CVIT 2025 clinical expert consensus document on intravascular ultrasound.

Intravascular ultrasound (IVUS) provides precise anatomic information in coronary arteries including quantitative measurements and morphological assessment. To standardize the IVUS analysis in the current era, this updated expert consensus document summarizes the methods of measurements and assessment of IVUS images and the clinical evidence of IVUS use in percutaneous coronary intervention.

Association Between Cannula Size of Extracorporeal Membrane Oxygenation and Prognosis in Patients With Out-of-Hospital Cardiac Arrest - A Secondary Analysis of the SAVE-J II Study.

Background: Selecting an appropriate cannula size is crucial for achieving an adequate extracorporeal membrane oxygenation (ECMO) flow rate. However, the association between ECMO cannula size and the prognosis of patients with out-of-hospital cardiac arrest (OHCA) has not been fully elucidated. We examined the associations between ECMO cannula size and neurological outcomes and survival at discharge in patients with OHCA who received ECMO.

Pseudogenization of the Slc23a4 gene is necessary for the survival of Xdh-deficient mice.

In most patients with type 1 xanthinuria caused by mutations in the xanthine dehydrogenase gene (XDH), no clinical complications, except for urinary stones, are observed. In contrast, all Xdh(- / -) mice die due to renal failure before reaching adulthood at 8 weeks of age. Hypoxanthine or xanthine levels become excessive and thus toxic in Xdh(- / -) mice because enhancing the activity of hypoxanthine phosphoribosyl transferase (HPRT), which is an enzyme that uses hypoxanthine as a substrate, slightly increases the life span of these mice.

Restoration of Genetic Code in Macular Mouse Fibroblasts via APOBEC1-Mediated RNA Editing.

RNA editing is a significant mechanism underlying genetic variation and protein molecule alteration; C-to-U RNA editing, specifically, is important in the regulation of mammalian genetic diversity. The ability to define and limit accesses of enzymatic machinery to avoid the modification of unintended targets is key to the success of RNA editing. Identification of the core component of the apoB RNA editing holoenzyme, APOBEC, and investigation into new candidate genes encoding other elements of the complex could reveal further details regarding APOBEC-mediated mRNA editing.

Rspo3-mediated metabolic liver zonation regulates systemic glucose metabolism and body mass in mice.

The unique architecture of the liver consists of hepatic lobules, dividing the hepatic features of metabolism into 2 distinct zones, namely the pericentral and periportal zones, the spatial characteristics of which are broadly defined as metabolic zonation. R-spondin3 (Rspo3), a bioactive protein promoting the Wnt signaling pathway, regulates metabolic features especially around hepatic central veins. However, the functional impact of hepatic metabolic zonation, regulated by the Rspo3/Wnt signaling pathway, on whole-body metabolism homeostasis remains poorly understood.

D-dimer cutoff values for predicting functional prognosis in patients with severe head trauma: a multi-centre prospective observational study.

Purpose: D-dimer, a fibrinolysis indicator, may predict functional and life outcomes in traumatic brain injury (TBI) patients. We aimed to identify optimal D-dimer cutoff values for poor functional outcomes in severe TBI.

Methods: We used data from a multi-centre prospective observational cohort study that included patients with TBI with a Glasgow Coma Scale (GCS) score ≤ 8 within 48 h after injury or required neurosurgical procedures.

Real-world effectiveness of mepolizumab in Japanese asthma patients with diverse backgrounds: Improvements in rhinosinusitis imaging (J-Real-Mepo).

Background: Although randomized controlled trials (RCT) have demonstrated the efficacy of mepolizumab for asthma, they have excluded certain patient subgroups. To bridge the gap between RCT and real-world practice, the effectiveness of mepolizumab in a diverse population, including those potentially excluded from RCT, was assessed. Its effects on imaging findings and symptoms of chronic rhinosinusitis (CRS) with asthma were also assessed.

