Disinfection and monitoring of Mycobacterium avium complex in the environment: A novel approach to the management of hot tub lung.

A 45-year-old man visited our hospital with a chronic cough and breathing difficulties. Chest computed tomography revealed diffuse granular shadows. Mycobacterium avium (M. avium) was cultured from bronchoalveolar lavage fluid (BALF). Surgical lung biopsy revealed non-necrotizing granulomas, and M. avium-specific PCR was positive in the tissue. M. avium was also cultured in a sample from the inlet of the patient's bathtub. Mycobacterium avium tandem repeat variable-number tandem-repeat loci (MATR-VNTR) analysis confirmed that the M. avium cultured from BALF and the bathtub inlet had identical allele profiles. The patient's symptoms and oxygenation improved while the patient was in hospital, presumably because of lack of ongoing exposure to M. avium. He was diagnosed with hot tub lung. We advised the patient to avoid bathing to avoid re-exposure. However, the patient was unwilling to follow this advice. Therefore, his bathtub and pipework were disinfected by heating them to over 70 °C. We confirmed that the disinfection has been successful by repeated culture of environmental samples. Three months after resuming bathtub use, the patient's symptoms resolved, and the pulmonary shadows seen on the initial radiography did not recur. For the treatment of hot tub lung, disinfection of M. avium complex in the environment should be considered and the environment should be monitored to confirm eradication.

Machine Learning-Based Interpretable Modeling for Subjective Emotional Dynamics Sensing Using Facial EMG.

Understanding the association between subjective emotional experiences and physiological signals is of practical and theoretical significance. Previous psychophysiological studies have shown a linear relationship between dynamic emotional valence experiences and facial electromyography (EMG) activities. However, whether and how subjective emotional valence dynamics relate to facial EMG changes nonlinearly remains unknown. To investigate this issue, we re-analyzed the data of two previous studies that measured dynamic valence ratings and facial EMG of the corrugator supercilii and zygomatic major muscles from 50 participants who viewed emotional film clips. We employed multilinear regression analyses and two nonlinear machine learning (ML) models: random forest and long short-term memory. In cross-validation, these ML models outperformed linear regression in terms of the mean squared error and correlation coefficient. Interpretation of the random forest model using the SHapley Additive exPlanation tool revealed nonlinear and interactive associations between several EMG features and subjective valence dynamics. These findings suggest that nonlinear ML models can better fit the relationship between subjective emotional valence dynamics and facial EMG than conventional linear models and highlight a nonlinear and complex relationship. The findings encourage emotion sensing using facial EMG and offer insight into the subjective-physiological association.

Older age is not a negative factor for video-assisted thoracoscopic lobectomy for pathological stage I non-small cell lung cancer: a single-center, retrospective, propensity score-matching study.

PURPOSE: Video-assisted thoracoscopic surgery (VATS) has changed the surgical approach to non-small cell lung cancer (NSCLC) dramatically. The current study compares the outcomes of older and younger patients who underwent VATS lobectomy for NSCLC. METHODS: In total, 424 eligible patients with pathological stage I NSCLC underwent VATS lobectomy between 2007 and 2017. Patients were classified into two groups (< 75 and ≥ 75 years old), after which propensity score-matching was performed. RESULTS: After matching, 143 patients were identified. No significant difference in postoperative complication rates was observed; however, the ≥ 75-year-old group had a longer postoperative hospital stay (p = 0.001). The 5-year overall survival, relapse-free survival, and lung cancer-specific survival rates of the < 75- and ≥ 75-year-old groups were 87.1% vs. 85.6% (p = 0.537), 82.1% vs. 79.0% (p = 0.531), and 93.5% vs. 92.7% (p = 0.832), respectively. CONCLUSION: Despite the longer postoperative recovery following VATS lobectomy, the short- and long-term outcomes of older patients did not differ from those of younger patients. Thus, for early-stage NSCLC, older age alone was not a negative factor for lobectomy performed via minimally invasive surgery. Naturally, the systemic condition of this population must be evaluated carefully before surgery.

Future Pose Prediction from 3D Human Skeleton Sequence with Surrounding Situation.

