Progressive multifocal leukoencephalopathy reports in rheumatoid arthritis concerning different treatment patterns-an exploratory assessment using the food and drug administration adverse event reporting system

Introduction: Progressive multifocal leukoencephalopathy (PML) is a rare but potentially life-threatening brain infection caused by the John Cunningham virus. PML is a known adverse effect associated with molecular-targeted drugs and immunosuppressive agents. Recent concerns have emerged regarding the link between methotrexate (MTX) and PML. However, limited information exists on the influence of concomitant drug use in rheumatoid arthritis (RA) treatment, where various medications are often used together.Methods: To explore treatment patterns and patient background that affect PML reporting in RA, we analyzed data on RA cases from the Food and Drug Administration Adverse Event Reporting System (FAERS; JAPIC AERS) database between 1997 and 2019.Results and Discussion: Our analysis revealed significantly elevated crude and adjusted reporting odds ratios (aROR) for MTX, rituximab (RIT), azathioprine, and cyclophosphamide. When considering treatment patterns, the concomitant use of MTX and RIT showed a higher aROR than using MTX or RIT alone. Additional TNF-α inhibitors or glucocorticoids did not increase PML reports. Moreover, male sex and older age were associated with increased PML reports. While limitations are inherent in studies using spontaneous reporting data, our exploratory assessment suggests an association between PML and the combination of MTX and RIT and a higher risk in men and older patients. These findings help enhance our understanding of PML risk factors in the context of RA treatment

Spectral Evolutions in Gamma-Ray Burst Exponential Decays Observed with Suzaku WAM

This paper presents a study on the spectral evolution of gamma-ray burst (GRB) prompt emissions observed with the Suzaku Wide-band All-sky Monitor (WAM). By making use of the WAM data archive, 6 bright GRBs exhibiting 7 well-separated fast-rise-exponential-decay (FRED) shaped light curves are presented and the evaluated exponential decay time constants of the energy-resolved light curves from these FRED peak light curves are shown to indicate significant spectral evolution. The energy dependence of the time constants is well described with a power-law function tau(E) ~ E^gamma, where gamma ~ -(0.34 +/- 0.12) in average, although 5 FRED peaks show consistent value of gamma = -1/2 which is expected in synchrotron or inverse-Compton cooling models. In particular, 2 of the GRBs were located with accuracy sufficient to evaluate the time-resolved spectra with precise energy response matrices. Their behavior in spectral evolution suggests two different origins of emissions. In the case of GRB081224, the derived 1-s time-resolved spectra are well described by a blackbody radiation model with a power-law component. The derived behavior of cooling is consistent with that expected from radiative cooling or expansion of the emission region. On the other hand, the other 1-s time-resolved spectra from GRB100707A is well described by a Band GRB model as well as with the thermal model. Although relative poor statistics prevent us to conclude, the energy dependence in decaying light curve is consistent with that expected in the former emission mechanism model.Comment: 11 pages, 7 figures, 5 tables. PASJ accepte

Rain-induced bioecological resuspension of radiocaesium in a polluted forest in Japan

放射性セシウムを含む真菌類の大型胞子の放出が森林環境での雨により増加することを発見 --降水によるバイオエアロゾル大気放出の新証拠--. 京都大学プレスリリース. 2020-10-01.It is the conventional understanding that rain removes aerosols from the atmosphere. However, the question of whether rain plays a role in releasing aerosols to the atmosphere has recently been posed by several researchers. In the present study, we show additional evidence for rain-induced aerosol emissions in a forest environment: the occurrence of radiocaesium-bearing aerosols in a Japanese forest due to rain. We carried out general radioactive aerosol observations in a typical mountainous village area within the exclusion zone in Fukushima Prefecture to determine the impacts and major drivers of the resuspension of radiocaesium originating from the nuclear accident in March 2011. We also conducted sampling according to the weather (with and without rain conditions) in a forest to clarify the sources of atmospheric radiocaesium in the polluted forest. We found that rain induces an increase in radiocaesium in the air in forests. With further investigations, we confirmed that the fungal spore sources of resuspended radiocaesium seemed to differ between rainy weather and nonrainy weather. Larger fungal particles (possibly macroconidia) are emitted during rainy conditions than during nonrainy weather, suggesting that splash generation by rain droplets is the major mechanism of the suspension of radiocaesium-bearing mould-like fungi. The present findings indicate that radiocaesium could be used as a tracer in such research fields as forest ecology, meteorology, climatology, public health and agriculture, in which fungal spores have significance

