Obesity Decreases Liver-Related Death in Patients With Cirrhosis: A Retrospective Propensity Score-Matched Study.

Aims: To determine the impact of obesity on the prognosis of patients with liver cirrhosis.

Methods: This present retrospective observational study enrolled 482 patients without hepatocellular carcinoma (HCC). The patients were evaluated for obesity during the subsequent 8-year follow-up period.

Vericiguat Use in Right Heart Failure Management Following Left Ventricular Assist Device Implantation: A Case Report.

Right heart failure (RHF) is a major cause of mortality in patients using left ventricular assist devices (LVADs). Vericiguat, an oral soluble guanylate cyclase stimulator, has recently been used to treat chronic heart failure (HF) with a reduced ejection fraction (EF) and is expected to improve RHF owing to its pulmonary vasodilatory and inotropic properties in patients with an LVAD. A 62 year old woman with advanced HF due to cardiac sarcoidosis was transferred to our center with HF recurrence and left ventricular (LV) thrombosis.

Development of severe pre-capillary pulmonary hypertension 7 years after heart transplant.

We present the case of a patient who developed severe pre-capillary pulmonary hypertension 7 years after heart transplantation. The transplantation was performed due to the dilated phase of hypertrophic cardiomyopathy with combined post- and pre-capillary pulmonary hypertension (CpcPH), which had initially improved. This case highlights the potential underlying factors contributing to pulmonary arterial hypertension in patients with CpcPH and the importance of careful long-term follow-up after heart transplantation.

Bronchopleural fistula: a multi-institutional analysis of the treatment outcomes and prognostic factors in the ESSG-01 study.

Objectives: Bronchopleural fistula (BPF) is a postoperative complication with a poor prognosis, and its treatment remains challenging. This study aimed to accumulate cases through a multi-institutional registry and gain insights to improve the treatment outcomes.

Methods: This retrospective multi-institutional study included patients who developed BPF after undergoing thoracic surgery between January 2000 and July 2023.

Case Report: Therapeutic effect of efgartigimod in refractory anti-GQ1b antibody syndrome coexisting with myasthenia gravis.

Anti-GQ1b antibody syndrome is a spectrum of autoimmune neurological disorders that includes Miller Fisher syndrome, Guillain-Barré syndrome (GBS) with ophthalmoplegia, Bickerstaff brainstem encephalitis, and acute ophthalmoplegia without ataxia. These conditions are characterized by the presence of immunoglobulin G (IgG) antibodies targeting GQ1b gangliosides. The coexistence of anti-GQ1b antibody syndrome and myasthenia gravis (MG) is rare and presents diagnostic and therapeutic challenges.

Postoperative Pain Reduction and Clinical Value of Uniportal Video-Assisted Thoracic Surgery: A Secondary Analysis of the J-RATSIG 01 Study.

Background: The J-RATSIG 01 multi-institutional prospective study found robot-assisted thoracic surgery to be inferior to video-assisted thoracic surgery (VATS) in terms of postoperative pain. Because reducing the number of ports was linked to pain reduction, we conducted a secondary analysis comparing uniportal VATS (U-VATS) and multiportal VATS (M-VATS).

Methods: This analysis included 205 patients who underwent anatomical lung resection using VATS at 12 institutions.

Ameliorative Effect of Ninjinyoeito on Reductions in Self-grooming in Lipopolysaccharide-Injected Mice: Involvement of Alpha7 Nicotinic Acetylcholine Receptor.

Ninjinyoeito (NYT) is a Japanese herbal medicine that is prescribed for individuals with depleted mental and physical energy. In this study, we examined the mechanism underlying the effect of NYT on depleted mental and physical energy in mice following a simulated infection. Injection of lipopolysaccharide (LPS), a bacterial endotoxin, decreased the motivational behaviors and body weight of the mice.

Prognostic indicators and nomograms for postoperative survival among younger patients with non-small cell lung cancer.

Background: Non-small cell lung cancer (NSCLC) diagnosed in younger patients represents a rare and distinct entity within lung cancer, yet prognostic indicators for younger patients surgically treated for NSCLC remain unclear. We aimed to analyze the long-term surgical outcomes in a large cohort and to identify predictors and to develop nomograms for effective survival prediction.

