Poor Tolerability of Lenvatinib in Elderly Patients with Advanced Hepatocellular Carcinoma after Disease Progression following First-Line Atezolizumab Plus Bevacizumab: A Multicenter Study.

Introduction: We investigated the effectiveness of lenvatinib (LEN) after disease progression following first-line treatment with atezolizumab plus bevacizumab (Atez/Bev) in patients with unresectable hepatocellular carcinoma (HCC).

Methods: One hundred and ten HCC patients treated with Atez/Bev as first-line systemic chemotherapy were enrolled and underwent dynamic computerized tomography/magnetic resonance imaging to determine the treatment response. We evaluated the treatment efficacy and prognosis after second-line LEN treatment, especially in elderly patients.

Delayed Vasovagal Reaction with Reflex Syncope Following COVID-19 Vaccination.

Coronavirus disease 2019 (COVID-19) has become a pandemic, and vaccines remain the only effective tools available for ending it. However, their side effects, such as syncope, which mimics sudden cardiac death, are serious concerns. We herein report 6 cases of delayed vasovagal syncope and presyncope (VVR) caused by COVID-19 vaccination among 25,530 COVID-19 patients.

Vasospasm-induced ST-segment elevation myocardial infarction in a premenopausal woman with endothelial dysfunction.

ST-segment elevation myocardial infarction (STEMI) can be caused by coronary artery vasospasm (VSA) due to endothelial dysfunction. However, the clinical role of endothelial function tests in VSA-induced STEMI is not fully understood. We present the case of a 43-year-old woman with atypical chest pain and no coronary risk factors.

Atorvastatin Reduces Circulating S100A12 Levels in Patients with Carotid Atherosclerotic Plaques - A Link with Plaque Inflammation.

Aims: Inflammation is involved in various processes of atherosclerosis development. Serum C-reactive protein (CRP) levels, a predictor for cardiovascular risk, are reportedly reduced by statins. However, several studies have demonstrated that CRP is a bystander during atherogenesis.

IgG4-related Sclerosing Cholangitis Complicated with Cholangiocarcinoma and Detected by Forkhead Box P3 Immunohistochemical Staining.

An 80-year-old man was admitted due to biliary stricture with autoimmune pancreatitis. Although radiographical examinations suggested Immunoglobulin G4-related sclerosing cholangitis (IgG4-SC), punched biopsies from the bile duct revealed adenocarcinoma. In the resected specimen, abundant N-terminus of Forkhead box P3 (Foxp3)-positive cells were localized in cholangiocarcinoma (CCA) tissue, while IgG4-positive cells were spread around the entire bile duct.

Utility of F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Fusion Imaging for Prediction of Metastasis to Sentinel and Nonsentinel Nodes in Patients with Clinically Node-Negative Breast Cancer.

Purpose: F-Fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging (F-FDG PET/CT) is an important diagnostic tool in breast cancer. The utility of maximum standardized uptake values (SUVmax) of primary tumors has been evaluated to predict sentinel node (SN) and non-SN metastasis in clinically node-negative (cN0) patients.

Patients And Methods: F-FDG PET/CT was performed on 414 cN0 patients.

Dual time point F-fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging (F-FDG PET/CT) in primary breast cancer.

Background: To evaluate the clinicopathological and prognostic significance of the percentage change between maximum standardized uptake value (SUV) at 60 min (SUV1) and SUV at 120 min (SUV2) (ΔSUV%) using dual time point F-fluorodeoxyglucose emission tomography/computed tomography (F-FDG PET/CT) in breast cancer.

Methods: Four hundred and sixty-four patients with primary breast cancer underwent F-FDG PET/CT for preoperative staging. ΔSUV% was defined as (SUV2 - SUV1) / SUV1 × 100.

Impact of oxidative posttranslational modifications of SERCA2 on heart failure exacerbation in young patients with non-ischemic cardiomyopathy: A pilot study.

Background: Oxidative posttranslational modifications (OPTM) impair the function of Sarcoplasmic/endoplasmic reticulum (SR) calcium (Ca) ATPase (SERCA) 2 and trigger cytosolic Ca dysregulation. We investigated the extent of OPTM of SERCA2 in patients with non-ischemic cardiomyopathy (NICM).

