Comparison of weighed food record procedures for the reference methods in two validation studies of food frequency questionnaires

Background: Although open-ended dietary assessment methods, such as weighed food records (WFRs), are generally considered to be comparable, differences between procedures may influence outcome when WFRs are conducted independently. In this paper, we assess the procedures of WFRs in two studies to describe their dietary assessment procedures and compare the subsequent outcomes. Methods: WFRs of 12 days (3 days for four seasons) were conducted as reference methods for intake data, in accordance with the study protocol, among a subsample of participants of two large cohort studies. We compared the WFR procedures descriptively. We also compared some dietary intake variables, such as the frequency of foods and dishes and contributing foods, to determine whether there were differences in the portion size distribution and intra- and inter-individual variation in nutrient intakes caused by the difference in procedures. Results: General procedures of the dietary records were conducted in accordance with the National Health and Nutrition Survey and were the same for both studies. Differences were seen in 1) selection of multiple days (non-consecutive days versus consecutive days); and 2) survey sheet recording method (individual versus family participation). However, the foods contributing to intake of energy and selected nutrients, the portion size distribution, and intra- and inter-individual variation in nutrient intakes were similar between the two studies. Conclusion: Our comparison of WFR procedures in two independent studies revealed several differences. Notwithstanding these procedural differences, however, the subsequent outcomes were similar

トウイン ニオケル キョウクウ キョウカ ショクドウ セツジョ ノ ドウニュウ ト タンキ チリョウ セイセキ ノ ケントウ

【背景】食道癌に対する胸腔鏡手術は本邦で広く行われており、施設ごとに手術手技の定型化がなされている.胸腔鏡下手術の利点として拡大視効果や緻密な手術操作が可能となることが挙げられるが、当院でも2016年より腹臥位胸腔鏡下食道手術を導入し、出血の少ない安全かつ確実な郭清を目指し、定型化に向けてその手技を刷新している.【対象と方法】】2016年4月から2019年4月までに当院で施行した胸腔鏡下食道切除38例につき、その短期成績を検討した.【結果】男:女＝32:6、年齢中央値 66歳(41-76)、cStage I / II / III / IVa: 17 / 6 / 13 / 2であった.胸腔内出血量中央値は10ml(0-53)、胸部操作時間中央値は192分(97-478)、胸腔内郭清リンパ節個数中央値は17個(1-42)であった.術後合併症は、縫合不全3例(7.9％)、反回神経麻痺7例(18.4％)、肺炎12例(31.6％)であった.術後在院日数中央値は19日(11-38)であった.導入期からの前半19例では反回神経麻痺を6例(31.6％)に認めたが、後半19例では１例(5.2％)であった(p=0.036).【結語】当院における胸腔鏡下食道切除術は安全に導入、施行可能であった.手術手技が定型化されることで反回神経麻痺を少なくする郭清が可能になると考えられた.Background: Thoracoscopic esophagectomy (TE) is increasingly being used worldwide in patients with esophageal cancer. In this study, we investigated the clinical short-term outcomes of TE performed in patients placed in the prone position. Method: We investigated the surgical and clinical outcomes in 38 patients with esophageal cancer who underwent TE at our hospital between April 2016 and April 2019. Results: Of the 39 patients investigated, 32 were men. Median patient age was 66 (range 41–76) years, the median intraoperative blood loss was 10 (0–53) mL, and the median operation time for thoracoscopy was 192 (97–478) min. The mean operation time for thoracoscopy in the latter group was significantly shorter than that in the former group (188 min vs. 232 min, p=0.013). The following postoperative complications were observed: 7 (18.4%) cases of recurrent nerve palsy, 3 (7.9%) cases of anastomotic leakage, 12 (31.6%) cases of pneumonia, and 0 (0%) cases of chylothorax. The incidence of recurrent nerve palsy was lower in the latter group than in the former group (5.2% vs. 31.6%, p=0.036). Conclusions: TE in the prone position is safe and feasible. As experience performing the procedure increases, the performance of the procedure stabilizes

The whole blood transcriptional regulation landscape in 465 COVID-19 infected samples from Japan COVID-19 Task Force

