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Abstract The tumor microenvironment plays a pivotal role in cancer development. We recently reported that in oral squamous cell carcinoma (OSCC), adipocyte enhancer-binding protein 1 (AEBP1) is abundantly expressed in cancer-associated fibroblasts (CAFs), leading to CAF activation and inhibition of CD8 + T cell infiltration. In the present study, we investigated whether AEBP1 contributes to the destruction and atrophy of muscle tissues in OSCC. By analyzing human skeletal muscle myoblasts (HSMMs), we found that AEBP1 is downregulated during muscle cell differentiation. Transcriptome analysis revealed that AEBP1 knockdown significantly upregulates myogenesis-related genes in HSMMs, and qRT-PCR and western blot analyses confirmed the induction of muscle-related genes, including MYOG, in HSMMs after AEBP1 knockdown. Conversely, ectopic expression of AEBP1 strongly suppressed myogenesis-related genes in HSMMs. Notably, indirect co-culture of HSMMs with OSCC cells led to AEBP1 upregulation and robust suppression of muscle-related genes in HSMMs. Treatment with TGF-β1 also upregulated AEBP1 and suppressed expression of muscle-related genes in HSMMs. Our findings suggest that AEBP1 is a negative regulator of skeletal muscle cell differentiation and that OSCC cells inhibit muscle cell differentiation, at least in part, by inducing AEBP1.

Abstract After developing job-exposure matrices (JEMs) for screen and sedentary time, we aimed to assess the associations between the JEM-derived exposures and various ocular diseases. We collected data from patients hospitalized from 2005 to 2021. JEMs were developed from 41,718 patients with occupational information and screen and sedentary times. The adjusted means of screen and sedentary time were calculated for 143 occupational groups and categorized into three classes based on the tertiles. The associations between ocular diseases and these JEM-derived exposures were examined using multivariable conditional logistic regression for 727,589 patients. The odds ratios of the class with highest screen time were 1.05 (95% confidence interval, 1.01–1.09) for cataract, 1.24 (1.06–1.45) for primary open-angle glaucoma (POAG), 1.26 (1.06–1.49) for rhegmatogenous retinal detachment (RRD), 1.49 (1.26–1.76) for ptosis, and 0.39 (0.27–0.57) for pterygium. The odds ratios of the class with highest sedentary time were 1.05 (1.01–1.09) for cataract, 1.24 (1.05–1.46) for RRD, 1.68 (1.42–1.99) for ptosis, and 0.60 (0.42–0.84) for pterygium. Both screen and sedentary time were positively associated with cataract, RRD and ptosis. Interestingly, POAG had a positive association with only screen time. Please check and confirm that the authors and their respective affiliations have been correctly identified and amend if necessary."I have confirmed that the content is correct. No amendments are necessary.Please check article title if captured correctly."?>"I have confirmed that the content is correct. No amendments are necessary.

Although coil embolization is commonly perceived as a minimally invasive procedure, the associated radiation exposure cannot be disregarded. To date, no specific study has investigated radiation exposure during coil embolization. This study aimed to investigate the potential of lowering the pulse rate to decrease radiation exposure during coil embolization while maintaining patient safety. Radiation data and clinical features of 70 patients who underwent coil embolization between 2015 and 2020 were retrospectively analyzed. Since July 2017, the pulse rate was regulated from 7.5 to 4 frames per second (f/s). Statistical analyses were performed to examine the correlation between pulse rate and radiation exposure. Out of the 70 procedures, 30 were performed at the standard pulse rate (7.5 f/s), and 40 were performed at the lower pulse rate (4 f/s). In the lower-pulse-rate group, the absorbed dose to the patient (AK) was 2580.7 (±217) mGy, whereas in the standard-pulse-rate group, it was 4760 (±411.1). Both the dose-area product (DAP) and AK were substantially reduced in the low pulse rate group (p = 0.000002). There was a significant correlation between DAP and AK and pulse rate (p = 0.004, p = 0.0017, respectively). Moreover, there was no significant correlation between pulse rate and perioperative complications. Our findings suggest that using a lower pulse rate (4 f/s) can effectively reduce radiation exposure during coil embolization for cerebral aneurysms while ensuring patient safety.

