Ovarian tissue cryopreservation in breast cancer patients: glass half empty or glass half full?

This is a commentary to a paper recently published in RBMOnline by Macklon and De Vos, in which they argue for a discontinuation of ovarian tissue freezing for fertility preservation in women with breast cancer. Instead, they suggest the use of oocyte vitrification following ovarian stimulation as the preferred method of fertility preservation. This commentary presents nine separate arguments that should be considered in the context of ovarian tissue freezing and fertility preservation in girls and women.

Rewired chromatin structure and epigenetic gene dysregulation during HTLV-1 infection to leukemogenesis.

Human T-cell leukemia virus type 1 (HTLV-1) broadly impacts host genes, affecting the infected cell population and inducing the development of a disease with a poor prognosis, adult T-cell leukemia-lymphoma (ATL). This study aimed to provide a comprehensive epigenomic characterization of the infected cell population and evaluated the transcriptome and chromatin structures of peripheral blood cells in HTLV-1-infected individuals using RNA sequencing (RNA-seq) and assay for transposase-accessible chromatin sequencing (ATAC-seq). The infected cells showed significant changes in gene expression patterns from the polyclonal stage and before ATL onset while demonstrating similarities to tumor-forming ATL cells.

Validation of British Society of Gastroenterology guidelines for acute lower gastrointestinal bleeding from 8,956 cases in Japan.

Background And Aims: We sought to validate the British Society of Gastroenterology (BSG) guidelines for acute lower gastrointestinal bleeding (ALGIB).

Methods: We analyzed 8,956 patients with ALGIB in CODE BLUE-J study and categorized them into four groups based on BSG guidelines. Outcomes included 30-day rebleeding, 30-day mortality, blood transfusion, therapeutic intervention, and severe bleeding.

Rivaroxaban for 18 Months Versus 6 Months in Patients With Cancer and Acute Low-Risk Pulmonary Embolism: An Open-Label, Multicenter, Randomized Clinical Trial (ONCO PE Trial).

Background: The optimal duration of anticoagulation therapy for patients with cancer and acute low-risk pulmonary embolism (PE) is clinically relevant, but evidence is lacking. Prolonged anticoagulation therapy could have a potential benefit for prevention of thrombotic events; however, it could also increase the risk of bleeding.

Methods: In a multicenter, open-label, adjudicator-blinded, randomized clinical trial at 32 institutions in Japan, we randomly assigned patients with cancer and acute low-risk PE of the simplified version of the Pulmonary Embolism Severity Index score of 1, in a 1:1 ratio, to receive either an 18-month or a 6-month rivaroxaban treatment.

Evaluation of diseases complicating long COVID: A retrospective chart review.

Background: Evidence for the pathogenesis and treatment of postacute coronavirus disease 2019 (COVID-19) (long COVID) is lacking. As long COVID symptoms are predicted to have an impact on the global economy, clarification of the pathogenesis is urgently needed. Our experiences indicated that some symptoms were complicated by diseases established before the COVID-19 pandemic.

Nationwide Survey on the Status of Oncofertility in Japan and Involvement of Embryologists in the Practice of Fertility Preservation.

To investigate the actual status of fertility preservation techniques in oncofertility in Japan and to clarify the involvement of embryologists in this field. This survey was conducted online, targeting embryologists working at 622 facilities registered with the Japan Society of Obstetrics and Gynecology for assisted reproductive technology. The response rate was 56.

Developing competencies relating to information science and technology in Japanese undergraduate medical education.

In response to the growing expectation and recognized potential for integrating information and communication technology (ICT) into medicine, the Model Core Curriculum for Medical Education in Japan incorporated 'the ability to use information science and technology' as a new competency in its 2022 revision. This study aimed to identify specific learning objectives that medical students should achieve to acquire this competency. The research team developed an initial list of 107 learning objectives through a literature survey.

Implementing digital transformation in the revision process for Japan's Model Core Curriculum: A qualitative document analysis.

