Coronary perfusion balloon for acute MCO

Background: We present the case of an individual with acute occlusion of the middle cerebral artery caused by atherosclerosis. The patient underwent angioplasty using a coronary perfusion balloon, which resulted in a favorable clinical outcome. Case Description: A 66-year-old male patient presented with an acute onset of right hemiplegia and dysarthria. Magnetic resonance imaging revealed an occlusion of the left middle cerebral artery, and alteplase was administered, followed by a mechanical thrombectomy and intracranial balloon catheter angioplasty. Due to restenosis, a coronary perfusion balloon catheter was used for a 15-minute angioplasty procedure while maintaining the perfusion. This treatment approach led to the recanalization of the artery and favorable clinical outcomes. Conclusion: The coronary perfusion balloon may represent a viable therapeutic alternative for the management of refractory intracranial atherosclerotic large vessel occlusion

Survey of iodine-125 seed assays in Japan

In conducting dosimetric assays of seed sources containing iodine-125 (125I), several major guidelines require the medical physicist to verify the source strength before patient treatment. Japanese guidelines do not mandate dosimetric assays at medical facilities, but since 2017, three incidents have occurred in Japan wherein seeds with incorrect strengths were delivered to medical facilities. Therefore, this study aimed to survey the current situation and any barriers to conducting the dosimetric assay of iodine-125 seeds at medical facilities in Japan. We conducted a questionnaire-based survey from December 2020 to April 2021, to examine whether seed assay and verification of the number of seeds delivered were being performed. We found that only 9 facilities (16%) performed seed assay and 28 (52%) verified the number of seeds. None of the facilities used an assay method that ensured traceability. The reasons for not performing an assay were divided into two categories: lack of resources and legal issues. Lack of resources included lack of instruments, lack of knowledge of assay methods, shorthand, or all of the above, whereas legal issues included the inability to resterilize iodine-125 seeds distributed in Japan and/or purchase seeds dedicated to the assay. Dosimetric assays, including simple methods, are effective in detecting calibration date errors and non-radioactive seeds. The study findings suggest that familiarization of medical personnel with these assay methods and investigation of the associated costs of labor and equipment should be recommended, as these measures will lead to medical reimbursement for quality assurance

LAMC2 as a predictive biomarker in PDAC

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal malignancies. While the extracellular matrix (ECM) components plays an integral role in PDAC pathogenesis and mediating chemoresistance, its role in predicting response to chemotherapy in PDAC patients remains unclear. METHODS: We performed a systematic biomarker discovery by analyzing genomewide transcriptomic profiling data from 423 patients (GSE71729, GSE21501 and TCGA) for predicting overall survival (OS). This was subsequently validated in two independent clinical cohorts of 270 PDAC patients (training cohort; n=121 and validation cohort; n=149). In addition, we investigated EUS-FNA biopsy specimens from 51 PDAC patients with an unresectable cancer for predicting therapeutic response to gemcitabine-based therapy. RESULTS: Following rigorous bioinformatic analysis, we identified LAMC2 to be a significant prognostic factor in all three PDAC datasets (GSE71729, HR=2.04, P=0.002; GSE21501, HR=2.17, P=0.031; TCGA, HR=2.57, P<0.001). High LAMC2 expression in PDAC patients associated with a significantly poor OS and relapse-free survival (RFS) in both training (P<0.001, P<0.001) and validation cohorts (P=0.001, P=0.003). More importantly, LAMC2 expression robustly identified PDAC patients with unresectable disease and those who responded to gemcitabine-based therapy (AUC= 0.79; 95%CI, 0.65-0.89). The univariate logistic regression analysis revealed that high LAMC2 expression was the only factor that predicted poor response to gemcitabine in PDAC patients (Odds Ratio [OR]=4.90; 95% CI, 1.45-16.6; P=0.011). CONCLUSION: We conclude that LAMC2 is a novel prognostic and predictive biomarker for gemcitabine-based therapy in both adjuvant and palliative setting; which could have significant impact in precision and individualized treatment of PDAC patients

Cross-Sectional and Longitudinal Associations between Skin Autofluorescence and Tubular Injury Defined by Urinary Excretion of Liver-Type Fatty Acid-Binding Protein in People with Type 2 Diabetes

It has previously been unclear whether the accumulation of advanced glycation end products, which can be measured using skin autofluorescence (SAF), has a significant role in diabetic kidney disease (DKD), including glomerular injury and tubular injury. This study was therefore carried out to determine whether SAF correlates with the progression of DKD in people with type 2 diabetes (T2D). In 350 Japanese people with T2D, SAF values were measured using an AGE Reader®, and both urine albumin-to-creatinine ratio (uACR), as a biomarker of glomerular injury, and urine liver-type fatty acid-binding protein (uLFABP)-to-creatinine ratio (uL-FABPCR), as a biomarker of tubular injury, were estimated as indices of the severity of DKD. Significant associations of SAF with uACR (p < 0.01), log-transformed uACR (p < 0.001), uL-FABPCR (p < 0.001), and log-transformed uL-FABPCR (p < 0.001) were found through a simple linear regression analysis. Although SAF was positively associated with increasing uL-FABPCR (p < 0.05) and increasing log-transformed uL-FABPCR (p < 0.05), SAF had no association with increasing uACR or log-transformed uACR after adjusting for clinical confounding factors. In addition, the annual change in SAF showed a significant positive correlation with annual change in uL-FABPCR regardless of confounding factors (p = 0.026). In conclusion, SAF is positively correlated with uL-FABP but not with uACR in people with T2D. Thus, there is a possibility that SAF can serve as a novel predictor for the development of diabetic tubular injury

Pulmonary Arterial Hypertension in Neurofibromatosis Type 1 : A Case with a Novel NF1 Gene Mutation

