin hemostatic matrix (FGHM) is known across several surgical fields, its effectiveness on TKA remains controversial. This study aimed to compare the amount of bleeding across three groups treated with different doses of FGHM in TKA. Methods Overall, 122 knee joints of patients who underwent unilateral primary TKA were included and divided into three groups according to FGHM dose: absence of FGHM (control group, N=48), administration of 5 mL of FGHM (5 mL group, N=46), and administration of 8 mL of FGHM (8 mL group, N=38). Total hemoglobin (Hb) loss, drain output, hidden blood loss (HBL), calculated total blood loss (TBL) on the first postoperative day (POD1) and one week postoperatively (POD7), postoperative flexion angle at one week and discharge, and incidence of postoperative deep venous thrombosis (DVT) were assessed. Results At POD1, the mean total Hb losses were 6.3±3.1g (control group), 5.5±3.3g (5 mL group), and 5.3±2.5g (8 mL group), with no significant differences. At POD7, the mean Hb losses were 9.1±4.6g (control), 8.7±3.6g (5 mL), and 8.3±4.0g (8 mL), also with no significant differences. Mean drain outputs and HBLs showed no significant differences among groups. While there was a decreasing trend in TBL with higher FGHM doses, it was not statistically significant at either POD1 or POD7. There were no statistically significant differences in the mean postoperative flexion angle at POD7 or discharge among the groups (99.7±12.6°, 95.7±12.5°, 98.3±13.8° at POD7; 115.9±9.7°, 113.8±9.6°, 116.6±9.2° at discharge). Of these, only one patient in the 8 mL group developed proximal DVT. Conclusion Despite a trend towards decreased bleeding with FGHM, no significant differences were found among the three groups. However, the clinical utility of this hemostatic agent for reducing blood loss after primary TKA remains still unclear., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. The Institutional Review Board of Oita University Hospital issued approval No. 1850. Informed consent was obtained in the form of an opt-out. The need for informed consent from individual patients was waived by the ethics committee of our institution. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Matsuda et al.)
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- 2024
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5. Emergency Patient Triage Improvement through a Retrieval-Augmented Generation Enhanced Large-Scale Language Model.
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Yazaki M, Maki S, Furuya T, Inoue K, Nagai K, Nagashima Y, Maruyama J, Toki Y, Kitagawa K, Iwata S, Kitamura T, Gushiken S, Noguchi Y, Inoue M, Shiga Y, Inage K, Orita S, Nakada T, and Ohtori S
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Objectives: Emergency medical triage is crucial for prioritizing patient care in emergency situations, yet its effectiveness can vary significantly based on the experience and training of the personnel involved. This study aims to evaluate the efficacy of integrating Retrieval Augmented Generation (RAG) with Large Language Models (LLMs), specifically OpenAI's GPT models, to standardize triage procedures and reduce variability in emergency care., Methods: We created 100 simulated triage scenarios based on modified cases from the Japanese National Examination for Emergency Medical Technicians. These scenarios were processed by the RAG-enhanced LLMs, and the models were given patient vital signs, symptoms, and observations from emergency medical services (EMS) teams as inputs. The primary outcome was the accuracy of triage classifications, which was used to compare the performance of the RAG-enhanced LLMs with that of emergency medical technicians and emergency physicians. Secondary outcomes included the rates of under-triage and over-triage., Results: The Generative Pre-trained Transformer 3.5 (GPT-3.5) with RAG model achieved a correct triage rate of 70%, significantly outperforming Emergency Medical Technicians (EMTs) with 35% and 38% correct rates, and emergency physicians with 50% and 47% correct rates ( p < 0.05). Additionally, this model demonstrated a substantial reduction in under-triage rates to 8%, compared with 33% for GPT-3.5 without RAG, and 39% for GPT-4 without RAG., Conclusions: The integration of RAG with LLMs shows promise in improving the accuracy and consistency of medical assessments in emergency settings. Further validation in diverse medical settings with broader datasets is necessary to confirm the effectiveness and adaptability of these technologies in live environments.
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- 2024
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6. Effects of salt intake reduction by urinary sodium to potassium ratio self-monitoring method.
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Shimoyama M, Kawamoto S, Nakatani Y, Banba N, Nagashima Y, Tomoe T, Sugiyama T, Ueno A, Kitahara K, Kawabe A, Otani N, Sugimura H, and Yasu T
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- Humans, Female, Male, Middle Aged, Aged, Sodium Chloride, Dietary administration & dosage, Sodium Chloride, Dietary urine, Diet, Sodium-Restricted, Adult, Blood Pressure physiology, Sodium urine, Potassium urine, Hypertension urine
- Abstract
Effective and feasible educational methods are needed to control salt intake. We performed a single-center, non-randomized controlled study to investigate the effectiveness and feasibility of self-monitoring using a urinary sodium/potassium (Na/K) ratio-measuring device in patients with difficulty in reducing salt intake. This study included 160 patients with hypertension, chronic kidney disease, or heart disease who were followed up in the outpatient clinic of the Dokkyo Medical University Nikko Medical Center. Urinary Na/K ratio measuring Na/K ratio meter were loaned for 2-6 weeks to the treatment (T) group (n = 80) and not to the patients in the control (C) group (n = 80). In the T group, patients were instructed to measure the urinary Na/K ratio at least three times a day and maintain a Na/K ratio below 2.0. Salt reduction education and home blood pressure measurement guidance continued in both groups. The mean device loan period in the T group was 25.1 days, the mean number of measurements was 3.0 times/day, and the proportion of patients achieving three measurements per day was 48.8% (39/80). Self-monitoring using the urinary Na/K ratio meter successfully reduced salt intake by -1.9 g/day at the second visit (p < 0.001) in the T group. In contrast, no change was observed over time in the C group. Self-monitoring using the urinary Na/K ratio meter successfully reduced salt intake in patients with difficulty reducing salt intake., (© 2024. The Author(s), under exclusive licence to The Japanese Society of Hypertension.)
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- 2024
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7. The Potential Role of Preoperative Posterior Cerebral Artery Involvement in Predicting Postoperative Transient Neurological Deficits and Ischemic Stroke After Indirect Revascularization in Patients With Moyamoya Disease.
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Araki Y, Yokoyama K, Uda K, Kanamori F, Takayanagi K, Ishii K, Nishihori M, Goto S, Tsukada T, Takeuchi K, Tanahashi K, Nagata Y, Nishimura Y, Tanei T, Nagashima Y, Muraoka S, Izumi T, Seki Y, and Saito R
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- Humans, Female, Male, Adult, Middle Aged, Adolescent, Retrospective Studies, Child, Young Adult, Child, Preschool, Infant, Nervous System Diseases etiology, Nervous System Diseases epidemiology, Nervous System Diseases diagnostic imaging, Moyamoya Disease surgery, Moyamoya Disease diagnostic imaging, Moyamoya Disease complications, Cerebral Revascularization adverse effects, Cerebral Revascularization methods, Postoperative Complications diagnostic imaging, Postoperative Complications etiology, Postoperative Complications epidemiology, Posterior Cerebral Artery diagnostic imaging, Posterior Cerebral Artery surgery, Ischemic Stroke diagnostic imaging, Ischemic Stroke etiology, Ischemic Stroke surgery
- Abstract
Objective: Transient neurological deficits (TNDs) are known to develop after direct bypass for Moyamoya disease and may be risk factors for subsequent stroke. However, the factors involved in the development of TNDs and stroke after indirect revascularization alone, including their association with subsequent stroke, remain unclear. The purpose of this study was to investigate this issue., Methods: The subjects of the study were 30 patients with Moyamoya disease who underwent a total of 40 indirect revascularization procedures at our institution. Clinical and radiological data were collected retrospectively. To examine factors associated with the development of postoperative TND/stroke/asymptomatic disease, the clinical characteristics of each group were statistically compared., Results: The mean age at surgery was 7 years (range 1-63). TNDs developed after surgery in 9 out of 40 patients (22.5%). Stroke in the acute postoperative period occurred in 3 patients (7.5%), all of whom experienced cerebral infarctions. Demographic data and preoperative clinical information were not different between the groups. However, posterior cerebral artery involvement on preoperative imaging was significantly associated with the development of TNDs and stroke (P = 0.006). Furthermore, postoperative stroke was associated with unfavorable outcomes (P = 0.025)., Conclusions: Posterior cerebral artery involvement is significantly associated with the occurrence of TNDs. In contrast, TNDs after indirect revascularization have little relationship with the subsequent development of stroke. TNDs usually resolve without new strokes, and a better understanding of this particular pathology could help establish an optimal treatment regimen., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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8. A Novel Evaluation for Vertebral Artery Course Using 3D Magnetic Resonance Imaging with Computed Tomography -like Bone Contrast and Magnetic Resonance Angiography: A Proof of Concept Study.
