Ono Clinic

Abstract Commercially available disposable products such as cell culture utensils and catheters do not necessarily possess sufficient quality for in vitro fertilization (IVF), from the perspective of pyrogen contamination. We aimed to comprehensively analyze the pyrogen contamination status, including bacterial endotoxins, of the products used for IVF in assisted reproductive technology (ART) and improve their cleanliness using a new sterilization technology. Pyrogen contamination levels were evaluated using a direct human cell-based pyrogen test that is not affected by the recovery ratio, unlike bacterial endotoxin tests. Pyrogen inactivation tests were performed using low-temperature ozone/hydrogen peroxide gas treatment. The residual hydrogen peroxide was colorimetrically quantified, and the effectiveness of its removal by drying treatment was evaluated using germ cell viability as an indicator. Significant amounts of pyrogen, from 0.014 to 1.110 EU/product, were detected in seven of the twenty products. Pyrogen contamination levels were reduced below the detection limit by ozone/hydrogen peroxide gas sterilization. Hydrogen peroxide remained on the surface of the GPS dish but was reduced to a level that did not affect human sperm viability and embryo development after drying at 80°C for 24 h following sterilization. These products may carry a potential risk of reducing ART success rates, and pyrogen contamination levels may exceed the previously reported allowable level of 0.01–0.02 EU/mL in human IVF during actual use. Our study suggests that the manufacturing of products free from pyrogens and without adverse effects on germ cells is possible using ozone/hydrogen peroxide gas sterilization and subsequent drying technologies.

Disease duration of urticaria is variable from days to decades. However, the mechanism of persistence for urticaria is largely unknown. To investigate factors which relate to the prognosis of urticaria, we conducted a cross-sectional analysis on disease durations of 1061 patients with urticaria who visited nine primary dermatology clinics from 1st October to 11th November 2020. Among them, 216 (20.4%) had acute urticaria, while 383 (36.1%) and 125 (11.8%) had suffered from urticaria for 3 years or more and for 10 years or more, respectively. There was no significant difference between males and females in disease duration. In patients under 20 years old, 75 (38.9%) had acute urticaria. By contrast, more than 20% of patients older than 50 years had urticaria for 10 years or more. Disease duration for 3 years or more of patients with dermographism and those with cholinergic urticaria was 42% and 45.3%, respectively. Although a majority of urticaria likely remit, more than one-third of patients at primary dermatology clinics suffer from urticaria for 3 years or longer. The disease duration was longer in older patients, those with dermographism and/or cholinergic urticaria.

Background: Impaired mucus drainage from the paranasal sinuses is often associated with nasal obstruction and reduced airway function in growing patients. Orthopedic maxillary protraction and expansion techniques can enhance airway dynamics, but their underlying fluid–structure mechanisms remain insufficiently understood. Objective: To validate that the Right Angle Maxillary Protraction Appliance (RAMPA), combined with a semi-rapid maxillary expansion (sRME) intraoral device gHu-1, improves mucus drainage by enhancing nasal airflow through nasal cavity expansion. Methods: The effects of RAMPA therapy were analyzed using computational fluid dynamics (CFD) for single-phase (air) and two-phase (air–mucus) flows within the nasal cavity, employing the unsteady RANS turbulence model. Finite element method (FEM) results from prior studies were synthesized to assess changes in the center and radius of maxillary rotation induced by RAMPA-assisted sRME. A male patient (aged 8 years 7 months to 11 years 7 months) treated with extraoral RAMPA and the intraoral appliance (gHu-1) underwent pre- and post-treatment cone-beam computed tomography (CBCT) and ear, nose, and throat (ENT) evaluation. Results: FEM analysis revealed an increased radius and elevated center of maxillary rotation, producing expansion that was more parallel to the palatal plane. CFD simulations showed that nasal cavity expansion increased airflow velocity and pressure drop, enhancing the suction effect that promotes mucus clearance from the frontal sinus. Clinically, nasal passages widened, paranasal opacities resolved, and occlusal and intermolar widths improved. Conclusions: RAMPA combined with sRME improves nasal airflow and maxillary skeletal expansion, facilitating paranasal mucus clearance and offering a promising adjunctive approach for enhancing upper airway function in growing patients.

No effective agents currently exist for treating loss of appetite and apathy in patients with dementia. This multicentre, randomised, comparative study aimed to evaluate the effect and safety of Ninjin'yoeito (NYT) for these symptoms in patients with Alzheimer's disease (AD) or dementia with Lewy Bodies (DLB). A total of 16 sites, including clinics and hospitals, participated in this study. The primary outcome measure was the 12-week change in the loss of appetite score in the 'eating behaviour' subcategory of the Neuropsychiatric Inventory-12 (NPI-12). Secondary outcome measures included changes in food intake, the NPI-12 score, the Japanese Version of the Zarit Caregiver Burden Interview, Vitality Index, Mini-Mental State Examination, Frontal Assessment Battery, body weight, red blood cell count, haemoglobin, albumin, and Controlling Nutritional Status Score. Regarding the efficacy evaluation, 24 and 25 patients were assigned to the NYT and control groups, respectively. Regarding the primary outcome-the change in the loss of appetite score-no significant difference was observed between the two groups at 12 weeks after the start of administration. Among the secondary outcomes, food intake showed a significant increase in the NYT group compared to the control group at both 4 and 12 weeks. In the NYT group, significant decreases were recorded in the NPI-12 total score at 4 and 8 weeks; in depression at 12 weeks; in apathy at 4, 8, and 12 weeks; and in eating behaviour at 4, 8, and 12 weeks. However, these changes were not different from those in the control group. In a post hoc subgroup analysis of participants with a loss of appetite score of ≥ 6, significant decreases from baseline at 8 and 12 weeks were observed in the NYT group compared to the control group. Although the primary endpoint did not reach statistical significance, likely due to insufficient sample size, the NYT group showed a significant improvement in food intake, a secondary outcome measure. Furthermore, exploratory post hoc subgroup analysis suggested that NYT may improve appetite in patients with more severe appetite loss at baseline. These findings indicate the potential role of NYT in appetite improvement in patients with AD or DLB, warranting further investigation.