Neurofibromatosis type 1 (NF1) is an autosomal dominant multi-organ disease. The clinical manifestations include not only skin lesions and malignant tumors but also lung complications, including pulmonary arterial hypertension (PAH). However, the association between gene mutations in NF1 and the occurrence of PAH has not yet been elucidated. We herein report a case of isolated PAH in a 67-year-old woman with NF1, presumably caused by a novel heterozygous mutation, c.4485_4486delinsAT (p.Lys1496Ter), in the NF1 gene

Brain response during silent and oral reading

This study aimed to investigate blood flow dynamics in the bilateral prefrontal cortex during silent and oral reading using near-infrared spectroscopy (NIRS). The subjects were 40 right-handed university students (20.5 ± 1.8 years old, 20 men and 20 women). After completing the NIRS measurements, the subjects were asked to rate their level of proficiency in silent and oral reading, using a 5-point Likert scale. During oral reading, the left lateral prefrontal cortex (Broca’s area) was significantly more active than the right side. During silent reading, prefrontal cortex activity was lower than that during oral reading, and there was no significant difference between both sides of the brain. A significant negative correlation was found between the change in oxy-hemoglobin (oxy-Hb) concentration in the left and right lateral prefrontal cortex during silent reading and silent reading speed. In addition, students with lower self-reported reading proficiency had significantly greater changes in oxy-Hb concentrations in the left and right lateral prefrontal cortex during silent/oral reading than did students with higher self-reported reading proficiency. Reading task assessment using NIRS may be useful for identifying language lateralization and Broca’s area. The results demonstrate that NIRS is useful for assessing effortful reading and may be used to diagnose developmental dyslexia in children

グリーンインフラに必要な生態学的視点

近年、日本では、急速な人口減少が進む中、自然災害の頻発化、地域経済の停滞、新型コロナウィルス感染症の流行等、様々な社会課題が顕在化している。一方で、SDGs や生物多様性保全に対する社会的関心が高まり、企業経営や事業活動と自然資本の関わりに注目が集まっている。このような状況を受けて、グリーンインフラ、NbS（自然を活用した解決策）、Eco-DRR（生態系を活用した防災減災）、EbA（生態系を活用した気候変動適応）、地域循環共生圏等、自然の資源や機能を活用した社会課題解決に関する概念が幅広い行政計画において取り上げられている。本稿では、日本生態学会の生態系管理専門委員会の委員によりグリーンインフラ・NbS に関する国内外の動向や、これらの考え方を整理するとともに、自然の資源や機能を持続的・効果的に活用するためのポイントを生態学的な観点から議論した。さらに、地域計画や事業の立案・実施に関わる実務家や研究者に向けた「グリーンインフラ・NbS の推進において留意すべき 12 箇条」を提案した。基本原則：1）多様性と冗長性を重視しよう、2）地域性と歴史性を重視しよう。生態系の特性に関する留意点：3）生態系の空間スケールを踏まえよう、4）生態系の変化と動態を踏まえよう、5）生態系の連結性を踏まえよう、6）生態系の機能を踏まえよう、7）生態系サービスの連関を踏まえよう、8）生態系の不確実性を踏まえよう。管理や社会経済との関係に関する留意点：9）ガバナンスのあり方に留意しよう、10）地域経済・社会への波及に留意しよう、11）国際的な目標・関連計画との関係に留意しよう、12）教育・普及に留意しよう。Recently, Japan has faced social challenges that include a rapidly shrinking population, frequent natural disasters, the stagnation of local economies, and the COVID-19 pandemic. Simultaneously, growing social interest in sustainable development goals and biodiversity conservation has drawn attention to the relationship between corporate management and natural capital. In response, many administrative plans feature concepts related to addressing societal challenges by utilising natural resources and functions, such as green infrastructure, nature-based solutions (NbS), ecosystem-based disaster risk reduction (Eco-DRR), eco- system-based adaptation to climate change (EbA) and the Regional Circular and Ecological Sphere. By summarising domestic and international trends related to these concepts, The Committee for Ecosystem Management of the Ecological Society of Japan discussed key points for sustainable, effective utilisation of natural resources and functions from an ecological perspective and identified 12 points for practitioners and researchers involved in regional planning and project implementation to keep in mind when promoting green infrastructure/NbS. Two basic principles emphasise: "diversity and redundancy" and "regional and his- torical characteristics". Six points cover the characteristics of ecosystems: "the spatial scale of the ecosystem"; and the "changes and dynamics", "connectivity", "functions", and "linkage of ecosystem services"; and "uncertainties" of ecosystems. The remain-ing four points concern the relationships between management and socio-economy, and focus on "the state of governance", "impacts to the local economy and society", "relationship with international goals and related plans" and "education and dis-semination"

Si PHOTONIC-INTEGRATED CHIP ASSEMBLY WITH WAVEGUIDE Ge AVALANCHE PHOTODIODE

The receiving characteristics of the silicon photonic-integrated chip assembly consisting of transimpedance amplifiers and butt-joint waveguide germanium avalanche photodiodes with lateral separated absorption and multiplication (SAM) structures were demonstrated based on conventional complementary metal-oxide-semiconductor processes. We experimentally verified a clear open eye diagram at 10 Gbps with a reverse bias of 17 V. Receiving sensitivities of −22.8 dBm and −22.0 dBm were obtained for the best and worst polarizations, respectively, with optical signals that had wavelengths longer than those of the absorption edges of Ge at a bit rate of 10 Gbps and a wavelength of 1600 nm. The proposed waveguide butt-joint germanium avalanche photodiodes with lateral SAM structures can be used to receive long wavelengths of downstream signals with low polarization dependence in next-generation optical access network systems