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Background: Direct surgery is an important option to treat vertebral artery (VA) stenosis. Method: A patient with symptomatic stenosis at the origin of the right VA underwent transposition of the right VA to the common carotid artery (CCA). Using the sternocleidomastoid sparing approach, the VA was anastomosed to the posterior wall of the CCA by twisting the CCA to expose its posterior wall to face the operative field. Conclusion: This approach, consisting of securing the proximal VA and then following it to its distal end, not only preserves the sternocleidomastoid muscle but also protects the sympathetic chains and thoracic duct. [ABSTRACT FROM AUTHOR]

In this paper, we present a damage identification method for small damages based on topology optimization and Lasso regularization. In particular, this work extends the applicability of the previously developed damage identification method using frequency response functions and topology optimization, by conducting rigorous parametric studies in terms of damping, measurement noise, and damage size. It is shown that the presented method successfully identifies small damaged regions with a reasonable accuracy. To evaluate the effectiveness of the proposed method, we applied the method to identify the damages in cantilevered plates that are subject to static or dynamic loads. The method succeeded in detecting the locations and shapes of damages more accurately than the method without Lasso regularization. Furthermore, in most cases we have considered, spurious damages generated during the optimization were successfully suppressed. [ABSTRACT FROM AUTHOR]

The recurrence of non-metastatic renal cell carcinoma (RCC) may occur early or late after surgery. This study aimed to develop a recurrence prediction machine learning model based on quantitative nuclear morphologic features of clear cell RCC (ccRCC). We investigated 131 ccRCC patients who underwent nephrectomy (T1-3N0M0). Forty had recurrence within 5 years and 22 between 5 and 10 years; thirty-seven were recurrence-free during 5–10 years and 32 were for more than 10 years. We extracted nuclear features from regions of interest (ROIs) using a digital pathology technique and used them to train 5- and 10-year Support Vector Machine models for recurrence prediction. The models predicted recurrence at 5/10 years after surgery with accuracies of 86.4%/74.1% for each ROI and 100%/100% for each case, respectively. By combining the two models, the accuracy of the recurrence prediction within 5 years was 100%. However, recurrence between 5 and 10 years was correctly predicted for only 5 of the 12 test cases. The machine learning models showed good accuracy for recurrence prediction within 5 years after surgery and may be useful for the design of follow-up protocols and patient selection for adjuvant therapy. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess the efficiency of artificial intelligence (AI) in the detection of visceral pleural invasion (VPI) of lung cancer using high-resolution computed tomography (HRCT) images, which is challenging for experts because of its significance in T-classification and lymph node metastasis prediction.This retrospective analysis was conducted on preoperative HRCT images of 472 patients with stage I non-small cell lung cancer (NSCLC), focusing on lesions adjacent to the pleura to predict VPI. YOLOv4.0 was utilized for tumor localization, and EfficientNetv2 was applied for VPI prediction with HRCT images meticulously annotated for AI model training and validation.Of the 472 lung cancer cases (500 CT images) studied, the AI algorithm successfully identified tumors, with YOLOv4.0 accurately localizing tumors in 98% of the test images. In the EfficientNet v2-M analysis, the receiver operating characteristic curve exhibited an area under the curve of 0.78. It demonstrated powerful diagnostic performance with a sensitivity, specificity, and precision of 76.4% in VPI prediction.AI is a promising tool for improving the diagnostic accuracy of VPI for NSCLC. Furthermore, incorporating AI into the diagnostic workflow is advocated because of its potential to improve the accuracy of preoperative diagnosis and patient outcomes in NSCLC.Methods: This study aimed to assess the efficiency of artificial intelligence (AI) in the detection of visceral pleural invasion (VPI) of lung cancer using high-resolution computed tomography (HRCT) images, which is challenging for experts because of its significance in T-classification and lymph node metastasis prediction.This retrospective analysis was conducted on preoperative HRCT images of 472 patients with stage I non-small cell lung cancer (NSCLC), focusing on lesions adjacent to the pleura to predict VPI. YOLOv4.0 was utilized for tumor localization, and EfficientNetv2 was applied for VPI prediction with HRCT images meticulously annotated for AI model training and validation.Of the 472 lung cancer cases (500 CT images) studied, the AI algorithm successfully identified tumors, with YOLOv4.0 accurately localizing tumors in 98% of the test images. In the EfficientNet v2-M analysis, the receiver operating characteristic curve exhibited an area under the curve of 0.78. It demonstrated powerful diagnostic performance with a sensitivity, specificity, and precision of 76.4% in VPI prediction.AI is a promising tool for improving the diagnostic accuracy of VPI for NSCLC. Furthermore, incorporating AI into the diagnostic workflow is advocated because of its potential to improve the accuracy of preoperative diagnosis and patient outcomes in NSCLC.Results: This study aimed to assess the efficiency of artificial intelligence (AI) in the detection of visceral pleural invasion (VPI) of lung cancer using high-resolution computed tomography (HRCT) images, which is challenging for experts because of its significance in T-classification and lymph node metastasis prediction.This retrospective analysis was conducted on preoperative HRCT images of 472 patients with stage I non-small cell lung cancer (NSCLC), focusing on lesions adjacent to the pleura to predict VPI. YOLOv4.0 was utilized for tumor localization, and EfficientNetv2 was applied for VPI prediction with HRCT images meticulously annotated for AI model training and validation.Of the 472 lung cancer cases (500 CT images) studied, the AI algorithm successfully identified tumors, with YOLOv4.0 accurately localizing tumors in 98% of the test images. In the EfficientNet v2-M analysis, the receiver operating characteristic curve exhibited an area under the curve of 0.78. It demonstrated powerful diagnostic performance with a sensitivity, specificity, and precision of 76.4% in VPI prediction.AI is a promising tool for improving the diagnostic accuracy of VPI for NSCLC. Furthermore, incorporating AI into the diagnostic workflow is advocated because of its potential to improve the accuracy of preoperative diagnosis and patient outcomes in NSCLC.Conclusion: This study aimed to assess the efficiency of artificial intelligence (AI) in the detection of visceral pleural invasion (VPI) of lung cancer using high-resolution computed tomography (HRCT) images, which is challenging for experts because of its significance in T-classification and lymph node metastasis prediction.This retrospective analysis was conducted on preoperative HRCT images of 472 patients with stage I non-small cell lung cancer (NSCLC), focusing on lesions adjacent to the pleura to predict VPI. YOLOv4.0 was utilized for tumor localization, and EfficientNetv2 was applied for VPI prediction with HRCT images meticulously annotated for AI model training and validation.Of the 472 lung cancer cases (500 CT images) studied, the AI algorithm successfully identified tumors, with YOLOv4.0 accurately localizing tumors in 98% of the test images. In the EfficientNet v2-M analysis, the receiver operating characteristic curve exhibited an area under the curve of 0.78. It demonstrated powerful diagnostic performance with a sensitivity, specificity, and precision of 76.4% in VPI prediction.AI is a promising tool for improving the diagnostic accuracy of VPI for NSCLC. Furthermore, incorporating AI into the diagnostic workflow is advocated because of its potential to improve the accuracy of preoperative diagnosis and patient outcomes in NSCLC.Graphical abstract: This study aimed to assess the efficiency of artificial intelligence (AI) in the detection of visceral pleural invasion (VPI) of lung cancer using high-resolution computed tomography (HRCT) images, which is challenging for experts because of its significance in T-classification and lymph node metastasis prediction.This retrospective analysis was conducted on preoperative HRCT images of 472 patients with stage I non-small cell lung cancer (NSCLC), focusing on lesions adjacent to the pleura to predict VPI. YOLOv4.0 was utilized for tumor localization, and EfficientNetv2 was applied for VPI prediction with HRCT images meticulously annotated for AI model training and validation.Of the 472 lung cancer cases (500 CT images) studied, the AI algorithm successfully identified tumors, with YOLOv4.0 accurately localizing tumors in 98% of the test images. In the EfficientNet v2-M analysis, the receiver operating characteristic curve exhibited an area under the curve of 0.78. It demonstrated powerful diagnostic performance with a sensitivity, specificity, and precision of 76.4% in VPI prediction.AI is a promising tool for improving the diagnostic accuracy of VPI for NSCLC. Furthermore, incorporating AI into the diagnostic workflow is advocated because of its potential to improve the accuracy of preoperative diagnosis and patient outcomes in NSCLC. [ABSTRACT FROM AUTHOR]

