Prognostic Value of Perioperative Serum Creatinine Kinase Levels for Metachronous Colorectal Liver Metastasis.

Background:  Although decreased serum creatine kinase (s-CK) levels are observed in some cancers, possibly due to consumption during tumor growth, the relationship between s-CK levels and colorectal liver metastasis remains unclear. This study investigated the prognostic significance of perioperative s-CK levels in patients with metachronous colorectal liver metastasis.

Methods:  A total of 46 patients who underwent liver resection from 2011 to 2023 were included in this study.

Could tolerance explain an individual's eight episodes of gonococcal treatment failure with ceftriaxone? A case report.

Objectives: Describe the clinical evolution of a person with recurrent gonococcal cervicitis despite appropriate treatment and lack of reinfection.

Methods: We used the tolerance detection test to confirm that all three culture-positive gonococcal isolates were tolerant to ceftriaxone.

Results: Over a period of 6 months, a transgender man with gonococcal cervicitis experienced eight episodes of treatment failure despite receiving ceftriaxone 1 g intramuscularly on each occasion.

Prognostic value of leaflet coaptation gap in transcatheter edge-to-edge repair for functional mitral regurgitation.

Background: Coaptation gap (CG) is one of the challenging anatomies of mitral transcatheter edge-to-edge repair (TEER), but its impact on patient outcomes is unclear. This study aimed to evaluate the impact of CG on procedural and clinical outcomes in patients with functional mitral regurgitation (MR).

Methods: Data from 2140 patients undergoing TEER for functional MR were analysed, focusing on the presence of CG, which is a missing leaflet coaptation between the anterior and posterior leaflets during systole.

A Classification Method for General Medicine Physicians to Advance Field Research in Japan.

Purpose: General medicine physicians in Japan play diverse roles depending on their work environments; however, there is no clear definition. In the United States, the establishment of a definition for "hospitalists" has contributed to the accumulation of evidence. To develop research in general medicine and build evidence in Japan, there is an urgent need to establish a systematic classification method for general medicine physicians.

Comparative analysis of teratogen-induced malformations and gene expression across zebrafish strains in early development.

Zebrafish embryos are widely used in developmental toxicity testing. However, the extent to which genetic background influences susceptibility to teratogenic compounds remains incompletely understood. We here evaluated inter-strain variability in both phenotypic and transcriptomic responses to six model teratogens using five commonly utilized zebrafish strains, AB, TU, RW, WIK, and PET.

Dual-atria rotor modification: A comparative analysis of rotor modification and posterior wall isolation in patients with persistent and long-standing persistent atrial fibrillation.

Background: Various methods have been devised for catheter ablation of persistent atrial fibrillation (AF). However, it remains difficult to understand the mechanism of AF and to determine the optimal method.

Objective: This study aimed to evaluate the effectiveness of rotor modification (RM) compared to posterior wall isolation (PWI) in the treatment of persistent AF.

Targeting IL-6 Signaling: Safety and Effectiveness in Older Patients with Rheumatoid Arthritis.

Interleukin (IL)-6 plays a central role in amplifying inflammation, and its inhibition is beneficial in managing immune-mediated inflammatory diseases (IMIDs) such as rheumatoid arthritis (RA). IL-6 signaling inhibition is associated with a slightly increased risk of infections in patients with RA, and older age has been identified as a risk factor for severe adverse events, including infections. Therefore, the combination of an aging population and the increasing use of IL-6R inhibitors in RA treatment highlights the importance of carefully evaluating the safety and effectiveness of these therapies in older patients with RA.

Predictors of poor outcomes after posterior decompression surgery in patients with degenerative cervical myelopathy.

Study Design: Retrospective multicenter study.

Objectives: To identify predictors associated with failure of neurological improvement after posterior decompression surgery for degenerative cervical myelopathy (DCM).

Setting: 17 institutions in Japan.

Components of particulate matter as potential risk factors for acute myocardial infarction.

Background: Particulate matter with an aerodynamic diameter of ≤2.5 µm (PM) is a heterogeneous mixture, and specific substances that affect cardiovascular events remain unknown. We aimed to examine the association of short-term exposure to PM and its components with hospital admissions for acute myocardial infarction (AMI).

