Effect of Proteinuria Before Lenvatinib Administration on Treatment Response After Atezolizumab Bevacizumab Combination Therapy.

Aim: We investigated the impact of proteinuria on the therapeutic effect before lenvatinib administration as second-line treatment after atezolizumab-bevacizumab.

Methods: We examined 64 patients who were administered lenvatinib as second-line treatment after discontinuation of atezolizumab and bevacizumab. Proteinuria assessed before lenvatinib administration was considered severe if the qualitative value test (QV) was 3+ or the urine protein/creatinine ratio (UPCR) was ≥ 2.

Evaluation of the Efficacy of Lusutrombopag for Chronic Liver Disease Based on Pre-Treatment Platelet Counts: A Retrospective Multicenter Study.

Background: Oral thrombopoietin receptor agonists are used to treat thrombocytopenia in patients with chronic liver disease who are scheduled for invasive procedures. The efficacy of lusutrombopag based on the pretreatment platelet count was investigated.

Methods: Patients treated at nine hospitals from December 2015 to December 2023 were included.

Change in Liver Function in Durvalumab Plus Tremelimumab Treatment for Unresectable Hepatocellular Carcinoma.

Background/aim: Maintaining liver function throughout the treatment of hepatocellular carcinoma (HCC) is crucial, yet the impact of durvalumab plus tremelimumab (DT) treatment on liver function is not well understood. This multicenter study aimed to examine the changes in liver function during DT treatment.

Patients And Methods: This nationwide multicenter study included 80 patients who received DT treatment for unresectable HCC.

A robotic fissureless right upper lobectomy using a posterior approach.

The fissureless technique in a lobectomy is considered useful to avoid postoperative prolonged air leak when a fissure is fused because it is not dissected. In particular, this technique has been used most frequently in right upper lobectomies because the dense fissure was most frequently found between the right upper and middle lobes. We believe that the surgical steps in this technique should be modified depending on the surgical approach, although the concept that the hilar structures, including the pulmonary vessels and bronchi, are each transected prior to division of a dense fissure is the same.

Disseminated infection that could have been predicted: A case report.

is a rare, filamentous fungus, that causes a disseminated infection in immunocompromised individuals. Disseminated infections caused by the fungus are difficult to diagnose early. It is resistant to multiple antifungal agents and has a high mortality rate.

A robotic left S6 and S1/2c segmentectomy using the lung-inverted approach.

In pulmonary segmentectomy, the dominant pulmonary arteries are traditionally divided at the fissure. However, this approach sometimes leads to inadvertent injury to the pulmonary artery and prolonged air leak when the fissure is fused. To overcome these problems, by taking advantage of the good visualization provided by robotic surgery, we have adopted the lung-inverted approach without fissure dissection for segmentectomy.

A case of prosthetic valve endocarditis and aortic abscess due to Bacillus cereus.

is commonly found in the environment and is often considered a blood culture contaminant. However, in patients with specific risk factors such as intravenous drug use, central venous access catheters, immunosuppression, or prosthetic valves, can cause severe infections. Herein, we present a case of prosthetic valve endocarditis (PVE) caused by in an 84-year-old woman with a history of aortic valve replacement for aortic stenosis five years earlier.

Nationwide epidemiology and health resource use among children with COVID-19 in Japan.

Background: The COVID-19 pandemic posed substantial challenges to healthcare systems. Understanding the responses of pediatric health services is crucial for future pandemic planning and preparedness, yet such data remains limited.

Methods: In this retrospective cohort study, we analyzed data from administrative databases developed by Japan Medical Data Center and DeSC Healthcare Inc.

Glasgow prognostic score and body mass index predict short-term discontinuation of the antifibrotic agents pirfenidone and nintedanib.

Background: The antifibrotic agents pirfenidone and nintedanib have been shown to be effective in patients with idiopathic pulmonary fibrosis (IPF). However, discontinuation of antifibrotic drugs is a major clinical concern because of the lack of alternative treatment options. Therefore, we identified factors that may be useful for predicting the termination of antifibrotic agents.

Impact of resuscitative endovascular balloon occlusion of the aorta on gastrointestinal function with a matched cohort study.

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) can temporarily control arterial hemorrhage in torso trauma; however, the abdominal visceral blood flow is also blocked by REBOA. The aim of this study was to evaluate the influence of REBOA on gastrointestinal function.

Methods: A retrospective review identified all trauma patients admitted to our trauma center between 2008 and 2019.

Kikuchi-Fujimoto Disease in Human Leukocyte Antigen Partially Matched Siblings: A Case Study of Familial Susceptibility.

