Glucocorticoid tapering pace in microscopic polyangiitis and granulomatosis with polyangiitis in Japanese real-world practice: A propensity score-matched retrospective cohort study from the J-CANVAS registry.

Objective: To assess the prevalence and outcomes among regimens of glucocorticoid tapering for microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) in real-world practice.

Methods: We retrospectively examined the Japan Collaborative Registry of ANCA-associated Vasculitis (J-CANVAS) registry, and evaluated the prevalence of glucocorticoid tapering regimens in the PEXIVAS trial. In patients with newly diagnosed MPA and GPA, we compared outcomes among standard and reduced pace regimens.

A multi-center, open-label, randomized clinical trial evaluating the preventive effect of perampanel on craniotomy-induced epileptogenesis in seizure-naive patients with supratentorial brain tumors: study protocol for a GRAMPAS trial.

Background: Early seizures after craniotomy are significant perioperative complications that can adversely impact patient outcomes. Despite current guidelines advising against the routine use of antiseizure drugs for seizure after craniotomy prevention due to limited efficacy data, many clinicians continue prescribing them. This discrepancy highlights the need for robust evidence to guide clinical practice.

[Questionnaire Survey on the Response to the Reduction of the Equivalent Dose Limit of the Crystalline Lens in the Tokai Region].

Purpose: We conducted a questionnaire survey on the measures to be taken after the reduction of the equivalent dose limit for lenses to clarify the current situation at each institution and to discuss future dose control and exposure protection for lenses.

Methods: A questionnaire survey was conducted among medical institutions in the Tokai area. A total of 65 items, including personal dosimeters, protective eyewear, imaging conditions, and protective equipment, were included in the survey.

Clinical impact of cancer cachexia on the outcome of patients with non-small cell lung cancer with PD-L1 tumor proportion scores of ≥50% receiving pembrolizumab monotherapy versus immune checkpoint inhibitor with chemotherapy.

This retrospective, multicenter cohort study aimed to determine whether cancer cachexia serves as a biomarker for determining the most effective treatment for patients having non-small-cell lung cancer (NSCLC) with high programmed death ligand 1 (PD-L1) expression treated with immune checkpoint inhibitors (ICIs) alone or combined with chemotherapy (ICI/chemotherapy). We included 411 patients with advanced NSCLC with a PD-L1 tumor proportion score of ≥50%. The patients were treated with pembrolizumab monotherapy or ICI/chemotherapy.

Impact of direct mesenteric perfusion on malperfusion in acute type A aortic dissection repair.

Objectives: Mesenteric malperfusion in acute aortic dissection remains a life-threatening complication with no standardized treatment strategy. This study aimed to describe and evaluate the outcomes of our integrated approach combining exploratory laparotomy, immediate mesenteric reperfusion, and central aortic repair.

Methods: We retrospectively reviewed patients with acute aortic dissection with a preoperative diagnosis of mesenteric malperfusion who were treated between August 2011 and November 2022.

combined with L858R mutation reduced afatinib sensitivity and associated to early recurrence in lung cancer.

Background: The third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) osimertinib is widely used as a first-line treatment for -mutated non-small cell lung cancer (NSCLC). However, there is no established treatment for osimertinib resistance, so second-generation afatinib is an alternative treatment option. The purpose of this study was to elucidate gene alterations associated with afatinib efficacy and resistance by analyzing cell-free DNA (cfDNA) obtained from patients with -mutated NSCLC.

Epiploic appendagitis on the vermiform appendix is often misdiagnosed as acute appendicitis.

Epiploic appendagitis of the vermiform appendix is a rare cause of right lower abdominal pain that can mimic acute appendicitis and result in unnecessary surgery. Despite this, the condition can be managed with non-steroidal anti-inflammatory drugs alone. Due to the lack of characteristic physical or laboratory findings, accurate diagnosis by imaging is crucial.

Efficacy and safety of mosunetuzumab monotherapy for Japanese patients with relapsed/refractory follicular lymphoma: FLMOON-1.

Background: In a global phase I/II study (GO29781; NCT02500407), single-agent mosunetuzumab had a manageable safety profile and induced durable complete responses in patients with relapsed/refractory (R/R) B-cell non-Hodgkin lymphoma, including in patients with R/R follicular lymphoma (FL). In this analysis, the efficacy and safety of mosunetuzumab monotherapy were evaluated in an expansion cohort, FLMOON-1, in Japanese patients with R/R FL who had received  ≥ 2 prior lines of therapy in a phase I study (JO40295, jRCT2080223801).

Methods: Mosunetuzumab was administered intravenously at the recommended phase II dose (with cycle 1 step-up dosing) for eight cycles or up to 17 cycles, or until disease progression or unacceptable toxicity.

