Piceatannol Upregulates SIRT1 Expression in Skeletal Muscle Cells and in Human Whole Blood: In Vitro Assay and a Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Comparison Trial.

Piceatannol (PIC), a polyphenol abundant in passion fruit seeds, is reported to promote fat metabolism. This study investigated whether PIC affects sirtuin 1 (SIRT1) expression and metabolic factors in C2C12 skeletal muscle cells. C2C12 myotubes were stimulated with PIC, and alterations in gene expression, protein levels, mitochondrial DNA content, and fatty acid levels were assessed using real-time PCR, Western blotting, and Nile red staining. Furthermore, we examined changes in SIRT1 expression following the consumption of a test food containing 100 mg PIC for 2 weeks among adults with varying age and body mass index ranges. Both PIC and passion fruit seed extract induced SIRT1 expression in C2C12 myotubes to a greater extent than resveratrol. PIC also increased the expression of genes associated with mitochondrial biogenesis and fatty acid utilization, increased mitochondrial DNA content, and suppressed oleic acid-induced fat accumulation. Moreover, participants who consumed PIC exhibited significantly higher SIRT1 mRNA expression in whole blood compared to those in the placebo group. These findings suggest that PIC induces SIRT1 expression both in vitro and in the human body, which may promote mitochondrial biosynthesis and fat metabolism.

Medical Record Survey after Comprehensive Health Checkup Referral and Its Contribution to the Early Detection of Cancer.

Comprehensive health checkups in Japan are a preventive method to detect cancer and metabolic diseases. Unlike group medical examinations, individual examinations in health checkups are possible, with additional tests possible for disease detection. However, it is difficult to accurately ascertain the results from only the report after referral to a medical institution in individuals suspected of having cancer who need to be examined. We aimed to conduct a medical record survey of patients referred to the Hospital after undergoing a comprehensive health checkup and investigate the contribution of comprehensive health checkups to the detection of cancer more accurately. The subjects were 1763 examinees who were referred to various departments of our hospital because of doubtful cancer from 23,128 examinees who underwent comprehensive health checkups in our center from January 2018 to December 2022 for 5 years. The medical record survey demonstrated that cancer was detected in more than twice as many individuals as reported and other sources. Early-stage cancers require a significantly longer time to establish a definitive diagnosis. In conclusion, short-term reports from the referring hospital are insufficient for a final diagnosis, and long-term follow-up is extremely important to increase the diagnosis rates of cancer for comprehensive health checkups.

Perioperative Management of a Patient With Severe Cold Agglutinin Disease Undergoing Total Hip Arthroplasty With a Cemented Stem: A Case Report.

Patients with cold agglutinin disease who undergo total hip arthroplasty (THA) are rarely encountered. Patients with cold agglutinin disease are very sensitive to cold ambient temperatures and require scrupulous perioperative body-temperature management. However, THA requires a cementing procedure that exposes patients to cold temperatures during surgery and may result in autoimmune hemolytic anemia in these patients. Thus, perioperative management of patients with cold agglutinin disease undergoing THA requires more than just scrupulous systemic temperature management. Here, we present the successful perioperative management of a patient with severe cold agglutinin disease who underwent THA with a cemented stem.

LOCAL LEVELS OF RADIATION EXPOSURE DOSES DUE TO RADIOCESIUM FOR RETURNED RESIDENTS IN TOMIOKA TOWN, FUKUSHIMA PREFECTURE.

Tomioka Town is located within a 20-km radius of the Fukushima Daiichi Nuclear Power Station. Radiation dose rates due to radiocesium in residents' living spaces were evaluated from the measurements of ambient dose rates and environmental samples after returning home. The mean ambient dose rates were 0.15-0.18-µSv/h indoors and 0.23-0.26-µSv/h outdoors during 2018 and 2019, and the additional radiation dose rates were calculated to be 1.4 mSv/y in 2018 and 1.1 mSv/y in 2019. Ambient dose equivalent from surface soils within housing sites were estimated to be 0.66 mSv/y in 2018 and 0.54 mSv/y in 2019. Moreover, committed effective doses from local foods were calculated in 19-74 µSv/y for children and 39-100 µSv/y for adults during 2018 and 2019. These findings suggest that current radiation exposure doses have been controlled at the levels close to the public dose limit (1 mSv/y) in residents' living spaces.

Risk perception regarding implementation of iodine thyroid blocking during a nuclear disaster of mothers living near a nuclear power station in Japan.

Pre-emptive evacuation orders following the accident at the Fukushima Daiichi Nuclear Power Station (FDNPS) in March 2011 and subsequent regulatory limits regarding contaminated food, milk, and water minimized the external and internal radiation exposure doses of nearby residents. However, with regard to implementation of iodine thyroid blocking (ITB), residents were confused because no information on the matter was released by the central and/or local governments. Based on lessons learned from the FDNPS accident, many countries have revised their guidelines regarding ITB during nuclear disasters. To adequately revise such guidelines and ensure effective ITB implementation during a nuclear disaster, however, residents' perceptions of ITB must be clarified. In this study, the perception of risks associated with ITB was investigated in mothers residing near the Sendai Nuclear Power Plant (SNPP) in Kagoshima Prefecture, Japan. Of the 520 mothers surveyed, 467 (89.8%) expressed anxiety regarding the administration of potassium iodine (KI) to their children. Logistic regression analysis revealed that the mothers' anxiety regarding the administration of KI to their children was positively correlated with their wish to consult an expert about KI and their hesitation to let their children eat foods produced in Fukushima, and negatively correlated with having confidence about administering KI to their children. Careful communication of potential risks to mothers residing near nuclear power plants is thus critical for implementing effective ITB in children.