Purpose: Digital transformation (DT) is significantly impacting medical education. Despite advancements such as virtual reality and remote education, the influence of DT on the development of curricula and guidelines has not been thoroughly explored. This study aims to explore the enabling factors and impacts of DT on the revision process for Japan's Model Core Curriculum (MCC) in 2022.

Case reports of identical twins with developmental and epileptic encephalopathy with STXBP1 gene mutations for whom different CBD supplementations were markedly effective.

Cannabidiol (CBD) is a compound found specifically in the cannabis plant. Although a clinical trial for intractable epilepsy started in Japan in 2023, it is also available in the market as a dietary supplement. Herein, we report two cases of identical twins with developmental and epileptic encephalopathy with gene mutation who achieved seizure suppression through different regimens of CBD supplementation.

Predictors and clinical outcomes of true mitral stenosis in patients undergoing transcatheter aortic valve implantation.

Aims: Predictors of true degenerative mitral stenosis (MS) in patients with aortic stenosis who underwent transcatheter aortic valve implantation (TAVI) remain unknown. This study aimed to investigate the predictors and prognostic value of true degenerative MS in this population.

Methods And Results: We retrospectively reviewed the records of 760 consecutive patients who underwent TAVI.

Use of an eligibility checklist on arrival of emergency room as a registry system for corneal donation-A 9-year retrospective cohort study.

Aim: This study aimed to evaluate whether the use of an eligibility checklist uncovered potential corneal donors among deceased outpatients and increased the donation.

Methods: In this retrospective cohort study, we applied the eligibility checklist to nearly all outpatients (age ≥ 18 y/o) who were transferred to our emergency department and identified as deceased between 2012 and 2020. Whether the use of the checklist contributed to the increase in corneal donation was examined, and the reasons for refusal of the donation were also evaluated.

Lymphaticovenular Anastomosis as a Treatment for Neurogenic Bladder in Patients With Lower Extremity Lymphedema After Gynecologic Cancer Treatment.

Background And Objectives: Neurogenic bladder (NB), a complication of gynecological cancer treatment, entails significant symptoms such as loss of urinary urgency, incontinence, and renal dysfunction. To investigate whether lymphatic fluid stagnation at the pelvis causes NB, we investigated the effectiveness of lymphaticovenular anastomosis (LVA) for NB.

Methods: In this retrospective study between 2014 and April 2024, LVA was performed on 52 patients complaining of preoperative urinary dysfunction with lower extremity lymphedema following pelvic lymphadenectomy in gynecologic cancer treatment.

Percutaneous core needle biopsy for para-aortic retroperitoneal lesions: impact of size and location on diagnostic accuracy of computed tomography-guided biopsy and feasibility of ultrasound guidance.

Aim: To evaluate the safety and efficacy of computed tomography (CT)-guided core needle biopsy (CNB) for para-aortic retroperitoneal lesions, identify factors affecting false-negative results, and explore the feasibility of alternative CT-guided and ultrasound-guided approaches for challenging anatomical regions.

Materials And Methods: This single-institution retrospective study included 317 consecutive patients who underwent CNB for para-aortic retroperitoneal lesions. A total of 345 biopsies were performed using 18-gauge cutting needles under CT or ultrasound guidance.

Efficacy and safety of carmustine wafers, followed by radiation, temozolomide, and bevacizumab therapy, for newly diagnosed glioblastoma with maximal resection.

Background: To improve the outcome in newly diagnosed glioblastoma patients with maximal resection, we aimed to evaluate the efficacy and safety of implantation of carmustine wafers (CWs), radiation concomitant with temozolomide and bevacizumab, and maintenance chemotherapy with six cycles of temozolomide and bevacizumab.

Method: This prospective phase II study enrolled glioblastoma patients considered candidates for complete resection (> 90%) of a contrast-enhanced lesion. The CWs were intraoperatively implanted into the resection cavity after achieving maximal resection.