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Inoue T, Maki S, Yokota H, Furuya T, Yoda T, Matsumoto K, Yunde A, Miura M, Shiratani Y, Nagashima Y, Maruyama J, Inoue M, Shiga Y, Inage K, Orita S, Masuda Y, Uno T, Yamazaki M, and Ohtori S
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- Humans, Male, Female, Adult, Middle Aged, Magnetic Resonance Imaging methods, Contrast Media, Aged, Vertebral Artery diagnostic imaging, Magnetic Resonance Angiography methods, Imaging, Three-Dimensional methods, Proof of Concept Study, Cervical Vertebrae diagnostic imaging, Cervical Vertebrae surgery, Tomography, X-Ray Computed methods
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Objective: Vertebral artery (VA) injury poses a significant risk in cervical spine surgery, necessitating accurate preoperative assessment. This study aims to introduce and validate a novel approach that combines the Fast field echo that resembles a computed tomography using restricted echo spacing (FRACTURE) sequence with Time of Flight (TOF) Magnetic Resonance Angiography (MRA) for comprehensive evaluation of VA courses in the cervical spine., Materials and Methods: A total of eight healthy volunteers and two patients participated in this study. The FRACTURE sequence provided high-resolution bone images of the cervical spine, while TOF MRA offered non-invasive vascular imaging. Fusion images were created by merging FRACTURE and MRA modalities to simultaneously visualize cervical spine structures and VA courses. Board-certified orthopedic spine surgeons independently evaluated images to assess the visibility of anatomical characteristics of the VA course by Likert-scale., Results: The FRACTURE-MRA fusion images effectively depicted the extraosseous course of the VA at the craniovertebral junction, the intraosseous course of the VA at the craniovertebral junction, the VA entrance level to the transverse foramen, and the side-to-side asymmetry of bilateral VAs. Additionally, clinical cases demonstrated the utility of the proposed technique in identifying anomalies and guiding surgical interventions., Conclusions: The integration of the FRACTURE sequence and TOF MRA presents a promising methodology for the precise evaluation of VA courses in the cervical spine. This approach improves preoperative planning for cervical spine surgery with detailed anatomy and is a valuable alternative to conventional methods without contrast agents., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
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- 2024
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9. Enantioselective Construction of Tetrahydroindole Skeletons by Rh-Catalyzed [2+2+2] Cycloaddition of Homopropargyl Enamides with Alkynes.
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Yamashiro K, Fujii K, Sato Y, Masutomi K, Shimotsukue R, Nagashima Y, and Tanaka K
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We have developed the Rh-catalyzed enantioselective [2+2+2] cycloaddition of homopropargyl enamides (tosylamide-tethered 1,6-enynes) with alkynes to construct tetrahydroindole skeletons found in natural alkaloids and pharmaceuticals. This cycloaddition proceeds at room temperature in high yields and regio- and enantioselectivity with a broad substrate scope. The preparative scale reaction followed by substituent conversion on the nitrogen atom and the diastereoselective [4+2] cycloaddition with singlet O
2 affords hexahydroindole-diols bearing three stereogenic centers and variable substituents on the nitrogen. Mechanistic studies have revealed that the substituents of the enynes change the ratio of intramolecular and intermolecular rhodacycle formation when using terminal alkynes, varying the ee values of the cycloadducts., (© 2024 The Authors. Angewandte Chemie International Edition published by Wiley-VCH GmbH.)- Published
- 2024
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10. Treatment of congenital auricular fistula with local skin flaps: Two case reports.
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Akutsu M, Masuyama Y, Nagashima Y, Fukami S, Tanaka Y, Hirabayashi H, and Haruna SI
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- 2024
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11. Vibration-mediated long-wavelength photolysis of electronegative bonds beyond S 0 -S 1 and S 0 -T 1 transitions.
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Araujo Dias AJ, Muranaka A, Uchiyama M, Tanaka K, and Nagashima Y
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Photolysis is an attractive method in organic synthesis to produce free radicals through direct bond cleavage. However, in this method, specific irradiation wavelengths of light have been considered indispensable for excitation through S
0 -Sn or S0 -Tn transitions. Here we report the photoinduced homolysis of electronegative interelement bonds using light at wavelengths much longer than theoretically and spectroscopically predicted for the S0 -Sn or S0 -Tn transitions. This long-wavelength photolysis proceeds in N-Cl, N-F, and O-Cl bonds at room temperature under blue, green, and red LED irradiation, initiating diverse radical reactions. Through experimental, spectroscopic, and computational studies, we propose that this "hidden" absorption is accessible via electronic excitations from naturally occurring vibrationally excited ground states to unbonded excited states and is due to the electron-pair repulsion between electronegative atoms., (© 2024. The Author(s).)- Published
- 2024
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12. An academic cooperation between the Japan Sports Nutrition Association (JSNA) and the Korean Society for Exercise Nutrition (KSEN).
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Kagawa M, Nagashima Y, Oshima S, Sato A, Ishizu T, Ishikawa-Takata K, and Taguchi M
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Purpose: The Japan Sports Nutrition Association (JSNA) is an academic society that aims to contribute to people's health and the development of sports in Japan., Methods: After numerous communication and academic events, the JSNA and the Korean Society for Exercise Nutrition (KSEN) exchanged a Memorandum of Understanding (MoU) in 2018., Results: Based on the MoU, the JSNA and KSEN organized academic exchange events until the Coronavirus Disease 2019 pandemic and subsequent travel restrictions and lockdowns., Conclusion: After four years of the pandemic and the downgrading of Coronavirus Disease 2019 infection risk, it is hoped that academic exchanges between the societies will resume gradually and enhance members' recognition of the cooperation between the JSNA and KSEN for active collaborations in the future.
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- 2024
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13. Identification of nonlinear effects of background asymmetry on solitary oscillations in a cylindrical plasma.
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Kobayashi T, Fujisawa A, Nagashima Y, Moon C, Yamasaki K, Nishimura D, Inagaki S, Shimizu A, Tokuzawa T, and Ido T
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A symmetry-breaking in rotational spatial pattern of quasi-periodic solitary oscillations is revealed with tomography measurement of plasma emission, simultaneously with background asymmetry in stationary plasma structure. Although the oscillatory pattern deformation is a natural course in the presence of asymmetry, elaborate analyses identify existence unfeatured nonlinear effects of the background asymmetry, i.e., its nonlinear couplings with harmonic modes of rotational symmetry, to produce non-harmonic mode to break the symmetry and cause the oscillatory pattern to be chaotic. The findings suggest the unrecognized fundamental process for plasmas to be turbulent., (© 2024. The Author(s).)
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- 2024
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14. Dearomative Construction of 2D/3D Frameworks from Quinolines via Nucleophilic Addition/Borate-Mediated Photocycloaddition.
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Shimose A, Ishigaki S, Sato Y, Nogami J, Toriumi N, Uchiyama M, Tanaka K, and Nagashima Y
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Dearomative construction of multiply-fused 2D/3D frameworks, composed of aromatic two-dimensional (2D) rings and saturated three-dimensional (3D) rings, from readily available quinolines has greatly contributed to drug discovery. However, dearomative cycloadditions of quinolines in the presence of photocatalysts usually afford 5,6,7,8-tetrahydroquinoline (THQ)-based polycycles, and dearomative access to 1,2,3,4-THQ-based structures remains limited. Herein, we present a chemo-, regio-, diastereo-, and enantioselective dearomative transformation of quinolines into 1,2,3,4-THQ-based 6-6-4-membered rings without any catalyst, through a combination of nucleophilic addition and borate-mediated [2+2] photocycloaddition. Detailed mechanistic studies revealed that the photoexcited borate complex, generated from quinoline, organolithium, and HB(pin), accelerates the cycloaddition and suppresses the rearomatization that usually occurs in conventional photocycloaddition. Based on our mechanistic analysis, we also developed further photoinduced cycloadditions affording other types of 2D/3D frameworks from isoquinoline and phenanthrene., (© 2024 Wiley-VCH GmbH.)
