Background Esophagectomy is an invasive and complication-prone surgical procedure. Therefore, a tool that can predict the occurrence of postoperative complications may be useful for perioperative management. In this study, we investigated whether the modified frailty index (mFI) could be a useful tool for predicting the postoperative complications of esophagectomy.

Methods In this study, 162 patients who underwent curative esophagectomy for esophageal squamous cell carcinoma from 2004 to 2019 at our institution were included. The patients were divided into the high mFI (≥ 0.27) and low mFI (< 0.27) groups, and the short-term postoperative outcomes of each group were examined retrospectively.

Results Regarding background factors, age and the American Society of Anesthesiologists physical status classification were significantly higher in the high mFI group (P = 0.049 and P = 0.002, respectively); however, the other items were not significantly different between the two groups. Regarding surgical outcomes, no significant differences in operative time, blood loss, and hospital stay were observed between the two groups. Regarding postoperative complications, pneumonia was significantly more common in the high mFI group (P = 0.035). In multivariate analysis, high mFI (P = 0.034) was an independent predictor of pneumonia, along with operative time ≥ 613 min (P = 0.03) and preoperative BMI < 20.48 (P = 0.006).

Conclusion The mFI is useful for predicting pneumonia after esophagectomy.

Background Canine mammary gland tumors can be used as predictive models for human breast cancer. There are several types of microRNAs common in human breast cancer and canine mammary gland tumors. The functions of microRNAs in canine mammary gland tumors are not well understood.

Methods We compared the characterization of microRNA expression in two-dimensional and three-dimensional canine mammary gland tumor cell models. We evaluated the differences between two- and three-dimensional cultured canine mammary gland tumor SNP cells by assessing microRNA expression levels, morphology, drug sensitivity, and hypoxia.

Results The expression of microRNA-210 in the three-dimensional-SNP cells was 10.19 times higher than that in the two-dimensional-SNP cells. The intracellular concentrations of doxorubicin in the two- and three-dimensional-SNP cells were 0.330 ± 0.013 and 0.290 ± 0.048 nM/mg protein, respectively. The IC₅₀ values of doxorubicin for the two- and three-dimensional-SNP cells were 5.2 and 1.6 μM, respectively. Fluorescence of the hypoxia probe, LOX-1, was observed inside the sphere of three-dimensional-SNP cells without echinomycin but not in two-dimensional-SNP cells. The three-dimensional-SNP cells treated with echinomycin showed weak LOX-1 fluorescence.

Conclusion The present study showed a clear difference in microRNA expression levels in cells cultured in a two-dimensional adherent versus a three-dimensional spheroid model.

Background Maspin is known to be a tumor suppressor protein: however, its prognostic value in patients with breast cancer remains controversial. The key influential factors contributing to this complexity may be the differences in antibodies used, as well as the positive criteria and sample size. To date, no study has investigated the prognostic significance of maspin expression by using two different antibodies in the same cohort. We aimed to clarify whether differences in antibodies could influence on the prognostic value of maspin in breast cancer patients.

Methods Immunohistochemical analyses using an anti-maspin antibody (clone G167-70) were performed on 164 resected specimens of invasive carcinoma of no special type (NOS). The correlation with clinicopathological factors was compared to previous results using clone EAW24, with longer follow-up duration.

Results The subcellular localization of maspin expression was as follows: cytoplasmic-only staining, 3 cases (1.8%), pancellular staining, 43 cases (26.2%); and no staining, 118 cases (72.0%). No nuclear-only staining was observed. There was no significant correlation between clinicopathological characteristics and the pancellualr expression of maspin. The pancellular expression group showed a significantly longer disease-free survival (DFS) than the other groups (P = 0.046). When clone EAW24 was used, the cytoplasmic-only staining group showed significantly shorter DFS than the pancellular staining group (P = 0.003).

Conclusion Clone EAW24 may be superior to clone G167-70 in selecting breast carcinoma with an aggressive phenotype, while clone G167-70 may be superior to clone EAW24 in selecting non-aggressive breast carcinoma.

Background Cytoplasmic mislocalization of TAR-DNA binding protein of 43 kDa (TDP-43) is a major hallmark of amyotrophic lateral sclerosis (ALS). TDP-43 aggregation is detected in the cortical and spinal motor neurons in most ALS cases; however, pathological mechanism of this mislocalized TDP-43 remains unknown.

