Lyme neuroborreliosis in Japan: Borrelia burgdorferi sensu lato as a cause of meningitis of previously undetermined etiology in hospitalized patients outside of the island of Hokkaido, 2010-2021.

Background And Purpose: Clinical manifestations of Lyme borreliosis (LB), caused by Borrelia burgdorferi sensu lato (Bbsl), include erythema migrans, Lyme neuroborreliosis (LNB), carditis, and arthritis. LB is a notifiable disease in Japan with <30 surveillance-reported LB cases annually, predominately from Hokkaido Prefecture. However, LB, including LNB, may be under-diagnosed in Japan since diagnostic tests are not readily available.

Effects of oral intake, symptom severity, and sex difference on cancer patient prognosis.

Purpose: For cancer patients, prognostication by physicians constitutes a fundamental basis of decision-making to manage the cancer journey, especially with advanced stages of cancer. Various tools such as the palliative prognostic index (PPI) have been established to estimate patient survival. Such reliable and widely applied tools unfortunately provide unexpected results of prognosis predictions in some cases.

Effectiveness of 4-dimensional maximum intensity projection (4D-MIP) for respiratory motion management with uncertain interobserver delineation.

This study was conducted to evaluate the use of 4-dimensional (4D) maximum intensity projection (4D-MIP) to compensate for the disadvantages of average intensity projection (AIP), which is used to determine the internal target volume (ITV) in lung tumors. A respiratory motion phantom with a simulated tumor was imaged using 4D computed tomography (4D-CT). AIP and 4D-MIP were generated based on 10 phases of 4D-CT, followed by contouring of the ITV and ITV; these were compared with the ITV contoured in 10 phases of 4D-CT (ITV).

Clinical Significance of Early Computed Tomography Scan on Thrombus Regression Rate in Acute Pulmonary Embolism: Insights from the SAKURA PE/DVT REGISTRY.

Aims: Direct oral anticoagulants (DOACs) are used to treat venous thromboembolism (VTE). However, their impact on thrombus regression and the clinical outcomes after 2-week post-therapy computed tomography (CT) monitoring remains unexplored. This study aimed to elucidate the characteristics of patients with VTE treated with individual DOACs, assess the incidence of clinical events, and evaluate their impact on pulmonary artery thrombus regression.

The Time Course of Catecholamine Dose Reduction in Septic Shock as a Predictor of Bacterial Susceptibility to Empiric Antimicrobial Therapy: A Retrospective Observational Study.

: The 28-day mortality rate for septic shock is high, necessitating rapid and effective empiric antimicrobial therapy. In this study, we investigate whether the rate of catecholamine dose reduction in septic shock can indicate bacterial susceptibility to initial antimicrobial therapy or not. This retrospective observational study involved 108 adult patients with bacteraemia and septic shock admitted to the intensive care unit of Nihon University Itabashi Hospital between January 2017 and December 2023.

Automatic motion correction for myocardial blood flow estimation improves diagnostic performance for coronary artery disease in F-flurpiridaz positron emission tomography-myocardial perfusion imaging.

Background: Motion correction (MC) is critical for accurate quantification of myocardial blood flow (MBF) and flow reserve (MFR) from F-flurpiridaz positron emission tomography (PET) myocardial perfusion imaging (MPI). However, manual correction is time consuming and introduces inter-observer variability. We aimed to validate an automatic MC algorithm for F-flurpiridaz PET-MPI in terms of diagnostic performance for predicting coronary artery disease (CAD).

Long-Term Survey of Japanese Children with Recurrent Nephroblastoma: A Report from Japan Children's Cancer Group.

In prospective Japanese studies of pediatric renal tumors, 5-year event-free survival and overall survival (OS) for patients with nephroblastoma ranges from 75-90% and 89-97%, respectively. However, treatments strategies for recurrent nephroblastoma in Japanese patients remain unclear. This retrospective study aimed to inform the development of treatment strategies by analyzing the long-term results and side effects of salvage therapies for recurrent nephroblastoma in Japan.

Impact of direct identification of bacteria in blood culture-positive specimens by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry on physician selection of antimicrobial therapy.

Background: Rapid identification of the causative organism in blood stream infections is essential for early initiation of appropriate antimicrobial therapy. Direct identification of bacteria in positive blood culture bottles using matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry is a promising application. A variety of direct identification methods have been reported; however, few studies have evaluated the impact of these methods on physician decision making regarding antimicrobial therapy.

Clinical study on the utility of allergy tests to detect IgE-mediated anaphylaxis after diclofenac etalhyaluronate administration.

