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Van der Waals (VDW) interactions provide fantastic properties for biological systems that function at room temperature. The VDW interaction, which primarily contributes to weak hydrogen bonding, is expected to play a key role in regulating hydrophobic hydration to express the biologically inert biocompatible function of polymerized MPCs (2-methacryloyloxyethyl phosphorylcholine). This report explores at the molecular level the biologically inert function of polymerized MPCs through an array of vibrational spectroscopic and computational characterization of MPC monomers, as temperature-dependent change of intramolecular weak hydrogen bonding. Synchrotron Fourier transform infrared microspectroscopy and terahertz time-domain spectroscopy were used to investigate temperature-dependent spectral changes in the low frequency vibrations of the MPC over the temperature range from cryogenic to room temperature, and the results were analysed by highly reliable well-established density functional theory (DFT) calculations. Complicated spectral features in the low frequency energy region and the uncertain conformations of the MPC in the amorphous powder state are clearly resolved under a polarizable continuum model and dispersion correction to pure DFT calculations.

Background Carbon ion Radiotherapy for prostate cancer is widely used, however reports are limited from single institute or short follow up. We performed a prospective observational study (GUNMA0702) to evaluate the feasibility and efficacy of carbon ion radiotherapy for localized and locally advanced prostate cancer. Methods Between June 2010 and August 2013, 304 patients with localized prostate cancer were treated, with a median follow-up duration of 60 months. All patients received carbon ion radiotherapy with 57.6 Gy (RBE) in 16 fractions over 4 weeks. Hormonal therapy was given according to the risk group. Toxicity was reported according to the Common Toxicity Criteria for Adverse Event, Version 4.0 by the National Cancer Institute. Results The overall 5-year biochemical relapse-free rate was 92.7%, with rates of 91.7, 93.4, and 92.0% in low-risk, intermediate-risk, and high-risk patients, respectively. The 5-year local control and overall survival rates were 98.4 and 96.6%, respectively. Acute grade 3 or greater toxicity was not observed. Late grade 2 and grade 3 genitourinary and gastrointestinal toxicity rates were 9 and 0.3%, and 0.3, and 0%, respectively. Conclusions The present protocol of carbon ion radiotherapy for prostate cancer provided low genitourinary and gastrointestinal toxicity with good biochemical control within 5 years. Trial registration University Medical Information Network Clinical Trial Registry number: UMIN000003827 .

Purpose The surgical Apgar score (SAS)—calculated using the intraoperative variables estimated blood loss, lowest heart rate, and lowest mean systolic pressure—is associated with mortality in cancer surgery. We investigated the utility of the SAS in patients with lung cancer undergoing surgery. Methods We retrospectively analyzed the data of 691 patients who underwent surgery for primary lung cancer between 2015 and 2019 in a single institute and analyzed the impact of the SAS. Results Of the 691 patients, 138 (20%), 57 (8.2%), and 7 (1.0%) had postoperative complications of all grades, grades ≥ III, and grade V, respectively, according to the Clavien–Dindo classification. The C-index for postoperative complications of grades ≥ III was 0.605. A lower score (0–5 points) (odds ratio 3.09 against 8–10 points, P  = 0.04) and a lower percentage of vital capacity (odds ratio 0.97, P  = 0.04) were independent negative risk factors for major postoperative complications. Patients with a lower score (0–5 points) had poor 5-year overall and cancer-specific survival rates (60.1% and 72.3%, respectively; P  < 0.05 for both). Conclusions The surgical Apgar score predicted postoperative complications and the long-term survival. Surgeons may improve surgical results using the SAS.

INTRODUCTION: Metastatic lung tumors typically exhibit well-defined, enhanced margins on chest CT. They may rarely present as ground-glass nodules (GGNs), making it challenging to differentiate from primary lung cancers, which can also manifest as progressively enlarging GGNs on CT.CASE PRESENTATION: The patient is a woman in her 50s who underwent surgery for adenoid cystic carcinoma of the hard palate 19 years ago. Seven years ago, chest CT showed GGNs in the upper lobe of the right lung as well as in the upper and lower lobes of the left lung. The patient underwent bilateral lung wedge resection for multiple lung nodules. The pathological diagnosis of the lung nodules was metastases from adenoid cystic carcinoma of the hard palate. In addition, chest CT performed 3 years ago revealed solid nodules in the left lung (S1+2/10), and a follow-up CT performed 1 year ago showed a solid nodule in the right lung (S1). Consequently, partial lung resections were performed for each lesion via thoracoscopic surgery. The pathological results indicated a metastatic adenoid cystic carcinoma. Recently, an enlarging GGN was found in the left lung (S4), which raised suspicion of primary lung cancer. Therefore, thoracoscopic partial resection of the left lingular segment was performed. The final pathology confirmed pulmonary metastasis of adenoid cystic carcinoma.CONCLUSIONS: In cases where a patient has a history of malignancy and a GGN on chest CT, metastatic lung tumors should be included in the differential diagnosis.

