Cerebral Infarction Triggered by Swallowing-Induced Compression of an Aberrant Right Subclavian Artery.

An 81-year-old man presented with recurrent cerebral infarctions despite the administration of dual antiplatelet therapy. Imaging revealed a severely stenotic, calcified, and aberrant right subclavian artery (ARSA) closely adjacent to the esophagus. Cerebral infarctions are repeatedly triggered by swallowing, and mechanical compression of the ARSA by food passage is considered to be a mechanism of cerebral infarction.

Intraoperative evaluation of bone resection accuracy in total knee arthroplasty using an augmented reality-based navigation system.

Introduction: Computer-assisted surgery (CAS) in total knee arthroplasty (TKA) has seen growing adoption, with over 30% of primary TKA procedures in Japan using CAS as of 2021. Augmented reality (AR) navigation has emerged as a novel alternative, providing real-time visualization and high-precision guidance during surgery. However, standardized protocols, long-term outcomes, and quantitative accuracy data remain limited.

Prognosis-anchored outcome evaluation (PAOE) for detecting functional benefit in aSAH: A multicenter analysis of clazosentan use.

Background: Although clazosentan has shown vasospasm-reducing effects in aneurysmal subarachnoid hemorrhage (aSAH), its impact on long-term functional outcomes remains controversial. Conventional randomized trials have reported limited benefits. This study applies Prognosis-Anchored Outcome Evaluation (PAOE), a model-based framework comparing observed outcomes to individualized prognostic expectations, to assess potential functional benefit in real-world practice.

[A multicenter phase 2 trial in children and young adults with newly diagnosed T-ALL: ALL-T11/ T-ALL-211-U from the Japan Children's Cancer Group and the Japan Adult Leukemia Study Group].

T-cell acute lymphoblastic leukemia (T-ALL) accounts for approximately 10-15% of childhood ALL, with its incidence increasing during the adolescent and young adult (AYA) period. The Japan Children's Cancer Group (JCCG) and the Japan Adult Leukemia Study Group (JALSG) conducted the ALL-T11/T-ALL-211-U clinical trial in newly diagnosed T-ALL patients under 25 years of age. The treatment protocol for this trial, which was based on the AIEOP-BFM-ALL 2000 trial, incorporated nelarabine and included dexamethasone induction, intensified L-asparaginase, and extended intrathecal therapy.

Hematopoietic cell transplantation in pediatric EB virus-associated hemophagocytic lymphohistiocytosis.

Background: Few reports exist on the transplant outcomes of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH). This nationwide survey evaluated the clinical outcomes of pediatric patients with EBV-HLH who underwent allogeneic HCT.

Methods: Data from 32 pediatric patients with EBV-HLH who underwent their first allogeneic HCT between 2000 and 2020 were reviewed retrospectively.

Potential drawbacks of manual aspiration with filter devices in carotid artery stenting.

BackgroundCarotid artery stenting (CAS) is a recognized intervention for preventing atherothrombotic cerebral infarction in patients with internal carotid artery stenosis. Although filter protection systems are used to prevent the migration of distal debris during CAS, in combination with manual aspiration and flow reversal systems, their behavior under retrograde blood flow remains poorly understood. This study aimed to evaluate the filter behavior under various flow conditions in CAS.

Real-time fluorescence-guided glioblastoma resection with 5-aminolevulinic acid using ORBEYE™.

Background: Although fluorescence-guided surgery (FGS) using 5-aminolevulinic acid (5-ALA) for glioblastomas (GBMs) can maximize the extent of resection (EOR), its superiority when used with ORBEYE™, a three-dimensional exoscope, compared with that of conventional microscopy remains unclear. This study aimed to evaluate the effectiveness of ORBEYE™ in 5-ALA FGS for GBM resection and compare the results with those of conventional microscopic FGS.

Methods: This retrospective, single-center study included 41 patients with histologically confirmed GBM who underwent 5-ALA FGS between January 2016 and April 2024.

Impact of center volume on outcomes in allogeneic hematopoietic cell transplantation for children.

The impact of center volume on outcomes in pediatric hematopoietic cell transplantation (HCT) is not well established. We retrospectively analyzed data from a nationwide registry, including 6966 pediatric patients who underwent their first allogeneic HCT at 123 centers in Japan between 2001 and 2020. Centers were categorized by transplant volume as low volume centers (C1, the smallest number of transplantation), medium-low volume centers (C2), medium-high volume centers (C3), and high volume centers (C4, the greatest number of transplantation), and outcomes were compared across these categories.

Influence of Polymorphisms in Pharmacokinetics-Related Genes on the Areas Under the Plasma Concentration-Time Curves of Doxorubicin and Doxorubicinol in Patients with Diffuse Large B-Cell Lymphoma Receiving CHOP Therapy.

Background And Objectives: Doxorubicin (DOX) and its metabolite doxorubicinol (DOXol) are drugs with large differences in pharmacokinetics (PK) between patients. In this study, we investigated the effects of polymorphisms in PK-related genes on the areas under the plasma concentration-time curves (AUCs) of DOX and DOXol.

Methods: This study included 43 patients diagnosed with non-Hodgkin lymphoma undergoing the first round of CHOP therapy.

Glioblastoma mimicking autoimmune meningitis in an adult: A complex diagnostic challenge.

Background: Glioblastoma multiforme (GBM) is a highly aggressive primary brain tumor with a poor prognosis. It commonly affects the brain and rarely spreads outside the central nervous system owing to barriers like the blood-brain barrier. We present a rare case of GBM with atypical features mimicking autoimmune meningitis, complicating the diagnosis.