Although voluntary muscle contraction modulates spinal reflex excitability of contracted muscles and other muscles located at other segments within a limb (i.e., intra-limb modulation), to what extent corticospinal pathways are involved in intra-limb modulation of spinal reflex circuits remains unknown. The purpose of the present study was to identify differences in the involvement of corticospinal pathways in intra-limb modulation of spinal reflex circuits among lower-limb muscles during voluntary contractions. Ten young males performed isometric plantar-flexion, dorsi-flexion, knee extension, and knee flexion at 10% of each maximal torque. Electromyographic activity was recorded from soleus, tibialis anterior, vastus lateralis, and biceps femoris muscles. Motor evoked potentials and posterior root-muscle reflexes during rest and isometric contractions were elicited from the lower-limb muscles using transcranial magnetic stimulation and transcutaneous spinal cord stimulation, respectively. Motor evoked potential and posterior root-muscle reflex amplitudes of soleus during knee extension were significantly increased compared to rest. The motor evoked potential amplitude of biceps femoris during dorsi-flexion was significantly increased, whereas the posterior root-muscle reflex amplitude of biceps femoris during dorsi-flexion was significantly decreased compared to rest. These results suggest that corticospinal and spinal reflex excitabilities of soleus are facilitated during knee extension, whereas intra-limb modulation of biceps femoris during dorsi-flexion appeared to be inverse between corticospinal and spinal reflex circuits. [ABSTRACT FROM AUTHOR]

For a graph G, define σ 2 (G) by σ 2 (G) = min { d G (x) + d G (y) : x , y ∈ V (G) , x ≠ y , x y ∉ E (G) } . If G is a bipartite graph with partite sets X and Y, we also define σ 1 , 1 (G) by σ 1 , 1 (G) = min { d G (x) + d G (y) : x ∈ X , y ∈ Y , x y ∉ E (G) } . Ore's theorem states that a graph of order n ≥ 3 with σ 2 (G) ≥ n contains a hamiltonian cycle and the Moon–Moser theorem states that a balanced bipartite graph G of order 2 n ≥ 4 with σ 1 , 1 (G) ≥ n + 1 contains a hamiltonian cycle. In Chen et al. (Discrete Math 343:Article No. 111663, 2020), we studied the relationship between Ore's theorem and the Moon–Moser theorem, and proved that the refinement of the Moon–Moser theorem given by Ferrara et al. (Discrete Math 312:459–461, 2012) implies Ore's theorem for graphs of even order. In this paper, we extend the above study to the graphs of odd order. Since no graphs of odd order contain a spanning balanced bipartite subgraph, the Moon–Moser theorem does not work in this case. We instead introduce its counterpart for the graphs in which the orders of the partite sets differ by 1, proved in Matsubara et al. (Discrete Math 340:87–95, 2017). We refine this result and prove that this refinement implies Ore's theorem. [ABSTRACT FROM AUTHOR]

Experimental modal analysis is one of the key technologies in structural dynamics analysis. However, in cases involving extremely high or low modal damping, it is difficult to accurately identify all the modal parameters. In particular, for systems with extremely low damping, there may not be sufficient data to allow curve fitting in the vicinity of the resonant peaks. To overcome this difficulty, we propose a linear fit method of modal parameters on a new mapping plane. This method uses a basic equation linearized from the nonlinear equation of the frequency response function (FRF) by erasing the residue, which is a modal parameter. Then, the basic equation becomes linear on a mapping plane related to the ratios of the real and imaginary parts of the FRF. The linearized basic equation can identify the modal parameters of a vibration system with extremely low damping. It was observed that the influence of the measurement noise degrades the identification accuracy of the linear fit method. Consequently, it was confirmed that the identification accuracy deteriorates when data with low coherence and far from the natural frequency are used. Thus, a weighted least squares method using the coherence and Gaussian kernel function was proposed for the linear fit method. Finally, the modal parameters obtained using the proposed method and the conventional least-squares complex frequency (LSCF) method, from the FRF including noise, were compared, which indicated that the proposed method can produce estimation results with an accuracy comparable to that pertaining to the LSCF method. [ABSTRACT FROM AUTHOR]

Voluntary contraction facilitates corticospinal and spinal reflex circuit excitabilities of the contracted muscle and inhibits spinal reflex circuit excitability of the antagonist. It has been suggested that modulation of spinal reflex circuit excitability in agonist and antagonist muscles during voluntary contraction differs among lower-limb muscles. However, whether the effects of voluntary contraction on the excitabilities of corticospinal and spinal reflex circuits depend on the tested muscles remains unknown. The purpose of this study was to examine inter-muscle differences in modulation of the corticospinal and spinal reflex circuit excitabilities of multiple lower-limb muscles during voluntary contraction. Eleven young males performed isometric plantar-flexion, dorsi-flexion, knee extension, and flexion at low torque levels. Motor evoked potentials (MEPs) and posterior root-muscle reflexes from seven lower-leg and thigh muscles were evoked by transcranial magnetic stimulation and transcutaneous spinal cord stimulation, respectively, at rest and during weak voluntary contractions. MEP and posterior root-muscle reflex amplitudes of agonists were significantly increased as agonist torque level increased, except for the reflex of the tibialis anterior. MEP amplitudes of antagonists were significantly increased in relation to the agonist torque level, but those of the rectus femoris were slightly depressed during knee flexion. Regarding the posterior root-muscle reflex of the antagonists, the amplitudes of triceps surae and the hamstrings were significantly decreased, but those of the quadriceps femoris were significantly increased as the agonist torque level increased. These results demonstrate that modulation of corticospinal and spinal reflex circuit excitabilities during agonist and antagonist muscle contractions differed among lower-limb muscles. [ABSTRACT FROM AUTHOR]

