Structural Transformation of Azonia[5]helicene Photoproduct via Reaction Field Function of Layered Inorganic Material.

In an attempt to generalize "on surface synthesis", which has unique potential in the area of organic synthesis, the focus was placed on layered silicates having a highly flat surface. The photoreaction of (±)-13-bromo-6a-azonia[5]helicene (AHHBr) and (±)-2-bromo-13-methyl-6a-azonia[5]helicene (AHBrMe) in solution and within the layers was examined. In the case of AHBrMe, the photoproduct was different from that in solution. 1H nuclear magnetic resonance (NMR), Fourier transform-infrared spectroscopy (FT-IR), and electrospray ionization-mass spectrometry (ESI-MS) measurements revealed that the photoproduct obtained within the layers was a benzo-perylene molecule with a completely flat lactone structure (AL). This study is the first example of the successful conversion of a chemical reaction path due to the steric effect of the flat surface of layered silicate.

Viability of sublethally injured indicator and pathogenic coliform bacteria on fresh-cut cabbage during storage in an active MAP of 10% CO2.

Shredded cabbage treated with either tap water or electrolyzed water was stored in an active modified atmosphere packaging (MAP) of 10% CO2 for 5 d at 10℃, 7 d at 5℃, and 8 d at 1℃ to evaluate the occurrence and viability of sublethally injured coliform bacteria. The CO2 and O2 concentrations in the packages approached an equilibrium of 10% CO2 and 10% O2 during storage at all temperatures tested. Coliforms in shredded cabbage increased during storage at all three temperatures, with the increase being greater at 10℃. Sublethal injury at 65% to 69% for the coliforms was detected only on cabbage samples treated with electrolyzed water and stored at 5℃ for 4 and 7 d. Enterobacter cloacae was one of the injured species of coliform bacteria in shredded cabbage. Shredded cabbage was inoculated with chlorine-injured Escherichia coli O157:H7 and stored at 5℃ for 6 d in an active MAP of 10% CO2. Counts of E. coli O157:H7 remained almost constant during storage, and injured E. coli O157:H7 ranging from 50% to 70% were found on shredded cabbage throughout the storage period. These results indicate that sublethally injured indicator and pathogenic bacteria would be found on fresh-cut cabbage in the realistic MAP storage at 5℃.

[Surgical Treatment of Congenital Absence of the Pericardium Found by Chance at Pulmonary Surgery:Report of a Case].

Absence of the pericardium is generally asymptomatic rare congenital disorder. However, it may be life-threatening problem due to cardiac deviation or herniation after the pulmonary resection. We described a case of complete defect of the pericardium found at surgery for metastatic lung cancer. Since the left lower lobectomy was necessary, the pericardium was reconstructed with an ePTFE sheet. Postoperative course was uneventful without any symptoms at two years post-surgery.

Senescence recovering by dual drug-encapsulated liposomal nanoparticles for large-scale human cell expansion.

Although regenerative therapy and bioartificial tissues and organs require a sufficient number of human cells, current cell expansion processes are accompanied by accumulation of senescent cells that are related to deterioration of cellular functions and induction of senescence-associated secretory phenotype (SASP). Therefore, suppression of replicative senescence during expansion is one of the crucial issues for dissemination of regenerative medicine. We herein developed dual drug-encapsulated liposomal nanoparticles (LNPs) to suppress cellular senescence in human adipose tissue-derived mesenchymal stem cells (hAT-MSCs) and natural killer (NK) cells by removal of dysfunctional mitochondria from the senescent cells. We found that LNP treatment reduced senescent makers; downregulation of p21 expression and reduction of SA-ß-Gal activity in both cells provably due to mitophagy reactivation in the cells. Moreover, SASP secretion in hAT-MSCs and tumor cytotoxicity in NK cells were also improved upon LNP treatments. These findings may contribute to the production of highly effective expanded cells for regenerative medicine and bioartificial tissues and organs.

Identification of factors affecting the surgical margin in wedge resection using preoperative lipiodol marking.