Methods We generated a tetracycline-inducible TDP-43 A315T system on a mouse artificial chromosome (MAC) vector to avoid transgene-insertional mutagenesis, established a mouse embryonic stem (ES) cell line holding this MAC vector system, and investigated whether overexpressed exogenous TDP-43 A315T was mislocalized in the cytoplasm of the ES cell-derived neurons and triggered the neurotoxic effects on these cells.

Results Inducible TDP-43 A315T system was successfully loaded onto the MAC and introduced into the mouse ES cells. These ES cells could differentiate into motor neurons and interneurons. Overexpression of TDP-43 A315T by addition of doxycycline in both neurons resulted in mislocalization to cytoplasm. Mislocalized TDP-43 caused cell death of motor neurons, but not interneurons.

Conclusion Vulnerability to cytoplasmic mislocalized TDP-43 is selective on neuronal types, whereas mislocalization of overexpressed TDP-43 occurs in even insusceptible neurons. This inducible gene expression system using MAC remains useful for providing critical insights into appearance of TDP-43 pathology.

Background Achieving an optimal work-life balance (WLB) is an important social issue not only for workers in general but also for doctors due to the shortage of women doctors. The present study aims to survey doctors’ WLB and their use of household chore support services (HCSS).

Methods A questionnaire survey was conducted with doctors working in Tottori Prefecture and a total of 289 responses (212 men, 77 women) were obtained and analyzed. To examine the relationship between gender and satisfaction with working patterns or with life for WLB, as well as the use of HCSS, a chi-squared test was conducted. Furthermore, a chi-squared test was conducted including age, marital status, whether or not they have preschool-aged children, and type of institution the participant worked.

Results A significant difference was found in type of institution the participant worked regarding satisfaction with work patterns and life. The proportion of those who have used HCSS was 12.5% of the total sample and was significantly higher for women than men (men: 8.5%; women: 23.4%). Regarding the reason to use HCSS, “to reduce the burden of household chores and childcare” and “to secure time for work” were most common with the same proportions, and amongst women, “to secure time for work” was the highest.

Conclusion Doctors working at a university hospital could have different work patterns and satisfaction with life compared to those working at other types of medical institutions. Additionally, the demand for HCSS was particularly high among women doctors, which suggests that HCSS may be used to reduce the burden of household chores and childcare, as well as to create time for work.

Background Childhood epilepsy with centrotemporal spikes (CECTS) is the most common epilepsy syndrome in school-aged children. However, predictors for seizure frequency are yet to be clarified using the phase lag index (PLI) analyses. We investigated PLI of scalp electroencephalography data at onset to identify potential predictive markers for seizure times.

Methods We compared the PLIs of 13 patients with CECTS and 13 age- and sex-matched healthy controls. For the PLI analysis, we used resting-state electroencephalography data (excluding paroxysmal discharges), and analyzed the mean PLIs among all electrodes and between interest electrodes (C3, C4, P3, P4, T3, and T4) and other electrodes. Furthermore, we compared PLIs between CECTS and control data and analyzed the associations between PLIs and total seizure times in CECTS patients.

Results No differences were detected in clinical profiles or visual electroencephalography examinations between patients with CECTS and control participants. In patients with CECTS, the mean PLIs among all electrodes and toward interest electrodes were higher at the theta and alpha bands and lower at the delta and gamma bands than those in control participants. Additionally, the mean PLIs toward interest electrodes in the beta frequency band were negatively associated with seizure times (P = 0.02).

Conclusion The resting-state delta, theta, alpha, and gamma band PLIs might reflect an aberrant brain network in patients with CECTS. The resting-state PLI among the selected electrodes of interest in the beta frequency band may be a predictive marker of seizure times in patients with CECTS.

Background Diffuse large B-cell lymphoma, not otherwise specified (DLBCL-NOS), is the most frequent type of lymphoid neoplasm.

Methods We investigated the relationships between clinical factors of DLBCL-NOS and MYC immunohistochemistry (IHC) staining.