Bone marrow-derived mesenchymal stem cells (BM-MSCs) are the most valuable source of autologous cells for transplantation and tissue regeneration to treat osteoporosis. Although BM-MSCs are the primary cells responsible for maintaining bone metabolism and homeostasis, their regenerative ability may be attenuated in postmenopausal osteoporosis patients. Therefore, we first examined potential abnormalities of BM-MSCs in an oestrogen-deficient rat model constructed by ovariectomy (OVX-MSCs). Cell proliferation, mobilisation, and regulation of osteoclasts were downregulated in OVX-MSCs. Moreover, therapeutic effects of OVX-MSCs were decreased in OVX rats. Accordingly, we developed a new activator for BM-MSCs using human umbilical cord extracts, Wharton’s jelly extract supernatant (WJS), which improved cell proliferation, mobilisation and suppressive effects on activated osteoclasts in OVX-MSCs. Bone volume, RANK and TRACP expression of osteoclasts, as well as proinflammatory cytokine expression in bone tissues, were ameliorated by OVX-MSCs activated with WJS (OVX-MSCs-WJ) in OVX rats. Fusion and bone resorption activity of osteoclasts were suppressed in macrophage-induced and primary mouse bone marrow cell-induced osteoclasts via suppression of osteoclast-specific genes, such as Nfatc1, Clcn7, Atp6i and Dc-stamp, by co-culture with OVX-MSCs-WJ in vitro. In this study, we developed a new activator, WJS, which improved the functional abnormalities and therapeutic effects of BM-MSCs on postmenopausal osteoporosis. [ABSTRACT FROM AUTHOR]

Orthotropic elastic moduli of composite structures can be identified by nonlinear least squares fit between measured and computed natural frequencies. However, due to measurement errors contained in the measured natural frequencies and mode shapes, the process of elastic moduli identification is error-prone. This paper proposes an efficient method to estimate the errors in the elastic moduli caused by the measurement errors in the natural frequencies. The method utilizes an efficient semi-analytic expression of the sensitivities of the eigenvalues with respect to the orthotropic elastic moduli. First, the first-order approximation of the analytic sensitivity of orthotropic elastic moduli with respect to the measurement errors is introduced. The approximation is then used to estimate the variability of the identified elastic moduli due to the measurement errors. It is shown that the aspect ratio of the test specimen greatly affects the standard deviation of the identified elastic moduli. Second, using the first-order approximation, the effects of aspect ratio of the test specimen as well as the values of the elastic moduli are further investigated. Based on the results of numerical experiments, guidelines for the dimension of the test specimen for the elastic moduli identification are proposed. [ABSTRACT FROM AUTHOR]

The quadriceps femoris (QF) muscle group plays an essential role in human movement, such as standing, walking and running. The ability to maintain a steady force during physical activity of the human lower limb is important for mobility, postural control and balance. Although prolonged mechanical vibration of the muscle-tendon unit can moderate the efficacy of synaptic input from Ia afferent onto the α-motor neuron pathway, the effect of prolonged tendon vibration on fluctuations of knee extensor force has received little attention. The purpose of the present study was to examine the effects of prolonged patellar tendon vibration on the force steadiness of the QF muscle. Nine healthy men performed a submaximal force-matching task involving isometric knee extension before and after patellar tendon vibration or quiet seated rest ( n = 7, control condition) for 30 min. The target force was 2.5, 10 and 30 % of maximal voluntary contraction (MVC). Surface electromyography (EMG) of the four QF synergists was recorded and normalized to EMG amplitude during the MVC. The knee extension force and the EMG amplitude of vastus medialis during the MVC were significantly reduced after the vibration, but did not significantly decrease in the control condition. Fluctuations of force and normalized EMG of individual QF muscles at each submaximal force level did not significantly change after the vibration. We conclude that prolonged patellar tendon vibration does not influence the force steadiness of the QF muscle during an isometric force-matching task. [ABSTRACT FROM AUTHOR]

Purpose: Growing teratoma syndrome (GTS) is a rare clinical phenomenon defined as the paradoxical growth of mature teratoma components during or after chemotherapy. The mechanism of this phenomenon is not well understood. We present two cases of pineal mixed germ cell tumors that exhibited the similar course to GTS and speculate its pathogenesis. Case report: The first case was accompanied by slightly elevated alpha-fetoprotein (8.8 ng/ml; normal <6.6 ng/ml). The tumor rapidly grew from 1.5 to 2.7 cm in diameter within 4 weeks. Despite this rapid preoperative growth, thorough pathological investigation found only mature teratoma components along with multiple micro- and macro-cysts. The other case was diagnosed as a pure germinoma based on biopsy and serological examinations. During three courses of chemotherapy, this tumor presented a honeycomb-like appearance on magnetic resonance (MR) images and an exceptionally rapid enlargement. Second-look surgery confirmed the histological diagnosis of a mature teratoma. In both cases, meticulous pathological examination of all whole tumor sections revealed no malignant histological features, and the MIB-1 labeling indices were too low to account for the extremely rapid tumor growth. Instead, both MR images and histological findings demonstrated a predominant formation of multiple cysts. Conclusion: We speculate that this paradoxical growth might not be tumorous proliferation but instead the formation and expansion of multiple cysts inside mature teratoma components and that the presence or absence of growth might be a subsidiary phenomenon. Our hypothesis appears consistent with the characteristic radiological findings of GTS reported in the literature. [ABSTRACT FROM AUTHOR]

Purpose: The tensor fascia lata (TFL) flap is used to reconstruct various anatomical structures in different regions of the body. We herein describe the use of TFL flaps for a variety of indications, and discuss the results of such procedures with respect to postoperative complications in oncology patients. Methods: We reviewed 15 oncology patients who were treated with TFL flaps. Results: The lesions were located in the groin in five patients, the lower abdomen in five, and the buttocks, ischium, shoulder, thigh and upper abdomen in one patient each. Abdominal wall reconstruction was performed in nine patients. Three patients underwent resection of femoral vessels and the tumor in the groin, followed by a vascular graft implant. In these patients, the combined flaps were transferred to reconstruct the defects. Nine patients developed complications. No total flap loss occurred in any patient. Conclusions: Postoperative complications, such as necrosis in the distal part of the flap (33 %) and ventral hernias (11 %) were seen, but these percentages were comparable to those seen in previous reports. Our review shows that the TFL flap is useful to reconstruct the defects in various anatomical sites in oncology patients. [ABSTRACT FROM AUTHOR]