BACKGROUND: The factors affecting the surgical margin distance in resection of small lung lesions after preoperative marking are still unclear. The purpose of this study was to identify these factors in wedge lung resection using a localization technique. METHODS: The subjects were 45 patients with small pulmonary nodules who underwent preoperative computed tomography-guided lipiodol marking followed by video-assisted thoracoscopic surgery between April 2017 and December 2019. Data were obtained for nodule size, depth from the pleural surface, imaging features, and procedure-related factors that could affect the surgical margin. Subjects were divided into groups with margin distances <10 and ≥10 mm. Logistic regression analysis was used to identify factors associated with the margin distance. RESULTS: Preoperative marking was performed using lipiodol prior to resection of 52 nodules (median size, 10.1 mm; range, 6.75-12.3 mm) in 45 patients (23 men, 22 women; median age, 65.4 years). The mean distance from the pleural surface to the pulmonary lesion was 13.8 mm (range, 5.44-22.2 mm). The 3D deviation of the radio-opaque nodule (lipiodol spot) from the lesion was the only significant difference in nodule- and procedure-related factors between the two groups. Multivariate analysis also showed that this 3D deviation was the most significant factor affecting the margin distance (odds ratio, 0.26; 95% CI, 0.08-0.81; P=0.02). CONCLUSIONS: The findings in this study may help to ensure a sufficient surgical margin after preoperative lipiodol marking, through recognition that the 3D deviation of the radio-opaque nodule from the target lesion has a particularly important influence on the margin distance.

Evaluating depression in cognitively healthy elderly people by using Mini-Mental State Examination.

AIM: We examined a method for evaluating depression with the Mini-Mental State Examination in cognitively healthy elderly people and employed the projective perspective. METHODS: In MMSE three groups-normal, depressed tendency, and depressed-completed the Mini-Mental State Examination (MMSE) and a Japanese version of the 15-item Geriatric Depression Scale. The Mini-Mental State Examination evaluated individuals' writing based on a sentence, the number of written words, and sentence content; it also assessed their copying of drawn figures. RESULTS: In the depressed group, the proportion corresponding to the characteristics of (i) to (iii) was higher than in the other two groups: (i) the calculation score was 0 or 1; (ii) subjects scored above the median in sentence writing relative to similar subjects with the same language and clinical setting; and (iii) subjects expressed feelings in their writing. One point was given for each characteristic, and we calculated the sum. Depressed subjects had a score ≥2. CONCLUSIONS: This evaluation method can differentiate depressed subjects with high accuracy (sensitivity: 77.8%, specificity: 76.4%) without placing an extra burden on the subjects.

The potential of lipid-polymer nanoparticles as epigenetic and ROS control approaches for COPD.

Chronic obstructive pulmonary disease (COPD) is a lung disease caused by an inflammatory response to various inhaled toxins, especially cigarette smoke. Reactive oxygen species (ROS) and epigenetic abnormality are intimately related to the pathology of COPD, and the overproduction of ROS results in a decrease of histone deacetylase 2 (HDAC2), leading to glucocorticoid resistance. Therefore, a novel treatment that simultaneously reduces ROS level and glucocorticoid resistance is urgently needed. In this study, we developed a codelivery system using core-shell type lipid-polymer nanoparticles (LPNs) composed of a poly(lactic acid) (PLA) core encapsulating a potent antioxidant Mn-porphyrin dimer (MnPD) and a cationic lipid (DOTAP) shell that binds HDAC2-encoding plasmid DNA (pHDAC2), as a new therapeutic approach toward COPD. The transfection of pHDAC2 combined with the elimination of ROS by MnPD exhibited a significant enhancement of intracellular HDAC2 expression levels, suggesting that the multi-antioxidative activity of MnPD plays a crucial role in the expression of HDAC2. Moreover, treatment with LPNs efficiently ameliorated the steroid resistance in COPD models in vitro as evidenced by the lowered expression levels of IL-8. Recovery from mitochondrial dysfunction may be the mechanism underlying the action of LPNs. The PLA-MnPD/DOTAP/pHDAC2 system proposed offers a new therapeutic approach for COPD based on the synergism of ROS elimination and HDAC2 expression.