Abstract Background Surgical treatment of pheochromocytomas is associated with circulatory dynamics instability, necessitating systemic management of the patient in the intensive care unit after surgery. Early mobilization after pheochromocytoma surgery is not described in the guidelines, and to our knowledge, no reports have specifically focused on circulatory dynamics during early mobilization after surgery. Case presentation A 31-year-old Japanese woman was diagnosed with bilateral pheochromocytoma and underwent a second-stage adrenalectomy for bilateral pheochromocytoma at our hospital. We evaluated circulatory dynamics during a passive upright posture on postoperative days 1 and 4. She was placed on a tilt bed in the supine position (0° head) for 15 min, passive upright posture (60°) for 15 min, and supine position again for 10 min. In the passive upright posture, both systolic and diastolic blood pressure decreased, and the heart rate increased by 10 bpm over approximately 10 minutes. After the postural change from the passive upright posture to the supine position, the heart rate decreased to a level lower than in the supine prior to the passive upright posture. The same measurements were taken on postoperative day 4. Systolic blood pressure decreased in the passive upright posture, but diastolic blood pressure remained unchanged. The heart rate also increased earlier after passive upright posture compared with that on the day after surgery. When the patient returned to the supine position from the passive upright posture, the heart rate decreased even further compared with its level prior to the passive upright posture, as observed on the day after surgery. Conclusion Circulatory dynamics may fluctuate after surgery for pheochromocytoma due to a relative decrease in epinephrine and norepinephrine secretion. In this case, the patient’s response may be close to normal by the fourth postoperative day, but circulatory dynamics fluctuations were noted on both the first and fourth postoperative days when the patient was supine after passive upright posture. Although the substantial variability of perioperative circulatory dynamics in patients with pheochromocytoma has improved considerably with the development of perioperative management guidelines, circulatory dynamics should be carefully monitored during early mobilization and after its completion.

In Japan, pharmaceutical approval for the use of the da Vinci SP (dV SP) Surgical System in colorectal cancer surgery was obtained in September 2022. This system has an operating arm with three instruments and one scope to be manipulated through a single incision in colorectal cancer surgery. An 88-year-old female presented to our hospital with melena and was diagnosed with cStage IIa descending colon cancer (cT3N0M0). The patient underwent left hemicolectomy with the dV SP using an Access Port kit. The Access Port kit was inserted into a 3-cm vertical skin incision at the umbilicus. With only this surgical wound, mobilization from the rectum to the colon, and lymph node dissection were performed. Herein, we report the world's first descending colon cancer resection with the dV SP using an Access Port kit.

Canopy coverage calculated from 2D images effectively estimates several parameters, such as dry weight above the ground, stem number, and risk of lodging, without destroying the crops. This study aimed to clarify how to accurately calculate canopy coverage, regardless of environmental conditions, using various colour models and a relative depth estimation model, MiDaS. For wheat cultivated in 2022/23, the canopy coverage at the initiation of the stem elongation stage (CC30), calculated using only the HSV colour model, was overestimated because of the presence of weeds. However, when the heatmap generated using MiDaS was combined with the results extracted from the HSV colour model, it showed a CC30 similar to the accurate CC30 calculated by hand drawing, regardless of the wheat variety, sowing pattern, and location of the image taken, with an RMSE as low as 3.48. The CC30 calculated by combining the HSV colour model and MiDaS was significantly positively correlated with the number of stems, dry weight above ground, and nitrogen content above ground at the initiation of the stem elongation stage of ‘Sanukinoyume 2009’ grown in 2021/22 and 2022/23 (n = 72, r > 0.798). The combination of the HSV colour model and MiDaS effectively and accurately calculates canopy coverage regardless of environmental conditions and can be used for growth diagnosis and variable nitrogen fertiliser application after the initiation of the stem elongation stage.

