Search

Purpose: The study aimed to explore and describe the lives of patients with persistent cloaca (PC) from childhood to adulthood. Methods: Semistructured interviews were conducted with nine adult patients with PC. Their experiences and thoughts regarding this disease were analyzed qualitatively and inductively. Results: After classifying the experiences and thoughts of patients with PC, 13 categories were extracted. The following five themes emerged from these categories. (1) Difficulties with excretion and vaginal management because of the disease. (2) The degree of understanding of those around them and society has a huge effect on their way of life. (3) The inferiority of a woman who is not a "normal woman." (4) A "never-ending disease" in which problems continue even after the transition period. (5) Differences in the central point of the narrative depending on the age group. Conclusions: In this study, qualitative and inductive analyses of data from semistructured interviews with patients with PC revealed their experiences and thoughts. The results will provide a guide for young patients and the medical professionals who treat them. Accordingly, monitoring their lives until adulthood is necessary. [ABSTRACT FROM AUTHOR]

Purpose: Megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS) is defined as a congenital visceral myopathy with genetic mutations. However, the etiology and pathophysiology are not fully understood. We aimed to generate a gene leiomodin-1a (lmod1a) modification technique to establish a zebrafish model of MMIHS. Methods: We targeted lmod1a in zebrafish using CRISPR/Cas9. After confirming the genotype, we measured the expression levels of the target gene and protein associated with MMIHS. A gut transit assay and spatiotemporal mapping were conducted to analyze the intestinal function. Results: Genetic confirmation showed a 5-base-pair deletion in exon 1 of lmod1a, which caused a premature stop codon. We observed significant mRNA downregulation of lmod1a, myh11, myod1, and acta2 and the protein expression of Lmod1 and Acta2 in the mutant group. A functional analysis of the lmod1a mutant zebrafish showed that its intestinal peristalsis was fewer, slower, and shorter in comparison to the wild type. Conclusion: This study showed that targeted deletion of lmod1a in zebrafish resulted in depletion of MMIHS-related genes and proteins, resulting in intestinal hypoperistalsis. This model may have the potential to be utilized in future therapeutic approaches, such as drug discovery screening and gene repair therapy for MMIHS. [ABSTRACT FROM AUTHOR]

Background: Few studies have reported reliable prognostic factors for immune checkpoint inhibitors (ICIs) in renal cell carcinoma (RCC). Therefore, we investigated prognostic factors in patients treated with ICIs for unresectable or metastatic RCC. Methods: We included 43 patients who received ICI treatment for RCC between January 2018 and October 2021. Blood samples were drawn before treatment, and 73 soluble factors in the plasma were analyzed using a bead-based multiplex assay. We examined factors associated with progression-free survival (PFS), overall survival (OS), and immune-related adverse events (irAE) using the Chi-squared test, Kaplan–Meier method, and the COX proportional hazards model. Results: Patients exhibited a median PFS and OS of 212 and 783 days, respectively. Significant differences in both PFS and OS were observed for MMP1 (PFS, p < 0.001; OS, p = 0.003), IL-1β (PFS, p = 0.021; OS, p = 0.008), sTNFR-1 (PFS, p = 0.017; OS, p = 0.005), and IL-6 (PFS, p = 0.004; OS, p < 0.001). Multivariate analysis revealed significant differences in PFS for MMP1 (hazard ratio [HR] 5.305, 95% confidence interval [CI], 1.648–17.082; p = 0.005) and OS for IL-6 (HR 23.876, 95% CI, 3.426–166.386; p = 0.001). Moreover, 26 patients experienced irAE, leading to ICI discontinuation or withdrawal. MMP1 was significantly associated with irAE (p = 0.039). Conclusion: MMP1 may be associated with severe irAE, and MMP1, IL-1β, sTNFR-1, and IL-6 could serve as prognostic factors in unresectable or metastatic RCC treated with ICIs. MMP1 and IL-6 were independent predictors of PFS and OS, respectively. Thus, inhibiting these soluble factors may be promising for enhancing antitumor responses in patients with RCC treated with ICIs. [ABSTRACT FROM AUTHOR]

The influence of chronic kidney disease stage on robot-assisted partial nephrectomy outcomes remains underexplored. This study aimed to assess the impact of chronic kidney disease stage on functional and surgical outcomes of robot-assisted partial nephrectomy and identify preoperative predictors of significant postoperative 1-year renal-function loss (RFL). Clinical data of 408 patients who underwent robot-assisted partial nephrectomy at Yokohama City University Hospital between 2016 and 2023 were retrospectively reviewed. The da Vinci Surgical System was applied in all patients, and outcomes assessed included surgical parameters, postoperative estimated glomerular filtration rate, trifecta and pentafecta achievements, and complications. Significant RFL was defined as estimated glomerular filtration rate reduction ≥ 25% from baseline. Higher chronic kidney disease stages correlated with older age, hypertension, diabetes, and solitary kidneys. Postoperative estimated glomerular filtration rate decline was most pronounced in patients with chronic kidney disease stages 4–5. Although the chronic kidney disease stage did not significantly affect most surgical parameters, pentafecta achievement was higher in patients with chronic kidney disease stage 3 than in those with stages 4–5. Two patients required hemodialysis after robot-assisted partial nephrectomy. Multivariable logistic regression analysis showed that preoperative hemoglobin level and maximum tumor diameter were significant predictive factors for significant RFL. In conclusion, preoperative CKD stage did not influence on surgical outcome except for pentafecta achievement. RAPN may be feasible for patients with CKD stages 4–5 because of no rapid progression to hemodialysis induction and no procedure-related mortality. Preoperative hemoglobin levels and tumor diameter emerged as predictors of significant RFL. [ABSTRACT FROM AUTHOR]

