A Japanese Family with a Novel Pathogenic Variant in KIF1A Presenting with Spastic Paraparesis, Cerebellar Ataxia, and Intellectual Disability.

Variants in KIF1A are associated with hereditary spastic paraplegia (SPG30), which can manifest in both pure and complex forms. We describe a Japanese family with a novel KIF1A variant presenting with a complex form of SPG30. Patient 1, a 69-year-old woman, experienced progressive gait disturbance due to spastic paraparesis and cerebellar atrophy, and intellectual disability.

Multimodal Treatment Approach for a Recurrent Hemorrhagic Scalp Arteriovenous Fistula: A Case Report.

Scalp arteriovenous fistula (AVF) is a rare vascular malformation that may present as a pulsatile scalp mass with complications like hemorrhage. We report a case of a large scalp AVF with recurrent bleeding, managed successfully with a multimodal approach. A 46-year-old man presented with a recurrently bleeding pulsatile scalp mass in the left temporal region, initially diagnosed as AVF following trauma.

Significance of targeted antimicrobial prophylaxis using rectal-culture selective screening media prior to transrectal prostate biopsy: A multicenter, randomized controlled trial.

Objective: To examine whether antimicrobial prophylaxis based on screening rectal cultures using selective media prevented acute bacterial prostatitis following transrectal prostate biopsy (TRPB).

Methods: In this multicenter, randomized controlled trial, we enrolled 403 patients undergoing TRPB with low risks of infectious complications. Patients were randomized into a cultured group (CG) or no cultured group (NCG).

Hemodynamic Insights Into the Asymmetrical Medullary Vein Sign on T2* Imaging in Hyperacute M1 Occlusion.

Background In treating acute ischemic stroke (AIS), asymmetrical vein signs (AVS) on blood-oxygen-level-dependent imaging reflect increased deoxyhemoglobin levels due to increased oxygen extraction fraction. Meanwhile, although veins connecting pial and deep venous systems, such as transcerebral veins, are well studied, dynamic observation of these veins remains challenging. This study aimed to elucidate the venous flow of the deep white matter (DWM), focusing on medullary AVS in patients with hyperacute cardioembolic M1 occlusion.

Classification of Interventional Radiology Reports into Technique Categories with a Fine-Tuned Large Language Model.

The aim of this study is to develop a fine-tuned large language model that classifies interventional radiology reports into technique categories and to compare its performance with readers. This retrospective study included 3198 patients (1758 males and 1440 females; age, 62.8 ± 16.

Building vancomycin population pharmacokinetic model for Japanese low birth weight infants in comparing it with previously reported pediatric population pharmacokinetic models.

Background And Objectives: Vancomycin (VAN) is one of therapeutic agents for severe infections, and its efficacy and safety are subject to therapeutic drug monitoring. However, there is a lack of data regarding the administration of VAN to low birth weight (LBW) infants. This presents a challenge to ensure optimal dosing and maximize the benefits of VAN therapy in this specialized patients.

Is Intraoperative Blood Loss Volume in Elderly Cervical Spine Injury Surgery Greater in Patients with Ankylosis? A Multicenter Survey.

Introduction: Preoperative estimations of blood loss are important when planning surgery for cervical spine injuries in older adults. The association between ankylosis and blood loss in perioperative management is of particular interest. This multicenter database review aimed to evaluate the impact of ankylosis on surgical blood loss volume in elderly patients with cervical spine injury.

Surgical strategy for metastatic spinal tumors based on Spine Instability Neoplastic Score and patient-reported outcomes: JASA multicenter prospective study.

Objective: Instrumentation surgery in combination with radiotherapy (RT) is one of the key management strategies for patients with spinal metastases. However, the use of materials can affect the RT dose delivered to the tumor site and surrounding tissues, as well as hinder optimal postoperative tumor evaluation. The association of the preoperative Spine Instability Neoplastic Score (SINS) with the need for spinal stabilization and life expectancy are unclear.

Cholesterol Crystal Embolism Following Mechanical Thrombectomy for Acute Ischemic Stroke.

Cholesterol crystal embolism (CCE) is a rare but serious complication of atherosclerotic plaque rupture, often occurring after endovascular interventions. We report the case of a 73-year-old man who developed CCE following mechanical thrombectomy (MT) for an acute ischemic stroke (AIS) due to left internal carotid artery occlusion. The patient, with a history of hypertension and hyperlipidemia, underwent successful MT with complete recanalization.