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- 2024
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15. Anisotropic Photodetachment of Positronium Negative Ions with Linearly Polarized Light.
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Michishio K, Chiari L, Tanaka F, and Nagashima Y
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We report on the anisotropic photodetachment of positronium negative ions, followed by the dissociation into p-wave electrons and positronium atoms, with a linearly polarized laser beam. We have observed a strong recoil effect of the photoelectrons on the translation momentum of the dissociated positronium atoms. With polarization angle-resolved measurements, the asymmetry parameter of the photoemission angular distribution of the ions at a photon energy of 1.165 eV was determined to be 1.97±0.04(stat)±0.07(syst), in agreement with a theoretical prediction. The present method can be applied to explore the unrevealed dissociation dynamics of exotic particle systems and their manipulation with polarized light.
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- 2024
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16. Conversion of T2-Weighted Magnetic Resonance Images of Cervical Spine Trauma to Short T1 Inversion Recovery (STIR) Images by Generative Adversarial Network.
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Yunde A, Maki S, Furuya T, Okimatsu S, Inoue T, Miura M, Shiratani Y, Nagashima Y, Maruyama J, Shiga Y, Inage K, Eguchi Y, Orita S, and Ohtori S
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Introduction: The short T1 inversion recovery (STIR) sequence is advantageous for visualizing ligamentous injuries, but the STIR sequence may be missing in some cases. The purpose of this study was to generate synthetic STIR images from MRI T2-weighted images (T2WI) of patients with cervical spine trauma using a generative adversarial network (GAN). Methods: A total of 969 pairs of T2WI and STIR images were extracted from 79 patients with cervical spine trauma. The synthetic model was trained 100 times, and the performance of the model was evaluated with five-fold cross-validation. Results: As for quantitative validation, the structural similarity score was 0.519±0.1 and the peak signal-to-noise ratio score was 19.37±1.9 dB. As for qualitative validation, the incorporation of synthetic STIR images generated by a GAN alongside T2WI substantially enhances sensitivity in the detection of interspinous ligament injuries, outperforming assessments reliant solely on T2WI., Conclusion: The GAN model can generate synthetic STIRs from T2 images of cervical spine trauma using image-to-image conversion techniques. The use of a combination of synthetic STIR images generated by a GAN and T2WI improves sensitivity in detecting interspinous ligament injuries compared to assessments that use only T2WI., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Yunde et al.)
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- 2024
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17. Protective Mechanism of Stem Cells from Human Exfoliated Deciduous Teeth in Treating Spinal Cord Injury.
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Nishii T, Osuka K, Nishimura Y, Ohmichi Y, Ohmichi M, Suzuki C, Nagashima Y, Oyama T, Abe T, Kato H, and Saito R
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- Humans, Rats, Animals, Male, Stem Cell Transplantation methods, Recovery of Function physiology, Stem Cells, Disease Models, Animal, Tooth, Deciduous cytology, Spinal Cord Injuries therapy, Spinal Cord Injuries metabolism, Rats, Sprague-Dawley
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Spinal cord injury (SCI) induces devastating permanent deficits. Recently, cell transplantation therapy has become a notable treatment for SCI. Although stem cells from human exfoliated deciduous teeth (SHED) are an attractive therapy, their precise mechanism of action remains to be elucidated. In this study, we explored one of the neuroprotective mechanisms of SHED treatment at the subacute stage after SCI. We used a rat clip compression SCI model. The animals were randomly divided into three groups: SCI, SCI + phosphate-buffered saline (PBS), and SCI + SHED. The SHED or PBS intramedullary injection was administered immediately after SCI. After SCI, we explored the effects of SHED on motor function, as assessed by the Basso-Beattie-Bresnahan score and the inclined plane method, the signal transduction pathway, especially the Janus kinase (JAK) and the signal transducer and activator of transcription 3 (STAT3) pathway, the apoptotic pathway, and the expression of neurocan, one of the chondroitin sulfate proteoglycans. SHED treatment significantly improved functional recovery from Day 14 relative to the controls. Western blot analysis showed that SHED significantly reduced the expression of glial fibrillary acidic protein (GFAP) and phosphorylated STAT3 ( p -STAT3) at Tyr
705 on Day 10 but not on Day 5. However, SHED had no effect on the expression levels of Iba-1 on Days 5 or 10. Immunohistochemistry revealed that p -STAT3 at Tyr705 was mainly expressed in GFAP-positive astrocytes on Day 10 after SCI, and its expression was reduced by administration of SHED. Moreover, SHED treatment significantly induced expression of cleaved caspase 3 in GFAP-positive astrocytes only in the epicenter lesions on Day 10 after SCI but not on Day 5. The expression of neurocan was also significantly reduced by SHED injection on Day 10 after SCI. Our results show that SHED plays an important role in reducing astrogliosis and glial scar formation between Days 5 and 10 after SCI, possibly via apoptosis of astrocytes, ultimately resulting in improvement in neurological functions thereafter. Our data revealed one of the neuroprotective mechanisms of SHED at the subacute stage after SCI, which improved functional recovery after SCI, a serious condition.- Published
- 2024
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18. Machine Learning Web Application for Predicting Functional Outcomes in Patients With Traumatic Spinal Cord Injury Following Inpatient Rehabilitation.
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Maki S, Furuya T, Inoue T, Yunde A, Miura M, Shiratani Y, Nagashima Y, Maruyama J, Shiga Y, Inage K, Eguchi Y, Orita S, and Ohtori S
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- Humans, Male, Female, Middle Aged, Adult, Aged, Internet, Inpatients, Treatment Outcome, Predictive Value of Tests, Spinal Cord Injuries rehabilitation, Spinal Cord Injuries physiopathology, Machine Learning, Recovery of Function physiology
- Abstract
Accurately predicting functional outcomes in patients with spinal cord injury (SCI) helps clinicians set realistic functional recovery goals and improve the home environment after discharge. The present study aimed to develop and validate machine learning (ML) models to predict functional outcomes in patients with SCI and deploy the models within a web application. The study included data from the Japan Association of Rehabilitation Database from January 1, 1991, to December 31, 2015. Patients with SCI who were admitted to an SCI center or transferred to a participating post-acute rehabilitation hospital after receiving acute treatment were enrolled in this database. The primary outcome was functional ambulation at discharge from the rehabilitation hospital. The secondary outcome was the total motor Functional Independence Measure (FIM) score at discharge. We used binary classification models to predict whether functional ambulation was achieved, as well as regression models to predict total motor FIM scores at discharge. In the training dataset (70% random sample) using demographic characteristics and neurological and functional status as predictors, we built prediction performance matrices of multiple ML models and selected the best one for each outcome. We validated each model's predictive performance in the test dataset (the remaining 30%). Among the 4181 patients, 3827 were included in the prediction model for the total motor FIM score. The mean (standard deviation [SD]) age was 50.4 (18.7) years, and 3211 (83.9%) patients were male. There were 3122 patients included in the prediction model for functional ambulation. The CatBoost Classifier and regressor models showed the best performances in the training dataset. On the test dataset, the CatBoost Classifier had an area under the receiver operating characteristic curve of 0.8572 and an accuracy of 0.7769 for predicting functional ambulation. Likewise, the CatBoost Regressor performed well, with an R
2 of 0.7859, a mean absolute error of 9.2957, and a root mean square error of 13.4846 for predicting the total motor FIM score. The final models were deployed in a web application to provide functional predictions. The application can be found at http://3.138.174.54:8501. In conclusion, our prediction models developed using ML successfully predicted functional outcomes in patients with SCI and were deployed in an open-access web application.- Published
- 2024
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19. Radiation Exposure During Lumbar Interbody Fusion Surgery Can Be Reduced by Using a Three-Dimensional Patient-Specific Template Guide.