Purpose: The number of accessible central veins (CVs) affects the prognosis of patients with intestinal failure (IF). The loss of residual CVs should be avoided. We, therefore, evaluated the efficacy of a new CV catheter-exchange technique using a subcutaneous fibrous sheath (FS) in pediatric IF patients. Methods: We retrospectively collected the CV catheter (CVC) data of pediatric IF patients managed from January 2009 to December 2019. The data were divided into two groups; Groups 1 (CVCs placed with the FS method) and Group 2 (CVCs placed by the primary or another insertion). The main outcome was the CVC indwelling time. Results: Eighty-five CVCs were analyzed. The FS method was attempted in 47 cases and succeeded in 40 (85%). No significant difference was observed between the groups regarding characteristics. A log-rank test revealed an equivalent CVC indwelling time between the two groups (Group 1: 268 [126–588] days vs. Group 2: 229 [126–387] days, p = 0.256). Conclusions: The FS method is highly recommended for pediatric IF patients, as its attempt showed a high success rate with an indwelling time equivalent to primary insertion. The FS method leads to the prolonged use of a single CV and thereby contributes to improving the outcomes of pediatric IF patients. [ABSTRACT FROM AUTHOR]

A clear understanding of the significance of arbuscular mycorrhizal fungi (AMF) to phosphorus (P) nutrition in intensively managed cover crop rotational systems with soybean [ Glycine max (L.) Merr.] will impact how we currently manage these systems, particularly crop rotation decisions. We investigated the impact of wheat ( Triticum aestivum L.), rapeseed ( Brassica napus L.), or fallow on composition of AMF communities in soil over 2 years of a consecutive soybean rotational system. The composition of AMF communities was characterized on the basis of the large subunit (LSU) ribosomal DNA (rDNA). AMF spore abundance in soil after cultivation of wheat was higher than that after rapeseed or fallow for the all sampling years. Phylogenetic analysis identified 19 AMF phylotypes, including five Glomus; three Gigaspora; two of Acaulospora, Funneliformis, and Rhizophagus; one of Racocetra, Claroideoglomus, Diversispora, and Sclerocystis; and an unknown glomeromycete in soil. Dominant phylotypes of Glomerales occurred widely across the winter cover crop rotations. However, the phylotype richness and diversity of AMF communities were unchanged among crop rotations and years. Redundancy analysis (RDA) demonstrated that AMF communities within a crop rotation were not significantly different. However, when analyzed over a 2-year period, the composition of AMF communities was clearly influenced by year where the distribution of specific AMF phylotypes responded to the winter cover crop management. Thus, diversity of AMF communities in soil was clearly shifted by rotation year, which indicated that other abiotic environmental factors may impact composition AMF communities more than winter cover crop rotational systems. [ABSTRACT FROM AUTHOR]

The impact of winter cover crops, specifically wheat ( Triticum aestivum L.), red clover ( Trifolium pratense L.), and rapeseed ( Brassica napus L.) or winter fallow, on community composition of arbuscular mycorrhizal fungi (AMF) in subsequent soybean roots was investigated in a 5-year field trial on andosolic soils in Japan. Soybean roots were sampled at full-flowering and analyzed for AMF communities using a partial LSU rDNA region. Phylogenetic analysis detected 22 AMF phylotypes, including eight Glomus, three Gigaspora, two Scutellospora, three Acaulospora, two Rhizophagus, and one of Funneliformis, Diversispora, Paraglomus, and an unknown glomeromycete in the roots. The 5-year rotation of different winter cover crops or winter fallow did not impact the molecular diversity of AMF communities colonizing the roots of subsequent soybean. In all of the rotations, Glomus and Gigaspora phylotypes were common to soybean roots over the 5-year period. Redundancy analysis (RDA) demonstrated that AMF communities in the roots of subsequent soybean were not significantly different among winter cover crop rotations or fallow. However, AMF communities in soybean roots were clearly influenced by rotation year suggesting that climate or other environmental factors were more important than winter cover cropping system management. [ABSTRACT FROM AUTHOR]

A new analytical method for the determination of bisphenol A (BPA) by LC/MS was developed and applied to environmental water samples. Quantitative MS detection of BPA was carried out in the negative mode. In order to preconcentrate the target compound yet prevent serious contamination of the water samples from the experimental environment, we employed column switching HPLC coupled with a pretreatment column of surface-modified molecularly-imprinted polymers. The recovery of BPA from a spiked environmental water sample was 102% and the repeatability of actual determinations of water samples containing 20 ng/L of BPA was 5.4% RSD. By modifying the surfaces of the molecularly-imprinted polymer particles packed in the pretreatment column, interference from the water samples was effectively removed, resulting in a significant increase in sensitivity and more reliable results. This method was successfully applied to the trace determination of BPA in environmental water samples using LC/MS. [ABSTRACT FROM AUTHOR]