[Successful Use of Percutaneous Left Ventricular Assist Device( Impella) and Veno Artery Extracorporeal Membrane Oxygenation( VA-ECMO) for Ischemic Cardiogenic Shock;Report of a Case].

A 73-year-old male was referred to our hospital for acute congestive heart failure. His cardiac and respiratory conditions were worsening with cardiogenic shock requiring intubation. Coronary angiography revealed severe triple vessel disease, and echocardiography showed severe left ventricular dysfunction. Therefore, he underwent veno artery extracorporeal membrane oxygenation (VA-ECMO) followed by percutaneous left ventricular assist device (Impella). His cardiac condition improved and VA-ECMO and Impella were removed on the 2nd day and the 4th day after surgery, respectively. He underwent off-pump coronary artery bypass grafting (OPCAB) without any complication on the 36th day. Postoperative course was uneventful and he was discharged on postoperative day 30. Concomitant use of Impella and VA-ECMO (Ecpella) remarkably improved ischemic cardiogenic shock by unloading the left ventricle and increasing the cardiac output.

Fistula between the Thoracic Duct and an Unusual Vessel Aneurysm Branching Off the Abdominal Aorta Revealed by Aneurysm Rupture: A Case Report.

Fistulas between an aneurysm branching off the abdominal aorta and the thoracic duct are rare. We report a case of aneurysmal-thoracic duct fistula diagnosed by angiography when aneurysm ruptured, and we successfully treated by catheter embolization. A 42-year-old man was referred to our hospital with a chief complaint of sudden back and chest pain. Computed tomography showed both post-mediastinal and retroperitoneal hematomas, with the aneurysm from the aorta being connected to the thoracic duct. After confirming the aneurysmal-thoracic duct fistula by angiography, we performed embolization of the aneurysm. The patient has remained well for 3 postoperative months, to date.

NMR-based structural validation of therapeutic antibody produced in Nicotiana benthamiana.

KEY MESSAGE: We successfully developed a method for metabolic isotope labeling of recombinant proteins produced in transgenic tobacco. This enabled assessment of structural integrity of plant-derived therapeutic antibodies by NMR analysis. A variety of expression vehicles have been developed for the production of promising biologics, including plants, fungi, bacteria, insects, and mammals. Glycoprotein biologics often experience altered folding and post-translational modifications that are typified by variant glycosylation patterns. These differences can dramatically affect their efficacy, as exemplified by therapeutic antibodies. However, it is generally difficult to validate the structural integrity of biologics produced using different expression vehicles. To address this issue, we have developed and applied a stable-isotope-assisted nuclear magnetic resonance (NMR) spectroscopy method for the conformational characterization of recombinant antibodies produced in plants. Nicotiana benthamiana used as a vehicle for the production of recombinant immunoglobulin G (IgG) was grown in a (15)N-enriched plant growth medium. The Fc fragment derived from the (15)N-labeled antibody thus prepared was subjected to heteronuclear two-dimensional (2D) NMR measurements. This approach enabled assessment of the structural integrity of the plant-derived therapeutic antibodies by comparing their NMR spectral properties with those of an authentic IgG-Fc derived from mammalian cells.

Concurrent administration of rituximab and CHOP chemotherapeutic agents for outpatients with CD20-positive lymphoma.

R (rituximab)-CHOP (cyclophosphamide, adriamycin, vincristin, and prednisone) is given to outpatients with CD20-positive lymphoma as a standard treatment. However, this regimen requires long-term infusion because of the necessity for monitoring the infusion reaction (IR) during R administration. In this study, pharmacological changes in anti-tumor agents were examined after the joint use of R and CHOP, and the possibility of concurrent administration of R and CHOP for outpatients was discussed. After combining antitumor agents with R, the binding capacity of R to the CD20 peptide and molecular changes in anti-tumor agents were measured by ELISA and LC/MS/MS-based analysis. At the same time, a pilot study involving concurrent administration of R and CHOP to patients with diffuse large B-cell lymphoma (DLBCL) was carried out after the first course of R-CHOP. After combining with either adriamycin or cyclophosphamide, the binding capacity of R to the CD20 antigen was equivalent to controls, and no molecular changes in adriamycin and cyclophosphamide were detected after combination with R. Twenty-one cases of DLBCL were treated safely with concurrent administration of R and CHOP. Twenty patients achieved complete remission after a full course of R-CHOP. The results indicated that long-term medication might not be necessary for outpatients treated with R-CHOP.

Effect of oral mucosal adhesive films containing ginsenoside Rb1 on 5-fluorouracil-induced oral mucositis in hamsters.

Oral ulcerative mucositis induced by chemotherapy or radiotherapy has an impact on quality of life, is dose-limiting for chemotherapy, and causes considerable morbidity. The aim of this study was to evaluate the effect of ginsenoside Rb1 on 5-fluorouracil (5-FU)-induced experimental oral mucositis in hamsters. Oral mucositis was induced in hamsters through a combination of 5-FU treatment and mild abrasion of the cheek pouch. Ginsenoside Rb1 isolated from ginseng was contained in chitosan-sodium alginate film (G-Rb1 film). The films were attached to the oral mucosa, and then the healing process was examined by measuring the area of mucositis, myeloperoxidase (MPO) activity and microscopic aspects. Films without ginsenoside Rb1 had no effect on 5-FU-induced oral mucositis in comparison to the control group. However, G-Rb1 films (10(-12) to 10(-4) g/g film) dose-dependently improved recovery from 5-FU-induced damage, and there were significant differences between doses of 10(-6) and 10(-4) g/g film. These results suggest that topical application of films that contain ginsenoside Rb1 has a healing effect on severe oral mucositis induced by chemotherapy.