From Headache to Altered Consciousness: Headache Attributed to Hypoxia and/or Hypercapnia in a Smoker With Undiagnosed Chronic Obstructive Pulmonary Disease.

We present the case of a 57-year-old male with a history of smoking, hypertension, dyslipidemia, and migraines who experienced a one-month history of dyspnea and headaches, followed by sudden-onset altered consciousness. Initial imaging ruled out cerebrovascular and infectious etiologies, and arterial blood gas analysis revealed severe hypercapnia and hypoxemia (partial pressure of arterial carbon dioxide: 117 mmHg, partial pressure of arterial oxygen: 111 mmHg under a 10 L/min oxygen mask). The patient's condition improved with mechanical ventilation, resulting in the resolution of both altered consciousness and headaches.

Endoscopic characteristics to differentiate SSLs and microvesicular hyperplastic polyps from goblet cell-rich hyperplastic polyps.

Among colorectal serrated polyps (SPs), sessile serrated lesions (SSLs) and hyperplastic polyps (HPs) have a similar endoscopic appearance. However, the endoscopic distinctions between those two categories, microvesicular HPs (MVHPs) and goblet cell-rich HPs (GCHPs), are not well understood. Therefore, we compared the endoscopic features of SSLs, MVHPs, and GCHPs.

Acute Kidney Injury Associated With Red Yeast Rice (Beni-kōji) Supplement: A Report of Two Cases.

Numerous health concerns, primarily kidney injury, have been reported with the use of Beni-kōji CholesteHelp, a functional food containing red yeast rice. Here, we describe 2 cases of kidney injury caused by beni-kōji. The first case had normal kidney function before consuming the product.

Effects of Palliative Surgical Treatment for Spinal Metastases on the Patient's Quality of Life With a Focus on the Segment of the Metastasis: A Prospective Multicenter Study.

Study Design: Prospective multicenter study.

Objectives: Palliative surgery is crucial for maintaining the quality of life (QOL) in patients with spinal metastases. This study aimed to compare the short-term outcomes of QOL after palliative surgery between patients with metastatic spinal tumors at different segments.

Combination of Percutaneous Endoscopic Gastrostomy and Lumboperitoneal Shunt: A Case Report.

The combination of percutaneous endoscopic gastrostomy (PEG) and cerebrospinal fluid (CSF) shunt surgery presents unique challenges in managing shunt-related infections. Although the association between PEG and ventriculoperitoneal (VP) shunt surgery is well documented, studies on the combination of PEG and lumboperitoneal (LP) shunt surgeries are limited. We report the case of a 70-year-old man who developed hydrocephalus after decompressive craniectomy for ischemic stroke.

Triple immunostaining demonstrates the possible existence of segregated-nucleus-containing atypical monocytes in human primary myelofibrosis bone marrow: a case report.

Background: Segregated-nucleus-containing atypical monocytes have recently been identified in mice. Segregated-nucleus-containing atypical monocytes are thought to originate from the bone marrow and induce fibrosis in the drug-injured lung. The Lyc6c murine monocyte subset is the counterpart to human CD14CD16 non-classical monocytes; however, the human counterpart to murine segregated-nucleus-containing atypical monocytes has not yet been identified.

Reversible Cerebral Vasoconstriction Syndrome without Headache.

A 49-year-old woman with a family history of Moyamoya disease presented with sudden onset of right hemiparesis without headache. Magnetic resonance imaging (MRI) of the head revealed a cerebral infarct in the left corona radiata, and magnetic resonance angiography (MRA) revealed severe stenosis of the bilateral internal carotid, middle, anterior, and posterior cerebral arteries. Antithrombotic therapy improved her symptoms.

Impact of home-based exercise on residual kidney function in patients initiating peritoneal dialysis: A feasibility multicenter randomized controlled trial.

Background: Although the impact of aerobic exercise (AE) and resistance training (RT) on peritoneal dialysis (PD) patients is well established, the impact of exercise programs on residual kidney function (RKF) has not been elucidated.

Methods: Patients were randomly assigned to either the exercise (= 25) or control groups (= 30). Patients in the exercise group performed AE three times a week and RT twice a week at home for 24 weeks.