Usefulness of Myelin Quantification Using Synthetic Magnetic Resonance Imaging for Predicting Outcomes in Patients With Acute Ischemic Stroke.

Background: Synthetic magnetic resonance imaging (MRI) is an innovative MRI technology that enables the acquisition of multiple quantitative values, including T1 and T2 values, proton density, and myelin volume, in a single scan. Although the usefulness of myelin measurement with synthetic MRI has been reported for assessing several diseases, investigations in patients with stroke have not been reported. We aimed to explore the utility of myelin quantification using synthetic MRI in predicting outcomes in patients with acute ischemic stroke.

Approaches for difficult-to-induce-seizures electroconvulsive therapy cases (DEC): a Japanese expert consensus.

Background: Seizure threshold increases with age and the frequency of electroconvulsive therapy (ECT). Therefore, therapeutic seizures can be difficult to induce, even at maximum stimulus charge with available ECT devices. Such cases are known as difficult-to-induce-seizures electroconvulsive therapy cases (DECs).

Advocacy in Action: International Patient Group Improves Hereditary Angioedema Diagnosis and Care Across the Asia-Pacific.

This study demonstrates that patient advocacy groups significantly enhance medication availability and improve diagnosis of hereditary angioedema (HAE), particularly in emerging economies within the Asia-Pacific region. This study supports integrating patient advocacy group involvement into management guidelines, emphasising their role in improving access to diagnostics and treatment for HAE.

Association Between Change in Prognostic Nutritional Index During Neoadjuvant Therapy and Dental Occlusal Support in Patients with Esophageal Cancer Under Neoadjuvant Therapy: A Retrospective Longitudinal Pilot Study.

A high prognostic nutritional index (PNI) is associated with good prognosis in patients with esophageal cancer. However, nutritional status often decreases during neoadjuvant therapy. Functional tooth units (FTUs) provide an index for the status of posterior occlusal support.

Effect of abdominal aortic calcification on long-term outcomes after the first liver resection in very old patients with hepatocellular carcinoma.

Aim: We previously reported that abdominal aortic calcification is associated with poor overall and recurrence-free survival after hepatectomy for hepatocellular carcinoma (HCC). However, the effect of abdominal aortic calcification on cancer-specific prognosis in very old patients with several comorbidities remains unknown. This multicenter study aimed to evaluate the impact of abdominal aortic calcification on the cumulative recurrence rate and recurrence-free survival in patients with HCC aged >80 years.

Use of Internet/Application-Based E-consults by General Practitioners in Japan to Resolve Patients' Problems: A Descriptive Observational Study.

Introduction Electronic consultations (e-consults) refer to digital health technologies that enhance clinical information sharing and improve patients' access to expert healthcare providers. This study aims to describe the current utilization of the Internet/application-based e-consult system and to assess how effectively it resolves clinical questions. Methods Participants were general practitioners (GPs) who had installed the e-consult platform on their personal computers or cell phones.

Detection of anti-MGL_1304 IgE using the ImmunoCAP system for diagnosis of type I allergy to sweat.

Background: Type I allergy to sweat is involved in the pathogenesis of atopic dermatitis (AD) and cholinergic urticaria (CholU), with MGL_1304 from Malassezia globosa being the major causative antigen. Currently, no standard diagnostic test exists for sweat allergy that uses serum.

Methods: The ImmunoCAP (iCAP) system to measure antigen-specific IgE was developed using recombinant MGL_1304 (rMGL_1304).

Impact of platelet-lymphocyte ratio after robot-assisted partial nephrectomy with renorrhaphy.

Renorrhaphy is often performed after tumor resection during robotic-assisted laparoscopic partial nephrectomy (RAPN). This study aimed to investigate the association between renorrhaphy performance and inflammatory markers. A retrospective cohort study was conducted including patients with renal cell carcinoma who underwent RAPN at eight institutions in Japan between April 2016 and November 2023.

Impact of long-term trends on outcomes in the management of colonic diverticular bleeding: mediation analyses in a large multicenter study.

Background: Despite accumulating evidence and recommendations for management of colonic diverticular bleeding (CDB), the changes in its clinical management and outcomes remain unknown.

Methods: We performed a retrospective tendency analysis on a biennial basis, a propensity score-matched cohort study between the first and latter half groups, and mediation analyses to compare the diagnostic and treatment methods between January 2010 and December 2019 (CODE BLUE-J Study).

Results: A total of 6575 patients with CDB were included.

Selective midfacial neurectomy for postparalytic facial nerve syndrome.

Chemodenervation with botulinum A toxin and neuromuscular retraining therapy are commonly performed as first-line treatments for postparalytic facial nerve syndrome (PFS). However, their effects are temporary, and side effects typically develop. Currently available selective neurectomy approaches are limited by variations in the anatomy of the peripheral branches of the facial nerve and the ability to reduce perioral synkinesis, but not periocular synkinesis.

Early initiation of intravenous cyclophosphamide and one-year outcome in super-refractory cryptogenic-new onset refractory status epilepticus.

To explore the potential efficacy of early initiation of intravenous cyclophosphamide (IVCPA), we reviewed consecutive four cases of super-refractory cryptogenic-new onset refractory status epilepticus (C-NORSE) between 2015 and 2023. We compared functional outcomes at 3 months and 1 year after the onset between patients who received IVCPA within 20 days (early-treated) and those who received it later (late-treated). All patients (median age: 43 years) had a prodromal fever.