Purpose: Electromyostimulation (EMS) induces a short-term change in muscle metabolism, and EMS training induces long-term improvements of muscle atrophy and function. However, the effects of EMS training on intramuscular fat in older adults are still poorly known. The purpose of this study was to examine whether the intramuscular fat index and biochemical parameters change with EMS training of the quadriceps femoris muscles in older adults. Methods: Nineteen non-obese older men and women performed EMS training of the quadriceps femoris for 12 weeks (3 times/week; single session for 30 min). The intramuscular fat content index was estimated by echo intensity of the vastus lateralis and rectus femoris muscles on ultrasonography, and muscle thickness was also measured. Muscle strength was assessed as the maximal voluntary contraction during isometric knee extension. Echo intensity, muscle thickness, and muscle strength were measured before and after EMS training. A rested/fasting blood samples were collected before and after EMS training for measuring plasma glucose, insulin, free fatty acid, triglyceride, and interleukin-6 concentrations. To examine the acute effect of a single-EMS session on biochemical parameters, blood samples were taken before and after the EMS session. Results: EMS training did not significantly change echo intensity in muscles, muscle thickness, muscle strength, or biochemical parameters. Regarding the acute effect on blood lipid concentrations, a single-EMS session increased free fatty acid and glucose concentrations. Conclusion: EMS sessions had an acute effect of increasing free fatty acid and glucose concentrations, but EMS training intervention did not improve intramuscular fat content. [ABSTRACT FROM AUTHOR]

Purpose: The posterior thigh flap is a reliable flap owing to the dependability of the inferior gluteal artery. Its utility for the reconstruction of sacral, perineal, ischial, pelvic, trochanteric and vulvar defects is well established. We herein describe the use of the flap for a variety of indications, and discuss the results with respect to postoperative complications in oncology patients. Methods: We reviewed nine oncology patients who were treated with pedicled posterior thigh flaps. We assessed the use of this treatment by recording the site of the defect, the type of flap used, and the presence or absence of previous surgical procedures, radiation therapy and postoperative complications. Results: Defects after resection of soft tissue sarcomas were the most common condition ( n = 4), followed by skin cancers ( n = 2), gastrointestinal cancers ( n = 2) and radiation osteomyelitis ( n = 1). Six patients (66 %) developed complications; three (33 %) were major and three (33 %) were minor. There was one case of total necrosis of the flap and two cases of partial necrosis. Conclusions: In oncology patients, the posterior thigh flap is an excellent choice for the reconstruction of sacral, ischial, pelvic or buttock defects, since it does not cause any donor site morbidity. [ABSTRACT FROM AUTHOR]

Coagulation disorders can be classified into two types: excessive bleeding and excessive clotting. Furthermore, the severity of the coagulation disorders can vary significantly among patients. We evaluated two relatively rare cases involving factor XIII subunit deficiency and antiphospholipid syndrome (APS) with concomitant systemic lupus erythematosus (SLE) in two patients undergoing flap reconstructions after tumor excision. In the patient with excessive bleeding as a result of a factor XIII subunit deficiency, flap necrosis occurred from a large subcutaneous hematoma that pressed on the perforator pedicle. Normal clotting function was restored during the surgery by administering a factor XIII preparation (Fibrogammin® P). The patient with excessive clotting as a result of APS and SLE suffered necrosis of the flaps after undergoing radial forearm free flap (RFFF) and pedicled pectoralis major musculocutaneous (PMMC) flap operations. With clotting factor deficiencies, there are patients in whom no evidence of a coagulation disorder exists preoperatively. It is important for surgeons to pay close attention to the potential for coagulation disorders patients and to consult with specialists promptly when indicated. Level of Evidence: Level V, risk/prognostic study. [ABSTRACT FROM AUTHOR]

Purpose: Fatigue-related muscle activity in the superficial quadriceps femoris (QF) muscles has been widely examined; however, there is no information on the activity of the deep vastus intermedius (VI) muscle during fatiguing dynamic knee extensions. The purpose of this study was to investigate neuromuscular activation patterns of the QF synergists, including the VI, during fatiguing dynamic knee extensions at two submaximal loads. Methods: Nine healthy men performed dynamic knee extensions with loads of 50 and 70 % of one-repetition maximum (1RM) until failure. Muscle activation of the VI, vastus lateralis, vastus medialis (VM) and rectus femoris was recorded using surface electrodes. Root mean square (RMS) amplitude was calculated during the concentric (CON) and eccentric (ECC) phases of each repetition, and normalized to the RMS amplitude during the CON and ECC phases of the 1RM. Each CON and ECC phase was further divided into three subphases according to knee joint angle. Results: The normalized RMS amplitude of the four individual QF muscles during the CON phase linearly increased with fatigue with contractions at both 50 and 70 % 1RM. The highest RMS amplitude was found in VI at flexed knee joint angles until fatigue. This activation pattern was more prominent at 70 % 1RM than 50 % 1RM. The RMS amplitude of VM at extended knee joint angles was selectively higher at 70 % 1RM than 50 % 1RM. Conclusions: These results suggest that the contribution of the four individual QF muscles to fatiguing dynamic knee extensions differs according to knee joint angle and intensity of load. [ABSTRACT FROM AUTHOR]

An amendment to this paper has been published and can be accessed via a link at the top of the paper. [ABSTRACT FROM AUTHOR]

With dense single-nucleotide polymorphism (SNP) maps for 199 drug-related genes, we examined associations between 4190 SNPs and 38 commonly measured quantitative traits using data from 752 healthy Japanese subjects. On analysis, we observed a strong association between five SNPs within the uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) gene and serum total bilirubin levels (minimum P-value in Mann–Whitney test=1.82 × 1010). UGT1A1 catalyzes the conjugation of bilirubin with glucuronic acid, thus enhancing bilirubin elimination. This enzyme is known to play an important role in the variation of serum bilirubin levels. The five SNPs, including a nonsynonymous SNP—rs4148323 (211G>A or G71R variant allele known as UGT1A1*6)—showed strong linkage disequilibrium with each other. No other genes were clearly associated with serum total bilirubin levels. Results of linear multiple regression analysis on serum total bilirubin levels followed by analysis of variance showed that at least 13% of the variance in serum total bilirubin levels could be explained by three haplotype-tagging SNPs in the UGT1A1 gene.Journal of Human Genetics (2009) 54, 317–323; doi:10.1038/jhg.2009.31; published online 3 April 2009 [ABSTRACT FROM AUTHOR]

A scan of 4,190 single-nucleotide polymorphisms (SNPs) in 199 different genes using 38 different quantitative traits to search for associations between genotypes and phenotypes detected an association between the genotypes at rs671 of ALDH2 and gamma-glutamyltranspeptidase (gamma-GTP) levels. We examined the associations between five factors such as gender, age, rs671 genotype, alcohol-drinking habit, and serum gamma-GTP level and found that all pairs were associated except for the pair of rs671 genotype and gender and rs671 genotype and age. We further analyzed the data by both multiple regression and subgroup analyses and found that the associations between rs671 genotype and alcohol-drinking habit, alcohol-drinking habit and gamma-GTP level, gender and gamma-GTP, and age and gamma-GTP were independent of other factors. Conversely, the association between rs671 genotype and gamma-GTP level was dependent on alcohol-drinking habit. Associations between genetic and environmental factors will become a focus of medical and biological studies. Our study has shown that (1) a large sample size combined with a replication study is necessary to overcome the multiple-comparison problem, and (2) subgroup analysis along with logistic and linear multiple regression analysis may be useful to dissect a complicated relationship. [ABSTRACT FROM AUTHOR]

