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The sperm of infertile men have higher rates of chromosomal abnormalities than those of fertile men. Miscarriage rate is also higher following testicular sperm extraction combined with intracytoplasmic sperm injection (TESE-ICSI). Sperm chromosomal abnormalities are assumed to be the cause of miscarriages. Previous testicular sperm karyotyping studies have only examined a few selected chromosomes using fluorescence in situ hybridization. The aim of this study was to provide a more detailed analysis of sperm karyotyping by analyzing all chromosomes using next-generation sequencing (NGS) in clinically usable testicular sperm. Sperm discarded after clinical use was collected for NGS. Additionally, sperm were individually collected by micromanipulation from patients with obstructive azoospermia (OA) and non-obstructive azoospermia (NOA) who underwent TESE-ICSI. For comparison, ejaculated sperm from control and balanced translocation (BT) carriers were examined. Karyotyping was performed on individual sperm cells using NGS. The number of normal and aberrant sperm was compared. Seventeen patients participated in this study: control (n = 4), BT (n = 3), OA (n = 5), and NOA (n = 5). Ten sperm samples per patient were analyzed. The total acquisition rate for single sperm karyotyping was 85% (145/170). Karyotyping of sperm from the BT group revealed sperm with unbalanced chromosomes derived from carrier translocations. Among the NOA group, 7/41 (17%) sperm samples exhibited aberrant karyotypes, whereas no aberrant sperm were identified in the control and OA groups. Individual differences were observed in the frequency of sperm chromosomal abnormalities among patients with NOA. In conclusion, sperm chromosomal abnormalities are frequently observed in patients with NOA even after sperm selection for clinical use. As the frequency of chromosomal abnormalities varies among patients with NOA, single sperm sequencing may help identify patients with NOA most likely to benefit from PGT-A.

Key Clinical Message Although extracorporeal membrane oxygenation is relatively contraindicated in patients with severe disseminated intravascular coagulation (DIC), it can be safely introduced by providing adequate anti‐DIC therapy. A uterine rupture caused massive postpartum hemorrhage and disseminated intravascular coagulation which resulted in maternal cardiac arrest.

Primary ovarian angiosarcoma is an extremely rare malignant soft tissue tumor that arises from the vascular endothelium, with a limited number of reports. It has no specific symptoms, and it is rarely diagnosed in the early stages because of rapid progression. Furthermore, no standard drug therapy is available, and the prognosis is poor.  The patient was a 68-year-old woman suspected of having a ruptured ovarian tumor on plain abdominal computed tomography and anemia was observed. An emergency laparotomy was performed to stop the bleeding. Thereafter, one transcatheter arterial embolization, three laparotomies, and local radiotherapy were performed in an attempt to achieve hemostasis. However, the intraperitoneal bleeding remained intractable, and the transfusion was terminated after thorough consultation with the patient. The patient died 44 days after admission. Autopsy findings confirmed the diagnosis of primary ovarian angiosarcoma and pulmonary metastasis. Intractable intraperitoneal hemorrhage similar to that observed in this case has been reported, and because the prognosis is extremely poor, establishing an appropriate treatment regimen is desirable. Previously, the most commonly used drug regimens included anthracyclines and ifosfamide. However, recently, the possibility of treatment with molecular targeted agents and immune checkpoint inhibitors has been reported. In the future, case accumulation and genetic analyses will be required to establish appropriate treatment methods.

Purpose This study proposes a detection support system for primary and metastatic lesions of prostate cancer using 18 F -PSMA 1007 positron emission tomography/computed tomography (PET/CT) images with non-image information, including patient metadata and location information of an input slice image. Methods A convolutional neural network with condition generators and feature-wise linear modulation (FiLM) layers was employed to allow input of not only PET/CT images but also non-image information, namely, Gleason score, flag of pre- or post-prostatectomy, and normalized z-coordinate of an input slice. We explored the insertion position of the FiLM layers to optimize the conditioning of the network using non-image information. Results 18 F -PSMA 1007 PET/CT images were collected from 163 patients with prostate cancer and applied to the proposed system in a threefold cross-validation manner to evaluate the performance. The proposed system achieved a Dice score of 0.5732 (per case) and sensitivity of 0.8200 (per lesion), which are 3.87 and 4.16 points higher than the network without non-image information. Conclusion This study demonstrated the effectiveness of the use of non-image information, including metadata of the patient and location information of the input slice image, in the detection of prostate cancer from 18 F -PSMA 1007 PET/CT images. Improvement in the sensitivity of inactive and small lesions remains a future challenge.