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Nagashima Y, Ishikawa T, Katsuragi J, Sasaki Y, Suzuki M, Umimura T, Sawada R, Hashiba D, Yamamoto M, and Ohtori S
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Background: The use of posterior lumber interbody fusion (PLIF) using cortical bone trajectory (CBT) with a patient-specific 3D template guide is increasingly widespread. To our knowledge, no studies have extensively evaluated the reduction of radiation exposure when using patient-specific drill template guides. The purpose of this study is to compare the intra-operative radiation dose and surgeon's exposure to radiation in CBT-PLIF when using a patient-specific drill guide with that in traditional minimally invasive (MIS)-PLIF., Methods: In this observational study, we retrospectively compared data from five patients who were treated with single-level CBT-PLIF using a patient-specific drill guide (G group) and five patients who were treated with single-level traditional MIS-PLIF (M group). We compared the surgical time, surgeon's exposure to radiation, and intra-operative radiation time and dose between the two groups of patients., Results: The mean age of the patients was 67.0 years in the M group and 74.2 years in the G group. The average surgical time was 242.8 min in the M group and 189.6 min in the G group (p = 0.020). The surgeon's exposure to radiation was 373.7 µSv in the M group and 81.75 µSv in the G group at chest level outside the protector (p = 0.00092); 42.0 µSv (M group) and 3.6 µSv (G group) at chest level inside the protector (p = 0.0000062); and 4.33 µSv (M group) and 1.20 µSv (G group) at the buttocks of the surgeon (p = 0.0013). Radiation time was 269.8 s (M group) and 56.6 s (G group) (p = 0.0097), and radiation dose was 153.7 mGy (M group) and 30.42 mGy (G group) (p = 0.00057)., Conclusion: The patient-specific drill template guide is an invaluable tool that facilitates the safe insertion of CBT screws with a low radiation dose from the outset., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Nagashima et al.)
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- 2024
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20. Total Synthesis of Lobatamides A and C.
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Yasui S, Banjo S, Nagashima Y, Okada Y, Yoshikawa K, Nakata K, Chida N, Okamura T, and Sato T
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The total synthesis of lobatamides A (1 a) and C (1 c) via a common bislactone intermediate is reported. The allylic aryl moiety including a trisubstituted Z-olefin was constructed by hydroboration of a 1,1-disubstituted allene and subsequent Migita-Kosugi-Stille coupling. Although the seco acid proved to be highly unstable even in the presence of weak bases, Zhao macrolactonization under acidic conditions via the α-acyloxyenamide successfully provided the common bislactone intermediate. Hydrozirconation-iodination of the terminal alkyne and subsequent copper-mediated coupling with primary amides proceeded successfully in the presence of the sensitive bislactone framework. The developed synthetic route enables the late-stage installation of enamide side chains, which are crucial structures for V-ATPase inhibition., (© 2024 The Authors. Angewandte Chemie International Edition published by Wiley-VCH GmbH.)
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- 2024
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21. Molecular insights and the role of 18F-FDG-PET/CT in the diagnosis of spinal gliomas.
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Nagashima Y, Nishimura Y, Eguchi K, Yamaguchi J, Haimoto S, Ohka F, Motomura K, Abe T, Matsuo M, Tsukamoto E, Hara M, and Saito R
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- Humans, Positron Emission Tomography Computed Tomography, Radiopharmaceuticals, Positron-Emission Tomography methods, Retrospective Studies, Fluorodeoxyglucose F18, Glioma diagnostic imaging, Glioma pathology
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Background: In recent years, molecular findings on spinal gliomas have become increasingly important. This study aimed to investigate the role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in the diagnosis of spinal glioma., Methods: This study included patients diagnosed with spinal cord glioma who underwent 18F-FDG-PET examination at the Department of Neurosurgery, Nagoya University Hospital between January 2016 and November 2023. The gliomas were divided into two groups, high-grade and low-grade, based on pathological and molecular studies. The maximum standardized uptake values (SUVmax) of the tumors were quantified and subsequently represented using receiver operating characteristic (ROC) curves., Results: Eighteen participants were included in this study. Of the participants, seven had high-grade glioma with an SUVmax of 6.76 ± 0.72, and eleven had low-grade glioma with an SUVmax of 4.02 ± 1.78, and a statistically significant difference between the two groups. The ROC curve delineated an SUVmax cutoff value of 5.650, with an area under the curve (AUC) of approximately 0.909. Based on the cutoff value, the results of the diagnostic performance rendered a sensitivity and negative predictive value of 1.0, whereas the specificity and positive predictive value were 0.909 and 0.875, respectively., Conclusions: The present study shows that 18F-FDG-PET exhibits a markedly sensitive and negative predictive value in the assessment of spinal gliomas. Additionally, these findings have potential implications for the qualitative assessment of spinal gliomas using 18F-FDG-PET/CT. This imaging modality may be useful for making timely treatment decisions in situations where a detailed diagnosis by molecular analysis is not possible., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)
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- 2024
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22. Asymmetric Implant Design for Posterolateral Overhang of the Femoral Component in Total Knee Arthroplasty: A Retrospective Computed Tomography-Based Study.
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Hirakawa M, Miyazaki M, Nagashima Y, Akase H, Matsuda S, and Kaku N
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Introduction During total knee arthroplasty (TKA), also referred to as total knee replacement (TKR), patients may experience pain in the posterolateral knee. One possible cause is the impingement between the popliteus tendon and the femoral components. The purpose of this study was to analyze the posterolateral overhang of the femoral component using 3D template software. Methods Preoperative CT scan images of 50 knees (11 males and 39 females) with osteoarthritis of grade 2 or lower according to the Kellgren-Lawrence classification were analyzed. The mean age of the subjects was 73.8±7.6 years (range 52-84 years). The Athena (Soft Cube Co., Ltd., Osaka, Japan) knee 3D image-matching software was used for the analysis. The positions of the two femoral components (symmetrical and asymmetrical) were simulated. In the coronal plane, the component overhang was measured between the resected lateral part of the posterior femur and its corresponding component size, and the two designs were compared in three zones (proximal, central, and distal). Results In the simulated femoral component, the asymmetric design had a significantly lower component overhang than the symmetric design in the proximal zone of the lateral posterior condyle (0.2±1.9 mm vs. 3.5±1.6 mm, p<0.01). In the proximal zone, significant overhang (>3 mm) was observed in 30 knees (60.0%) with the symmetric design, but only three knees (6.0%) had asymmetric designs (p<0.01). Conclusions The posterolateral overhang of the lateral posterior condyle occurs when a symmetrical prosthesis is used. The use of an asymmetric implant with a small, rounded proximal portion of the lateral posterior condyle improves this overhang and is expected to decrease problems such as impingement of the popliteus tendon and improve patient satisfaction., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Hirakawa et al.)
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- 2024
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23. Visible-Light-Induced trans -Hydroboration of Diaryl Alkynes Utilizing Excited State of Borate Complexes.
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Komaki T, Sato Y, Uchiyama M, Tanaka K, and Nagashima Y
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We have developed visible-light-induced trans -hydroboration of diaryl alkynes via direct photoexcitation of in-situ-generated diboron complexes, affording previously elusive ( E )-1,2-diaryl-vinylboronates with high stereoselectivity. Experimental, spectroscopic, and theoretical mechanistic studies revealed that the triplet-state borate complex facilitates B-B bond cleavage and the desired C-B bond formation. This methodology does not require any catalyst and is operationally simple. The highly borylated 1,2-diaryl alkenes [1-(2-borylphenyl)vinyl)boronates] are shown to be useful as building blocks.
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- 2024
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24. Endoscopic Features of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma without Helicobacter pylori .