We give a reduction theorem for 3-connected graphs of minimum degree at least four. Let $${\mathcal{P}}_{3,4}$$ be the class of 3-connected graphs of minimum degree at least four. For a vertex x of degree four in G, splitting at x is an operation of adding at most two independent edges connecting some of the neighbors of x and deleting x. A set of five vertices C = { a, b, x, y, z} in G is said to be a crown if N G ( a) = { b, x, y, z} and N G ( b) = { a, x, y, z}. Given a crown C in G, reduction of C is the operation of deleting { a, b} and adding all the missing edges among { x, y, z}. In this paper, we prove that for every vertex x in a graph $$G\in{\mathcal{P}}_{3,4}$$ , there exists either (1) an edge e such that its contraction yields a graph in $${\mathcal{P}}_{3,4}$$ and at least one of its endvertices is of distance at most two from x, (2) a vertex v of degree four such that v is of distance at most two from x and some splitting at v yields a graph in $${\mathcal{P}}_{3,4}$$ , or (3) a crown C containing x whose reduction yields a graph in $${\mathcal{P}}_{3,4}$$ . [ABSTRACT FROM AUTHOR]

The natural history of ruptured basilar artery dissecting aneurysms (BADAs) remains unclear compared to that of ruptured vertebral artery dissecting aneurysms (VADAs). In this study, we investigated the natural history and optimal management of ruptured BADAs. We identified 17 patients with ruptured BADA among 4586 patients with aneurysmal subarachnoid hemorrhage (SAH) treated in seven participating hospitals. A scoping literature review was undertaken to investigate prognostic factors. Six patients among the profiled patients (35.3%) died, all with poor SAH grades (World Federation of Neurological Societies Grade IV and V). Rebleeding after admission was observed in three patients (17.6%) with poor SAH grades. Aggressive treatment and conservative management were initiated in seven and ten patients, respectively. Patients with good SAH grades had significantly higher favorable treatment outcomes than those with poor grades (83.3% vs. 9.1%, P = 0.005). Moreover, based on a scoping review of 158 cases with ruptured BADA, including the patients from our series, approximately 90% of patients with good SAH grades had favorable outcomes. A good SAH grade and no rebleeding after admission were favorable prognostic factors (P < 0.0001 and P = 0.002, respectively). The rebleeding rates were 20.2%, 13.3%, and 6.3% for dilated, pearl and string, and stenotic lesions, respectively. We concluded that the natural history of isolated ruptured BADAs may be better than that of VADAs. Although definitive treatment, if possible, is undoubtedly important, conservative management with careful radiological follow-up for morphological changes might be a viable option for patients in good clinical condition and with non-dilated lesions. [ABSTRACT FROM AUTHOR]

Background: The treatment strategies for colorectal cancer (CRC) must ensure a radical cure of cancer and prevent over/under treatment. Biopsy specimens used for the definitive diagnosis of T1 CRC were analyzed using artificial intelligence (AI) to construct a risk index for lymph node metastasis. Methods: A total of 146 T1 CRC cases were analyzed. The specimens for analysis were mainly biopsy specimens, and in the absence of biopsy specimens, the mucosal layer of the surgical specimens was analyzed. The pathology slides for each case were digitally imaged, and the morphological features of cancer cell nuclei were extracted from the tissue images. First, statistical methods were used to analyze how well these features could predict lymph node metastasis risk. A lymph node metastasis risk model using AI was created based on these morphological features, and accuracy in test cases was verified. Results: Each developed model could predict lymph node metastasis risk with a > 90% accuracy in each region of interest of the training cases. Lymph node metastasis risk was predicted with 81.8–86.3% accuracy for randomly validated cases, using a learning model with biopsy data. Moreover, no case with lymph node metastasis or lymph node risk was judged to have no risk using the same model. Conclusions: AI models suggest an association between biopsy specimens and lymph node metastases in T1 CRC and may contribute to increased accuracy of preoperative diagnosis. [ABSTRACT FROM AUTHOR]

The spleen is a key source of circulating and tumor-infiltrating immune cells. However, the effect of splenectomy on tumor growth remains unclear. At 3 weeks after splenectomy, we subcutaneously injected LuM1 cells into BALB/c mice and evaluated the growth of primary tumors and lung metastases at 4 weeks after tumor inoculation. In addition, we examined the phenotypes of immune cells in peripheral blood by using flow cytometry and in tumor tissue by using multiplex immunohistochemistry. The growth of primary tumors was reduced in splenectomized mice compared with the sham-operated group. Conversely, splenectomized mice had more lung metastases. Splenectomized mice had fewer CD11b+cells, especially monocytic MDSCs (CD11b+Gr-1neg-lowLy6chigh), and NK cells (CD49b+CD335+). The proportion of NK cells was inversely correlated with the number of lung metastases. In splenectomized mice, the density of CD3+ and granzyme B+ CD8+ T cells was increased, with fewer M2-type macrophages in primary tumors, but NK cells were decreased markedly in lung. Splenectomy concurrently enhances T cell-mediated acquired immunity by reducing the number of monocytic MDSCs and suppresses innate immunity by decreasing the number of NK cells. Splenectomy has opposite effects on primary and metastatic lesions through differential regulation on these two immune systems. [ABSTRACT FROM AUTHOR]

Background: Recently, intestinal bacteria have attracted attention as factors affecting the prognosis of patients with cancer. However, the intestinal microbiome is composed of several hundred types of bacteria, necessitating the development of an analytical method that can allow the use of this information as a highly accurate biomarker. In this study, we investigated whether the preoperative intestinal bacterial profile in patients with esophageal cancer who underwent surgery after preoperative chemotherapy could be used as a biomarker of postoperative recurrence of esophageal cancer. Methods: We determined the gut microbiome of the patients using 16S rRNA metagenome sequencing, followed by statistical analysis. Simultaneously, we performed a machine learning analysis using a random forest model with hyperparameter tuning and compared the data obtained. Results: Statistical and machine learning analyses revealed two common bacterial genera, Butyricimonas and Actinomyces, which were abundant in cases with recurrent esophageal cancer. Butyricimonas primarily produces butyrate, whereas Actinomyces are oral bacteria whose function in the gut is unknown. Conclusion: Our results indicate that Butyricimonas spp. may be a biomarker of postoperative recurrence of esophageal cancer. Although the extent of the involvement of these bacteria in immune regulation remains unknown, future research should investigate their presence in other pathological conditions. Such research could potentially lead to a better understanding of the immunological impact of these bacteria on patients with cancer and their application as biomarkers. [ABSTRACT FROM AUTHOR]

A graph G is said to be distanced matchable if, for any matching M of G in which edges are pairwise at least distance d apart, there exists a perfect matching M ∗ of G which contains M. In this paper, we prove the following results: (i) if G is a cubic bipartite graph in which, for each e ∈ E (G) , there exist two cycles C 1 , C 2 of length at most d such that E (C 1) ∩ E (C 2) = { e } , then G is distance d - 1 matchable, and (ii) if G is a planar or projective planar cubic bipartite graph in which, for each e ∈ E (G) , there exist two cycles C 1 , C 2 of length at most 6 such that e ∈ E (C 1) ∩ E (C 2) , then G is distance 6 matchable. [ABSTRACT FROM AUTHOR]

