The potential hazard of a non-slip element balloon causing distal longitudinal stent deformation: the first clinical experience and in vitro assessment

Background: A new complication, longitudinal stent deformation (LSD), is increasingly reported withrecent intracoronary stent designs. There have been experiences of unusual cases of distal LSD causedby entrapment of a Lacrosse® non-slip element (NSE) balloon (Goodman Co., Ltd., Nagoya, Japan),which has three flexible nylon elements to prevent slippage. Accordingly, the aim of this study is to reportthe clinical experience of distal LSD caused by the NSE in the documented center and to investigate theincidence and mechanisms involved.Methods: Coronary intervention cases were retrospectively reviewed using the NSE balloon in hospitalbetween May 2014 and June 2017. In bench testing, distal LSD was reproduced in a silicon tube modelto identify its mechanism.Results: A total of 95 patients with 107 lesions underwent coronary interventions with NSE. Of these,72 lesions (12 de-novo lesions and 60 in-stent restenosis) were treated using in-stent dilatation. Twodistal LSD cases occurred, representing an incidence of 2.78% (2/72) among all procedures; 16.7%(2/12) of the de-novo lesions developed LSD. In vitro experimentation allowed indentification of themechanisms involved and bailout strategies.Conclusions: This is the first study to evaluate NSE balloon catheter entrapment complicated by distalLSD in which reconstruction of the deformed stent and retrieval of the NSE could be achieved successfully.There is a potential hazard for distal LSD during post-dilatation using the NSE balloon due to itsstructural characteristics. Careful assessment is needed to prevent this complication

Impact of Immediate Breast Reconstruction on Survival of Breast Cancer Patients: A Single-Center Observational Study

Although immediate breast reconstruction following mastectomy has become increasingly common, its oncological safety has been debated. We enrolled patients with breast cancer who underwent surgery at Okayama University Hospital between 2007 and 2013. The primary outcome was relapse-free survival (RFS). Secondary outcomes were overall survival and the duration from the surgery to the initiation of adjuvant chemotherapy. We divided into immediate breast reconstruction, mastectomy alone, and breast conservative surgery groups. Outcomes were compared using Cox’s regression analysis. A total of 614 patients were included (reconstruction: 125, mastectomy: 128, breast conservative surgery: 361). The median follow-up duration was 79.0±31.9 months. The immediate-reconstruction patients were younger, had more lymph node metastases, and more often received postoperative chemotherapy. The RFS was better after the breast conservative surgery compared to after reconstruction (hazard ratio 0.33, 95% confidence interval: 0.144-0.763). The proportion of local recurrence was highest in the reconstruction group. No patients in the reconstruction group underwent postoperative radiation therapy. However, reconstruction did not affect overall survival or the time to the initiation of adjuvant chemotherapy. Surgeons should explain the risks of breast reconstruction to their patients preoperatively. Careful long-term follow-up is required after such procedures

Design and lyophilization of lipid nanoparticles for mRNA vaccine and its robust immune response in mice and nonhuman primates

mRNA and lipid nanoparticles have emerged as powerful systems for the preparation of vaccines against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The emergence of novel variants or the necessity of cold chain logistics for approved mRNA vaccines undermines the investigation of next-generation systems that could preserve both potency and stability. However, the correlation between lipid nanoparticle composition and activity is not fully explored. Here, we screened a panel of ionizable lipids in vivo and identified lead lipid nanoparticles with a branched-tail lipid structure. Buffer optimization allowed the determination of lyophilization conditions, where lipid nanoparticle-encapsulated mRNA encoding SARS-CoV-2 spike protein could induce robust immunogenicity in mice after 1 month of storage at 5°C and 25°C. Intramuscularly injected lipid nanoparticles distributed in conventional dendritic cells in mouse lymph nodes induced balanced T helper (Th) 1/Th2 responses against SARS-CoV-2 spike protein. In nonhuman primates, two doses of 10 or 100 μg of mRNA induced higher spike-specific binding geometric mean titers than those from a panel of SARS-CoV-2-convalescent human sera. Immunized sera broadly inhibited the viral entry receptor angiotensin-converting enzyme 2 (ACE2) from binding to the spike protein in all six strains tested, including variants of concern. These results could provide useful information for designing next-generation mRNA vaccines

