Clinical practice guidelines for management of disseminated intravascular coagulation in Japan 2024. Part 3: solid cancers and vascular abnormalities.

This study discusses disseminated intravascular coagulation (DIC) associated with solid cancers and various vascular abnormalities, both of which generally exhibit chronic DIC patterns. Solid cancers are among the most significant underlying diseases that induce DIC. However, the severity, bleeding tendency, and progression of DIC vary considerably depending on the type and stage of the cancer, making generalization difficult.

Novel approach for quality control testing of medical displays using deep learning technology.

In digital image diagnosis using medical displays, it is crucial to rigorously manage display devices to ensure appropriate image quality and diagnostic safety. The aim of this study was to develop a model for the efficient quality control (QC) of medical displays, specifically addressing the measurement items of contrast response and maximum luminance as part of constancy testing, and to evaluate its performance. In addition, the study focused on whether these tasks could be addressed using a multitasking strategy.

Systemic Embolism and Clinically Significant Bleeding Events in Older Adults with Nonvalvular Atrial Fibrillation After Treatment with Direct Oral Anticoagulants and Warfarin: A Retrospective Cohort Study in Japan.

Anticoagulant therapy, particularly the use of direct oral anticoagulant agents (DOACs), is recommended for patients with nonvalvular atrial fibrillation (NVAF). This multicenter observational retrospective cohort study aimed to assess the efficacy and safety of DOACs compared to warfarin in Japanese patients aged 75 years and older with NVAF. Data from the Mie-Life Innovation Promotion Center Database were used to collect medical information on the patients.

A 15-Year Observational Cohort of Acute Empyema at a Single-Center in Japan.

Despite the advancements in diagnostic methods and antibiotic treatment, empyema is a critical respiratory infection, showing a high mortality rate of 10-25%. To evaluate the bacterial etiology and prognostic factors of acute empyema, we conducted this long-term retrospective cohort study at our institute between 2008 and 2022. A total of 80 patients were enrolled in this cohort.

Importance of EQA/PT for the detection of genetic variants in comprehensive cancer genome testing.

Comprehensive genomic profiling (CGP) is increasingly used as a clinical laboratory test and being applied to cancer treatment; however, standardization and external quality assessments (EQA) have not been fully developed. This study performed cost-effective EQA and proficiency tests (PT) for CGP testing among multiple institutions those belong to the EQA working group of Japan Association for Clinical Laboratory Science (JACLS). This study revealed that preanalytical processes, such as derived nucleic acids (NA) extraction from formalin fixed paraffine embedded (FFPE) samples, are critical.

Virtual Reality-Applied Home-Visit Rehabilitation for Patients With Chronic Pain: Protocol for Single-Arm Pre-Post Comparison Study.

Background: Pain inhibits rehabilitation. In rehabilitation at medical institutions, the usefulness of virtual reality (VR) has been reported in many cases to alleviate pain. In recent years, the demand for home rehabilitation has increased.

A lymph node lesion of hyper IL-6 syndrome mimicking plasmacytoma, IgG4-related disease, and Castleman disease.

A 72-year-old male patient presented fatigue, anemia, elevated total protein, IgG, IgG4, IL-6, and vascular endothelial growth factor (VEGF) levels. Initial diagnostics suspected multiple myeloma. A plane computed tomography (CT) scan showed pneumonia and the enlargement of generalized lymph nodes.

[Clinical Study of Lymph Node Dissection in Robot-Assisted Radical Prostatectomy for High-Risk Prostate Cancer].

We retrospectively analyzed the regions and perioperative outcomes associated with lymph node dissection in patients with prostate cancer. Of 543 patients who underwent robot-assisted radical prostatectomy for prostate cancer with or without lymph node dissection according to the modified D'Amico criteria, 333 (61.3%), 128 (23.

Evaluation of MAGE-A4 expression in breast cancer and its impact on prognosis.

Melanoma-associated antigen (MAGE)-A4, a cancer testis antigen, presents a promising target for chimeric antigen receptor T cell therapy in refractory solid tumors, including breast cancer (BC). However, the lack of highly specific Abs against MAGE-A4 is a major challenge for the development of MAGE-A4-targeted immunotherapies. This study aimed to validate the specificity of a novel MAGE-A4 Ab (E701U) and examine MAGE-A4 expression in clinical BC samples.

[Questionnaire Survey on the Response to the Reduction of the Equivalent Dose Limit of the Crystalline Lens in the Tokai Region].

Purpose: We conducted a questionnaire survey on the measures to be taken after the reduction of the equivalent dose limit for lenses to clarify the current situation at each institution and to discuss future dose control and exposure protection for lenses.

Methods: A questionnaire survey was conducted among medical institutions in the Tokai area. A total of 65 items, including personal dosimeters, protective eyewear, imaging conditions, and protective equipment, were included in the survey.

