Trastuzumab-Pertuzumab Plus Eribulin or Taxane as First-Line Chemotherapy for Human Epidermal Growth Factor 2-Positive Locally Advanced/Metastatic Breast Cancer: The Randomized Noninferiority Phase III EMERALD Trial.

Purpose: Trastuzumab-pertuzumab (HP) plus taxane is a current standard first-line therapy for recurrent or metastatic human epidermal growth factor 2 (HER2)+ breast cancer (BC). We investigated noninferiority of eribulin to a taxane when combined with dual HER2 blockade as first-line systemic treatment for locally advanced/metastatic HER2+ BC.

Methods: In the phase III EMERALD trial (target sample size, 480; ClinicalTrials.

A case of rapidly progressive prostate cancer with bone and lymph node metastasis after contact laser vaporization for benign prostatic hyperplasia.

Introduction: Prostate cancer is incidentally diagnosed in 6%-11% of benign prostatic hyperplasia surgeries.

Case Presentation: A 79-year-old man was diagnosed with benign prostatic hyperplasia. The prostate volume was 54.

Myasthenia Gravis Complicated by M-proteinemia and Demyelinating Neuropathy: A Report of Two Cases.

Myasthenia gravis (MG) is characterized by weakness and rapid fatigue of voluntary muscles. Here, we present two cases of early-onset MG, complicated with M-proteinemia and demyelinating neuropathy. Case one was diagnosed with MG at age 29, received tacrolimus post-thymectomy, and developed M-proteinemia and demyelinating neuropathies at age 66 before being diagnosed with B-cell lymphoma.

Impact of platelet-lymphocyte ratio after robot-assisted partial nephrectomy with renorrhaphy.

Renorrhaphy is often performed after tumor resection during robotic-assisted laparoscopic partial nephrectomy (RAPN). This study aimed to investigate the association between renorrhaphy performance and inflammatory markers. A retrospective cohort study was conducted including patients with renal cell carcinoma who underwent RAPN at eight institutions in Japan between April 2016 and November 2023.

Fatal Spitz Melanoma With MAD1L1::BRAF Fusion: A Case Report and Literature Review.

Spitz melanoma is extremely rare, and only a few cases of distant metastases have been reported. Herein, we describe a case of Spitz melanoma with multiple distant metastases. A 37-year-old woman presented with a 5.

Factors influencing lateral margin diagnosis challenges in Barrett's esophageal cancer: a bicenter retrospective study in Japan.

Background/aims: We aimed to clarify the clinicopathological characteristics and causes of Barrett's esophageal adenocarcinoma (BEA) with unclear demarcation.

Methods: We reviewed BEA cases between January 2010 and August 2022. The lesions were classified into the following two groups: clear demarcation (CD group) and unclear demarcation (UD group).

Association between the HAL score and the development of progressive pulmonary fibrosis in idiopathic interstitial pneumonia: A prospective observational study.

Background: Progressive pulmonary fibrosis (PPF) is a critical concern in interstitial lung disease (ILD) management. The HAL score, which incorporates honeycombing (H), age >75 years (A), and serum lactate dehydrogenase >222 U/L (L), can predict acute exacerbations in patients with idiopathic interstitial pneumonia (IIP). This study aims to evaluate the predictive utility of the HAL score for PPF development.

Validating knowledge-based volumetric modulated arc therapy plans with a multi-institution model (broad model) using a complete open-loop dataset for prostate cancer.

This study examined the characteristics of the broad model (KBP) through a complete open-loop evaluation of volumetric modulated arc therapy (VMAT) plans for prostate cancer in 30 patients at two institutions. KBP, trained using 561 prostate cancer VMAT plans from five institutions with different treatment protocols, was shared with two institutions. The institutions were not involved in the creation of KBP.

Cardiac resynchronization therapy by pacing the right ventricular dorsal site of inflow and anterior outflow for congenitally corrected transposition of the great arteries: a case report.

Background: Evidence regarding cardiac resynchronization therapy (CRT) for congenitally corrected transposition of the great arteries (ccTGA) is insufficient. The timing to perform CRT and optimal pacing sites have not been systematically studied. We performed CRT for ccTGA with a complete atrioventricular block (CAVB) by pacing the dorsal site of right ventricular inflow (dRVI) and anterior RV outflow tract (aRVOT).

Glucocorticoid sparing effect on Adalimumab for refractory Pyoderma gangrenosum in patients with Rheumatoid Arthritis: A Case series.

Pyoderma gangrenosum (PG) is a rare chronic skin disease characterized by painful skin ulcers. There are no treatment guidelines for PG; however, systemic treatment is often administered. Recently, adalimumab (ADA), a fully human monoclonal antibody against tumor necrosis factor, was approved for the treatment of refractory PG in Japan.

