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Decomposition of nitrous oxide (N2O) over titania (TiO2) supported copper (Cu) catalyst was investigated with the existence of oxygen and water vapor. The catalytic activity of TiO2 was promoted by copper loading. It was found that there are optimum levels of copper loading on TiO2, and these values are correlated to the specific surface area of TiO2 support being used. The relationship between the catalytic activity for decomposition of N2O and the crystal structure of TiO2 was also investigated. The result revealed that Cu/TiO2 catalysts with the rutile structure has a higher activity toward N2O decomposition than those with the anatase structure. In this research, Cu(5wt%)/TiO2 prepared from TiO2 JRC-TIO-4 (reference catalyst provided by Catalysis Society of Japan) which was mainly constituted of rutile showed the highest activity for N2O decomposition and it could decompose N2O completely at 650℃. The catalytic activity was inhibited by the existence of oxygen. However, there was no influence of water vapor to the catalytic activity of Cu/TiO2 for N2O decomposition.

A beam-monitor system for XFEL/SPring 8, “SACLA,” has been constructed. In order to maintain a stable self-amplified spontaneous emission (SASE) interaction, the straightness and overlap of the axes to within 3 μm between the electron beams and the radiated x rays for an undulator section of about 100 m length is necessary. This straightness means relative alignment to an experimental target sample. Furthermore, a temporal stability of 30 fs in order to maintain a constant peak beam current is also necessary to conduct stable SASE lasing. The monitor system was developed to satisfy these spatial and temporal stability and resolution criteria. The system comprises spatial monitors, such as cavity-type beam-position monitors and screen monitors, as well as temporal measurement instruments, such as current monitors, waveguide spectrometers, coherent synchrotron-radiation detectors, a streak camera, and an rf deflector. Commissioning of SACLA started from March 2011, and the monitors performed sufficient roles to tune the beams for lasing. The achieved overall performances of the system, including data acquisition, are: the beam position monitor has a spatial resolution of 600 nm in rms; the bunch-length monitors show ability to observe bunch lengths from 1 ns in an injector with velocity bunching to less than 30 fs after three-stage bunch compressors. The less than 3 μm spatial resolution of the screen monitor was also confirmed during practical beam operation. Owing to these fulfilled performances, such as the high spatial and temporal resolutions, stable lasing of SACLA has been achieved.

SummaryDuring mammalian fertilization, intracellular Ca2+oscillations are important for both oocyte activation and embryonic development. As the ability of round spermatids (ROS) to induce Ca2+oscillations and oocyte activation is different between species, we examined Ca2+oscillation- and oocyte activation-inducing abilities of human ROS originating from patients with non-obstructive azoospermia. Human ROS from 11 non-obstructive azoospermic patients were collected during their TESE?ICSI cycles. Following injection into mature unfertilized mouse oocytes, we examined the oocyte-activating and Ca2+oscillation-inducing activities of ROS by using Ca2+imaging and confocal laser scanning microscopy (mouse test). In these 11 cases, clinical TESE?ICSI using mature testicular spermatozoa was successful, with the exception of one case in which only one sperm-injected oocyte was not fertilized. The mean fertilization rate was 70.1% (40?100%); the mean cleavage rate was 97.9% (46/47). Two pregnancies were established from 10 transfer cycles (PR; 20%). When the ROS from these patients were injected into mouse oocytes, the ROS from all patients induced at least some intracellular Ca2+oscillations (25?100%). In all patients, 40 out of 82 oocytes injected with ROS exhibited normal oscillation patterns of [Ca2+]i.Human spermatogenetic cells acquired oocyte-activating and Ca2+oscillation-inducing abilities at the round spermatid stage, an earlier stage than found for rodent cells. These data indicate that human ROS might be useful for clinical treatments of non-obstructive azoospermic patients exhibiting mature spermatozoa in biopsied specimens. [ABSTRACT FROM AUTHOR]

Background: High-dose steroid administration is a common initial therapeutic approach for Vogt-Koyanagi-Harada disease (VKH). Nonetheless, administering substantial doses of steroids to pregnant women necessitates meticulous consideration due to the potential impacts on the mother and fetus. We present a case wherein steroid pulse therapy was administered to a patient who developed VKH during the late stages of pregnancy., Case Summary: The patient was a 26-year-old nulliparous woman. At 33 weeks and 1 day of her pregnancy, she experienced a decline in visual acuity and noticed metamorphopsia in her left eye. Examination revealed bilateral serous retinal detachment, leading to VKH diagnosis. A collaborative effort involving the departments of ophthalmology, internal medicine, and neonatology was initiated. Steroid pulse therapy was administered at 34 weeks and 1 day of pregnancy under hospital supervision. Complications, such as threatened preterm labor and gestational diabetes, emerged, necessitating the initiation of oral ritodrine hydrochloride and insulin therapy. Then, serous retinal detachment was resolved, and visual acuity was restored. Labor pains initiated 32 days post-initiation of steroid pulse therapy (at 38 weeks and 4 days of gestation), culminating in a normal delivery. Mother and newborn experienced an uneventful puerperal course and were discharged from the hospital on the 5th day following delivery., Conclusion: VKH management in pregnancy requires multidisciplinary coordination, emphasizing collaboration with ophthalmologists and specialists in internal medicine and neonatology., Competing Interests: Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Platelet-activating factor (PAF) is a potent classical lipid mediator that plays a critical role in various diseases such as allergy and nervous system disorders. In the realm of allergy, previous studies suggested that PAF is generated in response to extracellular stimuli and contributes to allergic reactions via PAF receptor (PAFR). However, the sources of endogenous PAF and its pathophysiological dynamics remain largely elusive in vivo. Here, we report that rapid and local PAF generation completely depends on lysophospholipid acyltransferase 9 (LPLAT9, also known as LPCAT2) expressed in mast cells in IgE-mediated passive cutaneous anaphylaxis. However, we found that LPLAT9 knockout (KO) mice did not display attenuated vascular leakage. Additionally, decreased vascular leakage was observed in PAFR KO mice, but not in endothelial cell-specific mice in this model. These divergences highlight a yet unsolved complexity of the biological functions of PAF and PAFR in a pathophysiological process., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: We report a case of uterine artery pseudoaneurysm (UAP) occurrence during hysteroscopic endometrial polypectomy and its treatment via uterine artery embolization (UAE)., Case Summary: A 48-year-old primigravid, primiparous patient was incidentally found to have an endometrial polyp during a health checkup, and underwent a hysteroscopic polypectomy at another hospital. Her cervix was dilated with a Laminken-R ® device. After the Laminken-R ® was withdrawn, a large amount of genital bleeding was observed. This bleeding persisted after the hysteroscopic polypectomy, and, as hemostasis became impossible, the patient was transferred to our hospital by ambulance. On arrival, transvaginal ultrasonography revealed a 3-cm hypoechoic mass with a swirling internal pulse on the right side of the uterus, and color Doppler ultrasonography showed feeder vessels penetrating the mass. Pelvic contrast-enhanced computed tomography (CT) confirmed the presence of a mass at this site, and vascular proliferation was observed within the uterine cavity. Consequently, UAP was diagnosed, and UAE was performed. The patient's postoperative course was uneventful, and 6 mo post-UAE, no recurrence of blood flow to the UAP was observed., Conclusion: When abnormal genital bleeding occurs during hysteroscopic surgery, ultrasonography and contrast-enhanced CT can assist in the detection of early UAPs., Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background : The effect of combining an α 1 -adrenergic receptor blocker (α 1 -blocker) and the β3-adrenoceptor agonist vibegron for treating persistent overactive bladder (OAB) symptoms associated with benign prostatic hyperplasia (BPH) on sexual function remains uncertain. Therefore, we aimed to evaluate the effects of vibegron as an add-on to α 1 -blocker therapy on both OAB and sexual function. Methods : Forty-three patients with BPH in whom OAB symptoms were inadequately controlled by α 1 -blocker treatment were included in this prospective open-label study. The OAB Symptom Score (OABSS), International Prostate Symptom Score (IPSS), 15-item International Index of Erectile Function (IIEF-15), and Erection Hardness Score (EHS), as well as the residual urine volume and serum-free testosterone (FT) and C-reactive protein (CRP) levels, were evaluated before and 8 weeks after the daily administration of 50 mg vibegron/α 1 -blocker combination therapy. Results : Vibegron/α 1 -blocker combination therapy significantly improved the OABSS (from 6.9 ± 2.6 to 5.1 ± 2.9, p < 0.0001) and IIEF intercourse satisfaction domain (from 1.1 ± 2.3 to 1.9 ± 2.6, p = 0.02). No significant differences were observed for the IPSS, EHS, total IIEF-15 score, residual urine volume, and serum FT and CRP levels. Conclusions : The study findings suggest that vibegron/α 1 -blocker combination therapy improves OAB and sexual satisfaction.