Clinical practice guidelines for management of disseminated intravascular coagulation in Japan 2024. Part 1: sepsis.

The Japanese Society on Thrombosis and Hemostasis (JSTH) published the first-ever disseminated intravascular coagulation (DIC) guidelines in 2009. Fifteen years later, the JSTH developed new guidelines covering DIC associated with various underlying conditions. These guidelines were developed in accordance with the GRADE system to determine the strength of the recommendations and certainty of the evidence.

Clinical practice guidelines for management of disseminated intravascular coagulation in Japan 2024. Part 2: hematologic malignancy.

Disseminated intravascular coagulation (DIC) associated with hematologic malignancies, particularly acute promyelocytic leukemia (APL), is characterized by marked fibrinolytic activation, which leads to severe bleeding complications. Therefore, appropriate diagnosis and management of DIC are crucial for preventing bleeding-related mortality. However, to date, no clinical guidelines have specifically addressed hematologic malignancy-associated DIC.

Ultra-low-dose coronary computed tomography angiography using photon-counting detector computed tomography.

Aims: Photon-counting detector computed tomography (PCD-CT), which allows the exclusion of electronic noise, shows promise for significant dose reduction in coronary CT angiography (CCTA). This study aimed to assess the radiation dose and image quality of CCTA using PCD-CT, combined with high-pitch helical scanning and an ultra-low tube potential of 70 kVp, and investigate the effect of a sharp kernel on image quality and stenosis assessment in such an ultra-low-dose CCTA setting.

Methods And Results: Forty patients (65% male) with stable heart rates and no prior coronary interventions were included.

Diverticular bleeding in the third part of the duodenum as a cause of overt obscure gastrointestinal bleeding.

A 65-year-old man with a history of chronic renal failure and ischemic heart disease who was receiving aspirin therapy was admitted for recurrent melena. Initial evaluation revealed severe anemia. Other than a diverticulum in the third part of the duodenum, the findings of upper and lower gastrointestinal endoscopies and computed tomography were unremarkable.

Four cases of early stage poorly differentiated non-ampullary duodenal adenocarcinoma: a case report.

Early-stage, poorly differentiated, non-ampullary duodenal adenocarcinomas are rare, and their clinicopathological features remain unelucidated. Between September 2006 and April 2022, 205 consecutive patients underwent endoscopic or surgical resection for early-stage non-ampullary duodenal adenocarcinomas at our hospital. There were no cases of poorly differentiated adenocarcinoma among the 188 cases of mucosal carcinoma.

A Pilot Study of Urine Oxytocin as an Objective Biomarker for Chronic Pain.

Measuring pain objectively or quantitatively is difficult. Since urine oxytocin (OXT) concentration has been reported to be potentially associated with chronic pain. We conducted a pilot study to evaluate the relationship between changes in numerical rating scale (NRS) score following nerve block and urine OXT concentration in patients with chronic pain.

Characteristics of multiple esophageal squamous cell carcinomas detected in the surveillance after endoscopic resection.

Background And Study Aim: Endoscopic resection (ER) of esophageal squamous cell carcinoma (ESCC) is an organ-preserving treatment; however, heterochronic carcinomas are often encountered. Most patients are treated using ER; however, for some, this is inadequate and requires additional treatment. We sought to identify the characteristics and frequency of lesions at high risk of metastasis during surveillance based on Lugol-voiding lesion (LVL) grading and esophagogastroduodenoscopy (EGD) intervals.

Closure of gastric mucosal defects using the reopenable-clip over the line method to decrease the risk of bleeding after endoscopic submucosal dissection: a multicenter propensity score-matched case-control study (with video).

Background And Aims: Endoscopic submucosal dissection (ESD) is a minimally invasive treatment for early gastric cancer. However, post-ESD bleeding presents significant risks. Closing mucosal defects following ESD may reduce the incidence of post-ESD bleeding.

A qualitative study on the current status and problems of pharmacists in home healthcare from the viewpoint of care managers in medically underpopulated areas in Japan.

Background: Unlike in urban areas, community healthcare in medically underpopulated areas in Japan is constantly challenged because of the uncertainty in effectively using the limited resources. However, no study has focused on human resources or identified the actual state of pharmacists' support in the community. Therefore, our study identified the actual status and problems of pharmacists involved in home medical care in medically underpopulated areas and discussed the roles required of pharmacists and specific methods of support.

Left ventricular perforation by Impella 5.5 during surgery for postinfarction ventricular septal rupture.

Background: The perioperative use of the Impella 5.5 has been increasing recently; however, the left ventricular perforation by this device during surgery has not been reported to date.

Case Presentation: Postinfarction ventricular septal rupture in a 75-year-old man was successfully repaired with support of a single Impella 5.