Novel tissue thickening around the notochord sheath found in deformed Japanese eel Anguilla japonica leptocephali.

Even though reared leptocephalus larvae of the Japanese eel Anguilla japonica have a high incidence of notochord deformities (>60%), the cause is unknown. We performed histological examinations of the notochord and associated organs in reared larvae to better understand the process causing notochord deformation in eel larvae. In deformed larvae, unknown tissue thickening was discovered near the notochord sheath. Azan staining revealed that these tissue thickenings are most likely collagen fibers within fibrous connective tissue. This was almost identical to the connective tissue found in the primordium of the vertebral body around the notochord sheath in properly metamorphosing larvae. Furthermore, the amount of the thyroid hormone triiodothyronine (T3) was significantly higher in deformed larvae than in normal larvae, indicating that notochord deformity is probably linked to metamorphosis despite the immature stage of growth. We suggest that the aberrant growth of connective tissue surrounding the notochord sheath induced by incomplete metamorphosis causes deformities in eel larvae. The reason why deformed larvae have greater thyroid hormone levels is still unknown. It is important to assess how environmental and dietary factors affect the thyroid hormone levels of eel larvae raised in captivity.

Prostaglandin-Associated Periorbitopathy Symptom Alleviation After Switching Prostaglandin F Receptor Agonist to EP2 Receptor Agonist in Patients with Glaucoma.

Purpose: Prostaglandin-associated periorbitopathy in patients with glaucoma is reportedly not caused by EP2 agonist, but it has been a cosmetic problem with prostaglandin F receptor (FP) agonists. In this study, patients with prostaglandin-associated periorbitopathy on FP agonists were switched to EP2 agonist and changes were investigated. Methods: Patients complaining of prostaglandin-associated periorbitopathy were included. The FP agonist was switched to EP2 agonist (omidenepag isopropyl), and patients were followed up for 7 months. Frontal photographs were taken at every visit, and objective changes in deepening of the upper eyelid sulcus were assessed by three observers. Subjective questionnaires (self-awareness of deepening of the upper eyelid sulcus, eyelid/peri-eyelid skin pigmentation, eyelash elongation, and conjunctival hyperemia) were acquired at the start and the endpoint. Factors associated with the change of prostaglandin-associated periorbitopathy were investigated using logistic regression analysis. Results: Included were 23 eyes of 23 patients (17 women; 60.6 years). At 7 months, objective deepening of the upper eyelid sulcus improved by 76%. The subjective questionnaires showed that deepening of the upper eyelid sulcus improved in 95%, eyelid/peri-eyelid skin pigmentation in 76%. The less extent of myopia was a significant factor in the eyes with improved eyelid/peri-eyelid skin pigmentation. After switching, no change in intraocular pressure or visual acuity was observed (P ≥ 0.22). Conclusion: Switching to omidenepag isopropyl increased patient satisfaction and might be the first step to lightening deepening of the upper eyelid sulcus and eyelid/peri-eyelid skin pigmentation. It was suggested that pigmentation may be more easily improved in nonmyopic eyes.

Malignant testicular unclassified sex cord stromal tumor: a case report.

BACKGROUND: Most testicular tumors are germ cell tumors; sex cord stromal tumors are infrequent, accounting for only 3-5% of testicular tumors. Unclassified sex cord stromal tumors are extremely rare. Generally, 10% of sex cord stromal tumors are malignant. We report a case of malignant unclassified sex cord stromal tumor with retroperitoneal lymph node metastasis at first visit and a corresponding literature review. CASE PRESENTATION: A 72-year-old Japanese man visited our department primarily for indolent right scrotum enlargement in September 2020. Blood biochemistry examination, urinalysis, and tumor markers (alpha-fetoprotein, human chorionic gonadotropin, and lactate dehydrogenase) showed no abnormal findings. Contrast-enhanced computed tomography showed enlarged para-aortic lymph node (18 × 16 and 10 × 102 mm); a 50 × 452 mm mass with uneven contents was found in the right testicle. The patient underwent inguinal orchiectomy in September 2020. As per immunohistochemistry, the tumor cells were diffusely positive for SF-1 and Ki-67, partially positive for inhibin, and negative for CAM5.2, CK7, CK20, C-KIT, CD30, LCA, GATA-3, TTF-1, and PAX8. Calretinin was expressed in approximately 5% of tumor cells; thus, sex cord/gonadal stroma components were considered to be involved. The final pathological diagnosis was unclassified malignant sex cord stromal tumor. The patient was diagnosed with pT1, N1, M0, S0, and tumor-node-metastasis stage IIA disease. The patient received postoperative chemotherapy with four courses of etoposide and cisplatin therapy from November 2020. Post-chemotherapeutic computed tomography showed new metastatic lesions including lung, liver, pancreas, and para-aortic lymphadenopathy, which increased in size. Disease progression was observed. Cancer genome research was performed using the OncoGuide National Cancer Center oncopanel system; however, no gene mutation for which the drug could be expected to be effective was found. The patient opted for best supportive care at a nearby hospital and died from cancer progression in January 2022. CONCLUSION: We encountered a case of malignant testicular unclassified sex cord stromal tumor pathologically diagnosed as testicular tumor with retroperitoneal lymph node metastasis in a patient who underwent inguinal orchiectomy. Future data collection is necessary to establish multimodality therapy for malignant testicular unclassified sex cord stromal tumor.