Methods: The Surveillance, Epidemiology, and End Results (SEER) database [2010-2020] was queried for pathologically confirmed NSCLC cases who underwent cancer-directed surgery.

Dual pathogenic mechanisms in lysinuric protein intolerance: Interplay between hyperammonemia and cellular metabolic dysregulation in astrocyte injury.

Background: Lysinuric protein intolerance (LPI) is a rare genetic disorder characterized by an inherited defect in cationic amino acid transport caused by pathogenic variants in the SLC7A7 gene. While LPI causes systemic complications, the underlying cellular mechanisms remain poorly understood. This study investigated the cellular characteristics of LPI, focusing on intracellular metabolite profiles and astrocyte response to hyperammonemia.

Autoimmune hepatitis following transition from prednisolone to thrombopoietin receptor agonist therapy in immune thrombocytopenic purpura: A clinical precaution.

Background: Autoimmune hepatitis (AIH) occasionally complicates immune thrombocytopenic purpura (ITP). The risk of AIH development after prednisolone (PSL) discontinuation and thrombopoietin receptor agonist (TPO-RA) initiation remains underrecognized.

Aim And Methods: We report two cases of AIH that developed or exacerbated after switching from PSL to TPO-RAs (avatrombopag and eltrombopag) for ITP treatment.

Optimizing Cabozantinib Dosing in Unresectable Hepatocellular Carcinoma of 7-on/7-off Regimen.

Cabozantinib (CAB) causes a high incidence of adverse events in unresectable hepatocellular carcinoma (u-HCC) and requires dose adjustments. We evaluated the efficacy and safety of the 7-on/7-off regimen composed of 7 consecutive days' administration of CAB followed by a 7-day rest period. This was a retrospective analysis of 35 patients with u-HCC, who were treated with CAB in a multicenter cohort in Japan from 2020 to 2024.

Uniportal video-assisted thoracoscopic surgery for lung cancer: the current opinions and future perspectives of thoracic surgeons in Japan.

Objectives: Uniportal video-assisted thoracoscopic surgery (U-VATS) is gaining global recognition as a minimally invasive approach. However, its current status and issues in Japan remain unclear. This study aimed to assess U-VATS adoption and barriers among Japanese thoracic surgeons through a nationwide survey.

Atf3 controls transitioning in female mitochondrial cardiomyopathy as identified by spatial and single-cell transcriptomics.

Oxidative phosphorylation defects result in now intractable mitochondrial diseases (MD) with cardiac involvement markedly affecting prognosis. The mechanisms underlying the transition from compensation to dysfunction in response to metabolic deficiency remain unclear. Here, we used spatially resolved transcriptomics and single-nucleus RNA sequencing (snRNA-seq) on the heart of a patient with mitochondrial cardiomyopathy (MCM), combined with an MCM mouse model with cardiac-specific Ndufs6 knockdown (FS6KD).

Heart transplantation with super-aged donors older than 65 years.

Background: This study elucidated the clinical outcomes and serial allograft function of heart transplant (HTx) recipients who received hearts from super-aged donors (SAD) ≥65 years of age.

Methods: Adult HTx recipients between 1999 and 2022 were retrospectively reviewed and divided into 2: donor age ≥65 years [SAD group ( = 12)] and donor age <65 years [younger donor, YD group ( = 140)]. The primary end-point was 3-year all-cause deaths after HTx.

Lethal co-expression intolerance underlies the mutually exclusive expression of ASCL1 and NEUROD1 in SCLC cells.

Small cell lung cancer (SCLC) subtypes, defined by the expression of lineage-specific transcription factors (TFs), are thought to be mutually exclusive, with intra-tumoral heterogeneities. This study investigated the mechanism underlying this phenomenon with the aim of identifying a novel vulnerability of SCLC. We profiled the expression status of ASCL1, NEUROD1, POU2F3, and YAP1 in 151 surgically obtained human SCLC samples.

Efficacy of adjuvant tegafur-uracil (UFT) in early-stage non-small cell lung cancer with poor prognostic factors.

