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Abstract Background Famotidine, a histamine2-receptor antagonist (H2Ras), is widely used to treat and prevent gastrointestinal symptoms during pregnancy. Although several studies have reported the use of H2Ras during pregnancy, limited data on famotidine were included in these reports. Therefore, we analyzed pregnancy outcome data to evaluate the effects of famotidine use during pregnancy on the fetus. Methods Pregnancy outcome data were used for females enrolled in two Japanese facilities that provided counseling on drug use during pregnancy between April 1988 and December 2017. For the primary endpoint, the incidence of congenital malformations was calculated from the data of live birth to pregnant women who took famotidine (n = 330) or drugs considered to exert no teratogenic risk (control, n = 1,407) during the first trimester of pregnancy. Considering secondary endpoints, the incidence of obstetric outcomes, including preterm delivery, was calculated from data on the use of famotidine (n = 347) and controls (n = 1,476) during the entire pregnancy. The crude odds ratios (cORs) for the incidence of congenital malformations were calculated using univariate logistic regression analysis, with the control group used as the reference. Adjusted ORs (aORs) were calculated using multivariate logistic regression analysis adjusted for various other factors. Results The incidences of congenital malformations in the famotidine and control groups were 3.9% and 2.8%, respectively. There was no significant difference between the famotidine and control groups (cOR: 1.40 [95% CI:0.68–2.71], aOR: 1.06 [95% CI:0.51–2.16]). Conversely, the preterm delivery rates were 8.1% and 3.8% in the famotidine and control groups, respectively, indicating a significant difference (cOR: 2.00 [95% CI:1.20–3.27]). However, the multivariate analysis eliminated famotidine use as a confounding factor. Conclusions This observational cohort study revealed that exposure to famotidine during the first trimester of pregnancy was not associated with an increased risk of congenital malformations in infants. Although a higher rate of preterm delivery was detected in famotidine users when compared with controls, this could be attributed to confounding factors, such as complications.

Abstract Securing a stable food supply and achieving sustainable agricultural production are essential for mitigating future food insecurity. Soil metabolomics is a promising tool for capturing soil status, which is a critical issue for future sustainable food security. This study aims to provide deeper insights into the status of soybean-grown fields under varying soil conditions over three years by employing comprehensive soil volatile organic compound (VOC) profiling, also known as soil volatilomics. Profiling identified approximately 200 peaks in agricultural fields. The soil of soybean-presented plots exhibited markedly higher VOC levels than those of non-soybean plots during the flowering season. Pentanoic acid, 2,2,4-trimethyl-3-carboxyisopropyl, isobutyl ester, a discriminative soil VOC, was identified through multivariate data analysis as a distinctively present VOC in fields with or without soybean plants during the flowering period. Soil VOC profiles exhibited strong correlations with soil-related omics datasets (soil ionome, microbiome, metabolome, and physics) and no significant correlations with root microbiome and rhizosphere chemicals. These findings indicate that soil VOC profiles could serve as a valuable indicator for assessing soil status, thereby supporting efforts to ensure future global food security.

Abstract Introduction Metastasis of malignant melanoma to urinary tract is reported to be rare. According to retrospective analysis of a single center study, improvement of overall survival was observed in patients with metastasis to the gastrointestinal tract that had undergone metastasectomy with curative intent. However, there is no significant evidence regarding resection for metastasis to urinary tract. Case presentation Case 1: an 86-year-old Japanese man was diagnosed with a small bladder tumor by computed tomography scan during post operative follow-up of malignant melanoma in the choroid of the left eye. Cystoscopy revealed black, nonpapillary tumors, suggesting metastatic malignant melanoma. Because no apparent invasive growth to muscle layer was observed by magnetic resonance imaging, transurethral resection was performed. Pathological appearance was compatible with metastatic malignant melanoma. No recurrence in urinary tract was observed; however, multiple liver metastasis was diagnosed at 3 months after surgery. Case 2: a 57-year-old Japanese man was diagnosed with right hydronephrosis due to ureteral tumor. He had a past history of subungual malignant melanoma to the left thumb 2 years prior to his visit. Right nephroureterectomy was performed, and pathological evaluation revealed metastatic malignant melanoma. He revisited 2 years later due to dysuria, and a large bladder tumor was revealed by ultrasound. Cystoscopy showed black-colored nonpapillary tumor, suggesting malignant melanoma. Total cystectomy was recommended; however, the patient withheld consent. Therefore, we performed transurethral resection. The resulting pathological finding was compatible with metastatic malignant melanoma without invasion to muscle layer. He remained free from local recurrence and metastasis for 22 years after surgery. Conclusion We successfully performed metastasectomy for bladder and ureteral metastases without recurrence in the urinary tract. Long recurrence-free survival was observed in case 2. Complete resection for metastasis of malignant melanoma may have the potential to improve survival.