Bioprosthetic Valve Positions in Patients With Atrial Fibrillation - Insights From the BPV-AF Registry.

Background: Data on the impact of valve position on clinical outcomes in patients with atrial fibrillation (AF) and bioprosthetic valves (BPVs) are limited.

Methods And Results: The BPV-AF Registry was a multicenter, prospective, observational study involving 894 patients with BPVs and AF. In this post-hoc substudy, patients were classified according to BPV position: aortic (n=588; 65.

Transmission of MRSA, ESBL , and within a tertiary care hospital and across surrounding facilities in Japan: a molecular epidemiological study with the PCR-based Open-reading frame typing.

Objective: To determine the regional impact of transmission of multidrug-resistant organisms (MRDOs) and () among a tertiary care hospital and surrounding facilities including long-term care facilities (LTCFs).

Design: Retrospective cohort study.

Methods: Patients admitted to a tertiary care hospital from July 2019 to July 2021 were recruited if their clinically collected cultures grew the following pathogens: Methicillin-resistant (MRSA), Extended-Spectrum Beta-Lactamase (ESBL) producing Enterobacterales, with difficult-to-treat resistance, Carbapenem-resistant Enterobaterales, Vancomycin-resistant Enterococci, and .

Impact of nutritional status in patients with metastatic spinal tumors who underwent palliative surgery.

Background: Preoperative nutritional status significantly affects postoperative outcomes in patients with metastatic spinal tumors. Understanding the relationship between nutritional status and survival rates can help optimize treatment strategies and improve patient outcomes.

Methods: This retrospective study was performed on 57 patients who underwent palliative surgery between May 2009 and April 2023.

A Prospective Observational Study on Analyzing Lung Cancer Gene Mutation Variant Allele Frequency (VAF) and Its Correlation with Treatment Efficacy.

A few studies have reported on the variability of the variant allele frequency (VAF) of gene mutations and the relationship between VAF and the therapeutic effect of molecular-targeted drugs. This joint study was conducted from May 2020 to January 2022 between St. Marianna University School of Medicine and the DNA Chip Research Institute.

Different efficacy of tyrosine kinase inhibitors by KIT and PGFRA mutations identified in circulating tumor DNA for the treatment of refractory gastrointestinal stromal tumors.

Background: While advanced gastrointestinal stromal tumors (GISTs) are primarily treated with tyrosine kinase inhibitors (TKIs), acquired resistance from specific mutations in KIT or PDGFRA frequently occurs. We aimed to assess the utility of circulating tumor DNA (ctDNA) as a modality of therapeutic decision-making in advanced GIST.

Methods: We conducted a pooled analysis of SCRUM-Japan studies for advanced GIST patients.

Qualitative and Quantitative Assessment of Atrial Functional Mitral Regurgitation: analysis from the REVEAL-AFMR registry.

Background: The prevalence, characteristics, and prognosis of atrial functional mitral regurgitation (AFMR) based on severity remain unclear. No studies have systematically evaluated quantitative thresholds, such as effective regurgitant orifice area (EROA) or regurgitant volume, in relation to outcomes in AFMR. This multicenter study aimed to clarify the clinical implications of both qualitative and quantitative assessments of AFMR severity.

Association Between Direct Oral Anticoagulant Score and Bleeding Events in Patients With Atrial Fibrillation Following Transcatheter Aortic Valve Replacement: A Retrospective Multicenter Cohort Study.

Background: The Direct Oral Anticoagulant (DOAC) Score can predict bleeding risk in patients with atrial fibrillation taking DOACs; however, it lacks external validation. Therefore, this study aimed to assess the association between the DOAC Score and bleeding events in patients with atrial fibrillation who underwent transcatheter aortic valve replacement.

Methods And Results: This retrospective multicenter cohort study included patients with atrial fibrillation who underwent transcatheter aortic valve replacement, as registered in a Japanese multicenter registry.