Human pose prediction is vital for robot applications such as human-robot interaction and autonomous control of robots. Recent prediction methods often use deep learning and are based on a 3D human skeleton sequence to predict future poses. Even if the starting motions of 3D human skeleton sequences are very similar, their future poses will have variety. It makes it difficult to predict future poses only from a given human skeleton sequence. Meanwhile, when carefully observing human motions, we can find that human motions are often affected by objects or other people around the target person. We consider that the presence of surrounding objects is an important clue for the prediction. This paper proposes a method for predicting the future skeleton sequence by incorporating the surrounding situation into the prediction model. The proposed method uses a feature of an image around the target person as the surrounding information. We confirmed the performance improvement of the proposed method through evaluations on publicly available datasets. As a result, the prediction accuracy was improved for object-related and human-related motions.

Dog/cat-origin quinolone-resistant Streptococcus agalactiae isolates with point mutations in quinolone resistance-determining regions: Relatedness with clonal complex 10.

OBJECTIVE: We aimed to investigate dog/cat-origin quinolone-resistant Streptococcus agalactiae isolates with point mutations in quinolone resistance-determining regions (QRDRs) and to define the relatedness between quinolone-resistant isolates and their microbiological features of capsular genotype, sequence type (ST)/clonal complex (CC), and antimicrobial resistance (AMR) gene. METHODS: With dog/cat-origin 22 isolates, type strain, and human-origin 6 isolates, we performed antimicrobial susceptibility testing by agar plate dilution method using levofloxacin, ciprofloxacin, and moxifloxacin. We also determined amino acid sequences in QRDRs of gyrA/gyrB/parC/parE genes and their point mutations. We conducted capsular genotyping, multilocus sequence typing, and AMR genotyping in our previous investigations. Correlations between quinolone-resistant population and their microbiological features were examined. RESULTS: We found dog/cat-origin seven (31.8%) quinolone-resistant isolates harboring minimum inhibitory concentrations (MICs) of levofloxacin 16-32 µg/mL, ciprofloxacin 32 µg/mL, and moxifloxacin 2-4 µg/mL: human three isolates indicated MICs of levofloxacin 16-64 µg/mL, ciprofloxacin 32 µg/mL, and moxifloxacin 2-16 µg/mL. Point mutations Ser81Leu in gyrA and Ser79Phe/Ser79Tyr/Asp83Asn/Gly128Asp in parC were observed among these resistant isolates: mutations Leu495Ile/Val503Ile in parE was found among quinolone-nonresistant isolates. There was a significant correlation between dog/cat-origin quinolone-resistant population and ST10 (p = 0.023)/CC10 (p = 0.021). CONCLUSION: To our best knowledge, this is the first report assessing dog/cat-origin quinolone-resistant S. agalactiae. Our observations could be applied in future, by veterinarians while treating dogs and cats with clinical symptoms/signs suggestive of streptococcal infections.

[Congenital Pulmonary Airway Malformation Diagnosed in Adulthood].

Congenital pulmonary airway malformation diagnosed in adulthood is very rare. A 54-year-old woman was admitted to our hospital with complaints of abnormal chest shadow. Computed tomography( CT) demonstrated multiple cysts, mass lesions, and consolidation in left lower lobe. Bronchofiber scopy could not establish the diagnose. Left lower lobectomy was performed for diagnosis and treatment. Pathologically the lesion was diagnosed as congenital pulmonary airway malformation.

[Surgical Treatment for Lung Cancer Associated with Hypertrophic Pulmonary Osteoarthropathy].

Hypertrophic pulmonary osteoarthropathy( HPO) is a rare paraneoplastic manifestation of lung cancer that causes joint pain, joint swelling, and limited range of motion. Two surgical cases of lung cancer with HPO are presented. Case1:A 43-year-old female was referred to our department with a diagnosis of cStage ⅡB left hilar lung cancer. She had difficulty in walking due to arthralgia caused by HPO. Left pneumonectomy was performed and the arthralgia disappeared on the first postoperative day. The patient is being well after surgery without relapse of joint symptoms. Case2:The patient was a 65-year-old male with cStage ⅡA right lung cancer. The symptoms of HPO appeared after he was found to have lung cancer. After right upper lobectomy, the arthralgia disappeared on the first postoperative day. Currently, he is receiving adjuvant chemotherapy, without relapse of joint symptoms.

Biofilm production ability and associated characteristics of Streptococcus agalactiae isolates from companion animals and humans.