Results A total of 110 patients diagnosed with DLBCL-NOS from 2012 to 2020 at Tottori University Hospital and treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) chemotherapy were included. IHC staining of MYC in formalin-fixed, paraffin-embedded tumor specimens was performed, and ROC-curve analysis revealed the cut-off value of the MYC positive rate as 55%. The 2-year overall survival (OS) rates of the MYC-negative and -positive groups were 84.7% vs 57.7% (P = 0.0091), and the progression-free survival rates were 77.8% vs 54.7% (P = 0.016), respectively. Multivariate analysis for OS showed prognostic significance of MYC positivity [hazards ratio (HR): 2.496; P = 0.032], and serum levels of soluble interleukin-2 receptor (sIL-2R) > 2000 U/mL (HR: 3.950; P = 0.0019), as well as age > 75 (HR: 2.356; P = 0.068). The original scoring system was developed based on these findings. By assigning one point to each item, age (> 75), MYC positivity, and sIL-2R level (> 2000), all patients were classified into three risk categories: group 1 (0 points), group 2 (1 point), and group 3 (2–3 points). The 2-year survival rates were 100%, 83.0%, and 47.1% for the groups 1, 2, and 3, respectively (P < 0.0001).

Conclusion We suggest that a prognostic scoring system using MYC expression and soluble interleukin receptor -2 level is useful for the prediction of prognosis, contributing to further stratification in DLBCL-NOS.

Background The administration of basic life support (BLS) by bystanders is essential to improve the survival rates of patients who have experienced out-of-hospital cardiac arrest (OHCA). Although providing BLS to individuals who experience OHCA greatly improves their chances of survival, the actual implementation rate is low. Therefore, we investigated the association between bystanders’ willingness to perform BLS and facilitative/obstructive factors with the objective of identifying educational methods that would improve the likelihood of bystanders performing BLS should they encounter a patient with OHCA.

Methods The study participants included 502 male and 498 female Japanese residents (total, 1000 participants) with no experience in performing BLS and 42 male and 59 female Japanese residents (total 101 participants) with experience in performing BLS. The participants were aged 15–65 years. Both groups graded the strength of their willingness to perform BLS in the future on a 4-point scale, as well as their level of agreement with factors facilitating or obstructing their willingness to perform BLS. These factors were established based on the theory of helping behavior, which defines psychological states when helping others in social psychology.We then analyzed the associations between willingness to perform BLS in the future and their level of agreement with factors facilitating or obstructing their willingness to perform BLS.

Results The willingness to perform BLS decreased in accordance with the increase in the level of intervention required for patients who experienced OHCA , and was significantly associated with four facilitating factors: sufficient ability and experience to perform BLS, personal advantage, high personal norms, and psychological closeness to the patient.

Conclusion Our results suggested that workshops and other educational activities focused on these facilitative factors may be helpful in increasing the rate at which bystanders perform BLS.

Background Low-vacuum scanning electron microscopy (LVSEM) enables the detailed three-dimensional imaging of archival tissues without special pretreatments. The clinical utility of LVSEM in the assessment of liver diseases has not yet been defined. So, we investigated the utility of LVSEM imaging in morphological assessments of normal and diseased liver tissues, with a focus on reticulin structures.

Methods Formalin-fixed tissue samples of two normal livers and two hepatocellular carcinomas with background regenerative nodules/areas were stained with platinum blue stain or silver-impregnated using Watanabe’s method and then comparatively observed under LVSEM. We also evaluated the applicability of LVSEM imaging of liver tissues to a quantitative analysis using a digital image analysis technique.

Results Optimal high-resolution images of reticulin structures were obtained using 10-μm-thick silver-impregnated sections. Reticulin fibers were clearly observed to run dendritically around sinusoids in normal livers, and markedly increased in regenerative nodules/areas. Normal reticulin frameworks were lost in hepatocellular carcinoma, leaving a few fragments of reticulin fibers within tumors. Moreover, when a quantitative analysis was applied to these images, we successfully demonstrated a significantly higher reticulin fiber density in regenerative nodules/areas than in the normal liver (P < 0.05).

Conclusion We not only obtained detailed three-dimensional images of reticulin structures in various liver tissues by LVSEM combined with silver impregnation but also showed their applicability to a quantitative analysis. The method presented herein may be applied to future studies for the more accurate diagnosis and better classification/risk stratification of various liver diseases.

