Spontaneous remission of Pneumocystis jirovecii pneumonia followed by severe pulmonary nocardiosis in a patient with HIV infection: A case report.

We describe a rare case of spontaneous remission of Pneumocystis jirovecii pneumonia (PCP) in a 42-year-old patient with human immunodeficiency virus (HIV) infection, followed by severe pulmonary nocardiosis. To our knowledge, this is the first report of spontaneous remission of PCP in a completely untreated patient with HIV infection. The patient, a bisexual Japanese man, presented with fever and anorexia and had a history of non-compliance with antiretroviral therapy (ART) for 13 years.

Effectiveness of the educational training program for Japanese chief residents: A one-year pilot study.

Background: Multi-institutional faculty development programs for chief residents were lacking in Japan. This study evaluated the effectiveness of the program for enhancing the knowledge and behaviors of chief residents at the national level.

Methods: Six participants completed self-assessment questionnaires at three points: before, immediately after, and 6 months post-program.

Genome-resolved year-round dynamics reveal a broad range of giant virus microdiversity.

Giant viruses are crucial for marine ecosystem dynamics because they regulate microeukaryotic community structure, accelerate carbon and nutrient cycles, and drive the evolution of their hosts through co-evolutionary processes. Previously reported long-term observations revealed that these viruses display seasonal fluctuations in abundance. However, the underlying genetic mechanisms driving such dynamics of these viruses remain largely unknown.

Contrast Agent Pooling in the Descending Aorta Due to Severe Heart Failure.

Case Presentation: An 86-year-old female presented to our emergency department with chest pain and orthopnea and was diagnosed with heart failure and ST-elevation myocardial infarction, prompting hospitalization. During hospitalization, she developed a fever. A chest and abdominal contrast-enhanced computed tomography (CT), conducted to investigate the cause of the fever, coincidentally revealed sedimentation of contrast agent in the descending aorta.

Temple Syndrome: Comprehensive Clinical Study in Genetically Confirmed 60 Japanese Patients.

Objective: Temple syndrome (TS14) is a rare 14q32.2-related imprinting disorder. Here, we report comprehensive clinical findings in TS14.

Residency Program Directors' Perspectives on Overtime Duty Hours and Professional Development Time in Japan.

Purpose: This study aimed to explore the perspectives of residency program directors in Japan regarding overtime duty hours and the balance between clinical training and self-improvement activities. This study explores the impact of work-hour regulations on resident well-being and training quality, contributing to global discourse on medical education reform.

Participants And Methods: A cross-sectional survey was distributed to 701 residency training hospitals across Japan to investigate their readiness for new duty-hour limits under the Medical Care Act, which categorizes working hours into Level A (960 hours/year), Level B (1440 hours/year), and Level C-1 (1920 hours/year).

A novel resident physician examination using clinical simulation video to assess clinical competence in Japan: a cross-sectional study.

Background: The general medicine in-training examination (GM-ITE) assesses physicians' clinical knowledge. This study expanded on findings from a previous pilot study to assess the relationship between general medicine in-training examination (GM-ITE) scores and the diagnostic skills of resident physicians in Japan by employing an innovative clinical simulation video (CSV-IE).

Methods: This multicenter cross-sectional study included 4,677 resident physicians who took the GMITE between January 17 and 30, 2023.

Adult Height in Girls with Central Precocious Puberty with Onset after 6 Years: Effects of Gonadotropin-Releasing Hormone Analog Therapy.

Introduction: Precocious puberty (PP), which is sometimes divided into gonadotropin-dependent or gonadotropin-independent PP, is a pathological condition characterized by premature secretion of gonadal steroids resulting in the early development of secondary sexual characteristics. Girls younger than 6 years with idiopathic gonadotropin-dependent PP (referred to as central PP or CPP) who receive gonadotropin-releasing hormone analog (GnRHa) therapy experience an increase in their adult height (AH) in contrast to girls who are aged 6 years or more, who show no consistent pattern of increase even with GnRHa therapy.

