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OBJECTIVES: Intraductal papillary mucinous neoplasms (IPMNs) are precursor lesions of pancreatic adenocarcinoma. Artificial intelligence (AI) is a mathematical concept whose implementation automates learning and recognizing data patterns. The aim of this study was to investigate whether AI via deep learning algorithms using endoscopic ultrasonography (EUS) images of IPMNs could predict malignancy. METHODS: This retrospective study involved the analysis of patients who underwent EUS before pancreatectomy and had pathologically confirmed IPMNs in a single cancer center. In total, 3,970 still images were collected and fed as input into the deep learning algorithm. AI value and AI malignant probability were calculated. RESULTS: The mean AI value of malignant IPMNs was significantly greater than benign IPMNs (0.808 vs 0.104, P < 0.001). The area under the receiver operating characteristic curve for the ability to diagnose malignancies of IPMNs via AI malignant probability was 0.98 ( P < 0.001). The sensitivity, specificity, and accuracy of AI malignant probability were 95.7%, 92.6%, and 94.0%, respectively; its accuracy was higher than human diagnosis (56.0%) and the mural nodule (68.0%). Multivariate logistic regression analysis showed AI malignant probability to be the only independent factor for IPMN-associated malignancy (odds ratio: 295.16, 95% confidence interval: 14.13–6,165.75, P < 0.001). DISCUSSION: AI via deep learning algorithm may be a more accurate and objective method to diagnose malignancies of IPMNs in comparison to human diagnosis and conventional EUS features.

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In the search for a more effective adjuvant therapy to treat multiple myeloma (MM), we investigated the effects of the traditional Chinese herbal medicines Huang-Lian-Jie-Du- Tang IntroductionMultiple myeloma (MM) is an incurable plasma-cell malignancy and the second most common hematologic malignancy, with 14 000 new patients diagnosed in the United States annually. 1,2 Although combination chemotherapy offers initial response rates of 40% to 70% in MM patients, 3 refractoriness to these regimens eventually develops. High-dose chemotherapy with stem cell support has achieved higher response rates than conventional therapy, but few patients remain in long-term remission. 4 Thus, the development of a more effective therapy to treat early and advanced MM has become a priority.Many components from herbs have been identified as effective in the treatment of human disease. Curcumin, a major component of turmeric, is able to correct defects associated with the homozygous expression of delta F508 cystic fibrosis 5 and to suppress the growth of myeloma cells. 6 Arsenic trioxide, a compound of arsenic, is very effective in the treatment of patients with acute promyelocytic leukemia who have developed resistance to all-trans retinoic acid (ATRA). 7 Artemisinins, extracted from sweet wormwood, are the most potent antimalarials available, rapidly killing Plasmodium falciparum at all asexual stages by inhibiting the sarcoplasmic or endoplasmic reticulum calcium ATPase (SERCA) ortholog (PfATP6) in Xenopus oocytes with a similar potency to thapsigargin. 8 Consequently, they are widely used to treat multidrug-resistant malaria, a disease that claims 1 million lives annually. 9 Inflammation and MM may be induced partly in the same way, as interleukin 6 (IL-6) is a potential mediator in these conditions. 10,11 Many Kampo medicines have been used historically in anti-inflammatory therapy. By screening the effects of antiinflammatory Kampo formulas on MM cells, we hoped to find one to treat MM. Huang-Lian-Jie-Du-Tang (HLJDT) contains Coptis rhizoma, Phellodendron bark, Scutellaria radix (root), and Gardenia fruit in 2.0, 1.5, 3.0, and 2.0 parts, respectively. It is recognized in Japan and China as an effective anti-inflammatory agent and has been widely used in the treatment of various inflammatory diseases such as gastritis, dermatitis, aphthous stomatitis, and hypertension. HLJDT exhibited anti-inflammatory activity in experimental colitis induced by dextran sulfate sodium, 12 and in animal experiments it inhibited the proliferation of lymphocytes under inflammatory conditions by suppressing the secretion of proinflammatory cytokines including interferon ␣ (IFN-␣) and IFN-␥. 13 The secretion of these cytokines was also reported to be suppressed by HLJDT in is the recipient of a Postdoctoral Fellowship Award for Foreign Researchers (P04500) from the Japan Society for the Promotion of Science (JSPS).Reprints: Michio M. Kawano, Department of Bio-Signal Analysis, AMES, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-...

The complete nucleotide sequence of the gene for the specific glycoprotein (gp55) of the polycythemic strain of Friend spleen focus-forming virus (SFFV) The spleen focus-forming virus (SFFV), which is contained in the Friend leukemia virus preparation (1), is a replication-defective murine retrovirus. When inoculated as a pseudotype, SFFV causes rapid splenomegaly and erythroleukemia in susceptible adult mice (2). Depending on the SFFV strain the erythroleukemia is accompanied by either anemia or polycythemia. SFFV is considered a member of a diverse group of the acute leukemia and sarcoma viruses of mammalian and avian origin, and it is distinguished in that it has a strict target cell specificity both in vivo and in vitro and has no unique sequence of cellular origin (3).For the elucidation of the mechanism of erythroleukemia induction by SFFV, the identification of the leukemogenic sequence and its protein product is the first step. Two specific proteins have been shown to be coded for by SFFV. One is a gag gene-related protein, and the other is an env gene-related glycoprotein (gp55; also designated gp52) (4-7). The gag generelated protein (p45) is coded for only by a certain strain of SFFV (8). In contrast, gp55 is observed in the cells infected with any SFFV strain and has been relatively well characterized in the examination of its role in leukemogenesis (3, 9). Although the molecular size and details of the peptide map of gp55 are somewhat variable depending on the SFFV strain (10), the gp55s coded for by different SFFV strains have a common structural property: they are immunologically crossreactive with gp7O, the major viral envelope glycoprotein, of the ecotropic murine leukemia virus (MuLV) (4-6). Analysis of the SFFV genome 32S RNA by molecular hybridization (11), oligonucleotide fingerprinting (12, 13), or heteroduplex formation (14)