Background This study aimed to determine whether the COVID-19 pandemic increased the number of medical consultations for depression, schizophrenia, and alcohol dependence in low-risk regions.

Methods National Health Insurance enrolments from March 2017 to March 2021 in Tottori Prefecture, Japan, where there were minimal COVID-19 cases in 2020, were included in this study. The all-cause mortality and proportion of National Health Insurance members with depression, schizophrenia, and alcohol dependence in the financial years (FY) 2017, 2018, 2019, and 2020 were calculated. The proportion in FY 2020 was compared with the average proportion from FY2017 to FY2019 and the proportion in FY2019.

Results The all-cause mortality for men aged 80–99 years and women aged 70–89 years decreased in FY2020. The proportion of men aged 20–29 years with depression increased to 4.1% in FY2020 compared with 3.0% in FY2019, while the proportion of women aged 20–29 years with depression was 4.4% in FY2017, 4.8% in FY2018, 4.8% in FY2019, and 5.5% in FY2020, confirming an increasing trend from before the COVID-19 pandemic. The proportion of men aged 30–39 years and 60–69 years with schizophrenia increased and that of women aged 40–49 years, 60–69 years, and 90–99 years with schizophrenia also increased, even before the pandemic. The proportion of people with alcohol use disorder has not changed significantly since FY2017.

Conclusion The pandemic has led to an increased proportion of men aged 20–29 years with depression, even in low-risk regions.

Background Parent training (PT) is a promising support for improving parents’ mental health, and behavior in children with autism spectrum disorders (ASD). In recent years, there has been an increase in online PT studies. We developed a prototype for the on-demand PT. In this study, we examined changes in the program implementation, accomplishment of homework, parents’ mental health, and behavior of children among parents of children with ASD.

Methods This study participated two mothers of children with ASD. The first was the mother of a child aged three years and eight months with ASD and intellectual disability; the second was the mother of a child aged four years and 5 months who had a diagnosis of ASD. An on-demand PT consisting of six sessions was provided online. The program was structured so that the participants watched lecture videos for each session, answered a confirmation test, and submitted homework to advance to the next session. Feedback for the submitted homework and questions was provided via email by the researchers.

Results Both participants watched the program on a schedule for all sessions and submitted all tests and homework assignments. The percentage of correct responses to the tests per session was 100% for both participants. Two of the four target behaviors of the children changed significantly. Pre- and post-questionnaires also showed improvements in the scores of parental depression and parenting stress, as well as overall behavior of the child.

Conclusion The program in this study was developed as a prototype for on-demand PT, and two case studies showed positive results. Although this program was on-demand, changes in parent and child behaviors were confirmed by the scale and actual behavior records. Further demonstration is needed to increase the number of cases and to compare the results between the groups.

Background Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli has been increasingly recognized as the cause of upper urinary tract infection (UTI) in children. We have been using flomoxef at our department since 2017 as the first-line empiric therapy for children diagnosed with UTIs, and we avoid using carbapenems, which are considered the first-line treatment for ESBL-producing E. coli. However, reports on the use of flomoxef for UTIs are limited, especially for pediatric patients. The presence of vesicoureteral reflux at the onset of pyelonephritis is a concern. Severe vesicoureteral reflux can lead to repeated UTI and future deterioration of renal function, but the indication for voiding urethrography, which closely examines the presence of vesicoureteral reflux complications, is controversial.

Methods We retrospectively reviewed the laboratory findings, treatment, and clinical course of 96 pyelonephritis cases experienced at our department over a 7-year period from April 2014 to March 2021.

Results ESBL-producing E. coli were identified as the cause of pyelonephritis in 51% of cases, and this value was significantly higher (88%) in 2017. No significant differences were found in the febrile period or recurrence rate between the flomoxef-initiated group and other antibiotics groups. We also examined clinical indicators to predict vesicoureteral reflux and found no significant differences in ultrasonographic findings of hydronephrosis.

Conclusion In the present series, 51% of all pyelonephritis cases were found to be caused by ESBL-producing E. coli, with a significant increase in recent years. Flomoxef may be a useful alternative to carbapenem for ESBL-producing E. coli and the initial antibiotic of choice for upper UTIs in children. The indication for voiding cystourethrography should be carefully determined.