In recent years, randomized controlled trials have demonstrated that upfront androgen receptor signaling inhibitors (ARSIs) prolong overall survival (OS) compared with androgen deprivation therapy (ADT) alone or combined androgen blockade (CAB) in patients with metastatic castration-sensitive prostate cancer (mCSPC). However, it remains unclear whether upfront ARSI is superior to CAB in Asian populations, among which the efficacy of ADT/CAB is considered relatively high. In this study, we compared the oncological outcomes of upfront ARSI and CAB in Japanese patients with mCSPC. Patients with mCSPC who underwent systemic therapy between May 2009 and October 2023 were enrolled retrospectively. Propensity score matching (PSM) was performed to compare the castration-resistant prostate cancer-free survival (CRPC-FS), cancer-specific survival (CSS), and OS between patients treated with upfront ARSI (ARSI group) and those treated with CAB (CAB group). In total, 30 and 142 patients were enrolled in the ARSI and CAB groups, respectively. After PSM (25 patients in each group), CRPC-FS was significantly longer in the ARSI group than in the CAB group (median: 36.7 vs. 12.3 months, hazard ratio: 0.44, 95% confidence interval: 0.20-0.97, p = 0.035). No significant differences were observed in CSS or OS between the two groups. In conclusion, when compared to CAB, upfront ARSI might have the potential to extend CRPC-FS among individuals in the Japanese population., Competing Interests: The authors have no conflicts of interest to disclose., (2024, National Center for Global Health and Medicine.)

Introduction: Although uterine perforation is a rare but serious complication, intrauterine devices are globally popular and effective contraceptive methods., Case Presentation: A 76-year-old female patient manifesting symptoms of vaginal leakage and lower abdominal discomfort was admitted to our hospital. Diagnostic imaging identified a vesicovaginal fistula and bladder calculi attributable to perforation of the bladder by an intrauterine device that had been inserted over four decades ago. The patient underwent open surgery for cystolith removal and vesicovaginal fistula repair., Conclusions: If a patient with an intrauterine device complains of bladder stones or ongoing lower urinary tract symptoms, bladder perforation caused by the device should be considered in the differential diagnosis., Competing Interests: The authors declare no conflict of interest., (© 2024 The Author(s). IJU Case Reports published by John Wiley & Sons Australia, Ltd on behalf of Japanese Urological Association.)

Introduction: Enfortumab vedotin is an antibody-drug conjugate targeting Nectin-4 for the treatment of advanced urothelial carcinoma in patients previously treated with platinum-containing chemotherapy and immune checkpoint inhibitors. Common adverse events include rashes, peripheral neuropathy, and hyperglycemia. However, there are no reports on the development of myelodysplastic syndrome during enfortumab vedotin therapy in clinical settings., Case Presentation: A 72-year-old male patient experienced prolonged and severe thrombocytopenia 18 weeks after the start of enfortumab vedotin therapy for metastatic urothelial carcinoma, requiring daily platelet transfusions. Bone marrow examination and chromosomal analysis confirmed the diagnosis of myelodysplastic syndrome. Treatment with eltrombopag proved to be effective., Conclusion: This is the first report of the development of myelodysplastic syndrome during enfortumab vedotin therapy in a clinical setting. Although rare, myelodysplastic syndrome can occur during enfortumab vedotin therapy., Competing Interests: The authors declare no conflict of interest., (© 2024 The Author(s). IJU Case Reports published by John Wiley & Sons Australia, Ltd on behalf of Japanese Urological Association.)

Background: Bone assessment using the MRI DEAL-IQ sequence may have the potential to serve as a substitute for evaluating bone strength by quantifying the bone marrow hematopoietic region (R2*) and marrow adiposity (proton density fat fraction: PDFF). Higher body mass index (BMI) is associated with increased bone mineral density (BMD) in the proximal femur; however, the relationship between BMI and R2* or PDFF remains unclear. Herein, we investigated the correlation between BMI and MRI IDEAL-IQ based R2* or PDFF of the proximal femur., Methods: A retrospective single-cohort study was conducted on 217 patients diagnosed with non-metastatic prostate cancer between September 2019 and December 2022 who underwent MRI. The correlation between BMI and R2* or PDFF of the proximal femur was analyzed using Spearman's rank correlation test., Results: Among 217 patients (median age, 74 years; median BMI, 23.8 kg/m 2 ), there was a significant positive correlation between BMI and R2* at the right and left proximal femur (r = 0.2686, p < 0.0001; r = 0.2755, p < 0.0001, respectively). Furthermore, BMI and PDFF showed a significant negative correlation (r = -0.239, p = 0.0004; r = -0.2212, p = 0.001, respectively)., Conclusion: In elderly men, the increased loading on the proximal femur due to elevated BMI was observed to promote a decrease in bone marrow adiposity in the proximal femur, causing a tendency for a transition from fatty marrow to red marrow with hematopoietic activity. These results indicate that the MRI IDEAL-IQ sequence may be valuable for assessing bone quality deterioration in the proximal femur.