Immunoglobulin G4-related disease diagnosed by prostate biopsy: a case report.

BACKGROUND: Immunoglobulin G4-related disease is characterized by swelling of various organs throughout the body and nodules/hypertrophic lesions. However, its cause remains unknown. We report a case of immunoglobulin G4-related disease that was diagnosed based on the histopathological findings of prostate biopsy. CASE PRESENTATION: A 72-year-old Japanese man had been treated by a nearby doctor for hypertension, but subsequently developed lower urinary tract symptoms and was prescribed an α1 blocker for 1 year. However, the patient was subsequently referred to our department because his symptoms did not improve. Prostate-specific antigen was 1.258 ng/ml; however, the nodule was palpable in the right lobe on digital rectal examination, and magnetic resonance imaging suggested Prostate Imaging and Reporting and Data System category 3. Therefore, transrectal prostate needle biopsy (12 locations) under ultrasound was performed. Histopathological examination revealed no malignant findings, although infiltration of lymphocytes and plasma cells, and partial fibrosis were observed. No remarkable findings of obstructive phlebitis were observed. Immunoglobulin G4-related disease was suspected, and immunoglobulin and immunoglobulin G4 immunostaining was performed. Immunoglobulin G4 positive plasma cells were observed in a wide range, immunoglobulin G4 positive cells were noted at > 10 per high-power field, and the immunoglobulin G4 positive/immunoglobulin G positive cell ratio was > 40%. Serum immunoglobulin G4 levels were high at 1600 mg/dl. Enhanced abdominal computed tomography findings suggested periaortitis. Additionally, multiple lymphadenopathies were observed around the abdominal aorta. The patient was accordingly diagnosed with immunoglobulin G4-related disease definite, diagnosis group (definite). We proposed steroid treatment for periaortic soft tissue lesions and lower urinary tract symptoms; however, the patient was refused treatment. A computed tomography scan 6 months after diagnosis revealed no changes in the soft tissue lesions around the aorta. Follow-up computed tomography examinations will be performed every 6 months. CONCLUSION: If immunoglobulin G4-related disease is suspected and a highly invasive examination is required for histopathological diagnosis, this can be performed by a relatively minimally invasive prostate biopsy for patients with lower urinary tract symptoms. Further evidence is needed to choose an optimal candidate for prostate biopsy for lower urinary tract symptoms patients with suspicion of immunoglobulin G4-related disease. For patients with lower urinary tract symptoms with immunoglobulin G4-related disease or a history, performing a prostate biopsy may avoid unnecessary treatment. However, if steroid therapy is ineffective, surgical treatment should be considered.

Influence of Dry Eye Disease on the Measurement Repeatability of Corneal Curvature Radius and Axial Length in Patients with Cataract.

