A Prospective Phase II Trial of First-line Osimertinib for Patients with EGFR Mutation-positive Non-small Cell Lung Cancer and Poor Performance Status (OPEN/TORG2040).

Introduction: Osimertinib is the first-line treatment for patients with non-small cell lung cancer (NSCLC) who have EGFR mutations and favorable performance status (PS). Despite increasing clinical data on osimertinib, evidence in patients with an impaired PS remains limited. Therefore, a multicenter phase II trial (OPEN/TORG2040) was conducted to evaluate the efficacy and safety of first-line osimertinib for patients with EGFR mutation-positive NSCLC and poor PS.

Eye movements during measurements of visual vertical in the post-stroke subacute phase.

The subjective visual vertical (VV), the visually estimated direction of gravity, is essential for assessing vestibular function and visuospatial cognition. In this study, we aimed to investigate the mechanisms underlying altered VV perception in stroke participants with unilateral spatial neglect (USN), specifically by examining their eye movement patterns during VV judgment tasks. Participants with USN demonstrated limited eye movement scanning along a rotating bar, often fixating on prominent ends, such as the top or bottom.

Efficacy and Safety Evaluation of Immune Checkpoint Inhibitors in Combination With Chemotherapy for Extensive Small Cell Lung Cancer: Real-World Evidence.

Introduction: Extensive small cell lung cancer (ES-SCLC) are currently managed using first-line chemotherapy options, including atezolizumab (Atezo) plus etoposide and carboplatin (CE) or durvalumab (Durva) plus etoposide with either cisplatin (PE) or carboplatin (CE). However, a definitive distinction in therapeutic effects between Atezo and Durva in these regimens remains unestablished.

Methods: We analyzed data from 100 patients diagnosed with ES-SCLC who received immune checkpoint inhibitors (ICIs) as first-line chemotherapy.

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.

Replantation of a Permanent Tooth With a Curved Root From Infected Tooth Germ: A Case Report With a Four-Year Follow-Up.

Intentional reimplantation has long been supported by many clinicians as a last resort before tooth extraction. With the accumulation of data and the development of techniques, the survival rate of reimplantation has increased. However, although there have been many reports and studies on replantation for common causes such as root fracture, root resorption, inadequate root canal treatment, perforation, and apical periodontitis, the method of replantation in unusual cases is not yet clear, and many cases result in tooth extraction.

Ultrasound-guided obturator nerve block technique at the distal end of the obturator canal: case series and cadaver evaluation.

The obturator nerve variably gives off the anterior, posterior, and hip articular branches along its course; however, all branches invariably pass through the obturator canal. Herein, we describe our obturator nerve block technique, which promises to deliver local anesthetic directly into the obturator canal. We performed the obturator nerve block in six patients undergoing transurethral resection of bladder tumor under spinal anesthesia.

[Relationship between Serum Testosterone Levels and Diagnosis of Late-Onset Hypogonadism in Patients Visiting an Outpatient Clinic].

The clinical practice manual for late-onset hypogonadism (LOH) was updated in 2022. This study analyzed the total and free testosterone levels of patients who visited our specialized hypogonadism outpatient clinic and examined the characteristics of patients eligible for androgen replacement therapy (TRT), using the 2007 guidelines and the new guidelines as references. Among a total of 770 patients that visited our clinic,11.

Diffusion equation quantification: selective enhancement algorithm for bone metastasis lesions in CT images.

Diffusion equation (DE) imaging processing is promising to enhance images showing lesions of bone metastasis (LBM). The Perona-Malik diffusion (PMD) model, which has been widely used and studied, is an anisotropic diffusion processing method to denoise or extract objects from an image effectively. However, the smoothing characteristics of PMD or its related method hinder extraction and enhancement of soft tissue regions of medical image such as computed tomography (CT), typically leaving an indistinct region with ambient tissues.

Real-world incidence of and risk factors for abemaciclib-induced interstitial lung disease in Japan: a nested case-control study of abemaciclib-induced interstitial lung disease (NOSIDE).

Purpose: The exact incidence of and risk factors for interstitial lung disease (ILD), a serious side effect of abemaciclib, remain unknown in real-world settings. We examined the incidence of and risk factors for abemaciclib-induced ILD in patients with advanced breast cancer (ABC) in Japan.