The Cingulate Island Sign on FDG-PET vs. IMP-SPECT to Assess Mild Cognitive Impairment in Alzheimer's Disease vs. Dementia with Lewy Bodies.

BACKGROUND AND PURPOSE: The cingulate island sign (CIS) on 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET); ie, the relative preservation of mid-posterior cingulate cortex metabolism, is a supportive biomarker in the diagnostic criteria for dementia with Lewy bodies (DLB). However, limited information is currently available on the diagnostic value of the CIS on FDG-PET or 123 I-iodoamphetamine single-photon emission computed tomography (IMP-SPECT) for differentiating between mild cognitive impairment (MCI) due to Alzheimer's disease (AD) (MCI-AD) and MCI due to DLB (MCI-DLB). METHODS: We examined the CIS ratio in 9 AD patients, 9 DLB patients, 8 patients with MCI-AD, and 9 patients with MCI-DLB using FDG-PET and IMP-SPECT. The CIS ratio was calculated using NEUROSTAT software. RESULTS: In the dementia groups, a receiver operating characteristic analysis of the CIS ratio showed significant accuracy for differentiating between AD and DLB on FDG-PET and IMP-SPECT. In the MCI groups, only the FDG-PET derived CIS ratio displayed significant accuracy for differentiating between AD and DLB. CONCLUSIONS: The FDG-PET and IMP-SPECT derived CIS ratios are both useful for differentiating between AD and DLB. The FDG-PET derived CIS ratio is more valuable than the IMP-SPECT derived CIS ratio for differential diagnosis in patients with MCI. A larger study is needed to confirm these results.

Type B3 thymoma with marked neuroendocrine differentiation: Report of a case.

Thymomas are tumors originating from the thymus epithelial cells and are the most common tumors of the anterior mediastinum. They have been classified into types A, AB, B1, B2, and B3 by the World Health Organization. Type B3 thymoma is composed of epithelial cell sheets with mild to moderate atypia and scant lymphocytes. An association between thymic carcinoma and neuroendocrine differentiation has been observed by some authors. However, cases of type B3 thymoma with neuroendocrine differentiation are very rarely discussed in the literature. A 68-year-old woman was referred to our hospital with an abnormal shadow on a chest roentgenogram. Chest computed tomography showed that the lesion was located in the anterior mediastinum. She underwent surgery, and the tumor was diagnosed as a type B3 thymoma with neuroendocrine differentiation. An extremely rare case of a type B3 thymoma showing neuroendocrine differentiation is presented herein.

Treatment of oral cancers during pregnancy: a case-based discussion.

BACKGROUND: Malignancies occur in approximately 1:1000 pregnancies; the most common being breast (46%) and hematological (18%) malignancies. Oral cancers account for only 2% of all cancers in pregnant women, and there are no standard guidelines for the treatment of oral cancer during pregnancy. METHODS: Between 2007 and 2014, our department managed 1109 patients with oral cancers; four (0.4%) had tongue carcinomas during pregnancy. These cases were retrospectively reviewed. RESULTS: The four women were aged 29-39 (median 32.5) years. Two underwent partial glossectomy at 39 and 40 weeks' gestation, respectively, one received radiotherapy at 17 weeks' gestation, and one underwent supraomohyoid neck dissection and hemi-glossectomy with a forearm flap reconstruction. CONCLUSION: In addition to tumor factors, the wishes of the patient and her family, gestational age, and fetal and maternal conditions are important factors in deciding on a treatment protocol. Moreover, treatment decisions require multidisciplinary approach.

Characteristics of dementia patients who described or did not describe the relationship between two people on the COGNISTAT speech sample.