A Successfully Treated Case of Intrahepatic Cholangiocarcinoma with Exacerbation of Dermatomyositis

Dermatomyositis (DM) is often found in conjunction with malignant tumors such as lung, cervical, and breast cancer. However, the association with intrahepatic cholangiocarcinoma (ICC) is extremely rare. Moreover, to our knowledge, there have been no previous reports of DM discovered because of exacerbation of DM. Our case was a 44-year-old female with dry cough, myalgia, and arthralgia. We performed hepatic resection for intrahepatic ICC. She was diagnosed with DM, and combination treatment with prednisolone and tacrolimus was started. During outpatient visits, her symptoms worsened, and she was hospitalized due to deterioration of her primary disease. On detailed examination, a malignant lesion in the liver was discovered. After operation, the symptoms of DM remain stable by taking prednisolone and tacrolimus. The patient was suspected to have paraneoplastic syndrome, which was discovered due to the exacerbation of the DM that was caused by the intrahepatic ICC

Fructo-oligosaccharides ameliorate steatohepatitis, visceral adiposity, and associated chronic inflammation via increased production of short-chain fatty acids in a mouse model of non-alcoholic steatohepatitis

Background: Non-alcoholic fatty liver disease (NAFLD) is a hepatic manifestation of metabolic syndrome. Within the spectrum of NAFLD, non-alcoholic steatohepatitis (NASH) in combination with hepatic inflammation and fibrosis can lead to liver cirrhosis and hepatocellular carcinoma. Dysbiosis was reported to contribute to NASH pathogenesis. This study aimed to determine the effects of fructo-oligosaccharides (FOS) on steatohepatitis and visceral adiposity in an obese mouse model of NASH. Methods: Twelve newborn C57BL/6 J male mice were subcutaneously injected with monosodium glutamate (MSG) to induce obesity on a conventional diet. Six mice were also administered 5% FOS via drinking water from 10 weeks of age. At 18 weeks, histological characteristics of the liver and epididymal fat were compared between the groups. Hepatic mRNA expression of lipid metabolism enzymes and SCFA in feces and sera were measured. Results: Hepatic steatosis, inflammatory cell infiltration, and hepatocyte ballooning in the liver and increased hepatic mRNA expression of fatty acid synthase and glycerol-3-phosphate acyltransferase were observed in the MSG-treated mice. FOS treatment improved the liver pathology and blunted the increases in the mRNA expression levels of lipid metabolism enzymes. In addition, FOS inhibited adipocyte enlargement and formation of crown-like structures and reduced the M1 macrophage frequency in the epididymal fat of the MSG mice (39.4% ± 3.0% vs. 22.8% ± 0.7%; P = 0.001). FOS increased not only the fecal concentrations of n-butyric acid (0.04 ± 0.01 vs. 0.38 ± 0.14 mg/g, P = 0.02), propionic acid (0.09 ± 0.03 vs. 0.42 ± 0.16 mg/g, P = 0.02), and acetic acid (0.65 ± 0.16 vs. 1.48 ± 0.29 mg/g, P = 0.03) but also the serum concentration of propionic acid (3.9 ± 0.5 vs. 8.2 ± 0.5 μmol/L, P = 0.001). Conclusions: FOS ameliorates steatohepatitis, visceral adiposity, and chronic inflammation by increasing SCFA production

The seasonal variations of atmospheric 134,137Cs activity and possible host particles for their resuspension in the contaminated areas of Tsushima and Yamakiya, Fukushima, Japan