Background The morphology of the maxillary sinus varies between individuals which could be used in the forensic personal identification process.

Methods In the current study, the CBCT images of the maxillary sinus in 453 patients (217 males, 236 females) aged 14 to 95 years were analyzed. In particular, each left, and right maxillary sinus of the subjects was measured for its maximum height, width, and breadth in 2-D, and volume in 3-D perspectives, and their usefulness for age and sex estimation was examined. Regarding age estimation, because the size of the maxillary sinus increases up to 20s and then decreases over time, two separate age estimation formulas were created, one for subjects in their 14–21 years and the other for those over 22 years old. For each age group, multiple regression formulas were generated using the diameters and volume as explanatory variables and the chronological age as a response variable. This study used 150 cases not included in the study as a validation set for age estimation.

Results Generally, all the diameters and volumes in both sinuses tended to increase till the mid-20s, and then gradually decreased over time. The derived formulas were tested for their accuracy on additional 150 subjects. Plausibly, the model could estimate the age between 14–21 years old with an average accuracy of ± 1.8 years for men and ± 3.2 years for women. Whereas for those over 22 years old, it was possible to estimate the age with an accuracy of ± 11.8 years for males and ± 10.3 years for females, respectively. A comparison of estimated age and chronological age did not show a statistically significant difference(P > 0.05). It was found that the left maxillary sinus had more age groups showing the most significant difference than other measurements between sexes(P < 0.05). The maxillary sinus height may be significantly affected by gender differences.

Conclusion Overall, this study showed the effectiveness of age and sex estimation using the maxillary sinus morphometric analyses.

Background Survival rates increase when basic life support (BLS) is provided by bystanders to patients with acute diseases, such as out-of-hospital cardiac arrest; however, its implementation rate is not high. In this study, we investigated “interest on BLS,” “knowledge on BLS,” and “experience on BLS” as factors related to the willingness to implement BLS among junior high school, high school, and college students who have multiple opportunities to learn it.

Methods This is an observational study using a questionnaire survey. The participants were 112 junior high school students, 114 high school students, and 109 university students (non-medical), totaling 294 (87.8% response rate). The questionnaire listed three items on the strength of willingness to perform BLS, three items on attributes of the participant, four items on the score of interest on BLS, one item on the score of knowledge on BLS, and two items on the score of experience on BLS.

Results Among junior high school students, the factors that were significantly associated with the willingness to perform BLS were “Presence of someone who died” and “Interest on BLS” score. Among high school and college students, the factors that were significantly associated with the willingness to perform BLS were “Interest on BLS” and “Knowledge on BLS” scores.

Conclusion For junior high school students, creating an environment in which they can visualize the actual situation may increase their interest, whereas for high school and university students, in addition to such an environment, conducting seminars of short duration may help them to consolidate their knowledge and increase their willingness to implement BLS.

Background Increasing cancer screening rates among working-age populations and providing employment support for employees with cancer are issues that need to be addressed in Japan. Therefore, this study aimed to clarify the situation regarding cancer screening promotion and employment support for employees with cancer at business establishments and the support they seek from medical professionals regarding these issues.

Methods This survey covered 1,058 business establishments and included the following items: attributes of the business establishments, cancer screening rate, support for employees to promote cancer screening, support sought by business establishments from medical professionals to promote cancer screening, presence of employees with cancer, support programs for employees with cancer, awareness of the resources available for employment support for employees with cancer, difficulties in supporting employees with cancer in the workplace, and support sought by business establishments from medical professionals in providing employment support for employees with cancer. Data analysis was primarily conducted using summary statistics.

Results This study included 153 establishments. The median cancer screening rate ranged from 50.00 to 99.15. Employee support for promoting cancer screening ranged from approximately 30% to 40% for “ensuring time for screening” and from 20% to 30% for “providing full subsidies for cancer screening cost.” The median screening rate for breast and cervical cancers was 50.00, and support for promoting screening was less than 30% for each. Business establishments sought support from medical professionals regarding cancer and study sessions on cancer prevention to promote cancer screening. Regarding support systems for employees with cancer, 49.7% of the establishments offered sickness benefits, and 42.5% offered paid leave on an hourly basis. Less than 10% were aware of the websites provided by public organizations regarding employment support for patients with cancer. Approximately 50% of the establishments reported difficulties regarding treatment policies and duration uncertainties.