OBJECTIVE: We evaluated biofilm production ability (BPA) of Streptococcus agalactiae isolates from companion animals/humans and clarified the relationship between BPA populations and other microbiological features. METHODS: Companion animal-/human-origin isolates were collected with host information. We measured BPA using crystal violet staining, via virulence-associated gene profiling (hylB-pavA-pilB-spb1-srtC1-brpA), capsular genotyping, multilocus sequence typing, and antimicrobial resistance (AMR) phenotyping/genotyping. Significant difference in BPA of isolates from different hosts was assessed. We analyzed the association between BPA populations and the virulence genotypes, capsular genotypes, sequence types/clonal complexes, and AMR phenotypes/genotypes. Inhibitory effect of berberine on BPA was evaluated. RESULTS: Five, twenty-six, and twenty-six isolates belonged to strong, moderate, and weak biofilm producers, whereas seventeen showed no biofilm production. We defined strong, moderate, or weak biofilm producers as the producer group (n = 57) to conduct a comparative analysis between the producer and non-producer populations. There was a significant correlation between the producer population and vaginal specimen. We found significant associations between the producer group and presence (57.9%) of pilB and between the non-producer population and presence (70.6%) of spb1. There was no association between the producer group and capsular genotypes, sequence types/clonal complexes, and AMR phenotypes/genotypes (except for a significant correlation between the producer group and AMR to minocycline). We confirmed inhibitory effect of berberine at sub-minimum inhibitory concentrations (MICs) against the type strain on BPA. CONCLUSION: Our observations suggest that S. agalactiae harboring pilB is more capable of producing biofilms, with berberine inhibitory effect at sub-MICs on BPA.

Intracellular invasion ability of Streptococcus agalactiae among non-invasive isolates from human adults and companion animals in Japan.

OBJECTIVE: This study evaluated the cell invasion ability (CIA) of Streptococcus agalactiae isolates from humans and companion animals and clarified the relationship between CIA populations and their microbiological features. METHODS: Human-origin and companion animal-origin isolates were collected along with host information. We measured CIA using human-lineage colon cancer epithelium (Caco-2) and keratinocyte (HaCaT) cell lines, via virulence-associated gene profiling (bca-rib-bac-lmb-cylE-hylB-pavA-pilB-spb1-srtC1-brpA), capsular genotyping, multilocus sequence typing, and antimicrobial resistance (AMR) phenotyping/genotyping. Significant differences in data regarding CIA into epithelium and keratinocytes and those of isolates from different hosts were assessed. We analyzed the association of CIA populations with the virulence genotypes, capsular genotypes, sequence types/clonal complexes, and AMR phenotypes/genotypes. RESULTS: A comparative analysis was performed between human (n = 15) and canine (n = 17) non-invasive isolates. There was a difference in CIA data between Caco-2 and HaCaT cells using human and animal isolates. For percent invasion ability into Caco-2 cells, we designated values ≥ 0.1 as high-frequency CIA and values < 0.1 as low-frequency CIA. Fourteen isolates harbored high-frequency and 18 isolates harbored low-frequency strains. There was no association between the high-frequency population and the virulence genotypes, capsular genotypes, sequence types/clonal complexes, and AMR phenotypes/genotypes. CONCLUSION: This is the first report assessing the invasion ability of S. agalactiae into HaCaT and Caco-2 cells. Our observations suggest that S. agalactiae is more capable of entering Caco-2 rather than HaCaT.

[Long-term Relapse-free Survival after Gefitinib Treatment Followed by Salvage Surgery for Postoperative Recurrence of Non-small Cell Lung Cancer:Report of a Case].

We present a case of a 54-year-old woman who had been performed video-assisted thoracic surgery (VATS) right upper lobectomy for stageⅡB adenocarcinoma. The patient had the recurrence of multiple lung metastases at 12 months after the surgery and was administrated gefitinib. The lung metastases disappeared at 3 months after the administration of gefitinib. A single metastasis in the left lower lung appearance again and VATS wedge left lung resection as salvage surgery was performed in postoperative 82 months. After salvage surgery, the patient has been followed up without additional treatment and is alive recurrence-free at 19 months.

[Experience of Complete Video-assisted Thoracoscopic Pneumonectomy].

Thoracotomy has been preferred to video-assisted thoracoscopic surgery( VATS) for performing pulmonary pneumonectomy, and there have been no reports of complete video-assisted thoracoscopic surgery (cVATS) for such a case. We present three cases of cVATS pneumonectomy. The operation method was based on four ports, and ports were added in difficult cases. In these cases, the blood loss and length of surgery were similar to results of VATS reported previously. We experienced bleeding complications in one case but were able to manage appropriately. There were no serious postoperative complications in our cases. In addition, it was considered acceptable in terms of safety because there were no deaths within 30 days after operation in all cases. The cVATS pneumonectomy for lung cancer is one of the useful treatment option because of safety and many benefits although the long-term results are unknown at present.