「コロナ制圧タスクフォース」COVID-19患者由来の血液細胞における遺伝子発現の網羅的解析 --重症度に応じた遺伝子発現の変化には、ヒトゲノム配列の個人差が影響する--. 京都大学プレスリリース. 2022-08-23.Coronavirus disease 2019 (COVID-19) is a recently-emerged infectious disease that has caused millions of deaths, where comprehensive understanding of disease mechanisms is still unestablished. In particular, studies of gene expression dynamics and regulation landscape in COVID-19 infected individuals are limited. Here, we report on a thorough analysis of whole blood RNA-seq data from 465 genotyped samples from the Japan COVID-19 Task Force, including 359 severe and 106 non-severe COVID-19 cases. We discover 1169 putative causal expression quantitative trait loci (eQTLs) including 34 possible colocalizations with biobank fine-mapping results of hematopoietic traits in a Japanese population, 1549 putative causal splice QTLs (sQTLs; e.g. two independent sQTLs at TOR1AIP1), as well as biologically interpretable trans-eQTL examples (e.g., REST and STING1), all fine-mapped at single variant resolution. We perform differential gene expression analysis to elucidate 198 genes with increased expression in severe COVID-19 cases and enriched for innate immune-related functions. Finally, we evaluate the limited but non-zero effect of COVID-19 phenotype on eQTL discovery, and highlight the presence of COVID-19 severity-interaction eQTLs (ieQTLs; e.g., CLEC4C and MYBL2). Our study provides a comprehensive catalog of whole blood regulatory variants in Japanese, as well as a reference for transcriptional landscapes in response to COVID-19 infection

ノウホウナイ シュッケツ ニ トモナイ シンゴウ キョウド ノ コトナッタ タボウセイ ノウホウ オ テイシタ スイショウエキセイ ノウホウ センシュ ノ 1レイ

症例は33歳，女性．経時的に増大する膵体部嚢胞性病変を認めた．MRIではT1強調画像で低信号を呈する部位とT1強調画像で淡い高信号を呈する，信号強度の異なる大小不同の多房性嚢胞性病変を認め，MRCPおよび超音波内視鏡検査で主膵管拡張および腫瘍と主膵管との交通が疑われた．以上よりmixed typeの膵漿液性嚢胞腺腫を疑ったが粘液性嚢胞腺腫や膵管内乳頭粘液性腫瘍を否定できず，腹腔鏡下脾温存膵体尾部切除術を施行した．病理組織学的検査所見では卵巣様間質は認めず，主膵管交通も認めず，mixed typeの膵漿液性嚢胞腺腫と診断した．膵漿液性嚢胞腺腫は漿液性嚢胞液を有するが，異なった信号強度を呈する多房性嚢胞を有するものはまれである．今回われわれは，信号強度の異なった多房性嚢胞を呈した膵漿液性嚢胞腺腫の1例を経験したので報告する．A 33-year-old woman presented at our hospital with cystic tumor increased over time at pancreatic body. Magnetic resonance image revealed multilocular cysts with different signal intensities, which were mixed to low and slightly high intensities in T1 weighted image. Moreover, the connection of the cyst and main pancreatic duct was suspected by magnetic resonance cholangiopancreatography and endoscopic ultrasonography. We diagnosed as mixed-type serous cystadenoma, yet we could not contradict mucinous cystadenoma and intraductal papillary mucinous neoplasm. Therefore, we performed laparoscopic spleen preserved distal pancreatectomy. Histopathological findings revealed mixed-type serous cystadenoma, and the connection of the cyst and main pancreatic duct was not seen. Serous cystadenoma usually has serous discharge in the cyst and shows uniform signal intensity in the image findings. However, serous cystadenoma with different signal intensities in the multilocular cysts is relatively rare. We described a case of serous cystadenoma of the pancreas with different signal intensities in the multilocular cysts that was treated by laparoscopic surgery

