Visualization of the scleral structure changes at various stages of eyes with myopic maculopathy using polarization-sensitive OCT.

Purpose: To observe the detailed structures of the inner and outer sclera at various stages of myopic maculopathy using polarization-sensitive optical coherence tomography (PS-OCT).

Methods: A PS-OCT system was developed for imaging the posterior eye using a swept laser. Data from highly myopic patients who underwent PS-OCT examination between May and June 2019 were used to generate birefringence images (showing scleral fiber density), optic axis images (visualizing the orientation of scleral fibers), and streamline images (providing 3D reconstructions to visualize scleral fiber stream).

Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device.

Thoracolumbar (TL) burst fracture is one of the most common indications for minimally invasive percutaneous pedicle screw fixation. Although the indication for surgical treatment of neurologically intact TL fractures remains under debate, studies have demonstrated that posttraumatic malalignment may lead to a deterioration in the patient's quality of life. For burst fractures with malalignment or fragments in the spinal canal, a reduction technique using ligamentotaxis is commonly used to improve long-term outcomes.

Clinical characteristics and results after conservative treatment or interfascicular neurolysis of 100 limbs with spontaneous anterior interosseous nerve palsy: A prospective Japanese multicenter study.

Background: Spontaneous anterior interosseous nerve (AIN) palsy is characterized by the sudden onset of upper limb pain followed by weakness of muscles mainly innervated by the AIN. Although this palsy is conventionally treated conservatively, interfascicular neurolysis to release hourglass-like fascicular constrictions has been recommended. The present study aimed to establish the clinical characteristics and treatment strategy for this condition.

Effect of Empirical Antimicrobial Therapy of Piperacillin-tazobactam Versus Carbapenems on Mortality for Patients with Sepsis from Nursing Homes.

Background Nursing home residents with a high risk of multidrug-resistant organism infection pose a complex challenge to broad-spectrum empirical antimicrobial therapy, particularly those infected with extended-spectrum β-lactamase-producing Enterobacteriaceae. The present study compared the efficacy of piperacillin-tazobactam and carbapenems as empirical antimicrobial treatments for patients with sepsis from nursing homes. Patients and Methods Using a nationwide inpatient database in Japan, we identified patients diagnosed with sepsis within two days of admission from nursing homes between 2018 and 2021.

Predictor of Steroid Replacement Duration after Removal of Cortisol-producing Adenoma.

Objective Cortisol-producing adenoma (CPA) is a major subtype of functional adrenal tumors. CPAs are generally treated with adrenalectomy; however, it is difficult to predict the ideal duration of glucocorticoid replacement after resection. This study explored pre-operative factors predictive of glucocorticoid replacement therapy duration after CPA resection.

Clinical Outcome of Endoscopically Assisted Mini-open Carpal Tunnel Release.

Carpal tunnel syndrome (CTS) can be treated surgically. Although the minimally invasive open surgical method is widely used, it is not possible to directly visualise the entire length of the carpal tunnel, especially the proximal end, which is on the side away from the skin incision. In this study, we performed a mini-open carpal tunnel release with endoscopic assistance to release the entire length of the carpal tunnel under direct vision and investigated the treatment outcomes.

Acute Calcific Tendinitis of the Flexor Hallucis Brevis Associated With Muay Thai.

Calcific tendinitis manifesting in the foot and toes is a rare condition that often goes unnoticed, even by podiatric specialists and healthcare practitioners. Characterized by an acute onset, this condition presents with pronounced local inflammatory indicators accompanied by pain, often complicating its differentiation from other conditions. We document our experience with a 27-year-old female patient presenting with calcific tendinitis in the flexor hallucis brevis (FHB), along with a review of the relevant literature.

The association between introduction of the micro-axial flow pump Impella in hospitals and in-hospital mortality in patients treated with extracorporeal membrane oxygenation: interrupted time-series analyses.