Aim: Metabolic dysfunction-associated steatohepatitis (MASH) is one of the most prevalent liver diseases and is characterized by steatosis and the accumulation of bioactive lipids. This study aims to understand the specific lipid species responsible for the progression of liver fibrosis in MASH., Methods: Changes in bioactive lipid levels were examined in the livers of MASH mice fed a choline-deficient diet (CDD). Additionally, sphingosine kinase (SphK)1 mRNA, which generates sphingosine 1 phosphate (S1P), was examined in the livers of patients with MASH., Results: CDD induced MASH and liver fibrosis were accompanied by elevated levels of S1P and increased expression of SphK1 in capillarized liver sinusoidal endothelial cells (LSECs) in mice. SphK1 mRNA also increased in the livers of patients with MASH. Treatment of primary cultured mouse hepatic stellate cells (HSCs) with S1P stimulated their activation, which was mitigated by the S1P receptor (S1PR)2 inhibitor, JTE013. The inhibition of S1PR2 or its knockout in mice suppressed liver fibrosis without reducing steatosis or hepatocellular damage., Conclusion: S1P level is increased in MASH livers and contributes to liver fibrosis via S1PR2., Competing Interests: Tatsuya Kanto has personal financial interests from Gilead Sciences for Lecture fees. Hideo Shindou was collaborated with ONO Pharmaceutical company, but the collaboration is not related to this manuscript. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2024 Osawa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Laparoscopic sacrocolpopexy (LSC) and robot-assisted sacrocolpopexy (RSC) using mesh are popular approaches for treating pelvic organ prolapse (POP). However, it is not uncommon that native tissue repair (NTR) should be presented as an option to patients who are expected to have extensive intraperitoneal adhesion or patients for whom LSC or RSC is difficult owing to various risk factors. Laparoscopic vaginal stump-uterosacral ligament fixation (Shull method) has been introduced as a method for NTR in case of POP. However, effective repair using this surgical procedure may not be possible in severe POPs. To solve the problems of the Shull method, we devised the laparoscopic vaginal stump-round ligament fixation (Kakinuma method) in which the vaginal stump is fixed to the uterine round ligament, a histologically strong tissue positioned anatomically higher than the uterosacral ligament. This study aimed to retrospectively and clinically compare the two methods., Methods: Of the 78 patients who underwent surgery for POP between January 2017 and June 2022 and postoperative follow-up for at least a year, 40 patients who underwent the Shull method (Shull group) and 38 who underwent the Kakinuma method (Kakinuma group) were retrospectively analyzed., Results: No significant differences were observed between the two groups in patient background variables such as mean age, parity, body mass index, and POP-Q stage. The mean operative duration and mean blood loss in the Shull group were 140.5 ± 31.7 min and 91.3 ± 96.3 ml, respectively, whereas the respective values in the Kakinuma group were 112.2 ± 25.3 min and 31.4 ± 47.7 ml, respectively. Thus, compared with the Shull group, the operative duration was significantly shorter (P < 0.001) and blood loss was significantly less (P = 0.003) in the Kakinuma group. Recurrence was observed in six patients (15.0%) in the Shull group and two patients (5.3%) in the Kakinuma group. Hence, compared with the Shull group, recurrence was significantly less in the Kakinuma group (P = 0.015). No patients experienced perioperative complications in either group., Conclusions: The results suggest that the Kakinuma method can serve as a novel and viable NTR procedure for POP., (© 2024. The Author(s).)

Background: Individuals with severe motor and intellectual disabilities have become an aging population, and high cancer morbidity and mortality are critical issues affecting their survival. Cancer screening is a crucial method of resolving this issue; however, a suitable screening method for them has not been established., Methods: We used ultrasonography alone and performed breast cancer screening for women over 30 years old in our facility from 2016 to 2023. We observed the outcomes and calculated the recall/detection rate in this screening., Results: Three cases among 379 tested positive in this screening, all of which underwent radical surgery. They are alive and well without relapse present. We detected these breast cancer cases with a low recall rate., Conclusion: We were able to successfully detect breast cancer cases using ultrasonography alone. Ultrasonography is an effective and feasible tool for breast cancer screening in individuals with severe motor and intellectual disabilities., (© 2024 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Objective: This study aimed to reveal the association between pretreatment serum testosterone levels and prognosis in patients with metastatic hormone-sensitive prostate cancer treated with androgen deprivation therapy., Methods: A total of 91 patients were included in this retrospective study. Clinical data were obtained through chart review. Multivariate cox proportional hazards analyses addressed the impact of variables on castration-resistant prostate cancer-free and overall survivals., Results: During a median follow-up of 41.7 months, 61 (67%) and 49 (54%) patients developed castration-resistant prostate cancer and died, respectively. The median castration-resistant prostate cancer-free and overall survivals were 15.5 and 59.9 months, respectively. The cutoff value for discriminating between low- and high-testosterone levels was determined as 450 ng/dl by calculating the receiver operating characteristic curve. Patients in the low-testosterone group (n = 37) had a significantly higher body mass index, worse comorbidities represented by the higher Charlson comorbidity index and higher serum lactate dehydrogenase levels, than those in the high-testosterone group (n = 54). Castration-resistant prostate cancer free and overall survivals were significantly shorter in the low-testosterone group than in the high-testosterone group (P = 0.021 and P < 0.001, respectively). Multivariate analysis identified testosterone level of <450 ng/dl as an independent factor predicting development of castration-resistant prostate cancer (hazard ratio 2.28, P = 0.007), along with high-volume disease and Gleason score 9-10. Similarly, testosterone level of <450 ng/dl was independently associated with shorter overall survival (hazard ratio 2.84, P = 0.006), along with higher Charlson comorbidity index, visceral metastasis and higher alkaline phosphatase level., Conclusions: Lower baseline serum testosterone levels predict poor prognosis in patients with metastatic hormone-sensitive prostate cancer., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Renal abscess (RA) is a collection of infective fluid in or around the renal parenchyma. It typically occurs in immunocompromised patients, including those with diabetes mellitus (DM), poor nutritional status, or steroid administration. We herein report a case of RA associated with DM in which hyperbaric oxygen (HBO 2 ) therapy greatly contributed to the resolution of this disease. The patient was an 85-year-old man with poorly controlled type 2 DM. Contrast-enhanced computed tomography for postoperative follow-up of appendiceal cancer showed a mass lesion with poor contrast enhancement extending from the upper pole of the left kidney to the dorsal side. Therefore, a diagnosis of RA was established. The lesion was percutaneously punctured, and a drainage tube was placed. Antibiotics following sensitivity testing were administered. The catheter was removed six days after its placement. However, pus discharge continued from the catheter removal site, with persistent redness around the wound. Therefore, a lumbotomy incision for abscess drainage was performed on the 49th day. However, the pus discharge persisted, and we decided to perform HBO 2 therapy, expecting decreases in bacterial proliferation, reduction in local edema, and improvement of host defense. HBO 2 therapy for 90 min at two atmospheres absolute was performed ten times. The amount of pus discharge decreased, and redness improved from the fifth day after HBO 2 therapy. One month after starting HBO 2 therapy, the wound was closed, and the pus discharge resolved completely. Four years have passed since the HBO 2 therapy, and there have been no symptomatic or imaging relapses of RA., Competing Interests: The authors of this paper declare no conflicts of interest exist with this submission., (Copyright© Undersea and Hyperbaric Medical Society.)

Nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes are interacting comorbidities of obesity, and increased hepatic de novo lipogenesis (DNL), driven by hyperinsulinemia and carbohydrate overload, contributes to their pathogenesis. Fatty acid synthase (FASN), a key enzyme of hepatic DNL, is upregulated in association with insulin resistance. However, the therapeutic potential of targeting FASN in hepatocytes for obesity-associated metabolic diseases is unknown. Here, we show that hepatic FASN deficiency differentially affects NAFLD and diabetes depending on the etiology of obesity. Hepatocyte-specific ablation of FASN ameliorated NAFLD and diabetes in melanocortin 4 receptor-deficient mice but not in mice with diet-induced obesity. In leptin-deficient mice, FASN ablation alleviated hepatic steatosis and improved glucose tolerance but exacerbated fed hyperglycemia and liver dysfunction. The beneficial effects of hepatic FASN deficiency on NAFLD and glucose metabolism were associated with suppression of DNL and attenuation of gluconeogenesis and fatty acid oxidation, respectively. The exacerbation of fed hyperglycemia by FASN ablation in leptin-deficient mice appeared attributable to impairment of hepatic glucose uptake triggered by glycogen accumulation and citrate-mediated inhibition of glycolysis. Further investigation of the therapeutic potential of hepatic FASN inhibition for NAFLD and diabetes in humans should thus consider the etiology of obesity.

Background: Microwave endometrial ablation (MEA) is a minimally invasive treatment for menorrhagia. It has been covered by the national insurance in Japan since April 2012, and its demand has been increasing as the importance of women's health has advanced in society., Aim: To examine the efficacy of MEA as a treatment option for menorrhagia., Methods: In this study, we retrospectively analyzed 76 patients who underwent MEA between January 2016 and March 2020 in our department. MEA was performed in the lithotomy position, under general anesthesia, and with transabdominal ultrasound guidance, including the entire endometrial circumference while confirming endometrial coagulation. The Microtaze AFM-712 and the Sounding Applicator CSA-40CBL-1006200C were used for MEA, and the endometrium was ablated using a Microtaze output of 70 W and coagulation energization time of 50 s per cycle. The visual analog scale (VAS) was used to evaluate menorrhagia, menstrual pain, and treatment satisfaction. Additionally, the hemoglobin (Hb) levels before and after MEA and associated complications were investigated., Results: The average age of the patients was 44.8 ± 4.0 years. While 14 patients had functional menorrhagia, 62 had organic menorrhagia, of whom 14 had endometrial polyps, 40 had uterine fibroids, and 8 had adenomyosis. The VAS score before MEA and 3 and 6 mo after the procedure were 10, 1.3 ± 1.3, and 1.3 ± 1.3, respectively, for menorrhagia and 10, 1.3 ± 1.8, and 1.3 ± 1.8, respectively, for menstrual pain, both showing improvements ( P < 0.001). The MEA Hb level significantly improved from 9.2 ± 4.2 g/dL before MEA to 13.4 ± 1.2 g/dL after MEA ( P = 0.003). Treatment satisfaction was high, with a VAS score of 9.6 ± 0.7. Endometritis was observed in one patient after surgery and was treated with antibiotics., Conclusion: MEA is a safe and effective treatment for menorrhagia., Competing Interests: Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