This study proposes a detection support system for primary and metastatic lesions of prostate cancer using -PSMA 1007 positron emission tomography/computed tomography (PET/CT) images with non-image information, including patient metadata and location information of an input slice image. A convolutional neural network with condition generators and feature-wise linear modulation (FiLM) layers was employed to allow input of not only PET/CT images but also non-image information, namely, Gleason score, flag of pre- or post-prostatectomy, and normalized z-coordinate of an input slice. We explored the insertion position of the FiLM layers to optimize the conditioning of the network using non-image information. -PSMA 1007 PET/CT images were collected from 163 patients with prostate cancer and applied to the proposed system in a threefold cross-validation manner to evaluate the performance. The proposed system achieved a Dice score of 0.5732 (per case) and sensitivity of 0.8200 (per lesion), which are 3.87 and 4.16 points higher than the network without non-image information. This study demonstrated the effectiveness of the use of non-image information, including metadata of the patient and location information of the input slice image, in the detection of prostate cancer from -PSMA 1007 PET/CT images. Improvement in the sensitivity of inactive and small lesions remains a future challenge.

CD206, a mannose receptor, is mainly expressed on the surface of alternatively activated macrophages where it acts as a pattern recognition receptor and plays a role in innate and adaptive immunity. This study investigated serum soluble CD206 (sCD206) levels in community-acquired pneumonia (CAP) and examined their clinical significance. sCD206 concentrations were measured in the sera of two independent cohorts with CAP (127 and 125 patients, respectively) and 42 controls. The expression of CD206 in the lung from autopsied cases was also examined. Patients with CAP showed significantly elevated sCD206 levels than did the controls (p < 0.0001). Notably, fatal CAP patients had more than two-fold higher sCD206 concentrations than survivors in both cohorts (p < 0.0001). Serum sCD206 concentrations were associated with Pneumonia Severity Index (PSI) and CURB-65 values. Importantly, even fatal CAP patients classified as PSI I-IV, CURB65 0–2 or age <75 years had comparatively higher levels of sCD206 than those classified as PSI V, CURB-65 3–5 or age ≥75 years. Immunohistochemically, the infiltration of CD206 + macrophages was found in the lungs of fatal cases. Elevated levels of sCD206 are associated with CAP prognosis, suggesting sCD206 might be a potential biomarker to predict severity for CAP.

Recently, the sodium (Na)/potassium (K) ratio was reported to be associated with blood pressure (BP). A Na/K ratio self-monitoring device using spot urine was established recently. Here, we assessed whether the urinary Na/K ratio change measured using the Na/K device was associated with BP change in a health checkup setting. We targeted 12,890 participants who attended the health checkup in Tome City, Miyagi between 2017 and 2018. Tome City introduced urinary Na/K ratio measurements during health checkups since 2017. For each year, we compared the baseline characteristics according to the urinary Na/K ratio and BP level. We assessed the relationship between change in urinary Na/K ratio and BP change using multiple regression analyses adjusted for age, sex, and change in body mass index (BMI) and alcohol intake. The average urinary Na/K ratio was significantly lower in 2018 than in 2017 (5.4 ± 3.0 to 4.9 ± 2.2, P  < 0.01). The systolic BP of the participants in 2018 (130.9 ± 17.4 mmHg) was lower than that in 2017 (132.1 ± 17.9 mmHg). Moreover, the change in systolic BP and diastolic BP was positively associated with the change in urinary Na/K ratio. In conclusion, the association of the change in urinary Na/K ratio with hypertension and changes in systolic and diastolic BP can be explained by a change in alcohol intake, BMI, and urinary Na/K ratio. Therefore, measuring the urinary Na/K ratio in community settings is a potential population approach for counteracting hypertension.

Background: It has been reported that chronic inflammation may play an important role in the pathogenesis of several serious diseases and could be modulated by diet. Recently, the Dietary Inflammatory Index (DII®) was developed to assess the inflammatory potential of the overall diet. The DII has been reported as relevant to various diseases but has not been validated in Japanese. Thus, in the present study, we analyzed the relationship between DII scores and high-sensitivity C-reactive protein (hs-CRP) levels in a Japanese population. Methods: Data of the National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged 2010 (NIPPON DATA2010), which contained 2,898 participants aged 20 years or older from the National Health and Nutrition Survey of Japan (NHNS2010), were analyzed. Nutrient intakes derived from 1-day semi-weighing dietary records were used to calculate DII scores. Energy was adjusted using the residual method. Levels of hs-CRP were evaluated using nephelometric immunoassay. Multiple linear regression analyses were performed. Results: After adjusting for age, sex, smoking status, BMI, and physical activity, a significant association was observed between DII scores and log(CRP+1) (standard regression coefficient = 0.05, P < 0.01). Although it was not statistically significant, the positive association was consistently observed in almost all age-sex subgroups and the non-smoker subgroup. Conclusions: The current study confirmed that DII score was positively associated with hs-CRP in Japanese.