Conclusion Business establishments sought the provision of relevant knowledge and specific information to increase cancer screening rates and provide employment support for employees with cancer. Furthermore, this study suggests that employees with cancer need to manage the information they provide their establishments.

Background There is a need for quick skin blood flow tests that can be performed in the wound healing field. Antera 3D® is a compact scanner using multispectral imaging. It can perform quick assessment of skin conditions. The purpose of the present study was to investigate the ability of the Antera 3D® to assess skin blood flow in comparison with transcutaneous partial pressure of oxygen (TcPO2) measurements.

Methods This study was conducted on 13 patients with a history of lower extremity ulcers. Measurements of hemoglobin average level (hereafter, Hb score) measured by Antera 3D® and TcPO2 measured by a transcutaneous blood gas monitor were obtained at the same sites on the dorsal foot and lower leg. Differences in Hb score and TcPO2 were analyzed by t-test for each measurement site and for the presence of peripheral arterial disease (PAD). The correlation between TcPO2 and Hb score was analyzed by Pearson’s correlation coefficient.

Results Twenty-four limbs were tested. Hb score was higher (P < 0.001) and TcPO2 was lower (P = 0.056) in the dorsal foot compared to the lower leg. In the dorsal foot, Hb score was higher (P = 0.023) and TcPO2 was lower (P = 0.046) in patients with PAD compared to those without PAD. A significant negative correlation (r = –0.68; 95% confidence interval –0.85 to –0.38, P < 0.001) between TcPO2 and Hb score was observed in the dorsal foot.

Conclusion The negative correlation between TcPO2 and Hb score may reflect compensatory peripheral vasodilation due to occlusion or stenosis of central arteries. This study showed that Hb score measured by Antera 3D® may be related to skin blood flow.

Background The use of stem/ progenitor cell-derived organoids to evaluate the toxicity of chemical substances has widely increased. Organoids with nephron-like structures (NLS) can be derived from rat adult kidney stem/ progenitor cells (rKS cells) using three-dimensional culture. In this study, we examined the effects of cisplatin, an anticancer drug that induces nephrotoxicity in vivo, on rKS cell-derived NLS.

Methods Twelve organoids were simultaneously derived from three-dimensionally cultured rKS cells in Matrigel matrices. The surface area of each organoid was measured using microscopy-based imaging, and the morphological changes of NLS were monitored using an image analysis method. NLS were exposed to cisplatin, and their associated effects were assessed.

Results NLS elongated over time. The surface areas of the 12 organoids were almost constant. Cisplatin exposure induced cell death in NLS and inhibited the increase in the surface area of the organoids.

Conclusion Cisplatin exposure induces damage to NLS derived from rKS cells. Thus, the organoids may be valuable as an in vitro model to assess nephrotoxicity.

Background The importance of support for the mothers of infants to cope with parenting stress due to isolated parenting environments is being emphasized. In order to reduce the parenting stress in parenting mothers while improving the quality of parenting support for them, it is important to identify factors influencing such stress. We investigated the effects of artwork production in different styles, conducted self-evaluation of such production, and identified factors influencing parenting stress in mothers, involving those who participated in a handprint artwork production workshop.

Methods We included 140 mothers who participated in a handprint artwork production workshop, dividing them into 2 groups: A: 70 with children younger than 3 years of age who engaged in artwork production alone; and B: 70 who engaged in it through collaboration with their children aged 3 years or older. The instructor distributed an anonymous, self-administered questionnaire to all the mothers, and collected their responses. The questionnaire examined the following items: attributes, the number of participations in the workshop, artwork production self-evaluation, and parenting stress.

Results There were 140 (100%) responses, and the number of valid responses was 65 from Group A and 54 from Group B, a total of 119 (85%). The mean [parenting strain] score was significantly higher in Group B. Multiple regression analysis identified the child’s age and presence/absence of his/her siblings overall and in Group A, and <confidence in one’s work>, an item for artwork production self-evaluation, in Group B as factors influencing the total [parenting strain] score.