健常人におけるA1型とA2型のボツリヌス神経毒素の電気生理学的検査による比較

Botulinum neurotoxin type A1 (BoNTs/A1) and type B (BoNT/B) have been used for treating hyperactive muscle contractions. In the present study, we compared the effect of botulinum neurotoxin subtype A2 (6.5 mouse LD50 units A2 neurotoxin, A2NTX) and onabotulinumtoxinA (10 mouse LD50 units BoNT/A1 product) by measuring the compound muscle action potentials (CMAPs) before and after administration. In total, 8 healthy subjects were examined in the present study. A2NTX was injected into the extensor digitorum brevis (EDB) muscle, followed by onabotulinumtoxinA injection into the contralateral EDB muscle after 16 weeks. The CMAP amplitudes from the EDB, abductor hallucis (AH), and abductor digiti minimi pedis (ADM) muscles were measured after each BoNT injection on days 1, 3, 7, 14, 28, 56, 84, and 112 to assess the effect of the toxin. On day 14, both A2NTX and onabotulinumtoxinA produced an approximately 70% decline in EDB CMAP amplitude compared to the baseline values; significant reduction of the CMAP continued through day 112. The CMAP amplitudes from neighboring muscles (AH and ADM) remained intact throughout the study period, except for a slight but significant drop at day 28 after onabotulinumtoxinA injection compared to A2NTX. The current findings indicate that small doses (6.5 units and 10 units) of A2NTX and onabotulinumtoxinA have at least comparable onset and duration of action, although similar clinical effects were obtained with lower dose using A2NTX

Subserosal Inflammatory Pseudotumor Causing Intussusception

We present an adult case of intussusception caused by subserosal inflammatory pseudotumor of the terminal ileum. Enteric intussusception was diagnosed by characteristic Xray finding, so called "beak-like" filling defect in the terminal ileum. An exploratory laparotomy revealed focal subserosal thickening in the terminal ileum, and partial ileocolectomy was performed. Microscopically, we identified a pseudotumor that extended through the muscularis propria into serosa. The pseudotumor was composed of fibrous stroma and chronic inflammatory cells with calcification

Japanese multicenter database of healthy controls for [¹²³I]FP-CIT SPECT

Purpose: The aim of this multicenter trial was to generate a [¹²³I]FP-CIT SPECT database of healthy controls from the common SPECT systems available in Japan. Methods: This study included 510 sets of SPECT data from 256 healthy controls (116 men and 140 women; age range, 30–83 years) acquired from eight different centers. Images were reconstructed without attenuation or scatter correction (NOACNOSC), with only attenuation correction using the Chang method (ChangACNOSC) or X-ray CT (CTACNOSC), and with both scatter and attenuation correction using the Chang method (ChangACSC) or X-ray CT (CTACSC). These SPECT images were analyzed using the Southampton method. The outcome measure was the specific binding ratio (SBR) in the striatum. These striatal SBRs were calibrated from prior experiments using a striatal phantom. Results: The original SBRs gradually decreased in the order of ChangACSC, CTACSC, ChangACNOSC, CTACNOSC, and NOACNOSC. The SBRs for NOACNOSC were 46% lower than those for ChangACSC. In contrast, the calibrated SBRs were almost equal under no scatter correction (NOSC) conditions. A significant effect of age was found, with an SBR decline rate of 6.3% per decade. In the 30–39 age group, SBRs were 12.2% higher in women than in men, but this increase declined with age and was absent in the 70–79 age group. Conclusions: This study provided a large-scale quantitative database of [¹²³I]FP-CIT SPECT scans from different scanners in healthy controls across a wide age range and with balanced sex representation. The phantom calibration effectively harmonizes SPECT data from different SPECT systems under NOSC conditions. The data collected in this study may serve as a reference database