Correlation between internal limiting membrane preservation and sub-epiretinal membrane space during epiretinal membrane surgery.

Purpose: Internal limiting membrane (ILM) is usually peeled simultaneously with epiretinal membrane (ERM), however, in eyes with glaucoma and ERM, ILM is preserved in order to prevent nerve fiber damage. The aim of this study was to evaluate if a new approach for ERM is effective to keep ILM during surgery.

Study Design: Retrospective consecutive case series.

Case report: Adult case of A20 haploinsufficiency suspected as neuro-Behçet disease.

Patients with A20 haploinsufficiency (HA20) presenting with central nervous system (CNS) symptoms are rare, and available reports are limited. Here, we describe a patient with HA20, previously followed up as Behçet disease, who presented with CNS symptoms in adulthood. A 38-year-old Japanese male who had been followed up for incomplete Behçet disease at another hospital since 28 years of age presented to our hospital with acute-onset diplopia and persistent hiccups that were severe enough to cause vomiting.

Adrenaline Dilution in Dental Local Anesthetic Cartridges: A Practical Method Using the Inner Needle of Intravenous Catheter.

Local anesthesia is a routine medical procedure for dentists. To achieve the desired anesthetic effect of lidocaine and favorable hemostatic effects by adrenaline, the combination of 2% lidocaine + 1:80,000 adrenaline is commonly used, including in dental patients with underlying diseases for whom adrenaline in local anesthetics is problematic due to its vasoconstrictive effects, as the adrenaline concentration in dental local anesthetic cartridges in Japan is commercially set at 1:80,000. To reduce the effect of adrenaline on the cardiovascular system, adrenaline is sometimes diluted in dental local anesthetic cartridges.

Interpretable machine learning model for outcome prediction in patients with aneurysmatic subarachnoid hemorrhage.

Background: Aneurysmatic subarachnoid hemorrhage (aSAH) is a critical condition associated with significant mortality rates and complex rehabilitation challenges. Early prediction of functional outcomes is essential for optimizing treatment strategies.

Methods: A multicenter study was conducted using data collected from 718 patients with aSAH who were treated at five hospitals in Japan.

Intentional staged embolization via the "highway bypass" using a radial artery graft for a large posterior circulation aneurysm: illustrative case.

Background: The presence of significant tortuosity in access routes to aneurysms can interfere with catheter guidance and manipulation and significantly impact treatment strategies.

Observations: In this report, the authors combined intentional staged aneurysm embolization with the construction of a new direct access route, which they call a "highway bypass," for a symptomatic posterior circulation cerebral aneurysm that was difficult to access with a catheter. Notably, the highway bypass is used for catheter passage, and technical tips should be considered.

Ultra-remote robot-assisted right upper lobectomy between the Shanghai and Kashi Prefectures: a case report.

Background: Robot-assisted thoracic surgery has been shown to have several advantages over conventional surgery. As mobile communication technology and surgical robotic devices in China continue to progress rapidly, the conditions for performing remote surgery have been optimized. Consequently, informatized and remote advanced medical cooperation is becoming a new direction for supporting the medical development of border regions and promoting the equitable distribution of medical resources in China.

A machine learning model to predict neurological deterioration after mild traumatic brain injury in older adults.

Objective: Neurological deterioration after mild traumatic brain injury (TBI) has been recognized as a poor prognostic factor. Early detection of neurological deterioration would allow appropriate monitoring and timely therapeutic interventions to improve patient outcomes. In this study, we developed a machine learning model to predict the occurrence of neurological deterioration after mild TBI using information obtained on admission.

Retrospective evaluation of a novel ultrasound-based imaging analysis software for predicting radiofrequency ablation areas.

Objective: This study aimed to introduce and evaluate a novel software-based system, BioTrace, designed for real-time monitoring of thermal ablation tissue damage during image-guided radiofrequency ablation for hepatocellular carcinoma (HCC).