BackgroundAgricultural or gardening activity (also known as hobby farming) is a simple strategy that may be effective for maintaining health and preventing lifestyle-related diseases. However, its preventive effect on the development of conditions associated with neurovascular aging (e.g., stroke and dementia) remains unclear.ObjectiveTo comprehensively investigate the preventive role of regular agricultural or gardening physical activity (AGPA) in neurovascular aging and its underlying mechanisms using two approaches.MethodsWe conducted an experimental study in which we assessed arterial stiffness, cognitive performance (Flanker and Stroop tests), and circulating biomarkers (e.g., plasmin-α2-plasmin inhibitor complexes, nitric oxide, brain-derived neurotrophic factor) in 12 male students (average age: 22 ± 1 years) before and after three 40-min interventions (resting, cycling, and simulated AGPA) under controlled conditions. We also conducted a cross-sectional study, in which we recruited 161 (79 in the AGPA group and 82 in the control group) hospital-based older individuals (average age: 78 ± 5 years) and assessed their history of stroke, cognitive function, and brain magnetic resonance imaging (MRI) findings.ResultsIn the experimental study, simulated AGPA reduced arterial stiffness, improved executive cognitive function, and elevated circulating plasmin-α2-plasmin inhibitor complexes, nitric oxide, and brain-derived neurotrophic factor. Brain MRI-assessed cerebral white matter hyperintensities caused by reduced blood flow to brain tissue and stroke prevalence were lower, and cognitive scores (as assessed by the Hasegawa Dementia Scale-Revised) were higher in the AGPA group than in the control group.ConclusionOur findings suggest that regular AGPA is associated with markers of slower neurovascular aging in older individuals. AGPA induces a combination of general physical activity-related and specific AGPA-related effects; moreover, it may offer similar or even greater benefits than physical activity alone. Therefore, habitual AGPA may serve as an effective preventive strategy for neurovascular aging.

Digital therapeutics (DTx) for hypertension are among the most promising treatment options, demonstrating proven antihypertensive effects. This study investigates the determinants of the home blood pressure (BP) lowering effect of DTx, using prospectively collected daily data. The B-INDEX study (Behavioral Modification Index) is a multicenter intervention study in patients with hypertension, involving a 6-month DTx period, followed by an additional 6 months without it. Home BP, body weight and composition, physical activity, and sleep patterns were monitored daily using digital devices. This first report on B-INDEX analyzed data collected during a 6-month DTx treatment period. A total of 198 patients with hypertension (mean age, 54.9±10.6 years; 57.1% male; mean body mass index, 26.7±5.3 kg/m2; 57.6% taking antihypertensives) were included in the analysis. A marked reduction in BP was observed in the first 4 weeks (morning home BP, -6.2/-2.6 mm Hg). Mixed model analysis demonstrated that baseline home BP, older age, self-efficacy score, reduction in self-reported salt intake, and mild initial weight loss (-0.5 kg at week 4) were significant determinants of home BP reduction at 6 months. Older age, salt reduction, and initial weight loss were predictive factors for effective BP reduction through DTx, independent of baseline BP values. We propose that the first 4 weeks are the key period for hypertension treatment with DTx. URL: https://www.umin.ac.jp/ctr/; Unique identifier: UMIN000050479.

Linked color imaging (LCI) was developed to detect gastrointestinal neoplasms. The current study aimed to determine whether the use of LCI, compared with white-light imaging (WLI), can improve the miss rates of colorectal polyp. A multicenter, randomized back-to-back study was conducted in 16 Japanese endoscopy units. Patients were randomized according to examination: tandem colonoscopy with WLI followed by LCI (WLI-LCI group) and with LCI followed by WLI (LCI-WLI group). The detected polyps were evaluated according to location, size, morphology, and histopathological diagnosis. The primary outcome was polyp miss rate per patient (PMR-PP) in total colonoscopy. The secondary outcome was adenoma detection rate (ADR) during the first assessment in each group. The full analysis set comprised 327 participants, and 320 were included in either two groups. The PMR-PPs were 9.3% and 20.6% in the LCI-WLI and WLI-LCI groups, respectively. Regarding location, the PMR-PP of LCI was significantly lower than that of WLI in the transverse and descending colons and rectum. In terms of diminutive adenomas (< 5 mm), the ADR of LCI (38.2%) was significantly higher than that of WLI (29.1%). LCI was superior to WLI in terms of polyp miss rate particularly in the transverse and descending colons and rectum.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-20633-2.

Influenza antivirals play an important role in the prevention and control of influenza. We reviewed data on the effectiveness of influenza antivirals for reducing influenza transmission. We found that antiviral prophylaxis, whether given pre- or postexposure, has been shown to reduce the risk of symptomatic influenza in a variety of settings and populations. During pandemic responses, antiviral prophylaxis could play an important role, as demonstrated by the use of amantadine in the 1968-1969 influenza A(H3N2) pandemic and oseltamivir during the 2009-2010 influenza A(H1N1)pdm09 pandemic. Antiviral treatment reduces symptom severity, prevents complications, and can reduce onward transmission of infection. However, resistance, accessibility, and timing pose challenges. Future research directions include innovative therapies and combination treatments. Continued research and stewardship are crucial to optimize antiviral impact.