Machine learning systems have recently received increased attention for their broad applications in several fields. In this study, we show for the first time that histological types of breast tumors can be classified using subtle morphological differences of microenvironmental myoepithelial cell nuclei without any direct information about neoplastic tumor cells. We quantitatively measured 11661 nuclei on the four histological types: normal cases, usual ductal hyperplasia and low/high grade ductal carcinoma in situ (DCIS). Using a machine learning system, we succeeded in classifying the four histological types with 90.9% accuracy. Electron microscopy observations suggested that the activity of typical myoepithelial cells in DCIS was lowered. Through these observations as well as meta-analytic database analyses, we developed a paracrine cross-talk-based biological mechanism of DCIS progressing to invasive cancer. Our observations support novel approaches in clinical computational diagnostics as well as in therapy development against progression. [ABSTRACT FROM AUTHOR]

Transcriptional coactivator with PDZ-binding motif (TAZ) regulates a variety of biological processes. Nuclear translocation and activation of TAZ are regulated by multiple mechanisms, including actin cytoskeleton and mechanical forces. TAZ is involved in lung alveolarization during lung development and Taz-heterozygous mice are resistant to bleomycin-induced lung fibrosis. In this study, we explored the roles of TAZ in the pathogenesis of idiopathic pulmonary fibrosis (IPF) through histological analyses of human lung tissues and cell culture experiments. TAZ was highly expressed in the fibroblastic foci of lungs from patients with IPF. TAZ controlled myofibroblast marker expression, proliferation, migration, and matrix contraction in cultured lung fibroblasts. Importantly, actin stress fibers and nuclear accumulation of TAZ were more evident when cultured on a stiff matrix, suggesting a feedback mechanism to accelerate fibrotic responses. Gene expression profiling revealed TAZ-mediated regulation of connective tissue growth factor (CTGF) and type I collagen. Clinical relevance of TAZ-regulated gene signature was further assessed using publicly available transcriptome data. These findings suggest that TAZ is involved in the pathogenesis of IPF through multifaceted effects on lung fibroblasts. [ABSTRACT FROM AUTHOR]

A graph is called $$2K_2$$ -free if it does not contain two independent edges as an induced subgraph. Gao and Pasechnik conjectured that every $$\frac{3}{2}$$ -tough $$2K_2$$ -free graph with at least three vertices has a spanning trail with maximum degree at most 4. In this paper, we confirm this conjecture. We also provide examples for all $$t < \frac{5}{4}$$ of t-tough graphs that do not have a spanning trail with maximum degree at most 4. [ABSTRACT FROM AUTHOR]

Reducing antibiotic usage among livestock animals to prevent antimicrobial resistance has become an urgent issue worldwide. This study evaluated the effects of administering chlortetracycline (CTC), a versatile antibacterial agent, on the performance, blood components, fecal microbiota, and organic acid concentrations of calves. Japanese Black calves were fed with milk replacers containing CTC at 10 g/kg (CON group) or 0 g/kg (EXP group). Growth performance was not affected by CTC administration. However, CTC administration altered the correlation between fecal organic acids and bacterial genera. Machine learning (ML) methods such as association analysis, linear discriminant analysis, and energy landscape analysis revealed that CTC administration affected populations of various types of fecal bacteria. Interestingly, the abundance of several methane-producing bacteria at 60 days of age was high in the CON group, and the abundance of Lachnospiraceae, a butyrate-producing bacterium, was high in the EXP group. Furthermore, statistical causal inference based on ML data estimated that CTC treatment affected the entire intestinal environment, potentially suppressing butyrate production, which may be attributed to methanogens in feces. Thus, these observations highlight the multiple harmful impacts of antibiotics on the intestinal health of calves and the potential production of greenhouse gases by calves. [ABSTRACT FROM AUTHOR]

In this paper, we propose grayscale-free topology optimization for a reactor design problem where the electromagnetic performance needs to be optimized. A reactor is an electric device to boost electric voltage, and is used as a part of a DC-DC converter in electric and hybrid vehicles. When designing reactors, we need to consider many performance indicators such as inductance and fringing loss. In general, high-performance reactor design that satisfies all requirements is not obvious, and topology optimization is promising for such non-trivial design problems. In this paper, we therefore establish a framework for the electromagnetic design of an in-vehicle reactor on the basis of boundary tracking type level-set topology optimization, which realizes grayscale-free topology optimization. Because of its grayscale-free characteristic, the established framework can completely resolve the numerical problems caused by the so-called grayscale elements. We present several numerical examples to demonstrate the usefulness of the established framework, and we discuss the possibilities for the expansion of the established framework to more difficult and valuable design problems. [ABSTRACT FROM AUTHOR]

Peritoneal dissemination is a major metastatic pathway for gastrointestinal and ovarian malignancies. The miR-29b family is downregulated in peritoneal fluids in patients with peritoneal metastases (PM). We examined the effect of miR-29b on mesothelial cells (MC) which play critical a role in the development of PM through mesothelial-mesenchymal transition (MMT). Human peritoneal mesothelial cells (HPMCs) were isolated from surgically resected omental tissue and MMT induced by stimulation with 10 ng/ml TGF-β1. MiR-29b mimics and negative control miR were transfected by lipofection using RNAiMAX and the effects on the MMT evaluated in vitro. HPMC produced substantial amounts of miR-29b which was markedly inhibited by TGF-β1. TGF-β1 stimulation of HPMC induced morphological changes with decreased expression of E-cadherin and calretinin, and increased expression of vimentin and fibronectin. TGF-β1 also enhanced proliferation and migration of HPMC as well as adhesion of tumor cells in a fibronectin dependent manner. However, all events were strongly abrogated by simultaneous transfection of miR-29b. MiR-29b inhibits TGF-β1 induced MMT and replacement of miR-29b in the peritoneal cavity might be effective to prevent development of PM partly through the effects on MC. [ABSTRACT FROM AUTHOR]

Epithelial–mesenchymal transition (EMT) is a cellular process during which epithelial cells acquire mesenchymal phenotypes. Cancer cells undergo EMT to acquire malignant features and TGF-β is a key regulator of EMT. Here, we demonstrate for the first time that TGF-β could elicit EMT in a mouse lung adenocarcinoma cell line. TGF-β signaling activation led to cell morphological changes corresponding to EMT and enhanced the expression of mesenchymal markers and EMT-associated transcription factors in CMT64 lung cancer cells. RNA-sequencing analyses revealed that TGF-β increases expression of Tead transcription factors and an array of Tead2 target genes. TGF-β stimulation also resulted in alternative splicing of several genes including Cd44, tight junction protein 1 (Tjp1), and Cortactin (Cttn). In parallel with EMT, TGF-β enhanced cell growth of CMT64 cells and promoted tumor formation in a syngeneic transplantation model. Of clinical importance, the expression of TGF-β-induced genes identified in CMT64 cells correlated with EMT gene signatures in human lung adenocarcinoma tissue samples. Furthermore, TGF-β-induced gene enrichment was related to poor prognosis, underscoring the tumor-promoting role of TGF-β signaling in lung adenocarcinoma. Our cellular and syngeneic transplantation model would provide a simple and useful experimental tool to study the significance of TGF-β signaling and EMT. [ABSTRACT FROM AUTHOR]

