Hachinohe Gakuin University

The energy requirement of renal proximal tubular cells depends on mitochondrial fatty acid β-oxidation. Enoyl-CoA hydratase-l-3-hydroxyacyl-CoA dehydrogenase (EHHADH) is a crucial enzyme in mitochondrial fatty acid oxidation, and mutations in EHHADH reportedly cause Fanconi syndrome. Here, we report the case of a 28-year-old Japanese woman with a long-term history of low-molecular-weight proteinuria (LMWP) who exhibited a missense mutation in the EHHADH gene. She was diagnosed with LMWP at 4years of age. The search for the CLCN5 gene was unremarkable, and kidney biopsy revealed no significant tubulointerstitial changes. The LMWP persisted, and glucosuria gradually developed thereafter. Unexpectedly, next-generation sequencing identified a heterozygous missense mutation in the EHHADH gene. Her father, who harbored LMWP, also had the same mutation. Furthermore, immunostaining of the stored kidney specimens showed decreased immunoreactivity for cytochrome coxidase subunit 4 in the proximal tubules, suggesting an underlying mitochondrial impairment.

Key Clinical Message (KCM)Pregnancy complicated by low-grade endometrial stromal sarcoma (LGESS) is extremely rare, and differentiation from benign conditions is often challenging. With the recent trend toward later childbearing, the incidence of mali

Dynamic stretching (DS) is a conditioning technique commonly used in sports. However, its effects on contralateral joint flexibility and elastic properties of the targeted muscle over several weeks remain unclear. Similarly, its impact on muscle functions, such as force or power exertion, is poorly understood. This study aimed to examine the effects of a 12-week DS program targeting the ankle plantar flexors on the joint flexibility, muscle strength, and elastic properties of the plantar flexors in stretched and contralateral legs. Eighteen healthy young adults (12 males and six females, aged 18-24 years) participated in this study. DS was performed on one leg of the ankle plantar flexors for 12 weeks (3 days weekly), while the other leg served as a non-intervention. Dorsiflexion range of motion (DFROM), muscle stiffness, and ankle plantar flexion strength (rate of torque development and isokinetic muscle strength) were assessed before and after the intervention. The muscle stiffness was measured using shear wave elastography on the gastrocnemius. DFROM significantly increased in both conditions (p < 0.05), whereas gastrocnemius stiffness significantly decreased only in the DS condition (p < 0.05). No significant changes were observed in the non-intervention condition. The ankle plantar flexion rates of torque development and isokinetic strength did not change in either condition. These findings suggest that 12 weeks of DS can reduce muscle stiffness and improve joint flexibility without affecting muscle strength while enhancing contralateral joint flexibility without altering muscle stiffness or strength.

Objectives: This study aimed to compare the quality of scarring of DERMABOND PRINEO (Ethicon, Inc., Somerville, NJ, USA)Ⓡ by conducting a half-side test on the same wound to determine its superiority. If the utility of DERMABOND PRINEOⓇ is established, its use can be expanded for more cases and higher quality medical care can be provided.Methods: Patients who underwent two-stage breast reconstruction were included. The first surgery was half closed with DERMABOND PRINEOⓇ and nylon threads, and the time was measured. At the second surgery, all scars were removed, and a histopathological examination was done. Scars were evaluated with the Vancouver Scar Scale (VSS) and visual analogue scale (VAS), and statistical analysis was performed.Results: Time to closure was significantly shorter in the DERMABOND PRINEOⓇ group. Postoperative VSS scores for pliability were significantly lower in the suture group, and the total VSS score was significantly lower in the suture group from 3 to 6 months postoperatively. Patients rated postoperative wound pain, itching, appearance, and satisfaction with the VAS, but no significant differences were observed between the two groups. The scars were compared with hematoxylin-eosin staining and Elastica van Gieson staining. Differences were seen in the increase of elastic fibers in the dermal reticular layer, a characteristic difference between the two groups.Conclusions: The use of DERMABOND PRINEOⓇ leads to a reduction in operative time and impacts the maturity of the scar. It is expected that the indications for DERMABOND PRINEOⓇ can be further expanded in the future.