Safety and efficacy of arsenic trioxide in intensification therapy for newly diagnosed childhood acute promyelocytic leukemia: results from the JPLSG AML-P13 study.

Arsenic trioxide (ATO) in combination with all-trans retinoic acid (ATRA) has been shown to be effective in both adult and pediatric patients with acute promyelocytic leukemia (APL). Addition of ATO to conventional chemotherapy could lead to a reduction in the doses of cytotoxic agents, but the long-term safety of ATO is not fully understood, especially in children. The Japan Children's Cancer Group conducted a risk-stratified prospective study to investigate safety and efficacy of ATO in children with newly diagnosed APL by replacing all three intensification phases with ATO.

Outcomes of gastrectomy in octogenarians and nonagenarians: a comparative analysis in the era of minimally invasive surgery.

Background: As the population of Japan continues to age rapidly, an increasing number of patients aged ≥ 80 years are undergoing surgery for gastric cancer. Although minimally invasive techniques have improved surgical safety, operative risks in the super-elderly population (≥ 85 years) remain a significant concern.

Methods: This retrospective, single-center study analyzed 72 patients aged ≥ 80 years who underwent gastrectomy for gastric cancer at our hospital between January 2014 and August 2024.

Aspirin-Free Prasugrel Monotherapy After Percutaneous Coronary Intervention in Patients With Non-ST Elevation Acute Coronary Syndrome.

Background: In the presence of a potent P2Yinhibitor such as prasugrel, the additional clinical antithrombotic benefit of aspirin is unclear. The feasibility of prasugrel monotherapy without aspirin after percutaneous coronary intervention (PCI) has been demonstrated in chronic coronary syndrome, but is yet to be assessed in patients with non-ST elevation acute coronary syndrome (NSTE-ACS) and low anatomical complexity.

Methods And Results: ASET-Japan is a single-arm study investigating the safety of prasugrel 12-month monotherapy with a locally approved dose (loading 20 mg; maintenance 3.

Detection of actinides in wound swabs by the measurement of spontaneously emitted characteristic X-rays.

In the event of an accident at a nuclear fuel handling facility, the wounds of the affected workers may be contaminated with actinides such as uranium, neptunium, plutonium, and americium. The accidental absorption of actinides from wounds can lead to a significant degree of internal radiation exposure, which can be hazardous to the human body. Although the current approach for identifying actinide contamination is based on the detection of α-particles, the applicability of this approach is reduced for wound contamination due to the α-particles being easily shielded by various components of bodily fluid.

Observation of the crossover from quantum fluxoid to half-quantum fluxoid in a chiral superconducting device.

Topological superconductors are one of the intriguing material groups from the viewpoint of not only condensed matter physics but also industrial applications such as quantum computers based on Majorana fermion. For real applications, developments of thin-film topological superconductors are highly desirable. Bi/Ni bilayer is a possible candidate for thin-film chiral superconductors where the time-reversal symmetry is broken.

Immunoglobulin G4-Related Disease Mimicking Meningioma and Dural Metastasis: A Case Report.

Herein, we report a case of immunoglobulin G4-related disease (IgG4-RD) that required differentiation from meningioma and dural metastasis based on neuroradiological imaging results, particularly focusing on magnetic resonance spectroscopy (MRS) and cerebral angiography findings. The patient was a 67-year-old woman who presented with left lower-limb weakness. She had been diagnosed with breast cancer 11 years earlier and was treated with surgical resection, followed by hormone therapy.

Computer-aided diagnosis based on 3D deep convolutional neural network system using novel 3D magnetic resonance imaging sequences for high-grade prostate cancer.

Background: With the rising incidence of prostate cancer (PCa), there is a global demand for assistive tools that aid in the diagnosis of high-grade PCa. This study aimed to develop a diagnostic support system for high-grade PCa using innovative magnetic resonance imaging (MRI) sequences in conjunction with artificial intelligence (AI).

Materials And Methods: We examined image sequences of 254 patients with PCa obtained from diffusion-weighted and T2-weighted imaging, using novel MRI sequences before prostatectomy, to elucidate the characteristics of the 3-dimensional (3D) image sequences.

Association between Cardio-Ankle Vascular Index and Heart Failure Outcomes: Insights from a Prospective Multicenter Cohort.