The electrocautery is an essential device in surgical operations, capable of performing both incisions and hemostasis. Hemostasis can be achieved by charring the blood, but issues such as re-bleeding due to adhesion on the electrode surface and the generation of surgical smoke have been noted. In this study, we aimed to suppress the adhesion of charred blood and the generation of surgical smoke by using silicone-coated electrodes to prevent blood adhesion. To investigate the causes of surgical smoke, we used simulations to clarify the Joule heating and convection of blood associated with discharge using axisymmetric models with flat and spherical cylinder tips. Furthermore, the impact of the presence or absence of silicone coating on the generation of surgical smoke and the movement of heat in the blood during discharge experiments using commercially available electrode shapes was clarified through high-speed infrared camera imaging. As a result, it was confirmed that, compared to commercial electrodes without silicone coating, in the case of side-exposed electrodes, unidirectional heat transfer on the blood surface was observed. Additionally, it was revealed that the amount of surgical smoke decreased when small bubbles were generated in the presence of silicone coating and suppressing spark generation around the electrode. From these results, it was found that side-exposed electrodes, which generate small bubbles and directional convection such as jet-type flow within the blood during discharge, are effective in suppressing surgical smoke.

When the lubricating oil flowing between the contact surfaces contains simulated wear particles, it is considered that there is a high possibility for the particles to enter between the contact surfaces if the particles are present on the disk side in a friction test between a fixed ball and a rotating disk. For particles with a diameter of 0.8 μm, it has been previously shown that the entrainment frequency changes with the outside oil film thickness, but the effect of the disk material on the amount of particle deposition and the visualization of particle movement direction due to vortices generated between the contact surfaces had not been performed. In this study, by using SiO2 disks and sapphire disks with different Hamaker constants, the effect on the amount of particle deposition in front of the contact surfaces was experimentally clarified by changing the van der Waals forces acting between the particles and the disks. Additionally, assuming that vortices generated in the oil film between the contact surfaces move the particles to the disk surface side, the flow direction of the lubricating oil was visualized using Navier-Stokes simulation.

Abstract Objectives Rheumatoid arthritis (RA) related interstitial lung disease (ILD) impacts on the treatment strategy and its prognosis in patients with RA. However, the relationship between RA disease activity and the severity of comorbid ILD has not been fully investigated. This study aimed to investigate the impact of RA disease activity on the severity of comorbid ILD in detail based on currently established visual scoring method along with physiological severity. Methods Consecutive patients with RA visiting to our Rheumatology Centre between December 2020 and December 2023 were analysed. The radiological severity of ILD was evaluated by averaging the extent of the combined lesion of ground glass opacity, reticulation and honeycombing in 5% increments in six representative high-resolution computed tomography slices ranging from 0% (no involvement) to 100% (all lung fields affected) according to Goh and Walsh’s method. Associations between the radiological and physiological severity of ILD and patients’ features were investigated using linear regression analysis. Results Among 124 patients (32 men, 92 women), the median age was 70 years, and the median disease duration was 2.92 years. Radiological severity of ILD was 0% (without ILD) in 107 (86.2%), ILD with extent

Abstract Background Undernutrition and underweight are osteoporosis risk factors. Therefore, improving the health of underweight young women in Japan is an important medical issue. However, few studies have evaluated the association between being preconception underweight and postnatal osteoporotic fractures in young women. Methods This retrospective cohort study used a Japanese nationwide claims database (JMDC Inc.) to evaluate the effect of preconception underweight on the incidence of osteoporotic fracture within two years after delivery. Data from 16,684 mothers who delivered their first singleton babies between January 2006 and December 2020 were analysed. The combination of disease codes of fractures at sites associated with osteoporosis and medical procedures for fractures was defined as the incidence of osteoporotic fractures, whereas the body mass index (BMI) recorded 12–36 months before delivery was used as the exposure. We estimated the incidence of osteoporotic fractures by BMI category using a Kaplan–Meier curve and examined the fracture risk using Cox hazard regression analyses. Results Fifty-one women (0.31%) were affected by osteoporotic fractures within two years of delivery. More than 80% of these were rib fractures, and approximately 65% of fractures occurred after the first year postpartum. Preconception underweight (BMI