The influence of dry eye disease (DED) on ocular biometric measurements is unclear. We aimed to investigate the effect of DED on the repeatability of ocular biometric measurements in cataract patients. Overall, 114 eyes scheduled for cataract surgery were enrolled. Before surgery, DED parameters including tear film break-up time (BUT), corneal and conjunctival staining scores, and subjective symptoms were examined. Corneal curvature radius and axial length were assessed twice on the same day using IOLMaster-500 (Carl Zeiss Meditec), and the absolute difference between the two measurements was calculated and used as an index of measurement repeatability. The measurement repeatability of the steep meridian of corneal curvature radius was significantly worse in eyes with DED than in those without DED (p = 0.044) and was significantly associated with BUT (r = -0.206, p = 0.031). The measurement repeatability of axial length was negatively correlated with BUT (r = -0.199, p = 0.041) and positively correlated with the corneal staining score (r = 0.253, p = 0.009). In conclusion, the measurement repeatability of corneal curvature radius declined in eyes with DED. Shortened BUTs were associated with a deterioration in the measurement repeatability of corneal curvature radius and axial length.

The Effect of Diquafosol Ophthalmic Solution on Clinical Parameters and Visual Function in Soft Contact Lens-Related Dry Eye.

INTRODUCTION: This study evaluated the efficacy and safety of diquafosol ophthalmic solution (DQS) in soft contact lens (SCL)-related dry eye using artificial tear as a control. METHODS: This study enrolled 26 patients with SCL-related dry eye. DQS and artificial tears (AT) were instilled into the right and left eyes, respectively, with their SCLs on. Dry eye examinations (including tear film breakup time, tear volume, and staining score) were performed and visual function (including contrast sensitivity) was also evaluated before (at baseline) and after treatment (at 4- and 8-week examinations). Subjective symptoms were assessed separately in each eye using a questionnaire on dry eye in contact lens wearers. The results were compared before and after treatment, and between the right eyes treated with DQS (the DQS eye) and the left eyes treated with AT (the AT eye) using the mixed effect model. RESULTS: Corneal and conjunctival staining scores at 8-week examination were significantly lower than those at baseline in the DQS eye (p = 0.03; p < 0.001, respectively), but no significant changes were observed in the AT eye. Most subjective symptoms improved significantly in both the DQS and AT eyes. However, major subjective symptoms (dryness and blurry vision) improved significantly only in the DQS eye at 8-week examination. Contrast sensitivity at 8-week examination in the DQS eye improved significantly at 12 cycles/degree compared to baseline (p = 0.001) and was significantly better than that in the AT eye (p = 0.03). There were no adverse events related to DQS or AT. CONCLUSIONS: DQS was effective and safe for SCL-related dry eye. DQS also improved contrast sensitivity. TRIAL REGISTRATION: University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR), Identification No. UMIN000024064.

Electromyographic evaluation of perioral muscle activities during facial expression and button-pull exercise.

BACKGROUND: Muscle weakness negatively affects perioral muscles and quality of life. The button-pull exercise is used to teach lip closure (LC) and to strengthen muscles. However, how the muscles accomplish LC during button-pull and its training effect on each muscle are unknown. OBJECTIVES: This study aimed to investigate the LC mechanism and the efficacy of perioral muscle training. METHODS: Electromyographic (EMG) activities were obtained from perioral muscles along with the lip closing force (LCF) and were normalised to the maximum LC activities. Correlations between muscle activities and LCF were assessed during LCF increment/decrement task. The effectiveness of training methods was evaluated during functional face tasks (FFT). The effects of button-pull on muscles were evaluated during static loadings with two sized buttons. RESULTS: The muscles were active during LC, and the amplitudes changed with the LCF. In FFT, the muscles were simultaneously active and the total activity was highest during the blowing task. In button-pull, maximum button-pulling forces (BPFs) were significantly larger with the large button (p = .0001). In the static loading task, muscle activities increased with increasing button load. However, the small button produced significantly greater EMG activity than the large button in most of the load (p < .005). CONCLUSION: LC is accomplished by the cooperation of perioral muscles. In button-pull, a larger button requires a larger BPF, but a smaller button shows higher muscle activities. Face expression exercises compare favourably with button-pull. Forceful LC and blowing tasks may be effective and balanced training of the perioral muscles.

Primary leiomyoma of the ureter: a case report.

