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.

Prognostic Significance of Lymphocyte-to-Monocyte Ratio in Patients With Unresectable Biliary Tract Cancer Undergoing Systemic Chemotherapy.

Background/aim: The incidence of biliary tract cancers (BTC), including cholangiocarcinoma and gallbladder cancer, has been increasing worldwide. Approximately 70% of BTC patients have advanced disease at diagnosis, leading to a poor survival rate. Recent clinical trials have demonstrated that the addition of immune checkpoint inhibitors, such as durvalumab or pembrolizumab, to gemcitabine plus cisplatin chemotherapy significantly improves survival rates, making triple therapy the current standard for first-line treatment of BTC.

Spherical periacetabular osteotomy via para-sartorial intermuscular approach with bikini incision for patients with acetabular dysplasia: surgical technique and preliminary results.

Purpose: This study introduces a new technique, spherical periacetabular osteotomy (SPO), performed via a para-sartorial intermuscular (PSIM) approach with a bikini incision, aiming to optimise the benefits of SPO, including preservation of muscles and providing cosmetic advantages.

Methods: Overall, 57 joints of 52 patients (mean age 36 ± 17 years) underwent SPO via the PSIM approach. Preoperative osteoarthritis was classified according to Tönnis grade, with 34 and 23 hips categorised as grades 0 and 1, respectively.

Added Value of Shaking Chills for Predicting Bacteremia in Patients with Suspected Infection.

Background: Detailed grading of chills is more useful for diagnosing bacteremia than simply classifying the presence or absence of chills. However, its value added to other clinical information has not been evaluated.

Objective: To evaluate the value of adding chills grading to other clinical information compared to simply noting the presence or absence of chills for predicting bacteremia in patients with suspected infection.

Refractory phenotype of -sensitized asthma with bronchiectasis and allergic bronchopulmonary aspergillosis.

Background: Sensitization to mucus plugs, and bacterial colonization may coexist and relate to a refractory phenotype during follow-up in asthma with bronchiectasis and allergic bronchopulmonary aspergillosis (ABPA).

Objective: This study aimed to clarify the features of -sensitized refractory asthma with bronchiectasis and determine the refractory phenotype in this population and ABPA.

Methods: This study included cases of the oldest available -specific IgE data and chest computed tomography images from a nationwide survey of refractory asthma with bronchiectasis.

Indocyanine Green-Guided Pulmonary Resection for Lung Cancer With Anomalous Systemic Arterial Supply to the Basal Segment.

A 78-year-old male who was undergoing treatment for diabetes was referred to our department after a chest X-ray revealed an abnormal shadow in the left upper lung field. A chest contrast-enhanced CT showed a tumor in the left upper lobe and a cystic lesion in the left lower lobe. Two aberrant arteries branching from the aorta were identified near the cyst.

Radiological features of the carpometacarpal joint in hamate body fracture on anteroposterior hand X-ray image.

Background: Hamate body fractures are rare and can be overlooked due to the diagnostic difficulty on X-ray. We focused on the carpometacarpal joint space width (CMC-JSW) and examined the features of this fracture on versatile anteroposterior hand X-ray images, initially taken for hand trauma cases.

Methods: Ten patients (nine males and one female; mean age, 34 years) diagnosed with a hamate body fracture on CT in our facility between January 2013 and October 2023 were included in this study.

Imaging findings in a case of primary intraosseous carcinoma arising from a mandibular cyst.

Primary intraosseous carcinoma not otherwise specified (PIOC NOS) is a rare tumor assumed to arise from the epithelium, such as odontogenic cysts or benign tumors. Its clinical and imaging diagnoses are often challenging, especially in the early stages, as it mimics jaw cysts and benign tumors, and no specific findings have been identified. This report presents the case of a 66-year-old male patient with mandibular PIOC, highlighting the imaging findings over time.

Added value of inflammatory markers to vital signs for predicting mortality in patients with suspected infection: external validation and model development.

It is crucial to identify high-risk patients with infectious conditions for appropriate management. We previously found that inflammatory markers added value to vital signs for predicting mortality in patients with suspected infection. In this study, the aim was to externally validate the added value of the inflammatory markers and to develop a new prediction model.

Bilateral Diaphragmatic Nerve Paralysis Secondary to Cervical Spondylosis: A Rare Case.

Bilateral diaphragmatic nerve paralysis due to cervical spondylosis is an extremely rare condition with only one previously reported case. We present a 64-year-old Japanese male with a history of left diaphragmatic nerve paralysis who developed sudden nocturnal dyspnea. Physical examination revealed orthopnea and type 2 respiratory failure.

Update of prognosis and characteristics of chronic obstructive pulmonary disease in a real-world setting: a 5-year follow-up analysis of a multi-institutional registry.

Background: We conducted a prospective observational study to elucidate the long-term prognosis and management of chronic obstructive pulmonary disease (COPD) in clinical practice in Japan in the mid-2010s.

