Inconsistent Associations of Modified Frailty Index-5 With Adverse Head and Neck Reconstruction Outcomes.

Objectives: To investigate the consistency of associations between modified frailty index-5 (mFI-5) and postoperative adverse outcomes in head and neck cancer (HNC) reconstruction.

Methods: American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2017 to 2022 was utilized to identify HNC patients undergoing locoregional or microvascular free tissue transfers. Kaplan-Meier estimates and multivariable Cox regression analyses were utilized to compare risk of infections, bleeding, readmissions, reoperations, major adverse cardiovascular events (MACE), and mortality within the first postoperative month for each mFI-5 score with mFI-5 = 0 as reference.

Beaware of Intracardiac Potentials Induced by Intravascular Lithotripsy.

Background: Intravascular lithotripsy (IVL), that generates shockwaves through spark gap discharge between emitters, has been increasingly used to treat severely calcified coronary artery lesions. However, there is a question as to whether IVL has no electrical effects on endocardial tissues or cardiac implantable devices (CIEDs).

Aims: The aim of this study was to investigate the effects of IVL-induced intracardiac potentials on cardiac electrophysiology and CIEDs.

Inappropriate Shocks in Brugada Syndrome Patients With a Subcutaneous Implantable Cardioverter Defibrillator.

Background: This study aimed to compare inappropriate shock (IAS) rates between subcutaneous implantable cardioverter-defibrillator (S-ICD) and transvenous ICD (TV-ICD) in Brugada syndrome (BrS) patients and identify risk factors for IAS in S-ICD use.

Methods: We enrolled consecutive patients with BrS who underwent ICD implantation between 2013 and 2023. Data on clinical characteristics, S-ICD screening test data, and IAS occurrence were retrospectively analyzed.

Toxic epidermal necrolysis with thrombocytopenia induced by intravenous immunoglobulin: a case report and mini review.

Background: Toxic epidermal necrolysis (TEN), a severe cutaneous hypersensitivity reaction induced particularly by drugs, is diagnosed when there is a fever of ≥ 38 °C, mucocutaneous symptoms, a rash with multiple erythema, and skin peeling of ≥ 30% of the body surface area. The mortality rate of TEN is high, and thrombocytopenia during treatment can lead to severe outcomes. Intravenous immunoglobulin (IVIg) is used when steroids are ineffective in TEN and may improve mortality; however, thrombocytopenia is a rare adverse event associated with IVIg use.

Relationship between humeral head translation, spur formations, and the locations of tendon tears in massive rotator cuff tears.

Objective: This study aimed to clarify the relationship between the directions of humeral head translation, the presence of acromial or coracoid spurs, and the locations of tendon tears in massive rotator cuff tears. Thirty shoulders from thirty patients with massive rotator cuff tears who underwent reverse shoulder arthroplasty were included. Preoperative 3DCT classified humeral head translation into three groups: minimal type, posterosuperior type, and anterosuperior type.

Remdesivir-induced severe hypoglycemia in an elderly man without diabetes: a case report.

Background: Remdesivir is recommended to treat hospitalized patients with coronavirus disease 2019 (COVID-19). Remdesivir is known to affect glucose metabolism in individuals with and without diabetes. However, little is known about the possibility of hypoglycemia associated with remdesivir.

Three effective cases of transcatheter arterial embolization after atezolizumab and bevacizumab treatment for hepatocellular carcinoma: a case report.

Background: The Barcelona Clinic Liver Cancer staging system classifies hepatocellular carcinoma on the basis of tumor characteristics, liver function, and Eastern Cooperative Oncology Group performance status. Hepatocellular carcinoma is divided into five stages, and the treatment options for intermediate-stage hepatocellular carcinoma have evolved in recent years. Transcatheter arterial chemoembolization remains the standard treatment for intermediate-stage (stage B) hepatocellular carcinoma.

A brief report of the status of self-medication with over-the-counter drugs: a pilot cross-sectional survey.

Objective: The extent of perceived knowledge and usage status regarding over-the-counter (OTC) drugs among Japanese citizens remains unclear. This study aims to assess OTC drug use through a pilot cross-sectional survey.

Results: Conducted on April 30, 2023, at the Graduate School of Pharmaceutical Sciences, Osaka University, the survey garnered 180 valid responses.

Outcome-based simulation training for ultrasound-guided central venous catheter placement: clinical impact on preventing mechanical complications.

Background: Central venous catheter placement has been associated with mechanical complications, some of which can be life-threatening. Recent studies have shown that simulation-based education on ultrasound-guided central venous catheter placement improves puncture success rates; however, its effect on reducing mechanical complications remains unclear. This observational study examined how outcome-based simulation training for ultrasound-guided central venous catheter placement affects the incidence of mechanical complications in a clinical setting.

Real-world assessment to estimate multiple attributes related to treatment cost driver for mantle cell lymphoma in Japan by econometric modeling.

This study was conducted using a nationwide health care database of Japan between 1 April 2008 and 30 September 2022 to evaluate the economic burden on patients with mantle cell lymphoma (MCL). Structural equation modeling (SEM) is an advanced multivariate analysis framework used to assess the relationships between observed and latent variables within predefined causal models. In this study, SEM was employed to identify cost drivers and estimate variables related to MCL treatment cost.

One-stage versus two-stage video-assisted thoracic surgery for synchronous bilateral pulmonary nodules: protocol for a single center, non-randomized clinical trial (OTVATS-1).