Methods: In total, 133 girls aged 6 years or more who visited any one of the seven study centers between April 2000 and March 2020 and who met the diagnostic criteria for PP in Japan were retrospectively examined.

Features of late local failure of early‑stage non‑small cell lung cancer treated with stereotactic body radiotherapy.

Local failure of non-small cell lung cancer (NSCLC) treated with stereotactic body radiation therapy (SBRT) often occurs within 2 years and delayed local failure is uncommon. In the present study, features of late local failure (LLF; >2 years after SBRT) after SBRT were investigated and compared with those of early local failure (ELF; ≤2 years after SBRT) to explore whether these two local recurrence features have different prognostic implications. Patients who underwent SBRT for stage I-IIA NSCLC between July 2006 and March 2014 were retrospectively reviewed.

Preterm Infant with Generalized Arterial Calcification of Infancy Who Survived Due to Early Diagnosis and Appropriate Treatment with Bisphosphonates: A Case Report.

Generalized arterial calcification of infancy (GACI) is a rare disease characterized by arterial calcification. GACI is caused by a mutation in the ENPP1 or ABCC6 genes. GACI causes severe hypertension and heart failure, and approximately 50% of patients die within the first 6 months.

Association between physicians' maldistribution and core clinical competency of resident physicians: a nationwide cross-sectional study.

Objectives: With physician maldistribution recognised as a global issue, Japan implemented the physician uneven distribution (PUD) index as a strategic measure. Currently, there is a lack of objective assessment of core clinical competencies in regions influenced by varying levels of physician distribution. In this study, we objectively assess the core clinical competencies in regions affected by physician maldistribution and explore the relationship between the PUD index and the clinical competencies of resident physicians.

Analysis of the life cycle of Helicobacter pylori bacteriophage KHP40 belonging to the genus Schmidvirus.

Bacteriophage (phage) KHP40 was previously isolated from the supernatant of a culture of Helicobacter pylori KMT83 cells. In this study, we analysed the infection characteristics of KHP40, phage release pattern from KMT83 cells, and state of KHP40 DNA in KMT83 cells. The findings revealed that KHP40 phage showed varied adsorption efficiencies for different strains, long latent periods, and small burst sizes.

Comprehensive study on central precocious puberty: molecular and clinical analyses in 90 patients.

Context: Defects in MKRN3, DLK1, KISS1, and KISS1R and some disorders, such as Temple syndrome (TS14), cause central precocious puberty (CPP). Recently, pathogenic variants (PVs) in MECP2 have been reported to be associated with CPP.

Objective: We aimed to clarify the contribution of (epi)genetic abnormalities to CPP and clinical and hormonal features in each etiology.

Diverse RNA viruses discovered in multiple seagrass species.

Seagrasses are marine angiosperms that form highly productive and diverse ecosystems. These ecosystems, however, are declining worldwide. Plant-associated microbes affect critical functions like nutrient uptake and pathogen resistance, which has led to an interest in the seagrass microbiome.

Prognostic assessment of patients with bone metastatic renal cell cancer treated with palliative radiotherapy.

The present study investigated the prognosis of patients who received palliative radiotherapy (RT) for bone metastases (BMs) from renal cell cancer (RCC), and assessed the prognostic factors specific to BMs from RCC. A total of 109 patients with RCC and BMs who underwent RT for the first time were included in the study. Prognostic factors were evaluated using multivariate analysis and a scoring system based on regression coefficients was devised.

Evaluation of the usefulness of non-weight-bearing tunnel view using X-ray in the short term after medial meniscus posterior root tear onset: a retrospective study.

Background: This study aimed to examine whether the non-weight-bearing tunnel view X-ray is effective for short-term evaluation of medial meniscus posterior root tear (MMPRT) by assessing the X-ray characteristics at the initial and follow-up visits.