Methods: BioTrace utilizes a proprietary algorithm to analyze the temporo-spatial behavior of thermal gas bubble activity during ablation, as seen in conventional B-mode ultrasound imaging. Its predictive accuracy was assessed by comparing the ablation zones it predicted with those annotated by radiologists using contrast-enhanced computed tomography (CECT) 24 hours post-treatment, considered the gold standard.

Pregnancy and Postpartum Trends in Self-Measured Blood Pressure and Derived Indices: The BOSHI Study.

In this study, we aimed to reveal the trends of self-measured blood pressure (SMBP) and SMBP-derived indices during pregnancy and the postpartum period. The Babies and Their Parents Longitudinal Observation in Suzuki Memorial Hospital in the Intrauterine Period (BOSHI) Study is a prospective cohort study in Japan. Participants were instructed to measure SMBP daily during pregnancy and for 1 month after delivery.

A Case of IgA Nephropathy in a Patient With Sarcoidosis: Confirmation of Glomerular Galactose-Deficient IgA1 Deposition.

A 63-year-old Japanese housewife was admitted to our hospital because of hematuria and proteinuria lasting for 3 months. At the age of 59 years, she was diagnosed with neurosarcoidosis at another hospital, and she received oral glucocorticoid therapy for 1 year. Her serum angiotensin-converting enzyme (ACE) and 1, 25-dihydroxyvitamin D levels were elevated.

The association between physician sex and patient outcomes: a systematic review and meta-analysis.

Background: Some prior studies have found that patients treated by female physicians may experience better outcomes, as well as lower healthcare costs than those treated by male physicians. Physician-patient sex concordance may also contribute to better patient outcomes. However, other studies have not identified a significant difference.

Influence of Worsening Renal Function and Baseline Chronic Kidney Disease on Clinical Outcomes in Patients With Chronic Coronary Syndromes: Insights From the REAL-CAD Study.

Background: The effect of worsening renal function and baseline chronic kidney disease (CKD) on outcomes in patients with chronic coronary syndrome in the setting of optimal medical therapy remains unknown.

Methods And Results: The REAL-CAD (Randomized Evaluation of Aggressive or Moderate Lipid Lowering Therapy With Pitavastatin in Coronary Artery Disease) study is a prospective, multicenter, randomized trial of high-dose (pitavastatin 4 mg/day) or low-dose (pitavastatin 1 mg/day) statin therapy in 12 118 patients with chronic coronary syndrome. The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, stroke, or unstable angina requiring hospitalization (major adverse cardiac and cerebral events [MACCE]).

Emergence of Chirality in an Optically Active Two-Dimensional Crystal with a Spiral Surface Pattern.

Some one-dimensional (1D) crystals containing a screw dislocation along their longer axis exhibit a helical twist due to lattice strain. These chiral structures have been thoroughly investigated by using transmission electron microscopy. However, whether two-dimensional (2D) crystals with a spiral surface pattern, presumably containing a screw dislocation, are structurally chiral remains unclear because their internal structures are not visible.

Ultrasensitive Specific Detection of Anti-influenza A H1N1 Hemagglutinin Monoclonal Antibody Using Silicon Nanowire Field Effect Biosensors.

Rapid and sensitive detection of virus-related antigens and antibodies is crucial for controlling sudden seasonal epidemics and monitoring neutralizing antibody levels after vaccination. However, conventional detection methods still face challenges related to compatibility with rapid, highly sensitive, and compact detection apparatus. In this work, we developed a Si nanowire (SiNW)-based field-effect biosensor by precisely controlling the process conditions to achieve the required electrical properties via complementary metal-oxide-semiconductor (CMOS)-compatible nanofabrication processes.

Optimization of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin therapy for Japanese patients with urothelial carcinoma.

Background: Dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (dd-MVAC) regimen has been established as a systemic chemotherapy for patients with urothelial carcinoma. However, it is rarely used in Japan owing to the challenges associated with managing the related adverse events. This study aimed to optimize the dd-MVAC protocol for Japanese patients.