In Japan, the hinotori™ Surgical Robot System obtained pharmaceutical approval for use in colorectal cancer surgery in October 2022. This system has an operating arm with eight axes, adjustable arm base, and flexible three-dimensional viewer, which are expected to be advantageous in colorectal cancer surgery. A 55-year-old man presented to our hospital with melena and was diagnosed with cStage IIA (cT3N0M0) rectal cancer. The patient underwent intersphincteric resection using hinotori™ Surgical Robot System. Appropriate port placement was available for rectal manipulation, lymph node dissection, and arm base angle adjustment. Herein, we report the world's first rectal cancer surgery using the hinotori™ Surgical Robot System with TaTME by two teams.

Introdução: A resistência a carbapenêmicos em Enterobacteriaceae (CRE) constitui uma crescente ameaça à saúde pública, particularmente em ambientes hospitalares, impulsionando a busca por alternativas terapêuticas eficientes. O transplante de microbiota fecal (TMC) surge como uma intervenção promissora, visando restaurar a flora intestinal e minimizar a dependência de antibióticos tradicionais. Objetivo: Avaliar a eficácia do TMC no controle de infecções por CRE e investigar sua capacidade de restaurar a diversidade microbiana intestinal. Método: Foi realizada uma revisão integrativa utilizando a estratégia PICo, com pesquisa nas bases de dados da Biblioteca Virtual em Saúde (BVS) e PubMed, resultando na seleção de oito estudos pertinentes que foram submetidos a análise crítica e avaliação de seu nível de evidência. Resultados: O TMC demonstrou ser eficaz no controle de infecções por CRE. Estudos como Davido et al. (2017) revelaram eficácia limitada devido ao pequeno tamanho da amostra. Huttner et al. (2019) observaram uma taxa de sucesso de 41% na descolonização, comparativamente superior aos 29% do grupo controle. Saïdani et al. (2019) relataram que 80% dos pacientes tratados com TMC eliminaram a colonização por CRE, uma taxa significativamente maior que os 10% observados no grupo controle. Lee et al. (2021) documentaram um aumento progressivo na descolonização, atingindo 90% após cinco meses. Liu et al. (2022) confirmaram a eliminação completa de CRE, com mudanças substanciais na microbiota dos pacientes. Adicionalmente, Shin et al. (2021) e Hyun et al. (2022) reportaram melhorias a longo prazo e redução na expressão de genes de resistência, respectivamente. Bar-Yoseph et al. (2021) encontraram uma eficácia de 69,2% na erradicação de CRE após um mês. Conclusão: O TMC é uma alternativa viável e sustentável para o tratamento de infecções por CRE. Sua variabilidade de eficácia, influenciada pela cepa bacteriana, técnica de administração e contexto clínico do paciente, sublinha a necessidade de pesquisas adicionais para aprimorar protocolos de tratamento e expandir a aplicação do TMC. A melhoria da comunicação sobre os benefícios e a segurança do TMC é essencial para ampliar sua aceitação e efetividade.

Background and objectives:. There has been a steady increase in the use of minimally invasive surgery, including conventional multiport laparoscopic surgery (MLS) and single-site laparoscopic surgery (SLS) for colorectal cancer. We aimed to evaluate how important the cosmetic outcome, one of the advantages of SLS, is to patients and whether SLS reflects social needs. Methods:. We used a web-based questionnaire to survey nonmedical and medical workers for what factors were considered on the assumption that respondents undergo colorectal cancer surgery and that the most important person for them undergoes. Five items (curability, safety, pain, length of hospital stay, and cosmetic outcomes) were compared. After paired photographs before and after SLS and MLS were shown, perceptions of body image and cosmesis were assessed using a visual analog scale. Results:. This study included a total of 1352 respondents (990 nonmedical and 362 medical). Curability had the highest score (49.9–53.7 points), followed by safety (23.8–24.7 points). The scores for cosmetic outcomes (6.2–7.1 points) were almost equal to those of the length of hospital stay (6.2–7.1 points), which was associated with medical costs and pain (10.0–11.1 points), one of the main reasons for fear of surgery. Participants who were female, younger, and in the nonmedical group placed great importance on cosmetic outcomes. For all questions regarding body image and cosmesis, SLS had superior scores compared with MLS. Conclusions:. Understandably, curability, and safety were most important in colorectal cancer surgery. However, medical workers should consider cosmetic outcomes, even in malignant cases.