Methods: This was a retrospective longitudinal study of 26 enrolled knees diagnosed with MMPRT on magnetic resonance imaging. The distance between the medial tibial eminence and medial femoral condyle (MTE-MFC distance) and medial tibiofemoral joint (MTFJ) width were measured by obtaining non-weight-bearing tunnel view and frontal view X-ray radiographs.

Robust growth hormone responses to GH-releasing peptide 2 in adolescents.

Objectives: GH-releasing peptide-2 (GHRP2) can be used for provocative growth hormone testing (GHT). Since it acts as a powerful stimulus for GH secretion, cut-off peak GH level in GHRP2 loading test (GHRP2T) is higher than in other GHT. Nevertheless, data on response at adolescents are limited.

Luminescent Silicon Nanocrystals as Metal Ion Sensors.

At relatively low concentrations in aqueous solution, Fe, Fe, Cu, and Ni quench the photoluminescence (PL) of the undecenoic acid-capped silicon (Si) nanocrystals. The PL could be restored by adding a chelating agent, such as ethylenediaminetetraacetic acid (EDTA), to remove the ions. Fe and Cu also significantly increase the PL lifetime.

Hospital Use of a Web-Based Clinical Knowledge Support System and In-Training Examination Performance Among Postgraduate Resident Physicians in Japan: Nationwide Observational Study.

Background: The relationship between educational outcomes and the use of web-based clinical knowledge support systems in teaching hospitals remains unknown in Japan. A previous study on this topic could have been affected by recall bias because of the use of a self-reported questionnaire.

Objective: We aimed to explore the relationship between the use of the Wolters Kluwer UpToDate clinical knowledge support system in teaching hospitals and residents' General Medicine In-Training Examination (GM-ITE) scores.

Association between tumor cell in air space and treatment outcomes in early-stage lung cancer treated with stereotactic body radiation therapy.

Background And Purpose: Spread-through air space (STAS) is an unfavorable factor in patients with lung cancer treated with surgery. However, the relationship between the treatment outcomes of stereotactic body radiation therapy (SBRT) for lung cancer and STAS has not been adequately investigated. This study aimed to evaluate the impact of tumor cells in the air space (TCIAS), which show a STAS burden, on treatment outcomes in patients with early-stage lung cancer treated with SBRT.

The Masquerade of Myocardial Infarction as Gastroenteritis: A Diagnostic Challenge.

Acute coronary syndrome (ACS) can present with varied symptomatology, often deviating from classic presentations, particularly in patients without the characteristic chest pain. This case report describes an ST-elevation myocardial infarction (STEMI) that closely mimicked acute gastroenteritis, illustrating the challenges of differential diagnosis in atypical ACS presentations. We present the case of a 65-year-old Japanese male with a history of hypertension and dyslipidemia who arrived at the emergency department with acute abdominal pain, vomiting, diarrhea, and fever, symptoms suggesting viral gastroenteritis.

Functional variants in a TTTG microsatellite on 15q26.1 cause familial nonautoimmune thyroid abnormalities.

Insufficient thyroid hormone production in newborns is referred to as congenital hypothyroidism. Multinodular goiter (MNG), characterized by an enlarged thyroid gland with multiple nodules, is usually seen in adults and is recognized as a separate disorder from congenital hypothyroidism. Here we performed a linkage analysis of a family with both nongoitrous congenital hypothyroidism and MNG and identified a signal at 15q26.

Medial Meniscus Posterior Root Reconstruction and Open-Wedge High-Tibial Osteotomy for Medial Meniscus Posterior Root Tear With Varus Knee Alignment: A Retrospective Study on Short-Term Outcomes.

Purpose: We describe 13 cases of medial meniscus posterior root tear (MMPRT) with varus knee alignment treated with medial meniscus posterior root reconstruction (MMPR-R) and open-wedge high-tibial osteotomy (OWHTO) to identify an optimal MMPRT treatment.

Methods: We retrospectively reviewed 13 patients (mean age: 66.3 ± 8.