BACKGROUND: Only 14 cases of leiomyoma with ureteral origin have been reported previously. Such primary leiomyomas often present as hydronephrosis, making the diagnosis difficult. Radical nephroureterectomy is often performed because of the possible diagnosis of a malignant tumor. We report the 15th case of primary leiomyoma with a ureteral origin. CASE PRESENTATION: A 51-year-old Japanese man presented with a chief complaint of asymptomatic gross hematuria with a history of hypertension. Enhanced computed tomography showed a tumor at the upper part of the right ureter that appeared to be the cause of hydronephrosis and contracted kidney; no retroperitoneal lymphadenopathy and distal metastasis were observed. A well-defined 20-mm (diameter) defect was identified at the upper of the right ureter on retrograde pyelogram with no bladder cancer on cystoscopy. Urine cytology and right divided renal urine cytology findings were negative. Laparoscopic nephroureterectomy was performed, and the extracted tumor measured 20 × 13 mm. Histopathological examination revealed primary leiomyoma with no recurrence 16 months after the operation. CONCLUSIONS: Preoperative examination with the latest available ureteroscopic technology can help preserve renal function in the case of benign tumors by enabling preoperative ureteroscopic biopsy or intraoperative rapid resection. Moreover, nephroureterectomy is recommended in the case of preoperative suspicion of ureteral malignant tumors.

Recovery of deepening of the upper eyelid sulcus after switching from prostaglandin FP receptor agonists to EP2 receptor agonist: a 3-month prospective analysis.

PURPOSE: To examine the effect of switching from a prostanoid FP receptor agonists to EP2 receptor agonist (omidenepag isopropyl) on the deepening of the upper eyelid sulcus (DUES) and intraocular pressure (IOP) in Japanese glaucoma patients over 3 months post treatment. STUDY DESIGN: Prospective observational study. METHODS: Patients with glaucoma who received FP receptor agonists treatment and had complained of DUES-related reduction in quality of life were included. Their FP receptor agonists was switched to omidenepag isopropyl without a drug holiday. At baseline and 1 and 3 months post-switch, photographs were taken and the changes in DUES were assessed by three independent observers. IOP and adverse events were also assessed. RESULTS: The study included 23 eyes of 23 patients (6 men, 17 women; average age, 60.6 years). After switching, DUES improved in 12 eyes at 1 month and in 16 eyes at 3 months; eyes in the remaining patients showed no worsening of the condition. The mean IOP before switching was 15.3 ± 3.3 mmHg (95% confidence interval 13.9-16.7 mmHg). Following the switch, the mean IOP values were 15.6 ± 3.3 mmHg (14.1-17.0 mmHg) at 1 month and 15.5 ± 3.3 mmHg (14.1-16.9 mmHg) at 3 months (P = 1.0 at 1 month, P = 1.0 at 3 months; both adjusted by Bonferroni correction). No adverse effects were observed. CONCLUSION: Omidenepag isopropyl improved DUES while maintaining IOP in over 70% of Japanese patients with glaucoma who exhibited DUES caused by FP receptor agonists; the improvement was observed within 3 months after switching from FP receptor agonists.

New method of recording the functional activity pattern of the buccinator from the mucosal surface.

OBJECTIVES: The buccinator (BUC) is an important muscle for oral function. Since it lies deep in the facial skin, recording its activity is difficult; thus, studies on its function are limited. We developed a method to access the deep facial muscles from the mucosal side. The aim of this study was to test the reliability of the new recording method for the BUC and to investigate the BUC behavior in typical facial functions. METHODS: To evaluate the new method, BUC activities were recorded simultaneously with a gel-type electrode on the skin and the newly developed surface electrode on the buccal mucosa. Electromyographic (EMG) activities in function, such as chewing and swallowing, along with the activities of the lower orbicularis oris (OO), zygomaticus major, masseter, and digastric muscles, were compared using the two recording methods. EMG activities among various tasks were compared using normalized values based on those obtained during maximum lip closure (MaxLC). RESULTS: The new surface electrode was made of gold plates on a thin plastic fixed to a stainless-steel wire frame and weighed less than 1 g. The BUC activity recorded from the mucosa was the highest during a corner-pulling task and was low during clenching. The BUC was active during MaxLC, similar to the OO, and the BUC activity pattern among tasks recorded from the mucosa was identical to that reported by previous studies using intramuscular electrodes. The new electrode evaluated the BUC activities quantitatively, and the recordings by the new electrode were free from contamination. CONCLUSIONS: The findings of this study confirmed the reliability of the new BUC recording method. It could be easily placed correctly within seconds, without the need for cleansing or sterilizing the skin. The BUC and OO were active during a MaxLC task, indicating that the BUC assists lip closure by pulling the corners of the mouth. The basic facial functions evaluated, including chewing, were similar to those studied by intramuscular electrodes.