[Extrapleural Hematoma Caused by Thoracic Vertebral Burst Fracture].

Extrapleural hematoma caused by thoracic vertebral burst fracture is very rare. We present the case of a 70-year-old man who was treated with a combination of video-assisted thoracic surgery (VATS) and extrathoracic operation. The patient was admitted to our hospital with complaints of dyspnea and pain in both legs. Computed tomography (CT) demonstrated a massive extrapleural hematoma in the right thoracic cavity, and 12th thoracic vertebral burst fracture. We treated the patient with pharmacotherapy because CT showed no active bleeding and the circulation and respiratory dynamics were stable. One week later, the hematoma was not reduced by pharmacotherapy, so we performed combination surgery of VATS. After surgery, there were no serious complications and the patient was discharged from the hospital on day 11 from surgery. In the following 2 months, there was no evidence of recurrence. The combination of VATS and extrathoracic operation was safe, and good result was obtained.

[Solitary Diaphragmatic Metastasis after Radical Surgery of Early Endometrial Cancer].

Solitary diaphragmatic metastasis from early endometrial cancer is quite rare. We present a case of a 58-year-old woman who had been performed radical surgery for stageⅠA, G1 endometrial cancer 3 years before. The patient was referred to our hospital for chest abnormal shadow. Computed tomography (CT) and Magnetic resonance imaging (MRI) showed a mass in the right diaphragm, without the finding of liver invasion. We performed partial resection of diaphragm through video-assisted thoracoscopic surgery (VATS). After surgery, there were no serious complications and was discharged from the hospital on day 6 from surgery. Nine months later, the patient is alive without recurrence.

Hunting Axion Dark Matter with Protoplanetary Disk Polarimetry.

We find that the polarimetric observations of protoplanetary disks are useful to search for ultralight axion dark matter. Axion dark matter predicts the rotation of the linear polarization plane of propagating light, and protoplanetary disks are ideal targets to observe it. We show that a recent observation puts the tightest constraint on the axion-photon coupling constant for an axion mass m≲10^{-21} eV.

Axion Dark Matter Search with Interferometric Gravitational Wave Detectors.

Axion dark matter differentiates the phase velocities of the circular-polarized photons. In this Letter, a scheme to measure the phase difference by using a linear optical cavity is proposed. If the scheme is applied to the Fabry-Pérot arm of Advanced-LIGO-like (Cosmic-Explorer-Like) gravitational wave detector, the potential sensitivity to the axion-photon coupling constant, g_{aγ}, reaches g_{aγ}≃8×10^{-13} GeV^{-1}(4×10^{-14} GeV^{-1}) at the axion mass m≃3×10^{-13} eV (2×10^{-15} eV) and remains at around this sensitivity for three orders of magnitude in mass. Furthermore, its sensitivity has a sharp peak reaching g_{aγ}≃10^{-14} GeV^{-1}(8×10^{-17} GeV^{-1}) at m=1.563×10^{-10} eV (1.563×10^{-11} eV). This sensitivity can be achieved without losing any sensitivity to gravitational waves.

Optical Ring Cavity Search for Axion Dark Matter.

We propose a novel experiment to search for axion dark matter that differentiates the phase velocities of the left- and right-handed polarized photons. Our optical cavity measures the difference of the resonant frequencies between two circular polarizations of the laser beam. The design of our cavity adopts a double-pass configuration to realize a null experiment and give a high common mode rejection of environmental disturbances. We estimate the potential sensitivity to the axion-photon coupling constant g_{aγ} for the axion mass m≲10^{-10} eV. In a low mass range m≲10^{-15} eV, we can achieve g_{aγ}≲3×10^{-16} GeV^{-1}, which is beyond the current bound by several orders of magnitude.

Complete thoracoscopic lobectomy versus hybrid video-assisted thoracoscopic lobectomy for non-small cell lung cancer.