Background: Postoperative recurrence is a significant problem in patients with early-stage non-small cell lung cancer (NSCLC), with recurrence rates of 35% for stage IB and 50% for stage IIA. This study aimed to evaluate the efficacy of tegafur-uracil (UFT) as an adjuvant therapy in NSCLC patients with poor prognostic factors.

Methods: A retrospective analysis was conducted of 330 patients with stage IB/IIA NSCLC who underwent lung resection between 2000 and 2019.

Impact of shear wave elastography and attenuation imaging for predicting life-threatening event in patients with metabolic dysfunction-associated steatotic liver disease.

We aimed to elucidate the value of ultrasound-based biomarkers for predicting the major life-threatening events in metabolic dysfunction-associated steatotic liver disease (MASLD). We established a prospective cohort of 279 patients who underwent two-dimensional shear wave elastography (2D-SWE), ultrasound-guided attenuation parameter (UGAP). An area under the curve analysis was performed to determine the cutoff values of liver stiffness measurements (LSM) by 2D-SWE and attenuation coefficient (AC) by UGAP for a moderate fibrosis and a moderate steatosis.

Exploring ethical considerations in medical research: Harnessing pre-generated transformers for AI-powered ethics discussions.

Introduction: In medical research involving human subjects, ethical review is essential to protect individuals. However, concerns have been raised about variations in ethical review opinions and a decline in review quality. Adequately protecting human subjects requires multifaceted opinions from ethics committee members.

The utility of the low motion area ratio for the preoperative detection of pleural adhesions: dynamic chest radiography analysis.

Background: Dynamic chest radiography (DCR) is useful for detecting preoperative pleural adhesions, predicting operation time and blood loss, and determining the surgical approach. However, since DCR evaluations are subjective, an objective index was needed. Therefore, we focused on the low motion area (LMA) ratio derived from the objective data obtained through DCR.

Mini-open periacetabular cementoplasty for periacetabular bone metastasis: a report of two cases.

Bone metastasis in the periacetabular region usually causes severe pain and functional disability. Some surgical procedures, such as the Harrington surgery and percutaneous cementoplasty, have been reported as treatment options for periacetabular bone metastases with limited efficacy. The former is highly invasive, while the latter may not allow the injection of a sufficient amount of cement.

Preventive effect of Tyr-Pro, a blood-brain barrier transportable dipeptide, on memory impairment in SAMP8 mice.

In a series of studies on blood-brain barrier transportable peptides, a soybean dipeptide, Tyr-Pro, penetrated the mouse brain parenchyma after oral intake and improved short and long memory impairment in acute Alzheimer's model mice. Here, we aimed to clarify the anti-dementia effects of this peptide administered to SAMP8 mice prior to dementia onset. At the end of the 25-week protocol in 16-week-old SAMP8 mice, Tyr-Pro (10 mg/kg/day) significantly improved the reduced spatial learning ability compared with that in the control and amino acid (Tyr + Pro) groups as indicated by the results of Morris water maze tests conducted for five consecutive days.

Dissociated rhythms between donor and recipient hearts after heart transplantation using the modified bicaval technique.

Unlabelled: The modified bicaval anastomosis technique is an orthotopic heart transplantation technique that preserves the posterior wall of the right atrium as a bridging tissue, creating a dual structure of the recipient and donor hearts between the superior and inferior venae cavae. In this report, we present a case with unique electrophysiological findings following heart transplantation using this technique. The patient, who had persistent atrial fibrillation before the procedure, achieved a maintained sinus rhythm afterward.

Detection of Gram-Ghost Bacilli and Additional Ziehl-Neelsen Stain for the Early Diagnosis of Driveline Infection: A Case Report.

Background: Driveline infections (DLI) caused by nontuberculous mycobacteria (NTM) in patients with implantable left ventricular assist devices (iLVAD) are rare but fatal, requiring early diagnosis and appropriate treatment. Herein, we present a rare case of DLI caused by Mycobacterium chelonae, which was promptly diagnosed using Gram stain and Ziehl-Neelsen stain and followed a favorable clinical course.

Case Presentation: A 51-year-old man with an iLVAD complicated by DLI was admitted to our center.