Overview of the Nishinoshima comprehensive scientific research project, in 2021

小笠原諸島の西之島は2013年から2021年までに5度の噴火で元の陸地は全域が溶岩に覆われ、火山灰が堆積して大地がリセットされた。この島は太平洋上に孤立し、最寄の陸地から130kmも隔離された無人島であることから、海洋島における生態系の一次遷移を人為的影響のない状態で観察できる世界に例のない場所と言える。生物、地質及び火山活動における網羅的な分野の調査を噴火直後から実施することで、火山島の形成過程、噴火による生物相への影響、新たな遷移の開始時点の状況等を把握することができる。そこで、西之島の自然環境の最新情報を記録して科学的価値を評価するための総合学術調査が企画され、2019年調査に続き、2021年7月、9月の2度にわたり、モニタリング調査を実施した。新規に海域調査を実施したほか、UAVやAUVを活用した新規の調査も取り入れた。本調査は環境省とともに、東京大学及び日本放送協会との連携により行われている。調査の実施に当たっては、火山活動が活発な島における安全管理には十分配慮したほか、調査による人為的な影響を最小限に抑えるため、外来生物の侵入を防止するための検疫を徹底した。Nishinoshima Island in the Ogasawara Islands has erupted five times between 2013 and 2021. The entire original land area was covered by lava, as well as by thick deposits of volcanic ash that have reset the land surface. As an uninhabited island isolated in the Pacific Ocean and 130 km apart from the nearest land, it offers an unique opportunity to observe primary succession on an oceanic island without human impacts. Thus, it is important to conduct comprehensive field surveys on its biota, geology and volcanic activities immediately after the eruption in order to understand the formation process of the volcanic island, the impact of the eruption on the biota, and the situations at the start of primary succession. Therefore, a comprehensive scientific survey was planned to record the latest information on the nature of Nishinoshima Island and assess its scientific value. It was conducted twice, in July and September 2021, following the 2019 survey. This is the first survey of marine biota around Nishinoshima Island, and UAVs and AUVs were also actively used to conduct the survey safely during volcanic activity. The survey was carried out in collaboration with the Ministry of the Environment, the University of Tokyo and the Japan Broadcasting Corporation (NHK). In carrying out the survey, sufficient attention was paid to safety management on the volcanically active island, and quarantine was also strictly enforced as a measure to prevent the invasion of alien species in order to eliminate any human impact of the survey.departmental bulletin pape

Recent Progress in the Study of Peroxiredoxin in the Harmful Algal Bloom Species <i>Chattonella marina</i>

Peroxiredoxin (Prx) is a relatively recently discovered antioxidant enzyme family that scavenges peroxides and is known to be present in organisms from biological taxa ranging from bacteria to multicellular eukaryotes, including photosynthetic organisms. Although there have been many studies of the Prx family in higher plants, green algae, and cyanobacteria, few studies have concerned raphidophytes and dinoflagellates, which are among the eukaryotic algae that cause harmful algal blooms (HABs). In our proteomic study using 2-D electrophoresis, we found a highly expressed 2-Cys peroxiredoxin (2-CysPrx) in the raphidophyte Chattonella marina var. antiqua, a species that induces mass mortality of aquacultured fish. The abundance of the C. marina 2-CysPrx enzyme was highest in the exponential growth phase, during which photosynthetic activity was high, and it then decreased by about a factor of two during the late stationary growth phase. This pattern suggested that 2-CysPrx is a key enzyme involved in the maintenance of high photosynthesis activity. In addition, the fact that the depression of photosynthesis by excessively high irradiance was more severe in the 2-CysPrx low-expression strain (wild type) than in the normal-expression strain (wild type) of C. marina suggested that 2-CysPrx played a critical role in protecting the cell from oxidative stress caused by exposure to excessively high irradiance. In the field of HAB research, estimates of growth potential have been desired to predict the population dynamics of HABs for mitigating damage to fisheries. Therefore, omics approaches have recently begun to be applied to elucidate the physiology of the growth of HAB species. In this review, we describe the progress we have made using a molecular physiological approach to identify the roles of 2-CysPrx and other antioxidant enzymes in mitigating environmental stress associated with strong light and high temperatures and resultant oxidative stress. We also describe results of a survey of expressed Prx genes and their growth-phase-dependent behavior in C. marina using RNA-seq analysis. Finally, we speculate about the function of these genes and the ecological significance of 2-CysPrx, such as its involvement in circadian rhythms and the toxicity of C. marina to fish