Treatment strategies for unruptured intracranial aneurysms (UIAs) should be carefully considered with reference to rupture and complication rates. It is also important to minimize the length of hospital stay (LOS) and to ensure a high quality of medical care. In this study, we aim to clarify the factors that affect the LOS of patients treated for UIAs using the Inpatient Clinico-Occupational Database of the Rosai Hospital Group (ICOD-R). This was a nationwide-multicenter study based on ICOD-R data from 2000 to 2019. Patients diagnosed with UIAs who were treated with clipping or coiling were included in the study. Multivariate analysis was performed to identify the factors affecting LOS. LOS was also compared between groups classified by surgical procedure or treatment period. We identified 3294 patients on the database who underwent clipping or coiling of UIAs during the study period. Multivariate analysis revealed hospital admission during the early 2000s and the late 2010s, age, and treating institution to be significantly correlated with LOS (p < 0.05). There was a significant difference between the mean LOS of the clipping group (20.3 days) and the coiling group (9.65 days) (p < 0.001). Compared by treatment period, LOS significantly shortened over time. Our results suggest that the type of treatment, time of treatment, patient age, and the treating institution affect postoperative LOS for UIAs. Although coiling was found to lead to a lower average LOS than clipping, treatment selection should take the characteristics of each patient's aneurysm into consideration.

Abstract Background Pancreatic adenosquamous cell carcinoma (PASC) is a relatively rare histological type of pancreatic malignancy, and preoperative diagnosis is difficult because of its rarity. PASC accounts for 1–4% of all pancreatic cancers, and even after curative surgery, its prognosis is poorer than that of ordinary pancreatic adenocarcinoma. Pathologically, it shows glandular and squamous differentiation of cells. Complete resection is the only method to achieve a good long-term prognosis, and an increasing doubling time of PASC is considered to indicate early recurrence after surgery. Here, we report a rare case of PASC with an infected pancreatic cyst that was difficult to treat, along with a review of the literature. Case presentation A woman in her 80s with a history of breast cancer presented with pericardial pain. Computed tomography revealed a 20-mm hypovascular tumor in the body of the pancreas and a 27-mm pseudocyst. Endoscopic retrograde cholangiopancreatography showed a severe main pancreatic duct stenosis in the body of the pancreas that made cannulation impossible, and contrast media extravasation was due to pancreatic duct disruption in the pancreatic tail. Endoscopic fine-needle aspiration revealed that the tumor was a PASC. Because the patient had an infected pancreatic cyst, central intravenous nutrition and antibiotics were administered, which stabilized her general condition. She was diagnosed with resectable PASC and underwent distal pancreatectomy with lymphadenectomy. The postoperative course was uneventful. Immunohistochemical analysis of the resected specimen confirmed T2N0M0 stage IB. Systemic adjuvant chemotherapy with S-1 is ongoing. Conclusion Appropriate preoperative management and preoperative accurate staging (T2N0M0 stage IB) of PASC with curative surgery can ensure predictable outcomes.

Medicinal plants and herbal medicines are used as integrative and complementary practices to provide comprehensive care, disease prevention, health promotion, and to improve quality of life (QoL). This scoping review aimed to identify and describe the use of phytotherapy in oral health care by adults and their outcomes, with a focus on perceptions of oral health-related QoL, healthcare access, and costs. A systematic search was conducted in six databases and supplemented in grey literature. According to a PRISMA-ScR protocol and eligibility criteria, publications were assessed for final inclusion, data charting, and narrative synthesis. Out of 4124 records, 542 publications were selected for full-text reading. A total of 32 studies were included: 21 studies assessed QoL, 7 reported access issues, and 11 reported costs issues. Herbal mouthwashes to prevent or treat non-infectious oral conditions were the most frequent treatment. Efficacy of phytotherapy was usually better than placebo or control treatment. Most studies reported QoL improvement, but several instruments were used with heterogeneous results. Limited healthcare access and high costs favoured traditional folk herbal medicine in underserved populations. It can be concluded that phytotherapy for oral health is used by adults worldwide, following modern clinical pharmacology and traditional knowledge concepts. Further studies should incorporate assessment of QoL, access, and costs in addition to clinical efficacy and safety, which are complementary aspects for delivering a comprehensive and efficient health care for all people.

