Successful Commando procedure using the superior transseptal approach in a high-risk case.

Background: The Commando procedure, which involves replacement of both the aortic and mitral valves along with reconstruction of the intervalvular fibrous body, is technically demanding. Commando procedure typically performed via an incision extending from the ascending aorta to the roof of the left atrium. However, in patients with extensive adhesions due to prior cardiac surgery, adding a superior transseptal incision can provide good exposure and reduce the risk of surrounding tissue injury.

Bridging therapy with valemetostat to allogeneic hematopoietic cell transplantation for adult T-cell leukemia/lymphoma.

Adult T-cell leukemia/lymphoma (ATL) is a peripheral T-cell malignancy caused by human T-cell leukemia virus-1. Patients diagnosed with aggressive ATL have a poor prognosis. As response duration to conventional multiagent chemotherapy is short, upfront allogeneic hematopoietic cell transplantation (allo-HCT) is recommended.

Minimal impact of prophylactic antibiotics in pediatric inguinal hernia surgery: Evidence from real-world data.

Background: The effectiveness of prophylactic antibiotics in pediatric inguinal hernia repair remains unclear. As the procedure is considered clean, the necessity of prophylactic antibiotics is debated.

Methods: We conducted a retrospective cohort study using the TriNetX Research Network.

Stem-like and effector peripheral helper T cells comprise distinct subsets in rheumatoid arthritis.

Peripheral helper T (T) cells can play pathogenic roles in human autoimmune diseases. T cells are proposed to be the major B cell helpers in inflamed joints in rheumatoid arthritis (RA), but whether and how T cells are engaged in tissue inflammation remains unclear. We demonstrate that T cells comprise two subsets in RA: stem-like T (S-T) and effector T (E-T) cells.

Human CD4 T cells regulate peripheral immune responses in rheumatoid arthritis via insulin-like growth factor-like family member 2.

Human CD4 T cells play a central role in the pathogenesis of autoimmune diseases, but their immunoregulatory mechanisms driving pathogenesis remain to be elucidated. We show that human T peripheral helper cells (T cells) regulate peripheral immune responses via insulin-like growth factor-like family member 2 (IGFL2), an inflammatory factor found exclusively in primates. Single-cell RNA sequencing of seropositive rheumatoid arthritis (RA) synovium showed that is specifically expressed by CD4 T cells, predominantly T cells.

Differential Impact of Concomitant Methotrexate and Glucocorticoids Dosages on Biologics and JAK Inhibitors: The ANSWER Cohort Study.

Aim: This multicenter retrospective study evaluated the differential impact of concomitant methotrexate (MTX) and glucocorticoids (GCs) administration by dosage on the effectiveness and safety of biological disease-modifying antirheumatic drugs (bDMARDs) and Janus kinase inhibitors (JAKi) in a real-world cohort of patients with rheumatoid arthritis, adjusting for clinical backgrounds variables.

Methods: The study included 3751 treatment courses (bDMARD- or JAKi-naïve cases, 48.9%; tumor necrosis factor inhibitors: 1668; tocilizumab [TCZ]: 865; abatacept [ABT]: 825; JAKi: 393).

Association between physical function and hospitalization among older patients with pre-dialysis chronic kidney disease after educational hospitalization: A single-center prospective cohort study.

Introduction: This study aimed to investigate the factors associated with hospitalization in older patients with pre-dialysis CKD, including physical function.

Methods: This single-center, prospective cohort study included 111 patients aged ≥65 years with stage 3-5 non-hemodialyzed CKD. Physical function was assessed using the short physical performance battery (SPPB), 10-m walk test, and grip strength test.

Simplified predictive model for intussusception in children: combining radiographic and clinical features.

Purpose: To evaluate the utility of combining plain abdominal radiography findings with clinical symptoms for the primary screening of intussusception in children.

Methods: A total of 152 children aged < 16 years, who were admitted with suspected intussusception between April, 2008 and October, 2024, were enrolled in this retrospective cohort study. We analyzed the demographic data, clinical symptoms, laboratory findings, and abdominal radiography results of all participants.

Associations between serum levels of alpha-calcitonin gene-related peptide and clinical features of neuromyelitis optica spectrum disorders.

Neuromyelitis optica spectrum disorders (NMOSD) are characterized by severe inflammation-mediated astrocytopathy in the central nervous system. Neuropathic pain (NP) is highly prevalent among patients with NMOSD, and significantly impairs their quality of life. Alpha-calcitonin gene-related peptide (α-CGRP) is a neuropeptide related to pain and neuroinflammation in the central and peripheral nerves; however, the involvement of α-CGRP in NMOSD pathophysiology remains unexplored.

Plexin D1 accumulation in the spinal motor neurons of patients with amyotrophic lateral sclerosis.

Background: Plexin D1 in endothelial cells (ECs) in the spinal cord (SC) has emerged as a key protein in spinal motor neuron (MN) maturation. Here, we pathologically investigated plexin D1 expression in the SCs of patients with sporadic amyotrophic lateral sclerosis (sALS) to clarify the association between plexin D1 expression in ECs and MN degeneration.

Methods: We measured plexin D1 expression in the ECs of lumbar SC tissue samples from 11 patients with sALS and 8 age- and sex-matched patients with other non-inflammatory neurological diseases (OND) by immunohistochemistry.

Lich-Gregoir vs. Cohen ureteral re-implantation surgery for bilateral vesicoureteral reflux: A propensity score analysis.