Abstract Introduction Paratesticular cellular angiofibroma is a rare benign mesenchymal tumor. The optimal management is surgical resection due to the difficulty of preoperative accurate diagnosis. Case presentation A 51-year-old Japanese male visited our hospital complaining of asymptomatic left scrotal swelling. Physical examination revealed a nontender elastic paratesticular mass (5.5 cm in diameter). Although testicular germ cell tumor was ruled out clinically, the possibility of malignant potential remained for the tumor. Since the patient consented to complete resection, a transinguinal radical orchiectomy was performed. The pathological diagnosis revealed cellular angiofibroma. The patient recovered without perioperative complications, and no apparent recurrence was observed at 5 years after surgery. Conclusion The pathological findings were compatible for cellular angiofibroma. The tumor was successfully resected, and no apparent recurrence was observed at 5 years after surgery.

Shun Nakazawa, Motoyasu Kato, Yuriko Terayama, Naho Sakamoto Matubara, Yoshihiko Sato, Ryoko Murashima, Daisuke Hayakawa, Shouichi Okamoto, Kazuhisa Takahashi Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, JapanCorrespondence: Shun Nakazawa, Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan, Tel +81 3-3813-3111, Fax +81 3-3812-7560, Email shu-nakazawa@juntendo.ac.jpAbstract: We report a case of a 62-year-old male who was diagnosed with advanced rectal cancer. The attending gastro-enterologist initiated chemotherapy using capecitabine plus oxaliplatin and bevacizumab; however, this treatment regimen was discontinued, as the patient developed a skin rash. Once the skin rash improved, chemotherapy was re-initiated using a combination of trifluridine and tipiracil hydrochloride (TAS-102). The patient developed high fever and dyspnea 2 months after initiation of TAS-102. Chest high-resolution computed tomography showed bilateral diffuse ground glass opacities in all lung lobes with traction bronchiectasis. At this time, the gastro-enterologist consulted our department. The patient was put on non-invasive positive pressure ventilation due to worsening respiratory symptoms. The patient was suspected to develop TAS-102-induced interstitial pneumonia based on positive TAS-102 drug-induced lymphocyte stimulation test. The patient’s respiratory symptoms and radiological findings improved after corticosteroid treatment. The corticosteroid dose was gradually decreased by 5 mg. Thereafter, chemotherapy was re-initiated using different anti-cancer agents.Keywords: TAS-102, colorectal cancer, DAD, corticosteroid

Abstract Introduction Methotrexate induces lymphoproliferative disorders on rare occasions; however, its pathogenesis remains unknown. A clinical diagnosis based on imaging studies alone is often difficult. Case presentation A 57-year-old Japanese woman was referred to our department for the evaluation of multiple lung and hepatic nodules that developed during methotrexate treatment for rheumatoid arthritis. Since she had a history of nephrectomy for localized renal cell carcinoma, multiple lung and hepatic metastases were initially considered. However, pathological diagnosis of the lung nodules (needle biopsy) revealed methotrexate-associated polymorphic-type lymphoproliferative disorders. After methotrexate discontinuation, continuous smooth shrinkage of the lung and liver lymphoproliferative disorders was observed. Conclusion Methotrexate-associated lymphoproliferative disorders should be considered in the event of newly appearing neoplastic lesions, even during follow-up for renal cell carcinoma, if methotrexate is being administered.

Background: In recent years, implant-assisted removable partial dentures (IARPDs) have been used clinically. However, the extent to which additional implants reduce the burden of supporting tissues is unclear. The aim of this study was therefore to investigate the influence of implanted IARPDs on stress sharing among supporting tissues, using finite element (FE) analysis. Methods: FE models were constructed based on the computed tomography (CT) of a patient with a unilateral defect of the mandibular premolars and molars and the surface data of an RPD with cuspids as abutments, designed using computer-aided design software. A titanium implant was placed in the area equivalent to the first premolar, second premolar, or first molar (IARPD4, IARPD5, and IARPD6, respectively). FE analysis was performed for laterally symmetrical models, i.e., bilateral distal free-end IARPDs. A vertical load of 200 N was applied to the central fossa of the artificial premolars or molars (L4, L5, or L6). Results: Equivalent stress in the alveolar mucosa and vertical displacement of the denture was smaller, with IARPDs under L5 and L6 loads, compared to RPDs. However, abutment teeth were displaced upward under an L6 load in the IARPD5 model. Conclusions: Within the limitations of this study, the area corresponding to the first molar was recommended as the location for an implant under the denture base of bilateral distal free-end IARPDs. Implants located in the area corresponding to the second premolar may apply non-physiological extrusion force on abutment teeth under the load on the artificial second molar.