Docosahexaenoic acid (DHA), an omega-3 fatty acid, usually presents as a constituent of phospholipids in the cellular membrane. Lysophospholipid acyltransferase 3 (LPLAT3; AGPAT3) is the primary enzyme that incorporates DHA into phospholipids. LPLAT3-KO mice show male infertility and visual dysfunction accompanied by decreased phospholipids (PLs) containing DHA (PL-DHA) in the testis and retina, respectively. In this study, we evaluated the effect of diets consisting mainly of triacylglycerol-bound DHA (fish oil) and PL-bound DHA (salmon roe oil) on the amount of PL-DHA in a broad range of tissues and on reproductive functions. Both diets elevated phosphatidylcholines (PCs)-containing DHA in most tissues of wild type (WT) mice. Although LPLAT3-KO mice acquired a minimal amount of PC-DHA in the testes and sperm by eating either of the diets, reproductive function did not improve. The present study suggests that DHA-rich diets do not restore sufficient PL-DHA to improve male infertility in LPLAT3-KO mice. Alternatively, PL-DHA can be biosynthesized by LPLAT3 but not by external supplementation, which may be necessary for normal reproductive function., Competing Interests: Conflict of interest Department of Lipid Life Science, National Center for Global Health and Medicine collaborates with ONO PHARMACEUTICAL CO., LTD and Maruha Nichiro Corporation., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Lysophosphatidic acid (LPA) is a simple phospholipid consisting of a phosphate group, glycerol moiety, and only one hydrocarbon chain. Despite its simple chemical structure, LPA plays an important role as an essential bioactive signaling molecule via its specific six G protein-coupled receptors, LPA 1 - 6 . Recent studies, especially those using genetic tools, have revealed diverse physiological and pathological roles of LPA and LPA receptors in almost every organ system. Furthermore, many studies are illuminating detailed mechanisms to orchestrate multiple LPA receptor signaling pathways and to facilitate their coordinated function. Importantly, these extensive "bench" works are now translated into the "bedside" as exemplified by approaches targeting LPA 1 signaling to combat fibrotic diseases. In this review, we discuss the physiological and pathological roles of LPA signaling and their implications for clinical application by focusing on findings revealed by in vivo studies utilizing genetic tools targeting LPA receptors., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Takao Shimizu reports financial support was provided by Ono Pharmaceutical Co Ltd., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background/aim: This study aimed to describe the voiding patterns of patients after surgical treatment of pelvic fractures and determine the predictive factors of lower urinary tract injuries (LUTIs) and spontaneous voiding failure among patients with surgically treated pelvic fractures at a tertiary trauma center in Japan., Patients and Methods: We retrospectively assessed patients with surgically treated pelvic fractures in our tertiary trauma center during May 2009-April 2021. We excluded patients who died during hospitalization and who had indwelling catheter prior to the injury. Patients' LUTIs and spontaneous voiding failure at discharge were recorded. Multivariate analysis was performed to assess the predictive factors of LUTIs and spontaneous voiding failure at discharge., Results: In total, 334 eligible patients were identified. Among them, 301 patients (90%) voided spontaneously with or without diapers at discharge. Thirty-three patients required some form of catheterization for bladder drainage. LUTIs were found to be associated with chronological age [odds ratio (OR)=0.96; 95% confidence interval (CI)=0.92-0.99; p=0.024] and pelvic ring fracture (OR=12.0; 95%CI=1.39-255.2; p=0.024). Spontaneous voiding failure was associated with intensive care unit admission (OR=7.17; 95%CI=1.49-34.4; p=0.004)., Conclusion: Overall, 10% of patients with surgically treated pelvic fractures were not able to void spontaneously at discharge. Spontaneous voiding failure after pelvic fractures was related to injury severity., (Copyright © 2023, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background: Giant malignant tumors have an increased risk of intraoperative rupture, which might lead to a worse disease condition and tumor recurrence. We performed a clinical study on patients with a giant ovarian mass who underwent laparoscopy combined with an Aron Alpha method., Methods: This retrospective clinical study spanned from January 2016 to September 2022 and included 23 patients with giant ovarian tumors treated with an Aron Alpha method., Results: The mean age of the subjects was 47.6 ± 17.8 years, mean tumor diameter 20.4 ± 5.8 cm, mean surgical duration 87.2 ± 33.1  min, and mean hemorrhage volume 94.1 ± 92.2 mL. No patient experienced intraoperative tumor rupture or surgery-related symptoms. Histopathology of excised samples revealed serous cyst adenoma and mucinous cystadenoma, mucinous cystadenoma of borderline malignancy and mature cystic teratoma, and endometriotic cyst adenoma in 6, 4, and 3 patients, respectively. The mean hospitalization period was 6.0 ± 1.2 days, and the hospitalization period was not extended in any subject., Conclusion: The Aron Alpha method allows tumor resection without capsular rupture and is a useful, minimally invasive surgical method for resecting giant ovarian tumors in which malignancy cannot be ruled out., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (©2023PublishedbyElsevierInc.)

Background: Amyloid-β peptide is well-known as a pathogen of Alzheimer's disease, but its precursor, amyloid-beta precursor protein (APP), remains unexplained 30 years after its discovery. APP has two homologues called amyloid precursor-like protein 1 (APLP1) and amyloid precursor-like protein 2 (APLP2), and shares a similar structural organisation with them and has partially overlapping functions. APP family proteins are essential for survival, shown by the crossbreeding analysis of knockout mice of APP family molecules, including APLP1 and APLP2. APLP2 is known to play the most important role among them, but the molecular metabolism of APLP2 is only partially understood. Here, we analysed ectodomain shedding and γ-secretase cleavage of APLP2 by molecular biological and biochemical techniques., Method: We analysed the culture supernatant of HEK293 cells overexpressing APLP2 and human cerebrospinal fluid. For the analysis of secreted APLP2 fragments, we raised the OA603 antibody that reacts with the juxtamembrane domain of APLP2. Substrate cleavage sites were identified by matrix assisted laser desorption/ionisation mass spectrometry., Results: By overexpressing in HEK293 cells, APLP2 undergoes ectodomain shedding at three sites in the extracellular region by α- and β-secretase-like activity and then is intramembranously cleaved at three sites by γ-secretase. In particular, in shedding, α-secretase-like activity was dominant in HEK cells. Surprisingly, in human cerebrospinal fluid, APLP2-derived metabolic fragments were mainly cleaved by β-secretase-like activity, not by α-secretase-like activity. Because APP is also mainly cleaved by beta-site amyloid precursor protein cleaving enzyme 1 in neurons and APLP1 is expressed exclusively in neurons, these findings suggest that APP family proteins may play a common role via β-secretase-like cleavage in the central nerve system., Conclusions: Thus, these findings may contribute to a better understanding of the role of APP family proteins in Alzheimer's disease., (© 2023 Japanese Psychogeriatric Society.)