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Watanabe M, Nonaka K, Kishino M, Nagashima Y, and Tokushige K
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Although gastric mucosa-associated lymphoid tissue (MALT) lymphoma without Helicobacter pylori (HP) has increased recently, a specific endoscopic classification has not been established; its endoscopic characteristics have not been investigated. In this study, we retrospectively investigated gastric MALT lymphoma without HP in our hospital and assessed differences in the endoscopic findings according to HP infection status. Fifty-seven patients with gastric MALT lymphoma Lugano stage I, diagnosed between January 2013 and March 2023, were divided into three groups (currently HP infected, previously infected, and uninfected), wherein their endoscopic findings were evaluated. Furthermore, the superficial type, as per the classification of Sano et al., was independently subdivided based on the endoscopic differential diagnoses, as follows: atrophic gastritis-like, angiodysplasia-like, superficial gastritis-like, and undifferentiated carcinoma-like. Compared with the currently infected group, the HP -uninfected group tended to have more small lesions without erosion and more discolored, undifferentiated carcinoma-like depressed lesions. In addition, the positive rate of the tree-like appearance (TLA) and ballooning characteristics of gastric MALT lymphoma in magnified findings was lower in the HP -uninfected group. In patients without HP infection, MALT lymphoma should be excluded, even in the absence of suspicious magnifying findings such as TLA or ballooning.
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- 2024
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25. Japanese Mucuna pruriens (Hasshou beans) Showed Fast-acting and Long-lasting Effects in Parkinson's Disease.
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Sakata M, Miyamoto K, Koh J, Nagashima Y, Kondo T, and Ito H
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Objective Mucuna pruriens (MP) is a legume whose seeds contain levodopa (LD), which has potential therapeutic effects against Parkinson's disease (PD). However, further research is needed to thoroughly evaluate its efficacy and safety for treating this condition. In this study, we analyzed the pharmacokinetics of MP grown in Japan and investigated its mechanism of action in PD. Methods MP seeds ground after roasting (containing 4.02% LD per MP powder) were used as the reagent and compared with an equivalent LD/carbidopa (CD) preparation. This clinical trial was conducted using a crossover design among PD patients attending our institution. Each patient received a single dose of 100/10 mg LD/CD tablets and 11 g of MP reagent. Results Among the seven patients with PD, MP prolonged the ON time 2-fold compared to LD/CD. The LD concentrations after MP intake were higher than those after LD/CD intake, whereas dyskinesia did not increase. An analysis of the LD metabolites showed that the 3-O-methyl-dopa/LD metabolic ratio was significantly lower after MP ingestion than after LD/CD ingestion, indicating that MP has a catechol-O-methyl transferase inhibitory effect. Conclusions This is the first report of a pharmacokinetic analysis conducted on actual patients with PD showing that MP significantly prolongs the ON time. The advantages of MP as a treatment for PD have been confirmed: it is inexpensive, as effective as LD, works faster and longer than LD, and does not increase dyskinesia.
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- 2024
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26. Advanced Renal Cell Carcinoma With Inferior Vena Cava Thrombus Treated With a Combination of Preoperative Lenvatinib and Pembrolizumab.
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Nagahisa C, Yoshida K, Kondo H, Nakayama T, Mizoguchi S, Minoda R, Fukuda H, Kobari Y, Iizuka J, Nagashima Y, Ishida H, and Takagi T
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- Male, Humans, Aged, Vena Cava, Inferior pathology, Nephrectomy, Retrospective Studies, Carcinoma, Renal Cell pathology, Kidney Neoplasms pathology, Venous Thrombosis pathology, Phenylurea Compounds, Quinolines, Antibodies, Monoclonal, Humanized
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Background/aim: Lenvatinib plus pembrolizumab combination therapy is a safe and effective treatment for patients with advanced renal cell carcinoma (RCC). However, there are no reports of the use of lenvatinib and pembrolizumab combination therapy for RCC with an inferior vena cava (IVC) tumor thrombus. Herein, we describe a case in which pembrolizumab and lenvatinib combination therapy was effectively used to treat RCC with the IVC tumor thrombus extending to the right atrium., Case Report: A 73-year-old man was diagnosed with a right renal tumor with the IVC tumor thrombus extending to the right atrium and multiple pulmonary metastases (cT3cN0M1). Using a computed tomography-guided renal tumor biopsy, the tumor was diagnosed as clear cell RCC. The International Metastatic RCC Database Consortium risk classification was poor according to three risk factors, and lenvatinib and pembrolizumab combination therapy was initiated. The primary renal tumor shrunk, the IVC tumor thrombus that reached the right atrium was reduced from level 4 to level 2, and the lung metastases disappeared 4 months after treatment initiation. Thereafter, a robot-assisted deferred cytoreductive nephrectomy was successfully performed. Pathologically, owing to the preoperative combination therapy, most of the tumor tissue was necrotic; however, some viable cells were present in the primary tumor and IVC tumor thrombus. Eight months following the operation, the patient remains recurrence-free., Conclusion: Treatment with lenvatinib and pembrolizumab combination therapy led to tumor shrinkage and allowed robot-assisted nephrectomy in a patient with advanced RCC with the IVC tumor thrombus extending to the right atrium, corroborating the efficacy of the treatment., (Copyright © 2024 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)
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- 2024
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27. Keratocystoma: A Distinctive Salivary Gland Neoplasm Characterized by RUNX2 Rearrangements.
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Bishop JA, Nakaguro M, Urano M, Yamamoto Y, Utsumi Y, Li R, Weinreb I, Nagashima Y, Gangahar C, Yamashiro K, Hashimoto K, Rooper LM, Carlile B, Wang RC, Gagan J, and Nagao T
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- Male, Female, Young Adult, Child, Humans, Adolescent, Adult, Middle Aged, In Situ Hybridization, Fluorescence, Core Binding Factor Alpha 1 Subunit genetics, RNA-Directed DNA Polymerase genetics, Biomarkers, Tumor genetics, Biomarkers, Tumor analysis, Adenolymphoma pathology, Salivary Gland Neoplasms pathology, Carcinoma, Squamous Cell pathology, Cysts
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Keratocystoma is a rare salivary gland lesion that has been reported primarily in children and young adults. Because of a scarcity of reported cases, very little is known about it, including its molecular underpinnings, biological potential, and histologic spectrum. Purported to be a benign neoplasm, keratocystoma bears a striking histologic resemblance to benign lesions like metaplastic Warthin tumor on one end of the spectrum and squamous cell carcinoma on the other end. This overlap can cause diagnostic confusion, and it raises questions about the boundaries and definition of keratocystoma as an entity. This study seeks to utilize molecular tools to evaluate the pathogenesis of keratocystoma as well as its relationship with its histologic mimics. On the basis of targeted RNA sequencing (RNA-seq) results on a sentinel case, RUNX2 break-apart fluorescence in situ hybridization (FISH) was successfully performed on 4 cases diagnosed as keratocystoma, as well as 13 cases originally diagnosed as tumors that morphologically resemble keratocystoma: 6 primary squamous cell carcinomas, 3 metaplastic/dysplastic Warthin tumors, 2 atypical squamous cysts, 1 proliferating trichilemmal tumor, and 1 cystadenoma. RNA-seq and/or reverse transcriptase-PCR were attempted on all FISH-positive cases. Seven cases were positive for RUNX2 rearrangement, including 3 of 4 tumors originally called keratocystoma, 2 of 2 called atypical squamous cyst, 1 of 1 called proliferating trichilemmal tumor, and 1 of 6 called squamous cell carcinoma. RNA-seq and/or reverse transcriptase-PCR identified IRF2BP2::RUNX2 in 6 of 7 cases; for the remaining case, the partner remains unknown. The cases positive for RUNX2 rearrangement arose in the parotid glands of 4 females and 3 males, ranging from 8 to 63 years old (mean, 25.4 years; median, 15 years). The RUNX2 -rearranged cases had a consistent histologic appearance: variably sized cysts lined by keratinizing squamous epithelium, plus scattered irregular squamous nests, with essentially no cellular atypia or mitotic activity. The background was fibrotic, often with patchy chronic inflammation and/or giant cell reaction. One case originally called squamous cell carcinoma was virtually identical to the other cases, except for a single focus of small nerve invasion. The FISH-negative case that was originally called keratocystoma had focal cuboidal and mucinous epithelium, which was not found in any FISH-positive cases. The tumors with RUNX2 rearrangement were all treated with surgery only, and for the 5 patients with follow-up, there were no recurrences or metastases (1 to 120 months), even for the case with perineural invasion. Our findings solidify that keratocystoma is a cystic neoplastic entity, one which appears to consistently harbor RUNX2 rearrangements, particularly IRF2BP2::RUNX2 . Having a diagnostic genetic marker now allows for a complete understanding of this rare tumor. They arise in the parotid gland and affect a wide age range. Keratocystoma has a consistent morphologic appearance, which includes large squamous-lined cysts that mimic benign processes like metaplastic Warthin tumor and also small, irregular nests that mimic squamous cell carcinoma. Indeed, RUNX2 analysis has considerable promise for resolving these differential diagnoses. Given that one RUNX2 -rearranged tumor had focal perineural invasion, it is unclear whether that finding is within the spectrum of keratocystoma or whether it could represent malignant transformation. Most important, all RUNX2 -rearranged cases behaved in a benign manner., Competing Interests: Conflicts of Interest and Source of Funding: Supported by Jane B. and Edwin P. Jenevein M.D Endowment for Pathology at UT Southwestern Medical Center. The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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28. Chronic Pain in the Lower Extremities and Low Back is Associated With Recurrent Falls in Community-Dwelling Japanese People Aged 40-74 Years.