Conclusion The present results suggest that the child’s age and presence/absence of his/her siblings could influence parenting stress in the mothers. Additionally, there was a correlation between the level of parenting stress and score for <confidence in one’s work> among the mothers who engaged in artwork production through collaboration with their children.

Background There lacks a sufficient research on the tumorigenesis of clear cell renal cell carcinoma (ccRCC), causing that the prognosis of ccRCC was not effectively improved. Micall2 contributes to the malignancy of cancer. Moreover, Micall2 is considered a typical cell mobility-promoting factor. However, the relationship between Micall2 and ccRCC malignancy is unknown.

Methods In this study, we first investigated the expression patterns of Micall2 in ccRCC tissues and cell lines. Next, we explored the in vitro and in vivo roles of Micall2 in ccRCC tumorigenesis based on ccRCC cell lines with different Micall2 expression and gene manipulation assays.

Results Our study showed that ccRCC tissues and cell lines expressed higher level of Micall2 than paracancerous tissues and normal renal tubular epithelial cell, and Micall2 expression was overexpressed on cancerous tissue with significant metastasis and enlargement. Among three ccRCC cell lines, the expression of Micall2 was the highest in 786-O cells and the lowest in CAKI-1 cells. Moreover, 786-O cells showed the highest malignancy in vitro and in vivo (including proliferation, migration, invasion, reduced E-cadherin expression and tumorigenicity of nude mice in vivo), while CAKI-1 cells showed the contrary results. Furthermore, the upregulated Micall2 by Gene overexpression promoted the proliferation, migration and invasion of ccRCC cells while the downregulated Micall2 by Gene silencing showed the opposite effect.

Conclusion Micall2, as a pro-tumorigenic gene marker of ccRCC, contributes the malignancy of ccRCC.

Heart rate variability (HRV) is measured to analyze autonomic nervous system function in humans, and pulse rate variability (PRV) assessed using the photoplethysmography method with a pulse oximeter has been proposed as a surrogate for HRV. To examine whether PRV is compatible with HRV in patients with chronic obstructive pulmonary disease (COPD), we simultaneously measured HRV with an electrocardiogram and PRV with a pulse oximeter in patients with COPD, and compared low-frequency and high-frequency components computed from HRV and PRV as indicators of autonomic nervous system function. In a Bland–Altman analysis, the low-frequency component computed from HRV exhibited good consistency with that computed from PRV. The high-frequency component showed a significant fixed error but relatively good consistency. Our results indicate that autonomic nervous system function may be estimated with the low-frequency component by measuring PRV with a pulse oximeter in patients with COPD.

The School of Medicine offers study counseling. In particular, the School of Medicine has many required courses, and it is important to respond to students with learning difficulties. It is necessary to discuss a new approach to learning counseling for such students, considering the prevention of COVID-19 infection, but online learning counseling has not been discussed so far. In the future, flexible selection and response based on an understanding of the advantages and disadvantages of online learning counseling will be required. To overcome this challenge, this paper examines the practice of online learning counseling at the University’s School of Medicine in the Corona Disaster. The practice could be characterized by seven advantages [behavioral understanding, physical condition consideration, continuity, confidentiality, sharing, immediacy, and convenience] and two challenges [grasping reactions and interruptions]. Subsequently, it was presented new possibilities for online learning counseling by examining the content related to learning.

Although acute cardiac tamponade is one of the major problems in clinical practice, a suitable animal model is still lacking. We tried to create acute cardiac tamponade in macaques by echo-guided catheter manipulation. A 13-year-old male macaque was anesthetized, and a long sheath was inserted into the left ventricle via the left carotid artery under the guidance of transthoracic echocardiography. The sheath was then inserted into the orifice of the left coronary artery to perforate the proximal site of the left anterior descending branch. A cardiac tamponade was successfully created. Injection of diluted contrast agent into the pericardial space via a catheter made it possible to clearly distinguish between the hemopericardium and the surrounding tissues on postmortem computed tomography. This procedure did not need an X-ray imaging system during catheterization. Our present model would help us examine the intrathoracic organs in the presence of acute cardiac tamponade.