Frost formation poses challenges in various sectors, impacting efficiency and safety. Active methods involve energy-consuming processes like heating, while passive approaches utilize protective coatings or hydrophobic surfaces to minimize frost aggregation. However, low thermal conductivity remains a concern. In previous research, lotus leaves inspired micro-meter-sized asperities were effective in controlling frost growth. Applying this concept to plastic, particularly low-cost PVC, raised challenges due to its low thermal conductivity. The study explores utilizing carbon black (CB) waste from hard coating processes to enhance PVC's thermal conductivity, forming a micro-plastic texture (MPT). The research investigates the influence of CB amount and AC voltage frequency on MPT features and thermal conductivity, aiming for a sustainable solution to address frost-related issues. Incorporating 0.9 vol.% CB into PVC solution under a 2 kV AC electric field (6 Hz) resulted in an extensively distributed MPT on the surface. This MPT, formed under the 6 Hz condition, exhibited no in-plane bias, making it an ideal surface for preventing frost formation. Adding CB to PVC within the range of 0 to 2.1 vol.% and applying a 2 kV, 6 Hz AC electric field led to independent MPT formation at concentrations between 0.4 to 1.2 vol.%. Conducting cooling tests in atmospheric and vacuum conditions, we found that MPT with 0.9 vol.% CB displayed a thermal conductivity of approximately 0.19 kW/mK in atmospheric conditions, similar to aluminum alloy. However, with 1.2 vol.% or more CB, it decreased to about 0.15 kW/mK. In vacuum conditions, MPT with 1.2 vol.% CB exhibited a higher thermal conductivity of 0.063 kW/mK compared to the 0.055 kW/mK observed in MPT with 0 vol.% CB.

With the increasing demand for active friction control, we newly proposed to use dielectrophoresis to change the flow of PG-droplet-containing PAO4 to reduce the friction coefficient. The friction result with a 1-mm roller shows 20% reduction in friction coefficient (from 0.065 to 0.052) at AC 100 V, and in situ observation exhibits that PG tracks are formed over the contact area. On the other hand, at a high bias of 1000 V, the friction coefficient increases to 0.065. In this situation, in situ observation exhibits that PG forms a horseshoe-shaped track covering only the roller edges. Controlled friction tests and FEM analysis using 5-mm rollers revealed a unique behavior; a balanced bias effectively attracts the PG to the roller surface, and surface forces can resist mild dielectrophoretic forces to spread the PG across the roller surface. The present study strongly suggests the importance that the bias strength should be controlled to achieve a balance between surface force and dielectrophoretic force in order to obtain excellent lubrication conditions.

Chihiro Kawasoe,1,2 Yoshi Miyamoto,1,3 Kaoru Ito,1 Takaya Murashima,1 Takahiro Nagai,1 Hiroki Takamori,1 Takumi Kiwaki,4 Toshio Kamimura,1 Shoichiro Mukai,1 Toshiyuki Kamoto1 1Department of Urology, Faculty of Medicine, Miyazaki University Hospital, Miyazaki, Japan; 2Department of Urology, Koga General Hospital, Miyazaki, Japan; 3Department of Urology, Miyazaki Prefectural Nichinan Hospital, Miyazaki, Japan; 4Section of Oncopathology and Regenerative Biology, Faculty of Medicine, Miyazaki University, Miyazaki, JapanCorrespondence: Shoichiro Mukai, Department of Urology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan, Tel +81-985-85-2968, Fax +81-985-85-6958, Email syoichiro_mukai@med.miyazaki-u.ac.jpAbstract: Epithelioid angiomyolipoma (EAML) is a rare variant of AML with malignant potential. It is occasionally difficult to distinguish EAML from renal cell carcinoma (RCC) on imaging. A 72-year-old woman was admitted to our hospital for the treatment of a left renal tumor with relatively high blood flow and a tumor thrombus extending to the inferior vena cava, suggesting RCC. The patient underwent presurgical combination therapy with axitinib and pembrolizumab. This treatment significantly shortened the thrombus, and radical nephrectomy was performed. The pathological findings were compatible with EAML, and the treatment effects were observed. We report a case treated pre-surgically with a combined therapy of pembrolizumab and axitinib, with a favorable response as a treatment option for EAML.Keywords: epithelioid angiomyolipoma, axitinib, pembrolizumab, tumor thrombus, presurgical treatment