Late testicular relapse two decades after primary extragonadal germ cell tumor with uncommon metastases: a case report.

BACKGROUND: Extragonadal germ cell tumor (EGCT) is a relatively rare condition, reportedly representing 3-7% of all germ cell tumors. We report a patient who had metachronous testicular tumor with uncommon metastases 20 years after primary retroperitoneal EGCT treatment, along with a corresponding literature review. CASE PRESENTATION: A 49-year-old Japanese man visited our department in November 2017 with chief complaints of indolent right scrotum enlargement and a right inguinal mass. History showed that the patient visited our department of gastroenterology with chief complaints of blackish feces and ill complexion in February 1997. Computed tomography (CT) showed a right retroperitoneal tumor, which was removed in the same month. Histopathological examination showed a teratoma and yolk sac tumor. He was diagnosed with primary retroperitoneal EGCT and received three courses of chemotherapy (bleomycin/etoposide/cisplatin; BEP). Periodic imaging and the determination of tumor markers (alpha-fetoprotein [AFP], human chorionic gonadotropin [HCG], and lactate dehydrogenase [LDH]) showed no recurrence or metastasis during the 5 years postoperatively. Subsequently, he did not visit the outpatient ward. In August 1999, he underwent surgery of right hydrocele. Contrast-enhanced CT showed a 35-mm contrast effect with uneven content in the right testicle and enlarged nodes that raised suspicion for metastases in the right inguinal and right external iliac lymph nodes. All tumor markers were within normal ranges. He underwent right high orchiectomy and resection of the right inguinal lymph nodes in the same month. Histopathological findings revealed seminoma (pT1, pN2, M0, S0, and TNM stage IIB). He received postoperative chemotherapy, one course of BEP therapy, and three courses of etoposide and cisplatin therapy. Post-chemotherapy CT confirmed a complete clinical response at the right external iliac lymph nodes, and this response continued 12 months later. No recurrence or metastasis has been found so far. CONCLUSIONS: We report a patient in whom a testicular tumor with uncommon metastases occurred 20 years after primary retroperitoneal EGCT treatment. After EGCT treatment, testicular relapses tend to occur after relatively long-term follow-up. After EGCT treatment, such patients must be closely monitored for testicular recurrences and onset of testicular tumor.

[Daily information-gathering behavior of natural disaster victims: Focusing on residents who experienced the Great East Japan Earthquake and the Kanto-Tohoku Heavy Rainfall Disaster].

Objectives　To obtain suggestions for improving disaster-prevention literacy, this study elucidated the daily information-gathering behavior of residents living in areas affected by two Japanese natural disasters (the Great East Japan Earthquake of 2011 and the Kanto-Tohoku Heavy Rainfall Disaster in September 2015) and examined factors affecting life backgrounds and disaster experiences.Methods　In June 2017, we administered a cross-sectional survey using a self-administered questionnaire to 1,065 households in areas affected by the Great East Japan Earthquake and the Kanto-Tohoku Heavy Rainfall. One person in each household responded to the questionnaire. Of 362 respondents (response rate 34.0%), 336 with definite attributes were analyzed. After ascertaining their daily information-gathering behavior, we applied binary logistic regression analysis, incorporating-as dependent variables-three variables previously used in times of disaster.Results　Of the respondents, 179 were men (53.3%); the average age (standard deviation) was 65.5 (10.6) years. Information-gathering modes used by more than half the subjects were "television," "newspaper," "conversation/word of mouth," "radio," and "community magazine" in descending order of use.　Examination of the factors of the three variables revealed the following. (1) Four variables were significantly and positively correlated with "conversation/word of mouth": "woman" (1.82 odds ratio [OR]; 1.05-3.15 95% confidence interval [CI]); "I have" a co-resident family member (OR, 2.46; 95% CI, 1.06-5.72); "I can expect" mutual aid from community residents (OR, 2.31; 95% CI, 1.27-4.21); and "I feel more" fear of typhoons and heavy rains now than before (OR, 1.82; 95% CI, 1.04-3.18). (2) "Radio" has two variables with significant and positive correlations: "I have" a co-resident family member (OR, 3.22; 95% CI, 1.35-7.67) and "I was affected" by the Great East Japan Earthquake and the Kanto-Tohoku Heavy Rainfall Disaster (OR, 1.73; 95% CI, 1.01.2.97). (3) Two variables are significantly correlated with "Internet service": "Age" has a negative correlation (OR, 0.91; 95% CI, 0.88-0.94); "I can expect" mutual aid from community residents has a positive correlation (OR, 2.66; 95% CI, 1.19-5.93).Conclusion　Damage and fear instilled by natural disasters influence subsequent information-gathering behavior. Disaster prevention literacy in ordinary times can be improved because of the correlation between awareness of mutual aid in local communities and information-gathering behavior.