Objectives: This study was conducted to investigate factors involved in anaphylaxis related to diclofenac etalhyaluronate (DEH) [product name: Joyclu® (JCL)] (containing DEH and macrogol 400), which is used to treat patients with osteoarthritis.

Methods: Patients with osteoarthritis were divided into two groups that had (experienced patients) or had not experienced anaphylactic symptoms after JCL administration (non-experienced patients). Five tests performed to assess factors related to anaphylaxis consisted of a skin prick test (SPT) as the primary endpoint and the other tests including basophil activation test, allergen-specific IgE (sIgE) tests using enzyme-linked immunosorbent assay or immunochromatographic kits, and genetic study were secondary endpoints.

Lower Blood Loss with Bicruciate-Retaining Total Knee Arthroplasty Compared with Bicruciate-Stabilized Total Knee Arthroplasty.

Total knee arthroplasty (TKA) is a common surgical procedure to treat end-stage knee osteoarthritis. This study compared blood loss volume and other clinical outcomes between bicruciate-retaining (BCR) and bicruciate-stabilized (BCS) TKA. Ninety-seven participants who underwent unilateral TKA were enrolled.

Oncologic and Functional Outcomes of Salvage Robot-Assisted Radical Prostatectomy: Report of the First 10 Cases.

Background: Salvage robot-assisted radical prostatectomy (sRARP) after PSA failure in patients who underwent initial radiotherapy or focal therapy has rarely been reported in Japan. We aimed to report the oncologic and functional outcomes of the first 10 cases of sRARP.

Methods: Ten patients underwent sRARP after failing to respond to initial radiotherapy or focal therapy.

Comparison of adverse events following the second/third dose of BNT162b2 in a medical institute in Japan.

Background: Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are crucial for ending the pandemic of coronavirus disease 2019 (COVID-19). Currently, the cumulative effect of booster shots of mRNA vaccines on adverse events is not sufficiently characterized.

Methods: A survey-based study on vaccine adverse events was conducted in a Japanese medical institute after the third dose of Pfizer BNT162b2.

Clonal Hematopoiesis Without Malignant Transformation Lasting Over 2 Years in a 9-Year-old Boy, Following Treatment for Acute Lymphocytic Leukemia.

Children with acute lymphocytic leukemia rarely develop secondary hematological neoplasms. A 5-year-old boy was diagnosed with standard-risk precursor B-cell acute lymphocytic leukemia. The patient exhibited aberrant chromosomal changes in the bone marrow at 6 months postchemotherapy: 46,XY,der(6) t(1;6)(q12;p22) dup(6)(p22p12)[15].

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.

Malignant melanoma in a 12-year-old boy 17 months after completing hepatoblastoma treatment.

Background: Melanoma is rare as a secondary malignant neoplasm among childhood cancer survivors.

Case: We report a case of a 12-year-old boy who developed malignant melanoma with systemic metastases 17 months after completing treatment for hepatoblastoma. The diagnosis was made unexpectedly based on a bone marrow examination.

Validity study of the Japanese version of the Nijmegen Questionnaire for verifying dysfunctional breathing in Japanese asthma patients.

Background: Dysfunctional breathing (DB) is a clinical condition characterized by irregular breathing patterns presenting a sensation of dyspnea and a feeling of chest tightness. DB is a known comorbidity of asthma that is difficult to control, leading to poor quality of life, so early diagnosis and therapeutic intervention are essential to improve the clinical condition of asthma. The Nijmegen Questionnaire (NQ), developed to screen for DB and translated into various languages, is used worldwide.

Transitional Changes of Anxiety, Pain and Other Symptoms in Cancer Patients Admitted to a Palliative Care Unit, Evaluated Using the Support Team Assessment Schedule - Japanese Version.

Association between physical symptoms and psychosocial difficulties of cancer patients has been reported widely. Nevertheless, the effects of pain and other symptom control on anxiety in such patients have not been investigated well. We investigated the association of improvement of pain and other symptoms with patient anxiety, and assessed factors associated with improvement of such symptoms.

Evaluation of the Angle Between the Long Axis of the Femoral Anterior Cruciate Ligament Footprint and Bony Morphology of the Knee: A Cadaveric Descriptive Study.

Purpose: There have been numerous studies of the anterior cruciate ligament (ACL) anatomy, but few have focused on the long axis angle of the femoral ACL footprint. This study investigated the angle between the long axis of the femoral ACL footprint and the bony morphology of the knee.

Methods: This study is a cadaveric descriptive study.