Background: Heart failure (HF) is a substantial public health concern associated with poor prognosis and limited tools for early prediction. Arterial stiffness contributes to the development of HF, particularly with a preserved ejection fraction. The cardio-ankle vascular index (CAVI) is a noninvasive, pressure-independent marker of arterial stiffness.

Nationwide estimates of patient numbers and prevalence rates of ulcerative colitis and Crohn's disease in Japan in 2023.

Background: Almost a decade has passed since the previous nationwide survey on the prevalence of ulcerative colitis (UC) and Crohn's disease (CD) in Japan was conducted in 2015. We conducted a new nationwide hospital-based survey to provide updated estimates of the patient numbers and prevalence rates of UC and CD in Japan in 2023.

Methods: Stratified random sampling was used to select hospital departments (internal medicine, surgery, pediatrics, and pediatric surgery) that routinely treat UC and CD patients.

Prophylactic oral antibiotic bowel preparation for colorectal surgery in Japan: results of a nationwide questionnaire survey.

Purpose: Surgical site infections (SSIs) incur a large burden in colorectal surgery. The importance of oral antibiotic bowel preparation (OABP) in SSI prevention has been affirmed; however, the current trends in Japan are unknown. This investigated bowel preparation practices among Japanese surgeons, focusing on OABP.

Effectiveness and Safety of Dupilumab Monotherapy in Japanese Patients With Chronic Rhinosinusitis With Nasal Polyps.

Objectives: The randomized, double-blind, placebo-controlled LIBERTY SINUS-24 and SINUS-52 studies demonstrated that dupilumab is effective for chronic rhinosinusitis with nasal polyps (CRSwNP) when used with an intranasal corticosteroid (INCS); however, INCSs are not approved for CRSwNP in Japan. The current study aimed to investigate the effectiveness and safety of dupilumab monotherapy in Japanese individuals with CRSwNP.

Methods: This phase 4, open-label, single-arm, multicenter study enrolled adult individuals with CRSwNP inadequately controlled with standard care therapies, including systemic corticosteroids and/or surgery.

Addressing severe spinal deformities associated with neurofibromatosis type 1: Surgical strategies and outcomes.

Background: Surgical strategies for spinal deformities associated with neurofibromatosis type 1(NF-1) have been still controversial due to the wide variety of pathologies, particularly, for deformities with severe dystrophic changes in pediatric patients remained challenging with high complication and reoperation rates. The purpose of this study was to validate our surgical strategies by evaluating clinical and radiographical outcomes.

Methods: We retrospectively evaluated 22 cases who underwent correction surgeries for spinal deformities in our institute.

Investigation of Ocular Blood Flow in Males with Metabolic Syndrome.

This study aims to investigate ocular blood flow in male subjects with metabolic syndrome (MetS) using laser speckle flowgraphy (LSFG). Subjects who underwent LSFG ocular blood flow testing during physical examinations were separated into a MetS group and a control group. The groups were propensity score-matched by age, with 138 male subjects compared in each group.

Effectiveness of Implementing Hospital Wastewater Treatment Systems as a Measure to Mitigate the Microbial and Antimicrobial Burden on the Environment.

The emergence and spread of antimicrobial-resistant bacteria (ARB) has become an urgent global concern as a silent pandemic. When taking measures to reduce the impact of antimicrobial resistance (AMR) on the environment, it is important to consider appropriate treatment of wastewater from medical facilities. In this study, a continuous-flow wastewater treatment system using ozone and ultraviolet light, which has excellent inactivation effects, was implemented in a hospital in an urban area of Japan.

A phase II study of intrapatient dose escalation of biweekly trifluridine/tipiracil plus bevacizumab for colorectal cancer (E-BiTS study).

Background: Trifluridine/tipiracil (FTD/TPI) plus bevacizumab (BEV) remains a standard of care for refractory metastatic colorectal cancer (mCRC), though hematological toxicities remain a concern. Although a biweekly regimen has shown favorable tolerability, the optimal biweekly dosage has yet to be established. Thus, this study was conducted to evaluate the feasibility and clinical impact of intrapatient dose escalation of biweekly FTD/TPI plus BEV.