In human autosomal recessive woolly hair/hypotrichosis (ARWH/HT), many mutations have been identified in a gene encoding LPA6, a G protein-coupled receptor (GPCR) for lysophosphatidic acid (LPA). However, information regarding the effects of such mutations on receptor function is limited. In this study, we examined functional impacts of selected amino acid changes in LPA6 identified in ARWH/HT patients. In our exogenous expression experiments, all mutants except S3T failed to respond to LPA, indicating that they are loss-of-function mutants. Among the nine mutants, five (D63V, G146R, N246D, L277P and C278Y) displayed impaired expression at the cell surface because of endoplasmic reticulum (ER) retention, indicating that these mutants are trafficking-defective, as reported in other disease-associated GPCRs. Notably, alkyl-OMPT, a potent synthetic agonist for LPA6 restored the defective cell surface expression of two of the ER-retained mutants, D63V and N246D, possibly by its chaperoning function that allows them to escape intracellular retention as well as proteasomal degradation. Furthermore, the alkyl-OMPT-rescued N246D mutant was shown be functional. Our findings encourage future application of pharmacoperone therapy for ARWH/HT patients with specific LPA6 mutations., (© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Background: Cervical pregnancies, interstitial tubal pregnancies, and cesarean scar pregnancies, which are ectopic pregnancies with intrauterine implantation sites exhibit increasing trends with the recent widespread use of assisted reproductive technologies and increased rate of cesarean deliveries. The development of high-sensitivity human chorionic gonadotropin testing reagents and the increased precision of transvaginal ultrasonic tomography have made early diagnosis possible and have enabled treatment. Removal of ectopic pregnancies using methotrexate therapy and/or uterine artery embolization has been reported. However, delayed resumption of infertility treatments after methotrexate therapy is indicated, and negative effects on the next pregnancy after uterine artery embolization have been reported., Aim: To examine the efficacy and safety of ultrasound-guided topical absolute ethanol injection in ectopic pregnancies with an intrauterine implantation site., Methods: In this study, we retrospectively examined the medical records of 21 patients who were diagnosed with an ectopic pregnancy with an intrauterine implantation site at our hospital, between April 2010 and December 2018, and underwent transvaginal ultrasound-guided local injections of absolute ethanol to determine the treatment outcomes. We evaluated the treatment methods, treatment outcomes, presence of bleeding requiring hemostasis measures and blood transfusion, complications, and treatment periods. Successful treatment was defined as the completion of treatment using transvaginal ultrasound-guided local injections of absolute ethanol alone., Results: There were 21 total cases comprising 10 cervical pregnancies, 10 interstitial tubal pregnancies, and 1 cesarean scar pregnancy. All patients completed treatment with this method. No massive hemorrhaging or serious adverse reactions were observed during treatment. The mean gestation ages at the time of diagnosis were 5.9 wk (SD, ± 0.9 wk) for cervical and 6.9 wk (SD, ± 2.1 wk) for interstitial tubal pregnancies. The total ethanol doses were 4.8 mL (SD, ± 2.2 mL) for cervical pregnancies and 3.3 mL (SD, ± 2.2 mL) for interstitial pregnancies. The treatment period was 28.5 days (SD, ± 11.7 d) for cervical pregnancies and 30.0 ± 8.1 d for interstitial pregnancies. Positive correlations were observed between the blood β- human chorionic gonadotropin level at the beginning of treatment and the total ethanol dose ( r = 0.75; P = 0.00008), as well as between the total ethanol dose and treatment period ( r = 0.48; P = 0.026)., Conclusion: Transvaginal ultrasound-guided local injections of absolute ethanol could become a new option for intrauterine ectopic pregnancies when fertility preservation is desired., Competing Interests: Conflict-of-interest statement: The authors have no relevant financial or non-financial interests to disclose., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

Introduction: Little research has examined the effects of anti-vascular endothelial growth factor therapy on subfoveal choroidal thickness (SCT), choroidal blood flow, aqueous flare, and humor levels of growth and inflammatory factors in patients with macular edema due to central retinal vein occlusion (CRVO)., Methods: In 58 patients with macular edema due to CRVO treated by intravitreal ranibizumab injection (IRI), we retrospectively assessed best-corrected visual acuity (BCVA, assessed as the logarithm of the minimum angle of resolution [logMAR]), 8 aqueous factors (by suspension array), mean blur rate (MBR; estimated by laser speckle flowgraphy as a measure of choroidal blood flow), aqueous flare (with a laser flare meter), and SCT and central macular thickness (CMT; by optical coherence tomography)., Results: After 4 weeks, IRI resulted in a significant improvement in BCVA and CMT and a significant reduction in SCT, choroidal MBR, and aqueous flare. SCT was significantly positively correlated with placental growth factor and significantly negatively correlated with platelet-derived growth factor-AA, and change in SCT was significantly negatively correlated with change in BCVA (logMAR). Aqueous flare was significantly negatively correlated with SCT., Conclusion: Growth and inflammatory factors may be associated with SCT, and changes in SCT may be associated with changes in BCVA after IRI to treat macular edema due to CRVO., (© 2023 The Author(s). Published by S. Karger AG, Basel.)

The G protein-coupled receptors, GPR43 (free fatty acid receptor 2, FFA2) and GPR41 (free fatty acid receptor 3, FFA3), are activated by short-chain fatty acids produced under various conditions, including microbial fermentation of carbohydrates. Previous studies have implicated this receptor energy homeostasis and immune responses as well as in cell growth arrest and apoptosis. Here, we observed the expression of both receptors in human blood cells and a remarkable enhancement in leukemia cell lines (HL-60, U937, and THP-1 cells) during differentiation. A reporter assay revealed that GPR43 is coupled with Gα i and Gα 12/13 and is constitutively active without any stimuli. Specific blockers of GPR43, GLPG0974 and CATPB function as inverse agonists because treatment with these compounds significantly reduces constitutive activity. In HL-60 cells, enhanced expression of GPR43 led to growth arrest through Gα 12/13 . In addition, the blockage of GPR43 activity in these cells significantly impaired their adherent properties due to the reduction of adhesion molecules. We further revealed that enhanced GPR43 activity induces F-actin formation. However, the activity of GPR43 did not contribute to butyrate-induced apoptosis in differentiated HL-60 cells because of the ineffectiveness of the inverse agonist on cell death. Collectively, these results suggest that GPR43, which possesses constitutive activity, is crucial for growth arrest, followed by the proper differentiation of leukocytes., (© 2022 Federation of American Societies for Experimental Biology.)

Background: Hypermenorrhea is characterized by excessive menstrual bleeding that causes severe anemia and interferes with everyday life. This condition can restrict women's social activities and decrease their quality of life. Microwave endometrial ablation (MEA) using a 2.45-GHz energy source is a minimally invasive alternative to conventional hysterectomy for treating hypermenorrhea that is resistant to conservative treatment, triggered by systemic disease or medications, or caused by uterine myomas and fibrosis. The popularity of MEA has increased worldwide. Although MEA can safely and effectively treat submucous myomas, some patients may still experience recurrent hypermenorrhea postoperatively and may require additional treatment., Aim: To investigate the efficacy of MEA combined with transcervical resection (TCR)., Methods: Participants underwent cervical and endometrial evaluations. Magnetic resonance imaging and hysteroscopy were performed to evaluate the size and location of the myomas. TCR was performed before MEA using a hystero-resectoscope. MEA was performed using transabdominal ultrasound. The variables included operation time, number of ablation cycles, length of hospital stay, and visual analog scale cores for hypermenorrhea, dysmenorrhea, and treatment satisfaction at 3 and 6 mo postoperatively. The postoperative incidence of amenorrhea, changes in hemoglobin concentrations, and MEA-related complications were evaluated., Results: A total of 34 women underwent a combination of MEA and TCR during the study period. Two patients were excluded from the study as their histopathological tests identified uterine malignancies (uterine sarcoma and endometrial cancer). The 32 eligible women (6 nulliparous, 26 multiparous) had a mean age of 45.2 ± 4.3 years (range: 36-52 years). Patients reported very severe hypermenorrhea (10/10 points on the visual analog scale) before the procedure. However, after the procedure, the hypermenorrhea scores decreased to 1.2 ± 1.3 and 0.9 ± 1.3 at 3 and 6 mo, respectively ( P < 0.001). The mean follow-up duration was 33.8 ± 16.8 mo. Although 10 women (31.3%) developed amenorrhea during this period, none experienced a recurrence of hypermenorrhea. No surgical complications were observed., Conclusion: Reducing the size of uterine myomas by combining MEA and TCR can safely and effectively treat hypermenorrhea in patients with submucous myomas., Competing Interests: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article., (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)