Speech sample of Cognitive Status Examination (COGNISTAT) is a task in which examinees freely talk about what is happening in a presented picture. We investigated whether there are differences in the characteristics between patients who described or did not describe the relationship between two people in the speech sample based on age, gender, cognitive dysfunction, and type of dementia (Alzheimer's disease and dementia with Lewy bodies). The participants were 60-year-old or older patients diagnosed with Alzheimer's disease or dementia with Lewy bodies who undertook the Mini-Mental State Examination (MMSE) and COGNISTAT at a general hospital specialized in care for the elderly. MMSE and COGNISTAT were performed by a female clinical psychologist in all patients. In a stepwise logistic regression analysis using the two groups (description and no description groups) as a response variable, and the age, gender, diagnosis, MMSE score, and score of each COGNISTAT subtest as explanatory variables, the MMSE score (OR = 1.09; 95% CI [1.03, 1.15]) and gender (OR = 1.79; 95% CI [1.09, 2.93]) factors were extracted. These results indicated that patients with severer overall cognitive dysfunction and male patients were unlikely to describe the relationship between two people in a speech sample.

The cingulate island sign in patients with dementia with Lewy bodies or Alzheimer's disease: A direct comparison between 18F-FDG PET and 123I-IMP SPECT.

The cingulate island sign (CIS) on 18F-fluorodeoxyglucose positron emission tomography (FDG PET); i.e., the relative preservation of mid-posterior cingulate cortex metabolism, is a supportive biomarker in the diagnostic criteria for dementia with Lewy bodies (DLB). Information is lacking, however, regarding the diagnostic value of the CIS on FDG PET or 123I-iodoamphetamine single-photon emission computed tomography (IMP SPECT) for differentiating between mild cognitive impairment (MCI) due to Alzheimer's disease (AD) (MCI-AD) and MCI due to DLB (MCI-DLB). We examined the CIS ratio for nine AD patients, nine DLB patients, eight patients with MCI-AD, and nine patients with MCI-DLB using FDG PET and IMP SPECT. The CIS ratio was calculated as the total count density for the mid-posterior cingulate cortex divided by the total count density for the precuneus and cuneus using the stereotactic extraction estimation method. In the dementia groups, receiver operating characteristic analysis of the CIS ratio showed significant accuracy for differentiating between AD and DLB on both FDG PET and IMP SPECT. In the MCI groups, only the FDG PET-derived CIS ratio displayed significant accuracy for differentiating between AD and DLB. A larger study is needed to replicate these findings.

Combined lipiodol marking and video-assisted thoracoscopic surgery in a hybrid operating room.

BACKGROUND: The development of diagnostic technology has led to detection of an increasing number of small pulmonary nodules (SPNs), which can be difficult to locate intraoperatively. Here, we report our experience performing single-stage lipiodol localization and surgical resection in a hybrid operating room (OR). METHODS: Between June 2016 and August 2017, 30 patients with 32 SPNs underwent sliding gantry-based multidetector computed tomography (MDCT)-guided lipiodol marking followed by video-assisted thoracoscopic surgery (VATS) in a hybrid OR. After induction of general anesthesia, all nodules were marked with 0.2 mL lipiodol under MDCT fluoroscopic guidance, followed by immediate VATS. RESULTS: The mean SPN diameter and distance from the pleural surface were 10.7±4.5 mm (range, 5.0-21.0 mm) and 18.0±9.0 mm (range, 2.8-32.0 mm) respectively. The MDCT-guided localization procedure required 15.8±6.0 min (range, 8.0-32.0 min). All the nodules were marked with lipiodol and detected during fluoroscopy as a clear spot. The median deviation between the radio-opaque nodule and the target nodule was 7.8±3.6 mm (range, 3.0-20.0 mm). In two cases, MDCT scans performed after completion of marking revealed mild pneumothorax, which did not need further intervention. VATS resection was converted to thoracotomy in two patients because of strong pleural adhesions and intraoperative bleeding from the pulmonary vein. No other complications occurred during the combined approach, and there was no intra- or post-operative mortality or morbidity. CONCLUSIONS: These results suggest that a combined approach using MDCT-guided lipiodol marking followed by VATS is feasible and has acceptable accuracy in resection of SPNs.

The Use of Short Versions of the Japanese WAIS-III to Aid in Differentiation Between Alzheimer's Disease and Dementia with Lewy Bodies.