Recently, linkage disequilibrium analyses have been used to detect disease-causing loci based on the common disease-common variant hypothesis. To see what methods can effectively identify the genes, we have to apply them to the practical data obtained from the human population. We extensively performed linkage disequilibrium and haplotype analyses on adenine phosphoribosyltransferase (APRT) genes in both control and deficient subjects. To examine the power to detect disease-causing loci, we analyzed SNPs, STRPs, and VNTR within and around theAPRTgene. When only SNPs were used,Pvalues did not necessarily show significant difference, even at loci close to the mutation site forAPRT*Jthat is exclusively observed among Japanese. However, the examination of the same samples with haplotypes based on the haplotype block data gave sufficient significance. In the case of STRP and VNTR, some single-marker loci showed significant difference. Our study suggested that the use of haplotype analysis based on the haplotype-block structure is more powerful than single-marker locus analysis for the detection of disease-related loci. [ABSTRACT FROM AUTHOR]

Introduction: The occurrence of early adverse events and the factors associated with these events in zoledronic acid-treated Japanese patients with osteoporosis were investigated. Materials and methods: All patients treated with zoledronic acid for the first time for primary osteoporosis were analyzed. Based on the history of bisphosphonate (BP) administration, the patients were divided into three groups: BP-switch, BP-washout, and naïve groups. The BP-washout and naive groups were combined into a non-BP group. Results: A total of 184 patients with a mean age of 77.4 years were included. Acute phase reactions (APRs) occurred in 32 patients (17.4%). The significant risk factors were hospitalization (vs. outpatients), BP-switch (vs. non-BP), and age > 80 years (vs. ≤ 69 years), and the odds ratios were 5.63, 0.12, and 0.23, respectively. The serum calcium levels were significantly reduced in the non-BP group, regardless of the co-administration of active vitamin D3. However, the patients who were co-administered active vitamin D3 had significantly higher values than those who were not. In the BP-switch group, no significant reduction in serum calcium levels was observed; however, the reductions tended to be smaller in the patients who were co-administered active vitamin D3. Conclusion: Occurrence of APRs might be lesser in clinical practice than in phase 3 clinical trials. Although serum calcium levels decreased in many cases, the decrease could be suppressed by the co-administration of active vitamin D3. [ABSTRACT FROM AUTHOR]

Background: This phase I study aimed to evaluate the safety, peptide-specific immune responses, and anti-tumor effects of a novel vaccination therapy comprising multi-HLA-binding heat shock protein (HSP) 70/glypican-3 (GPC3) peptides and a novel adjuvant combination of hLAG-3Ig and Poly-ICLC against metastatic gastrointestinal cancers. Methods: HSP70/GPC3 peptides with high binding affinities for three HLA types (A*24:02, A*02:01, and A*02:06) were identified with our peptide prediction system. The peptides were intradermally administered with combined adjuvants on a weekly basis. This study was a phase I dose escalation clinical trial, which was carried out in a three patients' cohort; in total, 11 patients were enrolled for the recommended dose. Results: Seventeen patients received this vaccination therapy without dose-limiting toxicity. All treatment-related adverse events were of grades 1 to 2. Peptide-specific CTL induction by HSP70 and GPC3 proteins was observed in 11 (64.7%) and 13 (76.5%) cases, respectively, regardless of the HLA type. Serum tumor marker levels were decreased in 10 cases (58.8%). Immunological analysis using PBMCs indicated that patients receiving dose level 3 presented with significantly reduced T cell immunoglobulin and mucin-domain containing-3 (TIM3)-expressing CD4 + T cells after one course of treatment. PD-1 or TIM3-expressing CD4 + T cells and T cell immunoreceptor with immunoglobulin and ITIM domains (TIGIT)-expressing CD8 + T cells in PBMCs before vaccination were negative predictive factors for survival. Conclusions: This novel peptide vaccination therapy was safe for patients with metastatic gastrointestinal cancers. [ABSTRACT FROM AUTHOR]

We developed a software program, NDesign, for the design of a study intended for detecting rare variants from next-generation sequencing (NGS) data. In this study design, the optimal depth of coverage and the average depth of coverage are first evaluated, and then the ability of the designed experiment to obtain a desired power is determined. NDesign has been developed to calculate both these depths, as well as to evaluate the power of the designed experiment. It has a simple implementation in the JavaScript language, and is expected to enable researchers to design optimal NGS studies. [ABSTRACT FROM AUTHOR]

Background: We introduce a novel operative technique to dissect lymph nodes adjacent to the recurrent laryngeal nerve, referred to as the "native tissue preservation" technique. Using this technique, there was no damage to the recurrent laryngeal nerve, which is maintained in its anatomical position.Methods: From September 2016 to December 2018, minimally invasive esophagectomy was performed in the left lateral decubitus position in 87 patients with esophageal cancer. The native tissue preservation technique for lymphadenectomy around the recurrent laryngeal nerve was used, and all patients were evaluated for recurrent laryngeal nerve paralysis.Results: Minimally invasive esophagectomy was completed in all patients without conversion to thoracotomy. Although an extended lymphadenectomy was performed in all patients, there were no grade II or higher complications (Clavien-Dindo classification) and no incidence of recurrent laryngeal nerve paralysis.Conclusion: The native tissue preservation technique may reduce the incidence of recurrent laryngeal nerve paralysis after minimally invasive esophagectomy with radical lymph node dissection. [ABSTRACT FROM AUTHOR]

Purpose: Intramyocellular lipid (IMCL) is influenced by physical exercise; however, whether the habitual level of physical activity affects resting IMCL content remains unclear. The purpose of this study was to determine the relationship between physical activity levels and resting IMCL content in young and older adults.Methods: In total, 15 nonobese young adults (21.0 ± 0.0 years) and 15 older adults (70.7 ± 3.8 years) were recruited. Time spent performing physical activities for 10 days was assessed using a three-dimensional ambulatory accelerometer, and intensity was categorized as light [< 3.0 metabolic equivalents (METs)], moderate (3.0-6.0 METs), or vigorous (> 6.0 METs). Physical activity level was calculated as the product of METs and time spent performing physical activities (MET h) at each intensity level. The IMCL content in the vastus lateralis was determined using 1H-magnetic resonance spectroscopy after overnight fasting.Results: No significant differences in IMCL content were observed between young and older adults. Vigorous intensity physical activity (time and MET h) was significantly lower in older than young adults (p < 0.01); this difference was not observed for light and moderate intensity physical activity. Light intensity physical activity (time and MET h) was significantly and inversely correlated with IMCL content in young adults (r = - 0.59 and r = - 0.58; both p < 0.05), but not in older adults.Conclusions: These results suggest that daily light intensity physical activity reduces resting IMCL content in young adults, whereas no significant relationship was seen between daily physical activity and resting IMCL content in older adults. [ABSTRACT FROM AUTHOR]