Osteoporosis is often accompanied by bone loss with fat accumulation of the red marrow. A novel technique for quantification of iron and fat content by MRI IDEAL-IQ can visualize hematopoietic areas and fatty deposits in bone marrow; however, the relationship between these indices and total hip bone mineral density (BMD) remains unclear. In this study, the proximal femur of 104 men who underwent pelvic MRI and bone densitometry prior to treatment for non-metastatic prostate cancer was retrospectively examined to investigate the R2* value to quantify iron and proton density fat fraction (PDFF) to assess bone marrow fat content. R2* was significantly positively correlated with BMD ( r  = 0.6017, p  < 0.0001), and PDFF was not correlated with BMD ( r  = -0.1302, p  = 0.0512). Patients with BMD T-score ≤ -2.5 had significantly lower R2* than patients with BMD T-score > -2.5; however, there was no significant difference in PDFF. In the ROC analysis, which examined the predictive ability of R2* with BMD T-score ≤ -2.5 as an outcome, the cut-off value of R2* was 50.7  s -1 (AUC 0.817). These results show R2* correlated with BMD. R2* may be a non-invasive surrogate marker for diagnosing male osteoporosis.

Purpose: To analyse the relationship between the extent of metamorphopsia and optical coherence tomography (OCT) parameters including the ectopic inner foveal layer (EIFL) in patients with epiretinal membrane (ERM) who underwent pars plana vitrectomy (PPV)., Methods: This study included 63 eyes of 62 patients who underwent PPV for ERM. Metamorphopsia was assessed by measuring the metamorphopsia score for vertical lines (MV) and metamorphopsia score for horizontal lines (MH) using M-CHARTS. Central retinal thickness (CRT), EIFL thickness and disruption of outer retinal layers were measured before and after surgery, and the relationship of these parameters with metamorphopsia scores at 3 months after vitrectomy was analysed., Results: Preoperative MV correlated with preoperative CRT and EIFL (p = 0.005 and 0.045 respectively). Postoperative MH correlated with preoperative CRT (p = 0.048), while postoperative MV correlated with preoperative CRT and EIFL (p = 0.002 and 0.0006 respectively). Postoperative MH correlated with postoperative CRT and EIFL (p = 0.001 and 0.002 respectively), and postoperative MV also correlated with postoperative CRT and EIFL (p = 0.0008 and < 0.0001 respectively). MH and MV did not correlate with outer retinal layer disruptions, both before and after vitrectomy. When multiple regression analysis was performed on preoperative and postoperative OCT parameters that correlated with postoperative metamorphopsia scores, only postoperative EIFL was identified as an independent factor associated with postoperative MV (p = 0.042)., Conclusion: When PPV was conducted for ERM, postoperative EIFL was found to be a significant factor associated with postoperative metamorphopsia score., (© 2022 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Objective: To assess the effectiveness and safety of modified silicone gel sheets applied to hypertrophic scars and keloids following laparoscopic surgery., Methods: Patients who had undergone laparoscopic surgery and who had either conventional or modified silicone gel sheets affixed to their surgical lesions for 6 months postoperatively (treatment groups), and control patients who had not received postsurgical treatment involving silicone gel sheets, were enrolled. The surgical wounds were assessed visually and using the Japan Scar Workshop (JSW) Scar Scale. Patients were interviewed before, 3 months after, and 6 months after sheet affixation., Results: A total of 45 patients were included, comprising 15 patients per group. Both silicone gel-sheet groups had significantly lower JSW Scar Scale scores at 3 and 6 months after affixation compared with controls. The scores were not significantly different between the conventional and modified treatment groups and no adverse events were observed in the latter., Conclusions: Modified silicone gel sheets were more effective than controls and comparable to conventional gel sheets, and there were no adverse events related to laparoscopic surgical wounds in the improved silicone gel sheet group, demonstrating the safety and effectiveness of the modified silicone gel sheets.

Bitter taste receptors (T2Rs) are G protein-coupled receptors involved in the perception of bitter taste on the tongue. In humans, T2Rs have been found in several sites outside the oral cavity. Although T2R38 has been reported to be expressed on peripheral lymphocytes, it is poorly understood whether T2R38 plays immunological roles in inflammatory skin diseases such as atopic dermatitis (AD). Then, we first confirmed that T2R38 gene expression was higher in lesional skin of AD subjects than healthy controls. Furthermore, skin T2R38 expression levels were correlated with serum thymus and activation-regulated chemokine and IgE levels in AD patients. In lesional skin of AD, section staining revealed that CD3 + T cells in the dermis were T2R38 positive. In addition, flow cytometry analysis showed T2R38 expression in skin T cells. Migration assays using T2R38-transduced Jurkat T cell leukemia cells revealed that T2R38 agonists exerted a dose-dependent migration inhibitory effect. Moreover, skin tissue extracts, as well as supernatants of cultured HaCaT keratinocytes, caused T2R38-dependent migration inhibition, indicating that there should be an endogenous ligand for T2R38 in the skin epidermis. These findings implicate T2R38 as a migratory inhibitory receptor on the skin-infiltrating lymphocytes and as a therapeutic target for allergic/inflammatory skin diseases., (© 2022. The Author(s).)

Background and Aims: Chronic liver congestion reflecting right-sided heart failure (RHF), Budd-Chiari syndrome, or Fontan-associated liver disease (FALD) is involved in liver fibrosis and HCC. However, molecular mechanisms of fibrosis and HCC in chronic liver congestion remain poorly understood., Approach and Results: Here, we first demonstrated that chronic liver congestion promoted HCC and metastatic liver tumor growth using murine model of chronic liver congestion by partial inferior vena cava ligation (pIVCL). As the initial step triggering HCC promotion and fibrosis, gut-derived lipopolysaccharide (LPS) appeared to induce LSECs capillarization in mice and in vitro. LSEC capillarization was also confirmed in patients with FALD. Mitogenic factor, sphingosine-1-phosphate (S1P), was increased in congestive liver and expression of sphingosine kinase 1, a major synthetase of S1P, was increased in capillarized LSECs after pIVCL. Inhibition of S1P receptor (S1PR) 1 (Ex26) and S1PR2 (JTE013) mitigated HCC development and liver fibrosis, respectively. Antimicrobial treatment lowered portal blood LPS concentration, LSEC capillarization, and liver S1P concentration accompanied by reduction of HCC development and fibrosis in the congestive liver., Conclusions: In conclusion, chronic liver congestion promotes HCC development and liver fibrosis by S1P production from LPS-induced capillarized LSECs. Careful treatment of both RHF and liver cancer might be necessary for patients with RHF with primary or metastatic liver cancer., (© 2021 American Association for the Study of Liver Diseases.)