A large quantity of radionuclides was released by the Fukushima Daiichi Nuclear Power Plant accident in March 2011, and those deposited on ground and vegetation could return to the atmosphere through resuspension processes. Although the resuspension has been proposed to occur with wind blow, biomass burning, ecosystem activities, etc., the dominant process in contaminated areas of Fukushima is not fully understood. We have examined the resuspension process of radiocesium (134,137Cs) based on long-term measurements of the atmospheric concentration of radiocesium activity (the radiocesium concentration) at four sites in the contaminated areas of Fukushima as well as the aerosol characteristic observations by scanning electron microscopy (SEM) and the measurement of the biomass burning tracer, levoglucosan.The radiocesium concentrations at all sites showed a similar seasonal variation: low from winter to early spring and high from late spring to early autumn. In late spring, they showed positive peaks that coincided with the wind speed peaks. However, in summer and autumn, they were correlated positively with atmospheric temperature but negatively with wind speed. These results differed from previous studies based on data at urban sites. The difference of radiocesium concentrations at two sites, which are located within a 1 km range but have different degrees of surface contamination, was large from winter to late spring and small in summer and autumn, indicating that resuspension occurs locally and/or that atmospheric radiocesium was not well mixed in winter/spring, and it was opposite in summer/autumn. These results suggest that the resuspension processes and the host particles of the radiocesium resuspension changed seasonally. The SEM analyses showed that the dominant coarse particles in summer and autumn were organic ones, such as pollen, spores, and microorganisms. Biological activities in forest ecosystems can contribute considerably to the radiocesium resuspension in these seasons. During winter and spring, soil, mineral, and vegetation debris were predominant coarse particles in the atmosphere, and the radiocesium resuspension in these seasons can be attributed to the wind blow of these particles. Any proofs that biomass burning had a significant impact on atmospheric radiocesium were not found in the present study

Targeted reversion of induced pluripotent stem cells from patients with human cleidocranial dysplasia improves bone regeneration in a rat calvarial bone defect model

BackgroundRunt-related transcription factor 2 (RUNX2) haploinsufficiency causes cleidocranial dysplasia (CCD) which is characterized by supernumerary teeth, short stature, clavicular dysplasia, and osteoporosis. At present, as a therapeutic strategy for osteoporosis, mesenchymal stem cell (MSC) transplantation therapy is performed in addition to drug therapy. However, MSC-based therapy for osteoporosis in CCD patients is difficult due to a reduction in the ability of MSCs to differentiate into osteoblasts resulting from impaired RUNX2 function. Here, we investigated whether induced pluripotent stem cells (iPSCs) properly differentiate into osteoblasts after repairing the RUNX2 mutation in iPSCs derived from CCD patients to establish normal iPSCs, and whether engraftment of osteoblasts derived from properly reverted iPSCs results in better regeneration in immunodeficient rat calvarial bone defect models.MethodsTwo cases of CCD patient-derived induced pluripotent stem cells (CCD-iPSCs) were generated using retroviral vectors (OCT3/4, SOX2, KLF4, and c-MYC) or a Sendai virus SeVdp vector (KOSM302L). Reverted iPSCs were established using programmable nucleases, clustered regularly interspaced short palindromic repeats (CRISPR)/Cas-derived RNA-guided endonucleases, to correct mutations in CCD-iPSCs. The mRNA expressions of osteoblast-specific markers were analyzed using quantitative reverse-transcriptase polymerase chain reaction. iPSCs-derived osteoblasts were transplanted into rat calvarial bone defects, and bone regeneration was evaluated using microcomputed tomography analysis and histological analysis.ResultsMutation analysis showed that both contained nonsense mutations: one at the very beginning of exon 1 and the other at the initial position of the nuclear matrix-targeting signal. The osteoblasts derived from CCD-iPSCs (CCD-OBs) expressed low levels of several osteoblast differentiation markers, and transplantation of these osteoblasts into calvarial bone defects created in rats with severe combined immunodeficiency showed poor regeneration. However, reverted iPSCs improved the abnormal osteoblast differentiation which resulted in much better engraftment into the rat calvarial bone defect.ConclusionsTaken together, these results demonstrate that patient-specific iPSC technology can not only provide a useful disease model to elucidate the role of RUNX2 in osteoblastic differentiation but also raises the tantalizing prospect that reverted iPSCs might provide a practical medical treatment for CCD

Prophylactic clip closure for mucosal defects is associated with reduced adverse events after colorectal endoscopic submucosal dissection: a propensity-score matching analysis

博士（医学）乙日本医科大学202

Carbon Ion Radiotherapy for Bone and Soft Tissues Sarcomas of the Head and Neck

PTCOG46 General Meetin