Two cases with ruptured vertebral artery (VA) dissection involving the origin of the posterior inferior cerebellar artery (PICA) are presented. Endovascular proximal occlusion of the dissected segment proximal to the PICA origin was performed, leaving the PICA patent in the acute stage. Stent placement from the PICA to the VA through the contralateral VA and coil embolization were added to the residual dissection in the chronic stage. Rebleedings were not observed. This is the first report of a staged, combined strategy for the treatment of a ruptured PICA involving VA dissection, which enabled preservation of the PICA without bypass surgery. [ABSTRACT FROM AUTHOR]

Background: In Fabry disease, progressive glycolipid accumulation leads to damage in kidney and other organs. This study was designed to determine the prevalence rate of Fabry disease in Japanese dialysis patients. Methods: All dialysis patients agreeing to Japan Fabry disease screening study (J-FAST) with informed consent were selected except for Fabry disease. The screening was performed by a method of measuring plasma and/or leukocytes lysosomal α-galactosidase A protein level and α-galactosidase A activity. If positive, genetic analysis was carried out upon patient's agreement. Results: J-FAST dealt with 8547 patients (male 5408, female 3139). At the tertiary examination, 26 out of 8547 patients were found to be positive. Six out of 26 patients could not accept genetic analysis because of death. Remaining 20 patients agreed with genetic analysis; then 2 patients (male 2, female 0) had a variation of the α-Gal gene and 11 patients showed E66Q variations. Therefore, the frequency of Fabry disease in J-FAST was 0.04 % (2/5408) in males and 0 % (0/3139) in females, and then 0.02 % (2/8547) in all patients. The presumptive clinical diagnoses of end-stage kidney disease (ESKD) were 10 chronic glomerulonephritis, 7 diabetic nephropathy, 3 unknown etiology, 3 nephrosclerosis, 1 gouty nephropathy, 1 autosomal dominant polycystic kidney disease and 1 renal tuberculosis among 26 tertiary positive patients. Two male Fabry patients were initially diagnosed as nephrosclerosis and chronic glomerulonephritis. Conclusions: The prevalence rate of Fabry disease in J-FAST was 0.02 %. Moreover, Fabry disease could not be ruled out as the clinical diagnosis of ESKD. [ABSTRACT FROM AUTHOR]

This issue is dedicated in honor of Professors Eiichi Bannai and Hikoe Enomoto on the occasion of their 75th birthdays. Graph Bannai and Enomoto are leading pioneers of combinatorics in Japan. [Extracted from the article]

Background: The objective of this study is to evaluate the lymph drainage from the primary focus to the regional lymph nodes in patients with melanomas of the upper extremity and upper trunk region. Method: The study is a retrospective study of 20 patients with upper extremity melanomas and 14 patients with upper trunk melanomas treated with axillary lymph node dissection (ALND) or sentinel lymph node biopsy at the hospital. ALND was performed in 14 cases. In these cases, 12 were curative dissections and 2 were elective dissections. The dominant lymph drainage patterns from the primary regions were analyzed. Results: Among the upper extremity and upper trunk region melanomas, lymph drainage to Level I was determined in all cases. In these two regions there were no cases of lymph drainage to Level II not passing through Level I. Furthermore, there were no cases where sentinel lymph node or metastasis of the lymph nodes was clearly determined in Level III. Among the upper extremity melanomas, lymph drainages to the cubital (10 %) and mid-arm nodes (5 %) were established. Among the scapular region melanomas, lymph drainages to the supraclavicular nodes (25 %) were determined. Conclusions: There was a dominant lymph drainage pattern of melanomas of the upper extremity and upper trunk region to Level I. No lymph node dissection of Level III in patients with melanomas of the upper extremity and upper trunk region is necessary unless preoperative examination determines a high possibility of metastasis-positive lymph nodes in level III. [ABSTRACT FROM AUTHOR]

Lung adenocarcinoma is the most common histological type of lung cancer, and its incidence is increasing worldwide. To identify genetic factors influencing risk of lung adenocarcinoma, we conducted a genome-wide association study and two validation studies in the Japanese population comprising a total of 6,029 individuals with lung adenocarcinoma (cases) and 13,535 controls. We confirmed two previously reported risk loci, 5p15.33 (rs2853677, Pcombined = 2.8 × 10?40, odds ratio (OR) = 1.41) and 3q28 (rs10937405, Pcombined = 6.9 × 10?17, OR = 1.25), and identified two new susceptibility loci, 17q24.3 (rs7216064, Pcombined = 7.4 × 10?11, OR = 1.20) and 6p21.3 (rs3817963, Pcombined = 2.7 × 10?10, OR = 1.18). These data provide further evidence supporting a role for genetic susceptibility in the development of lung adenocarcinoma. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to evaluate the superficial lymph drainage patterns from primary lesions, with the primary focus on cheek/eyelid and lip melanomas. Method: We conducted a retrospective study of 22 patients with facial melanomas who had undergone neck dissection or sentinel lymph node biopsy at the hospital from 1981 to April 2011. We then analyzed the dominant lymph drainage patterns from the cheek/eyelid and lip regions. Results: The cheek/eyelid regions have two lymph drainage patterns: one is to the parotid nodes and the other is to level IB. The lymph drainage patterns in the lip region are to level IA or IB. The lymph drainage patterns to superficial lymph nodes from the primary sites were determined in both regions. Conclusions: Cheek/eyelid and lip melanomas have lymph drainage patterns different from those of malignant tumors of the oropharyngeal and larynx regions. Superficial lymph node groups also play an important role in facial melanomas. [ABSTRACT FROM AUTHOR]

Radiation therapy for breast cancer has improved survival rates; however, a consequence of this is treatment-induced complications in longer-living patients. Decades after chest wall irradiation, very late onset radiation-induced osteomyelitis can develop, caused by osteoradionecrosis. This may lead to the development of small, but very refractory, skin ulcers. Many reports recommend well-vascularized tissue coverage after appropriate debridement for irradiation ulcers; however, when the ulcers are of very late onset, this sometimes causes recurrence of ulceration in non-muscle-covered areas after flap transfer. Thus, for very late onset cases, we propose treatment with an absolute muscle flap to cover both the obviously infected focus and the surrounding irradiated area. A muscle flap consisting of the entire latissimus dorsi, the shape of which is very large in the horizontal direction, satisfies this requirement. Latissimus dorsi muscle coverage for the treatment of very late onset osteomyelitis should be reappraised. [ABSTRACT FROM AUTHOR]

We report on synthesis of compressed silica phase formed inside a α-quartz host crystal using powerful shock-wave and thermal transients generated via local optical breakdown induced by low-energy, tightly focused femtosecond laser pulses. Structural characterization of irradiated areas by the X-ray diffraction technique reveals signatures of a new high-pressure phase of silica, which is theoretically expected to form at a pressure of 120 GPa. [ABSTRACT FROM AUTHOR]