Kikuchi-Fujimoto disease (KFD) is a rare and self-limiting disorder that predominantly affects young individuals of Asian descent. This case report describes familial KFD in partially human leukocyte antigen (HLA)-matched siblings. An adolescent male presented with cervical lymphadenopathy and elevated lactate dehydrogenase (LDH) levels, diagnosed by biopsy as KFD; approximately one year later, his sister presented with similar symptoms.

Robotic upper division segmentectomy of the left upper lobe without turning the lung.

The fissureless technique in lobectomy or the unidirectional dissection technique in segmentectomy is considered useful to avoid a postoperative prolonged air leak if a fissure is fused because it is not dissected. Another advantage of this technique is that it does not require repeated rotation of the lung to obtain a good surgical view, which may result in a shorter operating time. We believe that this technique is suitable for a robotic approach because we sometimes find it difficult to rotate the lung parenchyma in the limited rigid thoracic cavity when using the robotic approach.

Two cases of lower lobe segmentectomy (left and right) using the lung-inverted approach in a robotic operation.

In pulmonary segmentectomy, the dominant pulmonary arteries are conventionally divided at the fissure. However, this approach sometimes leads to accidental injury of the pulmonary artery and prolonged air leaks when the fissure is fused. To overcome these problems, we have adopted the lung-inverted approach without dissection of a fissure for segmentectomy, taking advantage of the good view provided by robotic surgery.

A robotic left S1+2c subsegmentectomy using preoperative simulation.

Although there are reports describing segmentectomy by a robotic approach, reports describing robotic subsegmentectomy are rare because this procedure requires more precise anatomical knowledge and exposure of subsegmental pulmonary vessels and bronchi. However, the robotic approach has several advantages, including a high-definition 3-dimensional surgical view and precise motion without tremor, which may allow us to perform the subsegmentectomy more easily. Considering these advantages of the robotic approach, we successfully performed a robotic left S1+2c segmentectomy with a short console time and a good postoperative course.

Factors associated with healthcare providers' satisfaction with end-of-life care in the intensive care unit: A systematic review.

Background: We aimed to synthesize published data on and identify factors associated with healthcare providers' satisfaction with end-of-life care for critically ill adults.

Methods: Electronic databases were searched from inception to January 23, 2023. We included trials involving adults admitted to intensive care units (ICUs) or high-dependency units to evaluate palliative care interventions.

A robotic anterior (S3) segmentectomy of the left upper lobe.

A robotic approach might be more suitable for pulmonary segmentectomy than the conventional thoracoscopic approach, because the high-definition 3-dimensional surgical view and precise motion without tremor allow us to dissect pulmonary vessels and bronchi to the periphery. However, among several types of segmentectomies, the anterior segmentectomy (S3) of the left upper lobe may be one of the most difficult to achieve in the robotic approach because the dissected hilar region tends to be obstructed by the lung parenchyma in the "looking-up" view. We offer two technical tips to achieve robotic left S3 segmentectomy.

MAdCAM-1 targeting strategy can prevent colitic cancer carcinogenesis and progression via suppression of immune cell infiltration and inflammatory signals.

Chronic inflammation caused by infiltrating immune cells can promote colitis-associated dysplasia/colitic cancer in ulcerative colitis (UC) by activating inflammatory cytokine signalling through the IL-6/p-STAT3 and TNFα/NF-κB pathways. Mucosal addressin cell adhesion molecule-1 (MAdCAM-1) expressed on high endothelial venules promotes the migration of immune cells from the bloodstream to the gut via interaction with α4β7 integrin expressed on the immune cells. MAdCAM-1, has therefore drawn interest as a novel therapeutic target for treating active UC.

Simulation to determine the approach of transcatheter aortic valve implantation in patients undergoing hemodialysis.

Purpose: The present study investigated potential access vessels in patients receiving hemodialysis who underwent surgical aortic valve replacement and determined which approaches were most suitable for performing transcatheter aortic valve implantation.

Methods: Consecutive patients undergoing hemodialysis with aortic valve stenosis who underwent surgical aortic valve replacement were included. Preoperative computed tomography data were analyzed to assess the vessel diameter and calcification.

Utility of growth differentiation factor-15 as a predictor of cardiovascular surgery outcomes: Current research and future directions.

In a world increasingly confronted by cardiovascular diseases (CVDs) and an aging population, accurate risk assessment prior to cardiac surgery is critical. Although effective, traditional risk calculators such as the Japan SCORE, Society of Thoracic Surgeons score, and EuroSCORE II may not completely capture contemporary risks, particularly due to emerging factors such as frailty and sarcopenia. These calculators often focus on regional and ethnic specificity and rely heavily on evaluations based on age and underlying diseases.