Search Results (11)

Background/Objectives: Diagnostic reasoning is essential in clinical practice and medical education, yet it often becomes an automated process, making its cognitive mechanisms less visible. Despite the widespread use of electronic medical records, few studies have quantitatively evaluated how clinicians’ reasoning is documented in real-world electronic medical records. This study aimed to investigate whether initial electronic medical records contain valuable information for diagnostic reasoning and assess the feasibility of using text analysis and logistic regression to make this reasoning process visible. Methods: We conducted a retrospective analysis of initial electronic medical records at Kochi University Hospital between 2008 and 2022. Two patient cohorts presenting with dizziness and headaches were analysed. Text analysis was performed using GiNZA, a Japanese natural language processing library, and logistic regression analyses were conducted to identify associations with final diagnoses. Results: We identified 1277 dizziness cases, of which 248 were analysed, revealing 48 significant diagnostic terms. Moreover, we identified 1904 headache cases, of which 616 were analysed, revealing 46 significant diagnostic terms. The logistic regression analysis demonstrated that the presence of specific terms, as well as whether they were expressed affirmatively or negatively, was significantly associated with diagnostic outcomes. Conclusions: Initial EMRs contain quantifiable linguistic cues relevant to diagnostic reasoning. Even simple analytical methods can reveal reasoning patterns, offering valuable insights for medical education and supporting the development of explainable diagnostic support systems. Full article

Background/Objectives: Non-saccular aneurysms are a rare subtype of intracranial aneurysms with complex morphologies. Although treatment strategies for ruptured non-saccular and saccular aneurysms differ significantly, large-scale comparisons of the outcomes between the two types remain limited. We aimed to compare the clinical characteristics, procedure-related complications, and functional outcomes between patients with subarachnoid hemorrhage (SAH) caused by non-saccular or saccular aneurysms. Methods: We retrospectively analyzed 1176 consecutive patients with aneurysmal SAH from a population-based stroke registry in Kochi Prefecture, Japan. Aneurysms were classified as saccular or non-saccular based on the morphology, and clinical variables, radiological features, and treatment modalities were compared. Additionally, 840 patients who underwent intervention for their aneurysms within 3 days of onset were further investigated to evaluate the impact of the non-saccular aneurysm shape on poor functional outcomes, defined as a modified Rankin Scale score ≥ 3 at discharge. Results: Non-saccular aneurysms were more common in younger patients and located in the posterior circulation. Procedure-related ischemic complications were more likely to occur in non-saccular aneurysms than in saccular aneurysms (odds ratio [OR]: 2.57, 95% confidence interval [CI]: 1.56–4.97, p < 0.001). In a multivariable logistic regression analysis, a non-saccular morphology was an independent risk factor of poor outcomes (OR: 2.92, 95% CI: 1.34–6.32, p = 0.007) after adjustment for potential confounders. Interaction and subgroup analyses revealed that the negative effects of non-saccular aneurysms on functional outcomes were more prominent in younger patients aged ≤ 60 years. Conclusions: Non-saccular aneurysms are independently associated with ischemic complications and poor outcomes after SAH, particularly in younger patients. Full article

Malaria remains a major global health problem that has been exacerbated by the impact of the COVID-19 pandemic on health systems. To combat this, the World Health Organization (WHO) has set a target of driving forward research into innovative treatment methods such as new drugs and vaccines. Quinones, particularly 1,4-naphthoquinones, have been identified as promising candidates for the development of antiprotozoal drugs. Herein, we report several methods for the preparation of 2-benzyl-1,4-naphthoquinones. In particular, the silver-catalyzed Kochi–Anderson radical decarboxylation is well suited for the preparation of these compounds. The antiprotozoal activity of all synthesized compounds was evaluated against Plasmodium falciparum NF54 and Trypanosoma brucei rhodesiense STIB900. Cytotoxicity towards L6 cells was also determined, and the respective selectivity indices (SI) were calculated. The synthesized compounds exhibited good antiplasmodial activity against the P. falciparum (NF54) strain, particularly (2-fluoro-5-trifluoromethylbenzyl)-menadione 2e, which showed strong efficacy and high selectivity (IC₅₀ = 0.006 µM, SI = 7495). In addition, these compounds also displayed favorable physicochemical properties, suggesting that the benzylnaphthoquinone scaffold may be a viable option for new antiplasmodial drugs. Full article