Background: The Lich-Gregoir procedure for bilateral vesicoureteral reflux (VUR) is limited by the risk of urinary retention. Here, we investigated the efficacy of the Lich-Gregoir procedure compared to that of the Cohen procedure for bilateral VUR in children.

Methods: We retrospectively evaluated children who underwent open ureteral re-implantation for bilateral VUR between 2010 and 2022.

Predicting rheumatoid arthritis progression from seronegative undifferentiated arthritis using machine learning: a deep learning model trained on the KURAMA cohort and externally validated with the ANSWER cohort.

Background: Undifferentiated arthritis (UA) often develops into rheumatoid arthritis (RA), but predicting disease progression from seronegative UA remains challenging because seronegative RA often does not meet the classification criteria. This study aims to build a machine learning (ML) model to predict the progression from seronegative UA to RA using clinical and laboratory parameters.

Methods: KURAMA cohort (training dataset) and ANSWER cohort (validation dataset) were utilized.

Remodeling Process of the Tendon Graft After Anterior Cruciate Ligament Reconstruction: Comprehensive Analysis With RNA Sequencing in a Murine Model.

The tendon graft is known to undergo a remodeling process after anterior cruciate ligament (ACL) reconstruction. However, little is known about the transcriptional profile of this process. The aim of the present study is to identify differentially expressed genes inside the remodeling ACL graft in the early phase after ACL reconstruction in our murine model using RNA sequencing (RNAseq).

Comparative effectiveness of subcutaneous sarilumab 200 mg biweekly, subcutaneous Tocilizumab 162 mg biweekly, and intravenous Tocilizumab 8 mg/kg every 4 weeks in patients with rheumatoid arthritis: a prospective cohort study.

Background: While targeting the interleukin-6 receptor (IL-6R) through the use of sarilumab (SAR) or tocilizumab (TCZ) has become a major therapeutic approach for rheumatoid arthritis (RA), direct comparisons between IL-6R inhibitors (IL-6Ris) for treating RA have not been conducted. We aimed to compare the effectiveness of subcutaneous sarilumab (SAR-SC), subcutaneous tocilizumab (TCZ-SC), and intravenous TCZ (TCZ-IV) against RA in a multicenter cohort study.

Methods: Within the target trial emulation framework, an incident new-user and active-comparator cohort design was used.

Utilizing Contrast-Enhanced Computed Tomography for Accurate Localization of an Omental Lymphangioma: A Case Report.

Omental lymphangioma, a rare congenital benign lesion, represents a small proportion of abdominal lymphangiomas. Its diagnosis can be challenging, owing to its nonspecific symptoms and features that overlap with those of other cystic abdominal conditions. The report presents a case of an eight-year-old girl with progressive abdominal distension noted since the age of two years.

Right-Sided Colonic Diverticulitis Mimicking Acute Appendicitis in a Pediatric Patient: A Case Report.

Colonic diverticulitis is rare in pediatric populations. In cases of right-sided colonic diverticulitis, the symptoms can mimic those of acute appendicitis, leading to potential misdiagnosis of acute appendicitis. We report a case of ascending colonic diverticulitis in a 15-year-old young man who presented with abdominal pain migrating from the epigastrium to the right lower quadrant, initially raising suspicion for acute appendicitis.

Factors Associated With Hallux Valgus Progression in Patients With Rheumatoid Arthritis: Insights From Non-Weight-Bearing Radiographs in the KURAMA Cohort.

Objectives: This longitudinal study investigated the factors associated with hallux valgus (HV) progression in patients with rheumatoid arthritis (RA).

Methods: We included 316 patients with RA who underwent foot radiography in 2015 and more than four years later. The HV angle (HVA), first-second intermetatarsal angle (IMA), first-fifth intermetatarsal angle (M1/M5 angle), and calcaneal pitch (CP) angle were measured.

Factors Influencing Presenteeism in Middle-aged and Older Workers with Chronic Kidney Disease: A Single-center Cross-sectional Study.

Objectives: Managing presenteeism among patients with chronic kidney disease (CKD) is important for balancing disease management and employment. This study aimed to investigate presenteeism, exercise self-efficacy (SE), and physical function indices in workers with CKD and to examine the factors that influence presenteeism in this patient group.

Methods: This cross-sectional study included 36 workers with stage 3-5 pre-dialysis CKD.

Cellular signatures in human blood track bone mineral density in postmenopausal women.

Osteoclasts are the sole bone-resorbing cells and are formed by the fusion of osteoclast precursor cells (OCPs) derived from myeloid lineage cells. Animal studies reveal that circulating OCPs (cOCPs) in blood travel to bone and fuse with bone-resident osteoclasts. However, the characteristics of human cOCPs and their association with bone diseases remain elusive.

Prediction models incorporating second metacarpal cortical index for osteoporosis in rheumatoid arthritis: Externally validated machine learning models developed using data from the KURAMA cohort.

Objective: Osteoporosis and osteopenia are significant concerns in rheumatoid arthritis (RA), predisposing patients to fragility fractures. While dual-energy X-ray absorptiometry (DXA) is the gold standard for bone mineral density (BMD) assessment, simpler screening tools are needed. This study aims to assess the correlation between the second metacarpal cortical index (2MCI) and BMD in RA patients, and to evaluate machine learning (ML) models utilizing 2MCI and clinical parameters for predicting osteoporosis/osteopenia presence and BMD.