Methods: This prospective cohort study included 29 facilities. Data from 427 patients clinically diagnosed with COPD, enrolled between September 2013 and April 2016, were analyzed.

Novel method for diagnosing takotsubo syndrome with left ventriculography using a microaxial flow pump in temporary surgical mode in a patient with cardiogenic shock: a case report.

Background: It is reasonable to introduce a microaxial flow pump (Impella) before coronary angiography and left ventriculography (LVG) to prioritize treating tissue hypoperfusion in patients with takotsubo syndrome (TTS) and refractory cardiogenic shock. However, left ventricular (LV) unloading by an Impella device might prevent contrast media from filling the left ventricle, making it difficult to evaluate LV wall motion abnormalities during LVG.

Case Summary: A 76-year-old female with ST elevations in I, II, aVL, and V1-6 on electrocardiography and severe LV dysfunction on echocardiography immediately received circulatory support with Impella CP to treat refractory cardiogenic shock.

Evaluation of Leg Length Difference on Perioperative Radiographs of Total Hip Arthroplasty Considering Lower Limb Malposition.

Background: During total hip arthroplasty (THA) in lateral decubitus, perioperative radiography allows the surgeon a simple evaluation of the leg length difference (LLD) by measuring the proximal femoral length. However, the effect of femoral malpositioning on proximal femoral length measurements during the evaluation of perioperative radiographs is not adequately understood. We aimed to (1) investigate the effects of malposition on proximal femoral length using three-dimensional computer simulations and (2) verify whether a simple correction formula can improve the accuracy of LLD evaluation on perioperative radiographs.

Effect of studying abroad on catch-up vaccination in young adults: A study using the Japan Pretravel Consultation Registry.

Purpose: To investigate the effect of studying abroad on catch-up vaccination coverage for measles, rubella, mumps, varicella, and tetanus during the pretravel consultation among young adult travelers.

Methods: This retrospective cohort study analyzed data from the Japan Pretravel Consultation Registry (J-PRECOR) on individuals aged 18-21 years with childhood vaccination records. Propensity score weighting was used to estimate the average treatment effect on the proportion of participants receiving catch-up vaccination.

WNT/β-catenin Signaling and CD8+ Tumor-infiltrating Lymphocytes in Tremelimumab Plus Durvalumab for Advanced Hepatocellular Carcinoma.

Background/aim: Tremelimumab plus durvalumab is an approved first-line therapy for advanced hepatocellular carcinoma (HCC). Previous studies identified WNT/β-catenin mutations or CD8+ tumor-infiltrating lymphocytes (TILs) as biomarkers that can predict responsiveness to immune checkpoint inhibitor therapy in HCC. However, biomarkers for effectiveness of tremelimumab plus durvalumab in HCC have not been reported.

Trousseau's Syndrome in Lung Cancer Patients: A Retrospective Study in a Japanese Community Hospital.

Trousseau's syndrome is a cancer-associated thromboembolism that significantly impacts patients' prognosis and quality of life (QOL). This study aimed to investigate the frequency, characteristics, and prognosis of Trousseau's syndrome in lung cancer patients at a Japanese community hospital and examine the effects of therapeutic agents on this condition. We retrospectively reviewed the electronic medical records of lung cancer patients diagnosed with thrombotic complications at the time of diagnosis in our department between August 2013 and April 2019.

Clinical Impact of Skeletal Muscle Mass and Nutritional Status in Patients with Recurrent or Advanced Gastric Cancer Treated with Nivolumab.

Introduction: This study aimed to evaluate the clinical impact of skeletal muscle mass and nutritional status in gastric cancer patients treated with nivolumab monotherapy as late-line treatment.

Methods: We conducted a multi-institutional retrospective study of 90 gastric cancer patients who previously received anti-PD-1 therapy (nivolumab). On computed tomography images captured before nivolumab induction, the skeletal muscle index (SMI, cm2/m2) was defined as the erector muscle area (cm2) divided by the height (m) squared.

Peritonitis caused by after laparoscopic total hysterectomy: A case report.

Infections after obstetric and gynecologic surgery are commonly caused by enterobacteria, commensal vaginal bacteria, or indigenous skin bacteria (primarily and ). () rarely causes postoperative infection in the field of obstetrics and gynecology and its treatment is generally delayed. This report describes a case report of peritonitis caused by after laparoscopic total hysterectomy.

A phase II study of weekly carboplatin and concurrent radiotherapy in older adults with locally advanced non-small cell lung cancer (LOGIK1902).

Background: Concurrent chemoradiotherapy is the standard therapy for locally advanced non-small cell lung cancer (NSCLC). However, there is little evidence supporting its use in older adults. Low-dose daily carboplatin combined with thoracic radiotherapy is considered a standard regimen for this population.