To explore the mitogenome characteristics of Tetratomidae and the phylogenetic position of this family in Tenebrionoidea, the mitogenome of Penthe kochi Mařan, 1940 was sequenced, annotated, and analyzed. The P. kochi mitogenome is consistent with Tenebrionoidea species in gene length, genomic organization, codon usage, and secondary structures of transfer genes (tRNAs). Most protein-coding genes (PCGs) originate with a typical ATN start codon, except nad1 and nad3, which start with TTG. In total, 10 PCGs are terminated with complete stop codon TAA and TAG, while cox1, cox2, and nad 4 contain an incomplete stop codon T-. Among the 13 PCGs, nad2 (Pi = 0.282) has the most diverse nucleotide composition, and cox2 is the most conserved gene with the lowest value (Pi = 0.154). The Ka/Ks ratio of cox1 (0.076) and cox2 (0.124) has a lower value. All the tRNAs can be folded in a typical clover-leaf secondary structure, except trnS1, which lacked a dihydrouridine arm. And phylogenetic analyses were performed based on 13 PCGs using the Bayesian inference (BI) method. The results showed that the clade of Tenebrionoidea was well separated from the outgroups, and Tetratomidae and Mycetophagidae were not well resolved. Phylogenetic analyses with more mitogenome samplings are needed to resolve the phylogeny of Tenebrionoidea. Full article

Understanding electrochemical reactions at the surface of electrodes requires the accurate calculation of key parameters—the transfer coefficient (α), diffusion coefficient (D₀), and heterogeneous electron transfer rate constant (k⁰). The choice of method to calculate these parameters requires careful consideration based on the nature of the electrochemical reaction. In this study, we conducted the cyclic voltammetry of paracetamol to calculate the values of these parameters using different methods and present a comparative analysis. Our results demonstrate that the E_p − E_p/2 equation for α and the modified Randles–Ševčík equation for D₀ is particularly effective for the calculations of these two parameters. The Kochi and Gileadi methods are reliable alternatives for the calculation of k⁰. Nicholson and Shain’s method using the equation k⁰ = Ψ(πnD₀Fν/RT)^1/2 gives the overestimated values of k⁰. However, the value of k⁰ calculated using the plot of ν^−1/2 versus Ψ (from the Nicholson and Shain equation, where ν is scan rate) agrees well with the values calculated from the Kochi and Gilaedi methods. This study not only identifies optimal methodologies for quasi-reversible reactions but also contributes to a deeper understanding of electrochemical reactions involving complex electron transfer and coupled chemical reactions, which can be broadly applicable in various electrochemical studies. Full article