Background: Previous retrospective studies demonstrated both one-stage and two-stage video-assisted thoracic surgery (VATS) for bilateral pulmonary nodules were safe and feasible in selected patients. However, prospective data is still lacking. The purpose of this trial is to prospectively compare the prognostic and perioperative outcomes between one-stage and two-stage VATS for synchronous bilateral pulmonary nodules.

Activated Cardiac Fibroblasts are a Primary Source High Molecular Weight Hyaluronan Production.

During acute myocardial infarction, the composition of the extracellular matrix changes remarkably. One of the most notable changes in the extracellular matrix is in the accumulation of collagen; however, hyaluronan rivals collagen in its abundance. Yet, the extent to which specific cells and enzymes may contribute to such accumulation has been largely unexplored.

Increased TSPO alleviates neuropathic pain by preventing pyroptosis via the AMPK-PGC-1α pathway.

Neuropathic pain poses a significant clinical challenge, largely due to the incomplete understanding of its molecular mechanisms, particularly the role of mitochondrial dysfunction. Bioinformatics analysis revealed that pyroptosis and inflammatory responses induced by spared nerve injury (SNI) in the spinal dorsal horn play a critical role in the initiation and persistence of neuropathic pain. Among the factors involved, TSPO (translocator protein) emerged as a key regulator.

Prolonged Febrile Seizure and Long-Term Neurological Sequelae in Otherwise Healthy Children.

The association between prolonged febrile seizure and long-term neurological sequelae in otherwise healthy children remains unclear. We conducted a retrospective cohort study using a Japanese nationwide medical database. In the cohort of 38,465 children with febrile seizures, 610 and 31,157 were classified into the prolonged and non-prolonged groups, respectively.

Impact of potentially inappropriate medications on emergency ambulance admissions in geriatric patients after discharge.

This study aimed to determine the risk of emergency admission by ambulance in patients taking potentially inappropriate medications (PIMs). We included 273,932 patients aged over 75 years of age admitted between January 1, 2019, and December 31, 2019, using the Japan Medical Data Center medical insurance database containing anonymized patient data. We excluded patients without a history of admission.

Decoding the Molecular Enigma Behind Asbestos and Fibrous Nanomaterial-induced carcinogenesis.

Objectives: Natural fibrous mineral, asbestos, has been useful in industry for many centuries. In the 1960's, epidemiology had recognized the association between asbestos exposure and mesothelioma and the IARC designated all kinds of asbestos as Group 1 in 1987. However, various scientific enigmas remained regarding the molecular mechanisms of asbestos-induced mesothelial carcinogenesis.

Dissecting Tumor Size Underestimation in Pancreatic Cancer: A Comparative Analysis of Preoperative Treatments.

Background: Tumor size (TS) in pancreatic ductal adenocarcinoma (PDAC) is one of the most important prognostic factors. However, discrepancies between TS on preoperative images (TSi) and pathological specimens (TSp) have been reported. This study aims to evaluate the factors associated with the differences between TSi and TSp.

Anatomic variations in origin and coursing of the transverse cervical artery: morphogenesis and relation to the high arch-shaped subclavian artery.

This case report presents an atypical transverse cervical artery with its detailed anatomy, morphogenesis, and association with the high arch-shaped subclavian artery. The atypical arteries, related arteries, and adjacent cervical and brachial plexuses were macroscopically examined in a 98-year-old Japanese female cadaver donated to The Nippon Dental University for medical education and research. The atypical deep branch of the transverse cervical artery originated from the internal thoracic artery and passed through between the C5 and C6 roots, in close contact with the C5 and C6 junction, to reach the dorsal side of the brachial plexus.

Impact of SARS-CoV-2 variants on viral infectivity and the role of the renin-angiotensin-aldosterone system.

Balance between Protective vs. Exacerbating Effects of ACEIs and ARBs in Omicron Variant Infections. The spike protein on the surface of the Omicron variant has a high affinity for ACE2, making it more prone to enter cells and induce ACE2 downregulation.

Nutrition and Hypertension Researches in 2023: focus on salt intake and blood pressure.

Hypertension is a major global health issue that contributes significantly to cardiovascular morbidity and mortality. The management and prevention of hypertension often involve nutritional and dietary modifications, which are considered effective non-pharmacological strategies. In 2023, the Hypertension Research published several papers highlighting nutrition and hypertension.

CVIT 2025 clinical expert consensus document on intravascular ultrasound.

Intravascular ultrasound (IVUS) provides precise anatomic information in coronary arteries including quantitative measurements and morphological assessment. To standardize the IVUS analysis in the current era, this updated expert consensus document summarizes the methods of measurements and assessment of IVUS images and the clinical evidence of IVUS use in percutaneous coronary intervention.

Preoperative low prealbumin independently predicts non-gastric cancer death after gastrectomy in elderly and young patients: a retrospective cohort study.

Purpose: To investigate the effect of preoperative prealbumin levels on long-term survival outcomes after gastrectomy in patients with gastric cancer (GC) dichotomized based on age.

Methods: This retrospective cohort study included consecutive patients who underwent radical gastrectomy for primary stage I-III GC between May 2006 and March 2017. Patients were allocated to groups based on age (≥ 70 or < 70 years) and subgroups based on prealbumin levels (high, ≥ 22 mg/dL; moderate, 15-22 mg/dL; or low, < 15 mg/dL), and multivariate Cox regression was used for survival analyses.