Repeated pancreatic juice cytology via endoscopic nasopancreatic drainage catheter combined with clinical findings improves diagnostic ability for malignant cases of suspected pancreatic cancer with non-identifiable tumors.

Background/objectives: The detection of pancreatic cancer (PC) often depends on indirect indicators such as parenchyma atrophy (PPA), main pancreatic duct stenosis, and low echoic areas, particularly when no mass is evident on imaging. While pathological evaluation is the gold standard for differentiating malignant from benign conditions, endoscopic ultrasound-guided fine-needle aspiration/biopsy is not always feasible in such cases. Serial pancreatic juice aspiration cytologic examination (SPACE) via endoscopic nasopancreatic drainage (NPD) has emerged as an alternative diagnostic method, though its accuracy remains underevaluated.

Pericardial Fenestration With Monitored Anesthesia Care Using Diluted Remifentanil: A Series of 10 Cases.

Introduction Monitored anesthesia care (MAC) is an anesthesia management method in which anesthesiologists use the minimum necessary intravenous anesthetics to achieve sedation and pain relief while maintaining spontaneous breathing. The challenge for the anesthesiologist is to find the correct balance between inhibiting the patient's stress response to invasive treatment, maintaining intraoperative hemodynamic stability, and doing so as quickly as possible. We hypothesized that diluting remifentanil (D-remi) to 10 μg/mL and increasing the rate of administration would increase the responsiveness of the syringe pump and allow for better control of anesthetic depth.

Combining three-phase EEG pattern and ipsilateral isolated eye deviation to predict seizure focus in the frontal interhemispheric fissure.

Objective: Identification of seizure focus on the interhemispheric fissure (IHF) is often challenging at the step of scalp video-EEG monitoring on preoperative evaluations. We previously reported ictal three-phase EEG patterns (3Ph-EEG) and isolated eye deviation (isolated ED) to side of the seizure focus during seizures, each of which is available for identifying the seizure focus for frontal IHF (F-IHF). This study aimed to evaluate the accuracy of predicting the F-IHF focus using a combination of 3Ph-EEG and isolated ED in patients with frontal lobe epilepsy and the accuracy of predicting lateralization of the F-IHF focus using the predominance of findings.

Efficacy of liposomal irinotecan + 5-FU/LV vs. S-1 in gemcitabine-refractory metastatic pancreatic cancer: a real-world study using inverse probability of treatment weighting.

Background: S-1 monotherapy had previously been widely used as a second-line treatment for pancreatic cancer (PC) after gemcitabine-based chemotherapy mainly in Japan. Based on the results of the NAPOLI-1 trial, the recommended second-line therapy is now liposomal irinotecan plus fluorouracil/folinic acid (nal-IRI + 5-FU/LV). However, there have been no studies comparing nal-IRI + 5-FU/LV therapy with S-1 monotherapy.

Development of dedicated phantom for end-to-end testing of multiple image-guidance configurations incorporating light-section-based surface guidance system.

Purpose: Radiotherapy devices with multiple image-guidance systems, such as surface-guided radiation therapy (SGRT), have been widely used in recent years. However, in the case of SGRT devices using the light-section method, coordinate coincidence evaluation using a phantom for SGRT devices with patterned light projection is not appropriate. Hence, this study aims to develop a dedicated phantom able to evaluate both the detection accuracy and coordinate coincidence of multiple IGRT configurations, including light-section-based SGRT devices.

Factors associated with uncontrolled severe asthma in the biologic era.

Background: Despite the development of biologics for severe asthma, individuals with uncontrolled status persist, posing a significant social problem. This multicenter prospective study aimed to identify factors associated with the uncontrolled status of patients with severe asthma in the biologic era assessed using the Asthma Control Questionnaire (ACQ).

Methods: Subjects with severe asthma diagnosed by respiratory specialists were enrolled from 11 hospitals.

Impact of Mannitol Administration on Postoperative Renal Function After Robot-Assisted Partial Nephrectomy.

This study investigated the effect of mannitol administration on postoperative renal function during robot-assisted partial nephrectomy (RAPN) in patients with renal cell carcinoma (RCC). Patients with RCC who underwent RAPN at eight Japanese facilities between March 2016 and November 2023 were enrolled. In this study, patients were categorized into two groups according to those who received mannitol during RAPN (Group I) and those who did not receive mannitol (Group II).

Antimicrobial Combinations as Novel Indicators for Clostridioides difficile infection development: Population-Based, Nested Case-Controlled Study in Japan-The Shizuoka Kokuho Database Study.

Background: Clostridioides difficile is a major cause of antimicrobial-associated colitis. While antimicrobial stewardship has reduced the incidence of C. difficile infection (CDI), managing CDI is challenging because knowledge about preventing it is limited among healthcare professionals.