Bifrontal craniotomy frequently involves opening the frontal sinus and mucosal injury. We report a new technique for mucosal repair in the frontal sinus using surgical titanium microclips. Six consecutive patients who underwent bifrontal craniotomy with frontal sinus exposure and mucosal injury underwent mucosal repair using surgical titanium microclips between April 2019 and August 2022. In all cases, the frontal sinus mucosa was peeled from the inner walls of the frontal sinus to ensure sufficient mucosal margin for clipping using ORBEYE. The repair was accomplished with the microclips in all cases. We also sealed the mucosal wound using fibrin glue and sufficiently filled the frontal sinus with bone debris, resulting in zero incidence of postoperative liquorrhea in all cases. Repairing the mucosa using surgical titanium microclips using ORBEYE may be a simple and quick technique when the frontal sinus mucosa is injured during craniotomy.

Objective: The risk factors of procedural cerebral ischemia (CI) in ruptured middle cerebral artery (MCA) aneurysms are unclear. This study proposed the neck-branching angle (NBA), a simple quantitative indicator of the aneurysm neck and branch vessels, and analyzed its usefulness as a predictor of procedural CI in ruptured MCA aneurysms. Methods: We retrospectively analyzed 128 patients with ruptured saccular MCA aneurysms who underwent surgical or endovascular treatment between January 2014 and June 2021. We defined the NBA as the angle formed by the MCA aneurysm neck and M2 superior or inferior branch vessel line. The superior and inferior NBA were measured on admission via three-dimensional computed tomography angiography on admission. We divided the patients into clipping (106 patients) and coiling (22 patients) groups according to the treatment. Risk factors associated with procedural CI were analyzed in each group. Results: Both groups showed that an enlarged superior NBA was a significant risk factor for procedural CI (clipping, P

Cohesive soils in nature are created under anisotropic stress and have various stress histories. Embankments generate greater vertical loads underground. Moreover, associated excavation activities can exacerbate the extensional stress state. This study investigated the effects of induced anisotropy on the shear modulus in saturated and unsaturated cohesive soils. A triaxial testing apparatus, equipped with local small strain (LSS) measurement devices and bender elements (BEs), was used to measure the small strain shear modulus. Two series of tests were conducted: (1) LSS and BE tests used specimens normally consolidated under a constant mean effective stress of p’ = 300 kPa or net mean stress pnet = 300 kPa with different stress ratios to investigate the effects of anisotropic consolidation. The values of the applied stress ratios, represented as K = σ'h/ σ'v for the saturated soil and Knet = (σh–ua)/(σv–ua) for the unsaturated soil, were 0.35, 0.43, 0.6, 0.8, 1.0, 1.5, 2.0, 3.0, and 3.5. (2) BE tests used specimens consolidated under various mean effective stresses in the order of p’ = 50, 100, 200, 300, 400, 500, and 600 kPa, and swollen in reverse order under K of 0.35, 0.43, 0.6, and 1.0, to elucidate p’ and the effects of the overconsolidation ratio (OCR). The results demonstrated that K-consolidation under constant p’ produces large differences in initial shear modulus G0 in saturated cohesive soil, but Knet produces only slight differences in unsaturated cohesive soil because of the influence of strong matric suction. Finally, G0 was normalized successfully considering the effects of void ratio e, K, and OCR.

A 47-year-old man had localized pulmonary edema (LPE) and a massive pulmonary embolism. The cause of LPE was believed to be a high blood supply to the spared pulmonary artery territories without a thrombus. The patient was successfully treated with unfractionated heparin and thrombolytic agents.