Lymphatic Filariasis (LF) affects over 120 million people in 72 countries, with sub-periodic filariasis common in the Pacific. Wuchereria bancrofti has three physiological races, each with a unique microfilarial periodicity, and each race is isolated to a specific geographical region. Sub-periodic W. bancrofti is transmitted by various Aedes mosquito species, with Aedes polynesiensis and Aedes samoanus being the primary vectors in Samoa. The Aedes scutellaris and Aedes kochi groups are also important vectors in the South Pacific Islands. Anopheles species are important vectors of filariasis in rural areas of Asia and Africa. The Anopheles gambiae complex, Anopheles funestus, and the Anopheles punctulatus group are the most important vectors of W. bancrofti. These vectors exhibit indoor nocturnal biting behaviour and breed in a variety of habitats, including freshwater, saltwater, and temporary water bodies. Effective vector surveillance is central to LF control and elimination programs. However, the traditional Human Landing Collection (HLC) method, while valuable, poses ethical concerns and risks to collectors. Therefore, this review critically analyses alternative trapping tools for Aedes and Anopheles vectors in LF-endemic regions. We looked at 14 research publications that discussed W. bancrofti vector trapping methods. Pyrethrum Spray Catches (PSC), one of the seven traps studied for Anopheles LF vectors, was revealed to be the second most effective strategy after HLC, successfully catching Anopheles vectors in Nigeria, Ghana, Togo, and Burkina Faso. The PSC method has several drawbacks, such as the likelihood of overlooking exophilic mosquitoes or underestimating Anopheles populations. However, exit traps offered hope for capturing exophilic mosquitoes. Anopheles populations could also be sampled using the Anopheles Gravid Trap (AGT). In contrast, the effectiveness of the Double Net Traps (DNT) and the CDC Light Trap (CDC LT) varied. Gravid mosquito traps like the OviArt Gravid Trap (AGT) were shown to be useful tools for identifying endophilic and exophilic vectors during the exploration of novel collection techniques. The Stealth trap (ST) was suggested for sampling Anopheles mosquitoes, although specimen damage may make it difficult to identify the species. Although it needs more confirmation, the Ifakara Tent Trap C design (ITT-C) showed potential for outdoor mosquito sampling in Tanzania. Furvela tent traps successfully captured a variety of Anopheles species and are appropriate for use in a variety of eco-epidemiological settings. By contrast, for Aedes LF vectors, no specific sampling tool was identified for Aedes niveus, necessitating further research and development. However, traps like the Duplex cone trap, Resting Bucket Trap (RB), and Sticky Resting Bucket trap (SRB) proved effective for sampling Aedes albopictus, offering potential alternatives to HLC. This review emphasises the value of looking into alternative trapping methods for Aedes and Anopheles vectors in the LF-endemic region. Further research is required to determine the efficacy of novel collection techniques in various contexts, even if PSC and AGT show promise for sampling Anopheles vectors. The identified traps, along with ongoing research, provide valuable contributions to vector surveillance efforts in LF-endemic regions, enabling LF control and elimination strategies to advance. Full article

Owing to steep terrain and complicated geology, constructing spur roads with low cost and sufficient strength is crucial for sustainable forest management in Japan. The Shimanto method was developed for making narrow spur roads robust against collapse around the 2000s in the Shimanto geology belt area, where the strata were slanted because of an accretion wedge. Kochi University Forest adopted this method and constructed some routes of spur roads in the 2010s. In the present study, we assessed the performance of this method in terms of the roadbed strength and bearing capacity. Two routes were selected, namely Sites 1 and 2, constructed in 2013–2016 and 2019–2021, and tested in 2017 and 2021, respectively. The roadbed strength was measured up to a depth of 100 cm using a handy dynamic cone penetrometer with a rammer of 5 kg. The results showed that the roadbed strength of the embankment side was weaker than that of the cut slope side, although the method was supposed to compact the roadbeds equally over the road width. However, most of the roadbeds had sufficient strength; the younger ones tended to have lower strength than the older ones, and the same tendency was observed for the bearing capacity. It was suggested that the soil under the road width should be excavated more widely toward the cut slope side before compaction. Full article

The Kochi University of Technology (KUT) Infrasound Sensor Network contains 30 infrasound sensors which are distributed all over Japan especially in Shikoku Island. At all infrasound stations installed with three-axis accelerometers to measure the peak ground acceleration (PGA). Many earthquakes were detected by our system after establishing of the network since 2016. In this study we will focus on all the possibilities for infrasound detection generated from earthquakes using KUT sensor network and International Monitoring system (IMS) stations for the earthquakes which were detected in southern part of Japan during 2019. As for earthquakes with strike-slip mechanisms the P-waves could not be detected by our sensors. In addition, The conversion from seismic to acoustic waves can be happened through the generating of the T-phase from oceanic earthquakes. On 9 May 2019, progressive multi-channel cross correlation (PMCC) method applied infrasound and hydroacoustic waves from two earthquakes happened in west of Kyushu Island as the T-phase was well-recorded at H11N station near Wake Island. Moreover, infrasound propagation modeling is applied to the reconstructed atmosphere profile by Ground to Space Model (AVO-G2S) to confirm the infrasound arrivals, furthermore the 3D ray tracing process and the calculations by using the transmission loss equation with normal modes and parabolic equation methods are investigated. The study confirmed the infrasound generation scenario from the T-phase of oceanic propagation. Full article