Use of barometric pressure and electromyography measurement techniques to elucidate the mechanisms by which bolus passes from the oral cavity to the oropharynx during swallowing.

OBJECTIVES: The exact timings associated with swallowing are difficult to measure with the currently available methods. In this study, we aimed to elucidate the timings of action of the swallowing organs in the oral and pharyngeal stages of swallowing by recording the barometric pressure (BP) and tongue muscle activities. METHODS: Dry and water swallows were studied in 10 adults using electromyography and small barometers. BPs were recorded during swallowing in the oral cavity (BP-o) and pharynx (BP-p), associated with muscle activities of the anterior (TA) and posterior (TP) parts of the tongue and of the suprahyoid (SHy) muscle. To analyze the temporal pattern of each activity, times of onset, cessation, and peak were measured. RESULTS: Two characteristic waveforms were obtained. BP-o peaked immediately after onset and decreased to atmospheric pressure following a short plateau. However, BP-p gradually increased, reached a peak, and returned to the atmospheric pressure immediately before the end of BP-o. Since pressure increments indicated that the sensor was compressed in a closed space, onset and cessation of BP-p could correspond to the duration of nasopharyngeal closure. The onset of BP-p and the peak time of BP-o occurred in close succession. Thus, nasopharyngeal closure could be evaluated from BP-o. The sensor and EMG measured durations of oral and pharyngeal stages as 0.4 and 0.6 sec, respectively. TA activation began earlier than the TP. TA and TP peaks appeared before the BP-o peak, suggesting that the tongue begins the activity for swallowing before nasopharyngeal closure. CONCLUSIONS: This study revealed movements of swallowing organs in the two stages with high temporal resolution. BP-o detected the duration of nasopharyngeal closure.

[A Case of Metachronous Testicular Tumor Developing Twenty Years after Treatment of Retroperitoneal Extragonadal Germ Cell Tumor].

A 49-year-old male visited our department of gastroenterology with chief complaints of blackish feces and ill complexion in February 1997. Computed tomography (CT) revealed a right retroperitoneal tumor, which was removed the same month. Histopathological examination showed teratoma and yolk sac tumor. He was diagnosed with primary retroperitoneal extragonadal germ cell tumor, and received three cycles of chemotherapy (bleomycin/etoposide/cisplatin ; BEP) starting in March 1997. Periodic imaging and determination of tumor markers (α fetoprotein, human chorionic gonadotropin, and lactate dehydrogenase) showed no recurrence or metastasis for five years after treatment. After his visit in April 2002 he stopped visiting our outpatient ward. In November 2017, the patient visited our department with chief complaints of indolent right scrotum enlargement and a right inguinal mass. Past history showed that he had undergone hydrocele of the right testicle in August 1999. Contrast enhanced CT showed a 35-mm contrast effect with uneven contents in the right testis, and enlarged nodes that were suspicious of metastases in the right inguinal and right external iliac lymph nodes. All tumor markers were within the normal ranges. He underwent right high orchiectomy and resection of the right inguinal lymph nodes in the same month. Histopathological findings revealed seminoma (pT1, pN2, M0, S0, and clinical Stage IIA). He received postoperative chemotherapy starting in January 2018 ; one cycle of BEP therapy and three cycles of etoposide and cisplatin (EP) therapy. Post-chemotherapeutic CT confirmed clinical complete response at the right external iliac lymph nodes, and this response was confirmed 12 months later. Neither recurrence nor metastasis has occurred so far.