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Nagashima Y, Kitamura K, Watanabe Y, Kabasawa K, Takahashi A, Saito T, Kobayashi R, Oshiki R, Takachi R, Tsugane S, Yamazaki O, Watanabe K, and Nakamura K
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- Aged, Female, Humans, Male, Middle Aged, Cohort Studies, Lower Extremity physiopathology, Adult, Chronic Pain epidemiology, East Asian People, Low Back Pain epidemiology, Accidental Falls
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Objective: To determine the longitudinal association between chronic pain in the lower extremities and low back and the odds of recurrent falls in middle-aged and older people., Design: A cohort study., Setting: Communities in Japan., Participants: Participants were 7540 community-dwelling volunteers aged 40-74 years (N=7540). The baseline survey was a self-administered questionnaire conducted between 2011-2013. Predictors were presence of chronic pain in the knee, foot or ankle, and low back, with the degree of pain categorized as none, very mild/mild, moderate, or severe/very severe. Covariates in the multivariate model of chronic pain in a site were demographics, body mass index, physical activity level, disease history, and chronic pain in the other 2 sites. Logistic regression analysis was used to calculate odds ratios (ORs)., Interventions: None., Main Outcome Measure(s): Recurrent falls in the year before the 5-year follow-up survey., Results: Mean participant age was 60.2 years. Higher degrees of chronic pain were associated with higher odds of recurrent falls for the knee (P=.0002) with a higher OR of 1.48 (95% CI: 1.11-1.97), for the foot or ankle (P=.0001) with a higher OR of 1.97 (95% CI: 1.36-2.86), and for the low back (P=.0470) with a higher OR of 1.45 (95% CI: 1.09-1.91) in those with any degree of pain relative to those without pain. Higher degrees of chronic knee pain were associated with higher odds of recurrent falls in women (P=.0005), but not in men (P=.0813). Meanwhile, higher degrees of chronic low back pain were associated with the odds of recurrent falls in men (P=.0065), but not in women (P=.8735)., Conclusions: Chronic pain in the knee, foot or ankle, and lower back was independently and dose-dependently associated with a higher risk of recurrent falls. A marked sex-dependent difference was also noted in the association., (Copyright © 2023 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)
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- 2024
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29. Rare Co-occurrence of Spinal Cord Hemorrhage from Radiation-induced Cavernous Hemangioma and Classical Hodgkin Lymphoma Post-transplant Lymphoproliferative Disorder.
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Shimizu T, Nagashima Y, Matsukawa T, Mitsutake A, Kawai M, Horiuchi Y, Yokoyama K, Takaoka K, Kurihara Y, Toyama K, Sakuishi K, Kurokawa M, and Toda T
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Post-transplant lymphoproliferative disorders (PTLDs) are lymphoproliferative diseases that occur after solid organ transplantation or hematopoietic stem cell transplantation (HSCT). The development of PTLD is often associated with reactivation of Epstein-Barr virus (EBV). A 26-year-old woman with a history of HSCT and total-body irradiation developed spinal cord hemorrhage from a radiation-induced cavernous hemangioma (RICH) shortly after the development of classical Hodgkin lymphoma PTLD with EBV reactivation. Although little is known about the factors leading to hemorrhagic events from spinal cord RICH, we suspect that EBV reactivation may have been a factor contributing to the hemorrhage in the present case.
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- 2024
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30. Exploring the extension quantities of a medial collateral ligament pie-crusting model using a finite element method.
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Matsuda S, Hirakawa M, Nagashima Y, Akase H, Kaku N, and Tsumura H
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Medial collateral ligament (MCL) pie-crusting can balance the soft tissue during total knee arthroplasty but requires more studies with the finite element method (FEM). We have developed three models of MCL pie-crusting utilizing FEM, treating the MCL in the following ways: (1) as a singular elastic body with both ends attached to the bone (model A), (2) as 19 bundled elastic bodies, each attached to both ends of the bone (model B), and (3) as 19 bundled elastic bodies with an adhesive component in the gap, attached to both ends of the bone (model C). The pie-crusting model was created by adding a cut around the center of each model. The left side of the model was fixed and forces of 80 and 120 N in the positive direction of the x -axis were applied. Model A was extended by 0.0068 and 0.010 mm for approximately 10 punctures. Model B-2 was extended by 1.34 and 2.01 mm, approximately twice as much as model B-1. Model C was extended by 0.34 and 0.50 mm for every 10 punctures added. These findings clarify that the model composed of aggregates of fibers with adhesive parts (model C) is suitable for MCL pie-crusting analysis.
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- 2024
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31. Underweight in young Japanese women over time: a longitudinal retrospective study of the change in body mass index from ages 6 to 20 years.
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Nagashima Y, Inokuchi M, Sato Y, and Hasegawa T
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- Adolescent, Child, Female, Humans, Young Adult, Japan epidemiology, Longitudinal Studies, Retrospective Studies, Body Mass Index, East Asian People, Thinness epidemiology
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Background: The high prevalence of underweight in young women has become a serious health problem in Japan. When and how young women reach a low body mass index (BMI) has not been clarified., Aim: To clarify the characteristics of BMI standard deviation scores (BMI SDS) trajectory of young Japanese women with underweight., Subjects and Methods: A total of 601 Japanese female university students aged 20 years were classified into underweight and healthy weight groups. Their school health check-up data were available from the ages of 6 to 20 years. We evaluated the estimated mean values of BMI SDS at each age and differences in BMI SDS (ΔBMI SDS) from 6 years to each age using a mixed-effects model and compared between the two groups at each age., Results: In the underweight group, the BMI SDS at every age (-1.67 to -0.91) and the ΔBMI SDS after 16 years of age (-0.76 to -0.38) were significantly lower than those in the healthy weight group (-0.41 to -0.13, -0.07 to 0.04), respectively., Conclusion: Young Japanese women with underweight have at least two characteristics of BMI SDS trajectory: being constitutionally underweight and shifting their weight status from baseline towards underweight in their late teens.
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- 2024
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32. Metabolic and Epigenetic Reprogramming in a Case of Nuclear Protein in Testis (NUT) Carcinoma of the Retroperitoneum.
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Serizawa M, Serizawa K, Masui K, Toguchi M, Murakami K, Yamamoto T, Nagashima Y, Takagi T, and Kurata A
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Nuclear protein in testis (NUT) carcinoma is a rare but highly aggressive carcinoma, driven by genetic rearrangement of the NUT midline carcinoma family member 1 ( NUTM1 ) gene on chromosome 15q14. Recently, a tight link has been suggested between genetic abnormalities and subsequent metabolic and epigenetic dysregulation to drive the progression of malignant tumors. However, it remains elusive whether such reprogramming could contribute to the pathogenesis of NUT carcinoma. We herein report an autopsy case of NUT carcinoma arising in the retroperitoneum of a 31-year-old male. Notably, reprogramming of glycolytic metabolism and epigenetic histone modifications was observed in this unusual NUT carcinoma case, and this phenomenon was further confirmed by an in vitro cell culture model with bromodomain containing 4 ( BRD4 )- NUT overexpression. The rationale for documenting the case is based on our findings to reveal that metabolic and epigenetic reprogramming could be one of the contributing factors to the pathogenesis of NUT carcinoma, which could be exploitable as a novel therapeutic target for this rare and aggressive cancer type., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Serizawa et al.)