We previously developed a new enzyme-targeting radiosensitization treatment named Kochi Oxydol-Radiation Therapy for Unresectable Carcinomas, Type II (KORTUC II), which contains hydrogen peroxide and sodium hyaluronate for injection into various types of tumors. For breast cancer treatment, the radiosensitization agent was injected into the tumor tissue twice a week under ultrasonographic guidance, immediately prior to each administration of radiation therapy. At approximately three hours after the second or third injection, computed tomography (CT) was performed to confirm the production and distribution of oxygen gas generated from the KORTUC radiosensitization agent by catalysis of peroxidases contained mainly in tumor tissue. The purpose of this study was to demonstrate that tumor hypoxia could be overcome by such a procedure and to evaluate the method of intratumoral injection in terms of confirming oxygen distribution in the target tumor tissue and around the tumor to be visualized on dedicated CT imaging. Three-dimensional reconstructed maximum intensity projection imaging of contrast-enhanced breast magnetic resonance imaging was used to compare the position of the tumor and that of the generated oxygen. Distributed oxygen gas was confirmed in the tumor tissue and around it in all 10 patients examined in the study. A region of oxygen gas was measured as an average value of −457.2 Hounsfield units (HU) as a region of interest. A slightly increased HU value compared to the density of air or oxygen was considered due to the presence of tumor tissue in the low-density area on 5-mm-thick reconstructed CT imaging. The results of this study showed that intratumoral oxygen was successfully produced by intratumoral KORTUC injection under ultrasonographic guidance, and that tumor hypoxia, which is considered a main cause of radioresistance in currently used Linac (linear accelerator) radiation therapy for malignant neoplasms, could be resolved by this method. Full article

Background: We have developed a new radiosensitization treatment called Kochi Oxydol-Radiation Therapy for Unresectable Carcinomas, Type II (KORTUC II). Using KORTUC II, we performed breast-conserving treatment (BCT) without any surgical procedure for elderly patients with breast cancer in stages I/II or patients refusing surgery. Since surgery was not performed, histological confirmation of the primary tumor region following KORTUC II treatment was not possible. Therefore, to precisely evaluate the response to this new therapy, a detailed diagnostic procedure is needed. The goal of this study was to evaluate the therapeutic response to KORTUC II treatment in patients with stage I/II breast cancer using annual breast contrast-enhanced (CE) magnetic resonance imaging (MRI). Methods: Twenty-one patients with stage I/II breast cancer who were elderly and/or refused surgery were enrolled in this study. All patients underwent MRI prior to and at 3 to 6 months after KORTUC II, and then approximately biannually thereafter. Findings from MRI were compared with those from other diagnostic modalities performed during the same time period. Results: KORTUC II was well tolerated, with minimal adverse effects. All of 21 patients showed a clinically complete response (cCR) on CE MRI. The mean period taken to confirm cCR on the breast CE MRI was approximately 14 months. The mean follow-up period for the patients was 61.9 months at the end of October 2014. Conclusions: The therapeutic effect of BCT using KORTUC II without surgery could be evaluated by biannual CE MRI evaluations. Approximately 14 months were required to achieve cCR in response to this therapy. Full article

We introduced non-surgical therapy with a novel enzyme-targeting radiosensitization treatment, Kochi Oxydol-Radiation Therapy for Unresectable Carcinomas, Type II (KORTUC II) into early stages breast cancer treatment. The purpose of this study was to examine changes in tumor shadows and microcalcifications on mammography (MMG) following KORTUC II for elderly patients with breast cancer. We also sought to determine whether MMG was useful in evaluating the therapeutic effect of KORTUC II. In addition to MMG, positron emission tomography-computed tomography (PET-CT) was performed to detect both metastasis and local recurrence. In all 10 patients, tumor shadows on MMG completely disappeared in several months following the KORTUC II treatment. The concomitant microcalcifications also disappeared or markedly decreased in number. Disappearance of the tumors was also confirmed by the profile curve of tumor density on MMG following KORTUC II treatment; density fell and eventually approached that of the peripheral mammary tissue. These 10 patients have so far have also shown neither local recurrence nor distant metastasis on PET-CT with a mean follow-up period of approximately 27 months at the end of September, 2010. We conclude that breast-conservation treatment using KORTUC II, followed by aromatase inhibitor, is a promising therapeutic method for elderly patients with breast cancer, in terms of avoiding any surgical procedure. Moreover, MMG is considered to be useful for evaluating the efficacy of KORTUC II. Full article