Methods And Results: Endomyocardial biopsy (EMB) was obtained in 40 consecutive patients with NICM.

Perivascular Epithelial Cell Tumor of the Pancreas Diagnosed Preoperatively by Endoscopic Ultrasound-guided Fine-needle Aspiration.

We herein report a 49-year-old woman with a perivascular epithelial cell tumor (PEComa) of the pancreas. Imaging studies demonstrated a relatively well-demarcated mass, measuring approximately 40 mm in diameter, located in the pancreatic tail. It was heterogeneously enhanced almost to the same degree as the surrounding pancreatic tissue in both the arterial and portal venous phases.

Spontaneous Regression of Germinomas After Salvage Surgery and Possible Mechanism of Induced Apoptosis.

Background: A few cases of spontaneous regression of germ cell tumors have been reported. Possible mechanisms include steroid medication, surgical intervention, diagnostic radiation exposure, and immune response. None of these hypotheses has been supported by sufficient data.

Acute Acalculous Cholecystitis Caused by Giardia lamblia.

We report a case of a 70-year-old man with acute acalculous cholecystitis caused by Giardia lamblia. Contrast-enhanced computed tomography (CT) showed distention of the gallbladder due to a pericholecystic abscess without gallstones. Magnetic resonance cholangiopancreatography and drip infusion cholecystocholangiography-CT demonstrated a stricture of the hilar bile duct and cystic duct obstruction.

Imatinib plasma levels during successful long-term treatment of metastatic-gastrointestinal stromal tumors.

Background/aims: To investigate whether imatinib dosage correlated with effective plasma levels and clinical characteristics for Japanese patients undergoing long-term (≥2 years) imatinib therapy for GISTs.

Methodology: Twenty-five patients who received imatinib for a metastatic pathologically diagnosed GISTs at our hospital were enrolled. Imatinib response was assessed according to Choi’s criteria.

Combined multi-kernel head computed tomography images optimized for depicting both brain parenchyma and bone.

Background: The hybrid convolution kernel technique for computed tomography (CT) is known to enable the depiction of an image set using different window settings.

Objective: Our purpose was to decrease the number of artifacts in the hybrid convolution kernel technique for head CT and to determine whether our improved combined multi-kernel head CT images enabled diagnosis as a substitute for both brain (low-pass kernel-reconstructed) and bone (high-pass kernel-reconstructed) images.

Methods: Forty-four patients with nondisplaced skull fractures were included.

Combined multi-kernel chest computed tomography images optimized for depicting both lung and soft tissue.

Purpose: To evaluate the quality of our improved multi-kernel chest computed tomography (CT) images.

Methods: A random sample of 50 normal patients was retrospectively selected from those who underwent chest CT scans between January 2010 and July 2010. Normal lung structures were divided into six categories, and two radiologists independently compared with lung images.

Novel nasogastric tube-related criteria for urgent endoscopy in nonvariceal upper gastrointestinal bleeding.

Background: Patients with active upper gastrointestinal bleeding (UGIB) require urgent endoscopy, but appropriate criteria for urgent endoscopy in these patients have not yet been established.

Aims: The goal of this study is to establish a simple system for the selection of UGIB patients who may benefit from urgent endoscopy.

Methods: Of the 335 patients who required emergency hospitalization for UGIB from May 2010 to March 2012 at Nagoya Daini Red Cross Hospital, 166 patients who underwent placement of a nasogastric tube (NGT) were retrospectively identified.

Quantitation of HBsAg predicts response to entecavir therapy in HBV genotype C patients.

Aim: To analysis the factors that predict the response to entecavir therapy in chronic hepatitis patients with hepatitis B virus (HBV) genotype C.

Methods: Fifty patients [hepatitis B e antigen (HBeAg)-negative:HBeAg-positive = 26:24] with HBV genotype C, who received naïve entecavir therapy for > 2 years, were analyzed. Patients who showed HBV DNA levels ≥ 3.