Correction: Feasibility of newly designed rotatable sphincterotome for endoscopic sphincterotomy (with video).

[This corrects the article DOI: 10.1055/a-2422-2425.].

Early Cryoablation After First Diagnosis of Atrial Fibrillation Reduces Arrhythmia Recurrence in Heart Failure Patients.

Background: Atrial fibrillation (AF) and heart failure (HF) often coexist, leading to increased mortality. A cryoballoon-based approach is a potential treatment for patients with HF because of its safety and efficacy.

Objectives: The authors sought to evaluate the optimal timing of cryoballoon ablation after the first clinical diagnosis of AF and its prognosis for patients with HF.

Achieving the United Nations Sustainable Development Goals in Spinal Surgery: Patient-Centered Care and Social Contribution.

Background: In recent years, achieving a sustainable society has become an international challenge. The medical field is also being called upon to contribute to the United Nations (UN) Sustainable Development Goals (SDGs). However, awareness of the SDGs in Japan is low, and relevant efforts in the healthcare sector are particularly lagging behind.

Feasibility of newly designed rotatable sphincterotome for endoscopic sphincterotomy (with video).

Endoscopic sphincterotomy can be challenging especially in patients with surgically altered anatomy. Although a rotatable sphincterotome (r-sphincterotome) may be useful, its rotational function is often inadequate. We evaluated the feasibility of a newly designed r-sphincterotome equipped with a well-conceived cutting wire.

Dynamic FDG PET/CT for differentiating focal pelvic uptake in patients with gynecological cancer.

This study aimed to evaluate the ability of serial whole-body dynamic PET/CT to differentiate physiological from abnormal F-FDG uptake in the abdomen and pelvis of gynecological cancer patients. We conducted a retrospective study of 61 F-FDG PET/CT examinations for suspected gynecological malignancies or metastases between March 2018 and January 2020. Our protocol included four-phase dynamic whole-body scans.

Comprehensive pathological evaluation of risk factors for metastasis after endoscopic resection of superficial esophageal squamous cell carcinoma.

Background: Esophageal cancer is a major cause of cancer mortality worldwide. Endoscopic resection (ER) is a curative treatment for esophageal squamous cell carcinoma (ESCC). Predicting risk of metastasis is crucial for post-ER management.

Which is more important for predicting de novo DSA production in donor-sensitized kidney transplant recipients, B-cell epitope or T-cell epitope analysis?

De novo donor-specific antibodies (dnDSA), particularly those against human leukocyte antigen (HLA) class II, can cause kidney allograft rejection, resulting in poor prognosis. Recently, HLA matching at both B-cell and T-cell epitopes, assessed by eplet mismatches and predicted indirectly recognizable HLA epitopes (PIRCHE) score, respectively, has been reported to be associated with dnDSA production. It remains unclear how these epitopes are involved in transplant immunology and how the results of the analysis can be applied in clinical practice.

Malignant transformation of vestibular schwannoma 29 years after Gamma Knife radiosurgery: illustrative case.

Background: Vestibular schwannomas are common posterior fossa tumors, often managed with stereotactic radiosurgery (SRS) due to its low invasiveness and high tumor control rates. However, malignant transformation of vestibular schwannoma (MTVS) is a rare but serious complication with a poor prognosis.

Observations: The authors present a case of MTVS occurring 29 years after initial SRS, the longest latency reported.

Embolization of Ruptured Aneurysms in the Intracranial Peripheral Arteries Using N-Butyl Cyanoacrylate Glue: A Case Series.

Ruptured aneurysms in peripheral arteries are rare, and an optimal treatment strategy has not yet been established. Herein, we evaluated the efficacy and safety of endovascular treatment of peripheral aneurysms located in small, tortuous vessels. In the present study, we report five consecutive cases of small, peripherally located ruptured aneurysms successfully embolized using N-butyl cyanoacrylate glue, with or without the adjunct use of coils.

Robot-assisted pyeloplasty for ureteropelvic junction obstruction complicating horseshoe kidney.

Introduction: Horseshoe kidney is characterized by midline fusion of the lower poles of both kidneys. We report a case where robot-assisted pyeloplasty was performed for hydronephrosis complicating horseshoe kidney.

Case Presentation: A 31-year-old man repeatedly developed fever since childhood.

YAP regulates HER3 signaling-driven adaptive resistance to RET inhibitors in RET-aberrant cancer.

Purpose: Rearranged during transfection (RET) aberrations represent a targetable oncogene in several tumor types, with RET inhibitors displaying marked efficacy. However, some patients with RET-aberrant cancer are insensitive to RET tyrosine kinase inhibitors (TKIs). Recently, drug-tolerant mechanisms have attracted attention as targets for initial therapies to overcome drug resistance.