Introduction Ureterosciatic hernia is a rare condition in which the ureter herniates through the sciatic foramen, causing ureteral obstruction, and urinary infection. Case Presentation A 72‐year‐old woman presented with left flank pain. Computed tomography revealed left hydronephrosis with ureterosciatic hernia. During treatment planning, she developed a cerebral infarction and worsening angina, and received conservative management. One year later, computed tomography showed spontaneous resolution of the hernia. Subsequently, she experienced left flank pain, and repeat computed tomography demonstrated recurrence of the hernia with emphysematous pyelonephritis. Due to the high surgical risk, she underwent antibiotic therapy and stepwise retrograde ureteral realignment with ureteral catheter insertion, followed by double‐J stent replacement. Conclusion This is the first report to describe the spontaneous resolution and intermittent recurrence of ureterosciatic hernia on serial radiographic examinations. Retrograde ureteral realignment may be a safe and effective alternative to surgical repair in frail patients.

A variety of microsystems have been developed that harness energy and convert it to mechanical motion. Here we have developed new autonomous biochemical motors by integrating a metal–organic framework (MOF) and self-assembling peptides. The MOF is applied as an energy-storing cell that assembles peptides inside nanoscale pores of the coordination framework. The nature of peptides enables their assemblies to be reconfigured at the water/MOF interface, and thus converted to fuel energy. Reorganization of hydrophobic peptides can create a large surface-tension gradient around the MOF that can efficiently power its translational motion. As a comparison, the velocity normalized by volume for the diphenylalanine–MOF particle is faster and the kinetic energy per unit mass of fuel is more than twice as great as that for previous gel motor systems. This demonstration opens the route towards new applications of MOFs and reconfigurable molecular self-assembly, possibly evolving into a smart autonomous motor capable of mimicking swimming bacteria and, with integrated recognition units, harvesting target chemicals. Various artificial cells that can store molecules in cages are designed to generate mechanical motion by dissipating energy through chemical reactions or through the reorganization of molecules. A hybrid biomimetic motor system consisting of a metal–organic framework and diphenylanaline peptides is now designed to release guest molecules in the isotropic direction via a bond-breaking framework.

INTRODUCTION: Recent advancements in chemotherapy, including immune checkpoint inhibitors, sometimes achieve complete remission in cases of stage IV lung cancer. On the other hand, immune-related adverse events may occur despite showing successful oncological effects. Herein, we report a rare case of a patient who underwent salvage lung resection after immune checkpoint inhibitor therapy for stage IVB lung cancer, which led to confirmed not only complete pathological remission but also complications with aspergilloma as a result of powerful effect for chemotherapy with immune checkpoint inhibitors.CASE PRESENTATION: A 71-year-old woman was diagnosed with stage IVB squamous cell carcinoma of the lung located in the right upper lobe, accompanied by distant organ metastases in the thoracic vertebrae and right adrenal gland. Because the tumor shrank after systemic cytotoxic chemotherapy plus immune checkpoint inhibitor therapy, a partial response was considered to have been achieved clinically, and chemotherapy was discontinued afterward. After 5 months, however, the primary lesion gradually regrew, and tumor regrowth was highly suspected. A bronchoscopic biopsy revealed Aspergillus organism infection other than lung cancer. As local recurrence could not be completely ruled out, salvage thoracoscopic right upper lobectomy with hilar lymph node dissection was performed uneventfully. The pathological diagnosis was pulmonary aspergilloma without residual cancer (pathological complete remission). After the surgery, an antifungal agent was administered for half a year and no obvious cancer recurrence or fungal relapse was detected over 1.5 years.CONCLUSION: A salvage lung resection via thoracoscopic surgery was considered a feasible procedure. However, preoperative imaging does not always provide clear evidence of residual cancer, especially after chemotherapy with immune checkpoint inhibitors, as seen in the current patient. Therefore, salvage surgery should be considered comprehensively for selected patients with downstaged or relapsed lung cancer based on close image findings.