Regression of inflammation in atherosclerosis by the LXR agonist R211945: a noninvasive assessment and comparison with atorvastatin.

Objectives: The aim of this study was to noninvasively detect the anti-inflammatory properties of the novel liver X receptor agonist R211945.

Background: R211945 induces reversal cholesterol transport and modulates inflammation in atherosclerotic plaques. We aimed to characterize with (18)F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) and dynamic contrast-enhanced cardiac magnetic resonance (DCE-CMR) inflammation and neovascularization, respectively, in atherosclerotic plaques with R211945 treatment compared with atorvastatin treatment and a control.

Radiation-induced myositis mimicking chest wall tumor invasion in two patients with lung cancer: a PET/CT study.

Two patients with lung cancer who had undergone stereotactic body radiation therapy (SBRT) exhibited increased F-18 FDG uptake in the chest wall after 6 months and 18 months, respectively, after SBRT. The prescribed dose of 50 Gy to the planning target volume was delivered on 4 consecutive days in each patient. It is important for nuclear medicine physicians to be familiar with F-18 FDG PET/CT findings ascribed to radiation-induced myositis in lung cancer patients treated with SBRT so that an appropriate differential diagnosis can be established.

Pioglitazone modulates vascular inflammation in atherosclerotic rabbits noninvasive assessment with FDG-PET-CT and dynamic contrast-enhanced MR imaging.

Objectives: We sought to determine the antiatherosclerotic properties of pioglitazone using multimethod noninvasive imaging techniques.

Background: Inflammation is an essential component of vulnerable or high-risk atheromas. Pioglitazone, a peroxisome proliferator-activated receptor-gamma agonist, possesses potent anti-inflammatory properties.

Pulmonary intravascular lymphoma diagnosed by 18-fluorodeoxyglucose positron emission tomography-guided transbronchial lung biopsy in a man with long-term survival: a case report.

Introduction: 18-Fluorodeoxyglucose positron emission tomography can detect the pulmonary involvement of intravascular lymphoma that presents no abnormality in a computed tomography scan.

Case Presentation: We report the case of a 61-year-old Japanese man who had pulmonary intravascular lymphoma and no computed tomography abnormality. We were able to make an antemortem diagnosis of pulmonary intravascular lymphoma by transbronchial lung biopsy according to 18-fluorodeoxyglucose positron emission tomography findings.

Planning of occupational dose reduction at BWR power plant by past dose record analysis combined with on-site workers' idea analysis.

In order to establish a plan for occupational dose reduction at operating plants, outage inspection works that involve high-dose exposure were selected and a determination of the major causes of high-dose exposure made by plant-by-plant comparison of doses received during inspection works. The comparison was made to investigate the relationship between exposure and the volume of objects to be inspected, working time and man-hour of each work process and ambient dose rates at work areas. In parallel with this, an analysis has also been carried out on 400 data items in a questionnaire survey conducted on relevant individuals, including foremen, radiation safety personnel, on-site workers and plant designers regarding ideas for dose reduction methods.

Accuracy of the Tokyo Guidelines for the diagnosis of acute cholangitis and cholecystitis taking into consideration the clinical practice pattern in Japan.

Purpose: Three years have passed since the publication of the Tokyo Guidelines for the management of acute cholangitis and cholecystitis, and we believe that the time has come to assess their validity.

Methods: In this study, we validated the diagnostic accuracy of these criteria in 74 patients with an initial diagnosis of acute cholangitis and 81 patients with an initial diagnosis of acute cholecystitis. We also statistically compared the accuracy of the diagnosis made based on the Tokyo Guidelines with that based on the presence of Charcot's triad for acute cholangitis and Murphy's sign for acute cholecystitis with use of the sign test to assess differences.

Variations in atherosclerosis and remodeling patterns in aorta and carotids.

Background: Atherosclerosis is a progressive disease that causes vascular remodeling that can be positive or negative. The evolution of arterial wall thickening and changes in lumen size under current "standard of care" in different arterial beds is unclear. The purpose of this study was to examine arterial remodeling and progression/regression of atherosclerosis in aorta and carotid arteries of individuals at risk for atherosclerosis normalized over a 1-year period.