Patients And Methods: Retrospective clinical information was collected from charts of patients with ABC who had started abemaciclib treatment at 77 participating institutions between November 30, 2018 and December 31, 2019.

Cone-Beam CT to CT Image Translation Using a Transformer-Based Deep Learning Model for Prostate Cancer Adaptive Radiotherapy.

Cone-beam computed tomography (CBCT) is widely utilized in image-guided radiation therapy; however, its image quality is poor compared to planning CT (pCT), thus restricting its utility for adaptive radiotherapy (ART). Our objective was to enhance CBCT image quality utilizing a transformer-based deep learning model, SwinUNETR, which we compared with a conventional convolutional neural network (CNN) model, U-net. This retrospective study involved 260 patients undergoing prostate radiotherapy, with 245 patients used for training and 15 patients reserved as an independent hold-out test dataset.

Phase II Trial of Pathology-based Tripartite Treatment Stratification for Patients with CNS Germ Cell Tumors: A Long-term Follow-up Study.

Background: A previous Phase II clinical trial, conducted from 1995 to 2003, evaluated CNS germ cell tumors (GCTs) using a three-group treatment stratification based on histopathology. The primary objective of the study was to assess the long-term efficacy of standardized treatment regimens, while the secondary objective focused on identifying associated long-term complications.

Methods: Total 228 patients were classified into three groups for treatment: germinoma (n=161), intermediate prognosis (n=38), and poor prognosis (n=28), excluding one mature teratoma case.

Adenoid glioblastoma: Stromal hypovascularity and secretion of chondromodulin-I by tumor cells.

The case of a 75-year-old man with a glioblastoma of the right frontal lobe showing features of adenoid glioblastoma is reported. The tumor consisted of two components: the adenoid component, in which large, cohesive, polygonal cells with vesicular nuclei and abundant basophilic cytoplasm showed nest-like, trabecular, or tubular growth on the myxoid matrix and formed a multinodular configuration; and the subsidiary component, in which short spindle cells showed compact fascicular growth. The features of ordinary glioblastoma were also found in a small area.

Randomized Phase II Trial of Amrubicin Plus Irinotecan Versus Cisplatin Plus Irinotecan in Chemo-naïve Patients With Extensive-Disease Small-Cell Lung Cancer: Results of the Japan Multinational Trial Organization (JMTO) LC 08-01.

Background: We conducted a randomize phase II study to evaluate the efficacy and safety of topoisomerase II inhibitor amrubicin plus topoisomerase I inhibitor irinotecan (AI) compared with cisplatin plus irinotecan (PI) as first-line therapy in patients with extensive-disease (ED) small-cell lung cancer (SCLC).

Patients And Methods: Chemo-naïve patients with pathologically proven ED-SCLC (including limited disease (LD) SCLC with malignant effusion) were enrolled. Patients were randomized 1:1 to receive either AI (amrubicin 90mg/m on day 1 and irinotecan 50mg/m on days 1 and 8 of a 21-day cycle) or PI (cisplatin 60mg/m on day 1 and irinotecan 60mg/m on days 1, 8 and 15 of a 28-day cycle).

Protocol summary of a randomized phase III study: comparing systemic therapy with and without debulking surgery (primary tumour resection) for clinical stage IVA (cT1-2bN0-1M1a) non-small cell lung cancer with radiologically undetermined pleural dissemination JCOG2103 (DEBULK-LUNG).

In patients with non-small cell lung cancer (NSCLC) who present with radiologically undetermined malignant pleural dissemination or incidental surgical diagnosis of the same, surgery is generally not the preferred option; systemic therapy is favoured. However, there is no consensus on incorporating primary site resection into the treatment plan. Retrospective analyses hint at potential benefits of combining systemic therapy with primary site resection, but prospective studies have yet to confirm these findings.

New strategy for shortening the consolidation period in distraction lengthening of phalanges or metacarpal bone.

Distraction lengthening of digits enhances hand function in patients with congenital phalangeal defects or traumatic hand amputations. Although callotasis is a useful distraction lengthening method, it is challenging and often results in various complications and prolonged fixation. Based on our experiences, we attempted to develop innovations to reduce the fixation period.