Involvement of propionate, citrulline, homoserine, and succinate in oral microbiome metabolite-driven periodontal disease progression.

Dysbiosis of the oral microbiome has been implicated in the onset and progression of periodontal diseases. An altered oral microbiome can significantly affect the concentration and composition ratio of bacterial-derived metabolites, thereby contributing to disease development. However, there is limited research on the role of metabolites derived from the oral microbiota.

Efficacy and safety of dose-dense chemotherapy for early-stage breast cancer under prophylactic pegfilgrastim administration: a systematic review and meta-analysis from clinical practice guidelines for the use of G-CSF 2022.

Background: In early-stage breast cancer, dose-dense chemotherapy, which involves the administration of standard doses at shorter intervals, is safer when administered with granulocyte colony-stimulating factor (G-CSF) to mitigate chemotherapy-induced neutropenia. This study aimed to thoroughly evaluate the advantages and disadvantages of dose-dense regimens based on the use of G-CSF.

Methods: A systematic review was conducted according to the "Minds Handbook for Clinical Practice Guideline Development" using PubMed, Ichushi-Web, and the Cochrane Library databases.

Perioperative management of craniopharyngioma resection through endoscopic endonasal approach in a super-super obese patient: A technical case report.

Background: The endoscopic endonasal approach (EEA) is increasingly used in minimally invasive surgeries for skull base lesions such as pituitary tumors. Although experienced facilities and neurosurgeons familiar with this technique can typically perform these surgeries routinely without special techniques or instruments, challenging cases can occasionally arise due to patient factors such as obesity. Here, we describe challenges encountered during neurosurgery in a patient with super-super obesity and introduce our unique technical nuances for management during tumor resection.

Branched-chain amino acids and specific phosphatidylinositols are plasma metabolite pairs associated with menstrual pain severity.

Menstrual pain affects women's quality of life and productivity, yet objective molecular markers for its severity have not been established owing to the variability in blood levels and chemical properties of potential markers such as plasma steroid hormones, lipid mediators, and hydrophilic metabolites. To address this, we conducted a metabolomics study using five analytical methods to identify biomarkers that differentiate menstrual pain severity. This study included 20 women, divided into mild (N = 12) and severe (N = 8) pain groups based on their numerical pain rating scale.

Growing knowledge impact of gene-editing technology on public acceptance: a longitudinal analysis in Japan.

Genome editing (GE) technology holds significant promise for advancements in crop development and medical applications. However, public acceptance of GE in Japan remains uncertain. This study aimed to examine how knowledge impacts public acceptance of GE technology, focusing on differences across diffusion stages and application purposes.

Discovery of MT-7117 (Dersimelagon Phosphoric Acid): A Novel, Potent, Selective, and Nonpeptidic Orally Available Melanocortin 1 Receptor Agonist.

Activation of the melanocortin 1 receptor (MC1R) mediates melanogenesis in melanocytes, anti-inflammatory effects in inflammatory cells, and antifibrotic effects in fibroblasts. Thus, MC1R agonists are expected to be beneficial for treating skin, autoimmune, inflammatory, and fibrotic diseases. Afamelanotide, an α-melanocyte-stimulating hormone (α-MSH) analogue MC1R agonist, is used clinically for treating erythropoietic protoporphyria (EPP) as a subcutaneous implant formulation.

JCCG ALL-B12: Evaluation of Intensified Therapies With Vincristine/Dexamethasone Pulses and Asparaginase and Augmented High-Dose Methotrexate for Pediatric B-ALL.

Purpose: The JCCG ALL-B12 clinical trial aimed to evaluate the effectiveness of unvalidated treatment phases for pediatric ALL and develop a safety-focused treatment framework.

Patients And Methods: Patients age 1-19 years with newly diagnosed B-ALL were enrolled in this study. These patients were stratified into standard-risk (SR), intermediate-risk (IR), and high-risk (HR) groups.

[Head-up Surgery in Current Neurosurgery with Neuroendoscope and Exoscope].

Neurological surgery requires techniques and equipment to magnify the delicate brain structures and blood vessels that are difficult to discern with the naked eye. The introduction of surgical microscopes in the 1960s marked a breakthrough leading to the development of microsurgery and significant improvements in the safety and efficacy of neurosurgery. Subsequently, minimally invasive neurosurgery became prevalent, particularly with advancements in endoscopic technology in the 1990s.

Tissue plasminogen activator for acute branch atheromatous disease exhibits transient improvement and worsening.

Background: Tissue plasminogen activator (tPA) is an effective treatment for acute ischemic stroke. Although initial improvement is observed when administered for branch atheromatous disease (BAD), some cases subsequently worsen. Clinical data on the characteristics of these patients is lacking, and the benefits of tPA are unclear.

Effectiveness and safety of primary prophylaxis with G-CSF for patients with Ewing sarcomas: a systematic review for the Clinical Practice Guidelines for the Use of G-CSF 2022 of the Japan Society of Clinical Oncology.

Background: Multidrug chemotherapy for Ewing sarcoma can lead to severe myelosuppression. We proposed two clinical questions (CQ): CQ #1, "Does primary prophylaxis with G-CSF benefit chemotherapy for Ewing sarcoma?" and CQ #2, "Does G-CSF-based intensified chemotherapy improve Ewing sarcoma treatment outcomes?".

Methods: A comprehensive literature search was conducted in PubMed, Cochrane Library, and Ichushi web databases, including English and Japanese articles published from 1990 to 2019.