カンサイボウガン ト カンベツ ガ コンナンデアッタ カンケッカンキン シボウシュ ノ １レイ

肝原発の血管筋脂肪腫（angiomyolipoma; AML）は、肝細胞癌と鑑別が困難な場合がある。今回、単発の肝腫瘍に対して肝細胞癌を否定できず切除を行ったが、病理組織学的検査でAMLと診断した一例を経験したので報告する。症例は50歳代の女性。検診にて外側区域の肝腫瘍を指摘され、加療目的に紹介となった。造影CT検査では肝外側区域、門脈臍部に接して2cm大の腫瘍性病変を認め、動脈相で濃染し平衡相でwashoutしていた。腹部MRI検査では同部位にT2強調像で高信号、T1 out of phaseにて若干の信号低下を認めた。Gadolinium-ethoxybenzyl-diethylene-triaminepentaacetic-acid(Gd-EOB-DTPA; EOB) MRIでは動脈相で濃染、門脈相から平衡相にかけてwashoutし、肝細胞相では低信号であった。画像所見から肝細胞癌を疑い、腹腔鏡下肝左葉切除術を施行した。病理組織学的には好酸性紡錘形細胞や淡明～淡好酸性細胞の上皮様配列がみられ、内部に脂肪組織が島状に介在し、また、平滑筋性の厚い壁を持った血管構造も一部存在しており、肝血管筋脂肪腫と診断した。一般に脂肪成分の少ないAMLは、肝細胞癌との鑑別が困難である。最近では、肝静脈への流出血管の有無が鑑別診断に有用であるとの報告が見られるため、これらを注意深く観察すべきと考えられた。Hepatic angiomyolipoma (AML) may be difficult to distinguish from hepatocellular carcinoma. Here we report a resected case of a hepatic AML mimicking hepatocellular carcinoma. The patient was a woman in her 50s referred for further evaluation of a tumor in the left lateral segment of the liver. Contrast-enhanced computed tomography showed a two cm-sized tumor attached with the umbilical portion in the left lateral segment of the liver, which was enhanced in the arterial phase and washed out in the portal venous phase. Abdominal MRI showed a high-intensity tumor on T2-weighted image and a slight decrease of signal intensity on T1 out of phase. The tumor on Gd-EOB-DTPA enhanced MRI displayed high intensity in the arterial phase and washout in the portal venous phase, and low signal intensity in hepatobiliary phase. Based on these imaging findings, we suspected hepatocellular carcinoma and a laparoscopic left lobectomy was performed. Histopathological examination showed spindle and perivascular epithelioid cells and a few fat cells, and immunohistochemical analysis revealed positive staining of HMB-45 and αSMA. The tumor was diagnosed as a hepatic AML. Hepatic AML with a small fatty component is generally difficult to distinguish from hepatocellular carcinoma. More recently, the presence of outflow blood vessels to the hepatic vein has been reported to be useful in the differential diagnosis for AML. These imaging findings should be carefully observed

DOCK2 is involved in the host genetics and biology of severe COVID-19

「コロナ制圧タスクフォース」COVID-19疾患感受性遺伝子DOCK2の重症化機序を解明 --アジア最大のバイオレポジトリーでCOVID-19の治療標的を発見--. 京都大学プレスリリース. 2022-08-10.Identifying the host genetic factors underlying severe COVID-19 is an emerging challenge. Here we conducted a genome-wide association study (GWAS) involving 2, 393 cases of COVID-19 in a cohort of Japanese individuals collected during the initial waves of the pandemic, with 3, 289 unaffected controls. We identified a variant on chromosome 5 at 5q35 (rs60200309-A), close to the dedicator of cytokinesis 2 gene (DOCK2), which was associated with severe COVID-19 in patients less than 65 years of age. This risk allele was prevalent in East Asian individuals but rare in Europeans, highlighting the value of genome-wide association studies in non-European populations. RNA-sequencing analysis of 473 bulk peripheral blood samples identified decreased expression of DOCK2 associated with the risk allele in these younger patients. DOCK2 expression was suppressed in patients with severe cases of COVID-19. Single-cell RNA-sequencing analysis (n = 61 individuals) identified cell-type-specific downregulation of DOCK2 and a COVID-19-specific decreasing effect of the risk allele on DOCK2 expression in non-classical monocytes. Immunohistochemistry of lung specimens from patients with severe COVID-19 pneumonia showed suppressed DOCK2 expression. Moreover, inhibition of DOCK2 function with CPYPP increased the severity of pneumonia in a Syrian hamster model of SARS-CoV-2 infection, characterized by weight loss, lung oedema, enhanced viral loads, impaired macrophage recruitment and dysregulated type I interferon responses. We conclude that DOCK2 has an important role in the host immune response to SARS-CoV-2 infection and the development of severe COVID-19, and could be further explored as a potential biomarker and/or therapeutic target