Estimation of the spawning time of Japanese eels in the open ocean.

To understand the spawning ecology of the Japanese eel, the spawning time of this species was estimated based on measurements of the ascending speed of eggs and previously obtained data. Two types of water temperature parameters were calculated assuming an arbitrary spawning time. The 'incubation temperature' of 53 eggs collected in the spawning area was estimated based on the developmental stage of each egg and experimentally determined relationships between water temperature and incubation duration. The 'experienced temperature' of eggs ascending in the water column after spawning was estimated based on an ascending egg speed of 3.69 m/h and spawning depth of 230 m determined from a pop-up satellite archival tag release experiment on silver eels conducted in the same area. The incubation and experienced temperatures of the eggs coincided only at 20:20-22:30 h, 3 days prior to the new moon. This period is only a few hours after the diel vertical migration of Japanese eels in the evening, when adults move up from a depth of ~800 m (approximately 5 °C) to shallower waters of 200-250 m depth (approximately 20 °C). Our findings will facilitate improvements in aquaculture techniques and the detection of eel spawning events in the open ocean.

Prospective, Multicenter, Cross-Sectional Survey on Dry Eye Disease in Japan.

INTRODUCTION: Dry eye disease (DED) is commonly encountered in eye clinics and hospitals, and it is therefore very important to understand DED prevalence in outpatients. METHODS: A multicenter, hospital-based cross-sectional study was conducted among outpatients in Japan to ascertain DED prevalence and relationships between DED and patient profiles, including eye disease, DED diagnosis history, and surgical history. DED was diagnosed according to diagnostic criteria of the Asia Dry Eye Society. Patient self-assessment of DED-related subjective symptoms was conducted using the 5-Item Dry Eye Questionnaire (DEQ-5). Tear break-up time was evaluated in subjective symptom-positive patients. RESULTS: The prevalence of DED was 55.7% in 990 patients (mean age 69.1 ± 13.4 years), DED was commonly experienced in combination with other ocular diseases. In revisiting patients, 15.2% had not previously been diagnosed as DED, and their total DEQ-5 scores were higher than those of patients who had undergone DED treatment. CONCLUSION: This study revealed that more than half of the outpatients had DED. Among revisiting patients, there were many "hidden" DED patients who had not been diagnosed with DED in the past. There is a high likelihood of finding DED comorbidity in patients with other eye diseases in eye clinics and hospitals. FUNDING: Santen Pharmaceutical Co., Ltd. TRIAL REGISTRATION: UMIN Clinical Trials Registry Identifier, UMIN000035506.

[A Case of Dedifferentiated Liposarcoma of the Spermatic Cord].

Liposarcomas are most commonly found in the extremities, in the retroperitoneum and, less often, in the head and neck area. The spermatic cord is a rare site of origin, accounting for about 4-7% of all liposarcomas. We report a case of dedifferentiated liposarcoma of the spermatic cord. A 51-year-old man was referred to our hospital for a painless hard mass in the left inguinal region. Abdominal computed tomography showed a left spermatic cord mass measuring 70 mm in diameter. We performed left high orchiectomy with resection of the mass. Immunohistochemical analysis revealed positive for murine double minute 2 (MDM 2) and cyclin dependent kinase 4 (CDK 4). Therefore, this sarcoma was diagnosed to be dedifferentiated liposarcoma. Since the surgical margin was positive, an additional wide resection including the surrounding normal tissue was performed. Complete excision was achieved after re-resection. He was alive 12 months postoperatively without any signs of recurrence. Dedifferentiated liposarcoma of the spermatic cord is a rare neoplasm. To the best of our knowledge, the present case is the 14th reported case in Japan.

Development of a novel composite sensor for evaluating lip function.