Objective The surgical result of early-staged lung cancer is not satisfactory due to unexpected postoperative lymph node metastasis and recurrence. This study aimed to investigate which preoperative factors—including the standard uptake value max (SUV max ) of positron emission tomography—could predict occult lymph node metastasis and survival. Methods We retrospectively analyzed data from 598 patients with clinical stage I lung cancer who underwent surgery, and examined their preoperative clinical characteristics. Results A total of 1586 patients had surgery for primary lung cancer between 2006 and 2019; 598 patients with clinical stage I lung cancer were the study inclusion; occult lymph node metastasis was detected in 102 (17.1%). Univariable and multivariable analyses showed that SUV max  ≥ 3 ( P  < 0.001), clinical invasive tumor size ≥ 2 cm ( P  = 0.009), and carcinoembryonic antigen > 5 ( P  = 0.03) were associated with significant risk factors rated (%) for occult lymph node metastasis, as follows: high-risk group (three factors), moderate-risk group (two factors) and low-risk group (one factor or none) corresponding to 32.2 (28/87), 22.8 (41/180) and 7.3 (19/262), respectively ( P  < 0.001). The 5-year overall survival rates (%) of patients without lymph node metastasis holding SUV max 6 or over were as poor as those of patients with lymph node metastasis (72.0% vs 64.1%; P  = 0.56). Conclusions We might consider wedge resection or segmentectomy, omitting lymphadenectomy, for the low-risk group; adjuvant therapy is indicated for patients without lymph node metastasis having SUV max 6 or over.

Background Pulmonary abscess is a severe infection commonly seen in patients with chronic obstructive pulmonary disease, interstitial pneumonia, immune deficiency disease, drug-induced immunocompromised state, and congenital pulmonary disease. The treatment strategy in pregnant women with a pulmonary abscess is considered challenging since adverse effects on the fetus must be avoided to ensure safe delivery. Case presentation A 34-year-old female patient at 24 weeks of gestation (G2P1) was admitted to the Department of Obstetrics and Gynecology due to sudden right chest pain. The patient had no significant medical history, including congenital anomalies, and no history of drug addiction or smoking. Laboratory data indicated high levels of inflammation (white blood cell 12,000/µL, C-reactive protein 16.0 mg/dL), and computed tomography demonstrated a large intrapulmonary cyst located in the middle of the right lower lobe, with some fluid collection. As the patient had no medical history of congenital pulmonary anomalies, she was initially diagnosed with a pulmonary cyst infection and treated with intravenous antibiotics. However, the infection did not resolve for over a week, and a spike in fever developed after admission. There was no definitive evidence concerning the risk of preterm delivery and fetal abortion during non-obstetric surgery. However, to control the severely infected pulmonary abscess that was refractory to antibiotics and obtain a pathological diagnosis while saving the life of both the mother and fetus, we elected to perform an emergent right lower lobectomy by open thoracotomy with a fissureless maneuver after receiving informed consent. Postoperatively, the infection gradually improved, and the patient was discharged on the 16th postoperative day without any major complications in the mother or fetus. Although she later experienced coronavirus disease-19 at 29 weeks of gestation, a boy was born at 40th weeks of gestation without any complications. Pathologically, no infectious agents, malignancies, or congenital anomalies other than lung abscesses associated with the pulmonary infarction were observed. The mother and child were healthy 1 year postoperatively. Conclusions We experienced a rare case of a pulmonary abscess in a pregnant woman who needed an emergent right lower lobectomy to control the severe infection and obtain a correct pathological diagnosis. Under cooperation from an obstetrician and anesthesiologist, emergency pulmonary resection can be performed safely for serious abscess formation even for pregnant women who have several months left until delivery.

Introduction Several prostate cancers carry homologous recombination repair mutations that respond to olaparib. Because of the mechanism, the efficacy of platinum‐based therapy can be used to predict the efficacy of poly(adenosine diphosphate‐ribose) polymerase inhibitors such as olaparib. Case presentation We experienced two neuroendocrine prostate cancer patients who achieved a response duration of more than 1 year with platinum‐based therapy. Case 1 had a BRCA2 mutation in the germline and case 2 had a BRCA2 mutation in a somatic chromosome only. Both patients responded well to olaparib. Conclusion Cisplatin and olaparib may overlap in response due to their medicinal action. It may be useful to consider genetic testing in some CRPC patients who have responded to cisplatin.