Background: In Japan, dilatation & curettage (D&C) has been performed under general anesthesia as a surgery for an early pregnancy miscarriage for a long time. In 2016, manual vacuum aspiration (MVA) under general anesthesia was introduced at our hospital and has been used as a surgical treatment for first-trimester pregnancy miscarriage, with its utility to date being reported here. In July 2018, our hospital introduced the MVA procedure under local anesthesia. In this study, we evaluated the efficacy and safety of MVA under general and local anesthesia in first-trimester pregnancy miscarriage surgery in Japanese women., Methods: In this retrospective observational cohort study, we enrolled 322 pregnant women at less than 12 weeks of gestation, who underwent MVA surgery under local anesthesia (n = 166) or conventional general anesthesia (n = 156). The duration of surgery, blood loss volume, quantity of anesthesia, presence or absence of retained products of conception, and clinical complications were evaluated. In addition, the intraoperative pain and treatment satisfaction were assessed using the visual analog scale (VAS)., Results: The duration of surgery was significantly shorter in the local anesthesia group. No significant differences were observed between both groups in terms of the blood loss volume and incidence of retained products of conception. In addition, no serious complications were observed in either group. No significant differences were noted between the two groups in the VAS scores for pain and treatment satisfaction., Conclusions: In this retrospective study, the use of MVA under local anesthesia for early pregnancy miscarriage surgery was found to be equally safe and effective when performed under conventional general anesthesia. This technique allowed the achievement of appropriate pain control with excellent patient satisfaction., (© 2022. The Author(s).)

Background: Patients with diabetes are at a higher risk for cognitive decline. Thus, biomarkers that can provide early and simple detection of cognitive decline are required. Neurofilament light chain (NfL) is a cytoskeletal protein that constitutes neural axons. Plasma NfL levels are elevated when neurodegeneration occurs. Here, we investigated whether plasma NfL levels were associated with cognitive decline in patients with type 2 diabetes., Method: This study included 183 patients with type 2 diabetes who visited Osaka University Hospital. All participants were tested for cognitive function using the Mini-Mental State Examination (MMSE) and the Rivermead Behavioural Memory Test (RBMT). NfL levels were analysed in the plasma and the relationship between NfL and cognitive function was examined., Results: Lower RBMT-standardized profile scores (SPS) or MMSE scores correlated with higher plasma NfL levels (one-way analysis of variance: MMSE, P = 0.0237; RBMT-SPS, P = 0.0001). Furthermore, plasma NfL levels (β = -0.34, P = 0.0005) and age (β = -0.19, P = 0.016) were significantly associated with the RBMT score after multivariable regression adjustment., Conclusions: Plasma NfL levels were correlated with mild cognitive decline which is detected by the RBMT but not the MMSE in patients with type 2 diabetes. This suggests that plasma NfL levels may provide a valuable clinical tool for identifying mild cognitive decline in patients with diabetes., (© 2022 Japanese Psychogeriatric Society.)

Purpose: Our aim is to make an ideal embryo culture medium close to human oviduct fluid (HOF) components, and to evaluate the quality of this medium with embryo quality and clinical outcomes in assisted reproductive technology (ART) by a prospective randomized controlled trial (RCT)., Methods: Study I: HOF was collected laparoscopically from patients ( n  = 28) with normal pelvic findings. According to HOF analysis results, the new medium "HiGROW OVIT ® " (OVIT) was designed. Study II: Embryos (2 pronuclei (2PN) = 9633) were assigned from 1435 patients. The blastulation rate (BR), good BR (gBR), utilized (transferred/cryo-preserved) BR (uBR), pregnancy rate (PR), and miscarriage rate (MR) were compared between the OVIT and control groups by RCT., Results: The novel medium 'OVIT' was produced according to 31 HOF components. The concentrations of essential amino acids (e-AAs) were lower in OVIT than in current media, yet the opposite was true for ne-AA concentrations. gBR and uBR were higher in the OVIT group than in the control group. In the older female group, gBT and uBR were significantly higher in the OVIT group., Conclusions: The novel medium 'OVIT' was produced according to HOF data. The OVIT had significantly better embryo quality and clinical outcomes than the current media., Competing Interests: Takafumi Utsunomiya has nothing to disclose. The remaining authors have nothing to disclose., (© 2022 The Authors. Reproductive Medicine and Biology published by John Wiley & Sons Australia, Ltd on behalf of Japan Society for Reproductive Medicine.)

Objective: This study aimed to determine the epidemiology of genitourinary injuries in pelvic fractures and elucidate the clinical outcomes of patients with pelvic fractures with and without genitourinary injuries at a tertiary trauma center in Japan., Methods: Patients with pelvic fractures in our tertiary trauma center between May 2009 and April 2021 were retrospectively assessed. The patients' demographics, mechanism of injury, and hospital course details were collected. The outcomes of patients with pelvic fractures with and without genitourinary injuries were compared., Results: Of 402 patients with pelvic fractures, 18 (4.5%) had genitourinary injuries. Falls were the most common mechanisms of injury for all pelvic fractures The incidence of bladder, kidney, urethral, and testis injuries were 2.0%, 1.2%, 1.2%, and 0.5%, respectively. Patients with genitourinary injuries were significantly younger (median age, 26 vs. 51 years; p < 0.001), had a higher rate of intensive care unit admission (94% vs. 58%; p = 0.002), remained hospitalized longer (median duration, 82 vs. 45 days; p < 0.001), and had a longer intensive care unit stay (median duration, 6 vs. 2 days; p < 0.001) when compared to patients without genitourinary injuries. Genitourinary injuries were not associated with in-hospital mortality., Conclusions: The incidence of genitourinary injuries with pelvic fractures was 4.5%. The presence of genitourinary injuries was associated with a higher rate of intensive care unit admission, longer hospital stay, and longer intensive care unit stay, but it was not associated with in-hospital mortality., (© 2022 Wiley Periodicals LLC.)