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- 2024
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33. Comparison of Endoscopic and Artificial Intelligence Diagnoses for Predicting the Histological Healing of Ulcerative Colitis in a Real-World Clinical Setting.
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Omori T, Yamamoto T, Murasugi S, Koroku M, Yonezawa M, Nonaka K, Nagashima Y, Nakamura S, and Tokushige K
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Background: Artificial intelligence (AI)-assisted colonoscopy systems with contact microscopy capabilities have been reported previously; however, no studies regarding the clinical use of a commercially available system in patients with ulcerative colitis (UC) have been reported. In this study, the diagnostic performance of an AI-assisted ultra-magnifying colonoscopy system for histological healing was compared with that of conventional light non-magnifying endoscopic evaluation in patients with UC., Methods: The data of 52 patients with UC were retrospectively analyzed. The Mayo endoscopic score (MES) was determined by 3 endoscopists. Using the AI system, healing of the same spot assessed via MES was defined as a predicted Geboes score (GS) < 3.1. The GS was then determined using pathology specimens from the same site., Results: A total of 191 sites were evaluated, including 159 with a GS < 3.1. The MES diagnosis identified 130 sites as MES0. A total of 120 sites were determined to have healed based on AI. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MES0 for the diagnosis of GS < 3.1 were 79.2%, 90.6%, 97.7%, 46.8%, and 81.2%, respectively. The AI system performed similarly to MES for the diagnosis of GS < 3.1: sensitivity, 74.2%; specificity: 93.8%; PPV: 98.3%; NPV: 42.3%; and accuracy: 77.5%. The AI system also significantly identified a GS of < 3.1 in the setting of MES1 ( P = .0169)., Conclusions: The histological diagnostic yield the MES- and AI-assisted diagnoses was comparable. Healing decisions using AI may avoid the need for histological examinations., Competing Interests: None declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation.)
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- 2024
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34. Primary Bone Lymphoma of the Spine: A Case Report Highlighting Diagnostic Complexities and Treatment.
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Tsukamoto E, Nagashima Y, Nishimura Y, Kuwabara K, and Saito R
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The diagnosis of primary bone lymphoma (PBL) of the spine is challenging due to its nonspecific symptoms and radiographic features. This report details the case of an 81-year-old female who presented with lower limb weakness and thoracic pain, consequent to a vertebral pathological fracture and spinal cord compression. The initial surgical intervention revealed granulomas with caseous necrosis; however, a definitive diagnosis remained elusive. Following a third surgical procedure and further histopathological examination, the patient was finally diagnosed with diffuse large B-cell lymphoma. The therapeutic course following diagnosis involved chemotherapy, resulting in a marked improvement of the symptoms. Previous studies have highlighted the diagnostic difficulties associated with PBL, reporting the frequent need for multiple biopsies to confirm the diagnosis due to the prevalence of necrosis, crush artifacts, or inadequate sample volume. While PBL of the spine has shown responsiveness to chemotherapy and radiation therapy, early surgical intervention is advocated in cases of severe spinal cord compression or vertebral instability. The presented case highlights the importance of making a definitive pathology diagnosis in cases of suspected PBL of the spine., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Tsukamoto et al.)
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- 2024
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35. Efficacy of intraoperative irrigation with artificial cerebrospinal fluid in chronic subdural hematoma surgery: study protocol for a multicenter randomized controlled trial.
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Nagashima Y, Araki Y, Nishida K, Kuramitsu S, Wakabayashi K, Shimato S, Kinkori T, Nishizawa T, Kano T, Hasegawa T, Noda A, Maeda K, Yamamoto Y, Suzuki O, Koketsu N, Okada T, Iwasaki M, Nakabayashi K, Fujitani S, Maki H, Kuwatsuka Y, Nishihori M, Tanei T, Nishikawa T, Nishimura Y, and Saito R
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- Humans, Length of Stay, Drainage adverse effects, Drainage methods, Reoperation, Tomography, X-Ray Computed, Treatment Outcome, Recurrence, Retrospective Studies, Randomized Controlled Trials as Topic, Multicenter Studies as Topic, Hematoma, Subdural, Chronic diagnostic imaging, Hematoma, Subdural, Chronic surgery
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Background: The surgical techniques for treatment of chronic subdural hematoma (CSDH), a common neurosurgical condition, have been discussed in a lot of clinical literature. However, the recurrence proportion after CSDH surgery remains high, ranging from 10 to 20%. The standard surgical procedure for CSDH involves a craniostomy to evacuate the hematoma, but irrigating the hematoma cavity during the procedure is debatable. The authors hypothesized that the choice of irrigation fluid might be a key factor affecting the outcomes of surgery. This multicenter randomized controlled trial aims to investigate whether intraoperative irrigation using artificial cerebrospinal fluid (ACF) followed by the placement of a subdural drain would yield superior results compared to the placement of a subdural drain alone for CSDH., Methods: The study will be conducted across 19 neurosurgical departments in Japan. The 1186 eligible patients will be randomly allocated to two groups: irrigation using ACF or not. In either group, a subdural drain is to be placed for at least 12 h postoperatively. Similar to what was done in previous studies, we set the proportion of patients that meet the criteria for ipsilateral reoperation at 7% in the irrigation group and 12% in the non-irrigation group. The primary endpoint is the proportion of patients who meet the criteria for ipsilateral reoperation within 6 months of surgery (clinical worsening of symptoms and increased hematoma on imaging compared with the postoperative state). The secondary endpoints are the proportion of reoperations within 6 months, the proportion being stratified by preoperative hematoma architecture by computed tomography (CT) scan, neurological symptoms, patient condition, mortality at 6 months, complications associated with surgery, length of hospital stay from surgery to discharge, and time of the surgical procedure., Discussion: We present the study protocol for a multicenter randomized controlled trial to investigate our hypothesis that intraoperative irrigation with ACF reduces the recurrence proportion after the removal of chronic subdural hematomas compared with no irrigation., Trial Registration: ClinicalTrials.gov jRCT1041220124. Registered on January 13, 2023., (© 2023. The Author(s).)
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- 2024
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36. Bilateral fumarate hydratase deficient renal cell carcinoma in a patient with hereditary leiomyomatosis and renal cell cancer syndrome.
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Ono A, Nakamura M, Takada T, Miura S, Tsuru I, Izumi T, Kusakabe M, Mitarai S, Nagashima Y, Kume H, Morikawa T, and Shiga Y
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Introduction: Patients with hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome have high risks of uterine and cutaneous leiomyomas and renal cell carcinoma (RCC), which are caused by germline mutation of the fumarate hydratase (FH) gene. RCC lesions are mostly high-grade tumors with a poor prognosis., Case Presentation: A 37-year-old man who had previously undergone treatment for a left RCC was referred to our hospital with a diagnosis of right RCC. Robot-assisted partial nephrectomy was performed, and the pathological diagnosis revealed fumarate hydratase (FH)-deficient RCC. The left RCC, which was originally diagnosed as mucinous tubular and spindle cell carcinoma, was reviewed and diagnosed as FH-deficient RCC. The patient's father and uncle both died of RCC, and the father's tumor was also immunohistochemically proven to be FH-deficient RCC., Conclusion: HLRCC-related RCC should be considered in a differential diagnosis of young patients with a family history of RCC., Competing Interests: None of the contributing authors has any conflicts of interest, including specific financial interests or relationships and affiliations relevant to the subject matter or materials discussed in the manuscript., (© 2024 The Authors. IJU Case Reports published by John Wiley & Sons Australia, Ltd on behalf of Japanese Urological Association.)
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- 2024
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37. Luminal B Breast Cancer Coexpressing p62 and ALDH1A3 Is Less Susceptible to Radiotherapy.