We have previously reported the mid-term efficacy and safety of tacrolimus (Tac)-based immunosuppressive therapy in such patients, and herein, we aimed to determine their long-term outcomes (over 10 years). We retrospectively evaluate the data of 13 consecutive patients with biopsy-proven long-standing LN who underwent a long-term Tac-based treatment regimen. Tac was administered once daily at a dose of 3 mg as reinduction or maintenance treatment. Treatment outcomes were defined using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), urinary protein/creatinine ratio (Up/cr), serum creatinine, estimated glomerular filtration rate (eGFR) and serological lupus markers (complement C3, complement hemolytic activity [CH 50], and anti-dsDNA antibody titre), and the concomitantly administered prednisolone (PDN) dose. Data on clinical parameters and serological lupus activity were collected annually from each patient throughout the study period. The patients' baseline characteristics at the treatment initiation were as follows: mean age, 18 years; Up/cr, 0.63 ± 0.69; serum C3 level, 57.2 ± 22.4 mg/dL (normal range, 79-152 mg/dL); CH50, 27.9 ± 15.7 U/mL (normal range, 23.0-46.0 U/mL); serum anti-dsDNA antibody titre, 111.7 ± 123.4 IU/mL (normal range, <12.0 IU/mL); serum creatinine, 0.60 ± 0.19 mg/dL; eGFR, 115.6 ± 21.3 mL/min and SLEDAI, 13 ± 8.1. Despite the gradual tapering of the concomitantly administered PDN dose from 18.7 ± 13.5 mg/day at baseline to 3.5 ± 2.8 mg/day at 10 years (p = .002), a marked improvement in the outcomes, compared with the baseline values, was observed within a year. Additionally, these favourable changes persisted throughout study period in most patients. Compared with the baseline values, the following measures confirmed sustained outcome improvements after a 10-year treatment: SLEDAI, 1.7 ± 2.0; serum C3 level, 83.8 ± 16.1 mg/dL; CH50, 45.6 ± 10.9 U/mL (all p < .01) and Up/cr, 0.16 ± 0.18 and serum anti-dsDNA antibody titre, 25.8 ± 28.8 IU/mL (both p < .05). Serum creatinine level and eGFR remained within the normal range in all study participants except for one patient who experienced several flare-ups. No serious adverse effects were observed. Our results suggest that long-term Tac-based immunosuppressive treatment as maintenance therapy is beneficial and has low cytotoxicity. Therefore, it represents an attractive option for the treatment of selected patients with paediatric-onset LN in a real-world setting.

日本建築学会では，本年3月，「建築物の解体工事施工指針（案）・同解説（鉄筋コンクリート造編・鉄骨造編）」を制定した。1998年発刊の「鉄筋コンクリート造建築物等の解体工事施工指針（案）・同解説」の改定として位置づけられる。2000年に施行された建設リサイクル法やアスベストの適正処理など，発刊当時とは社会状況が変化してきており旧指針では，現在の法規および実務に対応しきれていなかった。2014年の建設業法の改正により，2016年には「解体工事業」が新設され，行政，業界ともに新たな「解体工事」の姿を整備・模索している。これらを背景に四半世紀ぶりに改定されたものである。本稿では，主な改定内容について述べ，今後の課題にも触れている。

Eribulin (ERI), clinically utilized for locally advanced or metastatic breast tumors, has shown potential links to the immune system. Notably, the cGAS-STING pathway, a key component of innate immunity, has gained prominence. Yet, limited reports explore ERI’s effects on the cGAS-STING pathway. Additionally, the nuclear presence of cGAS remains poorly understood. This study uniquely delves into ERI’s impact on both the cytosolic cGAS-STING pathway and nuclear cGAS. ERI enhances nuclear localization of cGAS, resulting in hyper-activation of the cGAS-STING pathway in triple-negative breast cancer cells. Reduction of cGAS heightened both cell proliferation and ERI sensitivity. In clinical data using ERI in a neo-adjuvant setting, patients with low cGAS cases exhibited reduced likelihood of achieving pathological complete response after ERI treatment. These findings illuminate the potential of cGAS and IFNβ as predictive biomarkers for ERI sensitivity, providing valuable insights for personalized breast cancer treatment strategies.