Oral Inflammation and Microbiome Dysbiosis Exacerbate Chronic Graft-versus-host Disease.

The oral microbiota, second in abundance to the gut, is implicated in chronic systemic diseases, but its specific role in GVHD pathogenesis has been unclear. Our study finds that mucositis-induced oral dysbiosis in patients post-hematopoietic cell transplantation associated with increased chronic GVHD (cGVHD) even in patients receiving post-transplant cyclophosphamide. In murine HCT models, oral dysbiosis caused by bilateral molar ligatures exacerbated cGVHD and increased bacterial load in the oral cavity and gut with Enterococcaceae significantly increasing in both organs.

Clinical Significance of Lymphatic Involvement in Intramucosal (pT1a) Gastric Cancer Resected by Endoscopic Submucosal Dissection.

Background And Aim: Lymphatic involvement is sometimes detected during routine examination of intramucosal (pT1a) gastric cancer resected endoscopically. However, its clinical significance and association with the risk of metastasis remain unknown.

Methods: This was a retrospective cohort study of 6797 consecutive patients with pT1a gastric cancers treated by endoscopic submucosal dissection (ESD) at three institutions in Japan from January 2005 to August 2023.

Outcomes of allogeneic SCT versus tisagenlecleucel in patients with R/R LBCL and poor prognostic factors.

This study investigated the efficacy of tisagenlecleucel (tisa-cel) and allogeneic hematopoietic stem cell transplantation (allo-SCT) for patients with relapsed and/or refractory (r/r) large B-cell lymphoma (LBCL) with poor prognostic factors, defined as performance status (PS) ≥ 2, multiple extranodal lesions (EN), chemorefractory disease, or higher lactate dehydrogenase (LDH). Overall, the allo-SCT group demonstrated worse progression-free survival (PFS), higher non-relapse mortality, and a similar relapse/progression rate. Notably, the tisa-cel group showed better PFS than the allo-SCT group among patients with chemorefractory disease (3.

A Case of Cavernous Sinus Fistula Caused by Ruptured Spontaneous Aneurysm on Persistent Primitive Trigeminal Artery.

The most frequent of the embryonic persistent arteries that connect the internal carotid artery to the posterior circulation is the persistent primitive trigeminal artery (PPTA), which is recognized on 0.1%-0.6% on the basis of conventional angiography or magnetic resonance imaging (MRI).

Albumin-Butyrylcholinesterase as a Novel Prognostic Biomarker for Hepatocellular Carcinoma Post-hepatectomy: A Retrospective Cohort Study with the Hiroshima Surgical Study Group of Clinical Oncology.

Background: This study aimed to investigate the association between a new biomarker that incorporates albumin (Alb) and butyrylcholinesterase (BCHE) levels, as well as the prognosis of hepatocellular carcinoma (HCC) after hepatectomy.

Methods: The study enrolled 1712 patients who underwent primary hepatectomy for HCC between January 2003 and December 2019 at seven institutions belonging to the Hiroshima Surgical Study Group of Clinical Oncology. The entire dataset was randomly split into discovery and validation cohorts in a 7:3 ratio.

Electrocardiographic changes in severe quetiapine poisoning.

Introduction: Quetiapine shares sodium channel-blocking properties with tricyclic antidepressants. We present the electrographic findings in two patients with severe quetiapine poisoning.

Case Summaries: Two patients poisoned with quetiapine presented with impaired consciousness, requiring mechanical ventilation and vasopressor support, with one also experiencing status epilepticus.

Myelin measurement in amyotrophic lateral sclerosis with synthetic MRI: A potential diagnostic and predictive method.

Background: Myelin damage has recently been highlighted as a major causative factor of amyotrophic lateral sclerosis (ALS). Although myelin damage has been pathologically identified in ALS, it has not been clinically evaluated. This study aimed to quantify myelin volume using synthetic MRI to evaluate myelin damage in patients with ALS, and determine its association with clinical parameters.

Dilated common bile duct diameter as an indicator of bacteremia in patients with symptomatic common bile duct stones.

Background: The optimal timing and selection for blood culture collection in patients with acute cholangitis remains unclear. The relationship between common bile duct (CBD) diameter and the incidence of bacteremia in patients with CBD stones was elucidated.

Methods: This single-center retrospective observational study included patients with symptomatic CBD stones who presented to the emergency department between January 2019 and December 2021.

Influenza A Infection With Virus-Associated Pneumonia and Hemorrhagic Shock and Encephalopathy Syndrome in an Adult.

Hemorrhagic shock and encephalopathy syndrome (HSES) is a subtype of influenza-associated encephalopathy (IAE) and primarily occurs in infants. It presents with high fever, disorder of consciousness, convulsions, and shock, which rapidly progress to watery diarrhea, as well as liver and renal dysfunction. HSES is extremely rare in adults, with few reported cases worldwide.

Detecting Early Signs of Extrapericardial Cardiac Tamponade With ECG.

Cardiac tamponade is a condition with impaired cardiac function by acute fluid accumulation in the pericardium. Extracardiac masses, such as a mediastinal hematoma, can also cause cardiac tamponade. We report a case of impending extrapericardial cardiac tamponade secondary to traumatic sternal fracture with expanding mediastinal hematoma.