Background: The micro-axial flow pump Impella, a new mechanical circulatory device for cardiogenic shock, is still only available in a limited number of hospitals, due to the facility certification requirements and insufficient evidence of the benefit of introducing Impella in hospitals. This study aimed to evaluate the impact of introducing Impella in hospitals on in-hospital mortality of patients treated with extracorporeal membrane oxygenation (ECMO).

Methods: Using a nationwide Japanese inpatient database, we identified patients who received ECMO during hospitalization between 1 April 2014 and 31 March 2021.

Tape-Fixation for the Treatment of a Dorsal Boss in Lisfranc Joints of an Elderly Patient.

A dorsal boss, also known as a tarsal boss, is a bony prominence often associated with osteoarthritis (OA) of the tarsometatarsal (TMT) joints, leading to significant pain and a reduced quality of life (QOL) in elderly individuals. This condition frequently forces patients to abandon recreational activities and is typically resistant to conservative treatments. This report details a successful surgical intervention in an 83-year-old female patient with a dorsal boss and OA of the TMT joint, which involved osteophyte excision and semi-rigid fixation using ligament tape with an absorbable screw (Arthrex, Inc.

Effect of fluid resuscitation with albumin on mortality in patients with severe burns: A nationwide inpatient data analysis.

The present study aimed to evaluate the effect of albumin administration on mortality in patients with severe burns. We retrospectively analyzed data from the Diagnosis Procedure Combination Database, a nationwide inpatient database in Japan. We identified patients in the database aged ≥ 15 years who were admitted with severe burns (burn index ≥15) from April 2014 to March 2021.

Analysis of lens cloudiness during endoscopic submucosal dissection procedures: Effects of a novel lens cleaner.

Objectives: We aimed to identify independent factors for intraoperative endoscopic lens cloudiness during gastric and colorectal endoscopic submucosal dissections, investigate the effectiveness of Cleastay, an endoscope anti-fog solution, and examine factors associated with severe submucosal fat deposition.

Methods: A total of 220 patients who underwent gastric or colorectal endoscopic submucosal dissections in two institutions between January 2022 and October 2023 were included. Significant factors related to cloudiness were determined using univariate and multivariate analyses.

Multicenter prospective observational study to clarify the current status and clinical outcome in Japanese patients who have an indication for implantable cardioverter defibrillator (ICD) or wearable cardioverter defibrillator (WCD) (TRANSITION JAPAN-ICD/WCD study): Rationale and design of a prospective, multicenter, observational, comparative study.

Background: Despite the positive impact of implantable cardioverter defibrillators (ICDs) and wearable cardioverter defibrillators (WCDs) on prognosis, their implantation is often withheld especially in Japanese heart failure patients with reduced left ventricular ejection fraction (HFrEF) who have not experienced ventricular tachycardia (VT) or ventricular fibrillation (VF) for uncertain reasons. Recent advancements in heart failure (HF) medications have significantly improved the prognosis for HFrEF. Given this context, a critical reassessment of the treatment and prognosis of ICDs and WCDs is essential, as it has the potential to reshape awareness and treatment strategies for these patients.

Evaluation of ChatGPT-Generated Differential Diagnosis for Common Diseases With Atypical Presentation: Descriptive Research.

Background: The persistence of diagnostic errors, despite advances in medical knowledge and diagnostics, highlights the importance of understanding atypical disease presentations and their contribution to mortality and morbidity. Artificial intelligence (AI), particularly generative pre-trained transformers like GPT-4, holds promise for improving diagnostic accuracy, but requires further exploration in handling atypical presentations.

Objective: This study aimed to assess the diagnostic accuracy of ChatGPT in generating differential diagnoses for atypical presentations of common diseases, with a focus on the model's reliance on patient history during the diagnostic process.

Feasibility and Safety of the Early Introduction of Allergenic Foods in Asian Infants with Eczema.

Background: There is a lack of data regarding the early introduction of the consumption of allergenic food among Asian infants.

Methods: We examined infants who had early-onset eczema before 6 months of age and received instructions from certified allergists for the early introduction of hen's eggs, milk, wheat, peanuts, and tree nuts.

Results: The consumption rates of hen's eggs were 100% at 24 months.