OBJECTIVE: Video-assisted thoracoscopic surgery (VATS) is the standard approach to lobectomy for early-stage non-small cell lung cancer (NSCLC). However, there are many different types. One of its approaches is complete thoracoscopic surgery (CTS), which may be less invasive because of low chest wall stress. This study compared the treatment outcomes of CTS and hybrid VATS lobectomy for NSCLC. METHODS: In total, 442 eligible patients with clinical N0 NSCLC underwent lobectomy between 2007 and 2016. Patients were classified into a group of patients who underwent CTS and a group of those who underwent hybrid VATS. Propensity score matching was performed between the two groups. RESULTS: There were 175 patients after matching. The median follow-up period in the CTS and hybrid VATS groups was 60 and 63 months, respectively. The CTS group showed less blood loss (CTS, 50 mL vs. 100 mL, p = 0.005), fewer complications (CTS, 25.7% vs. 36.6%, p = 0.037), and shorter postoperative hospital stays (CTS, 8 days vs. 12 days, p < 0.001). There was no significant difference in the postoperative 30-day mortality rates. Between the patients who underwent CTS and hybrid VATS groups, the 5-year overall survival rates were 85.4% and 86.0% (p = 0.701), the relapse-free survival rates were 76.5% and 74.9% (p = 0.435), and the lung cancer-specific survival rates were 91.5% and 91.7% (p = 0.90), respectively. CONCLUSIONS: CTS is less invasive and has superior short-term outcomes as an approach to lobectomy for early-stage NSCLC.

Programming Spatial Cell Sorting by Engineering Cadherin Intracellular Activity.

The spatial sorting of cells into appropriate tissue compartments is essential for embryogenesis and tissue development. Spatial cell sorting is controlled by the interplay between cell surface affinity and intracellular mechanical properties. However, intracellular signaling that can sufficiently sort cell populations remains unexplored. In this study, we engineered chimeric cadherins by replacing the cadherin intracellular domain with cytoskeletal regulators to test their ability to induce spatial cell sorting. Using a fibroblast-based reconstitution system, we observed that Rac1 and RhoA activity in the cadherin tail induced outward and inward sorting, respectively. In particular, RhoA activity embedded cells toward the inside of E-cadherin-expressing spheroids and tumor spheroids, leading to tissue invagination. Despite the simplicity of chimeric cadherin design, our results indicate that differences in cadherin intracellular activities can determine the direction of spatial cell sorting, even when cell surface affinity is not different, and provide new molecular tools to engineer tissue architectures.

Successful complete thoracoscopic resection of costal osteochondroma: A case report.

Osteochondroma rarely occurs in the ribs; therefore, the treatment is not standardized. There are few studies of resection via complete thoracoscopic surgery (CTS), although video-assisted thoracoscopic surgery with mini-thoracotomy has been reported. Herein, we report a case of costal osteochondroma managed with CTS. A 23-year-old woman presented to our hospital due to left chest pain. Chest computed tomography revealed a bone-like structure protruding into the thoracic cavity from the left fourth rib. Thus, surgery was performed to obtain a definitive diagnosis and provide appropriate treatment. The tumor was resected from the base at the border of the normal bone via CTS using three 5.5-mm ports. A pathological diagnosis of costal osteochondroma was made. The patient had an uneventful clinical course and did not present with a recurrence 1 year after surgery. Therefore, CTS can be a good approach for cases with slim and stalked costal osteochondroma.

[Photodynamic diagnosis and preoperative chemotherapy for biliary tract cancer].

BACKGROUND: Cancer cells synthesize substantial amounts of protoporphyrin IX( PPIX) from aminolevulinic acid( ALA). PPIX emits red fluorescence when illuminated under blue light. Photodynamic diagnosis (PDD), based on this phenomenon, is currently used; however, various microorganisms also show the same fluorescence with ALA when illuminated under blue light, resulting in false-positive PDD results. PURPOSE AND METHODS: To avoid misdiagnosis, we incorporated novel systems into the PDD system. ALA, blue light (wavelength, 380-450 nm), different kinds of cell lines, and bacteria were used in this in vitro study. We used a 70% deacetylated chitosan solution (DAC-70 Sol), developed in-house, as an antibacterial agent and prepared ALA/DAC-70 Sol, used as a novel photoimaging agent. The antibacterial function of ALA/DAC-70 Sol was examined in vitro, and the photodiagnostic effects on using the novel systems were clinically evaluated using bile from patients with biliary tract cancer. RESULTS: DAC-70 Sol demonstrated an effective bactericidal function in vitro. Red fluorescence could clearly be identified, enabling the detection of cancer cells in the bile using ALA/DAC-70 Sol. CONCLUSIONS: Our novel systems have a great potential for use in clinical photodynamic cytodiagnosis( PDCD), which plays an important role in preoperative cancer chemotherapy.