OBJECTIVE: We examined the cognitive characteristics of patients with Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) using the Wechsler Adult Intelligent Scale-Third Edition (WAIS-III). In addition, the utility of short versions of WAIS-III for estimating IQ scores and index scores were examined. METHODS: The subjects were 83 patients with probable AD, 33 patients with probable DLB, and 83 cognitively normal individuals. RESULTS: Patients with DLB showed significantly lower scores in Performance IQ and Processing Speed compared with those with AD. The short versions of WAIS-III with Information, Similarities, Arithmetic, Digit Span, Picture Completion, Digit Symbol-Coding, and Block Design demonstrated relatively small amount of error, high correlations, and reliabilities with the full version. CONCLUSIONS: The results indicated that Performance IQ and Processing Speed in WAIS-III can be an indicator for differentiating AD and DLB in WAIS-III, and a short version obtained by the Similarities, Information, Picture Completion, Block Design, Arithmetic, Digit Span, and Digit-Symbol Coding yields high accuracy and can be used to estimate full-scale IQ scores on the WAIS-III.

Differences in responses to the Rorschach test between patients with dementia with Lewy bodies and Alzheimer's disease -from the perspective of visuoperceptual impairment.

Patients with Dementia with Lewy bodies (DLB) tend to perform worse in tasks on visuoperception than patients with Alzheimer's disease (AD). The Rorschach inkblot test has its utility for assessing perceptual and visuospatial abilities. In this study, we examined the differences in responses to the Rorschach test between patients with DLB and those with AD in terms of visuoperception, and investigated the utility of the test for assessing visuoperceptual impairment in DLB. Using the comprehensive system of Rorschach test, six variables were significantly higher, and three variables were significantly lower in DLB patients compared to AD patients. Among those variables, PTI showed high sensitivity and specificity for differentiating DLB from AD. Furthermore, when the PTI score was combined with the Dd score and a number of times a patient saw an eye in a shading part of an inkblot, the sensitivity and specificity reached 90.6% and 73.1%, respectively. These results indicate that the patients with DLB perceive objects in the inkblot differently from patients with AD, and suggest that some variables of the Rorschach test could assist with neuropsychological examinations when differentiating DLB from AD.

CD163-Positive Macrophages Within the Tumor Stroma Are Associated With Lymphangiogenesis and Lymph Node Metastasis in Oral Squamous Cell Carcinoma.

PURPOSE: Increasing evidence shows that tumor stromal components, particularly tumor-associated macrophages (TAMs), play an important role in the tumor progression of various solid malignant tumor types. However, their roles in oral squamous cell carcinoma (OSCC) have not been fully elucidated. MATERIALS AND METHODS: Seventy human tongue OSCC samples were analyzed in the present study. Immunohistochemistry was used to investigate the correlations between the densities of CD68-, CD163-, and CD204-positive TAMs and clinicopathologic parameters. Lymphatic vessel density (LVD) was estimated using the D2-40 antibody. In vitro studies also were conducted to investigate the effect of conditioned medium (CM) derived from OSCC cell lines on cytokine and chemokine expression in RAW264.7 mouse monocytic leukemia cells. RESULTS: Increased densities of CD68-, CD163-, and CD204-positive TAMs were significantly correlated with lymph node metastasis (P = .035, .0082, and .038, respectively). Higher LVD occurred considerably more frequently in patients with nodal metastasis than in those without such metastasis. Moreover, LVD was considerably increased in patients with higher CD163-positive TAM densities. Studies using immunofluorescence showed that vascular endothelial growth factor (VEGF)-C was expressed in 52 of 70 patients with CD163-positive TAMs (74.2%). Moreover, CM derived from OSCC cell lines stimulated the expression of Il-10, Ccl22, Vegf-a, and Vegf-c in RAW264.7 cells; however, Il-12p35 expression levels were not changed. CONCLUSION: CD163-positive TAMs promote lymphangiogenesis through VEGF-C expression, which contributes to regional lymph node metastasis in OSCC.