OBJECTIVE: To test a novel sensor for assessing lip function. METHODS: The electromyographic (EMG) activity of the upper orbicularis oris muscle (OOM), lip-closing pressure (LP) and intraoral baro-pressure (IP) were simultaneously recorded in 20 healthy subjects (10 women and 10 men) by using a novel composite sensor (CS). Subjects performed the lip-closure, blow and suck tasks. EMG activity of the upper and lower OOMs was recorded using conventional surface electrodes to evaluate the accuracy of CS electrodes. The subjects also rated the user-friendliness of the CS. RESULTS: Integrated EMG signals recorded using the CS and conventional electrodes from the upper OOM were highly correlated (r = 0.77 ± 0.12 in women and r = 0.81 ± 0.10 in men). The signal-to-noise ratio was higher with the CS than with the conventional electrodes. The mean LP during maximum lip closure, blowing and sucking ranged between 2 and 6 kPa in women and between 5 and 7 kPa in men. The corresponding IPs in women were 0.0 ± 0.5, 3.2 ± 1.4 and -4.4 ± 2.6 kPa, respectively, and in men were -0.5 ± 1.4, 4.9 ± 1.8 and -5.6 ± 2.8 kPa, respectively. All subjects rated the recording technique as excellent or good. CONCLUSION: The CS was highly user-friendly and accurate in recording the EMG activity of the OOM and could simultaneously measure the LP and IP. Therefore, it could be an effective tool for evaluating lip function.

Release of eDNA by different life history stages and during spawning activities of laboratory-reared Japanese eels for interpretation of oceanic survey data.

To assist in detection of offshore spawning activities of the Japanese eel Anguilla japonica and facilitate interpretation of results of environmental DNA (eDNA) analysis in their spawning area, we examined the eDNA concentration released by each life history stage of artificially reared Japanese eels in the laboratory using quantitative real-time PCR (qPCR). We also compared eDNA concentrations between before and after artificially induced spawning activities. eDNA was not detected from three 30 L seawater tanks containing each single fertilized egg, but eDNA was found from other tanks each containing single individuals of larval stages (preleptocephalus and leptocephalus), juvenile stages (glass eel, elver and yellow eel) or adult stage (silver eel). The eDNA concentrations increased in the life history stages, showed a significant difference among all stages, and were positively correlated with the total length and wet weight. Moreover, the eDNA concentration after spawning was 10-200 times higher than that before spawning, which indicated that the spawning events in the ocean would produce relatively high eDNA concentration. These results in the laboratory suggested that eDNA analysis appears to be an effective method for assisting oceanic surveys to estimate the presence and spawning events of the Japanese eel in the spawning area.

Randomized Controlled Study to Investigate the Effect of Topical Diquafosol Tetrasodium on Corneal Sensitivity in Short Tear Break-Up Time Dry Eye.

INTRODUCTION: Complex mechanisms underlie dry eye (DE) symptom provocation. In particular, corneal hypersensitivity may provoke symptoms in short tear break-up time (BUT) DE characterized by tear film instability. We hypothesized that improved tear film stability may alleviate corneal sensitivity in patients with short tear BUT DE. Therefore, we investigated the effect of topical diquafosol tetrasodium (DQS) on corneal sensitivity in unstable tear film DE. METHODS: This prospective, randomized study included 27 subjects (age: 39.1 ± 8.4 years; range: 25-59 years) with short tear BUT DE, defined based on the presence of DE symptoms and tear film instability. Subjects were randomly divided into DQS (3% DQS, 12 subjects) and artificial tear (AT; preservative-free AT, 15 subjects) groups. Subjects applied the medication 6 times a day for 5 weeks. The perception of touch (S-touch) and pain (S-pain) sensitivity was measured using a Cochet-Bonnet esthesiometer. Tear evaluation, corneal sensitivity, and DE symptoms were compared before and after DQS or AT administration. The correlation between the improvement degrees of corneal sensitivity and DE symptoms following medication was analyzed. RESULTS: DQS significantly improved tear BUT and tear meniscus height (TMH) scores (p < 0.05), while AT significantly improved tear BUT (p < 0.05) but not TMH score. Mean S-pain and DE symptom scores were lower after medication use in the DQS (S-pain and DE symptoms: p  < 0.05) and AT groups (S-pain: p  = 0.05; DE symptoms: p  < 0.05). However, S-touch did not change significantly in either group. A positive correlation was observed between the improvement degrees of S-pain and DE symptoms in the overall subjects studied. CONCLUSION: Both DQS and AT alleviate corneal hypersensitivity and DE symptoms in eyes with short tear BUT DE. However, DQS seems to be more effective to adjust tear environment, leading to the normalization of corneal sensitivity and DE symptoms. TRIAL REGISTRATION: UMIN Clinical Trials Registry Identifier, UMIN000014536.