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Ozaki A, Matsuda A, Maemura Y, Tada Y, Kasai T, Nagashima Y, Onaga C, Hara Y, Kitabatake K, Tsukimoto M, Tamori S, Sasaki K, Ohno S, and Akimoto K
- Subjects
- Humans, Female, Biomarkers, Tumor genetics, Biomarkers, Tumor metabolism, Breast pathology, Aldehyde Dehydrogenase 1 Family metabolism, Cell Line, Tumor, Neoplastic Stem Cells metabolism, Retinal Dehydrogenase metabolism, Prognosis, Breast Neoplasms genetics, Breast Neoplasms radiotherapy, Breast Neoplasms metabolism
- Abstract
Background/aim: We have reported that p62 (also known as sequestosome 1) is needed for survival/proliferation and tumor formation by aldehyde dehydrogenase 1 (ALDH1) -positive cancer stem cells (CSCs) and that p62
high ALDH1A3high expression is associated with a poor prognosis in luminal B breast cancer. However, the association between p62high ALDH1A3high and the benefit from radiotherapy in patients with luminal B breast cancer remains unclear., Materials and Methods: Datasets from the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) and The Cancer Genome Atlas (TCGA) were downloaded, and data from p62high ALDH1A3high luminal B patients treated without or with radiotherapy were analyzed by Kaplan-Meier and multivariate Cox regression analyses. We also performed an in vitro tumor sphere formation assay after X-ray irradiation using p62-knockdown ALDH1high luminal B BT-474 cells., Results: p62high ALDH1A3high patients had poorer clinical outcomes than other luminal B breast cancer patients treated with radiotherapy. The combination of p62 DsiRNA KD and X-ray irradiation suppressed in vitro tumor sphere formation by ALDH1high BT-474 cells. These results suggest that p62 is involved in the reduced effect of X-ray irradiation on ALDH1-positive luminal B breast CSCs., Conclusion: p62 and ALDH1A3 may serve as prognostic biomarkers for luminal B breast cancer patients treated with radiotherapy. Additionally, the combination of p62 inhibition and radiotherapy could be useful for targeted strategies against ALDH1-positive luminal B breast CSCs., (Copyright © 2024 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)- Published
- 2024
- Full Text
- View/download PDF
38. [Epstein-Barr virus-associated gastritis with perigastric lymphadenopathy accompanied by infectious mononucleosis:a case report].
- Author
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Watanabe N, Yamamoto Y, Ikegami R, Kobayashi K, Yoshimoto K, Nagashima Y, Kanno J, Yamaguchi K, Igarashi Y, and Matsuda T
- Subjects
- Humans, Female, Adult, Herpesvirus 4, Human, Antibodies, Viral, Infectious Mononucleosis complications, Epstein-Barr Virus Infections complications, Lymphadenopathy etiology, Lymphadenopathy complications, Gastritis etiology, Gastritis diagnosis, Hepatitis, Viral, Human
- Abstract
A 28-year-old female patient with no particular medical history had a sore throat seven days before admission. Subsequently, she developed malaise, right abdominal pain, and a fever of 38°C and visited our hospital. A blood test revealed a mild inflammatory response and elevated liver enzymes, and she was admitted to the hospital for detailed examination and acute liver injury treatment. Various viral tests and autoantibody measurements revealed elevated Epstein-Barr virus (EBV) immunoglobulin M and negative EB nuclear antigen antibodies. Therefore, she was diagnosed with primary infectious mononucleosis-associated EB viral hepatitis. Abdominal computed tomography upon admission revealed swollen lymph nodes around the stomach;thus, esophagogastroduodenoscopy (EGD) was performed. A histopathological examination revealed severe lymphocytic infiltration, and EB encoding region in situ hybridization demonstrated that 10-20% of the lymphocytes were EBV-infected. Drip and rest treatment improved the patient's liver enzymes, and her symptoms resolved. Repeat EGD after two months revealed improved gastric erosions. Here, we report a case of EBV-associated gastritis that was discovered due to perigastric lymphadenopathy accompanied by infectious mononucleosis. This report includes a review of the literature because a few studies reported EBV-associated gastritis.
- Published
- 2024
- Full Text
- View/download PDF
39. Renal cell carcinoma outcomes in end-stage renal disease: A 40-year study from two Japanese institutions.
- Author
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Ishihara H, Ikeda T, Fukuda H, Yoshida K, Kobayashi H, Iizuka J, Nagashima Y, Kondo T, and Takagi T
- Subjects
- Humans, Retrospective Studies, Japan epidemiology, Nephrectomy, Carcinoma, Renal Cell complications, Carcinoma, Renal Cell surgery, Kidney Neoplasms complications, Kidney Neoplasms surgery, Kidney Failure, Chronic complications, Kidney Failure, Chronic epidemiology
- Abstract
Objectives: The objective of the study was to analyze the outcomes of patients with renal cell carcinoma (RCC) arising in end-stage renal disease (ESRD) over a 40-year span., Methods: We retrospectively evaluated data of patients with ESRD-RCC diagnosed between 1979 and 2020 at two institutions. We assessed changes in stage, surgical approaches, and cancer-specific survival (CSS) following nephrectomy according to era between ESRD-RCC and sporadic RCC. Furthermore, perioperative outcomes in patients with ESRD-RCC were compared between laparoscopic and open surgery., Results: Patients with ESRD-RCC (n = 549) were diagnosed at an earlier stage (p = 0.0276), and the ratio of laparoscopic nephrectomy was increased (p < 0.0001) according to eras. Since 2000 (i.e., after implementation of laparoscopic nephrectomy), patients with ESRD-RCC (n = 305) had significantly shorter CSS (p = 0.0063) after nephrectomy than sporadic RCC (n = 2732). After adjustment by multivariate analysis and propensity score matching, ESRD status was independently associated with shorter CSS (p = 0.0055 and p = 0.0473, respectively). Improved CSS in sporadic RCC (p < 0.0001), but not ESRD-RCC (p = 0.904), according to era contributed to this difference. Laparoscopic nephrectomy showed favorable outcomes, including shorter surgery time, lower estimated bleeding volumes, transfusion rates, and readmission rates, and shorter postoperative hospitalization than open nephrectomy (p < 0.05)., Conclusions: Advances in diagnostic and treatment modalities potentially enable early diagnosis and minimally invasive surgery for patients with ESRD-RCC. As ESRD-RCC may not present indolently, careful post-operative monitoring is needed., (© 2023 The Japanese Urological Association.)
- Published
- 2024
- Full Text
- View/download PDF
40. Anti-tumor and cardiotoxic effects of microtubule polymerization inhibitors: The mechanisms and management strategies.
- Author
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Tochinai R, Nagashima Y, Sekizawa SI, and Kuwahara M
- Subjects
- Humans, Animals, Dogs, Cardiotoxicity, Polymerization, Neoplasms drug therapy, Antineoplastic Agents toxicity, Heart Diseases chemically induced
- Abstract
Microtubule polymerization inhibitors (MPIs) have long been used as anticancer agents because they inhibit mitosis. Microtubules are thought to play an important role in the migration of tumor cells and the formation of tumor blood vessels, and new MPIs are being developed. Many clinical trials of novel MPIs have been conducted in humans, while some clinical studies in dogs have also been reported. More attempts to apply MPIs not only in humans but also in the veterinary field are expected to be made in the future. Meanwhile, MPIs have a risk of cardiotoxicity. In this paper, we review findings on the pharmacological effects and cardiotoxicity of MPIs, as well as the mechanisms of their cardiotoxicity. Cardiotoxicity of MPIs involves not only the direct effects of MPIs on cardiomyocytes but also their effects on vascular function. For example, hypertension induced by impaired vascular function also contributes to the exacerbation of myocardial damage, and blood pressure control may be useful in reducing cardiotoxicity. By combined administration of MPIs and other anticancer agents, MPI efficacy may be enhanced, thereby potentially allowing to keep MPI dosage low. Measurement of myocardial injury markers in blood and echocardiography may be useful for monitoring cardiotoxicity. In particular, two-dimensional speckle tracking may have high sensitivity for the early detection of MPI-induced cardiac dysfunction. The exploration of the potential of new MPIs while understanding their toxicity and how to deal with them will lead to the further development of cancer chemotherapy., (© 2023 The Authors. Journal of Applied Toxicology published by John Wiley & Sons Ltd.)
- Published
- 2024
- Full Text
- View/download PDF
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