Median Arcuate Ligament Syndrome Without Static Image Findings of Celiac Artery Compression: The Potential Existence of a Pure Neurogenic Subtype.

Symptomatic median arcuate ligament syndrome (MALS) is considered to be a diagnosis of exclusion, and there is no consensus about its diagnostic criteria. We present the case of a 39-year-old woman, who presented with persistent epigastric pain. A computed tomography scan did not show external celiac artery (CA) stenosis.

Empowering pediatric, adolescent, and young adult patients with cancer utilizing generative AI chatbots to reduce psychological burden and enhance treatment engagement: a pilot study.

Background: Pediatric and adolescent/young adult (AYA) cancer patients face profound psychological challenges, exacerbated by limited access to continuous mental health support. While conventional therapeutic interventions often follow structured protocols, the potential of generative artificial intelligence (AI) chatbots to provide continuous conversational support remains unexplored. This study evaluates the feasibility and impact of AI chatbots in alleviating psychological distress and enhancing treatment engagement in this vulnerable population.

First Metatarsophalangeal Joint-Preserving Surgery Is Effective for Forefoot Deformity With Moderate to Severe Joint Destruction in Rheumatoid Arthritis.

Background: The study compares the clinical outcomes of first metatarsophalangeal (MTP) joint fusion vs joint-preserving surgery in rheumatoid arthritis (RA) patients with severe forefoot deformities.

Methods: This single-center retrospective study at Kyushu University Hospital reviewed RA patients who underwent either first MTP joint arthrodesis or joint-preserving surgery for hallux valgus (HV) deformity between January 2008 and December 2022. A total of 103 feet (73 cases) were analyzed, with 75 feet (58 cases) showing radiographic bone destruction of Larsen grade 3 or higher.

Challenges in Regulating Synthetic New Psychoactive Substances: Lessons from Japan's Generic Scheduling against Hexahydrocannabihexol.

On December 2, 2023, Japan's Ministry of Health, Labour and Welfare (MHLW) announced an ordinance regulating the possession, consumption, and distribution of hexahydrocannabihexol (HHCH) except for medical purposes. HHCH, a synthetic cannabinoid, has been linked to central nervous system symptoms, including nausea, dizziness, and numbness, presumably due to its structural similarity to tetrahydrocannabinol. This regulatory action reflects Japan's historical drug regulation approach, which has evolved to address synthetic substances not covered by earlier laws.

A detoxified TLR4 agonist inhibits tumour growth and lung metastasis of osteosarcoma by promoting CD8+ cytotoxic lymphocyte infiltration.

Background: Osteosarcoma is the most common malignant bone tumour with limited treatment options and poor outcomes in advanced metastatic cases. Current immunotherapies show limited efficacy, highlighting the need for novel therapeutic approaches. Systemic immune activation by Toll-like receptor 4 (TLR4) immunostimulants has shown great promise; however, current TLR4 agonists' toxicity hinders this systemic approach in patients with osteosarcoma.